VACCINATION. 03 



very troublesome condition. It occurs generally just after the child has cut its first 

 teeth, and is characterised by a foetid ulcerating condition of the gums, which usually 

 logins behind the front teeth, but soon spreads to the front. The gums are red and 

 swollen, and the margins next the teeth are sore, and covered with a buff-coloured, 

 pasty, sticky matter, which adheres to the surface of the sores, and usually smells 

 most offensive. This condition may be limited, or it may spread till it affects the 

 whole of the gums, and may be so deep as well as so extensive as to cause loosening 

 of the teeth. In extreme cases, the child is in a pitiable state, and runs no small 

 risk of being poisoned by the constant inhalation of the foetid exhalations from its 

 own gums, and the absorption of putrid matter. The disease is caused by 

 bad hygienic conditions, and is usually attributable to foul air and injudicious 

 feeding. 



The treatment consists chiefly in a most scrupulous attention to cleanliness. The 

 mouth must be constantly washed out with water to which some disinfecting fluid 

 has been added and perhaps Condy's Fluid is the best for this purpose; sufficient 

 being used to give a purple tinge to the water. 



Always after taking food the mouth must be washed out, and all offensive matter 

 removed with a camel's-hair brush. For a local application to the gums there is 

 perhaps .nothing better than a saturated solution of chlorate of potash. Glycerine of 

 tannin is also a valuable remedy in these cases. Good may also be done by applying 

 a solution of nitrate of silver. The child must be carefully and constantly fed with 

 milk and strong broths, and it is generally necessaiy to give some stimulant also. 

 The state of the bowels must be attended to, and the internal administration of 

 quinine in doses varying from half a grain to a grain, according to age, is very 

 strongly to be recommended. 



Ulcerations of tJie Mouth are exceedingly common in children who are in a weak 

 state of health, or who are injudiciously fed, or who are not kept clean ; and ulcera- 

 tions may generally be taken to indicate one of these three conditions. The most 

 common form of ulceration is small circular abrasions, situated generally on the 

 inside of the lips, or the cheek, or the side of the tongue. They are called apktkous 

 idcers. 



They are not usually difficult to cure. The first indication is to keep the child's 

 mouth perfectly clean; and the mouth should be washed out whenever it is fed. The 

 best thing to apply to the ulcers is glycerine of borax, or glycerine of tannic acid, 

 which may be got at any chemist's, and should be applied with a camel's-hair brush. 

 Another favourite and valuable application is chlorate of potash, a strong solution of 

 which may be used to wash the mouth, or the child may drink a mixture containing 

 four grains of the salt to every ounce of water. Borax and honey is also an old and 

 useful application, but inferior probably to the preparation made with glycerine. The 

 child's general health wants attending to, and it is often advisable to give a brisk 

 purgative of rhubarb, soda, and grey powder, or even a little calomel and jalap. The 

 diet should be as simple as possible. If any of the ulcers show a reluctance to heal, 

 it may be advisable to touch them with a solution of lunar caustic. 



Vaccination. Vaccinia is the name given to the slight constitutional disturbance 



