Page 37 - An essay on the diseasesof the jaws, and their treatment

DISEASES OF THE JAWS. 15 Such tumours ought always to be regarded as consequences of some other primary affections, the tumefaction taking place at any period of the primary disease; and it is probable, that the sooner or later occurrence of the swelling, or the formation of excre- scences, depends as much upon the state of the constitution, as on the local affection itself. In delicate, but otherwise not vitiated constitutions, the bones are much less dense in their structure ; and the disease more gene- rally proceeds in a chronic state, than in those that are strong and robust; the matter perforates the bony structure with more facility, and is discharged sooner, and more conveniently; and the disease is thereby constantly relieving itself when arrived at an acute state, and returns to its chronic form; and thus tume- faction is much retarded. It is in this form that the diseases of the jaws are observed most frequently to proceed in the United States; and perhaps also in all other warm climates.* In strong constitutions, in consequence of the dense structure of the bones, the disease finds more difiiculty in forming openings for the discharge of the pus, which is therefore retained and absorbed; the efforts of nature are also greater, the inflammation more active, and the action of the absorbents is more excited; the bones consequently sooner expand, and the surrounding parts en- large to a considerable size, so as even to produce much deformity at an early stage of the disease: many of the cases which I have seen in England were of this description ; and I believe it may be justly presumed, that the malady more frequently proceeds in this manner, than in the former, in this country and on the continent of Europe. • According to Dr. O'Shaughnessey, of Calcutta, this does not appear to hold good with regard to the progress of these diseases in India. That gentleman, in his " Essay on the Diseases of the Jaws," states, that in the East Indies these diseases are of rapid growth, and generally accompanied with much swelling. If a conclusion can be arrived at from a single case, I should say that these diseases have a similar character in the Levant. In the case of an old Turk, whom I saw at Smyrna in 1841, this disease, in the form of a firm tumour of the lower jaw, had developed itself to an enormous size in little more than fourteen months after its first appearance. This patient had many unsound teeth, and his gums generally were tender and partially absorbed. He was constantly smoking, and appeared very indiBerent about liis complaint, the origin of which he attributed to a blow on the part.