Page 535 - My FlipBook

GOUTY PERICEMENTITIS. 533

Under the head pi/orr/ica simplex are inchided all of those varie-
ties and cases in which local therapeutic measures suffice to effect
a cure.'
Pyorrhea complex covers those cases and varieties
in which local
therapeusis fails to subdue the dental disease, and which are associated
with some perversion of general nutrition. This class is subdivided
intofourgroups : (o) Those due to nutritional disorders such as gout,
diabetes, chronic rheumatism, nephritis, scurvy, chlorosis, anemia,
leukemia, pregnancv
; {b) Tiiose occurring during attacks of acute infec-
tive diseases, as typhoid fever, tuberculosis, malaria, acute rheumatism,
pleurisy, pericarditis, syphilis; (e) Those due to nervous disorders,
cerebral diseases, spinal diseases, neurasthenia, hysteria
; ((/) Con-
ditions resulting from the action of toxic drugs—mercury, lead,
iodids.
Dr. Rhcin believes from his studies that each member of the group
of pyorrhea complex has a distinctive clinical expression, which might
be utilized as diagnostic signs of the constitutional conditions.
One who is familiar with oral abnormalities and able to diiferentiate
them must be very liberal in the interpretation of causes in order to
embrace the wide range of pathological conditions which, in some stages
of development, present appearances that would or could very properlv
be termed pyorrhea alveolaris, yet whose very ready response to t()i)ical
remedies would naturally suggest that they were not associated with a
uric acid hal)it. While fully recognizing the fact that this uric acid
dyscrasia can be associated Avith almost any disease which is a concomi-
tant of malnutrition, we must remember and fully appreciate the fact
that imperfect assimilation of food and faulty metabolism are often
responsible for local abnormalities, and at the same time they mav be
factors in the establishment of a uric acid dyscrasia.
In one's judgment of the soundness or unsoundness of theories or
hypotheses, the fact must not be overlooked that aifections of the kid-
neys, the liver, the lungs, the heart, the mucous membrane, the stomach,
etc. may exist without any other recognized expression, or we may have
irritation of the pericemental membrane alone associated with any one
of them, the disturbance of the normality of this tissue being severe or
slight as the functional or organic abnormality of the organ is exalted
or inconspicuous.
While in the previous pages the treatment advocated had reference
mainly to that form of pyorrhea the concomitant of the gouty diathesis,
it must nevertheless be borne in mind that a similar condition of the
])ericemental membrane is at tiines associated with other perversions of
the general nutrition, as pointed out by Dr. M. I^. Rhcin, and wliich
' Venial Cosmos, 1894, p. 780.