518 Francis' cases of morbid anatomy. 



the disposition to take on spasmodic action may increase, and the 

 ability of the part to relax be diminished ; and that, ultimately, the 

 passage of the canal may become more narrow, and its sides at length 

 be brought into a state of co-aptation, seem to be opinions sufficiently 

 well established. In like manner a spasmodic may become a permanent 

 stricture. Certain habits of body are disposed to spasmodic affections 

 in general, and the same habit more at one time than at another : thus, 

 strictures of the oesophagus occur more frequently in females than in 

 males, and in persons whose susceptibility to impression is increased by 

 debility, or some other cause. Such is the fact with regard to almost 

 all the cases of stricture of the oesophagus recorded by Sir Everard 

 Home,* and with a very large majority of instances of the disorder as 

 related by other writers. 



In the present instance there can be no room to doubt, that the 

 derangement of the stomach, first occasioned by the malignant yellow 

 fever, most materially contributed to the formation of the stricture of 

 the oesophagus, by rendering this tube in a particular degree susceptible 

 of irritation and of morbid contraction : and the opinion so cautiously 

 expressed by the celebrated Abernethy, is strengthened by this view of 

 the cause of this disease. Speaking of spasmodic strictures of this 

 part, he observes ; " Many cases have occurred to me lately, in which 

 the irritation of the oesophagus seemed to be first excited and afterward 

 maintained by disorder of the digestive organs."! 



There are other reasons which may be advanced in corroboration of 

 this opinion, and they are those which seem to be obviously deduced 

 from what is known of the predisposing causes of some of the most 



* See Practical Observations on Strictures in the Urethra and in the (Esophagus. 

 f Surgical Observations, part 1. p. 184. Ed. 1809. 



