106 
DISEASES OF THE SUBMAXILLAIIY LYMPH GLANDS. 
by swelling, which is slightly painful and moderately firm, some¬ 
times appears as a circumscribed new growth, sometimes as a diffuse 
enlargement of the whole gland, or of single sections of it. It develops 
slowly, finally breaking in several places. So soon as the ray-shaped 
fungi of actinomycosis or the well-known bothryomyces forms are dis- 
chaiged, the nature of the disease may be recognised. In the horse 
Holier, however, repeatedly found chronic disease of these lymph 
glands, with ulceration of the skin and multiple abscess formation in the 
glands, without the presence of the above-named parasites; but in such 
cases pyogenic cocci were present. 
Treatment requires extirpation of the gland, or of those portions 
affected by the new growth. Resorbent or disinfecting materials are never 
satisfactory. In the horse Holler frequently removed the collective sub- 
maxillaiy lymph glands (see fig. 51), and even a portion of the sublingual; 
he recommends proceeding as follows The horse should be cast, chloro- 
formed, and laid on its back. The skin is now cut through at the point 
wheie it has become adherent to the underlying structures. The con¬ 
nective tissue which surrounds the gland is thus exposed, and the tumour 
divided from the sound structures by the fingers, aided by scissors and 
knife. . Great care must be taken not to injure the external facial artery 
and vein, or Stenson’s duct. If this seems unavoidable, they should 
previously be ligatured. Wherever practicable, the operation should 
commence at the posterior part, in order that the injured vessels be 
more conveniently ligatured. If the sublingual gland is diseased, it 
must also be removed. The seat of operation is then washed out, its 
surface sprinkled with iodoform and tannin, and, in order to check 
bleeding, a mass of tow or jute firmly inserted before sewing up the 
wound. The tampon is removed after twenty-four hours, and the wound 
treated as an open one, when regular healing usually follows. The 
appearance of normal or blood-stained saliva is unimportant. The dis- 
chaige ceases with the appearance of granulation. 
Diseases of the laryngeal region, of which little is to be found in 
recognised text-books, are sometimes seen in the horse and dog. Thus 
Vachetta has seen fistulas due to the non-closure of the branchial 
arches m the horse and dermoid cysts in horses and dogs. In the latter 
mucoid cysts, varying in size between a pigeon’s egg and a man’s fist, 
are seen m or near the submaxillary region ; they usually extend down¬ 
wards, sometimes behind the larynx and oesophagus. The cause of their 
formation is unknown; Frohner regards them as retention cysts due to 
the persistence of isolated fragments of the embryonic prototype of the 
sublingual gland. They appear as fluctuating swellings of slow growth, 
unaccompanied by inflammation. Surgical treatment is difficult, inas¬ 
much as the entire growth can seldom be removed, and a fragment is 
