Peroral endoscopy and laryngeal surgery . self between the diaphragmatic libers, which it hasspread apart in order that it mav enter the abdominal cavitv. It is notan elliptic orifice, but rather a cleft througli which the esuphagus agrees with others who havt been unable to demonstrate anyincrease in the circular fibers at the true cardia as com])ared with thecircular libers of other [xntions of the esophagus. In further confirmation of the authors contention ( llib. 2i)!) ) againstthe misleading word cardiospasm, anatomic study, in addition to thedemonstration by Liebault ab
Peroral endoscopy and laryngeal surgery . self between the diaphragmatic libers, which it hasspread apart in order that it mav enter the abdominal cavitv. It is notan elliptic orifice, but rather a cleft througli which the esuphagus agrees with others who havt been unable to demonstrate anyincrease in the circular fibers at the true cardia as com])ared with thecircular libers of other [xntions of the esophagus. In further confirmation of the authors contention ( llib. 2i)!) ) againstthe misleading word cardiospasm, anatomic study, in addition to thedemonstration by Liebault above <|uoted, has also demonstrated the al)-sence f)f anything th;it could be c;dled a sphincter at the cardia. and the 512 DISUASKS OF THE ICSOPHAGUS. narrowing at this ])oint that has been shown in so many text books onanatomy is a misfortune. Hill quotes McAllister to tlie effect that thereis no histologically demonstrable siihincter and he states that the circularmusculature at this point is weak. Brown Kellv and \\illiamina .\ble,. Fig. 410.—Drawing of the under surface of the diaphragm showing the con-stricting musculature at the liiatus. (After Liebault). by careful special dissections, ha\e demonstrated that it is quite ap-parent to the naked eye that both muscular coats are of uniform that no special aggregation of fibers exists at or near the cardia, andthat nothing was found in any of the dissections or in the anatomical DISEASES OF THE ESOPHAGUS. 513 works consullctl tu justify Dr. Hills statcnicm thai ihc circular fibermusculature was specially weak ui this region. IVrsoually, the author believes that it is only very rarely, if ever,that any spasm exists below the hiatal level, but in order to place thestudy on a systematic basis, he believes that, as endoscopists, it would bebetter for us to abandon the word cardiospasm and to substitute for itthe three clinical types, that may possibly be made out: namely, 1. Hiatal esophagismus. 2. Abdominal es
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectrespira, bookyear1915
