200 ON FOREIGN BODIES IN THE CFSOPIIAGUS, kc. 
for, in proportion to the force employed will be the counterac¬ 
tion of the muscular coats. 
The probang should undoubtedly be first used, and a mode¬ 
rate force employed for a sufficient time. If no ground be gain¬ 
ed, or only a little, and that with extreme difficulty, the tube 
should be withdrawn : fbr if the body can scarcely/be moved in 
the middle of the oesophagus it will become perfectly fixed to¬ 
wards the cardiac orifice. A half-pint of olive oil should then 
be given, and an attempt should be gently but firmly made 
with the fingers, applied externally, to give the body a retro¬ 
grade movement. This will succeed much oftener than is ima¬ 
gined. : If it can be forced upward, and brought to the upper 
part of the oesophagus or into the pharynx, then, by means of a 
piece of wood resembling that belonging to the common pro¬ 
bang, but with a hole sufficiently large to admit the hand, and 
firmly attached to the horns, the hand mights be passed into 
the mouth secure from injury from the grinders, and the sub¬ 
stance withdrawn. 
Should the foreign body be moved with difficulty, and be 
known to be irregular and rough, so that the villous coat of the 
oesophagus would be lacerated or injured by forcing it either way, 
there are two methods remaining : either to bleed to syncope, 
and, during the momentary relaxation, to' force the body up¬ 
ward or downward (the first if possible); or to have recourse to 
oesophagotomy. . I can speak from the experience of two cases, 
that this is an operation very easily and safely performed, al¬ 
though Mr. Cooper tells us, and I have no doubt truly, that, on 
the human^ being, few would venture to perform it. In one 
case the wound was healed in fourteen, and in the other 
in eighteen days. 
The operation is very simple. After having passed a little 
way down the neck, the oesophagus is on the left of the trachea, 
and between the carotid and the jugular. The artery will^ be 
detected by its pulsation, and the vein by its turgescence. Both 
are easily avoided, and a free incision may be made at once into 
the oesophagus, taking care not to wound the sterno-maxillaris 
muscle.. The foreign body is then to be extracted, one or two 
sutures passed through the sides of the oesophagus, and one or 
two more through the integuments. 
