. Atlas of clinical surgery; with special reference to diagnosis and treatment for practitioners and students. of the lungs and pleura may be mis-taken for tuberculosis, but the more advanced caseswith fistulas are unmistakable. Actinomycosis ofthe intestine may be mistaken for tuberculosis ormalignant growths, especially when it forms a tumor-like mass in the ileo-caecal region. Treatment. In extensive cases of antinomycosisof the buccal cavity attempts at total extirpation areuseless, but healing may take place after free incisionof abscesses and laying open all fistulas.
. Atlas of clinical surgery; with special reference to diagnosis and treatment for practitioners and students. of the lungs and pleura may be mis-taken for tuberculosis, but the more advanced caseswith fistulas are unmistakable. Actinomycosis ofthe intestine may be mistaken for tuberculosis ormalignant growths, especially when it forms a tumor-like mass in the ileo-caecal region. Treatment. In extensive cases of antinomycosisof the buccal cavity attempts at total extirpation areuseless, but healing may take place after free incisionof abscesses and laying open all fistulas. Granula-tion tissue must be scraped away, and indurated tis-sue removed as far as possible. The incisions shouldbe kept open for a long time by tampons. Cariousteeth must be removed. In actinomycosis of thelung extensive resection of ribs is often actinomycosis of the ileo-csecal region resectionof the gut may be necessary on account of intestinalobstruction or fistula. In other cases intestinal acti-nomycosis comes to the surface and then only requires 296 Bockenlieiiiicr. Atlas. Tab. Fiy. 116. yXktinomykosis progressiva. Pplnlinn r\>.; »^. free incisions. Metastatic deposits in the bones(which can be detected by the X-rays) may requireresection. General treatment consists in nourishins:diet and the administration of iodide of potassiumand arsenic. Fig. 115 shows a case of actinomycosis of the cheekin an old countrywoman. Infection took place froma carious molar tooth. A cord-like growth extendedfrom the root of the tooth to the gum, and thence tothe mucous membrane and muscles of the cheek, giv-ing rise to diffuse infiltration. The skin becamebluish red and several small fistulas developed whichdischarged pus containing yellow bodies. The latterwere found by microscopical examination to be acti-nomyces. A circumscribed patch of gangrene wascaused over the malar bone by pressure of the infil-tration. There was no fever and little tro
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