Diseases of Oesophagus

OESOPHAGUS, DISEASES OF. (See ALIMENTARY CANAL.) The human oesophagus is liable to certain accidents and diseases, from its function and its situation. One of the common est accidents is the lodgment of foreign bodies. An impacted sub stance may be removed by the oesophageal forceps, or a coin catcher or may be pushed down into the stomach. A purgative should never be given, but soft food such as porridge. Should gastric symptoms develop operation may be necessary. Charring and ulceration of the oesophagus may occur from the swallowing of corrosive liquids, strong acids or alkalis, or even of boiling water. Stricture of the oesophagus may be spasmodic, fibrous or malignant. Spasmodic stricture usually occurs in young hysterical women; under an anaesthetic a bougie will slip down easily. Fibrous stricture is usually situated behind the cricoid cartilage, and results from swallowing corrosive fluids or the healing of a syphilitic ulcer. Occasionally it is congenital. The ordinary treatment is repeated dilatation by bougies. Malignant strictures are usually squamous cell carcinoma (see TUMOUR) and chiefly occur in males between the ages of 4o and 7o years. An X-ray photograph taken of ter the patient has swallowed a preparation of bismuth will show the situation of the growth, and Killian and Bridnig have introduced the oesophagoscope, which makes direct examination possible. Dilatation by bougies must not be at tempted, the oesophagus being so softened by disease that per foration might take place. Radium treatment, so far, has not been successful. The method of transpleural approach to the thoracic oesophagus and insertion of radium into the wall of the tube has been introduced, but as yet it is too early to evaluate the results. The most satisfactory treatment is the operation of gastrotomy, a permanent artificial opening being made into the stomach through which the patient can be fed.

OETA

(mod. Katavothra), a mountain in Greece, 7,080 ft. high, to the S. of Thessaly, between the valleys of the Spercheius and the Boeotian Cephissus. Its east end, Callidromus, over hangs the sea at the famous pass of Thermopylae (q.v.). There was also a high pass W. of Callidromus into the upper Cephissus. In mythology Oeta is the scene of the death of Heracles.

OFFA

(d. 796), king of Mercia, obtained that kingdom in A.D. 757, after driving out Beornred, who had succeeded a few months earlier on the murder of Aethelbald. He traced his descent from Pybba, the father of Penda, through Eowa, brother of that king, his own father's name being Thingferth. In 779

he was at war with Cynewulf of Wessex from whom he wrested Bensington. It is not unlikely that the Thames became the boundary of the two kingdoms about this time. In 787 the power of Offa was displayed in a synod held at a place called Cealchyth. He deprived Jaenberht, archbishop of Canterbury, of several of his suffragan sees, and assigned them to Lichfield, which, with the leave of the pope, he constituted as a separate archbishopric under Hygeberht. He also took advantage of this meeting to have his son Ecgferth consecrated as his colleague, and that prince subsequently signed charters as Rex Merciorum. In 789 Offa secured the alliance of Berhtric of Wessex by giving him his daughter Eadburg in marriage. In 794 he appears to have caused the death of Aethelberht of East Anglia, though some ac counts ascribe the murder to Cynethryth, the wife of Offa. In 796 .Offa died of ter a reign of 39 years and was succeeded by his son Ecgferth.

It is customary to ascribe to Offa a policy of limited scope, namely the establishment of Mercia in a position equal to that of Wessex and of Northumbria. This is supposed to be illustrated by his measures with regard to the see of Lichfield. It cannot be doubted, however, that at this time Mercia was a much more formidable power than Wessex. Offa, like most of his predecessors, probably held a kind of supremacy over all kingdoms south of the Humber. He seems to have entertained the design of putting an end to the dependent kingdoms. At all events we hear of no kings of the Hwicce after about 780, and the kings of Sussex seem to have given up the royal title about the same time. Further, there is no evidence for any kings in Kent from 784 until after Offa's death. To Offa is ascribed by Asser, in his life of Alfred, the great fortification against the Welsh which is still known as "Offa's dike." It stretched from sea to sea and consisted of a wall and a rampart. An account of his Welsh campaigns is given in the Vitae duorum Offarum, but it is difficult to determine how far the stories there given have an historical basis.

See Anglo-Saxon Chronicle, ed. J. Earle and C. Plummer (1899), s.a. 755, 777, 785, 794, 796, 836; W. de G. Birch, Cartularium Saxonicum , vol. i. ; Asser, Life of Alfred, ed. W. H. Steven son (1904) Vitae duorum Offarum (in works of Matthew Paris, ed. W. Wats, 1640).