Chapter VIII.

Chapter VIII.Of Diseases of the Teeth.Sect.137.The Diseases of the Teeth, which are sometimes so tedious and so violent, as to cause obstinate Wakefulness, a considerable Degree of Fever, Raving, Inflammations, Abscesses, Rottenness of the Bones, Convulsions and Faintings, depend on three principal Causes. 1. On aCariesor Rottenness of the Teeth. 2. On an Inflammation of the Nerves of the Teeth, or of the Membrane which invests and covers them; and which affects the Membrane of the Gums. 3. A cold Humour or Defluxion that is determined to the Teeth, and to their Nerves and Membrane.§ 138. In the first of these Cases, theCarieshaving eat down to, and exposed the naked Nerve, the Air, Food and Drink irritate, or, as it were sting it; and this irritation is attended with Pain more or less violent. Every thing that increases the Motion or Action of the affected Part, as Exercise, Heat or Food, will be attended with the same Consequence.When the Tooth is greatly decayed, there is no other Cure besides that by extracting it, withoutwhich the Pain continues; the Breath becomes very offensive; the Gum is eat down; the other Teeth, and sometimes even the Jaw-bone, are infected with the Rottenness: besides, that it prevents the Use of the other Teeth, which are infected with a kind of tartarous Matter, and decay.But when the Disorder is less considerable, the Progress of it may sometimes be restrained, by burning the Tooth with a hot Iron, or by filling it with Lead, if it is fitted to receive and to retain it. Different corroding Liquids are sometimes used on these Occasions,Aqua fortisitself, and Spirit of Vitriol: but such Applications are highly dangerous, and ought to be excluded. When the Patients, from Dread, reject the Operations just mentioned, a little Oyl of Cloves may be applied, by introducing a small Pellet of Cotton, dipt in it, to the rotten hollow Tooth; which often affords considerable Ease, and Respite. Some make use of a Tincture of Opium, or Laudanum, after the same Manner; and indeed these two Medicines may be used together in equal Quantities. I have often succeeded withHoffman'smineral anodyne Liquor; which seemed indeed, for a few Moments, to increase the Pain; but Ease generally ensues after spitting a little Time. A Gargarism made of the HerbArgentina; that is Silver-weed or wild Tansey, in Water, frequently appeases the Pain that results from aCariesof the Teeth: and in such Cases many People have found themselves at Ease,under a constant Use of it. It certainly is an Application that cannot hurt, and is even beneficial to the Gums. Others have been relieved by rubbing their Faces over with Honey.§ 139. The second Cause is the Inflammation of the Nerve within the Substance, or of the Membrane on the Outside, of the Tooth. This is discovered by the Patient's Temperament, Age and Manner of living. They who are young, sanguine, who heat themselves much, whether by Labour, by their Food, their Drink, by sitting up late, or by any other Excess: they who have been accustomed to any Discharges or Eruptions of Blood, whether natural or artificial, and who cease to have them as usual, are much exposed to the Tooth-ach, from this Cause.This Pain, or rather Torment, if in an acute Degree, commonly happens very suddenly, and often after some heating Cause. The Pulse is strong and full; the Countenance considerably red; the Mouth extremely hot: there is often a pretty high Fever, and a violent Head-ach. The Gums, or some Part of them, become inflamed, swelled, and sometimes an Abscess appears. At other times the Humours throw themselves upon the more external Parts; the Cheek swells, and the Pain abates. When the Cheek swells, but without any Diminution of the Pain, it then becomes an Augmentation, but no essential Change, of the Disorder.§ 140. In this Species of the Disease, we must have Recourse to the general Method of treatinginflammatory Disorders, and direct Bleeding, which often produces immediate Ease, if performed early. After Bleeding, the Patient should gargle with Barley Water, or Milk and Water; and apply an emollient Cataplasm to the Cheek. If an Abscess or little Imposthume appears, the Suppuration or ripening of it is to be promoted, by holding continually in the Mouth some hot Milk, or Figs boiled in some Milk: and as soon as ever it seems ripe, it should be opened, which may be done easily, and without any Pain. The Disorder, when depending on this Cause, is sometimes not so violent, but of a longer Duration, and returns whenever the Patient heats himself; when he goes to Bed; when he eats any heating Food, or Drink, Wine or Coffee. In this Case he should be bled, without which his other Medicines will have little Effect; and he should bathe his Feet in warm Water for some Evenings successively, taking one Dose of the PowderNº. 20. Entire Abstinence from Wine and Meat, especially at Night, has cured several Persons of inveterate and obstinate Maladies of the Teeth.In this Species of Tooth-ach, all hot Remedies are pernicious; and it often happens that Opium, Venice Treacle, and Storax Pills, are so far from producing the Relief expected from them, that they have aggravated the Pain.