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No.

Boston
Medical Library

Association,

19 BOYLSTON PLACE

£ — - 9

THE

INTERNATIONAL DENTAL JOURNAL

A MONTHLY PERIODIOAL

DEVOTED TO

Dental and Oral Science.

EDITED BT

JAMES TRUMAN, D.D.S.

VOL. XI.

INTERNATIONAL DENTAL PUBLICATION COMPANY,

NJSW TOBK OITT AND PHILADELPHIA.

1890.

CATALOGUED.

MA ^ Iff 9 1

LIST OF CONTRIBUTORS TO VOLUME XL

Angle, Bdwabd H., D.D.S.
Atkinson, Charlks 6., D.D.S.
Bakeb, Djl H. a.
Bazin, Dr. J. A.
Blair, L. P., D.D.S.
Brtan, Dr. L. C.
Bruob, James A., D.D.S.
BuLKLET, T. Duncan, A.M.,

M.D.
Btrnes, B. S., D.D.S.
Cooke, William P., D.M.D.
Curtis, G. L , M.D., D.D.S.
DoDOE, Henry N., M.D., D.D.S.
DwiNELLE, W. H., M.D., D.D.S.
Fellows, Dr. D. W.
Gates, Willl^m H., D.D.S.
Gibbon, Dr. Kasson C.
Hamilton, Dr. H. F.
Howe, J. Morgan, M.D., D.D.S.
Jackson, V. H., D.D.S.
Laplace, Ernest, A.M., M.D.
McCauset, Dr. George H.
Marshall, John S., M.D.

Maxfield, George A., D.D.S.
Mate, Professor Charles.
Mills, William A., D.D.S.
Mitchell, W., D.D.S.
OsMAN, Dr. J. Allen.
Ottolengui, B. a. B., M.D.8.
Peck, Bdward S., A.M., M.D.
Beed, Dr. J. J.
Rehfuss, W. L., D.D.S.
BoBERTS, Dr. W. L.
Sachs, Wilhelm, D.D.S.
Smith, C. Stoddard, D.D.S.
Symington, Johnson, M.D.,

F.B.S.£!i.
Waitt, J. B., D.M.D.
Warren, Dr. George W.
Whitefield, George, M.D.,

D.D.S.
Wight, J. S., M.D.
Wilson, George A., D.D.S.
Winkler, George H., M.D.,

D.D.S.
Wright, B. P., D.D.S.

\V*

Internatioil^ml Journal.

Vol. XI. January, 1890. No. 1.

Original Communicatioiis/

FBEMBNTATION: ITS CAUSE AND EFFECTS.'

BY ERNEST LAPLAOS, A.M., M.D. (PARIS), PROFESSOR OF PATHOLOGY IN
THE MEDIOO-OHIRTJRQIOAL COLLEGE, PHILADELPHIA.

Gentlemen, — ^All that lives must die ; and dying, disintegrate
and resolve itself into elements that enter into new cycles of use-
fulness. This phenomenon of universal disintegration must have
aroused the interest of the human intellect from the first moment
that it reached such a state of perfection as led it to inquire into
the causes of things. If this disintegration did not exist, the
matter of organized beings would encumber the earth, and the law
of perpetuity of life would be compromised. A great phenomenon
presides over this work ; this phenomenon is fermentation.

Our forefathers may have been savages ; but they were clever
and observant ones. After organizing their own rude arts, they
turned beasts into servants ; they founded agriculture ; planted the
grape. This fruit was surely antediluvian, for we are told that
Noah, on leaving the ark, planted a vineyard, drank of the wine,

^ The editor and publishers are not responsible for the views of authors of
papers published in this department, nor for any claim to novelty, or otherwise,
that may be made by them. No papers will be received for this department
that have appeared in any other journal published in this country. The jour-
nal is issued promptly on the 15th of the month.

* Bead before the Odontological Society of Pennsylvania, at its regular
meetings November 2, 1889.

1 1

2 Original Communications.

and experienced its consequepces. Bat though wine and beer are
as old as history, it was not until within the last few decades that
anything positive has been known as to the true mode of their for-
mation. Our knowledge in the matter has been almost identical
with our knowledge of medicine, — ^that is empyrical. By this is
meant that we had observed the facts, aside from the principles
which produce them, and which are essential for a true understand-
ing of them. In a word, when light dawned upon the true secret
of the manufacture of beer, by the immortal discoveries of Pasteur,
that same beam spread itself over the whole realm of medicine ;
was the light of regeneration to the noblest of sciences.

The brewer learned from long experience the conditions, not the
reasons, of success. Often, however, the brewer's beer has fallen
into rottenness without any accountable cause. It is the hidden
enemies against which the physician, like the brewer, has had to
contend that recent researches are dragging into the light of day,
thus preparing the way for their final extermination.

While still a young man, Pasteur, who was then a professor of
chemistry in the £cole Kormale, of Paris, was attracted by a note
of the Grerman chemist Mitscherlich, in which he said to the Academy
of Sciences : ^' The tartrate and paratartrate of soda and ammonia
have the same chemical composition, the same crystalline form and
angles, the same specific weight, and the same double refraction.
Dissolved in water, the refraction is the same. But the dissolved
tartrate turns the ray of polarized light to the left, whereas the
paratartrate is indifferent But," adds Mitscherlich, *Hhe nature
and the number of the atoms is identically the same.*' Pasteur,
who was then but twenty-five years of age, discovered that the
crystals which turned polarized light were not symmetrical. He
noticed that all products of organic life were dissymmetrical, such
as starch, quinine, strychnia, etc., while all mineral crystals, or
products of the inorganic world, were symmetrical. He immedi-
ately suspected that tartrates were organic, — that is, connected di-
rectly or indirectly with life. It was a well-known fact that a Ger-
man manufacturer of chemical products having thrown away some
impure tartrate of lime, mixed with albuminoid materials, this had
fermented, giving rise to different products. Pasteur reproduced the
fermentation in the following way : Taking some tartaric acid, he
added a certain amount of albuminous material, and placed it in an
incubator. When fermentation had taken place, Pasteur found in-
numerable small living organisms; and after the process had stopped
he polarized the liquid, and found that, whereas before fermenta-

Fermentation : its Cause and Effects, — Laplace, 3

tion the polarization was to the left, it had now turned to the
right.

His suspicion was realized.

Hence, this sudden change of the direction of the ray of polar-
ized light was accompanied by a great development of small living
organisms during a process heretofore known simply as fermentation.
This was the first hint ever gotten of the influence of a living micro-
organism upon organic substances. This micro-organism was not
present apparently when the mixture was placed in the incubator,
and now it existed in swarms in the disintegrating mixture. They
surely grew during the fermentation.

Up to this time the most incomplete notions had been entertained
as to the true cause of fermentation. Liehig said " it was an acidi-
fication of albuminous substances when in contact with air;" Gay-
Lussac thought that the oxygen of the air was the causative agent,
for he had noticed that wine had turned sour from being poured
from one vessel into another; Berzelius and.Mitscherlich said that
ferments acted by catalysis, — that is, by their presence ; Schwann
and Cagnard Latour noticed that a living rounded body was pres-
ent in the manufacture of beer, but it did not occur to them to
ascertain what part was played by this organism. As soon as the
malt is mixed with hops it is boiled and allowed to cool ; this in-
fusion is called the wort, and that is placed in vessels with but one
aperture open to the air. Here it is mixed with the yeast. Soon
after a brown froth forms on the surface, which is really new yeast, and
issues from the aperture falling like a cataract into troughs prepared
to receive it. Whence is this new yeast ? Weigh it before and after.
The brewer sows ten pounds and he collects fifty pounds. Shall we
say that this is spontaneous ? Are we not reminded of the seed that
has fallen in good soil and brought forth fruit fifty- or a hundred-fold ?
In fact, this seed can be seen budding under the microscope before
our own eyes. It is a minute plant, the torula cerevisisB. This
marks a distinct epoch in the history of fermentation. But Liebig
was loath to accept the growth of this plant as the cause of fermen-
tation, and maintained that its life had nothing to do with the pro-
cess, that it was a purely chemical one, and that it was the chemi-
cal nature of yeast, not the fact that it was alive and could develop
life, which produced fermentation. In a memorable demonstration,
Ludersdorf proved the error of Liebig's assertion, and that yeast
acted as a ferment because of its organized or living character.
He destroyed the cells of yeast by rubbing them on a ground glass
plate, and he found that, with the destruction of the organism, the

4 Original Communications,

chemical nature remaining the same, the power to act as a ferment
disappeared totally. No experiment could possibly be more con-
clusive.

But in the manufacture of wine no yeast is added. The grape is
pressed, and the juice ferments after a short while. The torula
soon make their appearance, however, and where do they come
from ? If the filtered grape-juice be boiled, so as to destroy the
germs it contains, and be put in germless air, it will never ferment.
All the material for spontaneous generation is there, but the life
both in the grape-juice and the air being destroyed, no new life can
be produced in the shape of fermentation.

Pasteur has pushed this demonstration still further. The grape
is sealed by its own skin from contamination by the air. He con-
trived a way of extracting the juice without its touching any con-
taminated substance and placing it in pure air ; it did not ferment ;
then taking the skin of the grape and brushing the delicate grayish
dust upon this non-fermenting juice, fermentation soon developed,
and the yeast-plant appeared in great abundance ; proving that the
grape carries its yeast upon its own self For thousands of years,
therefore, the wine-grower has done unconsciously what the brewer
does purposely.

The germ of the yeast-plant exists in the air, but not in quanti-
ties suflScient to insure rapid fermentation, such as the brewer de-
sires, hence the brewer puts in a quantity himself Pasteur has
defined fermentation as life without air. These germs live on oxy-
gen, as we do, and give off carbonic acid gas ; but they do not take
their oxygen from the air, they take it from the substance upon
which they grow ; hence they do not need the oxygen of the air
for their development. Hence fermenting substances are placed in
vessels with but a small aperture to the open air, where the yeast
imbibes oxygen and pours forth carbonic acid. Where does it get
the oxygen ? It is wrenched from the liquid upon which it grows ;
liberates carbonic acid gas, and leaves the liquid product as our
familiar alcohol.

And in the same way exposing alcohol to the action of the fer-
ment known as the mycoderma aceti, acetic acid will be the result.

The air is full of germs of ferments differing from the alcoholic
leaven. Expose milk to the air, and coagulation will take place;
small globules of butter appear, — the butyric acid fermentation.
Within a short while larger organisms are seen wriggling in swarms
through the preparation. In curdled milk are found other organ-
isms linked together, as beads on a string, — that is the lactic acid

Fermentation : its Cause and Effects, — Laplace. 6

fermentation. Examine putrefying milk, and it will be seen to
swarm with millions of small and larger germs, showing wonderful
alacrity of motion. Keep your milk from the influence of the at-
mosphere, or boil it so as to kill the germs within it, and it will
remain sweet, the germs being destroyed. Expose meat to the
atmosphere, and it will soon putrefy ; it will swarm with the germs
of putrefaction, and will soon stink. Keep the germs away, and it
will not putrefy. Thus we begin to see that within the world of
life, to which we ourselves belong, there is another world requiring
the microscope for its discernment, but which, nevertheless, has a
most important bearing upon our welfare.

Gathering these facts together, and analyzing them, we see that
there are two elements always in action, a seed and a soil: the
seeds are floating continually in the atmosphere about us; the soil
is the particular substance upon which these germs fall, and at the
expense of which they grow. It follows also that the greatest
analogy exists between these various germs in the atmosphere and
the seeds of various planto that may be wafted by the wind from
one spot to another, and which develop when they happen to fall
upon a suited soil.

Another fact is that, just as when you sow corn, corn is reaped
and not barley, so each particular germ grows its particular kind.
Supposing you take a handful of seeds of various flowers, and sow
them in the same soil, then the different plants will grow alongside
of one another. So also, if various sorts of germs have access to
the same soil, they may grow plentifully together, as takes place in
putrefaction, where germs of many kinds are seen growing and de-
composing the soil upon which they grow, liberating not carbonic
acid, as in fermentation, but sulphuretted hydrogen, — the foul smell
of putrefaction.

All germs will not grow on the same soil, just as all seeds will
not grow in the same ground ; some plants being indigenous to some
countries and others to different climates. But a very astonishing
fact is that one germ, after developing in a particular soil, may leave
that soil in such a state as will render it favorable to the develop-
ment of a germ which could not have developed there before. Such
is indeed the case with the mycoderma aceti, which could not have
developed in the sweet solution. First, the yeast-plant developed
there, changing the sugar into alcohol, and now the mycoderma
aceti, falling into the alcohol, grows abundantly, changing this
alcohol into acetic acid or vinegar.

The most important and practical portion of the whole knowl-

6 Original Communications.

edge of the nature and development of micro-organisms is the
study of the changes incident to their growth in the soil upon
which they develop. The yeast-plant left the sugar changed into
alcohol, whose chemical nature* and physiological effects are quite
different from sugar. The mycoderma aceti has changed the alcohol
into vinegar, whose chemical nature and physiological effects are
vastly different from alcohol. Likewise the lactic acid germ has
produced in milk, which was once sweet, a substance (lactic acid)
having corrosive properties, and which curdles the milk.

This new product, which results from the decomposition incident
to the development of a germ, is called in medicine a ptomaine.
When germs are absorbed from the atmosphere and produce certain
diseases, the albuminoids are decomposed within us, and this pto-
maine or fermentative product is the chemical poison formed, which,
being resorbed by the economy, produces those physiological symp-
toms characteristic of a disease.

And would a substance putrefy without the action of germs ?
In other words, is there such a thing as spontaneous generation ?
TyndaU's and Pasteur's admirable researches have set this question
at rest. One will suffice. Having made veal broth, Pasteur placed
it in a round vessel, with but a small aperture. This was raised to
a temperature of 115^ C. for half an hour, so as to destroy all the
germs within it, and the tip end of the flask was soldered, so as to
prevent further air from coming in contact with the broth. A num-
ber of flasks so treated were placed aside. I have one in my pos-
session thus prepared, many years ago, by Pasteur himself, and its
contents are as pure as on the day of its preparation. This shows
conclusively that by heat he had sterilized the liquid and interior
of the flask, and, having soldered the end of the flask, thus prevent-
ing any germs of the atmosphere from having access to the fluid,
there was no possibility of life developing in it ; hence it remains
pure, and is likely to remain pure indefinitely.

Now, this simple experiment was a master stroke of genius, for
on it is founded our whole system of modern pathology and hygiene.

Do we wish to stop fermentation, putrefaction, contagious and
epidemic diseases, we must repeat Pasteur's experiment, — sterilize
first; then prevent the germs from having further access to the
parts thus purified.

Strange to say, this process of purification was applied to the
canning of goods before it was practically applied to scientific pur-
poses. In fact, canned fruits of all sorts are prepared exactly after
the manner of Pasteur's broth experiment. They are raised to a

Fermentation : its Cause and Effects. — Laplace. 7

high temperature and kept in air-tight vessels. And what occurs
when canned goods become spoiled? Simply, the germs of the air
have gotten into the goods, either through some small aperture in
the vessel or sufficient heat was not applied at first to destroy
them.

Lister, in England, was the first to make a practical application
of this to suppuration in wounds. He saw the analogy between the
foul smell of a suppurating wound and the process of putrefaction,
and concluded that, should he succeed in destroying the germs
which had started this putrefying process, and should he prevent
further germs from having access to the wound, this putrefaction
would cease and the wound heal kindly without suppuration. This
he did by sterilizsing the wound. There are two ways of sterilizing :
(1) by heat ; (2) by chemical agents : carbolic acid, sublimate, etc.,
which have the property of destroying the vitality of most micro-
organisms ; and when, used in proper strength, do so without im-
pairing the tissues with which they come in contact. The wound
is then covered with several layers of cotton that has been sterilized
or purified by heat, — and this prevents the germs of the air fVom
having further access to the wound ; for as these germs fall upon
the outer layers of the cotton, they are caught by the meshes of
the small cotton fibres and are not allowed to get any nearer the
wound; during this time the normal and unimpeded process of
repair goes on, and healing takes place without suppuration or
putrefaction produced by germs. And by this glorious discovery
Lister has blessed humanity with a reduction in mortality from
major surgical operations; a mortality reduced from fifty per
cent, before the days of antisepsis to two or three per cent, at the
present day in the best-conducted hospitals. Besides, it has widened
the domain of surgery, bringing to the surgeon success in such oper-
ations, in which he could not hope for success should suppuration
take place.

Applying these same principles to dental surgery which is a
special branch of general surgery, we are struck by the frequency
of processes of putrefaction or fermentation in the mouth. And
why ? Because the germs of the atmosphere, which we constantly
breathe through the mouth, lodge upon some remnant of food buried
in the sulci, fissures, and proximal surfaces of the teeth, and find
there a suited soil, accompanied by heat and moisture ; these germs
develop and cause putrefaction, as evidenced by the foul odors from
the mouth. Besides putrefactive processes, a fermentative process
also may take place in the presence of sugar which produces a cor-

8 Original Communications,

k

rosive element that destroys the enamel. The germs sink into this
impaired spot, and the same deleterious agent being generated there,
the process of decay attacks the dentine, the pulp, and an extensive
cavity follows. Such being the case for a healthy tooth, well paved
with enamel, the process is a much easier and more rapid one when
through some accident a mechanical abrasion already exists.

To the honor and credit of Professor W. D. Miller, of Berlin, be
it said that he was the first to discover that the corrosive substance
BO deleterious to enamel, and which results from fermentation in the
mouth, was lactic acid, which enters into composition with the cal-
cium salts of the tooth, producing a lactate of lime.

This being the case, as a student of pathology and practitioner in
surgery, I conjure you to apply to your special branch of surgery
the principles of antisepsis that Lister has applied to general surgery,
vouching that you will meet the same grand success. To reach this
end, sterilize, and prevent the further access of germs to the parts.
Sterilize with the acid sublimate solution, destroying the organisms
at one sitting. But when the pulp is dead use the heated platinum
broach in the root-canals, then use the antiseptic solution, which will
penetrate the minute nooks of the cavity, and destroy those few
germs that have perhaps escaped the heat ; finally, plug the tooth
with aseptic or antiseptic filling. And, gentlemen, as a physician,
knowing how many general disorders, gastric and others, are caused
by germs that found originally a brooding-place in the mouth, I im-
plore you to give this question of oral disinfection your most scru-
pulous attention, feeling confident that a rational and persistent use
of the antiseptic solutions now within our reach will afford you the
fbllest satisfaction, for in your treatment you will meet the same
glorious success as is achieved in surgery as practised at your
doors.

And now, having reviewed the various phenomena of fermenta-
tion, we see that in the eternal laws of the universe fermentation
was destined as a power for good, and, like electricity and steam,
it vastly benefits our existence, if only rightly understood and
maintained within its proper bounds; that most of the harm to
humanity resulting from fermentative processes is due to our still
incomplete mastery of its laws ; and that with the present strides of
science, we will completely overcome those micro-organisms or fer-
mentative agents that are deleterious to man and his surround-
ings.

Such is the triumph of the scientific age in which we live, that
has disclosed a world about us which we knew not of; a world of

The Waste Prodricts of the Body. — Mayr. 9

beings consisting of enemies as well as benefactors, in constant and

intimate relation with each of us.

We know of numberless stars above, infinitely large, but this

newly^iscovered world of infinitely small beings, its laws and pur-

poses, is to me not a lesser index to that Power, the Author of them

all,—

<* That Qod which ever lives and loves,
One God, one law, one element,
And one far off divine event
To which the whole creation moves/'

THE WASTE PEODUCTS OF THE BODY.^

BY PBOFXSSOB GHABLES MAYB, SPRINGFIELD, MASS.

The chief instruments supposed to be used in a dental office
are excavators, pluggers, and forceps, to which may be added vul-
canizers, and such appliances ; but the chemical " tools" have also
been multiplying of late too. The various antiseptics have come
in use more and more ; ansesthetics and disinfectants, which con-
stitute a large proportion of the materia medica of dentists' use at
present, are what might be called of a defensive nature. Very little
of it is positive ; that is, almost all medicines used are aimed at
the destruction of some enemy, not at the strengthening of the re-
sisting body in the struggle for life which goes on and in every cell,
every aggregation of cells, every tooth, every individual, every col-
lection of individuals, every thought, and every train of thoughts,
every system of philosophy or creed. This struggle for life can be
essentially reduced to two contending bodies, — the one the aggres-
sor, and the other the defendant. As in warfare, between the large
collection of cells called man the survival of one party is determined
by its own strength or by the weakness of the other party. We
have in history very many illustrations where a nation has been
victorious in its struggle against another nation by its superior
strength. Of course one has to be the weaker, but both may be
above the average in strength, and yet the still more vigorous party
will be victorious. We all want to be conquerors, none of us want

^liead before the New Jersey State Dental Society, at its nineteenth annual
session, at Asbury Park, July 19, 1889.

10 Original Communications,

to be beaten and crowded out ; for nature has only one penalty for
being beaten, and that is death. The conqueror Booner or later
must die. The conquered old Greeks and Bomans are dead. Cer-
tain elements among them which were stronger than those of the
conquering barbarians have survived. A conquest does not always
mean a conquest in every particular. The Goths, in the third,
fourth, and fifth centuries, conquered the whole of Spain. They
conquered the men, but they did not conquer the women. The
Spanish women taught the children of the Goths their unconquered
language, and thus the conqueror was vanquished on the field in
which he was weak. The Spanish woman and her language utterly
annihilated the Goths. There are not a hundred words in the
Spanish language to-day which testify to the possession of that
country by the Germanic invaders for three hundred years, and, if
we did not know the events from history, no linguist would ever
suspect such a long and thorough dominion.

The same principle applies to every single cell in the individual
man. Every man commands an army of thousands of millions of
soldiers. The enemy is just as numerous. Each cell has its enemy,
each aggregate of cells has an aggregate of cells as an enemy, and
the aggregate man himself has another aggregate man as an enemy.
What is the aim of man's existence ? Certain cells of the brain
may have different aims, but man, as a whole, wants to live as long
as possible and preserve the aggregate of its army intact as long
as possible. By two methods he tries to reach this aim : by weak-
ening the hosts and groups of enemies, and by strengthening his
own army and groups of soldiers. His staff of generals — ^that is,
his brain — must equal those pitted against him. His soldiers — that
is, his cells — must be equal or stronger than those of the enemy.
The generals in the brain employ auxiliary troops to strengthen
their army. The dentist is one of these auxiliaries. He has studied
certain points about the enemy; he has been a spy in their camp.
Under the guidance of that Pinkerton of detectives. Dr. Miller, of
Berlin, he has traced the enemy into his lair; he has investigated
his method of growth and attempted to reach him in a vital spot.
Almost all the efforts of dentists have now been directed towards
weakening the enemy. What is the use of a weak enemy if it puts
a premium on our own weakness ? I think it would be much better
to have a strong enemy pitted against our own strength.

To carry out the comparison still further, during our youth we
build our fortress on which we have to depend after our growth is
finished, until, with an army of crippled, maimed, and exhausted

The Waste Products of the Body. — Mayr. 11

veterans, we have to surrender. Our lungs lose daily some of their
best cell soldiers. Our heart burns up every day a few of the most
active workers. It is, therefore, best to start with as powerful an
organization as possible. The special branch of the army which
we have to consider in this meeting is that of the masticators, a
branch of the sutlery department. Now, many a strong army has
been beaten in its sutlery department. They do not have to do any
active service ; they have to attend to, perhaps, less heroic wants
than the brain or the eyes, but without strong grinders there can-
not be a strong army. The building up of strong teeth in children
seems to me to be a far more important problem than the extracting
of six-year molars. It is true that General Brain has also provided
for that emergency. It has hired steam grinders and furnishes
the grinding of the sutlery department. It supplies in hash-shape
all vegetables, meats, and cereals. Bread and cheese are made with
mushy softness. But without strong masticatory organs we will
always be conscious of a weak department in our army. The best
«and only natural process of growing good teeth in children is to have
their parents grow good teeth, of course before the children are
bom ; which saying is not quite as ridiculous as it might at first
appear, for it may be observed that parents very frequently do
things for the good of their children which they ought to have
done before the children were bom. But the fact remains, in spite
of all those probably correct principles, that children are born with
weak teeth. What shall we do ? We cannot afford to kill them
and grow better ones. For some time it has been the peculiar treat-
ment of dentists to give phosphate of lime and phosphate food in
general, with the idea of supplying that which was supposed to be
wanting, — the lime salts in teeth. You can pack such children in
a lime-barrel, and their teeth will not take up a particle more.
You can feed them lime hash and lime stew without effect. The
lime has to be introduced through the proper channels and in proper
form. The digestive department of the body is just as full of red
tape as that of any government. All its supplies have to go a cer-
tain regulated course, without which they are not accepted.

Another group attached to the staff of humanity has made the
investigation of leaks in the various departments their specialty.
Chemists and physiologists belong to that group. Very often they
are not admitted to the interior workings of the various depart-
ments, but they examine the refuse and see what is going on. They
also examine the refuse of the body and try to make conclusions
about the processes inside.

12 Original Communications,

The urine is a most interesting waste product. As a rule, I do
not think it has been considered to come within the province of the
dentist ; but perhaps I will be able to convince you that it is very
important that he should know something about it. Urine contains
a certain quantity of solid substances ; the rest is water. The solid
matter consists of more than twenty thousand dififorent substances.
There is salt, urea, phosphoric acid, lime, potash, soda, magnesia,
uric acid, etc.

