CHAPTER I.. Diseases of the Mouth.

DISEASES OF THE MOUTH.

STOMATITIS.

=Definition.= By stomatitis we mean inflammation of the buccal mucous membrane. Stomatitis may be simple—i.e., due to accidental causes, to varying local forms of irritation, or to wounds; or, on the contrary, it may be specific, of infectious origin, like the stomatitis of foot-and-mouth disease, gangrenous coryza, cattle plague, etc.; or, finally, it may be of toxic origin, like the stomatitis of mercurial poisoning.

Here we shall only study the simple forms of stomatitis, the gangrenous stomatitis of calves, and mercurial stomatitis. The others will be noticed in speaking of the diseases of which they form one of the symptoms.

SIMPLE STOMATITIS.

=Causation.= Simple stomatitis of bovine animals is often due to feeding with rough forage, or forage containing prickly or spiny plants, like thistles, sea holly, eryngo, etc. Sometimes it follows prolonged irritation by rough teeth, premolars or stumps, or accompanies the shedding of the temporary molars. Ingestion of irritant plants like nettles, certain specimens of the orders Labiatæ and Umbelliferæ, leaves covered with vesicant insects, cabbage and turnip leaves infested with aphides, oil beetles, etc., or the swallowing of hot liquids, may also, though more rarely, produce it. Finally, in grave diseases of the digestive apparatus, the buccal mucous membrane may secondarily become affected.

=Symptoms.= The primary symptoms are usually represented by ptyalism and a certain difficulty in grasping food. In other cases the mucous membrane appears slightly dry for some time before salivation sets in. On introducing the fingers into the animal’s mouth some elevation of temperature may be noted, and on direct inspection the non-pigmented regions are seen to be abnormally vascular, a fact which has earned for this form of stomatitis the names of “erythematous” and “erysipelatous stomatitis.”

If the stomatitis is due to local multiple irritation, such as results from spines and prickles in the food, the abnormal vascular appearance is confined to the neighbourhood of the abrasions or punctures, and the affected regions are of very varying size. In some cases, principally as a consequence of trifling local irritation and of burns of the first and second degree, blisters of varying size may develop and break, leaving behind ulcerations, which, however, always heal rapidly. The aphthous non-contagious stomatitis mentioned by certain authors seems most probably to pertain to this class.

=Diagnosis.= The diagnosis is usually easy, and a little attention to the accompanying symptoms is sufficient to avoid confusion with the various forms of symptomatic stomatitis.

=The prognosis= is favourable.

=Treatment= is based on removal of the determining cause, if this can be recognised, withdrawal of rough forage, removal of sharp points on the teeth, extraction of stumps, etc. As a rule, recovery follows rapidly. It can be hastened by washing out the mouth directly, or by means of a syringe, with water containing honey, vinegar, decoctions of brier twigs, oak bark, barley or rice. This treatment is completed by supplying nourishing gruel and food demanding little mastication.

CATARRHAL STOMATITIS IN SHEEP.

“The more delicate buccal mucosa in these animals would render them more subject to inflammations, but this is more than counterbalanced by the mode of prehension of aliments, not by the tongue, but by the delicately-sensitive lips, and further by the daintiness and care with which these animals select their food. The =treatment= would not differ materially from that prescribed for the ox.” (Law’s “Veterinary Medicine,” Vol. II. p. 15.)

NECROSING STOMATITIS IN CALVES.

=Definition.= This name is applied to a special stomatitis, which in very young animals produces superficial necrosis of more or less extensive areas of the buccal mucous membrane, and sometimes of subjacent parts.

The disease, although somewhat rare in France, has been mentioned by Lafosse and well studied by Damman and Lenglen.

=Causation.= Its cause is still imperfectly understood. Some regard it as a consequence of insufficient nourishment, of disturbance resulting from dentition, of general exhaustion, and of bad hygienic conditions. These explanations are scarcely sufficient, however, and at the present time there is a tendency to regard it as a complication of primary grave, debilitating diseases, like the diarrhœa of calves, omphalitis, omphalo-phlebitis, etc. Moussu has never seen it apart from omphalitis, and he considers the lesions due to the action of the bacillus of necrosis. Infection occurs through the umbilicus becoming soiled by contact with the litter.

