Quotation from: Manual of Surgery

Written by: Alexander Miles and Alexis Thomson


_The Mucous Membranes_, and especially those of the _mouth_ and
_throat_, suffer from lesions similar to those met with on the skin. On
a mucous surface the papular eruption assumes the form of _mucous
patches_, which are areas with a congested base covered with a thin
white film of sodden epithelium like wet tissue-paper. They are best
seen on the inner aspect of the cheeks, the soft palate, uvula, pillars
of the fauces, and tonsils. In addition to mucous patches, there may be
a number of small, _superficial, kidney-shaped ulcers_, especially along
the margins of the tongue and on the tonsils. In the absence of mucous
patches and ulcers, the sore throat may be characterised by a bluish
tinge of the inflamed mucous membrane and a thin film of shed epithelium
on the surface. Sometimes there is an elongated sinuous film which has
been likened to the track of a snail. In the _larynx_ the presence of
congestion, oedema, and mucous patches may be the cause of persistent
hoarseness. The _tongue_ often presents a combination of lesions,
including ulcers, patches where the papillae are absent, fissures, and
raised white papules resembling warts, especially towards the centre of
the dorsum. These lesions are specially apt to occur in those who smoke,
drink undiluted alcohol or spirits, or eat hot condiments to excess, or
who have irregular, sharp-cornered teeth. At a later period, and in
those who are broken down in health from intemperance or other cause,
the sore throat may take the form of rapidly spreading, penetrating
ulcers in the soft palate and pillars of the fauces, which may lead to
extensive destruction of tissue, with subsequent scars and deformity
highly characteristic of previous syphilis.

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