PATHOLOGY. Ill 
under the necefiity of recommending-the ufe of a ftiffier 
brufii, and a dentifrice made of (hells, for the purpofe of 
removing the tartar. 
With refpefit to the treatment of tartareous incruftations 
of the teeth in general, it is effential to remove the 
tartar, and clean the teeth well every day. It is alfo 
needful to correft the ftate of the falivary l'ecretion. 
Perfons who are in the habit of ufing acrid tin&ures or 
powders which diffolve the enamel, and make it porous, 
are frequently troubled with tartareous incruftations. 
The caufe being avoided, the mode of treatment is the 
fame as in the preceding cafes. 
This afte&ion fometimes arrives at fuch a pitch, that 
feveral of the teeth become concreted together. See 
Eultachius de Dent. cap. 2. 
7. Odontia excrefcens. Varieties: a, fpongiofa; 0 , 
extuberans. 
a.. O. fpongiofa is taken to apply to the difeafe which 
has been i'o well defcribed by Hunter as fcurvy in the 
gums, from its identity with one of the fymptoms of fea- 
Icurvy. It is not to be concluded however that the term 
is exactly correft, or that this fymptom is always con¬ 
nected with a general fcorbutic diathefis; on the con¬ 
trary, the above-mentioned author has often feen fcurvy 
of the gums in perfons quite healthy, in patients af¬ 
flicted with fcrofula, and other complaints equally re¬ 
mote in their nature from fcurvy. The primary fymp¬ 
toms of this complaint are thole of inflammation ; viz. 
pain, rednefs, and turgefcence. The gums bleed on 
the flighted: injury ; the tendernefs is firll obfervable on 
the edges; the fmooth fkin appears denuded on the 
latter parts; and often, particularly in the interftices be¬ 
tween the teeth, there (hoot up irritable granulations. 
To this ftate ulceration and abforption fupervene : the 
former procefs is often fo extenfively prefent as to denude 
all the teeth of each jaw ; more commonly, how'ever, it 
is confined to one part, at moft to one jaw. It frequent¬ 
ly happens in this cafe that the alveolar procefs difap- 
pears by abforption, in which event there is always a 
very confiderable difcharge of matter from the infide of 
the gum and alveolar procefs, flowing out in the direc¬ 
tion of the tooth. In many of thefe cafes, we find that, 
while the gums are ulcerating in one part, they are 
fwelling and becoming fpongy in another, and hanging 
loofe upon the teeth ; and this often takes place when 
there is no-where any ulceration. At length the teeth 
become loofe, and in a few years drop out, one after the 
other, at Ihort intervals, until the perfon is rendered 
toothlefs. It is from this complaint that many perfons 
lofe their teeth at a very early period of life. Indeed 
moft individuals are more or lei's fubjeCt to it ; as the 
gums, in fome part or another, although there be no 
iymptoms of the difeafe, are likely to become preterna- 
turally red, enlarged, and tender. Therefore, whenever 
a tendency to this difeafe is obferved, great care fhould 
be taken to apply fuch means as will arreft its pro- 
grefs. 
The treatment of fcurvy of the gums confifts in freely 
lancing them when in the inflamed or fpongy ftate. The 
ufe of aftringent lotions too is after this of effential 
fervice. Thefe ftimuli to be varied according to the 
feelings of the patient. The moft common are infufion 
of roles with the tinfture of myrrh, decodiion of bark, 
folutions of alum, arquebufade-water, &c. In fome 
cafes great benefit is derived from the ufe of fea-water, 
and Mr. Fox obferves, that he always recommends it 
to be ufed warm if the gums be tender. When 
the gums are exceedingly tender, and have any ten¬ 
dency to ulceration, Mr. Fox recommends wafhing the 
mouth very frequently with barley-water fweetened with 
honey. In two or three days, if the forenefs is diminilhed, 
the lancet is to be cautioufly ufed with the diluted tinfture 
of myrrh as a walh. When this treatment fails in mak¬ 
ing the edges of the gums heal, and they hang loofely 
about the necks of the teeth, Mr. Fox obferves, that 
Vox,. XIX. No. 1291. 
much good will be derived from the ufe of a folution of 
the argentum nitratum. He fays, that, if the difeafe be 
only partial, the cauftic Ihould be applied with a camel’s- 
hair pencil dipped in the folution. This remedy is de¬ 
fcribed as communicating a new action to the gums, and 
they generally get well in a Ihort time. Indeed, when¬ 
ever the gums are very full, and difcharge a good deal of 
offenfive matter, wafhing the mouth with a folution of 
lunar cauftic is, according to Mr. Fox, a very excellent 
means of rendering the mouth fweet and comfortable. 
