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powerfully astringent substance, as the soft inside of the nut-
gall ; this, by a gradual operation, hardens and obtunds the
nerve until we are enabled to plug the tooth without exciting
inflammation, which is the great danger in all cases of plug-
ging teeth, having their nerves exposed. The gall should be
carefully introduced, and a little wax put on its outside, so as
to keep it in and exclude the external air: it is necessary
sometimes to use the gall for some months before the irrita-
bility of the nerve is abated, so as to bear the plug without
inflammation succeeding. By the two last mentioned methods
we are most generally enabled to effectually cure the tooth,
and preserve its vitality.
Destroying the nerve of the tooth is sometimes done by
the use of caustics, strong acids, &c. but we at the same
time destroy the vitality of the crown of the tooth, which
causes it to lose its colour, and eventually to be lost or prove
offensive to the mouth ; and yet, in some rare cases, when
great pain is present, and our only choice is to extract the
tooth, or destroy the nerve, we may prefer the latter, and use
the actual cautery (a hot iron) lunar caustic, nitric, muriat-
ic, or sulphuric acids, caustic potash, or any caustic we
choose, and after this, plug the tooth. But it is only as a
dernier resort that I would ever think of destroying the
nerve of the tooth ; yet, in some cases, it seems to be more
advisable than to extract the tooth. The peculiar circum-
stances which must determine either to the extraction of the
tooth, or the destruction of its nerve, are very much
influ-
enced by the feelings of the patient, which may sometimes
A tooth
determine one way, and at other times the other.
may be extremely useful in consequence of its being wanted
to support artificial teeth, and we would 'rather destroy the
nerve of the tooth than extract it.
The fourth stage of caries is after it has so long exposed