A tonic treatment should be instituted. The syrup of iodide of iron is especially valuable; codliver-oil is preferable in poorly-nourished children. Hygienic surroundings and wholesome food should be insured.
Best treatment of stomatitis uleerosa consists in gargling the mouth with a solution of chlorate or permanganate of potassium before and after meals, and in inserting afterward an iodoform-, boric-, cr salicylic- gauze compress between the cheek and gums on the diseased side. This compress is removed before partak ing of a repast, and renewed afterward, care being taken always to use the gargle before inserting the gauze. Orak hovatz (Provincial Med. Jour., June 1, '94).
Parasitic Stomatitis (Stomatitis My cosa ; Thrush; Sprue; Muguet; Soor).
Definition. — A disease characterized by the formation upon the mucous mem brane of the mouth of pearly-white spots or flakes which gradually increase in size and spread to adjoining structures and organs.
Symptoms.—This form of stomatitis usually begins upon the tongue, and, spreading in every direction, may gradu ally involve the lips, the cheeks, the palate, the gums, the tonsils, the phar ynx, the larynx, and even the gastro intestinal tract down to the ileo-cmcal valve (Parrot). The superficial lesion appears as small, grayish-white spots, surrounded by a zone of blood-vessels. These soon become elevated, increase in size, and often coalesce to form a false membrane; this, in some instances, has a characteristic filmy, or lace-like, look; in others it simulates a thick, friable pseudomembrane (Holt). These areas or flakes may readily be brushed off, leaving no appreciable mark upon the surface from which they were removed. Sometimes the flakes appear yellowish or brown. and the seat of implantation bleeds, shallow erosions being then per ceptible. The constitutional symptoms are less marked than in the other forms, the local manifestations being compara tively benign. Indeed, dryness of the mouth and local heat, difficult nursing or feeding owing to more or less great tumefaction and stiffness of the mucous structures represent about all the dis comfort complained of. Still, the dis ease is a stubborn one and the lesions may persist for months. A fatal issue
is occasionally witnessed in debilitated children.
Epidemic of stomatitis in the Mater nity Hospital of Illaekwell's island, be 'ginning at birth or soon after.
The pearls constituting this form of stomatitis were small, white. globular tumors. varying in size from a pin-head to a millet-seed. and nmnbered from one to five in each ease. They were hard upon the outside and soft within. They were imbedded in the mucous membrane. and were usually covered with con densed subepithelial connective tissue. which merged into the surrounding tis tue without any distinct line of de markation. They were composed of epi thelial cells, like those of the mucous membrane of the mouth. Oarrignes (Med. News, Oct. 1, '92).
Symptoms of smile are nearly always found in the presence of other well known lesions discoverable by modern clinical methods. Careful study of these cases fails to indicate an additional etio logical factor. and with our pre,ent knowledge the writer believes that sprne is a symptom complex comparable ft) the typhoid state, occurring in the tropics in chronic diseases. especially hose af fecting- the gastro-intestinal canal. W. E. Alusgrave Omer. Nledicine.
15. 1902).
Etiology and Pathology. — The pri mary factor in the development of para sitic stomatitis is an abnormal condition of the oral mucous membrane, the Sac charomyces albicans: long branching mycelium filaments requiring an acid . !. 11 o eloping, upon •,1 . 11 a condition t-; AI\ :.r.•tizlit about in in f., • I.) 2, in ft.t.tliii-bottles when 41 , ; nut rition eo-exists.
. biUZ of acid food, and IT•,111‘." "f the mouth may act as • ; (.414n: 1.11. atidifying the normal • • -: cond.tion hich the growth 7 lin The transmis -1,.0 •'4,e thrush-spores hy means of f., spoons. cups, feeding l•... acounts for the epidemics • -; 0! sun ed.
.1 0 1.rt liTosing factors are mainly tt.nd to lower the general z the exanthemata, hereditary itc.: but it may also appear in trentiv robust children. Parasitic :•ci.t.at:ti.- is newise met with in adults inrlication or sequel of infectious and diathetic diseases: cancer, t. I - ete.