A manual of diseases of the throat and nose : including the pharynx, larynx, trachea, oesophagus, nose and naso-pharynx . -thickened, while the latter is al-most invariably congested, and fre-quently presents patches of ulcer-ation. Occasionally, hemorrhagicspots are seen, and the papilla? areoften much enlarged. The diagnosis of this conditionmay be assisted by the exclusion ofthe various other causes of dyspha-gia, but can only be arrived at withcertainty when, while unalteredfood is regurgitated some hoursafter it has been swallowed, a largebougie can be easily passed downthe gullet. The pr
A manual of diseases of the throat and nose : including the pharynx, larynx, trachea, oesophagus, nose and naso-pharynx . -thickened, while the latter is al-most invariably congested, and fre-quently presents patches of ulcer-ation. Occasionally, hemorrhagicspots are seen, and the papilla? areoften much enlarged. The diagnosis of this conditionmay be assisted by the exclusion ofthe various other causes of dyspha-gia, but can only be arrived at withcertainty when, while unalteredfood is regurgitated some hoursafter it has been swallowed, a largebougie can be easily passed downthe gullet. The prognosis as regards cure is exceedingly unfavorable, but by selection of suitable food the pa- »*? case of Dilated cesophagus (after tients life may be prolonged for Cohen). A, the thyroid cartilage : B. the thyroid body ; jnailV yeaiS C, the trachea; D, the oesophagus; E. the stomach. «£ •> . The treatment must consist inthe use of bland liquid food, taken at frequent intervals and in small quan-tities. If alcohol be indicated by the weak condition of the patient, itshould be given in a very dilute 1 Trans. Path. Soc, London, 1866, vol. xvii., p. 142. 2 Virchows Arcliiv., 1868, Bd. xliii., p 473 et seq. DILATATIONS OF THE GULLET. 83 SECONDARY DILATATIONS. These are always the result of obstruction. Although writers on stricture of the gullet frequently describe dilatationas existing above the narrowed part, this condition is, in fact, extremelyrare. Among the very large number of cases of cancer of the gullet whichI have examined, I have not met with a single example of secondary dila-tation. Wilks and Moxon state that they have not seen much of the con-dition, and suggest as reasons for the rarity of its occurrence that in suchcases little or no food is taken, and that if the disease is malignant, itscourse is usually too rapid for a dilatation to have time to form. A fewwell-marked instances of secondary dilatation have, however, been speaks of
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