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170 DENTAL MEDICINE.

freely present (although many cases progress to disaster with no
appreciable deposit of tartar), pus sometimes oozing from the
sockets, putrid taste in the mouth, tenderness of the teeth, already
noted, and many times considerable irregularities, the natural re-
sult of the loosening of the teeth. Observation may disclose
such systemic conditions as stomach dyspepsia, catarrh (as nasal
catarrh or other mucous surface debility), constipation, phthisis,
adenoid growths, general congestion due to intemperance, kidney
disease, rheumatism, cold feet and other extremities, indicating
poor circulation and mal-assimilation. Dr. Rhein has truly said
that incurable systemic disorders make only palliation of pyor-
rhoea disorders.
Causes.— Dr. Rehwinkel, who first suggested the name
" pyorrhoea alveolaris," ascribed this disease to constitutional
and hereditary causes ; Dr. G. C. Davis to low vitalitv and
feeble vascularity ; Drs. Witzel, Arkovey, and Black, that it is a
specific infectious disease ; Dr. L. C. Ingersol attributed it to
sanguinary calculus; Dr. A. O. Rawls to mercurial taint, and
the effects of chloride of sodium ; Dr. Talbot to perverted con-
ditions of secretions, low vitality and sanguinary calculus ; Dr.
J. D. Patterson to catarrh ; Prof. C. N. Peirce to its being a
manifestation of the gouty diathesis, having found uric acid and its
salts at the apical ends of roots. Dr. W. X. Sudduth opposes the
uric acid theory of Prof. Peirce, as also does Dr. Younger, who
believes it to be of local origin, and due to diseased activity of
the pericementum, caused by disturbed nutrition or local irrita-
tion : the late Dr. fionwill agreed with Dr. Younger.
Treatment.—The first and one of the most important indica-
tions is to sterilize the mouth so that pathogenic organisms will
not find access into the deep parts during the subsequent opera-
tions ; then to remove all deposits from the roots of the teeth, and all
necrosed bone from the margins of the alveolar processes. This
can be accomplished with what are known as Riggs' instruments.
An acquired and acute sense of touch is necessary to determine
the thoroughness of the cleansing operation. The pockets formed
in the gum may then be sterilized by syringing with a three per
cent, solution of pyrozone, or with iodoform and eucalyptus,