Ml MI'S. 



painful and inflammatory swelling of :he salivary glands. It is generally limited to 

 tin- ]>an>tid gland the one just below and in front of the ear on either side but it 

 may affect the glands which are undi-r the jaw and tongue as well. It is a genera! 

 disease, and not a local one. It is. in fact, a sjxvitic fever, and must be placed in the 

 same rlass as measles, small pox, Arc. The affection of the salivary glands is what is 

 known as the local manifestation of a general disease, and is distinctly analogous to 

 the eruption of small pox, the ulceration of the bowels in typhoid, and the sore throat 

 and rash of scarlet fever. It is distinctly infectious, and once being introduced into 

 a house it usually runs through the household. Although most common in childhood, 

 it is by no means limited to the first years of life, but is tolerably common at any 

 age up to thirty; but beyond this period it is said not to occur. The period of 

 the commencement of the second dentition is perhaps the most common time. The 

 period of incubation, i.e., the time which elapses between the exposure to the con 

 tagion and the first manifestation of the disease, is said to vary from one to three 

 weeks. The disease usually begins by a feeling of pain in the neighbourhood of one 

 ear, which is greatly increased during any exercise of the jaw, as in eating. The 

 characteristic swelling then appeal's, and this is often sufficient to cause a considerable 

 deformity of the face. The swelling is just below the ear, behind the angle of the jaw, 

 and extends also a little forward over the angle of the jaw to the front of the ear. It 

 is uniformly smooth, and is more or less tender all over the surface. The swelling 

 begins first on one side, and then, as this subsides, the other side is usually 

 attacked. When the swelling on. both sides occurs in this way, we may almost 

 certainly assert that the disease we have to deal with is mumps and nothing else. At 

 this period there is considerable general disturbance, and, besides the local trouble, 

 the patient complains of headache, thirst, loss of appetite, and general malaise. The 

 temperature in the earliest stage is considerably raised, and a thermometer placed in 

 the mouth will usually register 100 Fahrenheit, and may rise much higher, to 103, 

 and even over. The patient feels miserable, and prefers to be left alone. Even if 

 the appetite remains fairly good, the act of taking food is often so painful as to render 

 it impossible. When the glands under the jaw are affected as well as the parotids, 

 the patient's condition is really pitiable. It often happens that the pain is far less 

 in children than it is in adults. Associated with the swelling of the salivary glands 

 there is often a good deal of enlargement and tenderness of the lymphatic glands at 

 the side of the neck. Although the swelling is often very great, and the skin over 

 it may become reddened, matter hardly ever forms in the gland, and the swelling 

 usually subsides again completely. 



The disease usually reaches its height before the end of the first week sometimes, 

 in mild attacks, after a couple of days. It then begins to decline, and is fairly over 

 at the end of eight or ten days, and the child is quite well again. One attack 

 protects from another. 



Although the disease happilv, as a rule, runs a mild course, it does not always do 

 so. and there is a great liability in mumps for -metastasis to occur i.e., for the 

 inflammation to shift its ground and attack other parts. The parts most liable to 

 suffer are the pudenda, but this is especially the case with boys, and a watchful eye 

 must be kept over them for the first appearance of any trouble of this kind. 



