Of special interest is the neoplasm of the frenum which arises spontaneously and was first described by the Italian physicians under the name of produzione sottolinguale (Fede) or rather as fibroma sub linguale (CaIlari and Philippson). This affection has assumed a place in the German literature under the name of Riga's disease, although the priority belongs to Pandolfi (1875) and not to Riga (1880).
The disease attacks infants exclusively. Its geographical distribu tion is confined almost entirely to the southern provinces of Italy, but it has been observed in Venice, France and Austria.
The affection begins as a minute opaque whitish thickening in the frenulum. The growth rapidly increases in size and attains a diameter of about 1 cm. and shows in the centre a shining white area while the rest of the growth has a red appearance. The growth feels hard on palpati011.
The histological examination of the little tumor shows that we have to deal with a fibroma. To this are added inflammatory processes, which are strictly limited to the apex of the growth. At this point a large number of leucocytes are found which are mostly of the eosinophilous type. The inflammation ultimately leads to a superficial necrosis of the fibroma, which is the cause of the whitish discoloration.
The disease causes no other disturbance. Its treatment is entirely surgical. Callari and Philippson regard the disease as an hereditary anomaly, a racial peculiarity, which is disseminated by heredity through out the mentioned countries, and to which it is confined. An original relationship to dentition has not been definitely proven, hut the presence of the lower central incisors stancLing alone seems to be a predisposing factor. Another explanation of the frequent occurrence of the disease in Italy is that the mothers in the southern provinces nurse their babies long after the dentition period. During the act of nursing, the teeth can produce a considerable mechanical imitation of the frenum and thereby cause the growth.
An abnormal condition of the frenuni exists when it is too short or when it is inserted far forward to the tip of the tongue. This anomaly very seldom causes any trouble, but in order to meet the urgent demands of the mother or midwife, it can easily be torn through with one blade of the scissors.
In rare cases the lower surface of the tongue is grown to the floor of the mouth. This abnormality is usually congenital and consists in an epithelial adhesion which can readily be separated mechanically.