MOITTH AND LIPS, DISEASES OF THE.
Catarrhal Stomatitis.
Definition.—An acute inflammation of the mucous membrane of the mouth usually caused by local irritation or oc curring in the course of exanthematous diseases or prolonged febrile disorders.
Symptoms.—Although the entire buc cal membrane may be involved,—that of the tongue, lips, and cheeks,—the labio gingival region is -usually the seat of the most active inflammatory manifestations. Redness, heat, tumefaction, furring. of the tongue, and local discomfort consti tute the symptoms witnessed in light cases; but in some, and particularly in infants, there is severe pain, sufficient, indeed, in the majority of cases to pre vent nursing. Local pain also attends a form of stomatitis observed in nursing women. In severe eases of catarrhal stomatitis the tongue appears enlarged and the lingual papillfe project promi nently. The saliva is greatly increased in quantity and is often sufficiently acrid to excoriate the lips and chin. Minute areas of the epithelial covering often be come transformed into small, shallow, pultaceous, and quite painful ulcers, which are especially sensitive when touched or brought into contact with other mucous surfaces during mastica tion. Slight fever is sometimes present even in the condition occurring inde pendently of infectious febrile disorders, of which catarrhal stomatitis is a fre quent complication. The symptoms usually last from fonr to ten days.
In some instances the oral mucous membrane is dry, the inflammation manifeting itself by the presence of heat, pain, and redness. This consti tutes the "erythematous catarrhal stoma titis" of certain authors.
:Measles is always accompanied by a mild erythemato-pultaceous stomatitis Ivhich sometimes disappears before the eruption, sometimes accompanies it, but • always disappears with the rash. This stomatitis is characterized by a general, but moderate, swelling of the mucous membrane of the gums, cheek, tongue, and palate; a violaceous redness of all the parts with increased salivation: a pultaceous, creamy exudate which covers the surface and is easily removed by the fingers. This erythemato- pultneeous stomatitis may, in certain cases, serve as a point of diagnosis. Comby (1.a Tri
bune Med.; Med. Bull., Apr., '96).
Etiology and Pathology.—CniarrhaT stomatitis may be primary or secondary. In the primary form the causative factor is a local irritant,—ineclinnieal, eheni ical, or thermak—which gives rise to ex cessive desquamation of the epithelium. Undue acidity of the oral secretions, un duly hot or cold foods, tobacco. strong condiments, fermenting or decomposing. particles of food through insufficient cleansing of the mouth and teeth, etc., may give rise to the alTeetion. In the secondary form the oral inflammation is symptorna ic and often alfends i n fee tions diseases.—measles. typhoid fever, —and other exantheinala, and the pro longed fevers. It may also arise through continuity of tissue or hy infection, • ".1 • .4:. ti .11.1;iiiiiii.itOry 7. ,:111.ZINItiS., 11.yor r .11 C.. t,a,trie disorders • 1,% .ated t 11 Cal a I.
s- oral disease may • an t.Ni.ltifte of general de ..! ti e organism. the result of J*1. surroundin,zs and poor food.
:1 tr ,c catarrhal form thickening .- I f the mucous membrane ;:.._ -t tit pathological feature: r. sions covered with pulta .,. of cells undergoing retro tainoriliosis being observed in r in marked cases. The saliva •- acid in reaction.
Treatment.—•T imernal administra r Id. rate of potassium, frequently - 1 i- a pernicious practice in 4..rn .-f -tomatitis, owing to its evil ,T.iid• 11. upr,n the kidneys. Employed dution (about 1 drachm to 'WO as a mouth-wash, however, it u-eful. In many cases, 11) :zrain, to the ounce, is more em] loyed frequently during 11,. c‘try half-hour and with espe . —L are after eating. In infants the be ...fenny cleansed after :,,.,31112 and a preparation of boric 1: „zrains to the ounce of rose - 4..« li-d with a swab, or, better, on )1' linen over the fin zr7- • n ir,e. 1Vhen mastication is .r u.ry painful, tl.e local appli • l-per-cent. solution of eo .-.. : • 71 -et -itive spot. affords great ' • - ..1 i:or. the, patient to eat ! t•.,r IVIon the shallow ulcers e n.ea•-:ures they should Pr.iiclo,1 with blue-stone or a - ' of -orne of the silver salts, - r., 40' nitrate.