Middle Medicine

I have something to say:
CPR saves lives. It is an excellent resuscitation technique:

Millions of people receive CPR training each year, and its use has been shown to increase the survival rate of people who are suffering from otherwise fatal conditions.

CPR is used in a variety of situations, including drug overdose, near drowning and electrical shock. It is also used when a person has entered cardiac arrest, or the heart has stopped beating (most often due to an abnormal heart rhythm called ventricular fibrillation). Patients may avoid sudden cardiac death if they receive CPR until emergency medical help arrives (who may use a defibrillator to restore a natural heart rhythm).

A Brief History of CPR

1891: The first external cardiac massage in the Western world was reported to be done successfully by Friedrich Maass.

1960: Kowenhoven and Knickerbocker reported their method in JAMA that chest compression was accepted as a method of resuscitation for cardiac arrest.

1966: The first guideline for CPR was published.

1970: Teaching the lay public to do CPR was started.

1974: American Heart Association (AHA) formally promoted the practice involving the combination of rescue breathing and external cardiac massage for cardiac arrest in a ratio of 2:15.

2005: Ewy in Arizona showed that hands-only CPR, at a rate of 100 per minute until the emergency crew armed with automated cardiac defibrillators arrive, was superior to the traditional method of CPR.

The AHA was hesitant to accept Ewy’s idea in their new guidelines for CPR in 2005, but as a compromise, recommended a ratio of 2 breaths to 30 chest compressions instead.

2007: In March The Lancet reported a Japanese study on a series of over 4000 cases in Tokyo, comparing traditional CPR to hands-only CPR by bystanders. The results showed that the latter was more successful in the resuscitation of cardiac arrest with preservation of neurological function.

2008: In April, the AHA finally gave its approval on hands-only CPR from bystanders.

Oh wait, I forgot something – Chinese Medicine has been practicing CPR since at least 403 BC:

A more complete History of CPR

403-221 BC: (Warring Kingdoms period) External cardiac massage was practised as a method of resuscitation for victims of suicide by hanging. Some credited this to Bian Que.

6 BC – 221 AD: (Eastern Han Dynasty) The first description of CPR for resuscitation of victims of hanging came from Zhang Zhongjing.

In his Essence of the Golden Chest, miscellaneous therapy #23, he described the method as follows: “Lower the victim gently, don’t just cut the rope, and lie him on the blankets. One person should put his feet against the shoulders of the victim and pull on his hair, rendering it taut (to open the airway). One person should put his hands on the victim’s chest and compress rhythmically (external cardiac massage). One person should flex and extend the victim’s limbs (to promote venous return). One person should press on the victim’s abdomen (to enhance intrathoracic pressure during external cardiac massage). ….This method is the best and usually successful.”

Zhang Zhongjing’s writings were handed down and read by Chinese physicians through the centuries.

1186-1249 AD: (Sung Dynasty) The above passage in Essence of the Golden Chest was cited by Sung Ci in his book on forensic medicine “Washing Away of Wrongs (Xi Yuan Ji Lu)”, which is recognized as the first book of forensic medicine in the world and has been translated into many languages both in Asia and Europe.

If you read the description of CM CPR carefully, you will see that there is no mention of rescue breathing.

CM has been teaching the better form of CPR for over 2400 years.

The above two histories are very slightly abridged and are courtesy of Am An Zhang, Child Psychiatrist and Author of “The Cockroach Catcher”, which is a very interesting book and available at online bookstores, including lulu.com.