Internally, Chlorate of Potassium is held to possess specific power over this variety of stomatitis, and in absence of renal disease its adminis tration should be pushed; Perchloride of Iron appears to intensify its curative action. A child of 8 years may get the following mixture: Potassa Chloratis gr. lxxx.
Tinct. Ferri Perchlor. 5iiss.
Glycerini hiss.
Aquce Destillake ad Sviij. Misce.
Ft. mistura. Capt. cock. med. pater in die.
Parasitic Stomatitis, or Thrush.—This form of stomatitis is constantly met with in weak bottle-fed infants, the fungus being conveyed to the mouth by unclean feeding bottles. It speedily yields to absolute clean liness, including rigid sterilisation of all parts of the feeding bottle, and the disallowance altogether of the old-fashioned feeding bottle with the long rubber tube. When evidence of gastric or intestinal invasion by the parasite is forthcoming, the milk should be sterilised and Resorcin I gr., or Salol in r gr. doses may be administered.
Local treatment should consist in the smearing of the tongue and gums with Glycerin of Borax or Glyco-Thymoline; the movement of the infant's tongue may be depended upon to convey the remedy to all parts of the mucous surface, and it is not advisable to pursue the plan of rubbing off the small white flecks forcihlv with lint or wool or the finger-nails. When this is done by the officious or over-zealous nurse, abrasions arc produced which may afford entrance to the micro-organisms which produce the more serious types of stomatitis.
lVhen the pharynx is involved a warm 4 per cent. spray of Boric Acid may he employed, and difficulty in sucking or swallowing may be relieved by using for a few seconds a Carbolic spray (r in too), which produces a mild degree of anesthesia of the mouth and pharynx. When the carbolic
spray is used, the nurse should be directed to hold the infant with its mouth open and the head inclining forwards so that the condensed spray will flow out and not be swallowed, but a small quantity passing down the gullet will do good, and there is no risk of causing poisoning when due precautions are taken.
Gangrenous Simonds, Noma, or Cancruni Oris.—This form of stoma titis, much rarer in recent years, is usually fatal from septic absorption, and generally affects weak and underfed children whilst recovering from an attack of measles or scarlatina. Life can only be saved by immediately removing, under a general anesthetic, the gangrenous or dead eschar by the knife or scissors till healthy tissues are exposed, after which strong Nitric Acid must be freely applied on the smooth end of a piece of soft wood or by means of a glass brush or rod. Some surgeons prefer the application of pure Carbolic Acid, as this drug penetrates more deeply and reaches the specific bacillus which is believed to produce the necrotic action.
The mouth and wound must be incessantly cleansed with Hydrogen Peroxide, Euchlorine gargle, weak Sublimate or Permanganate solution. Concentrated soups, raw beef juice and stimulants are clearly indicated, feeding by the rubber tube being often necessary owing to the state of the mouth.