Cancrum Oris

Cancrum Oris, known also as Noma, Water-cancer, and Water-canker, is a peculiar form of mortification or Gangrene (q.v.), arising apparently from defective nutrition. The disease seldom occurs except between the second and eleventh years, and is usually preceded by measles, remittent or intermittent fever, or some other serious disease. The following is the ordinary train of symptoms: more or less general disturbance of the system, accompanied by loss of appetite, followed by swelling of the salivary glands, and a profuse flow of fetid saliva, which escapes from the mouth involuntarily during sleep; ulceration of the gums, which swell and become livid; looseness of the teeth; and the appearance of ash-coloured spots on the gums and adjacent mucous membrane, which turn into dark-coloured sloughy sores. These sores spread rapidly by a gangrenous process, expose the bone, and finally make a large aperture in the cheek. In some cases the entire cheek has been destroyed in a very few days. Fortunately, this terrible disease is more rare in this country than in some parts of the Continent, and most of the cases recorded are described by foreign writers. Van Swieten describes a case in which he saw the first set of teeth fall out, the second set destroyed, the lower jaw exfoliated, and the lips, cheeks, tongue, and chin eaten away before the child died. The obvious indications of treatment are to remove the patient to pure air, to administer tonics, nourishing food, and (in moderation) stimulants; to touch the diseased parts with nitrate of silver, or glyceride of earbolic acid, and to wash out the mouth frequently with a weak solution of Condyl's fluid.