170 PARASITES IN THE (ESOPHAGUS. 



to vomit, which are only relieved at intervals, or when the 

 parasites become displaced. 



presenting the same appearances as muscles which had been excessively 

 bruised, and this condition of the areolar tissue extended for several 

 inches into the chest. Nearly the whole of the right lung was consoli- 

 dated ; the pleura covering, which was green in colour, and adhering to 

 the pleura costalis ; the left lung was filled with tar-black blood, as also 

 were all the large venous trunks, and the blood perfectly fluid. The 

 abdominal viscera were all perfectly healthy. Having removed the oeso- 

 phagus, stomach, and wind-pipe entire, he proceeded to lay them open, 

 and on seeing the condition of the cuticular lining membrane of the 

 oasophagus, Mr H. at once concluded that my students would be pleased 

 at the opportunity of seeing so rare a case. We would also see by the 

 lining membrane of the trachea, that particles of bran and other ingesta 

 were adhering to it; they were also to be seen in the bronchial tubes, 

 which proved the correctness of his fears of what was taking place when 

 Mr H. first saw the case. 



[The origin of the dilatation above referred to appears to have been 

 an inflammation and superficial ulceration of the mucous membrane, 

 over which the cuticular coat was detached in patches. Whatever may 

 have been the cause originally of this disease, it must soon have affected 

 the action of the muscular coat, which, yielding to its contents, had 

 become paralysed and flaccid. Towards the lower part the muscular 

 coat was of considerable thickness. It is here that not unfrequently 

 abnormal dilatation occurs, and which, by favouring the effacement of 

 the folds at the cardiac orifice, favours regurgitation and vomiting. 

 The distension of the oesophagus by fluid in Mr Hunting's case, with 

 contraction probably at the lower end, led to the enormous and ulti- 

 mately incurable dilatation and atrophy of the muscular coat. What 

 our practice should be in these cases has not been well established. 

 Our experience would favour in all cases of enormous distension in the 

 cervical portion of the oesophagus, to open, and, by injection or other- 

 wise, to treat the mucous membrane. This opinion is based on the 

 observation of occasional thoracic obstruction treated by eesophagotomy, 

 and in which the oesophagus had suffered very considerably. J. G.] 



