A manual of diseases of the throat and nose : including the pharynx, larynx, trachea, oesophagus, nose and naso-pharynx . na-tion) in which the affection wasascribed to wearing too tight anecktie. I have recently met witha case (see Cicatricial Stricture)in which a small pouch 2£ length and 1 mm. in diameterresulted from the swallowing of a strong alkaline solution. The sac wassituated about 7 ctm. above the cardia. Half of it was really a fistulouspassage between the muscular coats, but the lower portion, which pro-jected obliquely downward and was covered with muscle, was a truepouch.
A manual of diseases of the throat and nose : including the pharynx, larynx, trachea, oesophagus, nose and naso-pharynx . na-tion) in which the affection wasascribed to wearing too tight anecktie. I have recently met witha case (see Cicatricial Stricture)in which a small pouch 2£ length and 1 mm. in diameterresulted from the swallowing of a strong alkaline solution. The sac wassituated about 7 ctm. above the cardia. Half of it was really a fistulouspassage between the muscular coats, but the lower portion, which pro-jected obliquely downward and was covered with muscle, was a truepouch. The sac communicated with the oesophagus by means of threlsmall openings (see Fig. 20, d). It probably became developed in the fol-lowing manner : The caustic solution caused an ulcer in which particles offood lodged ; further swallowing drove the first particles—possibly somegritty substance—more deeply into the wall of the gullet, which finallywas itself pushed out. The symptoms are at first so slight as not to attract much notice. Theyconsist chiefly in the temporary retention of small fragments of food. It. Fig. 17.—Ogles Case of Sacciform Dilatation Of theCEsophagus (afler Knott). 1 Trans. Path. Soc, London, 1866, vol. xvii., p. 141. 2 Loc. cit. ! Lancet, June, 1848. 4 Froriep: Chirurgische Kupfertafeln, Weimar, 1820-1S47, Taf. : Diss, de oesophagi diverticulis. Giessen, 1867. 6 Berlin Med. , 1870, Xo. 48, p. 578. 7 Gtinsburgs Zeitschr. fur klin. Med., 1850, Bd. i., p. 344. 8 Baldingers Xeues Magazin fur Aerzte, 1781, Bd. iii., p. 242. DILATATIONS OF THE GULLET. 87 is only when the diverticulum enlarges and begins to press on the gulletthat medical advice is sought. Owing to the situation of the pouch, whenit attains any size it is always visible in the neck at the. side of the swelling may be unilateral or bilateral. It is often impossible to passa bougie, but it sometimes happens that it can be pushed down one dayand not the n
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