Removal of the entire lower jaw.

  • Wood, James R. (James Rushmore), 1816-1882.
Date:
[1857?]
Catalogue details

Licence: Public Domain Mark

Credit: Removal of the entire lower jaw. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    by direct contact of the phosphorus with the periosteum, or whether it does*not first enter the blood, contaminate the system, and secondarily induce necrosis. This question would seem to be definitively settled by the following consid- erations : 1.—Operatives exposed to the fumes of phospho- rus do not suffer from any special or general malady, show- ing contamination of system, or the existence of a cachexia. 2.—The disease attacks only denuded bones. So well es- tablished is the fact, the operative is considered safe until he has carious or extracted teeth. We consider it established then, that the phosphorus must find access to the periosteum, when the morbid process is set up. It more often affects the maxillary than other bones, for this reason; and .the inferior maxilla than the superior. That other bones are equally affected, when the phosphorus vapor reaches the periosteum, is proved by experiments upon ani- mals. The frequency with which the different bones of the face are affected in this disease, is exhibited by the following collection of cases:— Whole No. Max. Sup. Max. Inf. Max Sup. and Iuf. 6G. 22. 36. 8. The pain. of the jaw, which ushers in the disease, is generally mistaken for toothache. It is usually slight at first, and intermittent, and is due to the slow process of per- iosteal inflammation which results in the formation of a lamina of bone beneath the periosteum, and around the old bone. This takes place around the base of the jaw, owing to the gravitation of the exudation from the inflamed periosteum. This, the first stage, is chronic and may be indefinitely pro- longed, without causing much inconvenience to the patient. The second stage begins with an attack of acute inflamma- tion in the diseased part, excited by cold, or otherwise; there is .great pain and swelling of the soft parts; the new forma- tion is destroyed, and- discharged, with an abundance of offen- sive pus; and the old bone remains a sequestrum in the midst of the products of suppuration, to be subsequently discharged