[=Notice= in examination: displacements; their cause, as by tumors,
etc.; dilatation; contraction or stricture, seat of; calibre at
stricture; above, below; condition of mucous membrane; ulcers, etc.
Contents of œsophagus; food, foreign bodies, wounds.]
These parts are liable to _inflammation_, _ulceration_, _stricture_,
_dilatation_ and _new growths_.
=Inflammation= of these passages, rarely occurs, except as the result of
mechanical injury, as from the lodgment of a foreign body, or from
swallowing some caustic or highly irritating substance. Catarrhal or
croupous inflammation of the mouth and tonsils, may, however, involve a
portion of the walls of the pharynx.
=Ulceration= may result from the same causes, and hence may be confined
to a small portion or may involve the greater part of the tube.
=Stricture= of the œsophagus may be either _spasmodic_ or _organic_. The
former usually occurs in hysterical women, and may result from the
irritation following the removal of some foreign body lodged in the
canal. Never proving fatal of itself, we seldom have the opportunity of
examining a case of this kind.
_Organic stricture_ is found usually at the commencement of the canal,
sometimes at its lower end. It may result from contractions attending
the healing of an ulcer, but is more frequently induced by a cancerous
affection of the walls, or by the projection of some morbid growth into
its interior, as from aneurism of the aorta, or tumors, abscesses, &c.,
in the lungs or left lobe of the liver.
=Dilatation= of the œsophagus may result from the presence of stricture.
When the latter is near the cardiac orifice of the stomach, the entire
length of the tube may be involved. The walls in these cases may be
either thickened or thinned. From the accumulation of food above the
point of stricture, the walls gradually yield to the distending force,
until a degree of dilatation is attained that is quite remarkable.
=Tumors= of various kinds are occasionally found within the walls of the
pharynx or œsophagus including cystic, fatty and fibrinous tumors of a
polypoid form.
_Malignant or cancerous_ growths may appear in any part of the tube, the
epithelial form being more common. Beginning in the submucous tissue,
the disease will soon involve the whole circumference of the tube, to
the extent of from one to three or four inches, producing a hardness of
the tissues with more or less contraction. Ulceration ultimately taking
place, a dilated cavity may take the place of the original stricture.