XIII. Diseases of the Salivary Glands.
Ptyalism.
Synonyms:—Hypersecretion; salivation.
Definition:—An abnormal secretion of saliva.
Etiology:—As an idiopathic disorder this disease is seldom seen. Occasionally in irritable, nervous children it appears, and it is present sometimes during an hysterical attack as a neurosis. In some adults there is a tendency to too free secretion when the patient is talking. The commonly observed cases occur as the result of the action of remedies which irritate the salivary glands or act as stimulants to the secretion, as jaborandi, tobacco, the iodids, mercury and muscarin. It results from disease of the mucous membranes of the mouth, as the various forms of stomatitis, and it is present at some time during the course of the infectious diseases, especially the exanthemata. It may be present during some forms of disease of the stomach, and at times, during the course of uterine disorder, and often during pregnancy. In diseases of the medulla oblongata, or of the nerves of the face, as facial neuralgia or odontalgia, it may appear. When the symptom occurs in infants or in feeble-minded persons, it is due usually to the fact that the normal saliva is not swallowed, and this in itself may cause an undue secretion.
Treatment:—Usually when the condition appears during the course of other disease, no special treatment is advised for this condition alone. The use of belladonna in frequent doses may be necessary in rare cases. Small, frequent doses of jaborandi will sometimes control it. When it occurs from excessive medication, the condition usually ceases when the remedy is stopped and after any that remains in the system is eliminated. In mercurial ptyalism, however, the cause is slow of elimination, and irritation of the glands is established, which continues sometimes for weeks after the agent is withdrawn. This must be treated with potassium chlorate. The remedy must be given in from three to five grain doses internally every three hours, and a wash should be prepared of this agent, with hydrastis and hamamelis. In the nervous forms of the disease, hyoscin, camphoric acid, the monobromate of camphor, or the bromids may be used. Attention should be paid to the general improvement of the patient, and tonics often are demanded.
