a minute acquaintance with all the irregularities and the diseases to which they are subject, and the causes and the cure of them, are indispensably necessary for the proper insertion of artificial teeth.

Indeed, the application of artificial teeth must be directed by great surgical knowledge as well as mechanical skill, and cannot be left with safety to the mere mechanical artisan alone. It is greatly to be lamented, that the number of those dentists who combine the necessary mechanical skill with medical and surgical attainments is so very limited; while all parts of the civilized world abound with operators, having neither the scientific nor the mechanical qualifications requisite to fulfil their professional duties.

Dental surgery, as a branch of the healing art, is in its science still very obscure; and, while it is at all events not less intricate and abstruse than any other of the branches of surgery, it is by far the least understood both by medical men and by the public at large.

CASE I.

As an evidence and as an illustration of the want both of mechanical skill and of scientific knowledge the following case will serve :

Mr. aged 55, constitution delicate, and greatly suffering from the mal-treatment of his teeth at various periods, consulted me. He stated, that, in consequence of the insertion of a few badly constructed artificial teeth at an early period of life, and a constant neglect of proper attention to the restoration and the preservation of his own by a judicious treatment of the diseases affecting the various parts of his mouth, he had successively been compelled to increase the number of artificial teeth, until, in a period of from ten to fifteen years, all his own teeth had been lost.

He had, first, two artificial teeth inserted, with pivots upon the roots of two incisors; in a few years afterwards he required the use of another, and in a short time the fourth incisor and two cuspid (canine) teeth were lost, and replaced in the same manner.

The diseases of his teeth now rapidly increased; his gums became very sore and inflamed, and the roots of some of the incisors became unfit to hold the artificial teeth. The mode of insertion was, therefore, changed to the use of ligatures, illcontrived springs, &c.; and from the mechanical pressure of these means, he was gradually losing his natural, and constantly compelled to increase his artificial masticating apparatus, until, at last, becoming convinced of the destructive effects which the state of his mouth was producing upon his constitutional health, he insisted upon the removal of all the dead teeth.

The teeth of this gentleman were of high importance to him, not less from the circumstance of his principal duties being those of a public speaker, than from the deep inroads made upon his spirits, and his health: these inroads being exhibited in greatly impaired digestion.

During and after the loss of his own, several double sets of artificial teeth had been successively prepared by his dentist, these being so ill-contrived, as to be unfit to fulfil any of their offices in any way satisfactory to the patient. Their appearance was disgusting, and from their clumsy make, No. 1 and No. 2, kept his mouth constantly sore, and affected him as just stated.

A new set of artificial teeth, No. 3 and No. 4, for the upper and under jaw, (No. 5, representing these after all the teeth were removed,) fitting quite comfortably to his gums, and properly assisting in speaking and mastication, being made, his face gained its original and healthy contour; his general health, vigour, and usual exhilarated spirits were restored to the sufferer.

This case shows that many difficulties exist in the proper application of artificial teeth, and that these difficulties being met, the real benefits result. It may be useful to add a few additional observations on these points.

In most instances, no sooner is a tooth of some importance to the appearance lost, than the restoration of such defect by mechanical means is considered an object of the highest moment, no attention being paid to the remaining teeth and the gums, which are either primarily or secondarily affected by the general morbid state of the mouth; and, like the most daring and desperate gambler, the patient entirely disregards common prudence, and puts at stake the whole of his remaining dental property, by useless and erroneous attempts to recover by improper and injudicious means his lamented partial loss, and ultimately ruins his teeth and constitution; becoming the most desirable prey of those impostors who are, either by means of promising advertisements, or other less suspicious methods, continually intruding themselves upon the notice of the public, thriving by practising usury upon human health and happiness.

From the erroneous views propagated with such confidence by these impostors, it has happened that persons are led to regard the absence of a tooth, which is but little observed, a much greater evil than the most disgusting breath and disagreeable maladies of the mouth; and thus the injury of the other teeth, as well as the general health, is often occasioned or aggravated by the injudicious insertion of a single ill-contrived artificial tooth, this drawing attention from the greater evil.

Moreover, these erroneous views, too often encouraged, and adopted even by numerous practitioners, have obtained such influence over the public mind, that the proper application to the dental art is accompanied with the greatest difficulties, and is in the same ratio opposed as the principles on which it is founded are better and more just. And thus with some of the scientific professors of dental surgery, this influence has too frequently overpowered their just professional principles, and though well possessed of the means of pursuing proper dental

practices, they have neither the courage nor the 'self-denial to proceed against the current of prejudice, or to sacrifice their immediate interest to their future permanent success and conscientious gratification, and they have been carried away and overpowered by the stream of general opinion, and have gradually fallen into and followed the path of their less informed brethren.

Men of high surgical eminence, it is further to be regretted, have scarcely entered on this part of dental surgery, either from want of experience or from the difficulties placed before them by the chaos of erroneous customs and prejudices, which have presented themselves, and the fallacy of which would necessarily have required to be in some degree exposed and removed before the introduction of better principles.

The celebrated John Hunter, in his "Natural History of the Human Teeth, &c.," has not investigated the subject of the mechanical part of dental surgery, and with respect to the restoration of lost teeth, he confines himself entirely to the one surgical remedy of transplanting living and dead teeth from the mouth of one individual to that of another, although this practice is far more dangerous than the insertion of any kind of artificial teeth. It is happily at present erased from the list of surgical treatments, and abandoned by every dental surgeon of judgment and integrity.

*

ACUTE BRONCHITIS, COMPLICATED WITH CEREBRAL

SYMPTOMS, CURED.

[Communicated by Dr. EPPS.]

Louisa Howard, (p. 1092, case book, 1846), aged four years.

Her mother consulted me on her behalf on Oct. 3, 1846. The child had the following symptoms:

Symptom 1. A great accumulation of phlegm and mucus in the chest.

A distressing and fatal case of disease, arising from transplanting of a single tooth, is related in "The Medical Transactions of the College of Physicians, of London," vol. 3, pp. 325, 338.

DD