108 P A T H O 
of Dr. Wilfon Philip on Indigeftion, we meet with want 
of due arrangement. The genus Limojis of the prefent 
fyftem will be made to comprehend molt of thefe difeafes, 
though perhaps the fubdivilions areimperfedt. We have 
not introduced any account of thofe various diforders 
which arife from, and are traceable to, derangement of 
thefe parts; fora dileafe cannot be much altered in its 
character by remote caufes; and hence the terms Dyf- 
peptic-FhthiJis, cum multis aliis, feems mifapplied ; not 
that we forget that complaints ariling from indigeftion 
are mod frequently curable, but becaufe we hold it in- 
difpenlible to pay particular attention to the ftate of the 
laboratory of the fyftem in every clafs of complaint. 
The clafs Cceliaca is divided into two orders and feven- 
teen genera. 
Order I. Enterica, [from the Gr. eyripov , an entrail.] 
Diforders aft'edting the Alimentary Canal. 
This Order contains twelve Genera. 
Genus I. Odontia, [from o^ou;, a tooth.] Pain or De¬ 
rangement of the Teeth in their Sockets. This genus 
embraces feven fpecies. 
i. Odontia dentitionis, difficult or painful teething, 
is further divided into four varieties: a, la&antium ; /•?, 
puerilis; y, adultorum ; fenum. 
a. O. dentitionis ladlantium is a difeafe well known,and 
of frequent occurrence. It is caufed by the tenfe ftate 
of gum covering the tooth ; or, on the other hand, by 
the too-rebxed ftate, which allows the tooth to pulh it 
up and prefs on the nerves, without producing abforp- 
tion. It feems, too, that conftitutional dilturbance has 
a great (hare, by rendering the nervous fyftem particu¬ 
larly fenfible, in encrealing the bad effeCts of dentition. 
Children of plethoric and irritable habits are pe¬ 
culiarly obnoxious to this complaint, as alfo thofe in 
whom coftivenefs is prefent. It is remarked alfo, that 
rickety children cut their teeth at advanced periods, and 
with much difficulty; and it is popularly known that 
favourable dentition is indicative of future health. 
The following are a few of the morbid fymptoms of 
difficult teething; viz. Inflammatory fwelling of the 
gums, tonfils, and parotid glands; rednefs of the eyes 
and cheeks ; vomiting, griping pains, tenefmus, profufe 
diarrhcea with green evacuations, and fometimes oblti- 
nate coftivenefs and retention of urine. Fever, accom¬ 
panied with cough and other catarrhal affeCtions, hic¬ 
cough, univerfal or partial tetanus, convulfions, &c. are 
the fymptoms by which, according to the eftimate of fe- 
veral writers, nearly a third of children are deftroyed in 
difficult dentition. 
Thefe are the common fymptoms of difficult dentition ; 
but occafionally peculiar ones arife, which not unfre- 
quently fnblide as foon as the tooth is cut; as, for in- 
ftance, gutta rofacea, (Lorry, Trait, de Morb. Cutaneis, 
1777. p. 411.) deafnefs; amaurotic blindnefs; enlarge¬ 
ment of the knees; paralyfis ; and lamenefs of one or 
both legs. (Pafch, Abhandlung aus der. Wundarzney 
von. den Zahnen, S. 25, 36.) Aphthae of the mouth ; 
an inflamed tubercle over the tooth which is about to be 
cut; fuppuration, ulceration, and even floughing of the 
gums. Rachitis is alfo alleged to have its origin fome- 
times from difficult dentition. But we ffiould rather 
fuppofe that in the laft inftance the caufe had been tnif- 
faken for the effeif. The firft fymptoms are local, and 
appear to be accompanied with pain, as the child is reft- 
lefs, uneafy, and rubs his gums, and carries every thing 
to his mouth. There are alfo generally inflammation, 
heat, and fwelling of the gums, and an increafed flow of 
faliva. A general ftate of fever follows, which is fome¬ 
times flight and fometimes violent, and is very remark¬ 
able both for its fudden rife and declenfion ; fo that in 
the firft hour of his illnefs the child ftiall be perfectly 
cool, in the Tecond fluffied and burning hot, and in 
the third temperate again. The local fymptoms which 
enfue in diftant parts, are various and complicated ; for 
LOGY. 
