'In eatarrhal stomatitis perfect clean 1..rs=s t.f mouth and nipples is of the ut mo-t importance. The mouth should be cleansed after each feeding by cotton NN rapped upon a small rod, or by in (hieing the child to suck ice-water from a piece of soft linen. Food, as far as possible, should be given cold, but the child should not be taken from the breast. Chlorate of potassium is useless and often harmful.
If the disease persist, the mouth should be penciled with a 12-per-cent. solution of nitrate of silver daily, and cracks or ulcerations should be touched with the mitiga t ed stick. L. EMMETT IIIDLT, Assoc. Ed., Annual, '901 In stomatitis ulcers may be touched with a tiny piece of absorbent cotton, which bas been dipped in the following solution:— 8 Borax, 45 grains.
Salicylate of sodium, 75 grains. Tincture of myrrh, 1 drachm. Syrup and water, of each, V, ounce.
The child should also take milk which has been boiled or sterilized. In ordi nary erythernatous stomatitis the child's mouth should be washed out, particu larly after each meal, with this solu tion:— 8 Borax, 30 grains.
Bicarbonate of sodium, I drachm. Distilled water, 4 ounces.
Morain (Jour. des Prat., Aug. 15, '96).
Aphthous Stomatitis.
Symptoms.—In this variety of stoma titis there appear, besides the more or less marked inflammation of the oral nmcosa, small, elevated, round or oval vesicles two to five millimetres wide, and surrounded by a red areola, which, as early as twenty-four hours after their ap pearance, form shallow, yellowish-white spots of ulceration, with bright-red gins. They may appear singly or in groups in any part of the mouth, but they are apt to appear in greatest num ber on the labial mucous membrane, along the external portion of the gums, inside the cheeks, and along the edges of the tong,ue. They are much more painful than those observed in the tarrhal form, and render nursing or the taking of food very difficult. The aph Ulm sometimes extend to the fauces.
The general symptoms are' somewhat more marked than in the previous form. Slight fever, anorexia, furring of the tongue, and heavy breath represent, how ever, about all the manifestations usually' witnessed. Although there is an in
creased flow of saliva, the latter is never fcetid (Holt). The pain attending the presence of the ulcers especially renders the child cross and fretful when food is taken, but the active nervous manifesta tions of the more severe forms are ab sent. In the form observed in connec tion with febrile diseases the general symptoms are obviously those of the causative affection. Aphthous stoma titis tends to recur when the primary general cause is not completely removed.
Etiology and Fathology.—Aphthous stomatitis is usually observed in children under three years old. It is a frequent complication of gastro-intestinal dis orders and is often seen in debilitated or poorly-fed subjects. It is most fre quently: met with in conjunction with, or as a sequel of, some febrile diseases, especially the acute exanthernata.
Local outbreaks of aphthous stomatitis have been traced to milk- of cattle in fected with foot-and-mouth disease (011i vier), but the claim of Siegel that the cause of the disease in man and the lower animals is the same has not as yet been accepted.
No parasite special to the affection has as yet been isolated.
Treatment. — The treatment of this condition does not differ from that pre viously described. Holt states that each ulceration may be touched with nitrate of silver, but that no other active meas ures should be employed. The disease tends to spontaneous recover3- in from seven to fourteen days. Cloppert has re cently (Jahrb. f. Kinderh., Jan., '99) recommended orthoform as a local ames thetic, the powder being simply blown over the diseased areas, after cleansing the whole oral cavity. Food should only be used fifteen minutes after each application. Marfan resorts to frequent washing of mouth with a saturated boric acid or a 1 to 500 solution of carbolic acid. To the nlcers he applies a 5-per cent. solution of nitrate of silver, a 1 to 500 solution of permanganate of potas sium, or a solution of iodine and iodide of potassium in glycerin and water.
The following preparation is much employed by French clinicians:— 4 Borax, 4 parts.
Tincture of benzoin, 2 parts. Distilled water, 10 parts.