Chapter II: Part 2

_Treatment._ Cadeac strongly recommends ½ oz. common salt daily with the food, or alcohol ¾ oz., or a strong infusion of coffee mixed with the milk. Lenglen advises quinoa in the form of tincture, ½ to 1 oz. McGillivray sulphate of soda. Tincture of chloride of iron 30 drops in an ounce of water with each meal would be an excellent resort.

_Locally_ antiseptics are our main reliance. Naphthol, naphthalin, salicylic acid, or salicylate of soda, may be applied directly to the diseased mucous membrane. Tincture of chloride of iron in water (1:2) is one of the best agents (James). Carbolic acid 1 drachm in 6 oz. water, and 1 oz. alcohol has been used safely and with excellent results (Lenglen). Like most other antiseptics, however, this latter must be used with caution as regards the amount. No actively poisonous antiseptic is admissible. The antiseptic should be swabbed over the whole interior of the mouth after each meal.

In case of deep gangrenous masses excision and antiseptics are demanded.

ULCERATIVE STOMATITIS IN LAMBS AND KIDS.

Causes: Accessory, locality, youth, debility, unsuitable food, impure
air, parasitism, contagion. Bacteria. Symptoms: difficult sucking,
frothing, salivation, buccal redness and swelling, white, softened
patches, suppuration, granulation, fœtor, emaciation, debility, bowel
symptoms, respiratory. Duration. Treatment: Artificial feeding,
antisepsis, disinfection, mild caustics, etc.

_Causes._ This has been noticed as an enzootic affection in young and debilitated animals, while the mature and more robust ones escape. Anæmic lambs, those that are fed on watery, innutritious materials (potatoes, grains, waste of sugar factories), those kept in close confinement, indoors, and those that suffer from distomatosis show the disease. Impure air, damp, dark places and impure water have their influence. The disease is manifestly contagious, but the infecting microbe has not been demonstrated. It was formerly supposed to be the _oidium albicans_, the fungus of _muguet_, but Neumann demonstrated its absence, and though he found _leptothrix buccalis_, _bacilli_, _spirochcæte_ and _micrococci_ he failed to show that any one of these in pure culture would cause the disease. Rivolta charged it on _bacterium subtile agnorum_ and Berdt on the _polydesmus exitiosus_ which according to him the sheep contract from eating rape cake. The withdrawal of the cake led to a rapid recovery.

_Symptoms._ The disease may begin insidiously without at first very marked symptoms. Sucking is painful and infrequent, an acid froth collects about the mouth, and white patches appear on the gums or other part of the buccal mucosa, with at times redness and swelling, and the separation of the gums from the teeth. The white epithelial patches soften and are easily detached, leaving bright red patches, which bleed easily, and tend to extension and coalescence. These are covered by a viscid mucopurulent matter, and may become the seat of granulations, or they may involve the subjacent tissues in ulceration causing evulsion of the teeth, or necrosis of the jaw bone. The odor of the mouth is fœtid. Prostration and emaciation set in, and often bear a ratio to the extension of the disease to the digestive and respiratory organs. This is manifested by uneasy movements of the hind feet, shaking of the tail, frequent lying down and rising, constipation or diarrhœa: or by cough, snuffling breathing, swelling of the submaxillary and pharyngeal glands, and hurried, oppressed breathing. The complication of vesicular and pustular eruption has been noticed. Death may occur in eight or ten days, or more commonly recovery ensues.

_Treatment_ must proceed on the same lines as in the calf. Artificial feeding on gruels, with antiseptic washes for the mouth at each meal are indicated. Chlorate of potash, chloride of lime, borax, sulphites and hyposulphites of soda, carbolic acid, and the salts of iron afford an ample field for selection. For ulcers, a pointed stick of nitrate of silver, or a solution of muriatic acid in three times its volume of water, applied by means of a glass rod or pledget of cotton will serve a good purpose.

ULCERATIVE STOMATITIS IN SWINE.

Causes: improper food; filthy pens; debility; toxins of specific
diseases; microbian infection. Symptoms: inappetence; grinding teeth;
champing jaws; salivation; fœtor; buccal swelling and redness; pulpy
spots; desquamation; ulcers; pharyngeal, enteric and osseous
complications. Treatment: Segregation; disinfection; local antiseptic
washes; tonics.

This is the Scorbutus of Friedberger and Fröhner, the gloss-anthrax 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 dullness 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 on the other animals. Sulphuric or hydrochloric acids in 50 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.

ULCERATIVE STOMATITIS IN CARNIVORA.

