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Nachdruck verboten. 



A Preliminary Review on progressive infective Ulceration of 

 the Periodontium or alveolar dental Membrane. 



By Dencer Whittles, L. D. S. R. C. S. Engl. (Birmingham). 



Much has already been written upon this vexed condition, under 

 various titles, perhaps the more familiar one being that of Pyorrhoea 

 alveolaris or Rigg's Disease — unfortunately the term has been 

 applied to any condition in which there has been an escape of pus 

 from around the roots of teeth — this is most confusing as I believe 

 the originator of the title intended it to be used only where there 

 was wasting of the alveolar walls going on, and subsequent loss of 

 the tooth or teeth, by its bone of attachment atrophying on account 

 of the peridontium (or periodontal membrane) being destroyed. 



It is unnecessary for me to give a lengthy description of the local 

 appearances of the disease and its effects upon the immediate sur- 

 rounding muco-periosteal tissue, except to call attention to the peculiar 

 characters of the oedema, this being somewhat coriaceous and resilient 

 to touch ; its bluish purple colour — denoting a considerable amount of 

 venous congestion, and nearest to the periphery of the tooth socket — 

 complete thrombosis of the vessels produced by the proliferation and 

 disintegration of the tissues, consequent upon the infection. 



The character of the pus is peculiar, being very greasy in com- 

 parison to that found in an acute abcess, the result of the ordinary 

 pyogenic bacteria. 



Is this greasiness and its difficult separation of the granules with 

 water prior to mounting cover glass specimens for microscopical 

 examination due to fatty degeneration or might be due in my opinion 

 to the disintegration of tissue in which the lymphatics are largely 

 concerned, as from my own observations I have reason to believe that 

 there are to be seen in such cover glass specimens — cystals of 

 stearic-acid , this I intend to clear up when more cases have come 

 under my notice. 



The assigned causes of the disease are numerously vexations, and 

 in the opinion of the writer a diagnosis on the part of the dental 

 practitioner should not be given until he has quite satisfied himself, 

 that he has before him a bona-fide case of Rigg's Disease, and not 

 one where only the presence of a little calculus is sufficient to effect 