The early symptoms consist in loss of appetite, congestion of the mucous membranes, and salivation. Early examination of the buccal cavity reveals the presence everywhere, except on the palate, of whitish-grey or yellowish patches, whose aspect is markedly in contrast with that of neighbouring parts. These are fragments of the mucous membrane undergoing necrosis. They are numerous, are surrounded by a narrow inflamed zone, and may be from ½ inch to 1 inch in diameter.

Necrosis advances rapidly, and extends throughout the thickness of the mucous membrane; the slough soon becomes delimited and separates. The odour of the mouth is then absolutely fœtid, and the saliva appears streaked with pus and blood.

The ulcerations exhibit a livid base, and show no tendency to heal. Necrosis extends in depth, and affects the muscles, tendons, and even the periosteum and the bones. The teeth are frequently loosened.

Grave complications, such as pharyngitis, broncho-pneumonia, infectious enteritis, and septicæmia soon appear, and the animals are carried off by septic infection and intoxication in a few days—at the longest in a week.

=Diagnosis.= The diagnosis is only difficult at first; and, at a later stage, the only mistake possible is that of confounding the condition with a very grave attack of aphthous stomatitis. Local sanitary conditions are sufficient to secure the avoidance of this error.

=Prognosis.= The prognosis is extremely grave; the disease usually results in death; recovery is exceptional. Very luckily the disease seems to become rare in direct proportion as the hygienic conditions of cattle breeding and keeping are improved.

=Treatment.= Curative treatment always appears to be ineffectual when a grave primary disease has already enfeebled the animal before necrosing stomatitis appears. In those cases where the stomatitis constitutes the primary condition, attempts should be made as far as possible to cleanse the wounds. The buccal cavity should be thoroughly washed out, and the wounds then cauterised with solution of carbolic acid of 6 per cent. strength, nitric acid of 10 per cent. strength, hydrochloric acid of 7 to 8 per cent. strength, or chromic acid of 20 per cent. strength.

This local cauterisation is performed with a tampon of cotton wool fixed to a handle; for necessarily it is impossible to apply any dressing whatever of a permanent nature. The cauterisations may be repeated twice a day. The stump of the umbilical cord should never be forgotten, for it sometimes contains a mass of necrotic tissue the size of a man’s thumb. It should be thoroughly cleansed and the wound plugged with a mixture of iodoform and boric acid.

This treatment will not avail unless the functions are stimulated by rich food that can be easily masticated and digested, and by giving milk of good quality, or boiled milk, eggs, meat-powder, cooked beans, etc. Aromatic infusions and hay tea containing coffee and small quantities of alcohol or tincture of quinine are also of service.

MYCOTIC STOMATITIS IN CALVES.

Thrush. Muguet.

“This is a form of stomatitis manifested by a raised white patch on the mucous membrane and determined by the presence of the Oidium albicans (Saccharomyces albicans), a cryptogam discovered by Berg in 1842 in thrush in children. It is closely allied to the mucor, and attacks only the young and feeble. The white crust consists of epithelial cells intermingled with an abundance of the white mycelium and oval spores of the fungus. Andry in his artificial cultures found that it was pearly white when grown on gelatine, dirty white on potato, and snow white on carrot.”

=Symptoms.= “Buccal mucosa, red, congested and tender, shows here and there white curdy looking elevations, or red erosions caused by the detachment of such masses. These bear a strong resemblance to the crusts seen on this mucosa in rinderpest, but are easily distinguished by the absence of the attendant fever, and by the discovery, under the microscope, of the specific microphyte. The eruption may extend to the pharynx and œsophagus and interfere fatally with deglutition, but usually it merely renders sucking painful and is not serious.”

