has been swallowed, a large quantity of olive oil should be
administered. The stomach should be washed out with water, the tube
being passed with the greatest gentleness to avoid perforating the
softened oesophageal wall. Subsequently the patient should be fed by
the rectum, but, in the majority of cases, gastrostomy is called for
to enable the patient to take nourishment and put the gullet at rest.

As soon as the oesophagus has healed, say in three or four weeks,
bougies should be passed every three or four days to prevent
cicatricial contraction. As the calibre of the tube is restored, the
instruments may be passed less frequently, but for some years--it may
be for the rest of the patient's life--a full-sized bougie should be
passed at least once a month.

#Impaction of Foreign Bodies in the Pharynx and Oesophagus.#--It is an
interesting fact that foreign bodies, even as large as a dinner fork,
when intentionally swallowed, can pass through the pharynx and
oesophagus and enter the stomach without apparent difficulty. When the
body is accidentally swallowed impaction is more liable to take place,
probably on account of the spasm induced by fright and by
inco-ordinated attempts to eject it. For obvious reasons the accident
is most liable to occur in children, in epileptics, and in those who
are under the influence of alcohol. It happens also during anaesthesia
for the extraction of teeth or if the patient vomits solid substances.
The clinical aspects vary according as the object is impacted in the
pharynx or in the oesophagus.

_In the Pharynx._--If a large bolus of unmasticated food becomes
impacted in the pharynx, it blocks the openings of both the oesophagus
and the larynx, and the patient may, without manifesting the usual
signs of suffocation, suddenly fall back dead, and if he happens to be
alone at the time of the accident, the cause of death is liable to be
overlooked unless the pharynx is examined at the post-mortem
examination. Most surgical museums contain specimens illustrating the
impaction of a bolus of meat in the pharynx; this fatal accident has
occurred especially in men in a condition of alcoholic intoxication.

An object of irregular shape, for example a large denture, also, is
most likely to lodge in the pharynx, obstructing the openings of both
the oesophagus and the larynx, and causing suffocation. The face
immediately becomes blue and engorged, the patient is speechless, and
violent efforts a