AN ESSAY ON THE TEETH.

THE complaint which generally attends the execution of a work of this kind ſeems to be, that the author, being puffed up with a vain conceit and opinion of his own abilities and conſequence, takes too frequent and unneceſſary occaſions of introducing in his writings technical terms, and obſcure expreſſions of the art; making that, which profeſſedly undertakes in a clear and ſimple manner to treat of the diſorders incidental to the teeth, and the remedial applications neceſſary in ſuch a caſe, a work of laborious inquiry, and a mere diſplay of anatomical [10]knowledge. This error I will endeavour cautiouſly to avoid; as well, becauſe the natural hiſtory and anatomical ſtructure of the teeth have been explained and amply treated of in ſome late very ingenious and elaborate treatiſes (thoſe I mean written by Mr. John Hunter, F. R. S. and ſurgeon to St. George's Hoſpital; and Mr. Beard⯑more, ſurgeon dentiſt in ordinary to his Majeſty) as becauſe I ſhould be too circum⯑ſcribed in ſuch an attempt by the limits of theſe pages: ſuch an attempt requiring more time and leiſure thoroughly to finiſh than I could be able to ſecure from my ne⯑ceſſary avocations of buſineſs. I therefore beg leave to recommend the treatiſes above mentioned, from the peruſal of which I have received great pleaſure and ſatisfaction, to thoſe, whoſe curioſity or profeſſion lead them to attend to the minutiae of the ſubject.

My deſign is merely to give a plain and brief account of the teeth, the compaints they are ſubject to, and the methods of cure; omitting nothing, I hope, which is [11]neceſſary to be known, and avoiding all obſcurities of ſtile and meaning. The ſub⯑ject has been already amply and copiouſly treated of, and I have not the vanity to think that I ſhall be able to ſet it, or any branch of it, in a new or more inſtructive point of view.

The teeth are hard ſubſtances of bone and enamel growing in the cavities of the upper and lower jaw. Theſe cavities anatomiſts call the alveoli, which have circular pro⯑ceſſes embracing the body of the tooth with great cloſeneſs, and thereby are to be con⯑ſidered as principal ſupports of the teeth.

Theſe alveolar proceſſes are covered by a compact elaſtic ſubſtance or fleſhy cove⯑ring, called the gums; which covering ad⯑hering firmly to the alveolar proceſſes inveſts and contains the teeth firm in their ſock⯑ets: and are beſides an admirable protec⯑tion for them againſt the injuries they might receive from an expoſure to the air and cold, and from the occaſional preſſure of our food againſt the thin membrane which covers them. The circular ridge [12]which ſeparates and diſtinguiſhes the body and roots, or fangs of the teeth, and to which the gums grow up, and are cloſely attached, is called the neck or collar of the tooth. The fangs or roots are thoſe parts which are hid from our ſight in the ſockets: they are covered with a thin vaſcular membrane, called the perioſtaeum, which unites them firmly to the jaw. The inner ſubſtance of the tooth is the bone, having an internal cavity, which extends nearly the whole length of the tooth; be⯑ginning at the point of the root or fang, and ending in the body of the tooth. This cavity is well ſupplied with nerves and blood veſſels, which nouriſh the teeth, pro⯑mote their growth; and when ſubject to any diſorder or obſtruction, are the ſeat of the moſt exquiſite ſenſations of pain. The enamel grows only on, and ſurrounds the body of the tooth. It is a very white and ſmoothly poliſhed ſubſtance, of a degree of hardneſs ſo great, as to be impenetrable to our keeneſt inſtruments: in cutting or di⯑viding it therefore, we are obliged to uſe files, and even thoſe muſt be ſkilfully uſed [13]by the operators, to prevent any damage being given to the remaining poliſh of the enamel.

