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532 PYORRHEA ALVEOLARIS. —

uliich ill their deposition and crvstnllization npon tlic ccnK'ntuin ol' the
root and infiltration of the more vascnkir tissnes, exert the infinen(!e
of foreign bodies and reaet as irritants.
(3) The salts in question, as disclosed by chemical analysis, are cal-
cium and sodium urates, free uric acid, and calcium phosphate.
(4) The chemical nature of these salts indicates a condition of the
bli)()d in which there is an excess of uratic salts and uric acid due to
either hicrcased formation or imperfect eliminatiou.
(5) The excess of these salts, as is well known, is regarded by gen-
eral pathologists as indicative of a faulty metabolism, and is the imme-
diate cause of a series of local disturbances to which the term gouty has
been applied, the nutritional disturbance giving rise to what is known
as the " uric acid diathesis."
(G) An attentiye study and accurate observation of the various
organs and tissues of patients suffering with jn'orrhea alveolaris have
disclosed the coexistence, in a very large proportion of them, of one or
more local expressions of this constitutional diathesis.
(7) Ivecognition of the fact that a constitutional malady presents
itself, one phase of which only has claimed the attention of the dental
practitioner, indicates that a treatment designed to be curative must
have reference not only to the local exi)ression, but especially to this
important systemic condition as well.
(8) llesults from constitutional treatment in connection with the
usual local applications in a ninnbei- of well-authenticated cases of
pyorrhea alveolaris have been so markedly satisfactory that the writer
feels fully justified in his assumptions regarding the origin of the
disease.
While the foregoing pages embody views quite consistent with an
extended experience, yet the writer fully a})preciates the fact that many
abnormal conditions closely allied in superficial characteristics to those
above recognized and described may exist without any other local
expressions indicating a uric acid dyscrasia.
The association of the class of dental diseases included under the
generic title of pyorrhea alveolaris with conditions of general mal-
nutrition has been recognized by many writers during the past hun-
dred years, but until within very recent times no systematic attempt
had been made at their classification. Dr. M. L. Khein, who has
closely studied the relations existing between general disorders and the
dental diseases, finding that many general diseases are accompanied by
the symptom pyorrhea alveolaris, and that the dental disorder persists
so long as the general disease is in activity, suggests that the diseases
known under the latter title be diyided into two classes pyorrhcd
simplex and pyorrhea complc.r.