135. Stomatitis-Inflammation of the Mouth.
SYMPTOMS.-Patches of redness on the lining of the mouth, which are sore, and from which an exudation takes place.
CAUSES.-Exposure of badly-nourished children to cold; gastric derangements; Measles or other eruptive fevers; or the introduction of hot and acrid substances into the mouth.
TREATMENT.-Kali Chloratum.-Foetid breath, great soreness, and Ulceration of the mucous surfaces of the tongue, palate, and check. We generally administer the IX trituration. This remedy may also be used as a wash for the mouth; eight grains of the Chlorate of Potash to four ounces of water.
Mercurius.-Abundant salivation; swelling of glands.
Ac-Nit. IX.- When concurrent with portal Congestion and the ordinary symptoms of biliousness.
China.-To invigorate the patient when the Ulcerations are healed.
Tannic Acid Gargle.-If used early the affection is often immediately suppressed by a wash of Ac. Tannic (3j. ad. aq. z3viij). The Sulphurous Acid Spray, with the administration of Sulph. and Hep-S., has rendered important service.
ACCESSORY MEANS.-The cause should, if possible, be removed, and if stomachic, the diet corrected. As a rule, the patient’s diet should be restricted for some time to milk, or milk and soda- water, in equal proportions, which is both nourishing and digestible, and may be taken without adding to the patient’s discomforts. Afterwards chocolate or coca may be gradually substituted, and continuously used instead of tea for the morning or evening meal. Good animal broths are also generally required as the disease declines.
136. Thrush (Aphthae) Frog-Sore Mouth.
DEFINITION.-An inflammatory condition, consisting of numerous minute vesicles terminating in white sloughs on the surface of the mouth, and sometimes extending to the whole of the gastro- intestinal mucous membrane, due to the growth of a minute fungoid organism.
SYMPTOMS.-Small vesicles or white specks appear upon all parts of the lining membrane of the mouth, and are sometimes so connected as to form a continuous covering over the tongue, gums palate, and in bad cases even extending to the fauces and gullet; feverishness; pain on swallowing. The neighbouring glands are sometimes swollen and tender. Extension of the disease to the bowels, dark-coloured eruption, and violent Diarrhoea, may arise in severe cases.
CAUSES.- A delicate or tubercular constitution; insufficiency or unhealthy condition of the mother’s milk; or in infants who are fed by hand, an unsuitable quantity or quality of food; acid secretion in the mouth; want of cleanliness; bad drainage, etc. Thrush sometimes occurs during the course of Measles, Enteric fevers, Consumption, and in the diseases attendant upon old age, and forebodes and early fatal termination, because it is then a sign of enfeebled vital energy.
TREATMENT.- Borax has a specific power over this affection, and will alone cure it if limited to the mouth. The mouth may also be washed with a weak solution of Borax (four grains to one ounce of water) in which three or four drops of Strong Carbolic Acid are mixed, by means of a soft brush. Or Borax and Glycerine may be used, half a drachm of the former to one ounce of the latter. The infant will swallow sufficient for a dose each time the solution is used.
Mercurius.-Offensive breath, dribbling saliva, Diarrhoea, gangrenous Ulcers, etc. If administered when the white specks first appear, it is often alone sufficient.
Arsenicum.-Extension of the eruption to the stomach and bowels; dark coloured eruption, having an offensive odour; exhausting Diarrhoea.
Sulphur may follow Arsenicum or any other remedy that does no further good; also when Thrush has nearly subsided to prevent a relapse, and when there are eruptions on the skin.
Bryonia or Nux V.-Gastric derangements, dryness of the mouth, white or yellow mucus on the tongue.
GENERAL TREATMENT.-Strict cleanliness, good ventilation, abundance of fresh, out-of-door air, and suitable diet. The mouth may be cleanses with cold water on a piece of fine linen rag, and emollient fluids infusion of linseed, thin solution of borax and honey, etc., are grateful and useful. Vinegar, Carbolic acid, Sulphurous acid, etc., diluted with water, are also recommended as local applications or gargles, to cleanse the affected surfaces. Sulphurous acid is best applied by means of the spray-producer, in the proportion of one part of acid to ten parts of water; it should be continued for two or three minutes, and repeated once or twice a day. If the Sore mouth be due to ill-health in the mother, the child should be at once provided with a wet-nurse or weaned. In the latter case, if under three months old, the child should be fed with milk and water, or if more than three months old, some good Farinaceous Food may be used in addition.