In order to make a perfect analysis of the urine it is necessary
to have a very nice set of chemicals. I have come to certain con-
clusions in my work, which those of you who are given to that kind
of work may be able to appreciate.

If we take urine voided at different times of the day, it shows
variations in its specific gravity, — say 1021 in the morning, 1018 at
noon, 1029 in the evening, and 1030 before going to bed. That is
about the regular course. The amount of urea will show a similar
variation. The phosphoric acid will show a corresponding variation,
and the salts and uric acid also. There is a law which, strange to
say, I have not found laid down in any of the text-books, namely,
the relative proportion of those constituents in normal urine is
almost a fixed one, regardless of the times.

The most constant relation is that of the urea to the phosphoric
acid, which in healthy, normal urine is 100 to 8. If 100 parts of
urea are excreted, 8 parts of phosphoric acid have to be excreted.
The variation of these constituents in normal urine are from a
maximum of 100 to 8} to 100 to 7}. If this relation of urea to
phosphoric acid varies any more than that it shows defective
nutrition.

I find that the ratio of phosphoric acid excreted is about the
same in food. In the body itself the phosphoric acid bears to the
nitrogeneous tissue the relation of 10 to 100. If the ratio of free
phosphoric acid in the urine is more than 8 to 100, it shows very
plainly that the person is living on his body, and not on the food
taken. If the ratio is 10 to 100, it is a very dangerous condition.
I have found it 11 to 100 during the last days preceding death. If
the ratio sinks to 4 to 100, it is a sign that the person is strongly
assimilating and gaining in weight. So also does the ratio of urea
to phosphoric acid tell us what the state of health of the person is,
and is most interesting in that respect.

Dentists have speculated a good deal about the dissolving of
phosphates. I have, unfortunately, not been conversant with any
specimens from dentists in marked cases to show in what way it

The Waste Products of the Body. — Mayr. 13

would have a bearing. I should say that if the ratio of phosphoric
acid to urea is 100 to 9, no phosphoric acid could be assimilated in
the body; and if the ratio be 100 to 4, phosphoric acid and tissues
would be freely retained in the body.

Another important constituent is uric acid. That is found in
small crystals, which look like Connecticut red sandstone. This
uric acid, when perfectly purified, is colorless. We do not know
where it is manufactured ; but we know it bears a close relation to
the digestive process. Uric acid in the proportion of 100 to 3}
shows a strong digestion ; in the proportion of 100 to 2 it shows a
weak digestion ; 100 to 3 is about normal. If you find a high
amount of phosphoric acid excreted from the body, with low per
cent, of uric acid, the person is feeding on his body. If you observe
a low per cent, of phosphoric and uric acid, there is a little wasting
away of the tissue, and not very good health.

Another important thing is the sum total of the other constit-
uents. Salt occurs in the urine in variable quantities. It depends
upon the food taken. After breakfast the quantity excreted is con-
siderably higher than after supper. It goes through the body
without much change ; therefore, chemically, the ratio of salt is
not very important. Of the other constituents there are several
thousand in normal urine that bear a strict relation to the unit of
urea. Those other constituents ought to be about as 100 to 40-70 ;
100 to 120 indicates the formation in the body of abnormal products.
There are, furthermore, coloring matters. These are totally un-
known substances that we have not yet isolated. There are organic
substances, like creatinine, etc. ; and finally a small quantity of
sugar, which is rarely absent. From an examination of the com-
parative quantities of these constituents you can form an excellent
opinion of the working of the body ; better than by any other
investigation.

I think the subject of urinary analysis is worthy the attention of
dentists. Suppose we have found, after investigation, that the per
cent, of phosphoric acid in the urine is high ; the person is excreting
more, in spite of a good digestion, than he ought to; he is consum-
ing more of his flesh than he ought to. What can we do? Shall
we give him acid phosphates ? Not at all. The acid phosphate is
not the phosphoric acid of the body. It is as different from that
of the body as it is from sulphuric acid. Therefore the idea of pre-
scribing phosphate drinks for the purpose of supplying the
deficiency of the phosphates seems to me unreasonable and useless.
Bone phosphate, made from the powdered bones of animals, was

14 Original Communications.

given, ID olden times, in the shape of powdered mice, carefully
dried, etc. A little bit of that phosphate may possibly be assimi-
lated, but I have my doubts whether any perceptible particle can be
assimilated. The assimilating apparatus will take only things that
are presented in a certain prescribed form; it will receive the
mineral elements when presented in combination with albuminous
substances, as in bones, plants, flesh tissue, etc., but it will not accept
phosphates alone. So I think that in cases of excessive excretion
of phosphoric acid it is of no use to try to put more into the body ;
it does not do any good. We have to see whether that excessive
excretion has not something to do with wrong digestion. As a rule,
where there is an excess of phosphoric acid excreted you will find
low uric acid, showing that, no matter how much phosphates you
put into the body, they are not assimilated. We have to direct our
attention to the digestive process. I am not sufficiently conversant
with the methods which you use to correct or improve them.

If a child were to be fed exclusively on potatoes, there might be
a certain deficiency of phosphates in the body ; and I do not doubt
that, to a certain extent, a lack of hardness in the teeth of the child
might be ascribed to the defective food.

It has been found that a certain ratio must be preserved between
urea and phosphoric acid, in order to keep the proper balance of
the economy of the body.

This conclusion, which I have reached by comparison of thou-
sands of experiments, seems to me a very valuable one. By ex-
amining the urine of a patient whose teeth seem to decay and go
rapidly, something valuable might be found, in order to see whether
this is owing to a solution of the phosphate substance within the
body or to the action of external agencies. This might be of special
value in children. Now, perhaps having discovered such a leak,
what can we do? We have to examine whether the wastefulness
in this department is owing to incompetency or to lack of supply.
If the first is the case, as we cannot do away with incompetent in-
testines, we must try to make them more competent by either vigor-
ously arousing their laziness with what we call tonics or by gently
pleasant treatment in the form of rest. The treatment has to be ad-
justed to the individual. If, on the other hand, we are well satisfied
that there is a deficiency of supply, we have excellent and abundant
supplies. Flour of the entire wheat, rye, and oats contain a vast
amount of phosphates, and in a form in which they are combined
with albuminous substance, and accepted by the red-tape depart-
ment of the body. If they are not combined with albuminous sub-

T?ie Waste Products of the Body. — Mayr, 16

stances, they are most universally rejected. Another very valu-
able indication as to the requirements of this department may be
furnished by another product of waste of the body, namely, uric
acid. We do not know exactly from what it is produced, nor
what part of the body produces it, but a relation between the
digestive powers of an individual and the excretion of uric acid
certainly exists. Especially in disease of the kidneys the ratio falls
very low, while in those of the stomach it goes high. If we there-
fore find a deficiency of phosphoric acid excreted with the ratio of
uric acid high, we may consider that person as suffering, if he
suffers, from too rapid digestive process, a thing just as bad as too
slow. If we run a boiler which requires for good working two tons
of coal a day with the consumption of four tons, we not only waste
money, but we burn out the boiler much quicker. If the excretion
of phosphoric acid is normal, while that of uric acid is high, prob-
ably only dyspepsia is indicated, — that is, irritability of the stom-
ach. If phosphoric acid be normal and uric acid low, the person is
in danger of having to live on his body at the least disturbance of
digestion. If, on the other hand, phosphoric acid is high and uric
acid is low, that person is severely sick. He lives on his body and
assimilates but little.

Thus you will see how those two constituents alone tell a pretty
&ir story of the working of the sutlery department of the body,
and if a body lives on its own phosphates, both will suffer more or
less; with the phosphates there go also a number of cells and
cellular substance that ought to be used otherwise than for
anthropophagy.

As you will see, I don't take any great stock in the various
forms of acid phosphates, the phosphate drinks, etc., which produce
as their most important result strong plethora in the pocket-book
of makers and corresponding pecuniary depletion in the consumer,
which, furthermore, tax the kidneys which have already plenty to
do with the unnecessary call for earning money for a patent medicine
maker.

16 Original Communications.

SENSATION.^

BT QEOBQE W. WHITEFIELD, M.D., D.D.8., OHIGAGO.
(Concluded from vol. x. p. 788.)

It is the law of nerve-action that a sensation once transmitted
is more easily passed over the same nerve-track and more readily
affects the nerve-centres ever afterwards ; and in proportion as the
same sensation is repeated over the same track, not only is the
transmission more easily accomplished, bat all the reflexes are
similarly affected; hence the dexterity acquired in any art by
practice,— dexterity consists in well-organized reflexes, produced
by the same sensations being passed over the same nerve-track till
you might say the track is worn smooth. In other words, the
habit is formed, either physical or mental.

The following, from a newspaper clipping, illustrates one phase
of the subject : " The regular tracks of thought sometimes betray
the speaker. Thus, one of our ministers, speaking, from the pulpit,
of the late Horace Cooke, called him Horace Greeley, there being a
well-worn track that united Horace and Greeley.

<^ And another spoke of the sufferings of our Lord in the garden
of Eden, the tracks between garden and Eden being better worn
than between garden and Gethsemane. When a mind is in ruins
it often runs in these well-beaten tracks. A very eloquent Presby-
terian divine, happening to use the word Peter in one of his sermons,
paused, and said, * Peter, Peter, pumpkin-eater.' This was the last
time he was permitted to occupy the pulpit."

Then, again, subjected to the influences that have gone before
of the same kind, the nerves are modified by the equally important
influence of sensations of a different kind.

Let me speak here of a theory of memory. Some physiologists
teach that nerve-cells are not originally gray, but that the gray
tint is imparted to the cells that have been called into use, and that
these cells are capable of receiving or responding only to such
sensations as have passed over them, and might be 6ompared to
sheets of paper that are written on and filed away for future refer-
ence ; and a good memory means that the librarian has filed away

1 Read before the Chicago Dental Club, September 28, 1889.

Sensation, — Whitefield, 17

these cells in systematic order, so that they are easily found when
needed.

For convenience, I have spoken of the sensations as if there were
simple sensations, while, in fact, such a phenomenon never occurs.
There are, however, paramount sensations, — ^that is, of all the sen-
sations coming to one of you at a given instant of time, there is
always a paramount sensation, and it is the one your attention is
called to, as you at the same instant of time are receiving sensations
by way of all the senses, but the sense that your attention is called
to is the sense that receives a sensation, that becomes a cognition,
but even that sense is incapable of receiving more than one sensa-
tion at the same time.

One would naturally suppose that the paramount impression on
the simple nerve-centres or the sensorium would result from acts of
paramount importance, which is not necessarily the case, as atten-
tion and habit cause sensations of minor importance to produce
results out of all proportion to their real value.

Why do we not profit by this fact when operating on sensitive
teeth ?

Our appreciation of all sensations, no matter by which of the
five senses they are received, is a mental act, and the meaning
attached to that sensation is biased by the mental habits of the
person receiving it. The effect of sensory impressions on the reflex
centres, as well as on consciousness, depends on a great variety of
interacting causes.

Foster says, " All the Information which can be gained by the
eye is limited to the field of vision, and, provided that the relative
positions of the sensations in the field of vision remain the same,
the actual position of external objects might, as far as vision is
concerned, be changed without our being aware of it. As a matter
of fact, the field of vision, in one important particular, does not
correspond to the field of external objects. The image on the
retina is inverted ; the rays of light proceeding from the object
which by touch we know to be on what we call our right hand,
fall on the left-hand side of the retina. If, therefore, the field of
vision corresponded to the retinal image, the object would be up-
side-down, and seen on the left side. We, however, see it on the right
hand, because we invariably associate the right-handed tactile
localization with left-handed visual localization. That is to say,
our field of vision, when interpreted by touch, is a reinversion of
the retinal image.''

We never hear anything just as the sound is produced. Take a

18 Original Communications,

person who never heard a telephone, and let him apply the ear-piece
to his ear ; how natural for him to be deceived with regard to the
evidence of his sense of hearing ! In &ct, without bringing other
senses to assist, it is hard to localize the sound, and it is the same
with regard to all our senses.

Our accumulated experience enables us to form a sense-judgment
of what has taken place, yet how often are we deceived !

It takes a very appreciable length of time for a sensation to be
conveyed from the periphery to the nerve-centres, where it takes
another appreciable length of time for the pulse of excitement to
take place in the nerve-centres, and another space of time for the
motor impulse to be carried to its appropriate organ. But if an
appreciable length of time is required for a sensory impulse to be-
come a conscious sensation, a still longer period of time is required
for that sensation to pass away, as is illustrated in the rapidly-
revolving point of fire. It appears to be a circle: before one sen-
sation has had time to fade, the point is back where it started.

Every one of you know how the sense of sight will play you
false on a very clear or very dull day. Any object that you are not
familiar with is liable to deceive you with regard to its size, unless
there is something near of a known size to compare it with. Men
standing near an object that is taller than we expect appear to be
much shorter than they are.

Our love of art (the grand and beautiful) depends largely on the
fact that many things may be suggested by the few. In this way
the eyes appeal to our imagination. A picture is more or less per-
fect as the artist is capable of making it appear to contain more
than is really on the canvas. A caricature depends entirely on
what is suggested, — and does not music do the same ?

Without the several senses the human mind would remain a
blank forever, as all sensations are received by way of the five
senses, — that is, so far as our present knowledge goes. I would
like to dip into the probable but uncertain ground of psychology,
but my paper will necessarily be too long if I give but a superficial
glance at my subject,— sensation.

No one sensation could impart much to our consciousness if
received only for the first time ; but when different sensations are
reproduced numbers of times, and the recorded impressions are
compared with themselves and with each other, there is established
the superstructure of memory, ideas, and perceptions, the arrange-
ment, development, and particular use of which constitute what is
termed culture.

Sensation, — Whitefield, 19

Professor Alexander Bain, the noted Scotchman, says that
** knowledge begins with differences. We do not know anything of
itself, but the difiference between it and something else/' Conse-
quently, the person is most cultivated in music who can perceive the
most difference in time, pitch, etc. ; so in a general sense those most
cultivated perceive the most difference in all impressions received, —
while he is wise who is capable of profiting by them, and formu-
lating these impressions into ideas, and using them as occasion may
require. These defined qualities we call mind.

I have been speaking of sensations received by the nei've-centres
from without, as rays of light falling on the retina cause a conscious-
ness of light. We become conscious of something touched, — ^vibra-
tions in the air (unless we accept the substantialists' theory of the
entity of sound) convey to our consciousness the sense of sound, —
we hear.

Minute particles of matter floating in the air coming in contact
with the lining membrane of the nose, we have the sensation of
smelling; and other particles mingled with the oral secretions
coming in contact with the gustatory or taste bulbs, there is passed
by the nerves to the sensorium the sense of taste.

Under the influence of multiplied sensations the nerve-centres
become modified in their action, so that after a while a slight im-
pulse is sufficient to arouse as much action as a stronger one could
do at first. You can each demonstrate for yourselves that by irri-
tating the optic nerve by pressure on the eye, you will see light. If
the irritation comes from a blow, you are liable to see stars.

Sensations become incorporated into the very substance of the
nerve-structure, so that one sensation is capable of calling out in-
definite numbers of other sensations or memories of other sensa-
tions, as the smell of fish cooking, coming from some kitchen, may
arouse memories of some exploits with the rod and line. You per-
haps recall some shady nook where yo,u have angled for bass. You
can even hear the water ripple as it eddies around a stump that juts
out into tbe stream, and perhaps you recall the balmy fragrance from
the wild apple- blossom overhead, hearing again the clear whistle
of the bobolink as he perches on a reed across the stream.

All these sensations may be caused by the commonplace odor
from a kitchen range. Nor is it at all necessary that there should
be first a sensation received from the afl^erent nerves to start a-going
all this train of sensations, as the mind is capable of initiating the
first impulse and all succeeding impulses.

These centrally initiated impulses are what we, as dentists, need

20 Original Communications,

to know a great deal about to manage intelligently many of oar
patients, for there are many — women especially — who are not trained
mentally, and who think that there is nothing less true than that
one cannot believe the evidence of the senses.

Attention plays an important part in the phenomena of sensa-
tion and perception. A sensation that would pass unnoticed while
the attention is engaged becomes apparent as soon as the diversion
ceases. Attention renders one acutely sensible of what would pass
unnoticed under ordinary circumstances.

You probably all know of good operators who have among the
public the reputation of being harsh, solely because they fail to
profit by this fact. The employment of mental anesthetics is
more than profitable, — it is humane. Our reputation is largely
measured by the mental training we give our patients. For nothing
is more true than that a painful operation can be rendered bearable
(as we might say) by proper mental handling before and during
the operation.

Do not accuse me of being a metaphysician, but think of the
fact that we are incapable of receiving more than one sensation at
one time, and that attention determines what that sensation shall
be. A juggler engages your attention, and does his tricks before
your very eyes without you seeing them.

An operator can, by controlling the attention of the patient,
perform painful operations with but little inconvenience to the
patient. This can be done without the unseating of the patient's
reasoning power by hypnotism, provided the operator can inspire
the patient with confidence, and to do that he must have confidence
in himself, besides possessing an amount of sympathy, a strong will,
and a thorough knowledge of his business. He brings into play
his individuality, and accomplishes the task, as the hypnotist would
say, by suggestion.

Attention determines the quality of the sensations we receive.

If you will carefully read the evidence offered in a court of law
of some occurrence witnessed by a number of people, all of whom
testify under oath, trying to be truthful in their statements, you
will find a great diversity of statements, each one perhaps equally
true, and stated as each one saw the occurrence, modified by the
temperament, surroundings, and mental habits of the person. Each
one would be impressed with what to that person was the paramount
sensation.

Among your acquaintances you can recall persons who always
catch those sensations which are ridiculous, — they see the funny

Sensation. — Whitefield. 21

Bide of life ; while there is old Longface who taints the very air
with melancholy, seeing yawning graves even in street excava-
tions ; he believes that all the world is in league against him. Then
there is the man who sees suspicious actions in every one he meets.
Compare this man's mental habits with the hearty, whole-souled
individual who sees the silver lining in life's blackest storm-clouds.
He rises above a]l ills, and says he is '' glad to see you" in a manner
that convinces you that he means just what he says.

How true this remark, which I heard Talmage make, — " The
world is the color of the glasses we wear." The dyspeptic views
the world through colored glasses. We expect to find him on the
negative side of the question '^Is life worth living?" while the
solution of the conundrum depends upon the condition of his liver.

We are constructed much like a piano. Raise the cover of the
instrument and halloo into it, and the sound sent back to you will
be produced by the strings that are tuned to the same pitch as
your voice, while all the rest will remain silent ; so with our mental
instrument : we tune it to catch the impressions we wish to receive.
We may be unconscious of the act in this regard, as our inherited
propensities, our surroundings, and our associations may have de-
termined the class of impressions that we shall receive before we
are capable of taking charge of our own education. But he is not
worthy of the name of man who will make this excuse for contin-
uing mental habits that are contrary to his judgment or wish. A
man can make himself what he wishes to be if he will : apparent
physical impossibilities will melt away to a large extent. We re-
ceive just what we have trained our minds to receive. On this
principle a man is just what he will make himself, and he is not
well balanced mentally who cannot make himself what he wishes
to be.

This, I admit, is a broad statement, but science will bear me out
in it.

There is a trite old adage, '* Evil communications corrupt good
manners." For, what we perceive is governed almost entirely by
what we train our minds to receive, as the interpretation of all sen-
sations is a mental act. This being true, as can be proven, what
more simple or easy to comprehend than this, — we are all free moral
agents? A man is what he makes himself.

Excuse this diversion. I am drifting from my subject.

I was saying that habit and attention largely determine what
we see and hear, and that what we see and hear is only imperfectly
received, as only one of our senses can receive a sensation that shall

22 Original Communications,

become a conscious sensation at the same instant of time, so that all
other sensations are lost or so imperfectly received that we are con-
scious of a vague something that we strive to give a meaning to,
and, if we have a similarly recorded sensation to compare it with,
we may, by using our reasoning powers, give {he sensation its
appropriate meaning.

I stated that a single sensation is capable of calling up other
sensations or memories of other sensations, and that the sensation
that shall start a-going this wonderful power of memory may be
centrally initiated ; that the mind is capable of initiating the first
and all succeeding sensations, and that they are just as real as if they
were received by way of the afferent nerves from the external world.
You will all admit, as they are so tangible, that they often deceive
even the most careful of us, and how much more are they liable to
deceive one whose mental balance is imperfect !

What I wish to speak of now are these centrally initiated sen-
sations, and the danger of mistaking them, as so many do, for sen-
sations of an external origin, for these pulses of nervous energy of
cerebral origin are accepted as evidence of bodily conditions by a
large portion of the community. People of the emotional tempera-
ments have a pulse of action rising higher than occasion requires :
an explosion of energy takes place when a mere pulse would be the
expression in an ordinary person. These people allow the evidence
of their senses to deceive them, — that is, they allow sensations of a
cerebral origin to impress them just as they would those reaching
the sensorium by way of the afferent nerves.

To illustrate : A lady sitting in my office, while I was using my
electric motor, complained of a headache ; as soon as I commenced
to use my instrument she said the headache had ceased, as electricity
always cured her headache. Now, the electric current did not pass
near her, and it was impossible for her to receive any benefit from
it : it was a freak of the imagination. This person interpreted the
assumed evidence of her feeling by another set of emotional evolu-
tions. This person lacked what many others do whose ideas of their
bodily conditions are the result of these double pulses of centrally-
excited nerve-action. Some of these creatures, where mental disci-
pline is at a big discount, are apparently made up of highly-explosive
material ; they go into ecstasies of delight or are plunged into the
depths of melancholy by occurrences that would go unnoticed by a
person possessed of a well-balanced temperament. Such a person
is always having queer or horrible sensations in that portion of the
body to which his or her attention is directed from any cause, — most

Sensation. — Whitefield. 23

«

oflen in the back and head. And why should there not be strange
sensations in these nerve-centres, where such prodigal waste is con-
stantly going on, where violent explosions take the place of throbs
of nervous force ? These people give to their sensations names which
usually correspond to nothing that they have any previous knowl-
edge of.

Emotional people are apt to be " marked" with certain antip-
athies ; certain things which they eat will have peculiar action on
them. I do not think that this can be easily combated; it is in-
corporated into the very structure of the individual. I know a
cultured young lady of rare courage and splendid mind, a leader
and queen among women, who will almost lose her self-control if a
cat approaches her, while she will not hesitate to mount and ride
the most fractious horse with absolute confidence. In nothing else
does she know what fear means.

My argument is not against emotional people ; it is only that
they shall know how to distinguish between emotions centrally in-
itiated and those from the periphery. For, what a dull, cold world
this would be should all emotional people or all emotions be banished
from it I Emotions are the bonds that unite the home; they are
the main-spring of the genus. What would inspire us to prolonged
exertion save our emotions ? Was it not the enthusiasm (emotions)
aroused in loyal breasts by our patriotic and soul-inspiring war-songs
that won us our men and victories in the late national unpleasant-
ness? "We are coming, Father Abraham, ten hundred thousand
strong." Did not these words carry truth with them ? How they
thrilled even the dried bones of apathy! The emotions nerved the
delicate man to endure hardships where the less emotional man
with stronger physique succumbed, — on the march, in the field, and
(where the emotions manifest their greatest power for physical
weal or woe) in the hospital : where hope was gone men died from
trivial injuries, while the enthusiasm inspired by success or the hope
of seeing loved ones would restore men who were literally shot to
pieces.

Persons possessed of good education, "smart" people, people
whom we naturally look to, expecting from them great things,
those whose mental poise we would not think to question, are often
guilty of accepting memories of past sensations as evidence of
present conditions; for this is what these centrally initiated sensa-
tions are, — they are distinct memories of sensations that have been
passed over the nerve-track and have worn the track smooth. As
I stated before, in speaking of habit, by irritating the optic nerve

24 Original Communications,

by electricity or a blow we perceive light, irritating the auditory
nerve produces sound, and interfering with our pet, the fiflh pair,
after it has been for some time conveying painful sensations, will
often cause it to transmit those sensations again, even when the
irritation is not of a painful character.

You probably all will have patients tell you, as I have had them
tell me, that they always have a tooth filled twice, — once in the
dental chair, and then afterwards their mind calls up to conscious-
ness memories of the operation, and they live the time over again,
going through the whole operation, experiencing all the pleasant (?)
seusations.

These centrally initiated sensations may be distinct memories,
as I stated before, or vague shadowy memories of sensations partly
forgotten, or but partly or imperfectly received, or they may be a
combination of many sensations that have passed over the nerve-
track, not being exponents of any sensation.

As an illustration of the first class, I will give the experience of
a young lady of undoubtedly good education, but of slightly sesthetic
tendencies. At the institution where she was a student she with a
number of others formed a circle for testing their ability to endure
shocks from an induction coil. As the result of the shock she
received, she had a violent headache, and each day after that, when
they performed experiments in the class, she would have a recur-
rence of the headache, although nothing would induce her to take
hold of the handles again. Now, while it may be that the first
headache was caused by the shock (which I doubt), each succeeding
attack must have been caused by these centrally excited sensations,
as the electric current would follow the conductors as accurately
as the water will fiow through the water-pipes.

With the teeth, it is not always that an operation is painful,
but attention renders one hypersensitive.

