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nary irritation, however, always subsides after the removal
of the temporary irritating cause.
Even at the time when the disease has penetrated the
whole bony structure, and has exposed the nerve to many
additional general and local causes of irritation, this delicate
membrane may sometimes remain in that state for a consid-
erable time, without producing any great inconvenience.
These symptoms, however, are often much aggravated by
certain general and local causes, such as general diseases,
especially inflammatory fevers of any kind, sudden and fre-
quent changes of temperature from extreme heat to extreme
cold, abuses in the application of active internal and external
medicines, such as mercury, opium, acids, improper tooth-
powders and tinctures, &c. as well as dental operations, such
as filing, cutting, and stopping the teeth, &c.

Of Internal or Deep-Seated Caries.*

Internal caries generally affects the parts between the
enamel and lining membrane, but somewhat nearer to the
former part of the tooth, on the surface of which, it is first
observed from its giving the tooth a bluish hue. It becomes
more evident by presenting the appearance of a blue mark,
and afterwards a brown spot, till it shall have penetrated
through the whole external bony structure and enamel, and
become a cavity, either on the grinding or on one of the lat-
eral surfaces.
The orifice of this cavity is at first very narrow ; but it
increases in time externally, in the same proportion as the
caries extends itself in the cavity. This disease as far as my

* Koecker, page 223 to 227.