MAXILLITIS. 



27 



ointments, of camphor, carbolic acid, or iodoform.^ When the 

 disease shows any tendency to become chronic we may use tinc- 

 ture of iodine, red ointment (hyg. iod. rub.), cantharides, etc. 

 The abscess must be opened as soon as possible. Salivary fistula, 

 resulting from abscess formation in the gland, is to be treated in 

 accordance with the rules of classical surgery. 



MAXILLITIS: INFLAMMATION OP THE MAXILLARY 



GLAND. 



Inflammation of the maxillary gland is usually the result of an 

 obstruction of Wharton's canal by the introduction of foreign 

 bodies. Most frequently it is caused by brome-grass [a kind of 

 oats or grass belonging to the genus Bromus — w. L. z.], which 

 when once introduced into the canal can progress as far as the 

 gland, due to the arrangement of its barbs. The same conditions 

 are sometimes caused by barley or oats. In exceptional cases the 

 trouble may be produced by calculi located in the canal. Maxil- 

 litis is almost always unilateral. 



The beginning of the disease is insidious. Appetite is preserved, 

 but mastication is slow and troublesome ; hard food and oats are 

 soon left untouched. Within a few days characteristic symptoms 

 appear. Salivation is abundant, the mouth hot, the mucous 

 membrane injected. In examining the floor of the buccal cavity 

 we observe a red, conical projection on the frenum of the tongue, 

 from which a purulent fluid escapes ; this is the tumefied free 

 opening of the duct. Often food accumulates between the tongue 

 and maxillary; on removing it we find Wharton's canal pro- 

 jecting and inflamed ; if compressed from behind forward, a 

 whitish purulent fluid, sometimes mixed with alimentary particles, 

 trickles out of it. Phlegmasia of the gland is also indicated by a 

 tumefaction in the cavity of the mouth, which is observed on the 

 side at the base of the tongue, and is a hard or œdematous, sensi- 

 tive pufiiness of the lingual canal. 



Maxillitis ends in resolution or suppuration. If we succeed in 



' [For some years the use of moist heat has been discarded, owing to its incon- 

 venience of application and the great difficulty of maintaining it in close apposition 

 to the skin. In its stead we use a thick poultice of cotton-wool, which is light and 

 clean, and in its therapeutic action far more satisfactory than moist heat. — W. L. Z.] 



