The Greek physician Galen may have been the first to describe artificial ventilation: "If you take a dead animal and blow air through its larynx through a reed, you will fill its bronchi and watch its lungs attain the greatest distention." Vesalius too describes ventilation by inserting a reed or cane into the trachea of animals.
In 1773, English physician William Hawes (1736–1808) began publicizing the power of artificial ventilation to resuscitate people who superficially appeared to have drowned. For a year he paid a reward out of his own pocket to any one bringing him a body rescued from the water within a reasonable time of immersion. Thomas Cogan, another English physician, who had become interested in the same subject during a stay at Amsterdam, where was instituted in 1767 a society for preservation of life from accidents in water, joined Hawes in his crusade. In the summer of 1774 Hawes and Cogan each brought fifteen friends to a meeting at the Chapter Coffee-house, St Paul's Churchyard, where they founded the Royal Humane Society as a campaigning group for first aid and resuscitation. Some methods and equipment were similar to methods used today, such as wooden pipes used in the victims nostrils to blow air into the lungs. Others, bellows with a flexible tube for blowing tobacco smoke through the anus to revive vestigial life in the victim's intestines, were discontinued with the eventual further understanding of respiration.
The 1856 works of English physician and physiologist Marshall Hall recommended against using any type of bellows/positive pressure ventilation, views that held sway for several decades. A common method of external mechanical manipulation, introduced in 1858, was the "Silvester Method" invented by Dr. Henry Robert Silvester in which a patient is laid on their back and their arms are raised above their head to aid inhalation and then pressed against their chest to aid exhalation.
The shortcomings of mechanical manipulation led doctors in the 1880s to come up with improved methods of mechanical ventilation, including Dr. George Edward Fell's "Fell method" or "Fell Motor", consisting of a bellows and a breathing valve to pass air through a tracheotomy, and his collaboration with Dr. Joseph O'Dwyer to invent the Fell-O'Dwyer apparatus, a bellows and instruments for the insertion and extraction of a tube down the patients trachea. Such methods were still looked upon as harmful and were not adopted for many years.