Diagnosis and Treatment of Cardiospasm

Abstract

The condition known as cardiospasm has been attributed to many causes and many names have been offered by the proponents of the various theories to take its place. But the name cardiospasm has remained the one that has been the most frequently used, partially because the various theories advanced were not altogether convincing, and partially because the names suggested were too cumbersome. The most recent term, achalasia of the cardia, sponsored by Arthur F. Hurst¹ is being used more and more in the English literature and is appearing more frequently now in America. The term is short and easily used and the theory behind it has considerable merit.

The earliest case was reported by Thomas Willis² in Pharmaceutice rationalis in 1672. He made a dilator of whalebone surmounted by a button of sponge which the patient used on himself for fifteen years. The early literature classifies these cases as Idiopathic Dilatation of the Esophagus.

An excellent and complete review of the literature has been made by Sturtevant³ and the earlier theories have been well covered by Freeman⁴ so I will make only brief reference to some of the better known theories.

Cardiospasm. This is one of the earliest theories and has been the most popular. It was sponsored by Kraus, Meltzer and Mikulicz. It would account for the obstruction to the passage of food into the stomach and for the beneficial effects of belladonna and atropine. It does not explain the marked dilation of the esophagus in the later stages. . . .