The ſhape of the teeth being within the immediate extent of every one's own knowledge, I ſhall not here make mention of it. Their number is uncertain; though I believe they rarely exceed thirty. Mr. Hunter ſays, that he once ſaw only twenty⯑ſeven, but never more than thirty-two; and makes thereupon this very ſenſible re⯑mark, "That where the number is leſs than thirty-two, the deficiency is in the laſt grinder."—This is, however (I mean the number of teeth in a full ſubject) a point of mere curioſity; ſince during the courſe of my practice, I never could diſcover any difference in the formation or ſtructure of them, whether more or leſs in number: but they all equally as well perform their uſual functions, and anſwer the purpoſes for which they are deſigned. The number is not certain, I think, for this reaſon, viz. that if it were, when the jaw bone [14]of a man is enlarged, and grows in propor⯑tion to the increaſe of his age, we do not find any difference in the alveolar ſpaces, either with regard to their number or ex⯑tenſion, which would otherwiſe undoub⯑tedly happen in the caſe between a man, who in his perfect ſtate, had thirty two teeth, and of another, who had only thirty.

The above is a brief deſcription of the ſituation and ſtructure of the teeth: the formation of them is curious and particular, which I will endeavour to give as ſatis⯑factory and conciſe an account of, as the limits of this work will permit.

The contents of the alveoli, or cavities in the jaw, in which the teeth grow; are at almoſt the earlieſt ſtate of infancy, ſome little ſoft pulpy ſubſtances which are attached to the bottom of the ſockets by a nervous filament, whoſe veſſels diffuſe themſelves through the pulpy ſubſtances, and the thin membrane that covers them. [15]Nouriſhment is hereby conveyed to theſe pulpy ſubſtances, which, as the child in⯑creaſes in age, begin gradually to oſſify, and advance higher and higher from the ſockets. The tooth is yet imperfectly formed, not having gained any degree of ſtrength and rigidity. By degrees they begin to preſs againſt the gums, which, by conſtant attrition are inflamed and affected with redneſs and ſwelling, and occaſion great pain and uneaſineſs to the infant. What is called the cutting of the teeth now begins, which is a violent effort of nature to pierce through the confinement of the gums, where the teeth have undergone the ſtate of formation and oſſification, and to appear above the ſockets. As this opera⯑tion of nature is attended with great and continued pain to the child, and frequently not finiſhed without the hazard of much danger, it has been a matter of ſurprize to ſome gentlemen of eminence in ſurgery. that a new and more expeditious method has not been introduced to aſſiſt the cutting of the teeth, and that the efforts and endea⯑vours [16]of nature have not been, as in almoſt all other caſes, promoted by the aſſiſtance of art. Thoſe gentlemen have thought, and with great appearance of reaſon and good ſenſe, that no danger or inconvenience would attend the opening of the gums at the particular time of the firſt appearance of dentition, with an inſtrument, and thereby, by making a way for the teeth to raiſe themſelves from the ſockets to pre⯑vent the ſlow advances of nature. The in⯑ſtrument certainly muſt be managed with a nice and ſkilful hand; or it may, by pene⯑trating too deep, do much harm and da⯑mage to the tooth itſelf, not yet ſufficiently hardened. I cannot ſuggeſt to myſelf any plauſible objection to the propriety and ex⯑pediency of this plan; however, I willingly ſubmit this opinion to the judgments of thoſe gentlemen, who claim a ſuperior knowledge in this point, from their atten⯑dance upon children in their infancy; my practice having been chiefly confined to the care of the teeth in their full grown and perfect ſtate.

Anatomiſts divide the teeth into three claſſes; viz. The inciſores, or cutting teeth, the canini, or canine teeth, and the molares or Grinders: the firſt claſs including the four anterior teeth; the ſecond including the two next, one on each ſide, called the canine teeth, from the ſimilarity and reſem⯑blance they bear to the teeth of dogs; and the third including the reſt. For a particular deſcription of which, I beg leave to refer the curious reader to Mr. Hunter's late treatiſe, which I mentioned before, where he will receive every degree of intelligence and ſatisfaction to his inquiries. I do not here take ſo much notice of them, as perhaps ſome people may think I ought; as their ſituation and parts are pretty univerſally marked out to every one's knowledge, and all that could be ſaid would amount only to ſome comparative remarks on their diffe⯑rent degrees of prominence, thickneſs, or other inherent properties.

