Phosphorus necrosis begins as a periostitis with the production of osteophytes, and is completed as a nearly total necrosis of the entire bone.
Treatment of the Toxic Forms.
—The preventive treatment should consist of supervision of the teeth, the use of alkaline mouth-washes, inhalation of terebinthinate vapors, which neutralize those of phosphorus, and the ventilation of establishments devoted to match-making. The curative treatment consists of buccal antisepsis, opening of abscesses, and the removal of diseased bone, especially of dead bone, upon the first provocation. The occurrence of fistulas should always be regarded as pathognomonic of diseased bone. In aggravated cases, such as are rarely if ever seen since legislation has been brought to bear upon the subject, practically complete necrosis of the lower jaw, either en masse or in portions, was far from unknown, and the possibility of regeneration of the bone was for a long time discredited, until the late James R. Wood, of New York, exhibited a specimen, both at home and abroad, which proved its possibility. Since then we have learned that it is possible for bone thus to regenerate, the cause of the disturbance having been removed.
PLATE XXXVII
Necrosis of Shaft of Femur with Sequestra. (Life size.)
Fig. 232
Phosphorus necrosis of the lower jaw. (Musée Dupuytren.)