EVERY PRACTITIONER MEETS with cases of foreign bodies in the pharynx, larynx, or oesophagus, such as a coin, bonbon, tooth, piece of meat bone or fish bone but rarely with a case of the entrance of a living fish into the pharynx.

Boy of eight, shore fishing on the Nile

At noon of August 23, 1918, a group of people came to my clinic, carrying a boy, Aboudy Morsi by name, eight years of age, from Talkha, a town on the opposite side of the Damietta branch of the Nile.

The boy was nearly dead. The people with him related to me that he was on the Nile, shore fishing. He caught, first, a small trout, which he carried between his teeth, while he had another in his hand. The first fish glided into his pharynx and lodged there and he was asphyxiated. All this took place half an hour before I saw him.

The boy was nearly dead. The people with him related to me that he was on the Nile, shore fishing. He caught, first, a small trout, which he carried between his teeth, while he had another in his hand. The first fish glided into his pharynx and lodged there and he was asphyxiated. All this took place half an hour before I saw him

A colleague, who saw him before I did, suggested opening the pharynx or larynx. I examined him hurriedly, and I found the following: bloody froth about the mouth, face blue, conjunctiva injected, jaws very stiff and extremely difficult to open, muscles of extremities stiff, pulse imperceptible, respirations stridulous, slow and interrupted, corneal reflex absent, and the boy wholly unconscious.

I examined him hurriedly, and I found the following: bloody froth about the mouth, face blue, conjunctiva injected, jaws very stiff and extremely difficult to open, muscles of extremities stiff, pulse imperceptible, respirations stridulous, slow and interrupted, corneal reflex absent, and the boy wholly unconscious

Treatment

I first opened the mouth with a gag with difficulty, and introduced my finger into the mouth. I touched the tail of the fish with the end of the finger, and tried to dislodge it, without success. I then introduced a tongue forceps and pulled the tongue, which had been thrown backward. I gave the boy an injection of camphorated oil. I introduced a long broad forceps, caught the tail and jerked it a little and pulled. Unluckily the tail had been cut. I tried once more, and got, at last, the fish, but unfortunately the child then lost respiration after the fish had been got out.

I at once started artificial respiration for 20 minutes, and happily, animation was restored. I think the loss was due to sudden spasm of the glottis.

He remained unconscious for 45 minutes. I restored his consciousness by all the known means; gave him an injection of strychnine, and warmed him with hot-water bottles, etc.

I examined his throat afterwards, and I saw, in different positions in the walls of the pharynx, small abrasions right down to the epiglottis. Then I examined the fish, and I found it of the kind called Nile trout; its length is 6 inches, and its greatest breadth about 3 inches.

I examined the boy on the fourth day, and found him to be in excellent health, and I ordered him a gargle of 1 per cent carbolic acid, and milk diet for a few days.