DENTITION, Disorders of.
Formerly nearly every symptom of illness occurring during late infancy was put down to teething; at present the opposite view is so strongly main tained that many regard the subject as practically outside the sphere of etiology, pathology, or treatment. Owing to the activity of the develop mental changes occurring in the nervous system of the infant from the middle of its first year of life till thecnd of the second year, the nerve centres are in a state of more or less unstable equilibrium, and it is a well-recog nised fact that comparatively trivial causes may excite a general convul sion or determine severe febrile, sensory or peripheral disturbances. The close anatomical connections existing between the nerve supply of the gums and the aural circulation render it probable that when the gum tissue becomes swollen, inflamed and tender, severe reflected aural pain and general distress may arise. In most instances the indications for incising the gum may be met with by scraping the swollen tissue with the scrupu lously sterilised finger-nail till the crown of the tooth is reached, a practice which effectually prevents the formation of tough cicatrices.
The abnormal sensitiveness of the nerves of the mouth and of the ear, as well as the instability of the motor and other centres, may be controlled or lessened by the judicious administration of harmless drugs, but Opium should never be employed for this purpose. Before the
employment of sedatives a smart purge should be given, the best being gr. of Calomel or i gr. Grey Powder administered in half a teaspoonful of Syr. Senna, or a teaspoonful of Castor Oil may be given. (Doubtless the vast bulk of cases regarded as due to dentition are examples of errors in feeding.) Bromide of Sodium is the best routine drug; it may be combined, when the motor irritability is marked, with minute doses of Chloral Hydrate. Antipyrine is often used, especially when marked febrile disturbances are present, but it is not so safe as the next-mentioned agent.
Spirit of Nitrous Ether has a decidedly beneficial effect; its soothing influence depends upon its power of causing dilatation of the small vessels and making the skin to act.
Restlessness, wakefulness, muscular twitchings, night terrors, vomit ing, auditory hyperacusis and other characteristic series of teething troubles often rapidly yield in an infant of about 12 months old to the following simple combination: R. Sodii Bromidi gr. xl.
Chloral Hydratis gr. iv. Liquor. Ammon. Acet. 5iv. Syrupi Sim licis 5iv.
Aqua Chloroformi ad S-1j.
Fiat mistura. Sumac 5j. omni secunda horn.