bezoar

• Food boluses (or boli; singular bolus) have the archaic and positive meaning of bezoar, and are composed of loose aggregates of food items such as seeds, fruit pith, or pits, as well as other types of items such as shellac, bubble gum, soil, and concretions of some medications.
• Lactobezoars are a specific type of food bezoar consisting of inspissated milk. It is most commonly seen in premature infants receiving formula foods.
• Pharmacobezoars (or medication bezoars) are mostly tablets or semiliquid masses of drugs, normally found following an overdose of sustained-release medications.{{Cite journal |vauthors=Buckley NA, Dawson AH, Reith DA |date=January 1995 |title=Controlled release drugs in overdose. Clinical considerations |journal=Drug Safety |volume=12 |issue=1 |pages=73–84 |doi=10.2165/00002018-199512010-00006 |pmid=7741985 |s2cid=72704953}}
• Pseudobezoars are man-made ingestible, permeable, expandable implements that can swell in the stomach or in the intestines and stay inflated for a certain period of time, during which they perform particular functions, such as reducing gastric volume.
• Phytobezoars are composed of indigestible plant material (e.g., cellulose), and are frequently reported in patients with impaired digestion and decreased gastric motility.
• Diospyrobezoar is a type of phytobezoar formed from unripe persimmons.{{Cite journal |last1=Kishan |first1=Asn |last2=Kadli |first2=NK |year=2001 |title=Bezoars |url=http://www.bhj.org/journal/2001_4304_oct/org_507.htm |url-status=dead |journal=Bombay Hospital Journal |archive-url=https://web.archive.org/web/20080828163902/http://www.bhj.org/journal/2001_4304_oct/org_507.htm |archive-date=28 August 2008 |access-date=31 October 2008}} Coca-Cola has been used to treat them.{{Cite journal |display-authors=etal |vauthors=Chung YW, Han DS, Park YK |date=July 2006 |title=Huge gastric diospyrobezoars successfully treated by oral intake and endoscopic injection of Coca-Cola |journal=Dig Liver Dis |volume=38 |issue=7 |pages=515–7 |doi=10.1016/j.dld.2005.10.024 |pmid=16330268}}{{Cite journal |display-authors=etal |vauthors=Ha SS, Lee HS, Jung MK |date=December 2007 |title=Acute Intestinal Obstruction Caused by a Persimmon Phytobezoar after Dissolution Therapy with Coca-Cola |url=http://www.kaim.or.kr/journal/view2.php?year=2007&vol=22&no=4&page=300 |url-status=dead |journal=Korean Journal of Internal Medicine |volume=22 |issue=4 |pages=300–3 |doi=10.3904/kjim.2007.22.4.300 |pmc=2687663 |pmid=18309693 |archive-url=https://web.archive.org/web/20110722141235/http://www.kaim.or.kr/journal/view2.php?year=2007&vol=22&no=4&page=300 |archive-date=22 July 2011 |access-date=19 December 2008}}{{Cite journal |last1=Hayashi |first1=Kazuki |last2=Ohara |first2=Hirotaka |last3=Naitoh |first3=Itaru |last4=Okumura |first4=Fumihiro |last5=Andoh |first5=Tomoaki |last6=Itoh |first6=Takafumi |last7=Nakazawa |first7=Takahiro |last8=Joh |first8=Takashi |date=12 November 2008 |title=Persimmon bezoar successfully treated by oral intake of Coca-Cola: a case report |journal=Cases Journal |location=London, England, U.K. |publisher=BioMed Central |publication-date=11 December 2008 |volume=1 |issue=1 |page=385 |doi=10.1186/1757-1626-1-385 |issn=1757-1626 |oclc=234326274 |pmc=2627813 |pmid=19077219 |quote=Referring to past reports [1-9], the period from the administration of Coca-Cola until the disappearance of the bezoars was a minimum of 1 day and a maximum of 2 months. |doi-access=free }}
• Trichobezoar is a bezoar formed from hair{{Cite journal |vauthors=Malhotra A, Jones L, Drugas G |date=November 2008 |title=Simultaneous gastric and small intestinal trichobezoars |journal=Pediatr Emerg Care |volume=24 |issue=11 |pages=774–6 |doi=10.1097/PEC.0b013e31818c2891 |pmid=19018222}} – an extreme form of hairball. Humans who frequently consume hair sometimes require these to be removed. In cases of Rapunzel syndrome, surgery may be required.

• A bezoar in the esophagus is common in young children and in horses; in horses, it is known as choke.
• A bezoar in the large intestine is known as a fecalith.
• A bezoar in the trachea is called a tracheobezoar.

