alive); fine
froth at the mouth and nostrils; cutis anserina; retraction of penis and
scrotum. On post-mortem examination, the lungs are found to be increased
in size ('ballooned'); on section, froth, water mud, sand, in air-tubes.
The presence of this fine (often blood-stained) froth is the most
characteristic sign of drowning. Froth like that of soap-suds in the
trachea is an indication of a vital act, and must not be mistaken for
the tenacious mucus of bronchitis. The presence of vomited matters in
the trachea and bronchi is a valuable sign of drowning. The blood
collects in the venous system, and is dark and fluid. Tardieu's spots
are not so frequently met with in cases of drowning as in other forms of
asphyxia. The other signs of death by asphyxia are present. Wounds may
be present on the body, due to falling on stakes, injuries from passing
vessels, etc.

The methods of performing artificial respiration in the case of the
apparently drowned are the following (the best and most easily performed
is Schaefer's prone pressure method):

1. _Schaefer's._--Place the patient on his face, with a folded coat under
the lower part of the chest. Unfasten the collar and neckband. Go to
work at once. Kneel over him athwart or on one side facing his head.
Place your hands flat over the lower part of his back, and make
pressure on his ribs on both sides, and throw the weight of your body on
to them so as to squeeze out the air from his chest. Get back into
position at once, but leave your hands as they were. Do this every five
seconds, and get someone to time you with a watch. Keep this going for
half an hour, and when you are tired get someone to relieve you.

Other people may apply hot flannels to the limbs and hot water to the
feet. Hypodermic injections of 1/50 grain of atropine, suprarenal or
pituitary extracts, may be found useful.

2. _Silvester's._--In this method the capacity of the chest is increased
by raising the arms above the head, holding them by the elbows, and thus
dragging upon and elevating the ribs, the chest being emptied by
lowering the arms against the sides of the chest and exerting lateral
pressure on the thorax. The patient is in the supine position--but first
the water must have been drained from the mouth and nose by keeping the
body in the prone position. The tongue must be kept forward by
transfixing with a pin.

3. _Marshall Hall's._--This consists in placing the patient in the prone
position,