"A simple examination which any one can make of his own buccal cavity will show that posterior to the last molar teeth, when the jaws are closed, is an opening bounded by the molars, the body of the superior, and the ramus of the inferior maxilla. If on either side the cheek is held well out from the jaw, a pocket, or gutter, is formed, into which fluids may be poured, and they will pass into the mouth through the opening behind the molars, as well as through the interstices between the teeth. When in the mouth they tend to create a disposition to swallow, and by this method a considerable quantity of liquid may be administered."

After I had worked with the patient in the open air, for four and three-quarter hours, he was carried to a cottage near by and placed, still unconscious, in bed. There had been an alvine evacuation during the time in which he lay in the blankets.

Consciousness began to return in the early part of the following morning, and with its advent it was discovered that the memory of everything which had occurred from half an hour previous to the accident, up to the return of consciousness, had been completely obliterated. With this exception the convalescence was steady and uncomplicated, and of about a week's duration. From a letter which I recently received from my patient, I learned that the lapse of memory still remains.

My experience with this case has taught me that, unless the data have been taken very accurately, we cannot depend upon any statements as to the time of submersion in cases of drowning. My first supposition was that my patient had been from thirteen to fifteen minutes under water, but a careful investigation reduced the supposed time by one-half. This makes the time of submersion about six minutes, and that which elapsed before the intelligent use of remedies about three minutes longer.

For a long time the opinion of Sir Benjamin Brodie concerning the presence of water in the lungs of the drowned was accepted, who says "that the admission of water into the lungs is prevented by a spasm of the muscles of the glottis cannot, however, be doubted, since we are unable to account for it in any other manner."

Later experiments made by a committee of the Royal Medico-Chirurgical Society, of London, demonstrated, on the contrary, that "in drowned animals not only were all the air passages choked with frothy fluid, more or less bloody, but that both lungs were highly gorged with blood, so that they were heavy, dark colored, and pitted on pressure, and on being cut exuded an abundance of blood-tinged fluid with many air bubbles in it." Dr. R.L. Bowles1 also holds that the lungs of the drowned contain water, and supports his views by a list of cases. In his words, "These examples show very conclusively that in cases of drowning in man, water does exist in the lungs, that the water only very gradually and after a long time is effectually expelled, and that it is absolutely impossible that any relief should be afforded in that way by the Silvester method." Dr. Bowles believes that the method of Dr. Marshall Hall is superior to any other in this class of cases. He thinks that on account of the immediate adoption and continued use of the prono-lateral position, this method is more to be trusted than any other for keeping the pharynx clear of obstruction. "It also empties the stomach and gradually clears the lungs of the watery and frothy fluids, and will surely and gently introduce sufficient air at each inspiration to take the place of the fluid which has been expelled." In the light of even my limited experience I cannot but feel that Dr. Bowles' opinion concerning the Silvester method would admit of some modification.

This is often the case with very positive statements concerning medical matters. In my own case the Silvester method answered well, but I was much impressed with Dr. Bowles' claims for the Marshall Hall method, and should bear them in mind were I called upon to attend another case of drowning.

I think it must be admitted that pulling the tongue forward as a means of opening the glottis, which has become a standard treatment in asphyxia, is unscientific, and not warranted by the results of experiments made to determine its value.2

Dr. Bowles also believes that "the safety of the patient is most perfectly secured by keeping him on one side during the whole treatment, one lung being thus kept quite free." With the account of my case I have brought forward such views of other writers as it seemed to me would be of practical service and throw light on a subject which is of great importance, since the yearly record of mortality from drowning is by no means inconsiderable. I think, however, that a knowledge of what ought to be done in cases of drowning should be much more generally diffused than is the case at present. It should be one of the items of school instruction, since no one can tell when such knowledge may be of immense importance in saving life, and the time lost in securing medical aid would involve a fatal result.

It is also very desirable that all doubt should be removed, by the decision of competent medical authorities, as to which "ready" method or methods are the best, since there are several in the field. With this should be decided what is the best means for securing patency of the air passages, and, in short, a very careful revision of the treatment now recommended for drowning, in order that there may be no doubt as to the course which should be adopted in such a serious emergency. - Medical Record.

Resuscitation of the Apparently Drowned, by R.L. Bowles, M.D., F.R.C.P., Medico-Chirurgical Transactions, vol. lxxii., 1889.

Dragging on the tongue's tip would not affect its base or the epiglottis sufficiently to make it a praiseworthy procedure. Medico-Chirurgical Transactions, vol. lxxii. See also Medical Record, April 4, 1891. Pulling out the tongue is a mistake, since irritation of nerves of deglutition stops the diaphragm. - Medical Times and Gazetteer.