Slie had swallowed one pice some hours before and since that time all food and liquids were immediately vomited. This statement was tested by giving the child some gruel which she was unable to swallow. There was no evidence of interference with respiration. The coin could be felt in the oesophagus posterior to the trachea about one finger-breadth above the jugular notch. Under chloroform anaesthesia several unsuccessful attempts were made to extract the coin with a pair of long forceps, and it was then decided to try manipulation. The coin was worked upwards by the fingers of the right hand applied externally and when it reached the back of the throat it was easily seized by the fingers of the left hand and removed. Relief was instantaneous and the child experienced no further trouble.