University of South Florida Medical Center VOLUME 6 November 1994 Number 2 Director's 30ru~ H. Worth Boyce, Jx, M. D. - Director and Hugh E Culverhouse - Chair of Esophagology In Memorium: Hugh F. Culverhouse On August 25, 1994 the person most responsible for the services and uses no donated funds for operational expenses. establishment and development of the Center for Swallow- Our patients, their families and others provide donations ing Disorders passed away. Hugh Culverhouse was a friend that are used to support research and educational programs. and gentleman in every sense of the words. He was a re- Before his death Mr. Culverhouse was aware of the success spectful and compliant patient who demonstrated warmth and fiscal independence of our Center and appropriately and affection toward all of us. As a strong proponent for took great pride in his pivotal role in this success. education and respect for the medical profession, he readily The Swallowing Center was opened for its clinical opera- supported many types of academic needs through his lead- tions in May, 1987 and in October, 1988 Mr. Culverhouse ership and benevolence, both in Florida, especially at the University of South Florida, as well as at his Alma Mater, and his family made another major contribution to medi- cine and medical education at the University of South Florida the University of Alabama. College of Medicine by establishing the Hugh F. Culverhouse Hugh Culverhouse was not asked to provide support for Chair for Esophageal Disorders. This Chair is related to the our Center - he asked how he could help when he learned Swallowing Center in that the incumbent for this chair also of the concept for developing the Swallowing Center. He will serve as the Director of the Center. This relationship had a personal interest in the difficulties suffered by patients will assure leadership in future years as well as an expanded with swallowing disorders since he had been bothered by commitment to patient care, teaching and research in swal- such a problem for many years. His initiative included the lowing disorders. of support from area corporations plus his own financial commitment for the purpose of providing funds to The Director and Staff of the Swallowing Center are ex- establish the Center, hire the needed medical support per- tremely grateful for the interest, encouragement and finan- sonnel and purchase the equipment needed to operate for cia1 support provided by Hugh Culverhouse and his family its first five years of existence. He did just that and we were and wish to formally express our gratitude and our sincere able to develop a broad patient referral base that has in- sympathy over the loss of this warm friend, patient and generous benefactor. All who knew him well are unanimous cluded patients from 27 states and 4 foreign countries to date. Our patient services are primarily oriented toward in recognizing him as one who was the epitome of a loyal management of complex swallowing disorders and offering friend, brilliant as a lawyer and in business, exemplary as a diaanostic tests and treatment techniaues usuallv not avail- leader and humanitarian, and a true gentleman. able in most areas. At present the center for swallowing H.Worth Boyce, Jr., M.D. Disorders operates from funds acquired through its patient Bizarre Swallowing* can swallow is determined of course by the distance from his lips to the pit of his stomach. Dan Mannix, a famous (Part 11) American performer, being tall was able to swallow a very long saber with a blade of 26 inches. Turning to bizarre swallowing, it is quite extraordinary the amazing variety of objects people swallow. There are a num- There is considerable rivalry between swallowers and a few ber of reasons for this; financial gain, an obsession or an years ago the Sword Swallowing Championship of the World act in the music hall, circus, fairground and, more recently, was organized between Manniz and a Hindu, Mohammed television. Ali. The latter had a considerable reputation calling himself "The King of Swords", with an impressive repertoire that . These have ranged from enormous amounts of food and included swallowing a sword with a tin blade and then twist- drink, to all sorts of metal objects - keys, rings, pieces of ing himself around until the sword was bent inside him. chain, razor blades; progressing to electric light bulbs, chew- Amazingly, he could straighten it out by contracting his stom- ing up drinking glasses and finally live creatures such as gold- ach muscles and then withdrawing it. fish, mice, frogs and - the mind boggles - even white rats. Mohammed was obviously a man of considerable ingenuity Apart from food and drink, there is in the trade a very defi- as he also swallowed red hot swords