Page 62 - An essay on the diseasesof the jaws, and their treatment

40 AN ESSAY ON THE teetli extracted from, the right side of the lowerjaw." [This tooth must have been extracted with considerable violence, or, what Is more probable, have been broken and the stump, or part of Its roots, been left In the socket.] " Two months after, he perceived a small nodule, which was produced from that part of the alveolar process whence the tooth had been drawn. It Imperceptibly In- creased in size for several years, but its progress was unaccompa- nied by pain. To the best of the man's recollection, sixteen years after the appearance of the nodule, the two remaining molares of that side became loose, and eventually dropped out. He then, for the first time, discovered a hardness extending from the bicuspid tooth of the same side backwards, to the ramus of the mylo-hyoid line ; occasional pains attacked the part, yet he did not seek medical aid. In the month of June last, a swelling began to manifest itself externally, which, taking the direction of the man's finger for our guide, occupied the space intervening between the right ramus, and the anterior edge of the masseter muscle; there was occasionally severe pain extending upwards to the side of the head. He applied at this period to a medical man In the country, whose advice gave great consolation. He desired him to apply a bread and water poultice, and gave him to understand he would expedite the cure In a week. Both patient and doctor were deceived, how- ever. Finding no relief, and fancying Galen rather out in his prognostics, he withdrew himself altogether from the benefits of * sound chirm'glcal.' In the month of October last, he fell, and struck the part against the shaft of a waggon : considerable bleed- ing took place into the mouth. A fortnight after the receipt of the blow, the tumefaction sensibly augmented; the pain became more severe, and of greater duration, and towards the end of December, exfoliation of a small portion of bone took place, close to the bicus- pid tooth, which was followed by temporary rehef. The swelHng continued to Increase up to his admission into the Hospital, on the 4th of February last. On examination, the disease extended from the angle along the ramus of the right side, as far as the cuspldati, and thence backwards to the basis of the tongue. A concavity of about an Inch in depth, occupies the vacant alveolar process, ex- tending from the bicuspid tooth to the ramus of the mylo-hyoid