212 



ACTINOMYCOSIS 



the subcutaneous connective tissue and the skin or to the oral 

 cavity in the direction of the molar teeth which become dis- 

 placed. (2) In the tongue. When the disease appears in this 

 organ it takes the form of an indurating glossitis. The tongue 

 becomes thicklj' sprinkled with round or oval, hard, fibrous 

 nodules which finally become purulent or chalky at the center. 

 Around these there is a con.siderable increase of connective 

 tissue which leads to the atrophy of the mu.scle fibers, l^pon 

 .section the tongue is found to be hard and often gritty. The 

 indurated tongue is often eroded from friction and various 



Fig. 47. Actinomycosis of the Jaw. {Photographed by Hopkins.') 



deformities of this organ are reported. (3) In the pharynx 

 the disease usuall}- takes the form of soft polypoid or fungoid 

 nodules or lumps with a smooth surface and short peduncle. 

 These nodules vary in size often reaching that of a goose's 

 ^Zg. The.se polypoid growths may cause great difficulty in 

 swallowing and likewise interfere with respiration. Tumors 

 of this kind may form in the oesophagus or trachea. Rarely 

 actinomycotic growths occur at other places in the alimentary 

 tract. There are some cases in which the lesions are 



