DISEASES OF THE LIPS AND CHEEKS. 247 



Diseases of the skin, like eczema and mange, are not infrequently 

 transmitted to the lips as a result of licking the diseased spots. 

 Thence they generally spread to the bridge of the nose, producing 

 a dermatitis chronica apostematosa, which gives great trouble, 

 especially if the area involved is too great to permit of all diseased 

 skin being removed with knife and scissors. The follicular inflam- 

 mation of the lips in young dogs, associated with lymphangitis and 

 suppuration in the submaxillary lymphatic glands, described by 

 Frohner, is probably due to extensive outbreaks of acne pustules. 

 A similar affection in an old dachshund was described in the 

 Berliner Tierdrztliche Wochenschrift. Death resulted from general 

 infection. 



In dogs and cattle, spontaneous necrosis of the cheek occurs, 

 resembling noma of children. In dogs the disease begins with 

 formation of a minute lesion at the corner of the mouth ; 

 the great swelling which simultaneously appears indicating the 

 character of the malady. The skin is soft, greyish-brown, and easily 

 removable ; the submaxillary lymph glands are swollen, and fever 

 and severe salivation exist. In dogs the process seldom terminates 

 before destroying a large portion of the cheek. The appearance of 

 granulations and of pus formation on the boundary indicate the 

 commencement of healing. After the necrosed portion sloughs, the 

 molars may become visible, and great difficulty exist in taking fluids. 

 In spite of this, complete recovery usually occurs ; difficulty in 

 feeding disappears, and even the animal's outward appearance does 

 not permanently suffer. The disease is rare in dogs, and its cause 

 is as little understood as that of noma in the human subject, though 

 it probably consists in infection by the necrosis bacillus or other 

 micro-organism. 



Treatment. The parts should at once be cauterised. Where this 

 is impractible, lotions of permanganate of potassium, carbolic acid, 

 or sublimate can be applied. Thin fluid nourishment is indicated, 

 and may be given from a bottle. As soon as the defect in the 

 cheek interferes with feeding, fluid or semi-solid nutriment becomes 

 indispensable. If required, animal broths may be given. Stockfleth 

 has described a similar disease in cattle, resulting from injuries, 

 but this does not extend as in dogs. Most commonly an abscess 

 forms in the cheek, and recovery occurs in a few days. The treat- 

 ment of other inflammatory processes should be adapted to their 

 special features. The cause must be removed and care taken that 

 the affected part is not irritated more than necessary, either by 

 rubbing or by mastication. Attention is accordingly required in 



