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Gastellier has reported the case of a young man of sixteen who swallowed a crown piece, which became lodged in the middle portion of the esophagus and could not be removed. For ten months the piece of money remained in this position, during which the young man was never without acute pain and often had convulsions.
Brick wrapped up in a flannel petticoat just as good, anyway!" "How's Ella's tonsils, Mr. Stowbody?" yawned Chet Dashaway. While Mr. Stowbody gave a somatic and psychic study of them, Carol reflected, "Are they really so terribly interested in Ella's tonsils, or even in Ella's esophagus? I wonder if I could get them away from personalities? Let's risk damnation and try."
Upon probing through a small fistulous opening just above the superior end of the sternum, the point of the arrow was found resting against the bone, about 1 1/2 inches below, the head lying against the trachea and esophagus, with the carotid artery, jugular vein, and nerves overlying.
A peculiarly fatal accident in this connection is that in which a foreign body in the esophagus ulcerates, and penetrates one of the neighboring major vessels. Colles mentions a man of fifty-six who, while eating, perceived a sensation as of a rent in the chest. The pain was augmented during deglutition, and almost immediately afterward he commenced to expectorate great quantities of blood.
"I'm glad t'see th' sight av ye," he said, holding out his hand, "for I do be wantin' some help on these three hunderd worrds th' prisidint has been simplifyin' down. 'T is a turrible job they be, thim three hunderd! Some av thim I never will be after learnin'. Look at this, now," he said, putting his finger on "orthopedic." "And this wan," he said, touching "esophagus." "Thim be tough wans!
There is one case in which a man of forty-seven suddenly died, after vomiting blood, and at the autopsy it was demonstrated that a needle had perforated the posterior wall of the esophagus and wounded the aorta. Poulet has collected 31 cases in which ulceration caused by foreign bodies in the esophagus has resulted in perforation of the walls of some of the neighboring vessels.
I picked Grundy up by the collar of his jacket, heaved him around and against a wall, where I could get my hand against his esophagus and start squeezing. His eyeballs popped, and the wrench dropped from his hands. When I get mad enough to act that way, I usually know I'll regret it later. This time it felt good, all the way. But Muller pushed me aside, waiting until Grundy could breathe again.
Swallowing is a series of reflexes in a row, so that food in the back part of the mouth sets a reflex going that carries it beyond the epiglottis; another reflex carries it to the esophagus and then one reflex after the other transports the food the rest of the way. Except for the first effort of swallowing, the rest is entirely involuntary and even unconscious.
Lloyd said that these cases were forms of neuroses, and were types of hysteric vomiting. There was no gustatory satisfaction connected with any form of hysteric vomiting that he had seen. In some of these cases of hysteric vomiting the food does not appear to enter the stomach, but is rejected by a sort of spasm of the esophagus.
At times the evacuation took place without effort, but was occasionally attended with slight pain in the esophagus and slight convulsions. Several hours before the evacuation the abdomen was hard and distended, which appearance vanished in the evening. In this case there was a history of an injury in the upper iliac region.
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