STOMATITIS.
In all cases of stomatitis solid food must be stopped and a liberal dietary of milk, soups, and pulpy farinaceous aliments administered.
Catarrhal primary cause should be searched for and removed, after which as a rule the inflammatory condition of the mucous membrane will rapidly subside without further treatment. Thus carious teeth, delayed dentition, errors in diet, dyspeptic troubles, the specific fevers, indulgence in tobacco either by chewing or smoking and the action of various drugs as mercury, iodides and bromides will all require attention. The best routine local application will be a solution of Boric Acid to cleanse the mouth every few hours in order to hasten natural resolution after the removal of the exciting cause. Chlorate of Potash (r in 8o) makes a good cleansing mouth-wash. In infants, smearing the tongue and gums fre quently with Glycerin. Boracis or Borax and Honey acts rapidly. Adults may be directed to suck slowly a tablet of Chlorate of Potash, or one containing Borax and a little Cocaine, in addition to the Chlorate. Mercurial stomatitis sometimes takes on a severe form when the adminis tration of the drug has been unwisely pushed, and the treatment of this variety of catarrhal stomatitis is detailed at further length in the article on l'tyalism.
Aphthous, Vesicular, Follicular or LIerpetir..titQrccatitis arises from causes similar to those which produce the catarrhal or simple type of stomatitis; it is commonly met with in infants and children suffering from gastric and intestinal disturbances, and is probably due to the presence of a micro organism. In the early stage local treatment properly carried out will cut short the disease and prevent or minimise ulceration. The best means of local treatment will consist in frequent painting of the tongue and gums with Glycerin of Borax, which by the movements of the tongue is applied to the entire buccal surface. Three or four times a day the mouth should be syringed out with a warm solution (i in:5o) of Chlorate:of Potash and a few grains of the salt may be advantageously administered every 4 or 6 hours in weak solution. When the ulcerative stage arrives a fine camel's
hair pencil, moistened with liquefied Carbolic Acid or a (t in 8) solution of Nitrate of Silver may he lightly applied to each minute ulcer. The solid caustic point is very efficacious but painful.
Bednar's Aphtlice is a similar affection arising in the mucosa over the hard palate, caused by the local pressure of the rubber teat of the feeding bottle; it is to be treated on exactly similar lines.
Ulcerative Stomatitis, also known as Phagedcenic Gingivitis Putrid Sore Mouth or Foetid Stontatitis, practically never occurs in infants, but often is met with in school-children living under had hygienic conditions with insufficient food and imperfect especially amongst those having carious teeth. It was common amongst the troops in the late war. The obvious treatment is to set right the unsanitary cause and take immediate steps to improve the general nutrition of the body by the liberal administration of strong soups, broths and fresh milk.
Local treatment should be thorough and employed assiduously, as the affection is very liable to end in shedding of the teeth and exfoliation of the alveolar processes. The mouth must be constantly cleansed with solution of Permanganate of Potassium (1 gr. to r oz.), saturated warm Boric Acid solution, weak Chlorinated Soda solution or Euchlorine gargle. This latter disinfectant is a powerful deodoriser of the fmtid saliva. It is made by mixing ro grs. Chlorate of Sodium with 3o mins. strong IICI in a pint bottle, and gradually adding distilled water with constant agita tion till the bottle is full. Between the times of using any of the above solutions, Peroxide of Hydrogen (ro vols.) or solution of Perchloride of Mercury (t in 3,000) should he occasionally employed as sterilisers.
As soon as the buccal cavity has been thoroughly cleansed, a mouth wash of r in 4o Chlorate of Potassium should constitute the main local treatment, though ulcerated patches may be touched with strong Liq. Ferri Perchlor., Weak Iodine, Carbolic Acid, Nitrate of Silver (r in 8) or Perchloride of Mercury (r in i,000).