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to them, a most violent action may, and often does com-
mence, but as the power of distention is so exceedingly
limited, that on this account the most excruciating pain is
felt ; in many cases a peculiar throbbing pain, which is syn-
chronous with the beat of the arteries ; sometimes the pain
will be like a shock returning at intervals. I had a case but
a short time since, in which the patient expressed the ut-
most anxiety to have the teeth (for two were affected) ex-
tracted instantly, and could hardly wait to have the instru-
ments applied for their extraction.
Tooth-ache usually occurs in defective teeth, whose nerves
by the progress of caries have become exposed, but is not
generally considered, I believe, by any judicious dentists, to be
occasioned by the progress of caries itself, but by the appli-
cation of cold, or of some irritating agent—as by wounding
or bruising the nerve mechanically, or what often is the cause
of tooth-aehe, dental operations performed upon the teeth
whose nerves are exposed, plugs applied to irritable nerves
without being prepared for the operation, &c. In the pro-
gress of scurvy, the chronic inflammation of the alveolar
membrane often changes to acute, and extends to the nerve
of the tooth, which compels the patient to have it extracted.
I think cases may and often do occur where rhuematic af-
fections extend to the jaws and teeth, and occasion great
pain in the latter. Females, during pregnancy, I have often
noticed to be very subject to this affection, more than at other
periods, and probably because at this time a general plethora
of their system is apt to take place.
Although tooth-ache is usually occasioned by the applica-
tion of cold to nerves exposed by a decay of the bony part
of the teeth ; yet inflammation may take place in the mem-
branes of teeth otherwise perfectly sound, and proceed to
the formation of pus. Mr. Fox mentions a case of this
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