Part Ii. P. 25.)

“The pain called tooth-ache, which Galen very properly considered the most cruel and grievous of all pains that are not mortal, seems clearly to be occasioned by decayed portions of bone, no matter how minute, acting by contact on the nerves of the teeth.--And I firmly believe the pain is never felt until the caries, which always acts from without inwards, has actually met a branch of nerve.

“No species of animal matter, in a state of decay, is so offensive to the vitality of the adjoining substance, whether nerve, or muscle, or membrane, or any part or portion of the living body, as decayed bone. How very small a portion of decayed bone in a tooth is capable not only of causing the most agonizing pains, but also of communicating a fœtor to the breath, is inconceivable by those who have not pursued the inquiry with minuteness: and this offensive matter, when it thus has an opportunity of acting, communicates, through the medium of the nerves, a sympathetic pain to the teeth which are perfectly sound.” (Hare on the Stomach, p. 240.)

In addition to the preceding remarks, I observe, that the tooth-ache is sometimes so severe as to produce alarming derangements of health; while at other times it is merely an annoying sensation, which can scarcely be termed pain. The cavity of the tooth, in most cases, is the original seat of this malady. But as the teeth are supplied by ramifications of those nerves which supply different parts of the face and head, it frequently happens that one or more of those parts may suffer more severely than the tooth itself.

Diseases in the wisdom teeth of the lower jaw affect the ear; and when those of the upper jaw are diseased, the temples generally become affected. The effects of disease in one tooth, from nervous influence, is sometimes felt in the opposing tooth of the other jaw.

No certain treatment can be laid down for the tooth-ache; it must be regulated entirely by a knowledge of the cause, whether arising from decay, the irritation of tartar, the application of cold, or merely as a sympathetic affection. The disease which occasions this malady is insidious in its progress, dangerous and sometimes fatal in its consequences; but the danger more frequently arises from an improper application of remedies, than from the disease itself. Powerful remedies for the tooth-ache, as well as for other diseases, are hazardous in the hands of the ignorant.

(35) And tooth-ache came, the terror of mankind!

“When pains in the teeth show a disposition to change their places with great facility, like all rheumatic affections, they may yield to the most insignificant means, even to the touch of some amulet, applied with an air of mystery and confidence which imposes upon the patient. Every one knows, that in timid people, the presence of a surgeon, in most instances, is sufficient, for a time, to dispel the pain of tooth-ache. It is particularly for these pains that some dentists have a favorite odontalgic elixir, of whose sovereign virtues they are so fond of boasting. These liquors are almost all spirituous tinctures, whose powerfully stimulating action often suffices to suspend the pain.

“In fact, a drop of the tincture of opium, or any one of the essential oils, applied to the part by means of a little cotton, may produce an instantaneous abatement of the pain, but which seldom fails, sooner or later, to return. Frequent successes of this kind, of which marvellous accounts are daily published, have successfully brought into vogue numerous elixirs and various other means, all more or less ridiculous.” (Gerbaux, pp. 80, 83.)

“Doctor Sims, a celebrated practitioner in London, relates that he was such a martyr to the tooth-ache, that he was confined to his house for several weeks together by that malady, but after he avoided taking his food either hot or cold, he entirely escaped it. He was particularly careful not to take soup or any other liquid, of a temperature higher than ninety--eight degrees less than blood heat. He was induced to try this experiment, by reflecting that heat expanded all bodies. When applied to a tooth, therefore, it must diminish its cavity, compress the nerve, and consequently produce pain. However defective this theory may be, the practice of endeavoring to preserve those parts in an equable temperature, will be found to be highly important.” (Duval.--Atkinson’s translation, p. 76.)

(36) To mercy deaf, by sorrowing man accurst.

The following characteristic lines are from the “Address to the Tooth-ache,” by Robert Burns:--

“My curse upon your venomed stang, That shoots my tortured gums alang, And through my lugs gi’es money a twang, Wi’ gnawing vengeance! Tearing my nerves wi’ bitter pang, Like racking engines!

“When fevers burn, or ague freezes, Rheumatics gnaw, or cholic squeezes, Our neighbors’ sympathy may ease us Wi’ pitying moan; But thou--the hell o’ a’ diseases, Ay mocks our groan!