{{expand section|other examples|date=May 2021}}

Esophageal bezoars discovered in nasogastrically fed patients on mechanical ventilation and sedation are reported to be due to the precipitation of certain food types rich in casein, which are precipitated with gastric acid reflux to form esophageal bezoars. Bezoars can also be caused by gastroparesis due to the slowing of gastric emptying, which allows food to form a bolus.{{Cite web |title=Gastroparesis |url=https://www.hopkinsmedicine.org/health/conditions-and-diseases/gastroparesis |access-date=26 May 2021 |website=Johns Hopkins Medicine |publisher=Johns Hopkins University}}

The word bezoar is derived from the Persian {{transliteration|fa|pād-zahr}} ({{lang|fa|پادزهر}}), literally {{gloss|antidote}}.{{Cite encyclopedia |title=bezoar |url= https://www.etymonline.com/word/bezoar |last= Harper |first= Douglas |encyclopedia = Online Etymology Dictionary}} The myth of the bezoar as an antidote reached Europe from the Middle East in the 11th century and remained popular until it started to fall into disrepute by the 18th century.{{Cite journal |last1= Eng |first1= Katharine |last2= Kay |first2= Marsha |date= November 2012 |title= Gastrointestinal Bezoars: History and Current Treatment Paradigms |journal= Gastroenterology & Hepatology |volume= 8 |issue= 11 |pages= 776–778 |issn= 1554-7914 |pmc= 3966178 |pmid= 24672418 | quote = Bezoars were introduced to Europe from the Middle East during the 11th century, and they were popular as medicinal remedies; however, their use started to fall out of favor by the 18th century.}} People believed that a bezoar had the power of a universal antidote and would work against any poison – a drinking glass that contained a bezoar could allegedly neutralize any poison poured into it.

File:Ring med besoarsten, 1600-tal - Livrustkammaren - 98876.tif

Ox bezoars ({{transliteration|zh|niu-huang}} ({{lang|zh|牛黃}}) or {{lang | la | calculi bovis}}) are used in Chinese herbology{{vague|date=May 2021}} to treat various diseases. They are gallstones or gallstone substitutes formed from ox or cattle bile. Some products allegedly remove toxins from the body.

The Andalusian physician Ibn Zuhr ({{abbr|d.|died}} 1161), known in the West as Avenzoar, is thought{{by whom|date=September 2016}} to have made the earliest description of bezoar stones as medicinal items.{{Cite book |last=Byrne |first=Joseph P. |url= https://archive.org/details/encyclopediablac00phdj |title= Encyclopedia of the Black Death |date= 31 January 2012 |publisher=ABC-CLIO |isbn=978-1598842531 |page=[https://archive.org/details/encyclopediablac00phdj/page/n55 33] |url-access=limited}} Extensive reference to bezoars also appears in the Picatrix.

In 1567, French surgeon Ambroise Paré did not believe that it was possible for the bezoar to cure the effects of any poison and described an experiment to test the properties of the stone. A cook in the King's court was sentenced to death and chose to be poisoned rather than hanged, under the condition that he would be given a bezoar after the poison. Paré administered the bezoar stone to the cook, but it had no effect, and the cook died in agony seven hours after taking the poison, proving that – contrary to popular belief – the bezoar could not cure all poisons.{{Cite book |last=Paget |first=Stephen |url=https://archive.org/details/ambroiseparandh00pagegoog |title= Ambroise Paré and His Times, 1510–1590 |publisher= G.P. Putnam's Sons |year= 1897 |pages= [https://archive.org/details/ambroiseparandh00pagegoog/page/n248 186]–187 |author-link=Stephen Paget}}

Modern examinations of the properties of bezoars by Gustaf Arrhenius and Andrew Benson of the Scripps Institution of Oceanography show that when bezoars are immersed in an arsenic-laced solution, they can remove the poison. The toxic compounds in arsenic are arsenate and arsenite; each is acted upon differently by the bezoars: arsenate is removed by being exchanged for phosphate in brushite found in the stones, while arsenite is bound to sulfur compounds in the protein of degraded hair, which is a key component in bezoars.{{Cite web |title=Bezoar Stones |url=http://www.melfisher.org/bezoar.htm |url-status=dead |archive-url= https://web.archive.org/web/20130116102735/http://www.melfisher.org/bezoar.htm |archive-date=16 January 2013 |access-date=30 November 2012 | quote = Modern examinations of the properties of bezoars by Gustaf Arrhenius and Andrew A. Benson of the Scripps Institution of Oceanography have shown that they could, when immersed in an arsenic-laced solution, remove the poison. The toxic compounds in arsenic are arsenate and arsenite. Each is acted upon differently, but effectively, by bezoar stones. Arsenate is removed by being exchanged for phosphate in the mineral brushite, a crystalline structure found in the stones. Arsenite is found to bond to sulfur compounds in the protein of degraded hair, which is a key component in bezoars.}}

A famous case in the common law of England (Chandelor v Lopus, 79 Eng Rep. 3, Cro. Jac. 4, Eng. Ct. Exch. 1603) announced the rule of {{lang|la|caveat emptor}} ("let the buyer beware") if the goods purchased are not in fact genuine and effective. The case concerned a purchaser who sued for the return of the purchase price of an allegedly fraudulent bezoar.

