Mary Cappello

by Swallow: Foreign Bodies

  In the alimentary canal, it is possible to find the foot of a chair, or a long hair pulled out by a mother. It’s the stuff of nightmare, or of whimsy—see the eyeglasses swallowed by a maniac trying to do himself in. Here are two iron forks swallowed by a girl during typhus that made their exit by means of “suppuration through the abdomen,” and the story of a group of Royal Guards who, after an orgy in which they had drunk a great deal, “broke their glasses and swallowed the pieces, thereby causing death.” The digestive canals of the insane are especially secretive, for their intestinal tracts often become “a rendezvous for the strangest articles,” often considerable in number, and often only discovered upon autopsy because few believed the patient when he or she confessed to swallowing things. The poet Gilbert introduced the key to his room into his fauces (the back of his mouth) and thereby died. No one believed he had swallowed the key. The same could be said of persons who had swallowed a thousand shoe nails, and a game of dominoes.

  Of course there are people who haunt public squares with no other intention than exhibiting their “skill in swallowing pebbles, nails and glass,” Poulet notes. Run out of ideas for how to make a living? In the case of Henrion, called Cassandra, born in Metz in 1761, “not satisfied with the various trades he followed in his youth, he began to force himself, at the age of 22 years to swallow pebbles.” Henrion pretended he was an “American savage” by first heating the pebbles and then plunging them into cold water.

  Sometimes people swallow things out of devotion or fidelity to a cause, as in the case of strategists and spies who make their way through enemy lines and then poop their war secrets at the foot of Napoleon.

  A waiter in a café opens a bottle of champagne with his teeth and swallows the cork. A practical joker throws a chestnut into the opened mouth of an onstage singer where it lodges and asphyxiates.

  An eel or a mouse enters the mouth of a sleeping person. No, this doesn’t really happen, but people say it does, or fear that it will. What really happens is worse, as in the person who uses one fbdy to extract another fbdy and ends up swallowing both, or the person who has the misfortune of swallowing something before Jackson opens up shop and must submit himself to instruments shaped like hooks and levers, whips and even chains. Or the person whose opened cadaver reveals fourteen knife blades in his stomach. What compelled him to compete with sword swallowers? What compelled Poulet to note that, while some of the knives were rusted, one still showed clearly the name of the cutler?

  Order and control aren’t really what Poulet is about, though his book is a gathering and a collecting and a sorting. The book becomes dimensionless in its consideration of fbdies introduced into any and all of the body’s orifices. Fbdies introduced through traumatism, introduced intentionally through malice or accidentally in depraved sexual manipulations; fbdies voluntarily concealed in the rectum or entered into orifices for curative purposes by both ignorant persons and medical men. Is it buffoonery or a physiological condition that leaves a person unable to eat peas without blowing one through his nose? Here’s a tender tale of a child who held a ladybug “in the half-closed hand, and held his fist against his ear in order to hear the buzzing of the insect,” then felt the bug actually enter “the auditory canal while endeavoring to escape.” A whole host of rationales accompanies the instances of fbdies in the openings of the genitals. Sometimes Poulet links such to identities—the pervert, the addict, the deviant; other times he yokes his examples to “idleness, solitude, and stupidity,” because he really can’t explain people’s “sickly curiosity” and “strange manipulations,” their tendencies toward violent self-pleasuring, to climaxing at all costs and perpetually. So a monk loses a key in his bladder, or a woman who, having tried to kill herself, apparently successfully, is found with an open compass in her vagina.