“Where’er the place be priests ca’ hell, Whence a’ the tones o’ misery yell, And ranked plagues their numbers tell, In dreadfu’ raw; Thou--tooth-ache, surely bear’st the bell, Amangst them a.’”

“We were interrupted by Mr. L. He is one of your plain, common sense sort of people, practical, fixed in his own opinions, a little inclined to stoicism, with a dash of savage philosophy, partly affected to hide tenderer feelings, and about six feet and an inch high, without his shoes.

“‘What’s the matter with your face?’ inquired he.

“‘Tooth ache,’ said I, ‘all swelled: keeps me awake, and’----

“‘Try my nitri dulcis and alum pulv.,’ said W.

“‘Curse your nitri dulcis and alum pulv.,’ said L., ‘there is but one cure for the tooth-ache, and that’s a sure one,’

“I looked tremblingly up. He had his great, square fist doubled, as if he held something in his hand. He raised it to his mouth, and screwed around with the motion of a dentist, uprooting some huge, double grinder, with three diverging prongs. My friends were silent. I turned a little pale. He saw what an impression he had made, and with a grin that went to my very soul, added;--

“‘Out with it, you fool, and there’s an end. It’s worth all the nitri dulcis and alum pulv. in the universe.’

“There was a melancholy truth in what he remarked. It sunk into my heart; I made up my mind; and when my worthy advisers left me, I walked around to Mr. ----. There was an awful silence--a moment of intense fear--a slight struggle--an agony--a cry from the heart’s core--I came out the happiest of men.”--(Dreams and Reveries of a Quiet Man, by Theodore S. Fay, Esq. Vol. I. p. 187.)

(37) And stops the fearful progress of decay.

As great disadvantages frequently arise when teeth are decayed, from their crowding against each other, it becomes expedient, with a view to stop the progress of incipient disease, to remove portions from their sides by means of a file; but, if this operation be not performed before considerable parts are decayed, it must not be expected to afford lasting benefit. The incisors and canine teeth may be filed with the greatest probability of success; but the bicuspides and molares have such large surfaces, that caries often extends itself by far too deep before it is observed, to be effectually removed by the file. Little advantage can be expected from filing, unless the whole diseased part be effectually removed.

It is proper to observe, that there are some teeth, which, although attended to at an early period, are but little benefitted by the operation, either from some original defect in their organization, or certain peculiarities of constitution: but this is, by no means, commonly the case; and the instances of its proving essentially serviceable are so innumerable, that it may be recommended with the highest confidence of success.

(38) Performs in nature one substantial use.

The benefits of the operation of stopping the teeth are so truly important, that it is impossible to recommend it too earnestly to the public; for thousands of the most useful teeth, which otherwise would, on account of their painfulness, be sacrificed by extraction, may thus be preserved, not only for many years, but for the remainder of a long life.

The finest teeth are commonly the most highly organized, and therefore become more acutely painful when only a very small portion is decayed. The operation of stopping will always succeed, if performed before the decay has reached the sensible part of the tooth, unless its cavity be superficial, or of a funnel shape, and not capable of being sufficiently deepened for retaining the gold. In such cases, all attempts at stopping it will be fruitless. But if the depth be sufficient towards the sensible part of the tooth to allow of the excavation being made larger, or directed obliquely or otherwise, as may be most eligible for receiving and securing the gold, the caries may be so effectually arrested as to cause no farther uneasiness to the patient.

“There is no object connected with dental surgery of more importance than that of stopping. There is none better deserving the attention of the student, nor is there any in which the dentist may more successfully display his professional skill. Were we to judge, indeed, from the almost innumerable cases of failure which occur, we might conclude that the uncertainty of the operation was so great as essentially to diminish its utility and importance. These cases, however, generally occur under the management of ignorant persons, who are alike incompetent to the mechanical and the surgical part of the operation, and who are equally incapable of choosing a proper time for its performance.” (Snell on the Teeth, p. 151.)

“If properly done,” says Dr. Fitch, “this is one of the most useful operations in dental surgery; and if practicable, it bears the preference to any other operation for the cure of diseased teeth. It should be an object of solicitude in every case, when we are called upon to extract or file the teeth, to obviate both operations by plugging them, if in any way expedient or practicable.” (Fitch on the Teeth, p. 398.)

“I have no hesitation in affirming this to be one of the most important and useful operations that can be performed.” (Sigmond.)

