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"CPR is a simple technique that can save lives. It is important for everyone to learn how to do CPR, so that they can be prepared to help in an emergency."
—Peter Safar, MD, Modern Father of CPR
Throughout history, medical advancements have often come through tragedy, trial, and no small amount of peculiarity.
The history of CPR or cardiopulmonary resuscitation, epitomizes this tortuous scientific journey.
From its crude beginnings as "the kiss of life" to the oddly apt rhythm of "Stayin' Alive," the story of reviving the dead contains many twists on the winding road toward saving lives.
In the late 18th century, drowning was a leading cause of accidental death, especially along the waterways of bustling Paris.
It was during this Age of Enlightenment that the Paris Academy of Sciences, an eminent scientific society, took up the question of how to rescue drowning victims.
While conventional wisdom held that those pulled lifeless from the water were doomed, the Academy pursued new solutions through reason and experimentation.
In 1740, the Paris Academy recommended reviving the drowned by placing one's mouth over theirs and breathing air into their lungs, then compressing their chest to expel the water—essentially artificial respiration and circulation.
This method became known as "the kiss of life" for its use of mouth-to-mouth contact, deemed improper in most contexts. Though anatomically primitive by today's standards, it was revolutionary for its time.
The technique spread across Europe, used on the banks of the Seine and Thames.
Even King Louis XV of France, impressed by the life-saving potential, had his personal physicians trained. However, many saw the kiss of life as a last resort, only if the victim was deemed of high social status.
The zeal of the Enlightenment had limits.
While the 18th century kiss of life may seem crude now, it pioneered the idea of actively reviving those thoughts lost.
As medical knowledge advanced, so too would resuscitation, from early manual methods to modern CPR.
It took those Enlightenment thinkers, challenging the limits of their era, to breathe life into the drowned and seed an idea that would save countless lives.
As the kissed-of-life resuscitation technique spread in the 19th century, the dangers of overzealous chest compressions became tragically apparent.
Though the early 1800s saw major advances in medical understanding, anatomy remained crude by today’s standards.
Doctors of the day knew the chest had to be compressed to push out water and restart circulation—but without the benefit of X-rays or stethoscopes, they compressed with abandon.
Cracked ribs and crushed organs were commonplace.
Medical literature began to describe alarming cases where patients were effectively compressed to death.
Distinguished doctors like Charles Kite and Benjamin Brodie raised the alarm—Kite warning in 1805 of “indiscriminate zeal” in performing chest compressions.
Gentler handling was urged when resuscitating drowning victims and the apparently dead.
But in the heat of desperation, with crude anatomical knowledge, erring on the side of force seemed the only hope. And so chests were crushed and ribs snapped well into the 19th century—an unfortunate medical reality before anatomy and physiology were better elucidated.
Clear-minded Brodie wrote in 1823: “The business is to restore life, not to destroy it.” It would be over a century before this logic prevailed.
Only through tragedies and mistakes could resuscitation methods be refined.
With advanced 20th century understanding of physiology and establishment of safe compression limits, CPR broke fewer ribs—but its practitioners had been sobered by their predecessors’ overzealous mishaps.
The peculiar case of smoking before mouth-to-mouth resuscitation exemplifies the perils of medical uncertainty. As kissed-of-life techniques became standard, practitioners wondered—does the rescuer’s breath matter? Many assumed foul breath would doom the drowning victim.
Hence smoking a cigarette or pipe beforehand was thought to purify the lungs.
In the mid-20th century, some pioneering CPR manuals recommended “a few vigorous puffs” to clear the airways before mouth-to-mouth. A well-meaning logic, given limited medical knowledge—though nicotine and tar hardly purified the lungs.
The ritual gave comfort despite lacking scientific basis.
The advice reached even the prestigious Red Cross, whose handbooks suggested a deep cigarette drag before mouth-to-mouth until the 1960s.
Of course, we now know smoking immediately poses its own hazards. The ritual continued largely unchecked until the landmark Surgeon General report of 1964 on “Smoking and Health” exposed the dire risks of cigarettes.
In hindsight, the practice appears ludicrous.
But it remains a sobering lesson on the perils of medical groupthink.
Decades of smoking being considered somehow healthful allowed dubious resuscitation advice to thrive, potentially harming some of those it intended to help.
The development of CPR training mannequins by the Norwegian toymaker Laerdal marked a pivotal advancement for life-saving instruction.
But an unforeseen hurdle arose—trainees were unwilling to practice mouth-to-mouth resuscitation on the creepily lifeless dummies.
The intimacy of the mouth on plastic evoked visceral discomfort.
To combat this queasiness, Laerdal added a rubber lung bag inside its Resusci-Anne model in 1960.
Students could pinch the mannequin’s nose and breathe into the attached lung bag, inflating it.
The bag mimicked the lungs filling with breath, providing a sanitary alternative to direct mouth-to-mouth contact. Trainees across the world rejoiced at the ingenious solution.
Of course, modern sensibilities recognize the absurdity of resisting practice on an inanimate mannequin.
But Laerdal’s lung bag workaround highlights how cultural hangups can impede medical progress, and how creative thinking provides solutions. The lung bag allowed vital CPR training to continue despite semi-irrational reluctance about mannequins.
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A particularly sobering chapter in medical history was the era when CPR was deemed futile and even dangerous for children.
Throughout the mid-20th century, conventional wisdom held that children's ribs were too pliable to generate adequate chest compressions.
Doctors were systematically instructed not to perform CPR on kids under age 8—resuscitating children seemed not just ineffective but harmful.
Tragically, this supposed anatomical “fact” was based more on assumption than evidence.
With adults as the test case, children were presumed unable to withstand life-saving CPR. It took brave doctors willing to challenge orthodoxy to prove otherwise.
In the 1960s, studies by pediatric resuscitation pioneers like Dr. Dorothy Elsner provided evidence contradicting long-held beliefs.
Elsner's work demonstrated that a child’s chest could sustain compressions and that their hearts responded to CPR just as adults did. Such empirical research gradually overturned decades of misguided caution about pediatric resuscitation.
An unlikely resuscitation aid emerged from the disco era—the Bee Gees' 1977 hit "Stayin' Alive."
With its famous repeating bassline, doctors realized the catchy tune's 100 beats-per-minute tempo perfectly matched the recommended pace for chest compressions. Though medically unintentional, the song provided an ideal musical metronome for performing CPR.
References to "Stayin' Alive" quickly entered resuscitation training culture.
CPR courses began timing compressions to the driving beat and using lyrics like "ah, ha, ha, ha, stayin' alive" to cement the right rhythm in trainees' minds.
The American Heart Association even endorsed the song as a mnemonic device.
Amusingly, pop culture began influencing proper medical technique.
While perhaps unintuitive for the laity, using a retro disco hit as a medical training tool made perfect sense to medical professionals.
The Bee Gees and their producer surely never imagined their chart-topper could help save lives through CPR timekeeping.
But such creative collisions of art and science often drive progress.
"Stayin' Alive" is now a staple reference point in resuscitation training, its unique place in pop culture history unexpectedly enriched by assisting proper CPR.
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