|Money Powder Mix equal amounts of the following herbs together: Chamomile, marigold, hyssop, jasmine, cinnamon, cloves, ginger, nutmeg, cinquefoil. allbine all herbs with your hands empowering them with your energy and your... Read more of MONEY POWDER at White Magic.ca|| Informational|
I KNOW a woman who says that if she wants to get her ...
Use the A D current always in rheumatic affections. If there ...
The Child As An Ideal
WHILE the path of progress in the gaining of repose c...
The Fulcrum Of The Bronchoscopic Lever Is At The Upper Thoracic Aperture
Disregard of this rule will cause subglottic edema and will ...
The lunar caustic is very useful in the treatment of this pai...
Physical Signs In Esophageal Foreign Body
There are no constant physical signs associated with uncompli...
Plain Every-day Common Sense
PLAIN common sense! When we come to sift everything d...
Scarlet-fever Or Scarlatina
is an eruptive fever, produced by a peculiar contagious poiso...
Bile On The Stomach
Take half a teacupful of hot water every ten minutes for ten h...
The Dissection Of The Oblique Or External And The Direct Or Internal Inguinal Herniae
The order in which the herniary bowel takes its investments f...
Varioloids And Chicken-pocks
_Varioloids_ and _Chicken-pocks_, are treated in the same man...
Troubles Of The Nervous System
The Nervous System is not easily Damaged. The nervous system ...
It may be proper, in this place, to spend a few words upon el...
Esophageal Foreign Body
After initial choking and gagging, or without these, there m...
The Vegetable Kingdom
As to the vegetable kingdom, there is here, so far as we can ...
Tricuspid Stenosis Tricuspid Obstruction
This is rare and probably always congenital, and is supposed ...
Our Telephone Exchange And Its Cables
The Brain. We are exceedingly proud of our brain and inclined...
Bruises Case Xv
The following case was far more severe, but the mode of treat...
Bowels Glands Of
Symptoms of glandular trouble in the bowels are--weariness and...
Habit And Nervous Strain
PEOPLE form habits which cause nervous strain. When t...
Paralysis Of The Esophagus
Category: DISEASES OF THE ESOPHAGUS
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
The passage of liquids and solids through the esophagus is a purely
muscular act, controlled, after the propulsive usually voluntary start
given to the bolus by the inferior constrictor, by a reflex arc having
connection with the central nervous system through the vagus nerve.
Gravity plays little or no part in the act of deglutition, and alone
will not carry food or drink to the stomach. Paralysis of the
esophagus may be said to be motor or sensory. It is rarely if ever
unassociated with like lesions of contiguous organs.
Motor paralysis of the esophagus is first manifested by inability to
swallow. This is associated with the accumulation of secretion in the
pyriform sinuses (the author's sign of esophageal stenosis) which
overflows into the larynx and incites violent coughing. Motor
paralysis may affect the constrictors or the esophageal muscular
fibers or both.
Sensory paralysis of the esophagus by breaking the continuity of the
reflex arc, may so impair the peristaltic movements as to produce
aphagia. The same filling of the pyriform sinuses will be noted, but
as the larynx is usually anesthetic also, it may be that no cough is
produced when secretions overflow into it.
Etiology.--1. Toxic paralysis as in diphtheria.
2. Functional paralysis as in hysteria.
3. Peripheral paralysis from neuritis.
4. Central paralysis, usually of bulbar origin.
Embolism or thrombosis of the posterior cerebral artery is a
reported cause in two cases. Lues is always to be excluded as the
fundamental factor in the groups 3 and 4. Esophageal paralysis is not
uncommon in myasthenia gravis.
Esophagoscopic findings are those of absence of the normal
resistance at the cricopharyngeus, flaccidity and lack of sensation of
the esophageal walls, and perhaps adherence of particles of food to
the folds. The hiatal contraction is usually that normally
encountered, for this is accomplished by the diaphragmatic
musculature. In paralysis of sensation, the reflexes of coughing,
vomiturition and vomiting are obtunded.
Diagnosis.--Hysteria must not be decided upon as the cause of
dysphagia, until after esophagoscopy has eliminated paralysis.
Dysphagia after recent diphtheria should suggest paralysis of the
esophagus. The larynx, lips, tongue, and pharynx also, are usually
paralyzed in esophageal paralysis of bulbar origin. The absence of the
cricopharyngeal resistance to the esophagoscope passed without
anesthesia, general or local, is diagnostic.
Treatment.--The internist and neurologist should govern the basic
treatment. Nutrition can be maintained by feeding with the
stomach-tube, which meets no resistance to its passage. Should this be
contraindicated by ulceration of the esophagus, gastrostomy should be
Next: Lues Of The Esophagus
Previous: Diverticulum Of The Esophagus