PATHOLOGY. 
The fame variety, in regard to time of appearance, exifts 
in the fecond dentition as in the firft. The common pe¬ 
riod is from eight or nine to thirteen years of age. 
Many cafes of three or more dentitions have been record¬ 
ed on undoubted authority. 
O. fenum. The reproduction of teeth in advanced 
age is another curious but well-authenticated fadt. In 
general the teeth which appear at this period are irregu¬ 
lar and ufelefs. John Hunter, however, faw one cafe in 
which a complete fet arofe in both jaws. Dr. Good men¬ 
tions two cafes in which a few draggling teeth were cut 
at a very late period of life; and which were further re¬ 
markable on account of the patients recovering, the one 
her hearing, the other her fight; fenfes of which they 
had been for years partially deprived. For further cafes 
in which teeth were produced very late indeed, the reader 
may confult Yfabern, Journ. de Med. tom. xxv. p. 316. 
Nitzfeh, Ephem. Erudit. Ann. 1666, p. 175. Ephem. 
Nat. Cur. Dec. 11. Ann.iii. Obf. 15. and the Phil. Tranf. 
vol. xxvii. 1713. 
2. Odontia dolorofa, acute pain in the teeth or their 
fockets. Dr. Good makes four varieties of this difeafe 5 
viz. a, cariofa ; /?, catarrhaiis ; y, nervorum ; fym- 
pathetica. 
a. It appears agreed by the mod: enlightened phyfiologifts, 
that the internal part and fang of the teeth are vafcular, 
while the enamel is an inorganic fecretion. Caries there¬ 
fore may arife from inflammation of the tooth giving rife 
to abforption of the fubltance and enamel; or the fame 
procefs may take place from chemical folvents applied 
externally. We (hould be inclined to think that the former 
caufe is the moft common. The more remote caufes of the 
inflammation of the teeth are various, and many of them 
infcrutable. Heatand cold, which are tranfmitted readily 
through the enamel, are perhaps the moft frequent. Dif- 
ordered fecretion from thefalivary glands are perhaps the 
moft ufual caufe of decompofition of the enamel; for we 
cannot fuppofe that the fubftances we fwallow, hetero¬ 
geneous as they are, can produce much effeCt in palling 
fo rapidly as they do through the mouth. It is fcarcely 
neceflary to remark that inflammation of the gums will 
generally communicate their morbid ftate to the teeth. 
By whatever means, however, as Dr. Good fays, a decay 
or caries of the teeth may be produced, it appears to ope¬ 
rate in three different ways : fometimes commencing in 
the internal cavity, and working its path outward ; fome¬ 
times out ward, and working its path within; and fometimes 
by a wafting of the enamel, and confequent denudation 
of the bony part. The firft is the leaft common affedtion, 
and is difcoverable by the appearance of the internal 
blacknefs through the external Ihell; the third is more 
common than the firft, and the fecond the moft frequent 
of the whole 5 evincing, at its commencement, the ap¬ 
pearance of an opake white fpot through the enamel, 
which gradually crumbles away about the fpot, and thus 
difcloles that part of the body of the tooth which forms 
the original feat of the difeafe, and which, by its conti¬ 
nuance, converts the early fpot into a hole, and at length 
deftroys it altogether, or at leaft down to its neck, unlefs 
the pain produced by its progrefs compel the patient to 
have it extrafted before the difeafe advances thus far. 
It is of no practical ufe to infert the various remedies 
by which the pain arifing from denudation of the nerves 
of the teeth has been attempted to be alleviated. They 
are for the moft part of that nature which, by exceflively 
ftimulating the nerve, entirely deftroys its fenlibility. 
Hence, perhaps, the moft efficacious are the ftrong mine¬ 
ral acids, carefully applied by means of a pin or probe 
to the carious furface 5 but this requires that the gum, 
&c. (hould not exhibit any marks of inflammation. 
Small degrees of caries, or (light fiffures, may be relieved 
by filing, filling up with gold, See. Of courfe, however, 
the only radical cure, where much caries is prefent, is to 
extradt the tooth ; for the mode of performing which fee 
the article Surgery. 
