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PRACTICAL GUIDE 
 
 TO THE 
 
 MANAGEMENT 
 
 OF THE 
 
 TEETH; 
 
 COMPRISING 
 
 A DISCOVERY OF THE ORIGIN OF CARIES, 
 
 OR 
 
 DECAY OF THE TEETH; 
 
 WITH ITS PREVENTION AND CURB. 
 
 BY L. S. PARMLY, 
 
 DENTAL PROFESSOR. 
 
 " The great distress which usually accompanies, and 
 the inconvenience which always follows the loss of the 
 Teeth, makes the discovery of same mode of prevention 
 of caries very desirable." Fox. 
 
 PHILADELPHIA: 
 PUBLISHED BY COLLINS 8c CROFT, 
 
 NO. 73, MARKET STREET. 
 J. R, A. Skerrett, Printer. 
 
 -WVWX- 
 
 1819. 
 

To BENJAMIN WEST, Esq. 
 
 ^-President of the Royal Academy of Jlrts 9 
 $c. Sfc. $c. 
 
 DEAR SIR, 
 
 In addressing this small performance 
 to you, my intention is less to congratu- 
 late you on the fame your unrivalled ta- 
 lents have secured to you in a depart- 
 ment of the Arts, demanding all the finer 
 powers of taste and genius, than to mark 
 my high esteem for your private charac- 
 ter as a man, in which the union of those 
 virtues that diffuse happiness in the va- 
 rious relations of domestic life are so 
 eminently conspicuous. 
 
 I have the honour to be, 
 Dear Sir, 
 Your very obliged 
 
 humble Servant, 
 
 X. S. PARMXY, 
 
 BUCKINGHAM STREET, 
 
 ADELPHI. 
 
CONTENTS. 
 
 PAGE 
 
 Dedication . ..... iii 
 
 Introduction 3 
 
 General view of the body .... 21 
 
 Formation and structure of the teeth . . 44 
 
 Shedding of the teeth .... 60 
 
 The adult teeth 66 
 
 Diseased teeth and gums .... 74 
 
 Caries 76 
 
 Tartar 86 
 
 Tooth-ache • 91 
 
 Occasional effects of diseased teeth . . 96 
 
 Structure of the gums . ... . 100 
 
 Structure of the alveolar processes . . 106 
 
 Management of the teeth . . . Ill 
 
 OPERATIONS ON THE TEETH. 
 
 Scaling 123 
 
 Extraction 127 
 
 Mending or capping diseased teeth . . 132 
 
 Artificial teeth 135 
 
 Transplanting of teeth .... 142 
 
 Irregularities of the teeth .... 145 
 
 Fractures of the teeth .... 151 
 
 Cracks of the enamel 155 
 
 Denuding process 157 
 
 Wearing of the teeth 159 
 
 Morbid growth cf the gums . . . 161 
 
 Artificial palates 165 
 
 Ligatures of the teeth .... 167 
 
 Antrum Maxillare ..... 170 
 
 Physiognomy of the teeth . . . 174 
 Domestic Advice - . . . .183 
 
PREFACE. 
 
 In submitting the following sheets to 
 the attention of the Public, the Author 
 feels it necessary to apologize for occa- 
 sional inaccuracies of style \ which the 
 circumstance of his being a foreigner, 
 combined with his anxious desire and 
 impatience to make known some import- 
 ant discoveries, has rendered it as diffi- 
 cult for him to avoid, as it has afforded 
 him but little leisure to correct. 
 
 The teefrh, it is well known, are or- 
 gans most important to the animal eco- 
 nomy. Their use in conveying distinct 
 articulation, in ministering to the com- 
 fort, or promoting the health, of the in- 
 dividual, is too obvious to be insisted on. 
 Suffice it to observe, that when, from 
 disease or accident, impediments arise 
 to the discharge of their proper func- 
 tions, calamities most mischievous to the 
 
 A 2 
 
PREFACE. 
 
 system ensue : every medical man know- 
 ing that imperfect mastication is a fruit- 
 ful cause of many disorders the most 
 distressing, dangerous, and even fatal 
 to the human frame. Numerous have 
 been the publications of able and skilful 
 men, who have preceded the Author in 
 this path of science. It is however me- 
 lancholy to reflect how little that is 
 really useful, has accrued from their la- 
 bours. Experience evinces that all their 
 instructions are but ill adapted to an- 
 swer the intended purpose. Diseased 
 gums, offensive breath, deficient and de- 
 cayed teeth, are still objects of public 
 notoriety. Conscious therefore how 
 much remained to be accomplished, in 
 every thing relating to the management 
 of the teeth, the Author was induced to 
 direct his attention very early to the 
 subject: and the result of many years 
 close application and study, has been at- 
 tended by a discovery the most import- 
 ant that has yet been made in this branch 
 
[PREFACE. 
 
 of physiology. Regulating his practice 
 by the principles of his own system, he 
 has now the pleasure of announcing to 
 the public, the signal success that has 
 marked his professional career in vari- 
 ous parts of the world, and more parti- 
 cularly in this metropolis. Testimonies, 
 as numerous as they are highly respecta- 
 ble, will satisfy the most incredulous, 
 that these are not the pretensions of an 
 empyric, and will convince those desir- 
 ous of placing themselves under his care, 
 of the decided superiority of his mode of 
 treatment in every possible case of dis- 
 eased dentition, and under every variety 
 of age, constitution, and habit of his pa- 
 tients. He also undertakes to initiate 
 the youth of both sexes, without any la- 
 borious process, in the dental art, so 
 as to enable them to preserve these im- 
 portant organs in a perfectly sound and 
 healthful state, to the most protracted 
 period of life. 
 
PHEFACE. 
 
 Wherever, in the following work, the 
 Author has ventured to criticise either 
 the opinions or practice of his prede- 
 cessors, he can truly say, he has been 
 influenced by no other motives, than a 
 wish to promote the improvement of an 
 art but too little studied, and to excite 
 the attention of the public, and the minds 
 of professional men in particular, to its 
 importance. Where their sentiments ap- 
 peared founded on just observation, he 
 has willingly adopted them, and in do- 
 ing so, he has not scrupled occasionally 
 to borrow their language. Should what 
 he has written, have the effect of rescu- 
 ing only one individual from the suffer- 
 ings incident to a neglect of the teeth, 
 lie will not regret the time the present 
 publication has cost him. 
 
 Buckingham Street, Melphi. 
 
DESCRIPTION OF THE PLATE. 
 
 Figure 1. Rabbit Mouth. 
 
 2. Toothless Mouth. 
 
 3. Projecting Chin. 
 
 4. Mouth, without any deformity. 
 
 Number 5. Mouth, expanded to shew all the teeth. 
 
 No. 1. 1. Front Incisores, *) 
 
 V or Cutting* Teeth, 
 
 2. 2. Lateral Incisores, J 
 
 3. 3. Cuapidati, Canine, or Eye Teeth. 
 
 4. 4. 4. 4. Two pair of Bicuspides, or small Grin- 
 ders. 
 5. 5. 5. 5. Molares, or large Grinders. 
 
 6. 6. Denies Sapientix, or Wisdom Teeth, 
 
INTRODUCTION. 
 
 THE division of surgery into various 
 branches, has, in a particular manner, served 
 to promote the advancement of the science, 
 and thereby been productive of the happiest 
 benefits to society. 
 
 In examining the progress of the improve- 
 ments in its different branches, it is to be 
 observed with regret, that the Dental Art 
 has not kept pace with many others of less 
 real utility. One cause of this slow pro- 
 gress of dental science is, that the subject 
 has not hitherto been considered as forming 
 an essential part of professional education. 
 Hence, the practice of it has generally been 
 considered in no higher light than a mecha- 
 
IV 
 
 nical occupation or trade. A great improve- 
 ment of this department of surgery, will de- 
 pend on pointing out to society the import- 
 ance of preventing diseases of the Teeth ; 
 and their connexion, in almost every instance, 
 with the general state of the health, and pre- 
 servation of the system. 
 
 Nothing can tend so much to accomplish 
 this object, as an institution for the exclusive 
 promotion of dentalogical science. The 
 wants of society, as well as the disposition of 
 the present enlightened period, so favoura- 
 ble to the universal diffusion of knowledge, 
 demand such an institution; and such, we 
 flatter ourselves, we are authorised shortly 
 to anticipate, when this noble art will be 
 rescued from that degraded state in which it 
 has long remained in the hands of ignorant 
 practitioners, or mercenary pretenders, who 
 have in a great degree made it a monopoly. 
 Within these few years, it must be admitted, 
 that some attempts have been made at im- 
 provement; and the publication of the late 
 Mr. Fox, joined with his regular course of 
 •lectures on this branch of physiology, has 
 
done more for its promotion than the labours 
 of any other individual, though occasionally 
 some important errors occur, which it will 
 be one object of the present treatise to no- 
 tice and correct. 
 
 When we advert to the progress of medical 
 and surgical science, during the last few 
 years, we are struck with the rapid and 
 beneficial changes which have taken place. 
 
 Medicine is now built on experimental 
 science, and conducted by those enlightened 
 principles which are the fruits of liberal edu- 
 cation, and the peculiar spirit of the present 
 times. The consequence of this has been, 
 that the prejudices of the nurse, the mysteries 
 of the empyric, and the pedantry of the 
 schools, are completely done away. 
 
 In surgery, the same fortunate improve- 
 ment is conspicuous ; the complicated prac- 
 tice of former times now yields to a mild and 
 natural proceeding: and such is the ad- 
 vancement of this branch, that operations 
 are daily performed of that bold and deci- 
 sive nature, that at a former period, would 
 
 B 
 
VI 
 
 have been deemed impracticable, and beyond 
 the power of art to accomplish. 
 
 This general state of improvement in sur- 
 gery gives great encouragement to the ex- 
 tention of the dental art. — Were mankind 
 sufficiently acquainted with the many dis- 
 eases and painful afflictions which originate 
 from want of attention to cleanliness of the 
 mouth; and were they convinced, that, from 
 this cause alone, numbers drag out a life of 
 distress, they would feel a greater curiosity, 
 and take a more lively interest in obtain- 
 ing information respecting an art, which the 
 considerations of appearance, comfort, and 
 health, render so essential. That such an in- 
 terest has not been felt is the more astonish- 
 ing, since we cannot but observe how anxi- 
 ously solicitous the mind daily discovers 
 itself to be on subjects of less importance* In- 
 deed, mankind, in general, are not sufficient- 
 ly impressed with the utility of improve- 
 ments, till their own feelings convince them 
 of their necessity. In the present instance, 
 the truth of this observation is but too obvi- 
 ous; for, in most cases, it is either the loss 
 
VIJ 
 
 of Teeth, or the sensation of pain that in- 
 duces people to pay attention to cleanliness 
 of the mouth. 
 
 Though, at every time of life, an attention 
 to the teeth is necessary, for their appearance 
 and preservation ; yet there are certain criti- 
 cal periods at which we are irresistibly led 
 to the contemplation of the subject. — In- 
 fancy is one of them: when the teeth suc- 
 cessively appear, the constitution of the child 
 suffers from their protrusive power, and a 
 general irritative action pervades the system; 
 the sleep is disturbed, the appetite suffers, the 
 bowels are deranged, the muscular flesh de- 
 cays, and marks of universal sympathy affect 
 every part. The anxious day and watchful 
 night then give importance, in the opinion 
 of mothers and female attendants, to this 
 part of the human structure; and it is then 
 that the greatest mortality of infancy occurs. 
 It is computed, that no less than one-fourth 
 of the human race die under two years of age, 
 and it is clearly connected with this source; 
 for the enlarged state of the nervous and 
 vascular system gives a predisposition, at this 
 
Till 
 
 dawn of life* to inflammation and disease 
 from the slightest causes. The next period 
 that calls the attention to the teeth, is the 
 time of shedding the temporary set. The 
 habit now more firm, does not suffer the 
 same general uneasiness as at the former pe- 
 riod: but the process of nature, often imper- 
 fectly performed in the removal of the origi- 
 nal set. requires to be assisted, in order to 
 prevent that local deformity or disfiguration 
 of countenance and features, winch is well 
 known to arise from tins cause. Hence, 
 this is a period to be earnestly watched bj 
 parents and guardians, especially when en- 
 trusted with the care of females, if personal 
 advantages are to be studied and a pleasing 
 exterior preserved. The last period of par- 
 ticular attention to the teeth is, when they 
 begin to decay; for not only do they give ex- 
 quisite pain, as the feeling of tooth-ache con- 
 vinces, but the cause which moulders them 
 away, like other species of gangrene, affects 
 the contiguous parts, taints the breath, and 
 causes the fetor of the mouth to be disagree- 
 ablej even to the individual himself. Thus 
 
IX 
 
 daily experience proves, that the teeth are 
 generally the subject of pain and disease; 
 and the question to be considered is. whether 
 this state be naturally entailed upon them, or 
 results from our own imprudence and neglect. 
 
 From the moment that the teeth have pro- 
 truded, and appear in their proper situation, 
 they are liable to be acted upon by every ar- 
 ticle of aliment that remains upon them : to 
 protect them against this action, they are 
 covered with an exterior coat, termed the Cor- 
 tejc Striatas, or enamel, different from other 
 bone, and the structure of which constitutes 
 their ornament as well as their defence. — 
 While a strict attention is paid to cleanli- 
 ness of the mouth, this enamel will be a suf- 
 ficient protection against the operations of 
 every external cause. 
 
 The teeth of the savage are generally 
 sound and regular, and no accumulation 
 forms to deface them. But this is different 
 in civilized society; refinements in the culi- 
 nary art give the food a greater tendency to 
 acquire noxious powers, and form chemical 
 combination. 
 
 b2 
 
This is displayed by the formation of that 
 extraneous matter, called tartar, which, as it 
 accumulates, seperates the teeth from their 
 chief support, the investing membrane of the 
 gums, and thus loosening them in their sock- 
 ets, exposes them, and produces inflamma- 
 tion. 
 
 But a more active cause of the premature 
 loss of the teeth, is the accumulation or lodg- 
 ment of food in their interstices. There the 
 putrefactive process commences, acts upon 
 the enamel and penetrates to the bone.* In 
 this way the tooth becomes gradually des- 
 troyed, and the individual suffers successive 
 inflammation and pain for a time, till this 
 active monitor, that leads to attention in all 
 
 * The Author is aware, that most of his prede- 
 cessors who have written on this subject, and 
 among the rest, the celebrated Mr. Fox, have given 
 a different Theory of Caries, supposing that it com- 
 mences in the internal part of the tooth, and at 
 length extends its ravages to the enamel. 
 
 For further information, however, on this subject^ 
 the reader is referred to the chapter ,on Caries. 
 
cases, speaks in a language not to be misun- 
 derstood, tlie mischief of neglect. 
 
 If cleanliness be essential to other parts 
 of the body, it is peculiarly necessary with 
 respect to the mouth, through which is the 
 opening for carrying on the two great pro- 
 cesses essential to continuance of animal life: 
 the process of digestion, which gives nourish- 
 ment and support to the system ; and the 
 process of breathing, which conveys a princi- 
 ple from the air connected with vitality. If, 
 then, the food, from uncleaniiness of the 
 mouth, be tainted in the preparatory step of 
 mastication, the process of digestion must in- 
 troduce into the system a tainted chyle, preg- 
 nant with the seeds of putrefaction : if the 
 air inhaled receive the same impregnation* 
 which is the opinion of some of the most 
 skilful of the faculty, it cannot animate the 
 body or give vital energy in a proper degree. 
 These effects, which are independent of its 
 injury to the teeth, have never been sufficient- 
 ly appreciated. Thus, in all cases of unclean 
 teeth, a putrid matter is daily passing into 
 the body, and acting as a slow and unseen 
 
xn 
 
 poison for months and years, on every part 
 of the frame. When this is reflected on, 
 can there be a stronger inducement to clean 
 the teeth in a regular and proper manner, as 
 a preventive of general disease ? 
 
 The more we examine the structure of the 
 human body, however varied and multiplied 
 its parts, the more we are struck with the in- 
 timate connexion of each part with the whole. 
 Numerous as they are, to each is assigned 
 some peculiar and needful office, and in a 
 healthy state, the most perfect harmony sub- 
 sists between them ; no one obstructs, but 
 each assists, the operation of the other, and 
 thus promotes the ultimate preservation of 
 the whole. By this wise adjustment, there 
 is no schism in the body, no separate or in- 
 terfering ends are pursued by the multiplicity 
 of members, but the safety and support of 
 each are the undivided care of all. Hence, 
 in this view, there is no part of the frame 
 that is not of importance, however trifling or 
 insignificant it may appear ; the most vital, 
 as well as those on which the lesser energies 
 
Xlll 
 
 of the system depend, are equally essential 
 to life and its comforts. 
 
 On these considerations, the teeth certain- 
 ly claim an important rank in the human 
 structure: for — 
 
 1st. On them depends the proper expres- 
 sion of the countenance. By their removal 
 the character and symmetry of the face is 
 lost, and beauty is thus deprived of its chief 
 attraction. The celebrated Lavater has paid 
 particular attention to this subject in his 
 work, and pointed out their effect and im- 
 portance in delineating the features of the 
 mind. From this effect on the features they 
 call for more particular attention on the part 
 of females ; for (to use a quaint expression) 
 no woman can be beautiful " in spite of her 
 teeth y- and when the mouth is deprived of 
 this ornament, the countenance loses its 
 principal charm. 
 
 2ndly. To the teeth also is assigned the 
 chief power of enunciation. If the great and 
 pre-eminent prerogative of man is the pos- 
 session of speech, that speech can never be 
 complete or perfect, without the teeth to mo- 
 
XIV 
 
 dulate the sound, and give proper utterance 
 to the words. Hence, when the teeth are 
 lost, the speech becomes imperfect and 
 scarcely understood. This circumstance 
 gives them additional value, particularly to a 
 man in public life 5 and the preservation of 
 the teeth ought to be one of the first objects 
 to those who wish to shine either in the se- 
 nate, at the bar, or in the pulpit. Without 
 these instruments of utterance, the graces of 
 their eloquence are lost, and the power of af- 
 fecting the mind and convincing the under- 
 standing, if n6t taken away, is considerably 
 diminished. 
 
 3dly. It is the loss of this part of the 
 structure, that produces the leading mark of 
 age, and occasions the contracted counte- 
 nance, the wrinkles of the face, and those 
 unseemly changes which youth and beauty 
 ever wish to see placed at a distance. 
 
 4thly. When the teeth are neglected, they 
 frequently assume a preternatural growth, 
 which produces a disagreeable change on the 
 countenance ; and this, of itself, should be a 
 sufficient inducement to their frequent in- 
 
XV 
 
 spection, where external appearance is con- 
 sidered of any importance. 
 
 Jthly. But the most dangerous effect of 
 neglect of the teeth, and their consequent 
 Joss, is the imperfect mastication of the food, 
 which occasions indigestion, and a variety of 
 disorders depending on this cause. In order 
 to a proper digestion, it is necessary that the 
 food be sufficiently comminuted by the action 
 of the teeth, while, during this action* it be- 
 comes blended with a certain quantity of 
 saliva; thus' rendering its solution easier 
 when it descends into the stomach to be mix- 
 ed with the gastric juice. Where the teeth 
 are wanting, the food can neither be proper- 
 ly divided or broken down, nor a due quanti- 
 ty of saliva elicited from the glands, to ren- 
 der its solution in the stomach complete for 
 forming it into perfect chyle. 
 
 6thly, A disagreeable, though not a dan- 
 gerous, effect from the neglect of the teeth. 
 is an offensive breath : this fact is suscepti- 
 ble of demonstration by positive experi- 
 ments, one is, that the breath, which is exhal- 
 ed by the nostrils, is widely different from 
 
XVI 
 
 that which ia expired through the mouth of 
 a person with diseased teeth and gums; foetid 
 breath therefore is confined entirely to the 
 state of the mouth, and has no connexion 
 with that of the stomach, or the digestive or- 
 gans, as is erroneously supposed :— eructa- 
 tation or belching can only produce a tem- 
 porary effect ; but, from uncleanliness of the 
 mouth, we find the taint constant and habi- 
 tual ; and, unless the cause be eradicated, all 
 the spices and perfumes of the east, though 
 they may conceal, cannot remove it. 
 
 7thly. Besides the reasons already assign- 
 ed, for the necessity of a strict attention to 
 the teeth and gums, may be added their 
 great influence on the state of the general 
 health. 
 
 The danger to the lungs from constantly 
 inhaling a putrid effluvium, has been strong- 
 ly commented upon by the faculty, as a 
 leading cause of pulmonary consumption. 
 When the great annual mortality from this 
 disease is considered, we cannot doubt that 
 this putrid matter may so change the nature 
 of the fluid inhaled, as to cause that slow in- 
 
XVII 
 
 flammation of tlie lungs, productive of those 
 tubercles which are the foundation of the dis- 
 ease. 
 
