May result from inflammation, or from the contraction of its walls after the healing of an ulcer. It may also be produced by aneurism, or by an abscess forming at one side. It usually develops gradually, the patient finding difficulty in swallowing steadily increasing until, at last, he cannot even swallow liquids. The obstacle always seems to the patient to be just beneath the upper part of the sternum, although its real position may be opposite the lower end or some intermediate part. When the obstruction becomes complete, several mouthfuls will often be retained, but only to be thrown up again. In most cases the patient gradually starves to death. The rational treatment is mechanical dilatation by probes, first smaller, and then larger, as the dilation increases. Some cases will not yield, and in these the result is, of course, starvation. It seems to us, however, that even complete closure of the oesophagus need not be the cause of death, at least not for a long time, since it is now so well known that the patient can be nourished not only for weeks but for months, and perhaps years, by the use of nutritive enemata, or injections into the bowels of properly prepared food.