Diseases and injuries of the teeth : including pathology and treatment / by Morton Smale and J.F. Colyer.

  • Smale, Morton.
Date:
1901
Catalogue details

Licence: In copyright

Credit: Diseases and injuries of the teeth : including pathology and treatment / by Morton Smale and J.F. Colyer. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

    615/712 (page 595)
    The patient was 20 years of age, of weakly build. Dr. Dorn had previously extracted a tooth, and no undue amount of bleeding followed. On May 5, about seven o'clock in the evening, he ex- tracted a lower molar, no unusual force was needed, the gum was not torn, and when the patient left the bleeding had ceased. About eleven o'clock the following morning the patient returned with profuse haemorrhage, the mouth being full of clots, and the blood still oozing away. The bleeding, she said, commenced about three hours after going home and had not ceased since, though cold alum and vinegar had been apphed. Dr. Dorn plugged the socket with iodoform gauze, covering it with a pad of ' stent.' The following morning he removed the dressing and believing that the haemorrhage had permanently ceased, he dismissed the patient. About six the same evening the bleeding recommenced and the dressings were reapplied as before. A couple of days after the dressings were again removed and the wound healed in the usual way. Her periods were usually regular, she menstruated in April and again in June, but in May menstruation, which should have occm-red at the period of the above-mentioned liEemorrhage, was absent. Curiouslv, a similar occurrence had coincided with severe haemorrhage from the nose a couple of years previously. Dr. Dorn regards the case as one of vicarious menstruation.^ Haemorrhage is generally divided into three stages—primary, intermediate and secondary. In the mouth we often find the primary running into the intermediate. - The treatment of primary hsemorrhage, or that occurring at the time of the operation, is not of serious import. If it is at all sharp a useful plan is to give the patient some tincture of hamamelis in the water used for rinsing the mouth. At the same time about 15 grains of gallic acid should be administered, and the patient ordered to take a similar quantity every two or three hours until the haemor- rhage ceases. The socket should also be loosely plugged with cotton-wool dipped in some styptic, such as gallic acid.^ Intermediate and secondary haemorrhage is more serious and generally sets in at night. When a case of intermediate haemor- rhage is first seen two important points should be ascertained before treatment :— ' An interesting paper on the subject of extraction during the menstrual period was published in the Deutsche Monatsschrift fur Zahnhoilkundc, May, 1897. -11 Acidi gallici .. .. .. 5!]. Ft. pulv. viij. One powder every two hours until the hajmorrhage ceases.