137. Offensive Breath.
In perfect health, the odour of the breath is sweet and agreeable; on the contrary, foetid breath is usually a concomitant of disordered digestion, Scurvy, malignant Sore throat, etc.; it is also disagreeable and infectious during the progress of the eruptive, enteric, and pestilential fevers; but in no disease is it more offensive than in Gangrene of the lung; indeed, that condition may be recognized by this symptom alone. Sometimes offensive breath arises from neglect of cleansing the mouth and teeth after meals. Of late years much attention has been directed to a disease known as Pyorrhoea. Alveolaris which consists in suppuration of the gums in and near the sockets of the teeth. This disease, when severe, can cause foul breath, and also the constant swallowing of small quantities of pus may give rise to a variety of symptoms. Gastric, nervous and chronic joint affection have been attributed to this cause, and it is always worth bearing in mind as a possible factor in obscure conditions, although often the septic condition may be rather an effect than a cause. Scrupulous cleanliness of the mouth and teeth naturally tends to prevent it, but special dental and medicinal measures may also be required.
TREATMENT.- Carbo Veg. Putrid odour of the breath from decayed teeth, bad condition of the gums, large doses of Mercury, or other causes. A dose thrice daily, for eight or ten days, or as long as may be necessary. Hep-S. or Ac Nit. may follow, especially when Carbo V. is insufficient and when the foetor results from previous mercurial salivation.
Arnica. – When not traceable to any definite cause.
Spigelia. – Offensive breath, perceived only by others, with much white or yellow mucus in the mouth, and throat; the back part of the tongue is painful, and feels swollen.
Mercurius. – Foetid breath from a sore or Aphthous mouth. Pyorrhoea alveolaris.
Nux Vom or Puls – From Indigestion.
Aur or Pulsatilla – In females advancing towards puberty.
Sulphur, morning and night for a week, may follow any of the preceding remedies, and complete the course.
Silicea is excellent for Pyorrhoea and also Phosphorus, and a lotion of Symphytum O, two drachms to eight ounces of water, is a good application to the gums in these cases.
ACCESSORY MEANS. – General attention should be given to diet, the use of water, pure air, regular out-of-door exercise, bathing, and such other hygienic means as are indicated in the first chapter of this Manual. Animal food should only be eaten in moderation; and the teeth and mouth should be carefully cleansed at least twice a day.
Perfumed Carbolic Acid, diluted with water, makes an excellent wash for the mouth for patients troubled with foetid breath, but carbolic tooth powders and pastes are best avoided.
138. – Cancrum Oris – Canker of the Mouth.
DEFINITION. – A sloughing or gangrenous ulcer of the mouth, occasionally occurring in ill-fed, tuberculous children, from two to six years old, especially in low, damp situations.
SYMPTOMS. – The Inflammation generally begins at the edges of the gums opposite the incisors of the lower jaw; the gums are white, spongy, and separate from the teeth, as if Mercury has produced its specific effects. Ulceration begins and extends along the gums until the jaws are implicated; and as the disease advances, the cheeks and lips swell and form a tense indurated tumefaction. The teeth are apt to fall out; and the parts taking on a gangrenous condition, the breath becomes intolerably foetid. There is generally enlargement and tenderness of the submaxillary glands. In severe forms of the disease the destructive process rapidly extends, so that in a few days the lips, cheeks, tonsils, palate, tongue, and even half the face may become gangrenous, the teeth falling from their sockets, a horribly foetid saliva and fluid flowing from the parts (Aitken).