Bezoars were important objects in cabinets of curiosity and in natural-history collections, mainly for their use in early-modern pharmacy and in the study of animal health.{{Cite journal |last= Heintzman |first= Kit |year= 2018 |title= A cabinet of the ordinary: domesticating veterinary education, 1766–1799 |journal=The British Journal for the History of Science |volume= 51 |issue=2 |pages=239–260 |doi=10.1017/S0007087418000274 |pmid= 29665887 |s2cid=4947361}}{{Cite book |last=Borschberg |first=Peter |url= https://www.routledge.com/Artistic-and-Cultural-Exchanges-between-Europe-and-Asia-1400-1900-Rethinking/North/p/book/9780754669371 |title=Artistic and Cultural Exchanges between Europe and Asia, 1400-1900 |date= 2010 |publisher= Ashgate |editor-last= North |editor-first= Michael |location= Burlington |chapter= The Euro-Asian trade in bezoar stones (approx. 1500 to 1700) |url-access=subscription}}

The Merck Manual of Diagnosis and Therapy notes that consumption of unripened persimmons has been identified as the main cause of epidemics of intestinal bezoars and that up to 90 percent of bezoars that occur from excessive consumption require surgery for removal.Merck Manual, Rahway, New Jersey, Sixteenth Edition, Gastrointestinal Disorders, Section 52, p. 780

A 2013 review of three databases identified 24 publications presenting 46 patients treated with Coca-Cola for phytobezoars. Clinicians administered the cola in doses of {{cvt|500|ml}} to up to {{cvt|3000|ml}} over 24 hours, orally or by gastric lavage. A total of 91.3% of patients had complete resolution after treatment with Coca-Cola: 50% after a single treatment, with others requiring cola plus endoscopic removal. Doctors resorted to surgical removal in four cases.{{Cite journal |vauthors= Ladas SD, Kamberoglou D, Karamanolis G, Vlachogiannakos J, Zouboulis-Vafiadis I |year=2013 |title=Systematic review: Coca-Cola can effectively dissolve gastric phytobezoars as a first-line treatment |journal= Alimentary Pharmacology & Therapeutics |volume= 37 |issue= 2 |pages= 169–173 |doi= 10.1111/apt.12141 |pmid= 23252775 |doi-access= free}}

• Bezoardicum
• Coca-Cola treatment of phytobezoars
• Enterolith
• Fecalith
• Gastrolith
• Goa stone
• Gorochana
• Regurgitalith
• Snake-stones
• Toadstone

{{Reflist}}

• Barry Levine. 1999. Principles of Forensic Toxicology. Amer. Assoc. for Clinical Chemistry. {{ISBN|1-890883-87-5}}.
• Martín-Gil FJ, Blanco-Ávarez JI, Barrio-Arredondo MT, Ramos-Sanchez MC, Martin-Gil J. Jejunal bezoar caused by a piece of apple peel – Presse Med, 1995 Feb. 11; 24(6):326.
• {{Webarchive |url=https://archive.today/20121205235734/http://members.tripod.com/~Prof_Anil_Aggrawal/poiso001.html |date=5 December 2012 |title=The Poison Sleuths: Arsenic – The King of Poisons. Retrieved March 10, 2007. (This webpage is a reprint by the author of an article originally published in the 1997 issue of Science Reporter, published by the National Institute of Science Communication (CSIR) in India.)}}
• This article incorporates text from a publication now in the public domain: {{Cite book |title=Cyclopædia, or an Universal Dictionary of Arts and Sciences |title-link=Cyclopædia, or an Universal Dictionary of Arts and Sciences |publisher=James and John Knapton, et al. |editor-last=Chambers |editor-first=Ephraim |chapter=Bezoar |chapter-url=http://digicoll.library.wisc.edu/cgi-bin/HistSciTech/HistSciTech-idx?type=turn&entity=HistSciTech.Cyclopaedia01.p0248&isize=M&id=HistSciTech.Cyclopaedia01}}

• Borschberg, Peter, "[https://www.academia.edu/4311591 The Euro-Asian Trade in Bezoar Stones (approx. 1500-1700)]", Artistic and Cultural Exchanges between Europe and Asia, 1400–1900: Rethinking Markets, Workshops and Collections, ed. Thomas DaCosta Kaufmann and Michael North, Aldershot: Ashgate, 2010, pp. 29–43.
• Borschberg, Peter, "The Trade, Forgery and Medicinal Use of Porcupine Bezoars in the Early Modern Period (c.1500–1750)", ed. Carla Alferes Pinto, Oriente, vol. 14, Lisbon: Fundação Oriente, 2006.

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{{Foreign bodies, burns, corrosion, and frostbite|state=collapsed}}

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Category:Gastrointestinal tract disorders

Category:History of medicine

Category:Magic items