92 INFECTIONS OF THE DIGESTIVE TRACT 



we see in the case of Miiller's superficial glossitis (geo- 

 graphical tongue) a condition in which varying areas 

 of the tongue suffer a temporary or permanent loss of 

 the superficial epithelial layers. In many cases of chronic 

 disorder of digestion of very long standing, the papillae of 

 the entire dorsal surface of the tongue show excessive 

 desquamation of the epithelium. In how far similar 

 conditions occur in other parts of the digestive tract 

 we do not know, but there is reason for believing that in 

 some chronic derangements of digestion there is in the 

 stomach and in the intestinal tract a similar thinning 

 of the epithelial layer. How far conditions of the tongue 

 may be regarded as an index to the conditions in other 

 parts of the digestive tract is uncertain. 



Of the pathological effects of excessive desquamation 

 of epithelium we have at present little definite knowledge. 

 It appears reasonable to suppose that where desquama- 

 tion is excessive without corresponding reproduction of 

 epithelial elements there must be diminished secretion, 

 provided the cells in question take any part whatever 

 in providing a secretion containing digestive enzymes. 

 It seems likely also that the process involved in transu- 

 dation may be abnormal under conditions in which 

 the epithelial layer is greatly thinned. There are some 

 patients in whom the tongue indicates an excessive 

 desquamation of the epithelium and in whom cathartics 

 such as salines no longer act promptly or efficiently. 

 It seems to me possible that the not uncommon appear- 

 ance of a loss of response to cathartics may be connected 

 with the partial failure in function of the epithelium of the 



