Page 44 - An essay on the diseasesof the jaws, and their treatment

22 AN ESSAY OX THE teeth, alveoli, periosteum, and gums; as also dead and loose teeth, and decayed roots, or stumps of teeth, and tartar; all of which will generally, more or less, be observed to accompany the dis- eases of the maxillai. See my " Principles of Dental Surgery," Cases 4, 24, 25, 26, 27, and 33 [being Nos. 60, 61, 62, 63, 64, and 65 of the Catalogue in the Appendix.] These local causes are much aggravated by the slightest de- rangements of the constitution, such as general maladies of an acute and chronic nature, and, more particularly, a disordered state of the fluids and solids. An unnatural and improper diet, whether deficient in nourish- ment or debilitating by its stimulating effects, such as the abuse of wine, and ardent spirits; all powerful medicines and narcotics, even those remedies generally considered specifics against cancerous such as henbane, hemlock, and mercury ; indeed, any disease ; general stimulating medicine which is administered, previously to the removal of the local irritating causes, will tend materially to aggravate the maladies. The improper use of mercury, in some instances, however, has been the original cause of these diseases; of this, case No. 3 of this Essay furnishes a striking illustration. The local predisposing or remote causes of these aflTections are a peculiar formation of the maxillae and teeth, such as a soft structure of the former, or unusual length, and curved formation ; and, espe- cially, an irregular and inconvenient situation of the fangs of the searches of M. Ribes, which are strongly corroborative of these statements, although he himself does not allow them to have any weight in the formation of his opinion of the pathology of the diseases of the jaws, which he states to be, that " the causes under the influence of which these tumours make their appear- ance are in general very obscure." Keferring, however, to these researches, he says :— " M. Eibes found on the body of a man, aged sixty, a hard tumour of the size of a walnut, situated on the right side of the lower jaw, near the first molar tooth. This tumour was dissected and separated from the gum, and was observed to occupy one of the alveolar depressions, whicli was greatly expanded. The substance of the bone surrounding it was cut away in slices and the tumour laid bare. He noticed that it adhered firmly to the walls of the cavity, especially near the top, and that at this part it was continuous with the dental blood vessels, the size of which was much augmented, the canal containing them being increased to double its ordinary volume. The tumour was pretty firm; when cut into, it presented a fibrous lardaceous appearance. There was neither caries nor necrosis of the bone to be detected. In another case, AI j\I. Eibes and Bayle dissected together a tumour similar to the preceding, but considerably larger ; and were able, as they say, to discover very plainly the connexion of the tumour with the dental vessels." i