Today is the second day of Explore Your Archive, a celebration of archives of all kinds across the nation, organised by the Archives & Records Association for UK & Ireland, and today’s theme is ‘Tiny’. In today’s post, we’re showcasing something tiny and mighty: St John Ambulance’s first manual of first aid.

St John Ambulance began when the Order of St John created the St John Ambulance Association here at St John’s Gate in 1877 to teach first aid and lifesaving skills to the public, and to share ambulance equipment. In October of the following year, the Association published its first English-language manual of first aid, called ‘Handbook Describing Aids for Cases of Injuries and Sudden Illness’. The Handbook is 9cm wide and 11.5cm tall when closed, and around a centimeter thick. It weighs just 68g, which is about the same as a chicken’s egg, 3,000 grains of rice, and about a three thousandth as heavy as the heart of a blue whale.

The manual was created by Surgeon-Major Peter Shepherd, one of the first Association’s lecturers in first aid, and the first person to use the term ‘first aid’ with civilians. It was designed for use in the Association’s first aid classes, by the Metropolitan Police, and by the Order of St John across England. The manual sets out the Association’s standard of training and follows the syllabus of its classes so that the same information given in classes could be accessed by those who held the manual. Its intended audience was not trained doctors or nurses, but non-professionals, who could be furnished with some simple rules and guidance for acting in cases of injury or sudden illness, pending the arrival of professional help. Many tens of thousands of copies of this handbook sold in the few months after it was published.

The manual is 19.5cm wide when open and it has content on both sides of the pages, and the content is almost entirely textual. Later editions of the manual included quite a lot of illustrations to accompany guidance for bandaging, depictions of reviving life, and other useful visual indicators, but this first edition is primarily textual, with few, if any, visual aids. There are less than 100 pages in these manuals, and they are divided into chapters for different areas, including insensibility, diseases and injuries of the head, treatments for cases, haemorrhage or bleeding, fractures, wounds, equipment for the sick and injured, disinfection, poisons, death, and a handy index at the back. Some of the reprints also contain an illustration of the skeleton and muscular outlines at the front of the manual.

For St John Ambulance, first aid saves lives, and lifesaving has always been at the core of its work. Towards the back of the manual, the chapter concerning death describes three modes of death (occurring in the heart, lungs, or head), lists nine of the most obvious signs of death, and what it considers to be the nine chief causes of sudden death. Drowning appears to be one of the highest concerns, as detailed instructions for restoring the apparently drowned are also given, alongside directions to restoring breathing which recommend placing the patient face down – guidance which is very out of date. There are also detailed treatments for haemorrhage for the different parts of the body, and the different kinds of haemorrhages (arterial, venous, capillary, and internal).

After a few years of publication, this manual changed its name to ‘First Aid to the Injured’, named after the first aid classes given by the Association, and continued to be published under this name until the early 1950s, when publication ceased and other first aid manuals were published instead. The St John Ambulance Association expanded overseas almost immediately after being established in the United Kingdom, predominantly to countries within the British Empire, and these handbooks were adapted to suit the needs of the different cultures and climates where the Association developed. An example is found in some of the early Australian versions of this manual, which include specific first aid for snake bites. This, and other manuals, were also translated into many different languages, including, but not limited to, Urdu, Gujarati, Assamese, Bengal, Afrikaans, Swahili, French, Maltese, Malay, and Welsh.