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Diseases of the Teeth. 67 ;
occasion the separation of the membrane—the loss of the me-
dium of organic communication between the tooth and the
general system—the whole tooth loses its vitality at once, and
becomes an extraneous body in the socket; under which cir-
cumstances, it indeed gradually assumes a darkened color,
but without any of those appearances which characterize the
disease in question.
" Still however, the true proximate cause of denta! gangrene
is inflammation; and the following appears to me to be the
manner in which it takes place : when from cold or from any
other cause, a tooth becomes inflamed, the part which suffers
the most severely is unable, from its possessing comparatively
but a small degree of vital power, to recover from the effects of
inflammation, and mortification of that part is the consequence.
That the bony structure of the teeth is liable to inflammation,
appears not only from the identity of the symptoms which take
place in them when exposed to causes likely to produce it,
with those which are observed in the other bones when inflam-
ed, but more conclusively still from the fact already mentioned,
that teeth are occasionally found, in which distinct patches,
injected with red particles of blood, have been produced by this
cause, after the continuance of severe pain. A tooth which
has been the subject of inflammation, will often remain with-
out any diseased appearance for weeks or months afterwards
but at length the consequence which I have described becomes
obvious, by the occurrence of a darkened spot which shows
itself through the enamel; and the gradual destruction of the
tooth follows, if means be not taken to arrest its progress."
Mr. Bell goes on, and gives as his opinion, that caries of the
teeth, is always produced by inflammation; and that it inva-
riably commences immediately under the enamel; which he
argues is the more probable, as this part of a tooth is furthest
from the internal membrane, and in consequence of it posses-
sing less vitality, has less power of resisting inflammatory
action.
The causes of caries, he devides into predisposing, remote