“By the beautiful and useful operation of stopping or plugging teeth which are greatly decayed by caries, they may be preserved for many years; in most instances during the remainder of life: and not unfrequently, from ten to twenty teeth may be preserved by this operation in the same individual.” (Koecker.)

(39) And pointing to the portal of the tomb.

“We have a most humiliating reflection, in observing the powers of renovation which are enjoyed by the inhabitants of shells, some of which, after their testaceous coverings have been broken, whether on the edges, in holes, or in cracks about the middle, no matter where--possess the power of directing, from their secretory vessels, a sufficient quantity of calcareous matter and animal gluten to repair the injury effectually;--whereas man has not the power of directing a single particle, either of earthy or glutinous matter, from his secretory system, to repair a small deficiency of enamel, which is literally a modification of porcelain shell, and the loss of which makes every accession of cold actually distressing.” (Hare on the Stomach, p. 277.)

(40) A shining panoply of orient pearls.

The chief object of attention in artificial teeth is, that the substance be durable, and not liable to change color. Human teeth and those of small animals have been heretofore supposed to answer the best purpose, while teeth cut from those of the sea horse have ranked next in importance; but lately, they have been formed with great success from certain materials known to the manufacturers, and have been variously denominated, according to the taste of the artist--silicious pearl teeth--mineral teeth--porcelain teeth--incorruptible, and terro-metallic. Under these titles, teeth of various degrees of excellence are now made, both in Europe and this country, and from their great beauty, cleanliness, durability, and unchangeableness in regard to color, will no doubt be generally adopted. They certainly possess some advantages over any other substitute for original teeth.

Of the various methods which have been devised for fixing artificial teeth, the most successful is, that of fastening a new tooth by means of a pivot to a sound fang. When thus fastened, the tooth may be worn for a considerable time without producing any inconvenience. The next method is, to adapt a tooth to the aperture from which another has been extracted, and to fasten it to the adjoining teeth. A third method is, to supply the place of teeth by means of a gold plate, to which the substitutes are firmly affixed, the plate being fitted to the gums, and supported by means of springs. A fourth mode of supplying teeth, by which whole sets may be provided and worn with great convenience, is to prepare gold or ivory frames, fitted closely to the gums, on which the teeth are firmly arranged, and, by means of springs, made to perform all the most essential functions of original teeth.

(41) Like Him who fills unnumbered worlds with joy.

“He who pursues his own advantage only, so far as he can do so without injuring another, is just; he who gives up his superfluity rather than do harm to another, is noble; he who works only for the common welfare, is the most noble, and no one but him deserves that name.” (Spurzheim.)

(42) Disturb the system when themselves destroyed.

“I have been made happy by discovering that I have only added to the observations of other physicians in pointing out a connexion between the extraction of decayed and diseased teeth, and the cure of general diseases. Several instances of the efficacy of that remedy in relieving head-ache and vertigo are mentioned by Dr. Darwin. Dr. Gatu relates that M. Petit, a celebrated French surgeon, had often cured intermittent fevers, which had resisted the bark for months, and even years, by this prescription; and he quotes from his work two cases, one of consumption, and one of vertigo, both of long continuance, which were suddenly cured by the extraction of two decayed teeth in the former, and two supernumerary teeth in the latter case.

“These facts should not surprise us, when we recollect how often the most general diseases are brought on by very inconsiderable inlets of morbid excitement into the system. A small tumor, concealed in the fleshy part of the leg, has been known to bring on epilepsy. A trifling wound with a splinter or a nail, even after it has healed, has often induced a fatal tetanus. Worms in the bowels have produced internal dropsy of the brain, and a stone in the kidney has excited the most violent commotions in every part of the system.--Many hundred facts of a similar nature are to be met in the records of medicine.

“When we consider how often the teeth, when decayed, are exposed to irritation from hot and cold drinks and aliments, from pressure by mortification, and from the cold air, and how intimate the connection of the mouth is with the whole system, I am disposed to believe they are often unsuspected causes of general, and particularly of nervous diseases. When we add to the list of those diseases the morbid effects of the acrid and putrid matters which are sometimes discharged from carious teeth, or from ulcers in the gums created by them, also the influences which both have in preventing perfect mastication, and the connection of the animal function with good health, I cannot help thinking, that our success in the treatment of all chronic diseases would be very much promoted by directing our inquiries into the state of the teeth of sick people, and by advising their extraction in every case in which they are decayed. It is not necessary that they should be attended with pain in order to produce diseases, for splinters, tumors, and other irritants before mentioned, often bring on diseases and death when they give no pain, nor are suspected as causes of them. This transition of sensation and motion to parts remote from the place where impressions are made, appears in many instances, and seems to depend upon an original law of the animal economy.” (Medical Inquiries by Dr. Rush, Vol. I. p. 199.)

