The practice of pediatrics . ssuealready prepared for their growth by a severe stomatitis and in anindividual whose powers of resistance have been greatly lowered byacute disease (measles, whooping-cough, etc.). DISEASES OF THE MOUTH AND 1IIAUYNX IS.) Symptomatology.—The disease almost always begins in a severeulcerative stomatitis. The gums have the appearances belonging tothat affection. About the bases of one or more of the teeth there is thecharacteristic line of necrosis. Salivation is present, but not first sign of the onset of gangrene is the change in the odor of thebreath a
The practice of pediatrics . ssuealready prepared for their growth by a severe stomatitis and in anindividual whose powers of resistance have been greatly lowered byacute disease (measles, whooping-cough, etc.). DISEASES OF THE MOUTH AND 1IIAUYNX IS.) Symptomatology.—The disease almost always begins in a severeulcerative stomatitis. The gums have the appearances belonging tothat affection. About the bases of one or more of the teeth there is thecharacteristic line of necrosis. Salivation is present, but not first sign of the onset of gangrene is the change in the odor of thebreath and saliva. Instead of the foul odor that belongs to ulcerativestomatitis we get the horrible stench that usually accompanies a wetgangrene of any part. At this time if examination is made we find theteeth in the affected area loosened; if pulled their roots are found bathedin thin, dark fluid, which emits the characteristic odor. The periosteumis loosened about the alveolar process and there may be some superficial Fig. 36. Noma. (Schamberg.) necrosis of the bone. The process more often attacks the upper jaw(Fig. 36). Within twenty-four to forty-eight hours the tissues overlyingthe affected teeth show a deep bluish-green color underneath the skin,very much like a deep bruise. At this time, also, swelling appears anda deep induration of the part can be made out. Gradually the color ofthe area deepens until there is a small circle showing the characteristicgreenish-black hue of gangrene. Meanwhile there is a further separationof the periosteum from the underlying maxilla, together with moresuperficial necrosis of the bone. We may find the process extendingupon the bone well up toward the orbit, before there is much breakingdown of the skin. The sloughing begins in the centre of the area, first 190 DISEASES OF THE TRACT appearing upon the lip or cheek, and once begun extends rapidly,destroying the whole lip or cheek, the side of the nose, laying hare thebony parts ben
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectchildren, bookyear190
