A manual of diseases of the throat and nose : including the pharynx, larynx, trachea, œsophagus, nose and naso-pharynx / by Morell Mackenzie.

  • Mackenzie, Morell, 1837-1892.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: A manual of diseases of the throat and nose : including the pharynx, larynx, trachea, œsophagus, nose and naso-pharynx / by Morell Mackenzie. Source: Wellcome Collection.

    14/610 (page 2)
    The oesophagus is often described a.s following the antero-posterior curves of the sinnal column in its descent. This is true in the cenrical region, but the backward cur\'e which is usually described as occurring in the dorsal region does not exist in the erect position of the body. In the upper part of its course the gullet is in the median line, but as it descends it cui-ves slightly to the left until it reaches the root of the neck ; at this point it inclines again towards the middle of the spinal column, which position it reaches opposite the fourth or fifth dorsal vertebra. Immediately before travei-sing the diaphragm it makes a short curve forwards and slightly to the left. Owing to the very loose attachments of the (Esophagus, the relations of the tube are apt to vary to some extent, its position being dependent on slight variations of the adjacent organs, scarcely amounting to abnormalities. The length of the (esophagus varies according to the stature of the individual, but in an adult male it generally measures from about twenty-four to twenty-six centimetres. The diameter of the tube varies at difierent levels, and, according to Sappey, it diminishes insensibly “from its upper extremity to the fourth dorsal vertebra, and increases again from that point in an almost insensible manner to its termination. It is therefore composed of two truncated cones united at the apex.’’^ Braune’s sections^ support this description in the main, but the measiu'ements of the diameter of the gullet made by Mouton* from plaster of Paris casts give quite different results :— Superior orifice of the (esophagus 14 millimetres. At 1 centimeti’e below superior orifice .... 19 s y >> .... 15 yy 4 ^ jy .... 15 yy At rather less than 7 centimetres from superior orifice 14 y y At 11 centimetres from sui)erior orifice . . . 20 14 ,, xrt ,, ,, .... 17 yy ,, ,, .... 21 yy ,,1/ ff ,, .... 20 yy y y yy yy .... 12 yy 99 ,, z.- ,, ,, .... 12 yy yy yy yy .... 12 yy yy ,, ,, .... 14 yy ■\Vith the view of determining still more accurately the calibre of the gullet in its whole extent, I jterformed some exjwriments .suggested by that of Mouton, but more elaborate and on more than one subject. The following were the methods adopted. In the first case the body was securelv fixed, with the head downwards, uixm a board placed periKuidicularly on the ground. The mouth and ]ihaiynx were then tightly stuffed with tow so as to close the upper outlet of the food-tract, the stomach laid open, a ligature ]ia.ssed loosely round the cardiac opening, and the ends held outside the wound so that they could be tightened at once when re<]uired. The nozzle of a large anatomical syringe, })revionsly charged with a mixture of jilaster and 1 “ TraiU^ d'Anatoniie Descriptive,” t. iv. i>. l.W. 3me edition, Paris. 1S79. 2 “ Atlas of Topographical Anatomy, translated by E. Bellamy. London, 1877. See plates vii. viii. ix. x. and xi. 3 “ Du Oalihre de I tEsopliagc. Paris, 1874, p. 17.