Here it is again. Attention determines what we shall become
conscious of. The degree of consciousness of a sensation depends
on the degree of attention paid to it. John may be sick while con-
templating the unfinished task, while base-ball means changed con-
ditions and occupied attention. The more our attention is called to
bodily ills the more we exaggerate them, while if something drives
self out of our minds we begin to improve. Does the metaphysi-
cian tell the dyspeptic to eat this and not to eat that? No: it
would defeat the object. He tells the patient to go about his or-
dinary employment and let the stomach alone. The stomach when
left alone will usually take care of itself. Poverty would cure

Sensation. — Whitefield. 25

maDj of the incurable invalids that can receive no good from their
physicians.

It is a well-known fact that many people are capable of self-
hypnotization, — that is, they surrender their entity to an idea,
just as to the hypnotized patient a suggestion of an idea makes that
idea real. Bennett mentions the case of a butcher who wished
to place a heavy piece of meat on a hook above his head ; he
slipped, the hook caught him by the arm, and he remained sus-
pended. He was taken down half-dead, his sleeve was cut open,
and, although he complained of great suffering, as soon as the arm
was exposed it was found to be absolutely intact : the hook had
only penetrated the coat-sleeve.

This novel case has a parallel in many bed-ridden invalids who
have been ill for years. Yes, I mean they are sick. These patients
received the class of sensations that they train their nerves to re-
ceive, which in turn so modifies their structure that organic struc-
tural change takes place. Such patients are more to be pitied than
those who are ill from structural change without the modified nerve-
action, as in one case when the cause is removed the nerves resume
their normal action, while in the other the pathological condition
is due to perverted nerve-action, produced in turn by the will of
the patient governed by attention, — ^victims of ideation due to sug-
gestion.

I know that I am laying myself open to harsh attacks by those
who are really sick, but such sickness is due to the same causes
that produced burns, etc., in the following subjects of hypnotic ex-
periments, except that these patients are their own hypnotists.

Charcot, at the Salp^tridre has produced the effect of burns on
the skin by means of suggestion.

During a seance Bourron and Burt, professors of the Bochefort
School, have produced blood-sweat by suggestion. On one occasion,
after one of these experimenters hypnotized the subject, he traced
his name on the subject's arm with the blunt end of a probe, and
told the patient that at four o'clock he would go to sleep, and blood
would issue from the lines on his arm. The subject went to sleep
at the time, and the letters appeared in bright red lines with an
occasional minute drop of blood. This subject in a spontaneous
attack of hysteria commanded his arm to bleed, and soon after the
cutaneous hemorrhage just described was displayed.

It is also well authenticated that any part of the body of a hyp-
notized patient may change in volume, simply owing to the fact
that the patient's attention is fixed on that part. This influence

26 Original Communications.

may be exerted in byperexcitable subjects by the simple phenom-
enon of ideation on the vaso-motor centres.

Disease in emotional people is not as often imaginary as due to
the imagination. It is the physiological excitement of peripheral
sensations till habit is formed and disease results, and it can be
combated by the nerves that caused it.

Expectation — faith — will cause that change to take place. It
may be faith in the physician, faith in prayer, change of climate or
surroundings: the patient's attention must be drawn from his
trouble.

It is not the object of this paper to attack any beliefs, — ^it is
simply to call attention to laws of nerve-action.

I will state, in closing this long paper, that persons of highly
sensitive nervous temperament do not possess that quality of level-
headedness requisite to put their sensations into the mental balance,
testing them to know for a certainty whether they are initiated at
the cerebral end of the nervous system or are received by way of
the senses, doubting even the evidence of their senses until their
reason confirms the sensations. In fact, unless such persons are
possessed of mental attributes that even a person of a wide mental
range is often deficient in, — ^viz., the ability to weigh thoroughly
all sensations received, giving just value to all by the aid of the
reason, rejecting the spurious or imaginary sensations, — in fact, sub-
jecting all sensations to the crucial test of mental analysis, — if, I
say, such persons do not possess those mental abilities and use them,
they will constantly be liable to deception.

Massachusetts State Dental Society. 27

Reports of Society Meetings.

MASSACHUSETTS STATE DENTAL SOCIETY.*

BRIDGE- AND CROWN-WORK THIRTY-FIVE YEARS

AGO.

BT D. C. E8TXS, B.D.S., LAKE CITY, MINN.

Without circumlocution, and with a desire to tax the time of
this convention as little as possible, I ask your attention to the
following very briefly stated facts :

In 1853 I was a student in the dental office of one Dr. Dumon,
in the city of Albany, N. Y., and, after a few months of study and
practice, was able to do about all the mechanical work connected
with the office.

My preceptor was a skilful operator, a very close-mouthed,
shrewd business-man, and had, for those days, a large practice.
He advertised very extensively, and often boasted in the press of
the amount of work he was doing; and in consequence of this
course he was, so to speak, an isolated dentist, having but little com-
munication with the local members of the profession. In the inser-
tion of artificial dentures he was as proficient and as successful as
any man I have since known, and resorted to about all the methods
known to the profession of to-day. What is now known as bridge-
work I know he practised, for the mechanical part of the work I did
with my own hands, he alone directing and doing the adjusting. I
supposed the method was common, and gave it no more attention
than other kinds of work, and it was some years after I left his
office that I learned that it was, perhaps, original with him.

Some three years after this time I became intimately acquainted
with Drs. Douglas, Wood, and John Austin, who were then prac-
tising in Albany, and I made the method known to them. I am
quite positive that Dr. Austin did some work of the kind, and per-
haps the others did. All these men, together with my old preceptpr,
have, I believe, long since passed away.

I will take time to describe only two pieces of bridge-work

^ Semi-annual meeting, Boston, June 6, 1889. The printing of the proceed-
ings has been unavoidably delayed on account of non-receipt of papers.

28 Reports of Society Meetings.

which was done in this office. I do not remember what name he
gave the work, — probably no particular name.

First Case, — The insertion of the right inferior cuspid and the ad-
joining bicuspid. The root of the cuspid remained, while the bicuspid
had been extracted. The root was first carefully treated, drilled,
and shaped, an impression taken, models made, dies cast, and a
gold plate about one-quarter of an inch wide swaged to fit over root
and all. Then a hole was punched in the plate directly over the
root-canal, as indicated by the impression, a gold pivot inserted and
firmly soldered. A short clasp to partly grasp the second bicuspid
was then attached, after which the trial was made, and the articula-
tion perfected in the usual manner. Common, plain plate teeth were
then backed and soldered to the plate or bridge. The final adjust-
ment was accomplished by partially filling the root-canal with amal-
gam and pressing the pivot and plate firmly into place. Just above
the gold clasp, on the second bicuspid, a cavity was drilled, and a
projecting gold filling inserted to keep the clasp and that end of the
plate firmly and permanently in place. This job was a beautiful
piece of work, and, as far as I know, successful in every respect.

Second Case, — A young man had had the two central superior in-
cisors knocked out and the two laterals broken ofPl The roots were
excised, nerves extracted, drilled, and otherwise properly shaped,
and then, as in the first instance, a bridge or narrow plate, with
metal pivots, constructed and inserted precisely as in the preceding
case, only there were no clasps on the adjoining teeth. The metal
pivots were slightly notched, but not, strictly speaking, barbed,
though answering the same purpose.

I now pass to consider the methods practised by my preceptor
for the insertion of what was then termed pivot-teeth, but was
really crown-work then as much as it is to-day.

In the first place, every root was thoroughly treated and medi-
cated, no matter what the time and labor required. Creosote was
his great medicament, and in his hands appeared to be really a spe-
cific, for with it be cured all ulcers, so that, after the insertion of a
pivot, no evil effects were discernible. The thorough preparation
of the root was the secret of his success, for to solidly attach th«
crown was much more easily accomplished. The same for many
years has proved true in my own practice.

Both wood and metal were used as pivots, which were cemented
in place with either amalgam or gutta-percha, or what was then
known as " HilFs stopping." To use the latter, the pivot was well
warmed and enveloped in it, and while in a soft state inserted in

Massachusetts State Dental Society. 29

the prepared canal of the tooth, and then pressed or driven home.
In case of a badly-decayed root, all the carious parts were first re-
moved, then the root properly medicated (ulcer cured) and drilled,
after which a temporary polished brass pivot was inserted. Around
this, amalgam was firmly packed with fine instruments, and the lost
parts of the root built up until a firm base for the crown was secured.
The slightly-projecting end of the temporary pivot was covered over
with gutta-percha or wax, and the patient dismissed until next day,
when the brass pin was removed, the root further shaped, and the
crown finally adjusted with wood or metal pivot.

In cases where a thin tooth was required, on account of the
peculiar occlusion of the antagonizing teeth, a gold cap was fitted
over the root, a pivot soldered to this, and a plate tooth attached
to the cap and then inserted in the same manner as described for
bridge-work. I have practised this method myself and found it
successful. Of course, all will remember that thirty years ago, and
even later, all our crown- work was confined to the incisor and canine
teeth, while we have at present crowns adapted to teeth with more
than one root. However, before these were known, more than
twenty-five years ago, I inserted my first artificial crown on a
plurality of roots.

The roots of the first right superior bicuspid were drilled and
shaped for base of crown, then a gold cap, as described above, was
properly fitted, into this two metal pivots, corresponding exactly to
the position of the two root-canals, and then a bicuspid plate tooth
was backed and soldered to the cap, and finally adjusted in the usual
way. I knew this case to have lasted more than twenty years,
when I lost track of the patient. I have never since been able to
do a more perfect piece of work, even with all our so-called modern
improvements ; and I may say that I have never seen a more service-
able job from the hands of any man. This, remember, is said for
the method, and not the operator.

In conclusion, let me say that long ago I ought to have made
the above facts known to the profession ; but having six years ago
lost all memoranda, all records, and most of my worldly effects by
fire, I became, foolishly perhaps, completely disheartened, and re-
solved to lay aside the pen. Wiser resolutions, however, have pre-
vailed, and now, with sight, nerves, and muscles unimpaired, I will
join in with any young man of my age in the profession for a right-
down lively race for the dental perfection. And Grod grant that we
may not be called to cross the bridge and to receive the crown until
we have fully attained unto this perfection.

30 Reports of Society Meetings.

HEALTH IN THE OFFICE.*

BT H. B. NOBLS, D.D.S., WASHINGTON, D. 0.

Since health is the comeivBtone of all good work, either of body
or mind, we venture on a few suggestions as to how this may be se-
cured in our office-surroundings.

Pure, fresh air is of prime importance to health, yet how little
value seems to be attached to it, if we may judge from the close
unhealthy atmosphere of many of our dental operating-roomSy
charged with the concentrated emanations from iodoform, creosote,
and half a dozen more ill-smelling compounds, and mixed with the
perfumes of dead pulps and foul teeth. Though the operator may
exist in these improper surroundings for a long time, yet nature,
insulted by such treatment, finally rebels, and protests in the form
of headaches, backaches, weakened eyes, and the like.

To secure a healthy office we must have good light and good
ventilation.

In regard to light, north, south, and east each has its advantages
and disadvantages.

The north is a clear, steady light, but is not strong ; and in the
short winter months and cloudy weather its defects are clearly seen
and felt.

The east is a good morning light, but is weakest in the closing
hours of the day, just when one is tired and wants the best light
possible.

A south light is the strongest and longest, and, if properly regu-
lated by white curtains in the middle of the day, the best.

A west light should never be chosen if either of the others can
be had, as it will be weak in the morning and bad in the afternoon,
even if you are protected from the direct rays by a necessary curtain.

The dental operating-room should not be a small one, or a box
partitioned off from an ordinary room, without apparent thought of
air or ventilation. This condition of affairs is often seen in our large
cities, sometimes several of these " stalls'' being found in one end
of a room. On the contrary, the operating-room should be of good
size and separate from the parlor, or anteroom. The laboratory

^ Read at the Beini-annual meeting of the Massachusetts State Dental So-
ciety, Boston, June 6, 1889.

Massachusetts State Dental Society, 31

should be a commodious, light, Bunny room, not the little back
pantry-closet or dark, damp cellar often seen.

Sun and air must be had if either good health or good work is
expected.

Then have all medicines in glass-stoppered bottles, in a case, so
as to keep the office as free as possible from disagreeable odors.

It is not at all necessary to have one's office, instruments, or
person so saturated with creosote and iodoform as to advertise
one's calling. This is neither gentlemanly nor agreeable. No pro-
fessional man is so likely to neglect proper exercise as the dentist,
with his tired back calling him to the lounge or easy-chair ; but air
and exercise must be had, either by riding, driving, or walking. To
this end it is well to have the office separate from the dwelling,
so that in walking back and forth the eye may be allowed to take in
fresh scenes and the lungs fresh air, thus refreshing both mind and
body.

DISCUSSION ON DB. NOBLE's PAPEB ENTITLED " HEALTH IN THE OFFIOE.''

Dr. Geo. F. Waters. — Some time ago I tried to solve the question
as to which was the best kind of light, whether the direct or the
reflected rays of the sun. The first thought that came to me was,
What action does sunlight have on the body ? I had a doubjp con-
vex lens, silvered on one side, and with this I discovered that a ray
of sunlight striking on my hand or foot gave tonicity to the body ;
it caused a contraction of nerve-fibres. After discovering this, I
mentioned the matter to a medical friend of mine, who was rather
sceptical, but still open to demonstration. I told him to take the
glass and get a focus, so that he could see the action of the iris. He
held the glass, and with a mirror I threw the light on the back
part of his head. I threw it on his hand, and he said, *' I think I
can see some of that light.'' I took a book, and thoroughly pro-
tected his eyes with it, and he found that whenever I threw the
sunlight upon the surface of his body the action of the eye told it
at once. I have come to the conclusion that sunlight upon the skin
— exposed a long time— causes arterial tension. This brings on
headache and meningitis, — sunstroke, which is nothing more than
apoplexy, — relief from which is obtained by bringing the blood
from the brain back to the heart. I concluded that for my eye a
north light would be best. I experimented some with some tad-
poles that were just hatched out, — little fellows, — and part of them
I put in a closed vessel with some plants, and set it in the sunlight.
A similar vessel, filled in the same manner, was placed in the north

32 Reports of Society Meetings,

light. Both vessels were filled with the same kind of water ; and
the result was that the tadpoles that were placed in the north light
grew to be very large fellows, while those placed in the sunlight
became frogs while they were veiy minute, — ^perfect frogs, only
one-half inch long. That was the tonicity of the sunlight con>
tracting the cells.

Dr. J, N, Crouse, — Are you sure, doctor, you had the same
species ?

Dr. Qeo> F. Waters, — ^There was no doubt about it. My reason
for selecting the north light was that, in a majority of cases, when
persons use light on their work they prefer the north light. It is
the case with engravers. They never allow the sun to shine upon
their work, but want the reflected north light. The essayist's idea
of the size of the room is good, although I do not care to have a
room so large that any number of persons, who are not interested
in the work going on, can press in and crowd upon the chair.

Dr. V, H. Jackson, — ^The doctor did not tell us what effect the
sun shining upon the hand had, — how it acted on the iris.

Dr, Waters, — It acted on the iris so as to contract the pupil.

Tuesday^ June J^ 1889, — Evening Session,

The evening session was devoted to a lantern exhibit by Dr. W.
Xavier Sudduth, Philadelphia, illustrating " The Nature of Forma-
tive Cells."

DISCUSSION ON DR. SUDDUTH^S LANTERN EXHIBIT.

Dr, B, B, Andrews, — I am somewhat familiar with these different
processes, as you know, and I must say that I never saw such a fine
exhibition as the one given to-night. It is something we may re-
member all our days, and my only regret is that we have not the
room full of physicians as well as dentists to appreciate this work.
The coloring of the slides is another important feature : it rests the
eye. Some of them are opaque and not clear, but with a little more
careful work could no doubt be made quite as clear as the others.
I think it is an improvement on our old method of preparing them.
There is only one fault in it that I see, and that is, you have to take
a section that covers the entire field.

In my appreciation of the work I feel much as an old gentleman
did some years ago. His son asked his advice regarding some
matter, when he answered, " I cannot advise you, — ^you are out of
my reach." Dr. Sudduth is so far out of the reach of most of us
that all we can say is a good Methodist "Amen."

Massachusetts State Dental Society. 33

Another point of interest and importance was the slide showing
the vascular supply of the pericementum and of the pulp of the
tooth. They are more intimately connected than we generally
suppose. I had taken for granted, as I presume every one here
has, that there was an arterial supply of considerahle size that went
into the foramen of the tooth, — some to the pericementum, and
some to the pulp. From the showing, however, it seems that we
have to proceed through a third party when we speak of inflamma-
tion of the pulp producing inflammation of the pericementum. I
suppose the nervous supply is made up in a similar way ; conse-
quently, it is easier now to understand how the peculiar sensitive-
ness of the pericementum from the irritation of the pulp occurs, and
why the irritation so quickly projects itself into the pericementum.

Dr. W. X, Sudduth. — I will add, that, if you will take ground
sections of oat's teeth you will find out how many foramina these
teeth have for vascular supply. I once had a case in practice where
a central incisor was lost because of pericemental absorption, caused
by an application of arsenic in the root-canal. After the root was
prepared a crown was placed on and worn for two weeks, after
which time the patient came back and had the root removed. I
found considerable absorption of the root. I studied it carefully,
and found a large foramen on the side of the root. It was through
that foramen the arsenic had passed out and given rise to the
trouble. In studying the anatomy of teeth, and of which we do
not do enough, you will find many of these points brought out.
It is important that students should be made to have a good knowl-
edge of the anatomy of the teeth, for when they get in practice then
they have little time for study.

Dr, (7. jT. StockwelL — I wish to add my personal emphasis to
everything that has been said in the way of appreciation of this
lecture. There was one thing that constantly ran through my
mind, and that was, *' Function precedes organism." I wish to ask
Dr. Sudduth if he has any criticism to make upon that scientific
postulate. It seems to me that in a general sense it has an immense
physiological meaning.

Dr. Sudduth. — If you mean that there is flinctional activity be-
fore there is organization of tissue I should say no, because all
tissue is organized in one sense, but if you mean that functional
activity exists before organs are developed, then I should answer
yes, as many forms of life perform function without any regularly
developed organs.

Dr. H. C. Merriam. — Some years ago I was interested in this

8

34 Heports of Society Meetings.

subject, and I got the impression very strongly that fbnction,
according to Spencer, was not only a determining cause of structure,
but that function preceded it.

Dr, Sudduth, — Only in so far as it is revealed in hereditary
tendencies. Each individual cell has in it the principle that will
cause the development of organs or, in other words, organisation.

Dr. Andrews. — In health or disease I

Dr. Sudduth.'^AcQording to the hereditary tendency of the
pre-existing cell, or according to the peculiar influence, normal or
pathological, which surrounds the developing tissue. Cells as well
as individuals are subject to environment.

Wednesday J June 6, 1889. — Afternoon Session.

NEW PBEPARATIONS.

Dr. W. X. Sudduth. — ^In my contact with the manufacturers, I am
always on the look-out for new points of interest to the dental
profession, and a year ago I presented to you an article, the silico-
fluoride of sodium. It is non-poisonous, and can be given internally
in doses of from Ave to ten grains three times a day without any
injurious effect. That it prevents acid fermentation is also an estab-
lished fact. Since I presented it, a year ago, it has been in constant
use by the manufacturers of syrups for soda fountains, as it keeps
them perfectly sweet. Lately, there has been a successful effort
made to prepare them in tablet form, and, by the addition of the
essential oils, to prepare a substitute for carbolic acid for use in the
mouth. These now come in tablets, so that one dissolved in two
ounces of water gives you the right strength to use as a stimulant
antiseptic mouth- wash. This is a very convenient form for use.
They can be procured from H. K. Mulford & Co., of Philadelphia.

PRESENTATION OF NEW INVENTIONS.

Dr. Horatio C. Merriam. — The Ives Dental Syringe (C. F. Ives,
M.D.S., New York City). — The special feature in this is the im-
proved packing. Instead of its being made like the ordinary
syringes which makes it so difficult to use acids or any strong
medicines, this has a piece of hard rubber with a feather edge, caus-
ing it to perfectly fit the barrel, which is carefully ground. Strong
acids nor any of these medicines have any action upon it. The
points are made of platinum and iridium, and the syringe is appli-
cable for all purposes where a small syringe can be used.

MassachiLsetts titate Dental Society, 35

Dr. W. H, Jones, Northampton, Mass. — New Forms of Excavators.

Dr. E. G. Blaisdell, Portsmouth, N. H. — Model of Instrument-
Solder. — ^The feature is that when the drawer is drawn out the
instruments, which cover a spring, are lifted into view. Upon
shutting the drawer the spring is pressed down and the instruments
are stored away again.

Dr. H. W. Gillett, Newport, E. I. — An Appliance for separating
Teeth to hold Matrices^ etc. — Also a bracket table to go on the S. S.
White bracket, which is large enough for a majority of instruments
used, — the excavators on one side, the gold-filling instruments on
the other, which shows what can be done in the way of getting
instruments into a compact and readily reached position. Another
appliance is a little instrument that will not slip, but hold the teeth
firmly in getting space. It consists of a small piece of piano wire,
with a thread cut upon it. One end is flattened, and on the other
end is a little nut. A small washer goes on the other side between the
teeth. It is a matter of considerable convenience, and in some cases
a very serviceable little separator. It is not applicable to cases
where it is liable to slip against the gum. That may be modified
by putting a little sand-paper washer under the nut.

Dr. Kirk A. Garland, South Boston, Mass. — Gas-Bracket for
heating Cases before soldering.

Dr. Horatio G. Merriam. — New Bracket and Socket Handle. — The
handles are not mine, but the invention of Drs. Perry and Darby.
We formed a club and had some made. They are very' strong, and
have a long taper. You will see the security with which the insti*u-
ments pass in. One turn tightens them. Many like this sort of an
instrument, and they are also suitable for holding a mirror where
you want a smooth handle.

The other is a new table, which I present to the profession. My
object was to secure a table of plain and substantial workmanship,
where the expense of manufacture was gotten rid of largely by
avoiding all curves and ornamentation, and also in such a way that
it gives the most space for the handling and working of instru-
ments. It works from two sides. The drawers can be divided into
halves, — one part being a receptacle for instruments used in prepar-
ing the cavity, — and by pushing it in and out of the way you have
brought out on the other side the instruments necessary for filling
or finishing the cavity. The covering of the table is of fancy
paper, — shellaced. This can be kept clean by wiping it ofl^ with a
sponge. The lower drawers are made for burrs, etc., but these can
be improved so as to hold a larger quantity.

36 Reports of Society Meetings.

I am just making some Btudies upon a subject entirely neglected
by the profession. As far as I learn, very few dentists have made
a study of files for the profession for use in an anatomical way.
My object is to find a file ^hat I can use at thie cervical wall, having
a safe border which can be rolled back and forth without injuring
the gum or rubber dam, and made of such a quality and workman-
ship that they will be serviceable instruments to us. These files
are now rights and lefts, but I am having other forms made. These
are professional files, — for the profession, and never will pass into
the hands of combination dealers. They are placed outside where
all can have an equal opportunity for enjoying their manufacture
and sale. If you think the files I have given you are of service to
the profession, and you can make use of them, and also the .table, I
shall be glad to have you accept them.

Dr. B. H. Teague, Aikin, S. C. — The impression material I have
here is a compound I have used for the past ten years. The advan-
tages are that it is fragile,— easily broken from the mouth, and of
great benefit in taking impressions when overhanging teeth make
it difficult to remove the ordinary material without destroying its
shape. It is a material you can cast melted zinc into by making a
proper mould. This can be done by encircling the impression with
an iron ring, and pouring sufficient of the material around it to form
a mould. It is a splendid material for soldering bridge-work. It
is also very easy to detach the impression from the plaster cast.
This impression was taken from a model I had made to construct a
set of teeth upon. With the exception of one or two little breaks
the impression is quite ready for another case. This material is
patented.

This appliance — an arm-rest — has been in use for at least five
years, and it has proved an infinite source of satisfaction to myself.
Many times I have been tired out in operating, and I could find no
help for it unless I put half of my body on the chair, or encircled
the head of the patient, or had a head-rest that resembled a pulpit
mare than it did a dental chair; so I devised this fixture, which is
swung from the ceiling, or wall, and by slipping my arm through it
and resting my body upon it at times, it is a great source of relief.

Another thing, in operating for a great many sick people, as I
have to in Aiken, I find that I get too near them, for their breath
is often very offensive, and this enables me to get a little farther
from the head of my patient, and at the same time hold my hand
and arm steady. An additional advantage is you are able to make
examinations of ladies' mouths without troubling them to take off

Massachusetts State Dental Society. 37

their hats. It is very easily arranged and you can slide it up and
down, and when a person learns how to use it he will never be
without it.

OLINICB. — ORAL BUBQEBT.

By Br, G, L. Ourtis, Syracuse, N. Y. — 1. Removal of Necrosed
Bone due to Alveolar Abscess, — The patient, a young man, had two
superior central incisors pulpless and abscessed, and for whom a den-
tist had practised immediate root-filling. A fistula led to the apex
of the right root, while the abscess of the left root was not indi-
cated by an external opening, and, in consequence, was styled a
*' blind abscess." The opinion of the operator was that there ex-
isted a subperiosteal opening leading to the fistula over the right
root. •

The operation consisted in passing a rose-head burr, of suitable
size, into the fistula, and following along its track into the excava-
tion in the maxilla, about half an inch in size. The dead necrosed
bone surrounding the cavity, including the sack attached to the
end of the root, was burred away, after which the cavity was care-
fully syringed with tepid water, and all dislodged diseased tissue
washed out. A few drops of aromatic sulphuric acid were then
injected into the cavity with the view of destroying any diseased
tissue remaining and stimulating the parts to healthy action.

