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coin, fishbone, toothplate or a portion of food. An impacted substance may be removed by the oesophageal forceps, or by' a coin-catcher; if it should be impossible to draw it up it may be pushed down into the stomach. When it is in the stomach a purgative should never be given, but soft food such as See also:

PORRIDGE (an altered form of " pottage," Fr. pelage, soup, that which is cooked in a pot)

porridge. Should gastric symptoms develop it may have to be removed by the operation of gastrotomy. Charring and ulceration of the oesophagus may occur from the swallowing of corrosive liquids, strong acids or alkalis, or even of boiling See also:

WATER

water. Stricture of the oesophagus is a closing of the tube so that neither solids nor liquids are able to pass down into the stomach. There are three varieties of stricture; spasmodic, fibrous and See also:

MALIGNANT (Lat. malignus, evil-disposed, from maligenus)

malignant. Spasmodic stricture usually occurs in See also:

young hysterical See also:

WOMEN

women; difficulty in swallowing is complained of, and a See also:

BOUGIE

bougie may not be able to be passed, but under an anaesthetic will slip down quite easily. Fibrous stricture is' usually situated near the commencement of the oesophagus, generally just behind the cricoid See also:

CARTILAGE (Lat. cartilage, gristle)

cartilage, and usually results from swallowing corrosive fluids, but may also result from the healing of a syphilitic See also:

ULCER

ulcer.

Occasionally it is congenital. The See also:

ORDINARY (med. Lat. ordinarius, Fr. ordinaire)

ordinary treatment is repeated See also:

DILATATION (from Lat. dis-, distributive, and lotus, wide)

dilatation by bougies. Occasionally See also:

DIVISION (from Lat. dividere, to break up into parts, separate)

division of a fibrous stricture has been practised, or a Symond's tube inserted. Miku]icz recommends dilatation of the stricture by the fingers from inside after an incision into the stomach or a permanent gastric See also:

FISTULA (Lat. for a pipe or tube)

fistula may have to be made. Malignant strictures are usually epitheliomatous in structure, and may be situated in any part of the oesophagus. They nearly always occur in See also:

MALES

males between the ages of 40 and 70 years. An X-See also:

ray photograph taken after the patient has swallowed a preparation of See also:

BISMUTH

bismuth will show the situation of the growth, and Killian and Brunig have introduced an See also:

INSTRUMENT (Lat. instrumentum, from insincere, to build up, furnish, arrange, prepare)

instrument called the oesophagoscope, which makes See also:

DIRECT

direct examination possible. The remedy of See also:

CONSTANT, BENJAMIN (1845-1902)

constant dilatation by bougies must not be attempted here, the walls of the oesophagus being so softened by disease and ulceration that severe See also:

HAEMORRHAGE (Gr. atµa, blood, and prryvvvac, to burst)

haemorrhage or perforation of the walls of the tube might take See also:

PLACE (through Fr. from Lat. platea, street; Gr. IrAar6s, wide)

place. The patient should be fed with purely liquid and concentrated nourishment in See also:

order to give the oesophagus as much See also:

REST (O. Eng. rest, reste, bed, cognate with other Teutonic forms, e.g. Ger. Rast, Riiste, rest, and probably Gothic Rasta, league, i.e. resting or stopping place)

rest as possible, or if the stricture be too tight rectal feeding may be necessary. Symond's method of tubage is well See also:

BORNE, KARL LUDWIG (1786–1837)

borne by some patients, the tube having attached to it a See also:

long See also:

STRING

string which is secured to the cheek or See also:

EAR (common Teut.; O.E. are, Ger. Ohr, Du. oor, akin to Lat. auris, Gr. ovs)

ear. The most satisfactory treatment, however, is the operation of gastrotomy, a permanent artificial opening being made into the stomach through which the patient can be fed.

End of Article: OESOPHAGUS (Gr. o'lvca=I will carry, and r/)ayeiv, to eat)

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