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DIAGNOSIS OF MOUTH AFFECTIONS. 151

quently septicemia, or pyemia and death may ensue. If not ar-
rested, a suppurative condition, alveolar abscess, ensues. A
modification of the symptoms just enumerated, the tooth being
tender to pressure, more or less raised in its cavity, and sur-
rounded by a reddened and swollen gum, with a varying amount
of pain, and the discharge of pus from around the neck of tooth,
or from a fistulous opening in the gum, and such symptoms con-
tinuing for a long time, indicate the chronic form of an ad-
vanced state of periodontitis, which often results from systemic
influences. The common cause of severe cases of pericementitis
is the entrance of pyogenic organisms from the pulp-canals of
teeth into the tissues of the apical space and into the lymphatics.
Treatment.—Remove all irritants; apply counter-irritants, such
as equal parts of tinct. iodine, tinct. aconite, tincture of canabis
indica, and compound tincture of benzoin ; or cantharidal collo-
dion; or iodine and creasote, or carbolic acid; or capsicum in
form of tincture, or in srnall bags of the powder to surface of
gum over root of affected tooth. Depletion by the lancet,
leeches or cups. Hypodermic injection of morphine, or tinct.
of opium. Application of spray of rhigolene or absolute ether
until gum is blanched. To relieve pain, a solution of equal
parts of tinct. aconite, tinct. of opium, and chloroform ; or lead
water and tinct. opium. Disinfecting the root canals, after the
removal of a decomposed or dead pulp, by means of disinfectants
and antiseptics, viz. : peroxide of hydrogen, or pyrozone, in
three, or five per cent, solutions or fifty per cent, solution of
peroxide of sodium, used alternately ; also, by the cataphoric
current with solutions possessing the requisite conductivity, such
as a saturated solution of iodide of potassium to which is added
about one fifth its quantity of a mixture of equal parts of the
tinctures of iodine and aconite. Constitutional treatment : Saline
cathartics ; bromide of potassium, gr, xxv, combined with gtt. v
of tinct. veratrum, every four hours ; or bromide of potassium
alone, in doses of gr. xxv or xxx ; or hot water applications to
face and neck, and calcium sulphide in yV gr. pill until eight have
been taken in two hours, then one every half-hour for two hours;
or, drachm doses of fluid extract of gelsemium, minims x, water