Ludwigs angina (lat. : Angina ludovici) is a type of severe cellulitis involving the floor of the mouth and is often caused by bacterial sources. Early in the infection, floor of the mouth raises due to swelling, leading to difficulty swallowing saliva. As a result, patients may present with difficulty speaking and drooling. As the condition worsens, the airway may be compromised and hardening of the spaces on both sides of the tongue may develop. Overall, this condition has a rapid onset over a few hours. The majority of cases follow a dental infection. Other causes include a parapharyngeal abscess, mandibular fracture, cut or piercing inside the mouth, or submandibular salivary stones. The infection spreads through the connective tissue of the floor of the mouth and is normally caused by infectious and invasive organisms such as Streptococcus, Staphylococcus, and Bacteroides.Prevention is by appropriate dental care including management of dental infections. Initial treatment is generally with broad-spectrum antibiotics and corticosteroids. In more advanced cases endotracheal intubation or tracheostomy may be required.With the advent of antibiotics in 1940s, improved oral and dental hygiene, and more aggressive surgical approaches for treatment, the risk of death due to Ludwigs angina has significantly reduced. It is named after a German physician, Wilhelm Frederick von Ludwig, who first described this condition in 1836. Signs and symptoms
Ludwigs angina is a form of severe, widespread cellulitis of the floor of the mouth, usually with bilateral involvement.
Docusate is the common chemical and pharmaceutical name of the anion bis(2-ethylhexyl) sulfosuccinate, also commonly called dioctyl sulfosuccinate (DOSS). It is on the World Health Organizations List of Essential Medicines.Salts of this anion, especially  docusate sodium, are widely used in medicine as laxatives and as stool softeners, by mouth or rectally. In 2019, it was the 187th most commonly prescribed medication in the United States, with more than 3 million prescriptions. Some studies claim that docusate is not more effective than a placebo for improving constipation. Other docusate salts with medical use include those of calcium and potassium.Docusate salts are also used as food additives, emulsifiers, dispersants, and wetting agents, among other uses. History
Sodium docusate was patented in 1937 by Coleman R. Caryl and Alphons O. Jaeger for American Cyanamid, which commercialized it for many years as a detergent under the brand name Aerosol OT. Its use for the treatment of constipation was first proposed in 1955 by James L. Wilson and  David G. Dickinson, and quickly popularized under the name Doxinate. Medical use
Constipation
The main medical use of docusate sodium is to treat constipation, acting as a laxative and stool softener. In painful anorectal conditions such as hemorrhoid and anal fissures, it can help avoid pain caused by straining during bowel movements. When administered by mouth, a bowel movement often occurs in 1 to 3 days, while rectal use may be effective within 20 minutes.Sodium docusate is recommended as a stool softener for children.However, its effectiveness for constipation is poorly supported by evidence.