80 
ABSCESS FORMATION IN SUBPAROTID LYMPH GLANDS. 
(3.) ABSCESS FORMATION IN THE SUBPAROTID 
LYMPH GLANDS. 
The lymph glands lying below the parotid often become diseased, 
especially during the course of strangles, sore-throat, and other com¬ 
plaints, a phlegmonous inflammation developing, and gradually leading 
to abscess formation. In cattle and dogs the condition is oftener due to 
injuries of the pharynx by foreign bodies; in swine to specific infections, 
like those of tuberculosis, swine-fever, and actinomycosis. 
Symptoms. Swelling appears in the parotid region, sometimes close 
under the ear, more frequently, however, in the lower posterior border 
of the gland, and usually spreads over the upper portion of the neck. 
The swelling increases, producing difficulty in breathing and swallowing, 
while the head is extended and held towards the sound side. Slight 
fever exists. Where both sides are affected, dyspnoea often develops to 
such a degree, especially during inspiration, that suffocation threatens, 
and tracheotomy becomes necessary. The difficulty in swallowing is 
attended by the danger of mechanical pneumonia. 
At first the swelling appears hard and firm, and painful on pressure. 
Gradually the centre bulges, and in eight to fourteen days unmistakable 
fluctuation may he detected. Failing an artificial opening, perforation 
occurs spontaneously in a few days. This commonly takes place 
externally, hut at times the abscess breaks into the pharynx, and danger 
ensues of pus flowing into the trachea and bronchi, and producing fatal 
pneumonia. In a few cases rupture takes place both inwardly and 
outwardly. From the external wound there then flows pus, mixed with 
necrotic material, saliva and particles of food and water, and -the 
formation of a pharyngeal fistula becomes possible. 
Diagnosis. The disease resembles parotitis and distension of the 
guttural pouch. From parotitis it is distinguished by the swelling 
being now diffused, and not confined to the parotid region; from disease 
of the guttural pouch, by the special characters of such attacks, by the 
progress of the case and the presence of fever. 
Treatment. Early opening of the abscess is desirable, but the use of 
sharp instruments for the purpose is contra-indicated, as, owing to the 
displacement of parts, the parotid may be wounded, producing salivary 
fistula, or the great blood-vessels injured, causing fatal bleeding. 
Yiborg describes the following excellent method, which is simple and 
without danger. A twitch having been applied, and the seat of operation 
cleansed and disinfected, an incision is made through the skin over the 
highest point of the swelling, and, if possible, below the edge of the 
parotid, the underlying fascia divided, and the forefinger inserted. The 
thick connective tissue 01 gland structure is now broken down, the free 
