I740 DISEASES OF THE MOUTH, THROAT, AND STOMACH 



Uronema caudatum has been recorded by Fischer, in 1914, in the 

 diarrhoeic stool of a European in Shanghai. Two days later only 

 cysts were present. 



ORAL INFECTIONS. 



The protozoal parasites reported as being found in the mouth 

 are: — , _ , i 



Loeschia gingivalis Gros. ) ' ' 



Leishmania tropica Wright, var. americana Laveran and 



Nattan-Larrier. 

 Spiroschaudinniadentium Miller, and many other spirochsetes. 

 Spiroschaudinnia huccalis Steinberg. 

 Treponema mucosum Noguchi. 

 Treponema macrodentium Noguchi. 

 Treponema micro dentium Noguchi. 



Flagellates have also been recorded. 



Gongylonema pulchrum. — This filarial worm is a parasite of the pig 

 in Europe and America, but was described, in 1916, by Ward as 

 occurring in the lower lip of a girl, aged sixteen years, at Jefferson in 

 Arkansas. The worm was 42*1 millimetres in length, and tapered 

 slightly at each extremity, of which the anterior was ornamental, 

 by a system of cuticular tubercles, while a cuticular ridge ran along 

 the lateral line. 



The most common and perhaps most serious affection is Pyorrhcea 

 alveolaris, in which condition pus wells up from alongside the roots 

 of the teeth, while the gums become swollen, reddish, and inflamed, 

 the teeth loose, and general septic absorption or infection may result. 



The organisms associated with this lesion are innumerable- 

 amoebae, spirochaetes, bacteria, etc. — and, therefore, the causal germ 

 is unknown, but the treatment is quite clear — viz., to remove all 

 teeth which are too far decayed to allow any hope of improvement, 

 or which are viewed as dangerous from a general health point of view. 

 Having done this, the next and most important point is ionization 

 with zinc sulphate. 



Apart from this, all bridges, crowns, and fillings have to be viewed 

 with suspicion in the tropics, and vague septic conditions, diarrhoeal 

 or even dysenteric-like symptoms, and more especially inflammatory 

 changes about the jaw, should lead to careful examination of teeth 

 treated in this manner. 



It will be remembered that streptococci are apt to enter the system 

 alongside the teeth and via the tonsils, and, therefore, the strepto- 

 coccal infection should be thoroughly and carefully treated. 



The inflammations oj the tonsils, diphtheritic, pseudodiphtheritic, 

 and streptococcal, are common in the tropics, though diphtheria is 

 somewhat rarer than in temperate climates, and require careful 

 treatment with local antiseptics and either serums or vaccines. 



Salivary calculi have been reported by Christopherson, and are 

 certainly not uncommon in Europeans and natives, and are apt to 



