IN THE year 1674, Willis10 encountered a patient with nonorganic obstruction of the lower esophagus and fashioned for his use a whalebone rod capped with a pad of sponge. With this crude instrument the patient successfully forced food into his stomach for a 15-year period. Although the condition was not called such, this report probably represents the first recorded case of cardiospasm. Mikulicz19 in 1882 discredited the then-existing terminology "primary esophageal dilatation" and postulated that the syndrome was due to functional cardiospasm. This concept remained unchallenged until Hertz11 in 1914 introduced the term achalasia, which was suggested to him by Sir Cooper Perry. This term was based on the belief that the region of the cardioesophageal junction failed to receive a relaxing neurogenic stimulus. During the years 192626 and 1927,27 initial pathologic observations involving a deficiency and degeneration of Auerbach's plexus appeared in the literature.