day. During an exacerbation the tongue looks red and angry; superficial erosions, patches of congestion, and perhaps minute vesicles appear on its surface, particularly about the edges and tip. Sometimes, from the folding consequent on swelling of the mucous membrane, the sides of the organ have the appearance of being fissured. The filiform papilla cannot be made out, although here and there the fungiform papillæ may stand up, pink and swollen. (Plate IX.) If the patient be made to turn up the tip of the tongue, very likely red patches of superficial erosion, sometimes covered with an aphthous-looking pellicle, may be seen on either side of the frsenum. On everting the lips, similar patches and erosions are visible; and if the cheek be separated from the teeth the same may be seen on the buccal mucous membrane. Occasionally the palate is similarly affected; very often in this situation the mucous follicles are enlarged, shotty, and prominent. The gullet and uvula may also be congested and, in places, raw and sore.
In consequence of the irritation caused by these superficial and exceedingly sensitive lesions, the mouth tends to fill with a watery saliva which may dribble from the corners. If the patient attempts to take any sapid food, strong wine, or anything except the very blandest diet, the pain and burning in the mouth are intolerable; so much so that, although perhaps ravenously hungry, he shirks eating. Not infrequently swallowing is accompanied and followed by a feeling of soreness and burning under the sternum; suggesting that the gullet, like the tongue, is also in an irritated, raw, and tender condition. During exacerbations of the disease the condition of the mouth becomes greatly aggravated. Although during the temporary and occasional improvements it becomes much less painful, even then salt, spices! strong wines, and all kinds of sapid foods sting unpleasantly; and the tongue, particularly along its centre, is seen to be bare and polished as if brushed over with a coating of varnish. At all times the tongue is abnormally clean and devoid of fur; during the ex-
