1160 



TONGUE. 



face ; and by smoothing the finger over the 

 tongue they could be brushed from one side 

 to the other. Their colour was deep Van- 

 dyke-brown, and they were most numerous in 

 the centre of the tongue. They looked ex- 

 actly like little brown hairs. Sensation and 

 taste were both a good deal damaged." To 

 my friend, Dr. Joseph Bullar, I am indebted 

 for the other instance. His patient was an 

 old lady of sixty-five ; she had been subject to 

 constipation, for which she was in the habit of 

 taking strong purgatives. The tongue was 

 large, vascular, and the papillae of all kinds 

 prominently marked. It looked in an irritable 

 condition, as if sympathising with a congested 

 mucous membrane. On the middle and back 

 of the dorsum was a patch of hypertrophied 

 filiform papillae, of a dark sepia colour, or 

 rather of the brown colour of a dark typhoid 

 tongue. These filamentous growths were re- 

 moved by forceps, and some were sent to me, 

 from which I made the accompanying draw- 

 ings. The specimens that I received were 

 very dark, almost black : I have some of them 

 in my possession now, nearly or quite half an 

 inch long ; their texture was very compact, 

 and their shape cylindrical, with hardly any 

 trace of tapering. They all, as seen by the 



Fig. 764. 



microscope, possessed a retrorse imbrication 

 of the same character as ordinary filiform pa- 

 pillae (Jig. 764.). The epithelium did not con- 

 tain any granular pigment, but the colour 

 appeared to pervade the whole cell, which 

 was evenly stained and semi-transparent. In 

 fig. 7C4. is seen a papilla, or hair, at full length, 

 and mfig. 765. a portion of another, showing 

 the imbrication of the epithelium. 



The Scarlatina tongue contrasts remarkably 

 with the preceding ; for here the deeper ele- 

 ments of the papilla? are principally the seat of 

 change. In scarlet fever the capillaries of the 

 papilla?, in common with the sub-basement 

 vascular system of so large a portion both of 

 the internal and external surfaces of the body, 

 become turgid, and the papillae themselves 

 not so much their epithelium become en- 



Fig 765. 



R 



A portion of hypertrophied papilla, showing well 

 the retrorse imbrication of its epithelium. Blag. 

 200 diameters. 



larged and red. In the early stages of the 

 fever this change is concealed by the fur 

 (which is a sodden and opaque condition of 

 epithelium), as it regards the filiform papilla-, 

 fur being, in all cases I believe, confined to 

 these and the papilla? conicas. Not so the 

 fungiform papilla? ; for these are exaggerated 

 and bright red. The result is, that the surface 

 is a combination of thick white cream-like fur 

 and red projected spots, the former being 

 most conspicuous where the filiform papillae 

 abound the central portions of the tongue, 

 and the latter in the regions of the papilla? 

 fungiforma? the edges and tip of the tongue. 

 These fungiform papilla? look like theacha?nia 

 scattered on the surface of the fruit of the 

 strawberry. As the disease advances, the 

 epithelial covering is shed, and only a thin 

 transparent epithelium remains : the papilla? 

 are consequently red and bright all over the 

 surface, which is clean, rough, red, and raw- 

 looking in every part. 



Atrophy of the papilla? is occasionally met 



,, , , . , j-Tf . , with. Mr. Lawrence mentions the case of a 



A portion of hypertrophiea filiform papilla, show- . , . . . . , . , 



ing its length and true hair character. Mag. 25 person in whom, from habitual drinking the 



and 80 diameters. tongue was, for the greater part of its surface, 



