104 
ACTINOMYCOSIS OF THE JAW. 
second lower molars, and had four fistulous openings, from which a 
yellowish pus was discharged. 
Symptoms. A hard, firm swelling develops on the lower jaw, which 
careful examination shows to be caused by an increase in the volume 
of the bone. The swelling spreads and increases in size ; and although 
it is at first only slightly painful, the animal soon shows difficulty 
in chewing, masticating slowly, holding the head obliquely on one side, 
and even allowing food to fall from the mouth. Closer examination 
discloses the presence of purulent alveolar periostitis of one or several 
molars, those, namely, at the point where the swelling appears externally. 
The diseased teeth lie deeper in the jaw than usual, or are pressed out 
of line. The masticated food collected around them possesses a 
Fi g. 62.—Osteoporosis of the upper jaw (Esser). 
peculiarly penetrating and unpleasant smell, always noticed in alveolar 
peiiostitis of heibivora. The external skin increases in thickness, and 
giadually becomes adherent to the swelling. Later, perforation takes 
place, and a thick fluid yellow pus is discharged, in which actinomyces 
may be found. A probe penetrates deeply into the bone and easily 
bieaks down its thin trabeculae. Granulations form around the wounds, 
and bleed readily when touched. As a rule, feeding is disturbed, and 
loss of condition sets in. 
Prognosis and course. The nature and position of the diseased processes 
make it evident that little can be done therapeutically. Actinomyces 
possess considerable powers of resistance, and when within the bone, 
are exceedingly difficult to reach. The disease must almost always be 
mcuiable, though Pilz and others claim to have had recoveries after 
giving iodide of potassium internally, and applying tincture of iodine 
locally. Nevertheless many unsuccessful cases have been recorded. 
Moussu unhesitatingly states that potassium iodide alone is insufficient 