This remedy, when applied to the fore edges of the gums 
with a hair-pencil, may be ufed as ftrong as in the pro¬ 
portion of a dram of the argentum tf> an ounce of diftilled 
water ; but, if the mouth is to be rinfed with it, not more 
than one grain of the cauftic fhould be put to two ounces 
of water, left, by being too ftrong and getting into the 
throat, it fhould occafion an unpleafant naufea. 
Perfons, who are often troubled with inflammation of 
the gums, ought to have them fcarified whenever they 
become painful, or are more turgid than ufual. By the 
lofs of a fmall quantity of blood, the affedtion is imme¬ 
diately relieved, and kept from committing the ravages 
which have been related. In fcarifying the gums, the 
lancet fhould be applied longitudinally to thofe parts 
which are fituated between the teeth, becaufe, if the 
gums are cut where they cover the fangs, they will 
flirink in healing, and leave the hecks of the teeth ex- 
pofed. On the other hand, if the gums are lanced in the 
angles between the teeth, they will be drawn tighter in 
healing, and the teeth be eventually ftrengthened. Fox 
on the Difeafes of the Teeth. 
In addition to thefe meafures, it will often be neceffary 
to correct the ftate of the conftitution, when fcorbutic or 
fcrofulous appearances are prefent. Frequently, too, 
fecretions from the alimentary canal fhould be procured, 
for the purpofe of removing irritation extending to the 
gums, as part of that ftrudture. It is to be remarked alfo, 
that the free fcarification we have urged above fhould be 
difpenfed with in fcrofulous cafes, fince, according to 
the teftimony of Hunter, they do harm in thefe cafes. 
This author fpeaks favourably of fea-bathing, and 
rinfing the mouth with fea-water. 
The next variety, | 3 , O. extuberans, feems clofely allied 
with the firll, as a confequence ; unlefs indeed we admit 
the belief that in this the inflammation is attached to the 
bony ftrudture. However this be, the tooth affedted in 
gum-bile is generally found fw’elled, or in advanced 
cafes abforbed at its fang, while the fubftance of it re¬ 
mains found. Sometimes, on the other hand, it is 
fuppofed to originate from a difeafe in the focket, or 
jaw, which has no connexion with the tooth, and only 
affedts it fecondarily. Upon drawing fuch teeth, fays 
Mr. Hunter, they are generally found difeafed at or near 
the point, being there very rough and irregular, like ul¬ 
cerating bones. The laft kind of gum-biles may arife 
altogether from fuch a caufe, the appearance on the fang 
of the tooth being only an effedl. 
The fame furgeon has explained, that thefe abfceffes, 
whether arifing from the teeth or the fockets, always 
deftroy the alveolar proceffes on that fide where the 
matter is difcharged, on which account the tooth is ren¬ 
dered more or lefs loofe. This event may be feen in 
many Ikulls, and alfo frequently in the living fubjedf ; 
for, when the alveolar procefs is deftroyed on the outfide 
of the tooth, if the latter part be moved, the motion may 
be obferved under the gum all along the fang. When 
thefe abfceffes have burft through the gums, they often 
clofe up, and put on the appearance of being healed ; but 
fuch as difcharge themfelves between the gums and teeth 
can never heal up, becaufe the gum cannot unite to the 
tooth. At certain periods, however, the difcharge from 
them diminiflies, owing to a fubfidence of the fuppura- 
tion ; but, either expofure to cold, or fome other acci¬ 
dental caufe, occafioning a frelh inflammation, an in- 
creafe of the fuppuration is the confequence; and either 
G g the 
