If the Patient can swallow, a Vomiting may be excited with the Prescription [Nº. 8], or with [Nº. 34], or [35]. By this Operation a Bone was thrown out, which had stopt in the Passage four and twenty Hours.
When the Patient cannot swallow, an Attempt should be made to excite him to vomit by introducing into, and twirling about the feathery End of a Quill in, the Bottom of the Throat, which the Feather however will not effect, if the obstructing Body strongly compresses the whole Circumference of the Gullet; and then no other Resource is left, but giving a Glyster of Tobacco. A certain Person swallowed a large Morsel of Calf's Lights, which stopt in the Middle of the Gullet, and exactly filled up the Passage. A Surgeon unsuccessfully attempted various Methods to extract it; but another seeing how unavailable all of them were; and the Patient's Visage becoming black and swelled; his Eyes ready to start, as it were, out of his Head; and falling into frequent Swoonings, attended with Convulsions too, he caused a Glyster of an Ounce of Tobacco boiled to be thrown up; the Consequence of which was a violent Vomiting, which threw up the Substance that was so very near killing him.
§ 416. A sixth Method, which I believe has never hitherto been attempted, but which may prove very useful in many Cases, when the Substances in the Passage are not too hard, and are very large, would be to fix a Worm (used for withdrawing the Charge of Guns that have been loaded) fast to a flexible Handle, with a waxed Thread fastened to the Handle, in Order to withdraw it, if the Handle slipt from the Worm; and by this Contrivance it might be very practicable, if the obstructing Substance was not too deep in the Passage of the Gullet, to extract it—It has been known that a Thorn fastened in the Throat, has been thrown out by laughing.
§ 417. In the Circumstances mentioned [§ 409], when it is more easy and convenient to push the obstructing Body downwards, it has been usual to make Use of Leeks, which may generally be had any where (but which indeed are very subject to break) or of a Wax-candle oiled, and but a very little heated, so as to make it flexible; or of a Piece of Whale-bone; or of Iron-Wire; one Extremity of which may be thickened and blunted in a Minute with a little melted Lead. Small Sticks of some flexible Wood may be as convenient for the same Use, such as the Birch-tree, the Hazel, the Ash, the Willow, a flexible Plummet, or a leaden Ring. All these Substances should be very smooth, that they may not give the least Irritation; for which Reason they are sometimes covered over with a thin Bit of Sheep's Gut. Sometimes a Sponge is fastened to one End of them, which, completely filling up the whole Passage, pushes down whatever Obstacle it meets with.
In such Cases too, the Patient may be prompted to attempt swallowing down large Morsels of some unhurtful Substance, such as a Crust of Bread, a small Turnep, a Lettuce Stalk, or a Bullet, in Hopes of their carrying down the obstructing Cause with them. It must be acknowledged, however, that these afford but a feeble Assistance; and if they are swallowed without being well secured to a Thread, it may be apprehended they may even increase the Obstruction, by their own Stoppage.
It has sometimes very happily, though rarely, occurred, that those Substances attempted to be detruded or thrust downwards, have stuck in the Wax-Candle, or the Leek, and sprung up and out with them: but this can never happen except in the Case of pointed Substances.
§ 418. Should it be impossible to extract the Bodies mentioned [§ 410], and all such as it must be dangerous to admit into the Stomach, we must then prefer the least of two Evils, and rather run the Hazard of pushing them down, than suffer the Patient to perish dreadfully in a few Moments. And we ought to scruple this Resolution the less, as a great many Instances have demonstrated, that notwithstanding several bad Consequences, and even a tormenting Death, have often followed the swallowing of such hurtful or indigestible Substances; yet at other times they have been attended with little or no Disorder.
§ 419. One of these four Events is always the Case, after swallowing such Things. They either, 1, go off by Stool; or, 2, they are not discharged and kill the Patient. Or else, 3, they are discharged by Urine; or, 4, are visibly extruded to the Skin. I shall give some Instances of each of these Events.
§ 420. When they are voided by Stool, they are either voided soon after they have been swallowed, and that without having occasional scarce any troublesome Symptom; or the voiding of them has not happened till a long Time after swallowing, and is preceded with very considerable Pain. It has been seen that a Bone of the Leg of a Fowl, a Peach-stone, the Cover of a small Box of Venice Treacle, Pins, Needles, and Coins of different Sorts, have been voided within a few Days after they had slipt down into the Stomach; and that with little or no Complaint. A small Flute, or Pipe also, four Inches long, which occasioned acute Pains for three Days, has been voided happily afterwards, besides, Knives, Razors, and one Shoe-buckle. I have seen but a few Days since a Child between two and three Years old, who swallowed a Nail above an Inch long, the Head of which was more than three Tenths of an Inch broad: it stopt a few Moments about the Neck, but descended while its Friends were looking for me; and was voided with a Stool that Night, without any bad Consequence. And still more lately I have known the entire Bone of a Chicken's Wing thus swallowed, which only occasioned a slight Pain in the Stomach for three or four Days.
Sometimes such Substances are retained within for a long Time, not being voided till after several Months, and even Years, without the least ill Effect: and some of them have never either appeared, nor been complained of.