348 INFLAMMATION OF THE ARTICULATION OF THE JAW. 



joint immobile in a goat, on account of the formation of extensive 

 exostoses. The condition had resulted from severe bruising. Dry 

 chronic arthritis (arthritis chronica sicca) of this joint is also seen 

 in horses. 



Symptoms and course. Impaired mastication is the most frequenl 

 accompaniment. The mouth cannot be properly opened, whence the 

 condition is sometimes mistaken for trismus, from which it may be 

 distinguished by a swelling affecting one or other, but seldom both 

 articulations. The lower jaw is generally displaced sideways, so 

 that the grinding surfaces of the teeth do not exactly correspond, 

 and patients, in consequence, quickly fall off in condition, and some- 

 times cannot take any food at all. They often develop the shear- 

 like mouth. Sometimes the disease ends in anchylosis of the joint. 



Bosenroth saw a case of this kind in a horse, and has described 

 the post-mortem appearance. Several similar cases occurred in 

 Moller's practice. In a dog, which suffered from inability to open 

 the mouth, and showed extensive atrophy of the muscles of 

 mastication, Moller found formation of new bony material in both 

 articulations. This had been produced by an arthritis chronica. 

 Siedamgrotzky has described a similar case. 



The disease is of a very grave character, especially in animals 

 which have to consume much food, such as working-horses and 

 milch-cows. Cases like that described by Weiss, where a horse was 

 able to masticate regularly after displacement of the inter-articular 

 cartilage, are exceedingly rare. An error in diagnosis may possibly 

 have occurred in the case described. 



Treatment. The patient's strength must be conserved, suitable 

 diet provided, wounds and inflammatory processes properly treated, 

 and the ill effects of decubitus guarded against. So long as purulent 

 arthritis does not exist, recovery, as in Siedamgrotzky's case, may 

 be expected. When suppuration has occurred, the parts must be 

 washed out with sublimate solution, iodine in solution of iodide of 

 potash, or with iodoform aether. Any fragments of bone must be 

 removed. Re-section of the joint was successfully performed by 

 Frohner, but is only commendable as a last resort. Delamotte 

 recommends injecting the cavity with carbolic or sublimate solution, 

 and limiting the movement of the lower jaw as far as possible by 

 means of a tightly applied nose strap. Fluid nourishment alone is 

 indicated. 