=Treatment.= Cleanse and disinfect the sheds, “and invigorate the young animals by sunshine, free air and exercise. Locally ... borax, which arrests the growth of the parasite, whether in artificial cultures or in the mouth. The powder may be rubbed into the sores, or it may be mixed with ... molasses and used as an electuary. As substitutes boric acid, salol, thymol, potash chlorate, or Condy’s fluid may be used.” (Law’s “Veterinary Medicine,” Vol. II. p. 36.)

ULCERATIVE STOMATITIS IN SHEEP.

The name of ulcerative stomatitis of sheep has been given to a disease which is characterised by the appearance of a pultaceous deposit on the surface of the buccal mucous membrane and later by the development of ulcerations and of vegetative growths.

=Causation.= The cause is imperfectly understood. In certain years the disease appears to attack lambs at the time of weaning, but it may also affect flocks of animals as old as fifteen or eighteen months, two years, or even more. It is contagious, and may extend to one-half or two-thirds of the entire number in the flock. Full-grown and old animals appear to be immune.

It was formerly thought, à priori, and in consequence of the character of the buccal deposit, that the disease was identical with thrush, and that the lesions were produced by Oidium albicans. Neumann in 1885 declared, however, that he could not find the fungus in question in scrapings from the mucous membrane.

Moussu had similar negative results in the experiments he made during 1894, when he examined both young and old animals belonging to flocks in the departments of Berry and of La Brie.

In addition it has been suggested that the disease affects badly cared-for and badly fed lambs, and subjects suffering from “watery cachexia.” This seems correct in many cases, and Moussu has seen ulcerative stomatitis decimate flocks which had previously been attacked with intestinal helminthiasis and verminous broncho-pneumonia; but, on the other hand, in the environs of Melun he saw it in animals which had previously been quite free of disease and were kept under perfect hygienic conditions.

The conditions in which animals are reared, the use of common drinking ponds, and the method of supplying flocks with food, are the chief causes of the distribution of the disease.

=Symptoms.= The symptoms consist in loss of appetite, or rather in difficulty in grasping and masticating food, wasting, a certain degree of dulness, and salivation. Somewhat later one often sees appear on the free margin of the upper and lower lips an eruption of small vesico-pustules, which quickly become covered with yellowish-brown crusts and bleed on the slightest touch. The lips swell, become sensitive and painful, so that examination of the cavity of the mouth should be made with care. The mucous membrane is then seen to present a very varying number of greyish-white or greyish-brown points, each of which is due to the destruction of the epithelium and to the production of a pultaceous deposit, which can very readily be removed, leaving uncovered superficial ulcerations, which bleed if very lightly touched. These ulcerations are of irregular shape, and are distributed most freely over the gums, the internal surface of the lips and cheeks. The palate and tongue are only invaded in the last stages. Still later one notes, instead of these ulcerations and as a consequence of abnormalities in the process of repair, reddish-violet turgid vegetations varying in size from that of a millet seed to that of a pepper-corn or even of a small mulberry.

The total duration of the disease varies with its degree of intensity. In favourable cases it may not exceed eight to ten days; in grave cases it continues for fifteen to twenty days. Recovery is usual when the subjects are vigorous and well-nourished lambs, or well-kept sheep, previously free of disease. On the other hand, Moussu has noted a mortality of 15 to 20 per cent. in thin animals of bad bodily condition and already depressed by verminous broncho-pneumonia and intestinal helminthiasis. When the attack is about to prove fatal, complications such as gastro-enteritis, resulting from septic infection or intoxication, and accompanied by fœtid diarrhœa, often make their appearance.

=Diagnosis.= The diagnosis presents no difficulty, the characteristics of this stomatitis being entirely different from those of the aphthous form. The claws are never affected, and there is no lameness.

=Prognosis.= In this connection the practitioner will do wisely to avoid committing himself, and to closely study the conditions under which the disease has developed. In all cases the appearance of fœtid diarrhœa must be regarded as of very unfavourable augury.

=Treatment.= The first precaution to take consists in separating all the healthy animals in the flock, and placing them in a non-contaminated spot.

