The relation between the teeth, and certain diseases of the skin and mucous membrane / by W. Knowsley Sibley.

  • Sibley, Walter K. (Walter Knowsley), 1862-
Date:
1911
Catalogue details

Licence: In copyright

Credit: The relation between the teeth, and certain diseases of the skin and mucous membrane / by W. Knowsley Sibley. 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.

    18/20 (page 14)
    DISCUSSION. Mr. James asked Dr. Sibley in what way he definitely associated diseases of the skin with conditions arising in the mouth. The paper covered a very large area and it was rather difficult to follow at the moment exactly what Dr. Sibley was endeavouring to prove. There appeared to he three classes of cases—those which occurred by direct extension from the mouth, those due to reflex disturbance, and those due to gastro-intestinal disturbances. With regard to the first group, the speaker had seeir cases in children w'hich undoubtedly appeai'ed to be of this nature. Of the second group it seemed liossible that vascrdar changes and possibly trophic changes could occur which might favour a skin lesion, although this w’as hardly borne out by clinical experiences. The chief affections seemed to Ire those due to gastro-intestinal trouble, wdiich might be the result of oral sepsis. Mr. Gabell was very much in the same difficulty as Mr. James. It appeared to hiirr that most of the cases described were nervous reflexes and not direct infections. He bad seen acne rosacea as a mere extension in people wdio bad pyorrhoea. Dr. Sibley described a great many cases of affections of the skin, found that the patieirts had pyorrhoea, and inferred that the pyorrhoea was the cause. But did Dr. Sibley realize the enormous number of peo])le who had pyorrhoea—how^ very few had not got it ? If he did, w'hy did he attribute the skin affections to pyorrhoea ? It did not seem to him a very sound argument. The treatment by vaccine was very interesting, but as Dr. Sibley appeared to leave the local condition untouched, he could not see very much hope of success. The first patient shown had violent pyorrhoea, and copious infection w'as still going on; it seemed hopeless to treat the case by mere vaccination. Dr. Knowsley Sibley, in reply, said that if, as the result of a dermatitis on some part of the body, produced by a local irritation after a short time, owing to a reflex or sympathetic irritation of the nerves of the skin, a similar lesion appeared on the opposite side, or even on some other region of the body, so he maintained, that when there was a violent nerve irritation, such as was pro- duced in dentition, a nerve irritated by caries or other causes, it was explicable to get a skin lesion due to trophic changes of the nerves in the skin area, especially in the superficial areas supplied by the same or an associated nerve. The whole of the areas of the skin supplied by the other branches of the fifth nerve must be equally irritated. He had seen so many cases in which local treat- ment of the skin failed to cure, but which had been rapidly healed by treating the condition in the mouth. One case was that of a hospital nurse, who had for years been under treatment for the condition of the skin of her face, but until she had her teeth attended to there was no success from the treatment, and then she got perfectly W'ell. Even the colour of her nose, which had been red since she was a girl, became normal. The other cause was septic absorption. A large number of skin diseases were proved to be gastro-intestinal in origin.