112 
PATHOLOGY. 
the old orifice in the gum becomes opened again, or the 
difcharge by the fide of the tooth is augmented. In the 
latter cafe, Mr. Hunter believes, that the affeCtion is lefs 
fevere than in the former, in which frefh ulceration is 
required for the paflage of the matter. Thus a gum-bile 
goes on for years, healing and opening alternately ; the 
effeCt of which is, that the alveolar procefi'es are at length 
abforbed, and the tooth gets loofer and loofer, till it 
either drops out, or is extracted. Mod probably, in all 
fuch cafes, fays Mr. Hunter, the communication between 
the cavity of the tooth and the jaw is cut off; yet it keeps 
in part its lateral attachments, efpecially when the gum 
grafps the tooth ; but thefe attachments are lefs when the 
matter paffes between the gum and the tooth ; though 
fome of them are ftill retained, particularly on the fide 
oppofite to the paflage for the matter. 
With regard to the fymptoms of gum-biles, thofe which 
open through the gum may be diftinguiihed by a fmall 
riling between the arch of the gum and the attachment 
of the lip. Upon prelfing the gum at the fide of this 
point, fome matter will commonly be obferved oozing 
out at the eminence. This eminence feldom fubfides 
entirely ; for even when there is no difcharge, and the 
opening is healed over, a fmall rifing may itill be per¬ 
ceived, which Ihows that the gum-bile has been there. 
Such gum-biles as difcharge themfelves between the 
gum and the tooth are always difcovered by prefling the 
gum, whereby the matter is forced out, and is feen lying 
in the angle between the gum and the tooth. 
A fungus will fometimes Ihoot out of the orifice of a 
gum-bile, in confequence of a luxuriant difpofition to 
form granulations on the infide of the abfcefs, and the 
opening being backward to heal. In this cafe, the tooth 
aCls as an extraneous body ; and, by the fecretion of 
matter, the abfcefs is prevented from healing. There is 
no difference in the treatment of gum-biles, whether they 
arife from a difeafed tooth, or a difeafe in the locket. 
When an abfcefs forms round the root of a tooth, the 
tooth, by lofing its connexion with the other parts, lofes 
every power of union, as it is not endowed with the power 
of granulating. Hence it becomes an extraneous body, 
or at leaft aCts here as one, and that of the worft kind, 
which, fays Mr. Hunter, it is not in the power of any 
operation in the machine to get rid of. In this cafe, 
therefore, the only cure is by the extraction of the tooth ; 
and, as this is the laft refource, Mr. Hunter obferves, that 
every thing fliould be done to make the parts as eafy 
under the difeafe as polfible, fo that this operation may 
be poftponed. 
When the abfcefs has burft through the gum, Mr. 
Hunter advifes us to keep the opening from doling, with 
a view of preventing future gatherings. He recommends 
enlarging the opening, and keeping it enlarged till all 
the infide of the abfcels is Ikinned over, or the aperture 
in the gum lofes the difpofition to dlofe up. This will 
in a great meafure prevent any future formation of mat¬ 
ter, or at lead whatever is formed will find a ready out¬ 
let, fo that no accumulation can happen. The end of 
the fang, indeed, will be expofed ; but, under fuch cir- 
cumftances, it will not be in a worfe fituation than when 
foaked in matter. Mr. Hunter next remarks, that one 
method of doing this is to open the gum-biles by a cru¬ 
cial incifion the full width of the abfcefs, and fill it with 
lint, which fliould be dipped in lime-water, or a diluted 
folution of lunar cauftic, made by diflolving one drachm 
of the cauftic in two ounces of diftilled water; and the 
wound fliould be dreffed very frequently, as it is with 
difficulty that the drefling can be kept in. If this is not 
fufficient to keep the wound open, it may be touched 
with the lunar cauftic, fo as to produce a flougli ; and 
the application may be repeated, if found necefl'ary. 