The diseased are then treated one by one; each day the buccal cavity is washed out with boiled water or with a solution of borax or boric acid. After each washing the ulcerations should be touched with tincture of iodine or with some other rather active antiseptic solution. Finally it might be useful, and would be of value, to add to the gruel or water a small quantity of common salt and of salicylate of soda at the rate of 15 grains to the pint.

GENERAL CATARRHAL STOMATITIS IN SWINE.

=Causes.= “Swine suffer from simple stomatitis when exposed to thermal, mechanical, or chemical irritants. Such irritants comprise food that is too hot, or is hard and fibrous, or which contains spikes and awns, capable of entering and irritating gland ducts or sores, or food which is fermented or putrid, food or medicine of an irritant character. The habit of catching and holding swine with a running noose over the upper jaw, and the forcing of the jaws apart with a piece of wood in search of the Cysticercus cellulosa are further causes. In several specific infectious diseases inflammation of the mucous membrane, with eruption or erosion, is not uncommon. This aphthous fever is marked by vesicular eruption, muguet by epithelial proliferation and desquamation, hog cholera and swine plague by circumscribed spots of necrosis and erosion. Patches of false membrane are not unknown, and local anthrax, tubercle, and actinomycosis are to be met with. Inflammation may start from decaying teeth.”

“=Symptoms= resemble those in other animals, refusal of food, or a disposition to eat sparingly, to select soft or liquid aliments, to swallow hard materials half chewed, or to drop them, to champ the jaws, and to seek cold water. Accumulation of froth around the lips is often seen, and the mouth is red, angry, dry, and hot, and exhales a bad odour.”

“=Treatment= does not differ materially from that adopted in other animals: Cooling, astringent, antiseptic lotions, honey and vinegar, and in case of spongy or eroded mucosa, tincture of myrrh daily or oftener. Soft feeding, gruels, pulped roots, ... and clean water should be constantly within reach. In case of ... indigestion a laxative, followed by vegetable tonics, will be in order.” (Law’s “Veterinary Medicine,” Vol. II. p. 17.)

ULCERATIVE STOMATITIS IN SWINE.

“This is the scorbutus of Friedberger and Fröhner, the glossanthrax of Benion.”

=Causes.= “It has been attributed to insufficient or irritant food, to damp, close pens, and to chronic debilitating diseases, and all these act as predisposing causes. In gastritis and in infectious fevers like hog cholera, swine plague, and rouget (hog erysipelas) the spots of congestion and petechiæ on the buccal mucous membrane may become the starting points for ulcerative inflammations. These conditions appear, however, to be supplemented by infection from bacteria present in the mouth or introduced in food and water, and, as in the case of other domestic animals, the most successful treatment partakes largely of disinfectant applications.”

=Symptoms.= “Loss of appetite, grinding of the teeth, champing of the jaws, the formation of froth round the lips, fœtor of the breath, redness of the gums and tongue, and the formation of vesicles, or white patches, which fall off, leaving red, angry sores. These may extend, forming deep unhealthy ulcers, with increasing salivation and fœtor. As the disease advances the initial dulness and prostration become more profound, and debility and emaciation advance rapidly. Unless there is early improvement an infective pharyngitis or enteritis sets in, manifestly determined by the swallowing of virulent matters from the mouth, and swelling, redness, and tenderness of the throat, or colics and offensive black diarrhœa, hasten a fatal issue. Rachitis may be a prominent complication, as it seems in some instances to be a predisposing cause.”

=Treatment.= “Isolate the healthy from the diseased, and apply disinfection to all exposed articles and places. Employ local antiseptics as in other animals. Sulphuric or hydrochloric acids, in fifty times their volume of water, or tincture of iron, chlorate of potash, or chloride of ammonia, or borax have been used successfully. Bitters and aromatics have also been strongly recommended.” (Law’s “Veterinary Medicine,” Vol. II. p. 29.)

MERCURIAL STOMATITIS.

This form of stomatitis possesses certain distinguishing characters, and develops after severe or trifling mercurial poisoning.

=Causation.= Sheep sometimes suffer from mercurial poisoning as a result of the use of baths containing corrosive sublimate or mercurial ointment for acariasis or other cutaneous parasitism. Animals of the bovine species seem predisposed to the disease as a consequence of their special sensitiveness to the action of mercury, which is not shared by other species.

