The Head and Neck yy 



They may become wedged in between the teeth or perforate the 

 soft tissues. Youngs treated a case in which he found a splinter 

 of wood lodged between the upper gums behind the incisors, and 

 observed also a small wound on the left side of the frenum. Later, 

 an abscess formed in the throat and burst, and this led to the dis- 

 covery of another piece of wood which had penetrated the tissues 

 from the mouth and had lodged in the subcutaneous tissue slightly to 

 the right of the trachea. Annular bodies, rubber bands, or threads 

 may encircle the tongue, the ends of threads extending into the 

 esophagus. Servais recorded a remarkable case of constriction of 

 the base of the tongue by an annular portion of the aorta of a cow, 

 which had slipped over the tongue while the animal was feeding and 

 had become worked back by muscular movements of the organ. In 

 districts where porcupines abound, it is not uncommon for dogs, in 

 attacking these creatures, to receive a mouthful of quills. The 

 latter make a very awkward foreign body as it is hopeless to ex- 

 tract them without causing extensive laceration. When they pene- 

 trate out of sight, they usually work their way through the skin in 

 course of time and cause considerable pain in so doing. 



Symptoms and Diagnosis. The presence of foreign bodies in 

 the mouth may be recognized by the persistent attempts of the ani- 

 mal to rid itself of the offending object by pawing at the mouth 

 and shaking the head. The jaws are champed or held open and 

 immobile, and saliva dribbles from the mouth. The presence of pins 

 and needles does not always give rise to indicative symptoms. They 

 may penetrate the base of the tongue so deeply as to be invisible and 

 only discovered by digital exploration, or they may gradually work 

 their way through neighboring tissues and ultimately find exit at 

 some other part of the body. 



In Servais's case of constriction of the tongue the latter was 

 enormously swollen and gangrenous. 



Treatment. Substances wedged in between the teeth arc re- 

 moved without much difficulty with suitable forceps or they may 

 be displaced by drawing a piece of silk or catgut to and fro in the 

 interdental space. Needles and pins lodged in the tongue are ex- 

 tracted with forceps. The tongue should be firmly grasped and 

 drawn well forward to permit of more easy removal. If the point 

 of the needle has penetrated in an anterior direction, the visible por- 

 tion is seized with forceps and extracted by traction in the opposite 

 direction. Bodies lodged in the cheeks may be removed by exter- 



