THE TEETH. 657 



with each other by delicate threads, therefore representing a tissue. The 

 endothelia of the capillaries share in the inflammation by being transformed 

 into coarsely granular irregular bodies, which, by division, also produce new 

 medullary elements, partly nucleated, partly devoid of nuclei. By the new 

 formation of inflammatory elements from the endothelia the caliber of the 

 capillary is first considerably narrowed and afterward completely lost. An 

 exuberant growth of the endothelia will, as a rule, result in the destruction of 

 the capillaries by suppuration, and will probably give rise to formations 

 which I shall presently describe. 



In most of my specimens of inflamed pericementum I have met with a 

 singular formation. A number of medullary corpuscles coalesce into globular 

 masses, greatly varying in size, and in some instances surrounding a central 

 polyhedral space, evidently made by the compression of the former blood- 

 vessel. The globular masses are either composed of medullary elements, 

 shining, homogeneous, and split into smaller lumps of living matter, or they 

 are continuous masses of a coarsely granular bioplasson, in which varying 

 numbers of nuclei are seen. Formations of this kind are well known in in- 

 flamed periosteum and medulla of bone ; they have been termed myeloplaxes, 

 myeloid bodies, giant cells, etc. 



My specimens plainly show that in the so-called plastic inflammation of 

 the pericementum all inflammatory corpuscles remain connected with each 

 other, and thus represent a medullary, embryonal, or indifferent tissue. In 

 slight degrees of inflammation the morbid process may yield to what has 

 been termed " the resolution of inflammation." Nothing is required but the 

 re-formation of the basis-substance, and the normal condition is reestablished. 

 More severe forms of plastic pericementitis, or repeated recurrences of the 

 inflammatory process, will result in a new formation of the connective tissue, 

 the so-called hyperplasia. 



Higher degrees of plastic pericementitis are invariably accompanied by 

 inflammation of the gum, the cementum, and the bony alveolus. 



Inflammation of the gum (ulitis, gingivitis) in its mildest form is marked 

 clinically by the so-called oadema. Higher degrees of ulitis manifest them- 

 selves in essentially the same manner as pericementitis, viz. : first, the forma- 

 tion of scattered, afterward confluent, nests of inflammatory corpuscles. The 

 origin of these nests from the connective-tissue bundles of the gum is exactly 

 the same as in the pericementum. 



Cementitis is shown under the microscope by the presence of bay-like 

 excavations on the periphery of the cementum, and sometimes also beneath 

 the surface. These excavations are filled with medullary or multinuclear 

 bodies. To their presence is due the peculiar corroded appearance of the 

 cementum on teeth extracted during an attack of pericementitis. 



Osteitis on the bone of the alveolus is manifested by a dissolution of the 

 basis-substance of the bony tissue, either in the shape of bay-like excava- 

 tions corresponding to the territories of the bone-tissue, or in irregular fields 

 filled with medullary elements penetrating from the surface into the depth of 

 the bone. This process is invariably combined with osteomyelitis, and the 

 result of both processes is the transformation of the hard, bony tissue into a 

 soft medullary or inflammatory tissue. In some. of my specimens of osteitis 

 this change is exhibited to a very high degree, so that only small islands of 

 bony tissue are left as remnants of the former wall of the alveolus. 



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