File:The principles and practice of surgery (1916) (14741187676).jpg

Identifier: principlespracti1916warr (find matches)
Title: The principles and practice of surgery
Year: 1916 (1910s)
Authors: Warren, Richard, 1876-
Subjects: Surgery Surgery
Publisher: Philadelphia : Lea & Febiger
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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can-cerous. (3) Tuberculosis of theTongue. This is almost always secondary to pulmonary phthisis anddue to contact infection into abrasions from rough teeth. The ulcer isusually near the tip of the tongue, and there may be some induration ofthe base and the floor covered with small dry granulations ; in otherexamples there is no induration, but the floor is sloughy with weak,prominent granulations, and the edges undermined or vertical. Theformer condition somewhat resembles early cancer, but there is noeversion of the edge and less induration. The position, pain, and tenderness of the ulcer and the condition of thelungs will usually enable a diagnosis to be made ; sometimes small tuberclesmay be noted surrounding the edge of the ulcer, while glandular enlargementis very common. Treatment. Where the patients condition is good and the ulcer verypainful it may be worth excising the latter under local anaesthesia, butwhere the lung condition is too far advanced for such attempts the pain
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Fig. 144. Chronic superficial glossitis, showing white patches (leucoplakia) and crack-ulcers (which are likely to become cancerous). (Kindly lent by Dr. Gilbert Scott.) SYPHILIS OF THE TONGUE 42.5 may be relieved by painting with cocain before meals, dusting with ortho-form, and using weak antiseptic mouth-washes. (4) Syphilis of the Tongue. The tongue may be affected in all stages ofthe acquired disease, and also, though not commonly, in the congenital form. (a) Lingual chancres may arise from infection with pipes, glass-blowingimplements, kissing, &c. The callous, indolent ulcer with indolent secondarybubo in the submaxillary region is suggestive, and the serum reactionor appearance of cutaneous secondaries will clinch the diagnosis. (b) In secondary syphilis occur mucous patches or areas of soddenepithelium, which does not desquamate and remains heaped up, found onthe tongue, inside of the lips and cheeks. Ulceration may follow or thepapillae under the patches become hypertrop

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