356 DISEASES OF THE SUBMAXILLARY LYMPH GLANDS. 



firm, sometimes appears as a circumscribed new growth, sometimes 

 as a diffuse enlargement of the whole gland, or of single sections 

 of it. It develops slowly, finally breaking in several places. The 

 nature of the disease may be recognised by microscopical examination 

 of the discharge which frequently contains either the ray fungi of 

 actinomycosis or colonies of botryomyces. In the horse, however, 

 Moller repeatedly found chronic disease of these lymph glands, with 

 ulceration of the skin and multiple abscess formation in the glands, 

 without the presence of the above-named parasites ; but in such 

 cases pyogenic cocci were present. 



Treatment requires extirpation of the gland, or of those portions 

 affected by the new growth. Resorbent or disinfecting materials are 

 never satisfactory. In the horse Moller frequently removed the 

 collective submaxillary lymph glands (see Fig. 319), and he recom- 

 mends proceeding as follows : — The horse should be cast, chloroformed, 

 and laid on its back. The skin is now cut through at the point where 

 it has become adherent to the underlying structures. The connective 

 tissue which surrounds the gland is thus exposed, and the tumour 

 divided from the sound structures by the fingers, aided by scissors 

 and knife. Great care must be taken not to injure the glosso-facial 

 artery and vein, or Stenson's duct. Wherever practicable, the 

 operation should commence at the posterior part, in order that 

 the blood-vessels be more conveniently ligatured. If the sub- 

 lingual gland is diseased, it must also be removed. The seat of 

 operation is then washed out, its surface sprinkled with iodoform 

 and tannin, and, in order to check bleeding, a mass of tow or cotton 

 wool firmly inserted before sewing up the wound. The tampon is 

 removed after twenty -four hours, and the wound treated as an open 

 one, when regular healing usually follows. The appearance of normal 

 or blood-stained saliva is unimportant. The discharge ceases with 

 the appearance of granulation. 



Cysts and fistulse of the laryngeal region are sometimes seen in 

 the horse and dog. Thus Vachetta has seen fistulae due to the non- 

 closure of the branchial arches in the horse and dermoid cysts in 

 horses and dogs. In the latter mucoid cysts, varying in size between 

 a pigeon's egg and a man's fist, are seen in or near the submaxillary 

 region ; they usually extend downwards, sometimes behind the larynx 

 and oesophagus. The cause of their formation is unknown ; Frohner 

 regards them as retention cysts due to the persistence of isolated 

 fragments of the embryonic prototype of the sublingual gland. They 

 appear as fluctuating swellings of slow growth, unaccompanied by 

 inflammation. Surgical treatment is difficult, inasmuch as the entire 



