Honking like a goose

Removal of a goose larynx from that of a boyThis blog has on several occasions chronicled the unlikely range of foreign objects which patients have managed to get stuck in various parts of their anatomy. See, for instance, the tale of the man who swallowed knives, the wine glass up the bottom, and the barometer stuck in the bladder.

But I think the following tale takes the prize for sheer outlandishness. In 1850 the British and Foreign Medico-Chirurgical Review printed a report by a German physician, Dr Burow. The object he was asked to remove from a patient’s throat was… another throat.  A goose’s throat, in fact:

The children in Dr. Burow’s vicinity are very fond of blowing through the larynx of a recently-killed goose, in order to produce some imitation of the sound emitted by this animal.

That’s one way to spend your free time, I suppose.

A boy, aged 12, while so engaged (Nov. 1, 1848), was seized with a cough, and swallowed the instrument; a sense of suffocation immediately ensued, which was, after a while, replaced by great dyspnoea [difficulty in breathing]. Dr. Burow found him laboring under this eighteen hours after, his face swollen, of a bluish-red color, and covered with perspiration. At every inspiration, the muscles of the neck contracted spasmodically, and a clear, whistling sound was heard; and at each expiration, a hoarse sound, not very unlike that of a goose, was emitted.

Overlooking the fact that the child’s life was in danger, I must admit I would like to have heard a child honking like a goose.

goose
Honking no longer

As, on passing the finger down to the rima glottides [the opening between the vocal cords], it was found closed, Dr. Burow felt convinced (improbable as, from the relative size of the two bodies, it seemed) that the larynx of the goose had passed through it. Tracheotomy was at once performed; but owing to the homogeneousness of structure of the foreign body and of the parts it was in contact with, the greatest difficulty existed in distinguishing it by the forceps.

Tracheotomy is one of the oldest surgical procedures known, described by many ancient authors. In this case the inhaled goose larynx (a phrase I never expected to write) had entirely obstructed the boy’s airway, so making an incision in the throat to help him breathe was the sensible thing to do.

Moreover, so sensitive was the mucous membrane, that the instant an instrument touched it, violent efforts at vomiting were produced, and the entire larynx was drawn up behind the root of the tongue. At last, after repeated attempts, Dr. Burow having fixed the larynx in the neck by his forefinger, so that it could no longer be drawn up on these occasions, he contrived to remove the entire larynx of the animal. The child was quite well by the ninth day.

Tracheotomies were fraught with danger in this era, since postoperative infections were common. This was undoubtedly an excellent result.

Dr. Burow says that it was a matter of great congratulation for him that many pupils were present during this operation, and thus able to confirm the correctness of a statement so incredible as to stand much in need of such confirmation.

Well, he had a point. Without witnesses I doubt many people would have believed his story.

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