 The teeth may be considered, in some 
 measure, as extraneous bodies ; and thus do 
 not, like the other parts of the human frame. 
 possess the power of freeing themselves from 
 whatever is injurious. The importance 
 therefore of an acquaintance with the den- 
 tal art, as a part of education appears indis- 
 pensable, is the only means by which this de- 
 partment of science can be enabled to take 
 that rank, which its importance in promoting 
 the health and comfort of mankind so impe- 
 riously demands. Nothing will be a source 
 of greater satisfaction to the author, than that 
 his humble efforts should be instrumental in 
 effecting so desirable a purpose, by impress- 
 ing on the minds of parents and guardians, 
 the necessity of the care and management of 
 the teeth as a primary duty, with a view to 
 the entire prevention of dental disease and 
 deformity. If begun in childhood, and con- 
 tinued in the regular manner recommended, 
 no accumulation could be formed. — The pre- 
 
XV111 
 
 vention of dental disease is founded on an 
 important discovery of the author: expe- 
 rience has satisfied him fully of its success; 
 and this experience makes him more eager 
 to impress the same conviction on others. 
 If to vaccination we owe, of late years, a 
 decrease of the annual mortality, a point 
 clearly proved, the prevention of dental 
 disease will add to this decrease ; for the 
 constitution will not be worn out, and the 
 health impaired, by sleepless nights and 
 days of tormenting pain from dental irrita- 
 tion, as happens to too many who date the 
 first symptoms of their ill -health from this 
 cause. 
 
 It has been a common opinion, that the 
 teeth are intended by nature to decay sooner 
 than the other parts ; but this opinion is erro- 
 neous. Their premature decay is the con- 
 sequence of neglect ; and neglect acts here 
 in the same manner as in other cases, by 
 sapping the vital energy of the part, if we 
 may use the expression, and thus occasioning 
 them to moulder awav. 
 
XIX 
 
 After these observations on the importance 
 of the care of the teeth, and as a preliminary 
 to the present work, it may be proper to take 
 a general view of the organized structure of 
 man. 
 
A 
 
 GENERAL VIEW 
 
 OF THE 
 
 BODY. 
 
 THE body is composed of a solid and 
 fluid part, mutually dependent on each 
 other : the former gives it stability, form, 
 and the powers of action ; the latter sup- 
 plies the waste, which the solid parts 
 necessarily undergo in the prosecution 
 of their functions. 
 
 The solid part has been divided by 
 anatomists into the head, chest, abdomen, 
 and extremities : the first contains that 
 organ, — the brain, which is the origin 
 and seat of life and feeling; it is en- 
 closed in a case of bone for its greater 
 defence and security, and is thus equally 
 c 2 
 
screened from heat and defended from 
 cold. This part is further covered and 
 beautified by an extensive and constant 
 growth of hair; and to the most promi- 
 nent part of it, the face, is assigned the 
 situation of the different senses which 
 guide and regulate the actions of the 
 body. The chest contains the principal 
 organs which give to the nourishment 
 the peculiar changes that make it pass 
 from a fluid to a solid state, and convert 
 it to supply the decay of the solid parts : 
 of these organs, the principal are the 
 heart, the lungs, and the liver. 
 
 The heart is that strong, indefatigable 
 muscle, by which the blood or vital 
 stream is conveyed to every part; it is 
 enclosed in a membranous bag, the inner 
 surface of which is lubricated by a thin 
 exhalation to allow it its proper play : it 
 possesses two separate cavities. Each 
 cavity contains an auricle and a ventri- 
 cle. — From the right ventricle the blood 
 passes into the lungs by means of the 
 
33 
 
 pulmonary arteries, and is again return- 
 ed to the left cavity of the heart by the 
 pulmonary veins. From the left cavity 
 it passes into the aorta, to be transmit- 
 ted to every part of the system j after 
 this, it is received into the cava, and re- 
 turned to the heart to undergo the same 
 process. Thus, the blood constantly cir- 
 culates in an interchangeable tide, whe- 
 ther asleep or awake, and knows no in- 
 termission in its flow. Through the ar- 
 teries it sallies briskly, and returns more 
 slowly through the veins. The action 
 of the arteries evolves the heat received 
 by the lungs, and contained in the blood 
 for the animation of the body : this heat 
 we find increased by whatever augments 
 the velocity of the circulation, and les- 
 sened by 'whatever renders it languid. 
 
 The lungs, the next important organ, 
 receives the blood from the heart, to 
 draw a new principle through them from 
 the air, and to return this principle into 
 
24 
 
 the circulation, to be dispersed to every 
 part, conveying increased animation and 
 life : they consist of two divisions, one 
 on each side the chest, and they open to 
 the throat by the trachea, or wind-pipe. 
 
 The liver, the largest gland of the 
 body, is situated in the abdomen. Through 
 this gland all the blood circulates, in its 
 return to the heart, after that principle 
 is expended, which it receives from the 
 lungs. This organ secretes a peculiar 
 fluid, the bile, of great use in the animal 
 economy ; and often, by its accumula- 
 tion, its deficiency, or obstruction, is the 
 source of numerous and serious maladies. 
 The gall-bladder is appended to it as 
 the reservoir of that secretion. 
 
 Besides these, some of the lesser or 
 secondary organs may be notited. The 
 kidneys, two small glands situated be- 
 tween the back and loins ; the spleen, 
 for forming the red globules of the blood, 
 or some other important use $ and the 
 
25 
 
 pancreas, secreting that fluid, termed 
 saliva, which assists mastication, and 
 moistens the mouth. 
 
 These divisions of the body are cover- 
 ed partly with bones and cartilage, form- 
 ing a regular arch, gently moveable in 
 respiration, which protects the chest, 
 and partly with a fine membrane, the 
 omentum, and with muscles, which en- 
 close the contents of the abdomen: these 
 parts are appended to the back bone, 
 which sustains the weight of the whole 
 structure, and serves also to form a con- 
 veyance to that elongation of the brain 
 termed the spinal marrow, which gives 
 out part of those fine cords or nervous 
 filaments, that give sensibility to the 
 system. 
 
 The last division of the body is the 
 extremities, — the arms, the hands, the 
 thighs, the legs, and feet. The arms are 
 pendent on either side, proportioned to 
 each other, being the guards which de- 
 
26 
 
 lend, and agents which serve, the whole 
 frame; fitted, by their shape and struc- 
 ture, for the most diversified and exten- 
 sive operations, and capable of perform- 
 ing, with singular expedition and ease, 
 all manner of useful motions. 
 
 The hands consist of numberless small 
 bones and muscles, forming a nice and 
 varied mechanism, capable of assuming 
 many shapes, and performing every use- 
 ful service. 
 
 The lower extremities show the same 
 peculiar adjustment of structure for the 
 office intended by them. The thighs and 
 legs are articulated in such a manner, 
 that they administer most commodiously 
 to the act of walking, and do not ob- 
 struct the easy posture of sitting. By as- 
 suming a gentle projection, they under- 
 go a diminution of bulk, and acquire a 
 more graceful form. 
 
 The feet, the last part of the extre- 
 mities, compose a firm and neat pedestal, 
 far beyond what statuary or architec- 
 
87 
 
 ture can ever accomplish. This pedes* 
 tal is capable of altering its form, and 
 extending its size, as different circum- 
 stances require. It contains a set of 
 active springs, which tend to place the 
 body in a variety of graceful attitudes, 
 and qualify it for a multiplicity of ad- 
 vantageous motions. The undermost 
 parts of the feet are covered with a 
 sinewy substance, preventing that undue 
 compression of the vessels which the 
 weight of the body, in standing or 
 walking, might otherwise occasion. 
 
 Such are the four principal divisions 
 of the body ; but a part of the structure 
 we have hitherto omitted : it is the one 
 by which the aliment is received and 
 prepared for being introduced into the 
 body, to supply the waste that daily and 
 hourly takes place. 
 
 This part begins with the mouth ; con- 
 taining, first, the teeth set in alveolar 
 processes formed on the jaw-bones : the 
 upper jaw consists of six pair of bones, 
 
and one without a fellow, viz. ossamax- 
 illaria, ossa malarum, ossa nasi, ossa 
 lacrymalia, ossa spongiosa inferivra, and 
 ossa palati ; of each of these there are 
 two: the thirteenth is a single bone 
 called the vomer. 
 
 Ossa maxillaria.~- -These bones con- 
 stitute the greater part of the upper 
 jaw, of the nose, and of the roof of the 
 mouth. They have many processes and 
 depressions, which render their figure 
 extremely irregular; by the union of 
 which, and other bones, are formed the 
 cavities called the maxillary sinuses. 
 These cavities are situated beneath the 
 cheek-bones, and are lined with a con- 
 tinuation of the fine membrane which 
 lines the cavities of the nostrils and 
 frontal sinus : this membrane is called 
 the Schneiderian, from the name of its 
 discoverer; and upon it the olfactory 
 nerves are distributed. The upper sides 
 of the maxillary bones form the lower 
 and internal circumference of the or- 
 
29 
 
 bits ; and in their lower sides are the 
 sockets for the teeth. They have several 
 holes for the admission of nerves and 
 vessels ; the principal of which, are the 
 foramen orbit ale externum 9 the foramen 
 incisivum, and the posterior palatine 
 foramen^ which admits the maxillary 
 nerve to pass to the teeth. These bones 
 are joined to the os frontis and ossa la- 
 erijmalia at the great angles of the eyes, 
 and to each other under the upper lip. 
 
 Ossa malarum. — These are the pro- 
 minent bones which form the cheeks : 
 their figure is nearly quadrangular; 
 they jnin the os frontis at the little an- 
 gles of the eyes, their upper sides form- 
 ing the lower and external circumference 
 of the orbits. They are smooth and 
 convex on the surface, and unequal and 
 concave within. The internal sides join 
 the ossa maxularia ; and the external 
 sides are joined by long processes to the 
 temporal bones, which union forms an 
 arch called the zygoma. 
 
so 
 
 Ossa nasi. — So named from their situ- 
 ation and use, forming the upper part or 
 bridge of the nose : they are thin bones, 
 of an irregular, oblong, square figure, 
 externally convex and smooth, and in- 
 ternally concave and rough. They are 
 joined above to the frontal bone — below, 
 to the cartilages of the nose — behind, to 
 the maxillary bones — in front, to each 
 other — and are supported internally by 
 the partition between the nostrils, called 
 the septum narium. 
 
 Ossa unguis, or lacrymalia. — These 
 bones bear some resemblance to the 
 finger nail; from whence their name 
 unguis : they are also called lacrymalia, 
 from the water of the eye passing over 
 them into the nose. Their situation is in 
 the great angles of the eye, separating 
 the orbit from the cavity of the nose. 
 Their surface, next the eye, is concave, 
 and forms part of the orbit on which 
 the eye-ball moves. They join above 
 with the os frontis — below, with the 
 
31 
 
 maxillary bones- — and, internally, with 
 the ethmeid bone. 
 
 Ossa spongiosa inferiora, are so called 
 from their spongy texture. — These bones 
 form part of the nose, enlarge the sur- 
 face, and extend the organ of smelling; 
 they also assist in forming the under 
 part of the lacrymal duct, the orifices 
 of which into the nose are concealed by 
 them. 
 
 Ossa palati are bones of a very irre- 
 gular figure. — They form part of the roof 
 of the mouth, of the nose, and of the 
 orbits. The portions which form part 
 of the palate are irregularly square and 
 concave; and, though thin, are firm 
 and strong : — they have many pro- 
 cesses which joins the other bones of the 
 face. 
 
 The vomer has its name from the re- 
 semblance it bears to the ancient plough- 
 share : its situation is in the middle of 
 the lower part of the nose, of which it 
 forms the partition. This bone is smooth, 
 
32 
 
 thin, and of a solid substance ; it en- 
 larges the organ of smelling, by allow- 
 ing space for expanding the membrane 
 of the nose. 
 
 The lower jaw is admirably adapted to 
 the necessity which exists for a great va- 
 riety of motions, combined with strength 
 of action; it is, at first, composed of 
 two bones, — the ossific fibres of which 
 unite with each other at the chin, soon 
 after birth, and, by complete ossifica- 
 cation, become one bone ; this union is 
 called symphysis. 
 
 This jaw is formed of two lamince, 
 whose surface is hard and smooth ; its 
 internal substance is cellular : its base 
 thick, compact, and hard, particularly 
 at the chin, where it is most exposed to 
 injury. It has two processes on each 
 side ; the anterior of which, called the 
 coronoid processes, end in points which 
 pass under the zygomatic arches. The 
 temporal muscles are inserted into these 
 processes. The posterior processes, calK 
 
33 
 
 ed condyloid, or articulatory processes, 
 are thicker and less elevated than the 
 coronoid processes ; they terminate in 
 oblong, smooth condyles, or heads, sup- 
 ported by a cervix. To each condyle 
 is attached a strong moveable cartilage, 
 which is also attached to the cavity and 
 eminence, which are for that purpose in 
 the temporal bones $ they are further 
 strengthened in their situation by a strong 
 ligament attached to the temporal bones, 
 and to the cervix of the condyles on each 
 side. Thus, the under jaw is firmly 
 united to the skull ; the loose intervening 
 cartilage greatly facilitates its lateral 
 motion, so necessary in mastication. 
 The lower edge of this jaw is called its 
 base, and the end of its base is its angles. 
 In this bone are four holes ; two inter- 
 nal, near the processes ; and two exter- 
 nal, near the chin : by the internal holes 
 enters a branch of the fifth pair of 
 nerves, an artery from the carotids and 
 vein fromthe jvglares, branches^: which 
 
34 
 
 pass into the fangs of the teeth ; these 
 vessels emerge again by the external 
 holes, and spread upon the chin. That 
 part of the bone in both jaws, which 
 immediately surrounds the fangs of the 
 teeth, is called the alveolar process. 
 
 The growth of this process commen- 
 ces with that of the teeth, and advances 
 with them to maturity. 
 
 The existence of the teeth and alveoli, 
 so entirely depend on each other, that 
 the loss of the former, is inevitably fol- 
 lowed by the waste and absorption of the 
 latter. Thus, the jaw bones of persons 
 become toothless through age, have no 
 sockets for teeth, but have a smooth and 
 solid surface. 
 
 The teeth are so formed as either to 
 tear or grind, according to the nature of 
 the aliment presented to them : which be- 
 ing masticated, is received on the tongue, 
 that, without the assistance of either bone 
 or joint, adapts itself to every shape and 
 posture, for the purpose of introducing 
 
35 
 
 the food. This important organ also 
 renders our thoughts vocal, enables us 
 to communicate our sentiments, and by 
 this faculty of speech, qualifies us for all 
 the comforts and benefits of society. The 
 tongue is terminated by the throat, con- 
 taining the passage to the lungs, through 
 which we breathe ; and the passage to 
 the stomach, or gullet, by which we re- 
 ceive food. The stomach, the reservoir 
 of the food, may be considered as its di- 
 latation. In its figure, it resembles the 
 pouch of a bagpipe, and has two ori- 
 fices ; the one which receives the crude 
 aliment from the mouth, and the other 
 which conveys the digested food, or 
 chyle, to the upper part of the intestines. 
 The food on being received into the sto- 
 mach, undergoes an importanlchemicai 
 change : the solvent fluid of the stomach, 
 secreted from its coats, termed the gas- 
 tric juice, acts upon it; and by the fur- 
 ther assistance of heat, it is converted 
 into chyle. This chyle is drawn off by 
 
36 
 
 all the secretory orifices of the lacteal 
 vessels, spread on the surface of the in- 
 testines ; and the useless part separated, 
 and receiving an admixture with the bile 
 and other active fluids, is discharged un- 
 der the form of feculent matter, after 
 passing through the long and intricate 
 convolutions of the cavity of the intes- 
 tines. 
 
 Thus, is the body supplied with food, 
 and its waste repaired. For the choice 
 of this food we are indebted to the senses, 
 which are five in number, viz. the sight, 
 the hearing, the smell, the taste, and the 
 feeling. The eyes, which are the or- 
 gans of vision, are placed in the upper 
 part of the face, are of a globular struc- 
 ture, and consist of simple fluids enclo- 
 sed in thin tunicles. These tunicles 
 are furnished with an apparatus of 
 muscles, enabling them to perform all 
 the varied motions of which they are 
 susceptible. This power, combined with 
 its elevated position, renders the sight 
 
37 
 
 the most extensive of all the senses. It 
 is through this sense only, that we are 
 made capable of enjoying the sublime 
 and most beautiful in nature and art. 
 In sleep, its exercise is suspended, and 
 the lids, those natural curtains, spon- 
 taneously close for its protection, till the 
 light of day again calls forth its active 
 powers. 
 
 Next to the sight is the hearing ; and 
 the organ subservient to this, consists 
 of an outward porch, the external ear, 
 and an internal apparatus of the most 
 admirable contrivance and workman- 
 ship. The hammer, the anvil, the stir- 
 rup, and the drum, are the names of its 
 parts ; the winding labarynths, and the 
 rounding galleries, with other pieces of 
 its mechanism, are all formed to increase 
 the power of hearing, in a manner cu- 
 rious and intricate beyond description. 
 It is through this sense the charms of 
 music are enjoyed, and social inter- 
 course maintained. While the eye is 
 
38 
 
 Watchful only in our waking hours, the 
 ear is expanded to receive impressions 
 at all times, arid to warn us of danger 
 before its approach. So important are 
 the organs of sight and hearing in the 
 estimation of nature, that she has shewn 
 her anxiety of guarding against their ac- 
 cidental loss, by bestowing duplicates 
 of each. 
 
 Smell, the next sense, is one through 
 which also we receive much enjoyment. 
 It has its seat, a fine set of nervous con- 
 geries, spread every where on the inter- 
 nal surface of the nose. Through this 
 sense we inhale the flowery breath of 
 Spring, the scent of autumnal fruits, the 
 delights of the hay-field, the fragrance 
 of the orchard, and the more delicious 
 odours of the garden-rose. 
 
 Taste, the next sense, has its resi- 
 dence in the tongue and palate. Like 
 a friendly monitor, it apprises, us of the 
 safety or mischief of what we eat or 
 drink, and, with the vigilance of a sen- 
 
39 
 
 tinel refuses admission to any article of 
 food till its qualities have been subject- 
 ed to its scrutinizing test. 
 
 The last sense, the touch, is seated in 
 the skin, orthat covering which envelopes 
 the whole body j it possesses, therefore, 
 a wide range, and is not circumscribed 
 to a particular place, as the others are. 
 The skin is formed of the most delicate 
 net work, whose texture is exceedingly 
 minute, and whose threads are multi- 
 plied even to a prodigy : they are so 
 minute, that nothing passes them which 
 is discernible by the eye, though they 
 discharge every moment what con- 
 stitutes insensible perspiration. The 
 threads, indeed, are so multiplied, that 
 the point of the smallest needle cannot 
 pierce a single part without causing an 
 uneasy sensation. The outermost co- 
 vering of the skin is that soft whitish 
 tegument, raised by a blister, termed 
 the cuticle or scarf-skin. The true is 
 that reddish and exquisitely tender part 
 
40 
 
 which appears beneath the blister when 
 broken. The former is void of sense, 
 and intended to screen the true skin 
 from the impressions of the air, and 
 the effect of injuries. The colour of 
 the cuticle is white. The apparent 
 black or brown it acquires in the Ne- 
 gro or Indian, is entirely owing to the 
 mucous substance lying under it. 
 
 The functions of the skin are exten- 
 sive and important. It is the seat, as 
 observed, of the sense of touch ; it is 
 the channel of perspiration, and it ob- 
 serves a sympathy with the internal 
 parts; so that an intimate relation sub- 
 sists between them, and a derangement 
 of the internal organs is always mani- 
 fested by the state of the skin : hence 
 the countenance is a sure index of 
 disease ; and nature has intended this 
 change, in order to give us alarm in 
 the first instance, and warn us of dan- 
 ger : but the sense of touch is more ex- 
 quisite in the points of the fingers than 
 
41 
 
 any other part. Both the fingers and 
 toes are furnished with the defence of 
 nails, which are now considered as a 
 continuation of the cuticle, as they are 
 removed with it by boiling water or 
 maceration. Like the cuticle, they are 
 insensible, are renewable when separat- 
 ed, and have no evident vessels : but 
 they differ from the cuticle in structure, 
 being formed of plates with longitudinal 
 fibres, closely compacted ; they begin by 
 a square root, a little before the last 
 joint of the fingers and toes ; in their 
 appearance, when separated, they are 
 transparent as horn ; but in the living 
 body are coloured by the vessels of the 
 skin, to which they adhere, and from 
 which they derive nourishment : — they 
 are fixed at their root to a semilunar 
 fold of the skin, and are there covered 
 by a reflexion of the cuticle, which firm- 
 ly adheres to them. Their growth pro- 
 ceeds from the roots, not the points : by 
 them the ends of the fingers and toes are 
 
strengthened and defended. In the fin- 
 gers they increase the power of appre- 
 hension, particularly in laying hold of 
 minute bodies. 
 
