46 
ALVEOLAR PERIOSTITLS. 
that in horses. Closer examination shows that the gum has receded 
from the affected tooth, which is so loose as sometimes to be movable 
by the fingers. It is usually pushed out of line or lies deeper than 
the others. As might be expected from the direction of their wearing 
surfaces, the upper molars are generally displaced outwards, the lower 
inwards. 
In cattle, epileptiform seizures occur. In chronic cases the animal 
wastes. In the lower jaw the bone sometimes swells and fistulge form, 
indicating the position of the diseased tooth. If the interior of the 
mouth be illuminated by a mirror, changes in the teeth as well as in the 
gums may usually be very plainly seen. 
Treatment. Extraction is the only certain method of dealing with 
alveolar periostitis. This is comparatively easy in old subjects, whether 
horses or oxen, but may be more difficult in younger animals, especially 
when the crown of the tooth is broken, as not seldom happens. Several 
teeth may be simultaneously diseased, or one soon after another, and 
under such conditions the prognosis is less favourable. It may then be 
a question whether the animal, with its still remaining teeth, can chew 
sufficient food, and vegetable feeders frequently cannot do so. 
The only available cure for alveolar periostitis in the larger animals 
lies in extraction of the faulty tooth. Operating on man and small 
animals requires considerable strength, and a vastly greater degree 
is needed in herbivora, and especially in horses. The two Gunthers, 
Eobertson, and Gowing have all rendered their profession valuable 
service in constructing necessary instruments for operations on the 
teeth of horses, and laying down general principles for their use. 
Punching out the diseased tooth, as adopted in former times, is now 
employed only where the forceps cannot be used, owing to the loss of 
the ciown. "Wheie the anteiior molars of the upper jaw are diseased, 
it is still employed. The operator commences by trephining the jaw¬ 
bone as nearly opposite the root of the affected tooth as possible. The 
success of the operation depends on the choice of the proper spot. In 
the uppei jaw the landmark is the lower end of the zygomatic ridge 
of the supeiioi maxillary bone, which lies at the division between 
the thiid and fourth molars. Alterations in the diseased tooth or its 
gum may usually be detected by introducing the hand into the mouth. 
Should the tooth be displaced and loose, there need be no doubt as to 
its condition. A round punch about one half to three quarters of 
an inch thick and with a flattened end is now placed on the root of 
the diseased tooth, care being taken that the punch points in the 
general direction of the tooth itself. A few strong blows on the punch 
with a rather heavy hammer drive the tooth from its socket and it 
falls into the mouth. The pain of the operation makes the use of 
