Part 8

Treatment. By way of prevention, the avoidance of injuries by yokes, forks, pokes, and goads is important. Also the disinfection of the mouth by a liberal supply of pure water and even by antiseptic washes:—borax, boric acid, creolin, tannin, chlorate of potash. Also by the removal of foreign bodies or calculi from the canal.

When the inflammation has set in, a saline laxative is often of value. Wash the mouth with a solution of vinegar and salt, or other antiseptic, repeating this at least after every meal. The swollen, painful gland may be covered with a damp compress or anointed with vaseline to which may be added a little creolin, naphthol, carbolic acid or salicylic acid, together with lead acetate and belladonna or other anodyne. The diet must be soft, cool mashes, sliced or pulped roots or any bland agent that will demand little or no mastication. Cool, fresh water should be allowed ad libitum. When the laxative has set, it may be followed by cooling diuretics such as nitrate or acetate of potash.

If suppuration occurs it should be opened as soon as the pus can be definitely recognized, and the cavity treated antiseptically to prevent further local or general infection by the microbes. In deep abscess there is a certain danger of wounding blood vessels and salivary ducts, but this can be to a certain extent obviated by making an incision through the skin only and then boring the way into the abscess with a grooved director or the points of closed scissors. When the cavity is penetrated the pus will ooze out through the groove or between the scissor blades. When the pus has been evacuated the cavity should be washed out two or three times a day with mercuric chloride solution (1 : 1000), or permanganate of potash solution (1 : 100).

When the gland becomes indurated and indolent seeming to merge into the chronic form it may be stimulated to a healthier action by a cantharides blister, or it may be subjected to daily massage, or to a daily current of electricity for ten or fifteen minutes. If the inflammation is slight or unrecognizable, the surface of the gland may be daily painted with tincture of iodine, and iodide of potassium maybe given internally, in daily doses of ½ to 1 drachm.

Gangrene, the result of septic microbes, a weak system or too severe treatment, may be met by astringent and antiseptic agents locally, and by tonics, stimulants and a generous diet internally.

In =cattle= the disease usually responds readily to local antiseptics, and stimulating germicidal embrocations. Camphorated spirit, alone or combined with tincture of iodine; cantharides ointment with carbolic acid; and camphor and phenol may be cited as examples.

SUB MAXILLARY ADENITIS. MAXILLITIS.

Mostly in solipeds and unilateral. Causes; traumatic; calculus; infections; ablation of papillæ. Symptoms; tardy mastication; salivation; buccal heat and fœtor; submaxillary swelling and tenderness; morsels retained under tongue; papilla and duct swollen, tender and firm; abscess. Treatment; remove causes; dislodge foreign bodies; antiseptic lotions and packing.

This is rarely seen in other animals than solipeds, is mostly unilateral, and due to the introduction of microbes along with vegetable spikes (barley awns, brome, wheat or oat spikes or glumes) or other foreign bodies. It may also be caused by calculi obstructing the duct. The orifice of each duct, to one side of the frænum lingui, is imperfectly closed by a triangular valvular projection, which in some countries is erroneously cut off as a diseased product (barbs), thus opening the way for the introduction of foreign objects. The microbes are usually pus germs and tend to abscess of the gland. As in the case of the Stenonian duct the presence of these germs tends to the precipitation of the salivary salts and the formation of calculi.

Symptoms. The animal may seem hungry, but masticates tardily and imperfectly, and may even drop morsels partly chewed. He prefers ground feed to whole, and soft mashes to ground feed, while hay and other fibrous aliments may be altogether rejected. Salivation may be excessive, the secretion drivelling from the lips, the mouth may feel hot and the submaxillary salivary gland swollen and tender. This may be detected in the intermaxillary space, but is especially noticeable along the lower and lateral aspect of the tongue. If the mouth is opened and the tongue drawn to one side a mass of food may be found to one side of the frænum lingui, and beneath this the projecting, red inflamed papilla which covers the Whartonian orifice. Extending backward from this the duct is felt as a thickened cord, and when this is compressed a purulent liquid flows from the orifice. The mouth becomes offensively fœtid.

The tendency is to suppuration, and if this is determined in the Whartonian duct only, by the presence of foreign bodies, calculi, or microbes it may recover in connection with an abundant muco purulent discharge and a free secretion of saliva. If it occurs in the gland tissue itself by reason of the penetration of the microbes into the follicles, the tendency is to circumscribed abscess, which may point and burst by the side of the root of the tongue, or externally in the intermaxillary space. In the first case the tongue is displaced upward and to the other side of the mouth by the hard, firm swelling, which is felt on one side beneath the back part of that organ, and later there is the wound, the profuse muco purulent discharge, and intense fœtor. If on the other hand the abscess forms nearer the skin, there is the firm, painful intermaxillary swelling, which finally points and bursts discharging pus of a septic odor. It may be mixed with the foreign bodies that have penetrated through the canal, with morsels of necrosed gland tissue and with blood.

Treatment. The first consideration is to extract any foreign bodies which have lodged in the duct causing irritation and infection. The finger passed along the line of the swollen duct may detect the seat of such foreign body by the extra swelling, and may extract it by manipulation from behind forward. This may sometimes be assisted by the introduction of a grooved director as far as the foreign body, or even by a catheter which can be made to distend the canal in front of the object and open the way for its easier passage. In case of failure and in all cases of the introduction of small bodies like vegetable awns or spikes pilocarpin may be given to cause an excessive secretion and thus as it were purge the canal of its offensive contents. Incision of the canal over the foreign body is the dernier resort.