 The skin is also adorned in certain 
 parts with a foliage of hairs: they arise 
 by roots or bulbs from the cellular sub- 
 stance under them. The bulbs are of 
 various shapes in different parts of the 
 body, and have blood-vessels dispersed 
 upon them for their nourishment. Each 
 of the bulbs has two membranous cap- 
 sules, containing an oily fluid between 
 them, which gives colour to the hair; 
 for want of this in age, or under certain 
 diseases, the hair changes its colour. 
 Each hair consists of smaller hairs in- 
 closed in a membrane, and is somewhat 
 like the nature of the nails. Like them, 
 it grows from the roots. Though all the 
 uses of the hair are not yet known, it 
 evidently serves for the warmth, pro- 
 tection, and ornament of those parts, 
 on or near which it is placed. 
 
43 
 
 Such is a general view of the compli- 
 cated and varied structure of man. When 
 we contemplate the nicety and art with 
 which every part is constructed, we 
 should suppose it was intended to last 
 for ages : experience, however, daily 
 teaches us the reverse ; and that certain 
 parts giving way, and falling into decay, 
 occasion the destruction of the whole 
 machine. 
 
 The teeth, though the hardest parts of 
 the human frame, and intended hy nature 
 to survive every other, are, through ne- 
 glect and mismanagement, the soonest 
 which give way. The nature and dis- 
 eases of these organs are what we are 
 now to consider as the subject of the 
 present volume. 
 
44 
 
 OF THE 
 
 FORMATION AND STRUCTURE 
 
 TEETH. 
 
 THE teeth consist of two parts : osse- 
 ous matter, the sama as other bone j and 
 enamel, their peculiar covering, which 
 gives them their whiteness and polish of 
 surface. Each tooth may be properly 
 divided into three parts. 
 
 First, — The crown, or that part which 
 projects from the gum, and is the only 
 division which possesses the covering of 
 the enamel. 
 
 Secondly, — The neck, or that part 
 where the enamel immediately termi- 
 
45 
 
 nates, and to which the gum is closely 
 attached. 
 
 Thirdly, — The fang, enclosed hy the 
 socket, and inserted deeply into the 
 jaw. 
 
 At the point of the fang there is a 
 small opening, placed for the passage of 
 nerves and vessels, which are ramified or 
 spread out on the lining of the opening 
 within the tooth. In this manner the 
 circulation and sensation of each tooth 
 are supplied. The fang is, therefore, an 
 important part, and of the same value 
 as the root to vegetables ; preserving the 
 tooth in its due position, and, at the 
 same time, conveying to it the proper 
 degree of nourishment. 
 
 Man differs from other animals in be- 
 ing provided with two sets of teeth : 
 the first intended for the period of in- 
 fancy, and consequently limited in their 
 duration j the second intended for the 
 remainder of life, and, therefore, of a 
 stronger and more compact texture. The 
 
 E 2 " 
 
46 
 
 teeth, in their first formation, unlike 
 other bone, instead of having for their 
 base cartilage or membranous substance, 
 are formed from a soft pulpy matter 
 resembling their shapes, and may be 
 distinctly seen at the time of birth. As 
 soon as they have attained their shape, 
 grooves are formed, into which the sur- 
 rounding vessels deposit the pulpy mat- 
 ter, constituting the rudiments of the fu- 
 ture teeth. 
 
 At the age of five or six months, this 
 pulpy matter has a regular arrangement, 
 and is enclosed in membranous sacs or 
 bags, ten in number, in each jaw, cor- 
 responding to the number of the tempo- 
 rary teeth. This first appearance is 
 succeeded by ossific fibres shooting 
 across, and dividing the sacs into their 
 respective compartments, which are the 
 commencements of the future sockets. 
 About the seventh month, the ossifica- 
 tion commences, both on the cutting 
 edges of the first teeth, and on the pro- 
 
47 
 
 minent points of those situated further 
 back in the jaw. 
 
 At birth, the bodies of all the first set 
 appear distinctly formed in each jaw ; 
 but, at this time, they are ossified only 
 on the external parts, and the unossified 
 pulp within is merely covered with a 
 shallow bone. As the teeth proceed in 
 their ossification and shape, the invest- 
 ing membranes adhere more closely to 
 their necks ; and by this attachment 
 they secrete and deposit over the crowns 
 of the teeth a fluid, from which a very 
 white substance is deposited upon the 
 bone. This is the enamel, which is at 
 first of a consistence not harder than 
 chalk; but in age it acquires such a 
 hardness, that a file in cutting it, is soon 
 worn smooth. 
 
 After birth, the growth of the teeth is 
 rapid, and cannot, therefore, be confined 
 long within the alveolar cavity or socket; 
 they lengthen chiefly from the bodies ; 
 those of the under jaw downwards, and 
 
those of the upper jaw upwards. The 
 parts that first lengthen are shaped into 
 fangs ; and, as this takes place, the sockets 
 grow round, and more closely invest them. 
 On the progressive ossification of the 
 teeth, their original membranous cover- 
 ings undergo the process of absorption, 
 and are carried out of the system, having 
 completed their original and destined 
 purpose. In the progress of this growth 
 of the teeth, a corresponding growth 
 takes place in the sockets or alveolar 
 plates; at first, they grow much faster 
 than the teeth themselves, which are 
 consequently, but loosely, contained in 
 them ; and this rapidity of growth is 
 necessary, both to render the soft gum 
 capable of sustaining pressure, as well 
 as to protect the embryo teeth from 
 injury. Hence, in the mode of their 
 growth, it may be observed, that the 
 outer edges of the sockets or plates grow 
 higher, and turn a little over in order to 
 approach each other : the gum then 
 
49 
 
 hardens over ; — and thus the teeth are 
 fully protected, and the gums rendered 
 sufficiently firm to undergo every neces- 
 sary degree of pressure. 
 
 The protrusion of the first set of teeth 
 begins as early as at the end of four or 
 five months after birth, though in this 
 there is a considerable variation ; nor 
 does this variation depend on the strength 
 or delicacy of the child ; for we often 
 find that delicate children commence 
 dentition very early,' while, on the other 
 hand, strong children are very slow in 
 acquiring their teeth : nay, there are 
 some instances where children have 
 shewn no appearance of teething until 
 the fourteenth or fifteeth month. The 
 general rule, however, is, that their 
 protrusion begins from the sixth to the 
 eighth month after birth : the mode in 
 which they affect a passage through the 
 gums, is by the process of ulceration. 
 The teeth pressing on the membrane 
 which encloses them, occasions its ab- 
 
50 
 
 sorption ; and the pressure being next 
 continued on the gum, causes that also 
 to give way. 
 
 The order in which the teeth succes- 
 sively make their appearance, may be 
 thus described : first, the two front in- 
 cisores, or cutting teeth, of the under 
 jaw, — one generally appearing a few 
 days before the other; for, though form- 
 ed in pairs, they seldom protrude at the 
 same time. In about a month after, those 
 are succeeded by the front incisores of 
 the upper jaw. Next follow the lateral 
 incisores of the under jaw, and soon after 
 those of the upper jaw. A deviation 
 from the order, hitherto observed, then 
 takes place; and, instead of the cuspidati, 
 or canine teeth, which are next in suc- 
 cession, the anterior molares, or double 
 teeth, appear in the under jaw ; and 
 these are soon after succeeded by those 
 of the upper jaw. Then follow the 
 large inolares which completes the first 
 or temporary set. The whole process 
 
51 
 
 generally occupies a period of about two 
 years and a half. 
 
 Though this is the regular course 
 observed by nature, there are, at times, 
 exceptions to this order of protrusion ; 
 for, instead of the front incisores, the 
 lateral incisores are discovered first 
 through the gums, and the small molares 
 before the lateral incisores. It may be 
 remarked, also, that children have been 
 born with the two front incisores of the 
 under jaw through the gum, but such 
 premature birth is always imperfect; 
 these teeth possess no fangs, and are 
 attached chiefly to the gum, which oc- 
 casions pain and irritation to the child; 
 on which account it is generally found 
 necessary to extract them. 
 
 The period of dentition is often highly 
 critical to the constitution of the child, 
 as it not only occasions disease, but 
 generally aggravates any other disorder 
 which may occur at the time ; yet, it is 
 well known, that this period sometimes 
 
52 
 
 elapses unaccompanied by any particu- 
 lar symptoms of pain or uneasiness. 
 
 The appearance of the teeth is clearly 
 an effort of nature, in which she effects 
 the absorption of the investing mem- 
 brane, the alveolar process, and the 
 gums, to make way for their passage ; 
 but the teeth sometimes advancing too 
 rapidly, occasion a strong tension and 
 pressure on the vessels of the gums, 
 which produces pain and irritation in 
 the surrounding parts. Hence, the gums 
 appear swelled and inflamed, a constant 
 discharge of saliva takes place from the 
 mouth, and often a general sympathetic 
 fever prevails over the whole system. 
 
 At this stage of the fever, which fre- 
 quently proves fatal, the treatment of 
 the child, both as respects the parts 
 affected, and the system in general, de- 
 mands particular attention. 
 
 It is commonly recommended to allow 
 the child some hard substance to press 
 against the gums, which, though it may 
 
53 
 
 afford a temporary relief, generally in-^ 
 creases the inflammation and uneasiness. 
 A more effectual means of relief would 
 be afforded by producing a gentle fric- 
 tion on the gum, with the finger and a 
 little fine salt; which, by exciting a co- 
 pious flow of saliva, and thus reducing 
 the action of the vessels, would tend to 
 alleviate the inflammatory symptoms. 
 But an early recourse to the lancet is 
 the safest expedient, and the only one 
 that is to be depended on. An incision 
 made with this instrument over the tooth 
 that is the cause of irritation, either in 
 a linear or cruciate form, as the tooth is 
 single or double, would not only ad- 
 minister instantaneous ease to the little 
 sufferer, but would prevent or remove 
 ^very distressing and dangerous symp- 
 tom with which dentition is often at- 
 tended. But little skill is required in 
 performing so simple and safe an opera- 
 tion, particularly if the lancet, the au- 
 thor has invented for the purpose, be 
 
5$ 
 
 employed. The operator must see that 
 his instrument reaches the seat of the 
 mischief ; and not be satisfied with 
 barely dividing the gum, but, also, the 
 membrane below the gum, that is in im- 
 mediate contact with the tooth. The 
 division of this membrane, from its 
 tougher texture, will acquire some little 
 pressure of the lancet, (and, with the 
 instrument commonly used, a conside- 
 rable one,) from which it need not be 
 apprehended the tooth can sustain the 
 slightest injury. 
 
 And here I cannot but seize the pre- 
 sent opportunity of combating the preju- 
 dice that so generally prevails in the 
 minds of parents against the use of the 
 lancet. Let them be assured, it is ab- 
 solutely impossible the slightest harm 
 can arise from its use, even when the 
 operation is discovered to have been un- 
 necessarily performed. When parents 
 are even convinced of its necessity, their 
 fears frequently induce them to postpone 
 
55 
 
 the operation till fatal symptoms of 
 convulsion appear, which frequently 
 prove fatal, and in one moment awfully 
 reproach their indecision, by hurrying 
 their infant offspring to another world. 
 But let not the most threatening symp- 
 toms of danger deprive the afflicted 
 mother of her presence of mind, but let 
 her apply immediately to the lancet; 
 for the author has known many a child 
 snatched, as it were, from the arms of 
 death, when the delay of its application, 
 even for a few seconds, he has the 
 strongest reason to suppose, would have 
 terminated their existence. 
 
 The general irritation of the system 
 which attends teething, is marked by 
 the following leading symptoms : 
 
 Flushings of the cheek and fever, 
 which is generally sudden in its attack. 
 The eyes of the child first become heavy; 
 he is hot and restless, putting his hand 
 often into his mouth. The tongue be- 
 comes white, the skin dry, and the ap- 
 
56 
 
 petite and rest are disturbed. These 
 symptoms become often so aggravated, 
 that delirium succeeds, convulsions su- 
 pervene, and a fatal termination takes 
 place. 
 
 Where fever is not so predominant, 
 diarrhoea is a common symptom, which, 
 if gentle, is attended with beneficial 
 effects, and assists in taking off the irri- 
 tation ; but when, on the contrary, it is 
 violent, of a green colour, and attended 
 with much griping, the child becomes 
 exhausted, its rest is constantly disturb- 
 ed, startings and convulsions supervene, 
 and the termination is often fatal. 
 
 Another symptom of general irrita- 
 tion at this period is, the appearance of 
 different eruptions on the skin. These 
 are attended with considerable variety, 
 and are often thought to arise from a 
 different cause than that of teething j but 
 the period of their occurrence marks 
 their origin, and every remedy is found 
 ineffectual, till the irritation of teeth- 
 
57 
 
 ing is past. — Such are the symptoms 
 which the protrusion of the first set oc- 
 casions. 
 
 The permanent set, on the contrary, 
 occasions no uneasiness or pain. These, 
 like the others, are formed before birth ; 
 but, in the formation and perfection of 
 this set, we may observe, a very impor- 
 tant part of life is occupied ; twenty 
 years being necessary for their complete 
 evolution. They consist, generally, of 
 thirty-two in number; being twelve more 
 than the primary set, and are divided 
 into four classes, namely, eight incisores, 
 four cuspidati, eight bicuspides, eight mo- 
 lares, and four dentes sapientice: if more, 
 they are termed supernumerary teeth. 
 
 The formation of both sets of teeth 
 correspond to the elongation or growth 
 of the jaws, and the changes are exhibit- 
 ed in the following order : the tempora- 
 ry incisores and cuspidati of the child, 
 are succeeded by larger ones of a similar 
 form i while those which succeed the 
 f2 
 
98 
 
 temporary molares, are much smaller, 
 and, being divided or irregular on their 
 grinding surfaces, are called bicuspides. 
 The adult molares, which succeed each 
 other as the jaws advance in growth, all 
 differ in the number and shape of their 
 fangs. 
 
 The size of the teeth is originally de- 
 termined by the deposition of ossilic 
 matter assigned them, so that, on their 
 appearance beyond the gum, their growth 
 may be considered as completed, for 
 they neither increase in size nor alter in 
 shape. 
 
 The first set, or temporary teeth, hav- 
 ing answered their purpose, the perma- 
 nent teeth, formed in sockets behind 
 them, and which have been gradually 
 proceeding in growth, by pressing for- 
 ward, possess the situation of the others : 
 and in this, they are often impeded by 
 the roots of the temporary set, which 
 have never been absorbed. 
 
 This effort, which facilitates the re- 
 
59 
 
 moval of the temporary set, is one of 
 the most curious operations of nature. 
 The absorption takes place in the in- 
 cisores about the fifth or sixth year, and 
 proceeds in rotation, as the teeth origi- 
 nally protrude through the gums. The 
 Absorption is retarded by uncleanliness, 
 and disease of the teeth and gums, which 
 occasion irregularity in the permanent 
 set 
 
60 
 
 SHEDDING OF THE TEETH, 
 
 THE changes which the teeth under-* 
 go form a very interesting part of Na- 
 tural History ; and is absolutely requisite 
 to be known by every parent, to enable 
 them to render such assistance, during 
 the progress of the second dentition, as 
 may prevent the permanent teeth from 
 acquiring that irregularity which occa- 
 sions so much deformity of the face, and 
 often destroys correct enunciation. 
 
 The period when the temporary teeth 
 begin to shed, is usually between the 
 fifth and seventh year. On the removal 
 of the front incisores of the under jaw, 
 the permanent ones immediately succeed, 
 and next the four first permanent molares 
 appear ; and then the permanent inci- 
 sores of the upper jaw, which are sue- 
 
61 
 
 ceeded by the lateral incisores of the un- 
 der jaw, and soon after by those of the 
 upper. The bicuspides are the next in 
 order : first, the anterior ones of both 
 jaws, and soon after the posterior ones ; 
 the cuspidati of the under jaw next ap- 
 pear; then the corresponding ones of 
 the upper ; and, near the same time, the 
 middle molares make their appearance 
 in both jaws, which is, generally, be- 
 tween the eleventh and thirteenth year; 
 and, lastly, the posterior molares, termed 
 dentes sapientise, or wisdom teeth. The 
 time of their protrusion is more uncer- 
 tain than the others ; sometimes they 
 appear as early as the eighteenth year, 
 and at other times not before the fortieth 
 year. Such is the time occupied by na- 
 ture in the perfection of the permanent 
 set of teeth ; and such is the order in 
 which they generally appear. Though 
 the number of the second set is found to 
 be thirty-two in all, yet a natural defi- 
 ciency of them often occurs ; but these 
 
62 
 
 aberrations of nature are very rare: in- 
 stances are even stated of persons not 
 having any teeth; in such cases the 
 gums are found sufficiently callous, and 
 competent to every purpose of mastica- 
 tion. 
 
 Having thus described the two sets of 
 teeth, it will be further necessary to con- 
 sider, that part of their structure which 
 is peculiar to these organs, and which 
 qualifies them for the proper discharge 
 of their office. This part is the cortex 
 striatus, or enamel, which consists of a 
 crystallization, formed by a soft earthy 
 matter, deposited by the investing mem- 
 branes on the bony layers of the crowns 
 of the teeth. Its appearance, at first, 
 is in fibres or streaks, running from the 
 circumference to the centre of the teeth. 
 As it hardens, these fibres arrange 
 themselves into arches over the bodies of 
 the teeth. Hence, by this mode of ar- 
 rangement, arises its durability and 
 strength, to resist, without injury, the 
 
63 
 
 frequent actions to which it is exposed. 
 The enamel, though thus so hard and 
 strong, is not above half a line in thick- 
 ness; but this thickness is increased on 
 the cutting edges and grinding surface 
 of the teeth; its hardness may be consi- 
 dered as tempered steel, and when struck 
 againstthe latter it will emit sparks. The 
 enamel, in many cases, appears imper- 
 fect ; and where indented spots are seen on 
 its surface, they may generally be attri- 
 buted to uncleanliness of the mouth dur- 
 ing the growth of the teeth. The ena- 
 mel consists of three principles, viz. 
 phosphate of lime, carbonate of lime, and 
 gelatine, in different proportions. It is, 
 at first, of a consistence not harder than 
 chalk; though, when the teeth appear 
 through the gums, it has acquired the 
 firmer texture of bone ; yet it is often so 
 acted upon by particles of food and dis- 
 ease of the gums, as to assume a honey- 
 comb appearance. 
 Having considered the formation and 
 
64 
 
 progress of the teeth, to the complete 
 evolution of the permanent set, it will 
 now be proper to examine, not only the 
 diseases to which, as organized bodies, 
 they are exposed, in common with other 
 bone, but also the disorders to which 
 they become liable, from the peculiarity 
 of their situation. 
 
 As diseases of the teeth not only injure 
 the gums and taint the breath, but also 
 affect the alveolar processes, their treat- 
 ment should be undertaken only by an 
 operator that is thoroughly acquainted 
 with the principles of surgery. 
 
 Whatever affects the teeth, is readily 
 communicated to their appendages ; and 
 hence, the alveolar processes and sock- 
 ets, from their intimate connection, in- 
 variably become more or less diseased. 
 The teeth, from the compactness of their 
 structure, do not, like other bone, pos- 
 sess sufficient power to effect exfoliation, 
 or the natural removal of disease ; neither 
 is it in their power to bring on the pro- 
 
65 
 
 cess of suppuration, which nature em- 
 ploys as a salutary change to carry off 
 the morbid effect that takes place; and 
 when inflammation commences, if not 
 speedily removed, occasions gangrene, 
 or a death of the affected parts. 
 
66 
 
 THE ADULT TEETH. 
 
 THE teeth may be viewed, in some 
 degree, as extraneous bodies, not liable 
 to those diseases which affect the rest of 
 the system. This has not been duly con- 
 sidered by preceding writers, who have 
 generally supposed these substances to 
 be affected by all those circumstances 
 which influence the rest of the body, and 
 which are here, on the contrary, from 
 the nature of their composition, of no 
 effect whatever. The diseases of the 
 teeth are simple; and they are only 
 changed by that chemical agency which 
 is immediately applied to them, and 
 which never fails, when exposed for 
 any length of time to its influence, to 
 produce an erosion of their enamel. 
 The adult, on the discovery of a carious 
 
67 
 
 tooth, may date the mischief even as far 
 back as the period of childhood, when 
 the means of prevention should have 
 been administered. 
 
 Numerous are the causes of diseased 
 teeth and gums, stated by writers ; but 
 these causes may be considered, for the 
 most part, as ideal. It has been assert- 
 ed, that climate has a considerable in- 
 fluence in this respect; that the inhabi- 
 tants of warm countries have sound 
 teeth, while those in the colder regions 
 have diseased teeth. But this is contra- 
 dicted by plain fact ; for we find persons 
 both with sound and diseased teeth in 
 every climate, which shews it is not to 
 that cause the disease is to be attributed. 
 The same may be said of the luxuries 
 of the table, in respect to sauces, acids, 
 sweetmeats, &c. For the teeth, the hard- 
 est substance of the animal machine, 
 can never be acted upon by the transient 
 passage of certain articles of food and 
 beverage into the stomach. The same 
 
68 
 
 observation will apply to heat and cold, 
 and to the temperature of substances 
 taken into the mouth. This temporary 
 influence can never, of itself, produce 
 disease in the teeth. 
 
