262 HEALTH AND DISEASE 



upon the size of the opening and also upon the act of mastication. When 

 feeding, the secretion of saliva is most active and the How is very consider- 

 able, but becomes comparatively slight when food ceases to be taken. 



Treatment. — The indications here are to close the external wound 

 promptly, and by so doing cause the saliva to flow along and keep open 

 its proper channel and allow the rent in the vessel to heal. Success will 

 greatly depend upon: 



1. Whether the vessel is partially or completely divided. 



Fig. 94.— Fistula of the ParotM Duct 



2. Upon the period of time which is allowed to elapse between the 

 injury and recourse to treatment. 



3. As to the state of the duct itself. 



When the duct is cut through, or its walls are involved in an ulcerative 

 condition, the prospects of cure are remote; when, however, the duct is 

 simply perforated it is more favourable. 



Whatever treatment is undertaken, solid food must be altogether with- 

 held for three or four days, or more if necessary, and the patient supported 

 on liquid aliment such as thin oatmeal and maltmeal gruel mixed with 

 eggs, beef-tea, and milk alternately, the object being to keep the jaws at 

 rest and the secretion of the saliva as far as possible in abeyance. 



The hair must now be removed from about the wound and the part 

 thoroughly cleansed with soap and water and afterwards freely irrigated 

 with a solution of carbolic acid. With a small needle and catgut-thread 

 the lips of the wound are then to be carefully and completely drawn 

 together, in doing which a sufficient hold should lie taken of the skin to 

 guard against tearing out. The part is then to be covered by a thick 



