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]
Catalogue details

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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    9 the afTections of the mouth, anus, and genitalia. He recommended for treatment aromatics, stimulants, and caustics, and recognized the necessity of the red-hot iron. Celsus, who is credited with giving the most precise description, according to Tourdes, was not describing noma but malignant pustule. Arethacus described an aphthous ulceration which had many analogies to the gangrenous affections of the mouth. Caelius Aurelianus and Alexander Trallianus both used the term noma with the idea of putrid decomposition. Noma was probably rarer then than later, because the conditions predisposing to it were less prevalent. The absence of hospitals and the cru])tive fevers account for its infrequent occurrence in ancient times, according to Tourdes. Baltus, in 1620, a Dutch surgeon, furnished the first accurate description of gan- grene of the mouth in his Handbook 0} Surgery. Van de Voorde (1662), introduced the name “ water-kanker,” which was usually employed by subsequent Dutch writers. Van Swieten gave it the name “gangrene.” J. Van Lil called it “ulcus noma, stomacace, and water-kanker.” He referred to many Dutch authors who observed epidemics of the disease following exanthematous diseases. Most of the Dutch writers pointed out the influence of scurvy on this condition. Swedish physicians were also familiar with the nature and course of the disease. Lund based his writings on ii cases, only one of which recovered. He recognized the fact that it occurred only among the children of the poor who lived in damp, unhealthy atmosphere and were poorly nourished. Leutin described the disease most accurately under the name of “ulocace.” In England, Boot first described the disease. Subsequent writers in England were Underwood, Symmonds, Pearson, S. Cooper, Marshall-Hall, West, and others. In America the disease was early described by Coates, Gerhard, Meigs and Pepper. Coates, writing in 1826, states that ever since the establishment of the Children’s Asylum in Philadelphia, in the spring of 1819, the institution had been annually %'isited by the new and distressing scourge. He further says; “It has here prevailed in a considerable number of cases, forming the principal source of anxiety and trouble during the winter season, and annually sw'eeping off its little victims in a manner rendered peculiarly awful by its insidious approach, its loathsome effects, and its apparently uncontrollable progress.” He observed 70 cases among 240 children, but from his description he evidently included cases of ulcerative stomatitis. Coates says the disease was rare in Philadelphia, but quite prevalent in Salem, N. J. He refers to other American authors who had observed cases of the disease. German physicians have furnished the most and best monographs upon this disease. Preceding A. L. Richter it was carefully studied by Fabricius von Hilden under “de catarrho ad gingivas,” by A. G. Richter, and by Jawandte under “noma or gangrene of the mouth.” Wendt recognized it as the most fearful .sequel of scarla- tina and measles, and called it “sphacelus” of the mouth. C. F. Fischer and Siebert sought especially to turn attention to this disease. The latter believed a scorbutic dis- position essential for its development, and emphasized the value of local remedies, especially acids. Hildebrand, Girtanner, Fleisch, Feiler, Henke, Jorg, and Raimann held that water cancer is the latest stage of the symptoms belonging to scorbutus. Raimann discarded the name cancer, and proposed that of very acute, pultaceous or caseous gangrene. Wiegand and Klaatsch undertook to differentiate between water cancer and scorbutus. In 1828 A. L. Richter published the first monograph on noma, under the title of Wasserkrebs, and in 1832 he completed it by a supplement. Hi s