The " blind abscess'' was opened into directly over the end of
the root by means of a spear-pointed drill, and the diseased part
cut away and treated as in the case of the right central. A twenty-
five-per-cent. solution of cocaine was employed, reducing the pain
to a minimum. The operation was completed in ten minutes.

2. Transplantation, — Patient, a boy thirteen years old. Five days
previous to clinic he foil, knocking out his superior left lateral
incisor, which was lost.

The overlapping gum was dissected away, and a spiral knife
used to cut out the granulations which filled the socket, which
was afterwards cleansed and sterilized. The tooth, which was
previously prepared and sterilized by Dr. Fillebrown, was then
placed in position, and retained by means of clasps attached to
approximating teeth. The gum surrounding the central incisors
was much inflamed and the teeth quite loose and tender to pressure,
consequent upon the original injury.

3. Dentigerous Cyst, — Patient, a man twenty-seven years of age.
The lesion was due to the non-eruption of an inferior right cuspid.
The case was mistaken and treated for alveolar abscess six weeks
previous to the clinic, which operation consisted of simply lancing

38 Reports of Society Meetings,

the gum over the tumor. The tooth was fouud to be parallel with
the jaw, deep in the substance of the bone, and around it the
alveolar wall was necrosed to a considerable extent, the disease ex-
tending past the symphysis as far as the left cuspid, where an open-
ing appeared in the gum. Between these points (the right second
bicuspid to the left first bicuspid) the soft tissues were completely
detached from the jaw, and, to a marked degree, hypertrophied.
The patient experienced no pain from probing while the case was
being demonstrated.

4. Bridge- Work, — Dr. Curtis demonstrated his removable bridge,
the model being a bridge composed of the superior left second
bicuspid and first molar, attached to the first bicuspid and second
molar. The attachment was by an arm extending from the second
molar and first bicuspid over which a sleeve, attached to the bridge,
was slipped, and which locked the teeth together and prevented
movement. The case is fastened by chloro-percha, and is not in-
tended to be removed by the patient. It can be kept as clean as the
full soldered bridge, and a marked advantage is, it can be applied to
teeth in any position, and does not necessitate the cutting away of
the teeth until the walls are parallel with each other. The bridge
was well made, and admitted by all to be the most complete and
practicable of its kind now in use.

Dr, Thos. Fillebrown demonstrated the quick preparation of
proximal cavities without separation, using a left superior central
for the purpose ; also a superior method of attaching the rubber
dam.

Dr. T. S, Parramorej Hampton, Ya., demonstrated his method
of capping with sterilized sponge, the case being an inferior right
lateral incisor, so far exposed that the nerve could be plainly seen.
The sponge was applied, and the cavity filled with oxyphosphate.
After allowing six months to elapse the oxyphosphate, excepting
a thin layer over capping, is to be removed and gold substituted.

Dr. S. C G, Watkins, Montclair, N. J., gave a clinic, the opera-
tion being the filling of an inferior second molar with copper amal-
gam, using his trimmers and special instruments.

Dr. W. H. Pomeroy^ Gloucester, Mass., filled a right superior
molar, masticating surface, by a method similar to Herbst's, and
using soft pellets worked by his patent mechanical engine mallet
and smooth burnishers.

Dr. J. F. Adams, Worcester, Mass., demonstrated a method of
filling and contouring by means of hand-mallet, using Williams's
crystalline gold, the case being a superior left canine tooth.

Massachusetts State Dental Society. 39

Dr. &, L. Chewningj Fredericksburg, Ya., exhibited a model of
fracture in three places of the inferior maxilla that had been suc-
cessfully treated by him. The feature was, to take the impression
while holding the parts in their normal position instead of securing
the impression as the fracture exists, and then breaking the cast
and adjusting to the proper relation.

Dr. G. C. Carroll^ of the Carroll Aluminium Manufacturing Com-
pany, New York City, exhibited and demonstrated practical cases,
artificial as well as crown- and bridge- work, made of aluminium, and
also introduced a non-cohesive aluminium foil, new to the profession,
for the purpose of filling teeth.

Dr. V. H. Jackson, New York City, exhibited a large number
of models of cases of irregularities that had been successfully cor-
rected by him by means of his various appliances for the purpose.

Dr. Joseph E. Waitt, Boston, Mass., demonstrated a method of
making mouth-mirrors by which the cost was reduced to a mini-
mum. It consisted of making three dies, each with a round
hole, the first for shaping and the others for finishing the backing
for the mirror, which backing is made of German silver and stamped
into the die by a steel mandrel. The mirrors are cut by a diamond
glass-cutting machine, and cemented into the backing. This method
is not patented, and was exhibited for the benefit of the profession.

Dr. Waitt also exhibited a nitrous oxide light for use in making
photo-micrographs and also as a light for stereopticons.

Mr. E. T. Wetzel, Basel, Switzerland, illustrated his manner of
winding springs from piano wire for dental engines and other
purposes.

Dr. 8. S. Stowell, Pittsfield, Mass., demonstrated his method of
making and setting crowns. The root is prepared in the usual
way and the pin and cap of metal carefully measured and adjusted.
The pin in the crown, if it be a Logan, is next cut off, with the
exception of a small piece that is allowed to remain. The crown
is next ground and fitted to the cap over the root, after which it is
removed and gold melted into the undercut and around the pin,
the metal being spatted down while in a state of fusion, which
forces it to every part and produces a flat surface. The crown is
again ground to fit the cap, and afterwards soldered to it, thus pro-
ducing the most cleanly crown it is possible to make. It is ce-
mented to the root in the usual way.

Dr. George A. Maxfidd, Holyoke, Mass., showed an ingenious way
of making hard rubber corundum disks. The corundum grit is
incorporated with the rubber by being passed through a clothes-

40 Sq>orts of Society Meetings.

wringer (the qaantity of the mineral used iDfluencing the coarse-
ness of the disk), and, after being cat to the required diameter by a
mandrel for the purpose, they are vulcanized, being strung on a
fine wire, the diameter of the engine mandrel, and separated from
each other by a small circular piece of tin, the whole encased in a
clamp to press and hold them together. A great many can be
made at one time, and at a cost that is not worth mentioning.

Dr. A. RitteTy ITtica, N. Y., exhibited an engine standard of his
own construction, the propelling power being furnished by a one-
tenth horse-power motor. This was covered with a box which
greatly reduced the noise, and was controlled by a switch that
would start and stop it instantly. The cable could be detached at
will and any other light mechanism run in its stead. The contri-
vance also included a fan and a corundum wheel for grinding, all
running at the same time. It was an ingenious arrangement and
invaluable in the many advantages it contained. The motor can
be run by power from a street wire.

Dr. A. H. Brockway, Brooklyn, N. Y., demonstrated a method of
applying the rubber dam.

Dr. W. S. Elliot, Hartford, Conn., exhibited a new rubber-dam
holder and separator. Simplicity and efficiency are qualities always
desirable in any instrument or appliance that is called into daily
use. Among those that seem to be capable of improvement is
the rubber-dam holder. The well-known Cogswell instrument has

served exceedingly well a general purpose ; but to smooth out the
wrinkles and folds of the dam something different was needed, and
this need is abundantly supplied by a new device, of which the cut
is a fair representation. The dam is first adjusted to the teeth, then

New Jersey State Dental Society, 41

over each cheek, the folds are smoothed out, and while the spring
of the holder is slightly compressed the rubber is made to stretch
over the rings at the ends of the wires. Upon releasing the spring
the rubber is caught and held firmly as the braid is passed over and
adjusted behind the head*

The exhibition of goods by the dental dealers is deserving of
special mention. An arrangement of this kind has a twofold and
mutual benefit, the society being able to examine in one building
the latest novelties and appliances of interest and use to the pro-
fession, while the dealers have the advantage of reaching a large
number of men at one time. The present exhibit was fully in
keeping with those of former years, and the executive committee
are to be congratulated on the success that attended their carefully-
laid plans and unremitting efforts.

NEW JBBSBY STATE DENTAI^ SOCIETY.

DISCUSSION ON PROF. HATB'S PAPER ENTITLED " THE WASTE PRODUCTS

OP THE BODY."

I>r, Sudduth, — ^Mr. President, the paper that Professor Mayr has
given us has been intensely interesting to me. But to some of you,
perhaps, what has been said is more or less Grreek. You may have
listened to his figures and propositions without a clear understand-
ing of what they indicate, or the exact meaning of the formulsB.
It is impossible for a man to grasp in its entirety the subject as

•

given here. Too much stress cannot be laid, however, upon the
value of such work as this. Yery often, in my practice, I come to
a practical application of my scientific studies in the examination
of the waste products of the body. We cannot too highly appre-
ciate the rapid advance that has been made in the past few years
in methods of making more accurate diagnoses. There is no longer
any need of making guesses as to whether a man has a good or a
weak digestion, or whether his nutrition is good or deficient, we
can locate the very point of the body where the lack of assimila-
tion occurs, make an accurate diagnosis, and administer medicines
which will act directly. A chemist of Professor Mayr's standing,
or any other man, whose life work has been in this direction, can
take the waste products of the body, provided he knows the diet

42 Reports of Society Meetings.

of the patient, hiB age, the time of day, and the quantity of urine
passed daily, and give you a very correct diagnosis of the disease
from which the patient is suffering. It has been done time and
again, and the result is as accurate as mathematics. The day of
accurate diagnoses is here. You should consult specialists in this
work. Dentists do not understand the influence and bearing that
this character of work will have in giving them accurate bases
upon which to argue and to build their theories. I cannot say too
much regarding the benefit that will come to the dental profession
from this line of investigation. I simply want to make this gen-
eral application of the technical talk that has been given you. But
bear away this thought, that the specialties of the specialists are
being brought to the highest state of perfection, and you want to
consult them in order to get a solid foundation on which to base
your theories.

Dr. V. H. Jackson. — There is a practical bearing of this paper
upon our work ; and as dentists we should search for what can best
assist us in our work. All dentists cannot make analyses of urine,
or understand urine analyses. Dr. Sudduth has very nicely ar-
ranged it for us, in turning the subject over to specialists. I think
it is proper that we should consult specialists. I spent three or
four months in each of two different courses of study in order to
prepare myself to understand this subject. It requires a long
course of study; and we should not deceive ourselves into the
belief that we can master the subject like our friend, Professor
Mayr. My suggestion would be to try to get the most benefit we
can out of the subject by dealing with the practical side of it; to
try phosphate feeding, and learn in what forms the phosphates are
best assimilated. Intricate cases, where there is pyorrhoea, I think
we should turn over to the specialist and let him determine it for
us. I would like Dr. Mayr's suggestions as to the most practical
method of feeding patients that are deficient in phosphates, and
how we can promote the hardening of soft tooth-tissue. I have
great faith in phosphate feeding.

Dr. Faught — The question resolves itself down to the control
of the whole nervous system, as one of the ways to build up the
tissues, as much as to administer the proper assimilable material.
If we can reduce the waste, we take a great step towards the build-
ing up of the tissues. The elimination of urea shows a breaking
down of the nervous forces, and the tissues and the phosphates
bear their portion of the loss. That being the case, dentists must
direct their attention to means of controlling their patients' mental

New Jersey State Dental Society. 43

forces. By controlling the nervous forces you will control the loss
of urea, and with it the elimination of the phosphates.

Dr. Idttig. — What portion of the wheat kernel is assimilable in
the body, — the phosphite or the phosphate ?

Prof, Mayr. — I think that where an albuminous substance is di-
gested and taken up by the system, the phosphate in combination
with it is also digested and taken up ; and phosphoric acid excreted.
If we could label the food that goes into the body, we would find
that the phosphoric acid that comes out is not the same that went
in. It is an old one, perhaps weeks old. The phosphate that is
excreted comes from the tissues that have been eaten up, and not
necessarily from the food that has recently been digested. The
phosphoric acid excreted is not much influenced by a meal that is
taken ; it depends upon the urea. By examining the urea excreted
by a man I can get an exact measurement of his mental energy ;
I can tell how much a man thinks in the next two hours after
eating.

The excretion of urea at different times, according to the activity
or inactivity of the mind, is very interesting. At midnight it reaches
the lowest point. About three o'clock the subject begins to dream,
and the excretion of urea begins to rise. Between three and' five
o'clock is the time for dreaming ; dreams cause thought, and thought
is expressed in the urea. Then the person falls into a quiet slum-
ber from five to six o'clock, and the urea falls. From nine to ten
o'clock there is hard work, and at twelve o'clock (noon), the urea is
tremendously high. It has been formed during the period of work.
The kidneys do not immediately excrete it, but -two or three hours after.
At twelve o'clock the man has his dinner. That does not require
much thought ; and so the quantity of urea found falls off during
the dinner hour. Two hours are taken for digestion, and there is
not much change. From two to five there is generally hard work ;
and at six o'clock the urea rises again, and keeps up until seven or
eight o'clock. At six o'clock comes supper; after which there is
sometimes a good deal of work done, sometimes there is not, but
the urea excreted will mark the energy expended.

The phosphoric acid excreted goes exactly parallel with the
urea ; showing that the phosphoric acid excreted is precisely that
acid which goes with the tissue from which the urea is made. I
think that is most conclusive proof that it is not the phosphoric
acid put into the system in the food. If it were, it would be high
after breakfast and high after dinner, which is not the case. The
phosphoric acid that we excrete is made from the tissue. The urea

44 Reports of Society Meetings.

is made from the brain, and is excreted in the kidneys. The uric
acid is entirely different. It has nothing to do with the urea ; but
has a great deal to do with the digestive process. The urea is
lowest after every meal ; the uric acid is highest after dinner and
after breakfast ; three or four hours after a meal it shows the high-
est. The salt, on the other hand, which is purely a waste product,
shows the influence of the meals in a most striking mciDner. In it
you can see exactly the speed of digestion. The excretion of salt
shows that it comes from the meals taken, and does not necessarily
come from the tissues of the body.

There are many other constituents of the urine that I have
omitted. I have made thousands of careful examinations, and
given this subject much study. I think there is conclusive proof
that the phosphoric acid we excrete is not the particular one we
take into the system in our food. The phosphoric acid which we
take in as phosphate has to be worked over, and the phosphate
excreted is ^m the tissue burned up.

Dr, Suddyth, — It was stated, in the discussion on the treatment
of the teeth during pregnancy, that pregnant women crave lime
and chalk ; and the question was raised whether it was the phos-
phate or the phosphite that the system demanded and assimilated.

Prof, Mayr, — I should say the phosphate ; because the phosphite,
as a distinct chemical compound, is not found in the body.

Dr. Rhein. — In connection with Dr. Sudduth's question; I would
like to ask Professor Mayr's opinion about the action of a prepara-
tion that has been very widely recommended, — that is, in regard to
the various compounds of hypophosphites mixed with lime and
other ingredients. I have heard it claimed that the phosphates
and lime salts were assimilated when taken in that way.

Prof. Mayr. — I have made experiments on that subject; and
there seems to be proof that the phosphates, etc., are excreted just
as they are taken in. By analysis you can recover everything
again. The hypophosphites appear mostly as phosphates, but not
altogether. A certain amount seems to pass through the alimentary
canal as hypophosphites ; but they do not seem to be assimilated.
When five grains of phosphate are taken five grains will invariably
be excreted in excess of the ordinary proportion. The administra-
tion of hypophosphites seems to have a good influence in certain
cases of defective digestion. They act merely as a tonic, such as
the subnitrate of bismuth.

Dr. Meeker. — Is the preparation called " Horsford's Acid Phos-
phates" excreted in the same form ?

New Jersey State Dental Society, 45

Prof. Mayr, — It is excreted, as a rale, in the form of phosphoric
acid. It is a mixture of pyro- and ortho-phosphoric acids.

Dr, Meeker, — Is not a portion assimilated ?

Prof, Mayr, — ^In my opinion it is not ; not the least particle of it.

Dr, Thayer, — Did you ever test the urine of persons whose
bread foods are confined entirely to the products of unbolted wheat
flour and compare the results with those obtained in cases where
the bread food had been made of fine flour only ?

Prof, Mayr, — Not sufiiciently to form any definite conclusions.
I do not always have the right subjects and circumstances for such
tests. I have made tests in cases of vegetarians, those who avoid all
kinds of meat, and the ratio is the same. It makes no difference
whether the person is a beef-eater or a bean-eater ; the results are
the same.

To make such investigations of real value, the total urine voided
in a day should be mixed and the examination made from that.
The weight of a person does not bear any relation to the quantity
of urea excreted. A short person with an active brain bums up as
much or more than a tall and sluggish person. I have made care-
ful examinations in persons where violent exercise had been taken ;
and, on the other hand, of persons who did not exercise much but
thought a great deal ; and I found that the man who thought beat
the athlete in the production of urea by long odds, although he was of
lighter weight. The athlete evidently used up the fatty constitu-
ents more ; the other one did not assimilate the same amount of fat,
and did not care for it, but he burned the saccharine constituents
and the nitrogeneous tissues.

Dr. Stockton. — Where there is waste of the tooth-structure from
some cause, can that be remedied by taking a particular kind of
food to supply that waste?

Prof. Mayr. — Certainly. My opinion is that it can : but the food
has to be prepared in a form in which it is naturally and normally
taken. One person won't eat bread ; another person won't have
meat; or, if they take it, the digestive apparatus don't work it
right. Sometimes there is a defect in the stomach, sometimes in the
absorbent qualities; very often the food is not presented in palatable
form owing to bad cooking ; and sometimes they don't like, or will
not appropriate, a particular article of food. I think that bread
made of the entire wheat kernel is by far the best kind for supply-
ing the phosphates. There is a good amount of indigestible matter
in it; but the intestinal tract requires to be filled up; therefore
the waste matter is necessary. We do not want to live on the

46 Reports of Society Meetings,

most concentrated food ; we are not bnilt on that plan. The twenty-
two feet of intestine has to be filled up. Pig's feet, which contain a
great deal of gristle, are sometimes an acceptable food and sometimes
not ; veal, in various forms, is also ^ very good food. Yeal contains
a large amount of phosphates and formative tissue. I think chil-
dren are not usually given enough veal. It is considered a sort
of unripe meat; but children like unripe things; they are unripe
themselves, and unripe things are sometimes good for them.

Dr, lAttig, — It was stated that the urea was made by the brain
and excreted by the kidneys. Is it not elaborated in the kidneys ;
not excreted there ?

Prof. Mayr, — My conclusion would be contrary to that : unless
we suppose the kidneys were closely occupied with the thinking
process, and that the brain is only an appendage of the kidneys.
Urea circulates in the blood ; and you purchase it in the stores as
extract of beef, which is concentrated urine. It contains some salts
that are very valuable, as creatine and creatinine ; both are found in
the muscular tissue which we eat. It is excreted, apparently, in the
same quantity as taken in. It has a very pleasant taste, and stim-
ulates digestion. The process of carrying the urine and its salts
and filtering it through the epithelia of the kidneys is a very com-
plicated one. I do not think the kidneys manufacture anything, in
any important sense. They may contribute towards the formation
of uric acid, or some of the less known constituents of the urine.

Dr, Rhein, — Judging from the scale you have on the black-board,
is it not a good, practical conclusion to come to, that where exami-
nations are made for the purpose of determining the existence of
pathological conditions, it is always necessary to make several ex-
aminations of the urine excreted at different times?

Prof Mayr. — Certainly. This scale was obtained by the exami-
nation of probably thirty specimens a day for several weeks.

Dr. Rhein You would not make a diagnosis in any individual

case from a single specimen ?

Prof Mayr, — Certain pathological products occur at all times,
and a general diagnosis may be obtained from random samples, but
nice work could not be so done. In the case of a man who sleeps
during the day and works during the night, the result would be
totally reversed. I could tell his work if I had a sample of his
urine and the time when taken.

Dr. Rhein. — I mean in pathological conditions ; would it not be
preferable not to depend on a single secretion, at a single hour?

Prof Mayr, — That is a point on which I have had to fight a

New Jersey State Dental Society, 47

good deal. Yery often physicians send me specimens of urine with-
out saying when it was voided, or how old the specimens were or
anything. Without that information it is very difficult to form an
intelligent opinion. In the morning the urine shows best the ex-
cretion of urea and salts and such things ; but it is not conclusive
in cases of diabetes and Bright's disease. In the evening, and up
to midnight the urine will best show those disturbances. In these
hours the disease is aggravated. Of course, an examination of the
urine voided every hour would lead to more reliable conclusions.

Dr. Bhein, — My plan is to take the morning urine, the mid-day,
and just before retiring, and make a comparison of the three speci-
mens. I would like to know whether that is sufficient to form
correct conclusions regarding pathological conditions ?

Prof. Mayr. — ^I think that would give a very fair idea.

Dr. Faught — Mr. President, I would like to state a case in
which I am much interested, and which has direct reference to
practitioners of dentistry. A dentist who worked very hard at
bis profession during the day, and mentally at night, for a number
of years, passed phosphates in large quantities through the urine.
He did not seem to suffer physically in any way from it, but in-
creased in weight. At that time an examination of his mouth
revealed no salivary deposits. After quite a long period the secre-
tion or elimination of phosphate through the urine ceased; and
then he immediately suffered fVom severe inflammation of the
kidneys, particularly on the left side. I thought that the condition
might be due to the vascular supply on the left side being different
from that on the right side. He also suffered immediately with
hemorrhoids and varicocele. Probably these conditions were ag-
gravated by his work at the chair. Albumen was found in the
urine in appreciable quantities. This condition continued for a
period of three to five weeks. At the end of that time the albumen
disappeared from the urine, under treatment; and immediately
upon his being pronounced well he began to throw off phosphates
in large quantities again. During the five or six weeks when he
was suffering from these troubles there was in his mouth a very
great deposit of calculus.

Prof. Mayr. — That is a very interesting case. He <' gained
weight." But what is weight in our bodies ? The greater part of
it is nothing but water. You often find that we increase in weight
while we lose strength. We pump water into our systems, but it
does not give us strength. Gain in weight is not necessarily a gain
in strength. In regard to the excretion of phosphates in the case

48 Reports of Society Meetings.

mentioned, I would ask what the figures were as to the phosphates
obtained ?

Dr. Faught. — I have no statistics in the case.

Prof. Mayr, — We have first to inquire whether it was really so.
The description of the case would seem to be indicative of a clog-
ging up, or diphtheria, of the tubes of the kidneys. It is quite
correct to say diphtheria of the kidneys. I have a case where
the kidneys refused to work ; and upon treatment with turpentine
there came violent spasms ; and I found in the first urine voided a
perfect tree of a]g»-like threads (plants), showing the ramifications
of the tubuli of the kidneys. It was a fungus which had grown
up in the tubuli of the kidney. The action of the turpentine
enabled the kidney to throw it off, and the patient was cured. I
think the case which the gentleman mentioned here might have'
been a case of that kind.

Dr, Peirce. — Yesterday we had very beautifully shown the effect
of over-work upon the teeth of young misses in the public schools,
and Professor Mayr has brought out a similar thought in regard
to mental work generally. I would like to have him speak more
at length in connection with those points.

Prof Mayr, — I do not think you will fail to agree with me.
The more mental work, the more urea is produced. Young misses
occasionally over- work, but a boy seldom over- works himself You
have this state of affairs: people while thinking are continually
burning up their tissues for the purpose of producing urea and
phosphoric acid. They excrete the phosphoric acid set free from
their tissues. They produce too much urea, and are therefore com-
pelled to excrete too much phosphoric acid ; because the propor-
tion of one hundred to eight is maintained ; therefore, as they can-
not think, and especially worry, without producing much urea,
they have to excrete a corresponding amount — the constant ratio
of one hundred to eight — of phosphoric acid. For every foot-
pound of thought you will have a given amount of urea excreted ;
therefore, as long as you keep the brain at work and make it per-
form so many foot-pounds of thought, you will have excreted so
many grains of urea. One thing is to control fretfulness. A
fretfulness that produces activity, but no actual results, causes a loss
of just so many grains of urea. Another wearing cause may be
intestinal parasites; or the limbs may be moving around uneasily,
caused by a tendency to epilepsy or St. Yitus's dance. A peculiar
fretfulness of the nerves produces work that is not work, but which
turns out urea just the same.

Odantological Society of Pennsylvania, 49

Dr. Jackson. — Are we to underBtand the doctor to imply that
phosphate feeding is not of advantage to the patient ?

Prof, Mayr. — My opinion woald be strongly against feeding phos-
phates pure, — that is, not in combination with the albuminoids, such
as are accepted by the body. The phosphate in wheat is actually
in such chemical combination. We have not been able to produce
that combination chemically. We have been able to dissolve it.
Take the phosphates away from the albuminous substance and it
becomes an entirely different compound. It is no longer soluble
in water. Dogs have been starved by feeding them on the cakes
from which the extract of meat is obtained. Those cakes were like
so much rubber, and the dogs starved on it.

ODONTOLOGIOAL SOCIETY OP PENNSYLVANIA.

Tax Odontological Society of Pennsylvania held its regular
monthly meeting in Justus Hall, November 2, 1889. A paper was
read by Dr. Ernest Laplace on fermentation.

DI80US8I0N ON PB0FE880B LAPLACX's PAPER.

Dr. Suddvth, — I would like Dr. Laplace to answer a few ques-
tions which will bring out points which may not be as clear in the
minds of some as they should be. First, I would like to know what
effect the ^'alteration of the soil" has to prevent the growth of
these germs?

Dr. Laplace. — I can only say that it is a fact which has been
observed from the time Jenner inoculated cow-pox against small-
pox ; but just why this should render the soil unfit for their growth
I am unable to say.

