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ETIOLOGY OF CARIES. 743
the greater number of persons I have examined ; especially is this so if
the gums about the necks of the teeth are slightly irritated. Indeed,
I may say that from my own observations I have conclusively con-
firmed Mr. Tomes's findings as to the frequency of acidity of the fluids
of the mouth. But this does not constitute a satisfactory explanation
of the occurrence of caries. Against such a supposition the argument
of Desirabode, quoted in a note elsewhere, applies with its full force.
If we succeed in accounting for the production of decay on the chemical
hypothesis at all, we must account for the application of the acid to the
particular point where that decay manifests itself, to the exclusion of
other jmrts of the denture ; otherwise we must fail. Therefore, acidity
of the fluids of the mouth cannot be the active exciting cause of caries,
though it is possible that this condition may be indirectly instrumental
as a predisposing cause. This feature of the subject will be discussed
on another page.
There is no doubt that the writings of Mr. Tomes had a powerful
effect in drawing the thought of tlie profession away from the fermen-
tation hypothesis as an explanation of the active cause of caries of the
teeth. This, however, can hardly have delayed the full explanation of
the phenomena, for before the processes of fermentation and putrefac-
tion could become explainable a vast deal of labor in other directions
was necessary ; and this, from the very nature of the case, could best
be done by others than those actively engaged in dental practice.
This search in the fluids of the mouth for the active factor in the
production of caries did not begin, however, with Mr. Toines. Amos
^\^estcot, for the purpose of ascertaining what effect the acids supposed
to be present in the oral fluids would exert on the teeth, had already
made a series of experiments, in which he found that they were decal-
cified by very high dilutions.
These experiments were published in the third volume of the Ameri-
can Journal of Dental Science, and have been referred to by many
writers since that time. They led to a vast number of analyses of
the oral fluids in all conditions of health and disease, and almost
unlimited experimentation in decalcification of tlie teeth in varied
dilutions and compounds of the various known acids, an intimate
acquaintance with the varying conditions of the oral secretions and
the effects of acids on dentine being thus developed, but little or noth-
ing being accomplished explaining the processes of caries of the teeth,
except to demonstrate that in simple solution by acids certain of the
phenomena of caries are absent.
In the progress of this study the most diverse views have from time
to time appeared, and the formation in the fluids of the mouth of almost
every known acid, by some possible changes of molecular groupings, has
been assumed.
Some few have been satisfied with the theory of fermentation, as was
^
Goddard, who supposed acetic fermentation to be the prime factor ;
but the great majority of writers have invoked the aid of vital processes
resident in the tooth itself for the production of caries or for limiting its
effects, or for both ; and, altogether, the agency of vitality in this process
^ Goddard on the Teeth, 1854.