Choking

“ Whatever object causes the choking, it may lodge in the upper part of the esophagus, at its middle portion, or close to the stomach, giving rise to the designations of pharyngeal, cervical, and thoracic choke. In some cases where the original obstruction is low we find all that part of the gullet above it to be distended with feed. ”

“ So again if our infants, during many generations, and each of them during several years, had almost daily suffered from prolonged choking-fits, during which the vessels of the eye are distended and tears copiously secreted, then it is probable, such is the force of associated habit, that during after life the mere thought of a choke, without any distress of mind, would have sufficed to bring tears into our eyes. ”

“ In some districts the choking sensation in the throat known as the rising of the lights is held to forebode death, but more usually it is regarded as an insignificant physical condition, to be remedied by swallowing small shot, the weight of which will keep the lights in their proper place. To break a looking-glass; to open an umbrella in the house, especially if it is held over the head; to put the bellows on the table; to drop a comb—are all deeds which forebode somebody’s death. ”

“ Let me hear from you often, a few lines only; enjoy yourself, and come back in good condition. When I know that you are in Rome I shall give you some commissions. Good-bye again.
CCLXII Paris, May 20, 1863.
Dear Friend: I am writing to you with an abominable grippe. For two weeks I have coughed instead of sleeping, and I have frequent attacks of choking. The only remedy is to take laudanum, and this gives me headache and stomach-ache, which are as distressing as the cough and the choking. In short, I feel weak and avvilito, and I am going to the dogs, my health and myself. ”

“ Choking.—In case of Choking, a violent slap with the open hand between the shoulders of the sufferer will often effect a dislodgment. In case the accident occurs with a child, and the slapping process does not afford instant relief, it should be grasped by the feet, and placed head downwards, and the slapping between the shoulders renewed ”

“ If the mucous membrane is injured, there is severe stabbing pain and choking attacks, both due to spasm, sometimes even after the body has passed on, and the pain is not always referred to the seat of the injury. ”

“ Choakee, or CHOKEY, the black hole.—Military Anglo-Indian. Chokey is also very vulgar slang for prison.
Chock-Full, full till the scale comes down with a shock. Originally CHOKE-FULL, and used in reference to theatres and places of amusement.
Choke Off, to get rid of. Bulldogs can only be made to loose their hold by choking them. [60] Suggestively to get rid of a man by saying something to him which “sticks in his gizzard.”
Choker, a cravat, a neckerchief. White-choker, the white neckerchief worn by mutes at a funeral, waiters at a tavern, and gentlemen in evening costume. ”

“ A Something dropped, as it seemed, from the ceiling, plumb upon my chest, and the next instant I felt two bony hands encircling my throat, endeavoring to choke me.
I am no coward, and am possessed of considerable physical strength. The suddenness of the attack, instead of stunning me, strung every nerve to its highest tension. My body acted from instinct, before my brain had time to realize the terrors of my position. In an instant I wound two muscular arms around the creature, and squeezed it, with all the strength of despair, against my chest. ”

“ Thus, an oppression of the chest, which had a pathological significance in relation to the spirit, pointed to the therapeutic necessity of beating it with the greatest violence; if the convulsionary had a sense of burning heat, he exposed himself to the flames; an acute and boring pain in the mouth, neck, eye, or any other organ required a dagger to be thrust into the afflicted part, but, strangely enough, no force could make the sharpest instrument enter the flesh or inflict a wound. ”

“ The flaccidity of a frog from ' shock,' for a minute or so after his medulla oblongata is cut, is an in- hibition from the seat of injury which quickly passes away. What is known as ' surgical shock ' (unconsciousness, pallor, dilatation of splanchnic blood-vessels, and general syncope and collapse) in the human subject is an inhibition which lasts a longer time. Goltz, Freusberg, and others, cutting the spinal cord in dogs, proved that there were functions inhibited still longer by the wound, but which re- established themselves ultimately if the animal was kept alive. ”

