ESOPHAGITIS. INFLAMMATION OF THE GULLET. 



Causes : Alimentary and therapeutic ; parasitic and accidental trauma- 

 tisms ; mechanical irritants ; acrids ; caustics ; parasites — gongylonema, 

 coccidia, spiroptera. Extension inflammations. Lesions : hypersemia ; 

 epithelial degeneration and desquamation ; erosion ; petechiae ; suppura- 

 tion ; fibroid contraction ; sacculation ; polypi. Symptoms : dysphagia, 

 difficult deglutition ; eructation ; cough ; upward wave motion in jugular 

 furrow ; colicy pains ; probang arrested ; fever. Treatment : liquid or 

 semi-liquid food ; for caustics, antidotes ; cold water ; ice ; antiseptics ; 

 derivatives ; open abscess ; potassium iodide. 



Causes. This usually arises from injury to the mucous mem- 

 brane and iu the milder forms remains confined to this structure. 

 In the more severe, it extends to the muscular coat and even to 

 the perioesophagean tissues. The causes may be divided into 

 alimentary and therapeutic irritants ; parasitic or accidental 

 traumatisms ; and extension of inflammation from the pharynx 

 or other adjacent part. 



Among irritants taken as food, may be named hot mashes, 

 bolted by a hungry and gluttonoushor.se, and temporarily arrested 

 in the gullet by reason of the resulting irritation of the mucous 

 membrane. In other cases, coarse fibrous fodder is bolted without 

 previous mastication, and scratches and abrades the oe.sophagean 

 mucosa leading to transient or progressive inflammation. In 

 other instances diseases of ^the teeth, jaws, temporo-maxillary 

 joint, or salivary glands prevent the nec&sssary trituration of the 

 food, and it is swallowed in a rough, fibrous, or even a dry con- 

 dition. Again the impaction of a solid body (turnip, apple, 

 potatoe, egg) or of a quantity of finely divided grain or fodder 

 so as to obstruct the lumen of the gullet, is an occasional cause. 

 The density of the epithelium reduces these dangers to the mini- 

 mum, yet a too rough morsel, or an undue detention of the less 

 irritating material will determine hyperaemia and even inflamma- 

 tion and infective invasion. Acrid and irritant vegetables in the 

 food are Ie.ss injurious when thoroughly insalivated, as their con- 

 tact with the cesophagean walls is then very slight and transient. 



Irritant and caustic chemical agents given for therapeutic pur- 

 poses, attack the mouth, pharynx and stomach, more severely 

 86 



