Periscope of Medical and General Science in their Relations to Dentistry. [Volume: 2, Issue: 2, September, 1860, pp. 124-129]

128

THE DENTAL COSMOS.

border, and from its continuance on the gums after the tartar has been
scaled off. But if we exercise due care, there is not much danger of
going astray, for there is no evidence that the gingival margin ever occurs
in any other malady; such, at least, is the testimony of Drs. Thompson,
Roe, Pierce, and Smith, who have had extensive opportunities of observation at the Brompton Hospital for Consumptives, London. * *
" 1st. Thompson's gingival margin is an unfailing sign of the tubercular diathesis.
" 2d. That when present, no matter how obscure every other symptom
and sign of phthisis is, we may, with certainty, prognosticate its development at no distant day.
"3d. In managing cases of phthisis, if the margin is present, and disappears, under treatment, it is an evidence of amendment, and should be
regarded as a favorable omen.
" 4th. When the margin at first appears on the incisors, and gradually
extends around the molar teeth, when suitable treatment is employed, it
may be regarded as an unfavorable indication; and if it changes from the
bright vermilion to a dark red or purple, the case will terminate more
rapidly.
"5th. In cases where the margin is absent, whatever be the general
symptoms, we may hope that the constitution is not so greatly injured by
the morbid condition of the vital fluid, that we can restore the individual
to comparative health by the use of suitable remedies, and thus avert or
retard the permanent existence of pulmonary tuberculosis."
"Neuralgia of the Face of Thirteen Years' Standing; Cure by Removing a Portion of the Nerve. By E. ANDREWS, M.D.-JB -, of Kankakee, had suffered, by his account, thirteen years, with a
most terrible neuralgia in the lower part of the right side of his face.
The pain seemed to recur in paroxysms every three or four minutes, when
he would be incapable of attending to anything but his extreme torture,
and endeavor to alleviate a little his agony by rubbing the part briskly
with his hand until the paroxysm subsided.
" On examination of the case, I discovered that the pain was limited
exclusively to the nerves which make their exit from the right anterior
mental foramen. I judged, therefore, that the cause of the trouble was
at that opening, and that a section of the nerve on the proximal side of
it would relieve the pain. I was the more willing to adopt this course
because the patient had already exhausted almost every other resource in
vain, and his suffering was so terrible that the paralysis of the nerve, by
removing a portion, was comparatively a trivial evil. I therefore administered chloroform and ether to anesthesia, and operated as follows:
I made a semicircular incision over the masseter muscle down to the
ramus of the jaw, with the convexity of the incision downward. Dissecting the flap upward, the external surface of the ramus of the jaw
was laid bare, and the trephine applied. If a line be drawn from the
angle of the jaw upward and forward to a point half an inch behind the
last molar tooth, and the centre pin of a half inch trephine be placed
upon this line at such a point that the crown of the instrument is a quarter of an inch from the anterior edge of the ramus, the nerve will be
found crossing the centre of the opening made by the instrument. I have
found this direction rather more convenient than those laid down by our