15th December 2017, Volume 130 Number 1467

By D. STEVEN, M.D., Medical Superintendent, Stratford Hospital

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December 1917 

On 30th October, 1917, at 6 a.m., I was called to the T—— Boarding-house to see Wm. O. He gave a history that the night before, about 10 p.m., he was troubled with constipation, and to get ease he inserted the neck of a bottle into his rectum, but the bottle slipped in and could not be recovered.

Previous health good; total abstainer; in camp a year ago, but discharged September, 1916, because of some old injury to his left elbow, which interfered with him when he was shooting in the prone position; now working at his trade as a painter, but under notice to parade for medical examination on 6th November, 1917.

Patient was a well-nourished and healthy man of 40 years, with powerful muscles and a thick abdominal wall. Two fingers could easily be inserted per rectum, and the smooth base of the bottle could just be felt but not grasped. Three inches to the left of the umbilicus a hard swelling could be easily felt, but with difficulty outlined, it being evidently caused by the upper end of the bottle. All attempts to move the obstruction by getting the man to strain, or by manipulation per rectum, were fruitless, so he was admitted to hospital and deeply anaesthetised by Dr. Cooper. The base of the bottle could then be grasped between two fingers, but was wedged too tightly to be moved; nor had we any forceps or specula that were of any avail. Finally forcible pressure was made over the upper end through the abdominal wall, and the rectal mucous membrane gradually pushed from below the base on to the side of the bottle. In this way it was slowly extracted. The neck was found to be smooth, and examination by sigmoidoscope showed no serious injury of rectal mucosa.

The bottle was an ordinary rennet bottle, exactly eight inches high (the rule shown in the photograph was not vertical), and with a diameter at the base of two and an eighth inches. This diameter is the same for about four inches from the base, and then gradually lessens to one inch at the top of the bottle.

There were a few abrasions of the mucous membrane caused by the rather violent manipulations, but no haemorrhage to remark about, and the man had no ill-effects at the time of his discharge, 36 hours later.