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The general appearance of the children afflicted with these diseases was extremely unhealthy, they were pale and cold, their flesh flabby and soft, and the secretions very offensive and unnatural. Before giving the chlorate of potash, when it has been possible to induce the child to swallow an aperient, I have given in the first place a dose of rhubarb and sulphate of potash with a grain of calomel; but generally the pain and tenderness of the mouth has been so great that it has not been feasible. I have therefore given the chlorate at once, and have waited a day or two, until the mouth has become less tender, and then have ordered the aperient.
The quantity of the salt that I have been in the habit of prescribing varies from twenty to sixty grains, according to the age of the child, in divided doses in twenty-four hours, dissolved in water; the beneficial effect is often observed on the following day, almost always on the second; the disagreeable foetor soon lessens, the sores put on a healthy reparative action, the dribbling of saliva diminishes, and if there is mere ulceration it very speedily heals, if there is an eschar, it soon separates, and the sore granulates kindly. In no other disease did I ever see the beneficial effects of any medicine so soon manifested, as that of the chlorate of potash in these diseases. It is sometimes advisable, indeed necessary, that the aperient should be occasionally repeated.
- Hutchins, ætat. 3), was brought to me, having a sore mouth, he was pale and haggard, flesh soft and flabby, the surface of the body was cold, pulse quick and weak, and he appeared to suffer much in his mouth, the saliva continually dribbled away, and the breath very offensive, so like the mercurial odour that I attributed the state of his mouth to the effect of calomel. With some difficulty I was enabled to examine his mouth, the gums were in a state of ulceration, particularly on the right side, and there was a brown ragged ulcer in the inside of the cheek; on the outside, corresponding to it, there existed a hard painful swelling, with a slight blush of inflammation on it, the tongue as well as I could see it was sodden, and swelled, and indented at its edges by the teeth ;—the belly was large, and the alvine evacuations very offensive, and the food passed but little digested; the child had been pale and ailing for some time, but the state of the mouth had only been observed three or four days, and was getting rapidly worse. I prescribed the following mixture: R. Potassæ chloratis zss syr. simplicis zj aquæ zxi misce. :-a tea spoonful to be taken every hour, or oftener if possible. On the following day the smell of the breath was much less disagreeable, the salivation considerably lessened. On the succeeding day the ulceration of the gums was evidently checked, and the tenderness had much diminished, so that an examination was made with much less difficulty ; the ulcer on the cheek had begun to put on a more healthy action, and the external swelling was lessened. The same remedy was continued, and a grain of calomel, with eight of rhubarb and twelve of sulphate of potash, was ordered for the morning : this cleared out the bowels of offensive stools, and the child appeared in every respect better, the brown ragged appearance of the ulcers had given place to a more healthy surface, which was rapidly healing. The plan was pursued for a week longer, by which time the child was perfectly sound. This rapid progress has been made, without exception, in every case in which I have given this medicine, when there has been no eschar. In those cases where there has been one, more time has been required to throw off the slough, but all have shown almost immediately the power of this medicine in arresting the disease.
, ætat. 3, the son of a turnpike keeper, who lived on the top of a hill in the purest air, was brought to me October 5th ; he was pale and sickly, and had been out of health for some weeks; he had refused his food for several days, from great soreness in his mouth; the cheek on one side was occupied by an ill-conditioned ulcer, extending to the gums, they were spongy and separated
from the teeth ; the cheek was swelled, hard and painful, of its natural colour; the child's belly was full and tense, and the evacuations very unhealthy.
I ordered a mixture containing potassæ chloratis zij syr. simplicis zij aquæ ziiss, -of which he was to take a dessert spoonful occasionally, so that the whole was taken in twenty-four hours. When I saw him two days after, the 7th, the ulceration was arrested and healing. An aperient of calomel, rhubarb, and sulphate of potash, was ordered for him, and to continue the chlorate; at the end of the week his cheek was perfectly healed.
With the exception of the following case all have terminated favourably; and in this, the child lived sufficiently long to show the beneficial influence of the remedy.
In August 1836, I was requested to see a child, a girl between 5 and 6 years old, who had been under the care of another practitioner. I found almost the whole cheek of the right side in a state of mortification, quite black, which was rapidly increasing, with a margin of dusky-red inflammation without the slightest trace of separation; some teeth had fallen out, and others were loose, the gums having been eaten away by the phagedænic ulceration; almost the whole inner part of the cheek was one large foul ulcer, the stench was most fætid—the pulse was rapid and fluttering, and the extremities cold. The attention of the mother had been attracted to the state of the mouth a week before, by the child's complaining of the soreness of it, and by its refusing all kinds of food excepting liquids, and by the salivation Medical assistance had been called in, but the ulceration continued its ravages, and a black spot had been observed first, four days before I saw it, in the centre of the part which had been previously swelled. Without hope of benefit I ordered the following mixture: R. Potassæ chloratis Dij syr. simp. zij aquæ ziss misce.-two tea spoonfulls to be taken every hour; and that as much of the salt should be taken as possible, I ordered two more scruples to be dissolved in a wine-glass of port wine with as much water, the whole of which was to be given during the next twelve hours, or sooner if possible : at the expiration of that time, I fancied there was less disagreeable smell, and the child appeared to have rallied a little ; I therefore ordered the chlorate to be continued in the same quantities : on the following day the smell had certainly diminished, and there was a slight crack between the dead and living parts; this separation increased so much during the next twenty-four hours, that it showed the disease was arrested. On the following day, the edges of the eschar began to separate, and the internal ulceration had put on a more healthy appearance, but during the following night