TREATMENT. – Mercurius (often specific in cases not caused by Mercury); Ac.-Mur. (Canker associated with severe disease – Measles, etc.); Ac.-Nit. (from excessive doses of Mercury); Arsenicum (extensive disorganizations, extreme prostration); K. – Chlorum
General Treatment same as prescribed in the previous Section. Strong beef-tea, raw eggs beaten up in milk, and cod-liver oil, are often necessary. Also a lotion of K.-Chlorum
139. – Teething.
There are two sets of teeth; the first – the milk-teeth – appears during the early period of life, and falls out in the seventh or eighth year, to be replaced by a permanent, which is not completed till the commencement of adult life. The order in which the milk-teeth appear is generally as follows- about the sixth month the two middle incisors of the lower jaw, followed in a few weeks by the corresponding incisors of the upper jaw; next appear the two outside incisors of the lower jaw, and soon after those of the upper; after another interval of perhaps about two months, the first four molars, then the eye-teeth, and, lastly, four other molars, completing, by about the second year, the teeth of the first set. Should there be any little derivation from this order, or should dentition be a little prolonged, no great importance need be attached to it.
Dentition being a natural process, should certainly not be regarded as in itself a disease, still less a dangerous one, but simply a natural period of the development of the child’s organism. Notwithstanding, in feeble children, the process of teething is a trying one, and in some instances may be even dangerous.
DISORDERS. – The increased activity and excitement in the vascular system, combined with the nervous irritation which sometimes attends Dentition, may, in delicate children, give rise to a greater or less amount of local or constitutional disturbance. Rickets greatly influence the progress of teething. If this disease sets in previous to the commencement of Dentition, the evolution of the teeth may be almost indefinitely delayed; or, if some are already cut, further progress is arrested. Rickety children of eighteen months to two years old may often be seen with very few teeth, and those few black and carious. In Tuberculosis and congenital Syphilis, on the other hand, the teeth are cut early, and before the frame is sufficiently consolidated to sustain the necessary changes.
But, as in too early Dentition, the constitution is rarely sufficiently strong to sustain the evolutions it has to undergo; so in late Dentition there is a languid condition, indicative of a weakly constitution; and in neither case should domestic treatment be confided in.
SYMPTOMS. – Irritation in the mouth, swollen or tender gums, and increased flow of saliva; starting as if in fright, or interrupted sleep; sudden occurrence of febrile symptoms; various eruptions on the head or body; derangement of the digestive organs – Diarrhoea, sickness, or Constipation; and sometimes Spasms and Convulsions. Diarrhoea and other symptoms of Indigestion are most frequent in the summer and autumn, and when, therefore, children are most exposed to sudden changes; disordered Dentition, further, is often coincident with a change of diet from the mother’s milk to various articles which are unsuited to the age of the child.
CAUSES. – Weakly constitution; Rachitis. The exciting causes are irregular feeding; excessive feeding; improper quality of food; keeping the head too hot; too little out-of-door air. By such means the stomach is disordered, the nervous system disturbed, and restlessness, crying, Colic, and even Convulsions follow. In nearly every case these causes may be avoided, and the sufferings reduced to a minimum, even in tubercular constitutions.
Local affections of the gums, as inflammation; or disproportion between the jaw and the number and form of the teeth, are also causes of suffering.
EPITOME OF TREATMENT. – 1. Feverishness, etc. – Aconite, Chamomilla (fretfulness; one cheek pale, the other flushed.)
2. Diarrhoea. – Chamomilla (sudden; pinching pains; slimy or yellow, sour-smelling, offensive motions); Mercurius (green or bloody); Coloc. (Colic); Podoph. (paroxysms of pain, with Prolapsus Ani); Belladonna (nervous irritability flushed cheeks); Calcarea carb. or Sulph. (tubercular children); Arsenicum (with emaciation); Iris. (With vomiting).
3. Constipation. – Bryonia, Nux V., Sulphur, Aconite, Plumb.
4. Sleeplessness, etc. – Coffea (nervous excitability); Belladonna (flushed face); Gelsemium (simple wakefulness); Kreas. (agitation).
5. Convulsions. – Bell, Chamomilla, etc. See Section on Convulsions.
6. Irregular Dentition. – Calcarea carb. (too early or late); Ac.- Phosphorus (excessive weakness; rachitic constitution; see also Section 69; Silicea (perspirations about the head); Kreas. (thin, irritable children; early dental decay). Also the use of lime- water.
