Page 29 - An essay on the diseasesof the jaws, and their treatment

DISEASES OF THE JAWS. f attempt tlieir cure at every hazard, and with the greatest sacrifices, by such means as are within tlic comprehensive reach of general surgery. The baneful effects which result from the present imperfect pathology of the teeth and their relative parts, are particularly evinced by the following most extraordinary instance of severe treatment, extracted verbatim from the " Medico Chirurgical Re- view," for July, 1826, p. 288. " Dr. Regnoli, of Forh, relates a case, in which a fungoid affec- tion of the maxilla and gums, was successfully treated by the re- moval of the alveolar process, of both jaws. The patient, a woman, thirty-five years of age, had had carious teeth from her infancy, and was almost constantly tormented with severe tooth-ache. She was, besides, subject to frequent erysipelas of the head and neck. " Towards the close of 1824, she discovered a small tumour, behind the last molar tooth of the lower jaw on the right side. It soon ulcerated, and rapidly spread to the gums and alveoli of both jaws. These parts were much swollen, and considerably contracted the cavity of the mouth. The fungoid excrescences poured out blood on the slightest touch, and continually produced a thin and fetid discharge. The deformity was considerable, and the voice was altered. The limits of the disease were well defined, and the lymphatic system did not appear to be affected, but the patient experienced much pain, her countenance was dull and cachectic, she lost flesh, and had febrile exacerbations in the evening. In this state of things, the patient was admitted into the hospital at Pesaro, where, after having first performed the operation on the dead subject, Dr. Regnoli" [no doubt, after having divided both cheeks to a considerable extent at the angels of the mouth,] " re- moved the teeth and alveolar processes of both jaws, with the ex- ception of the last molar tooth on the left side of the lower jaw, the socket of which appeared to be sound. From the situation of the parts, the saw could hardly be employed, hence, it was merely used to form a shallow groove in the most prominent parts of the bone, the separation of which was effected by means of a chisel and mallet. Actual cautery was applied to the bleeding vessels, and to such suspicious parts as were not accessible to the knife.