Berard also met with a similar case in a child three years old. The tumour was of almost the same volume, but simulated an erectile tumour. The veins were found very niuch enlarged and the arteries normal, the cellular tissue reddish and granular, and the true tissue of the gland remarkably hyper trophied.
Sallow- y fistuke occur in the course of the excretory duct of the parotid, in it or its smaller ramifications, and arise from accidental injury, the result of inflammation, or from ulceration of a salivary tumour, which has gradually enlarged in consequence either of inflammatory obstruction at some part of the duct, or the presence of calculi.
Marti relates the case of a congenital de formity of the parotid duct (simulating fistula) in an otherwise healthy female infant.§ The orifice opened on the exterior of the right cheek, down which the saliva flowed.
The exact nature of ranula has not been clearly determined. It consists of a sublingual tumour, varying considerably in size and demity. Some consider it as a mere dilatation of the duct from obstruction at its orifice ; others as a submucous tumour, external to' the duct, causing its compression ; and others, again, as an encysted tumour developed in its interior. Although the analysis of the con tained fluid (see SALIVA) would appear to indicate that the last opinion were correct, it is by no means certain whether mere ob struction at the orifice of the duct may not give rise to a similar change in the quality of the saliva.
The morbid condition of the labial glands has been made the subject of distinct inquiry by Sebastian*, who arranges their affections under the heads of— 1. Obstruction of the excretory duct. 2. Atrophy. 3. Tumefac tion with hypermmia. 4. Ulceration.
The first affection occurs under two forms : The one as a transparent painless tumour of a bluish tint, resemblin, a vesicle or hydatid in the substance of the lip, of the size of a pea, and containing a transparent viscid fluid. He has only met with it in the lower lip, on the right side, near the angle of the mouth, and always solitary, and of quick formation. The other form is comparatively frequent, and appears as small round elastic, more or less transparent indolent tumours, frequently as many as fifteen in the lower lip. . They exude on puncture a thick, viscid, greakr matter. The second affection is distinctly re marked in the incipient stage of cancer of the lip, which, according to his opinion, com mences in the cellular tissue. The third occurs in follicular duodenitis ; and typhoid fever, as observed by him in children. He has frequently' met with the fourth affection in phthisical individuals, &c.