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ings, like granules, are at times noticed, which are very sen-
sible and bleed readily
; they will be often noticed in this
state, whilst the surrounding gum appears pale and almost
destitute of vitality.

Causes of Scurvy.

The causes of this affection are constitutional and proba-
bly local.
Tins disease is always produced by local causes,
which act on susceptible persons.
Constitutional Causes.—First, any thing which produces an
increased irritability of the system on persons who are natural-
ly irritable, or possess a considerable mobility of the system, as
is most perfectly demonstrated in those cases where this dis-
ease attacks the gums of children, the mobility of whose sys-
(chil-
tems render them extremely liable to be affected by it
dren who live much on animal food)—the improper use of mer-
curial remedies, especially when taken so as to excite saliva-
tion ; and if this is long continued, it is apt to bring on this
disease in an aggravated form—frequent attacks of inflam-
matory fever—chronic inflammation of the stomach—a gen-
eral plethoric state of the system, accompanied with a pecu-
liar inflammatory diathesis—scorbutic and scrofulous taints
of the general system, &c. &c.
The inordinate use of spirituous liquors, by producing an
inflammatory state of the system, may predispose to this
affection.
Mr. Koecker* notices the use of narcotic medicines ; smo-
king and chewing tobacco, &c. With respect to this last
cause, namely, chewing and smoking tobacco, I cannot say
but it often causes this disease, or predisposes to it ; but in

Koecker on the Teeth, Part II, page 282.
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