Dr. Sudduth. — Might there not be a slight change in the albumi-
noid substances of the body ?

Dr. Head. — Might not the weaker microbe act on the stronger
as a restraint ?

Dr. Laplace. — ^As an illustration, suppose two young men,
brothers, both in health, are exposed to the same infection. One
from exposure contracts pneumonia. After the one has recovered
from the pneumonia they are again exposed, this time, however, to
the germs of tuberculosis. The germs which before fell harmless on
the soil of each of their lungs now find suitable soil in the lungs of

4

50 Meports of Society Meetings,

the one who has had pneumonia, and take root and grow, while
they are still harmless to the one who has never had pneumonia.

I conld entertain you a good while with many of the experiments
of Pasteur. But as this one illustrates the point in question I will
relate it. Pasteur was told that a chicken could not be inoculated
with anthrax or splenic fever. In experimenting with the cultures
of the anthrax bacillus he found that, when grown, at a temperature
of 42° C, these germs were not virulent; but when cultivated at
37^ C, they were highly virulent to its growth. He then took the
temperature of a chicken and found it to be 42®. He then went
down to the Academy of Science, and took his chicken and a basin
of ice- water. He plunged thechicken into the ice-water until its
temperature was mitf^^fil^^MMs^en inoculated it. In twenty-
four hours the c^iricfceb was dead fro^o^M^thrax.

Dr. Kirk. — S|M)ose you have IreitfCea a tooth thus theoretically
antiseptically, land ibiM ttme-^VHr months or more afterwards —
there develops >hi Ihat i^^^tm • aliaipUu' abscess, then would you
say that there mi^^S^n^lafiL ih^^jpme germs, or, that the germs
had since been intrn^^tn? ^^"'^

Dr, Laplace. — We know that germs will travel through mucous
membrane through the stomata or little mouths of blood-vessels.
They may get there in this way or perhaps be carried direct by the
blood-vessels, in some diseased state of the blood, such as erysipelas
or pysBmia.

Dr. Faught. — Why does it select this particular tooth and not
another?

Dr. Laplace. — I can only give you the reason which I gave
before, that of lowered vitality. To have a correct idea of the
process, one must take into consideration the histology of the part.
When a part of the body is irritated by the germs, more blood is
sent to that part, and the white blood-corpuscles pass through the
vessel walls and attack the microbes, and, if in sufficient numbers
and strength, destroy them, and the part regains its health. If,
however, the germs are in too great numbers, they will gain the
upper hand in the deadly strife, and disease will follow. A Russian
pathologist, in looking at this conflict, discovered the microbe inside
the white blood-corpuscle, and from this fact named them phagoctfteSy
— the Greek to eat. When a great number of white blood-corpus-
cles have been thus destroyed by the action of a local irritant,
chemical or a living micro-organism, and are retained in that
special locality in a certain amount of fluid, we have the pathologi-
cal product commonly known as pus.

Odontological Society of Pennsylvania, 51

Dr, Sudduth, — Will the doctor give us some idea of the best
antiseptic, and how used ?

Dr. Laplace, — The first antiseptic used was carbolic acid. This
was discarded in favor of the bichloride of mercury, which Koch,
in 1882, found to be destructive to the life of the anthrax bacillus
in the proportion of 1-1000, — that is, in a watery solution of this
strength the germs would be destroyed. But when the mercury
was brought in contact with the albumen of the tissue of the
bodies, there was thrown down a heavy precipitate of the albumi-
nate of mercury, which rendered the solution inactive. When in
Koch's laboratory, taking a subject for special investigation, I un-
dertook to find some way to prevent this deposit and keep the
solution active. I took this deposit and planted therein the germs
of suppuration, and they grew and thrived, thus proving the use-
lessness of it where this deposit was. After a long series of experi-
ments, I found that by adding five per cent, of acid to the solution,
I had not only solved the question of preventing the deposit, but
had rendered the solution much stronger and efficacious.

Dr, James Truman, — Prom the time when Senwenhoeck, in 1680,
found that yeast consisted of globular particles to the period when
Schwan and Latour independently proved them to be vegetable
cells, was a period of less activity than that which followed ; yet it
was the commencement of that greater work that has been so
prolific in results in more recent times.

The views of Schwan naturally led to opposition, and Leibig's
molecular action theory held its place as the most prominent, and,
at the same time, most difficult theory to combat. When Schroeder
proved that he could filter out the spores from the air, another
advance was made, and rendered possible other steps in the investi-
gation of this subject. Bastian aided materially in this labor ; but
his spontaneous generation theory has not found a place, and he
failed to sustain the views of Lei big that the molecular movements
were the cause of fermentation by adding on his own, that they
actually became vital. From this period to that more recent, when
Koch proved the existence of the tubercle bacillus, there has been
continued progress, and the germ theory of disease has ceased to be
a speculation. The theories brought forward from time to time, to
combat it have fallen into deserved oblivion.

The address and the remarks of Professor Laplace this evening
abundantly prove the thoroughness with which the whole subject
of fermentation has been treated by those to whom we are most
indebted for its elucidation. To us, as dentists, this subject appeals

52 Reports of Society Meetings.

with daily increasing force. We are constantly brought in contact
with conditions that must be intelligently met, and it is only by a
satisfactory knowledge of fermentation and antisepsis that these
can be properly met. To Professor Miller we owe a debt of grati-
tude that he has, unquestionably, solved the problem of dental
caries, and his labors in investigating the ferments of the oral cavity
have shown the necessity for an equal degree of thoroughness in our
operations with that which made Lister's name famous in those of
general surgery.

When it is fully recognized that the mouth is, without doubt,
the culture place for many pathogenic forms, and that many of the
zymotic diseases have their genesis therein, more attention will be
paid to its condition by general practitioners than is given at
present. When the dentists of to-day appreciate the possibilities of
fermentation, they will govern all their operations in the mouth
with a care as to possible results from infection. The time is cer-
tainly not far off when prophylactic measures will be studied with
special reference to the mouth and its secretions. Efforts will be
made to destroy these germs as they enter this vestibule of the
entire organism, and prevent them from beginning their insidious
and poisonous work. That this is to be the labor of the future I
have no doubt. That it will, in degree, stamp out many forms of
disease I am equally well satisfied, and the time will, in my opinion,
most assuredly come when we will know less of the destructive
work of the tubercle bacillus than we now do, but this will be
accomplished in advance of pathological conditions.

Dr. Sudduth. — I WQuld say for the benefit of those who are not
aware of the fact that tablets of the acid sublimate, put up after
Dr. Laplace's formula, are to be had at tf ulford's drug store.

Editorial 53

Editorial.

PATENT-OFFICE EXAMINEES.

Ykby few persons have any idea of the amount of business done
in the Patent-0£Sce in Washington or the technical character of
the work necessary to be accomplished in the examination of appli-
cations for patents.

Every facility has been provided by the government to assist
the examiners in the performance of their duties. Well-equipped
laboratories have been placed at their disposal. This is especially
noticeable in the chemical and electrical departments. Many of the
men are experts in their department. And they must needs be ;
otherwise the country would be flooded with duplicate patents and
the courts overcrowded with " patent" litigation. The examiners
are not required to possess a knowledge of outside matters, nor are
they expected to know whether an article has been long in use ;
but, if possessed of such knowledge, they would be capable of ren-
dering much more efficient service to the government. Such
knowledge is not always needed, but at times would be most valu-
able indeed. Professor G, D. Seeley, of the electrical department, is
said to be an electrical expert who is thoroughly posted not only
in the history of electricity but in its science, and is engaged almost
daily in the laboratory testing the practicability of the many inven-
tions that come before him, as well as deciding upon their claims
for novelty, etc.

Dr. Antisell is an expert chemist and fully qualified to pass upon
inventions that come in his line. Mr. Pierce is also said to be an
expert machinist, and especially well posted in the complicated
machinery of sewing-machines. And so we might go on through
the whole list of examiners and still leave a department which, in
our judgment, is not filled as it should be. We refer to dental
patents,'which form a peculiar class, and should be under the juris-
diction of a competent dentist who is fully conversant with the
mechanical features of dentistry. Such a need does not exist in
regard to medicine, for there is, strictly speaking, no such thing as
a medical patent ; but in dentistry, owing to the mechanical nature

64 Editorial.

of its practice and to the fact that the patent system has been fos-
tered by certain dealers and, to a great extent, by the dental press,
there is a~ distinct and large class of patents which have been desig-
nated as " dental patents/' These affect such a large class of indi-
viduals that it seems to us that an examiner should be chosen from
the dental ranks who would look out for the large interests at stake
in a way that a non-professional man, no matter how competent
and faithful, could not do, — some retired practitioner of dentistry,
who, through long practice and acquaintance with practical den-
tistry, would be specially fitted for the position, and no doubt could
be readily found to fill the place. With a competent dental ex-
aminer in the Patent-Office, it would be impossible for any more
patents to be issued upon methods of practice which have been in
vogue from time immemorial almost, — as some of those which have
been issued and passed into the hands of the International Tooth-
Crown Company, which, besides the patent on the method of making
the so-called '^ Low bridge," that is still pending in the courts, have
patents — according to Dr. Crouse — on " twelve or fifteen different
forms of crowns," and also on ^' a method of preparing roots for
crowning," " for cutting off teeth," " for driving out a pulp," " for
filling the end of a root," ^^ for freezing a tooth so as to make it
insensible," " for cementing a pin or post into a root," *^ for filling a
tooth with some fibrous material," etc.

Not only would a dental examiner prevent the issue of such
patents, but^ being one of us, he would look out that abuses in other
directions wore not foisted upon us, as has been done recently in
two instances. The first of these is so well described by '^ Nemo"
in the December number of the Ohio Journal of Dental Science that
we cannot do better than quote from his article. The case is one
where a patent had been granted on the form of the gum for artificial
teeth. In summing up the law governing the issuing of patents, he
says,—

" The plain language of the patent laws of the United States is thai the
claimant should be the first and original inventor of the thing claimed, also
that it should be the result of * effort, industry, or genius' in the claimant.
When these conditions are complied with, no one can reasonably object to the
granting of a patent, and the purpose of the law, ' to promote the progress of
science and the useful arts,' will be attained.

« Keeping the distinction plainly in view between the purpose of the
people in granting patents and that of the inventor in soliciting the grant, we
shall see that certain considerations ought not to influence the decisions of the
Patent-Office.

** First, the fact that the patents granted by the commissioner may be re-

Editorial. 55

YMed by the courts should not be allowed to influence his decUions. Often,
apparently, this is not the case.

" Then, again, too often it seems plain that well-paid solicitors have suc-
ceeded in worrying the officials into favorable reports on the most trivial appli-
cations for inventions either worthless or requiring a great stretch of the
imagination to And anything new or any evidence of 'effort, industry, or
genius' in them.

" Such decisions in the Patent-Office afford unscrupulous men an oppor-
tunity to hinder the business of other manufacturers or extort royalties to which
they have no moral right, although they may legally claim them. . . .

''The patent under consideration, it will be observed, is for a farm of the
artificial gum as connected with artificial teeth.

" Now, the parties who obtained this patent claim to make the most perfect
imitations of the natural teeth and gums, and therefore the claim in their patent
is for something which is only a copy of a well-known natural form, and not an
invention the result of an expenditure of 'effort, industry, or genius,' and
therefore, under the law, clearly not patentable.

"Again, suppose the form were patentable, the law requires that the
claimant shall be the first and original inventor to entitle him to a patent."

Whioh was not the case in this instance, as the writer proceeds
conclasively to show that Mr. Justi had teeth of similar construc-
tion on exhibition at the Centennial Exhibition, and on which he
had not asked for any patent, because they were a copy of the
natural gums, and therefore not entitled to being patented.

There is another objectionable feature to this patent, and that is
that it was allowed to pend from April 6, 1884, till October 15,
1885, when it was finally issued. By allowing the application to
lie in the Patent-Office the patentee gained five years additional
time in the monopoly, which was finally granted for fourteen years,
making nineteen years.

Another similar fiagrant case is to be found in the patent granted
for an improvement in the foot-rest on the Morrison chair, the ap-
plication for which was made January 5, 1875, and allowed to lie
until August 30, 1887, when it was finally pushed through in time
to prevent the free manufacture of said chair. By this means of
procedure the owners of the patent are granted the monopoly of
the manufacture of the Morrison chair for another seventeen years,
which is acquired by a patent applied for over twelve years ago ;
making a total of over twenty-nine years, a thing that was never in-
tended by the framers of the laws governing the issuing of patents.
Had we had a dental examiner in the Patent-OfiSce, the matter
would have been brought to light and the remedy applied. Let us
have a representative of the dental profession in the Patent-Ofiice
whose duty it shall be to look out for the interests of the body he

56 Editorial,

represents, and thus prevent the issaing of patents on articles which
possess no real value, are devoid of novelty, are copies of nature,
thereby presenting no new features, or are based upon methods of
procedure which have long been in use.

THAT "MEMORIAL MEETING."

The meeting proposed by Dr. AUport, and first published by this
Journal in an editorial on the American Dental Association, in the
October number, for an anniversary meeting in that society upon
the occasion of the World's Fair, in 1892, seems to meet with favor
in several quarters. The December Cosmos has a comprehensive
editorial on the subject, in which the position taken by us through-
out the discussion on the Second International Dental Congress is
thoroughly sustained. It says, —

** It seems, therefore, eminently lit and proper that the American Dental
Association should assume the direction of a dental branch of the celebration
of the birthday of America, and we earnestly hope that the youngest of the
professions and one by birthright distinctively American may look with confi-
dence to the American Dental Association for an arrangement providing for a
fitting celebration in 1892."

That is what we have claimed firom the first, — ^that, in the event
of a dental congress, it should be under the supervision of the
American Dental Association, and that any and all benefits to foe
derived from such a meeting should accrue to the already existing
organizations in America. It matters not whether the World's Fair
be held in New York, Chicago, or Washington, all true lovers of
our profession should join heartily and help make the movement a
success. The matter should be fully discussed before the next
meeting of the association, and some tangible plan be ready for pres-
entation at that time, so that committees could be appointed in
order to insure arrangements that shall be in keeping with the
event to be celebrated.

It has been remarked that the title '< Memorial Meeting" is
hardly appropriate, and it has even been hinted that the name
suggests a death in the family, and that it is necessary to hold a
memorial meeting for the American Dental Association. Such is
not the case. It is not a memorial meeting for the American
Dental Association but in the American Dental Association for
the late Second International Dental Congress, which suffered an
untimely death at Saratoga last summer.

Foreign Correspondence, 67

Foreipi Correspondence.

To THE Editob:

Though this Hawaiian kingdom is but a dot in the great Pacific
Ocean, there are gathered into it perhaps a greater variety of
nationalities than exist in any other land. From the Swede of
the North to the inhabitant of the Atolls of the South Seas — ^from
the Indians of the Bast to the dwellers in the land of Sinim, all
gather upon these sunny shores, and come, more or less, under our
observation and care. By the near roar of the breakers upon our
encircling reefs, we are thrown into dose relations and learn much
of each other's ways and character. It has occurred to me that
some observations, made during my twenty years' practice among
this people, might not be without interest to your readers.

The Hawaiians of the past had good teeth, but by no means the
perfect teeth that writers have so often told us were the especial
boon of all savage races. Fortunately for the student in such
matters, the ancient Hawaiians were often buried in the almost
inaccessible lava caves with which some parts of the country
abound, or in the shifting sands of the sea-shore, which, sooner or
later, leave the whitened bones exposed to the observer. In the
hundreds of crania which I have examined, in which the superior
and inferior maxillaries were together, I have found few cases
where there were not greater or less effects of dental caries, not
infrequently salivary calculi, and, in a few instances, unmistakable
evidences of pyorrhoea alveolaris. In one cranium in my posses-
sion there were eight alveolar abscesses in the superior maxillary
at the time of death. Though, on the whole, the teeth of these
ancient people, as well as those of the present generation, are very
regular, the inferior third molar seems to have been a frequent
cause of great misery. I have one specimen in which this crowded
dens sapientice has retaliated by causing complete anchylosis of the
jaw. The second molar was forced out, evidently to give space for
the individual to be fed.

The Hawaiians in middle life today have better teeth than their
European neighbors ; but their children have very little advantage
over their white playmates. I attribute this rapid deterioration
to the fact that while their parents ate much the same food that

58 Foreign Correspondence.

their fathers used before civilization came to them, the children,
usiDg the less simple foreign diet, with little personal attention to
their teeth, are more subject to dental diseases.

The Chinese (large numbers of whom, of the better classes, have
been under my care) are quite similar to the Hawaiians in the
soundness and strength of their teeth, but from a different cause.
These people, evidently, from ages, have taken great care of their
teeth, as far as personal attention could go. The majority of those
whom I have met who would be called the upper class are afflicted
with pyorrhfEa alveolaris^ while the laborers are no more subject to
it than other nationalities. I attribute this in a great measure to
the free use of their tooth-powder, which consists of finely powdered
pumice or silicon. This in time separates the gum from the teeth,
and paves the way for more serious trouble. Irregularities, espe-
cially in the third molars, are common among all classes.

I have examined with great interest the teeth of the South Sea
Islanders, especially those coming from the low islands, where little
but cocoanuts and bread-fruit will grow. So far as my observation
extends, they have large teeth, but of very poor quality. The
teeth have a yellow, opaque look, with soft enamel, which readily
wears down and breaks off. The dentine has that peculiar tallowy
cut well known to the dentist as not hopeful for long retaining the
filling. The secretions of the mouth seem normal, so that these
teeth, indifferent as they are, remain to do good service, giving
them little trouble, except from periostitis. The teeth of these
people have not been influenced by civilization.

We often hear the teeth of the American people represented as
more frail than those of their cousins across the Atlantic. But it
is my observation from a cosmopolitan practice that they are not
inferior to any, and are superior to several of the European nation-
alities. One reason why this sentiment has prevailed among
travellers may be that Americans take more care of their teeth,
and show their care both by their conversation and the evident

appearance of the mouth.

J. M, Whitney.

HONOLITLir.

To THE Editob:

The letter of Dr. Darley, in the October number of the iNTsa-
national Dental Journal, induces me to give the conclusions I
have arrived at from an experimental use of Watt's crystal gold.
When I say an experimental use, I mean that I have used up

Foreign Correspondence. 59

about four packages of it, that fillings of it were packed in various
ways, and that a considerable number were made out of the mouth
in cavities cut in bone or ivory. The fillings that I made out of the
mouth were treated for cohesion and toughness by cutting with ex-
cavators, for surface hardness by firm burnishing, and for adaptation
by removing the filling intact and examining it with a magnifying
glass. I found that it was possible to arrive at perfect adaptation if
very small pieces were used and very great care was taken : a bet-
ter adaptation, in fact, than I was able to obtain by the ordinary
methods of working foil. Burnishing pellets of either cohesive or
non-cohesive foil being the only means by which I could get as
good results. The only apparent difference being that the ^' bur-
nished-to-place" gold was bright and polished where it was in con-
tact with the cavity walls, and the crystal gold was quite dull. To
obtain this good adaptation with crystal gold requires more time and
care than the average practitioner can give. Unless this minute
care is taken, and minute pieces used, it is, I believe, inferior in this
respect to foil. The hardness of the filling is greater than those
ordinarily made of foil, but the cohesion and toughness of the filling
is decidedly inferior. To prove this, make two fillings, one of
crystal gold and one of foil. Use relatively small pieces of each.
Then try to dig out the gold with a moderately strong excavator.
Don't just pick at the surface, but press the sharp blade in with
force at an angle of forty-five degrees and try to lever up the layers
of gold. The difference is at once apparent. These experiments
and others lead me to the conclusion that it is an easy material
with which to make inferior fillings in a short time ; but that, in
order to do superior work, it necessitates more care and time than
foil ; and that, no matter what care is taken, the filling is not so
absolutely cohesive as if foil were used. The cohesion may, how-
ever, be sufficient for all practical purposes. The instruments I
used were very finely serrated.

Wm. C. Gbayston, L.D.S.

SCABBOBOVQH, EVOLAND.

60 Domestic Correspondence,

Domestic Correspondence-

To THE Editor:

American Academy of Dental Science. — The twenty-second an-
nual meeting of the American Academy of Dental Science was
held at Young's Hotel, in Boston, on Wednesday, November 13,
1889. There was a veiy good attendance of members present, and
the chair was occupied by the president, Dr. Cecil P. Wilson, of
Boston. He welcomed the members to the hospitalities of this
twenty-second anniversary, and spoke of the pleasures and benefits
derived from gatherings like this, of earnest professional gentlemen
united together for the public good and for the promotion of the
best interests of their chosen profession, and he congratulated them
upon the prosperity and progress of the Academy. After listening
to the annual reports, and other routine business having been trans-
acted, the following officers were elected for the ensuing year:
President, Dr. F. N. Seabury, of Providence, R. I. ; Vice-President,
Dr. G. A. Brackett, of Newport, R. I. ; Corresponding Secretary,
Dr. B. N. Harris, of Boston ; Recording Secretary, Dr. V. C. Pond,
of Boston ; Treasurer, Dr. B. C. Briggs, of Boston ; Librarian, Dr.
Charles Wilson, of Boston.

Executive Committee. — Df'. B. H. Smith, of Boston ; Dr. Thomas
Fillebrown, of Portland, Maine ; and Dr. F. B. Banfield, of Boston.

Dr. W. N. Potter, of Boston, was appointed editor of the Acad-
emy proceedings for the ensuing year. Dr. Harris, corresponding
secretary of the Academy from 1867 to 1877, by urgent solicitation
of the members, consented to accept that position again.

Resolutions of respect to the memory of Dr. F. Searle, of Spring-
field ; Dr. S. P. Stearns, of Boston ; and Dr. J. W. Smith, of New-
port, members of the Academy who departed this life during the
past year, were adopted by a rising vote.

The annual address was delivered by Dr. J. T. Codman, of Bos-
ton, taking for his subject " Retrospect and Prospect." He spoke
of the conditions of life under which professional men lived seventy-
five years ago, and gave a very interesting sketch of their sur-
roundings, and a synopsis of the many improvements made in
society and in dentistry since that time.

A vote of thanks was given to Dr. Codman for his address, and
a copy requested for publication.

Domestic Correspondence. 61

A vote of thanks was also presented to the retiring president,
Dr. Wilson, for the able and impartial manner in which he has
pr^ided over the Academy during the past two years.

At six o'clock, adjourned to partake of the anniversary dinner
and banquet, which was an elegant affair. The newly-elected presi-
dent. Dr. Seabury, presided, and he thanked the members for the
honor conferred upon him, and called upon the venerable Dr. Elisha
G. Tucker, who was present, and now in his eighty-second year,
for some remarks. Dr. Tucker responded, and expressed his grati-
fication at having had the pleasure and privilege of attending every
annual meeting since the Academy was organised, and spoke of the
old pioneer dental practitioners of Boston and other parts of our
country, who have nearly all passed away. Other pertinent and
well-timed remarks were made by many of the members, and every-
thing passed off very happily.

This society was founded in 1867, in Boston, and its career has
bpen one of uninterrupted success, and it has accomplished much
for the advancement of dental science and for the elevation of the
profession. Monthly meetings are held at the rooms of the Bos-
ton Medical Library Association, 19 Boylston Place, which are well
attended and replete with interest. At the last meeting, held De-
cember 4, papers were read by Dr. D. W. Fellows, of Portland,
upon " Fracture of the Jaws," and by Dr. J. B. Waitt, of Boston,
on " A Bapid Method of Inserting and Finishing Contour Fillings
without a Matrix." Each paper was followed by a discussion on
the subject presented. Dr. F. O. Eddy, of Providence, exhibited a
new mouth-piece for saliva-ejectors, and Dr. Waitt exhibited a
nitrous-oxide light for photo-microscopic purposes. Greorge T.
Baker, D.D.S., of Boston, and William S. Sherman, M.D., D.D.S., of
Newport, were elected associate members, and W. W. H. Thacks-
ton, M.D., D.D.S., of Farmville, Virginia, was elected an honorary
member.

Edwabd N. Habbis,
Corresponding Secretary.

866 OOLXTMBUS AVXKUE, BOBTOV.

To THE Editor:

I think you would do the profession a favor if you called atten-
tion to the Perry Separators editorially. They have been written up
by Dr. Perry very fully, but I do not think that they have been
appreciated by those who have not tried them as they deserve to

62 Domestic Correspondence,

be. Among my friends I find few who have used them. They are
expensive ; but from two months' use I am free to say that, to a
dentist who has even a moderate practice, they would pay for them-
selves in the increased work he can do if he had to get a full set
every three months, to say nothing of the better work that can
be done with them, and the comfort they are to both patient and
operator. If used with judgment, they give at once sufficient
working space, and cause, practically, no pain. I have repeatedly
separated the six front teeth, opening and examining each space
at one sitting, that too for nervous, ''skittish" children, without
objections being made by the patient, and in no case have I seen
any injury done, or their use followed by any unpleasant after-effect.
I can readily appreciate how their use, in the hands of one who
was anxious to see how much space he could make, or one who
forgets that patients have feelings, would be very painful, and that
serious and permanent injury might follow. They were, I venture
to say, not invented to be so used. There is a little pain at times,
in separating the molar teeth, but if they are opened slowly it is
very bearable and soon over.

There is need for a dam clamp that can be used without being
in the way of the separator. With all that I have or have seen,
the clamp must be put one tooth back of the separator or the dam
be held by a ligature. Either expedient is at times very incon-
venient, and in some cases either the dam or the separator must be
dispensed with.

