The lowly household toilet plunger won't fit in a doctor's bag, but it has proved its medical mettle.

A doctor says a San Francisco heart patient was revived twice by family members who reached for the plumber's helper.Dr. Keith G. Lurie of the University of California-San Francisco Medical Center related the incidents in a letter in the Journal of the American Medical Association.

He said a 65-year-old man with severe heart disease collapsed while watching television one evening. His son, poorly trained in cardiopulmonary resuscitation, tried unsuccessfully to revive the man by mouth-to-mouth resuscitation and chest compression.

Lurie said the son then remembered that his mother had resuscitated her husband six months earlier with a toilet plunger. So the son got the plunger and used it to plunge his father's chest for 10 minutes until paramedics arrived.

By that time, the patient had begun to move and breathe on his own, Lurie said.

The doctor speculated that the plunger delivered a "precordial thump," just as medical experts would have, and served as an effective chest compressor.

Lurie said the plunging also may have helped draw air into the patient's lungs.

He said the son suggested that toilet plungers be placed next to all beds in the hospital's coronary care unit.