This is a disease of children, although it may not be limited to them,
as it occasionally occurs in epidemics and affects all ages. It occurs
chiefly in the families of the poor and in places where the hygienic
surroundings are bad, the food poor and personal cleanliness lacking.
It may begin as an aphthous stomatitis. Often sufferers from severe,
acute diseases are subjects of attack.
=Symptoms.=—The gums of the lower jaw are chiefly affected. They are
at first congested, swollen and bleed readily. Pain is increased by
mastication and deglutition, the mouth is hot, the breath fetid, the
saliva dribbles and the digestion and bowels are disordered. The ulcers
may appear at various points upon the cheeks, lips and tongue; the
deposit is yellowish-gray.
In the more severe cases the gums are spongy and the teeth are
loosened. In proportion to the constitutional disturbances, fever and
enlargement and tenderness of the submaxillary glands occur. Even
necrosis of the bone may follow.