s and
tonsillitis. Erysipelas on the face may infect the mouth, and an acute
stomatitis due to the diphtheria bacillus, Klebs-Loeffler bacillus, has
been described. A distinct and very dangerous form of stomatitis in
infants and young children is known as "aphthous stomatitis" or
"thrush." This is caused by the growth of _Oidium albicans_. It is
always preceded by a gastro-enteritis and dry mouth, and if this is not
attended to, soon attracts attention by the little white raised patches
surrounded by a dusky red zone scattered on tongue and cheeks.
Epidemics have occurred in hospitals and orphanages. Mouth breathing is
the cause of many ills. As a result of this, the mucous membrane of the
tongue, &c., becomes dry, micro-organisms multiply and the mouth becomes
foul. Also from disease of the nose, the upper jaw, palate and teeth do
not make proper progress in development. There is overgrowth of tonsils,
and adenoids, with resulting deafness, and the child's mental
development suffers. An ordinary "sore throat" usually signifies acute
catarrh of the fauces, and is of purely organismal origin, "catching
cold" being only a secondary and minor cause. In "relaxed throats" there
is a chronic catarrhal state of the lining membrane, with some passive
congestion. The tonsils are peculiarly liable to catarrhal attacks, as
might a priori be expected by reason of their Cerberus-like function
with regard to bacterial intruders. Still, acute attacks of tonsillitis
appear on good evidence to be more common among individuals predisposed
constitutionally to rheumatic manifestations. Cases of acute tonsillitis
may or may not go on to suppuration or quinsy; in all there is great
congestion of the glands, increased mucus secretion, and often secondary
involvement of the lymphatic glands of the neck. Repeated acute attacks
often lead to chronic inflammation, in which the glands are enlarged,
and often hypertrophied in the true sense of the term. The oesophagus is
the seat of inflammation but seldom. In infants and young children
thrush due to _Oidium albicans_ may spread from the mouth, and also a
diphtheritic inflammation spreads from the fauces into the oesophagus. A
catarrhal oesophagitis is rarely seen, but the commonest form is
traumatic, due to the swallowing of boiling water, corrosive or irritant
substances, &c. A non-malignant ulceration may result which later leads
on to an oesophageal stricture. The physical changes presented by th