“It is neither connected with inflammation, nor with the formation of ulcers, but depends upon the abundant development of a microscopic fungus, the candida albicans (Robin), which combines with the epithelium into thick, white membranes, and covers a great portion of the surface of the mouth.” (Vogel)
We may frequently foretell its coining when we observe that the mouth of the infant is getting dry, hot and sticky and its secretion gives an acid reaction. Then after a few hours white points the size of a pin’s head appear mostly at first on the inner surface of the cheeks, quickly spreading over various other places and soon covering in some cases the entire buccal cavity, and even the pharynx and oesophagus with a white membrane. After a while its white color turns yellowish or brown if bleeding occurs from rough handling. The first few days this membrane adheres firmly to the mucous membrane. Later, on about the third or fourth day it becomes loose and can easily be wiped away.
According to Reubold this fungus confines itself to the squamous epithelium solely, and therefore the larynx, trachea, and the nasal cavities, the stomach and intestines remain free from it. It has been found, however, on the lowest portions of the rectum, upon the female genitals, and excoriations of the external skin, especially in the vicinity of the mouth, on the chin and neck.
During the continuance of this fungous growth the mouth of the nursling is hot, has an acid reaction and is sensitive to touch in a degree that even nursing sometimes is painful to the child. But as long as the affection is not complicated with intestinal catarrh, its course is quite mild and short, and passes away in a few days if proper attention is paid to cleanliness. Even if a reproduction should occur, it offers no special difficulty to cleansing and leaves the substance of the mucous membrane intact. It is different with artificially fed children when an intestinal catarrh is superadded to the trouble. Under it the child may sink with signs of a follicular enteritis.
The formation of this fungus is favored by acid fermentation. The secretion of the mouth is a mixture of saliva and mucus. The saliva is of alkaline reaction, more so after a meal, less so on an empty stomach. The buccal mucus, however, has an acid action, which is visibly increased on contact with atmospheric air, when acid fermentation at once begins. In young infants the secretion of mucus is in preponderance over the secretion of saliva. There is therefore a physiological tendency to acidity in a young child, and if in addition to it, the child is nourished artificially and improperly by substances which easily undergo acid fermentation, (sucking-bags, poor milk from badly cleansed bottles, etc.) an outbreak of thrush is sure to follow.
We find, therefore, that thrush attacks more frequently artificially fed children than those who suck their mother’s breast, and for this additional reason that the latter in sucking draw the saliva out of their salivary glands, while the easy flow from the bottle requires nothing but swallowing. I would rather have the baby fed by the spoon, as in this way chewing motions are induced and a more thorough mixture of the food with saliva is insured.
We find thrush also in adults, but it is of rare occurrence, and then always in consequence of protracted and exhausting diseases, such as phthisis, diabetes, cancer, etc. — setting in shortly before death. Its pathological character is identical with that described above, and its causes are the same — anomalies in the chemical composition of the fluids of the mouth, accelerated acid fermentation and absence of the movements of chewing.
The remedy must be chosen according to existing symptoms which accompany this affection. Wash the mouth always after nursing with a rag dipped in water or a mixture of wine and water.
Aethusa – Vomiting of milk in lumps; diarrhoea.
Arsenicum – In adults and children, great burning, exhaustion, deep illness.
Baptisia – Last stage of consumption.
Borax – Great heat and dryness in the mouth.
Chamomilla – Child is fretful, wants to be carried about all the time, has colic, and green, sour stools.
Hepar – When worse on inside of lower lip.
Mercurius – Confluent thrush, changing into cankers, ptyalism, bad smell from the mouth, feverishness, green slimy stools.
Staphisagria – Thrush changing into canker-sores with a bluish-red or yellowish bottom, more or less flow of saliva and bad smell.
Sulphur – Sour smell from the mouth, stools slimy with much straining, or painless, worse in the morning.
Sulph. Ac -After borax, increased flow of saliva, yellowish color of the skin.
Excerpted from: From: Special Pathology and Diagnostics with Therapeutic Hints – C.G.Raue, MD (1882)