656 



THE TEETH. 



the midst of the connective-tissue bundles. The shape of these nests is, as a 

 rule, oblong, corresponding to the longitudinal direction of the connective- 

 tissue bundles, or roundish, in accordance with the cross-section of bundles. 

 The scantier these nests, the milder is the inflammatory process. With high 

 magnifying powers of the microscope, we learn that the earliest stage of the 

 inflammation consists in a transformation of the connective-tissue fibers into 

 bioplasson. ( See Fig. 288.) 



According to the spindle shape of the elementary fields of the basis-sub- 

 stance, spindle-shaped bioplasson bodies have appeared, wholly identical with 

 the normal plastids within the fibrous connective tissue. All these bodies are 

 separated from each other by light rims, and connected with each other by 



the delicate threads of living 

 matter traversing those rims. 

 The finely granular, newly 

 appeared bioplasson bodies 

 soon afterward become coarse- 

 ly granular, which means that 

 the living matter therein has 

 increased in size. 



We see next that a number 

 of granules the points of in- 

 tersection of the reticulum 

 have increased in size to such 

 an extent that they resemble 

 small nuclei, and from these 

 foci new elements are formed, 

 partly shining and homogen- 

 eous, partly reticular in struc- 

 ture. After the originally solid 

 lumps of living matter have 

 split into a reticulum, many of 

 the newly formed elements 

 contain solid nuclei. All elements are uninterruptedly connected with each 

 other by delicate threads of living matter. Thus, the inflammatory infiltra- 

 tion is established at first in the shape of scattered nests, the centers of 

 which correspond to the capillary blood-vessels. In later stages almost the 

 whole amount of the connective tissue is transformed into medullary ele- 

 ments to such a degree that only scanty bundles of the original connective 

 tissue are left. The swelling of the pericementum accounts for the painfulness 

 of the process ; while the loss of the firm basis-substance and its replacement 

 by medullary elements explain the looseness of the tooth. These features 

 will also account for the peculiar sensation experienced by the patient that 

 the tooth is raised out of its socket. 



The largest accumulation of the inflammatory elements takes place in the 

 immediate neighborhood of the blood-vessels, for in the middle of many nests 

 capillaries can be traced. We readily understand that in the immediate 

 vicinity of the source of nutrition the inflammatory process must be most 

 active. This fact has been taken up as an argument by those who assert that 

 the inflammatory nests are altogether due to an emigration of colorless blood- 

 corpuscles. I am strongly opposed to this opinion, because my observations 

 show that the majority of the inflammatory elements are originally connected 



FIG. 288. INFLAMED PERICEMENTUM IN AN 

 EARLY STAGE. 



V, capillary blood-vessel, the endothelia of which 

 are coarsely granular and proliferating ; M, medullary 

 or inflammatory elements, imbedded in a finely 

 granular basis-substance; S, spindle-shaped elements. 

 Magnified 1000 diameters. 