 To what then are the disorders of the 
 teeth to be attributed ? This is an inter- 
 esting question ; and one whose solution 
 escaped even the penetration of those ce- 
 lebrated physiologists, Hunter and Fox. 
 I esteem it, indeed, a most fortunate 
 circumstance, that my attention was so 
 early and closely engaged by an enquiry 
 of such general importance : and I can 
 now assure my readers, that the result 
 of my labours, founded on the successful 
 prosecution of a series of the most nu- 
 merous and satisfactory experiments, 
 few have had even an opportunity of 
 making is, that the relics of what we eat 
 or drink, (without regard to its qiialitij) 
 being allowed to accumulate, stagnate, and 
 putrefy, either in the interstices of the teeth, 
 as is most commonly the case, or else in 
 
09 
 
 those indentures on their surface, favour 
 able for the lodgement of food, is univer- 
 sally the cause of their decay, and general- 
 ly of most otlier disorders, to which they 
 are exposed. 
 
 The great and leading cause, there- 
 fore, of the diseases of the teeth and 
 gums, is to be sought for in the exercise 
 of their functions. Being the agents of 
 introducing the supplies to the system, 
 they must act on these supplies mechani- 
 cally, and fit them for passing into the 
 stomach ; and, in doing so, part of that 
 matter, of which the supplies consist, 
 must adhere, and receive, if allowed to 
 remain, that change which enables it to 
 act upon, and erode their enamel and 
 bone ; and to contribute to that peculiar 
 secretion on the teeth, known by the 
 name of tartar, which is another cause 
 of inflammation and disease of the gums. 
 
 This is the true source o/caries, or decay 
 
 of the teeth, which the two late eminent 
 
 writers before-mentioned, find so difficult 
 g 2 
 
70 
 
 to account for ; and of which discovery 
 I cannot help feeling a pride and pleasure 
 in avowing myself the author; for I can, 
 with confidence, assert, that if the teeth 
 and gums are regularly cleaned with the 
 dentifric apparatus, recommended by the 
 author, no caries can possibly take place. 
 This then is a simple and clear view of 
 the subject, and the grand desideratum 
 for retaining these important organs in 
 a sound and healthy state, to the latest 
 period of existence. The mode of clean- 
 ing the teeth, as usually performed, is to 
 rub them with a brush and a prepara- 
 tion of tooth powder, or tinctures, (to 
 which some great quality is ascribed f) 
 but, in wiiatever way it is employed, 
 the source of the evil still remains; for 
 the interstices and irregularities of the 
 teeth afford a lodgement for whatever is 
 taken into the mouth ; and no contrivance 
 hitherto discovered can, from these 
 parts, remove the accumulation. 
 
 After much experience and reflection 
 
71 
 
 on the subject, I found it necessary to 
 construct a dentifric apparatus, which 
 is found to answer every purpose, and 
 to obviate the defects in common prac- 
 tice. This apparatus consists of three 
 parts, contained in a small case, with a 
 dental mirror, fit for the toilet or the 
 pocket. 
 
 The first part to be used is the brush.* 
 It is made hollow 7 in the middle, to em- 
 brace every part of the teeth, except the 
 interstices ; and thus, at one operation, 
 the top, (a part hitherto entirely ne- 
 glected) the outer and inner surfaces 
 are completely freed from all extraneous 
 
 * As public utility, more than emolument, is the 
 object of Mr. Parmly, he has resisted the advice 
 of his friends, in declining to take out a patent for 
 his brush; he cannot, however, but submit it to the 
 feelings of a well known Dentist, at the west-end of 
 this Metropolis, how far sentiments of candour or 
 justice can warrant him in affixing his name to this' 
 article, and assuming to himself the credit of the 
 invention* 
 
. 72 
 
 matter. The second part is the dentifiic 
 polisher, for removing roughness, stains, 
 &c. from the enamel, and restoring to 
 the teeth their natural smoothness and 
 colour. The third part is the waxed silken 
 thread, which, though simple, is the 
 most important. It is to be passed 
 through the interstices of the teeth, be- 
 tween their necks and the arches of the 
 gums, to dislodge that irritating matter 
 which no brush can remove, and which 
 is the real source of disease. With this 
 apparatus, thus regularly and daily used, 
 the teeth and gums will be preserved 
 free from disease ; the use of powders, 
 tinctures, &c. will be superseded ; and 
 the breath will not be loaded with that 
 putrid effluvium, which, besides its pub- 
 lic annoyance, is the cause of numerous 
 disorders. Indeed, were persons suf- 
 ficiently attentive to cleanliness of the 
 mouth, diseases of the teeth and gums 
 might be prevented, without the neces- 
 sity of any painful operation, which 
 
73 
 
 would contribute no less to the improve- 
 ment of the features of the countenance, 
 than to the promotion of general health 
 and comfort. Having thus pointed out 
 the simple and successful method of 
 preserving the teeth and gums, and 
 rendering the breath agreeable, we will 
 now consider their treatment when in 
 a diseased state, and rectify the practice 
 of former dentists. 
 
74 
 
 TREATMENT 
 
 DISEASED TEETH AND GUMS. 
 
 THE means of prevention, pointed out 
 in the preceding part of the work, ap- 
 pear at first sight, interesting only to 
 those whose teeth are not yet attacked 
 by disease. Where, however, it has 
 actually commenced, and undergone the 
 specific treatment adapted to its cure, 
 the means of prevention, already insist- 
 ed on, will be equally efficacious against 
 any future attack. 
 
 The treatment of the diseases of the 
 teeth constitutes an important branch of 
 surgery ; and it is proper and almost 
 indispensable, that every person, and 
 particularly parents, should have some 
 acquaintance with the operations be- 
 
75 
 
 longing to this branch, that they may 
 form some idea themselves of what is 
 proper to be done, and what may be 
 reasonably expected from the person 
 who denominates himself a professor of 
 the dental art ; individuals will thus be 
 guarded against the exaggerated pro- 
 mises of empyrics, and form just expec- 
 tations for themselves of what can be 
 done for their relief and improvement. 
 For, whatever experience and manual 
 dexterity the dentist may profess, he can 
 never perform miracles, or effect any 
 thing more than is rendered practicable 
 by the laws of nature, and a knowledge 
 of the structure of the teeth and their 
 appendages. 
 
76 
 
 CARIES. 
 
 CARIES, or the decay of part of the 
 teeth, arising from uncleanliness of the 
 mouth, is the most frequent disease to 
 which they are liable. It commences, 
 generally, in the interstices and irregu- 
 larities of the teeth, in the form of a 
 small dark spot on the enamel, which, 
 eating it away, passes inwards, and oc- 
 casions a still more rapid decay of the 
 bone, till the tooth is entirely destroyed. 
 It has been a grand mistake with authors 
 on this subject, that caries commences 
 internally, and acts on the bony sub- 
 stance of a tooth. The enamel, how- 
 ever, may be considered at all times, the 
 first seat of attack; though, on the bone, 
 from its softer texture, it makes a 
 greater and quicker havock than on the 
 
77 
 
 outer crystallized covering, which, to 
 the eye, appears oftentimes scarcely 
 perforated. 
 
 The wasting of the hone thus deprives 
 the enamel of its support, so that the 
 least pressure, on masticating hard sub- 
 stances, causes it to break away, which 
 exposes it to the action of every external 
 substance ; and then a cavity is disco- 
 vered in a tooth which had been sup- 
 posed, previously to this, perfectly sound. 
 Mr. Fox, and other writers, observed, 
 that one part of a tooth is not more lia- 
 ble to disease than another j but the very 
 nature of the cause which produces ca- 
 ries, viz. the relics of the food lodging 
 in the interstices, proves, that those are 
 the parts in which diseases generally 
 commence. The molares are usually 
 more decayed than any other of the teeth. 
 This arises not only from their being 
 more neglected than those placed in the 
 prominent part of the mouth, but, from 
 their indented surface, affording easier 
 
78 
 
 lodgements for food than the other teethj 
 and for the removal of which, my new 
 invented brush is so well adapted. The 
 caries, or decay often begins on those 
 sides of the teeth which are placed in 
 apposition to each other ; and, from the 
 nature of the cause, which acts by a 
 putrefactive process, there is no doubt, 
 that, among the sound teeth, any one 
 which is contiguous to a tooth that is 
 decayed, is the most liable to diseased 
 action. The incisores of the upper jaw, 
 are, also, very frequently affected in this 
 way, while those of the under jaw are 
 very seldom known to decay. Their 
 preservation arises from the under jaw 
 being more exposed to the action of the 
 saliva, the solvent powers of which pre- 
 vent the relics of the food from injuring 
 the teeth. The first appearance of ca- 
 ries, in every instance, is, by a disco- 
 louration, as before noticed, of the af- 
 fected part ; and, when a decayed tooth 
 is examined, the diseased part appears 
 to be disposed in strata, the external 
 
79 
 
 layers of which are most decayed, as- 
 suming a blacker appearance, and are 
 rendered so soft as easily to be cut away. 
 The next are of a harder nature, less 
 discoloured, and gradually exhibiting a 
 firmer texture, till we reach the part that 
 is perfectly sound. When the opaque- 
 ness of the enamel indicates the attack 
 of caries, if the tooth is sawn through, 
 a brown mark will be discovered, ex- 
 tending towards the natural cavity. — It 
 is in this direction the disease proceeds, 
 and, on the cavity being exposed, the 
 investing membrane, and its ramifying 
 nerves and blood-vessels, discover inflam- 
 mation, which is the cause of tooth ache. 
 During the progress of caries, the inter- 
 nal part of the crown, from its softer 
 texture, suffers most, and is, therefore, 
 soonest removed, which causes the inside 
 to appear excavated. When the whole 
 crown is destroyed, the progress of dis- 
 ease seems somewhat suspended ; and the 
 fangs will often remain, for many years, 
 
80 
 
 with little alteration, from the cause of 
 the disease not having the same field to 
 act upon as it had on the crown, which 
 is always an exposed part; and the 
 fangs will even continue firmly attached 
 to the socket, without the least incon- 
 venience. 
 
 Hence, persons seldom experience the 
 pain of tooth ache, from what are termed 
 stumps ; for, hy the disease destroying 
 the body of the teeth, the investing mem- 
 brane, and its blood-vessels, are remov- 
 ed, and the circulation to the fang is thus 
 cut off. 
 
 Pain, therefore, from stumps, arises 
 from their acting as extraneous bodies 
 on the sockets ; and thus exciting in- 
 flammation, which often terminates in 
 suppuration. 
 
 It is surprising, that the cause of caries 
 should have been so much misunderstood. 
 Mr. Hunter goes so far as to say, that 
 it does not arise from external injury, 
 or from menstrua, which have the power 
 
81 
 
 of dissolving part of a tooth, and that 
 we may reasonably suppose that it is a 
 disease originally arising in the tooth 
 itself. This idea is acceded to by Mr. 
 Fox, who expresses the same doubt and 
 obscurity respecting it. But if we at- 
 tend to the commencement and progress 
 of the disease, it appears evident, that 
 the cause is of an extraneous nature, as 
 before-mentioned ; that it first affects 
 the enamel in one point, and that this 
 point is in a situation most liable to be 
 acted upon, by the relics of the food and 
 beverage which, from heat and stagna- 
 tion, undergoing a putrefactive fermen- 
 tation, acquire a sufficient solvent power 
 to produce disease. The proof that this 
 is the true cause of caries, is evident 
 from the fact, that those who daily and 
 regularly clean their teeth, even in the 
 common method, are not so subject to 
 this disease, because less lodgement can 
 then take place in the interstices, or else- 
 where to act upon them. 
 
 H 2 
 
82 
 
 Mr. Fox, therefore, following his pre- 
 decessors, has bewildered himself on this 
 subject, and lost sight of the true cause. 
 
 He ascribes it, in the first place, to a 
 state of ill health, during the formation 
 of the teeth, which renders them unable 
 to resist the causes of disease. But this 
 cause would extend equally to all the 
 teeth, if it arose from a general weak- 
 ness of the system. He next attempts to 
 account for it, from a state of constitu- 
 tion connected with dyspeptic symp- 
 toms, or stomachic complaints. 
 
 But this cause, like the other, could 
 only act by depriving the body of its 
 due portion of nourishment, and the 
 teeth of course as a part : to this must 
 be ascribed, the pearly white appearance, 
 he remarks on them : but it never could 
 induce a specific action on particular 
 teeth, the leading point contended for. 
 Certain kinds of diet, he next resorts to, 
 as the source of caries ; but whatever 
 we eat or drink, can only act on the 
 
83 
 
 teeth while it remains in the mouth : yet 
 so far we agree with him, that the relics 
 of any diet, allowed to stagnate in the 
 interstices, as we have already pointed 
 out, will be sufficient to produce the dis- 
 ease, without the aliment being of any 
 particular kind. The same objections 
 apply to the influence of temperature of 
 the atmosphere ; for in all countries 
 teeth are found sound and healthy. This 
 is a proof, that the cause is entirely of 
 a local nature, and confined to that part 
 where the disease first appears. 
 
 Caries, it is clear, can never arise 
 from irregularity of the teeth, nor yet 
 from their being placed too close to each 
 other, or improperly situated in any 
 part of the mouth; excepting, so far, as 
 such circumstances may afford a more 
 convenient lodgement for food and other 
 matter, to act upon them chemically. On 
 the subject of caries, from the above 
 facts, we are led to conclude, that no one 
 part of the teeth is more liable to 
 
84 
 
 disease than another; and that caries is 
 not peculiar to them at any certain pe- 
 riod of life : but, when the cause is ap- 
 plied, the decay is more rapid in child- 
 hood than in the adult; which has given 
 rise to the common expression of « bad 
 teeth, so young, I am surprised.' 5 This 
 surprise instantly ceases, when it is con- 
 sidered, that the teeth of young children 
 are very little harder than wood. In 
 dismissing this subject on caries, it may 
 not be amiss to state, that the calamities 
 of war have afforded the author an op- 
 portunity, with which few, perhaps, of 
 his profession, have been favoured, of in- 
 vestigating the true cause of caries; and 
 of satisfying himself, in regard to the 
 accuracy of his own theory. He lias 
 now, in his possession, thousands of 
 teeth, extracted from bodies, of all ages, 
 that have fallen in battle, inflicted with 
 caries from its first commencement to 
 the last stage of the disease; and he 
 will undertake to satisfy the most seep- 
 
83 
 
 tieal on this point, that caries univer- 
 sally commences externally. What has, 
 in all probability, given rise to a con- 
 trary opinion is, that the aperture in 
 the enamel, through which this disease 
 finds its admission, is, in many cases, so 
 exceedingly minute, as to escape the de- 
 tection of all, but those who are aware 
 of its true cause. 
 
86 
 
 TARTAR. 
 
 EXCEPTING the disease of caries, 
 nothing is so destructive of the healthy 
 condition of the mouth, or of the dura- 
 bility of the teeth, as the accumulation 
 of tartar. This is an earthy substance, 
 held in solution by the saliva, and is 
 deposited on the teeth as the saliva 
 undergoes decomposition. Almost every 
 person is subject to the formation of it, 
 in a greater or less degree ; in some, 
 the deposit is so habitual and copious, 
 that, without unremitting attention, there 
 is no guarding against its accumulation ; 
 whereas in others, it is so small in quan- 
 tity, that the least degree of care is suf- 
 ficient to keep the teeth perfectly free 
 from it. Similar concretions are known 
 to be deposited in other parts of the 
 
87 
 
 body, of a nature corresponding with the 
 fluids that pervade those parts of the 
 system. 
 
 In some, the tartar is deposited in 
 greater quantities, during disorders of 
 the alimentary canal. It is also in- 
 creased by an inactive and obstructed 
 perspiration. Hence, its accumulation, 
 during sleep, is greater than at any other 
 time. It soon acquires a hard con- 
 sistence, insinuates itself under the 
 gums, and detaches them from the necks 
 of the teeth. Thus the gums become 
 subject to inflammation and pain, gradu- 
 ally recede from the teeth, and produce 
 an absorption of the alveolar process. 
 So, in proportion to the increase of tar- 
 tar, and its adhesion to the teeth, their 
 natural support is destroyed, they be- 
 come loosened in their sockets, and at 
 last fall out. This happens to one tooth 
 after another, until the whole are lost. 
 When the teeth come out in this man- 
 ner, they appear, on inspection, perfectly 
 
88 
 
 sxwnd, and betray no mark of caries or 
 other disease ; for the tartar acts as an 
 artificial covering to the natural enamel ; 
 and while it loosens them in their sockets 
 and detaches them from their situation, 
 it protects them from the action of other 
 external agents, whenever it covers them. 
 When it is allowed to accumulate, it 
 thickens, and becomes hard on the parts 
 which do not undergo friction, parti- 
 cularly between the teeth, and at the 
 base of their crowns next the gums, as 
 well as about those teeth situated near the 
 openings of the salivary ducts. Hence 
 the incisores of the under jaw, and the 
 molares of the upper, are most covered 
 by it 
 
 Where any of the teeth are wanting, 
 so that friction does not take place in 
 the act of mastication, the tooth corres- 
 ponding to the one lost, very rapidly be- 
 comes encrusted with tartar. 
 
 The colour of tartar is various, as 
 well as its consistence j when soft, it has 
 
89 
 
 a yellowish appearance, but, as it thick- 
 ens it becomes of a dark brown or of a 
 blackish colour. Its accumulation gives 
 always to the teeth, a disgusting and 
 uncleanly appearance, and though in 
 itself inodorous, yet from its effect in 
 producing diseased gums, the breath re- 
 ceives a disagreeable taint. 
 
 As it forms, it deposits itself in layers, 
 acquiring often such an extraordinary 
 magnitude, as to equal the size of the 
 teeth themselves. In some cases, the 
 tartar has been known to acquire a pe- 
 culiar corroding nature : in this case, its 
 colour differs from common tartar, being 
 of a dark green, and it is more of a fluid 
 than of an earthy nature, having little 
 tendency to incrustate. It is perhaps 
 this species of tartar, which is mention- 
 ed by Dr. Armstrong, of St. Vincent, 
 when he states the fatal diseases which 
 often follow the bite of the negro there, 
 and which he attributes to the noxious 
 i 
 
90 
 
 qualities contained in the tartar of their 
 teeth. 
 
 The analysis of tartar has been made 
 by several chemists, and it seems chief- 
 ly made up of phosphate of lime—its 
 earthy part ; the remainder, consisting 
 ofjibrina, the foundation of the animal 
 solid, and a proportion of oil or fat. Of 
 these materials, the phosphate of lime is 
 by far the most abundant. 
 
91 
 
 TOOTH ACHE. 
 
 THE ultimate effect of caries, is, by 
 denuding the internal structure of the 
 teeth, to produce that unpleasant and 
 painful sensation, termed tooth ache. 
 The pain attending it, is, in various de- 
 grees, according to the influence of ex- 
 ternal agents, on the denuded part. 
 Often it is so acute, as to produce deli- 
 rium and convulsions. At other times 
 it is moderate, and rather a gnawing 
 than an acute pain. The caries has ge- 
 nerally made some progress before tooth 
 ache commences. The pain is com- 
 monly sudden in its attack, darting 
 from the tooth through the head, and 
 affecting the whole jaw. Where fits of 
 tooth ache frequently occur, they be- 
 come so violent and constant, that the 
 
92 
 
 rest is disturbed, the appetite fails, and 
 the person is unable to pursue his usual 
 vocations. The original seat of tooth 
 ache is always confined to the cavity 
 of the teeth, and not to the investing 
 membrane, as erroneously supposed. In 
 the progress of the disease, the mem- 
 brane, and all the contiguous parts, be- 
 come inflamed, occasioning considerable 
 swelling, which having attained a cer- 
 tain height, the pain often, in some de- 
 gree, subsides, though in other cases it 
 becomes more acute, and ends in suppu- 
 ration of the surrounding parts. In se- 
 vere cases of tooth ache, the swelling 
 and inflammation of the surrounding 
 parts is so great, that the mouth cannot 
 be opened, and the eye often becomes 
 nearly closed. The swelling has even 
 been known to extend down the neck, 
 and to be productive of general irrita- 
 tion. When this is the case before its 
 termination, suppuration ensues, and the 
 alveolar processes in consequence of 
 
93 
 
 their inflamed state, are removed by the 
 process of absorption. 
 
 Where matter repeatedly forms about 
 the fangs of the teeth, the sockets be- 
 come so much absorbed as to loosen the 
 teeth ; and even the jaw bone occasion- 
 ally suffers from this inflammation, and 
 its partial mortification at times is known 
 to ensue. 
 
 When this misfortune happens, it can 
 only be remedied by the process of ex- 
 foliation, which is slow in its progress, 
 and occasions a greater or less deformity 
 for the remainder of life. The pain of 
 the teeth is often peculiar to the situ- 
 ation of the tooth affected. Thus, when 
 it attacks the dentes sapientice, or wisdom 
 teeth, of the lower jaw, it is not felt so 
 much in the teeth themselves as in the 
 ear. When it affects those of the upper- 
 jaw, it seems to shoot more directly up 
 to the temple. In all cases, a remarkable 
 sympathy seems to prevail between the 
 affections of the teeth and the earj for 
 I 2 
 
n 
 
 pains in the teeth cause a similar suffering 
 in the ear, and, in like manner, harsh and 
 discordant sounds produce an unpleasant 
 sensation, known by the term of the teeth 
 being set on edge. But the most alarm- 
 ing disease, connected with the state of 
 the teeth, is that affection, known by the 
 name of Tic Douloureux. This disease 
 consists in the irritation of certain 
 nerves, the commencement of this irri- 
 tation is connected with the teeth, and is 
 of a most alarming nature. The pain is 
 most excruciating, and recurs in fits on 
 the slightest agitation, produced by mas- 
 tication, speaking, walking, riding, &c. 
 The nature, however, of this disease is 
 but little understood, and is fortunately 
 but of rare occurrence. 
 