Causes: dietary causes; constitutional debilitating diseases; dental
disorders; microbian infection; microbes. Symptoms: difficult sucking
or mastication; salivation; dullness; prostration; mucosa red with
gray patches, erosions, and ulcers; fœtor; loose teeth; excess of
tartar. Extensions to face, throat, lymphatics, nose, eyes, stomach,
liver, bowels. Duration. Treatment: clean teeth; antiseptics; mild
caustics; stimulants.

_Causes._ This affection is more common in this class of animals than in the herbivora, being apparently dependent in great part on their artificial habits of life, the sweet and stimulating diet and the derangement of the digestive organs. The lowering of the general health in connection with privation or disease and especially canine distemper, rachitism or indigestion must be recognized as predisposing causes, while the accumulation of tartar on the teeth, or the decay of the teeth themselves, constitutes a potent exciting local cause. In connection with such cretaceous deposits the decomposing elements of the food collect, and the irritant products of their fermentation lead to disease of the gums, congestion and ulceration. Superadded to this is the bacteridian infection of such diseased parts, through which the ulceration is started, maintained and extended. This infection is not that of a specific microbe, but usually of a multiplicity of germs, one or more of the bacteria that live habitually in the healthy mouth, taking the occasion of the existence of a wound, or of a reduction of vitality to colonize the mucosa which would otherwise have remained sound. The microbes actually found in the ulcers are very varied. Pasteur isolated a spirillum, Fiocca the bacillus salivarius septicus, others have found pus bacilli, and in sucking kittens the bacillus coli communis.

But the attempts made to convey the disease to healthy mouths by the transfer of the microbes have usually failed (Pasteur, Netter, Cadeac). To establish their pathogenic action therefore, it appears to be necessary to furnish a susceptible mucosa as well as an infecting microbe. This explains why the disease does not spread as an infection, the average mouth is immune and it is only when it becomes the seat of a wound, bruise or other injury, or when the general system has become so reduced that the resisting power is a minor quantity, that the hitherto harmless germ becomes actually pathogenic.

_Symptoms._ There is indisposition to suck or eat, the patient leaves the teat or the food, and looks dull, depressed and disposed to lie down apart. There is evident salivation and on opening the mouth we may find the offensive odor, the tartar covered teeth with red or ulcerated gums, and on the cheeks, lips and tongue dark red patches of congestion, or whitish or yellowish gray, soft, pulpy spots of disintegrating epithelium. This is followed by shedding of these epithelial patches, and the formation of rounded ulcers of a line in diameter or less. These are tender, and bleed readily. They may extend to the skin of the lips, or deeply into the mucosa, the muscles or bones, and the attendant morbid process may cause loosening and evulsion of the teeth. There may be implication of the pharynx, the lymph glands, the nose, the eyes, the stomach, the liver, or the intestines with corresponding symptoms. Death may supervene in from six to thirty days, or a more or less speedy recovery may take place.

_Treatment._ The first step as a rule is to remove the tartar from the teeth. This is often done with a wooden spud dipped in a weak solution of hydrochloric acid. A steel scraper will usually act well and without the solvent action of the acid.

Next will come the removal of all diseased teeth which are operating as local irritants and as centres for infectious microbes and their hurtful products.

Then antiseptics in the form of liquids applied as in the other animals with each meal, will be necessary to counteract infective action, and give the tissues an opportunity to re-establish their integrity. Cadeac recommends a 10 per cent. solution of oil of thyme, as a safe and efficient application. Boric acid, borax, salol, salicylic acid, tannic acid, sulphurous acid, or carbolic acid largely diluted may be substituted. Internally iron tonics and bitters are of great value in improving the tone of the system and securing antisepsis of the intestinal canal. The sulphites too may be given with advantage internally. In depressed conditions alcoholic stimulants may be used both as local antiseptics and general stimulants. As in other animals ulcers may be touched with a rod dipped in tincture of iodine, or a strong solution of chloride of zinc, or nitrate of silver.

MERCURIAL STOMATITIS.

Animals suffering. Causes: mercurial baths, ointments, blisters and
surgical dressings; mercurial vapors; deposits on vegetation; rat
poisons; malicious poisoning. Lethal dose in horse, ox, sheep and
goat. Mature and old eliminate more slowly. Symptoms; Salivation; red,
swollen buccal mucosa; gingivitis; loosening of teeth; fœtor;
ulceration; anorexia; gastro-intestinal tympany; loose, fœtid stools;
fever; weakness; dyspnœa; langor; blood extravasation in nose, mouth,
throat, bowels, womb, skin; abortion; skin eruptions. Lesions in
mouth, stomach, intestines, serosæ, kidneys, muscles, encephalon.
Treatment; stop the introduction of mercury; as antidote potassium
sulphide; emetic; cathartic; mucilaginous and albuminous antidotes;
potassium iodide as an eliminating agent. Locally potassium sulphide
or chlorate. Iron tonics.

