Before defibrillators, before CPR, before ambulances with anything more than a blanket and good intentions, humanity spent thousands of years trying to bring the dead back to life. The results were, to put it charitably, mixed. But the impulse was always there — and some of what people tried was surprisingly close to the mark.
The Ancients Had a Go
The ancient Egyptians believed the heart was the seat of the soul, which meant a stopped heart was not merely a medical problem but a theological one. Their approach to resuscitation leaned heavily on incantations, ritual, and the intervention of the god Thoth. Effective? Probably not. Dramatic? Almost certainly.
The Bible contains what may be the earliest recorded description of mouth-to-mouth resuscitation. In the Second Book of Kings, the prophet Elisha revives a child by lying upon him and placing his mouth on the child’s mouth — after which “the flesh of the child waxed warm.” Whether this was genuinely mouth-to-mouth breathing or simply the warmth of an adult body is debated. Either way, it predates James Elam’s laboratory experiments by roughly two and a half thousand years.
The Tobacco Smoke Enema (Yes, Really)
The 18th century was a golden era for well-intentioned but spectacularly wrong ideas about resuscitation. The most memorable — and the one that gave rise to the expression “blowing smoke up someone’s backside” — was the tobacco smoke enema.
The Royal Humane Society, founded in London in 1774 to save drowning victims, promoted the use of bellows to insufflate tobacco smoke into the rectum of the apparently dead. The logic was that tobacco was a stimulant, and stimulation was what a stopped heart needed. Resuscitation kits containing the necessary equipment were installed along the banks of the Thames. The practice was eventually abandoned when it became clear that it was, at best, ineffective and, at worst, actively harmful. It is perhaps the single greatest argument for evidence-based medicine.
Warming, Rolling, and Hanging Upside Down
Other popular 18th century approaches included rubbing the body vigorously with warm cloths, rolling it over a barrel (to simulate breathing by alternately compressing and releasing the chest — which was actually closer to the right idea than the tobacco approach), tickling the throat with a feather, and in some traditions, hanging the person upside down. The upside-down method was based on the observation that newborn babies are sometimes held inverted and slapped — which, of course, works because they are alive.
The Royal Humane Society also recommended warmth, friction, and bellows ventilation into the lungs — the latter being a genuine step in the right direction, even if the tobacco variant rather overshadowed it.
The 19th Century Gets Closer
By the mid-1800s, chest compression techniques began to emerge. Dr Henry Robert Silvester described a method in 1858 in which the patient’s arms were raised above the head and then pressed down onto the chest — a rhythmic motion designed to simulate breathing. The “Silvester method” was widely taught for nearly a century and was still being used in some countries well into the 1950s.
Meanwhile, in 1849, John Alexander MacWilliam demonstrated that electrical stimulation could induce ventricular contraction — the first hint that electricity and the heart had a relationship worth exploring. It would take another hundred years and several wrong turns before that relationship was properly understood.
The First Half of the 20th Century
By the early 20th century, internal cardiac massage — literally reaching into the chest and squeezing the heart by hand — was occasionally performed in operating theatres on patients who arrested during surgery. It worked, sometimes. Open-chest defibrillation using electrodes applied directly to the heart was demonstrated in dogs in the 1890s and in humans by the 1940s. But these were surgical procedures requiring a scalpel, a sterile environment, and a surgeon. They were of no use whatsoever to anyone who collapsed on a pavement in Brighton.
That was the state of affairs until the late 1950s, when James Elam and Peter Safar proved that exhaled air could sustain life, Paul Zoll demonstrated external defibrillation through the intact chest wall, and Frank Pantridge put a defibrillator in a van and drove it to the patient. Within a decade, modern resuscitation was born.
It had only taken about three thousand years to get there.