 Indeed, such is the sympathy of the 
 teeth with each other, and the diffusion 
 of pain from one to another, that the pa- 
 tient has often a difficulty to point out 
 the original tooth from which the pain 
 proceeds. Hence, it is not uncommon 
 
95 
 
 for a person to feel a pain in the teeth 
 of the upper jaw, when the disease ori- 
 ginated in a tooth of the under jaw. 
 But, independent of their sympathy with 
 each other, the teeth have a remarkable 
 one with other parts of the system. 
 Thus tooth ache is often one of the ac- 
 companying symptoms of pregnancy 
 during the first months; though, w T hen 
 the teeth are examined, they discover no 
 apparent marks of disease. The treat- 
 ment of tooth ache is a subject of much 
 importance, and mu^t be varied accord- 
 ing to the circumstances of the case ; it 
 is, therefore, necessary to ascertain, 
 whether it arises from caries, tartar, 
 rold, or sympathetic affections. 
 
96 
 
 OCCASIONAL EFFECTS 
 
 DISEASED TEETH, 
 
 DISEASED teeth often occasion that 
 affection of the gum termed epulis, or 
 gum boil : the inflammation of the tooth 
 extending to the vessels at the point of 
 the fang, and thence to the periosteum 
 and sockets; the circulation becomes 
 necessarily impeded, and the inflamma- 
 tory action thus begun, ends in the for- 
 mation of matter within the alveolar 
 processes. While this matter is confined, 
 it excites considerable pain ; the face is 
 swelled and inflamed, which continues 
 till the collected matter escapes. This it 
 does, by eroding the socket on the outer 
 
97 
 
 side* where a natural opening or ulcera- 
 tion takes place ; the sore occasions a 
 perpetual discharge, and the skin rises 
 and becomes fungous, with a red spongy 
 appearance. If the diseased tooth, which 
 is the source of the evil, be removed, 
 the discharge then gradually diminishes, 
 and the sore heals externally : but, in 
 healing, the former destruction of the 
 parts, occasions a contraction of the 
 skin, and a deep scar is formed, which 
 to a female cannot fail to be highly disa- 
 greeable, and a source of great uneasi- 
 ness. When, under these circumstances, 
 carious teeth are .extracted, a fleshy 
 substance appears to cover their fangs, 
 which extends to the bottom of the 
 socket; and is that method which nature 
 employs by means of granulation, (the 
 effect of the healing process,) to fill up 
 the cavity, occasioned by the loss of sub- 
 stance, during the inflammatory action. 
 Where the disease is entirely ne- 
 glected, the inflammation often extends 
 
98 
 
 deep into the jaw bone, and the conse- 
 quence is, that a part of it separates, 
 and mortification ensues. Before this 
 happens, and exfoliation is accomplish- 
 ed, a continual uneasiness prevails, and 
 a constant discharge takes place in the 
 mouth. 
 
 As the process of mortification, or 
 separation, of the parts proceeds, the 
 alveolar processes are gradually left by 
 the gums, and the bone, separating and 
 gradually loosening, should as soon as 
 the separation is completed, be taken 
 away. When a gum boil forms with any 
 of the temporary teeth, it requires very 
 particular management; for, if allowed 
 to proceed so far as to cause an exfolia- 
 tion of the jaw bone, the teeth may be 
 entirely destroyed. 
 
 These circumstances point out the ne- 
 cessity of early care, to prevent a malady 
 of this kind. But, sometimes, instead 
 of matter forming, the inflammation at- 
 tending a carious tooth is of an indolent 
 
99 
 
 nature, producing, at the bottom of the 
 socket, a hard lump, about the size of a 
 nutmeg. This appearance will continue 
 without any change for months, ex- 
 cept when some active irritation occurs 
 from cold or other causes, which pro- 
 duces considerable uneasiness and pain 
 of the parts. Such tumours are always 
 to be considered dangerous; for there is 
 no dependence on their continuing in an 
 indolent state. 
 
 From the view taken in the preceding 
 pages of the teeth, and their diseases, 
 we are led to notice the parts which 
 support them ; namely, the gums and the 
 alveolar processes. 
 
100 
 
 STRUCTURE OF THE GUMS. 
 
 THE gums, when in a healthy state, 
 are of a vermillion colour, of a semi- 
 cartilaginous consistence, and highly 
 vascular. They adhere firmly to the 
 necks of the teeth, passing between 
 them and attaching to the bony divisions 
 of the alveolar processes, (which connect 
 the inner and outer gums) and their ex- 
 treme edges lie upon the enamel. The 
 gums, which are between the teeth in 
 the upper jaw, descend lower, and in the 
 under jaw, are situated higher than the 
 other parts. Hence, at the necks of the 
 teeth they form an arched appearance. 
 In their natural state they possess little 
 sensibility ; but, from accumulations 
 about the teeth, they acquire such an 
 extreme degree of it, that the least pres- 
 
101 
 
 sure occasions pain : they are liable to 
 bleed, and become considerably disco* 
 loured, thickened, and enlarged. In in- 
 fancy, during the progress of dentition, 
 should there be inflammation of the 
 gums, the slightest touch produces so 
 much suffering, that children will even 
 refuse the breast, on account of the pain 
 attending the necessary pressure of the 
 nipple. On the contrary, where there 
 is no inflammation, the gums are so in- 
 sensible, that infants are pleased with 
 sucking or biting a hard crust. In old 
 age, when there are no teeth, the gums 
 possess so little sensibility, that the 
 chewing or bruising of food is attended 
 with no pain ; and it is well known, 
 that those who have lost all their teeth, 
 enjoy their food much more than those 
 who have diseased ones. It is clear, 
 therefore, that all diseases of the gums, 
 at every period of life, originate either 
 from dentition, or from uncleanliness of 
 the mouth, and are not peculiar to the 
 
 K 
 
102 
 
 gums themselves, as erroneously assert- 
 ed by authors on this subject. The most 
 frequent disease, which has been sup- 
 posed peculiar to the gums, is what is 
 commonly, but erroneously, called scur- 
 vy, from their assuming an appearance 
 similar to that of the scurvy at sea; a 
 complaint always proceeding from un- 
 cleanly teeth. The disorder is marked 
 by the gums becoming redder than ordi- 
 nary, spongy, discoloured, and bleeding 
 from the slightest touch, caused by the 
 fulness of the vessels. This disease of 
 the gums is entirely of a local nature, 
 and when neglected, is productive of 
 much uneasiness and distress; for, be- 
 sides their being soft and spongy, the 
 mouth becomes very painful and sore, 
 and the teeth so tender as scarcely to 
 allow the mastication of food. Matter 
 forms and oozes out near the necks or 
 lower parts of the teeth, in consequence 
 of the ulceration, forming between them 
 and the gums. The natural arch of the 
 
103 
 
 gums is thus destroyed ; they become 
 uniformly straight, recede from the ena- 
 mel, and thus expose the fangs of the 
 teeth to whatever is taken into the 
 mouth. This affection next attacks the 
 alveolar processes, where absorption 
 taking place, they are gradually destroy- 
 ed, and thus the teeth, losing their sup- 
 port, become loose, and successively 
 drop out at intervals, until the person is 
 rendered toothless. Persons who lose 
 teeth from this cause, complain that they 
 come away perfectly sound, not consi- 
 dering it as the effect of uncleanliness. 
 
 Scurvy of the gums, is a disease with 
 which most individuals are more or less 
 affected, under the usual method of 
 managing the teeth. It is, as before 
 stated, local ; and, from the very nature 
 of the cause, will affect the gum on one 
 side of the tooth, and not on the other. 
 In its early stage, this disease is easily 
 cured by the use of the dentifric appa- 
 ratus. The habitual application of this 
 
104 
 
 apparatus will produce a healthy action 
 in the vessels, and keep the teeth clean ; 
 thus preventing any recurrence of the 
 cause which produced it. The brush, 
 when first used, should be employed 
 rather delicately, as also the waxed silk, 
 until the gums harden and regain their 
 arched appearance. Although the gums 
 may at first become subject to a slight 
 bleeding, yet in a few days, by a perse- 
 verance in the treatment recommended, 
 this bleeding will cease; nor will the 
 slightest pain be experienced. 
 
 When the disease has proceeded to 
 such a length, that matter oozes from 
 the gums, £nd the teeth feel tender and 
 painful, a dental operation is the only 
 remedy. 
 
 After the operation, the above treat- 
 ment will have all its influence, in pro- 
 ducing the desired effect ; but there is 
 an ultimate stage of this disease, where 
 it does not prove altogether effectual, in 
 consequence of a death taking place in 
 
105 
 
 the periosteum, which covers the fangs 
 of the teeth. 
 
 Persons occasionally subject to inflam- 
 mation of the gums, should clean their 
 teeth often with the waxed silk ; when 
 a new and healthy action will be com- 
 municated to the gums, and they will 
 be restored, in a short time, to their na- 
 turally firm and adhesive state. By this 
 uniform proceeding, the interstices will 
 be kept clean, and the teeth will become 
 more firmly attached in their situation. 
 
 K % 
 
106 
 
 STRUCTURE 
 
 ALVEOLAR PROCESSES. 
 
 THE alveolar processes, though origi- 
 nally elongations of the jaw bones, do not 
 belong to them, but are considered as 
 appendages to the teeth. In these parts, 
 as we have shewn, are deposited the first 
 rudiments of the teeth, which they con- 
 tinue to retain in all the stages of their 
 growth, and to the fangs of which, their 
 shape is gradually accommodated. Like 
 the periosteum in other bones, they are 
 invested with a vascular membrane, 
 which is attached to the fangs of the 
 teeth, and by which the latter are fixed 
 in their sockets. The destruction of the 
 
107 
 
 membranous lining loosens the teeth, 
 and from this circumstance the single 
 fanged ones drop out, whilst those that 
 are double and irregularly fanged are 
 retained. This dependence of the teeth 
 on the membrane for their attachment, 
 allows them a certain motion, intended 
 by nature, in some degree to prevent 
 injury, as it enables them to yield to 
 the resistance occasioned by hard sub- 
 stances, during the process of mastica- 
 tion. This motion is most sensible where 
 the fangs are inflamed ; and from the 
 increased sensibility of the periosteum, 
 the teeth appear as if loose to the pa- 
 tient, and he is led to suppose, that the 
 extraction may be performed without 
 difficulty or pain, which has too often 
 been proved to be a complete mistake. 
 
 In all cases of diseased teeth and 
 gums, the alveolar processes, from their 
 intimate connexion with them, are more 
 or less exposed to injury. The inflam- 
 mation of the former extends to the 
 
108 
 
 latter, which, from increased action of 
 their absorbent vessels, undergo a re- 
 moval of their substance. Thus their 
 absorption constantly attends the loss of 
 the permanent teeth, under every variety 
 of age, from whatever cause that loss 
 may proceed. 
 
 Where all the teeth are lost, it may 
 be observed, that the upper jaw is dimi- 
 nished in length, the roof of the mouth 
 loses its arch and becomes flat, and the 
 under jaw is a mere piece of bone 
 covered by the gums. Thus the face 
 loses an inch and a half, of its former 
 extent; and, from the muscles of the 
 lower jaw, being obliged to act more 
 forcibly to draw it against the other, are 
 produced those striking and well known 
 marks of old age, the deformed features, 
 the hollow cheeks, the wrinkled face, 
 and projection of the chin. 
 
 Some authors, particularly Mr. Fox, 
 have considered the alveolar processes 
 as subject to peculiar diseases, inde- 
 
109 
 
 pendent of the teeth and gums : but these 
 I have never been able to trace; and 
 wherever their absorption takes place, 
 at any period of life, it will be found to 
 have proceeded from an affection of the 
 primary parts. Whenever the alveolar 
 processes become diseased, the gums 
 will be detached from the teeth, and will 
 recede in proportion as the alveolar pro- 
 cess is destroyed, the absorption gradu- 
 ally advances, the necks of the teeth 
 and the fangs become more and more 
 exposed, and seem to those unacquainted 
 with their structure, as if increased in 
 length. The causes of alveolar absorp- 
 tion are, continued inflammation of the 
 teeth or gums, an accumulation of tar- 
 tar, that affection of the gums called 
 scurvy, and their diseased state arising 
 from an excessive use of mercury. 
 
 The symptoms of this state of the al- 
 veolar process having commenced, are, 
 the length of the teeth, the wider space 
 between them, and a difficulty in chew- 
 
110 
 
 ing hard substances. The teeth next be- 
 come loose, and mastication is alto- 
 gether impracticable. 
 
 Besides absorption ofthealveolarpro- 
 cesses, an opposite affection may be no- 
 ticed. The bottom of the socket fills up, 
 or becomes contracted, by which it is 
 proportionally shorter, and the teeth 
 are forced out, while the gum undergoes 
 no change, but still retains its place; 
 and the teeth continuing to advance, 
 gradually lose their support, and in the 
 end drop out. 
 
 In many persons, the loss of a tooth 
 is hastened by being longer and striking 
 against the others ; this may be easily 
 rectified, by shortening the tooth with 
 a new dental instrument I have invent- 
 ed for the purpose. 
 
Ill 
 
 MANAGEMENT OF THE TEETH. 
 
 THE first and most important object, 
 is cleanliness of the mouth, which is the 
 only preventive of disease. Of the va- 
 rious causes of diseases of the teeth and 
 alveolar processes, we have found that 
 the greater part as enumerated by 
 writers, are merely theoretical, and 
 are built on no solid facts. The only 
 true cause of all the diseases to which 
 they are liable, is, the contact of the 
 accumulation, and the action of that 
 matter upon them, which forms the re- 
 lics of our food and beverage, and which 
 operates by undergoing the putrefactive 
 process, as a deleterious poison, or cor- 
 roding agent to their structure. 
 
 Where the teeth are kept clean and 
 free from such matter, no disease will 
 
US 
 
 ever arise. Their structure will equally 
 stand against the summer's heat, and 
 winter's cold ; against the changes of 
 climate, the variations of diet, and even 
 the diseases to which the other parts of 
 the system may be constitutionally sub- 
 ject. 
 
 This being the case, the means of 
 prevention are clear and simple : name- 
 ly, to avoid the accumulation of matter 
 which injures their substance : and it is 
 in the mode of cleaning them, that the 
 whole secret of avoiding disease consists. 
 
 The means commonly resorted to, are 
 the use of the brush, joined with the 
 friction of tooth powder; but, that both 
 brushes and dentifrices, as they are at 
 present used, however ingeniously con- 
 trived or often employed, are insuffi- 
 cient for the purposes of effectual cleans- 
 ing, is obvious from this circumstance, 
 that the teeth and gums are still left in a 
 diseased state. Tooth powders, being 
 generally composed of insoluble sub- 
 

 113 
 
 stances are acid ingredients, and evi- 
 dently hurtful, both by their mechanical 
 and chemical agency. 
 
 The brushes and powders are gene- 
 rally applied to the outside only of the 
 teeth; and to shew the injury of these 
 applications, we shall make some obser- 
 vations on their composition and nature. 
 The sulphuric acid, or oil of vitriol, 
 from its peculiar and well known pro- 
 perty, of giving a beautiful white appear- 
 ance to the teeth, forms a principal ingre- 
 dient in all those ruinous compositions, 
 sold under the title of tooth powders, 
 tinctures, or pastes. In tinctures and 
 lotions, it is combined with some spiri- 
 tuous or watery infusion, of an aromatic 
 ature, variously coloured and scented, 
 according to the taste of the composer. 
 In the paste it is united with some gritty 
 powder, to which a light vegetable mat- 
 ter is added, when the whole is made of 
 a proper consistence with honey, or 
 other glutinous substance. The powders, 
 
114 
 
 also, not admitting the acid in its natural 
 form, have corrosive salts substituted, 
 un of tarter, alum, fee <kc. 
 united with powdei often cons 
 
 of brick-dust, blended with some other 
 ingredient, to colour and conceal it. But, 
 besides these compositions, which are 
 expressly sold for the purpose, many are 
 in the habit of using substances al their 
 own option for cleaning the teeth, with- 
 out having recourse to these advertised 
 specifics. Of this kind, soot is one; to 
 which I see no other objection, than that 
 it is a dirty, di-agreeable. and indelicate 
 substance. Its use has, perhaps, arisen 
 from the observation, that chimney 
 sweepers have white teeth. This is gene- 
 rally more in appearance than in reality 
 when examined, it is found to be oc- 
 casioned by the contrast of the face with 
 the natural colour of the teeth. Another 
 substance in much greater use of late 
 years, for the purpose of cleaning teeth, 
 uarcoal pulverized : but highly as it 
 
115 
 
 is celebrated for its antiseptic qualities, 
 it is very improper as a dentifrice ; for, 
 however fine may be the powder to which 
 it is reduced, every chemist knows, that 
 the substance continues perfectly inso- 
 luble. The finer indeed it is pulverized, 
 the easier is the admission it finds be- 
 tween the teeth and gums, where its 
 insinuation, like every other extraneous 
 matter, is a perpetual source of irrita- 
 tion and disease ; and its constant fric- 
 tion may injure the health and beauty 
 of the gums ; its effect also, as a purifier 
 of the breath, is very transient. Denti- 
 frices similar to charcoal, are formed 
 by the burning of bread, leather, betle 
 nut, peruvian bark, &c. ; in their effects, 
 however, they all differ little from com- 
 mon charcoal : gunpowder and iron rust, 
 is another composition in use, but it owes 
 its quality entirely to the charcoal, as 
 the nitre it contains is in too small a 
 quantity to be of any use. Prepared 
 alum, is another substance used for the 
 
116 
 
 same purpose ; but, being a combination 
 of sulphuric acid and clay, when it comes 
 in contact with the teeth, it undergoes 
 a decomposition, and they are conse- 
 quently exposed to the action of the acid. 
 The same injury arises from the use of 
 cream of tartar, which, though it whitens 
 the teeth, acts powerfully on the enamel. 
 
 The best dentifrice that can be used, is 
 common table salt : it is perfectly inno- 
 cent, as it completely dissolves in the 
 saliva, and produces all the friction that 
 is necessary for cleansing the teeth. 
 Nitre, is also a valuable application, both 
 as it reduces the inflammation of the 
 gums, and removes the tough viscid 
 slime, which is then apt to collect in the 
 mouth. But the cleaning of the teeth 
 and gums, in order to preserve them in 
 health, and prevent the attack of disease, 
 can only, as we have before stated, be 
 done in a proper manner, by using the 
 dentifric apparatus already described. 
 
 This is as simple in its construction 
 
117 
 
 as it is easy in its application ; and its 
 use, if persevered in, will preserve the 
 teeth, gums, and sockets, in a healthy 
 state, and render them less subject to 
 disease than any other part of the body. 
 The idea, that the teeth are more de- 
 structible than any other part of the sys- 
 tem, is founded on a mistaken opinion, 
 of which we find evidence every day, ia 
 bodies, which have been buried for years, 
 where the teeth have been found entire 
 and sound, while the other bones w 7 ere 
 decayed and mouldered to dust. This is 
 a sufficient proof that disease is not 
 naturally entailed upon their structure, 
 but the effect of carelessness, inatten- 
 tion, or the want of cleanliness. 
 
 It is in the power, therefore, of every 
 individual to preserve the teeth and gums 
 in perfect health, when once instructed 
 in the proper method of cleaning them. 
 What a world of pain and distress are 
 we thus enabled to avoid by a little trou« 
 12 
 
118 
 
 ble and care! — the attack of serious dis- 
 eases, sapping the foundation of health, 
 arising from this cause, might be en- 
 tirely prevented; and the stomach and 
 digestive organs would also be preserved 
 in their natural and regular state. By 
 perfect mastication, the process of as- 
 similation would be greatly facilitated, 
 and the nourishment would enter the 
 system in that complete form capable of 
 transmitting its benefits to the most 
 minute recesses of the body ; and thus 
 dyspeptic complaints, which begin at an 
 early period, and are the bane of those 
 past the meridian of life, would not be 
 so frequent as at present, nor call for 
 the aid of the physican, or the constant 
 use of the stomachic tincture and pill. 
 
 When the teeth and gums are capable 
 of performing their proper offices, the 
 food is always relished, and health, that 
 greatest of blessings, uninterruptedly 
 preserved. It may, perhaps, be neces- 
 sary to give some directions for clean- 
 
119 
 
 ing the teeth, adapted to the varieties of 
 age. 
 