This has been especially seen in the sheep, dog and ox, and less frequently in other domestic animals.

_Causes._ In sheep the use of baths containing corrosive sublimate, or of mercurial ointment for acariasis or other cutaneous parasitism. In other animals it comes mostly from licking mercurial dressings applied to the skin—calomel, red precipitate, mercurial ointment, protoiodide of mercury. The red iodide being more irritating is less frequently taken in. The modern extensive usage of mercuric chloride solutions as surgical antiseptics opens up a new channel of infection. In the injection of the uterus or of large abscesses, or in the daily irrigation of large wounds a dangerous amount may be absorbed. The application of this agent as a caustic in cases of tumors is correspondingly dangerous. Vapors from metallic mercury in confined spaces as in ships’ holds, or from fires on which the mercurial compounds have been thrown, are ready means of poisoning, acting primarily on the air passages and lungs and later on the mouth. The condensation of mercury on vegetation and other food products in the vicinity of factories where mercury is handled (Idria) affects domestic animals directly. Finally the small animals are poisoned by eating the mercurial rat poisons, and all animals are subject to malicious mercurial poisoning, with sublimate especially.

Stomatitis with fatal pharyngitis and enteritis will result in the horse from 2 drs. of corrosive sublimate. About one-half of this may poison the ox, and one-fourth the sheep or goat. Ruminants are more susceptible to the toxic action of mercury than monogastric animals, one evident reason being the long delay of the successive doses in the first three stomachs, so that finally a large quantity passes over at once into the fourth stomach and duodenum for absorption. The old too are more readily poisoned than the young, as the functions of the kidneys are more impaired in age and the poison is not eliminated with the same rapidity.

_Symptoms._ Mercurial stomatitis is a local manifestation of a general poisoning. Salivation is one of the most prominent phenomena, the watery saliva falling in streams from the angles of the mouth. The buccal mucosa generally becomes red and swollen and the tongue becomes indented at the edges by pressure against the molars. The gums especially suffer and the teeth raised in their sockets by the swelling of the periodontal membrane, become loose, and easily detached. The mucosa of the gums becomes soft and spongy, bleeds readily under pressure and soon shows erosions and ulcers. This condition extends to the lips, cheeks and lower surface of the tongue while the upper surface of the latter organ, the fauces and pharynx commonly escape. The breath and buccal exhalations are very offensive, and the animal loathes food, and has little power of mastication or deglutition. Sometimes the ulcers extend even to the bones.

Along with these local symptoms there are usually gastro-intestinal irritation, tympany, inappetence, continuous rumbling in the belly; badly digested fœtid stools, often diarrhœa, small weak pulse, hyperthermia, accelerated breathing, cough, and great langor and prostration. A tendency to blood extravasation is shown in sanguineous fæces, epistaxis, bleeding from the mouth, the throat or the womb and even into the skin. Pregnant females may abort. The eyes are dull and sunken, and the conjunctiva yellow. Eczematous or pustular eruptions may appear on the skin on the nose, lips, neck, back, loins, croup or perineum.

_Lesions._ In addition to the lesions described above, there are usually gastro-intestinal inflammation, œdema of the peritoneum and pleura, in the lung as well as in the serosæ, (pneumonia is not uncommon especially in sheep), intestines, kidneys and muscles, hæmorrhagic spots are not uncommon, the blood forms a loose black coagulum, and the encephalon is anæmic and softened.

_Treatment._ The first consideration is to cut off the supply of mercury. Mercurial applications on the skin should be washed off with tepid water and if necessary soap. An application of sulphide of potassium will precipitate the mercury in an insoluble form. For mercurial agents in the alimentary canal an emetic may be given (if the animal is one susceptible to emesis) followed by a saline laxative. This may be combined with or followed by raw eggs, mucilage, wheat gluten or other albuminoid, sulphide of potash or sulphur, to precipitate the mercury and prevent its absorption. Later, when the bowels have been cleared, iodide of potassium in small doses will serve to dissolve and remove what mercury may be lodged in the tissues.

Locally one of the best applications is chlorate of potash as a mouth wash, 2 drs. to the quart of water. To this may be added tannic acid or other vegetable astringent and even alcohol.