This accomplished, the injection of antiseptic solutions (permanganate of potash, boric acid), and the liberal use of pure water and detergent lotions in the mouth (vinegar, borax, carbolic acid or salicylic acid in solution) will go far to establish a cure. In case of an abscess bursting internally the antiseptic solutions should be injected into its cavity. When the abscess bursts externally this is doubly demanded, as the introduction of aerial germs tends to produce very unhealthy action. The cavity may be stuffed with carbolized, or iodoform, or acetanilid cotton, or with boric or salicylic acid.

SURGICAL LESIONS OF THE SALIVARY GLANDS.

Among these may be named calculi of the Stenonian and Whartonian ducts, ranula, stenosis and fistulæ of these ducts, tumors, special infections like actinomycosis.

TONSILITIS IN PIGS, AND OTHER ANIMALS.

Causes; debilitating, climatic, microbian. Symptoms; fever, dullness; lies under litter; ears and tail droop; watery eyes; anorexia; vomiting; pharyngeal swelling; buccal redness and fœtor; tonsils swollen with pus or caseous mass in follicles; cough dry and hard, later loose. Abscess. Calculus. Course. Treatment; antiseptic electuaries; embrocations; laxatives; diuretics; tonics.

This is seen in both the acute and chronic form. In the former it has the general causes and symptoms of pharyngitis. There is more or less fever, dullness, a disposition to lie with head extended and buried in the litter, ears drooping, eyes watering and red, carelessness of food, deglutition painful, and liable to be followed by vomiting. The mouth is red and hot, the breath fœtid and the tonsils swollen, and their alveoli filled with muco purulent matter or at times with a fœtid cheese-like product. The cough is at first dry and hard and later loose and gurgling.

In the chronic form there is general swelling of the tonsils with the overdistension of the follicles by the above mentioned whitish putty-like masses, which are often even calcareous. These are due to the proliferation of microbes which find in these alveoli a most favorable field for their propagation. A similar condition is found in the carnivora and to a less extent in the horse, in keeping with the restricted development of the amygdalæ in these animals. It may be attended by ulceration, or in rare cases by the formation of veritable calculi in the follicles of the tonsils.

The gravity of the disease is largely determined by the nature of the infecting microbe and the debility and susceptibility of the animal attacked. The affection usually ends in recovery, but may go on to grave local ulceration, and general infection.

Treatment consists largely in astringent and antiseptic applications to the buccal mucous membrane. In the acute forms frequent smearing of the mouth with electuaries of honey or molasses and borax, boric acid, salammoniac, chlorate or permanganate of potash, and the application of stimulating embrocations to the skin around the throat. In other cases solutions of tincture of chloride of iron, or of tincture of iodine can be used with profit. The iron can be swallowed with advantage, but it is objectionable to pour liquid rapidly into the mouth of the pig, because of the danger of its entering the lungs and setting up fatal pneumonia. A better way is to apply it to the interior of the mouth and fauces on a swab or sponge dipped in the liquid. Short of this one of these agents may be mixed with the drinking water, or muriatic acid may be used in the same way, though at some detriment to the teeth. The general health must at all times be attended to. Any costiveness may be corrected by Glauber salts or jalap, and elimination through the kidneys must be sought through the use of nitrate of potash or other diuretic.

CALCULI IN THE TONSILS.

Diagnosis and treatment of tonsillar calculi; spud; acid dressings. Trauma of soft palate by stick, probang, file, molar. Abscess of palate. Treatment; laxative; expectorant; antiseptic; lancing. Cleft palate and hare lip.

Rudimentary as these organs are in the equine race they are important enough to have become the seat of hard calculous masses. These have been found by Goubaux and Blanc in old asses, and by the author in old horses. They vary in size from a pin’s head to a pea and consist of concentric layers of a granular material arranged around a central nucleus, which is usually a foreign body introduced with the food. This nucleus is usually of a vegetable nature, while the enveloping material is made up largely of the imprisoned and degenerated epithelium of the follicle. Both diagnosis and treatment are difficult in such cases. The adventitious masses should be dislodged by the aid of a smooth, blunt metallic spud, and the surface thereafter washed or swabbed with an antiseptic and astringent solution. Swabbing with a solution of hydrochloric acid will tend to dissolve and remove them.

INJURIES TO THE SOFT PALATE AND FAUCES.

The region of the fauces is sometimes injured by sharp pointed bodies swallowed in the food, by the giving of boluses on the end of a pointed stick, or by the careless use of a probang or of a file upon the posterior molars. An overgrown last molar will sometimes lacerate the velum. In other cases the inflammation of sore throat is especially concentrated on this part, giving rise to cough, difficulty of swallowing, redness, infiltration and swelling of the parts, and even abscess. In the dog it is often associated with tonsilitis.

Treatment. A laxative is usually desirable to be followed by salammoniac or chlorate of potash. In case of actual traumatic lesions, the astringent and antiseptic lotions advised for tonsilitis will be in order, and if abscess is recognized it should be opened promptly.

CLEFT PALATE.