be removed as they become fixed again
when the stomatitis subsides.

_Gangrenous stomatitis_, or cancrum oris (Fig. 245), has already been
described (Volume I., p. 102).

[Illustration: FIG. 245.--Cancrum Oris.

(Mr. D. M. Greig's case.)]

#Roof of the Mouth.#--_Suppuration_ in the muco-periosteum of the
palate is usually secondary to suppuration at the root of a carious
tooth. It may also arise in excoriations caused by an ill-fitting
tooth-plate, or from the impaction of a foreign body, such as a fish
or game bone, in the mucous membrane. The inflammation begins close to
the alveolus, and may spread back along the palate. The
muco-periosteum becomes swollen, red, and exceedingly tender, and, as
pus forms, is raised from the bone, forming a prominent, firm,
elongated swelling, which on bursting or being incised gives exit to
foul-smelling pus.

The _syphilitic gumma_, which begins as a rounded indolent swelling,
is usually situated in the middle line near the posterior edge of the
hard palate. The swelling gradually softens and ulcerates, and a
sequestrum may separate and leave a perforation in the palate (Fig.
246). The treatment consists in employing the usual remedies for
tertiary syphilis. If the perforation persists and causes trouble by
allowing food to pass into the nose, or by giving a nasal tone to the
voice, it may be closed by an operation on the same principle as that
performed for cleft palate, or an obturator may be fitted to occlude
the opening.

[Illustration: FIG. 246.--Perforation of Palate, the result of
Syphilis, and Gumma of Right Frontal Bone.

(From Dr. Byrom Bramwell's _Atlas of Clinical Medicine_.)]

_Tuberculous_ disease is chiefly met with in the form of lupus which
has spread from the nose or lips, and it may lead to widespread
destruction of the soft tissues, or even to perforation of the bony
palate.

Mucous cysts, dermoids, adenomas, lipomas, and fibromas are
occasionally met with. _Papillomatous thickening_ of the mucous
membrane sometimes occurs in association with leucoplakia. It resists
anti-syphilitic treatment, but yields to scraping with the sharp
spoon. _Endotheliomas_, or _mixed tumours_, similar to those met with
in the parotid gland, also occur in young subjects, and grow in the
submucous tissue of the soft palate, usually to one side of the middle
line. In their early stages they are of slow growth, and give rise to
no inconvenience save from their size, are easi