§186. Stomacace.

The local affection is almost always preceded by lan-gupr, ill-humour, loss of appetite, with gastric symptoms and fever. At first the anterior portion of the mouth is affected, gradually the uvula, tonsils and fauces are involved. The disease generally commences with burning heat, redness, swelling and great sensitiveness about the gums, inner lips and cheeks, tongue and palate, with intolerable, cadaverous smell from the mouth, painful swelling of the glands of the throat, copious discharge of tenacious, fetid mucus or saliva; the gums are spongy, swollen, recede from the teeth, the teeth are painful, covered with sordes, frequently loose and fall out; mastication, deglutition, talking and breathing are very much impeded. Flat, painful, obstinate, spreading ulcers make their appearance, with lardaceous or spongy base, and soft, slightly elevated, inflamed, unequal edges. The cavity of the nose is sometimes involved, the mucous membrane is thickened with copious secretion of offensive and fetid mucus; the nasal and palate bones are likewise sometimes affected. Aphthae sometimes make their appearance in the inner mouth, in one or the other form of angina.

For this kind of stomacace Merc sol. is the best remedy; and if the aphthae, ulcers and ptyalism should be very violent, Merc. subl. is preferable to Merc. sol. I have sometimes given Dulc. when those symptoms arose from a cold. Iod., Acid. nitr. and Phosph. are important remedies for this affection. When symptoms of humid gangrene set in, (angina gangrenosa,) China should be given; but when the glands of the throat show symptoms of gangrene, Arsenic, or perhaps Acid, mur., Carb. veg., Baryt., Graph., etc., will be found very useful.

There are cases of stomacace where Nux v. is to be given; these are doubtful cases,