gangrenous stomatitis

A case of cancrum oris following whooping cough. While whooping cough was resolving, a black sore was noted on the cheek. The sore remained there for 5 days, and on the fifth day spread to the gums and all the nearby teeth fell out. Cheek sloughed away soon after. Standard treatment for noma (gangrenous stomatitis) was given, but to no avail. Child died within 72 hours. Though noma was and is a serious disease, it was rarely so quickly fatal, especially when treated. On autopsy, the bronchi were inflamed and filled with mucous as happens with children who die of broncho-pneumonia.

The author of the book noted that noma and cancrum oris were two separate conditions. From what I can find in the modern literature, cancrum oris is now considered an antiquated term for noma, and noma is a disease of varying degrees. 

Somewhat frighteningly, the only successful method of arresting the advance of what was known as “cancrum oris” was noted to be destroying all gangrenous tissue with nitric acid. These days, very strong antibiotics and greatly improved nutrition are the typical cures, though gangrenous tissue does still have to be excised in the end. At least we don’t have to burn it off with acid.

From The Surgical Diseases of Children. By J. Cooper Forster, 1860.