Page:Transactions of the Provincial Medical and Surgical Association, volume 4.djvu/307

the gullet occurred. This disease almost always ends fatally. From some inquiries I have made on this subject, there is reason for believing that it is of more comparative frequency in this than in the neighbouring counties." In a communication of later date, with which the same gentleman favoured me, he further observes on this complaint—"I have not observed this disease in young persons, but have seen it both in the temperate and intemperate. It has invariably ended fatally. I have examined some of the bodies after death, and found the upper part of the gullet filled, to the extent of two inches or more, with a firm semi-cartilaginous substance, with the remains of a passage not larger than a crow-quill winding in a spiral direction through it." I have not the means of verifying the exact nature of the greater number of the cases, but from what I observed myself, and from what is known of the general character of such cases, I think myself authorised to conclude, that the greater number, or sixteen cases, were examples either of chronic inflammation and thickening of the part, or of actual scirrhus. It is, indeed, so difficult, if not impossible, in many cases, to separate these two affections from each other, that it might, probably, be a preferable arrangement to comprehend them under one head, and extend the classification to the whole extent of the alimentary canal; thus including, under one head, stricture of the œsophagus and rectum, and scirrhus of the cardia and pylorus. I have, however, already noticed, under the general head of scirrhus and cancer, the affections of the cardia and pylorus of this description; it, therefore, only remains