dures, is made to be free from these pains. The name matters not it is the deliverance that is the matter.

Another fact, too, of interest, appears in the history of this case. The patient has no action of the bowels for NINE days and gets better without any action, for the improvement began several days before the action of the bowels took place: a fact testifying to these truths, that the action is not necessary in order that the curative action shall set in, and, second, that, when the curative action has set in, the bowels will act of themselves.

Hundreds have been introduced to death by the exhibition of purgatives to them while labouring under peritoneal disease. There is hardly a greater barbarism than that of imagining the bowels being forced to act, (that is poisoned, and thus forced to act to expel the poison,) is a method of cure. One would think from the common practice in this matter that men thought the intestinal tube, instead of being a living, moving, self-acting canal, to be a mere sewer, which became blocked up and required to be forced.

ON ARTIFICIAL TEETH,

BY LEONARD KOECKER, ESQ., M.D., D.D.S., SURGEON DENTIST.

ESSAY FIFTH.

ON THE PRINCIPLES FOR THE PREPARATION AND THE INSERTION OF SETS OF ARTIFICIAL TEETH, EMBRACING BOTH A CONSIDERABLE PART OR THE WHOLE OF THE UNDER JAW: AND ALSO DOUBLE SETS OF ARTIFICIAL TEETH FOR THE UPPER AND UNDER JAW.

Sets of artificial teeth for a considerable part or the whole of the under jaw only, are less frequently required than for the upper jaw, the loss of the teeth of the upper generally preceding that of the lower. They are, however, sometimes required, and are to be made and applied under the same principles as those for the upper jaw, with this difference in the manufacture and the application, that, from their situation, they NEVER require any spiral springs for their attachment.

In cases where some of the living teeth remain in the lower jaw, in order to increase the basis and lessen the

pressure upon the gums in mastication, the application of gold caps over such teeth is often desirable, as they afford great support in mastication, and admit of hard pressure by the whole apparatus, without producing pain of the gums.

As illustrative of the mode and the effects both of improper and proper proceeding in these cases, the following history is presented.

Miss, of, aged 28, had been in an exceedingly delicate state of health for many years, but for the last five or six she had been PERFECTLY BEDRIDDEN from the effects of a most extensive mercurial treatment. Her digestive powers being almost destroyed, her nourishment principally, indeed almost exclusively, consisted for years of tea, and occasionally coffee, so that she was reduced nearly to a perfect skeleton. She could not sit up in the bed without support, and the constant pressure had, in many places, notwithstanding the best care, occasioned abrasion of the skin. She complained of violent pain in the back of the head, as well as of the left side in the region of the stomach; the latter was greatly increased by taking the least food of any description, and continued severe until vomiting relieved the stomach of its contents, generally in a few minutes after the food was swallowed. So severe were these symptoms as to induce a suspicion of organic disease of the stomach.

All previous medical treatment seemed at best to have been but palliative, and Mr. Greig, under whose care she had been for three years, was from the first of opinion that her illness must chiefly be dependant on the state of her mouth and teeth, which were in a most deplorably diseased condition, and that, unless some relief could be obtained, she must inevitably sink in a short period under this accumulation of disease and pain, and deprivation of food and sleep.

Deeply impressed with this opinion, Mr. Greig had consulted with other medical men, but was invariably overruled by their opposite opinion, until the patient consented to abide by his advice alone. A new difficulty, however, now presented itself; he could find no dentist who would coincide with him, and afford his practical assistance; and after repeated ineffectual endeavours to obtain it, he abandoned all

hope of saving the life of his patient, a hope on which his mind had been firmly fixed, a hope now turned into despair.

Accidentally my "Principles of Dental Surgery" fell into his hands, and we had a consultation. The patient's state was as detailed; but she was blessed with an uncommon flow of spirits, and manifested strongly the confidence with which she clung to the hope of relief. She implored me to relieve her from her suffering and save her life, assuring me of her strength and power to support any pain necessary for the purpose, and endeavouring to persuade me that she really possessed greater strength than she appeared to do.

I proceeded to examine her mouth; but, in this was much impeded, not by her disinclination, but by the incapability of opening the mouth more than about a quarter of an inch, in consequence of ADHESIONS, which had resulted from ulcerations of the gums, as well as on account of a great degree of nervousness, and of the excessive pain produced by the slightest effort she made to open her mouth. By the best examination I could make, I ascertained that she still had all her teeth in her mouth, though almost every one of the under jaw was either partially or entirely deprived of its vitality, and some of the upper jaw were in a similar condition.

All the remaining parts of the gums were in a state of great inflammation and suppuration, a great portion of these structures having already been destroyed and removed by ulceration and mortification. The osseous parts also of the sockets of the upper and under jaws were in a state of mortification to a con iderable extent, the whole inner circle of the lower jaw and part of the upper being perfectly black; while all the living structures were under the powerful influence of the irritation consequent on such extensive disease.

The discharge of matter, arising from this diseased state of the parts of the mouth, was extremely great, and the stench of it so disgusting, that, though the windows were opened, and the room of the patient had been carefully fumigated, it was almost intolerable.

In operating on her, she was placed on an arm-chair, and supported by Mr. Greig and her sister, for she had not sufficient strength to sit erect without assistance. Within an

U U

hour I removed twenty-two teeth, all which I considered formed part of the cause of her local and general sufferings.

On October 6th, a great portion of the bone forming the inner circle of the sockets was removed; her appetite and digestion were gradually improving. Four days afterwards, some more pieces of dead bone were removed by rinsing the mouth, and others by the fingers, and the powers of nature were active in restoring health to the remaining parts of the mouth, represented by figure, No. 1.

In November, the treatment necessary to preserve the remaining teeth was adopted, and the patient's health was so rapidly improving, that she was able to walk across the room, and soon afterwards take airings in a carriage; and, in two or three months, we had the satisfaction of seeing our patient, not only entirely free from danger, but perfectly cured of the painful diseases of her mouth, and almost also of her constitutional affliction.

The most important part remaining now was the artificial restoration of the loss of her under teeth; and set of artificial teeth was prepared, represented by figure, No. 2, and

the appearance of the mouth, when this was introduced, is represented clearly in figure, No. 3.

The patient has since gradually improved in general health in the same proportion as the healthy state of her mouth had advanced to perfection. Her constitutional strength is so far recovered, that she now is able to take every necessary exercise, even a walk of three or four miles in extent.

Reference may now be made to cases, in which both upper and under teeth are required to such an extent as to render it necessary to unite the piece for the upper with that for the under jaw by means of spiral springs, swivels, &c.

A whole set of artificial teeth for the upper and under jaws is properly indicated, not only when all the teeth are lost, but also when some of them still remain. In every instance in which the deficiency of molar teeth is of such a nature as to deprive the two jaws of that necessary support by which they are kept in their proper situation, and at a proper distance from each other, a double set of teeth is very desirable. Thus when, for instance, the front teeth are still in a healthy condition, and the small and large grinders that remain in both jaws are in each without an antagonist, the whole weight of the two jaws must rest upon the front teeth; these, in most instances, lap over each other, and, by this oblique pressure, must soon be rendered loose, and consequently be lost, unless they are supported by an artificial apparatus. But should this support of the upper and under front teeth be