HIATUS M_DIT "Why not dilate strictures ? " you ask. "The operation is safe in competent hands; the immediate results are gratifying ; the risks of alternative operations are considerable; and histological preparations have shown that, even in patients who have had a long clinical history of dysphagia, muscle may predominate over scar in the 'tumour.' Moreover, many patients have been jockeyed along from year to year by repeated endoscopies."The case against dilatation is this. Immediate relief of dysphagia is no crit-erion of cure. By stretching a stricture of this sort nature's barrier against reflux is broken down, and the inexorable complications of oesophagitis are rekindled to flame again. With each exacerbation the scar, that remains for ever, penetrates the muscle of the gullet more deeply and rises upwards in the mediastinum. The end is worse than the beginning. (1953). Thorax, 8, 38. Barrett, N. R. (1950). Brit. J. Surg., 38, 175.- (1954). Ibid., 42, 231. -(1956