Finally a course of iron and bitter tonics will serve a good purpose in restoring the general tone.

STOMATITIS FROM CAUSTICS.

Caustic Alkalies; symptoms, lesions and antidotes. Caustic Acids;
symptoms, lesions and antidotes. Caustic salts; symptoms, lesions and
antidotes.

=Caustic Alkalies= (soda, potash, ammonia and their carbonates) often cause stomatitis. What is supposed to be _weak lye_, given to counteract indigestions, colics, and tympanies often proves dangerously irritating, and some of the worst forms of stomatitis we have ever seen in the horse originated in this way. As the animal refused to swallow, the caustic liquid lay in the mouth and virtually dissolved the epithelium and surface layers of the fibrous mucosa. The surface in such a case is usually of a deep red, and where the cuticular covering remains, it is white and corrugated. The antidote is a weak, non-irritant acid, such as vinegar, boric, citric, or salicylic acid. When the caustic alkali has been thoroughly neutralized in this way the ordinary treatment for catarrhal stomatitis may be followed. The attendant gastritis must receive its special treatment.

=Caustic Acids.= Sulphuric, nitric and hydrochloric acids act by abstracting liquids and charring the tissues. The lesions from strong sulphuric acid turn black, those due to nitric acid, yellow, (zanthoproteic acid,) and those due to muriatic acid are white, with the characteristic odor of chlorine. The antidote in such cases is a non-irritant basic agent, such as chalk, lime water, soapsuds, calcined magnesia, and mucilaginous liquids, albumen, gluten, flax seed, with opium. The same agents are applicable to the attendant gastritis and when the acids are thoroughly neutralized the treatment is as for simple inflammation.

=Caustic Salts.= Among caustic salts may be named mercuric chloride, sulphates of copper and iron, chlorides of iron and zinc, tartar emetic. These may be treated by albumen, blood, white of egg, milk, gluten, mucilage and other sheathing, protecting agents which will form with the salts insoluble and harmless coagula. The subsequent treatment will follow the lines marked out for simple stomatitis. To prevent infection of the raw surface Cadeac recommends: tannic acid 1 oz., benzo-naphthol 3 drachms, powdered gentian 6 drachms, honey, sufficient to make an electuary.

MYCOTIC STOMATITIS IN FOALS, CALVES AND BIRDS. THRUSH. MUGUET.

Oidium (saccharomyces) albicans; a parasite of the young; cultures.
Symptoms in foals and calves; congested buccal mucosa; curd-like
concretions; erosions. Diagnosis from rinderpest. Treatment;
disinfection; sunshine; open air; exercise; locally antiseptics.

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.

=Foals and Calves.= _Symptoms._ The 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 concretions seen on this mucosa in rinderpest, but are easily recognized 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._ It is always well to destroy floating germs by cleansing and whitewashing the stable, and to invigorate the young animals by sunshine, free air and exercise. Locally the most effective agent is the old favorite remedy 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 honey or molasses and used as an electuary. As substitutes boric acid, salol, thymol, chlorate of potash, or permanganate of potash may be used.

=Birds.= The affection has been twice observed as occurring in the œsophagus and crop of two chickens. Martin tried in vain to inoculate it on other fowls, and Neumann failed to convey it from child to chicken by feeding. The element of individual susceptibility was manifestly lacking. From its seat in the crop the malady passed unnoticed during life. In cases that can be recognized, treatment would be the same as in young mammals.

PARALYSIS OF THE TONGUE. GLOSSOPLEGIA.

Causes: Nervous lesions—central or peripheral, parasitic,
inflammatory, infectious, traumatic or degenerative. Symptoms:
unilateral and bilateral. Treatment: remove cause; use nerve
stimulants, embrocations, blisters, frictions, galvanism, suspension
of tongue.

Paralysis of the tongue depends on a lesion of the medulla oblongata, or of the 7th or 12th cranial nerve. The central lesions may be connected with cœnurus or other parasites in the brain, hydrocephalus, meningitis, cerebro spinal meningitis, infectious pneumonia, abscess (strangles), and tumors. The distal or nerve lesions may be due to neuroma, tumors, traumas, lacerations, bruises, or violent distension of the tongue. Parotitis, abscess of the guttural pouch and tubercle may be added as occasional causes. As direct traumatic injuries those caused by wearing a poke by a habitual fence-breaker, excessive dragging on the tongue in operations on the mouth, and compression of the tongue by a loop of rope passed over it, require mention.