 In childhood, before the loss of the 
 temporary teeth, the mouth should be 
 regularly cleaned every evening, the 
 relics of the food, which have been all 
 the day accumulating, are thus prevented 
 from committing their ravages during the 
 night ; and the habit of cleanliness will 
 become fixed, from being so essentially 
 connected with personal comfort. The 
 brush should at first be but gently ap- 
 plied, and then particular care taken to 
 pass the waxed silk in the interstices, 
 and round the necks of the teeth, where 
 lodgements of the food (the causes of 
 disease) are usually formed. Warm 
 water is always preferable to cold for 
 cleaning the mouth, from its being a 
 better solvent of the usual articles of 
 their diet. But when the permanent teeth 
 begin to make their appearance, then is 
 the time that the greatest attention to 
 cleanliness is particularly necessary. 
 
120 
 
 It is a common practice with most peo- 
 ple after meals, to make use of a tooth- 
 pick, to remove whatever may be lodged 
 between the teeth. This practice, how- 
 ever, is highly to be reprobated: the 
 constant use of a tooth-pick cannot fail 
 to make improper openings between the 
 teeth ; and when once that part of the 
 gum which forms the arch, is removed 
 from their interstices, a small hollow is 
 made for the reception of accumulating 
 matter, which, if neglected to be remov- 
 ed, will, from its immediate action on the 
 bone, rapidly excavate a tooth, and pro- 
 duce early pain, that would never have 
 existed, but for the use of so improper 
 an instrument. 
 
 Some popular writers have objected 
 entirely to the use of hard brushes, and 
 considered the finger as sufficient for 
 cleaning the teeth, on account of its soft 
 pliancy, and the gentle roughness of its 
 papillary vessels. But, if this were 
 sufficient, the tongue would answer yet 
 
121 
 
 better; for its papillary vessels are still 
 more numerous, and it possesses alsa 
 greater sensibility, softness, and pliancy; 
 yet, with all these advantages, it does 
 not prevent the accumulation of tartar, 
 which is always more abundant on the 
 inside of the teeth, where the action of 
 the tongue is most powerful. The same 
 objection may be applied to cleaning the 
 teeth with a cloth, which, though it may 
 partially remove what is on the surface, 
 cannot, from their inaccessible situation, 
 act on those parts that it is of the most 
 importance should be kept clean. 
 
 Many people suppose that the gums 
 cannot be preserved in a healthy state, 
 unless they are exposed to the daily fric- 
 tion of the brush. This, however, is a 
 mistaken opinion ; and, indeed, if the 
 friction is constantly applied in a per- 
 pendicular direction, it will, by forcing 
 them from the teeth, be highly injurious. 
 If the gums are actually diseased, the 
 application of a composition of salt and 
 
122 
 
 alum, in the proportion of one of the lat- 
 ter to four of the former, either in a state 
 of solution, or used as a powder, will, in 
 the course of two or three days, effect a 
 temporary cure ; when if the tartar is 
 immediately removed, and the interstices 
 of the teeth kept clean, no other means 
 will be necessary to keep them perfect- 
 ly pure and wholesome for the remain- 
 der of life. 
 
133 
 
 OPERATIONS ON THE TEETH. 
 
 SCALING. 
 
 THE first and simplest operation on 
 the teeth, is the removal of the tartar, 
 termed scaling. The instruments for 
 this purpose are made of various forms, 
 and so constructed as to be applied easily 
 to the different parts of the teeth. It is 
 an operation which is not attended with 
 pain ; and, for its utility, we may refer 
 to the observations already made on the 
 accumulation of tartar, as one cause of 
 disease. In employing the instruments, 
 I can with confidence say, I have never 
 found a patient complain of the slightest 
 
124 
 
 pain, nor even perceive the smallest 
 scratch on the enamel, after the tartar 
 had been removed. This is prevented 
 from the lightness of hand, with which 
 the instrument is conducted over the sur- 
 face of the teeth j a dexterity acquired 
 only by practice and experience. 
 
 Instead of performing this operation 
 by means of instruments, some dentists, 
 from a desire to make the teeth appear 
 white, have employed chemical solvents. ■ 
 But, as the tartar contains the same 
 principle of solidity, as the teeth them- 
 selves, — namely, phosphate of lime and 
 fibrina, whatever acts in destroying the 
 tartar, must also act in injuring the 
 teeth : such means, therefore, are to be 
 strongly condemned, and will never be 
 employed by an operator of any re- 
 spectability. The benefit derived from 
 the removal of tartar, is not to be esti- 
 mated according to its quantity, but ac- 
 cording to the situation in which it is 
 
125 
 
 placed ; for, if a very small quantity has 
 insinuated itself in the interstices, or 
 round the neck of a tooth under the gums, 
 the removal of it, is of more importance 
 to the patient, than a greater quantity 
 on the crown. This fact is proved by 
 daily observation ; for teeth become 
 loose, and fall out early, with very little 
 tartar upon them. 
 
 A popular prejudice prevails against 
 scaling the teeth, from its having been 
 observed, that, after such an operation, 
 they tend more rapidly to decay ; a cir- 
 cumstance easily explained. For, while 
 tartar is confined to the crown of the 
 teeth, so as not to interfere with the 
 gums, however disagreeable in appear- 
 ance, it acts as a complete preservative 
 against the attack of caries. This na- 
 tural protection, therefore, being re- 
 moved, it will be easily seen why, if the 
 teeth are again neglected, their liability 
 to decay should be increased. This ef- 
 
 M 
 
126 
 
 feet, however, is completely prevented* 
 by the constant use of the dentifric ap- 
 paratus, which will also supersede the 
 necessity of future scaling. 
 
EXTRACTION OF TEETH. 
 
 THIS is an operation which always 
 creates some little alarm to the patient, 
 and is sometimes attended with difficulty 
 and danger ; but, in this, as in many sur- 
 gical operations, the ease and safety 
 with which it is executed, will depend 
 on the skill of the operator; though, 
 for the consolation of patients, my ex- 
 perience warrants me in asserting, that 
 extraction is much oftener resorted to 
 than is necessary. Whenever a tooth is 
 painful, it is advisable to have it ex- 
 amined, and an endeavour should be 
 made to remove the malady by palliative 
 means j but, if it prove carious, the dis- 
 eased part should be removed, and the 
 tooth repaired. Indeed there is no ne- 
 cessity for having recourse to this dan- 
 
138 
 
 gerous expedient, even if the crown be 
 entirely decayed ; for the fangs of the 
 teeth will always admit of engrafting, 
 on a plan I have for years so success- 
 fully practised. Extraction therefore 
 can only be necessary, either to prevent, 
 or remedy, irregularity in the arrange* 
 ment of the permanent teeth of children, 
 or, in some diseases of rare occurrence 
 in the adult, as in neglected cases of the 
 antrum maxillare, as well as, where the 
 diseased state of their fangs has, from 
 neglect, terminated in what is called an 
 ulcerated tooth. In all other cases it 
 is to be opposed, and is a wanton outrage 
 on the unhappy individual, who, from the 
 effect of pain, is brought to submit to 
 this harsh and often unavailing mea- 
 sure. But, independent of the little ne- 
 cessity for such an operation, we know 
 that it has sometimes been attended 
 with the most serious and fatal conse- 
 quences. 
 
129 
 
 Even in the most favourable case, 
 there must be a fracture of that part of 
 the socket where the fangs are situated; 
 and if the alveolar process is firmer 
 than usual, and does not yield to the 
 power of the instrument, the fracture 
 may be extended through the alveolar 
 processes of several teeth, and the jaw 
 bone be exposed to a most serious injury, 
 the effects of which the patient may re- 
 tain for life ; and the formation of matter 
 taking place, several of the contiguous 
 teeth will be rendered useless. But, 
 though the operation may be success- 
 fully performed, a dangerous haemorr- 
 hage often follows. Some patients have 
 suffered a continued bleeding for twenty- 
 four hours, and their lives have been 
 with difficulty preserved, while other 
 cases have ended fatally from this cause 
 alone, in spite of all the boasted powers 
 of styptics. 
 
 This alarming effect of extraction 
 arises from the artery not always con- 
 
 M2 
 
130 
 
 tr acting after the removal of the tooth, 
 
 either from the injury done to the parts, 
 or from its being of a larger size than 
 usual, and the coagulum that is formed 
 not being sufficient to prevent the effusion 
 of blood. As these consequences cannot 
 be foreseen, the operation is a more 
 serious one than is commonly imagined ; 
 and should,, therefore, never be trusted 
 to the rash or ignorant. Much likewise 
 depends on the state of the patient's con- 
 stitution at the time of extraction. In 
 some persons we find so strong a dispo- 
 sition to gangrene or mortification, that 
 the slightest scratch or cut will produce 
 a tendency to it. In such habits the ex- 
 traction of a tooth,, aided by the putre- 
 factive process arising from a diseased 
 state of the sums, will easily excite in- 
 flammation. when either a tedious ulce- 
 ration and exfoliation of the parts will 
 ensue, or else the patient will be cut off 
 by a mortification rapidly extending its 
 effects to the jaws, face, and throat. 
 
131 
 
 A dreadful instance of which lately oc- 
 curred in Guy's Hospital, where a pa- 
 tient died solelv in consequence of the 
 extraction of a tooth. 
 
 For these reasons I strongly object to 
 the extraction of teeth in all cases, but 
 those specified in the preceding observa- 
 tions; where extraction, however, is ad- 
 visable, I employ an instrument similar 
 to that of an engraver's tool. In this I 
 differ from all other operators ; for they 
 uniformly prefer the key instrument, so 
 long in use. It is true, that it has un- 
 dergone several alterations, and has re- 
 ceived some improvements; but the prin- 
 ciple of it, even in its most improved 
 state, remains the same, and cannot be 
 too strongly reprobated. 
 
132 
 
 MENDING OR CAPPING 
 
 DISEASED TEETH. 
 
 THIS is an operation which is rarely 
 attempted by dentists ; and it must give 
 no little satisfaction to those having ca- 
 rious teeth, to know they can be com- 
 pletely repaired by a new mode of ope- 
 rating peculiar to myself. 
 
 The carious teeth are thus rendered 
 ornamental and useful through life, and 
 every complaint prevented which arises 
 from imperfect mastication. An acci- 
 dental circumstance first convinced me 
 that a part of a tooth might be supplied, 
 and that in so perfect a manner as com- 
 pletely to escape detection. 
 
 The frequent performance of this ope- 
 ration has enabled me to execute it with 
 
133 
 
 success, in situations where I did not at 
 first conceive it practicable. It is at- 
 tended with scarcely any pain ; and the 
 discovery will, in most cases, supersede 
 the necessity of extraction. 
 
 A knowledge of the evils which may 
 result from a carious tooth, even if un- 
 accompanied by pain, should influence 
 every person, on its first discovery, to 
 seek the proper remedy ; for by cap- 
 ping the diseased tooth, the lodgement 
 of food, occasioning the putrefactive 
 process, is prevented, and the conse- 
 quent taint of breath removed ; the pro- 
 gress of decay is arrested, and the pain 
 arising from tooth ache, or any other 
 cause, completely done away. But where 
 the teeth are painful, and attended by 
 inflammation of the gums and sockets, 
 this operation should be suspended till 
 the painful symptoms subside ; for the 
 cavity of an inflamed tooth is then so 
 sensible, that the accidental introduction 
 of any substance will excite the most 
 
134 
 
 acute pain: it is therefore advisable, 
 first to diminish the increased action, 
 which may be done by filling the carious 
 tooth with cotton, dipped in an infusion 
 of oil of cinnamon and gum camphor; 
 and, as soon as the tenderness or pain 
 is removed, then should the operation 
 of capping be performed. 
 
 In cases where the crown of a tooth is 
 entirely decayed, I have found means of 
 supplying the deficiency without having 
 recourse to metallic aid, or ligatures. 
 
135 
 
 ARTIFICIAL TEETH. 
 
 THE utility and importance of this 
 invention may be fully appreciated, when 
 we consider, that by the loss of teeth, the 
 youthful countenance acquires all the 
 character and deformity of age; the 
 natural expression of the features is 
 changed, mastication impeded, and the 
 power of correct enunciation entirely 
 destroyed. 
 
 My mode of supplying teeth is as dif- 
 ferent from any employed by my prede- 
 cessors, as it is far superior to all that 
 are at present known. They are formed 
 from a substance warranted not to change 
 its colour, are rendered perfectly durable, 
 contrived so as to baffle detection, com- 
 bining ease with beauty, and are, in all 
 
136 
 
 inspects, as efficient as those of the na- 
 tural set. 
 
 On this branch of the dental art much 
 labour and ingenuity have been bestow- 
 ed ; and it is the exactness with which 
 artificial teeth are adapted to the mouth, 
 and the ease with which they can be 
 worn, that constitutes their chief excel- 
 lence. The mode of supporting teeth, 
 by means of ligatures, round the con- 
 tiguous ones, I very early found suffi- 
 cient reason to discontinue in my own 
 practice; nor is the other method of 
 fixing the artificial crown by means of 
 a gold or silver pivot, as was recom- 
 mended and practised by Mr. Fox, lia- 
 ble to less objection ; as, on this plan, 
 the pivit soon wears away the fang, the 
 artificial crown becomes loose, and will 
 at last drop out. This has been gene- 
 rally considered as the fault of the ope- 
 rator, in not adapting such teeth with 
 sufficient nicety to the fangs; but the 
 blame attaches rather to the principle 
 
137 
 
 than to the dentist; for it is impossible 
 that a pivot, made from a harder substance 
 than the bone of a tooth, can be used with- 
 out the latter sustaining injury from the 
 constant friction. The same objection 
 may be applied to the fastening artificial 
 teeth by clasps, or springs, round the 
 necks of the natural teeth, or securing 
 them by means of fine wire, or Indian 
 grass ; for, in whatever way it is appli- 
 ed, it tends to destroy the periosteum, 
 
 But, besides these inconveniences aris- 
 ing from the use of artificial teeth, se- 
 cured by ligatures, pivots, clasps or wire 5 
 a still greater objection is the taint the 
 breath receives from the particles of 
 food, which remain about the teeth, and 
 which, from the nature of these contriv- 
 ances, appears to be unavoidable. 
 
 The author has long abandoned this 
 destructive practice, and is able to per- 
 form the operations in such a manner, 
 as to render artificial teeth completely 
 secure, without either of the above me- 
 
 N 
 
138 
 
 ihods. This, he has no doubt, will be 
 a matter of astonishment to those, who 
 are acquainted only with the common 
 mode of operating; but he is ready to 
 convince the most sceptical on this sub- 
 ject. Incredible as it may appear, the 
 witnesses of his practice, both abroad 
 and in this country, will prove the de- 
 cided superiority of the Farmltjan Sys- 
 tem. His method, he is satisfied, is 
 entirely new in this country, and is con- 
 sidered one of the greatest improvements 
 in the dental art. 
 
 Where the teeth are mostly gone, in 
 both or in either of the jaws, the method 
 is to form an artificial set, by first 
 taking a mould of the risings and de- 
 pressions of every point along the sur- 
 face of the jaw, and then making a cor- 
 responding artificial socket for the 
 whole. 
 
 If this be accurately fitted, it will, in 
 most cases, retain itself sufficiently firm, 
 by its adhesion to the gums, for every 
 
139 
 
 purpose of speech and mastication. K 
 this adhesion cannot he rendered suffi- 
 ciently complete, from the irregular form 
 of the jaw, then it must he supported by 
 springs. On its first application, such 
 a mechanical apparatus feels unpleasant, 
 but habit soon reconciles the wearer to 
 its use. The gums become hard, and 
 the sensibility of them nearly oblitera- 
 ted, so that at last the person feels un- 
 easy without them. 
 
 Artificial teeth are commonly made 
 from the tusk of the hippopotamus or 
 sea horse, which has been preferred for 
 its whiteness, durability, and fine ena- 
 mel. The chief objection to its use, is, 
 that it does not resemble the human 
 teeth in colour. This difference is more 
 apparent, when placed by the side of a 
 natural tooth, than when the entire set 
 is made from the same substance. 
 
 Artificial teeth have likewise been 
 formed of a paste, termed mineral teeth ; 
 they are composed of baked earth, 
 
140 
 
 covered with an enamelled flux, and co- 
 loured to imitate nature. This sub- 
 stance is best suited to entire sets, but 
 objections arise to such teeth, as they 
 are easily broken, and do not assume 
 the healthy appearance of the human 
 teeth. Neither have they ever been formed 
 so as exactly to imitate nature, but are 
 easily discovered to be artificial machi- 
 nery ; and many improvements are still 
 wanting to render them complete. Hav- 
 ing succeeded in supplying the loss of 
 teeth, as already stated, without the aid 
 of ligature or any metallic substance, 
 and, aware of the prejudice prevailing 
 against the use of natural teeth for this 
 operation, I succeeded in discovering a 
 substitute, possessing all their advan- 
 tages of form, durability, and colour, 
 in the teeth of certain quadrupeds smaller 
 than the sea horse ; the beauty of whose 
 enamel is superior, and whose form re- 
 quires little or no alteration. This in- 
 vention I have now successfully employ- 
 
14* 
 
 ed for years ; and my practice requires 
 only a comparison with the operations 
 of other dentists, to estimate fully the 
 importance of such an improvement. 
 
 In all cases of artificial teeth, an at- 
 tention to cleanliness is indispensably 
 necessary ; for they, as well as the hu- 
 man teeth, unavoidably accumulate tar- 
 tar ; and from the particles of food ad- 
 hering to them, they become highly dis- 
 agreeable. They should be frequently 
 cleaned with warm water; and, by 
 means of the dentifric apparatus, they 
 may be rendered equal in appearance* 
 wholesomeness, and durability to the na- 
 tural set. 
 
142 
 
 TRANSPLANTING OF TEETH, 
 
 THIS is a painful operation, and not 
 often attended with the desired success. 
 It was once a popular practice ; and is 
 performed by completely extracting the 
 diseased tooth, in whose place another 
 is to be introduced. The tooth to be 
 substituted, is then to be removed from 
 the mouth of a person, previously pro- 
 vided for this purpose, and instantly 
 transferred to its intended situation, 
 where it is properly fixed till it unite 
 firmly to the socket. 
 
 This operation is, at best, but limited, 
 being confined to the front teeth, or those 
 having single roots. 
 
 The practice was first suggested, and 
 acted upon, by the late Mr. John Hun- 
 ter ; it continued a few years after his 
 
143 
 
 death, but is now, for strong reasons, 
 entirely given up ; for, first, it did not 
 always succeed, nor could it be expected ; 
 facts proving that when teeth are ex- 
 tracted by mistake, they do not always 
 become firm again, even when immedi- 
 ately replaced. Much less can a tooth, 
 belonging to another person be expected 
 to become fixed, when inserted in a 
 socket of unsuitable dimensions. 
 
 Besides, after submitting to the ope- 
 ration, and undergoing, for weeks, all 
 the penance of a fluid regimen, and even 
 where a transplanted tooth, under the 
 most favourable circumstances, has fast- 
 ened, experience has shewn that its du- 
 cation is limited to a very few years. 
 
 To this may be added the turpitude of 
 disfiguring; one person for the sake of 
 another j and the danger of introducing 
 disease, which Mr. Hunter has laboured 
 so strongly, but unsuccessfully, to op- 
 pose. He admits, however, that this 
 operation has occasionally produced dan- 
 
144 
 
 gerous symptoms ; but that these arise 
 from the principle of irritation alone, ex- 
 citing deranged sympathies. But what- 
 ever may be the cause, the consequences 
 have been, in many instances, unplea- 
 sant and alarming ; and, if the mere ir- 
 ritation of a foreign body, applied in 
 this way, is sufficient to produce them, 
 it is a strong reason for laying the prac- 
 tice aside, whether it is capable of intrc^ 
 ducing infection and general disease info 
 the system or not. 
 
145 
 
 IRREGULARITIES. 
 
 TEETH. 
 
 IN all cases of irregularities, during 
 the shedding of the teeth, the treatment 
 to be observed, is to remove the obstruct- 
 ing temporary teeth, and then to ap- 
 ply pressure, in the most convenient 
 manner, upon the irregular tooth, in 
 order to direct it into its proper situa- 
 tion. But parents, unfortunately, do not 
 in general, perceive the necessity of 
 having recourse to professional aid, until 
 the irregular growth of their childrens 
 teeth, is so far increased as to amount 
 to a manifest deformity. Where suffi- 
 cient room is not made for the perma- 
 
146 
 
 nent teeth, by the timely removal of the 
 temporary set, irregularities of the for- 
 mer are often met with ; and where 
 these irregularities are allowed to pro- 
 ceed and become fixed, it is often a mat- 
 ter of difficulty, and sometimes of im- 
 possibility, to rectify them. 
 
 Thus, where the permanent teeth are 
 large, and the jaw bones have not grown 
 sufficient to admit of their enlargement, 
 in a regular manner, they crowd and 
 over-lap each other. In the same man- 
 ner the central incisores of the upper 
 jaw are often pressed forward, and ren- 
 dered so prominent, as somewhat to re- 
 semble in shape the mouth of a rabbit. 
 When the space of the jaw is not suffi- 
 cient for the regular arrangement of the 
 teeth, some must then be considered as 
 superfluous ; and it will be necessary to 
 remove one or more of the bicuspides 
 from each side of the jaw, before the 
 fangs are formed, to give room to the 
 vest ; the incisores must then be gradu- 
 
147 
 
 ally forced into their proper situation. 
 The occasional pressure of the finger 
 and thumb, if attended to, before age has 
 given too much firmness to the jaw, will 
 invariably bring the teeth into their 
 proper places, without the necessity of 
 having recourse to continued pressure 
 by means of instruments adapted to the 
 arch of the mouth, as recommended by 
 Mr. Fox. 
 