Mercurial poisoning may occur accidentally, but is usually the result of some attempt at treatment. Any preparation containing mercury or mercurial salts may produce it. In domesticated animals it most frequently results from the action of the ordinary mercurial blister or mercurial ointment of the pharmacopœia, or again of calomel. Sometimes it follows the use of mercurial salts in uterine douches, or in lotions used to wash out large abscess cavities or wounds.

The application of blisters or of anti-parasitic dressings, or infriction with grey ointment over extensive surfaces, favours this intoxication. It may result from direct local intra-cutaneous absorption, from vapour given off by mercurial applications obtaining entrance into the body through the broncho-pulmonary and digestive tracts, from vapour given off by metallic mercury (as in ships’ holds), or from ingestion of mercurial compounds licked off the skin, as certainly occurs. Hitherto in all discussions, even the most recent, on the mechanism of poisoning, partisans of different views do not appear to have given sufficient attention to these now clearly proved facts. The conclusion to be drawn is that in animals of the bovine species mercurial preparations ought to be used with caution, and that even under such conditions stomatitis may appear. Finally, it should be remembered that all lesions of the kidney indicated by albuminuria and other signs, and all lesions of the liver, favour poisoning by checking or preventing the elimination of mercury by the kidney, or by interfering with its transformation in the hepatic cells.

=Nature.= Regarding the essential nature of stomatitis, it would appear (according to the work carried out in 1890 by Gallipe on mercurial stomatitis in man), that we should regard it as a septic stomatitis, and not as a primary toxic stomatitis. The mercury absorbed by the body not only produces salivation, but a very important change in the chemical composition of the saliva. The vitality and toxicity of the saprophytic microbes normally present in the buccal cavity appear greatly to increase, and although only the most trifling erosions may exist in the mucous membrane, true intra-mucous inoculation takes place, and forms the point of origin for septic stomatitis.

It has been found that it is not even necessary to have lesions in the buccal mucous membrane; in fact, this is the weak point in the theory emitted. Nor is a modification in the chemical composition of the saliva sufficient; for when a mixture of iodine and the iodides, for example, is being given, the saliva is chemically modified, and yet stomatitis, properly so-called, does not occur.

What seems most probable is that mercurial stomatitis is a toxi-infectious stomatitis, in the development of which mercury acts primarily by its toxic effect on the salivary glands, whose secretion it modifies, and on the buccal epithelium, the renewal of which it checks. Infection of the mucous membrane is thereby favoured, even in the absence of any previous lesion, and stomatitis develops.

=Symptoms.= The symptoms consist in abundant salivation with discharge from the mouth, suggesting the existence of foot-and-mouth disease. In grave cases the saliva appears streaked with blood, even from the beginning. The buccal cavity exhales an intense fœtid odour which, during the following days, becomes more marked; the mucous membrane is pale in colour, and coated with a greyish exudate. The mouth is hot and sensitive, the gums are swollen, reddish-violet in colour, and painful. Alveolar periostitis soon sets in, the teeth become loose, and mastication is rendered impossible, especially as the inflammation causes the tongue to swell and lose its mobility. These symptoms are unaccompanied by fever.

In the last stage ulcerations and local necroses appear on the gums, on the inner surface of the lips and cheeks, and around the commissures of the lips. The patients are almost unable to feed, rapidly lose flesh, become anæmic, and die from septic infection. The temperature is often below normal.

A toxi-infectious gastro-enteritis, with fœtid, blood-stained diarrhœa, is grafted on the primary stomatitis. Complications in connection with the respiratory, circulatory, and urinary apparatus appear, and the patients die in a condition of absolute exhaustion.

Naturally this termination is not inevitable; trifling cases of poisoning, and even grave forms, when properly treated, may, and should, recover.

=Diagnosis.= The diagnosis is mainly based on the history, except in cases of accidental and unsuspected poisoning.

