538 DISEASES OF THE niARYNX, (ESOPHAGUS, ETC.". 



cesopliafTus, immediately behind the seat of the obstruction, and|! 

 Kecondly, on tumefaction, caused by the irritation set up by the. 

 foreign body. Tliese conditions should be borne in mind in 

 tlie treatment of a difficult case ; and instead of ruthlessly 

 endeavouring to push the object down with the probang, an 

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

 failing thi?, the spasm of the cesophagiis should be modified by 

 the administration or subcutaneous injection of morphia or 

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

 on tlie cardiac extremity of the oesophagus, producing aiiti- 

 peiistaltic action and attempts at vomition. 



DILATATION AND STRICTURE OF THE CESOrHAGUS. 



Tlieae two conditions are very frequently associated : for 

 example, if a stiicture is situated at any part of the tube, all th(» 

 portions above it become dilated from the constant accumulation 

 of aliment. 



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

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

 ture of the whole tube was found to depend upon inflammation- 

 and thickening of its walls, the symptoms of wliich prior t(> 

 death were — inability to swalloAv, attempts at vomition, and tho 

 presence of a diffuse swelling along the course of the oesoi^hafni-? 

 The subject of it was a cow, and it seemed to have arisen fror.i 

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

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

 eeveral points connected with this subject : — 



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

 ofGcer of the 4th Dragoon Guards. She discharged masticated 

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

 a swelling in the situation of the oesophagus as large as a per- 

 son's arm, commencing about six inches from the pliaiynx, 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 di-onched ivith 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 applied 

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



