(From to inflame). Called also, by
This disorder appears in white specks upon the tongue, and the back part of the palate in children; these specks gradually spread all over the inside of the mouth, and from thence through the stomach and intestines; the size of these specks increases as the violence of other symptoms is augmented; and they are then more yellow, or of other more unfavourable colours.
Dr. Hunter thinks these white specks inflammatory exudations, and not ulcers; which seems to be confirmed by their successively falling off, and being as often succeeded by thicker ones. Sometimes no other symptoms attend, but more frequently they are accompanied with sour belchings, gripes, diarrhoeas, fever, or soreness of the mouth.
Infants are the most frequent subjects of this disorder, and those fed by the hand are more often affected than those that have the breast. In adults, they are often accompanied with miliary eruptions.
Celsus observes that aphthae are most dangerous in infants; and Boerhaave, that in adults they are frequent in acute diseases, and are then attended with inflammation of some of the viscera. The more they spread, the danger is the greater.
In adults, the aphthae in the mouth are distinguished from the ulcerations in the angina maligna, by the whiteness of the sloughs, by the edges not being red and inflamed, and.by there not being a shining redness or rather pink colour over the fauces, with other symptoms that usually attend this species of angina.
If the cure is not soon effected in children, the contents of the bowels become more acrid, and produce vomitings, sour and curdled stools, gripings, convulsions, and often death, from the extension of the eruptions, and mortification their frequent attendant.
The stomach and bowels must be first cleared with as much of the following mixture as will operate both upward and downward.
Mannae ss. aq. purae ij. f. solutio colaturae adde vin. antim. tartaris. gutt. xx. m. detur. cochl. me-diocr. pro re nata.
The best topical applications are as follow:
Boracis opt. subtilis. pulv. 3 i. mel Britan. i. m. f. linctus.
In severer cases, double this quantity of the borax may be added in this linctus. Whichever is used, a small tea-spoonful should be rubbed well about the mouth, once in an hour or two, and gradually swallowed. Gargarisma allminis, alum gargle. In two pints of barley water dissolve two drams of alum, and three ounces of honey of roses. Gargarisma myrrhae, myrrh gargle. To six ounces of lime water add one ounce and a half of honey of roses, and half an ounce of tincture of myrrh. Mixtura myrrhae composita, compound mixture of myrrh. To two drams of tincture of myrrh, and the same quantity of honey of roses, add one ounce and a half of lime water. All these are very proper for ulcerations in the mouth, throat, and gums; but the alum gargle is also serviceable in relaxations of the uvula and other cases requiring topical astringents; and the myrrh mixture is considered as useful for scrofulous sores, where greasy applications arc inadmissible.
If after the removal of the specks the mouth is very sore, let a thin solution of the gum tragac. in rose-water be frequently held in it.
As a purge in this disorder, the ol. ricini is strongly recommended; and at the intervals of purging, much relief is obtained by giving the ipecacuanha to promote perspiration.
That severe degree of the thrush which is so frequent in the West Indies requires the application of perpetual blisters, which should be kept open with the ung, can-tharidis, and in this case much relief is given to the patient by a due use of a proper detergent.
Boracis opt. subtil. pulv. 3 iij. mel rosar. ij. acidi vitriolici diluti, 3 ij. m. f. litus ut supra utend.
Dr. Cullen considers this complaint as associated with a synochus, and says the tongue is slightly swelled: and, as well as the fauces, is of a purplish colour; the eschars appearing first in the fauces, and at the margins of the tongue, afterwards seizing the whole internal part of the mouth, are white; and, if abraded, soon return and continue an uncertain time. There is only one which he considered idiopathic, and that is the aphtha infantum, called lactucimen or milk thrush. The rest appear to be symptomatic, and are either called febrile, malignant, syphilitic, scorbutic; and are attendant on petechial fevers. Many disputes have arisen, particularly in Germany, whether the aphthae are in any instance idiopathic. It is useless to enlarge on this almost forgotten subject, since the disease is now admitted to have been epidemic, and sometimes infectious. We have more than once known it to be both; and, in such cases, mortification was no very unfrequent termination among young children. The best method of cure,, after the evacuations, was a warm tonic plan, with wine; and, at last, considerable doses of bark were required. A gentle perspiration was kept up by such remedies as would, at the same time, support the tone and strength.
The black thrush is rare, and always a putrid symptom.
Hippocrates speaks of aphthae of the pudenda of pregnant women, and of aphthae of the aspera arte-ria.
See Celsus, Aretaeus, Oribasius, Actuarius, Hoffman, Med. Rat. Syst. Boerhaave, Blackrie's Disquisition on Solvents of the Stone, Canvane's Diss. on the Ol. Palm. Christi, Hillary on the Disorders of Barbadoes, Cul-len's First Lines, edit. iv. vol. ii. p. 254.