_Scleroma of the trachea_ is characterized by infiltration of the tracheal mucosa, which greatly narrows the lumen. The infiltration may be limited in area and produce a single stricture, or it may involve the entire trachea and even close a bronchial orifice. Drying and crusting of secretions renders the stenosis still more distressing. This disease is but rarely encountered in America but is not infrequent in some parts of Europe. Treatment consists in the prevention of crusts and their removal. Limited stenotic areas may yield to bronchoscopic bouginage. Urgent dyspnea calls for tracheotomy. Radium and roentgenray therapy have been advised, and cure has been reported by intravenous salvarsan treatment (see article by S. Shelton Watkins, on Scleroma in Surg. Gynecol. and Obst., July, 1921, p. 47). _Atrophic tracheitis_, with symptoms quite similar to atrophic rhinitis is a not unusual accompaniment of the nasal condition. It may also exist without nasal involvement. On tracheoscopy the mucosa is thinned, pale and dry, and is covered with patches of thick mucilaginous secretion and crusts. Decomposition of secretion produces tracheal "ozena," while the accumulated crusts give rise to the sensation of a foreign body and may seriously interfere with respiration, making bronchoscopic removal imperative. The associated development of tracheal nodular enchondromata has been described. The internal administration of iodine and the intratracheal injection of bland oily solutions of menthol, guaiacol, or gomenol are helpful. [235] CHAPTER XXX--DISEASES OF THE ESOPHAGUS The more frequent causes of the one common symptom of esophageal disease, dysphagia, are included in the list given below. To avoid elaboration and to obtain maximum usefulness as a reminder, overlapping has not been eliminated. 1. Anomalies. 2. Esophagitis, acute. 3. Esophagitis, chronic. 4. Erosion. 5. Ulceration. 6. Trauma. 7. Stricture, congenital. 8. Stricture, spasmodic, including cramp of the diaphragmatic pinchcock. 9. Stricture, inflammatory. 10. Stricture, cicatricial. 11. Dilatation, local. 12. Dilatation, diffuse. 13. Diverticulum. 14. Compression stenosis. 15. Mediastinal tumor. 16. Mediastinal abscess. 17. Mediastinal glandular mass. 18. Aneurysm. 19. Malignant neoplasm. 20. Benign neoplasm. 21. Tuberculosis. 22. Lues. 23. Actinomycosis. 24. Varix. 25. Angioneurotic edema. 26. Hysteria. 27. Functional antiperistalsis. 28. Paralysis. 29. Foreign body in (a) pharynx, (b) larynx, (c) trachea, (d) esophagus.