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292 DENTAL PERIOSTITIS.

Indeed, so circumscribed is this affection often
found, that the periosteum on one side of a root, will
pass through all the successive stages of inflammation
to suppuration and destruction, without that upon the
opposite side having undergone anything more than a

slight irritation, if even that. In such cases the
vitality has sufficient power to hold the disease at
bay, and confine it to the immediate point of attack.
When there is a systemic predisposition, the local
exciting causes will sooner and more vigorously at-
tack. Always when the pulp of a tooth is devitalized,
the periosteum is more liable to disease, and perhaps
for several reasons. In almost all cases there are
irritants at hand, that did not exist before ; and the
periosteum is either enfeebled, and consequently less
resistant, or the demand upon its function greater
than before, in view of its being the medium of
connection, between the normally vital tissue and

that which is devitalized, or at best, its life very
much impaired, and when the latter condition exists,
the nourishment received by the cementum and den-
tine is wholly through the periosteum. In these facts
doubtless are to be found the cause of the greater
susceptibility of the dental periosteum to disease, after,
than before the death of the pulp.
The exciting causes of this affection are to be found
in the acrid debris of the dead and decaying pulps of