ADDITIONS TO THE REVISED EDITION OF 1880. 461 



ration caused by affections of the stomach, intestines, uterus, etc., is 

 also most readily improved by proper treatment of the original affec- 

 tion ; in other forms the causal indications cannot be fulfilled. 



For the indications of the disease, derivatives, " general baths, ap- 

 plication of blisters and mustard to the throat and nape of the neck," 

 astringent mouth-washes of alum, sulphate of zinc, sage, or oak-bark, 

 have been recommended. The use of opium deserves most confidence. 

 It is always satisfactory when, as in this case, theory and practice 

 agree in supporting a therapeutic measure. The use of opium in sali- 

 vation was recommended by the first practitioners of medicine ; and, 

 since salivation depends on excitement of the nerves, it appears ra- 

 tional to use for it remedies which, like the narcotics, diminish the ex- 

 citability of the nerves. There are cases of spontaneous salivation that 

 defy all treatment. 



[In troublesome salivation atropine should be tried, for Hei- 

 denheim has shown that it paralyzes the secretory filaments of the 

 chorda-tympani nerve. Ebstein saw a decided diminution of saliva 

 from taking a pill of -j-Jir of a grain of sulphate of atropine three 

 times daily. Subcutaneous injection of -j-J-g- of a grain near the 

 submaxillary gland arrested the flow of saliva after a few minutes. 

 A dose of ^5- of a grain arrested the flow entirely from 4 P. M. to 

 6 A. M.] 



ADDITIONS TO THE REVISED EDITION OF 1880. 



SECTION I. DISEASES OF THE MOUTH. 



1. P. 437. 



The state of the coating of the tongue gives a valuable but un- 

 certain aid in judging of the course of a fever, stomach-affection, 

 etc. In fever, a change in the tongue, whether it be coated or not, 

 is often important in prognosis. Diminution of its moisture, or ab- 

 solute dryness, is the first sign of serious change in the fever, of an 

 approaching adynamia ; and, on the other hand, recurrence of moist- 

 ure on a previously dry tongue shows that the patient is escaping 

 this danger. 



In persons who chew on one side of the mouth, we sometimes 

 find half the tongue coated. A yellow or brown color of the coat- 

 ing may be due to vomited bile or decomposed blood, but most 

 often to dietetic or medicinal substances. 



The severest diseases of the stomach, such as round ulcer or 

 cancer, may be accompanied by a clean tongue j but, generally 