 But, in some cases, the cause of irre- 
 gularity arises not from the want of 
 space in the jaw, but from the protru- 
 sion of supernumerary teeth, which are 
 generally of a deformed shape, and some- 
 what resembling the cuspidati. These 
 protrusions usually take place in the 
 upper jaw, and if inside, they are in front 
 of the jaw, or when without, near the 
 molares ; and are always very conspicu- 
 ous, and should, as soon as their growth 
 will admit of it, be extracted. 
 
 But the most frequent irregularity, 
 which occurs in the appearance of the 
 
148 
 
 teeth, is, where one is longer than the 
 other, or where they have ragged edges. 
 This often takes place in the edges of 
 the front teeth, which are so irregular 
 as to resemble a saw. 
 
 These irregularities, in order to avoid 
 inflammation in those parts of the mouth 
 that come in contact with them, it will 
 be necessary to remove, which is easily 
 effected by the improved dental instru- 
 ments, which cut much faster than the 
 file, without producing any unpleasant 
 sensation. 
 
 No injury will attend this operation; 
 on the contrary, it will improve the 
 shape, and prevent any further crack- 
 ing, or separation of the enamel. The 
 application of the file has heen consider- 
 ed injurious, by those who suppose the 
 removal of part of the enamel, to occa- 
 sion the decay of the teeth. But a partial 
 loss of the enamel, or even a larger por- 
 tion of the tooth, while the cavity re- 
 mains untouched, will never occasion 
 
149 
 
 its decay. This is confirmed in those 
 cases where the enamel is broken by 
 accident, as well as by the operation of 
 filing, for the purpose of removing the 
 carious part, which preserves the rest 
 of the tooth entire. The truth of this 
 observation will further appear from a 
 practice that obtains among savages; 
 for, it is well known, that the Abyssinian 
 negroes remove the corners of the cutting 
 edges of the incisores, so as to give 
 them a pointed appearance ; and, by not 
 interfering with their cavities, such 
 teeth receive no injury whatever, from 
 the operation of the file : the Malay 
 Indians likewise file the incisores of the 
 upper jaw, in a direction across their 
 anterior surface, giving them the ap- 
 pearance of being fluted; but, by this 
 operation, the cavities of the teeth be- 
 come exposed, and caries accordingly 
 soon takes place. The chief objection, 
 however, of patients, to the operation of 
 filing arises from the unpleasant sen- 
 
150 
 
 sation it produces : — but here the fault 
 attaches rather to the dentist, than to the 
 instrument ; and I have the satisfaction 
 to state, that, in the method invariably 
 adopted by myself in the use of this in- 
 strument, but little inconvenience is ex- 
 perienced, much less any excitement of 
 pain. 
 
151 
 
 FRACTURES OF THE TEETH. 
 
 THE teeth are as liable to injury 
 from accidents as other bones, and the 
 incisores of the upper jaw are, from their 
 situation the most exposed to them. 
 Boys, in their quarrels or amusements 
 with each other, frequently have their 
 front teeth fractured by blows received 
 on the mouth. Falling on the face has 
 been attended with the same effect, as 
 also the attempt to catch a cricket ball, 
 and many other circumstances of the 
 same kind. Even the mastication of 
 hard substances, when the muscles of the 
 jaw are in strong action, will produce 
 the fracture of a sound tooth. 
 
 In such accidents, the treatment must 
 be regulated by the extent of the injury. 
 If the fracture is confined to the point of 
 
152 
 
 the tooth, nothing more will he required, 
 than to make it smooth and equal with 
 the other surface, by a fine file; and, 
 as the tooth has not previously been in 
 a state of disease, there will be no dan- 
 ger of the attack of caries. But, if the 
 injury extend into the cavity of the 
 tooth, it will then become tender, and 
 for some time become subject to occa- 
 sional fits of pain ; but nature generally 
 repairs this mischief by a fresh deposit 
 of bone, in the cavity which defends the 
 nerve, and often prevents any further 
 trouble for the remainder of life. 
 
 Where fractures are of a more serious 
 nature, and the cavity is completely ex- 
 posed, then the age, and other circum- 
 stances, must regulate the treatment. 
 If it occur at so early a period of life as 
 fifteen years, the best plan is, to extract 
 the fractured tooth ; and, at the age of 
 maturity, the teeth will be found to have 
 approached so near to each other, as to 
 render the loss scarcely perceptible. 
 
153 
 
 This treatment applies only to fractures 
 of the permanent teeth ; for such acci- 
 dents happening to the primary set, are, 
 from their temporary duration, of little 
 consequence ; when the injury occurs at 
 an advanced period of life, the loss is 
 very serious, not only from its unseemly 
 appearance, but also from its occasion- 
 ing a defect in the speech. If assistance, 
 however, can be procured before inflam- 
 mation has commenced, the tooth may 
 be easily repaired. 
 
 If a tooth is completely knocked out, 
 and the alveolar process is not injured, 
 it should be immediately returned to its 
 place, and secured to the adjoining teeth, 
 when it will fasten in a very short time. 
 
 Where a fracture is of a very serious 
 nature, and the person is anxious about 
 the future appearance, the remainder of 
 the crown may be cut away, and a new 
 one fixed to the fang. 
 
 If the blow or accident only loosen 
 the tooth, it will in a young subject, 
 o 2 
 
154 
 
 readily fasten again, though it is apt to 
 lose its colour, and so assume a bluish 
 tinge ; but, where a tooth is thus loosen- 
 ed in more advanced life, it rarely fas- 
 tens, for the fang becomes deceased, 
 which communicates to the socket, and 
 then the tooth becomes so loose as to re- 
 quire extraction. 
 
 But, in all cases, of accidents, where 
 the alveolar processes have suffered, the 
 fastening of the tooth or teeth can never 
 be depended on; for inflammation is 
 apt to arise, matter forms in the socket, 
 and nothing but extraction will give ease 
 to the patient. 
 
155 
 
 CRACKS OF THE ENAMEL, 
 
 THESE are confined to the incisores, 
 and are mostly caused by the too fre- 
 quent or violent action of their cutting 
 edges against each other. This arises 
 in a great measure, from the loss of the 
 back teeth, when the incisores are not 
 only more frequently used in the act of 
 mastication, but are necessarily brought 
 into contact by a stronger muscular 
 power. This action upon each other, oc- 
 casions them to assume an appearance 
 something like caries ; but the teeth do 
 not, as in caries, become softer, nor 
 does it commence with inflammation, 
 but it consists solely in the enamel part- 
 ing from the bone, and it proceeds no 
 further than to effect the exterior sur- 
 face of the teeth. 
 
156 
 
 Whenever such cracks or separation 
 of the enamel appears, it is advisable, in 
 order to stop its progress, to cut and 
 file away the part that appears thus dis- 
 figured, taking particular care to leave 
 the cutting edges somewhat rounded. 
 
157 
 
 DENUDING PROCESS. 
 
 THIS disease, at first, begins by a 
 wasting of the enamel, by which a small 
 portion appears as if scooped out, or 
 filed away. This wasting continues to 
 increase till the bone is exposed, during 
 which time the tooth becomes discolour- 
 ed, assumes a brownish hue, is smooth 
 and polished, and will often continue so 
 for years. In some teeth the anterior 
 part of the enamel has, in this way, 
 been entirely removed, but without any 
 exposure of the natural cavity, and the 
 bony part has remained prominent as 
 before. It is not unfrequent for the 
 teeth in this state to be very tender, and 
 susceptible of the slightest application 
 of heat or cold. In the whole extent of 
 
158 
 
 my practice, I never met with this dis- 
 order, whose cause I could not safely 
 attribute to the use of acids in the den- 
 tifrices that were employed. 
 
159 
 
 WEARING OF THE TEETH. 
 
 THE natural effect of mastication is, 
 to wear the teeth by the friction and at- 
 trition with which it is accompanied. — 
 Thus, where the incisores, when the 
 mouth is closed, are so situated, that 
 they meet each other at the cutting 
 edges, instead of those of the upper jaw 
 over-lapping the corresponding ones of 
 the under set, mastication cannot be 
 performed without a more extensive la- 
 teral motion of the jaws, which, of 
 course, occasions a greater friction, by 
 which the teeth gradually wear away. 
 
 This circumstance always takes place 
 in the front teeth, where the back ones 
 have been lost in the early part of life, 
 and often the whole crowns have been 
 removed*. The effect of this process is 
 
160 
 
 to render the teeth tender, and occasion- 
 ally subject to pain ; this tenderness 
 and sensibility of the fangs, however, 
 are gradually lessened by the ossific 
 matter that is deposited by the vessels, 
 until the whole cavity is completely ob- 
 literated. This deposit of ossific matter 
 led Mr. Hunter erroneously to believe, 
 that the teeth were extraneous bodies, 
 with respect to a circulation through 
 their substances ; but, he justly observes, 
 that they rarely decay after a person 
 has passed fifty years of age ; because 
 the bony or osseous matter of the tooth 
 has then acquired a degree of firmness 
 of texture, nearly equal to the enamel 
 itself. 
 
161 
 
 MORBID GROWTH 
 
 OF THE 
 
 GUMS. 
 
 THE irritation produced by decayed 
 teeth, on the circulation of the gum-ves- 
 sels, is often the cause of a preternatural 
 growth of the gums, by which excrescen- 
 ces or tumours form on them of various 
 sizes. Carious stumps, are the most 
 frequent source of this morbid growth ; 
 for, if the socket is not close at the bot- 
 tom, a protrusion takes place, which 
 makes the edges of the gums grow irre- 
 gularly over it, and thus, by the pres- 
 sure of the sharp edges of the stumps, a 
 constant soreness and inflammation is 
 kept up j the soft parts assume a diseased 
 
162 
 
 action, and the gums rapidly increase in 
 size. An enlargement of this kind, will 
 often equal the size of a walnut and no 
 cure can take place, till the cause or ir- 
 ritating edges be removed ; on this being 
 accomplished, and the fang repaired, the 
 fulness of the vessels is taken off by the 
 haemorrhage accompanying this opera- 
 tion, while the morbid growth, or en- 
 largement from its fungus nature, soon 
 decays, and the gum is reduced. At 
 other times, tumours form on the gums 
 without any evident cause, and uncon- 
 nected with the state of the teeth. This 
 is the cause, also, in other parts of the 
 body, wherever a soft vascular stricture 
 prevails. Such tumours are of a firmer 
 consistence than where they arise from 
 decayed teeth, resembling the gum in its 
 healthiest state. 
 
 When troublesome, their removal 
 should be attempted either by excision 
 or ligature. Wherever a ligature can 
 be applied, it is the safest method j for, 
 
163 
 
 in performing excision, the operation 
 from the vascular nature of the tumour 
 is always attended with danger, on ac- 
 count of the great loss of blood, which 
 ensues from the impossibility of taking 
 up the vessels, or of employing any 
 other means of stopping the effusion, 
 than the actual cautery. Other tumours 
 of a different nature form on the gums, 
 which are distinguished by their parti- 
 cular softness and disposition to bleed. 
 Such tumours are generally the conse- 
 quence of a diseased jaw bone ; and, as 
 no cure can take place without the re- 
 moval of the cause, the operation above 
 mentioned, either by excision or liga- 
 ture, has, in these cases, generally fail- 
 ed. If however, they arise only from 
 the fangs of the tooth being in so very 
 diseased a state as to have occasioned a 
 destruction of part of the alveolar pro- 
 cess, then a cure can be effected only 
 by extracting the diseased tooth ; and if, 
 on examining the socket, it be found 
 
16* 
 
 rough and denuded of its periosteum, 
 a weak solution of nitrous acid applied 
 to it, with lint, and frequently renewed, 
 will cause an exfoliation of the diseased 
 jaw bone, and the tumour will be remov- 
 ed. But there is nothing, from which 
 the gums are more apt to suffer, both 
 in their healthy consistence and general 
 texture, than the use of mercury, em- 
 ployed in various diseases. By in- 
 creasing the active powers of the saliva, 
 as a solvent, the solidity of their compo- 
 sition is gradually destroyed, and a 
 spongy state takes place, giving a dis- 
 position to bleed on the slightest touch : 
 the weakness of their texture detaches 
 them from the teeth and socket; and 
 thus the bony parts are left loose, and 
 totally deprived of every kind of support. 
 
165 
 
 ARTIFICIAL PALATES. 
 
 FORMERLY, when the treatment of 
 diseases, was not so well understood as 
 at present, the loss of the palate, and an 
 opening between the mouth and the nose, 
 was a frequent misfortune, producing a 
 defect of speech, as well as an inconveni- 
 ence in the taking of food. 
 
 This defect, however, from the im- 
 provements in medical practice, is now 
 but of rare occurrence ; and is confined 
 to those unfortunate cases where medical 
 aid has been deferred too long. A sub- 
 stitute is then required to fill up the 
 opening formed by the loss of the na- 
 tural palate, between the mouth and 
 nose ; and this substitute consists of a 
 thin plate of gold or silver, made con- 
 vex, so as to cover the orifice, and se- 
 p 2 
 
166 
 
 cured in its place by a piece of sponge 
 connected with it. Many ingenious im- 
 provements have taken place in this con- 
 trivance; and in the hands of some skil- 
 ful dentists, they are applied with such 
 a nicety, and so admirably fitted to the 
 part as to require no sponge, nor any 
 other of those additional aids formerly 
 employed. 
 
 Whenever an artificial palate is worn, 
 cleanliness must be strictly enjoined: 
 and, on this account, it will require to 
 be frequently removed. 
 
167 
 
 LIGATURES OF THE TEETH. 
 
 THIS is an application generally 
 used by dentists, as an artificial support 
 to the teeth, till they become firm again, 
 after being loosened, either by a blow, 
 by the accumulation of tartar, or by the 
 absorption of the alveolar processes. 
 This practice, however, should never be 
 employed to any extent; for, if the liga- 
 ture is made with such a degree of tight- 
 ness as to give a proper support, it must 
 loosen the sound teeth it passes over, 
 and thus increase the evil it is intended 
 to remedy. The fastening of a tootb 
 when loose, is entirely the effect of a 
 process of nature, and depends on the 
 healthy condition of the appendages of 
 the teeth, to enclose and root it again in 
 its situation. 
 
168 
 
 In cases of an accidental blow, where 
 the parts have not suffered from disease* 
 ligatures may be successful as a tem- 
 porary support ; but where disease has 
 occasioned an absorption of the alveolar 
 processes, or where the accumulation of 
 tartar has detached the gum, and per- 
 haps even the periosteum, this success 
 is not to be anticipated. Ligatures, 
 therefore, if at all admissible, should be 
 but seldom employed. 
 
 In cases of accident, after the loose 
 tooth is properly replaced, it will be 
 better to keep the patient on a fluid 
 diet till it fastens, than to employ any 
 means of support which may injure the 
 rest. Even where ligatures are applied, 
 they seldom continue fast for any length 
 of time, but often break or become loose, 
 from the solvent properties of the saliva 
 acting upon them ; when the operation 
 must be repeated, and thus give the pa- 
 tient much unnecessary trouble. 
 
 For these reasons I have, in my own 
 
169 
 
 practice, avoided the use of ligatures, 
 whether formed of silk or metallic sub- 
 stance, and employ, what I conceive, a 
 far preferable method for answering the 
 same purpose. 
 
170 
 DISEASE 
 
 OF THE 
 
 MAXILLARY SINUS 
 
 OB, 
 
 ANTRUM MAXILLARE. 
 
 WHEN the inflammation of the teeth 
 and gums of the upper jaw is long con- 
 tinued and very considerable, whether 
 proceeding from accident, or from th& 
 natural effects of disease, it is often 
 communicated to the lining or investing 
 maxillary sinus. 
 
 This affection is distinguished by a 
 deep throbbing pain, which appears to be 
 seated at the roots of the molares of the 
 upper jaw. In its progress, it affects 
 the eye, nose, and ear ; and the in- 
 
171 
 
 flammation proceeding to suppuration, 
 matter accumulates in the cavity, and, 
 having no vent or passage, destroys, by 
 its corroding effects and pressure, the 
 neighbouring bone. Where the symp- 
 toms are more moderate, matter will 
 often remain in a confined state, for a 
 considerable time, without producing 
 much injury. 
 
 As soon as the symptoms of this dis- 
 ease are discovered, (a fact exceedingly 
 difficult to ascertain till matter is actu- 
 ally formed,) the great point is to give 
 it a free opening or discharge. The 
 readiest way of doing this, is to extract 
 the middle grinder or molares, the 
 situation of which is immediately under 
 the maxillary cavity, and afterwards to 
 pierce through the socket with a small 
 trochar to the sinus. The opening thus 
 made should be preserved for some time, 
 and detergent applications occasionally 
 injected with a syringe, till every ap- 
 pearance of discharge subsides. 
 
m 
 
 This state of the antrum, independ- 
 ent of the diseases of the teeth, has often 
 been produced by the lodgement of 
 worms or insects. They are conceived 
 to have had their ovse, or eggs, deposit- 
 ed in the nostril, or to have been drawn 
 in with the breath into the nose, and 
 thus conveyed into the antrum. 
 
 Their removal, when discovered, is to 
 be accomplished by the operation above 
 jnentioned, and the use of oily, or other 
 injections, till they are entirely exter- 
 minated. 
 
 We have thus enumerated the various 
 diseases which affect the teeth, the gums, 
 and the alveolar processes ; and, with 
 respect to the latter, in concluding we 
 may observe, that while their growth 
 lengthens the countenance of the infant, 
 and gives its first and early character 
 of youth, so, on the other hand, as we 
 
173 
 
 have before repeatedly noticed, it is the 
 loss of these processes by the destruction 
 of the teeth, which gives the character 
 of advanced life, or old age ; for, by this 
 loss, the chin necessarily approaches 
 nearer to the nose, the lips turn in, and 
 the skin, being more loose, naturally 
 falls into wrinkles ; as may be seen in 
 figure 2, in the frontispiece, 
 
1?4 
 
 PHYSIOGNOMY 
 
 TEETH. 
 
 THE importance of the teeth, in 
 speech, in mastication, and in giving 
 symmetry and expression to the counte- 
 nance, has been already sufficiently no- 
 ticed. 
 
 But, it has been attempted to carry 
 their importance further, in supposing 
 these organs to exert an influence in the 
 formation of the human character; and, 
 for this doctrine, there exists perhaps 
 some slight foundation, but certainly not 
 to that ridiculous extent contended for 
 hy authors, whose imagination on their 
 
175 
 
 favourite subject appears so completely 
 to have misled their judgment. 
 
 That the state of the mind is often 
 discovered in the countenance every one 
 will admit; but the countenance is made 
 up of parts in a high degree flexible, 
 which vary their motions and expres- 
 sions with every changing impulse of 
 the soul. Where then the mind broods 
 over any particular passion, or yields to 
 one continued train of thought or feel- 
 ing, the expression of such mental affec- 
 tion may remain fixed in the counte- 
 nance, and give a determined and de- 
 cided character to the features. 
 
 The teeth, on the contrary, are fixed 
 bodies ; they can receive no change 
 from the influence of the mind, and they 
 merely fill up, or give that finish to the 
 countenance which can admit of no other 
 change, as far as these organs are con- 
 cerned, than what will arise from their 
 loss. 
 
 In the ingenious system of Lavater, 
 
176 
 
 they have met particular notice; and, 
 from the appearance of the teeth and 
 projecting chin, he has drawn many 
 plausible conclusions. 
 
 « Thus, small short teeth have been 
 considered as denoting a weakness of 
 character and constitution ; and, though 
 such have been observed in many per- 
 sons of extraordinary strength, yet, in 
 those persons, they are seldom of a pure 
 white. Long teeth are considered as 
 sure signs cf weakness and pusillani- 
 mity. White clean well arranged teeth, 
 visible on -opening the mouth, but not 
 projecting, nor always seen, have been 
 esteemed marks of good, acute, honest, 
 candid, and faithful men. Where, in 
 such persons, they appear otherwise, or 
 are foul, uneven, and ugly, it is either 
 the effect of sickness, or some mental 
 imperfection which has changed them. 
 Short broad teeth, standing close toge- 
 ther, are the characteristics of tranquil- 
 lity, firmness, and strength. Persons of 
 
177 
 
 a melancholy habit, have seldom teetli 
 well arranged, clean, and white." 
 
 Such are the maxims laid down by 
 Lavater ; but they have no foundation 
 in truth. The size and shape of the teeth 
 we have seen, are originally developed, 
 and arrive at perfection long before the 
 anental qualities are established, and the 
 mind acquires its character. 
 
 But, though the teeth can have no ap- 
 parent influence on the mental qualities 
 of individuals, yet a considerable differ- 
 ence is visible in their appearance in the 
 inhabitants of different countries j and, 
 in this point of view, they may be con- 
 sidered indicative of the character of 
 nations. Thus, the Spaniards are dis- 
 tinguished in general for their well ar- 
 ranged teeth. The Tartars, for their 
 long and separated ones ; and the Hot- 
 tentots, for their extremely white ones. 
 
