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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    collection of the literature up to that time is so complete that subsequent writers have found it needless to go back of his work. In France the disease had early received much attention. Poupart and Saviart observed gangrene of the mouth in H6tel-Dieu. Berthe described it under the name, “scorbutic gangrene of the gums” (“gangrene scorbutique des gencives”). Sauvages described it under “necrosis infantilis.” Baron in i8i6 published a description of the disease, and concluded that gangrene of the mouth is an affection sui generis, and local. He found the best treatment, if perforation has occurred, to be the hot iron. In i8i8, Isnard, in his inaugural thesis, described gangrene of the mouth and vulva. He favored the use of the actual cautery after excision of gangrenous tissue. Some less important publications by diet, Rey, Destr^es, Billard, Murdock, Boeckel, Constant, Taupin (1839), and others, were followed by the very complete monograph by Tourdes in 1848. Boulcy and Caillault published a valuable contribution in 1852. This brings us up to the publication of the most comprehensive description by Barthez and Rilliet in 1855. Among the more recent noteworthy and exhaustive writings upon noma may be mentioned those of Bruns in 1859, Gierke in 1868, Hirsch 1862-64, und Bohn in 1880. Bruns says that Uzanam in 1823 describes the disease occurring in Spain, as “ fegra,” “fegar, ”or “fegarite.” In 1810 it occurred among the French troops in Madrid, attacking more than 100. It was said to occur among children in Spain, appearing to be contagious. Gangrene of the mouth appears to have been rare in Italy. Benevoli, Bartholomeo, Maggi, and Joanns Togault are mentioned by German writers as contributing articles on the subject of noma. FREQUENCY OF OCCURRENCE. Noma is an uncommon di.scase. In private practice it is almost never met with, and the experience of Meigs, who “never met with a case in private practice,” corre- sponds with that of most practitioners. Even in hospitals the disease is uncommon. Allbutt says that only one case appeared on the records of Westminster Hospital in 10 years. According to Allchin, at the East London Hospital for Children, which is .situated in a very poor and densely crowded district, during seven years, 1881-87 inclusive, only five cases occurred in a total of 6,364 admissions during that time. At Great Ormond Street Hospital, during 13 years, 1876-88, only six cases occurred, with a total of more than 13,000 patients. In some continental hospitals the proportion of cases seems larger. Gierke states that during 16 years, 20 cases were observed in the Children’s Hospital of Stet- tin. In the Children’s Hospital in Prag, according to Springer, 65 ca.ses occurred in 30 years from 1857 to 1887, and 23 cases in the 16 years from 1888 to 1903. Woroni- chin saw noma occur in 22 out of 8,286 hospital patients, and in 24 out 207,259 ambu- latory patients. ETIOLOGY. Age. Noma is a disease which occurs almost exclusively in young children. The largest number of the cases are observed between the second and seventh years of age, a few being seen in the first year, and occasional ones up to the twelfth Accord- ing to Tourdes many physidans believed that immunity was acquired against the disease dunng the penod of lactation. This author (1848) reported nine authors who had seen noma in persons between 15 and 72 years of age. Bruns in 1859 referred