Lecture XVIII

This becomes obvious if we study a condition on which a question has been put: Pyorrhœa alveolaris, the inflammation of the alveolar rim. If pyorrhœa develops, it is not solely owing to some local cause, as many suppose, but it is due to a tendency of the whole organism, a tendency localised only in the mouth and teeth. If it were accepted as part of the professional routine that dentists who observed the onset of this condition were somehow to suggest to physicians that the patient suffering from this particular alveolar inflammation was very probably also liable to diabetes, much good could be done. For that same process—already outlined in these lectures—which manifests as diabetes, is also (while it remains localised in the upper sphere and amenable to treatment) the germ of Pyorrhœa alveolaris. It is far too little realised that the lower sphere can, as it were, seize or invade the upper; and in consequence there is either an impoverishment or an undue augmentation of the one sphere or of the other. If the inflammatory tendency is first manifest in the upper sphere, one form of disease ensues; if first manifest in the lower sphere, there ensues its polar opposite. So very much depends on this knowledge.