In 19081I reported forty cases of "cardiospasm." In this series, thirty-eight patients had diffuse dilatation of the esophagus. Since that time fifty-six cases of diffuse dilatation of the esophagus without anatomic stenosis have come under my observation. The purpose of this paper is to report the result of treating these cases by dilating the cardia with a hydrostatic dilator. The following have been advanced as factors in the etiology: first, primary cardiospasm (Meltzer2and M ikulicz3); second, primary atony of the musculature of the esophagus (Rosenheim4); third, the simultaneous development of cardiospasm and paralysis of the circular musculature of the esophagus brought about by degenerative changes in the vagi (Krause5); fourth, congenital disposition (Fleiner,6Zenker7and Sievers8); fifth, primary esophagitis (Martin9); sixth, kinking at the hiatus esophagi; seventh, gross lesions of the esophagus or stomach, such as ulcer, carcinoma, etc.;