Diseases of the mouth : for physicians, dentists, medical and dental students / Tr. and edited by John Bethune Stein.

  • Zinsser, Ferdinand, 1865-
Date:
[1912]
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the mouth : for physicians, dentists, medical and dental students / Tr. and edited by John Bethune Stein. Source: Wellcome Collection.

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    or an annular syphilide—at best only pemphigoid and erythematous lesions—can pass through such and so many changes in a few days as are to be seen upon the geographical tongue. Therefore the geographical tongue is sometimes designated “Annulus migrans” or “Wandering Rash.” The condition exists at birth and lasts during life. Sometimes it shows itself but slightly, at others it appears in its severest form. It usually gives no trouble and there are many who have no presentiment of the condition of their tongue. Some are sensitive to mechanical stimulation (can- not eat hard bread, nuts, ete.) and are inclined to develop glossitis, which however is transitory. The cause of the condition is unknown. It has been at- tributed to an exudative diathesis and has been looked upon as a manifestation of scrofula. Against these surmises we have the facts that, it has been seen immediately after birth and that it remains through- out life in spite of all kinds of therapy. The geographical tongue is surely not syphilitic, but it resembles very much those changes which are caused by an annular syphilide of the mucous mem- brane and on superficial inspection may be easily mis- taken for an annular syphilide. If there are discrete spots (about 5 mm. in diameter) or small bow-formed areas where the epithelium is thickened, the diagnosis becomes difficult and can only be made by repeated examinations and availing one’s self of all accessory means [ Wassermann reaction, dark-field-microscope, etc.—TR.] of diagnosis. Syphilis and a geographi- cal tongue can be present at the same time and with such an occurrence the difficulty of a differential di- agnosis is obvious. Although there is no doubt but that Leukoplakia Buccalis is not exclusively a syphilitic lesion, never- theless there is also no doubt that syphilis in a great measure predetermines conditions for its occurrence, and that an especially high percentage of those who suffer from leukoplakia are syphilitic.