471 



DENTITION, DISEASES OF. 



DEPARTMENT. 



473 



frbrilo attack. The feverish symptom* disappear or remit toon to 

 recur or exacerbate; and these remision and exacerbations are 

 characteristic marks of the dileaae. The colour of health is gone, and 

 the culour often change*. A Buih of the countenance, preceding 

 light rigor and paleness of face, ia luoceeded by alight headache. 

 There is a remarkable desire to pick, principally the now, sometimes 

 the lips and fingers, often other object*; frequently the breath is 

 offensive, and cough, headache, and griping pains in the bowels are 

 present, with more or leas of sickness, faintness, sighing, starting, 

 more particularly in sleep, moaning in sleep, grating the teeth, sleeping 

 with the eves half open, and a relaxed or on the contrary an exceedingly 

 constipated state of the bowels. Occasionally the pupil* suddenly 

 dilate, perhaps only one pupil, and then as suddenly contract 

 " Perspiration is part of fever, and this is sometimes observed night 

 after night succeeding to no very remarkable heat of skin, but to a 

 great drowsiness, which in itself U a proof of exacerbation, though the 

 accelerated pulse of fever may be wanting. The moaning, picking, or 

 starting, with any of these conditions, constitutes part and parcel of 

 this disorder. Sometimes the ailment is slight in degree, or it may 

 assume an acute form with all the fire and anger of a hot lev. r. 

 Sometimes it is typhoid in its type. Whatever character may be 

 assumed by this disorder, it is coincident with on irregular course of 

 the development of some organ of the body ; and commonly the irre- 

 gular development is in the nutrient organs, and of these most 

 commonly the teeth and jaws." 



Fatal disease may arise from abnormal dentition long before the 

 usual period of cutting the teeth. A turgid condition of the vessels 

 about the soft and delicate pulp, and in the membrane that envelopes 

 the whole rudimentary tooth, may compress the dental and even the 

 maxillary nerves ; and pressure on these nervous tendrils may, under 

 certain conditions, be tantamount to pressure applied directly to certain 

 parts of the brain ; hence irregularity in the course of growth, at the 

 earlier period of teething, may produce a sufficient degree of pressure 

 to excite a high degree of irritation in the brain, producing even fatal 

 convulsions. Many striking cases of this kind ore on record, of which 

 the following brief history may serve as an example : A fine healthy- 

 looking child, of a strong healthy mother, died, at thirteen weeks of 

 age, of a convulsive fit. The cause of death was ascertained, at the 

 earnest wish of the mother, by a careful examination of the body after 

 death. The internal organs, for the most part, were healthy; the 

 stomach contained only a little milk ; the mucous surfaces of the 

 intestines were free from disease ; the contents of the thorax were 

 healthy. In the head, the membranes that envelope the brain, and 

 more especially the pia mater, were more tinged with blood than 

 natural, but the brain itself was healthy. The jaws were carefully 

 examined. " The capsules of the incisor teeth were large and very 

 vascular, much more advanced than usual With a lancet, the cartila- 

 ginous rim of the lower jaw was attempted to be removed, with a view 

 of exposing the capsules of the molar teeth ; but these were so 

 unusually distended with fluid, that the instrument cut into them 

 and let it out. This was an example of development proceeding too 

 hastily." 



It is common for the symptoms of irritation which attend on the 

 evolution of the teeth to appear about the third or fourth month ; 

 they usually precede the appearance of the teeth by several weeks, and 

 they occasionally subside and then re-appear a short time before the 

 tooth makes its way through the gum. 



Disease arising from abnormal dentition is not confined to the period 

 of infancy. In children of irritable constitutions in whom the maxilla; 

 are imperfectly developed, the irruption of the second or permanent 

 teeth is sometimes attended with serious and even fatal disorders. 

 Nay, even the period of adolescence is by no means free from severe 

 disease* produced by this same cause; for in consequence of the 

 development of some of the teeth having been preternaturally delayed, 

 or in consequence of an imperfect development of the jaws, at" the 

 period when the denies sapientitc are about to appear, delicate, nervous, 

 and irritable subjects are not uufrequently affected with swelling of 

 the parotid and submaxillary glands, painful and sometimes periodical 

 affections of the ear and face, slight or recurring ophthalmia, irregular 

 convulsions, epilepsy, and chorea ; which affections have disappeared at 

 once upon the irruption of the teeth or the removal of the local 

 irritation. 



Animals are not afflicted with these or any analogous evils fr. t he 

 . volution of their teeth, and they are produced in the human species 

 altogether by the unnatural circumstances in which Iho infant is placed 

 in the present artificial state of society. The chief causes of these 

 grievous evils are : 1. Food, unnatural in quality and too great in 

 quantity. It u seldom that an infant lives solely upon its natural 

 food (human milk) during tup early months of its existence 

 take other food, th.it f.wd u either digested or it is not. If it be not 

 digested, numerous ailmenU are produced; if it be digested, the system 

 * too highly nourished, and becomes too full of blood, from which it 

 u easy to see that any one or any number of the diseases which have 

 described may result, !. The practice, too common in this 

 try, of keeping the heads of infants and young children very warm 

 by clothing, by their wearing flannel caps, and by having their heads 

 almost constantly wrapped in a warm woollen shawl, from the dread of 

 their catching cold. The naturally great determination of blood to the 



head is too much favoured by this practice, which co-operates more 

 powerfully than may at first view be apparent with the other circum- 

 stances that conspire to produce disordered dentition. 8. The < 

 nient of infants in close and heated apartments, in the impure air of 

 Urge towns and cities without exercise. Such children in whom .ill 

 the evils of dentition are most frequently produced in the severest 

 forms, are deprived of the natural stimulus afforded to the varied 

 processes of growth by pure air and active exercise. 



