Chapter XLI

, may be readily appreciated. Sometimes it is due to the entrance of foreign bodies, as fish-bones, bone-splinters, and the like.

Most urgent danger is that of asphyxia from pressure, and of inspiration pneumonia, for the infected saliva in these cases will trickle down within the larynx and trachea. Even _gangrene of the tongue_ has been observed as the result of pressure, while the teeth will leave their impress upon the sides of a swollen tongue.

The more _chronic infections of the tongue_ are _syphilis_, _tuberculosis_, and _actinomycosis_. Syphilis may assume a primary type and occasionally typical chancres may be seen on the tongue. It is frequently the site of mucous patches and of other ulcerative lesions. Tuberculous ulcerations of the tongue assume less indurated and irregular borders, and may be suspected in connection with well-marked tuberculous lesions of other parts of the respiratory tract, being

## particularly common in consumptives. These ulcers yield best to

cauterization and antiseptic mouth-washes, whereas syphilitic lesions rarely disappear without active antispecific medication. Both syphilis and tuberculosis produce gummatous tumors, the former more frequently than the latter. The former will disappear equally readily under suitable treatment.

## Actinomycosis of the tongue is rare in man. It constitutes a granuloma

which may soften and present a ragged, ulcerated surface. (See

## Actinomycosis,