Dentium dolor. Cels. VI. 9. Mal gia as he terms it) is arranged as a species of rheumatism after Hoffinan. In the fourth and succeeding editions it is raised to the rank of a distinct genus, and placed (xxii) between arthrodynia and podagra. The Anglo-Saxon name for this affection was toth-eçe. "There may possibly be other varieties than are here offered, Every tooth has an internal cavity, which commences at the point of its fang, and enlarges as it ascends into its body. This cavity is not cellular, but smooth in its surface; it contains no marrow, but appears to be filled with blood-vessels, which are doubtless accompanied with nerves, which must necessarily be derived from the second and third branches of the fifth pair, though they have never been distinctly traced, In the interior of this cavity the teeth ap-. pear to be peculiarly sensible, and hence direct or indirect exposure to the external air, or, in other words, a carious aperture, or a current of sharp air without such aperture, (for the air seems, in many instances, to act through the substance of a sound tooth), will be sufficient to produce acute pain, and is, in fact, the common cause of tooth-ach: on which account, the readiest modes of cure consist in stopping up the aperture with metal or some other substance, defeuding the tooth from the access of cold, or destroying the nerve by caustics or cauteries through the aperture itself. Perhaps the pain called scorbutic may be regarded as an example of the sympathetic variety; that from gout is for the most part a real transfer of action, the organ previously affected being generally at ease, or nearly so, during its continuation, "For the caries of perfect teeth it is not easy to account. Out of the body they are indestructible, excepting by very powerful chemical agents; and yet, in the judgment of many physiologists, they are nearly in the same state in the body as out of it, being extraneous substances formed complete at first, without vascularity, growth, or internal action, and even destitute of absorbents. Such, at least, was the opinion of Mr, J. Hunter when composing his Natural History of the Human Teeth,' an opinion drawn from the impossibility of injecting them, the perfection in which they are produced at first, and their retaining their natural colour after so long a use of madder as a food, that all the other bones of the body have become thoroughly tinged with it. 'But they have most certainly,' says he, a living principle, by which means they make part of the body, and are capable of uniting with any part of a living body; and it is to be observed, that affections of the whole body have less influence upon the teeth than upon any other part of the body. Thus in children affected with the rickets, the teeth grow equally well as in health, though all the other bones are much affected; and hence, their teeth being of a larger size in proportion to the other parts, their mouths are protuberant.' Admitting the soundness of these experiments, and the accuracy ith 2 of Mal de dents. F.. a Cariosa. of this reasoning, it seems impossible that the teeth, when once perfectly produced in the gums, should ever decay: for no action of the living principle can occasion a secretion of those chemical agents which would alone, in such case, be capable of destroying them. It is probable, therefore, that this reasoring is erroneous, and that the teeth are vascular, though the art of injection is incapable of tracing the vascular structure, and the colouring particles of madderroot are not sufficiently attenuate to enter their vessels. Mr. Hunter himself, indeed, appears to speak with some degree of hesitation in the treatise before us; and, in his subsequent treatise On the Diseases of Teeth,' offers observations that seem to show he had at that time embraced a different opinion. In the first essay, indeed, he allows that the fangs of teeth are liable to swellings, seemingly of the spina ventosa kind, like other bones;' but he immediately adds, that there may be a deception here, for the swelling may be an original formation.' Yet, in the second essay, he treats of this swelling as one of the diseases to which the teeth are perpetually liable he regards the teeth as subject to the common inflammation of other bones, and, like other bones, evincing at times great sensibility through the entire substance of the organ, as well as in the central cavity itself. Nor is it quite certain that the body of á tooth does not occasionally enlarge as well as its fangs; for nothing is more common than for the space produced by extracting one of the grinders of a healthy adult to be filled up by an approximation of the two adjoining teeth. Mr. Hunter, indeed, endeavours to account for this, by supposing that each of these teeth has been pressed into the vacancy by the teeth behind them, in consequence of their want of a proper support in this direction; but, in such case, there must be some vacuity discoverable between themselves and the teeth which have thus urged them forward. In various cases, the author has never been able to trace any such vacuity whatever; and has a decisive example to the contrary in the state of his own teeth: for having, when a boy of twelve years old, had the second of the bicuspidati extracted, the vacancy thereby pro duced has been so completely filled up by the enlargement of the adjoining teeth, that these teeth closely touch, and he is only able to introduce a fine probe between them at the neck, or lowest and narrowest part; while he can introduce nothing between any of the other teeth, which have in no respect given way or.separated from each other. 66 There is probably, therefore, some internal action continually taking place, though we are not able to trace it very evidently. And it is probable, also, that a caries of the teeth is occasionally produced by some internal cause operating upon and vitiating this action, though there can be no doubt that the chief causes are external." 5 [The Nervorum. Chiefly or altogether confined to the nerves of the sockets or jaw-bone, and not relieved by extracting the suspected teeth. Hunter on Teeth, p. 190. Sympathetica. From sympathy: as that of pregnancy, or irritating sordes in the stomach. Found also, occasionally, as a symptom, in scurvy (porphyra), erratic gout, and hysteric diathesis. 