Page 169 - My FlipBook

DIAGNOSIS OF MOUTH AFFECTIONS. 167 a;

Or patches touched with a weak solution of nitrate of silver ; in
severe cases gr. v to water f. oj- A dose of castor oil or calomel
to clear the alimentary canal, small dose of chlorate of potash,—
few grains three times a day, attention to diet.
Jphthce or Follicular Ulceration^ common to childhood, is indi-
cated by the mucous membrane becoming inflamed, and the for-
mation of small, round, transparent vesicles on the frasnum, in the
sulcus between the lips and gums, and on lower surface of tongue.
On the bursting of the vesicles, small, spreading ulcers, with red
and swollen margins, appear, which become coated with a layer
of micro-organisms.
Treatment.—Demulcent applications, such as mucilage of gum
acacia, or flaxseed. Mel-boracis or a solution of boric acid in
glycerole, applied with a camel's-hair brush. In more obstinate
cases touch the patches with a solution of nitrate of silver — gr. v
to f. oj of water. For constitutional symptoms, administer laxa-
tives and the bromides, with warm foot bath.
Epulis is indicated by a growth on the gums, either small and
pedunculated, or large and sessile.
If it is firm in texture and slow of growth, the epulis is generally
fibrous ; but if rapid in growth and dark in color, it is myeloid
if prone to ulcerate and very painful, it may be an epithelioma.
Treatment.—Removal of the growth, and its reproduction pre-
vented by the application of nitrate of silver, or chromic acid, or
a fire cautery. Generally it is necessary to remove the perios-
teum and a thin scale of the bone beneath, as this growth is con-
nected with the periosteum. Extract all roots of carious teeth,
and when the epulis is connected with the alveolar cavity of a
tooth and has tendency to the interior of the jaw, it is generally
myeloid, and several teeth will have to be sacrificed, so that the
alveolus can be thoroughly excavated. When very extensive, a
considerable portion of the alveolus and bone of the jaw must be
removed.
Epithelioma is indicated by a ragged ulcer on the lower lip,
commencing as a wart, the skin around being hard and infiltrated,
with enlargement of the submaxillary lymphatic glands, which
become tender, or even ulcerated.