Mary Roach - Gulp

Though you do read case reports in which patients say they heard a bursting noise, the experience is more often described as a sensation, as in “a sensation of giving way.” The “sudden explosion” recalled by a seventy-two-year-old woman following a meal of cold meat, tea, and eight cups of water was more likely something she felt, not heard. (The old eight-cups-of-water-a-day advice should possibly be qualified with the clause, “but not all at once.”)

With one exception. While the consumption record for many foods exceeds eight and even ten pounds, no one has ever been able to eat more than four pounds of fruit cake.

Available in four languages, with minor modifications.The Portuguese edition, for instance, makes a distinction between the sausage of Types 2 and 3 (referred to as linguiça , a fatter German-style product) and that of Type 4, which is compared to salsicha (the more traditional wiener). The Bristol scale is, after all, a communication aid for physicians and patients. The more specific phrasing was undertaken “for better comprehension across Brazil.”

In a more perfect world, Whitehead would be a dermatologist, just as my gastroenterologist is Dr. Terdiman, and the author of the journal article “Gastrointestinal Gas” is J. Fardy, and the headquarters of the International Academy of Proctology was Flushing, New York.

Back in 2007, while researching a different book, I came across a journal article with a lengthy list of foreign bodies removed from rectums by emergency room personnel over the years. Most were predictably shaped: bottles, salamis, a plantain, and so on. One “collection”—as multiple holdings were referred to—stood out as uniquely nonsensical: spectacles, magazine, and tobacco pouch. Now I understand! The man had been packing for solitary.

Biofeedback can help. The anal sphincter can be briefly wired such that tightening and relaxing causes a circle on a computer screen to constrict and widen. The patient is instructed to bear down while keeping the circle wide. The maker of that program has one for children, called the Egg Drop Game, wherein clenching and relaxing causes a basket to move back and forth to catch a falling egg. The website of the American Egg Board has a version of the Egg Drop Game that does not require an anus (or cloaca) to play, just a cursor.

Especially if the exam entails defecography, which is pretty much what it sounds like. The patient is the star in an X-ray movie viewed by an audience of technicians, interns, and radiologist. “As close to pornography as medicine will come,” says gastroenterologist Mike Jones. Worse, the patient is passing a barium-infused “synthetic stool” crafted from a paste of plasticine (or in simpler days, rolled oats) and introduced wrong-way into the rectum. For the constipated patient, notes Jones, it can be a real ordeal. “It’s like, ‘Dude, if I could do this, I wouldn’t be here now.’”

Customs officers at Frankfurt Airport have it easier. Suspects are brought to the glass toilet, a specially designed commode with a separate tank for viewing and hands-free rinsing—kind of an amped-up version of the inspecting shelf on some German toilets. P.S.: The common assumption that the “trophy shelf” reflects a uniquely German fascination with excrement is weakened by the fact that older Polish, Dutch, Austrian, and Czech toilets also feature this design. I prefer the explanation that these are the sausage nations, and that prewar pork products caused regular outbreaks of intestinal worms.

Other red flags for customs agents include the unique breath odor created by gastric acid dissolving latex, and airline passengers who don’t eat. For years, Avianca cabin crew would take note of international passengers who refused meals, and report the names to customs personnel upon landing.

Occasionally the justice system has no choice but to step right in it. In State of Iowa v. Steven Landis , an inmate was convicted of squirting a correctional officer with a feces-filled toothpaste tube, a violation of Iowa Code section 708.3B, “inmate assault—bodily fluids or secretions.” Landis appealed, contending that without expert testimony or scientific analysis of the officer’s soiled shirt, the court had failed to prove that the substance was in fact feces. The state’s case had been based on eyewitness, or in this case nosewitness, testimony from other correctional officers. When asked how he knew it was feces, one officer had told the jury, “It was a brown substance with a very strong smell of feces.” The appeals judge felt this was sufficient.

My thanks to Judge Colleen Weiland, who drew my attention to the case and did me the favor of forwarding a logistical question to the presiding judge, Judge Mary Ann—may it please the author—Brown. “It appeared,” Brown replied, “that he liquefied the material and then dripped it or sucked it into the tube.”

Seriously, published by Oxford University Press. But highly readable. So much so that the person who took Inner Hygien e out of the UC Berkeley library before me had read it on New Year’s Eve. I know this because she’d left behind her bookmark—a receipt from a Pinole, California, In-N-Out Burger dated December, 30, 2010—and because every so often as I read, I’d come upon bits of glitter. Had she brought the book along to a party, ducking into a side room to read about rectal dilators and slanted toilets as the party swirled around her? Or had she brought it to bed with her at 2 A.M., glitter falling from her hair as she read? If you know this girl, tell her I like her style.

Of or relating to the belly or intestines. With crushing disappointment, I learned that Dr. Gregory Alvine is an orthopedist. Staff at the oxymoronic Alvine Foot & Ankle Center did not respond to a request for comment.

You would think the percentage would be higher, but in fact 80 to 90 percent of nondigestible objects that make it down the esophagus pass the rest of their journey without incident. If a man can swallow and pass a partial denture, a drug mule has little to worry about.

Close to but not quite the most egregious indignity bestowed on a corpse by drug dealers. Smugglers have occasionally recruited the mute services of a corpse being repatriated for burial and stuffed the entire length of the dead man’s GI tract. Heroin sausage.

A term coined by sexologist Thomas Lowry. In his efforts to research fisting, Lowry found himself writing letters to strangers at academic institutions that would begin like this: “Dear Dr. Brender: We spoke on the phone several months ago about ‘fist-fucking.’ At that time you mentioned two surgical articles.” There was no academic term, so eventually Lowry made one up. “I Googled it recently,” he told me, “and found over 2,000 hits. Made me chuckle.”

Simon refined his technique on cadavers, rupturing a bowel or two along the way, and then began offering training seminars. Cadavers were replaced with live, chloroformed women, thighs flexed on their abdomens. “A large number of professors and physicians” flew all the way to Heidelberg to practice “the forcible entrance.”

Flammable is a safety-conscious version of inflammable . In the 1920s, the National Fire Protection Association urged the change out of concern that people were interpreting the prefix in to mean “not”—as it does in insane . Though surely those same people must have wondered why it was necessary to warn of the presence of gas that will not burst into flame .