Having thus briefly treated of the forma⯑tion and ſtructure of the teeth, the third [18]propoſed point, viz. their uſe, comes under our conſideration. This, though already apppearing ſufficiently clear and compre⯑henſive, may be thought to ſtand in need of no farther explanatory elucidation; but really the preſervation and care of the teeth being a matter of no ſmall conſequence, indeed of much greater importance than the generality of mankind ſeem from their indolence and inattention to them to ſuſ⯑pect, I beg leave to be indulged in a few words. The teeth are parts which will ſooner decay and become diſordered through neglect, than any other parts of our Frame; and, when diſordered, occaſion greater pain, and introduce a greater variety of other complaints than can be conjectured upon caſual conſideration. An enumera⯑tion of the benefits ariſing from their perfect ſtate may therefore make us more attentive to them, and more deſirous of avoiding the numerous train of inconveniences and diſor⯑ders we ſhall feel upon their decay and im⯑perfect ſtate.

The moſt common and principal uſes which we find to reſult from the growth and perfection of the teeth, are the aſſiſtances they give us in maſtication, and in ſpeech. I ſpeak from the common experience which every one muſt be preſumed to be in poſſeſ⯑ſion of, when I mention the painful and unpleaſant operation of chewing our food, at a time when any accident or diſorder has deprived us of the temporary or entire loſs of our teeth, not to mention any phy⯑ſical reaſons of the harm it may do our conſtitution, when the neceſſary aſſiſtance which the food we eat requires to promote its ſpeedy mixture with the ſalivary liquor, facilitating thereby its paſſage into the ſtomach, and occaſioning a pleaſant and ſafe digeſtion, is loſt or impaired. Another inconvenience will ariſe in this caſe, from the continual preſſure of our food againſt the gums, which may irritate and inflame them; occaſioning, thereby, ſoreneſs and ſwellings.

In ſpeech, we all know the well timed, and regular aid, which the teeth in their perfect ſtate give to our voice and pronuncia⯑tion; and, by conſequence, the eſſential ſervice they are of to the ſtudy and practice of oratory in public life; where the form of the Engliſh government and conſtitution, the elevated rank and eſteem in which the liberal profeſſions are held, and the reputa⯑tion and faſhionable celebrity which public ſpeaking claims, give the happieſt opportu⯑nities for eloquence to diſplay her powers, and engage and captivate the attention of the largeſt aſſemblies: and in private life, where a graceful and elegant addreſs are no leſs neceſſary to attach us to the good opinion and favour of our neighbours, who would not be ſuſceptible of ſo favourable an im⯑preſſion in our behalf, by an imperfect and broken voice, and a difficulty of expreſſing our ſentiments with fluency, and facility; which I affirm, will be the caſe in a diſor⯑dered and rotten ſtate of the teeth. The tongue, indeed, modifies the voice, and gives it different forms, but I cannot help [21]being ſeriouſly of opinion, that the various graces of pronunciation ariſe from the aſſiſt⯑ance of the teeth; I mean according to the propulſion of the tongue againſt the teeth, which detains or tranſmits the ſounds at pleaſure. This is, indeed, too curious, and indeed too philoſophical an argument to be attended too in this ſhort treatiſe, nor is it at all of conſequence in common obſer⯑vations. The eaſineſs wherewith we ſpeak, and the pleaſure we take in hearing an harangue gracefully, and well pronounced are, I am ſure, not ſuperficial or trifling recommendations to us to keep, when in our power, the organs of ſpeech perfect and unimpaired; of which organs I by no means reckon the teeth in an inferior claſs.

