THRUSH. 351 



THRUSH. 



Thrush is a local' disease, preferably attacking mucous 

 membranes lined with pavement epithelium, and resulting 

 from the lodgment and proliferation of the thrush-fungus. 

 The lodgment of the fungus leads to the formation of 

 milky-white deposits varying from the size of a millet-seed 

 to that of a lentil. These gradually undergo enlargement 

 toward the periphery, and in the absence of therapeutic 

 intervention coalesce finally into large membranes. 



Microscopic Examination of Thrush-deposits. Mi- 

 croscopic examination of the white points that represent 

 the first stage of the thrush-eruption discloses, in addition 

 to squamous epithelium, molds and bacteria of various 

 kinds, always in large number, the two phases of the 

 thrush-fungus (pidium albicans) : the mycelial threads and 

 the conidia. The former are threads of double contour 

 and of varying thickness and length, with transverse septa 

 and indentations, from which often lateral branches of 

 equal or less thickness pass off. The conidia, which grow 

 from the mycelia, at their extremities or in the neighbor- 

 hood of the septa, are more or less spherical, separate 

 readily from the mycelia, and lie among them, at times iso- 

 lated, at times in groups. 



Occurrence of Thrush. Thrush occurs most commonly 

 in new-born children, principally about the second week of 

 life. In older children and in adults thrush occurs only 

 when protracted disease (typhoid fever, tuberculosis, etc.) 

 has induced general enfeeblement of the organism. In the 

 new-born, however, an eruption of thrush by no means 

 presupposes a particular impairment of the general health. 

 The mucous membrane of the infant is obviously quite espe- 

 cially predisposed to the vegetation of the thrush-fungus. 

 In experimental transmission of thrush the disease will 

 develop upon the healthy mucous membrane of well- 

 nourished children. 



The preferable seat of thrush is the mucous membrane 

 of the mouth, and here the tongue, the inner surface of the 

 lips and of the cheeks, are most commonly invaded. Next 

 in frequency deposits of thrush appear upon the gums, in 

 the pharynx, and also in the upper portion of the esopha- 

 gus, on the anterior and upper surface of the epiglottis, and 

 exceptionally upon the true vocal bands. In all of these 



