Fig. 269.—Actinomycosis in the region of the incisors.
Fig. 270.—Actinomycosis in the region of the incisors.
For reasons difficult to explain, but probably because inoculation is less easy, actinomycosis is much rarer in the upper than in the lower jaw. The disease develops exactly as above described, but shows much less tendency to external ulceration. It invades the maxillary sinus and the region of the palate, and fistulæ are found opening into the buccal cavity, while at the same time the region of the forehead is often deformed.
ACTINOMYCOSIS OF THE TONGUE.
Actinomycosis attacks the tongue apart from any lesion of the jaws, and produces what is commonly called “wooden tongue.”
The disease develops in the tongue itself, generally in the submucous zone, and causes chronic interstitial inflammation, infiltration of the connective tissue, and, in time, changes in the muscular structures themselves.
The tongue shows progressive hypertrophy, and becomes hard, sensitive, rigid, and incapable of free movement. As a result the patients first have difficulty in grasping food, then in swallowing their saliva, which dribbles from the mouth, and finally are quite unable to feed themselves.
