nsequence. When hiccoughs set in during the course of any serious
disease it is a very unfavorable sign.

SORE MOUTH: STOMATITIS

Stomatitis is an inflammation of the mucous membrane (inner lining) of
the mouth. The gums and the inner surface of the lips and cheeks may be
red and angry-looking. There may be small grayish spots on any part of
the mouth. If the case is very bad or if it has lasted some time and has
been neglected, these spots grow larger and join together forming
irregular grayish plaques. A large percentage of the cases never go
further than this because the proper care and attention is given them.
It is possible, however, for any case to progress further and become
ulcerative. This will be observed first as a faint yellow line
at the margin of the teeth and gum. Ulceration never takes place unless
the child has teeth. The quantity of saliva is very greatly increased,
so much so that it flows out of the mouth soiling the clothes. The
saliva is intensely acid and it consequently irritates the skin, causing
more or less eczema. The mouth is painful and hot. There is slight
fever, but seldom any marked prostration. If, however, the ulceration
should be severe, the fever may be quite high.

There is one feature of these cases that sometimes proves vexatious and
annoying. Because of the soreness of the mouth, the child cannot draw
strongly enough on the nipple to get a normal feeding, and as a result
the nutrition of the child is poor. These children are hungry and when
offered the nipple grasp it greedily, draw a few mouthfuls then stop
because of the pain and begin to cry.

If the ulceration is extensive, there is usually an odor and the gums
bleed easily. Sometimes the teeth fall out or have to be drawn out.

Strong, well-fed children are as likely to develop stomatitis as are
those who are weakly and ill fed.

The disease is caused by infection and is contagious. Just what the
infection is we do not know; we do, however, know that children whose
mouths are carefully cleaned after each feeding do not have sore mouths
of this character. When cleaning the mouth care must be observed not to
injure the tender mucous membrane.

Treatment.--As soon as the condition is observed mouth-washing should
be systematically and thoroughly carried out. After each feeding the
mouth should be washed with a saturated solution of boric acid in boiled
water. (See page 626.)

It is not necessary to use any further tr