Page 71 - An essay on the diseasesof the jaws, and their treatment

DISEASES OF THE JAWS. 49 teeth and sockets, whicli had become so loose as to "be removed without much difficulty. Aug. 11th. Captain M. visited me to state that all the re- maining dead teeth and sockets had been removed some time pre- viously by Mr. Lawrence. His health had much improved, and his mouth was healing very rapidly. His speech, however, re- mained very defective, a misfortune principally owing to the almost total loss of motion of his under jaw. He intended in a few days to depart for Ireland, to visit his relations and friends, and to return, after some time, to submit to the necessary opera- tions to cure the adhesions of his mouth, agreeably to the advice of Mr. Lawrence, and then to supply the deficiency of his teeth by a double set of an artificial masticating apparatus. OF THE TREATMENT OF FISTULOUS ABSCESSES OF THE JAWS. A similar treatment to that which has been already recommended in cases of simple inflammation and suppuration is applicable to fis- tulous abscesses, especially if the afiection be seated in the upper jaw; for, by the removal of the injurious teeth, a convenient and sufficient outlet for the matter will be invariably obtained, and every external opening of the face will be readily closed by the requisite surgical management; and a perforation of the partition between the antrum and the nose, or any other part of the max- illaj, will not only be unnecessary,* but will always form an artificial cause of aggravation, and tend to retard the recovery of the aflfected part.f * In the advanced form of disease treated of in this section, I believe that the extraction of the affected teeth wliich are in the immediate neighbourhood of the antrum, will always afford a sufficient opening for the discharge of the matter; but in cases which might, in the course of treatment, prove exceptions, the ordinary means are to be employed to make an opening, care being taken that, at all events, it be sufficiently large. t If any portion of the bone be in a state of necrosis, attention must, of course, be directed to facilitating the separation of the sequestrum. The use of instru- ments may be required to bring away the loose portions of bone, and in some cases it will be necessary to enlarge the existing openings. E \