Definition.—An inflammation of the parenchyma of the tongue, usually terminating in resolution, though suppuration occasionally results.
Etiology.—This may occur as the sequel of pneumonia, or as a complication, though the exciting cause is most frequently the result of bites or stings from insects, or scalds from hot fluids, or from corrosives. Anders suggests that injuries to the tongue provide an entrance for various bacilli, which may be an exciting cause.
Symptoms.—These depend somewhat upon the form, whether a primary or a secondary lesion. In the one case, swelling of the tongue begins rapidly, soon filling the mouth, and even protruding from the lips.
The tongue may be coated, though usually it is dry, red, and glossy. There is tenderness and pain and great difficulty in swallowing. The dyspnea is distressing and sometimes endangers life. The patient is unable to talk and distress is evident in every feature. There is an increased flow of saliva, with swelling of the submaxillary glands. The pulse is rapid, and the temperature ranges from 102° to 104°. It usually runs its course in from five to seven days. Where the disease is secondary the symptoms are developed more slowly, though similar to the ones just described.
Diagnosis.—The swollen, stiff, and immobile tongue renders the diagnosis easy.
Prognosis.—It is favorable in the acute form, but must be guarded, if a complication of a grave disease.
Treatment.—Where the tongue is badly swollen and tense, I have found soft linen cloths dipped in a solution of glycerin and potassium chlorate and hydrastis, and applied to the tongue, to give the greatest relief. Alkaline washes may also be used. Internally, aconite and phytolacca are useful; bits of cracked ice may be held in the mouth, and is grateful to the patient.
I would discourage scarifying the tongue, as the relief is but momentary and the pain quite severe. Inhalations of steam from hops and tansy or eucalyptus will also give relief. If the dysphagia is great, feeding by rectum may be necessary. Where the disease is secondary, in addition to the means above mentioned, appropriate remedies should be used for the primary lesion.