A collateral advantage ariſing from the care and preſervation of the teeth, is the grace and ſymmetry they give to the coun⯑tenance, keeping the complexion in a ſtate of youthful bloom, and preventing all wrinkles about the face; which the de⯑preſſion of the jaws, in conſequence of the [22]loſs of our teeth, would inevitably occaſion. It is, I am told by my own and other peo⯑ple's obſervations, a prevailing faſhion in the preſent age to keep the face and the complexion as delicate and ſmooth as art can make them: (I ſpeak not here of our Engliſh ladies, whoſe care in this particular is laudable, graceful, and characteriſtic of that amiable part of the creation) but, without meaning any offence to that part of mankind, whom the uncouth ruſticity and unpoliteneſs of ſome amongſt us think they diſgrace by giving them the appella⯑tion of Beaus, I beg leave to remind the younger part of my readers, that though they may poſſibly take too much pains in adorning their perſons, and thereby incur the charge of effeminacy, and the want of a decent and proper manlineſs, yet I think they may oftentimes take too little care in this particular; and none can be attended with more diſagreable and offenſive ſenſa⯑tions, both to themſelves and their friends, than the neglect of the teeth.—Excuſes may be made frequently for any neglect of [23] Dreſs—ſlovenly apparel—or unpowdered curls, which may be occaſioned by a want of time to undergo the various proceſſes of dreſſing, or the avocations of buſineſs. But no excuſes can be made, or taken for a dirty and foul ſet of teeth, which argue an habitual neglect of them, and either a wilful or (what is juſt as bad in this caſe) an unintentional omiſſion of the employ⯑ment of cleaning them; which employ⯑ment, when rightly underſtood, and fre⯑quently practiſed, is attended with no length of time, nor the leaſt trouble.

The diſorders to which the teeth are ſub⯑ject, either ſimply from the neglect of them, or from an ill habit and ſtate of body, are numerous. Suffice it here to mention a few; a perfect knowledge of which will, I am perſuaded, give weight to my opinion and advice, relative to the care of them. The tooth ache, is a pain, which, as it ariſes from various cauſes, I ſuppoſe, there are few amongſt us, who have at all times been totally exempt from. The pain and [24]anguiſh are more violent and excruciating than the viſitation of diſeaſes to other parts of the body. Shakeſpear, the immortal poet of the Engliſh nation ſays,

Meaning certainly thereby, that with what⯑ever great fortitude, and philoſophical pa⯑tience, other diſorders might be born and combated with.—The pain of the tooth ache ſurpaſſed all human reſolution and cou⯑rage. The anguiſh is frequently ſo inſup⯑portable that it forces us to uſe violent means to obtain ſome kind of temporary eaſe, which means occaſion, not a long time after, a greater and more afflicting return of the diſorder.—Such are, I think unneceſſary extraction of the teeth, which, according to ſome modern operators, is the univerſal method of cure; without conſidering that the pain may be oftentimes alleviated by gentle methods, and the tooth preſerved entire. It frequently happens that the pain is ſeverely felt in ſound teeth, [25]owing to ulcers and excreſcencies on the gums, ſudden colds, from ſympathy with the neighbouring affected parts, or other cauſes. Can the extraction of thoſe ſound teeth be therefore in ſuch caſes deemed ne⯑ceſſary, or even expedient? common expe⯑rience and ſenſe ſhew the contrary.—We cannot perform the operation without in⯑creaſing the evil which it is intended to di⯑miniſh or remove. By uncovering the roots, and baring the ſockets of the neigh⯑bouring teeth, we make them looſe, and ſuſceptible of pain, and cauſe frequent in⯑flammations in their nerves and vaſcular parts. I have known not a few inſtances where the extraction of one of the molares or grinders has conſiderably weakened the jaw, though performed in a ſkilful manner, and by a violent diſtenſion of the muſcles of the jaw, brought on a great ſoreneſs and inflammation of them. I am, however, a great friend to extraction when [26]the circumſtances of the caſe poſitively demand it. Another method no leſs in⯑judicious of expelling the pain, and gaining a temporary relief, is the filling the mouth with acrid and hot ſpices and ſubſtances, and burning ſpirituous liquors; which deaden all ſenſation for a while, but when their influence is at an end the pain returns with redoubled ſtrength and ſeverity: ex⯑cluſive of the harm which ſuch applications certainly do the gums by diſpoſing them to inflammations, and occaſioning ſoreneſſes, and external ſwellings.

