To the Editor:—
I read with great interest the paper on "Black Hairy Tongue Associated with Penicillin Therapy" by S. A. Wolfson (J. A. M. A. [Aug. 13] 1949, p. 206). I should like to draw attention to the observations of Doxiades and Tiliados (Schweiz. med. Wchnschr. 86:1041 [Oct.] 1948). These authors observed black tongue in avitaminosis of human beings. The avitaminosis was complicated by other diseases, such as duodenal ulcer, complete paresis and Wernicke syndrome, disturbances of the digestive tract, furuncular myelosis and pernicious anemia. Administration of riboflavin precipitated the onset of the hairy tongue symptom. Treatment with vitamin B1 plus nicotinamide or vitamin B complex cured the symptom.Could penicillin treatment increase the requirements of the organism for vitamin B complex?