On the causes and treatment of closure and immobility of the jaws / by Christopher Heath.

  • Heath, Christopher, 1835-1905.
Date:
1863
Catalogue details

Licence: Public Domain Mark

Credit: On the causes and treatment of closure and immobility of the jaws / by Christopher Heath. 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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    fever, are its most common victims; but I liave also seen many cases of it in adults and elderly sid)jects. In the worst cases tlierc is always extensive perforation of the checks, permitting a constant escape of the saliva, and inducing the most disgusting disfigurement. “ Secondly, the affection may depend upon anchylosis of the tcmporo-maxillary joints, in consequence of injury, as a severe sprain or concussion, or arthritic inflammation, leading to a deposi- tion of ])lastic matter, and the coiiA ersion of this substance into cellulo-fihrous, cartilaginous, or osseous tissue. 1 have met with quite a number of such cases, several in very young sidjccts. “ Thirdly, the immobility is occasioned by a kind of osseous bridge, extending from the lower to the upper jaw, or from the lower jaw to the temporal bone; such an occurrence, however, is not common, and is chiefly met with in persons who have suffered from chronic articidar arthritis. “ Finally, immobility of the jaw may be caused by the jn’cssure of a neighboiu'ing tumour, especially if it occupies the parotid region, so as to make a direct impression iq)on the temporo- maxillary joint. “ How’ever induced, the effect is not only inconvenient, seriously interfering with mastication and articulation, but it is often followed, especially if it occur early in life, by a stunted development of the jaw, exhibiting itself in marked shortening of the chin and in an oblique direction of the front teeth. “ When complicated Avith perforation of the check and destruction of the lips, the patient has little or no control over his saliva, and is so terribly deformed as to render him an object, at once, of the deepest disgust and the Avarmest sympathy. “ The treatment of this affection must depend upon the nature and situation of the exciting cause. When the difficulty is in the joint, occasioned by the formation of cellulo-fibrous adhesions, the only thing that can be done is to break up the adhesions, upon the same principle as in anchylosis of any other joints. For that purpose— the patient being thoroughly under the influence of chloroform—the jaAv is forcibly depressed, either by a Avedge made of cedar-Avood or by an instrument constructed on the lever-and-screw principle, and figured by Scultetus in his Armamentarium Chirurgicum. “When the immobility depends upon the presence of inodular tissue, the proper remedy is excision of the offending substance, an operation Avhich is both tedious, painful, and bloody, and unfor- tunately, not often folloAved by any but the most transient relief.