Page 35 - An essay on the diseasesof the jaws, and their treatment

DISEASES OF THE JAWS. 13 The diseases of the maxillae rarely, if ever, have their origin in the cavity or antrum; but, almost -without exception where the mucous membrane lining the cavity is affected, this will be found the consequence of disease, or necrosis of some part of the osseous structure surrounding it; these diseases have, therefore, very in- correctly received the general denomination of diseases of the maxillary antrum; a mistake which has led to both erroneous theory and practice, with respect to them.* Incorrect nomenclature is, without doubt, injurious to science; and it is surprising, how the most enlightened and celebrated pathologists have sometimes been misled by improper names, and, notwithstanding they have been sensible of the inconvenience, have exerted themselves to justify error rather than correct it. Indeed, not a small number of the best curative remedies in surgery, as well as in medicine, may be proved to have been frequently misapplied, or rendered injurious, by the improper technicalities which have been gradually admitted into patholo- gical science. That the upper and under jaws are equally subject to the dis- eases in question, is sufficiently evident from the cases related by * It is chiefly in the performance of their peculiar offices that organs are ex- posed to the occurrence of tliose derangements which constitute diseased action. In regard to the bones, this may be observed to hold good, not only in particular bones, but in particular parts of them. According to Baron Dupuy tren, of the entire skeleton, the long bones and the jaws are most frequently attacked with osteo-sarcoma and other morbid growths ; and out of nineteen cases of timiours of the bones, related by him in his " Lemons Orales," thirteen occurred in the maxillae, five in the long bones, and one in the second phalanx of the index finger. In the cylindrical bones, the parts which exhibit the greatest tendency to dis- ease, are the ends, and in the maxilla?, this is the case with the alveolar ridge ; these being in both instances the parts most liable to external impressions. The principal office of the maxillary bones is to give support and attachment to the alveolar processes and teeth, and hence it is in this character that they are so liable to take on diseased action. It is, then, to the alveolar connexions of the j maxillary bones that we have to look, as the peculiar seat of these affections, rather than to the antrum : they are peculiarly diseases of the jaws and not of the sinus maxillare. This can hardly admit of a doubt, when we consider that, in the words of Baron Boyer, " abscess in the frontal sinus is infinitely more rare than in the antrum;"whilethelower jaw, with amere cana/ instead of an anfn^m, is nearly as often affected as the upper. But it is obvious, that the circumstance of the entire body of the superior maxilla being composed of the thin walls of a cavity, lined throughout with a delicate membrane, has much influence in modi- fying these afiections, as they occur in the upper jaw.