had long suffered from constipation, having some vague notions of the efficacy of suppositories, introduced into his rectum a shuttle with its roll of yarn. After five days he applied at the Hôtel Dieu. M. Bonhomme extracted it with a pair of lithotomy forceps. The two following cases are related by Hevin.1 M. Quesnay pushed a bone, which was arrested in the œsophagus, into the stomach. It was afterwards arrested in the rectum, and induced great pain. The patient again applied to M. Quesnay, who found the bone sticking obliquely across the intestine, with the lower end fixed in its walls. He removed it with a pair of forceps, first disengaging its inferior extremity by pushing it upward. Fagèt removed a mutton bone from the rectum of a man he was called to see: the bone had been swallowed eight days previously.

Méeckren2 mentions a case in which the jawbone of a turbot was arrested in the rectum. The patient attributed the local and constitutional symptoms he experienced to hemorrhoids. The true cause was not discovered till, in attempting to administer a lavement, the pipe of the instrument came in contact with a foreign body. Méeckren made an examination, and detected the bone with its ends fixed in the walls of the intestine; he removed it with his fingers. The patient recollected having swallowed it eight days previously, and experienced great pain in its passage through the intestine. Méeckren also mentions a case which occurred to Tholuix, in which the jawbone of a fish became arrested in the rectum. It was cut across with a pair of strong scissors, and the two portions extracted with ease.

Thiandière details the case of a man, aged twenty-two, who, with the view to overcome costiveness, introduced a forked stick into the rectum. This stick was five inches long; one prong was an inch and a half longer than the other, and they were separated to the extent of two inches, each prong being about four lines in diameter, and the stem formed by their union half an inch. He inserted the one stem first, and when the short prong had entered the bowel, he endeavored, by dragging on the long one, to force out the indurated fæces. In this ingenious essay it is unnecessary to say he failed completely: the pain being very severe, he ceased his

Op. cit. tome iii.

2 “Obs. Med.-Chirurg."

3 Bullet. Gén. de Thérapeut., Janv. 1835.

manipulations, and, finding it impossible to withdraw the fork, he forced the long prong completely within the anus, with the extraordinary idea that it would be consumed with the food. Fearful to divulge the nature of his case, he bore his sufferings in solitude and despair, until the abdominal pain and difficulty in urinating led him to seek the aid of Thiandière, who, on making an examination, soon discovered the foreign body, but it was so high up that he could scarcely touch it. He endeavored, but in vain, to extract it with a forceps passed through a speculum. The happy idea then struck him of using his hand, which, after having washed out the rectum, he insinuated finger by finger. Conducted by the long branch, he succeeded in reaching the bifurcation of the stick, and disengaged it with difficulty from a fold of the mucous membrane, in which it had become entangled, then compressing the prongs together, he safely removed it.

A similar case to the foregoing is recorded in the "Lancet."" A man, twenty-nine years of age, had suffered from his childhood from prolapsus recti, and was in the habit of replacing the intestine without aid. On one occasion, when the rectum was prolapsed, he cut a branch of willow, which divided into two prongs: holding these in his hand, with the other end of the stick he pushed up the gut, but using too much force the whole of the stick passed up also. The prongs expanding rendered him unable to withdraw it. After eight days, he was seized with acute pain in the breast, which he ascribed to the presence of the foreign body in the rectum. An examination was made per anum, but nothing detected: two months afterwards, abscesses formed over the gluteus muscle, which were opened, and the bifurcated ends of the stick protruded; they were seized, and broken at their angle of junction, and the pieces extracted. Each prong was nine inches in length, and the conjoined stem two inches long and three-quarters of an inch in diameter.

Marchetti2 mentions the following case: Some students of Goettingen introduced into the rectum of an unfortunate woman all, save the small extremity, of a pig's tail, from which they had cut enough of the bristles to render it as rough as possible.

1 Vol. ii, 1835-6, p. 23.

2 "Obs. Med. Rarior Syllog.," cap. vii.

Various attempts were made to extract it, but in vain. Marchetti being consulted, adopted a very simple and ingenious procedure, which consisted in securing its inferior extremity with a strong waxed thread, and slipping over it into the rectum a canula prepared for the purpose. He thus defended the bowel from the effects of the bristles, and easily removed it.

Custance mentions the case of a man who fell on an inverted blacking-pot, and had the whole of it forced up the rectum. Attempts were made for an hour and a half to dilate the sphincter, and remove it with a forceps, but in vain. The small end of an iron pestle was then introduced, till it touched the bottom, and, being held there firmly, was struck with a flat iron. At the second blow the pot was broken into several pieces, which were removed piece by piece by the forceps, or the fingers. Next morning he labored under severe intestinal inflammation, with incessant vomiting and excruciating pain over the whole belly; he died at night. The pot was two inches and three-eighths in diameter at the brim, an inch and a half at its base, and two inches and an eighth in depth.

