RANULA 9 



that the swelling is circumscribed sharply, differen- 

 tiates ranula from all other abnormalities in this part 

 of the anatomy, and it can not be mistaken for any 

 other disease. 



The treatment is chiefly surgical and consists of 

 lancing the swelling in the mouth at the point proximal 

 to the incisors. A straight abscess knife is merely 

 thrust into the front of the swelling and withdrawn; 

 no extensive incision need be made. If the disease is 

 of recent occurrence the discharge which is emitted 

 following the lance is quite thick and of a dark gray 

 color; in fact, more of the appearance and consistency 

 of necrotic tissue shreds than of pus. If the disease 

 has existed for a considerable length of time the swell- 

 ing, which is then not so firm, contains a rather thin, 

 syrupy fluid. Nothing further is done to the lesion in 

 the mouth, but the external swelling is to be treated 

 with a mild counter-irritant or an absorbent. 



Relief is immediate when the cyst has been lanced 

 and the cow begins to eat normally. The essential 

 feature in the handling of this condition lies in lancing 

 the swelling in the mouth. The external swelling 

 should never be incised. Further, no time should be 

 wasted in waiting for the internal swelling to "point"; 

 it should be lanced even if it is apparently "not ready" 

 to be lanced. Whenever ranula has reached the stage 

 in which it produces trouble in eating it is ready for 

 opening, no matter how firm it may feel. The knife 

 should penetrate to the center with one thrust; upon 

 its withdrawal the contents of the cyst makes its exit. 



