Bunged up

Most of the injuries chronicled on this blog were caused by bad luck, and a few by misadventure; but here’s one which can only be attributed to rank stupidity. In 1852 The Half-Yearly Abstract of the Medical Sciences published this report from an Italian surgeon, Signor Riali:

In December, 1848, a peasant was admitted into the hospital of Orvieto, in the last degree of feebleness and prostration. Under the idea that he would save the trouble and expense of eating, he had plugged his rectum with a piece of wood.

Such a simple idea, it makes you wonder why nobody thought of it before, doesn’t it? Just imagine the doctor’s face when the patient explained the rationale behind this decision.

This was nine days previously. Many attempts were made in the interval to relieve him of the awkward predicament, but without success. After his admission, M. Riali, of Italy, reiterated these attempts, but their only effect was to force the foreign body further from the outlet, and to increase the impaction; already this body had passed beyond the reach of the finger.

If there were any medical students within five miles of the hospital I imagine they had all been ordered to have a go at retrieving the ghastly object.

In the circumstances it was determined to expose the descending colon by cutting through the abdominal parietes.

In other words, to cut open the wall of the abdomen. A hazardous business in 1848, and exquisitely painful for the patient (laparotomies aren’t much fun, even with modern anaesthetics).

Having done this, the attempts were made to force the piece of wood from the termination of the colon, at which it was distinctly felt into the rectum, and so downwards, and again without success. An incision was therefore made into the bowel, and the foreign body—the dimensions of which were about six and one-fourth inches, by one, and the form of a bluntish cone—was extracted through the opening.

A courageous undertaking. Opening the bowel was rarely performed at this date, because it so often ended fatally – owing to likely contamination of the abdominal cavity with bowel contents and consequent infection.

The edges of the wound in the intestine and parietes were united by suture and cold applications placed over the usual dressings. During the first few days there was much flatulent distention of the abdomen, with considerable sickness and vomiting, for which symptoms three bleedings, three applications of leeches, and some doses of croton oil, were thought necessary. The bowels acted on the fifth day; the wound had healed on the fourteenth, when the patient was well, though for the sake of prudence he was kept two months in the hospital.

That does seem rather a long time. Signor Riali was taking no chances.

And now, two years and nine months afterwards, he continues well, eating and drinking all before him, and no longer disposed to distress himself on the ground of his appetite.

And, one hopes, a bit less clueless about the relationship between eating and bowel movements.