History of Cardiopulmonary Resuscitation - First Attempts at Resuscitation in The 18th Century

First Attempts At Resuscitation in The 18th Century

The first city to teach and promote resuscitation was Amsterdam, located in the heart of the European Enlightenment and also a city of canals—therefore a city with many drownings – as many as 400 per year. Death from cardiac disease was still not prevalent and sudden deaths were mostly from accidents.

In August 1767 a few wealthy and civic-minded citizens in Amsterdam gathered to form the Society for Recovery of Drowned Persons. This society was the first organised effort to respond to sudden death.

Within 4 years of its founding, the society in Amsterdam claimed that 150 persons were saved by their recommendations. Their techniques involved a range of methods to stimulate the body. The members of the society recommended:

1. Warming the victim
2. Removing swallowed or aspirated water by positioning the victim's head lower than feet
3. Applying manual pressure to the abdomen
4. Respirations in to the victim's mouth, either using a bellows or with a mouth-to-mouth method (mouth-to-mouth or mouth-to-nostril respiration is described including the advice that "a cloth or handkerchief may be used to render the operation less indelicate")
5. Tickling the victim's throat
6. 'Stimulating' the victim by such means as rectal and oral fumigation with tobacco smoke. This may seem very unusual in modern times, however it may have been that the nicotine was enough of a stimulant to engender a response in the “almost” dead
7. Bloodletting

The first four of these techniques (or variations of them) are still in use today, whereas the last three are now out of line with modern medical thinking. However, regardless of the scientific merit of these techniques, it started a collective belief that resuscitation was possible, and the suddenly dead could be revived.

Following successes of this first society, rescue societies soon sprang up in most European capitals, all with the goal to find a way of successful resuscitating victims of sudden death. This theory proved so popular that Hamburg, Germany passed an ordinance in 1769 providing notices to be read in churches describing assistance for drowned, strangled, and frozen persons and those overcome by noxious gases, probably the first example of mass medical training. The Royal Humane Society in London (no connection to the animal welfare organization in the United States), founded in 1774, served as the model for societies in New York, Philadelphia, and Boston. These rescue societies of the 18th century were the precursors of today’s emergency medical services.

Similar techniques were described in early 20th century jujutsu and judo books, as being used as far back as early 17th century. A New York Times correspondent reported those techniques being used successfully in Japan in 1910. In jujutsu (and later on, judo), those techniques were called kappo or kutasu.

For the next 150 years, scientists and quacks alike advocated literally hundreds of resuscitation techniques. Some were even partly effective especially for respiratory emergencies. For example, the back pressure-arm lift method (“out goes the bad air, in goes the good air”) taught to countless thousands of Boy Scouts until the late 1950s could occasionally have saved a drowning victim, as in drowning, the initial problem is a cessation of respirations and for the first 5–10 minutes the heart is still beating and if the victim can be extracted from the water and be induced to breathe the outcome may be good, but the technique was of no benefit for cardiac arrest as it did nothing for circulation, which it is now known, is the key factor to address in these victims.