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Thrush

mouth, patches, usually and found

THRUSH, a form of parasitic stomatitis, due to the presence in the mouth of the thrush-fungus, white-moutte or sprue. (See Mourn). The disease usually occurs in in fants, but may appear later in life, even in old age, in association with some severe acute ill ness or some wasting disease, as pulmonary tuberculosis. The patches of thrush (techni rally aphthz) are most commonly found on the dorsum and edges of the tongue, on the hard palate and on the inside of the lips and cheeks, and resemble curdled milk. Although the fungus may enter and even be formed in a healthy mouth, it will not flourish there. In flammation or other abnormal condition of the mucous surface, and acid secretions, cause it to grow and develop. Thrush may be propa gated by contagion, and in some institutions is at times almost endemic. It may be conveyed from one babe to another through an infected nipple of a nurse, or by means of infected spoons, feeding-bottles, teats, etc. Usually the mucous membrane of the mouth underlying the fungous patches is of a bright or livid red, but when the system of the patient is much dete riorated, and the mycelium has penetrated deeply, shallow ulcerations may result. Some times the fungus of thrush is found in diphthe ritic membranes. Any doubt as to the nature of white patches in the mouth should be settled by a microscopic examination.

Of itself thrush is not dangerous, but it is usually significant of a deteriorated state of health. Occurring in apparently healthy chil

dren, it lasts but a few days; in children having gastrointestinal catarrh and diarrhoea, and who are 4nuch debilitated, it may last for weeks, fresh spots appearing as others vanish. The redness and excoriation around the anus and adjacent skin of infants so affected is vulgarly regarded as an indication that the °thrush has run through the patient,'" and if the mouth condition has improved it is considered a favor able sign. While the thrush-fungus has been found in the cesophagus, and even lower in the alimentary canal, there is no reason to believe that it is the cause of the redness and excoria tion above referred to, which are rather due to a superficial dermatitis resulting from an ex cess of starchy food and a vitiated blood state.

Strict attention to diet is necessary in treat ment; diminish the amount of sugar and starchy food, and give milk and lime-water. The mouth must be kept clean, and the chance of acidity diminished by dilute alkaline fluids, such as limewater or Vichy. A solution of borax and glycerine, or of sulphite of sodium, should he frequently sprayed upon the patches or ap plied with the finger, covered with soft cloth. The general health is to be maintained by tonics, hygienic measures and relief of debili tating ailments.