Chamomilla. – Bilious Diarrhoea, with intestinal irritation, fretfulness, restlessness, disturbed circulation.
Calcarea. – Valuable for tubercular children; also in cases complicated with slimy or mucous Diarrhoea.
ACCESSORY TREATMENT. – Regularity in the times of feeding and sleep; correction of any habits in the mother which may affect the child unfavourably; restriction to suitable quantities of food at one time. Keeping the head cool and the feet warm, washing the child daily in cold water, and allowing it to be much in the open air tend to prevent determination of blood to the head. Neave’s Farinaceous Food, prepared according to the directions supplied with it, is a good artificial diet for children. Purgatives are to be strictly avoided. Costiveness in children in generally due to errors in diet; if obstinate, or if worms are present, injections may be used.
140. – Toothache.
CAUSES. – Decay is the most common predisposing cause; sudden changes of temperature, derangements of the digestive organs, pregnancy, and general bad health, are the most frequent exciting causes. When the cavity of a tooth has been exposed by caries, the dental pulp is extremely liable to pain from contact with food, liquids, or atmospheric air; and if the health be much impaired, or the central pulp greatly irritated, acute Inflammation, with extreme pain, may result.
NEURALGIC TOOTHACHE occurs in paroxysms, which come and go suddenly (see Section on Neuralgia).
TREATMENT. – If Kreasote, Laudanum, etc., have been used as local applications, the mouth should be thoroughly cleansed before taking any of the following remedies. After three or four doses of any medicine have been administered without mitigating the symptoms, another should be selected.
EPITOME OF TREATMENT. –
1. From cold or chill. – Aconite, Belladonna, Chamomilla, Dulcamara, Mercurius, Gloninum
2. From decayed teeth. – Kreas., Staphysagria, Belladonna, Mercurius, Silicea, Ant. -C., Phosphorus, Nux V., Aconite, Mercurius, Camph. is said to cure the pain and arrest decay.
3. From Indigestion. Bryonia, Nux vomica, Pulsatilla, Mercurius
4. Nervous. – Belladonna, Chamomilla, Nux V., Coffea, Ignatia, Arsenicum
5. Rheumatic. – Chamomilla, Mercurius, Cimic., Bryonia
6. In children. Aconite, Chamomilla, Belladonna, Silicea
7. In pregnancy. – Belladonna, Nux., Coffea, Chamomilla, Sepia, Kreas. (6x).
8. Preventives. – Arsenicum, Kreas., Mercurius, Phosphorus, Silicea Euphor.
LEADING INDICATIONS. –
Chamomilla. – Toothache from a draught, or suppressed perspiration, and affecting the ear; the teeth feel long and loose; the cheeks and gums are swollen, but the skin is not very red; and the pain aggravated by eating or drinking, especially by warm drinks. It is suited to children during teething, with watery, greenish, foetid diarrhoea.
Belladonna. – Shooting, throbbing pains, affecting several teeth on one side, so that it is impossible to point out the exact tooth; the pains shift about, and are increased by contact of the teeth or by warm or cold applications; determination of blood to the head, flushed face, excessive sensitiveness to external impression, swelling of the cheek or glands, dryness of the mouth or throat, inflammation of the dental pulp.
Mercurius. – Decayed teeth; violent scraping or lacerating pain in the cheek-bones, or pains aggravated by eating or drinking, and also at night in bed; pains affecting the entire side of the face-extending to the temples, glands, and eats; Toothache with Salivation (not caused by Mercury); profuse perspirations in bed, which do not afford relief.
Glonoine. – Pulsation in the teeth, with Headache; Toothache after being overheated and taking cold.
Arsenicum. – Unbearable jerking pains, coming on or aggravated at night. This remedy may be continued for some time after the cessation of pain, to prevent a recurrence.
Arnica. – Pain consequent on extraction or other dental operations; the mouth should be rinsed with a mixture of one part of the strong tincture to about ten of water.
