re made to eject the object by retching and coughing.
It may be seen from the mouth and touched with the finger.

In the case of small sharp bodies, such as fish, game, and mutton
bones, there is not the same urgency, and a methodical search for the
foreign body is carried out. Even after the foreign body has been got
rid of, the patient may have the sensation that it is still present.
This may be due to a scratch of the mucous membrane, or to spasm, in
which case the swallowing of a few drops of cocain solution will cause
the sensation to disappear.

_Treatment._--In the presence of impending suffocation, the mouth must
be forced open by an extemporised gag, the finger passed into the back
of the throat, and the body hooked out. If this is impossible, and if
suitable forceps are not at hand, it may be necessary at once to
perform laryngotomy, followed by artificial respiration, because,
although the patient may appear lifeless, the heart continues to beat
after breathing has ceased. The foreign body should then be removed
with forceps. Sub-hyoid pharyngotomy, which consists in opening the
pharynx by a mesial vertical incision carried through the hyo-thyreoid
membrane, may be called for, as in the case of a denture, the hooks of
which have penetrated the wall of the pharynx.

_In the Oesophagus._--Smaller bodies, such as coins, bones, or pins,
usually enter the oesophagus, and the great majority become impacted
above the level of the manubrium sterni. Those that pass farther down
are liable to stick where the tube is narrowed at the crossing of the
bronchus, or at the opening through the diaphragm. In children, coins
predominate and are nearly always arrested at the level of the upper
end of the sternum; in adults, dentures are the commonest foreign
bodies, and may be impacted anywhere.

At the moment of impaction there is pain, which assumes the character
of cramp due to spasm of the muscular coat, and which is increased on
attempting to swallow, and violent retching and coughing are set up;
in many cases, as when bodies are impacted in the pharynx, respiratory
distress is again the predominant feature. If the passage is
completely obstructed, food and saliva--sometimes blood-stained--are
regurgitated with retching soon after being swallowed. When the
obstruction is incomplete, fluids may pass into the stomach while
solids are regurgitated.

If the mucous membrane is injured, there is severe stabbing pain and
cho