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out of the external part of the tooth, as it is said always to
do before it affects the nerve of the tooth.*
Inflammation and suppuration of the lining membrane
do in some rare cases take place, of which some cases
will be given ; and when the tooth appears perfectly sound
externally, the excessive pain occasioned by the matter col-
lected in the cavity of the tooth, compels us to extract it to
relieve the patient. It was proposed by Mr. Fox,f to bore
into the tooth and discharge the matter ; others deny its
utility. The teeth are said in some cases to have been ca-
rious before they have passed through the gum. See Koccker,
page 231.

The Proximate and Exciting Causes of Caries.

Having taken some notice of the commencement of ca-
ries, and of some of its remote and exciting causes, we will
proceed into a more minute investigation of its proximate
and exciting causes.
Mr. Fox observes,J " that the proximate cause of caries,
appears to be an inflammation in the bone of the crown of
the tooth, which on account of its peculiar structure, termi-
nates in mortification."
Mr. Koecker observes,|| that " Caries in fact, is that state
of the tooth in which mortification has taken place in one
part, and inflammation in the part contiguous to it ; the for-
mer originally produced by the latter, and the latter kept up
by continual contact with the former." This is so until the
whole tooth has lost its vitality.

* See Hunter, page 137.
t See Fox, Part II. page 12.
\ See Fox, Part II. page 12. [| See Koecker, page 210.