1746 DISEASES OF THE MOUTH, THROAT, AND STOMACH 



LINGUAL AFFECTIONS. 



Patches of Leucoplakia of the tongue are common in natives, and 

 may be of various origin — syphihtic, framboetic, or due to irritation 

 caused by smoking or chewing various substances. Case of the 

 so-called Circinate pityriasis linguae or Annulus migrans are not 

 rare. Lingua nigra is occasionally seen. We have already called 

 attention to the dark patches found on the tongue in natives, and 

 which by some writers have been described as a sign of ankylo- 

 stomiasis. These pigmented patches are roundish or oval, and 

 may be found also on the gums, the mucosa of the lips, on the soft 

 and hard palate, and are apparently congenital. A condition 

 which might be called Red or Purple tongue, and which often 

 puzzles the newly arrived medical man, who does not know its 

 origin, is extremely common in Ceylon among the coolies and 

 lower-class natives, and is simply due to chewing betel. The pig- 

 mentation slowly disappears on the native discontinuing the use of 

 betel. Cases of Furrowed tongue (scrotal tongue) are not rare. 

 We have seen a case of Fordyce's disease (pseudo-colloid of the 

 lips) in a half-caste. A case of Chelitis exfoliativa in a European 

 lady and cases of Perleche have been observed by us among 

 European children. Under the term seasonal recurrent ulceration 

 of the lips, Gros has described a very superficial ulceration on the 

 lower lips in Algerian natives which is very common in the hot 

 season, and is due, according to him, to a diplobacillus. 



Pityriasis Linguae Spirochaetica. — This condition has been described 

 by Castellani. There is as a rule no sign of acute inflammation 

 and no ulcers, but the dorsum of the tongue is covered by a thick, 

 persistent, whitish-yellowish or greyish-brownish fur, which on 

 microscopical examination seems to consist solely of innumerable 

 spirochsetes, with some epithelial cells. Of course, a few spirochsetes 

 are always found in scrapings from the tongue, but never in such 

 enormous amounts. 



HALZOUN. 



Definition. — Halzoun is the invasion of the pharynx by the 

 adults of Fasciola hepatica (Linnaeus, 1758), which cause dyspnoea, 

 dysphagia, and sometimes more severe symptoms, and even death. 



Historical. — In 1904 Khouri described this disease as occurring 

 in Northern Lebanon. 



etiology. — The disease is caused by eating raw livers, especially 

 raw goat (Capra hircus Linnaeus) livers, which are infected with 

 Fasciola hepatica (Linnaeus, 1758), when the worm (p. 565) fastens 

 itself on to the mucosa of the pharynx and sucks blood. 



Symptomatology. — The patients suffer from dyspnoea, dysphagia, 

 dysphonia, and congestion of the head, and occasionally die, but 

 more usually, after lasting from a few hours to a few days, the victim 

 vomits and the parasites are expelled, and recovery results. 



Treatment. — An emetic will cause the parasites to come away. 