  “The reader will not have forgotten the monstrous histories, the scene of which was laid in the rectum” one paragraph begins, and we might feel as though we’re inside of (but now that innocent prepositional phrase feels tainted) a Gothic novel of scatological proportions. Even (or is it mostly?) civilized folk have been known to punish each other by inserting things into the rectum of those accused—of adultery, for example, in the Greek practice of rhaphanidosis, whereby “a peeled radish covered with hot ashes” was entered into the rectum, a practice that morphed in the Victorian era and into contemporary S/M usage as “figging,” the forcible insertion of peeled ginger into the anus. While such examples might test our squeamishness or make us ill to contemplate them, Poulet’s detailed narration of a case of live snails up the arse wins the prize for the most entirely gross. “When the index finger was introduced into the rectum to .08 [centimeters] above the margin of the anus, it came in contact with a series of hard, smooth bodies, of the size of a large hazel-nut, swimming and clashing against one another in a liquid mass” reads the report from 1875. “After the patient was anaesthetized, the three first fingers of the right hand were introduced into the rectum, and forty-five small snails were extracted in succession, together with hardened faeces.” While the patient reported eating the snails, the doctor concludes that they were entered into the anus. On a dare. Following the taking of some wine.

  Poulet’s book is a bit like the famous folk poem that begins with a woman swallowing a fly, “I don’t know why”: that crucial line gives way to the woman swallowing a spider, a bird, a cat, a dog, a goat, a cow, and a horse, from which she dies, “of course.” The invocation of the great chain of being, a predatorial hierarchy, a dilation of examples, each one outstripping the one before it in size or maw—in Poulet’s menagerie, in grossness—shows the poet and the doctor, annoyed or enfeebled by this difficult “why,” responding by flexing. Frustrated by the detachment that might be required by the question, or even just the alienating horror of the fbdy lodged, the writer opts for indulgence, because there’s definitely something voyeuristic and (dis) gustatory about Poulet’s book, something brimming with guilty pleasure. The physiology of swallowing and the psychology of swallowing are fascinating, but the urge to collect and report extreme instances can make for pornographic compendia, the point of which seem to be to hang out on the outskirts of decorum, to get really depraved, all the while still, significantly, authoritatively, wrapped in your lab coat.

  If I collect stray instances of swallowing—rather than matchbooks, cow-shaped creamers, or albino animals—does that make me like Poulet? Recently, without the benefit of Jackson, the world’s largest man was instead called in to reach into the throat of a struggling dolphin and release the plastic lodged there. Articles on the subject were so delighted by the image of the man with the overly large arm functioning as superhero that they overlooked the environmental tragedy of dolphins swallowing plastic.

  Some indigestible stuff they can’t put a price on. A whale belch can be heard for miles around, and out plops ambergris. At first the stuff stinks until the ocean leaches it, and then it’s mined by perfume sellers for its incomparably sweet aroma.

  The euro has been found to be more swallowable than other coins: there’s a factoid we might find humorous so long as we’re no victim of the new economy. Snakes swallow their young to protect them from danger, then spit them out when the danger is passed. In yoga, the throat chakra is imagined as an endlessly opening lotus flower made up of sixteen intersecting petals, blue-green and silvery as moonlight. When the energy that founds the universe is kindled at the base of the spine, it’s said to bound upward like a snake. I’m not sure why, but I picture the snake coming out of my mouth.

  Recently, a man in the Urals, complaining of a pain in his chest, was discovered to have a tiny fir tree growing in his lung. Complete with needles but devoid of sun. Had the man, snoring during a midday nap, inhaled a seed as it fell from a tree? The fear this tale—tall or short—taps into is of that which grows inside of us, is always growing inside of us. Is it death? But the beauty of it and the chill of it is its entwining—when the fir tree comes to be inextricable with its
host, like a Hawthorne character’s birthmark. The power of the alien thing taking root within us.

  It has been said that poets are people who love the names of things. In the realm of medicine, to name something is to begin to know it, but also, in various crucial ways, to be done with it. The Greek suffix “-phagy” in particular takes us into relatively unspeakable realms. Take “placentophagy,” the practice of eating the placenta following childbirth, where the afterbirth is understood to be a double of the fetus, a highly nutritive life support that had performed all of the major organ functions for the fetus before birth, a substance that is to be treated with awe and with reverence, thus leading to some people’s ritual consumption of it. Or “polyphagi,” the word for a glutton or a person who overeats for sport, or who is compelled by others who need to watch a person eat to excess for their own amusement. “Polyphagi” are perfect contenders for fbdy-discourses-as-pornographic-compendia, accounts in which the writer seems to take as much relish in reporting on the phenomena as the glutton’s audience was amused and disgusted by it.

