MORBID ANATOMY 3H 



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

 The indurated tongue is often eroded from friction and various 

 deformities of this organ are reported. 



3. In the pharynx. Here the disease usually 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 egg. These polypoid 

 growths may cause great difficulty in swallowing and likewise 

 interfere with respiration. Tumors of this kind may form in 

 the esophagus or trachea. Rarely actinomycotic growths 

 occur at other places in the alimentary tract. There are some 

 cases in which the lesions are not restricted to the digestive 

 tract'. 



4. In the skin and subcutaneous tissue. The lesions of 

 the skin and subcutis are found chiefly on the head and neck. 

 They usually consist of firm nodules from the size of a hazel 

 nut to that of a man's fist or even larger. Sometimes these 

 nodules are pedunculated and at others they are attached to 

 the skin by a broad base. Instead of the hard tumor there 

 may occur soft granular fungoid proliferations covered with a 

 brown crust or with a purulent secretion. At other times 

 minute nodules appear in these proliferations and the skin 

 becomes thickened and indurated. However, the skin lesions 

 may become very large. In this organ, the disease may be 

 either primary or secondary. 



5. In the lymph glands. Actinomycosis often appears in 

 the lymph glands of the head, larynx and pharynx. The 

 parotid and submaxillary glands are sometimes involved as 

 secondary infections. It is reported that the sub-parotid 

 glands are most frequently affected. 



6. In the lungs. The lesions in the lungs vary. They 

 may consist of firm, somewhat yellowish nodules which event- 

 ually become calcareous in their center and vary in size from 

 mere specks to that of a pea. This form is spoken of as 

 miliary actinomycosis. In the second form the actinomycotic 

 foci soften and become filled with a gray muco-purulent fluid. 



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