TONGUE. 



1153 



arch the velum palatl posterius. At the same 

 time that this is taking place, the base of the 

 tongue is thrown back upon the epiglottis*,the 

 larynx being drawn upwards and forwards 

 to meet it, so that the rima glottidis is com- 

 pletely closed, and the food glides safely down, 

 over the inclined plane thus formed, into the 

 pharynx raised and dilated to receive it : 

 the food then comes within the grip of the 

 constrictors of the pharynx, which successively 

 pass it downwards to the oesophagus. This 

 process takes place so rapidly that it is difficult 

 to trace its parts in succession, and indeed 

 some of them, which apparently succeed one 

 another, are in reality contemporaneous : thus, 

 the first stage the raising of the dorsum of 

 the tongue to the palate is that which mainly 

 contributes to the inclined plane of the second 

 stage; and the raising and carrying forwards 

 of the larynx under the tongue is that which 

 principally dilates the pharynx.f 



The third stage, or the oesophageal, conducts 

 the food to the stomach ; it is of that peri- 

 staltic or vermicular nature that characterises 

 all the succeeding movements of the alimentary 

 canal ; the muscles concerned are entirely 

 involuntary, and the nature of the act purely 

 reflex. The tongue is not concerned in it. 



Speech. The tongue is the instrument 

 principally engaged in those modifications of 

 the oral passages which give rise to articulate 

 sounds, which, definitely grouped and com- 

 bined by man, and taken as the representa- 

 tives of certain objects, actions, qualities, and 

 relations, constitute Language. The con- 

 sideration of this interesting subject, however, 

 will more appropriately fall under the article 

 VOICE, to which the reader is referred. 



MORBID ANATOMY OF THE TONGUE. 

 The tongue is obnoxious to a variety of 

 morbid changes, which might naturally be 

 expected from the number and nature of 

 the elementary tissues which enter into its 

 formation, as well as from the diversity of the 

 functions it has to perform, and the exposure 

 to injury in which it is placed; changes 

 which may consist either in some increase, 

 decrease, or disproportion of its normal ele- 

 ments, in some lesion or morbid change in 

 those elements, or else in the superaddition of 

 some adventitious growth. 



The tongue may be affected with inflam- 

 mation, hypertrophy, atrophy, induration ; 

 with ulceration, numerous morbid changes in 

 the conditions of the papilla? ; with tumours, 

 cancer, aphthae ; and the organ, moreover, is 

 subject to be displaced, there is prolapsus 

 of the tongue, the tongue may be inverted 



* It would seem that the epiglottis is not abso- 

 lutely necessary for the protection of the rima glot- 

 tidis, but that the pressure of the base of the tongue 

 over it is sufficient ; as there are authentic cases on 

 record, in which the epiglottis was quite destroyed 

 by syphilis, and yet deglutition was never attended 

 with any inconvenience. 



f For a detailed account of this process, see 

 Dzondi, die Functionen des weichen Gaumens. 

 le, 1831. 



VOL. IV. 



,,, ; 



and embraced by the pharynx swallowed; 

 and the tongue may be unnaturally fixed by 

 an unusual extent of frenum, the individual 

 thus circumstanced being tongue-tied. 



Inflammation of the tongue. The morbid 

 changes caused by inflammation of the tongue 

 are modified by the structure of the organ. 

 There is one form of this disease in which, 

 from the extreme vascularity of the tongue 

 and the distensibility of its covering, it swells 

 to an enormous size with great rapidity, and 

 subsequently recedes without suppuration : 

 this I have ventured to call erectile. In other 

 cases the tongue suppurates. The constitu- 

 tional action of mercury is another cause of 

 glossitis. I therefore divide glossitis, for its 

 more complete consideration, into I. Idio- 

 pathic (1. Suppurative ; 2. Erectile) ; and 

 II. Mercurial. 



Suppurative glossitis. This is an extremely 

 uncommon affection. It commences with 

 heat, swelling, induration, and some fever; 

 matter presents itself at various lengths of 

 time, forming a more or less circumscribed 

 abscess. It generally occurs on one side, and 

 points just beneath the edge of the tongue. 

 According to Dr. Moller, of Zealand, scrofu- 

 lous persons are most liable to this affection. 

 Instances are recorded by Mr. A. Smee, Dr. 

 Graves, Dr. Moller, and one example occurred 

 in the practice of the author's father. This 

 latter patient was a lady, recovering from 

 an attack of influenza. Her tongue, which 

 was affected principally on one side, became 

 swollen, tender, hard, stiff, and incapable of 

 movement. She could not speak, and swal- 

 lowed with great difficulty. At length the 

 pus was evacuated, and the tongue healed, 

 and recovered all its functions immediately. 

 This lady now possesses a remarkably good 

 use of the organ. 



Erectile glossitis. This malady, though 

 less rare than the preceding, is still quite un- 

 common. The morbid condition of the tongue 

 in this disease appears to consist in an enor- 

 mous and rapid distension of the organ by 

 blood, rendering it very large, hard, and stiff'. 

 In the majority of cases it occurs in people in 

 perfect health, and seems to be a purely idio- 

 pathic inflammation : in some cases it seems 

 to have followed exposure to cold, and in 

 others it was associated with febrile disorders. 

 In this disease the first change which occurs 

 is a perceptible enlargement of the tongue, 

 which feels rather stiff, painful, and tender 

 with a little difficulty in speaking, the patient 

 being in other respects well. The case gene- 

 rally proceeds rapidly ; in two or three hours 

 the tongue is much larger; there is a good 

 deal of distressing burning felt in it. Sy- 

 nocha, symptomatic of the local inflammation, 

 now occurs, and goes on increasing with the 

 glossitis, and the patient becomes anxious and 

 alarmed. The tongue occupies now the whole 

 cavity of the mouth, or even protrudes, and 

 the jaws are kept apart. Mr. Martin thus 

 describes the condition of the tongue at this 

 stage : "On examining the tongue, I found 

 that it occupied a large proportion of the 



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