The tooth ache is frequently occaſioned by acrid humours being lodged in the ſock⯑ets of the teeth, and purulent matter, which affects the roots of the teeth, and is always attended with a foul and offenſive ſmell of the breath. In this caſe, if the cure be not ſpeedily undertaken, the whole [27]tooth becomes quite rotten and carious: the nerves and veſſels are corrupted, and ulcerations of the parts will enſue. Of this kind is the ſcurvy, that moſt inveterate enemy to the ſoundneſs of the teeth, which is however very effectually diſſodged by lan⯑cing the gums, and extracting the coagula⯑ted blood and matter. The tartar of the teeth is another cauſe of their deſtruction, which is a yellowiſh ſubſtance formed on the teeth, which hardens in time, and forms a compleat incruſtation over them: deforming and diſcolouring them, and by ſecretly and imperceptibly inſinuating itſelf in the interſtices of the teeth, open too great a paſſage between them, prevent the growth of the gums by an inconvenient preſſure of them, and are productive of a numerous train of diſorders. This tartar, however, when early diſcovered, is very eaſily removed, being at firſt of a ſoft pulpy nature, and may be rubbed off the teeth by [28]waſhing the mouth with clean water, and afterwards gently rubbing the teeth with a ſoft ſpungy bruſh, or by uſing any common tooth powder. When however it has for⯑med an incruſtation too hard to be rubbed off in that manner, having acquired a ſtrong adheſion to the teeth, the operator's inſtru⯑ment muſt be uſed, but great care is ne⯑ceſſary to be taken in the uſe of it, ſo as not to damage the enamel. Some kind of an inflammation in the gums generally attends this operation, which inflammation may however be reduced with gentle means.

Venereal complaints, and the great quan⯑tities of mercury which are generally admi⯑niſtered, in ſuch caſes, affect the teeth and gums in a violent degree: deſtroy the nou⯑riſhment which the teeth ſhould receive from the nerves and blood veſſels, impove⯑riſh and render the gums pale and flaccid, looſen the teeth from their ſockets, and oc⯑caſion [29]putrid diſorders, attended with foul⯑neſſes of breath. I am not verſed in ſurgery enough to be able to declare what methods, to prevent ſuch complaints and evils, ſhould be taken, during the continuance of that venereal diſorder to which they owe their riſe, but certainly would recommend at the re-eſtabliſhment of the patient's health, that he ſhould have his teeth thorougly cleaned, his gums lanced, and all the other neceſſary proceſſes performed, whereby the gums will regain their former redneſs and firmneſs, and adhere, as originally, cloſely to the teeth; the teeth will be cleared from all foul diſcolorations, all the coagu⯑lated blood will be removed from the ſockets, and every part be braced a new and ſtrengthened.

The tooth-ache is frequently communi⯑cated by ſympathy, from one tooth to ano⯑ther. This may ſeem ſurprizing, but I find [30]all writers on the ſubject I have conſulted, agree in the opinion, though without aſſigning any cauſe for ſo extraordinary a phaenomenon. We muſt not, however, carry our notions of ſympathetic affections ſo far as I remember one writer of my own country has done. I mean one Durlach Coſel, who was a German and lived I think in the year 1558 under Ferdinand the Firſt. In a treatiſe of his writing upon ſurgery, (which I remember to have ſeen in manu⯑ſcript in Leipſic) he poſitively affirms, that ſympathy may be communicated by contact to other animals: and mentions ſome inſtances where he has known the tooth-ache transferred from a man to a cat, by applying the man's cheek for a conſider⯑able time together, to that of the cat. The tooth-ache left the man, and the ani⯑mal was ſeized with the violence of the pain, as was ſuppoſed, by the agony ſhe ſeemed to labour under, and the ſqualling [31]ſhe made. This will, I make no doubt, be looked upon by all ſerious and ſenſible people as a fooliſh notion, and not founded in fact; and indeed I am greatly ſurprized that that writer ſhould ſo warmly inſiſt on the reality of it, as he was undoubtedly, by ſeveral works which he left behind him, a man of great wiſdom and learning.

