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/lit29465/1167/
TONGUE. 1157 
inch or an inch in front of the circumvallate 
papillae, and on one side of the mesial line. 
Sometimes they form over the whole surface 
of the tongue. I am acquainted with a gen¬ 
tleman who, at the time he was suffering from 
syphilitic psoriasis, got an attack of dyspepsia ; 
in less than thirty-six hours the whole of his 
tongue was one mass of these tubercles, and 
not a papilla was to be seen ; in a few days 
(under the influence of iodide of potassium) 
every papilla had reappeared, and the tongue 
was in every way natural. This influence of 
disordered stomach being the immediate and 
exciting cause of the manifestation of the 
syphilitic poison on the tongue, I have fre¬ 
quently noticed ; a person who has a taint of 
lues venerea can scarcely sustain the least dis¬ 
order of the stomach or bowels without its 
showing itself upon the tongue. These tu¬ 
bercles of the tongue, when left to themselves, 
are very apt to become fissured and form 
rhagades ; the space between two of them is 
liable to be the seat of an ulcerated fissure. 
Deep circular ulcers sometimes form on these 
tubercles. 
Phagedœnic syphilitic ulcers are seen occa¬ 
sionally on the tongues of feeble debilitated 
people. 
All these forms occur as the result of 
the constitutional taint of lues venerea, at 
various periods after the primary symptoms. 
I have known the glossy tubercle and 
rhagades occur fifteen years after the primary 
sore. 
Cancer of the tongue. — The tongue is liable 
to be affected with scirrhus, having all the 
properties of genuine cancer. Mr. Travers 
has given a very graphic description of cancer 
of the tongue, which I shall take the liberty of 
quoting in extenso. — “ This is not a smooth 
and firm rounded tubercle, such as is often 
met with in this organ, but an irregular rugged 
knob in its first stage, generally situated in the 
anterior third, and midway between the raphé 
and one edge. It sometimes, but seldom, 
extends across the middle line, although it 
often extends alongside of it. The hardness 
is unyielding, inelastic, and the mucous surface 
puckered and rigid. It also gives to the finger 
and thumb of the surgeon the sensation of 
solidity, or of its penetrating the entire mus¬ 
cular substance, being perceived equally on 
either surface. Sharp shoots of pain are felt 
through the side of the affected organ, towards 
the angle of the jaw and ear. The disease 
tends to run backwards towards the base or 
posterior edge. It sometimes acquires great 
bulk before ulceration takes place, so as to 
project the tongue from the mouth. In this 
state a female patient of mine was seen some 
time ago in St. Thomas’s Hospital, in whom 
the permanent projection of the diseased organ, 
beyond the widely distended lips, was from 
three to four inches. The ulceration often 
extends from the edge of the tongue to the 
membrane of the mouth and gums, when the 
elevated and distended membrane at length 
gives way, and ulceration is rapid. The sur¬ 
face of the ulcer is very uneven ; clean and 
bright granulations appearing in parts, and in 
others deep and sloughy hollows. The dart¬ 
ing pain is very acute, but only occasional. 
There is a dull aching always present, and as 
constant a spitting as in deep salivation. It 
happens to strong and hitherto healthy per¬ 
sons, for the most part males from the age of 
forty onwards. There is generally an evening 
paroxysm of pain, and the nights are much 
disturbed by the secretion accumulating in 
the throat, which excites cough. Often the 
patient is roused by a painful compression of 
the tongue falling between the jaws. Speech 
is much affected and painful. 
“ Towards the fatal termination of the dis¬ 
ease, occasional profuse haemorrhages take 
place at shortening intervals, and alarm and 
weaken the patient, who ultimately dies tabid 
and exhausted, generally with symptoms of 
more extensive disease of the mucous mem¬ 
brane in other parts. 
“ The period at which the sublingual and 
contiguous lymphatic glands become affected, 
and the extent of their change, are very vari¬ 
able. I have known them form the base of 
the tumor, the cauliflower fungus occupying 
half the tongue, i. e. two or three inches long 
and one broad ; after death the jaw was found 
covered with fungus.” (Medico-Chirurgical 
Transactions, vol. xv. part i. p. 245.) 
The scirrhus is not infrequently at the very 
margin of the tongue. Louis mentions a case 
where 'here was a little circumscribed tubercle 
of scirrhus, about the size of a filbert, at the 
edge of the tongue : it was ulcerated. 
It occasionally shows itself early in life : 
Arnott mentions a case where it was present 
in a girl of fifteen. 
In a subject who died of lingual cancer, 
dissected by myself, I found that the whole 
of the right side of the tongue, right tonsil, 
the upper part of the pharynx on the right 
side, and the mucous membrane, extending 
from the tongue to the epiglottis on the 
same side, were removed by ulceration, and 
the inner surface of the lower maxilla laid 
bare. The other half of the tongue was 
healthy, and only the ulcerated edge was 
scirrhous. The lymphatics were enlarged, 
and of a greenish-yellow colour : they con- 
ained pus. 
Tumours of the tongue. — A variety of tu¬ 
mours have been met with in the tongue. 
Fatty tumours have been found by Mr. Lis¬ 
ton on the under surface of the tongue. Mr. 
Hale Thomson exhibited to the Westminster 
Medical Society, in 1839, a fatty tumour 
which he removed from the side of the tongue. 
It consisted of fat contained in a cyst. 
Encysted tumours. — Many of the so-called 
instances of ranula* have been abundantly 
proved by Dupuytren, Breschet, and Malgaine 
to be simply serous cysts, and not obstructed 
salivary ducts. They consist of dense mem¬ 
branous cysts, containing a thick albuminous 
* The consideration of ranula belongs to the mor¬ 
bid anatomy of the salivary glands, and not of the 
tongue. 
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