s.
2. Esophagitis, acute.
3. Esophagitis, chronic.
4. Erosion.
5. Ulceration.
6. Trauma.
7. Stricture, congenital.
8. Stricture, spasmodic, including cramp of the diaphragmatic
pinchcock.
9. Stricture, inflammatory.
10. Stricture, cicatricial.
11. Dilatation, local.
12. Dilatation, diffuse.
13. Diverticulum.
14. Compression stenosis.
15. Mediastinal tumor.
16. Mediastinal abscess.
17. Mediastinal glandular mass.
18. Aneurysm.
19. Malignant neoplasm.
20. Benign neoplasm.
21. Tuberculosis.
22. Lues.
23. Actinomycosis.
24. Varix.
25. Angioneurotic edema.
26. Hysteria.
27. Functional antiperistalsis.
28. Paralysis.
29. Foreign body in (a) pharynx, (b) larynx, (c) trachea, (d)
esophagus.

[236] _Diagnosis_.--The swallowing function can be studied only with
the fluoroscope; esophagoscopy for diagnosis, should therefore always
be preceded by a fluoroscopic study of deglutition with a barium or
other opaque mixture and examination of the thoracic organs to
eliminate external pressure on the esophagus as the cause of stenosis.
Complete physical examination and Wassermann reaction are further
routine preliminaries to any esophagoscopy. Special laboratory tests
are done as may be indicated. The physical examination is meant to
include a careful examination of the lips, tongue, palate, pharynx,
and a mirror examination of the larynx when age permits.

_Indications for Esophagoscopy in Disease_.--Any persistent abnormal
sensation or disturbance of function of the esophagus calls for
esophagoscopy. Vague stomach symptoms may prove to be esophageal in
origin, for vomiting is often a complaint when the patient really
regurgitates.

_Contraindications to Esophagoscopy_.--In the presence of aneurysm,
advanced organic disease, extensive esophageal varicosities, acute
necrotic or corrosive esophagitis, esophagoscopy should not be done
except for urgent reasons, such as the lodgment of a foreign body; and
in this case the esophagoscopy may be postponed, if necessary, unless
the patient is unable to swallow fluids. Esophagoscopy should be
deferred, in cases of acute esophagitis from swallowing of caustics,
until sloughing has ceased and healing has strengthened the weak
places. The extremes of age are not contraindications to
esophagoscopy. A number of newborn infants have been esophagoscoped by
the author; and he has removed foreign bodies from patients over