26 



DISEASES OF THE DIGESTIVE APPARATUS. 



The disease described by Stockfleth, in his Treatise on Surgery y 

 under the title " Chronic Inflammation of the Salivary Glands/^ 

 is without doubt actinomycotic parotitis. According to his obser- 

 vations, animals pasturing on, or eating hay from, low swampy 

 meadows are more exposed to contract the disease. The parotid 

 is most frequently attacked, exceptionally the maxillary and sub- 

 lingual glands are also affected. The inflammations develop 

 slowly, the gland being hard and irregular, gradually increasing 

 in size; they are indolent, but in most cases break down into 

 abscess. The neighboring lymphatic ganglions almost always take 

 part in the inflammation. As soon as the hypertrophied gland 

 reaches a certain size it exerts pressure upon the larynx and 

 pharynx, and becomes an obstruction to the function of respira- 

 tion and deglutition. All remedial agents are absolutely useless. 

 Extirpation of the diseased organ is the only successful treatment. 



Symptoms. Three forms of parotitis are to be considered 

 here : the idiopathic form, the form which results from an inflam- 

 mation of the surrounding tissue, and the metastatic form. They 

 present a common symptom : the swelling of the parotid gland. 

 In the first the tumefaction is uniform, and extends over the 

 whole organ. The other two varieties are distinguished by a 

 limited swelling, and by consecutive abscess formation of the 

 affected glandular lobules (see Toussaint's case). Inflammation 

 can also spread to the surrounding tissue. In the epizootic form, 

 observed by Franze upon the goat, the maxillary bones and 

 glands participated in the inflammation. The patients partook 

 of neither food nor drink. 



The rational symptoms and the fever of parotitis have not yet 

 been described. 



Differential diagnosis. Parotitis has often been confounded 

 with inflammation of the pharyngeal ganglions. The topography 

 of these organs, and the signs furnished by the general condition 

 of the patients, allow us to make a correct diagnosis. 



Parotitis may also be simulated by purulent collection of the 

 guttural pouches, by tumefaction produced by old jugular phthisis, 

 by an œdematous or phlegmonous inflammation of the subcutaneous 

 connective tissue, and by tumors of any nature developed in the 

 parotid region. 



Treatment. Parotitis showing no tendency to form abscess 

 must be treated with moist heat and by the local application of 