“ Oppression about the heart, as if it had stopped beating, as going into convulsions. Feels as if a spasm of the heart, tetanic. As if the blood too thick to circulate. Thinks she would have died but for the Camphor I gave her. Felt as she did when near dying of hemorrhage. Brain is active, intellect clear, thoughts vivid, the whole being intensified. Next morning, sense of constriction at base of lungs. Some cough. Clammy feeling of skin. Very sensitive to air.
No. 2. Causes a glow all over, hands sweat. Some pain in finger joints. Throat feels obstructed. ”

“ There are a few who sadly collapse before the onslaught of adverse circumstances, who give way without a fight to nervous prostration, and who are subject at times to wild spasms of uncontrolable trembling, finally going down the line with a form of shell-shock altogether distinct to shock from violent concussion. ”

“ Concussion.—Temporary loss of function was often observed in the limbs, corresponding to the distribution of one or more nerve trunks when wound tracks had passed in their vicinity. Interference with function sometimes amounted to loss of sensation alone: in others to loss of both sensation and motor power. Such symptoms were of a transitory character, lasting for a few days or a week; if both sensation and motion were impaired, sensation was usually the first to be regained. ”

“ The touch could not but have been slight, but to me the concussion was dreadful, and almost made me scream with the surprise and pain; the sensation being very similar to that which a heavy person feels on touching the ground, when he has jumped from a higher place than he ought. ”

“ The convulsion picture is a stiffening of the body—sometimes arching backwards—rolling or staring of the eye-balls, blueness of the skin, a drooling mouth (often foamy mucus at the mouth) , clinched hands, biting the teeth—if there are teeth—and even biting the tongue. There is at first a succession of quick, jerking, convulsive movements of the body which in a few moments grow less and less violent and finally cease. The child begins to cry and then soon goes off into a deep sleep, while the body seems more heavy and logy than usual. ”

“ Drawing and stinging between the shoulders with oppression of breath.
Drawing pains between the shoulders, extending downward along the spine, toward the liver and upward into the chest; then the respiration becomes oppressed and frequent shooting pains traverse the entire body.
In the left axilla, an electric shock which shakes the whole body, and in all the joints there occurs a trembling, such as might be produced by an electric machine, and which causes each time a sensation of fear. ”

“ In the present state of our knowledge respecting concussion or cerebral shock it may, I think, be accepted (1) that concussion is dependent on an acute inhibition or paralysis of the vaso-motor centre; (2) that the milder cases are unassociated with any pathological visible changes; (3) that the prolongation and severity of the depression stage are directly proportionate to the extent of the brain lesion, such lesions varying from œdema and contusion to extensive hæmorrhages and lacerations. ”

“ Concussion of the brain may arise from falls on the nates, or from blows on the head. The face becomes pale, the pupils contracted, the pulse weak and small, the extremities cold, the respiration scarcely perceptible, and the sphincters relaxed. The tendency to death is from syncope. Reaction may then occur: the pulse quickens; the skin is hot and dry; there is great confusion of thought, from which the patient ultimately recovers; vomiting is present in most cases. Concussion often passes into compression, due to hæmorrhage from the lacerated cerebral vessels. ”

“ Secondary shock develops, insidiously, some hours after injury, burns, or hemorrhage. Its outstanding feature is low blood pressure. It has been found that practically every man injured during battle is in a state of shock, either real or potential. The condition is influenced or caused by hemorrhage, tissue destruction, mental trauma, fatigue, and many other factors. Shock must receive the first attention after hemorrhage is controlled.
Fortunately, today we can afford to wait and let shock be relieved before operating. ”

“ In bulbar paralysis the loss of power usually extends from the tongue through the lips, cheeks, jaws, pharynx, larynx, to the respiratory muscles and heart. Coughing may be roused by irritation of the external auditory meatus, liver, stomach, bowels, or generative organs as well as from the air passages. ”

