Page 54 - An essay on the diseasesof the jaws, and their treatment

32 AN ESSAY ON THE ON INFLAMMATION AND SUPPURATION OF THE JAWS. Inflammation of the maxillaj, tlie most common disease to which they are liable, much resembles inflammation of the sockets of the teeth, being either an extension of it, or originating from the same causes which produce the latter affection. At the commencement of the disease, and frequently for some time after, the morbid irritation arising from the above causes, either in consequence of the immediate contiguity or the sympathy may doubtless induce disease directly as in other bones, but in the great majority of such cases, the immediate effects soon pass, the remote effects which follow being the consequence of injury primarily sustained by the teeth or their sockets. Moreover, some of the teeth may be in a state of disease at the time of the acci- dent, and the chances are very great that this is the case. Indeed, it will very often be found, where disease of the jaws comes on after the receipt of an in- jury or exposure to cold, that there previously existed some affection of the teeth or sockets. Mr. Liston's remarks, in regard to the influence of diseased teeth under the action of atmospheric impressions, apply with equal force to cases of external violence. " A person," says he, " has laboured some time under caries of the teeth, the crowns have wasted away, and the jaws contain some considerable number of stumps. The patient is, perhaps, out of health, or has been exposed to severe weather, and his face begins to swell, the sockets of his teeth become inflamed, and perhaps an abscess forms at the root of one of them, In this way inflammation may or sometimes a sort of fungus grows about it. be propagated into the antrum, an abscess may be formed in it, and then you have the foundation laid for a great deal of mischief."—On the Tumours of the Mouth. " Transactions of the Medical and Surgical Society," vol. xx. The conclusion to be drawn from the above facts and considerations, namely, that the diseases of the jaw-bones are almost invariably caused by primary affec- tions of the teeth and sockets, is supported by the authority of some of the most eminent surgeons of the present day. "Where matter forms in the cavity of tlie antrum," says Sir Benjamin Brodie, " I certainly believe that, in most instances, there is some local mischief first, and that suppuration of the membrane lining the antrum supervenes as the consequence." (" Medical Gazette," vol. xv., p. 437.) To the same effect, Mr. Liston observes, — " Disease of the lower jaw is by no means uncommon in consequence of a bad state of the teeth. These are over- looked and allowed to become carious; they break away perhaps, and leave a ragged stump, which, after lying dormant for some time, causes at last irritation and inflammation of the sockets, and thus lays the foundation of more extensive mischief— such as abscess of the jaw, necrosis of the alveolar processes, &c." (" Lancet," 1844, vol. i., p. 1 70.) Again, in his Papers on the Tumours of the Mouth, Mr. Liston unhesitatingly refers the osteo-sarcomatous and fungous tumours, which affect alike both jaws, to decayed teeth and alveolar irritation, as the most frequent causes; and, alluding to the fleshy growths which jbrm at the fangs of unsound teeth, further remarks, " it is not unlikelj that many of the more solid and less malignant diseases, involving the upper and lower maxillary bones have a somewhat similar origin."