_Symptoms._ In =unilateral= paralysis the affected half of the tongue remains soft and flaccid and is liable to be crushed between the teeth, the active muscles of the opposite half pushing the organ over to the paralyzed side. In =bilateral= paralysis the tongue hangs out of the mouth, and being crushed and torn by the teeth, it swells up, and may even become gangrenous.

_Treatment._ Will vary according to the cause. After removal of the central or nervous lesions, the remaining functional paralysis may be treated by strychnia, internally or hypodermically, by frictions or stimulating embrocations to the intermaxillary region, or by electricity. The tongue must be suspended in a sling to prevent œdema, inflammation and wounds by the teeth. In bad cases of bilateral traumatic glossoplegia in meat producing animals it has been advised to have the subject butchered.

DISEASES OF THE SALIVARY GLANDS.

Modifications of the secretion are commonly simple excess or deficiency, with a correspondingly high or low specific gravity of the product. There may, however, be a virulent element as in the case of rabies.

SUPPRESSION OF SALIVARY SECRETION. XEROSTOMIA.

Causes; fever; vascular vacuity, after bleeding, diarrhœa, etc.;
destruction of glands; Calculus. Symptoms; slow, difficult
mastication; digestive disorder. Treatment; remove mechanical
obstruction; correct constitutional disorder; employ stimulation to
gland—pilocarpin, electricity.

Entire suppression of salivary secretion is usually the result of some other disease. It may be a manifestation of the general tendency to retain water in the febrile system, or it may be an indication of vacuity of the vascular system as after bleeding, profuse diarrhœa, diuresis, or diaphoresis, or it may be the result of the entire destruction of a salivary gland or the obstruction of its duct by some foreign body or calculus. In proportion to the completeness of the suppression, mastication and deglutition become difficult or impossible. The condition must be met by the removal of the cause which is operative in the particular case. The treatment may be surgical for the removal of obstructions, or medical with the view of overcoming anæmia, fever, profuse secretions from other emunctories, or the simple physiological inactivity. To meet the last indication small doses of pilocarpin, or the application of a gentle current of electricity will usually succeed.

EXCESSIVE SECRETION OF SALIVA. SALIVATION. PTYALISM.

Causes; a symptom of other diseases, of the mouth, teeth, throat or
stomach; rank aqueous vegetation, lobelia, pilocarpin, muscaria,
tobacco, mustard, and other acrid vegetables; caustic alkalies, acids,
salts; compounds of mercury, gold, copper, iodine; palsy of lips;
harsh bit; fungi on clover, sainfoin, etc. Symptoms; salivary escape;
frequent deglutition; thirst; disordered digestion, etc. Treatment;
remove cause; astringent washes; sedatives; embrocations to the
glands.

This is often a symptom of some other affection such as aphthous fever, dumb rabies, epilepsy, stomatitis, pharyngitis, dentition, caries and other diseases of the teeth, wounds and ulcers of the mouth, gastric catarrh, etc. In other cases it is due to direct irritants in the food or medicine, as very rank, aqueous, rapidly grown, spring grass, lobelia, pilocarpin, muscarin, tobacco, wild mustard, colchicum, pepper, garlic, ginger, irritant and caustic alkalies, acids and salts, and the compounds of mercury, gold, copper, or iodine employed locally or internally. The application of mercurials to the skin is especially liable to salivate cattle and dogs, partly because of a special susceptibility to the action of this metal and partly from the tendency of these animals to lick the medicated surface. Paralysis of the lips causes a great flow of saliva from the mouth though no more than the normal amount is secreted. The irritation of a large or harsh bit will increase the secretion and still more the former habit of attaching to it small bags of spicy or irritant chemicals. Certain fungi determine salivation. Mathieu saw profuse salivation in horses, cattle and sheep fed on clover and sainfoin which had become brown.

_Symptoms_ consist in the profuse flow of saliva, either in long stringy filaments, or if there is much movement of the jaws, in frothy masses; frequent deglutition; increased thirst and disordered digestion (tympany, inappetence, colics, constipation, diarrhœa). In mercurial salivation there may be loose teeth, swollen, spongy, ulcerated gums, tympany, rumbling, and the passage of fœtid flatus and soft ill-digested stools.

_Treatment_ consists in removing the cause, whether this is to be found in faulty food or drink, diseased teeth or gums, disordered stomach, or the irritant food medicine or poison ingested. If more is wanted simple astringent washes like those recommended for stomatitis and a free access to pure water will often suffice. Tartar emetic or opium has been known to succeed in obstinate cases. Friction over the parotid or submaxillary gland with camphorated spirit, tincture of iodine or soap liniment is sometimes required. In mercurial salivation chlorate of potash is especially to be commended, and when the bowels have been unloaded of the agent, iodide of potassium will hasten its elimination from the tissues and blood.

