Causes: traumatic; calculus; grains; barley and other beards;
infecting microbes. Symptoms: fever, dullness, buccal heat,
salivation, difficult mastication, swelling of gland and duct,
protruded nose, stiff neck, fœtor, dyspnœa, facial paralysis,
induration of gland, abcess. Diagnosis from pharyngitis, abcess of
guttural pouch or pharyngeal glands; from tumors. Treatment: avoidance
of causes; derivation; astringent, antiseptic washes; wet antiseptic
bandages to throat; cool pultaceous diet. Open abscess and disinfect.
For induration deobstruents. For sloughing antiseptics.
This may be caused by traumatism, such as incised punctured or bruised
wounds. Wounds inflicted by the goad, by horns, and even by the yoke in
cattle must be looked on as factors. It occurs from obstruction of the
salivary ducts by calculi, or by grains, seeds, or pebbles introduced
from the mouth; from their irritation by the beards of barley and other
plants (brome, rye, wheat, etc.); and from the localization in the gland
of specific inflammations like strangles, pyæmia, canine distemper,
tuberculosis and pharyngitis. In most of these cases infective microbes
are prominent factors. They enter with penetrating bodies from the skin;
they extend through the weakened and debilitated tissues in bruises;
they penetrate the Stenonian duct with the various foreign bodies from
the mouth; irrespective of foreign objects they make their way up the
duct by continuous growth from the buccal orifice; in case of calculus
or other obstruction their extension is favored by the local congestion
and debility and by the stagnation of the saliva above the point of
arrest. When present these microbes even favor the deposition of the
salivary salts and formation and increase of calculi so that the
affection may advance in a vicious circle, the microbes favoring
calculus and the calculus favoring the increase of microbes.
_Symptoms._ In the horse in particular there may be premonitory symptoms
of fever, dullness, heat of the mouth, ptyalism, slow and imperfect
mastication, and the retention of food in the cheeks.
The Stenonian duct becomes swollen and painful. The parotid becomes
hard, hot, tender, and is surrounded by a softer pitting infiltration
which may extend down around the entire throat, and even along the
intermaxillary region to the chin. When the canal is obstructed it may
stand out as a thick rope-like resilient swelling extending around the
lower border of the jaw and upward toward the cheek as far as the point
of obstruction. When one parotid only is involved, the contrast with the
other is quite marked. The head is extended and carried stiffly. When
the nose is depressed, or when the head is turned to one side or the
other, the patient gives evidence of suffering from compression or
stretching of the inflamed region. The breath and mouth exhale an
offensive odor, determined by the decomposition of mucus and of the
retained food products.
Among remote effects may be named dyspnœa and threatened suffocation
from pressure on the pharynx and laryngeal nerves, and facial paralysis
from pressure on the seventh nerve.
The disease may go on to induration and remain permanently in this
condition, or it may suppurate and discharge through the skin, into the
pharynx or through the duct of Stenon. It may communicate with both the
duct and the skin and determine a fistula. When suppuration occurs there
is an access of fever, a chill may be noticed, the swelling becomes more
tense, harder, more tender to the touch, and even emphysematous, and
finally points internally or externally. This may take place from the
fifth to the tenth day or later. When it opens into the duct it may be
seen oozing from the orifice in the cheek when the mouth is opened, and
in case the jaws are suddenly parted, it may escape in a jet. In such a
case and especially if the microbes have come originally from the food
the odor is very fœtid. The abscess is not always single and when
multiple the pus may escape externally by a variety of orifices. The pus
is usually whitish, yellowish or grayish and creamy, but it may be
grumous or bloody or serous and of a most offensive odor. In exceptional
cases the gland becomes more or less gangrenous and such parts, exposed
in the wound are hard, bloodless and insensible, and add very materially
to the fœtor. This may lead to general septic infection, or the necrosed
masses may slough off and the cavities fill up by granulations.
_Diagnosis._ Parotitis is distinguished from pharyngitis and abscess of
the guttural pouch by the absence of cough and nasal discharge; from
abscess of the pharyngeal glands it is differentiated by the limitation
of the hard swelling to the parotid gland and by the superficial seat of
the resulting abscess. The co-existence of active inflammation serves to
distinguish it from ordinary tumors.
_Treatment._ By way of prevention, the avoidance of injuries by yokes,
forks, pokes, and goads is important. Also the disinfection of the mouth
by a liberal supply of pure water and even by antiseptic washes:—borax,
boric acid, creolin, tannin, chlorate of potash. Also by the removal of
foreign bodies or calculi from the canal.
When the inflammation has set in, a saline laxative is often of value.
Wash the mouth with a solution of vinegar and salt, or other antiseptic,
repeating this at least after every meal. The swollen, painful gland may
be covered with a damp compress or anointed with vaseline to which may
be added a little creolin, naphthol, carbolic acid or salicylic acid,
together with lead acetate and belladonna or other anodyne. The diet
must be soft, cool mashes, sliced or pulped roots or any bland agent
that will demand little or no mastication. Cool, fresh water should be
allowed _ad libitum_. When the laxative has set, it may be followed by
cooling diuretics such as nitrate or acetate of potash.
If suppuration occurs it should be opened as soon as the pus can be
definitely recognized, and the cavity treated antiseptically to prevent
further local or general infection by the microbes. In deep abscess
there is a certain danger of wounding blood vessels and salivary ducts,
but this can be to a certain extent obviated by making an incision
through the skin only and then boring the way into the abscess with a
grooved director or the points of closed scissors. When the cavity is
penetrated the pus will ooze out through the groove or between the
scissor blades. When the pus has been evacuated the cavity should be
washed out two or three times a day with mercuric chloride solution
(1 : 1000), or permanganate of potash solution (1 : 100).
When the gland becomes indurated and indolent seeming to merge into the
chronic form it may be stimulated to a healthier action by a cantharides
blister, or it may be subjected to daily massage, or to a daily current
of electricity for ten or fifteen minutes. If the inflammation is slight
or unrecognizable, the surface of the gland may be daily painted with
tincture of iodine, and iodide of potassium maybe given internally, in
daily doses of ½ to 1 drachm.
Gangrene, the result of septic microbes, a weak system or too severe
treatment, may be met by astringent and antiseptic agents locally, and
by tonics, stimulants and a generous diet internally.
In =cattle= the disease usually responds readily to local antiseptics,
and stimulating germicidal embrocations. Camphorated spirit, alone or
combined with tincture of iodine; cantharides ointment with carbolic
acid; and camphor and phenol may be cited as examples.