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OANOREXOUS TOOTH-PULPS AS CENTERS OF INFECTION. 289

chemosis with some proptosis followed, and slight rigors oc-
curred. Death ensued in a state of coma (Tomes).
Porre^*^^ (International Medical Congress, 1887) reported on
eleven cases of chronic pyemia proceeding from the teeth, all of
which were healed by the extraction of the teeth. In one case
he meutions the following symptoms :
The patient, male, good constitution and habits, suffered for
the last thirty years from neuralgia, besides ha^dng constantly
recurring furuncles and eruptions in various parts of the body,
which would often for months become running abscesses. He
experienced burning and itching eruptions of hands and feet,
which finally changed to stubborn ulcerations. His bowels
were either stubbornly constipated or exhaustingly loose. He
suffered from frequent rigors and febrile attacks of varying
intensity, profuse night-sweats, retention of urine, serious con-
strictions of the bowels and urethra. Lancinating pains darted
from the maxilla of right side to bowels, bladder, limbs, hands,
and feet, or to whatever part was locally affected at the time.
This latter peculiarity, together with the discovery of a little pus
exuding from the locality of the wisdom-tooth, led to a final
correct diagnosis of his case. The tooth referred to was extracted,
and a speedy and complete recovery followed.
A case of chronic pytemia following upon an alveolar abscess
has been observed by Mr. Howse. Suppuration occurred in
the inferior dental canal, and acute periostitis in the posterior
half of the lower jaw, which was denuded of its periosteum ; the
inflammation extended thence through the pterygoid fossa into
the orbit, and thence backward. Ostitis of the vault of the
skull followed, and general pyaemia, resulting in the patient's
death on the ninth day after the supervention of the acute stage.
(Tomes.)
A similar case is described by Baker.^^" Metastatic abscesses
formed in diflerent parts of the body. The patient was healed
by antiseptic treatment and filling of the root-canal. Baker
also reports on a case of fatal pyaemia proceeding from an abscess
of a second molar; Poncet^''^ on a case of osteitis which, pro-
ceeding from a carious tooth, led to a general septical infection,
and ended fatally in forty-eight hours. Fripp '" saw a case of
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