2514. The Treatment in all cases of painful teething is remarkably simple, and consists in keeping the body cool by mild aperient medicines, allaying the irritation in the gums by friction with a rough ivory ring or a stale crust of broad, and when the head, lungs, or any organ is overloaded or unduly excited, to use the hot bath, and by throwing the body into a perspiration, equalize the circulation, and relieve the system from the danger of a fatal termination.
2515. Besides these, there is another means, but that must be employed by a medical man; namely, scarifying the gums—an operation always safe, and which, when judiciously performed, and at a critical opportunity, will often snatch the child from the grasp of death.
2516. There are few subjects on which mothers have often formed such strong and mistaken opinions as on that of lancing an infant's gums, some rather seeing their child go into fits—and by the unrelieved irritation endangering inflammation of the brain, water on the head, rickets, and other lingering affections—than permit the surgeon to afford instant relief by cutting through the hard skin, which, like a bladder over the stopper of a bottle, effectually confines the tooth to the socket, and prevents it piercing the soft, spongy substance of the gum. This prejudice is a great error, as we shall presently show; for, so far from hurting the child, there is nothing that will so soon convert an infant's tears into smiles as scarifying the gums in painful teething; that is, if effectually done, and the skin of the tooth be divided.
2517. Though teething is a natural function, and to an infant in perfect health should be unproductive of pain, yet in general it is not only a fertile cause of suffering, but often a source of alarm and danger; the former, from irritation in the stomach and bowels, deranging the whole economy of the system, and the latter, from coma and fits, that may excite alarm in severe cases; and the danger, that eventuates in some instances, from organic disease of the head or spinal marrow.
2518. We shall say nothing in this place of "rickets," or "water on the head," which are frequent results of dental irritation, but proceed to finish our remarks on the treatment of teething. Though strongly advocating the lancing of the gums in teething, and when there are any severe head-symptoms, yet it should never be needlessly done, or before being satisfied that the tooth is fully formed, and is out of the socket, and under the gum. When assured on these points, the gum should be cut lengthwise, and from the top of the gum downwards to the tooth, in an horizontal direction, thus——, and for about half an inch in length. The operation is then to be repeated in a transverse direction, cutting across the gum, in the centre of the first incision, and forming a cross, thus +. The object of this double incision is to insure a retraction of the cut parts, and leave an open way for the tooth to start from—an advantage not to be obtained when only one incision is made; for unless the tooth immediately follows the lancing, the opening reunites, and the operation has to be repeated. That this operation is very little or not at all painful, is evidenced by the suddenness with which the infant falls asleep after the lancing, and awakes in apparently perfect health, though immediately before the use of the gum-lancet, the child may have been shrieking or in convulsions.
Convulsions, or Infantine Fits.
2519. From their birth till after teething, infants are more or less subject or liable to sudden fits, which often, without any assignable cause, will attack the child in a moment, and while in the mother's arms; and which, according to their frequency, and the age and strength of the infant, are either slight or dangerous.
2520. Whatever may have been the remote cause, the immediate one is some irritation of the nervous system, causing convulsions, or an effusion to the head, inducing coma. In the first instance, the infant cries out with a quick, short scream, rolls up its eyes, arches its body backwards, its arms become bent and fixed, and the fingers parted; the lips and eyelids assume a dusky leaden colour, while the face remains pale, and the eyes open, glassy, or staring. This condition may or may not be attended with muscular twitchings of the mouth, and convulsive plunges of the arms. The fit generally lasts from one to three minutes, when the child recovers with a sigh, and the relaxation of the body. In the other case, the infant is attacked at once with total insensibility and relaxation of the limbs, coldness of the body and suppressed breathing; the eyes, when open, being dilated, and presenting a dim glistening appearance; the infant appearing, for the moment, to be dead.
2521. Treatment.-The first step in either case is, to immerse the child in a hot bath up to the chin; or if sufficient hot water cannot be procured to cover the body, make a hip-bath of what can be obtained; and, while the left hand supports the child in a sitting or recumbent position, with the right scoop up the water, and run it over the chest of the patient. When sufficient water can be obtained, the spine should be briskly rubbed while in the bath; when this cannot be done, lay the child on the knees, and with the fingers dipped in brandy, rub the whole length of the spine vigorously for two or three minutes, and when restored to consciousness, give occasionally a teaspoonful of weak brandy and water or wine and water.
2522. An hour after the bath, it may be necessary to give an aperient powder, possibly also to repeat the dose for once or twice every three hours; in which case the following prescription is to be employed. Take of