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subsides, the tooth-ache generally ceases, and the tooth will
be quite free from pain or uneasiness, until the inflammation
is produced again by the same, or similar causes.
When the disease has arrived at its third and last stage,
that is, when the whole lining membrane is inflamed and pro-
ceeding to suppuration, it is exquisitely painful, and the symp-
toms are then very violent, and sometimes very alarming.
Inflammation now increases in one, and suppuration fol-
lows in the other part of the nerve of the tooth, and the
pain and morbid action are constantly excited, not only by
the previous causes but also by the suppurated matter of the
diseased parts ; which as it cannot be discharged like that
formed in other soft parts, so as to afford relief, continues a
constant cause of irritation and rapid destruction.
The disease, therefore, proceeds, constantly changing from
acute to chronic inflammation, and vice versa, accompanied
by more or less pain in the whole affected tooth.
At this period, the teeth nearest to the diseased tooth, and
sometimes those of one or both sides of the same jaw, are
symptomatically affected, and rendered almost as painful as
the one primarily diseased.
The symptomatic inflammation frequently extends not only
to the gums, periosteum, alveoli, and maxillary bones, but
also to parts more or less distant ; such as the eyes, ears, and
throat, and sometimes the digestive organs, as well as the
whole nervous system, are symptomatically affected, the lat-
ter to such a degree, as almost to produce madness, on which
account the French have given the acute state of tooth-ache
the appropriate term of " une rage de dens."
When the disease has continued to rage in this manner for
some time, and the suppuration has carried off the principal
part of the lining membrane, its powers become partly ex-
hausted, and it returns into the chronic state, without inter-