In the first volume of the "Medico-Chirurgical Transactions,” Mr. Thomas relates the following case: "A gentleman, of an inactive and sedentary disposition, had for many years suffered from constipated bowels, which increased to that degree that the most active cathartics failed in producing the desired effect. By the advice of a practitioner, whom he consulted in Paris, he daily introduced into the rectum a piece of flexible cane (about a finger's thickness), where it was allowed to remain until the desire to evacuate the

fæces came on. This plan succeeded so well that for more than a twelvemonth he never had occasion to resort to any other means. One morning, being anxious to fulfil a particular engagement in good time, in his hurry he passed the stick farther up, and with less caution than usual, when it was suddenly sucked up into the body, beyond the reach of his fingers. This accident did not interrupt the free discharge of the fæces, and the same evacuation regularly took place every day, whilst the stick remained in the gut. It was seven days afterwards when I first saw him he was in a very distressed state, with every symptom of fever, tension of the abdomen, and a countenance expressive of the greatest anxiety. His relatives and friends were totally ignorant of the real nature

of the case; and nothing less than the urgency of his sufferings could ever have prevailed upon him to disclose it to me. Such were his feelings on the occasion, that a violent hysteric fit was brought on by the mere recital of what he termed his folly.

"Upon examination no part of the cane could be discovered; but one end of it was readily felt projecting, as it were, through the parietes of the abdomen, midway between the ilium and the umbilicus on the left side. The slightest pressure upon this part gave him exquisite pain. After repeated trials, I was at length enabled, with a bougie, to feel one extremity of the stick lodged high up in the rectum; but without being able to lay hold of it with the stone-forceps. To allay the irritation for the present, an emollient clyster, with Tinct. Opii, 3ij, was given, which passed without the least impediment, and did not return. On the next examination, two hours after, I found the sphincter ani considerably dilated, and, by a continued perseverance to increase it, the relaxation became so complete, that in about twenty minutes I was enabled to introduce one finger after the other, until the whole hand was engaged in the rectum. I found the bottom of the stick jammed in the hollow of the sacrum, but, by bending the body forward, it was readily disengaged and extracted. Its length was nine inches and a half, with one extremity very ragged and uneven.

"For several days after, the situation of the patient was highly critical, the local injury, joined to the perturbation of his mind, brought on symptoms truly alarming. At length I had the satisfaction of witnessing his complete recovery; and he has ever since, more than two years, enjoyed good health, and the regular action of the bowels, without the assistance of medicine or any other aid."

A man, æt. seventy-three, was admitted into the St. Marylebone Infirmary. He was delirious, and made his complaints very incoherently. He said there was a stick in his rectum, but no further information could be gained from him. He was seen by Mr. B. Phillips, who suggested that the sensation of something in the rectum might be caused by the enlarged prostate, and that in his delirious condition the sensation of a foreign body was sufficient to impress upon his mind the idea that it was a stick. He died the day after his admission; and upon a post-mortem examination being made, a stick rounded at each end was found; its superior

extremity had penetrated through the sigmoid flexure of the colon into the peritoneal cavity.1

In the thirtieth volume of the "Medical Gazette "2 is an account of a Greenwich pensioner, who was admitted into the infirmary on the 20th of October, 1814, having eight days previously introduced a large plug of wood into the rectum, for the purpose of stopping a diarrhoea. a diarrhoea. It was with great difficulty extracted by Mr. McLaughlan, surgeon to Greenwich Hospital.

In June, 1842, a man, æt. sixty, was brought to King's College Hospital, laboring under obstruction of the bowels, which he attributed to having eaten a large quantity of peas six days previously. He expired while being carried in a chair up to the ward.

On examining the body after death upwards of a pint of gray peas was found in the rectum: they had been swallowed without mastication, and had undergone no alteration in passing through the alimentary canal, except becoming swollen by warmth and the absorption of moisture. The urethra was pressed upon, and he had had retention of urine for four days. The bladder was enormously distended, its apex reaching the umbilicus, and its base nearly filling the brim of the pelvis.3

Mr. Liston removed from the rectum half a jawbone of a rabbit, which had been swallowed in a plate of curry.

Mr. Lawrence had a case in which a man had broken the neck of a wine-bottle into his rectum; he gradually dilated the sphincter, introduced his whole hand, and removed it.

Mr. Fergusson removed a bougie from the rectum of an old gentleman who was in the habit of using such an instrument: on one occasion he passed the bougie within the sphincter, and could not withdraw it. Several unsuccessful attempts had been made to remove it, previous to Mr. Fergusson seeing the patient: with some difficulty he succeeded in seizing the end with a pair of lithotomy forceps, and withdrawing it. The bougie was nine inches in length, and an inch in diameter.

"Medical Gazette," vol. xxix, p. 846.

2 Pp. 461, 462.

3 "Medical Gazette," vol. xxx, pp. 605, 606.

4 "Practical Surgery," by Robert Liston, Fourth Edition, 1846, p. 431.

5 "Practical Surgery," Third Edition, p. 750.