WHEN SUPPURATING, ETC. 377 



gam substituted ; walls of tooth too thin to bear 

 gold/' 



Nov. 13. — The patient called in consequence 

 of the filling having come out, owing to a large 

 portion of the masticating surface of the tooth 

 having broken away. I thought I might now 

 venture to cut away the tooth in the direction of 

 the pulp-cavity. After removing a substance of 

 the consistency of leather, and more resembling 

 it than anything else, the outline of the pulp- 

 cavity was exposed, which was filled with a mass 

 of fawn-coloured dentine, of a consistence some- 

 what harder than horn. 



The plan of treatment adopted in this case is 

 the one I almost universally pursue, theoretically, 

 upon the following grounds. I believe a tooth, 

 in both its modes of nutrition, considerably re- 

 sembles a long bone, at least that portion between 

 its epiphyses. If by accident an oblique fracture 

 divides and cuts off the nutrient artery from such 

 a bone, its periosteal supply of blood is insuffi- 

 cient to maintain its vitality, and the bone becomes 

 necrosed ; and so, I believe, a tooth suddenly cut 

 off from the supply of blood which enters it 

 through its fangs is also liable to become necrosed, 

 and a series of troublesome abscesses to result. 

 I therefore deem it of great importance to pre- 

 serve as much of the dental pulp as possible, 

 which, I think, will render periostitis less liable 

 to occur ; for, though much of the pulp may even- 



