Abstract
Bougienage of one variety or another has been practiced for more than fifty years in relieving dysphagia due to cardiospasm. A discussion of the various diagnostic terms applied to this type of pathologic condition of the esophagus such as achalasia, phrenospasm, hiatal esophagismus, megalo esophagus or idiophatic esophageal dilatation is not pertinent to this paper. The success of this form of therapy and the increasing frequency of diagnosis render our introduction of a most satisfactory combined dilator and divulsor an important item for publication. In a review of the history of dilators adequate mention must be given semistiff fiber bougies and mechanical divulsors inserted through the esophagoscope. Their use necessarily involves a semioperative procedure and they are more applicable in cases in which scarring or fibrous stricturing exists. Sippy's graduated olives, and those of others, in various sizes and shapes attached to a fiber and guided by a swallowed thread,
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