462 DISEASES OF THE MOUTH. 



speaking, there is an unexplained but close sympathy between the 

 mucous membrane of the tongue and that of the stomach. 



2. P. 438. 



He rejects any relationship between them and the follicles, but 

 compares aphthae with pustular eruptions, and calls the affection 

 impetigo of the mucous membrane. In adults aphthae may be due 

 to mechanical or chemical irritations, such as ragged teeth, acrid 

 tobacco-smoke, etc. When accompanied by fever and herpes labi- 

 alis, they may be due to cold ; occurring in adults with chronic 

 gastric catarrh, they are very obstinate. In women they occasion- 

 ally recur at the menstrual epochs. 



3._p. 441. 



In cancrum oris one peculiarity is the tendency of the affected 

 parts to death and decomposition. It always affects originally and 

 chiefly the gums along the teeth, almost never attacking tooth- 

 less children or old persons ; and even in patients with teeth, only 

 those parts where teeth actually exist are affected. Sometimes ul- 

 cerous stomatitis occurs without perceptible cause in children, and 

 even in adults living under unfavorable circumstances. Extensive 

 epidemics of this form occur in orphan asylums, barracks, etc., and 

 even in armies in the field ; it may be suspected of spreading by 

 contagion. Cases also arise from poisoning by mercury and phos- 

 phorus, from scurvy, or diabetes mellitus. 



The infiltration and disintegration almost always begin at the 

 front part of the gum of the lower jaw ; in severe cases the destruc- 

 tion advances from this point to the gum behind the teeth, as well 

 as to the adjacent parts of the lips, teeth, and tongue. Exception- 

 ally the periosteum is attacked and necrosis of the bone occurs. In 

 some mild cases the tissue does not die, nor do ulcers form, but the 

 gum remains puffed up and red. 



TREATMENT. Repeated cleansing of the teeth and mouth from 

 the decomposing particles, keeping warm, and having the room well 

 aired, are very important points of treatment. 



While severe mercurial stomatitis may have the worst results, 

 many physicians consider a mild mercurial affection of the mouth 

 in syphilis as a favorable sign of the completeness of the cure. 



