FOREIGN BODIES OBSTRUCTION IN ESOPHAGUS 131 



purulent infiltration in the submucosa. This condition is 

 usually seen around foreign bodies when they penetrate the 

 membranes, and, as a rule, remains localized. Gangrene of 

 the membrane is sometimes seen where the injury or infec- 

 tion has been severe. 



Symptoms. In the milder forms of esophagitis the symp- 

 toms are unobserved. In more severe forms there is great 

 difficulty in swallowing which act is often soon followed by 

 vomiting. The vomitus contains blood, the solid particles 

 covered or streaked with it. Frequent attempts at swallow- 

 ing, constantly extending the head or moving it from side 

 to side. In some cases where corrosives have been swallowed 

 fragments of the mucous membrane will be ejected with the 

 vomitus. Profuse salivation, blood is often mixed with the 

 saliva. Palpation along the cervical portion of the esophagus 

 produces severe pain. ' When localized in the cervical por- 

 tion the esophagus should be palpated carefully for foreign 

 bodies. 



Course and Prognosis. In the majority of cases, recovery 

 takes place in one to two weeks. In very severe inflammation 

 complications are liable to occur. Strictures or abscess with 

 perforation of the walls of the esophagus may result. In the 

 latter when the thoracic portion is involved the termination 

 is fatal from infectious pleuritis. 



Treatment. In the early stages cold milk, or tannic acid 

 (1-2 per cent.) in cold water is indicated to allay the inflam- 

 mation and to produce astringent action. Cold compresses 

 to the cervical portion of the esophagus often have a beneficial 

 action. Inflammations from caustic substances should be 

 treated as early as possible with the proper antidote. When 

 severe pain is shown small doses of morphin should be admin- 

 istered subcutaneously. Tincture of opium in dilute solution 

 may be given per orem. In very severe cases where foods 

 cannot be given via the mouth, enemata should be employed. 



FOREIGN BODIES. OBSTRUCTION IN ESOPHAGUS. 



Etiology. Obstruction in the esophagus occurs most fre- 

 quently in dogs. The body 'lodges immediately posterior to 



