634 A CASE OF STRICTURE OF THE OESOPHAGUS. 
opposite the sixth cervical vertebra into the oesophagus, about 
four inches in length. On opening the oesophagus, it seemingly 
was divested of its muscular fibres, the cuticular coat being the 
principal part that here composed the tube. Having exposed 
part of the masticated food which it contained, the contents, from 
their density, were removed with some difficulty, and she was 
afterwards drenched with warm water, to wash out the oeso¬ 
phagus. 
The dimensions of the dilated portion I could not correctly 
ascertain; but its inferior part I imagined, when distended, to be 
three or four inches in diameter. v 
On examining the cyst, I found the tube so much contracted 
at the opening downw r ards, that it would only admit a probang 
half an inch in diameter to pass, and that not without a slight 
rotatory motion and some degree of force. 
After withdrawing the probang she was allowed to get on 
her feet; she then drank freely of warm w ater, which by apply¬ 
ing’ pressure on the w r ound, passed on to the stomach w ithout 
interruption; but when the pressure was removed, the greater 
quantity passed out by the w ound: her pulse, which before w as 
65, having risen to 75 after the operation, I abstracted from the 
jugular vein five quarts of blood, administered a laxative drench, 
and left her at five p.m. 
At nine p.m. I again visited her, and found the pulse 90; the 
w r ound foul, with an ichorous discharge having an offensive smell. 
Fomentations of tepid water were then applied and continued 
all night, and a solution of the chlorate of lime injected into the 
wound every half hour. In the course of two hours she was 
much relieved, and, the pulse having fallen to 80, she took freely of 
gruel through the night, and by four next morning the wound 
had lost the offensive smell, the discharge was much less, and 
the pulse 75. 1 now left her, a poultice having been applied 
over the w ound. 
At eleven a.m. the symptoms being much the same, the wound 
was bathed with tepid w ater, and a fresh poultice applied. In 
the evening the pulse w as 65, in which state it continued for two 
days. Similar treatment w as pursued with the w ound; her regi¬ 
men was gruel, with mashes of bran and a decoction of linseed 
of a thin consistence. 
On the 12th a sloughing in the wound commenced, extending 
to the oesophagus, part of which became detached, and in a 
week the wound assumed a healthy condition and the fetor 
abated. I now introduced a probang of a similar size as men¬ 
tioned formerly through the stricture, and repeated it two or 
three times a-day for ten days, increasing its size gradually. 
