538 DISEASES OF THE PHARYNX, (ESOPHAGUS, ETC. 



asox)liagus, immediately behind the seat of the obstruction, and, 

 secondly, on tumefaction, caused by the irritation set up by the 

 foreign body. These conditions should be borne in mind in 

 the treatment of a difficult case ; and instead of rutlilessly 

 endeavouring to push the object down with the probang, an 

 attempt should be made to withdraw it with the screw ; and 

 failing this, the spasm of the oesophagus should be modified by 

 the administration or subcutaneous injection of morphia or 

 aconite — the latter in preference, as it has a direct influence 

 on the cardiac extremity of the oesophagus, producing anti- 

 peristaltic action and attempts at vomition. 



DILATATION AND STPJCTURE OF THE (ESOPHAGUS. 



These two conditions are very frequently associated : for 

 example, if a stricture is situated at any part of the tube, all the 

 portions above it become dilated from the constant accumulation 

 of aliment. 



I have met with cases of stricture caused by scalding, by 

 tumours pressing upon the cesophagus, and in one instance stric- 

 ture of the wdiole tube was found to depend upon inflammation 

 and tliickening of its walls, the symptoms of wliich prior to 

 death were — inability to swallow, attempts at vomition, and the 

 presence of a diffuse swelling along the course of the cesophagus. 

 The subject of it was a cow, and it seemed to have arisen from 

 no traceable cause. The following case, published in the Veteri- 

 narian for 1830, by Mr. Cheetham of Glasgow, throws light upon 

 several points connected mtli tliis subject : — 



" Mr. Cheetham was called to attend a mare belonging to an 

 officer of the 4th Dragoon Guards. She discharged masticated 

 food from the nose ; and on the near side of the neck there was 

 a swelhng in the situation of the cesophagus as large as a per- 

 son's arm, commencing about six inches from the pliarynx, and 

 gradually increasing to opposite the sixth cervical vertebra, and 

 there terminating abruptly. There had existed a partial obstruc- 

 tion for many months, which had so increased of late, that the 

 animal had been obliged to be drenched with water to wash 

 down the contents of the sac ; on other occasions a probang had 

 been used. After such palliations as these, a blister was apphed 

 ever the tumour, and she was turned to grass. While there it 