3. STUPORIS. Tingling pain in the teeth from stridulous sounds, vellication, or acrid substances. Hæmodia, (aindia). Aristot. Odontalgia hæmodia. Sauv. Dolor dentium à stridore. Darw. Zähne-stumpf. G. Agacement des dents. F Tooth-edge. A stridóre. From grating sounds. Ab acritúdine. From vellication or acrid substances. 4. DEFORMIS. Deformity of the teeth from error of shape, posi tion, or number. 5. EDENTULA. Loss or want of teeth. Nodosia (radora). Auct. Græc. Peculiaris. From constitutional defect. Senilium. From old age. [The author here refers to a very general opinion concerning extremes of heat and cold.] By whatever means, however, a decay or caries of the teeth may be produced, it appears to operate in three different ways: sometimes commencing in the internal cavity, and working its path outward; sometimes outward, and working its path within; and sometimes by a wasting of the enamel, and consequent denudation of the bony part. The first is the least common affection, and is discoverable by the appearance of the internal blackness through the external shell; the third is more common than the first, and the second the most frequent of the whole; evincing, at its commencement, the appearance of an opake white spot through the enamel, which gradually crumbles away about the spot, and thus discloses that part of the body of the tooth which forms the original seat of the disease, and which, by its continuance, converts the early spot into a hole, and at length destroys it altogether, or at least down to its neck, unless the pain produced by its progress compel the pa tient to have it extracted before the disease advances thus far." 6. INCRUSTANS. 6. INCRUSTANS. Teeth incrusted with extraneous matter. Tartar of the Teeth. Hunter, p. 192. Concreted by it into one mass. Eustach. Tr. de Dent. cap. 2. 7. EXCRESCENS. The substance of the surrounding gums excres cent. Epulis (Touis). Paul. Egin. iii. 26. Spongiosa. Fungous or spungy gums. Scurvy of the gums, vulgarly so called. J. Hunter, p. 184. C Extuberans. With distinct extuberances on the surface. Epulis. Heister. Chir. tom. I. p. ii. c. 85. Sarcoma epulis. Sauv. Sometimes softer and fleshy. J. Hunter, p. 169; and sometimes thicker and callous. Id. p. 188. Produced by vermicles." This description of the cavity in the tooth, and of the three kinds of disease, is similar to Mr. Hunter's. Exposure to cold, is not, we believe, mentioned by him, and it seems too general to be a cause of these diseases. There is something obscure in the manner in which the teeth are said by Mr. Hunter to be vascular and not vascular, with action and without action, making a part of the body and yet being extraneous to it. It should be remembered, that the "Natural History of the Teeth" was the first of Mr. H,'s publications in the year 1771, and that it was sold to the booksellers,-a mode which he was often heard to say he never would repeat. When the second part appeared in 1778, it was tacked to the first, and the whole called a second edition. In 1803, a third edi. tion was published without any alteration, the author being then no more. It is not, therefore, to be wondered if the whole should not seem to harmonize. But a little attention will explain the discrepancy. Mr. Hunter's meaning is, that the teeth when completely formed, do not seem supported like other bones by a circulation from the neighbouring vessels, but, to possess a life of their own, like parasyte animals in a living body. On this account, they have no means of restoration when diseased. Mr. Good is mistaken in saying, that they retain their colour when the other bones are tinged by feeding the animal on madder. If this mode is used for feeding young animals whilst the teeth are forming, they will be tinged; but do not, like the other bones, recover their colour on leaving off the madder, nor can teeth, when completely formed, be tinged by any change of food. It is no argu ment against their extraneous nature, that they will anchy lose with the sockets. Under inflammation, new actions take place, and different parts of different animals may be made to unite, as is well known by Mr. Hunter's experiment of inserting the testicle of a cock into the abdomen of a hen, hen, and even transplanting a tooth into the comb of a cock; in both which instances blood-vessels are found communicating between the parts in contact. Nor is there any more reason why teeth should not decay because they are extraneous to the neighbouring parts, than that hydatids should not die. But, whether healthy teeth are vascular or not, must be a matter of conjecture till we can discover their vessels. Mr. Hunter has not overlooked the impossibility of the teeth becoming diseased by those menstrua which have a power of destroying part of a tooth, "for any thing of this kind (says he) could not act so partially;"* and it is worth while to mark the coincidence of language between Mr. Hunter and Mr. Good in their account of the various diseases of the teeth, and even in their causes, excepting that the one makes no mention of those external causes, of the existence of which the other has "no doubt." We suspect, however, the events act with too little uniformity to be admitted as of "no doubt." We shall see too, that Mr. Hunter has not been inattentive to all that Mr. Good describes in his own case. In his chapter " Of the Irregularity of the Teeth," Mr. H. shows, that the vacancy from the loss of a tooth may be readily, and often is, filled up by the gradually altered situation of several, which before overlapped each other. He shows also, that the approximation of teeth is most certain early in life. There is, however, one most important disease on which Mr. Hunter bestows much time, but which is not noticed by Mr. Good in this place. It will come before us hereafter in the selection we make of certain articles in the Nosology. In searching for aneurism, a subject which of late has been often before us, by some error of the index-maker, we were brought the article Elephantiasis. We were not aware of the length of the present article, till our printer reminded us of several others besides our Intelligence; the remainder must therefore be left for the succeeding Number. Meanwhile, if we have any-where mistaken Mr. Good's meaning, we shall be thankful to be corrected by himself or his friends; for we scarcely know a subject more important than the present, nor of course one on which we are more anxious to be perspicuous and correct. * See Hunter on the Teeth, Part II. Chap. I. 1 A Botanical |