William H. Tbtteman.
Fhxladxlphia.

To THB Bditob:

Composition and process for tempering instruments : rosin, 7i
parts; whale oil, li parts; pulv. charcoal, i part.

Directions for use: the instruments should be dipped in the

mixture same as in water, then polish and draw the temper as usual.

Small instruments should be dipped but once, larger ones two or

three times. For engine and other small drills, which I want very

hard, I heat to a bright red and dip in just the drill point, and do

not draw the temper. In dipping for this last work dip the point

straight down, not obliquely.

William Steele, D.D.S.
Forest Gitt, Iowa.

CStrretU News. 63

Current News.

To induce an alkaline condition of the oral secretions during
pregnancy, Dr. Jno. H. Coyle prescribes fifteen grains bicarbonate
of potassa, in cinnamon- water, fifteen minutes after each meal.

Dr. B. 6. Adaib syringes the pocket of an alveolar abscess with
equal parts of peroxide of hydrogen and bichloride of mercury one
to five hundred.

Dr. Wabblaw thinks the influence of sex positive as a predis-
posing cause of caries, the excessive liability in the case of pregnant
females being explained upon the principle of the vitiated condition
of the fluids of the mouth consequent upon systemic disorder, their
corrosive properties being thus increased.

For starting a filling in a large cavity, Dr. W. C. Browne places
in the bottom a pellet touched on the under-side with damar
dissolved in chloroform.

Dr. H. S. Coldinq thinks that the best way to make a dentist is
to select a boy with good mechanical abilities, and put him to work
at the machinist's trade for two or three years ; then give him the
spring and summer course in the infirmary of a first-class dental
college. He thinks this a better preparation for the college course
proper than years under a preceptor.

Antisxptio mouth-wash. Dr. S. A. White's : four drachms car-
bolic acid crystals; three ounces glycerine; three ounces water.
Use with soft tooth-brush.

Kxxp on hand a supply of Belding Bros, embroidery silk on
small spools; teach your patients how to use it, and give the
patient a spool, exacting the promise of frequent use. The cost,
one cent a spool, is nothing compared with the good you will do.

B. H. Catching.

64 Current News.

A OOMPLETE, separate, cross-topioal index is now in preparation.
Do not have Volume X. bound until you receive it.

The topical index for Yolume X. will be bound separately this
and succeeding years.

Do not make the mistake of having the topical index for Yol-
ume IX.— contained in the January number of Yolume X. — ^bound
in the latter volume, but wait till you receive the topical index for
Yolume X., whi<5h will be ready in a few days.

The topical index for Yolume IX. has been so popular that other
and rival journals have adopted our idea ; but to the International
belongs the credit of introducing an exhaustive annual topical index.

CHICAGO AND YICINITT.

Dr: Allpobt treats hyper»mia of the pulp due to thermal
changes, after inserting large gold jSllings, by covering the filling
with oxyphosphate of zinc cement, and renewing it as occasion
requires until such time as normal action is re-established.

The Chicago Dental Society is making preparations for its
annual banquet. We hear that strict prohibition is to be enforced,
that nothing stronger than apollinans and cigars will be permitted.

Beoent news in regard to the health of our friend. Professor
Truman W. Brophy, is not very encouraging, but we hope to be
able to give a more favorable report later.

Db, Fernandez, of Chicago, has a neat little wrench for use with
the Brophy band matrix. It is constructed with a flexible shaft
and can be used at any angle. The shank of a watch-key is soldered
to a short piece of steel coil spring, and the opposite end of the
spring to a straight shaft of any desired length. It can be made in
a few minutes and is very useful.

La grippe has reached Chicago, and many of her citizens are in
its grip just at present. So far it has not assumed a serious form,
and, no doubt, out of respect for our record as the most healthy
city in the union, it will touch us mildly.

THE

International Dental Jonrnal.

Vol. XI. Februart, 1890. • No. 2.

Original Communications.'

TEBATMBNT OP THE TEETH DURING PREGNANCY.'

BY W. H. DWINBLLB, M.D., D.D.8., NEW YORK CITY.

The mere mention of pregnancy suggests to the mind of all a de-
ranged and, in a certain sense, an abnormal condition of the system
involving acrid and acidulated secretions of the alimentary canal,
especially of the mouth. Before proposing a system of treatment
for teeth during pregnancy, we will consider their condition under
this contingency, the cause of that condition, and then the remedy.
The causes may be (1) local and (2) constitutional, — the nervous
derangement of the system and the profound constitutional and
mental disturbance.

In a pregnant woman we recognize a human being whose func-
tion and office is to reproduce within herself another living being. «
She is to supply from the alembic of her own ever-accumulating
and ever-wasting storehouse the material to be modified and
assimilated into a duplication of herself. All the elements must
be appealed to to contribute to build up and perfect the organiza-
tion in her charge; especially must she furnish an abundance of the

^ The editor and publishers are not responsible for the views of authors of
paperi published in this department, nor for any claim to novelty, or otherwise,
that may be made by them. No papers will be received for this department
that have appeared in any other journal published in this country.

' Head at the Nineteenth Annual Session of the New Jersey State Dental
Society, Asbury Park, July 19, 1889.

5 65

66 Original Communications.

elements of the phosphate and carbonate of lime for the bones and
teeth of the embryo man. These elements must be supplied and
derived from the food taken into the system by the mother. If
there is not a sufficient supply furnished from this source, it must,
to a certain extent, be taken indirectly from her own organization
and appropriated to that purpose. So that her system, being robbed
at large of the elements needed for the child, literally feeds on
itself, like Dr. Tanner, fasting for forty days, consuming seventy
pounds of himself, or like bears hibernating,— the winter cannibals I

We do know that we are but chemical laboratories, containing
all of the elements within ourselves. Knowing this, it is easy to
conceive how these elements may be constantly changing their re-
lation to each other, 'how they may, by chemical resolution, be
brought into solvent condition and be appropriated or diverted from
one part of the system to another. To pursue the subject of waste,
absorption, and appropriation further, it may be possible that in the
process the tax on the tooth-material is not alone called upon, but
that the bones generally have to yield a portion of their lime salts,
even to the loss of their integrity for the time, to satisfy the
demands of nature. We have no doubt that rickets and bone-mal-
formation generally might be traced to deficiency of lime at the
critical period when it was most needed.

The craving or longing of pregnant women for lime, for chalk,
plaster, and clay are indicative of this demand of nature. Hens
will not lay eggs with perfect shells unless they have access to lime
in some form, and every aviary has for its motto, " No lime, no eggs ;
no eggs, no birds." The wild animals of the woods make pilgrim-
ages to the ^' deer lick'' to abate their longing for salt; all of these,
and scores of others, are but dumb appeals from the unsatisfied
chemistry of nature.

Assuming that we have a full appreciation of all the unhappy
environments and associations connected with pregnancy, the
exalted nervous tendencies, the mental and physical disturbances, the
acrid and irritating secretions that come of them, the appeals to our
higher sympathies and loving and tender care, giving the fullest
meaning to the sentiment that the gentlest natures, when shattered
by incessant pain, enfeebled by disease, often misrepresent them-
selves and permit the spasmodic thi*oes of a pain-goaded organiza-
tion to be the exponent of what they are not Admit all these
things, and assuming every sweet sentiment in tribute to '^ Gbd's
best gift to man," the practical question is still before us, — the treat-
ment of the teeth during pregnancy.

Dreatment of the Teeth during Pregnancy. — Dwindle, 67

The first thing and the last that meets us at the very threshold
of our investigation is acids and acrid secretions, dissolving and de-
stroying the teeth, accompanied with pain and exalted sensitiveness,
to a degree beyond expression. I have repeatedly observed
instances where patients' teeth have decayed and wasted more dar-
ing a single period of gestation than during all their lives before.

What is the remedy and what the treatment f

The first thing to be done is to consider the importance of the
general nutrition of the mother with well-selected diet, and
especially whole wheat food, to make sure of the phosphate portion
of them which is contained in the four outer capsules of the kernel,
and which in the manufacture of superfine flour are wholly rejected.
Oatmeal, too, is an excellent phosphate cereal. The next thing is
to charge the system, through the stomach, with bone phosphate of
lime in solution or in the form of a powder, spreading the same upon
the food to be eaten, or distributing it over the same with a recep-
tacle in the form of a pepper-box, literally using it as a diet, until
the system is saturated with it ; at the same time, it will be well to
use lime-water, natural Yichy water, ever dieting towards the
alkaline.

Use tooth-powder in which bicarbonate of soda is a generous
ingredient, and have all washes of the mouth contain the same.
For general tonics I use sometimes other forms of the phosphates,
such as the hypophosphates and lactophosphates, with excellent
results. Under some conditions I use nux combined with myrrh
and tinctui*e of iron ; this last, when used with Yichy water, is
entirely harmless to the teeth.

In using the phosphates, select that which is derived from the
bones of animals, never that from the phosphate rock ; the bone-
phosphates are potent and are readily taken into and assimilated
with the system. The phosphates from the rock are inert, extra-
neouB, non-assimilable, and useless to our animal economy, although
chemically they are the same.

For acid and sensitive teeth, subdue with soda applied in satu-
rated solution to the teeth, then with such obtunders as may be
most effective ; excavate and fill with pink gutta-percha to bridge
over to the period when the patient is able to endure more perma-
nent operations.

Extracting the teeth during pregnancy should be avoided, if
possible ; try such palliative treatment as may bring the teeth into
subjection ; but if this cannot be done, and the pain from them
becomes hazardous, do not hesitate to remove them. *

68 Original Communications.

We know that we can change to a great degree the density of
the soft structure of the teeth of young, overgrown girls — who, by
overstudy, under-feeding, and under-sleeping, have rendered them
80 — ^in a few months by proper mental and physical rest and
phosphate treatment ; for we have ourselves done this repeatedly to
the welfare and safety of the teeth which otherwise would have
been lost, giving us assurance that in the ever-changing chemistry
of the vaiying solvents of our organization they may be so directed
that the problem of recalcification will be capable of demonstration
and subject in a large measure to our control. I forgot to mention,
in passing, that none of the cereals is richer in phosphates than
Indian corn. Barlow, one of our New England poets, referring to
the sturdiness of the men of his time, said of them, —

" WhoM bonei are made of Indian com !''

I might refer to phosphate paste and my method of using it,
but time forbids. I might refer to a case reported several years
ago, wherein rapid erosion of the teeth was immediately arrested
by its use, together with general treatment, to general absorption,
and wasting of the teeth ; but this would come under another head,
except so far as it might illustrate the theory of the diversion of
the elements of our system.

I copy from my note-book two cases which, with many others,
confirm in my mind all I have said in favor of the bone-phosphate
of lime.

*' Mrs. C. had passed through two painfhl periods of gestation,
with excessive acid secretions and vomiting most of the time, giving
birth to a girl ten years ago, and two years later to a boy. The
girl's first teeth were remarkably poor. All that were erupted of
the second set can be cut away as though they were chalk. The
teeth of the boy are all even worse than those of the sister.''

When the mother became pregnant a third time, with all the
symptoms in an unusually aggravated form, I at once put her on
the phosphate treatment, and prescribed diet together with general
tonics. She at once began to mend. The acid secretions and eruc-
tations abated entirely, her vomiting ceased at the end of the second
month, and did not return. She passed through a remarkably
healthy gestation, free from ail annoyance or discomfort, when she
gave birth to a boy. You may anticipate that I watched the erup-
tion of his first teeth with interest. They proved to be of the
finest quality. The six-year teeth are already fully erupted, perfect
in all respects, and of unusual density.

Treatment of the Teeth during Pregnancy. — Dwindle. 69

Another case, which I will not give in detail, wherein a mother
had four children. With the first there was no phosphate treat-
ment; child's teeth very poor. In the second phosphate treatment;
the best of teeth, second set most all in. Third child, mother away
in Europe, no treatment ; veiy poor teeth, both sets. Fourth child,
phosphate treatment; the best of teeth so far. I could refer to
many other cases confirming the benefits of phosphates.

As regards the primitive phosphate rock, it is unassimilable
and inert to the animal economy. It had to go through a process
nearly commensurate with the age of the world up to a compara-
tively recent period, — a process involving its passing from its primi-
tive state through the stomachs of animals, ever evolving higher
and higher through the ages till it reached the kindred mammalia,
the phosphates of whose bones alone are potent and assimilable
to the human system, and yet each are chemically the same ; show-
ing that there is a subtle chemistry behind, which the chemistry
of our boyhood takes no cognizance of.

The vegetable kingdom cordially responds to the tonic influence
of animal phosphates, as all agriculturists and fruit-growers know.

The theme of the ever-changing chemistry of our systems could
be enlarged upon to the extent of a very interesting essay. I hope
some will avail themselves of the opportunity of distinguishment
in this direction.

I do not claim any special originality in what I have laid before
you. Others have given their experience and successes, for which
I feel under great obligations to them. I attempt only to give you
my own and my faith in the promise it gives.

In the Aiture I believe that the preparations of the animal phos-
phates are to take an important place in our practice. With chil-
dren as well as those of maturer years its influence for good is
marked and decisive, as we have already demonstrated. Pregnant
women thrive on it, nature responds to it with avidity, and the
most happy results follow its use. Our profession more than any
other is interested in its quality and its potency to overcome many
of the evils that beset us, which I believe we shall yet accomplish
to the relief of humanity and the glory of our calling.

70 Original Communications.

BLEACHING OP DISCOLORED DENTINE PRACTICALLY

CONSIDERED.*

BT X. P. WRIGHT, D.D.8., &IOHMOND, YA.

In the report of the proceedings of the March meeting of the
First District Dental Society of New York there appeared a paper
which was most scientifically discussed, — ^a method of bleaching
discolored dentine, by Dr. Kirk, of Philadelphia, in which he gave
the credit of inventing the apparatus, there used, to myself.

I do not design nor wish to make an elaborate or scientific de»
fence of this method ; that Dr. Kirk has done sufficiently; but I sim-
ply desire to set up claims for the restoration of discolored crowns
to comparative usefulness by bleaching and filling, as against decap-
itation and crowning. To ratify these claims it is obviously neces-
sary that certain prejudices, in the minds of a large class of practi-
tionera, should be done away with.

First of all, our experience has proved, beyond question, that
dentine can be bleached without subsequent re-discoloration. To
this proposition, however, we allow consideration for that state of
peculiar discoloration which is so familiar to us all, the color of
which is from a light to a very dark yellow. The cause of this
discoloration seems to be attributed, by the profession, to some de-
fective or peculiar arrangement of the dentinal tubuli, which takes
place during the stages of calcification.

When two years ago I began a series of experiments, with a
view to the application of free chlorine and other bleaching agents
to discolored dentine, I found such insufficient data to go upon, that
my labors were crowned with poor success, and at the same time
proving an expensive thing to my patients ; as I candidly admit that
I ruined several teeth by making them darker than they were be-
fore I began treatment. I trust, however, that the victims on the
altar of science may be properly resigned, and have no malice stored
up for me.

When we are able to make up our minds to the importance of

1 Read at the opening meeting of the Odontological Society of Penniylya-
nia, October 6, 1889.

Bleaching of Discolored Dentine Practically Considered, — Wright. 71

preserving the tooth-structure, even when it is not so sightly as
ype might desire, and refrain from removing the natural tissue for a
questionable substitute, we will have come to a wise conclusion.

With great respect for those who are madly rushing to porcelain
teeth, I would say that they are doing the profession an injury, as
there is no higher glory for one who professes the healing art than
that of preserving the natural tissue. This tendency to porcelain
crowns and bridge-work, in its many phases, is going to have, ulti-
mately, the same effect upon the profession and the public that the
introduction of a plastic base plate has had.

I would place the porcelain crown on the one hand, and the vul-
canite base on the other, — they stand in the same relation to the
advancement of our profession. We all regret the universal favor
which has been accorded the vulcanite base, and rather look for-
ward, I think, to the time when we shall have a reliable method by
which we can retain the natural organs. Are wo not taking a step
in the right direction by aiming to accomplish this, and thus put a
curb on that bent of our disposition to a retrograde movement?

A student of dentistry, looking through our journals, would be
inclined, I imagine, to the impression that there was little else in
dentistry than crowning and bridge-work. This is wrong; and
while it is true that all plans are made clearer and plainer by dis-
cussion and illustration, yet too great emphasis on any theory is
hurtful to the people.

In advocating the retention of the natural crown, at a sacrifice
of symmetry and beauty, compared with an artificial one, we would
avoid this error, desiring only to present to you the intrinsic merit
of the question, stimulated by a firm conviction that, if we do our
duty in preserving the natural organ, it will be a gain to the pro-
fession and keep us on the upper plane.

While it is an easy matter to bleach discolored dentine and pre-
serve the natural crown in good shape, still it must be admitted
that it is easier to remove the natural crown and substitute a por-
celain one ; but, as before stated, it is not well, nor is it to the inter-
est of the highest aims of our calling, to consider too much the
matter of ease or other minor effects, either to the patient or the
operator; and as we are considering this subject from a practical
point of view, we should look at it in that way, because, even
though the individual efforts may not be so beautiful or, at first, so
satisfactory from an sesthetic point, still we have satisfied our con-
science, we are teaching our patients the importance of the natural
organs, and encouraging an inventive and upward tendency among

72 Original Ckmimunieationa,

our brethren. We are maintaining the standard set for us by oar
great men ; in short, we are doing the best we can.

Before discussing the matter in the light of a valuable principle,
we want to know what has been accomplished.'

In the outset we state our positive belief that teeth properly
treated — and certainly those amenable to the chlorine treatment —
do not re-discolor ; this assertion is based upon experience extend-
ing over two years ; and, after many experiments, so far, I have
not had a single re-discoloration where I have succeeded in bleach-
ing. In my experience, the yellowish condition, of which mention
is made at the beginning of the paper, has been very difficult of
correction. It may be well to state that the present literature on
the subject favors the idea that this latter peculiar discoloration can
be removed by the use of dilute sulphuric acid, and there are many
methods by which it is applied. My prejudice to sulphuric acid or
any other acid known to act upon, in a deleterious sense, the organ-
ization of the tooth-structure has prevented me from experimenting,
to any degree, in that particular line ; therefore I cannot enlighten
you upon the uses of sulphuric acid as applied to bleaching teeth.
Saying this much of this peculiar discoloration, which is a yellowish
mud-color, and of which we know so little in a remedial sense, and
of the supposed activity of the agent (sulphuric acid), we pass on
to the discussion of that class of discolored dentine with which we
are familiar, and of which we know something positive.

Very lately, through the assistance of an eminent chemist, Dr.
Froehling, I have succeeded in formulating a theory as to the cause
of these peculiar discolorations. The value of this theory is ques-
tionable, and I hesitate to advance it. It may be well, however, to
state in general terms that these discolorations can only be organic
and perhaps of a fatty nature, and our failure to remove it hereto-
fore has probably been due to the inadaptability of the method em-
ployed to destroy the fatty matter contained in the tubuli. I regret
that this conclusion should not have been arrived at sooner. I have
now, however, formulated a plan by which it seems there will be no
difficulty in the future in thoroughly removing every particle of
fatty matter from the tubes.

That you may understand more clearly the plan I wish now to
place before you, I will hand around the apparatus to be used in the
first steps towards the treatment of discolored teeth, as aforesaid.
The instrument consists simply of an exhaust-pump, made on a small
scale, of a simple retort connected with the barrel in which the pis-
ton works ; tfie contents of the retort are controlled by a stop-oock

Bleaching of Discolored Dentine Practically Considered. — Wrights 73

which governs the flow of whatever chemical it may contain. The
agent recommended to be used is ether, chloroform, or petroleum
ether (rhigolene), either one of which will act powerfully upon and
dissolve the fatty globules. This apparatus must have its point in
sorted into a preparation such as is used in the hectograph, a material

which is not affected by either of the three agents mentioned ; it is,
however, easily acted upon by another of our favorites, ammonia,
and thus its use is debarred.

I believe the hectograph composition can be made by putting
pure glue in cold water, leaving it until it swells, draw off the water,
melting it in its absorbed water, and mixing about six parts of
the glue solution to one of glj^cerin. This compound is intended to
be used after the rubber dam has been placed around the tooth and
the tooth made dry, that the rubber dam, which is designed to keep
back the moisture, shall not be interfered with by the action of the
chemical agent employed.

The modus operandi^ with the exception of the incompleteness
of preparatory treatment, as will be shown later on, has been
clearly described by Dr. Kirk, and published in the Cosmos. I
shall therefore not take up your time in repenting it, but will dose
my paper with the proposition that ninety-five per cent, of discol-
ored teeth can be bleached in from not more than one to three
sittings of one hour each. Of course, preparatory treatment is
necessary, and precaution also in regard to the use of oleaginous
substances within the canal. If such have been used, from one to
two sittings, close upon each other, will be required, and the oily
substance previously removed as before indicated.

Of the two or three failures, strictly speaking, which I have
encountered, I can attribute none of them to other causes than
defective preparatory treatment. I think I see, judging from fail-
ures to bleach at all, a strong argument in favor of the theory

74 Original CammunicatioM.

advanced early in the paper, — ^to wit, malformation of the tubuli;
however, it would not be safe, in view of our lack of information
and experience, to conclude that this is a fact, and thus not enter
into the experiment suggested, and determine positively why we
have failed in this class of discolorations. The use of chlorine gas,
the agent we have employed until recently, we have concluded to
be loss effective than chlorine water, and shall in the future— and
do now — recommend it to this body as the agent to be used in all
bleaching operations.

I think that we have fallen into an error when we conclude that
we can remove All that is necessary of the fatty matter by a simple
application of some such agent as ammonia, borax, or bicarbonate
of soda. This I believe to be impossible, and suggest the idea firom
the known bleaching properties of chlorine; and when we have ex-
perimented further, we will find that the elaborateness of our treat-
ment will bo confined to the primary instead of the finishing stages
of the operation ; at any rate, we will come down from the elaborate
chlorine treatment to the apparatus mentioned earlier, — the object
of which shall be the thorough cleansing of the tubuli of oleaginous
matter, and when we have done this a simple application for a short
time, within the canal of the tooth, of freshly-made chlorine water
will bo sufficient.

If you will take the trouble thoroughly to remove all fatty mat-
ters from the canal of an extracted tooth, and then immerse it in
chlorine, you will find no perceptible change in .its appearance even
after hours of such immersion ; if, however, this tooth is immersed
in chlorine water, you will find that you have thoroughly and per-
manently restored its color.

There is no inducement for chlorine gas to penetrate to the
ramification of the tubuli if the contents are dry; therefore, a
very considerable force is necessary to force it through these rami-
fications, and the operation, so far as my experience goes, is necessa-
rily uncertain, or at least unsatisfactory.

It is the periphery rather than the base of the tubuli that is to
be treated, and we should not overlook the fact that the peripheries
of the dentinal tubuli frequently extend into the enamel, making it
that much more necessary that this zone should be bleached, as the
nearer the labial surface the tubuli extend the surer they are to
show themselves through the translucent enamel.

How to Splice Engine Bands. — Maxfield, 76

HOW TO SPLICE ENGINE BANDS.*

BY GEORGE A. MAXFIELD, D.D.8., HOLTOKE, MASS.

In thinking over what I could present nnder the head of Dental
Technics, and after extended inquiries among mj dental friends,
and finding that none of them knew of this method of making a
splice, I decided to demonstrate it at this meeting. This method
is not original with me, — though I am prol)ably the first to demon-
strate it to the profession, — but was invented, I believe, a few years
ago by a foreman in one of our woollen-mills at Holyoke, and is
now used in most of the mills where a braided band is used. The
manner in which most of the dentists splice their bands is, to say
the least, a very clumsy one. It takes considerable time to make it,
it is not very strong, and never runs smoothly. The splice which I
shall show you is made very quickly, makes a strong, even splice,
and runs smoothly ; in fact, the harder you pull on the band the
stronger it holds. The instrument, which I shall call a needle,
used in making the splice is made of piano wire, bent in the form
of a hair-pin, the free ends inserted in a wooden handle, and
fastened so that they will not pull out, allowing the bow end to
extend about two and one-half inches from the handle. The sides
of the bow must be bent near enough together to allow it to pass
easily through the centre of the band.

To make the splice : Measure the exact length the band must
be when spliced, mark it, then cut off the band say seven inches
longer. This extra length is taken up in the splice. A splice six
inches long is stronger and runs smoother than one only four inches
long. Unravel about an inch of each end of the band. Take the
needle and pass the bow into the band where you have marked the
end to be, then pass it through the centre of the band one-half of
the extra length, and then out again, as at Fig. 1. Take the other
end of the band And insert into the bow of the needle just enough to
hold, and pull it through and out where the needle first entered.
(See Fig. 2.) Treat the other end of the band in the same way as
the first (see Fig. 3) and draw the free end through. Smooth out

1 Demonstrated at the Union Dental Meeting at Springfield, Mass., October
28, 1889.

76

Original Chmmunications.

Fio. 1.

the splice, and out the ends so that they will oome inside of the
band, and your splice is finished. If you wish to make the splice

^ Pio. 2.

smoother, roUjit between two pieces of wood. If your band has a
core, it requires more painstaking in making the splice ; yet it is

Fio. 8.

easily done. First draw out the core from each end the length
the splice is to be, say six inches, and so manipulate it as to have the

Fracture of the Jaws Fellows, 77

ends come inside the band, exactly where the core has been cut.
If you are not particular about this, you will have a weak spot at
each end of the splice. If you are particular in splicing this kind
of a band, you will hardly be able to detect the splice after it is
finished.

