In yellow fever the bleeding from the gums usually precedes the black vomit.
In kala-azar and possibly in malaria we may have gangrenous conditions of the cheek, as cancrum oris.
In the miliary type of verruga we may have the granulomatous lesions appearing on the mucous membranes of the mouth.
In typhus fever the mouth is strikingly foul with marked sordes covering the teeth. The dry brown tongue in this disease is known as the “parrot tongue.”
We may rarely have parotid gland enlargement in Malta fever, malaria and tsutsugamushi.
Parotitis is not uncommon in typhus fever. A type of parotitis which differs from mumps in not being contagious has been reported from the Philippines.
Stomach and Oesophagus
Very important in diagnosis is a tenderness in the pyloric end of the stomach, which is brought out by attempting to palpate the epigastric region. It is marked in yellow fever and acute pernicious beriberi as well as in blackwater fever and bilious remittent fever. We also frequently have epigastric tenderness, extending to the right, in ancylostomiasis.
Hookworms patients are often “pot-bellied” and the craving for eating unusual articles, as earth, may be connected with the gastric hyperacidity which the patient desired to neutralize with alkaline earth.