Knoxville journal. [volume] (Knoxville, Iowa) 1874-1986, 1874-06-25
pened, the Partisan papers quote all the

pened, the Partisan papers quote all the
analogous cases they find in old records,
more to excite curiosity than to help the
poor fellow by good suggestion. After
fifteen days of experiments made in view
OF relieving him, without success, by
eminent surgeons, he left the hospital de
la Piete and resumed his position in the
store, where / see him again.
He is nineteen years old, we'll built,
healthy and intelligent; shows no trace
| of suffering, but some of preoccupation
| Of his mind; though he knows by the ex-
| amples quoted that he runs very little
| risk. The fork, whose presence in the
stomach has been ascertained beyond
doubt, does not cause him any pain, ex-
cept when he bends his body sideways,
| or when the stomach is empty. The lat
ter obliges him to eat oftener than he
would only for the satisfaction of true
appetite.
| To understand how this accident hap
| pened, and, moreover, to warn the i'm
prudents who expose themselves to q
similar mishap it is good to know how
this takes place. When food or body is
| introduced into the mouth, it remains
there under the control of the will but
If it is allowed to go even partly farther,
it, or part of it, is seized between the
muscular fibers which form the middle
coat of the digestive canal, upon which
the will has no action, and down it goes,
carried by the peristaltic (naturaD move
ment of these muscles, unless it is
stopped by its bulk, weight or form.
Children, in particular, must be made, as
early as possible, aware of this danger, of
which the details are quite unknown.
| Things thus involuntarily swallowed may
become dangerous by their substance,
whose chemical decomposition may pro-
duce poisons; by their bulk, which can
obstruct the alimentary canal; by their
configuration, whose asperities may hurt;
by their length, which cannot follow uor
straighten the f1exuosities of the organs
of digestion.
The chemical alteration of fork-as
in the present instance-may, according
to its composition, produce oxides, sui
| phurets, salts of copper, of nickel, Of zinc,
of arsenic, whose danger is lessened by
constant elimination, but greater if anti.
mony is present in the compound, and
greater if lead. Therefore it is necessary
in case of that sort to have analysed an
| object similar to the one swallowed, and
to watch for the advent of the possible
signs of absorption. Another danger
consequent to chemical decomposition of
such body may be an alteration of its
shape, by which cutting or pointed sur
faces may be formed, capable of forcing
their way out through the tissues
In the present case the fork is not of a
| bulk sufficient to obliterate the ways.
The handle, first introduced, has slipped
along the grand curve of the stomach, and
is directed toward the pylore. Thus, so
| far, the fork lies at the bottom of the
stomach. If it enters the intestines, their
peristaltic movement will carry 1t along
| but their curves are so numerous and
short that it is difficult to imagine how
they could be travelled through by an in
| flexible, straight body, seven inches long.
| On this account such movement does not
seem desirable.
On the other hand, the digestions are
good. BY some inflammatory process
the stomach may eventually adhere to the
wall of the abdomen, and, with or with
out abscess, permit an opening to be eff
fected. By means of caustic applications
the surgeon can initiate nature in this
Iparticular, with this advantage, that he
Icould select the anterior region, far from
the essential organs.
f. In the hospital the extraction by the
mouth has been vainly attempted To
render it successful it would be necessary
to contrive an instrument which could
raise up the fork and protect the parts at
the passage of its prongs. Something OF
the sort was successfully applied thirty
years ago by Leroy d'Etiolles for the ex-
| traction OF fragment of bougie. This
precedent is encouraging, but does not
warrant success, the object and the
parts offering little analogy.
| Lastly, to go behind the most delicate
organs, to uncover the 9sophagus, to cut
| it open (esophagotomy), and through the
greatest periIs find only the narrow open
ing of the cardia, through which the fork,
| if held across, will not pass, would be a
rash undertaking.
In my estim alton the greatest obstacle
to a success is the length of the fork. L
consider it certainty that if an instru:
ment could be constructed capable OF
seizing and saving the fork, without too
much Of fatigue to the patient or lesion
to his stomach, there would be reasonable
chances for the pieces to make their way
downward.
1t was wise advice to persuade the
young man to leave off all trials OF that
sort for the present; to go to work, and 10
let the surgeons think over his case, and
possibly find the means OF relieving him
from his fork and the anxiety.
julius SEGUIS, NJ. ID.
III Not True Love, What Can 1t BE!