File:A new manual of surgery, civil and military (1917) (14580012269).jpg

Identifier: newmanualofsurge00ochs (find matches)
Title: A new manual of surgery, civil and military
Year: 1917 (1910s)
Authors: Ochsner, Albert J. (Albert John), 1858-1925 Percy, Nelson M. (Nelson Mortimer), b. 1875
Subjects: Surgery
Publisher: Chicago, Cleveland Press
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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the disease. Etiology. The cause of the spasm is a matter of speculation. In the ma-jority of the cases a definite etiological factor cannot be found. A few caseshave been reported associated with gross lesions of the esophagus such asulcers, fissures, carcinoma of the cardia and of the stomach. Plummer hasfound three cases of carcinoma complicated by cardiospasm and one case ofhourglass stomach due to syphilis with secondary cardiospasm. In his studyof forty cases of cardiospasm only three of them had neurasthenic symptoms,and evidence of esophagitis previous to the onset of the cardiospasm couldnot be elicited from any of them. Symptoms. Three stages. The symptoms of cardiospasm may be dividedinto three stages; first, cardiospasm with some difficulty in swallowing but noregurgitation of food; second, cardiospasm with immediate regurgitation offood; third, cardiospasm with the dilated esophagus with retention of food inits dilated portion and its regurgitation at irregular intervals.
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Plummers Whalebone Staff with Ivory Tip Drilled and Thread Passing Through Same. In the majority of cases the first attack of spasm occurs suddenly whileeating. A spasmodic choking sensation is experienced at some point alongthe course of the esophagus, most often located in the region of the cardia.This sensation is rarely described as a pain and may be referred entirely tothe epigastric region or to the upper portion of the esophagus. Sometimesthe spasm is described as a delay in the passage of food, or that the foodsticks beneath the sternum. Soon it is noticed that the patient eats veryslowly and finds it difficult to swallow. It may be necessary to wash the fooddown with water. The patient may go through certain movements of the bodyand arms or take deep breaths to force the food down. In the second stage the patient has regurgitation of food which occursimmediately after swallowing. During the early portion of the history theattacks occur periodically, but with varying degrees o

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