Actinomycosis of bone. 081 



all these symptoms diminish and disappear soon after the adminis- 

 tration 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 addi- 

 tional reason for following the course above suggested. 



Other lesions of soft tissues, such as disease of the parotid or cer- 

 vical glands, etc., yield to the same treatment, but it is advisable first 

 of all to clean out the fistulfe, 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 probabl}^ ex- 

 plained by the much less abundant blood supply in bone as com- 

 pared with very vascular tissues, such as the tongue. 



To have any chance of success the iodide treatment must be sup- 

 plemented 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 bod}^ of the maxilla can be partiall}^ 

 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. 



A very small local iodoform dressing is applied, and, when healthy 

 granulations appear, cicatrisation can be left to natural means. 



Cases of actinomycosis of the jaw are much more troublesome. If, 

 as usually happens, the lesion is ulcerated before the practitioner is 

 called in, the external fungoid growth should be removed by means 

 of an elliptical incision through the skin, the axis of the ellipse being 

 parallel with the branch of the maxilla. The bony fistula is then 

 exposed. 



