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The local appearances at the commencement, did not ap-
pear to be of an inflammatory nature, at least generally. If
the gums were really the first part affected, it was not so ; as
these parts when inflamed, as they frequently are in affec-
tions of the teeth, exhibit decided soreness, pain, swelling,
and an increase of redness. The ulcerated part was in
about nine cases out of ten paler than natural ; and then
neither soreness nor increased heat was perceptible, except
in a few cases, in which the mouth was generally hotter than
natural, though it was not in a striking manner referrible to
the gums. In a few cases, distinct redness, and a slight
swelling, were perceptible round the ulcer. These patients
generally did better than the others. If on the other hand,
we suppose the original derangement to have taken place in
the periosteum, we shall be enabled more easily to explain
some of the phenomena. We then reason thus ; the whole of
the body had shrunk considerably from disease, and the cir-
culation being deprived of a part of its usual vigour,
the periosteum, apart possessed of little vitality, was un-
able to bear the additional extension which it underwent
across the unyielding bone of the tooth. The blood ceased
to circulate in it, and it died. Ulceration of the adjacent
parts followed, as a matter of course ; and these parts, es-
pecially the periosteum being possessed of but little sensibili-
ty, the sympathies of the other part of the system were but
little interested, until an extensive portion of the mucous
membrane of the mouth, or a mass of cellular substance
became affected. We certainly see that in every case but
two, the disease commenced in contact with the teeth. This
doctrine will also explain the rapid and deep penetration of
the ulcer along the roots of the teeth, and the destruction of
the bone. We may recur to the statement, that a portion of