I have a patient with a peculiar tongue. I will describe it as nearly as I can, and will ask your readers to tell me what is indicated by it. The tongue is usually very red, the surface may be white or it may have a brown coat, but the red foundation at the base of the papilla is plain. Upon this there are very many little spots of a deep red color, which closely resemble flea bites. I have heard the name of flea-bite tongue; I should think it would be applicable to this case. Occasionally, there is only a brown streak down the center of the tongue, with these red spots. I have never read anything that suggests what this symptom is diagnostic of.
The patient is a young lady who has a long train of unpleasant symptoms. She has chronic indigestion, which is accompanied with vomiting spells. After vomiting she feels much better. Certain kinds of food, as beans and sour kraut, will lay for days in her stomach. She lives in a malarial neighborhood. She is anemic and poorly nourished. About two years ago she was operated on for ovaritis, and a ventral suspension was done. Now she is frequently troubled with a persistent dull pain in the pit of the stomach.
If the editor or the readers of this journal would kindly give me an explanation of this tongue, and a diagnosis of the underlying conditions of which this patient suffers, and would suggest a plan of treatment for me, I should certainly appreciate it very much indeed.
COMMENT:—I am not able to find a description of the condition of the tongue similar to that described above. It does not correspond to the strawberry tongue of scarlet fever, but seems to be in some particulars similar to that which indicates the use of rhus tox. at any rate, I should give rhus tox. and echinacea in this case, based upon that indication. However, the nervous system first needs attention. The operation on the ovaries and the ventral suspension have undoubtedly produced an influence upon the sympathetic nervous system, and a shock to the general nervous system, which must have the utmost care and attention. The digestive apparatus must be put into the best possible condition also.
A close study of the existing conditions, and of new conditions as they appear, will enable the doctor to prescribe single remedies in this case with beneficial results.
Ellingwood's Therapeutist, Vol. 2, 1908, was edited by Finley Ellingwood M.D.