 Even the ideas of beauty, in respect to 
 the colour of the teeth, differ in different 
 countries. In Europe, and in civilized 
 
178 
 
 society, the degree of whiteness consti- 
 tutes their perfection. But, amongst 
 savage tribes, black is preferred, in or- 
 der to make them differ from the brute 
 creation. Thus, the women of the Ma- 
 rian Islands blacken their teeth ; — the 
 same is done by the Tonquinese and 
 Siamese, and by the inhabitants of Suma- 
 tra and Malacca. In Java, this distinc- 
 tion is confined to the married women, 
 as a mark of greater respect ; while, in 
 the other parts of the East India Island?, 
 the two central incisores of the upper 
 jaw are often gilded, and the adjoining 
 teeth made of a black colour. 
 
 In the East Indies, particularly in 
 Hindoostan, the care of the teeth among 
 the Bramins is made a part of their re- 
 ligious rites. As soon as they rise in 
 the morning, their teeth are rubbed for 
 an hour with a twig of the fig-tree. 
 During this operation, their prayers are 
 fervently addressed to the sun, invoking 
 the blessing of heaven on themselves 
 
179 
 
 and families. This practice, it is pre- 
 sumed, is coeval with their religion and 
 government ; and certainly nothing can 
 shew their high regard for cleanliness, 
 and particularly for the purity and beau- 
 ty of the mouth, than by making it both 
 a law and religious duty. The white- 
 ness and regularity of the teeth seems 
 to have been considered by their poets* 
 as one of the principal charms of a mis- 
 tress. Hence, the epithets of « sparkling 
 teeth: teeth, white as the cunda blos- 
 som/' In other places of India, the 
 teeth are made of a reddish cast, by the 
 constant use of the betel and areca nut. 
 But not content with changing the natu- 
 ral form and colour of their teeth, many 
 savage tribes try to make an alteration 
 in the very shape of their mouths 5 and, 
 by this means, the inhabitants of Prince 
 ^Viiliam's Island, in the South Seas, 
 appear at a distance to have two mouths. 
 In order to do this, an incision is made 
 in the under lip, in a line with the mouth, 
 
180 
 
 sufficient to admit the tongue to pass 
 through it, which, after being healed, 
 continues to have all the appearance of 
 lips. This artificial mouth is adorned 
 with a shell, which is so cut, as to re- 
 semble a row of teeth. 
 
 These circumstances all conspire to 
 prove, that the importance of the teeth is 
 equally appreciated by all nations. 
 
 In civilized society, their care is re- 
 garded as a matter of fashion and orna- 
 ment; and among the ruder nations, their 
 preservation and cleanliness are enjoined 
 as a religious duty, and their value so 
 highly rated, as even at times to be 
 offered in sacrifice to their deities. 
 
 Lavater has carried his whimsical sys- 
 tem so far, as even to form from the 
 teeth ideas of character in the brute 
 creation. To the sea-horse, from the 
 structure of his teeth, he gives the dis- 
 position of foolish, self-destructive ma- 
 lignity. To the sheep, he gives the 
 character of little or no wildness, from 
 
181 
 
 the line of the mouth, or form and posi- 
 tion of the teeth. But, as we have al- 
 ready stated, it is not in the teeth, but on 
 the countenance the great lines of charac- 
 ter are exhibited. This is the theatre 
 on which the soul delineates itself, and 
 where the muscles of the face give it the 
 expression of the inward workings of 
 the mind. That countenance, which can 
 at one moment display the most savage 
 ferocity, or the greatest stupidity, will, 
 on other occasions, exhibit the greatest 
 meakness and placidity; and in all these 
 circumstances, the teeth suffer no change. 
 How unjust then to characterize all those 
 who have irregular teeth, as possessing 
 the most malignant passions ; or to ex- 
 clude from our friendship, all who have 
 long and separated teeth, lest they should 
 rob and murder us. 
 
 But though the teeth can have no in- 
 fluence in the elucidation of character, 
 yet, in regard to appearance, their influ- 
 ence is great. No face can be consi- 
 
183 
 
 dered as truly beautiful, which is dis- 
 figured by foul, unsound, or irregular 
 teeth. The laugh, which is the test of 
 good humour and openness, excites only 
 disgust, where the mouth exhibits foul- 
 ness and deformity. A pleasing coun- 
 tenance naturally prepossesses, but it 
 never can be complete, unless beauty 
 and regularity of the teeth unite in the 
 attraction; so that where a person 
 wishes to please, the care of the teeth 
 forms an essential consideration : and 
 hence, with justice, Lavater observes, 
 that the form, position, and cleanliness 
 of the teeth, so far as depends on the 
 individual himself, is a certain proof 
 of his taste in other matters. 
 
483 
 
 CONCLUSION ; 
 
 DOMESTIC ADVICE 
 
 ON THE 
 
 TEETH. 
 
 HAVING considered, at considerable 
 length, the evolution, progress, and dif- 
 ferent diseases of the teeth ; it only re- 
 mains to point out to parents and guar- 
 dians, how much the future health and 
 beauty of their charge depend on their 
 attentively watching over the changes 
 that take place at different periods, in 
 this part of the human structure. 
 
 It is a fact well known, and which 
 
184 
 
 every one's experience daily confirms, 
 that few persons pass through life, with- 
 out more or less inconvenience from 
 diseases of the teeth. In infancy, we 
 have seen that their formation and 
 growth is the source of great and con- 
 stant anxiety to the fond parent ; and 
 that they produce deviations from health, 
 which often continue for the remainder 
 of life ; for, at that early period, con- 
 stitutional diseases arc called into action 
 by the irritation of dentition, which 
 would otherwise have remained dor- 
 mant 
 
 But that period of childhood at which 
 the temporary teeth begin to shed, is 
 the critical time that calls for the atten- 
 tion of parents ; for, by neglect at that 
 time, irregularities are, as we have seen, 
 apt to arise, which might easily have 
 been prevented by proper care, and a 
 due attention to cleanliness of the mouth. 
 
 The chief deformities produced by ir- 
 regular teeth, are the rabbit mouth and 
 
185 
 
 the projecting chin. But these and all 
 other defects, may be prevented by time- 
 ly attention. 
 
 The rabbit mouth is caused by a pre- 
 ternatural projection of the front teeth 
 in the upper jaw, accompanied by a de- 
 formed irregularity in their arrange- 
 ment ; as exhibited at figure 1, in the 
 frontispiece. 
 
 The projecting chin chiefly arises from 
 a casual irregularity in the protrusion 
 of the front teeth in the under jaw, 
 which assumes an unnatural projection, 
 while those of the upper jaw do not ad- 
 vance sufficiently forward, the direction 
 of their points when in contact being 
 contrary to what nature intended ; for 
 the incisores of the upper jaw are within, 
 or on the inside of those of the under, 
 instead of standing out beyond them $ as 
 shewn at figure 3, in the frontispiece. 
 
 In proportion as the teeth grow, the 
 deformity becomes increased and more 
 conspicuous ; and so disagreeable is it, 
 
186 
 
 that Physiognomists have attached to it 
 a hrutal disposition. 
 
 This instance is sufficient to shew, 
 how much depends on domestic atten- 
 tion ; for teeth that are too prominent 
 or irregular, can always, by pressure 
 made at an early period, be brought into 
 their proper arrangement ; so that it is 
 not the means of cure that are wanting, 
 but inclination in those concerned to ap- 
 ply them. That disagreeable appearance 
 termed the rabbit mouth, is always in 
 the power of the dentist to rectify ; and 
 what parent, who has a regard for the 
 personal appearance of their offspring, 
 would allow such a deformity to exist. 
 
 It is a truth, which most persons will 
 admit, that before they have arrived at 
 the years of maturity, disease has com- 
 menced in their second or permanent 
 teeth ; and it is for this reason they are 
 induced to believe that the teeth are 
 more easily destructible than the rest of 
 the frame. 
 
187 
 
 But this, we have endeavoured to 
 prove, is a gross mistake ; and that, on 
 the contrary, the commencement of the 
 diseases of the teeth arises, from a want 
 of that early and habitual cleanliness 
 which is the only means, as we have al- 
 ready pointed out, of preserving them. 
 
 This we have seen confirmed in the 
 cases of the African and Indian, who> 
 from constant care, preserve their teeth 
 in perfect health. 
 
 Nothing, therefore, is required to ren- 
 der this part of the human structure less 
 destructible than any other; but the 
 same attention, which, from personal 
 delicacy and fashion, is paid to cleanli- 
 ness of the face and arrangement of the 
 hair. 
 
 Nor should the teeth themselves btf 
 the only objects of care, the gums, or 
 envelope which surrounds them, de- 
 mand equal attention ; and the character 
 of a healthy state of the gums should be 
 known to every mother. These cha- 
 
188 
 
 racters are — a vermillion, or red colour 
 —a close texture — their firmly embrac- 
 ing the necks of the teeth — and the gum 
 forming projections in every interstice, 
 and receding in front, so as to surround 
 each tooth in the form of a small arch. 
 
 Where the gums, on the contrary, are 
 pale and rough, their texture loose and 
 flabby, and no adhesion takes place to 
 the necks of the teeth, which are partly 
 laid bare, it is but too apparent, that 
 want of cleanliness and neglect have long 
 existed, and disease of the teeth must 
 already have occurred, or will soon 
 follow. 
 
 To guard against this state, the early 
 management of the teeth becomes the 
 duty of the mother. As soon as the 
 child is weaned, the task of cleaning the 
 teeth should commence; every night 
 and morning the mouth of the child 
 should be washed, or rinsed out with 
 warm water, the tongue wiped clean 
 with a cloth, the teeth gently brushed, 
 
189 
 
 and the waxed thread passed between 
 them. This practice, so healthy and so 
 conducive to comfort, will not only pre- 
 vent all disease of the teeth and gums, 
 but will also extend its beneficial effects 
 in promoting the absorption of the fangs, 
 and securing a regular arrangement to 
 the future set. 
 
 Children, under such management, 
 will be less subject to catarrhal affec- 
 tions, and sore throat, by the secre- 
 tions of the mouth and throat proceed- 
 ing in a regular and uninterrupted man- 
 ner. 
 
 There is nothing which, in an after 
 period, is so destructive to the health of 
 teeth as the use of tooth-picks. They 
 are usually formed of hard materials, 
 and their insinuation between the teeth 
 detaches the gums from their adhesion ; 
 and by laying the necks of the teeth 
 bare, hollows or cavities are formed, 
 which afford lodgements for the food, and 
 proves a certain source of disease, and 
 
190 
 
 the commencement of caries. The na- 
 tural character of the gum is thus de- 
 stroyed, their arched appearance va- 
 nishes and becomes flat, and inflamma- 
 tion succeeds. 
 
 The use, therefore, of tooth-picks is 
 to be strongly condemned, whatever 
 their form, or the materials of which 
 they are made, and are as improper for 
 children as for adults. When a pin is 
 substituted, it is even more injurious 
 than any other substance ; for, by the 
 w r ounds it makes, if the teeth are neglect- 
 ed, and tartar is allowed to accumulate, a 
 putrid matter is inoculated into the gum, 
 which renders it unhealthy and dis- 
 eased. 
 
 We have already recommended the 
 tongues of children to be cleaned with a 
 towel, the same should be continued at 
 every period of life, instead of the com- 
 mon instruments, termed tongue-scra- 
 pers, from the frequent use of which, 
 and their mechanical operation on this 
 
m 
 
 part, which naturally possesses great 
 sensibility, much irritation is excited, 
 and the organ becomes gradually injured, 
 which lessens the powers of feeling, 
 and thus destroys in a certain degree 
 the sense of taste. 
 
 Nor is the use of tooth powders, 
 though so much recommended, to be re- 
 garded in a more favourable light. In 
 ♦the manner in which they are employ- 
 ed, by acting on the periosteum, they 
 detach and destroy that part of it which 
 immediately surrounds the necks of the 
 teeth, and thus occasions the loss of this 
 useful and ornamental part of the human 
 structure. 
 
 The same objection applies even to 
 the constant use of tooth brushes, unless 
 properly adapted, in their dimensions, 
 to the corresponding dimensions of the 
 teeth. This is a subject of very great 
 importance, and has never been suffi- 
 ciently or scientifically reflected on by 
 dentists, consequently the rules they 
 
192 
 
 Jiave laid down for their use, have been 
 highly erroneous, and often attended 
 with injury, instead of answering any 
 beneficial effect. It is clearly intended 
 that a brush should only be applied to 
 the surface of the tooth in order to re- 
 move tartar or other accumulation, but 
 if it is made of such a size as to proceed 
 further, it rubs upon the periosteum or 
 investing membrane of the teeth; and 
 thus, if daily used, cannot fail to destroy" 
 it, and the sooner if armed with tooth 
 powder. This will shew the necessity 
 for every person making a choice of a 
 particular tooth brush for himself, se- 
 lecting it according to the size of his 
 teeth. 
 
 When children begin to shed their 
 teeth, if irregularities form in their ar- 
 rangement by over-lapping each other, 
 a frequent inspection should take place; 
 for all deformity can at that time be 
 easily rectified, nor indeed is a cure of 
 any deformity to be despaired of under 
 
193 
 
 the age of fifteen. In bringing irregu- 
 lar teeth into their proper situation, it 
 will be always preferable to extract one 
 1ooth, in order to give room for the rest, 
 instead of using the file, which can ne- 
 ver allow of so complete and natural an 
 arrangement. 
 
 The most frequent and dangerous dis- 
 ease of the teeth, we have stated to be 
 caries; this affects them at a very early 
 period j indeed it is often coeval with 
 their first irruption, particularly when 
 dentition is slow, for then the accumu- 
 lated matter is apt to lodge on their 
 edges, and unless carefully removed* 
 disease is entailed for life. 
 
 In every family, it should be a rule to 
 have the teeth of children frequently 
 inspected by a dentist; but there is an 
 unfortunate prejudice entertained by 
 parents, that his operations tend to in- 
 jure the teeth. On this account, the 
 proper time is often neglected, which 
 occasions deformity and disfiguration of 
 
194 
 
 the countenance for life. In many public 
 seminaries this practice has been lauda- 
 bly followed. It will always prevent 
 much future pain and regret; and chil- 
 dren, when they attain the age of reason 
 and reflection, will be more grateful for 
 this attention, than for those accom- 
 plishments or indulgences which have 
 no connection with health and comfort. 
 The first traces of disease in the teeth 
 are always unknown to the patient. 
 Caries, in particular, is so insidious in its 
 attack, that its existence often requires 
 the most minute inspection of the den- 
 tist's eye to detect. 
 
 Whatever neglect may attach to the 
 conduct of dentists in general, the one 
 so commonly imputed to them, of dis- 
 missing their patients without the neces- 
 sary instruction for preserving their 
 teeth in the state of order to which they 
 have been restored, is one, for which 
 they certainly are not responsible. Why 
 should they be blamed for withholding 
 
195 
 
 that information of which they were 
 never in possession ? It being a fact, the 
 public decision can sufficiently establish, 
 that an attention to the interstices of the 
 teeth, so much the object of the present 
 work to recommend, is an improvement 
 in the professional practice, which has 
 hitherto wholly escaped their attention. 
 The regular use of my dentifric appa- 
 ratus, will however render any further 
 instructions from the dental operator 
 perfectly unnecessary. 
 
 Most dentists have an opinion that the 
 teeth are sometimes too close to each 
 other. But this can never be the case; 
 for, in the closest set, there will be always 
 room sufficient to pass the waxed thread 
 in their interstices, provided there be no 
 tartar to prevent it. Close teeth, on the 
 contrary, have the advantage of afford- 
 ing a greater support to each other, and 
 of causing a more general and firmer 
 adhesion of the gum. 
 
 Among the popular prejudices which 
 
196 
 
 Lave been sanctioned by dentists, is that 
 of bad teeth being hereditary or running 
 in families. This is a most erroneous 
 idea, and ought to be strongly combated, 
 as under such a prepossession the teeth 
 will generally be neglected. Parents 
 supposing that every means used for the 
 prevention of disease will be fruitless. 
 
 I have no hesitation in affirming, that 
 bad teeth are always accidental, and are 
 to be considered either as the conse- 
 quences of neglect, or improper manage- 
 ment. This is confirmed by the appear- 
 ance of the teeth in all animals but man ; 
 in the former we discover no diseased 
 structure or other deformity, and there- 
 fore we are induced to ascribe it to for- 
 tuitous, not constitutional or hereditary 
 causes. In favouring this opinion, den- 
 tists seem little aware how materially 
 they injure themselves, and the discredit 
 that is reflected on their own profession. 
 
 The use of the tooth brush we for- 
 merly stated, as only injurious when not 
 
197 
 
 adapted to the size of the teeth, and 
 acting too powerfully on the gums. 
 With attention to this regulation, brush- 
 ing the teeth is a most healthy and 
 useful operation, provided no tooth pow- 
 der is used, otherwise the ingredients 
 of which it is composed will be liable to 
 insinuate between the gum and perios- 
 teum, producing irritation and all its 
 consequences. The period of shedding 
 the first teeth, we haVe stated as the cri- 
 tical time for insuring to them regularity 
 of arrangement, and beauty of appear- 
 ance. It is at this time, the care of the 
 dentist becomes indispensable, that the 
 primary teeth, whose fangs are not ab- 
 sorbed, may be removed in time to pre- 
 vent the permanent teeth acquiring any 
 deformity, as well as to secure symmetry 
 to the countenance, and harmony to the 
 features. 
 
 The above observations have been 
 dwelt on thus earnestly, from a wish to 
 impress upon parents their serious im- 
 
193 
 
 portance, to secure them from falling 
 into improper hands, and to induce 
 them to follow a system founded on rea- 
 son and experience, eminently calcu- 
 lated for promoting the beauty and 
 health of the human structure. 
 
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 one large volume, 8vo. Price g4 50, bound. 
 
 15. 
 JOHN AND CHARLES BELL'S ANA- 
 TOMY OF THE HUMAN BODY, illus- 
 
•Yew Works, Sfc. by Collins Sf Croft. 
 
 tinted by 125 Engravings. In 3 volumes. 
 Price 11 Dollars. — The London Edition of 
 this highly important work sells at 24 Dol- 
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 Of the character of Bell's Anatomy, it may not 
 become the publishers to say any thing. The fol- 
 lowing extract will satisfy every enquirer : — 
 
 4< It would be injustice to confound this work 
 with the ordinary compilations from the common 
 stock of elementary writers, and the transcribed 
 lectures of the Class Room. It is obviously the re- 
 sult of very extensive study, both in books and in 
 the Dissecting Room, and its completion now sup- 
 plies a want very much felt by the English reader." 
 AikitiLS Annual Review, 
 
 16. 
 
 A TREATISE ON SURGICAL DIS- 
 EASES, and the Operations suited to them, 
 by Baron Boyer, member of the Legion of 
 Honour, Professor of Surgery of the Faculty 
 of Medicine of Paris, Principal Adjunct sur- 
 geon of the Hospital de la Charite, Member 
 of several National and Foreign learned So- 
 cieties, &c. &c. Translated from the French 
 by Alexander H. Stevens, M. D. Professor 
 
New Works, Sfc. by Collins Sf Croft. 
 
 of the Principles and Practice of surgery in 
 the Medical Institution of New York, and of 
 Queen's College, New-Jersey; one of the 
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 by the Translator. 
 
 The Proprietors and Publishers cannot more 
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 Translator, which is subjoined. 
 
 " The character of Baron Boyer, as a practical 
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 Bones, which was long since translated into English 
 is justly ranked among the Medical Classics. The 
 high encomiums that have been bestowed upon 
 these volumes, and the want of a comprehensive 
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 sufficiently explain the translator's motives in of- 
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 conciseness and perspicuity have been aimed at, 
 and four volumes of the original are compressed in- 
 to two. The author's motives in preparing this 
 system of surgery, are illustrated by the following 
 short extract from his Preface. • After having 
 practised Surgery more than four and twenty years, 
 I might easily have confirmed each precept by 
 cases which have occurred to me ; but fearing to 
 
JVcw Works, Sfc. by Collins Sf Croft. 
 
 render my work too voluminous, I have related on- 
 ly such cases as appeared to me to present some 
 remarkable peculiarity of novelty and utility.' " 
 
 17. 
 INNES'S SHORT DESCRIPTION OF 
 THE HUMAN MUSCLES, arranged as 
 they appear on Dissection, together witli 
 their several uses, and the synonyma of the 
 best authors ; an improved edition, with 17* 
 engravings, 12mo. Price $ 1 50. 
 
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 BARD'S COMPENDIUM OF MID- 
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 during Pregnancy, in Labour, and in Child- 
 bed, illustrated by many cases, and particu- 
 larly adapted to the use of students. Fourth 
 edition, enlarged. By Samuel Bard, M. D. 
 L. L. D. president of the College of Physi- 
 cians and Surgeons in the University of the 
 State of New York. 1 vol. 8vo. Price § 3. 
 

 
 
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