Malignant disease of the throat and nose / by David Newman.

  • Newman, David, 1853-1924.
Date:
1892
Catalogue details

Licence: Public Domain Mark

Credit: Malignant disease of the throat and nose / by David Newman. Source: Wellcome Collection.

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    cases, the most prominent symptom was difficulty or impossi- bility of swallowing food. When we study the general symptomatology of diseases of the throat, we know that many conditions may manifest them- selves by difficulty in, or even impossibility of, swallowing food. Hence various terms are employed to designate the character or degree of obstruction to the passage of food. When swallow- ing is painful, the patient is said to be suffering from odynphagia, as, for example, in inflammation of the oesophagus resulting from the action of corrosive agents. On the other hand, when the lesion is of a chronic character, such as cicatricial stricture or the pressure of tumours upon the gullet, the patient may suffer comparatively little pain, whde the obstruction to swallowing is great. To this condition the term dysphagia is applied. Again, should the obstruction be complete, as in Cases 3, 4, and 8, the patient is said to be suffering from aphagia. Besides stricture of the gullet properly so called, the lesions which give rise to oesophageal dysphagia are numerous and varied; but as most of them will require to be referred to when we come to consider the question of diagnosis, I will simply enumerate them at present. Congenital malformations and the impaction of foreign bodies in the gullet very seldom give rise to much difficulty in diagnosis, but it is otherwise in those cases of aneurism of the aorta, mediastinal tumour, enlarged lymphatic glands, exostosis or curvature of the spine, which, by causing pressure upon, or distortion of, the oesophagus, may lead to serious difficulty in swallowing. The cases of aneurism of the transverse arch of the aorta causing pressure on the gullet at the level of the bifurcation of the trachea are perhaps the most important. Using the term stricture of the oesophagus in its proper sense, it may be divided into four varieties, viz:—malignant stricture, obstruction by benign tumours, cicatricial stricture, and spasmodic stricture. We shall now consider these diseases in detail, and afterwards discuss the questions of prognosis and treatment.