bmaxillary gland, known
as _angina Ludovici_, is referred to at p. 597.

The _treatment_ consists in making incisions through the deep fascia
in order to relieve the tension, or to let out pus if it has formed.

Acute suppurative inflammation of the #sublingual gland# may occur
under the same conditions as in the parotid, and is associated with
the formation of an exceedingly painful and tender swelling under the
tongue. The tongue is gradually pushed against the roof of the mouth,
so that swallowing is difficult and respiration may be seriously
impeded. There is marked constitutional disturbance. An incision into
the swelling is immediately followed by relief of the symptoms.

#Tuberculous disease# of the salivary glands is rare. It usually
begins in the lymph glands within the capsule of the parotid or
submaxillary, and spreads thence to the salivary gland tissue.

TUMOURS.--#Cystic Tumours--Ranula.#--The term ranula is applied to any
cystic tumour formed in connection with the glands in the floor of the
mouth. Formerly these tumours were believed to be retention cysts due
to blocking of the salivary ducts. They are now known to be the result
of a cystic degeneration of one or other of the secreting glands in
the floor of the mouth. They contain a thick glairy fluid, which
differs from saliva in containing a considerable quantity of mucin and
albumin, while it is free from any amylolytic ferment or
sulpho-cyanide of potassium. Numerous degenerated epithelial cells are
found in the fluid.

The _sublingual ranula_ is the most common variety. It appears as a
painless, smooth, tense, globular swelling of a bluish colour. It
usually lies on one side of the frenum, and over it the mucous
membrane moves freely. As it increases in size it gradually pushes the
tongue towards the roof of the mouth, and so causes interference with
speech, mastication, and swallowing. It is to be differentiated from a
retention cyst of the submaxillary gland by the fact that a probe can
usually be passed down the submaxillary duct alongside of the
swelling, and from sublingual dermoid (p. 539).

The _treatment_ consists in making an incision through the mucous
membrane over the swelling, dissecting away the whole of the cyst wall
if possible, and, if any portion cannot be removed, swabbing it with a
solution of chloride of zinc (40 grains to the ounce), after which the
cavity is stuffed with bismuth gauze and allowed to close by
granulatio