“ If it be pricking, the Wound is deeper, but of small Moment: If it be a battering or bruising Instrument, the Wound is accompany'd with Contusion, producing a great Suppuration, besides the Concussion and Commotion of the Part, which are inseparable, and often cause very dangerous Symptoms. {151}
Inferences may be made also from the disposition of the wounded Person; for a strong robust Man may better bear the Stroke than a weak one ”

“ Take it as a concrete fact that any [Pg 42] man, however courageous, who comes close enough into contact with a shell to be conscious of its hot breath on his face and to be violently thrown by its concussion, will regain his feet with shaken nerves to a degree necessitating half-hour or more before restoration to normal. Some few never recover—hence the term "shell shock."
There are tales of iron men who are unaffected by a dozen such experiences—perhaps! ”

“ The person may die from the concussion, or he may slowly or quickly recover. The insensibility may be for a time complete . The pulse may be small, quick and imperceptible, and, no blood being pumped up by the enfeebled heart, the face will be pale and the surface of the body cold. ”

“ If a fracture, then, occur in the head, it is discovered by the sharpness, weight, hardness, or violent force of the body which struck it, and by the symptoms which supervene upon the person who has been struck, such as vertigo, loss of speech, and sudden prostration, more particularly if it be a fracture with depression, or contusion, or expression, or the internally-arched fracture, owing to the compression of the brain. ”

“ When it is affected sympathetically with the brain, the liver, the orifice of the stomach, and from sorrow, fear, and many other causes, it brings on the affection called syncope, being a sudden collapse of the vital powers, indicated by prostration of strength, deliquium animi, a small pulse, coldness of the extremities, and copious perspiration. When this affection is of a violent nature, it also is irremediable; but if the strength stands out, it may sometimes be relieved. But strong palpitations of the heart often arise from a fulness or effervescence of its blood. ”

“ When the fracture is associated with severe concussion. In the event of persistence of concussion symptoms of a severe type the prognosis is decidedly unfavourable. This prolongation of cerebral shock is undoubtedly dependent in its persistence on severe vaso-motor depression, and in the majority of cases ending unfavourably it will be found that the brain is generally œdematous and regionally contused or lacerated. ”

“ When the soft parts only were affected, even high velocity did not produce much effect; but when to a flesh wound a severe bone fracture or injury to any part of the nervous system was added, shock might be severe or profound. ”

“ A shock acts on an explosive body, the body explodes: the shock is considered the cause. An induction shock acts on a muscle, the muscle contracts; the induction shock is looked upon as the cause of the muscle contraction. To regard only the last added condition as being of especial importance to the taking place and the explanation for a process is, however, a standpoint which could satisfy only the most superficial of observers. ”

“ The organ in these cases has been merely disturbed and shaken, without visible rupture or hurt having occurred. Again, many patients are supposed to labour under concussion only, in whom fracture of the base of the cranium, or extravasation of blood on the surface, or into the substance of the brain, are discovered after death. It is always difficult to distinguish between the effects of mere concussion and those of compression of the brain by extravasated fluid; for, in the greater number of cases, the symptoms of both affections are blended together. ”

“ Concussion induces affections of the brain and of its membranes of an equally serious nature, at a more distant period of time, when the stage of stupefaction and insensibility is wanting; it is to guard against such an occurrence that persons who suffer from falls or severe blows on the head usually lose blood. ”

“ Pathology.—Concussion produces laceration of the brain, or at least a jarring of the nervous elements, which, if not sufficiently severe to produce sudden death, may lead to softening or inflammation, with their respective symptoms of functional derangement. ”

“ Immediately a dull, sickening pain becomes apparent at the base of the neck, and insensibility rapidly ensues. This arises from the affection of the respiratory nerve centre. In a short space of time the face becomes dark and congested through the veins being gorged with blood, and the heart ultimately ceases to beat. ”

“ When shock is absent or little marked, however, the amount of suffering may be great. When the injury proves fatal during this period, death is due to shock, probably aggravated by the absorption of poisonous substances produced in the burned tissues. In fatal cases there is often evidence of cerebral congestion and oedema.
The _second period_ begins when the shock passes off, and lasts till the sloughs separate. ”