Page 78 - An essay on the diseasesof the jaws, and their treatment

56 AN ESSAY ON THE At all events, the temporary delay of such an operation in a chronic malady can be productive of no disadvantage, while a proper dental treatment must tend to improve the healthy action of the mouth, and thus insure a greater degree of success, should the amputation still be deemed necessary; besides, a premature or hasty performance of the operation will frequently lead to a treat- ment that may not only frustrate the cure, but unnecessarily endanger the health or life of the patient. Indeed, the relief afforded to the affected parts by the re- moval of the teeth, although not actually suffering from caries, as well as the healthy stimulus thereby excited, is not sufficiently ap- preciated, and the manner in which it tends to promote the pro- cess of exfoliation and absorption is practically far more impor- tant than has hitherto been conceived ; and I feel warranted by considerable observation and experience in asserting that in almost every case where a recovery can be reasonably expected, after a complete or partial amputation of the jaw, it will be more certainly and better obtained by the above treatment. Under a conviction of its efficacy, I feel it my duty to urge that the formidable operation of amputating the jaw should not be undertaken until a fair trial of this milder system of treatment has by amputation. Even when performed very early, and very completely, there is absolutely no advantage to be expected from excision ; and it is never now at- tempted to make these cases the subjects of amputation. But in these, as in the milder forms of the disease, dental treatment is not only admissible, but affords the only means that hold out any prospect of cure, imless indeed the disease has proceeded to its latter stages, when owing to the displacement and destruction of parts, dental treatment can hardly be brought to bear, and in that case, if the affection be of a non-malignant character, excision may still be had recourse to. Thus the distinction made between the benign and malignant forms of these dis- eases, is one that does not at all influence the curative treatment, but is only of importance in distinguishing those cases that are suited to the idtima ratio of sur- gery from those that are not. But every advanced case of disease has had its early stages, and if in these it was curable, its unarrested progress must be attributed to mismanagement. The patients who come under the hands of the operating surgeon have, with few ex- ceptions, been previously under treatment by the general practitioner. It is he who is entrusted with the care of diseases in tlieir most manageable stages and ; wl»o, tlicrefore, has the greatest opportunities of applying curative measures. To the general practitioner, then, I would more particularly recommend the ap- plication of the principles of this essay. J