In lingual actinomycosis, for example, the effects may be seen a few days after treatment is begun. The tongue becomes softer and more mobile, can be protruded beyond the mouth and retracted into it, and day by day tends progressively to resume its normal appearance.
The patients, which were previously slowly dying of inanition because they were unable to feed themselves, again take to their food and begin to put on flesh. To ensure the treatment being efficacious it should, as a rule, be continued for three or four weeks.
During the course of this treatment the system becomes saturated with the drug, but no bad effects follow. The patients suffer from lachrymation, coryza, bronchorrhæa, and especially iodic eczema, but all these symptoms diminish and disappear soon after the administration of the drug is discontinued.
Recovery, however, is not always permanent, and even when the tongue has resumed its normal appearance a relapse may occur. We have seen several such cases after treatment extending over more than six weeks, and it is therefore often advisable to fatten the animals as rapidly as possible and prepare them for slaughter.
If no relapse occurs, and recovery is regarded as permanent, another complication may make its appearance, viz., sclerous atrophy of the tongue. This is almost as dangerous as the primary lesion, because it prevents the animals from feeding, and constitutes an additional reason for following the course above suggested.
Other lesions of soft tissues, such as disease of the parotid or cervical glands, etc., yield to the same treatment, but it is advisable first of all to clean out the fistulæ, scrape off exuberant granulations, cleanse the irregular culs-de-sac, and thoroughly curette all accessible parts.
Treatment is much longer than in the case of actinomycosis of the tongue, but it is not always necessary to push the remedy to extreme limits. As soon as symptoms of iodism appear only a drachm or two of the drug need be given daily.
Actinomycosis of Bone.—As a general rule, actinomycosis of bone resists the administration of iodide of potassium, a fact probably explained by the much less abundant blood supply in bone as compared with very vascular tissues, such as the tongue.
To have any chance of success the iodide treatment must be supplemented by surgical interference. As regards the surgical aspect of the case, the affected bone should be removed as far as possible, together with all broken down tissue. Should this be neglected, the disease returns in a little while.
In actinomycosis of the region of the incisors the method is radical when adopted in time. The body of the maxilla can be partially removed with a fine saw, two cuts being made disposed thus: < (the letter V sideways). The upper and lower layers of compact tissue should be spared as much as possible, so that the body of the bone may not afterwards break. Recovery is only a matter of time.