that in order to its harmony there must be perfect coinci dence in the work of composition and decomposition: for, should the fibrous membrane not be removed in time, a barrier will be opposed to the emancipation of the teeth, and pressure continuing to be made on it by the advancing teeth, irritation first and then inflammation must be excited in its tissue. This is what happens in fact when dentition is morbid; and the inflammation extending to the gums, they become red, tumid, and painful, ending sometimes in ulceration. When it is remembered that inflammation exalts the sensibility of all the tissues, some idea may be formed of the pain that must be produced in the inflamed fibrous membrane, whose tension is at the same time increased, and this pain, Mr. Bell alleges, is exasperated by counter-pressure on the sensitive pulp itself.

The question now recurs, is there here a sufficient focus of irritation to produce any of the morbid effects ascribed to dentition? With regard to convulsions, there can be no hesitation in answering the question in the affirmative, for we are familiar with them as the consequence of other local irritations. Intense pain in any part may modify the brain so as to give rise to convulsions, nor can the minutest post mortem scrutiny always detect inflammation in this organ or its membranes in such cases. Ought it to be esteemed strange that a febrile state of system may arise from dental irritation? With what are we more conversant than symptomatic fever from local injuries attended with less pain? Ought we to be surprised that derangements of the digestive organs should proceed from this cause? The membrane that lines them is implicated in the mouth and the irritation of this point spreads with peculiar facility in infants, to say nothing of their sympathetic participation in the derangement of the nervous and circulating systems.

But, as it may be said that this reasoning is analogical only, and affords at most but presumptive proof of the point at issue, we shall adduce evidence which, we think, must be regarded as conclusive. That the morbid effects in question are sometimes produced by dentition is to be inferred: first, from the fact that they occur simultaneously with the inflammation of the gums and disappear when this subsides, to be renewed when the inflammation is again excited by the irritation of other teeth. Second, from the amelioration or complete removal of all the symptoms when the dental irritation is relieved by a free incision through the gums and fibrous membranes, an operation which, notwithstanding all the clamor that has been raised against it, is attended with little or no pain, involves no risk, and greatly facilitates the protrusion of the teeth. There is à vulgar prejudice against this operation which supposes that as the scar which follows the incision is harder than the gums, it will be more difficult for the teeth to make their way through it, and this prejudice is fostered by those who are incredulous as to dentition's being a cause of disease, and taken advantage of by charlatans, who have some nostrum to recommend instead of the lancet. It is not surprising that the latter should hold this up as a scarecrow to frighten parents to the use of ridiculous "soothing syrups," but it is both surprising and reprehensible that an enlightened physiologist, such as M. Billard, should countenance such an absurdity. We had supposed that it was known to every tyro in medicine, that all adventitious tissues designed to repair breaches of original structure, are possessed of less vitality, and that, though their hardness may be greater, they are less capable of resisting a vital force. Hence, when inflammation attacks a part or pressure excites the absorbents to action, cicatrices, if any exist, are the first to yield to ulcera

tion or absorption, The teeth will, therefore, make their way through this hard scar much more easily than through the original gums.

From our subject, imperfectly as it has been handled, it would appear that disease is inseparable from the laws of organization, ordained for the production and growth of living beings, whose existence depends on the establishment of certain functions, the exercise of which may induce such derangement as to extinguish life, before the machinery it animates is put in harmonious motion. It is melancholy to reflect on the wrecks that are so thickly strewed on the broad and impetuous river of life in the very commencement of our voyage. Of the millions of frail barks launched on its treacherous bosom, with their gay pennants fluttering in the breeze, how few reach the haven of manhood, how many are ingulphed in infancy!

Although such is the constitution of nature, we may reasonably hope to mitigate the calamities of our lot, by the study and observance of her laws, and without a knowledge of those pertaining to organization, the diseases of infancy cannot be understood or scientifically treated. It must be allowed, indeed, that in spite of all the lights of science a degree of obscurity veils the diseases of this early period, from which those of a more advanced age are exempt. The diagnosis of the latter, besides being more strongly marked perhaps, is greatly assisted by the disclosures of the patient himself, an advantage which is denied to the former. But this obscurity is not as great as is commonly alleged: for, though infants have not the faculty of speech, their physiognomy, including not merely expression of countenance but the manner in which the different functions are performed, is very significant and reveals oftentimes not only the seat but nature of the

diseases to which they are a prey. This inarticulate language cannot be learned from lexicons nor can it be taught, except in a very general manner, in the prelections of the schools: it must be acquired by the diligent observation of nature, for which the major number of practitioners have so little relish that they turn from it with a feeling of irksomeness, if not with disgust. Spread before them a list of diseases which have been dissected by catachetical inquisition and methodically arranged according to their several groups of symptoms, leaving them only to inquire by responses whether the patient is suffering from this or that disease, and the task imposed has nothing in it revolting; the whole nosological nomenclature is patiently ransacked, and the disease singled out and prescribed for; but ask them to observe for themselves and in default of oral language to catch the lights and shades of disease, which no language can depict, and they are ready to sing a requiem to such aspirings, composed of lamentations over the darkness of pathology, which, it may be, exists only in their own minds. This blameable apathy has, in a measure, consigned the diseases of infants to the ignorance of nurses and the tender mercies of quacks, whose congenial element is darkness, real or fictitious. It is incumbent on Medicine to rescue infants from such incompetent hands, and by the profound study of the peculiarities of their organization and diseases to curtail the fearful mortality to which they are exposed.

ART. II.-Cuse of Fatal Abscess of the Right Kidney. By L. POWELL, M. D. of Louisville.

MR. B. S., ætat. 30, of tall stature, spare habit, and irritable temperament, had for several years been more or less affected with a sense of weight and fulness, with a feeling of uneasiness or obscure pain in the lumbar region, accompanied with an irritable state of the bladder, the urine being habitually discharged at short intervals, in small quantity and of unnatural color and consistence, being always more or less turbid, sometimes milky and frequently of brownish red color and depositing on standing more or less sediment.

When consulted in his case, and informed of the symptoms just detailed, I could not fail to infer a serious irritation or perhaps a subacute inflammation of the kidneys to be its true diagnostic character or the real pathological condition.

In accordance with this view he was restricted of exercise, confined to a strict anti-phlogistic regimen, subjected to one general bleeding and to frequent cuppings over the loins, to the moderate use of laxative medicines and demulcent drinks, and finally to counter irritation by a seton inserted in the back and worn for several months. Under this course of treatment the symptoms were palliated, and the comfort of the patient improved. It was obvious, however that no permanent benefit had accrued, and in the vague hope that travel and mineral waters might restore his health, the unfortunate gentleman visited the most celebrated springs of Virginia, made frequent and extensive excursions through the country, and sojourned one winter in the south, by which time a very sensible impairment of his general health had succeeded to the local symptoms. He returned to Louisville late in the