(43) And spreads disease with every pulse that beats.

That the general health of the body is affected by the state of the stomach and lungs, is a proposition which few, if any, will deny.--And that the condition of either depends on the nature of whatever is introduced into it, will likewise be readily admitted. The effects which the state of the teeth may have upon the lungs, may therefore be considered in the first place. The chemical process which is carried on in the mouth, by means of its moisture and heat, will always, in a greater or less degree, cause the putrefaction of whatever extraneous matter is permitted to lodge upon or between the teeth. The air, even in the most open situation, is affected by passing over any putrescent substance. Now as the mouth is the chief passage by which the air enters the lungs, and as the air is affected by whatever it passes over or through, the lungs can never receive it in a pure state, except the mouth, through which it is introduced, be perfectly clean and healthy. But while any extraneous matter is permitted to accumulate and remain on the teeth, the mouth will naturally become unclean and unhealthy, imparting an infectious taint to the air which is inhaled.

“Fetid breath is occasioned by the state of the mouth, and seldom results from the condition of the stomach or digestive organs, as erroneously supposed. The escape of vapor from a disordered stomach can produce only a temporary effect, but from uncleanliness of the mouth, we find the taint constant and habitual; and unless the cause be eradicated, all the spices and perfumes of the east, though they may for a moment conceal, cannot remove it. Cleanliness of the mouth, therefore, is of great importance to the general health; in fact, the danger of the lungs from a constantly putrid effluvium has been strongly commented upon by the faculty of medicine, as a leading cause of pulmonary consumption.” (L. S. Parmly’s Lectures.)

“We respire,” says Dr. Fitch, “about twenty thousand times in twenty-four hours, and yet, for months and years, this vast quantity of air is rendered poisonous by one or more diseased teeth. How little does it avail an individual, if by every possible means the purity of the air is preserved; if no impurities are suffered to remain in the streets; if his tenements are kept clean, his apartments ventilated; if he make distant journeys at a great expense of time and money, for the benefit of pure air, and, at the same time, carry the cloaca of filth in his own mouth? If this state of the breath, caused by bad teeth, so affects the olfactory nerves of a person near an individual having bad teeth, what must be its effect upon the delicate and sensible tissues of the lungs of the person himself? Nature has formed the lungs most delicate and sensible, and susceptible to the slightest injurious impressions:--She has also finely tempered the atmosphere for its safe and healthy reception in these delicate organs; but an accident, or a disease, may render it impure, unfit for respiration, and cause it, instead of harmonizing with the lungs in the most perfect manner, to exercise a baneful influence, armed with pestilence, and scattering the seeds of disease over the lungs, thus pouring the streams of deadly poison through every vein in the system. The matter thrown off from the teeth in a state of disease and putrefaction, and also some states of diseased gums, is very acrid in its nature, as is demonstrated by its vitiating the saliva so much as to dissolve and oxydate metals, even silver, and to tarnish gold. We know that many of our organs have the power of resisting, for a length of time, in a wonderful manner, the effects of injurious impressions; but with the lungs I am disposed to believe that even slightly injurious impressions, if continued, will, sooner or later, prove to them a cause of disease and disorganization.” (Fitch on the Teeth, pp. 300, 301.)

(44) Each dental malady a thousand ways.

“These sympathetic pains arising from carious teeth, proceed from the intimate connection that subsists between the branches of the fifth and those of the seventh pair of nerves. The pain in the ear is therefore sympathetic, arising from disease in the dens sapientiæ. From the connexion which subsists between these two pairs of nerves, it happens that not only inflammation in the teeth causes a sympathetic pain in the ears, but disagreeable and unharmonious sounds produce a sympathetic effect upon the teeth, and occasion that unpleasant sensation called the teeth being set on edge.” (Fox on the Teeth,