EPULIS 41 



Ranula 



Ranula is a large, fluctuating swelling which ap- 

 pears at the lateral or under surface of the tongue, 

 usually near the frenum. It is painful, produces 

 profuse salivation, and may attain such size as to 

 prevent the complete closure of the mouth. 



Cause. — This trouble is due to the blocking up 

 or closure of the mucous gland and the consequent 

 enlargement of the gland. An obstruction of Whar- 

 ton's duct sometimes produces a similar condition. 

 The contents of ranulse are of a thick, glairy, 

 mucoid nature. 



Treatment. — This should be surgical, the instru- 

 ments required are a mouth speculum, a small 

 scalpel, scissors, and tissue "forceps. The instrument 

 having been sterilized by boiling for twenty min- 

 utes, the mouth is fixed open with a mouth specu- 

 lum and the tongue drawn into such a position as to 

 place the ranula in the most suitable situation for 

 removal. The sac is then punctured with the 

 scalpel and the whole of the wall dissected out; 

 unless this is thoroughly done, the ranula will recur. 

 After-treatment consists in washing out the wound 

 three or four times a day with, an antiseptic and 

 astringent mouth wash. Boracic acid, ten grains to 

 the ounce, and chinosol, one-half grain to the ounce 

 of water, make useful antiseptic washes. 



Epulis 



This name is given to a hard, smooth, periosteal 

 tumor which appears on the gums at the edge of 

 the alveoli. There may be only one tumor, or they 

 may be numerous, and may be benign or malig- 

 nant in character. Unless these tumors cause pain 

 and undue inconvenience in eating it is better not 

 to interfere with them. If an operation is decided 

 upon, they may be removed with a scalpel or scis- 