109 
If inflammation have not produced caries (and there 
is often violent and excruciating pain irreferrible to de¬ 
cayed teeth), lancing the gums freely, and attending to 
the fympathetic adlion whence they derived their difeafes, 
e. g. difordered gaftric or uterine fundtion, will often 
effedt the cure. The inflammation often extends over 
the whole face, and is particularly diftinguilhed by the 
exafperation of the pain which warm liquids give rife to 
when applied internally. This is moft effedlually com¬ 
bated by cooling lotions and by purges. The ill effedls of 
the ufe of the ftimulating remedies in this kind of tooth¬ 
ache is exemplified (tronglyby the following cafe, extradled 
from the London Medical Journal, vol.iii. communicated 
by Mr. Fowler, of Princes-ftreet, Hanover Square. “ A 
gentleman whom I attended, wasafflidfed wuth the tooth¬ 
ache in the firft dens ltiolaris. Being much alarmed at 
the idea of extradtion, he applied to an old woman, who 
at that time was efteemed famous for the cure of the 
tooth-ache without drawing. She had applied her nof- 
trum to the tooth twice within the fpace of three days; 
and, on the fourth, he came to me, complaining of a lore 
mouth, telling me where he had been to get relief, and 
that the liquid which had been ufed was very cauftic. 
From the appearance of the violent inflammation, which 
had taken place from the difeafed tooth to the epiglottis, 
I advifed him to confult fome medical gentleman of emi-' 
nence immediately ; with which advice, I am forry to fay, 
he did not comply. Not hearing from him on the third 
day, I called (en paflant), but he w'.as too ill to be feen ; 
a derangement of intellects had taken place. I called 
again four days afterwards, and was informed, that he 
had died raving on the preceding day. I had every rea- 
fon to believe, that the fluid which had been inferred into 
the tooth with a view of deftroying the nerve, had pro¬ 
duced this tragical end.” 
y. Difeafe of the nerves of the teeth is perhaps the moft 
troublefome fpecies of tooth-ache. The appearances it 
exhibits are anomalous ; and the complaint is fo fre¬ 
quently aflbeiated with caries of the teeth, that its pre- 
cife nature is often unknown until fome of the teeth have 
been extradled without the leaft alleviation. This affec¬ 
tion arifes from the fame caufe as other morbid affedtions 
of nerves; often from gaftric,inteftinal, or biliary, derange¬ 
ment; pregnancy, plethora, worms, &c. and is to be com¬ 
bated only by removing the caufe, anti by the ufe of re¬ 
medies having the effedl of allaying nervous irritation. 
As this affedtion feems, then, to arife from various caufes, 
it is capable of comprehending the other varieties men¬ 
tioned by Dr. Good. We (hall have occafion to fpeak 
more at large on this fubjedt when treatingof Neurotica. 
3. Odontia lluporis, or tooth-edge, has two varieties : 
a,, a ftridore ; / 3 , a acritutide. The former, which is af- 
fociated in a remarkable manner with peculiar imagina¬ 
tions, is the fenfation we feel when the edges of two 
knives are rubbed acrofs, when we cut a cork, or rub 
our coat-fleeves together. Dr. Good mentions the cu¬ 
rious circumllance, that a friend of his experienced this 
fenfation in a remarkable degree from hearing a woman 
cry bullaces for fale. It is perhaps difficult to explain 
this phenomenon. It is moft probably fomehow connec¬ 
ted with fympathetic adlion between the nerves of teeth 
and ear; unlefs we could admit the notion of Hagerup, 
that the nerves of the teeth are auditory, in which cafe 
this operation of harffi founds might readily be accounted 
for As connedled with this point, we beg the reader to 
notice the conclufion of our article Dumbness, vol. vi. 
p. 117. 
j 3 . The latter variety is produced by moft chemical 
fubftances that can denude or diflolve the enamel. It is 
felt at the edge of the teeth, perhaps on account of the 
tbinnefs of the enamel at that parr. Morbid fecretions 
ejedled from theftomach into the mouth frequently caufe 
this unpleafant fenfation. Mechanical injuries, as gnaffi- 
ing the teeth, attrite the enamel likewife ; and it is laid 
to be a fymptom in rachitis, bilious diforders, See. The 
removal 
3 