Hepar Sulphur. – Decay of teeth, and easily bleeding gums, from Mercury. Carbo Veg. and Ac.-Nit. are also useful in similar conditions.
Aconitum. – Acute, stinging pain, or hard aching, relieved temporarily by cold water; there is throbbing, heat of the face, and sometimes chilliness, but not the mental confusion and sensitiveness to noise, light, etc., which indicate Belladonna A drop or two of the strong tincture or of the first dilution, applied to the tooth by means of piece of lint, will sometimes promptly relieve this kind of Toothache.
Administration. – Every fifteen or twenty minutes till the pain is mitigated; afterwards every four or six hours. Plantago O may be used in the same way, and often gives relief.
The Sulphurous Acid Spray, or a plug of lint dipped in the Acid and inserted in the tooth, will often give immediate relief. (See Homoeopathic World. vol. viii. p. 277)
The local application of the galvanic current often affords speedy relief. A mild current for two or three minutes generally suffices.
The occurrence of any pain or discovery of any decay in the teeth should be a warning to consult a competent dentist at once. With the gradual perfection of the art of dentistry, it is possible to get the utmost value out of teeth originally imperfect and poor, but the sooner the expert can attack the problem the better is likely to be the solution of it. Homoeopathic remedies will generally quickly relieve pain, but the attention of the dentist should not, therefore, be neglected.
MEANS OF PRESERVATION. – The function of the teeth is so important, that their preservation is a matter of the highest moment. The first teeth determine the nature of the second set, and persons suffer lamentably from early neglect. Proximate decay might be prevented, in five cases out of ten, by simply passing a thread between an infant’s teeth, twice a week, from the time of their eruption. Professional inspection should also be sought before symptoms of decay present themselves, and while there is still hope that the dentist may fulfil what should be regarded as his mission, that of saving the teeth. Cleanliness, with respect to the teeth, is all-important for infants and children, as well as adults. The teeth should be kept clean by rinsing the mouth with pure cold water, and brushing the teeth with a moderately soft brush every morning; and, if possible, after every meal, especially when animal food or sweet and sticky food has been taken; and contact with all disorganizing agents avoided. The idea that frequent brushing the teeth is liable to lacerate the gums and separate them from the teeth is erroneous, for it is one of the best methods of restoring them to a healthy condition when they are spongy and liable to bleed. But when a tendency to decay of the teeth or inflammatory action of the gums exist, a dilute solution of Myrrh, or other dentifrice, should be regularly and continuously used. The habit of taking very hot substances into the mouth should be avoided, as the expansive power of heat may rupture the enamel, which in turn becomes the nucleus of decay. On the other hand, the habit of subjecting the teeth to the opposite extreme of temperature, as by sucking ice, etc, is also to be avoided. Chewing or smoking tobacco and the habitual use of strong drinks, tend to destroy the teeth. LAstly, as an important means of preserving the teeth, the general health should be maintained in the highest state of integrity, by the use of plain, nourishing food, cold sponging or bathing, and early and regular habits.
141. – Gum-boil.
DEFINITION. – A small Abscess commencing in the socket of a tooth, and bursting through the gums or even through the cheek.
CAUSES. – Usually, the irritation from a decayed tooth. A cold may excite Inflammation of the dental periosteum, the morbid products of which are thus discharged.
SYMPTOMS. – Pain in a tooth, spreading over a portion of the jaw, with heat, throbbing, swelling, and the formation of an Abscess. This may heal by resolution; or it may burst into the mouth, or even percolate the cheek. The sufferings are sometimes great, worse at night, and incessant till swelling has taken place, when it usually abates. There is frequently some febrile disturbance.
TREATMENT. – Mercurius. – Constant aching, much Salivation, swelling of the gum, and throbbing. Persons who are liable to Gum-boils should continue the use of this remedy as a preventive twice a day for a week or two.
Aconitum. – In alternation with Mercurius for feverishness. Prescribed early, Aconite often checks the disease at the onset.
Belladonna. – Throbbing Headache, flushed face, and sensitiveness to noise, light, etc. Two or three doses may suffice.