460 DISEASES OF THE MOUTH. 



secretioD, but on neglecting to swallow that which is produced in 

 mal amount. 



ANATOMICAL APPEARANCES. We do not know the anatomical 

 changes undergone .by the salivary glands in increased salivation. In 

 continued and excessive salivation, slight swelling of the parotid occurs 

 in some rare cases. The fact, that the secretion may still be obtained 

 after the heart has ceased to beat, proves that overloading of the ves- 

 sels, or hyperaemia of the salivary glands, which instantly causes their 

 infiltration and swelling, is not the sole cause inducing increased secre- 

 tion. 



SYMPTOMS AND COURSE. The pains in the mouth, and painful 

 swellings of the neighboring lymphatics, which occur in salivation, be^ 

 long to the various forms of stomatitis exciting it ; salivation itself 

 causes no pain, but it greatly inconveniences the patient. The fre- 

 quent collection of fluid in the mouth obliges him to spit constantly ; 

 frequently he cannot speak two words without interruption. Best at 

 night is also disturbed, partly by the saliva flowing from the mouth 

 and wetting the pillow, partly by that which, flowing backward, passes 

 into the pharynx and larynx. The escaping fluid may reach the 

 amount of six or eight pounds in twenty-four hours. Lehmann and 

 other observers have found it, at first, more mucous, cloudy, of greater 

 specific gravity, and richer in solid constituents (young and old epi- 

 thelial cells), than normal saliva. The fluid is alkaline, contains much 

 fat and little ptyaline, and only rarely perceptible amounts of sulpho- 

 cyanide of potassium. Subsequently, the secretion was less cloudy, 

 and, like the saliva that I/udwig obtained, by continued irritation of 

 nerves influencing the secretion, it contained less solid constituents 

 than normal saliva. This fluid was also alkaline, rich in fat and so- 

 called mucous corpuscles ; it contained no sulpho-cyanide of potassium. 

 When salivation has continued a long while, albumen may occasional- 

 ly be found in the fluid. The patients usually emaciate ; the loss of 

 water and organic constituents has little to do with this, but, as the 

 accompanying stomatitis interferes with chewing, the patients take 

 little nourishment, and what they do take is badly assimilated, be 

 cause the quantity of saliva swallowed interferes with digestion. 



TREATMENT. The causal indications require a careful treatment 

 ol the original disease when the salivation is caused by affections of 

 the mouth. When resulting from the misuse of mercurials, slight laxa- 

 tives are to be recommended. Cullerier calls constipation " one of the 

 best known of the exciting causes of salivation," and, indeed, it is more 

 rational to suppose that the mercurials which reach the mouth through 

 the salivary glands, and are swallowed, would be more readily removed 

 bv purgatives than by remedies directed to the skin or kidneys. Sali- 



