GULLET, or Oesophagus, in anatomy, is a long, round, and capacious tube, destined to convey the food from the mouth into the stomach. It descends between the windpipe (which see) and the joints of the neck and back, as far as the fifth joint of the spine, where it turns somewhat to the right till it arrives at the ninth; where it again changes its direction towards the left, climbs over the aorta, or the largest blood-vessel in the human body; and, after rising above it, penetrates the midriff, and then extends to the left orifice of the stomach.
Instead of enlarging upon the situation and structure of the gullet, we shall give a few directions for removing substances stopt between the mouth and the stomach.
If the matter detained within the gullet, is of an alimentary or harmless nature, it may then safely be pushed down by means of a heated and oiled wax-candle, to render it flexible; because the manner in which the obstruction is formed, may often occasion death.
On the contrary, if the substances swallowed are indigestible, such as pins, needles, pieces of bone, glass, buckles or other pointed bodies, immediate attempts should be made to extract them: When they have not descended too low, the fingers will frequently be sufficient to reach and withdraw them, but if they be deeper within the gullet, other means must be instantly adopted; as delay may prove fatal. For this purpose, the most simple instrument is a crotchet, or a kind of hook, made of smooth and thin iron wire, by bending it into an oblong ring at one end, reflecting the wire to the top, and forming a large handle: thus, no pointed part will injure the throat by introducing the hook; and there will be no danger of its slipping from the operator's hand. We have seen a more effectual instrument contrived by a double and triple ring or thin wires crossing each other in an oval form, so as to leave spaces between them, in order to loosen and extract a pin, or other sharp substance: the handle must, in either case, be somewhat bent, and accommodated to the curve of the neck.
As, however, the construction of such a crotchet requires some ingenuity; and as wires may not always be at hand, there is another more simple and expeditious method of procuring relief, by means of a small piece of dry sponge, or tough meat, which should be fastened to a fine silken or linen tape, so that after swallowing the sponge or meat, it may again be gradually extracted. Thus we have frequently seen pins, or sharp pieces of bone, removed without farther inconvenience. In order to facilitate the operation, a little lukewarm milk or water should be swallowed by the patient, before the string is withdrawn from the throat.
If, however, none of these expedients prove successful, it will be necessary either to administer an emetic, consisting of half a dram of ipecacuanha in powder, to be taken in a draught; or, if the patient be unable to swallow, to excite vomiting by stimulating his throat with a leather dipped in sweet oil;—and, if this attempt likewise be ineffectual, a clyster, made by boiling one ounce of tobacco in three quarters of a pint of water, and then straining the decoction, should be given in dangerous cases:—such an injection has often been attended with speedy vomiting, and the consequent discharge of the substance which obstructed the gullet.
After these remedies have been fairly tried, no other prospect remains of saving the patient's life, than by opening the wind-pipe, an operation which, in the hands of a skilful surgeon, is neither difficult, nor painful to the person threatened with suffocation.