Excerpt from Medical Science Abstracts and Reviews, Vol. 4: April-September, 1921
J ardet records four cases of parotid swelling occurring in adults characterized by sudden enlargement of the gland, which almost always occurred after the first meal of the day and rapidly increased during mastication, its subsequent development depending on whether it was a primary attack or a relapse, and the character of the food. The swelling was accompanied by local tension, restricted movement of the jaw, and some times by pain, which was acute for the first half hour and dull afterwards, as in mumps. Contrary to what occurs in mumps, however, on pressure on the gland distinct lobulation could be felt, and occasionally a hard cord of the size of a pencil representing Steno's duct. Pressure on the gland caused expulsion of a plug of mucus followed by a flow of saliva. The affection usually starts the first week that a tooth-plate is worn, but it may occur later. It may last for some days, but usually disappears more or less completely the same day, and recurs the next and for five or six days in succession. It then subsides, but returns after an interval of a month or six weeks as the result of a chill, irritating food, or the onset of menstruation. The condition is due to the tooth-plate producing irritation of the gum and obstruction of the orifice of Steno's duct with subsequent retention of saliva. Cure is effected by removal of the tooth-plate and its careful readjustment, together with the use of a potassium chlorate mouth-wash.
Gastric analysis. Briining, director of the Rostock University Children's Clinic, reports the results of about 300 examinations Of the gastric contents in children aged from 2 to 15 years. While the total normal acidity in adults is 30 - 60 and the average free hydrochloric acid is 20 - 40, the average total acidity in children was found to be 488 and the free hydrochloric acid 143. Hardly any differences were noted between boys and girls, either in the upper or lower classes of society. On the other hand the figures rose as the age of the child advanced. Thus between 2 and 10 years the total acidity was 46-9 and the free hydrochloric acid 115, and between 11 and 15 the total acidity was and the free hydrochloric acid 2ol. During the war there was almost invariably a diminution of the hydrochloric acid values, as was found by other writers in adults. On ranging the children in two groups, according as their digestion was normal or diseased, it was found that the total acidity and free hydrochloric acid were higher in normal children than in those suffering from gastro-intestinal disturbance. There were no less than 63 cases, or 21 per cent., with hypo chlorhydria or achlorhydria. It was a remarkable fact that 13 of the cases of achlorhydria had no gastro-intestinal symptoms, while the rest suffered from abdominal pain, diarrhoea, or constipation.
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