FEACTURE OF THE JAWS.*

BY DR. B. W. rKLLOWS, PORTLAND, ME.

Mr. President and Gentlemen : — It is my purpose to-night to
consider fracture of the jaws, and particularly fracture of the lower
jaw ; but I think it not inappropriate to present a brief review of the
nature, causes, and diagnosis of fractures, the principles of treat-
ment, and mode of cure.

Fracture is defined as a solution of continuity of the osseous
tissue.

Fractures may be simple, compound, comminuted, or impacted.
These terms are familiar and need no explanation.

Yarious diseases, by impairing the structure of the bones, act as
predisposing causes of fracture. The most important of these are
syphilis, cancerous diseases, osteomalacia, and rickets. But fracture
of healthy bones must be always a result of violence, and nearly
always of external violence, either direct or indirect, though in
numerous instances bones have been broken by muscular contrac-
tion.

The reliable symptoms of simple fracture are crepitation, de-
formity, and preternatural mobility. The peculiar sound caused
by rubbing the ends of the broken bone together, known as crepi-
tation, is characteristic of fracture. It may generally be felt as
well as heard. This symptom may be obscured by much swelling
or by great depth of soft tissue, and in impacted fracture it will be
absent.

Deformity is generally, but not always, present, and it may be
a result of the cause which produced the injury or of the action of
muscles upon the fragments.

Preternatural mobility is an important symptom of fracture, and
is rarely absent unless the fracture be impacted.

.The manner of repair in cases of fracture merits some considera-
tion. The first stage, which is a period of preparation, occupies

^ Bead before the American Academy of Dental Science, December i, 1889.

78 Original Communications.

about one week. Daring this period, in favorable cases, inflamma-
tion subsides, the inflammatory products and extravasated blood
are absorbed ; pain, swelling, and traumatic fever disappear. From
the eighth to the seventeenth or twentieth day the parts become
red and injected, and covered with a layer of embryonic cells, and
towards the end of this period the granulation tissue becomes more
and more firm, until, finally, the tissue is converted into bone,
forming, in the case of long bones, two layers, one within the
medullary canal and the other encircling the ends of the fragments.
This is known as the temporary or provisional callus, which is
Nature's splint for holding the fragments in position until repair is
rendered complete by the deposit of osseous tissue between the
broken ends. The temporary callus, it may be stated, is much
harder than normal bone. The final stage of repair, after the bone
has been united by a sound bony tissue, consists in the absorption
of the provisional callus, leaving the bone smooth and in proper
condition for continued performance of its function. The whole
process may occupy several months, and if the ends of the frag-
ments are qot in proper relation to' each other the process may be
rendered very long and tedious. In union of a fractured lower
jaw the temporary callus is found to be much less than in ordinary
long bones, the union being direct after the formation of a small
encircling band of temporary callus.

Surgeons declare that the treatment of fractures requires a
greater amount of ready knowledge, skill, and judgment than any
other department of surgery, and that they always approach them
with some misgiving.

Surgeons assure me, further, that fhictures of the lower jaw are
perhaps the most difficult of ail fractures to treat successftiUy, or in
such a manner that there shall be no subsequent impairment of
function, no discomfort, and no deformity.

The diagnosis of fracture of the lower jaw is usually not difficult.
Nearly always crepitation may be found, together with preternatu-
ral mobility, and, I believe, in most case§ there will bo some de-
formity, though in a single fracture of the body of the bone it may
not be marked ; and yet the injury, like many others, may be easily
overlooked unless the attention is specially directed to it. In one
case that I treated the patient was examined by two physicians at
different times and no fracture discovered, although the bone was
broken through the body at the right of the symphysis, and
through the left ramus. The man was afterwards taken to the
Maine General Hospital, and when I saw him crepitation was

i

Fracture of the Jaws. — Fellows. 79

diBtinct, and the deformity and mobility of the parts quite pro-
nounced.

The methods that have been employed for reducing and treat-
ing fractures of the jaw are almost innumerable. The various
forms of bandaging, and external splints, tying the teeth with
thread or wire, piercing the fragments and wiring them together,
have all proved very troublesome or ineffectual, except in simple
cases without displacement of the fragments.

The idea of an interdental splint is far from new, some such
appliance having been used by Pare three hundred and fifty years ago.
Dr. Hamilton used gutta-percha moulded to the teeth. Plates or
splints of metal have also been used, but the peculiar adaptability
of vulcanized rubber for the purpose seems to have been first
recognized by Dr. Gunning, of New York, who used it nearly
thirty years ago (February 12, 1861).

Dr. Bean, of Georgia, used it in the same manner at about the
same time or a little later.

The fullest description of the appliance and its application is
given by Dr. Gunning in the New York Medical Journal (between
1861 and 1867).

For a single, simple fracture of the lower jaw he employed a
splint covering the lower teeth and gums, which he kept in place
without fastening, the upper teeth resting upon the smooth upper
surface, thus allowing free motion of the jaws, and causing but
little inconvenience in speaking and eating. When found neces-
sary, however, the splint was fastened by passing two or more
screws through the rubber and into holes drilled in the teeth. In
all fractures back of the teeth, Dr. Gunning advised a splint fitting
over the crowns of the upper teeth as well as the lower, and so
fastened by wings and straps that the lower jaw shall be held in a
constant relation to the upper.

An apparatus constructed, it would seem, upon correct princi-
ples, but too complicated for general use, was devised by Dr. E. A.
Clark and Dr. Homer Judd, of St. Louis. This consists of two
separate plates fitted upon the upper and the lower teeth, with
spiral springs between, and an elastic sling bandage passing under
the jaw strong enough to counterbalance the action of the springs,
and thus pressure and counterpressure are exerted upon the jaw
to keep the fragments in position, while the whole is movable and
under the control of the muscles.

I have recently been called upon to make and adjust the inter-
dental splint in two cases, in each of which the lower jaw was

80 Original Communications,

broken through the body in the region of the right lateral incisor
and through the lefl ramus.

The first was a merchant of Portland, who, on entering a railway
station in a neighboring town, suddenly became faint or dizzy and
fell forward, striking the face upon the corner of the door-step,
inflicting severe bruises, breaking the lower jaw as described, and
completely severing the superior maxillary bones from all connec-
tion with the bones of the skull. Just what the line of fracture
was in the upper jaw it was impossible to determine ; but it was
probably through the body of each maxillary bone. This lesion
was discovered while preparing to take the impression of the upper
jaw, for, on grasping the upper teeth, the motion was quite free, the
sensation being similar to that of taking hold of a very ill-fitting
set of artificial teeth in the mouth.

The other case was that of a man employed in discharging coal
from a vessel. A staging gave way and be fell to the deck.

One arm was brf>ken, severe bruises inflicted, and the crown of
the upper left central incisor broken off, in addition to the double
fracture of the lower jaw. In each of these cases impressions were
taken of the upper and the lower teeth without any attempt to
reduce the fracture. Plaster models were made and the model of
the lower jaw sawed through at the point of fracture, and adjusted
in normal occlusion with that of the upper jaw. The two were
then put in an articulator, and separated to a small extent to allow
space between the front teeth for taking food. In one case a
superior incisor had been previously lost, and in the other, one was
broken at the time of the injury. This condition was somewhat
convenient, but by no means necessary, in the treatment. ' After
forming the splint in wax to cover the crowns of all the teeth, and
to fill the space between the grinding surfaces of the teeth, the
whole was removed from the articulator, fiasked, packed, and
vulcanized.

In finishing, the rubber was cut away in front, so that the upper
front teeth were not covered, thus leaving a space. A narrow
opening was also made at each side to allow the parotid saliva to
flow into the mouth.

The splint was adjusted to the teeth of the upper jaw, and then
the fragments of the lower jaw were brought into position, the teeth
inserted in the sockets prepared for them, and the jaws kept
closed for a time by means of the Garretson bandage. These were
worn, in each case, about six weeks without removing, when the bone
was found to be so well united that they were no longer needed.

Odontological Society of Pennsylvania, 81

Reports of Society Meetings.

ODONTOLOGICAL SOCIETY OF PENNSYLVANIA.

EECOLLECTIONS AND IMPKESSIONS OF MY VISIT TO
THE AMERICAN DENTAL SOCIETY OF EUROPE, AT
PARIS; BRITISH DENTAL ASSOCIATION, AT BRIGH-
TON; AND THE FIRST INTERNATIONAL DENTAL
CONGRESS, AT PARIS.^

BY W. a. A. BONWILL, D.D.8., PHILADELPHIA.

As your minister accredited to these foreign courts, it is expected
that I shall relate whatever of interest came under my observation.

It is very proper that delegations should be sent on all state
occasions, in order that an estimate may be drawn of just how
nearly related we are to those who are so infrequently in commu-
nion with us. Nothing else has promoted the well-being of pro-
fessions, trades, and societies so much as the close relations of in-
timacy gained only by personal contact with these great bodies.

That we, especially, should know our brothers across the water
more intimately, as a body, is evident, for it would promote a better
feeling than now exists towards " American Dentistry,'* and ma-
terially enhance and elevate the broad standard of dentistry which
is so needed to give all a higher social status among ourselves
and among the classes for whom we operate. The dental journals
have carried every phase of work and thought from all parts to
every hamlet of the civilized globe, yet I know, from this summer's
experience, that we are far from that goal which every true man
could desire, — the status vouchsafed to all the other learned pro-
fessions,— and which we cannot hope to reach until we can learn to
treat each other individually and collectively as is becoming gen-
tlemen ; until we can learn to estimate a man by what he has done,
and extend to him the honor due him ; until we can forget that
science knows no nationality; then dentistry will succumb to the in-
evitable, and divest herself of her swaddling-clothes as a trade. I did
not know when I left here the animus against the " American den-
tist;" but it did not take me long to sniff it when I reached England.

Personally, I was treated with the greatest consideration,

6

82 Itq>orts of Society Meetings.

Everything was done to make my visit honorable and pleasant.
At my clinics, at Brighton, the crowd around me was dense, and I
was told — in fact, I could see and feel the spirit animating nearly
every one— that no closer attention to my speeches nor demonstra-
tions could have been given. To see such an anomaly as packing
— welding — Abby's soft foil with smooth oval points was beyond
belief, and they were as incredulous as my own countrymen after
twenty years' teaching.

When I attempted to demonstrate the extraction of a tooth
by rapid bi*eathing the crowd was so great as to overpower my
patient with fright, and he could not rapidly breathe. But I de-
monstrated it upon myself, to their satisfaction, by their pulling my
beard and hair, pinching, and placing finger on the conjunctiva of
my eye.

But, aside from all this personal respect and attention given me,
I saw clearly that when the reports were made frdm the dailies, no
mention was made of my operations, nor of me further than that
*'Dr. Bonwill, a leading American dentist, was present at the
meetings." Another thing: before I went to Brighton, I found
that my clinics were not down on the manuscript programme, al-
though I had stated in advance that I would be present, and would
assist in every way I could to make the meeting profitable. It
was finally added.

What first led me to suppose that there was an undercurrent of
feeling against the '* American dentist'* was, when I proposed to go
into the American Dental Institute, a branch of which was at
Brighton, in order that I could see what American dentistry was
doing to honor its country, I was begged not to do so, as the
next day there would appear in the circular, published regularly
by the Institute, '* That the celebrated Dr. , an American den-
tist, had honored it with a call ;" and it thereby would give status
to its nefarious business and work to the detriment of the English
dentist.

This American Institute, I learned, had several branches, and
was run by a Jew who was not a dentist, but employed many
young American dentists to give the most approved style of opera-
tions in every department ; and they resorted to extensive adver-
tising and special circulars as operations done only by the '* ad-
vanced American dentist.'' Not wishing to give offence, I did not
enter their portals. Notwithstanding the novelty of all I had de-
monstrated, this treatment could but confirm me now in my con-
jecture that I must suffer silent praise on account of the out-

Odontological Society of Pennsylvania, 83

rageous conduct of many men who were posing as American
dentists.

To make it still more noticeable, I found that I was not down
on the banquet programme for a speech in reply to the toast of
'< Visitors." Now after such personal attention by the best men in
London, and at a banquet given by the dentists alone of Brighton,
whore I had already received the most honored seat, I was some-
what doubtful about accepting the invitation to the grand banquet.
It was so very noticeable, I could but feel that there was some mis-
take, and that it would be corrected at the last moment. This was
not done. At the banquet they gave me, next the officers, the most
honored seat. All went off well until the visitors were called upon
to i*eply to the toast. The French delegates were, with another
visitor, called upon, — none of whose names were down for a speech
on the programme; but my name was not called by the toast-
master. At this juncture I was boisterously called for by a large
number. It was an embarrassing moment to me. I could feel that
the affair was intended to be not an insult to me, but a silent re-
buke, at my expense, to the '^ American dentist."

I had already made a few remarks, at the opening of the meet-
ing, extremely complimentary to the English dentists: That I was
pleased to meet them ; and, while I came to drink from their foun-
tain of experience and knowledge, I should feel that my visit had
been in vain if I could not give some recompense in what I would
demonstrate of the class of operations I was personally doing in
my office. This was very palatable to them, and yet it was not
noticed publicly, except as a *' characteristic American speech." At
the banquet, to be sure that it was not aimed, at me, I, while again
using quite the same language and sentiments as previously made,
spoke of what I had seen* already in England, Grermany, and France,
as to the materials used, finding that plastics were the rule and gold
the exception ; and added, that we in America had concluded that
there was nothing so well calculated to give to every operator such
dexterity in manipulating plastics as excelling in the use of gold in
contour work under both hand-pressure and the mallet. By the
use of " we" I thought I would be sure to take the burthen off my
own shoulders and perhaps please them by the greater authority
than myself, my honored countrymen. This " we,'' however, brought
things to a crisis, as I learned before I retired that night. One of
England's honored Sirs told me that had I spoken for myself alone
all would have been well, as they well understood what my char-
acter and standing was in their country.

84 Reports of Society Meetings.

This feeliog was not univereal, for many men came to me after
my remarks and thanked me for my gentle touch. While very un-
pleasant for me at the moment, I did not regret that the blunder
was made, for it brought to the surface what was already at fever
heat; but the English dentist was too proud to speak of it, unless
some good opportunity should offer. I am glad to have been the
means of their laying before me, in all its blackness, the doing of
the " American dentist" abroad. I shall expose these to you to-
night in order that something may be done to make a radical
change, so as to blot from the European escutcheon the ignoble
title of ^' American dentist."

To make my position impregnable as a bearer of despatches
to you from the dentists of Europe, I wrote to many of the leading
practitioners in England, France, and Germany, and they were
unanimous in denouncing the average American dentist as found
among them. I need quote but from one of the best men in
London. He said, ^^Then, there is another thing. We are ac-
customed to have everything possible made use of and perverted
for their own purposes, by advertising-folks, like the American
Dental Institute; and it was thought — I do not know as I said it
before of my own knowledge — that your speech contained some
plums for them — this Institute — to pick out and use."

This tells in unmistakable language what I had to bear for my
countrymen, because of the dishonorable and disreputable men from
America. There are others, too, who come from England, as well
as from all the European countries, for the sole purpose of returning
and placing on tlieir signs the reputable and honored name, <' Ameri-
can dentist," many of whom cannot speak one word of English.

The blunder of simply saying " we," while making me the target,
also gave me the high privilege of being the exponent of the ag-
grieved, and I shall feel amply rewarded for the unpleasant position
in which it placed me, if the schools of this country grow more
careful in the class of students and the restrictions tbey place
upon those intending to practise abroad. I was asked to lay this
matter before my society, and have it agitated in order that this
condition of affairs may soon terminate. To go on would place
a veto on all international congresses, whether associated with the
medical or as dental only. Were another congress to be held in
London or England, Americans would not have a right to expect
the courtesy which was so extensively lavished upon them in 1881.

The noble movement of the dentists of England then, in gaining
for us a recognition in the ^'International Medical Congress" for the

Odontological Society of Pennsylvania. 85

firBt time, entitles them to the highest consideration and thanks.
Everything is heing done in their schools to give that social status
to the dentist which is enjoyed by even the average medical man.
They are more careful than we, by far, about the higher general
education and men who have already better social standing. But
they feel that their work is largely in vain when we are turning
out such vast numbers to flood the market and sail under the
banner of '' American dentist.''

While the average Englishman is a free-trader, yet, when it
comes to the professions, he at once sees that it is unfair and un-
profitable. Free thought they advocate, but not the freedom to
force ignorance and ordinaiy ability upon them under the name
of ^' American dentist.'' That they honor individual Americans for
much of the advancement and progress of the last quarter of a cen-
tury, and adopt the methods and practice of any of us who have
proven it to be best, I have the honor to know, and the name of
such is never withheld.

Until this assumption of one country over another as to being
first can be settled to the honor of all, we need not expect that
such parading will add to the character of dentists before the
world. While America has justly the right to the title and honor
of leading in the race of practical dentistry, we need not feel that
it is because we have any better material to make dentists of. I
found as bright men wherever I went as we have at home. But,
gentlemen, circumstances very much alter the results. We have
had the widest field for development in the immense destruction of
teeth from our habits, with more general distribution of wealth to
pay for operations, while in Europe it is the reverse. How few
dentists are to be found in Germany, France, or England compared
with the number in America ! Besides, as dentists become better
educated and are brought from the ranks of such as can be
made gentlemen, and who value the tone and air that hang around
the true professional man, we shall find fewer turned out than
now.

At present there are more dentists than have a right to legitimate
business, unless they will turn their attention to the poorer classes
who are in such need of the competent operator. I can see that
competition must come to the rescue or the poor will go without
their teeth being preserved. Artificial teeth will be the universal
degradation of the poor, and no effort will be made to rescue the
living organs. I had many examples of high-toned American den-
tists pointed out to me who had given no cause for offence, and

86 Reports of Society Meetings,

who had at the same time made large practices without having
advertised or spoken against the native talent.

I do not wonder that the American dentist should have such
bad repute, and the feeling against the American physician is just
as high. Grermany and Switzerland particularly are growing more
intolerant every year. When you consider how impoverished the
average medical man or dei^ist is in any of the European countries,
you can well understand that self-preservation must step to the front.
If we could make the operations cheaper and better, and could reach
thereby the poorest, who need our services as well, we might have
the American push on.

One strong point I must make against my countryman is that,
when he goes abroad as an American dentist, he does not hold up
the standard of dentistry as taught here, but at once falls into the
same rut as the native dentist. Many of those I met abroad con-
fessed to me that they would starve if they did not give up and
cater to the desires of those who had been educated to a certain
standard I Few plates of partial sets are made without clasps, and
the old gold spiral springs, which are seldom used in this country,
are still in universal favor wherever I visited. To attempt to make
them without would be suicidal to even the American. Instead of
extracting every root, as we do here, all are retained and the plate
placed in over them.

I did find one exception, in my student at Leipsic, — a graduate
of the University of Pennsylvania, whom I taught my plan of
articulation. He has braved it because he has a remedy by which
he can do without the spring. When this is generally understood
and practised the rule will change. If our men would follow the
line of practice taught them, they could more honorably place on
their cards, not " American dentist,'' but " Graduate of an American
school."

Again, they take advantage of their own inability to perform
good and lasting fillings, and resort to crowning in every instance,
where we know that amalgam, and even gold, and for less money,
could have been used. The reckless destruction of splendid teeth
by crown- and bridge-work is something too awful to contemplate.
I have seen, not only in Europe but at home, teeth crowned that
could have been preserved for ten or fifteen years with amalgam,
and often with gold. I heard one of our American boys, on the
other side, boasting of the character of his practice, which had
almost been revolutionized since crowning came into vogue, and he
was doubling his income.

Odontological Society of Pennsylvania. 87

Now, while the average American has acted 80 uDprofessionally
abroad, I can see that his mission has aroused the native dentist to
attempt more than he ever did before. His energy has been doubled,
and it has urged him on to study and to fly. for graduation to some
school at home or abroad ; and thus the American has been a bless-
ing in disguise.

On the whole we cannot blame the American so much, for he
has only gone, just as the Englishman, where the English language
is spoken. This thing will correct itself in time. The schools in
England, France, and Germany are doing a good work, and are
holding on to many students who once would have sought our
shores. In the University at Berlin I found, under Professor Mil-
ler, two hundred students. When I gave a clinic with gold and
smooth points in my mechanical mallet, they piled up around me
as if they were greedy to see and profit thereby. They were full
of enthusiasm. The professor of mechanical dentistry gave me
especial attention when I demonstrated my articulator and its laws.
He sat up all night to arrange a set such as I had exhibited, so
determined was he to succeed before I left. This school will be a
great thing for the German student, as soon as Professor Miller can
have more help from demonstrators. The burden on him now is
rather too much. The demands in that country cannot be great,
and consequently the number of students must be for a long time
rather limited as long as there are so many poor who cannot pay
high prices.

In Paris there are two flourishing schools, in which there is
rather too much rivalry, but no more than to be found here. The
French are ready and willing to add their ability and earnestness
to elevate their profession. Their enthusiasm is unbounded in
whatever they undertake, and I see no reason why there should
not be a central school, where, from their ingenuity and precision
in all lines of work, they should make splendid dentists, who will
rival any of us.

It would be impossible to give you any idea of the character of
the operations done in England and the continent, as their offices
are sealed books. I could judge of them only by the description
from each individual. The clinics given at the Brighton meeting
I could not see on account of being engaged on my own work, but
they were not very extensive. The papers read on ansssthetics were
fine and worthy the highest commendation, showing thorough in-
vestigation and practical experience. The mixing of oxygen and
nitrous oxide was certainly of value, and should be always used, as

88 Beports of Society Meetings.

it no doubt lessens any tendency to injury and obviates that purple
hue so frightful to look upon when the gas alone is given.

These papers alone gave character to the whole proceedings and
had an elevating influence. The practical part of dentistry did not
have much show in extensive papers. Prosthetic dentistry was
scarcely touched, and no discussion on the one paper that was read.
The microscopical section was very fine, and showed great care and
research.

The many abnormal and anomalous cases were not only interest-
ing but instructive. Many plans of pivoting were shown as models,
and bridge-work came in for its full share, even in England. There
was one method of removable bridge which was well worthy of
special mention. It was a bar anchored permanently between two
teeth by either caps or amalgam in cavities of decay. This bar was
narrow and allowed to be as wide or deep as possible, reaching from
the gum to grinding surface, that it should prevent the teeth,
which straddled the bar, from moving laterally, but allow of suffi-
cient frictional bearing to keep the block of teeth firmly thereon.
"Where there was plenty of room, or rather depth or length to the
crown, it was very practicable. It reminded me of Dr. Wm. C.
Eastlack's plan of doing black work on metal plates.

The exhibits of manufacturers of teeth and instruments and
chairs were fully equal to anything I have seen at our American
Dental Association meetings. The English tooth is certainly
beautiful and well made, and has all the advantages of ours, except,
perhaps, it will not stand the test in soldering on account of the
greater density. But for vulcanite and crown — all porcelain — we
need nothing stronger or more beautiful and natural in the mouth.

The buiTs given me by Ash & Sons are all cut by young women,
and compare well with anything we have on this side of the water
made by men. The '^Dental Manufacturing Company'' is not
behind in anything, and proves that dentists can manage such an
establishment both with profit and success, as well as manage a
dental journal in the interest of dentists.

The colleges I had no chance to visit, as they were practically
closed in London. While so much has been done to raise the stand-
ard, the end in view — to give to dentistry the same status as the
physician — is not an accomplished fact.

I sat beside an M.D. who, with many other physicians, was a
guest at the banquet, and, in conversation with him, he frankly
stated that dentists were not considered on a par with physicians,
although associated in the section of an International Medical

Odontologiccd Society of Pennsylvania. 89

Congress. They feel towards the bulk of them their superiority,
and only a favored few have the coveted social standing. I know
one who was highly respected by the English dentists, yet he told
me that the social status of dentistry, whether American or native,
is far from gratifying.

We need not soon expect that same social position and recogni-
tion held by medical men, who have labored for years to reach it.
Then, a higher educational step, such as the colleges in this country
have just taken in the three years' course, will, if they have an
honest preliminary examination, rapidly elevate the dentist. In
England they are surely working to this end. I can see the
barometric marks of* elevation since I commenced in 1854. While
you may turn out of your schools all that may come, instruct them,
should they go abroad, not to assume the name of " American den-
tist," thereby implying a superiority to all other nationalities.

As I said, science is broader than nationality, and we should be
a universal brotherhood, that, by our conduct to each other, we can
let the world see that we are above the competition, of the trades-
man. This is all they ask of us abroad. So high has the feeling
run against us, that the American Dental Society of Europe is
frowned upon by the natives all over the continent, and it has but
few to attend its gatherings.

The patent craze, in England, is not without defenders, espe-
cially when it comes to certain articles that require time, capital,
and labor to perfect and put on the market, and where they are
adapted to other uses than dental. Notwithstanding the number
of inventions I have patented, I was not cut at, as at home, at any
place or by any one. One prominent dentist of Paris, who had al-
ways opposed me, when in America, on patents, after he had read
my argument in the International Dsntal Journal for July, 1889,
and after a talk with him and some invited scientific gentlemen on
the laws of articulation and its application against evolution, asked
me, " Bon will, did you patent the articulator T For several days I
gave him no reply. He said, '^ If you did not, you should have
done so, for it well merits a patent."

Then I feel satisfied that, if wo shall have more consideration
for the dental profession on the other side, and shall teach students
not to use " American dentist'' on their sign or specially refer to it,
but simply to state the college or colleges where they have gradu-
ated, we shall bring about a change in the condition of affairs.

