Bauhaus-Universität Weimar

Titel:
The Cyclopaedia of Anatomy and Physiology, vol. 4: Pla [corr.: Ple] - Wri
Person:
Todd, Robert Bentley
PURL:
https://digitalesammlungen.uni-weimar.de/viewer/image/lit29465/1164/
1154 TONGUE. 
cavity of the mouth ; and I could with diffi¬ 
culty introduce my little finger between it and 
the upper jaw. It felt smooth and hard to 
the touch, and had a thick coating of viscid 
mucus : from the high degree of tension, 
the point presented a glistening appearance.’’ 
(Edinburgh Med. and Surg. Journal, vol. xxviii. 
p. 76.) As the case advances the tongue 
increases still further in size, the patient can¬ 
not perform the first part of the act of deglu¬ 
tition, and the liquid food is obliged to be 
conveyed by some mechanism into the pha¬ 
rynx ; respiration through the mouth ceases, 
and that through the nares is impeded : the 
patient is now almost on the verge of suffoca¬ 
tion, and his distress and anxiety become 
extreme. Mr. Martin remarks: — “At this 
period respiration through the mouth was 
totally suspended ; and he could not breathe, 
even through the nostrils, but with difficulty. 
His countenance was flushed and anxious, the 
pulse was fluttering, his breathing offensive : 
in short, he was threatened with immediate 
suffocation.” (Loc. cit., p. 77.) The condition 
of the tongue sometimes approaches gangrene. 
Mr. Hayes, in describing a similar case at an 
advanced stage, observes : — “It now began 
to look of a dark black colour, or rather as if 
it had been broiled over a smoky fire; indeed, 
I expected it would mortify.” (Memoirs of the 
Medical Society of London, vol. ii. p. 193.) 
I am not aware that mortification has ever 
resulted in these cases ; neither does abscess 
appear to be thus produced,* which, however, 
may be accounted for by the fact, that these 
urgent cases almost always render it necessary 
that the organ should be freely incised on the 
dorsum to evacuate the distending blood, and 
this would prevent the formation of abscess ; 
though in some very severe instances, where 
incision has not been practised, no abscess 
has resulted. When the inflammatory action 
ceases, which is immediate when the before- 
mentioned operation is performed, the tongue 
rapidly recovers, and the fever vanishes. 
When the tongue is incised, the quantity of 
blood discharged is very great. 
The morbid change in the tongue does not 
always go to the extent above described, and 
then milder symptoms are produced. Dr. 
England mentions two mild cases, in both of 
which the left half of the tongue alone was 
affected. Dr. Graves relates a severe case, 
also confined to the left side, in which he 
says the part “ appeared on the verge of gan¬ 
grene.” (Dublin Hospital Reports, vol. iv. 
p. 43.) De Lamalle narrates an example, in 
which the patient was almost suffocated in 
five hours from the first appearance of the 
malady. The tongue was more than three 
times its natural size ; it filled the whole 
mouth, and protruded between the teeth. 
Free incisions saved the organ and the patient. 
Trincavellius mentions a case where it oc¬ 
* Since the above has been in type, a case occur¬ 
ring to Dr. Schneider has been published, -where 
this form of inflammation terminated in abscess. 
(Casper's Wochenschrift. No. 23.) 
curred in Variola ; Mr. Hayes an instance, 
where an individual, licking an urticarious 
eruption, had this effect produced to a slight 
extent on her tongue ; and the same thing, to 
a small degree, I have known occur from a 
person eating mussels. 
Collier, Taynton, Job à Mekren, Paletta, 
Elbuig, Frank, and Orgill, also enumerate ex¬ 
amples of this condition. 
Dr. Craigie has described a peculiar form 
of glossitis, under the name of Lingual 
Quinsy, which is an extension of ordinary 
quinsy, or tonsillitis. The portion of the 
tongue involved is that bounded in front by 
the circumvallate papillae, behind by the epi¬ 
glottis, and at the sides by the mucous mem¬ 
brane passing off upon the pharynx and rami 
of the lower jaw. The inflammation extends 
down the palato-glossus muscle from the ton¬ 
sils to the base of the tongue, and seems to 
involve the mucous, submucous, and muscuiar 
tissues. The parts are swollen, infiltrated, 
and stiff ; the lower jaw cannot be depressed, 
and attempts at deglutition are not only diffi¬ 
cult, but the completion of the act is impos¬ 
sible. There is an abundant secretion of 
ropy mucus. Dr. Craigie had one fatal case, 
in which he found fter death, that “ the base 
of the tongue was cumid, hard, and much 
distended with blood and serum infiltrated 
into its cellular tissue, and the parts between 
that and the angle of the jaw were in like 
manner infiltrated.” (Edin. Med. and Surg. 
Journal, vol. xlii. p. 26.) 
Mercurial glossitis. — Inflammation of the 
tongue, the result of the mercurial action, is 
but one symptom of the constitutional influ¬ 
ence of that drug. The tongue in this case 
becomes large, soft, painful, white and furred, 
and much indented by the teeth along its 
edges : the epithelium is soft and readily re¬ 
moved, and the surface is apt to ulcerate. 
The swelling is sometimes very great and 
rapid. Siegel and Trincavellius each mention 
such a case. I believe it has never-caused 
suppuration of the organ ; but the discon¬ 
tinuance of the mercury is followed by com¬ 
plete resolution. 
Ulceration of the tongue.—This is the most 
frequent of the morbid changes occurring in 
the tongue, and of it there are several species 
and varieties. The different species may be 
enumerated as, I. The Dyspeptic ulceration, 
or that arising from disorder of the primae 
viæ ; II. Indurated non-malignant ulceration ; 
III. Gangrenous ulceration ; and IV. Syphi¬ 
litic ulceration. 
Dyspeptic ulceration is met with in three 
principal forms. 1. Small circular ulcerations 
at the tip and along the edge of the tongue ; 
2. Severe and deeper ulcerations of the body 
of the tongue ; and, 3. Aphthous ulceration. 
The small circular ulcers of the tongue are 
extremely common, and have been personally 
experienced by almost every individual. They 
consist of small, circular, generally regular and 
well defined ulcers, which are superficial and 
look as if a piece of mucous membrane had 
been punched out ; the edges are sharp and
        

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