The treatment of the various and formidable diseases produced l>v 

 abnormal dentition can never be judiciouaty-conducted without a con- 

 stant reference to the causes on which they depend. Without a 

 proper regulation of the diet, clothing, air, exercise, and a state of the 

 bowels, nothing can be effectually done to prevent the occurrence of 

 the most formidable of these evils. When they are actually present no 

 remedy can be other than palliative which does not aim at two things : 

 first, the entire correction of everything ascertained to be faulty in the 

 i lie -I . el. -thing, ic. &c. ; secondly, the removal of pressure upon the nerves, 

 produced by the advancing and unliberated tooth, which occasions all the 

 mischief. " As soon therefore as any of the affections now described, 

 or any others which can possibly be supposed to arise from this cause, 

 make their appearance, the gums should be carefully examined, and 

 wherever there is any unusual redness or turgescence, and especially if 

 it occur over the part where the next tooth is expected to appear, the 

 including parts should be freely and effectually divided. It is not 

 sufficient that the incision should merely pass through the gum, the 

 lancet must be carried down to the rising tooth itself, and only stopped 

 when the resistance of it* point is felt against the edge of the instru- 

 ment. The form of the gum-lancet should be broad and somewhat 

 rounded, and its edge extremely sharp. The only precaution necessary 

 in its use is so to direct it in making the incision that the cord of con- 

 nection between the temporary and permanent tooth shall be carefully 

 avoided, which is readily insured by directing the edge rather towards 

 the outer part of the gum. 



" The prejudices of former times against this simple and most 

 efficacious operation are fast yielding to the frequent evidence of its 

 harmlessness and utility. It is impossible for the most prejudiced to 

 witness the effects which continually result from it without becoming 

 a convert to its use. In the midst of the most imminent danger, v. li. n 

 death has almost been anticipated as the only relief from severe and 

 hopeless suffering, this simple and trifling operation has, in innumerable 

 instances, restored the little sufferers to their parents in a state of ease 

 and safety, and in so short a space of time as would scarcely have 

 appeared credible." 



There are few cases in the management of disease which require 

 more prompt decision in the application of remedies or more judicious 

 selection of remedial agents than some of the sympathetic affect i.m.s 

 which have been now adverted to. Life will often depend on the 

 choice of the remedy which is made, and the cautious boldness with 

 which it is administered. It is not possible here to pursue the discus- 

 sion of this subject further than merely to add that the bowels should 

 be constantly kept in a somewhat loose state ; that if a slight degree 

 of diarrhoea be naturally established, nothing whatever should be done 

 to check it ; that even when the purging becomes considerable, it 

 should be only moderated, not stopped ; and that the most extreme 

 caution should be exercised in meddling with any eruptions upon 

 the skin. 



(Bell on the Teeth ; Dr. Ashburner on Dentition ; Dr. John Clarke's 

 Commentariei on the Diseases of Children ; and Copland's 1> 

 Practical Medicine in Loc.) 



I iKNUNCIATION. [DILIGENCE.] 



DEODAND (Deo dandam, given to God). This name was given to 

 whatever personal chattel occasioned the death of a man without the 

 default of another, and also to the instrument with which murder was 

 committed ; because by our ancient law these chattels were forfeited 

 to the crown, to be applied to pious uses and distributed in alms by 

 the high almoner. 



Blackstone supposes " that the custom was originally designe.1 in 

 the blind days of popery as an expiation for the souls of such as were 

 snatched away by sudden death, and for that purpose ought properly 

 to have been given to holy church, in the same manner as the apparel 

 of a stranger who was found dead was applied to purchase masses for 

 his soul." But it is perhaps more reasonable to imagine that it was a 

 civil institution intended to produce care and caution on the part of 

 the owners of cattle and goods, and tliat the subsequent application of 

 the things forfeited has been mistaken for the origin of the law itself. 

 The custom was also a part of the Mosaic Law. ( Kxod. xxi. 28.) In 

 England it prevailed from the earliest period, the custom being men- 

 tioned by Brae ton, one of the earliest writers on English law, who 

 lived in the reign of Henry HI. " Omniaqiuo inorcnt ad mortem sunt 

 deodanda," which ia Englished in the ' Termes do la Ley : 



What moves to death, or kill'cl the dead, 

 Is deodand, and forfeited. 



Deodands were abolished by stat. 9 ft 10 Viet., c. 02. (Blackst. 

 ' Cornm.,' Mr. Kerr's ed., vol. i. p. 297.) 



DEPARTMENT (or in French DEPARTEMENT), a territorial 

 division of France, introduced by the States General in the latter part of 

 the reign of Louis XVI. The departments are divided into arrondisse- 



