Hypersecretion.

Synonym.—Ptyalism.

Definition.—An excessive secretion of saliva.

Etiology.—The disease may occur in a number of affections; thus it is occasionally seen in nervous, emotional children, and also in hysteria, here being due to a neurosis. It is sometimes present in the acute infectious fevers, notably small-pox. It is quite common in several forms of stomatitis, as has already been noted. Pregnancy is occasionally accompanied by an annoying flow of saliva. Certain vegetable agents cause an excessive secretion, jaborandi, muscarin, and tobacco being the most common examples, though their action is soon over.

The most frequent cause, and by far the most serious, is from the ingestion of mercury, it sometimes lasting for weeks after a patient has been thoroughly mercurialized.

Symptoms.—The mouth is constantly bathed with saliva, which necessitates frequent spitting on the part of the patient, or, in children, an almost constant dribbling. Where it is very excessive, talking is carried on with difficulty. The almost constant wetting of the lips may be attended by chapping and cracking at the angles of the mouth.

Diagnosis.—The continued dribble, or frequent emptying of the mouth of saliva, is confirmatory of the lesion.

Prognosis.—The prognosis is favorable, though in pregnancy it may continue to full term, and, in the worst cases of mercurialization, may persist for weeks.

Treatment.—This will depend somewhat upon the cause. In the case of stomatitis, the treatment recommended for the local disease is sufficient for a cure. If it be due to pregnancy, iris versicolor will sometimes afford relief. Where it results from mercury, potassium chlorate, both as a wash and internally, will give good results. Belladonna, especially where there is general capillary congestion, is very efficient. Atropia in 1/100 grain doses once or twice a day is useful in some very persistent cases. Small doses of jaborandi will be found beneficial.

The Eclectic Practice of Medicine, 1907, was written by Rolla L. Thomas, M. S., M. D.