less weI1 differentiated, metastasize earlier, and are mol’e srositive to irradiation therapy. Wetastases from the lower gingiva, tongue, floor of’ the mouth, ntld torlsils o(*cur extrusivrlv and with great rapidity. To detect early malignant disease, the entire oral cavity must be carefully examinetl with al3equate visualization. Any thickened area or ulceration with a soft or hard lkase tihoald be palpated with the gloved finger. A lesion persisting over a period of three or four weeks should have adequate biopsy. III most instances, the gross appearan*>e of t.htb (‘ancer permits a diagnosis. Carcinoma occurring along the posterior third of the tongue, or the occlusal line of the buccal mucous membrance, is painful early because of associated induration, infection, and trauma, with resultant inability to masticate food and swallow normally. When a burcal cancer infiltrates the bucciuator, masseter, and pterygoid muscles, trismus results. It is essential to determine hy roentgen examination if there is a bone invasion iu Lymph nodrr extensive malignant lesions occurring on the soft or hard palate or gingiva. TO in the drainage area must be carefully palpated to determine if they are involved. effect a cure it is essential to eradicate the involved lymph nodes, as well as the T~rirnar,! lesion, since oral cancer ofteu remains localized to the mouth and lymph rtode drainage area, e\en in advanced stages. ‘I’. J. C’. The Displacement
Submaxillary Gland and Its Clinical Importance. (Ueber submandibularis und ihre klinische Bedeutung.) Rhin., Otol. 32: 36.5, 1953.
Verlagerungen der Glandula Herrmann. Ztschr. f. Laryng.,
When performing tonsillectomies one finds, not too rarely. posterior displacement of the submaxillary gland. Sometimes it is ouly an extension of the posterior lobe which is In cases of inflammatory changes in the tonsillar seen aftei the tonsil has been removed. Tt. salivation lasting several weeks. and peritonsillar region, one may observe continuous mav also give rise to the formation of salivary stones. 1.:. I’. H.
ORAL MEDICINE The Clinical Signi5cance of the Increasing Resistance of Organisms to the Antibiotics. F. L. Meleney and B. A. Johnson. Surg., Gynec. & Obst. 97: 267, 1953. Organisms are becoming increasingly resistant to the antibiotics. From year to year more and more cases are failing to respond to antibiotics indiscriminately selected and administered in the treatment of infections. These facts point to the necessity for determining as quickly as possible, by means of laboratory tests, the causative organisms and their sensitivity to the available antibiotics. Most of the investigators and laboratory workers who have tried to startdardize these tests in order to make them of clinical significance have