ACTINOMYCOSIS. 



675 



of the connective tissue, and, in time, changes in the muscular struc- 

 tures themselves. 



The tongue shows progressive hypertroph}', and becomes hard, sensi- 

 tive, rigid, and incapable of free movement. As a result the patients 

 first have difficulty in grasping food, then in swallowing their saliva, 

 which dribbles from the mouth, and finally are quite unable to feed 

 themselves. 



The tongue is enlarged and indurated, and fills the entire cavity 

 of the mouth. Sometimes it projects beyond the incisors, excoriated 

 and bleeding. On passing 

 the hand into the mouth it 

 is found that the surface is 

 covered with little yellowish 

 or red ulcerated nodules, 

 varying in size from that of 

 a large pin's head to that of 

 a lentil. 



In eating, the animals 

 seize food between the lips 

 and lift the head high, so 

 as to allow the food to fall 

 between the rows of molars. 

 The motion is very similar 

 to that of a fowl drinking. 



ACTINOMYCOSIS OF THE PHARYNX, 

 PAROTID GLANDS AND NECK. 



Actinomycosis may some- 

 times leave the mouth and 

 tongue unaffected and attack 

 the pharynx, from which it 

 extends in the direction of 



the parotid glands and external surface of the neck. In these cases, 

 however, the inoculations are more localised than when the surface 

 of the tongue is attacked, and the lesions consist of vegetations, polypi, 

 or actinomycomata. 



The growths develop on the posterior pillars of the fauces, on the 

 sides of the pharynx, or near the entrance to the oesophagus. They 

 interfere with swallowing, and produce symptoms which are easy to 

 detect and interpret. 



The lesions may also affect deeper-seated tissues and produce 

 growths in the parotid or subpa'rotid region, or lead to the develop- 

 ment of fistulae in the region of the neck. Most fistulse, however, in 



X X 2 



Fig. 271 — Actinomycosis of the tongue. 



