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ATBOPHY OF THE TEETH. 13

the gums. In reply to my inquiries she could not remember
that the child had had an illness of any kind. The boy had always
been healthy and had escaped all of the infantile diseases. Being
convinced that something had occurred that would have been
noted, I asked her if the child had had any kind of an injury.
This quickly brought out the statement that the child had had a
severe burn, a scald, on the side and back, that had healed slowly
after much suppuration. Indeed, the child had been very ill with
septicemia for a month or six weeks. The time corresponded
with the marks upon the teeth.
Cases like these, but every one different in detail, could
be multiplied almost indefinitely. Scarlet fever, measles and
whooping-cough come in for a large share in producing these
marks. My observations for some time led me to believe that
scarlet fever and measles are most often to blame for the rows
of fine pits, but of late I have found so many of these following
other forms of disease that I am led to doubt the distinguishing
features of these marks. Certainly, hereditary syphilis comes
in for its full share of these cases.
On the other hand we can not say, at least I can not, that
marked teeth will result from this or that illness. If the hair
falls out or the finger nails show a groove after an illness we are
apt to find the teeth marked also. Very many of the cases that
I have noted and watched for the coming of the permanent teeth
have presented teeth without a blemish. Indeed, among all of
the cases that I have noted and watched, the marked teeth have
been the exception rather than the rule. Still, it remains true
that when I have been able to obtain a satisfactory history, the
marked teeth have coincided in time with some form of disease
that might well have interfered seriously with the nutritive proc-
esses. The history is not always easy to get, even among intel-
ligent people. I once remarked to a lady in my chair that she
had been very sick with scarlet fever when she was about two
years old. She was very sure she had not, for she had neV^er been
told of such an occurrence. AVhen I explained that accurate
knowledge of the facts was of considerable scientific value she
said she would question her mother regarding it. The next day
I received a note saying her mother 's story agreed with my sup-
position, both as to the particular disease and the date of the
illness. I have seen many of these cases, however, in which I
could find no history of the illness causing them.
As an assistance in searching for the cause that has led to
atrophy in cases coming before us. I introduce a diagrammatic