DILATED SALIVARY DUCTS. SALIVARY CALCULUS. SALIVARY FISTULA.

These are all surgical diseases and are to a large extent inter dependent. The impaction of the calculus in the duct leads to overdistension of the duct posterior to the obstruction, and the rupture or incision of the distended duct, determines the fistula. It is only necessary here to point out the seat of these lesions: the distended sublingual ducts constituting a more or less rounded swelling to one side of the frænum lingui, the Whartonian duct forming a tense rounded cord from the papilla back of the lower incisor teeth backward on the inner side of the lower jaw, and the Stenonian duct forming a similar tense cord from near the middle of the cheek down around the lower border of the jaw in company with the submaxillary artery and backward on the inner side of its curved border to the parotid gland.

For the more precise lesions, symptoms and treatment of these, see a work on surgery.

INFLAMMATION OF THE PAROTID GLAND. PAROTITIS.

Causes: traumatic; calculus; grains; barley and other beards;
infecting microbes. Symptoms: fever, dullness, buccal heat,
salivation, difficult mastication, swelling of gland and duct,
protruded nose, stiff neck, fœtor, dyspnœa, facial paralysis,
induration of gland, abcess. Diagnosis from pharyngitis, abcess of
guttural pouch or pharyngeal glands; from tumors. Treatment: avoidance
of causes; derivation; astringent, antiseptic washes; wet antiseptic
bandages to throat; cool pultaceous diet. Open abscess and disinfect.
For induration deobstruents. For sloughing antiseptics.

This may be caused by traumatism, such as incised punctured or bruised wounds. Wounds inflicted by the goad, by horns, and even by the yoke in cattle must be looked on as factors. It occurs from obstruction of the salivary ducts by calculi, or by grains, seeds, or pebbles introduced from the mouth; from their irritation by the beards of barley and other plants (brome, rye, wheat, etc.); and from the localization in the gland of specific inflammations like strangles, pyæmia, canine distemper, tuberculosis and pharyngitis. In most of these cases infective microbes are prominent factors. They enter with penetrating bodies from the skin; they extend through the weakened and debilitated tissues in bruises; they penetrate the Stenonian duct with the various foreign bodies from the mouth; irrespective of foreign objects they make their way up the duct by continuous growth from the buccal orifice; in case of calculus or other obstruction their extension is favored by the local congestion and debility and by the stagnation of the saliva above the point of arrest. When present these microbes even favor the deposition of the salivary salts and formation and increase of calculi so that the affection may advance in a vicious circle, the microbes favoring calculus and the calculus favoring the increase of microbes.

_Symptoms._ In the horse in particular there may be premonitory symptoms of fever, dullness, heat of the mouth, ptyalism, slow and imperfect mastication, and the retention of food in the cheeks.

The Stenonian duct becomes swollen and painful. The parotid becomes hard, hot, tender, and is surrounded by a softer pitting infiltration which may extend down around the entire throat, and even along the intermaxillary region to the chin. When the canal is obstructed it may stand out as a thick rope-like resilient swelling extending around the lower border of the jaw and upward toward the cheek as far as the point of obstruction. When one parotid only is involved, the contrast with the other is quite marked. The head is extended and carried stiffly. When the nose is depressed, or when the head is turned to one side or the other, the patient gives evidence of suffering from compression or stretching of the inflamed region. The breath and mouth exhale an offensive odor, determined by the decomposition of mucus and of the retained food products.

Among remote effects may be named dyspnœa and threatened suffocation from pressure on the pharynx and laryngeal nerves, and facial paralysis from pressure on the seventh nerve.

The disease may go on to induration and remain permanently in this condition, or it may suppurate and discharge through the skin, into the pharynx or through the duct of Stenon. It may communicate with both the duct and the skin and determine a fistula. When suppuration occurs there is an access of fever, a chill may be noticed, the swelling becomes more tense, harder, more tender to the touch, and even emphysematous, and finally points internally or externally. This may take place from the fifth to the tenth day or later. When it opens into the duct it may be seen oozing from the orifice in the cheek when the mouth is opened, and in case the jaws are suddenly parted, it may escape in a jet. In such a case and especially if the microbes have come originally from the food the odor is very fœtid. The abscess is not always single and when multiple the pus may escape externally by a variety of orifices. The pus is usually whitish, yellowish or grayish and creamy, but it may be grumous or bloody or serous and of a most offensive odor. In exceptional cases the gland becomes more or less gangrenous and such parts, exposed in the wound are hard, bloodless and insensible, and add very materially to the fœtor. This may lead to general septic infection, or the necrosed masses may slough off and the cavities fill up by granulations.

