Thrush.

Synonyms.—Parasitic Stomatitis; Stomatitis Mycosa.

Definition.—A specific fungous disease of the buccal mucous surfaces, characterized by whitish or yellowish deposits, in which are found the saccharomyces albicans.

Etiology.—Predisposing causes are such as furnish a soil suitable for the propagation of the thrush fungus; such as tuberculosis, congenital syphilis, or any disease whereby the blood is impoverished. In bottle-fed children, when cleanliness is not observed, and the bottle and tube contain sour milk; in adults, typhoid fever, diabetes, and carcinoma, are fruitful causes.

The specific cause is the fungus above mentioned (saccharomyces albicans), which thrives in the changed condition of the mouth secretions, fermentation having changed the normal alkaline secretion to acid.

Symptoms.—The child is fretful and peevish, the result of the burning pain, and frequently a diarrhea, with greenish stools, occurs. On inspecting the mouth, we find the mucous membrane dry and of a dusky red color, upon which are seen the thrush spots in the form of white patches, first upon the tongue, rapidly extending to the lips, cheeks, pharynx, and sometimes to the esophagus and stomach.

When the extension is so general, a troublesome diarrhea exists. The saliva, after a few days, becomes profuse, but is acid in character; in fact, we find an acid saliva in nearly all forms. of stomatitis.

Diagnosis.—The dryness of the mouth in the early stage, the white patches, which can be readily removed without bleeding, the absence of the yellow ulcers seen in aphthous stomatitis, makes the diagnosis comparatively easy. The presence of the fungus, revealed by the microscope, makes the diagnosis positive.

Prognosis.—This is favorable unless there is marked cachexia, in which case it may be quite stubborn.

Treatment.—Remembering that the fungi thrive in an acid medium, our mouth-washes will be selected to correct this condition; hence the alkalies are used; bicarbonate of sodium, boracic acid, potassium chlorate, etc. After each feeding, the mouth is to be carefully washed, every particle of food being removed. Sweets of all kinds are to be avoided, as they favor fermentation. The general health is to be improved by adopting more favorable hygienic conditions. Plenty of fresh air and wholesome and easily digested food will be important factors in the cure.

Phytolacca, echinacea, nux vomica, rhus tox., and others of like character, will be used. Inunction of quinine and lard will improve the condition of the skin, and act as a tonic. In all these cases we are not to overlook the great fact that the impoverished condition of the blood furnishes the soil for the development of the parasite, and remedies are to be used which will give us a better blood, and consequently a more healthy body. When we fail in this respect, the local trouble persists in spite of local treatment.

The Eclectic Practice of Medicine, 1907, was written by Rolla L. Thomas, M. S., M. D.