Abstract
The evils resulting from undue lateral pressure of the teeth, have not been sufficiently dwelt upon by authors on dental pathology. Crowded or reflex action of the fifth and seventh pairs upon the uterine nerves, has in some rare cases, produced abortion. The object of the present effort is more for the purpose of directing the attention of the profession into that channel, than from any desire to attempt to fill up the hiatus ; we shall therefore present the most available evidence that comes within our reach, from the experience of others, in connection with the result of our own observations during a series of years.
Yelpeau relates several cases in which mal-position of the wisdom tooth, was followed by necrosis and exfoliation of large portions of the inferior maxilla, fungous growths, immobility of the jaw, epilepsy and insanity. In one case

[Jan'y, ARTICLE The nervous disturbance is frequently so distant from the primary cause as to present serious obstacles to a correct diagnosis. The toothache of pregnant women, unaccompanied with caries, is an instance of this kind, while the sympathetic or reflex action of the fifth and seventh pairs upon the uterine nerves, has in some rare cases, produced abortion. The object of the present effort is more for the purpose of directing the attention of the profession into that channel, than from any desire to attempt to fill up the hiatus ; we shall therefore present the most available evidence that comes within our reach, from the experience of others, in connection with the result of our own observations during a series of years.
Yelpeau relates several cases in which mal-position of the wisdom tooth, was followed by necrosis and exfoliation of large portions of the inferior maxilla, fungous growths, immobility of the jaw, epilepsy and insanity. In one case 1859.] Selected Articles. 125 of extensive abscess, the communication with the surface, was by means of a sinus extending down to the clavicle. Some of these cases had been previously treated as rheumatic affections, others as syphilitic ; in one case the surgeon was about to extirpate the right tonsil, when the true cause of the patient's suffering was accidentally discovered to be an advancing wisdom tooth.
Mr. Tomes upon this subject says: "It is obvious that the evils produced by the development of irregularly placed wisdom teeth, arise wholly from pressure produced by the gradual growth of the dental pulp, preparatory to its calcification ; by which the super-imposed tooth is forced against the tissues by which it is covered. In the natural course of things, these tissues are absorbed, and make way for the rising tooth ; but if they are not absorbed, and, therefore, resist the advance of the tooth, the pressure reacts through the tooth upon the developing pulp. We all know that pressure upon a nerve or nerves, though slight in degree, will produce more or less pain, and that the pain will be felt in the part to which the fibres pressed upon are ultimately distributed. Instead, then, of being surprised that interruption to the growth of a tooth should produce pain, extending through the whole jaw, or to the side of the head, or about the ear, we should be led to infer that such phenomena would exist. I found them both sufficiently advanced to be readily arrested, and therefore advised their immediate removal, which was accordingly done. I had frequent opportunities of seeing the gentleman after wards, and found that his freedom from pain, and freedom from the teeth, took place at the same time.
As the superior wisdom teeth advanced, however, another round of troubles ensued, similar to those we have just described ; these were also removed, and with them, the cause. All four of the teeth were sound at the time of removal, which forces us to the conclusion that the sufferings of the patient resulted from lateral pressure, consequent upon the want of room for the proper eruption and regular arrangement of the wisdom teeth.
[Jan'y, Case 11.?In 1822, Dr. Olmade was attacked with odontalgia, with which he was tortured for three months. The violence of the symptoms was such that his mouth was closed spasmodically, and he was compelled to subsist entirely upon liquid aliment. Having had occasion to see him, at the time his sufferings commenced, it was observed that one of the wisdom teeth of the lower jaw was on the point of coming through. To this cause alone the disorder was attributed, and the patient was advised to have it extracted. Dr. Olmade deferred submitting to the operation until an abscess hadformed, which caused a fistulous opening through the cheek.
At the same time a portion of the maxillary bone became necrosed, and some fragments escaped with the pus.
Becoming convinced that he could obtain no relief from medicine, he determined to follow our advice. The condition of the parts contiguous, was now such as to add very much to the difficulty of the operation. It was therefore found necessary first, to remove the second molar, the crown of which was almost destroyed. The roots of this tooth were anchylosed to the alveolar walls in their whole extent, although they were very short. It was this anatomical arrangement to which was to be attributed all the sufferings of the patient. The wisdom tooth, in fact not having room enough between the angle of the jaw and the second molar, and not being enabled to displace the latter, it had taken an almost horizontal direction from behind forward, so that the posterior face of the crown presented upward.
A short time after we effected the extraction, the abscess and fistula closed, but the cure was not completed till after the lapse of two months.
Case 12.?The subject of this case was the son of a rich merchant of Bordeaux, who had been obliged to submit to the extraction of the first right inferior molar, which was deeply excavated by decay. From the various testimonies which have now been offered, it is evident that numerous nervous disorders are dependent upon the irritation caused by lateral pressure of the teeth, and that these disorders occur most frequently about the time of eruption of the wisdom teeth, in consequence of imperfect development of the maxillary bones, or the too early removal of the deciduous teeth, whereby contraction of the dental arches is produced, and a consequent insufficiency of space for the proper arrangement of the permanent teeth.
In relation to the treatment, it will be unnecessary to extend our remarks, farther than to say, that the various phenomena attending these affections require the closest scrutiny.

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