ated the tip of an atomizer while spraying his
throat. In many other cases the accident had been forgotten. In still
others, in spite of the patient's statement of a conviction that the
trouble was due to a foreign body he had aspirated, the physician did
not consider it worthy of sufficient consideration to warrant a
roentgenray examination. It is curious to note the various opinions
held in regard to the gravity of the presence of a bronchial foreign
body. One patient was told by his physician that the presence of a
staple in his bronchus was an impossibility, for he would not have
lived five minutes after the accident. Others consider the presence of
a foreign body in the bronchus as comparatively harmless, in spite of
the repeated reports of invalidism and fatality in the medical
literature of centuries. The older authorities state that all cases of
prolonged bronchial foreign body sojourn died from phthisis
pulmonalis, and it is still the opinion of some practitioners that the
presence of a foreign body in the lung predisposes to the development
of true tuberculosis. With the dissemination of knowledge regarding
the possibility of bronchial foreign body, and the marvellous success
in their removal by bronchoscopy, the cases of prolonged foreign body
sojourn should decrease in number. It should be the recognized rule,
and not the exception, that all chest conditions, acute or chronic,
should have the benefit of roentgenographic study, even apart from the
possibility of foreign body.

Often even with the clear history of foreign-body aspiration, both
patient and physician are deluded by a relatively long period of
quiescence in which no symptoms are apparent. This symptomless
interval is followed sooner or later by ever increasing cough and
expectoration of sputum, finally by bronchiectasis and pulmonary
abscess, chronic sepsis, and invalidism.

_Pathology_.--If the foreign body completely obstructs a main
bronchus, preventing both aeration and drainage, such rapid
destruction of lung tissue follows that extensive pathologic changes
may result in a few months, or even in a few weeks, in the case of
irritating foreign bodies such as peanut kernels and soft rubber. Very
minute, inorganic foreign bodies may become encysted as in
anthracosis. Large objects, however, do not become encysted. The
object is drawn down by gravity and aspirated into the smallest
bronchus it can enter. Later the negative pressure below from