TONGUE, DISEASES OF.
Tongue-tie, or Ankyloglossia. — The condition known as tongue-tie is due to an abnormally short frwnum linguae. To this condition was formerly at tributed many of the disorders of in fancy, and section of the frTnum was frequently resorted to. Although it is frequently restricted in length, it is only when it is bound down so as to cause it to be held behind the incisors that a short frfenum can prevent suckling or interfere with articulation. Undue elongation of the frfenum may produce similar symptoms, especially when its upper insertion is unusually near the tip.
TREATMENT.—Although section of the inenum is an operation presenting no difficulty, it may become dangerous if the presence of the ratline arteries is not borne in mind, fatal luemorrhage having Occurred. The tissues should therefore be carefully examined and the portion cut should be isolated from any vessel that may be encountered. Blunt-pointed scissors are usually employed, after anTs thetizing the parts with a 10-per-cent. solution of cocaine, applied with a camel's-hair pencil. The mouth should be kept scrupulously clean.
Section of the frwnum should be ex tremely limited in its application; it is warranted, for example, when there exists an ankyloglossia, congenital or acquired, immobilizing the tongue more or less in a part of the mouth. This may be total or partial. When the fru num is excessively long, reaching some times to the point of the tongue and im peding its movements, simple section is not sufficient; excision must be resorted to. It is wrong to think the operation is always indispensable if the child nurses badly. A few exercises in suc tion on the finger may correct this defect without any operative intervention. In all cases excision of the frunum is abso lutely useless for correcting faults of pronunciation. These are amenable only to a methodical, natural, and rational education of the organs of speech, the duration of which need not exceed three weeks. Chervin (Revue Inter. de 141ed. et de Chir., Sept. 10, '94).
Lingual Papillitis.—This is a form of b cflossitis often met with in gastric dis orders, localized in the papilla of the tongue, and described by Cotard. Its only symptom is a burning or lancinating pain on the anterior two-thirds of the tongue, with greater intensity on its tip and borders. The pain, often recurring
at intervals in the form of neuralgic at tacks, is aggravated by the ingestion of food,—solid or liquid, with the excep tion of milk. No other trouble, either of general and special sensibility or of the salivary secretion, is observable. Ex amination with the naked eye does not reveal any remarkable alteration, but ex amination with the magnifying-glass shows, in several places, and chiefly on the borders and tip of 'the tongue, some little red points, ulcerated and very pain ful when ,touched, whose number is greater in proportion as the pain is more violent. The seat of this lesion is evi dently in the nervous terminations in the lingual mucous membrane, or, more exactly, in filiform papillae.
The best treatment is galvanic cauter ization (with the aid of the magnifying glass) of the ulcerated points, a few points being touched at each sitting (Duplaix).
Glossitis.—Inflammation of the tongue is usually due to traumatism. It may be caused by hardly-perceptible injuries in flicted during mastication, or to more evident factors: carious teeth, scalds, bites, incised or punctured wounds, laceration, etc. It is quite probable that inflammation of the tongue never occurs without the introduction in its paren chyma of some pyogenic organism.
— The first symptom is tumefaction of the organ, which is some times so great as to cause it to protrude from the mouth. Severe pain is usually present and deglutition is seriously im peded through the marked sensitiveness of the organ. When the swelling in volves the lymphatic elements in the posterior portion of the tongue, dyspncea may appear, owing to the pressure upon the epiglottis. Stomatitis is usually pres ent and ptyalism is more or less marked. The breath is usually foetid, a feature due to a thick, yellowish coating on the lingual surface, which may also present strife of ulceration. There is usually considerable fever. The symptoms gen erally become aggravated up to the third or fourth day, when there is a lull, fol lowed by gradual improvement. Occa sionally an abscess forms deep in the organ and occasionally close to the pe riphery. In the latter case it is quickly ,relieved by incision, which soon reduces the glossitis. Gangrene sometimes oc curs. In rare cases one side only is in volved in the inflammatory process.