=Prognosis.= The prognosis is grave, for even when the disease does not prove fatal the animals remain anæmic and exhausted for long periods.

=Treatment= should principally be directed towards combatting the local complications. When poisoning is due to external applications of mercury or its salts the skin should be washed with soap and water, and afterwards dressed with a soluble sulphide, which renders the mercury insoluble. The mouth should frequently be rinsed with boiled water, with decoctions of barley or marsh-mallow, with a 30 per cent. solution of boric acid or alum, or with a 1 to 2 per cent. solution of salicylic acid.

Fully grown cattle receive daily doses of 1¼ to 2 drams of chlorate of potash internally. This drug appears to owe its favourable action to the fact that it is partly eliminated by the salivary glands. Lastly, with the idea (which may, perhaps, be illusory) of minimising and checking the bad effects of the mercury introduced into the body, certain practitioners have recommended the administration of eggs, flowers of sulphur (2½ to 5 drams), sulphate of iron (1¼ to 2½ drams), and of iodide of potassium (1¼ to 2½ drams), drugs which are alleged to form insoluble compounds with mercury.

GLOSSITIS.

The term “glossitis” is applied to all inflammations of the tongue, whether superficial or deep seated. These inflammations may result from trifling causes, in which case they are termed “simple, acute, or chronic glossites”; or, on the other hand, from well-recognised causes, like tuberculosis or actinomycosis, in which case they receive the name of “specific glossites.” Here only ordinary glossites are investigated, the others being more particularly described in chapters specially reserved for the description of the primary diseases of which these form symptoms.

SUPERFICIAL GLOSSITIS.

This condition is characterised by lesions in the mucous membrane or in the immediately subjacent tissues, deeper seated structures not being involved.

The causes are similar to those of simple stomatitis, and as in animals of the bovine species the tongue is the principal and almost the only organ of prehension, it is particularly exposed to the chance of injury.

As mechanical injury done by rough fodder first makes its effects felt on the tongue, superficial glossitis is often due to the action of sharp or prickly plants like furze, wrestharrow, thistles, sea holly, etc. The glumes, awns, and spikelets on certain plants play a similar part.

Caustic medicinal draughts, hot drinks, and sharp points on the molar teeth may also produce the disease without the rest of the buccal mucous membrane being involved.

=Symptoms.= These are extremely simple. There is, first of all, some difficulty in grasping the food and some diminution of appetite, which, however, is more apparent than real, the digestive organs acting well. The second symptom consists in moderate salivation without special characters.

The local symptoms alone are characteristic. The mucous membrane covering the tongue appears red, swollen, locally inflamed, and painful. The inflamed areas are usually located on the free part near the frænum or opposite the molar teeth.

Thorns, foreign bodies, awns or spikelets of rough grasses can often be seen implanted in the tongue, and if the disease has existed for a short time, little ulcerations may not improbably be discovered.

=Diagnosis.= The characteristics of this superficial glossitis are sufficiently marked to allow of easy diagnosis, and to prevent it being confused with the lesions of actinomycosis or tuberculosis or with the extensive desquamation which accompanies foot-and-mouth disease.

=Prognosis.= The prognosis is never grave. Recovery occurs in six to eight days, provided the primary cause be removed.

=Treatment= consists in avoiding the use of rough food, in removing foreign bodies implanted in the mucous membrane or in rasping rough and irregular teeth. For the rest, as in stomatitis, mere attention to cleanliness suffices. The mouth is washed out with boiled water, boric acid solution, mixtures of vinegar and water, or with water containing a small percentage of alcohol.

ACUTE DEEP-SEATED GLOSSITIS.

This disease has also been termed parenchymatous and interstitial glossitis, because all the deep-seated tissues, including the muscles and connective tissue layers are involved in the inflammation.

=Causes.= The disease may be due to a neglected attack of superficial glossitis, to some grave microbic infection, or to excoriation and ulceration of the mucous membrane. Very often it is of traumatic origin, and is due to violent traction on the tongue by herdsmen or others when administering draughts of their own composition. This traction causes rupture of the muscle and slight interstitial hæmorrhage.