Some difficulty is experienced in keeping on the dreflings ; 
but conftant attention will make up for the inconvenience 
of fituation. Mr. Hunter alfo fpeaks in favour of touch¬ 
ing the furface of the abfcefs with the lapis fepticus, and 
keeping the lip from coming into contaCf with the part 
for one minute, within which fpace of time the cauftic 
will penetrate to the bottom. The furface of the bile 
fliould be wiped as dry as poflible, that the cauftic may 
not do mifchief by fpreading. 
It has been a practice to extract the tooth, then file off' 
any difeafed part of it, and immediately replace it. This 
method has often failed, in confequence of the tooth 
being introduced into a difeafed jaw ; but occafionally it 
has fucceeded. 
When a gum-bile is formed on a back-tooth, the 
treatment, according to Mr. Hunter, need not be fo 
nice as when the abfcefs is fituated upon any of the fore¬ 
teeth, becaufe appearances are then of lefs confequence. 
Therefore the gum may be flit down upon the fang 
through its whole length, from the opening of the gum- 
bile to its edge; which proceeding will preventany future 
union, while the healing of all the cavity of the abfcefs 
will prevent any future collection of matter. The wound 
afterwards refembles the liare-lip. Hence this practice 
is not advifable when the place of the cut would be much 
in view, as when the abfcefs is fituated upon any of the 
fore-teeth. In thefe cafes, when the granulations pro¬ 
trude from the fmall opening, a cure may be effected in 
the manner above mentioned, or the granulations may 
be cut off with a knife or lancet. However, in general, 
a permanent cure cannot be thus effected, and the gra¬ 
nulations rife up again. 
In confequence of bad teeth, excrefcences alfo arife 
from the gum, near or in contaCt with the teeth which 
are difeafed. In general, fuch growths may be eafily re¬ 
moved with a knife, or any other cutting inftrument 
which may be found moft convenient. They will often 
rife, in a day or two after the operation, as high as ever; 
but this newly-generated matter generally foon dies, and 
the difeafe terminates well. They frequently have fo 
much of a cancerous appearance as to deter furgeons 
from meddling with them ; but Mr. Hunter believed, 
that, when they arife at once from the gum, and appear 
to be the'only difeafed part, they have no malignant dif¬ 
pofition. However, this great furgeon had feen them 
with very broad bafes when the whole could not be re¬ 
moved, and yet no bad confequences refulted from the 
partial removal of them. In a few years they often rife 
again, by which means a great deal of trouble is occa- 
fioned. The writer of this article has feen a cafe of this 
nature, in which the extent and rapid growth of the 
fungus rendered excifion impracticable, very fuccefsfully 
removed by tearing out, and the life of cauftic. 
The few remarks we have made on the fubjeCt of dif- 
eafes of the teeth and gums, clearly indicate the regula¬ 
tions which fliould be adopted for the prefervation of 
thefe beautiful ltruCtures; viz. by abolifhing the ufe of 
all dentifrice capable either of mechanically detriting, 
or chemically diflolving, the enamel, qs well as of all ali¬ 
mentary fubftances which have the fame effeCts; but at 
the fame time of diligently removing, at leaft once a-day, 
all fordes from the mouth. Perhaps nothing conduces 
to the fame purpofe more than healthy action of the fto- 
mach ; for the vifcid ftate of the falivary fecretions are 
well known when that organ is deranged ; and we may 
further remark, that fine teeth are moft ufually obferv- 
able in thofe who are free from gaftric difturbance; and 
that few animals are fubjeCt to decayed teeth in an equal 
proportion to our own race. As a popular notion is pre-, 
valent, that the ufe of fugar is prejudicial to the teeth, 
it is proper in this place to contradict it as far as regards 
the circumftance of its diflolving the enamel ; for general 
de Beaufort ate every day for forty years a pound of fu¬ 
gar, and lived to the age of feventy. After death, his 
vifcera were found free from difeafe, and his teeth found. 
(Anecdotes de Medecine, tom. ii. p. 35.) Plenck put a 
healthy tooth into fome fyrup diluted with water, and 
kept it there two months, at the end of which time it 
was taken out, and found to have undergone no change. 
(DoCtrina 
