An Account of the Case of an Extraneous Body Forced into the Lungs: By William Martin, Esquire, of Shadwell. Communicated by Mr. Emanuel Mendez da Costa, Librarian of the Royal Society

IV. An Account of the Case of an extraneous Body forced into the Lungs: By William Martin, Esquire, of Shadwell. Communicated by Mr. Emanuel Mendez da Costa, Librarian of the Royal Society. Read Jan. 17, 1765. On Tuesday 23d October, 1764, about six in the evening, as one of my maid servants was drinking coffee, and eating toast and butter, having a child in her lap, who had like to have scalded itself, and she was apprehensive would have broke the cup, being surprized, and attempting to speak hastily, in the very action of deglutition, unfortunately forced a piece of the crusty part under the epiglottis, which made its way into the larynx, or upper part of the wind-pipe; which, notwithstanding the many vigorous efforts nature made (by a violent and incessant cough) to discharge it, yet it fixed like a wedge (as she gave me to understand); and in a few hours she was deprived of her senses and her speech, and lay in great agonies, with violent agitations of body, resembling strong convulsions, fetched her breath very short, and it was expected she would expire that night. As I was in the house when the accident happened, every method that I could possibly think of was made use of for her relief, but without effect; and as respiration was attended with the greatest difficulty, ficulty, I ordered about ten ounces of blood to be taken from her arm, which seemed in some measure to relieve her breath; this was two hours after the accident. The cough continued about three hours, till her strength was in a manner quite exhausted, and she seemed to be entirely senseless, except at intervals, pointing to her breast; and whenever I examined her pulse, forcibly, and in great agonies pressing my hand to the scrobiculus cordis, or heart pit, as the seat of her disorder. I left her about twelve o'clock that night; and desired my servants, who attended her, to call me, if they observed any sudden alteration, which they accordingly did about two in the morning, when I was informed she was expiring (as they thought) and indeed, as I soon hastened to her assistance, I was of the same opinion. However, as I found her somewhat more sensible, but in great agonies; and making motions to be blooded again, as she had a full pulse, and the greatest difficulty in respiration, I took away about the same quantity as before, which seemed to give her some relief, and she continued much more quiet. At this time her cough had left her, and I was convinced, by her complaints, the extraneous body had made its way into one of the lobes of the lungs. It was with the greatest difficulty we could get her to swallow any liquid, which for some time threw her into violent commotions. In this languid state she continued for several days, begging of God to release her by death; and desiring me to open her body, which I promised. But what was very remarkable in this case, notwithstanding the great agonies she was in whilst awake, yet the second night after the accident happened, she fell asleep about twelve o'clock (whilst (whilst insensible) slept sound for several hours; and whilst in that state of relaxation fetched her breath quite easy, as she did every night after, when asleep, with a serene pulse, but always waked in exquisite pain, and in great agitations. In a few days I observed her breath to smell very strong, and I made a prognostick, that nature (in order to expel her enemy) would form an abscess or apostemation in the lungs (as the only chance for her life) and would bring it up, by the same channel it went down; though I was not without apprehensions (as there was a prominence pointing outwards, and attended with great soreness) that an empyema or collection of matter would be formed in the concavity of the breast, which, if it had made its way outwards, would (in all probability) have proved fatal. However, on the eleventh day from the accident, she was of a sudden seized in the morning in bed, with a nausea, violent sickness, and a cough, when the impostume in her lungs broke and discharged itself by the mouth, with a large quantity of bloody matter, in which the portion of crust was happily entangled, about the bigness of a large hazel nut, or filberd (being rather oblong than round) with a great quantity of slimy substance, in which it was enveloped. After which, for an hour or more, she complained of violent pain and soreness in the whole cavity of the breast, with great tremors; however they soon went off, and her speech returned immediately, and as perfect as before the accident, though languid; for, during the major part of her illness, she could express herself no otherwise, than by applying one's ear close to her mouth, and by giving her time, time, she could then (by a slow whisper) make us sensible of her wants; the extraneous body pressing, or in some measure obstructing, the fine threads or ramifications of the par vagum, or eight pair of nerves that come out of the brain, and are dispersed on the larynx, and accompany the bronchi of the trachea or wind-pipe, even to their minutest branches. She is now in a fair way of recovery, though weak, and afflicted with a dry cough, attended with an uncommon hollow sound, as if her lungs were impaired. I would beg leave to observe that the late baron Suasso's lady died by an accident similar to this, only different as to the extraneous body; viz. a cherry-stone, which was the cause of her death. And the famous Greek poet Anacreon died by the kernel of a grape, in the same manner. Another instance happened lately to an acquaintance, who was killed by a piece of chesnut, which went the wrong way, as we commonly express it. And a gentleman, no long since, had the misfortune of swallowing a quarter of a guinea, in the same manner, which killed him. Nor did I ever of hear any person's recovering in a case of the like nature. William Martin. Shadwell, Nov. 22, 1764.