=The symptoms= develop somewhat rapidly. Whilst at first the animal shows difficulty in grasping food, it is soon totally incapable of doing so. The tongue loses its mobility, is no longer protruded from the mouth, and swallowing becomes so painful that salivation sets in. On direct examination the tongue is found swollen, thickened, immobile, painful, and occupying the whole of the oral cavity, sometimes projecting beyond the region of the incisors, and preventing the mouth being closed. Inflammation may become so intense that the point of the tongue hangs out of the mouth. It becomes blackish, bleeding, swollen, and excoriated by contact with foreign bodies or simply with the row of incisor teeth. The saliva becomes fœtid, blood-stained and purulent, and contains large quantities of broken down epithelial cells. It is not uncommon to note more or less extensive necrosis.

=Diagnosis.= The diagnosis of this form of glossitis presents no difficulty, for if under certain conditions it may resemble, for example, the glossitis of actinomycosis, it differs essentially from that disease by its rapidity of development, by its complications, and also by the absence of the specific ray fungus.

=Prognosis.= The prognosis is grave, not only on account of the possible complications, but also because the animals are unable to feed and therefore lose flesh with very great rapidity.

=Treatment.= The first steps in treatment are in the nature of local disinfection, in order to prevent general infection. The mouth therefore should be washed out five or six times per day with boiled water, followed by antiseptic injections until improvement commences. Solutions of boric acid or borax (3 per cent.), chlorate of potassium (2 to 3 per cent.), or salicylic acid (3 to 4 per cent.), are useful, but the free employment of 1, 2, or 3 per cent. solutions of chloral is even preferable.

With the idea of protecting the organ from external injury, Lafosse formerly suggested the use of a suspensory bandage for the tongue, fixed to the base of the horns by small bandages. Guittard recommends scarification of the free part, and the application of a support perforated at the bottom to allow the blood, saliva, pus, etc., to escape. In spite of careful attention the disease may last from two to three weeks.

CHRONIC GLOSSITIS.

This form of disease has also been termed “sclerosing glossitis” and “non-actinomycotic wooden tongue,” because it is anatomically characterised by induration of the tissues, and because apparently it resembles true “wooden tongue,” with which it was confused until within the last few years. Imminger in 1888 and Pflug in 1891 described two forms. The first, termed “superficial sclerosing glossitis,” is said to be the more frequent, and most commonly affects young animals suffering from irregularities in dentition. It seems due to a superficial acute glossitis assuming a chronic form. The submucous connective tissue in time undergoes hyperplastic changes, so that the tongue at first becomes swollen and afterwards absolutely rigid. One never finds ulcerations or actinomyces.

=Diagnosis.= A close examination will always enable the case to be diagnosed at the first visit, or under any circumstances after a short time.

=The prognosis= is very grave, because the animal has the greatest difficulty in grasping and masticating food, or may even be unable to do so. Patients lose flesh very rapidly, and end by dying of hunger.

=Treatment= is of little service. The administration of iodine, the only drug which appears indicated, has proved of very questionable value. Economically, it is better to slaughter the animal.

* * * * *

The second variety is rare, and has been termed “deep-seated sclerosing glossitis.” It is simply a chronic form of ordinary deep-seated glossitis. The layers of connective tissue separating the muscles are represented by very hard, inelastic vertical partitions. As a consequence, the whole tongue becomes indurated and more or less completely immobile. In this condition, again, there is neither ulceration nor actinomyces.

=Diagnosis.= The diagnosis necessitates a careful examination. In the living animal it is very difficult to establish a distinction between this and the preceding form, though after death the task becomes much easier.

=The prognosis= is grave, complete restoration of the parts being impossible.

=The treatment= differs in no respect from that given in the preceding instance. It is of little value.

* * * * *

Imminger and Pflug have also described a deep-seated nodular sclerosing glossitis, characterised anatomically by the existence in the depth of the tongue of fibrous nodules, varying in size between a small nut and a fowl’s egg. The tongue is only slightly increased in size.

This disease may perhaps be due to actinomycosis.