Roach explores the limits of human eating capacity through the lens of medical case studies and competitive eating. The chapter begins with the 1891 case of Mr. L., a Stockholm carriage driver who overdosed on opium pills and died when medical staff ruptured his stomach during gastric pumping procedures. This incident prompted Swedish professor Algot Key-Åberg to conduct systematic experiments on 30 cadavers to determine stomach capacity limits, discovering that stomachs typically burst at three to four liters when safety mechanisms are compromised.

Under normal circumstances, the stomach employs sophisticated protective systems to prevent rupture. When overstretched, stretch receptors signal the brain to create feelings of fullness, while the lower esophageal sphincter relaxes to release gas. Additional warnings include pain, nausea, and eventually vomiting. However, these safeguards can fail when disrupted by drugs, medical conditions, or specific circumstances.

Roach examines rare cases of spontaneous stomach rupture, finding that dangerous substances often include bicarbonate of soda (baking soda), which neutralizes acid while producing gas that can prevent natural venting. She describes several fatalities involving fermenting foods, massive meals, and chemical reactions that created deadly pressure. One particularly striking case involved a bulimic woman who died from asphyxiation when her distended stomach pushed her diaphragm into her lungs.

The author contrasts these medical emergencies with competitive eating, interviewing professional eaters like Tim Janus (Eater X) and Eric Denmark (Eric the Red). Research by gastroenterologist David Metz revealed that competitive eaters possess naturally compliant stomachs that can expand dramatically without triggering discomfort signals. Surprisingly, their stomachs empty food more slowly than average, contradicting theories about rapid gastric processing.

Roach discovered that competitive eaters combine natural anatomical advantages with intensive training, including “water-loading” exercises where they consume up to two gallons of water to condition their stomachs. Professional eaters learn to override natural safety mechanisms, including suppressing regurgitation reflexes during competitions.

The chapter concludes with counterintuitive findings: People with larger stomach capacity are not necessarily more prone to obesity, and competitive eaters rarely suffer stomach ruptures despite consuming enormous quantities. Roach emphasizes that mortality typically results from what people consume rather than quantity alone.

In this chapter, Roach explores rectal smuggling in prisons and the physiological mechanisms that make such concealment possible. She visited Avenal State Prison in California, where Lieutenant Gene Parks showed her confiscated contraband that inmates smuggled internally—primarily tobacco and cell phones worth thousands of dollars on the prison black market.

Roach explains the basic physiology of defecation to demonstrate how the rectum naturally functions as a storage chamber. The defecation reflex occurs when stretch receptors detect sufficient pressure against rectal walls, triggering muscle contractions and sphincter relaxation. However, humans can override this reflex through conscious effort, which forms the basis of toilet training and enables smuggling activities.

The author interviews Rodriguez (a pseudonym), a lifer at Avenal who began smuggling weapons for gang protection and later moved on to tobacco. Rodriguez described how smugglers must learn to suppress natural bodily urges, explaining that anxiety makes retention more difficult by reducing rectal volume and increasing urgency.

Roach contrasts prison smuggling with international drug trafficking, noting that most airport smugglers swallow contraband rather than using rectal concealment. She examines the case of Rosa Montoya de Hernandez, whose 16-hour detention at Los Angeles International Airport reached the Supreme Court and established precedents for border searches. The case demonstrates how suspects can resist bodily functions for extended periods, though medical research shows the body eventually shuts down digestive processes to prevent rupture.

The chapter addresses cultural taboos surrounding rectal use, particularly in Caribbean, Latin American, and Islamic communities, which often associate any anal activity with gay culture. Despite these stigmas, prison environments create circumstances that override cultural prohibitions.

Roach concludes by exploring the medical and sexual aspects of rectal anatomy, citing emergency room cases involving foreign objects and research on anal sensitivity. She notes that the anus contains dense nerve networks that enable precise discrimination between solid, liquid, and gas—a remarkable feat of biological engineering that makes it both functionally crucial and potentially erogenous.