PAROTITIS 117 



parotitis produced by injuries, lesions are often found on 

 the skin. In most cases only one gland is affected and general 

 disturbance will not be noted. When resulting from pharyn- 

 gitis and stomatitis, the symptoms are modified by the 

 swelling of the mucous membrane and connective tissues. 

 There is quite an extensive edema of the lips, tongue and in 

 the tissue around the gland. Chronic parotitis is charac- 

 terized by a firm enlargement of the gland, acute symptoms 

 being absent. Steno's duct may be distended from a closure 

 of the buccal opening. 



Diagnosis. Acute parotitis may be confused with enlarge- 

 ment of the lymph glands and therefore must be examined 

 carefully. The position, shape and nature of the enlarge- 

 ment are to be considered in making the diagnosis. 



Prognosis. Usually favorable. When abscesses develop 

 a fistula may result from the opening of some of the ducts. 

 In chronic indurative parotitis, the prognosis is less favorable. 



Treatment. In the early stages when the glands are 

 enlarged endeavor to hasten resolution, or abscess formation. 

 Later a stimulating liniment (soap or white) may be used 

 with good results. When abscesses develop, they should 

 be opened early so as to secure good drainage. When the 

 incision is made, it should be only through the skin, and the 

 tissues then separated with the fingers in order not to injure 

 the gland any more than is absolutely necessary. Irrigate 

 the cavity daily with antiseptic solutions (boric acid 2 per 

 cent., etc.). In cases where the discharge is persistent and 

 abundant, tincture of iodin or Lugol's solution injected into 

 the gland gives good results (see Salivary Fistula). 



In chronic parotitis recovery may be hastened by the 

 application of iodin ointment over the surface of the glands. 

 Lugol's solution may be injected directly into the gland. 

 Insert the needle rather deep into the gland substance, being 

 careful that it does not enter a bloodvessel, which will be 

 shown by the free flow of blood. Injections may be made at 

 different parts of the gland and repeated in a few days if 

 necessary. Small doses of potassium iodid (0.05-0.10) given 

 once daily will assist in the absorption of the deposits in the 

 gland. 



