"The canker of the mouth is a deep, foul, irregular, fœtid ulcer, with jagged edges, which appears upon the inside of the lips and cheeks; and is attended with a copious flow of diseased saliva.
"This disease is seldom seen in adults; but it most commonly attacks children, from the age of 18 months, to that of 6 or 7 years. When the ulceration begins at the inner part of the lip, it exhibits a deep, narrow, sulcated appearance, and quickly spreads along the inside of the cheek; which becomes hard, and tumefied externally. The gums are very frequently interested in this complaint, and, in such cases, the teeth are generally found in a loose and diseased state; matter is often found in their sockets, and abscesses sometimes burst externally through the cheek, the lip, or a little below the maxilla inferior: and it is not uncommon to see an exfoliation of the alveolar processes, or even of the greater part of the lower jaw. Among the children of poor people, where this disease is neglected or mismanaged at the beginning, a dreadful gangrene will sometimes supervene.
"The remote causes that give origin to this disease are not very obvious. I think it occurs most frequently among children that live in a marshy situation; that are sustained by unwholesome food; and where a due attention to cleanliness has been wanting. The cancrum oris has been described by some writers, as a complaint very common in England and Ireland, where it is sometimes epidemical among infants. It, however, is commonly seen in other kingdoms, and prevails more especially in those houses where a great number of children are crowded together. I am not able to determine whether it is or is not contagious.
"But adults are not wholly exempted from this morbid affection, and it is not easy in all cases, to distinguish the cancrum oris from a cancerous or venereal ulcer in the mouth; since the uvula, tonsils or fauces may be the seat of each disease. I have seen ulcerations on the uvula and tonsils, with all the marks of a venereal sore, in patients where the presence of such a virus could not be suspected; and by treating them as canker of the mouth, they have been speedily cured.
"The canker of the mouth ought to be distinguished from aphthæ, the epulis and parulis, scurvy, cancerous ulcers, venereal ulcers and exulceration from the use of mercury.
"The mode of treatment.—It will be proper,
"1. To remove the diseased teeth, bone, &c. if possible.
"2. To prescribe a milk and vegetable diet, and to allow a prudent use of fermented liquors.
"3. It will be adviseable to exhibit such remedies as, Peruvian bark; sarsaparilla; elm bark; mineral acids.
"The external applications that I have generally found successful have consisted of such as the following: