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358 world's history and

surrounding nations, and was used originally, it is said, as a medica-
ment to prevent decay of the teeth. This it surely does, but it
brings also many far worse evils. The quid of betel, which is
chewed as a quid of tobacco would be, is made up of several in-
gredients. First a leaf of the betel-pepper,* which is spread
over with prepared lime and rolled up, similar in shape to a cigar-
ette, then a piece of the areca nutf , to which is added a pinch of
tobacco, which is rubbed along over the teeth and then lodged
dexterously either under the upper or lower teeth, causing a
peculiarly bulging deformity of the mouth. There is a profuse
flow of saliva, which is the color of blood, the lips are red and
cracked, the teeth black, and the appearance of the mouth very
disgusting to those unaccustomed to the sight. The habit is in-
dulged in by both men and women, beginning when only chil-
dren of five or six years of age, and is continued incessantly
through life. One lady told me that she used about sixty quids
a day. Its use is so general as to have become a matter of eti-
quette, it being considered an insult not to offer it to a guest, nor
to accept it when offered. Persons of rank never go out without
having a well-stored box of betel carried along by a servant.
" From the constant use of quicklime (which is dyed with
tumeric, giving it a vermilion color), the oral cavity becomes
excessively thickened and tough. For this reason plates once
fitted seldom give any trouble, and there is nothing of the story
of tender mouths to contend with. In enumerating the various
conditions presented in the mouths of those who use betel, I
would mention first the shrinking of the gums, with a deposit of
hard lime along the roots of the teeth. This gradually increases,
bringing on inflammation and excessive suppuration of the gums,
with destruction of the sockets of the teeth. This condition
favors the most aggravated form of alveolar abscess, with all its
ill effects on the constitution. The most severe pain is often
experienced by the patients, which prevents them from using the
teeth in any way. The all-important betel is, in such cases,
pounded in a mortar until quite soft, and then held in the mouth
with the hope of relieving the offensiveness of the breath. After
a variable lerigth of time the inflamed gums subside, leaving the
teeth sticking only by the end of the roots. Then also, the con-
stant habit of chewing betel, or at least holding the huge quid on

* Serileaf Piper betel (L.).
t Betel nut—Areca Catechu L.