  Pagophagia : excessive eating of freezer frost. Acuphagia : swallowing sharp objects. Amylophagia : ingesting laundry starch. Cautopyreiophagia: doing the same with burnt matches. Coprophagia, feces; foliophagia, leaves, grass, acorns, pinecones; geomelophagia, raw potatoes; geophagia, dirt, sand, clay; lignophagia, wood, bark, twigs; lithophagia, rocks, gravel, pebbles; trichophagia, hair. All of these neologisms were invented to exemplify a more global diagnostic term for a form of disordered eating called pica.

  Pica refers etymologically to a genus of magpies, birds known for their insatiable or indiscriminate appetite. From the sixteenth century onward, it has been used to refer to “disordinate longing,” “deprav’d” or “perverted” appetite, “untoward hankerings of nature,” “morbid craving,” and “desire for innutritious substances.” Because there is no definitive etiology for pica, the term is relatively useless, but, as we can see, it has generated a boundless set of companionate lingo. It can afflict pregnant women, autistic individuals, people with developmental disabilities, psychotic patients, prison inmates, and people suffering from nutritional deficiencies, which are hardly groups in common. Best of all, as Lillian N. Stiegler points out in “Understanding Pica Behavior,” “many individuals with normal intellect report that they engage in pica simply because they take pleasure in the texture, smell and/or taste of the items they ingest.”

  Pica appears to be a bona fide DSM-IV category, and yet commentators on the (presumed) disease note with surprise that pica receives scant attention from psychologists in the literature. Dr. David F. Gitlin observes that “most reports on intentional swallowing do not appear in the psychiatric literature; rather, they are found in the surgical and gastroenterological literature, and they focus on complication rates and surgical techniques for removing the object. They contain little to no commentary about patient intentions, psychological meaning or psychopathology.” Perhaps this is why treatment methods for dealing with people presenting with the disorder are as barbaric-seeming as many of the horror show techniques featured in the Glore Psychiatric Museum. According to Lillian Stiegler, the hell realm that a pica patient might be made to enter includes having hot sauce squirted into his mouth or ammonia forced up his nose; being outfitted with a fencing mask, mesh bags, or a hood to cut off access to his mouth; or being made to wear a specially constructed helmet made from “sheet metal and plexiglass and pop-riveted to a jacket that laces up the back.” “Over-correction” methods—an interesting euphemism for forms of punishment—are also used, such as requiring the patient to immediately brush his teeth with strong antiseptic mouthwash for five to ten minutes following a pica attempt; such methods demean the sufferer, and “work” only temporarily.

  Just as no one specialty is adequate to treating the complex matrices that form the human swallow, so behaviors or conditions that fall under the category of intentional swallowing of nonnutritive substances in humans are too diverse to be adequately named. Of course we name things so that we can treat them, but oftentimes we name things so that we can dispense with them, or at least stop thinking about them.

  One thing that can be said for pica is that it is as generative, as proliferative of categories as its origins are diverse. No matter how carefully researchers try to systematize it and, in systematizing it, treat it, pica remains utterly baffling and impossible to regulate. Sufferers of pica are sort of like what Ian Hacking (1999) calls the “motley of impaired individuals that at different times, and in different ways, have been handily lumped together as schizophrenics.” These people are not “of a kind,” Hacking argues, and it only takes some reading in the primary documents that constitute the history of the term “schizophrenia” to see that people like E.E. Southard, who lobbied for its replacing “dementia praecox” as a diagnostic category, saw themselves as creating taxonomies of humans.