§ 141. When the Disease arises from a cold Distillation, or Humour, tending to these Parts, it is commonly (though equally painful) attended with less violent Symptoms. The Pulse isneither strong, full nor quick; the Mouth is less heated, and less swelled. In such Cases, the afflicted should be purged with the PowderNº. 21, which has sometimes perfectly cured very obstinate Complaints of this Sort. After purging they should make Use of the Diet Drink of the WoodsNº. 22. This has cured Tooth-achs, which have baffled other Attempts for many Years; but it must be added, this Drink would be hurtful in the Disease from a different Cause. Blisters to the Nape of the Neck, or35elsewhere, it matters not greatly where, have often extraordinary good Effects, by diverting the Humour, and restoring a compleat Perspiration. In short in this Species, we may employ, not only with Safety, but with Success (especially after due purging) Pills of Storax, Opium and Venice Treacle. Acrid sharp Remedies, such as hard spun35Tobacco, Root of Pellitory ofSpain, &c. by exciting much Spitting, discharge part of theHumour which causes the Disease, and hence diminish the Pain. The Smoke of Tobacco also succeeds now and then in this Disorder, whether this happens from the Discharge of the Rheum or Spittle it occasions; or whether it is owing to any anodyne Efficacy of this Plant, in which it resembles Opium.§ 142. As this last Cause is often the Consequence of a Weakness in the Stomach, it daily happens that we see some People, whose Disorder from this Cause is augmented, in Proportion as they indulge in a cooling, refreshing Way of living. The Increase of the Disorder disposes them to increase the Dose of what they mistake for its Remedy, in Proportion to which their Pain only increases. There is a Necessity that such Persons should alter this Method; and make use of such Medicines as are proper to strengthen the Stomach, and to restore Perspiration. The PowderNº. 14. has often produced the best Consequences, when I have ordered it in these Cases; and it never fails to dissipate the Tooth-ach very speedily, which returns periodically at stated Days and Hours. I have also cured some Persons who never drank Wine, by advising them to the Use of it.§ 143. But besides the Diseases of the Teeth, that are owing to these three principal Causes, which are the most common ones; there are some very tedious and most tormenting Disorders of them, that are occasioned by a general Acrimony, or great Sharpness, of the Mass of Blood,and which are never cured by any other Medicines but such, as are proper to correct that Acrimony. When it is of a scorbutic Nature, the wild Horse-radish (Pepperwort) Water Cresses, Brooklime, Sorrel, and Wood-sorrell correct and cure it. If it is of a different Nature, it requires different Remedies. But very particular Details do not come within the Plan of this Work. As the Malady is of the chronical or tedious kind, it allows Time to consider and consult more particularly about it.The Gout and the Rheumatism are sometimes transferred to the Teeth, and give Rise to the most excruciating Pains; which must be treated like the Diseases from which they arise.§ 144. From what has been said on this Disorder, the Reader will discern, in what that imaginary Oddness may consist, which has been ascribed to it, from the same Application's relieving one Person in it, and not affording the least Relief to another. Now the plain Reason of this is, that these Applications are always directed, without an exact Knowledge of the particular Cause of the Disease, in different Subjects and Circumstances; whence the Pain from a rotten Tooth, is treated like that from an Inflammation; that from an Inflammation, like the Pain from a cold Humour or Fluxion; and this last like a Pain caused by a scorbutic Acrimony: so that the Disappointment is not in the least surprizing. Perhaps Physicians themselves do not always attend distinctly enough to the Nature of eachparticular Disorder: and even when they do, they content themselves with directing some of the less potent Medicines, which may be inadequate to accomplish the necessary Effect. If the Distemper truly be of an inflammatory Disposition, Bleeding is indispensible to the Cure.It happens in Fact, with Regard to the Diseases of the Teeth, as well as to all other Diseases, that they arise from different Causes; and if these Causes are not opposed by Medicines suited to them, the Disease, far from being cured, is aggravated.I have cured violent Tooth-achs, of the lower Jaw, by applying a Plaister of Meal, the White of an Egg, Brandy and Mastich, at the Corner of that Jaw, over the Spot where the Pulsation of the Artery may be perceived: and I have also mitigated the most excruciating Pains of the Head, by applying the same Plaister upon the temporal Artery.****

Of Diseases of the Teeth.

