CONTRACTED CARDIA. 91 
during the day. His extremities were generally cold : his mouth 
hot and dry. 
On the 11th of January, reduced almost to the extremity of 
emaciation and debility, he was shot. 
The treatment consisted in the first instance of occasional, 
but small venesections; doses of aloes and calomel and nitre, 
compounded with common treacle: clothing warmly; flannel¬ 
bandaging, &c. Towards the end of December, imagining 
there might be some chronic visceral disease, his sides were 
blistered, and subsequentlyfour setons, two into each, were 
introduced. All appeared to have little or no avail: his com¬ 
plaint, whatever it was, was daily consuming his flesh and 
strength ; and, every time I visited him, served as a reproach 
to me, either for my own ignorance, or the defective state of the 
art I professed to practise. 
On dissection, I found the cardiac orifice of the stomach con¬ 
tracted to such a degree that a sharp-pointed knife could hardly 
be forced through it to slit it open, and the contiguous portion 
of the esophagus thickened and indurated ; but, above all, 
the muscular fasciculi surrounding the opening and thence di¬ 
verging over the cuticular coat, attracted notice: many of them 
were so prodigiously augmented as to equal in volume my little 
finger; indeed, every part of the tunic investing the cuticular 
pouch had grown morbidly thick in substance, but most remark¬ 
ably so around the cardia. The internal or cuticular lining 
was thrown into unusually large and thick rugae; but, other¬ 
wise, presented nothing remarkable in its aspect.—The thoracic 
and other abdominal viscera were sound.—The brain was not 
inspected. 
It may not be amiss to add, that the only case similar to the 
above which has come to my knowledge is the one I have noted 
in my Lectures/’ Part II. page 391. 
William Percivall. 