_Diagnosis._ Parotitis is distinguished from pharyngitis and abscess of the guttural pouch by the absence of cough and nasal discharge; from abscess of the pharyngeal glands it is differentiated by the limitation of the hard swelling to the parotid gland and by the superficial seat of the resulting abscess. The co-existence of active inflammation serves to distinguish it from ordinary tumors.

_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.

In exceptional cases the soft palate has failed to unite in the median line, and is represented by two lateral flaps separated by a v-shaped hiatus in the middle. In a specimen in the N. Y. S. V. College, taken from a trotting colt, the fissure is continued forward for several inches between the palatine bones and the palatine processes of the superior maxillary, establishing a direct communication between the mouth and nasal chambers. In still other instances the fissure is continued forward between the maxillary and anterior maxillary bones, throwing the whole length of the buccal and nasal chambers into one irregular cavity, and forming harelip.

It would be possible to remedy some of these conditions by plastic operation, but the value of the young animal will rarely warrant any such resort.

CATARRHAL PHARYNGITIS.

Causes: traumatic; thermic; gaseous; medicinal; chemical;
physiological irritants; in solipeds, cattle, swine, dogs; debility;
exposure; cold baths; youth; age. Microbes in solipeds, cattle, dogs,
birds; facultative microbes. Symptoms: constitutional; difficult
swallowing; nasal rejection of water; pharyngeal swelling and
tenderness; extended head carried stiffly; cough loose; salivation; in
cattle, grinding of teeth; in dogs, rubbing of chops; buccal heat and
redness; often fœtor. Course. Duration. Diagnosis from parotitis, from
abscess of guttural pouch, from pharyngeal tuberculosis, from
actinomycosis, from adenitis and phlegmonous pharyngitis, from
specific fevers affecting the pharynx. Lesions: redness and swelling
of mucosa, epithelial degeneration, elevations, erosions, and ulcers;
lesions of tubercle, glanders, rabies, anthrax, actinomycosis, etc.
Prevention. Treatment: soothing; dietetic; laxative; expectorant;
eliminating; locally antiseptic astringents in solid, liquid, or
vapor; embrocations and blisters; tonics.

_Causes._ As in stomatitis the starting point of pharyngitis is usually in a local injury or a systemic condition which lowers the vitality of the pharyngeal mucous membrane. It may come in all animals from the hot air of burning buildings, from acrid gases inhaled, food, drink or medicines given at too high a temperature, from caustic alkalies, acids or salts, from physiological irritants like croton, euphorbium, cantharides, from barley and other spikes entangled in the follicles, from drinking freely of iced water. In _solipedes_ there are the injuries caused by giving boluses on pointed sticks, and the wounds caused by tooth files in careless hands, and by coarse fibrous fodder, which has been swallowed without due mastication. In _cattle_ injury comes from foreign bodies impacted, from the rough use of probang, rope or whip and even of the hands in relieving choking. _Swine_ have the part scratched and injured by rough or pointed objects which they bolt carelessly with the food. _Dogs_ and especially puppies are often hurt by solid and irritant bodies that they play with, and swallow accidentally or wantonly. They also suffer at times from the pressure of a tight or badly adjusted collar.

The system is debilitated and rendered more susceptible by chills consequent on exposure to cold blasts, or draughts, or rain or snow, when heated and exhausted, by cold damp beds, by pre-existing disease, by underfeeding and by overwork. In the larger animals this may come from the excessive ingestion of iced water, while in dogs the plunging in rivers, ponds or lakes may chill.

The weakness of _early age_ and _old age_ have a perceptible predisposing influence especially in solipeds and carnivora.

Finally as in other catarrhal inflammations the local action of disease germs on the mucous membrane must ever be borne in mind. These may be the germs of specific diseases localized in the pharynx;—in =Solipeds= the streptococcus of strangles, the bacillus of glanders, the diplococcus (streptococcus) of contagious pneumonia, the germ of influenza, and actinomyces;—in =Cattle= the bacillus tuberculosis, the bacillus of anthrax, actinomyces, the germs of aphthous fever and of pseudomembranous angina; in _dogs_ canine madness and distemper;—in birds the bacillus of pseudomembranous pharyngitis.

In addition to such specific germs the micrococci, streptococci and bacilli which are normally present and harmless in the mouth and pharynx, enter, colonize and irritate the debilitated tissues in case of trauma, inflammation or constitutional disorder and serve to perpetuate and aggravate the affection.

