When Rogue Riderhood’s wherry is cut in two this month we see the riverside community of Limehouse Hole swing rapidly into action. Boats put off, torches light up, taunts are uttered ‘in tones of universal hoarseness’ and, as Bob Gliddery reports, the river itself fills up with ‘“ever so many people”’ all eager to help search for survivors. Between them they manage to grapple Riderhood’s body from the Thames and transport it to the upper room of Six Jolly Fellowship Porters in a scene whose intense physical activity is underpinned by a sense of shared experience and mutual investment in the lives of individuals. Everybody, we are told, in a list that moves slyly from bodily involvement to something less tangible, ‘lends a hand, and a heart and soul’.
Upon examining Riderhood’s ‘dank carcase’, the doctor ‘pronounces, not hopefully, that it is worth while trying to reanimate the same’. Thus begins the only episode of artificial respiration in Dickens’s fiction; an episode which has a successful outcome, inasmuch as Riderhood is saved, but which ultimately disappoints those who believe that their efforts, and Riderhood’s dumb luck, ought to be rewarded with the salvation of a soul and not just the salvaging of a body.
By far the most common form of artificial respiration today is the technique known as ‘the kiss of life’, but this wasn’t the case in March 1865: the only thing which passes from ‘mouth to mouth’ in this month’s number is ‘A cry for the life-buoy’. In fact, Dickens was writing in the immediate aftermath of a revolution in life-saving techniques, which had been transformed in the previous decade. What had traditionally been seen as a matter requiring artistry, luck and, perhaps, divine intervention (after all, the first recorded example of artificial respiration comes from Egyptian mythology, when Isis revives Osiris with the breath of life) had been placed on a newly scientific footing in the years before Dickens began to write Our Mutual Friend, and this month’s number reflects this shift in several ways.
The history of artificial respiration is one of slow and infrequent change. The ‘four rough fellows’ who help the doctor revive Riderhood were no doubt grateful that new techniques had been developed since Bagellardus first recommended, in 1472, that a body could be resuscitated by someone blowing ‘into its mouth, if it has no respiration…or into its anus’. Until 1856, however, most methods of reviving the drowned showed a similarly optimistic grasp of human physiology. Not even the establishment of groups dedicated to reviving the apparently dead, such as the Royal Humane Society, improved matters much, and in the absence of any scientifically sound method for reviving the drowned people muddled along as best as they could using a variety of techniques.
The most popular was the submersion of the recovered body in a hot bath, which was heated to around 100°F – a practice based on a belief that it was extreme cold, rather than lack of oxygen, that caused the drowning to lapse into unconsciousness. If this didn’t work then cold water might be thrown at the patient, snuff or feathers held beneath their nose, or their face might be repeatedly slapped to try and wake them up. Bellows, thrust up the patient’s nose, were favoured by some, while others advocated flinging the body over a pony and having it jog-trot until the victim recovered. Still others like Captain Joey, the ‘bottle-nosed’ pub regular, held that ‘the body should be hung up by the heels…and should then, as a particularly choice manoeuvre for promoting easy respiration, be rolled upon casks’. Dickens plays Joey’s ‘sagacious’ suggestion for laughs, and Miss Abbey bars him from the room where the attempt to revive Rogue Riderhood takes place, but depending on the length of the Captain’s last voyage he simply may not have known that his favoured techniques were newly out of date.
In March 1856, Dr Marshall Hall of London wrote to The Lancet detailing a new technique for reviving the drowned, in which the mouth and one nostril were closed using a sticking plaster, while a length of ‘caoutchouc tube’ was inserted into the open nostril. At the other end of this tube, which was about three feet long, was fixed a bent glass tube ‘of the same size’ into which was poured a teaspoon of water:
The operator then took hold of the subject (which was lying in the prone position) by the left shoulder and hip, and gently raised it, until the whole body was resting on the right side. This movement caused the air to enter the glass tube, creating bubbles in the water as it passed on into the lungs; and on the body slowly being replaced on the stomach, the air was freely expelled from the lungs, and caused the same agitation in the water as it made its exit through the glass tube. (The Lancet, 1 March, 1856: 229)
Marshall Hall provided experimental proof that rolling the body from side to side produced artificial, and that if these rolling movements were made precisely sixteen times per minute the patient’s life could be maintained long enough to allow an apparently lifeless body to revive.
