264 ACTINOMYCOSIS 
hard and often gritty. The indurated tongue may be eroded from 
friction and various deformities of this organ are reported. Jcest has 
given a detailed account of the histological changes that take place in 
actinomycosis of the tongue and mucous membrane. 
In the pharynx. Here the disease usually takes the form of soft 
polypoid or fungoid nodules or lumps with a smooth surface and short 
peduncle. These nodules vary in size often reaching that of a goose’s 
egg. These polypoid growths may cause great difficulty in swallow- 
ing and likewise interfere with respiration. Tumors of this kind may 
form" in the esophagus or trachea. Rarely actinomycotic growths 
occur, at other places in the alimentary tract. There are some cases 
in which the lesions are not restricted to the digestive tract. The 
lesions sometimes occur on the nasal mucosa. 
— 
Fic. 60. ACTINOMYCOSIS OF THE TONGUE. (a) NORMAL TONGUE MUSCLE; (b) ACTINO- 
MYCOTIC NODULES; (¢) ACTINOMYCOTIC NODULES IN SUBMUCOUS TISSUE; (d) IN 
THE PROPRIA MUCOSAB; (¢) NORMAL MUCOUS MEMBRANE; (f) GREATLY THINNED 
MUCOUS MEMBRANE. (AFTER JOEST). 
