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Diseases Cesophagus

esophagus, swallowing, difficulty and food

CESOPHAGUS, DISEASES OF.—The oesophagus, or gullet, is a membranous tube about nine inches in length, which is connected with the stomach, and which serves as a passage for food (see INTRODUCTORY CHAPTERS, S. V. ORGANS OF DIGESTION [pp. 147-1_0]). It is subject to a number of affections, which may be caused either by the material ingested, or be due to morbid changes in its various tissues.

Cancer is the most frequent and dangerous of all disease; of the (esophagus. The tumour is generally situated where the (esophagus enters the stomach ; sometimes its site may be in the middle, rarely at the beginning of the gullet. Cancer develops very slowly, insiduousiy, at first hardly perceptibly. It may often exist for months before difficulty in swallowing sets in. On account of the increasing stricture of the (esophagus, this difficulty becomes more and more marked until only liquids will pass, and finally not even these. The danger of starvation can be avoided only by artificial feeding through the rectum, or by gastrostomy. Up to the present time medical skill is perfectly helpless when confronted with cancer, and even surgery is not yet able to remove these growths from the (esophagus.

Contractions of the (esophagus occur principally in consequence of corrosion of its mucous membrane by acids or alkalies which have been drunk either with suicidal intent or by accident. This causes ulcers which heal

as scars. These scars contract the calibre of the (esophagus and cause difficulty in swallowing ; at times this may be so severe that it becomes impossible to take food, and the patient is in danger of starvation. Sometimes the physician succeeds in gradually enlarging the contracted parts by stretching the (esophagus. At other times, however, it becomes necessary to perform the operation of gastrostomy in order to nourish the patient.

Dilatations arc situated chiefly in the upper, seldom in the lower part of the (esophagus. They cause difficulty in swallowing, because the food may remain for hours and days in these dilatations, thereby obstructing the passage. ThC food often decomposes, and produces a foul odour. It may finally be vomited up. Generally, the only cure is found in operative treatment.

Spasm of the (esophagus is always of nervous origin ; generally speaking, it is a rare sign of nervous weakness. The symptoms, which are nearly identical with those of real contraction of the (esophagus, consist in trouble in swallowing the nourishment taken, even fluids. The spasms come and go, their appearance being very uncertain. It is a tedious but harmless complaint, which generally yields to proper medical treatment.