TONGUE, Diseases of.
Cancer of this organ will be found dealt with on p. 129 in the article on Cancer.
Inflammation of the tongue is to be treated as described under the article Glossitis, upon p. 338.
Superficial ulcerations arc to be dealt with as mentioned under Stoma titis, upon p. 9to.
Deeper ulceration is commonly the result of injury caused by the organ coming into constant contact with jagged stumps of decaying teeth or imperfectly constructed dental fittings. The abrasion so formed through the admission of various micro-organisms always present in the mouth is liable to become deep,with thickened and inflamed margins and a sloughing base. The treatment of these so-called " dental ulcers " consists in the immediate removal of the offending tooth or dental plate and the free use of any antiseptic mouth-wash after cleansing the surface of the ulcer and swabbing it lightly with pure Carbolic Acid. A chronic indurated dental ulcer should be thoroughly excised to prevent the supervention of epithelioma.
Tuberculous ulcer should be excised by a A-shaped incision cutting wide of the affected tissue, after which the lips of the wound must be brought together by deep sutures.
Syphilitic affections of the tongue are to be treated by the rules and principles mentioned under Syphilis, according to the stage of the disease at which they appear. The secondary ulcers are usually slight and super ficial, yielding to Mercury. Mien extensive, the drug should be adminis tered by inunction. In the late tertiary stage deep ulcers may result from the breaking down of gummata, and these must be treated by very large doses of Iodides internally. Ulcers occurring in the early tertiary or very late secondary period should be treated by both mercury and iodides. The best local treatment will consist in drying the ulcerated surface and lightly touching it with Liq. Ilyd. Pernit., 5 per cent. Chromic Acid solution, or Strong Carbolic Acid.
Hypertrophy of the tongue, or Muscular Macroglossia, has been, when of limited extent, successfully treated by pressure in a few cases. Any
concentrated astringent solution which does not produce irritation may be applied on strips of lint wrapped around the enlarged and protruding organ. Over these, strips of Isinglass Plaster may be placed so as to exert moderate pressure in a uniform manner.
In the condition known as Lvmphaugioumatous ilacroglossio„ as in the simple muscular form, when the enlargement is great, the question of operation will have to be met. This may be done by the knife, scissors, ecraseur, thermo- or gal•ano-cauter•. A few stout needles are passed through the enlarged organ in front of the spot where the section is to occur, the tip being well pulled forward, the ecraseur is laid on, and the anterior portion of the tongue removed.
Where the deformity is not so great the favourite operation is to make a A-shaped incision, and remove the wedge of tissue by the knife or scissors, after which the edges of the incision may be brought together by a series of deep and superficial wire sutures, after any bleeding vessels have been secured and twisted or ligatured with catgut. When the surgeon has the choice of time, he may defer operation till about the end of the fourth month, but where feeding is rendered difficult he must operate sooner.
Neuralgia of the tongue is a rare and intractable disease. The only hope in this affection of any permanent relief will lie in the persevering use of the remedies mentioned under Neuralgia, upon p. 583. Beginning with large doses of Quinine, combined with Chloride of Ammonium and a little Morphia, the various antineuralgic agents should get a fair trial, whilst. by improved food, change of air. freedom from worry and other ills, the general health is brought up to the highest standard. A weak continuous current passed through the organ gives good results if steadily adhered to. and relief has been known to follow even a few applications of the battery.