_Symptoms._ Acute pharyngitis is manifested by impaired or lost appetite, dullness, weakness, by difficulty in deglutition, by the rejection through the nose of water or other liquids swallowed, by swelling over the parotid and above the larynx, and by a disposition to keep the head extended on the neck and the nose raised and protruded. Fever is more or less marked according to the severity of the attack the temperature being raised in mild cases to 100°, and, in the more violent, to 104° or 106°. The pulse and breathing may be excited, amounting sometimes to dyspnœa, the throat is tender to the touch and its manipulation rouses a cough, the nasal mucosa is congested and the buccal membrane, and especially along the margin of the tongue may be red and angry. Salivation is shown more or less, in _solipeds_ the saliva accumulating especially during mastication in froth and bubbles at the commissures of the mouth, while in _ruminants_ the grinding of the teeth or frequent movement of the jaws in the absence of food or actual mastication leads to a free escape of the filmy liquid at the same points. _Dogs_ will rub the jaws with the foot as if to remove some irritating object from the mouth. In the last named animals the swelling of the tonsils, fauces and pharyngeal mucous membrane, may be seen marked by patches and spots of varying redness and swelling, covered with glairy or opaque mucopurulent secretions, or particles of food, or even showing erosions.

The cough of pharyngitis is painful, paroxysmal, and softer and more gurgling (even in the early stages) than that of laryngitis or bronchitis. It is roused by handling the throat, by swallowing, by a draught of cold air or by passing out of doors, in _dogs_ by opening the mouth, and in _cattle_ by pulling on the tongue which causes pain and resistance. The cough is followed by the rejection, mainly through the nose in _solipeds_, but also through the mouth in other animals, of a glairy mucus or an opaque mucopurulent discharge often mixed with and discolored by the elements of food or in bad cases by blood.

The _course_ of the disease is comparatively rapid, and it usually ends in recovery in seven to fifteen days, in cases that are not complicated by dangerous local infections.

_Diagnosis_ is mainly based on the stiff carriage of the neck with the nose elevated, the swelling and tenderness of the throat, manipulation above the larynx rousing the cough, the soft or rattling nature of the cough, the ejection of liquids and foods through the nose, the movements of the jaws apart from mastication and the salivation. From _parotitis_ it is distinguished by the concentration of the swelling and tenderness to the deepseated region above the larynx, by the abundance of the discharge, by the ejection of liquids through the nose, and by the readiness with which the cough is aroused. From _abscess of the guttural pouch_ it is differentiated by the more continuous discharge from the nose, rather than the intermittent one. From _tuberculous pharyngeal glands_ by its acute nature, by the absence of the glandular swellings in which the tuberculosis is concentrated, also by the absence of tubercles in other parts of the body. From _actinomycosis_ by its more rapid progress and by the absence of the hard indurated cutaneous or subcutaneous swellings, and of the open sores with minute sulphur colored granules that mark that affection. From _adenitis_ and _phlegmonous pharyngitis_ it is distinguished by the absence of the glandular swelling and dyspnœa which attend on that affection. From the various fatal _febrile affections_, the germs of which may be localized in the throat, it may be diagnosed by the absence of the more profound constitutional disturbance, and of the more characteristic local symptoms of these which are seldom altogether awanting, though often greatly modified.

_Lesions._ Beside the thick covering of mucopurulent and alimentary matters, the pharyngeal mucosa, when washed, shows redness, ramified or reticulated, more or less swelling amounting at times to œdema, a soft friable consistency, which like the œdema may in bad cases extend into the submucous tissue, granular elevations, and raw abrasions caused by the destruction and removal of the epithelium. In some instances the ulcers may become quite extensive.

In the more specific inflammations (tubercle, glanders, rabies, aphthous fever, contagious pneumonia, anthrax, actinomycosis), the lesions will vary according to the specific nature of the disease.

_Prevention._ Avoid the various thermal, chemical, mechanical, and unhygienic causes already referred to, and the exposure to such infectious diseases as are liable to localize themselves in the throat.

_Treatment._ A piece of blanket or sheepskin placed round the throat with the wool turned inward, a moderately warm stall with pure air, and a diet composed of soft, warm or tepid mashes, (all hard or fibrous food, oats, hay, etc. being withheld) are important conditions.

If costiveness exists a dose of Glauber salts for the larger animals, and of jalap for the small, may be useful. Or pilocarpine or eserine may be given hypodermically. Following this, mild saline diuretics will serve at once to eliminate offensive products of the disease and lower the general temperature.