Page 57 - An essay on the diseasesof the jaws, and their treatment

; DISEASES OF THE JAWS. 35 fistulous opening through the bony structure and gums; at a later period it perforates the under edge ofthejaw, the matter forming an abscess under ihe chin, and being ultimately discharged externally. By the partial removal of the pus the progress of the disease is again retarded in some degree, and considerable swelling prevented or removed ; in this state it may proceed for a considerable time, even for many years, without the patient being sensible of his danger, so that even in this advanced state, he neglects to apply for proper surgical aid, especially if he belongs to the lower class of society, who are habitually inattentive to the cleanliness of the mouth, and apt, in accordance with their vulgar notions, to include all these diseases in the common expressions, face-ache, cold, or rheumatism of the face or jaws, or as the French term it, un coup d'air oxfluxion, §-c. See " Principles of Dental Surgery," case 24. OF MALIGNANT OR CANCEROTJS AFFECTIONS OF THE JAWS. In advanced stages of maxillary affections, or when they are influenced by a weak or disordered constitution, the malady some- times increases to an alarming degree, the mortification of the bones rapidly extending, and the inflammation and tumefaction of the surrounding parts becoming more or less augmented ; and frequently such is the expansion of the bony structure, that the sur- rounding parts of the jaw-bone are enormously increased in size. The constitution now necessarily suffers to a great extent, and if the disease be not arrested, the ulceration rapidly increases, and its destructive ravages are soon extended to other important structures of the mouth, as the palate, the fauces, &c.; at length inflammation is communicated to some important part, as to the brain, and thus becomes fatal; or the disease assuming a cancerous character, the unhappy victim ultimately sinks under its pro- tracted and heart-rending progress. See " Principles of Dental Surgery," cases 4 and 27.* * The form of carcinomatous disease here described is comparatively rare that affection generally occurring in the form of a tumour of distinctive charac- ter at a very early stage. In its usual form, therefore, of carcinomatous tumour, it more properly belongs to the next section. D 2