Page 39 - An essay on the diseasesof the jaws, and their treatment

DISEASES OF THE JAWS. It But the constitution being more active in its curative efforts, although incapable of removing the local causes without surgical assistance, the morbid action is liable to be increased by such powerful exertions of nature. If, moreover, these natural efforts are improperly interfered with by the treatment usually applied in cancerous afiections, such as the exhibition of henbane, hemlock, mercury, &c., or by opei*ations usually adopted in general surgery, tlie disease is seldom even palliated, and frequently aggravated by such unnecessary and painful operations, or stimulant remedies, all of which, when applied without a previous removal of the exciting causes, must naturally augment the disease in the same manner as, though in a greater degree than, the unsuccessful efforts of nature. Hence it is in this state, that the disease is more frequently considered incurable, while in fact it is more manageable than in any other; the difference is, that in this the it doubtless would come to cancer; he therefore advised the patient to have the tooth drawn without deiay. The lady immediately waited upon the dentist, a gentleman of the highest reputation in his profession, who, however, either from the agitation of the patient, or probably the inflamed state of the mouth, mistook the tooth, and extracted a sound one instead of that aflected. A lotion was now applied to the cheek, but, instead of getting better, the face grew worse, till there appeared no alternative but that of undergoing the dreaded operation, the Doctor at the same time declaring, that he could not be answerable for the result. A few days' delay having been granted to the patient's fears, and that she might see, and, as it were, take leave of her friends, one of the latter strongly urged her to allow him to bring a medical friend of his, in whose experience and abilities he had the greatest confidence, to visit her. This being agreed to. Dr. D. came, and after examining the face, and questioning the patient at con- siderable length, gave it as his opinion that Dr. P. had been right, that the case was a fistula, and that had the tooth been extracted, the face, with proper treat- ment, would soon have got well : nor did he think it now too late. In short, it was finally settled, that the lady should put herself under his care at his own dwelling that she might have the advantage of his constant advice and atten- dance. This being done. Dr. D. proceeded to extract the decayed tooth, which Dr. P. had in the first instance, and he at present supposed to liave caused the mischief. The tooth being out, on examining it, the doctor's opinion was confirmed by its bearing all the evidence of the case. He continued to apply the remedies necessary to the inflamed and ulcerated cheek and jaw, being obliged from time to time to cut away or destroy by caustics the foul flesh and excres- cences which had formed themselves; extracting, at various periods, as many as eight teeth, till finally, at the expiration of twelve months, or somewhat more, the face was healed, and brought to the state it has since remained in—a period of ten years." It may be instructive to remark, that the time when this patient was threa- tened with amputation of the jaw, was exactly that at which tl:e indiscriminate use of the operation was most in vogue. C