Riga's disease has been observed al most exclusively in the southern prov inces of Italy, where it seems to be en demic, occasionally' attacking all the children in a family, whether the parents be healthy' or not. It is observed: when the first teeth make their appearance, apart from whooping-cough, sometimes in children whose general health shows nothing wrong, sometimes in cacbectic children who are exhausted by ordinary attacks of gastro-intcstinal catarrh. It begins as an ulceration under the tongue, close to the frtenum. It is about the size of a flaxseed, and gradually- enlarges to the size of a sixpence. It is gray in color and painless. The border is irregular and not sharply marked, and extends some what over the sound tissue. It may cause death, or, after a long time, re covery may take place. The children waste in flesh, their skin becoming of an earthy hue. Enlargement of the liver and spleen occur. There is no fever. Beginning at the age of three or four months, it frequently lasts until the twentieth month. It is mostly heredi tary, and only seldom do the children of such families live, unless nursed at the breast of a healthy woman.
Judging from results of histological examination, Riga's disease is a local lesion: a sort of traumatic ulceration di rectly connected with the rubbing of the inferior surface of the tongue on the sharp edges of the two lower incisors, the repeated friction being considered as the probable cause of the papillary appearance of the ulceration. F. Brun (Annual, '96).
Parrot's Disease.—This disorder is ob served in the newborn and is character ized by the presence on both sides of the middle line of the hard palate of sym metrically-disposed ulcers which tend to increase in size. The ulceration often penetrates the underlying soft tissues to the bone, causing necrosis. It is a stub born affection and requires the active measures advocated under ulcerative stomatitis.
Herpes zoster, or zona, of the mouth as described by IItigenschmidt, is an in flammatory affection of one part and only one side of the buccal cavity', char acterized by an eruption of herpctic ves icles, disposed in groups according to a regular direction. The eruption is pre ceded and accompanied by a neuralgic pain of the whole fifth nerve. The evo lution of the disease may he divided into two periods: (1) the period of invasion; . 1 1 r (1 of ! • -( of th( inpern , J`• ft r: thin litadaelle, • (o•;•••tilt. inten-e • . .1, %C,..I( r(.;... (.1. f the fifth r • rtt anti is foi e ln ... i• .11 pits t( e involved Nk'N i.ainful to the touch: •0.(11.1 rare is rcd and presents - 1,:z1. hirpoic visicles. dis ... ..!r•ail• and having size of a •u-f- h. A 1. Of them are united.
!.. v rezular direction: usually - ,,f nine. No vcsieles are [”. f .:.1 minattd 'n the mouth.
1,(1 v.hich is general for the zlirti, days, lccalizcs itself as soon as (!riiii•ion occurs.
Very ,itnilar is a disorder described by al-o characterized by an herpetie trupti.,n, and el:served in neurotic sub jo,:s. In eases it accompanies ery tIL.ma multiforme. The treatment in is that of the genera' disorder.
zr,ster invoiving the mouth, arynx. larynx. and especially the epi gb.ttis has oceasionally been observed and (I. seribed—one ease by ine (Phila. NIcd. Jour., 'OS, and one by Joseph S. Gil.h I'hila. Polyclinic) and others. T•,•se cases were accompanied by gen erAlized zrna. -.M.ADION TAYLOR.] C.ze rf stomatitis which followed the adn,ini-tration of antipyrine. The man a- ,u(Tcring from rheumatic neuralgia *nd • a. given antipyrine in mixture. On the next day three or four patches of perfirial storratitis appeared on the 1 u.,a1 rnueru; n.embrane and two or •lare rn the hard palate. No erythem at, u. rish appfared. ()illy forty grains •f 1...P drug v-as given. C.. K. -.Martvn 'P.ri•. Merl. Jour., r.r-t. 17. '9S).
Lips. Diseases of.
Inflammation, Cracks, and Fissures.
In9ammation frequently occurs inde rcrdently rf Fral or general affections a: a result of cold during the winter month, \\lien the slight vascular tur gcset nee present, is complicated with cracks or fissures, considerable discom fort results. Of diagnostic importance, however, is the fact that fissures, which are usually situated in the middle of the lips, often betoken a strumous diathe sis; enlarged cervical glands are usually present in such cases, however. Again, cracks at the angles of the mouth sug g,est the possibility of general syphilis; the surrounding tissues in that case often appear soddened, while the fissure is apt to contain pus. Labial fissures are also often witnessed in women who, in threading a needle, first bite the thread and drag it between the lips before pass ing the tip through the eye (Jamieson).
Treatment. —Uncomplicated conge.s tion of the lips soon yields to mild as tringents. or to a preparation such as the following, in which a resinoid sub stance is contained:— I; Tinet. of benzoin, 1/2 ounce. (ilyeerin, 1/., ounce.
Rose-water, enough to make 4 ounces.
1Vhen slight fissures or cracks are present, rose-water ointment or 10 grains of salicylic acid to the ounce of cold cream usually bring about prompt reso lution. Fissures often resist all simple measures, and require the application of solid nitrate of silver. In children per sistent fissures leave deep furrows, and are apt to produce slight deformities. They should therefore be scraped with the curette under local anwsthesia, and the edges of the wound be drawn to gether and held in position by means of court-plaster until healed.
In tabulation of ninety-eight cases of extragenital chancre, it is found that the lips are by far the most common seat of these leFions. Neumann (Inter. klin. flund., .Apr. 10, '92).