Sect.137.

The Diseases of the Teeth, which are sometimes so tedious and so violent, as to cause obstinate Wakefulness, a considerable Degree of Fever, Raving, Inflammations, Abscesses, Rottenness of the Bones, Convulsions and Faintings, depend on three principal Causes. 1. On aCariesor Rottenness of the Teeth. 2. On an Inflammation of the Nerves of the Teeth, or of the Membrane which invests and covers them; and which affects the Membrane of the Gums. 3. A cold Humour or Defluxion that is determined to the Teeth, and to their Nerves and Membrane.

§ 138. In the first of these Cases, theCarieshaving eat down to, and exposed the naked Nerve, the Air, Food and Drink irritate, or, as it were sting it; and this irritation is attended with Pain more or less violent. Every thing that increases the Motion or Action of the affected Part, as Exercise, Heat or Food, will be attended with the same Consequence.

When the Tooth is greatly decayed, there is no other Cure besides that by extracting it, withoutwhich the Pain continues; the Breath becomes very offensive; the Gum is eat down; the other Teeth, and sometimes even the Jaw-bone, are infected with the Rottenness: besides, that it prevents the Use of the other Teeth, which are infected with a kind of tartarous Matter, and decay.

But when the Disorder is less considerable, the Progress of it may sometimes be restrained, by burning the Tooth with a hot Iron, or by filling it with Lead, if it is fitted to receive and to retain it. Different corroding Liquids are sometimes used on these Occasions,Aqua fortisitself, and Spirit of Vitriol: but such Applications are highly dangerous, and ought to be excluded. When the Patients, from Dread, reject the Operations just mentioned, a little Oyl of Cloves may be applied, by introducing a small Pellet of Cotton, dipt in it, to the rotten hollow Tooth; which often affords considerable Ease, and Respite. Some make use of a Tincture of Opium, or Laudanum, after the same Manner; and indeed these two Medicines may be used together in equal Quantities. I have often succeeded withHoffman'smineral anodyne Liquor; which seemed indeed, for a few Moments, to increase the Pain; but Ease generally ensues after spitting a little Time. A Gargarism made of the HerbArgentina; that is Silver-weed or wild Tansey, in Water, frequently appeases the Pain that results from aCariesof the Teeth: and in such Cases many People have found themselves at Ease,under a constant Use of it. It certainly is an Application that cannot hurt, and is even beneficial to the Gums. Others have been relieved by rubbing their Faces over with Honey.

§ 139. The second Cause is the Inflammation of the Nerve within the Substance, or of the Membrane on the Outside, of the Tooth. This is discovered by the Patient's Temperament, Age and Manner of living. They who are young, sanguine, who heat themselves much, whether by Labour, by their Food, their Drink, by sitting up late, or by any other Excess: they who have been accustomed to any Discharges or Eruptions of Blood, whether natural or artificial, and who cease to have them as usual, are much exposed to the Tooth-ach, from this Cause.

This Pain, or rather Torment, if in an acute Degree, commonly happens very suddenly, and often after some heating Cause. The Pulse is strong and full; the Countenance considerably red; the Mouth extremely hot: there is often a pretty high Fever, and a violent Head-ach. The Gums, or some Part of them, become inflamed, swelled, and sometimes an Abscess appears. At other times the Humours throw themselves upon the more external Parts; the Cheek swells, and the Pain abates. When the Cheek swells, but without any Diminution of the Pain, it then becomes an Augmentation, but no essential Change, of the Disorder.

§ 140. In this Species of the Disease, we must have Recourse to the general Method of treatinginflammatory Disorders, and direct Bleeding, which often produces immediate Ease, if performed early. After Bleeding, the Patient should gargle with Barley Water, or Milk and Water; and apply an emollient Cataplasm to the Cheek. If an Abscess or little Imposthume appears, the Suppuration or ripening of it is to be promoted, by holding continually in the Mouth some hot Milk, or Figs boiled in some Milk: and as soon as ever it seems ripe, it should be opened, which may be done easily, and without any Pain. The Disorder, when depending on this Cause, is sometimes not so violent, but of a longer Duration, and returns whenever the Patient heats himself; when he goes to Bed; when he eats any heating Food, or Drink, Wine or Coffee. In this Case he should be bled, without which his other Medicines will have little Effect; and he should bathe his Feet in warm Water for some Evenings successively, taking one Dose of the PowderNº. 20. Entire Abstinence from Wine and Meat, especially at Night, has cured several Persons of inveterate and obstinate Maladies of the Teeth.

