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tact with the living membrane, when the same regular dis-
eased action produces that gradual chronic inflammation and
almost imperceptible suppuration, which gradually destroys
the soft parts, without any particularly painful symptoms.
When, at a later period, many teeth are carious at the
same time, and the other parts of the mouth are in a more
or less diseased state ; or when, by accident or injudicious
treatment, many diseases are produced in the teeth and their
relative parts, it also frequently happens that no tooth-ache
is produced, although perhaps one tooth is lost very soon
after another ; and thus, by the constant counter irritation
which is produced by one diseased part upon another, all
are kept in a state of constant disease of a chronic kind
while at the same time the tender state of all parts of the
mouth obliges the patient to be perpetually on his guard, to
avoid accidental irritations, which might produce acute in-
flammation.
And even if it should happen that acute inflammation
should arise from some temporary exciting cause, such as
fever, derangement of the digestive organs, pregnancy, or
suckling, cold, or other external irritation, it will frequently
be of short duration, and both the inflammation and the pain
will be confined either to one tooth only, or, as is most fre-
quently the case, to the parts more or less related to the
teeth ; and the general state of the mouth will soon change
to its chronic state again, and the. tooth-ache or pain will
cease. '
In consequence of this long duration and slow progress of
these chronic maladies, and the apparently small inconveni-
ences produced by the diseased nerve, or lining membrane
of the tooth, complicated caries is, frequently, altogether over-
looked ; the pain being considered as a symptom of general
disease, or of some remote morbid cause and the tempo-
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