. Radiography and radio-therapeutics . hagus. The diseases most likely to cause difficulty are : (1) Simple stricturewith dilatation of the oesophagus above ; (2) malignant disease with orwithout dilatation ; (3) simple dilatation, cardiospasm. (Esophag-eal Obstruction.—The causes of oesophageal obstruction arenumerous, and may be divided into several groups : (1) Obstruction due to pressure from without.—This is usually due todiseases of other organs, such as aneurism ; new growth of the mediastinum,lungs, pleura ; tumour of the spine ; enlarged mediastinal glands ; mediastinalabscess. ^ The
. Radiography and radio-therapeutics . hagus. The diseases most likely to cause difficulty are : (1) Simple stricturewith dilatation of the oesophagus above ; (2) malignant disease with orwithout dilatation ; (3) simple dilatation, cardiospasm. (Esophag-eal Obstruction.—The causes of oesophageal obstruction arenumerous, and may be divided into several groups : (1) Obstruction due to pressure from without.—This is usually due todiseases of other organs, such as aneurism ; new growth of the mediastinum,lungs, pleura ; tumour of the spine ; enlarged mediastinal glands ; mediastinalabscess. ^ The consistency of the opaque food is important. It should not be too thin, becausein an early stricture it mjtiht pass down freely and so lead to error; on the other hand, ifit is too thick it might caui-e appreciable delay in a normal oesophagus. For a thoroughexamination of the organ it may be well to i;se two preparations, commencing with the thinone, and, if no delay is observed with this, finishing with tlic thicker (ESOPHAGEAL OBSTRUCTION 311 (2) Actual obstruction of the GEsopJia/jus. — Due to disease in theoesophagus itself, such as new growth ; ulcer of the oesophagus, with super-added spasm, leading tostricture, which may beof a temporary nature;cicatrisation followingupon trauma or caustics. (3) Obstruction due toforeign bodies, coins,brooches, pins, etc. Thesemay cause more or lesscomplete obstruction. The recognition of anobstruction in the oeso-phagus is easy, but theexact determination of thecause is exceedingly diffi-cult, and may be impos-sible to determine withouthaving recourse to someof the other methods ofexamination. In the Quarterly Jour-nal of Medicine for July1916, Dr. Arthur J. Hallremarks: It has beensomewhat the customin former times to dis-miss all growth of theoesophagus (with the exception of carcinoma) as mere pathological curi-osities, having little or no clinical importance. The routine use of X-raysin the diagnosis of dis
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