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November 1940


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Arch Surg. 1940;41(5):1043-1059. doi:10.1001/archsurg.1940.01210050003001

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The replacement of inferential diagnostic methods by objective procedures has revolutionized methods of diagnosis and treatment of disease. This is particularly true of diseases of the esophagus. Inspection of the entire length of the esophagus has conclusively demonstrated that many of the inferential diagnoses made in preesophagoscopic days were based largely on error.

To understand more fully the symptoms, diagnosis and treatment of esophageal disease it is important to recall that the esophagus is a long, redundant and movable tube contained in great part in the thoracic cavity, where it occupies whatever space may be allotted it by surrounding viscera. Its fixed points are at the hypopharynx and at the diaphragm. Its course is moderately tortuous, and its lumen presents certain anatomic constrictions, several of which are of clinical importance. The upper end of the esophagus is maintained in a state of tonic closure by the cricopharyngeus muscle, the horizontal

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