the appearance they put on is in fome degree determined 
by the nature of the parts which they affeCh 
It is to be recollected, that the lymptoms of irritation 
from teething have often very clofely refembled inflam¬ 
matory difeafe, efpecially of the brain, fo that practition¬ 
ers ffiould in ail cafes take particular notice of the ftate 
of the teeth. The treatment of the difeafe is of courfe 
Ample ; namely, to keep the bowels open ; in plethoric 
children to apply a few' leeches behind the ears ; when 
much irritability prevails, a narcotic of the leaft ftimu- 
lating kind, as hyofeiamus, may be given. But the moll 
advifable ftep, in addition to the above, is to divide the 
gum over the tooth. The incifton is to be made with 
the common inftrument, well known by the name of the 
gum-lancet, which is far better for the purpofe than an 
ordinary lancet, as that is apt to cut the tongue and lips, 
efpecially when the child moves about much. The 
grinding teeth require a crucial incifion : all the others a 
Ample tranfverfe cut completely through the gum. The 
wound is then to be examined with the finger, in order 
to afeertain that no tenfe fibre over the tooth continues 
undivided. In this country practitioners feldom apply 
any thing to the incifion ; but abroad, it is not uncom¬ 
mon to put to it a mixture of lemon-juice and honey. 
A premature incifion of the gum foon clofes again, and 
therefore does little fervice ; but it is improbable that 
the cicatrix, thus produced, can be any impediment 
afterw’ards to dentition, as many have imagined ; for it is 
an eftabliflied faCt, that cicatrices in general are more dif- 
pofed to ulcerate and be abforbed, than the original parts 
of the body. Mr. Hunter, indeed, informs us, that he 
performed the operation above ten times upon the fame 
teeth, where the difeafe had recurred as often, and every' 
time with the abfolute removal of the fymptoms. No 
idle apprehenfions ffiould therefore deter us from divi¬ 
ding the gum, where there is any chance of benefit 
from the proceeding. At the fame time this is not recom¬ 
mended as a prophylactic meafure, but as being proper 
only when illnefs, fufpedfed to arife from dentition, ac¬ 
tually exifts. 
The life of hard applications, as biting the root of 
marfli-mallow's, fmooth corals, boars’ tulks, See. render 
the gums callous ; but more good might, perhaps, be de¬ 
rived, if fubftances with roughifti furfaces were employed. 
The anomalies which w>e remark in regard to the back- 
wardnefs, or on the contrary unufual forwardnefs, of den¬ 
tition, do not feem worthy of notice in this place, be¬ 
caufe they are fcarcely within the reach of medical affift- 
ance : it is ufually remarked that healthy children cut 
their teeth early ; while thofe who are rickety, or other- 
wife affefted with chronic complaints, are equally late 
in performing the fame procefs. The molt common or¬ 
der of the firft teething is as follows : In the fixth or fe- 
venth month after birth, the firft or milk teeth make 
their appearance through the gums. The two middle in- 
cifores of the lower jaw are thofe which moll frequently 
firft come out; and, in the courfe of a few weeks, they 
are generally followed by the two middle incifor teeth 
of the upper jaw. At length, after fome months more, 
the lateral incifors and the canine teeth (how themfelves. 
The anterior molares, or front grinders, do not com¬ 
monly pafs through the gums until the child is a twelve- 
month old. 
( 3 . O. puerilis; and y. O. adultorum. Thefe two va¬ 
rieties may be confidered together. It feldom happens 
that much irritation is produced in thefe advanced terms 
of dentition. Occafionally, indeed, the protrufion of the 
dentes fupientia, or “ teeth of wifdom,” in adults,, is fo 
long delayed, that, the jaw having ceafed to enlarge, and 
being completely filled with the other teeth, the preflure 
of the wife teeth on the coronoid procefs when they arife 
from the upper, and on the fuperior teeth when from the 
lower, produces a trifling inconvenience; but this is 
eafily remedied by freely opening the gum, or by extract¬ 
ing thefe ufelefs teeth. 
The 
