FISTULOUS FAROTID DUCT. 
387 
or long-continued accumulation of the secretion; indeed, so 
remarkable is this alteration, that in some cases the duct no 
longer resembles the original formation. I remember operating 
in a case of this desciiption, in which I became quite confounded 
after the parts were exposed by incision, owing to mistaking the 
parotid duct (whose,natural volume is that of a large goose-quill) 
for the sub-maxillaiy vein : the excretory tube, when opened, to 
my surprise, admitted the introduction of my fore finger. In 
addition to this, the tunics of the duct lose their pellucidity and 
shiny exterior, and become opaque and thick, and even indurated ; 
in which state their contractility is either greatly diminished or 
altogether destroyed. 
The causes of salivaiy fistula admit of classification into natural 
and artijiciaL Those I denominate natural” which operate 
through the medium of the constitution. For example, abscess 
or suppuration of the parotid gland, whether it be a concomitant 
of strangles or catarrh, or a distinct affection by itself; but, 
should it originate in wound or contusion, I would say (for dis¬ 
tinction’s sake) that it had an artificial origin. We all know 
that parotiditis occasionally makes its appearance in horses, not 
only in a symptomatic or collateral form, but also as an idiopathic 
disease; and we are also aware that the parotid is a part by no 
means unlikely to be injured, both on account of its exposed 
situation, and from the frequent use that is made of scissars in 
particular in trimming the ears. I need not enter into any 
account of the malady vulgarly called the vivesits name is 
sufficiently indicative of what I mean. Hurtrel d’Arboval in¬ 
forms us, that for this disease in France, the ignorant farriers 
and cow-leeches are in the practice of pinching, bruising/ and 
lacerating the parotids ] and that phlegmonous inflammation, 
abscess, and fistula, are in some cases the consequences of such 
an absurd and barbarous proceeding.” 
In one of the cases selected from my own practice, the fistula 
was the result or rather the concomitant of strangles ; in another, 
the cause (though unknown to me) had to every appearance been 
a punctured wound. In a case related by Hurtrel d’Arboval, it 
originated in the excision of the sub-maxillary lymphatic glands. 
Treatment ,—The case may be regarded as calling for measures, 
simple, complicated, or even hazardous, depending on the situa¬ 
tion of the fistula, its duration, or some unforeseen incidental 
circumstance. Should the breach be recent, every measure likely 
to produce adhesion of the divided or separated parts is to be 
speedily resorted to; such as approximation of them by plaisters, 
bandages, or sutures, and quietude of the jaws ; to which may 
