Noma : gangrenous stomatitis, water cancer, scorbutic cancer, gangrena oris, gangrene of the mouth / George H. Weaver and Ruth Tunnicliff.

  • Weaver, George H. (George Howitt), 1866-1947.
Date:
[1907]
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Licence: In copyright

Credit: Noma : gangrenous stomatitis, water cancer, scorbutic cancer, gangrena oris, gangrene of the mouth / George H. Weaver and Ruth Tunnicliff. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    NOMA*t (gangrenous stomatitis; water cancer; scorbutic cancer; GANGRENA ORIS; GANGRENE OF THE MOUTH.) George H. Weaver and Ruth Tunnicliff. {From the Memorial Institute for Infectious Diseases, Chicago.) INTRODUCTION. Tourdes has defined noma as a gangrenous affection of the mouth especially attacking children in whom the constitution is altered by bad hygiene and serious illness, especially from the eruptive fevers, beginning in an ulcer of the mucous mem- brane with edema of the face, extending from wdthin out, rapidly destroying the soft parts a nd the bone, accompanied most often by hepatization of the lungs, and almost always quickly fatal. Other writers have included under this head all of the gan- grenous processes which involve the skin of children. There has been much differ- ence of opinion as to the relationship borne by various ulcerative processes in the mouth to noma. Some of the studies carried on during the past few years seem to point to a common etiology for many of the pseudo-membranous and ulcerative lesions of the naso-pharyngeal mucous membrane and for noma, the difference in the degree of destruction of tissue depending upon varying degrees of vulnerability of the tissues, and perhaps in a less degree upon varying degrees of virulence of the bacteria concerned. In the following article we shall use the word “noma” as a term to cover all these forms of gangrene which involve the mucous membrane and skin with the intervening isssues in the neighborhood of the orifices of the body, HISTORICAL SKETCH. Such a striking and fearful disease as noma could not fail to be noted by the first physicians who came in contact with it. That this was the case is evident from the abundant literature relating to it collected by A. L. Richter in his publications in 1828, 1832, and 1834. Richter was the first author of a monograph upon noma, and in his first publication he collected 74 references to this disease in the literature. They were gleaned from the various parts of the world. A few of the earlier his- torical facts connected with the disease are given here, many being quoted from Richter’s monograph. The disease was known to the most ancient medical writers, such as Hippocrates, Galen, Celsus, Arethaeus, Caclius Aurelianus, and Alexander de Tralles. Hippoc- rates applied the name noma to all kinds of gangrene and ulcers, and connected it especially with putrid decomposition and considerable destruction of tissue. Galen mentions noma in many passages of his work. He defines it as an s.ffection charac- terized by destruction of tissue extending from the diseased parts to the healthy. He also connected noma and putrid decomposition. He classed together noma and * Received for publication, May i, 1906. t In the study of the case of noma herein reported, a review of literature covering many years was undertaken. With the hope of sparing some of this labor to those who in the future may have occasion to study such cases, an effort has been made to incorporate in this article the most important facts bear- ing upon the subject.