A most remarkable accident

Remarkable accidentHere’s a case from The Medical Museum published in 1764 – more than seventy years after the patient had been treated and cured. To be fair to the tardy journal editor, it is a pretty unusual story:

A most remarkable accident befell a young man near Hall in Saxony, whose name was Andreas Rudleff, being about twenty-six years of age, on January 3, 1691, as he was heedlessly playing at some juvenile diversions, he fell down and forced a little knife with a stag’s horn handle, which he had unmindfully put into his mouth, into his throat and swallowed it. Divers people who offered him assistance finding it impossible to extract it, gave him oil to make it go down with the more ease.

In case you’re wondering, this was not a folding penknife, but one with a fixed blade. You may well ask what on earth he was doing running around with a knife in his mouth at the age of 26.

He became afterwards much disordered by it, and had frequent vomitings, which were removed by proper remedies by the physicians and surgeons, but he felt great pain in the left hypochondria, near the fore-ribs.

The hypochondria (more properly hypochondrium) is the upper part of the abdomen. Early modern doctors recognised a rather unspecific condition which they termed hypochondriasis, consisting of vague symptoms of pain in this region. This is the origin of the modern sense of hypochondria meaning ‘anxiety about one’s health’.

In the following January a hard red swelling was perceived in the same region, with great pain and inflammation, which gradually went off together. At length in the following May a reddish tumour appeared again in the same part, and increased so as to give suspicion of an abscess being formed, which being opened by a surgeon on the twenty-fourth of the same month, a very foul and stinking matter came out, till on the eighteenth of June the point of the knife appeared; and the second of August the knife itself came in sight, but corroded in several parts and wasted (whether by any corroding medicines given by the physicians does not appear) and was happily extracted, after it had been a year thirty weeks and three days in his body. The young man was quite eased and lived free from his former symptoms, and continued to do so for a great many years after.

The case report is not sufficiently specific about the site of removal to be sure about what happened here – but it seems that the knife punctured the oesophagus or stomach and somehow worked its way through the wall of the abdomen. That it did so without causing fatal haemorrhage is little short of miraculous.

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