glowing in the dark nite distinction between the amateur and the professional, with puffs of stream coming out his mouth, having surrepti- the former merely swallowing inanimate things and hoping tiously swallowed an asbestos scabbard beforehand off-stage. that his digestion will cope, and the latter, who has learnt His finale was swallowing an apparently very thick sword the act of re-gurgitation, bringing up the object under strict which was really a sword in a scabbard, the latter being control. covered with aluminum paint to resemble a sword blade. However, the two most celebrated arts of swallowing are He then pulled out the sword leaving the scabbard inside fire eating and sword swallowing. him. This contained paper flowers and, the American flag which he withdrew out of his mouth with great gusto to the In the last issue we presented Fire Eating and below the fine tune of "The Star Spangled Banner". art of Sword Swallowing is discussed. The final test between the Gowas who could swallow the Sword Swallowing longest sword. Mannix reckoned he could not lose as he was a tall man and proceeded to swallow a 26 inch sword Turning to sword swallowing, this art is very old. Traveling making sure the hilt rang against his teeth. However, the jugglers did it for the Pharaohs, Agrippa mentions seeing it crafty Indian, much the shorter of the two ate a heavy meal in ancient Rome, but he was somewhat drunk at the time weighing down his stomach before the contest and won by and later ascribed what he saw to the wine. Remy, the great swallowing a sword 3 inches longer. 15th century philosopher decided sword swallowing was done with the aid of demons. For a long time many people A fascinating alternative to swords is the swallowing of neon thought it was a fake with the blade folding up into the tubes in the dark, when stripped to the waist and they are handle. Robert Houdin, the famous French magician was turned on, the light shinning through the chest is pretty sent by his government to Algeria, towards the end of the effective. Even skeptics are impressed. They are specially last century, to expose the Arab conjurers. He could ex- made, being thin, brittle "U" shaped tubes with the ends plain all their tricks except sword swallowing. sticking out of the mouth to which are attached the electric leads. This presents certain problems as they easily shatter Many different types and sizes of implements are used, in- and if too warm stick to the performer's insides, which would cluding swords, cavalry sabers, rapiers, bayonets, scissors make for a difficult oesophagoscopy. and even a giant corkscrew. The latter in particular pro- duces a horrible effect, making the Adam's apple leap about. Accomplished regurgitators have already been mentioned. Training is much the same as for sword swallowing but it Swords vary in length from 8 inches up to 2 feet and are can take 6 months or more of steady practice before con- usually bought from pawn shops where they are cheap. They trol is achieved. The act is probably a crude form of yoga require to be nickel plated to make them smooth, it is im- and many people practice it as a health measure. Certain portant to always wipe the sword before swallowing it, be- animals have the power and trappers have~foundit difficult cause even the smallest particles of dust on the blade will to poison wolves as the animals can discharge the bait as produce retching. It is also essential to ensure that the blade soon as they feel the first warning pangs. is firmly fitted into the hilt, otherwise it falls out and the performer really does swallow it. There was a delightful Austrian character who toured the Continent and used to say he was trained in the "Viennese The technique of course, is exactly that of passing a rigid Ostrich School". Although it was his living, he stoutly main- oesophagoscope, the problem being to overcome the gag tained it was also his hobby as other people go in for golf reflex and sudden closure of the cricopharyngeal sphincter and bridge. To complete his act the Ostrich would swallow which is the main obstacle. Most artists start training by 20 glasses of water and then regurgitate it slowly to the swallowing a crude ball of wadding around a lead pill at- tune of 'The Indian Love Call" played on a guitar. What a tached to a length of cotton.This is swallowed and pulled up marvelous picture this conjures up! repeatedly until the time has come to try a sword but even then it is some while before the throat becomes accustomed * From Lund, WS.:Jnl Royal Soc Med 1990;83:138-142. to the touch of cold steel. The length of sword that the man Effect of Decaffeination of Coffee or Tea Wear loose clothes - A tight belt, girdle, or waistband on Gastroesophageal Reflux can cause heartburn.