  Since the advent of pica as an identifier of a type of mental illness, other, more contemporary eating disorders are being named, like night eating syndrome (NES), the consumption of nonnutritive, high-caloric items all through the night; nocturnal sleep-related eating disorder (NS-RED), people who eat while sleepwalking, typically high-fat and high-sugar foods; and orthorexia nervosa, which is so new it has not yet earned an anagram: people so obsessed with eating healthily that they no longer enjoy food and consequently begin to isolate themselves.

  When Dr. Samuel Gross applied the word “outré”—as in “There is hardly any substance, however singular or outré, that may not enter the air-tubes, and give rise to severe, if not fatal mischief”—he took a word that we usually associate with human custom, social decorum, and the boundaries of behavior and applied it to the object world, as if to suggest that when objects enter the human body, they become animated, almost as if they had a will of their own. It’s a fanciful idea indicative of the excitement—in medical terms, the efference—produced by fbdy narratives, whether the items are ingested or inhaled, and most especially when the incorporation of a foreign body is intentional. Reading through an article on pica today regarding the proximity of pica to autism and the various “treatments” employed (many of which seem inhumane), it becomes clear that, for some people, the presumably odd or unbelievable or incredible is part of a daily, profoundly difficult “norm” (especially if they are parents of developmentally disabled pica sufferers). Stiegler quotes one exasperated father, who, writing in an online chat group, asks: “Is there no end to the variety of odd objects autistic children will eat? There are days when I believe my son would be quite happy with a daily menu of baby lotion, rabbit food—and perhaps a little toilet paper for roughage!” Finding accounts of fbdy ingestion in some strange way thrilling might depend on where you stand.

  Swallowing that which is nutritive seems to require degrees of imitation and intelligence in humans. And yet, as a poetry student of mine once put it, riffing on John Ashbery’s line “All things are secretly bored,” perhaps “All things are secretly edible.” Perhaps none of us, if we really thought about it, could supply a simple, true, or definitive answer to the question Stiegler tells us people suffering from pica are asked after they’ve been put through enough rounds of aversion therapy: the intensely bewildering “What is food?”

  The kind of girl I was, I could swallow ink. Paper, too. A hangnail, laces, possibly a fin, a dove, a jack-in-the-box, cement, and, with a little urgent purpose, someone’s dry wrap, a buoy.

  —DAWN RAFFEL, “We Were Our Age,” In the Year of Long Division

  In notes, handwritten or typed, tacked onto case studies or incorporated therein, in articles and in textbooks that Chevalier Jackson authored in the long course of his career, he never used the term “pica” to refer to acts of intentionally swallowed foreign body Things. He used the word “hysteria.”

  “Hysteria” is no less ambiguous or problematic than “pica” and “schizophrenia” are as descriptors of human behavior or states of mind, but the term both enables us
to access psychoanalytic (rather than psychiatric) discussions of the phenomenon and lends a historical dimension to otherwise free-floating curiosities. Is it possible to attempt an explanation of hysterical behavior—the swallowing of hardware in large quantities, for example? Can we seek to understand what might be going on there, without resolving the uncanny cast of hysterical embodiment and its potential to unnerve us? “Hysteria” as a semantic envelope might make it possible for us to hold voluntary forms of untoward consumption before us so we can study them without quite pinning them down.

  In 1909, Jackson published an article in Laryngoscope called: “Voluntary Aspiration of a Foreign Body into the Bronchi, Removal by Bronchoscopy.” The case involved a forty-one-year-old woman who was referred to him by a doctor in New York City. Jackson carried out the removal of two tacks from a posterior branch of the right inferior lobe bronchus at the Eye and Ear Hospital in Pittsburgh. In one amazing paragraph, Jackson explains that, after the tacks had been removed, the patient swallowed and aspirated more tacks, and therefore had to undergo bronchoscopy once again, this time at the French Hospital in New York City, to which Jackson traveled: