Licence: Public Domain Mark
Credit: Lectures on the theory and practice of physic (Volume 1). Source: Wellcome Collection.
Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)
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![see taking the tongue as the unerring index of various conditions of the digestive tube? hundreds and thousands. It is unquestion- ably true, that in certain cases of gastritis, particular morbid appear- ances, as redness, dryness, pointing, and a tremulous state of the tongue, are observed, but what I wish to impress on you is, that it is necessary that these phenomena should coincide with other symp- toms. I do not wish you to believe, that the inspection of the tongue, or the knowledge derived from its appearance, is useless, particularly in cases of fever: the state of the tongue is never to be overlooked, but you should understand on what principle it is to be examined. You should examine the tongue not so much as to guide to the knowledge of local disease, but as an index of the condition of the general system. For instance, if, during the course of a fever, the appearance of this organ changes and becomes more favourable, it is a sign that the whole disease has taken a favourable turn, and vice versd. Tins is the proper way to look at the tongue in fever, not as reflecting any particular stale of the intestinal canal, but as being indicative of some modification of the whole economy.* Symptoms derived from the Respiratory and Nervoxis Systems.— Let us now consider the sympathetic relations of the nervous and respiratory systems in gastritis. This is a very curious and interest- * [I know well a person, who, for twenty-five years, never had an entirely clean tongue; and who for years used to awake every morning with his tongue dry, furred, and yellow, or often brown, and sometimes giving out a little blood mixed with the first saliva. In fact, the tongue of this individual often resembled that of a patient in the advanced stage of typhoid fever; and yet he has been seldom laid up by sickness. His digestion was regular, but slow and labo- rious; and was particularly troublesome in the colon, in its being attended with flatulence, and alternate diarrhoea and constipation. His renal secretion was habitually disordered by the presence of uric acid. He was a moderate eater, and abstinent generally from all kinds of intoxicating liquors. He found that the appearance of his tongue and the dryness of his mouth, together with epigas- tric heat and tenderness, were increased much more evidently by late hours of even quiet study, than by indulgence in suppers, or the occasional excesses of the table. Of late years, his brain and nervous system have been less continually excited, and he now awakes in the morning with a moister and less morbid tongue ; al- though his dyspepsic symptoms are nearly as before. But whilst thus adducing evidence in support of the opinion advanced in the text, I ought to add, that any unusual article of food, salted or smoked meat, pastry, or an apple at dinner, will cause disturbed sleep and a drier tongue the next morning in this individual. A circumstance worthy of notice, in his case, is, that, when he happened to awake in the night, or at two, or three, or four o'clock in the morning, his tongue was moist, and his mouth without any feeling of dryness or discomfort: but alter the last sleep, and at the common hour of rising, the tongue and mouth would be dry and parched, and other- wise changed, as above described. — 13.] vol. i.—10](https://iiif.wellcomecollection.org/image/b21156955_0119.jp2/full/800%2C/0/default.jpg)