I will now juſt mention a few caſes, in which extraction of the teeth may be expe⯑dient or neceſſary, which will introduce ſome obſervations upon artificial teeth, and the practice of filling up hollow teeth with gold or lead.

When the ſcurvy, or other putrid hu⯑mour, lies preying upon the roots or fangs of the teeth, removed beyond the reach of thoſe inſtruments that can extract it from the gums by lancing them; when it deſtroys the nerves, and corrupts the foun⯑dation [32]of the tooth; in ſuch caſes, I muſt deem extraction neceſſary, and that it is ſo, will inconteſtibly appear, ſince we find the root or fang of the tooth quite covered with the corrupted matter, when we have pul⯑led it out: which corrupted matter there is no poſſibility of reaching with our in⯑ſtruments, or expelling by any other means than extirpation, as it lies ſo cloſe and con⯑cealed. Were the tooth to continue in the head, the corrupted matter would eat the tooth gradually upwards, and occaſion a putrid decay of the gums. Stumps or por⯑tions of the roots of teeth which have either been broken off, or injudiciouſly ex⯑tracted, ought certainly to be drawn. There is not much pain in this operation, when ſkilfully performed, in a comparative ſenſe with regard to whole teeth being extracted. Mr. Beardmore's opinion is, that ‘"when any tooth-ache ariſes from a portion of the root left behind, if the [33]patient is unwilling to try this ſecond operation, the pain may be ſometimes removed by burning the nerve, or by applying a very ſmall bit of lint dipped in eſſential oil of cinnamon, over the hollow part of the ſtump, or by intro⯑ducing a bit of paſte made of opium, camphor, and eſſential oil of pepper mint."’ But with all poſſible deference to his opinion, I ſhould certainly prefer the extraction of the ſtump, and recommend it in ſuch ſtrong terms to the patient, as would, I think induce him to ſubmit to the opera⯑tion. Palliative applications may give eaſe, though Mr. Beardmore ſeems him⯑ſelf to own the caſe to be uncertain, by making uſe of the word "ſometimes;" but I think the pain will return in a ſhort time, or the gums will grow over theſe ſtumps, and being conſtantly wounded by them, will be expoſed to frequent inflammations, and extremities of pain. I am happy in [34]having Mr. Beardmore's authority to ſanction my opinion, that ‘"The ſtump or root of a tooth is at all times eaſily taken out, unleſs it grows to the jaw bone, which is a very rare caſe; and nothing is more erroneous than the popular notion that ſtumps are very difficult to be remo⯑ved, and that digging and punching (as they call it) are abſolutely neceſſary."’

Stopping the teeth, or filling them with gold, or lead, is a very uſeful practice, and attended with no inconveniences. This is neceſſary when the internal part of the tooth is deſtroyed, or waſted away, and ſomething muſt be put in the cavity, to prevent the air from piercing to the fang, or root of it, and occaſioning the tooth⯑ache, or a further decay; as alſo for hin⯑dering looſe bits of our food, &c. from lod⯑ging in the ſaid cavity. The cavity then, in which the nerve formerly lodged, muſt [35]be well filled up with gold or lead, and, if occaſion be, may be faſtened by a wire or thread to the neighbouring teeth: how⯑ever, after it has been well preſſed down in the hole, there will be no danger of its falling out.