In this Species of Tooth-ach, all hot Remedies are pernicious; and it often happens that Opium, Venice Treacle, and Storax Pills, are so far from producing the Relief expected from them, that they have aggravated the Pain.

§ 141. When the Disease arises from a cold Distillation, or Humour, tending to these Parts, it is commonly (though equally painful) attended with less violent Symptoms. The Pulse isneither strong, full nor quick; the Mouth is less heated, and less swelled. In such Cases, the afflicted should be purged with the PowderNº. 21, which has sometimes perfectly cured very obstinate Complaints of this Sort. After purging they should make Use of the Diet Drink of the WoodsNº. 22. This has cured Tooth-achs, which have baffled other Attempts for many Years; but it must be added, this Drink would be hurtful in the Disease from a different Cause. Blisters to the Nape of the Neck, or35elsewhere, it matters not greatly where, have often extraordinary good Effects, by diverting the Humour, and restoring a compleat Perspiration. In short in this Species, we may employ, not only with Safety, but with Success (especially after due purging) Pills of Storax, Opium and Venice Treacle. Acrid sharp Remedies, such as hard spun35Tobacco, Root of Pellitory ofSpain, &c. by exciting much Spitting, discharge part of theHumour which causes the Disease, and hence diminish the Pain. The Smoke of Tobacco also succeeds now and then in this Disorder, whether this happens from the Discharge of the Rheum or Spittle it occasions; or whether it is owing to any anodyne Efficacy of this Plant, in which it resembles Opium.

§ 142. As this last Cause is often the Consequence of a Weakness in the Stomach, it daily happens that we see some People, whose Disorder from this Cause is augmented, in Proportion as they indulge in a cooling, refreshing Way of living. The Increase of the Disorder disposes them to increase the Dose of what they mistake for its Remedy, in Proportion to which their Pain only increases. There is a Necessity that such Persons should alter this Method; and make use of such Medicines as are proper to strengthen the Stomach, and to restore Perspiration. The PowderNº. 14. has often produced the best Consequences, when I have ordered it in these Cases; and it never fails to dissipate the Tooth-ach very speedily, which returns periodically at stated Days and Hours. I have also cured some Persons who never drank Wine, by advising them to the Use of it.

§ 143. But besides the Diseases of the Teeth, that are owing to these three principal Causes, which are the most common ones; there are some very tedious and most tormenting Disorders of them, that are occasioned by a general Acrimony, or great Sharpness, of the Mass of Blood,and which are never cured by any other Medicines but such, as are proper to correct that Acrimony. When it is of a scorbutic Nature, the wild Horse-radish (Pepperwort) Water Cresses, Brooklime, Sorrel, and Wood-sorrell correct and cure it. If it is of a different Nature, it requires different Remedies. But very particular Details do not come within the Plan of this Work. As the Malady is of the chronical or tedious kind, it allows Time to consider and consult more particularly about it.

The Gout and the Rheumatism are sometimes transferred to the Teeth, and give Rise to the most excruciating Pains; which must be treated like the Diseases from which they arise.

§ 144. From what has been said on this Disorder, the Reader will discern, in what that imaginary Oddness may consist, which has been ascribed to it, from the same Application's relieving one Person in it, and not affording the least Relief to another. Now the plain Reason of this is, that these Applications are always directed, without an exact Knowledge of the particular Cause of the Disease, in different Subjects and Circumstances; whence the Pain from a rotten Tooth, is treated like that from an Inflammation; that from an Inflammation, like the Pain from a cold Humour or Fluxion; and this last like a Pain caused by a scorbutic Acrimony: so that the Disappointment is not in the least surprizing. Perhaps Physicians themselves do not always attend distinctly enough to the Nature of eachparticular Disorder: and even when they do, they content themselves with directing some of the less potent Medicines, which may be inadequate to accomplish the necessary Effect. If the Distemper truly be of an inflammatory Disposition, Bleeding is indispensible to the Cure.

It happens in Fact, with Regard to the Diseases of the Teeth, as well as to all other Diseases, that they arise from different Causes; and if these Causes are not opposed by Medicines suited to them, the Disease, far from being cured, is aggravated.

I have cured violent Tooth-achs, of the lower Jaw, by applying a Plaister of Meal, the White of an Egg, Brandy and Mastich, at the Corner of that Jaw, over the Spot where the Pulsation of the Artery may be perceived: and I have also mitigated the most excruciating Pains of the Head, by applying the same Plaister upon the temporal Artery.

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