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DIAGNOSIS OF MOUTH AFFECTIONS. I57

Arsenical Necrosis of the Alveolar Process is indicated by a dark
purple and swollen condition of gum, with offensive purulent dis-
charge from one or more fistulous openings, or from between
the gums and the teeth. The gum becomes soft and spongy,
very sensitive, bleeds readily, and loses its connection with the
necrosed bone beneath.
Treatment.—(See Necrosis of the Jaws.)
Phosphor-Necrosis is indicated by pain in jaw, similar to odon-
talgia, at first not constant, but soon becoming severe, and ex-
tending alongside of the head, and to the shoulder, with swelling
and great tenderness near the seat of the affection, the integument
becoming red and tense, the teeth elongated and extremely pain-
ful when closed together, and also becoming loose; the gums
and mucous membrane of the cheeks swollen and livid ; at
length, suppuration ensues, with fever, rigors, etc. ; gums become
spongy, with escape of pus around necks of necrosed teeth, and
the pus fetid, and the swelling very great, especially when the
lower jaw is affected ; a dense plastic exudation encases the under
and external surface of the bone ; intense glistening redness of
the skin, as the pus approaches the surface ; at length, intense
fever, with delirium and great suffering; the throwing out of a
bony deposit of a peculiar appearance, like pumice-stone.
Treatment.— Removal of* patient from exposure to fumes of
phosphorus, and the excision of diseased portions of bone ; the
subsequent treatment being that for Necrosis of Bone.
Fracture of the Alveolar Process is indicated by a swollen, red
and painful state of gum and tissues covering maxillary bone, oc-
curring some days after the receipt of the injurv, and, if
neglected, may result in necrosis of the body of the bone.
Treatment.—Antiphlogistic lotions, to reduce the inflammation,
such as —

R. Plunibi acetatis ^]
Tinct. opii ^ss
Aquae ^ viij or x. M.
SiG.—Apply on lint.
Remove any detached portions of process, and secure loose
teeth with waxed sterilized ligatures.