André Smout, a gastroenterologist at the University of Amsterdam in the Netherlands, said he read those reports when they came out.

"But we never saw the condition, so we didn't believe that it existed in real life," he said.

Smout's doubts persisted until he and colleagues studied a small group of patients a few years ago. The researchers gave eight patients with a reported inability to burp a "belch provocation" in the form of carbonated water, and used pressure sensors to observe how their throats moved. Indeed, the air stayed trapped. A Botox injection resolved their problems by giving them the ability to burp, or, to use an academic term, eructate.

"We had to admit that it really existed," Smout said.

On the morning of the event, he returned to Urology clinic, where his wound appeared well-healed and the overlying staples were removed. He and his wife went to breakfast to celebrate.
During breakfast, the man sneezed forcefully, followed by coughing. He immediately noticed a “wet” sensation and pain in his lower abdomen. Looking down, he observed several loops of pink bowel protruding from his recent surgical site. He later related that he was unsure of how to proceed, so he covered the exposed intestines with his shirt. He initially decided to drive himself to the hospital, but concerned that changing his position might injure his bowel, his wife requested an ambulance.

The most obvious explanation of these findings is that type A personalities are prone both to gesticulation and to coronary heart disease. It is possible that people with coronary heart disease move their arms more because they are otherwise physically inactive or their disease causes them to become agitated. However, my own suspicion is that arm movements over a lifetime may be a factor–combined with other known factors–in the development of coronary heart disease.

The article is entitled "The Influence of Sewing Machines on the Health and Morality of Workwomen." It is an analysis of a paper read to the Societe Medicale des Hopitaux of Paris, at the meeting of May 9th, by M. Guibout. He begins with the recital of a case.

A young woman, whom he had known as the very picture of vigorous health, presented herself at his office in such a condition of emaciation, and with such a change of countenance, that he was greatly shocked at her appearance. The explanation which she gave was as follows.

For seven months, from morning till night, she had worked at a sewing machine, known as the "American machine." The constant motion of the lower extremities in propelling it had produced such an excessive excitement of the sexual organs that she was often compelled to suspend her work; and to the frequency of this effect and the fatigue resulting from it, she attributed the leucorrhoea and attendant loss of flesh and strength from which she was suffering.

The effect seemed to be naturally enough explained by the cause alleged, especially as in some of the machines at which she had worked the pedals were depressed alternately with one food and the other. This case, so serious in its nature, was regarded by M. Guibout as probably the result of a peculiar susceptibility on the part of the patient, and so very exceptional at the time as only worthy of record as a curiosity. But during the past year, he goes on to say, he found in the hospital Saint-Louis, three similar cases; and during the present year he had already found five in the same hospital.

He also adds that within a month "two females, entirely unknown to each other, and working in different shops, called upon him on the same day, to consult him for similar symptoms. The first of these, a blonde, in the most vigorous health when she began to work at the machine, in seven or eight months has become enfeebled, her embonpoint was gone, her general health had declined, and she had become the subject of a profuse leucorrhoea, which was daily increasing.

She said also that many of the girls in the same establishment were affected in the same way, by the same cause, "the continual movement of the lower limbs, the jar and the swaying of the body." She denied, however, that she had been troubled by the special symptoms mentioned by the first patient, but said that many of her companions had been. Many of them had been so annoyed as to be obliged frequently to suspend their work and leave the shop for the purpose of bathing with cold water.

The second of these two patients was a brunette, of entirely different temperament from the other. She had been obliged to give up her place after working at the machine for a year, on account of the same symptoms. To the inquiry as to any local excitement produced by it, she answered in the affirmative. To translate her own words: "Among 500 women who worked with me, there were at least 200 who, to my knowledge, suffered as I did; so that the operatives were constantly changing, none of them being able to stay long. It is a constant going and coming of women, who enter strong and well, and who go out weak and emaciated."

M. Guibout went on to recite other instances equally serious, but it is not necessary to quote them. The subject is one of very grave moment and worthy of the consideration of every physician. In the discussion which followed the reading of his paper, some of the members of the Society were disposed to question the frequency of the peculiar symptoms which he reported. He, however, maintained his position, urging that it was very difficult to get a confession from many of the victims of the machine, so that when directly interrogated, a negative response should not always be received as the truth. The large number of cases which had come under his own observation had led him to lay this painful subject before the Society.