Page 45 - An essay on the diseasesof the jaws, and their treatment

DISEASES OF THE JAWS. 23 latter, by which an unnatural and morbific mechanical irritation is produced, by the pressing of one jaw upon the other, particu- larly during mastication ; this irregularity I have frequently ob- served in cases I have had an opportunity of examining. To these may be added a great variety of mechanical, acci- dental, and artificial causes, such as external injury, exposure to cold, and all improper and improperly performed dental opera- tions. Among the latter may be enumerated the extracting or breaking out of teeth with undue violence; the injudicious inser- tion of artificial teeth ; the transplanting of teeth from one mouth to another (the danger accompanying this operation is best illus- trated by referring the reader to a most distressing case, which proved fatal, related in the " Medical Transactions of the College of Physicians of London," vol. III., page 325— 338*); the re- placing of teeth, which have been extracted either by mistake, or with a view to render them incapable of being painful ;t the * As the "Medical Transactions" are comparatively little known, I shall transcribe this interesting and melancholy case. " An unmarried lady, twenty- one years of age, had one of the incisor teeth in her upper jaw affected Avith caries; it was extracted, and its place very dexterously supplied by a like tooth from another yoimg woman, who, upon a most rigid examination for the purpose, appeared to be in excellent health. The implanted tooth very rapidly took a firm hold, and soon bade fair to be of great service and orna- ment. In about a month, however, the mouth became painful, the gums inflamed, discoloured, and ulcerated. The ulceration spread very fast; the gums of the upper jaw were destroyed and the sockets left bare. Before the end of another month the ulceration stretched outwardly over the upper lij) and nose, and in- wardly to the cheeks and throat, which were corroded by large, deep, and foetid sores. The gums soon became carious, several of the teeth successively dropped out, and these at length were followed by the implanted tooth, which had hitherto remained firm in its place. About this time also blotches appeared in the face, neck, and various parts of the body, many of which became painful and exten- sive ulcers: a considerable degree of fever, apparently hectic, was excited; a copious and foetid discharge flowed from the mouth and throat and impeded sleep, and the soreness of the parts which performed deglutition prevented a sufli- cient nourisliment from being swallowed. Medicines exhibited in every possible form that science matured by experience could suggest, failed altogether of re- moving or even mitigating the unhappy sufferer's distresses: the virulent taint or putrescent tendency established in the system, though occasionally driven back, as often rallied and ultimately prevailed: the patient fell a victim to it, in the greatest anguish and misery. The person from whom the tooth had been taken had all along continued to enjoy the most perfect health ; she was frequently and scrutinously examined, without a single trace of disease being discovered existing in her person or constitution." t The retaining in the mouth or the replacing of teeth that have been luxated