Two years later Dr Henry Silvester announced, again in The Lancet, that he had made improvements to Marshall Hall’s technique: ‘In my method we lift the ribs and sternum by the pectoral and other muscles…by steadily extending the arms up by the side of the patient’s head; by elevating the ribs the cavity of the chest is enlarged, a tendency to vacuum is produced, and a rush of air immediately takes place into the lungs. Expiration is brought about by a simple compression of the sides of the chest by the patient’s arms’.
Both Marshall Hall and Silvester emphasised the paramount importance of quick treatment and maintaining a supply of oxygen to the blood, but there are some differences between the two. Marshall Hall claimed that the great advantage of his method was ‘the readiness by which one person can perform the operation, in the absence of any other assistance’. Indeed, he nicknamed it ‘the Ready Method’ of resuscitation, although much of its readiness depends upon the presence of caoutchouc tubing and a bent glass tube. It was to this end that Marshall Hall invented a device made of silk, rubber and glass which he called ‘the Pnoeometer’.
Silvester’s technique required no such apparatus, but did require at least two people if it was to work properly: an ‘operator’ to stand behind the patient’s head, raising and lowering their arms, and an assistant to check their airways for obstructions, turn the patient as required, and place a roll of cloth or a pillow beneath the patient to elevate their rib cage (a role assigned, in Riderhood’s case, to his daughter Pleasant).
In both methods further assistants may be employed in applying friction to the patient’s body using either their hands or warm handkerchiefs and flannels, always encouraging the blood to flow towards the patient’s heart. This manual labour is what Bob Glamour et al are engaged in during this month’s number, each lending their hands to aid Riderhood’s heart, even while his soul remains sadly out of reach.
Survival rates increased dramatically as a direct result of these scientifically based developments of traditional techniques, and throughout the early 1860s medical journals and newspapers recorded a string of successful resuscitations from around the world. Our Mutual Friend was thus written in an age when artificial respiration had, for perhaps the first time in history, become a subject of genuine public interest, and this episode’s narration reflects the novelty of the proceedings. Dickens leaves the details a little vague, giving only an impressionistic and subjective view of the resuscitative process, but a shift in narrative focalization registers the significance of proceedings. The narrator inhabits first the subjective ‘I’ of the doctor and then the collective ‘we’ of the group in the upper room, each of whom works ‘so hard’ and ‘with such patience’ at the ‘flabby lump of mortality’ which had so recently been Rogue Riderhood.
Dickens is characteristically keen to embrace the new in this scene, even if he doesn’t make clear which version of the new his anonymous doctor employs (and this despite the fact that proponents of the two methods would argue vociferously about the merits of each for the rest of the century). In 1864 the National Lifeboat Institution published their ‘Instructions for the Restoration of the apparently Dead from Drowning’, which suggests that both should be employed, but only after some of the more traditional techniques had been tried and found wanting: ‘In these Instructions (a copy of which should be in the possession of every family), it is recommended, that if breathing cannot be excited by the application of stimulants to the nostrils, or by dashing-water on the face, Marshall Hall’s method should be tried; and that if this do not prove successful in from two to five minutes, Dr Sylvester’s (sic) method should be resorted to.’
This belt-and-braces approach suggests that official distrust of the new techniques was widespread as late as 1864. If we are to judge from the dismissal of Captain Joey, and Riderhood’s bathetic awakening, Dickens was rather more impressed, both with their potential to revive the drowned and their ability to forge mutual ties among those who unite to haul Riderhood back from the dead.