Page 239 - My FlipBook
P. 239
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237
appeared to me to depend, principally, upon the inflamma-
tion of the mouth, which is secondary to the original dis-
ease, and, in most cases, to arise from the acrimony of the
discharge. It is aggravated by loss of resf, want of nour-
ishment, and, probably, by putrid matter finding its way into
the stomach. To this latter cause I also refer a diarrhoea,
which almost uniformly comes on towards the close.
There are accounts of a similar disease having begun on
the inside of the cheeks. I have, however, never seen a
well marked instance of this ; the cases which were sup-
posed to be such having, in every instance, been also found
to exhibit ulcerations at the edges of the gums. That the
disease spreads from the gums to the cheek, is a fact which
I have often seen exemplified. It is, indeed, the most usual
termination of bad cases. After producing gangrene and
necrosis in the gums and alveoli, and after the discharge be-
comes, as above stated, acrimonious, a gangrenous spot is
not unfrequently found about the opening of the Stenonian
duct, on the inside of the upper or lower lip, opposite the in-
cisors, in some other part of the inside of the lip, or cheek,
or in more than one of these situations at the same time.
Whether this be owing to excoriation from the discharge, or
it has, however, in every
to some other cause, I cannot say ;
instance which I have seen sufficiently early to witness
its rise, been subsequent to the symptoms previously des-
cribed.
When the gangrene reaches the cheek or lip, however,
very active inflammatory symptoms are uniformly developed.
In the cellular substance of these parts, they assume the well-
known characters which have been attributed to the phleg-
monous species. We have a great thickening forming in
the cheek, a large, rounded, prominent tumour, with great
heat and pain. Sometimes redness is perceived externally
237
appeared to me to depend, principally, upon the inflamma-
tion of the mouth, which is secondary to the original dis-
ease, and, in most cases, to arise from the acrimony of the
discharge. It is aggravated by loss of resf, want of nour-
ishment, and, probably, by putrid matter finding its way into
the stomach. To this latter cause I also refer a diarrhoea,
which almost uniformly comes on towards the close.
There are accounts of a similar disease having begun on
the inside of the cheeks. I have, however, never seen a
well marked instance of this ; the cases which were sup-
posed to be such having, in every instance, been also found
to exhibit ulcerations at the edges of the gums. That the
disease spreads from the gums to the cheek, is a fact which
I have often seen exemplified. It is, indeed, the most usual
termination of bad cases. After producing gangrene and
necrosis in the gums and alveoli, and after the discharge be-
comes, as above stated, acrimonious, a gangrenous spot is
not unfrequently found about the opening of the Stenonian
duct, on the inside of the upper or lower lip, opposite the in-
cisors, in some other part of the inside of the lip, or cheek,
or in more than one of these situations at the same time.
Whether this be owing to excoriation from the discharge, or
it has, however, in every
to some other cause, I cannot say ;
instance which I have seen sufficiently early to witness
its rise, been subsequent to the symptoms previously des-
cribed.
When the gangrene reaches the cheek or lip, however,
very active inflammatory symptoms are uniformly developed.
In the cellular substance of these parts, they assume the well-
known characters which have been attributed to the phleg-
monous species. We have a great thickening forming in
the cheek, a large, rounded, prominent tumour, with great
heat and pain. Sometimes redness is perceived externally
