The Tongue and it's common diseases
In healthy persons the tongue is red, firm and moist. In ill health, digestive disturbance, fever, or mouth breathing is likely to cause fur and dryness of the tongue. Fur forms most readily during sleep, particularly when the patient is on a milky diet. The tongue is especially likely to be dry in feverish conditions such as septicaemia (blood poisoning), peritonitis, and typhoid fever, when it becomes brown and shaggy.
In diabetes the tongue is often large and red. In pernicious anaemia it is red, sore and glazed at the tip; this soreness and redness may also be seen in other forms of anaemia.
Tongue tie is a condition occasionally seen in young babies, and it may cause some difficulty in suckling. The membranous fold under the tongue is short, and the tongue cannot be protruded forward. It is sometimes necessary to make a small snip through the fold of the frxnum, but it must not be too freely divided or the child will then tend to swallow its tongue.
Inflammation of the Tongue
Inflammation of the tongue, or glossitis, may be associated with stomatitis of various types; it generally causes soreness, and there may be swelling of the whole tongue, with difficulty in speaking and swallowing. Patchy inflammation may be of a chronic nature, and often affects the sides and tip of the tongue; it is sometimes caused by smoking, dyspepsia, anaemia, pyorrhoea, dental sepsis, too hot or highly seasoned foods, or tertiary syphilis.
The tongue may show red patches or raised white areas which, if persistent for a prolonged period, may develop cracks, fissures and ulceration. This condition is called leukoplakia, which often precedes cancer of the tongue, and every possible means to reduce dental sepsis or irritation from teeth or any other source must be used. Any case of leukoplakia should be examined by a doctor, since it is also seen in cases of tertiary syphilis which must be treated. In other cases a doctor should keep the patient under observation.
Smoking, condiments, chewing of tobacco, alcohol and so forth must be abandoned, and mild antiseptic washes used daily.
‘Smoker's patch' is a red area commonly seen on the front part of the tongue, the membrane being smooth, or covered by a yellowish crust.
In this condition the back of the tongue is stained black; even persistent scraping cannot remove much of the discoloration which is due to the growth of a yeast-like substance. The condition is not serious. The infection develops after the usual mouth organisms have been destroyed by longterm taking of antibiotics. When the antibiotic is stopped, the yeast organisms disappear.
The furry discoloration can be partly removed by brushing the tongue twice daily with a toothbrush and swabbing with 10 per cent sodium bicarbonate solution.
Ulcers of the Tongue
Ulcers of the tongue are moderately common, especially dyspeptic ulcers which are small but painful and generally appear near the tip.
Dental ulcers are the result of irritation from broken or roughened teeth or dentures, and occur round the edges of the tongue. They should not be neglected, owing to the possibility of cancer if they become chronic. Other types of ulcers are less commonly seen, but include those due to syphilis or lupus.
In whooping cough small ulcers sometimes appear on the fraenum under the tongue, and are a diagnostic sign of this disease.
Cancer of the Tongue
Cancer of the tongue generally occurs in men over forty years of age; it often follows glossitis or chronic irritation from decayed or rough teeth, and excessive smoking or tobacco chewing. The disease often starts at the side of the tongue, which is first hard or fissured, or there may be a raised warty patch or early ulceration.
The breath becomes foul, with pain in the tongue and difficulty in movement as the growth progresses. The glands of the neck become enlarged, and the pain extends to the ear.
Treatment is either by surgical removal of the affected part or by radium irradiation. Any teeth which cause irritation should be removed.
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