“In the youth suffering from a phagedenic affection in the mouth, the lower teeth fell out, as well as the front upper ones, which left a cavity in the bone. The loss of a bone in the roof of the mouth causes depression in the middle of the nose; the falling out of the upper front teeth sometimes causes a flattening of the point of the nose. The fifth teeth counting from the front ones had four roots (two of which were almost united to the two contiguous teeth), the points of which were all turned inward. Suppurations arising from the third tooth are more frequent than from any of the others; and the dense discharge from the nose and pains in the temples are specially owing to it. This tooth is more apt to decay than the others; but the fifth does so, as well. This tooth had a tubercle in the middle and two in the front; a small tubercle in the internal part, on the side of the other two, had first begun to decay.[58] The seventh tooth had only one large, sharp-pointed root. In the Athenian boy, there was pain in a lower tooth on the left, and in an upper one on the right. When the pain ceased, there was suppuration of the right ear.”
This last fact—of the suppuration of the ear—is mentioned by Hippocrates not as a simple coincidence, but as a fact intimately connected with the cessation of the toothache. This may be argued from the general ideas of Hippocrates in regard to the beginning and the resolution of diseases. He considers a malady to be produced by a humor, which becomes localized in a given point of the body. The crisis gives exit to the peccant humor,[59] and the mode in which this is evacuated constitutes the critical phenomenon; the same may be represented either by a profuse perspiration, by abundant urine, by diarrhea, by vomiting, by expectoration, by bleeding or discharge of other humors from the nose, by the issuing of pus from the ear, and even by deposits on the teeth.[60] If by effect of organic sympathies the morbid humor, instead of being thrown outward, be transported into another region of the body, this constitutes the so-called metastasis.
The hints just given will serve to render some of the passages which we quote from the works of Hippocrates more intelligible.
In the fourth book on Epidemics we find among other clinical cases the following:
“Egesistratus had a suppuration near the eye. An abscess manifested itself near the last tooth; the eye directly got quite well; there was a dense discharge of pus from the nostrils; and small, rounded pieces of flesh were detached from the gums. It seemed as though a suppuration at the third tooth were going to take place, but it went back; and suddenly the jaw and the eye swelled up.”[61]
And farther on one reads:
“In Egesistratus the two last teeth were decayed in the parts where they touched one another. The last had two tuberosities above the gum, one on the decayed side, the other on the opposite side. In the part in which the two teeth were in contact with one another there were two roots in each, large and similar, and corresponding to those of the contiguous tooth; on the other side there was only a half root[62] and rounded.”
Toward the end of the fourth book on Epidemics, we find repeated an observation which we have already noted:
“The third upper tooth is found to be decayed more frequently than all the others. Sometimes a suppuration is produced all around it.”[63]