Inflammation of the Parotid Gland. 43 



discharge ; from abscess of the pharyngeal glands it is differenti- 

 ated by the limitation of the hard swelling to the parotid gland 

 and by the superficial seat of the resulting abscess. The coexist- 

 ence of active inflammation serves to distinguish it from ordinary 

 tumors. 



Treatment. By way of prevention, the avoidance of injuries 

 by yokes, forks, pokes, and goads is important. Also the disin- 

 fection of the mouth by a liberal supply of pure water and even 

 by antiseptic washes : — borax, boric acid, creolin, tannin, chlorate 

 of potash. Also by the removal of foreign bodies or calculi from 

 the canal. 



When the inflammation has set in, a saline laxative is often of 

 value. Wash the mouth with a solution of vinegar and salt, or 

 other antiseptic, repeating this at least after every meal. The 

 swollen, painful gland may be covered with a damp compress or 

 anointed with vaseline to which may be added a little creolin, 

 naphthol, carbolic acid or salicylic acid, together with lead acetate 

 and belladonna or other anodyne. The diet must be soft, cool 

 mashes, sliced or pulped roots or any bland agent that will de- 

 mand little or no mastication. Cool, fresh water should be al- 

 lowed ad libitum. When the laxative has set, it may be followed 

 by cooling diuretics such as nitrate or acetate of potash. 



If suppuration occurs it should be opened as soon as the pus 

 can be definitely recognized, and the cavity treated antiseptically 

 to prevent further local or general infection by the microbes. In 

 deep abscess there is a certain danger of wounding blood vessels 

 and salivary ducts, but this can be to a certain extent obviated 

 by making an incision through the skin only and then boring the 

 way into the abscess with a grooved director or the points of 

 closed scissors. When the cavity is penetrated the pus will ooze 

 out through the groove or between the scissor blades. When 

 the pus has been evacuated the cavity should be washed out two 

 or three times a day with mercuric chloride solution (1 : 1000), 

 or permanganate of potash solution (1 : 100). 



When the gland becomes indurated and indolent, seeming to 

 merge into the chronic form it may be stimulated to a healthier 

 action by a cantharides blister, or it may be subjected to daily 

 massage, or to a daily current of electricity for ten or fifteen 

 minutes. If the inflammation is slight or unrecognizable, the 



