Page 59 - An essay on the diseasesof the jaws, and their treatment

DISEASES OF THE JAWS. 37 tipper jaw, and all in the inferior jaw, were very loose, encrusted with tartar, and tender. The cheeks were but little swollen, but the glands of the lower jaw on each side were greatly enlarged and very hard to the touch. The affected parts, and, indeed, all the structures of the mouth were very tender, and the patient often suffered lancinating^ pains in different parts of the head. The disease had evidently committed great and deep ravages in the affected structures, the external surfaces of which had a florid red appearance, and were covered with a tough, greenish, dark, and exceedingly foetid matter, which was constantly discharged in considerable quantity. The greater part of this matter, during a recumbent position of the body, was swallowed by the patient. When asleep he made a constant gargling noise, and his throat seemed to be frequently choaked up, being relieved only by swallowing the collected matter and saliva; and by this channel, as well as by absorption, the matter was without doubt led to affect the general system. It is by a consideration of this that we may, perhaps, best account for the following very curious and uncommon symptomatic phenomena accompanying this case, which, as taken in connexion with the maxillary disease, are particularly deserving of attention. On the abdomen were two subcutaneous tumours, and at the lower part of the cliest another; the latter of a round, the two former of a flattened and circular form, and about one inch in diameter; they were hard and firmly attached to the skin imme- diately covering them, wliich had assumed a blue appearance, but did not adhere to the parts beneath them; the two made their appearance about seven, and the other about three months ago. Formerly the patient enjoyed tolerably good general health, but for the last ten years he has been occasionally affected with gout and rheumatism ; during the last three months, however, his con- stitution has appeared much broken ; and when I last examined liim, in the presence of Mr. Travers, he was so weak as to be hardly able to remain, for a few minutes out of bed, to afford the necessary opportunity for a minute examination of the local disease. It was then evidently in a malignant state, and every