When the child loses its appetite and the stomach and bowels become
deranged, the tongue generally becomes coated. Children who are overfed
and in whom the food is not digested, may have a thick fur over the
tongue, but as a rule only on the back of the tongue there is a whitish
coat. In diseases of the mouth that are purely local, the tongue is
sometimes coated, quite independently of any disease of the stomach,
as for instance in thrush, in catarrhal inflammation of the mouth,
diphtheria, burns and other injuries.
(_a_) Catarrh of the mouth is an inflammation of the mucous membrane
and is recognized by redness and increased secretion. It is most
intense on the tongue, which presents the appearance as though it
were coated with raspberry syrup. Sometimes the redness is most on
the inside of the cheeks and soft palate, while the tongue is covered
with soft fur. The inflammation of the mucous membrane of the mouth,
extends in aggravated cases to the throat and nasal passages and along
the Eustachian tube into the ear. There is many a baby suffering, no
one knows from what, when it has an earache due to this cause. When the
catarrh has existed for some time, clear, minute water-vesicles rise
upon the tongue, gums and mucous membrane of the lips and cheeks. These
burst and leave behind them small, flat ulcers, which in the first few
days run together and present large, flat, ulcerated surfaces. The
children become feverish and refuse to eat and drink for days, partly
because to do so, pains them and partly from a loss of appetite.
The most common cause is the eruption of the teeth. Mothers of
experience know that when the baby drools, it is teething, and if she
examines a little closer she will discover the catarrhal condition
described. Another cause is the old-fashioned sugar teat with its
souring contents; so is the nursing food, when either too hot or too
cold, and in older children irregular or improper food has the same
effect, for instance, sour ripe fruit eaten in excess.
The treatment for catarrh of the mouth is simple and successful if
directed to the removal of the causes that we have enumerated. The
mouth should be cleansed every few hours with a little borax water, and
the febrile symptoms generally subside with a dose of mild laxative.