Page 76 - An essay on the diseasesof the jaws, and their treatment

54 AN ESSAY ON THE it, or until the general healthy action of the mouth, and the whole system shall have been to a certain degree restored, after which it may be extirpated by the most convenient surgical means. In the Essay on Exostosis, contained in that wy valuable and practical work, entitled, " Surgical Essays," by Sir A. Cooper, sides of the teeth, and half an inch deep. The whole mouth was in a state of great inflammation, especially the diseased parts, and excessively painful, even to the slightest pressure of the tongue, and his breath was excessively offensive. The fungous excrescences in many parts extended beyond the chewing sur- faces of the teeth, and hence any attempt to close them occasioned agonising pain, in consequence of which the sufferer was totally unable to take any solid food. The patient was still in possession of nearly all his teeth, and with the exception of one or two of them, they were all, as far as I could ascertain, sound and firm in their sockets ; but my experience having taught me that such a state of the mouth generally arises from a diseased condition of the roots of the teeth or their sockets, and other osseous structure of the jaws, I gave it as my opinion that the removal of the diseased mass alone would be the far more painful operation, and still be productive of only temporary relief; and as the condition of the patient permitted of no delay or doubtful treatment, I proposed, in preference, to com- mence by emancipating the diseased mouth from the immediate cause of irritation, namely, aU the teeth, and afterwards to remove the excrescences. " Mr. Lawrence and Mr. Dickenson perfectly agreed with my views, and the patient himself earnestly requested that the most speedy remedy should be adopted, at the same time urging the immediate performance of the operation. By the assistance of some of his family he was placed in a chair, and in the course of ten or fifteen minutes I removed twenty-nine teeth, the extraction of which he bore with the most extraordinary fortitude. Being replaced in bed, he stated that he already felt somewhat relieved from his sufferings. It may be necessary here to remark, that such an operation must be performed with the greatest care and judgment, as it is not improbable that, in the ordinary mode of removing teeth, the strength of the patient would have failed, and he could not have borne the extraction of so many. On inspecting the teeth I found, as I had anticipated, that many of them were diseased, some affected with caries, some with denudation of the periosteum and sockets, and some with exostosis in va- rious stages. "Eleven days afterwards I removed all the fungous growths with strong scissors of different forms, and having requested to be informed of the progress of the case, and receiving repeated information that the patient was rapidly im- proving in health, I did not deem it necessary to see him again. " Nearly two years afterwards I visited Ealing, and calling at the house of my patient, I was introduced to a robust, tall, healthy-looking old gentleman, whom I certainly should not have recognised as my patient. His mouth I found to be in a perfectly healthy state. He could masticate well, and articulated with so little imperfection, that his loss of teeth would not have been noticed. He has long been able to resume his public duties as parish-clerk. He stated that since the operation he had been free from any attack of the gout requiring medical attendance; he had not suffered from the annoying pain of ear-ache, and his hearing was perfectly restored ; and such was the excellent state of his health, that though he had reached the age of sixty-two, he confidently expressed his conviction that he should ' get rid' of the gout altogether."