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.