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DIAGNOSIS OF MOUTH AFFECTION'S. 1C9

length, held in their cavities by a tough, ligamentous attachment,
due to the degenerative change occurring in the peridental mem-
brane.
A simple form of this disease may manifest itself at the margin
of the gum, indicating its presence by a congested appearance,
beneath which may be found a granule of calcified material.
While in many cases there is general congestion of the affected
gum, and a proneness to hemorrhage, in other cases the gum may
present an anaemic appearance — pale and bloodless. This dis-
ease may also be associated with syphilis, mercurial salivation and
scurvy. The deposit of salivary calculus or other calcified sub-
stance is supposed to be secondary to the disease, as a deep-red
and denuded gum tissue about the necks of the teeth may be
present without any deposit.
Dr. Charles B. Atkinson describes this affection as follows :
" Perhaps the earliest condition presented to us is a tumefaction
of the margin of the gum—from pearly-red and light lilac to
purplish-blue in tint—sometimes puffing to such an extent as to
be easily confounded with an alveolar abscess. The tumefied
gum bleeds readily on brushing. A probe passed carefully under
the gum will disclose a pocket embracing more or less the cir-
cumference of the root, in some places nearly or quite to its
apical end. Sometimes the gum will be found receded, perhaps
on one side only. A purulent discharge more or less marked,
may be demonstrated by pressure of the finger over the root,
from its end towards the crown of the tooth. A further demon-
stration of the pressure of pus may be secured by injection,
about the necks of the teeth, of peroxide of hydrogen. A gen-
eral hypertrophy of the oral tissues mav be noticed. Suppura-
tion, perhaps preceding, perhaps following, a solution of the
dental ligament, which permits the pocket to be formed, and is
the antecedent usually responsible for the loosening of the teeth.
This loosening may, however, be present as a result of inflamma-
tion before suppuration has succeeded. The loosening mav be
attended with recession of the gum or not, and with or without
pain. Locallv, aside from the gingival congestions already
noticed, the teeth may be found elongated, the breath fetid, tartar