When there is a real neceſſity of extract⯑ing teeth, or they grow looſe from any venereal or putrid diſorder in the blood, I am a great friend to the practice of ſupply⯑ing their places with artificial teeth. After a little uſe, they equally as well perform the different offices of real teeth, in maſti⯑cation, in ſpeech, and in appearance. In⯑deed to ſuch a pitch of greatneſs has the art and ingenuity of modern times arrived, that operators can make them, and fit them in the ſockets in ſuch a manner as not to be diſcernible from our natural teeth. Af⯑ter waſhing the mouth conſtantly for ſome time afterwards with ſome aſtringent liquors, [36]we find that the gums will cloſely adhere to theſe artificial teeth. I have frequently made and ſet whole rows of artificial teeth, which have looked very ornamental, and have given an healthy air to the coun⯑tenance. The general objection ſeems to be that they do not fit firm and eaſy in the ſockets, but are apt to fall out. This ob⯑jection I flatter myſelf, in the courſe of my practice as a dentiſt, I can wholly obviate: for without meaning or wiſhing to be my own paneygriſt, or deſirous of arrogating any credit to extravagant profeſſions which ſome modern operators for the teeth among us do, I can ſafely pronounce that this branch of the profeſſion has employed greatly my time and attention, and I have, in conſequence of that attention, diſcovered a method of ſetting and fixing them almoſt immoveably in the ſockets, without the great number of wires and ligatures which are commonly uſed.

It remains for me now to ſay ſomething of the care and treatment of the teeth and gums, to prevent diſeaſes and complaints in them,—the methods of cure, and the ne⯑ceſſary inſtructions for cleaning them, and preſerving their poliſh and whiteneſs.—But I here perceive a difficulty which I was not aware of at firſt, which is, the impoſ⯑ſibility of all the rules and directions I mean to propoſe being equally ſalutary and efficacious in all caſes.—Different modes of treatment muſt be preſcribed in different caſes;—and as it would be morally im⯑poſſible for me now to know the different ſtate of the teeth in all my different readers, the various complaints they labour under, and whether they have ever taken care of their teeth or not, it is equally as impoſſible to advance any directions which would be of neceſſary aſſiſtance to all, in all caſes; I ſhall however be exceedingly happy when any perſons approve ſo far of the ſentiments [38]and opinions advanced in the above pages, and think the contents of this work of con⯑ſequence enough to let me have the honour of attending them; whereby I ſhall be able upon a perſonal and direct view of the caſe to decide with ſome degree of certainty, and to found my advice upon ocular proofs.—The ſcurvy muſt certainly be removed from the gums, and all tartareous concretions ſeparated from the teeth, and all putrid matter diſlodged from the ſock⯑ets, before we can think of uſing any ex⯑ternal application to make the teeth white and clean: for otherwiſe, might they not be compared, with great plauſibility, to ſepulchres and monuments, which are painted and adorned with pure and ſplen⯑did marble on the outſide, but within con⯑tain nothing but rotteneſs and corruption? [39]—I think it therefore neceſſary, as I ſaid before, to have the ſcurvy removed from the gums; all tartareous concretions ſepa⯑rated from the teeth; and all putrid matter diſlodged from the ſockets firſt; and then external applications may be uſed to make the teeth white, and free them from all diſcolorations.

I cannot help thinking, (notwithſtanding what I am going to ſay oppoſes the opi⯑nions and advice of ſome of our modern writers on the ſubject, though I believe that Hoffman and Heiſter, two German writers of eminence on phyſic and ſurgery, have introduced their approbation of the point in queſtion) that the occaſional uſe of tooth-picks is neceſſary in an high de⯑gree to remove what ſcraps of our food have lodged between the interſtices of our [40]teeth, and to give a ſalutary ſtimulus to the gums. The objections I hear, are certainly levelled againſt too conſtant an application of tooth-picks; but to argue againſt a practice and uſe in general terms, becauſe it is frequently abuſed, and carried to too great extremities in particular inſtances, is abſurd and ridiculous. The cuſtom of waſhing the mouth with clear water, after the uſe of tooth-picks, is certainly judi⯑cious, and the cuſtom of uſing occaſionally cool emollient gargles.

I could willingly indulge my pen in a further prolixity, but am fearful of enga⯑ging the attention of my readers longer than their patience will countenance: and likewiſe of making this a work of labo⯑rious and diligent inveſtigations, which is only a ſhort collection of a few caſual ob⯑ſervations [41]and looſe remarks, which I have haſtily thrown together, and now venture to ſolicit the patronage and protection of the Gentlemen of the Univerſity of Oxford, as this publication is in conſequence of the deſire of many of them, founded upon too favourable an opinion of the author's merit.