I would, in the mean time, advise my English friends to dash
ahead and show that they can be equal to any emergency. Let

90 Reports of Society Meetings.

tbem rise above such surroundlDgs, and take the advice which I
so generously gave them at the banquet, and which I gave where-
ever I went on the continent, to cultivate the art of filling with
gold, as I showed them at ray clinics. This would not only enable
them to place in more gold fillings, but, from the less time consumed
by these methods, they could make equally as much money as when
plastics are used. Besides, patients would bear the operation with
pleasure, since gold certainly looks superior to amalgam in many
places ; and, as to pain, it could not bo an objection, and the time
consumed would not be much greater than that for some amalgam
fillings or the placing on of a crown.

If they could universally change their system of fees, I think,
they would command more profit and be to the advantage, in every
way, of operator and patient. But whatever changes they may
make, there cannot be so many teeth preserved satisfactorily unless
more time is taken to wedge them apart and contour every
approximal filling. If they only use amalgams and other plastics,
it must be done only by getting greater space between the teeth to
prevent future decay, a^d make it tolerable in mastication. Con-
touring in England and on the continent is done but seldom ; nor
can it be done to be of value unless, as I have said, time is taken to
wedge teeth apart to prevent future caries.

Then what I said at the banquet, at Brighton, I do not regret,
for it brought to the surface the drift, and I have no doubt of the
result of the airing. When we look at homo, we find the same
spirit existing among our own countrymen. Jealousy, envy, and
competition, from members alone, is rampant, and so it may ever
be. We have, perhaps, as great a number of poor dentists, in
proportion, as elsewhere. Higher education and better material
will weed out the weaker, and by the strenuous execution of the
laws we can expect that dentistry will rise or go down, as, by the
laws of political economy, they must.

We should not lose sight of the ever-present fact that the poor
are not to be forgotten. We cannot all be high chargers. We
must let every man set a valuation on his own operations, and he
who does the best need not fear. The increasing numbers will or
should make it better for the world at large.

The American Dental Society of Europe I attended in Paris.
They had a two days' session only. But few were present, and
they mostly Americans. As I before intimated, it is not recognized
by the natives of England or on the continent. It is evidently
kept up as a social affair. I do not think the natives should feel

Odontological Society of Pennsylvania. 91

too strongly towards them, for it is not done to keep out any one,
no matter what his nationality. It is only a few of the natives
who can travel the long distances and go to the expense, unless
there could be a universal language. The many literary journals
now sent to every hamlet fill largely the place of the dental society
in countries where men cannot afford to travel. The illustrations
and fhll proceedings of the principal societies in the large cities
are so complete that men need not often leave their offices to know
what is being done every month. Now and then clinics can be held
that reinforce the mere description of difficult operations. To me it
was very gratifying to meet dentists whom I had known through
their writings and labors. Go where we will, each nation has
its colony; socially, nothing is thought of it; professionally, they
should be tolerated, if no insult is. intended to the nation on whose
ground they meet. It might be less objectionable to call themselves
the Americo-European Dental Society. I saw as good operations in
gold, amalgam, tin, tin and gold, oxyphosphate, and gutta-percha,
in one mouth, in contour as well as flat surfaces, done by a German
dentist as well as I could ask at the hands of any American dentist.
. They did not do justice to the meeting, for there was such a rush
to 'Mo'' the exposition and hurry back to their offices. The prin-
cipal feature was the lantern exhibition of Professor Miller of his
special work in bacteriology, which was very fine ; but this can be
really better studied when trunsfeiTcd to a journal and experiments
are made in one's laboratories. The subject of gold and tin for
filling was fully discussed, as it has been before, without new light
from those who advocate it.

I was asked for my views as to the conservatism of filling-ma-
terials, and I had occasion for the first time to combat the views of
Drs. Miller and Jenkins, who are the bulwarks of the gold and tin
combination. This elicited from them the true reason why they
use it so largely. 1st. Gold alone, in caries of any extent, is not
only too expensive for the bulk of their patients, but they cannot
afford to take the time necessary to pack in so much gold with the
old methods and appliances they still use, and the patients will not
put up with lengthy operations. Tin alone, while it will save, thoy
admit, as well as the combination of gold and tin, yet, it will not
stand mastication so well as the latter. 2d. In teaching at the
Berlin University, the combination is almost exclusively taught
over gold, for the reason that it can be more easily grasped by the
average student than learning to manipulate gold by the ofd plan
that has proven a failure.

92 Reports of Society Meetings,

Professor Miller and Dr. Jenkins were fair enough to say that
they did not doubt my ability, with the instruments I used in clinic,
especially the mechanical mallet, to do all I claimed in the use of
gold ; that it would perfectly preserve tooth-structure in just such
cases as I advocated, as well as the combination, and more, — ^that
perfect contour could be restored, and would resist mastication,
which would be impossible with the combination. But, inasmuch
as most of their operations are made flat faces with permanent
separations and allowed to approach each other at the cervix, when
caries does occur again it can more easily be repaired or renewed
than if gold is used.

They further admitted that, with such an instrument as the
mechanical mallet, with the points I am now using, it is possible to
put in a large contour gold filling as quickly as when done with
gold and tin. So that there is really nothing in the combination
that cannot be done with gold alone, provided the operator has the
ability to manipulate gold as easily and has our advantages of ap-
pliances. Then I could well understand that it was justifiable to
use the combination if the patient had not the money, nor the time, *
nor the pride to submit, when there was a probability that gold
would not last. When I placed in a large compound filling of gold
at the University of Berlin, Professor Miller admitted it would take
him as long to have done it with the gold and tin. ^

There was but one clinic given besides the one I gave in amal-
gam ; because of an injury to my right index finger I could not make
a gold filling. I found that my method of impacting amalgam
with bibulous paper under heavy pressure was quite universally
practised ; but, strange to say, the true spirit of the procedure was
not grasped. They mixed their amalgam too thin, and did not use
as much pressure as would perfectly drive out the mercury. I
found the same trouble in England, which arose from a miscon-
struction of the description given by Mr. Charles Tomes. Myelinic
soon convinced them that the amalgam, while it should not be
squeezed dry, should be as stiff as could possibly be worked in the
palm of the hand with the fingers.

To be satisfactory the meetings of the American Dental Society
of Europe should never be less than three days. The social side
was iblly met by a splendid private entertainment given by Dr.
Crane, and the banquet, which was on the Eiffel Tower, was unique
and in every way a success.

I regretted to see so few of the French dentists and of the Amer-
ican dentists of Paris in the meetings. I think, if they would use

Odontological /Society of Pennsylvania. 93

their efforts to form local societies throughout Europe, it would
have a happier and more useful effect in drawing together men who
would be glad, no doubt, to gain knowledge from any source. There
is not enough new material every year that is worthy of exposure,
and they should have a triennial meeting when the International
Medical Congress meets in Europe. This would be quite often
enough, unless it be for social and mutual admiration.

I was invited to clinic and lecture in Leipsic, Germany, but my
stay was too limited. This school is very well fitted up, and com-
mands quite a class, which is largely German. The students are not
taught the use of gold for filling as we understand it, for they have
not the appliances. They were very desirous of seeing me operate in
gold and amalgam. In fact, wherever I went they were anxious to
see how we do things in this country, and they had some curiosity
to see how fast I could operate, and^the reason why it could be done
so much quicker than by their processes. I said thej"^ are not taught
at the university any but the slower methods. While this is a fact,
yet it need not bo so, for my student. Dr. Paul Schwartz, of Leip-
sic, a graduate of the University of Pennsylvania, who is demon-
strator in their Mechanical Department, is well capable of teaching
them every minutia as he was taught here. He has necessarily
met with opposition at his own home, as our system is so radically
different; yet he persists in carrying out to the letter what he
knows from the chances he had in witnessing so many of my pri-
vate operations. In a short time, notwithstanding the chances
are largely against our methods, with such men in their midst,
great changes may be expected.

It is not that the European dentists do not wish to learn and
adopt the very best system; but with them reform must come
slowly, since they have not the means at their command in the
shape of wealthy patients. Since it is an accepted fact that gold
can be packed so quickly as to overcome the serious objection to
its use of consuming much time without adequate pay, and that
crown- and bridge-work can be made so profitable, as perfected in
this country, they must adopt it very soon or fall far to the rear.

It remains for me now to speak of the First International
Dental Congress, held in Paris, September 1, 1889. As the first ex-
periment of an International Dental Congress it was a grand success ;
and considering the opposition given it both at home and in Amer-
ica, and England particularly, it was marvellous that it should have
had so many delegates and attendants. It was not surprising that
it should have met such stanch opposition. It was a serious ques-

94 Reports of Society Meetings.

tion whether such a step would not be Bufficient ground to make the
International Medical Congress, as well as the American Medical
Association, refuse further to recognize us by a section in their
meetings.

I am proud to have been one of its members, assembled to test
whether we had the ability to stand alone. Its representation was
equal to that of any congress held in Paris, and by men from every
country in Europe ; and even from America, where so much was
done to make it a failure. As to enthusiasm, we had it from the
moment the congress opened. The meetings were replete with
interest and the rooms always full, notwithstanding the attractions
of the Exposition and of the gayest capital of Europe.

The clinics were crowded to suffocation. Once I had to give up ;
the numbers were so great I was almost suffocated, so anxious were
they to see everything done which was calculated to demonstrate
the greatest advances of our art. Never before, on any occasion,
did I see so many wild with delight at the sight of so much- to carry
to their homes. While the element was largely French, there was
not such complete organization as could have been wished; yet,
like everything done in Paris, on this their greatest f6te, it was
worthy of having been born on French soil.

It was just there where the congress should have had its birth.
There, in conjunction with so much of the Old World, which
needs to have had this at its own doors, we, who are ahead
in the race as dentists, should have been glad of the opportunity
of lending a helping hand by our presence and action. If dentistry
needs the cultivation of art, with the science which has been
achieved, it would be more apt to receive it from France ; for surely
she stands at the head of the world in all that is grand and beauti-
ful in art and sculpture, and to aid such a people in our peculiar
practical way would have not been lost to us. Besides, we need
not feel that we are the only ones who have done anything for
dentistry. When the French once get a start under their new
Bepublican principles, we shall see an advance in every line that
will startle us. Hence, I say, ^' Yive le First International Dental
Congress," for the good work it did in arousing the dentists of
Europe.

As to whether there should be a second congress is a matter to
be discussed. Now that the physicians have given us a section, it
is well we should hold to this, at least until we become so unwieldy
a body that we shall have to stand alone. The advantages of our
present association with medicine is surely something. To have

r

OdontologiccU Society of Pennsylvania, 95

been recognized as worthy of the attachment to the main body,
establisheB the fact that we have done it for ourselves, and not that
we are so much the gainers as they. The French will not have
their pride touched should there not bo another similar meeting
anywhere else. They did a good thing, and they will feel and see
its influence in the future, and there was not a man at their meet-
ings who regrets he participated.

As to the social side of the congress, it was equal to anything
to which I was ever invited. Their banquet as well as their private
entertainments had an enthusiasm and spirit shown that would be
well for us to imitate. They surely believe in enjoying life to the
full.

The cases at the Exposition of cleft palate and various restorations
of the face were the largest collection and finest I ever saw. In
this work they excel. For some reason they have more of such
operations than we have, and they lead us here. I saw one case in
the private practice of Dr. Michaels where all of the superior max-
illa to near the orbit of the eye, and as far up and back as possible
to reach without involving the main arteries and the whole of the
inferior jaw, had been completely removed by one of the celebrated
French surgeons. It was a frightful case. I have here photo-
graphs of the woman before and after the restoration by Dr.
Michaels, of Paris, who was successful in placing in not only a
nose and upper lip, but a set of teeth for both jaws, so far as ap-
pearances go, but not for actual use, as it was impossible for him to
take an impression. He had to fit the whole thing in by individual
pieces. The appearance was all that could be asked, but it necessi-
tated a great deal of trouble to remove the apparatus and cleanse it.^

^ In further justice to Dr. Michaels, I must mention his new style of gold or
silver plates for artificial teeth, which was rather unique.

Clasped plates, as small as possible, are the rule on the continent ; and, to
enahle the operator hastily to form a plate without getting up dies, he con-
ceived the plan of having twenty-two-carat gold rolled into sections or blocks
of one-sixteenth of an inch square, so that the blocks were held together by
not being cut entirely through, leaving the plate very thin between each section.
With a cloth, or the finger alone, this could be pressed on to the surface of
the plaster cast and take its form quite perfectly. The clasps and teeth are now
adjusted on to the cast, and the plate held down on the plaster cast with wire.
Twenty-carat solder is run on the surface of the plate, which fills up between
the blocks, and makes a solid plain surface and quite stiff. The plaster cast
has as much sand mixed with it as is used in making the usual investment for
soldering. For cheap and hasty work it is good. The great objection with me
would be that, as I never solder the clasps to the plate from the plaster model

96 Reports of Society Meetings.

One very novel instrument that I saw was a pair of forceps, at one
of the schools, invented by one of the professors. It was on the
same principle as a monkey-wrench, with the regular jaws of for-
ceps, which enabled the operator to hold the jaws or beaks in close
contact with the tooth to be extracted, and there was no possibility
of crushing the tooth, nor slipping off, from grasping too tightly.

Compressed air and electricity are playing quite a part in many
of the offices in running all their machinery, and aiding in many
ways to secure better results with less expenditure of force. My
own clinics were in gold and amalgam filling, and the use of the
articulator in making artificial teeth. It was a surprise to all to
see perfectly smooth oval pluggers wiping in gold at the rate. of
one book and a half in forty-three minutes ; also how it was possi-
ble to make Abby's old-fashioned gold foil adhere as perfectly as
any of the most cohesive foil. Compared with the slow packing of
gold this was to them a revolution, and they could well see and
express the belief that it was now possible for them to begin to use
gold as much as we do, and get results never before attained.

When I spoke before the congress of my articulator and its uses
and the importance of the geometrical laws concerned in studying
cases of irregularity. Dr. Davenport read the following, which I feel
in justice to myself should be repeated :

^' The long observation and study I have given the articulation
of the. teeth, with the hope of determining the laws governing their
relations to each other and to the surrounding parts, anatomi-
cally, physiologically, and mechanically, enable me to appreciate
with the keenest delight what Dr. Bonwill has so beautifully ex-
plained to us. He has expressed a most intense practicality in the
very highest scientific terms.

'' Those observers who object to ideal standards of comparison,
and insist upon average conditions as the only safe basis, ought

on account of making an imperfect fit, I fit the plate to mouth first, then the
clasps to teeth in the mouth, and while the plate is held ^in position I place
plaster over the clasps and plate, and allow it to harden, and when removed
from the mouth run into this plaster and sand and solder. This will always
make perfect adjustment, and there will be no wear on the teeth and the clasp
can be very loose. To do this with Dr. Michaels's plate, it would have to be
soldered over its face first, and then the teeth and clasps afterwards. I saw this
same thing at Louisville, Ky., in 1888, but made from fine twenty-two-carat
wire gauze or netting, and the meshes afterwards filled in with solder. I think
this would make a better adjustment. This is only intended for partial sets ; it
will not do for suction.

w

J

Odontological Society of Pennsylvania. 9t

to close their ihouths until the pure science first taught by Dr.
Bonwill penetrates their ears, and their eyes have seen its practical
results.

'' As a profession we ought to confess to Dr. Bonwill our regret
that the meaning of his words uttered thirty years ago are only
now being comprehended by us. To-day, the profession, in reopen-
ing an old mine, has uncovered a priceless gem which once was
thrown aside as worthless."

I had previously explained, on several occasions, to him and
several scientific gentlemen whom he had invited to meet me, until
he had become very thoroughly imbued with its importance, as the
lines just read plainly indicate.

I do not know whether you will consider it any honor to you
for your delegate to have had any special favors shown him at the
congress ; but, as it was done, and as no one else received a like
ovation, and as it comes to you in the report of their own journals,
you cannot doubt it. They could not have shown more consid-
eration for any hero, and it was done unstintedly and on all
occasions.

I trust there will be no misunderstanding of what I have said by
any of my good friends on the "other side," for I have sedu-
lously endeavored to impress my countrymen with the facts as I
have received them. Something should be done to harmonize the
status of dentistry in all parts of the world, so that each man can
feel that there are no lines of nationality ; that the sole aim is the
greatest good to the greatest number. We must always expect
more or less of contention, for the medical profession, ailer three
thousand years, has the same to face everywhere. The native
practitioner is always jealous and envious of the foreigner wherever
he may be. We have it here, rampant, in every hamlet. The best
way to eradicate it is to make ourselves competent, and so far above
the competition as not to fear his inroads. This must lead the
weaker one a step higher also.

As we appear to have so much in our hands that is calculated to
advance the interests of dentistry, and make us all more akin
throughout the world, I would advise that we do all we can to
make of us a profession that knows no nationality, that every man,
in whatever nation he may be born, educated, or may practise,
should feel the assurance of being well received here, and that,
when any of us go abroad to practise, we shall do nothing under
the title of " American dentist."

7

98 BepoTts of Society Meetings.

<< isrvAnnTMn '*

DISCUSSION OF DR. S. P. WRIGHTS PAPER ON "BLEACHING.

Dr, E. C. Kirk. — I feel that the thanks of the society are due to
Dr. Wright for the trouble he has taken in coming to oar meeting
and giving us the valuable and practical points which he has pre-
sented in his paper. I am especially interested in one point he has
made, — ^viz., the necessity for the complete removal of all fatty
matter from the tooth-structure previous to the application of- the
bleaching agent. While I have not experienced great difficulty in
restoring teeth of a bluish tint to a normal color, I have found —
and I have no doubt that it is the common experience of all who
have made the attempt — ^that it is well-nigh impossible to get satis-
factory results in bleaching teeth which are of a dark yellow or
brown tint; and this result obtains regardless of the agent or
method employed, for, I think, I have tried them all. It may be
— and indeed it seems likely from the experiment reported by Dr.
Wright — that a complete removal of all fatty matter by the method
he suggests, or one of a similar nature, may prove to be the solution
of the difficulty in these obstinate cases.

A special point made by the speaker, and one which cannot be
too strongly emphasized, is the necessity for continuing the treat-
ment until the bleaching agent has penetrated to the ultimate ends
of the dental tubuli, otherwise a recurrence of discoloration will re-
sult. With regard to the choice of use between dry chlorine and
its aqueous solution, it is well to bear in mind that, in general, chlo-
rine bleaches best in the presence of moisture. It does not act
directly on the coloring matter, but indirectly, by virtue of its
affinity for hydrogen. In the presence of moisture it seizes upon
the hydrogen of the water molecule, liberating its oxygen, which
in its nascent state is the active bleaching agent.

Dr. Head. — When the fatty matter is to be removed, is your
cavity moist, or dr>'?

Dr. Wright. — I do not think it of much importance whether it
is wet or dry. The obstruction to the passage of the chlorine
water, from the centre to the periphery, must be removed. This I
believe to be the fatty matter. The other day I took some hygro-
metric material, placed it around a tooth, exhausted the native air
by the piston, and put in four or five drops of ether, which, with the
loss, amounted to perhaps two drops, and by means of the chlorine
the tooth was made beautiful and white. The apparatus which
has been shown is simply a means of putting the tooth in a
vacuum.

Odontological Society of Pennsylvania. 99

«

The most important part is the removal of the fatty matter ;
after this is done, pack your cavity with cotton saturated with dis-
tilled water, and with your syringe inject the chlorine gas, and you
have chlorine water at work.

Dr. Head, — I know if you drop a dry tooth in ink it will
be colored only on the outside; but if the tooth bo previously
wet with water, it will be colored through and through. I
thought this might make some difference in the action of the
chlorine.

Br, Woodward. — Is the apical foramen open, or how do you fill
it?

Dr. Wright — At the apex I put gold to one-third the distance ;
then gutta-percha ; scrape out as much dentine as the tooth will
allow, and then proceed. Always scrape out a little more than you
think is enough.

Dr, Sudduth. — Dr. Wright has given us clinically what I have
demonstrated microscopically in the laboratory, and my obser-
vations coincide perfectly with his theory. The histology of the^
part, as I have demonstrated for fifteen years, shows that coloring-
matter can be extended along the living fibres. On the other hand,
I have taken a tooth and made a section of it, immediately follow-
ing an inflammation of the pulp, and found a condition of fatty
degeneration in the dentinal fibrillse. When this is present the finest
tincture will not succeed in coloring the periphery of the fibres; but
when the fat is removed by ether, the staining shows to the very
outside.

Dr, Truman, — ^I confess to being much interested in the paper
and the remarks of Dr. Wright. I think his process marks an
advance, and should be permanently brought forward, so that all
may become familiar with it. I imagine very few here have a
practical idea of its form or application. I have had so much to do
with bringing this subject before the profession, and have had to
combat so frequently unthinking prejudice, that I feel disinclined
to say more upon it.

Like all other processes, it has had its period of origin and sub-
sequent development, its time of crude ideas and more perfected
modes; but the education of dental thought in this direction has
not kept pace with improvements.

The professional mind is no more prepared to-day to believe that
the bleaching of teeth is a part of operative dentistry than it was
twenty-five years ago, when I first attempted to prove its impor-
tance. This is due, doubtless, to many reasons ; but prominently to

100 BeporU of Society Meetings,

the one fact that but few will observe the rules laid down for their
government; and, consequently, the result does more hann than good,
the process shouldering the responsibility of the failure. Hence I
welcome an apparatus that eliminates, to a large degree, the personal
equation.

The use of chlorine for bleaching is not new ; indeed it is the
oldest process ; but its irritating effects made it impossible to use.
Dr. Wright's apparatus overcomes this entirely, and hence my
reason for some degree of faith in it. I have not seen it in opera-
tion but in one case, and that was one of the worst possible. This
came into my hands for treatment after it had been tried by some
inexperienced operator. I found it entirely black. Suspecting the
cause of this, I proceeded to bleach in the usual way, and soon
returned the tooth to a deep yellow tinge. This the patient re-
ported as the original shade. Satisfied that this color could not
be changed, I handed the case to a professional friend to try his
plan. This resulted the same way. Dr. Wright, happening in the
fXty at the time, made a fourth attempt, and the temporary result
was remarkable ; but, unfortunately, it failed as the others had done*
This case is cited in detail not to antagonise the process, but to
emphasise the difficulties that must surround ail attempts at bleach-
ing, and the importance of giving more attention to it. We have
yet to learn whether speedy bleaching by Dr. Wright's process will
be as lasting as by slower modes. If this proves to be the case,
then there is no question but that we have in this plan a more
effective mode than has heretofore been brought to the notice of
the profession, and one that is, at the same time, so easily applied
and is so positive in its action, that it would seem to have a future
of usefulness before it. I, however, do not believe it or any other
process will change the yellow color of teeth. These constitute but
a small proportion, the blue predominating.

Dr. Jameson, — Can one-half or one-third be bleached ?

Dr. Wright — More.

Dr. Tees, — How often is the apparatus used before the bleaching
is done ?

Dr, Wright. — ^Only once.

Dr. Tees, — How about the tooth of which Dr. Truman spoke ?

Dr, Wright, — As I said before, there are some teeth that cannot
be bleached;. and I think the doctor admitted thai; this particular
tooth had resisted all other efforts to bleach it. But I find that
ninety-five per cent, of all teeth may be bleached.

Dr. Tees. — Will these ninety-five per cent, remain white long?

Odontologiccd Society of Pennsylvania. 101

Dr. Wright, — I can show you cases that have been bleached
more than eighteen months, and they are just as white now as when
first done.

Subject passed.

INOIDENTS OF PBAGTIGB.

Dr, Place. — A young lady came to me suflfering periodically
with severe pain through the nerve which supplies the first and
second lower bicuspids on the right side. She had been suffering
for over a week. It comes every half-hour or fifteen minutes, and
lasts five or ten minutes. While it lasts it is excruciating. A care-
ful examination of the mouth showed the wisdom-tooth and
second molar in place, the sixth-year molar having been extracted
years ago. In the wisdom-tooth as well as the twelfth-year molar
there were large amalgam fillings. The bicuspid teeth are entirely
sound, with no sign of decay between them. I took an instrument
and tapped it lightly on the wisdom-tooth, also on the twelfth-year
molar, and in neither could I get a response. As soon as I tapped
the second bicuspid she felt a slight pain. I applied the rubber
dam on the wisdom-tooth, to see if the nerve was alive, and found
it was; likewise that in the twelflh-year molar and that in the
bicuspid, — all alive. I hardly knew what course of treatment was
indicated. I applied to the gums arsenic and aconite, and she is
now under the care of a physician, who, I suppose, is treating her
with quinine. If there is better treatment I would like to use it*
By pressing on the nerve at the mental foramen, there is a tendency
to relieve the pain. It was used several times when the pain was
very severe, which gave temporary relief.

Dr. James Truman. — ^Are the teeth very dense? If so, there
might be granular deposits in the pulp. I think I should drill into
one of these bicuspids.

Dr. Bassett. — Is it not possible that this trouble comes from the
wisdom-tooth, — from the amalgam filling? The trouble might be
reflected forward into the bicuspid. I have seen one or two cases
where this has been the result, and it may be so with this case.

Dr. Kirk — I think the fact of cold relieving the bicuspid pre-
cludes the idea of the trouble arising from pulp granules.

Dr. €hiilford.-^A% there are several points in Dr. Bonwill's paper
about which I should like to speak, and which I think others here
would like to discuss, I move that the discussion be postponed until
our next meeting, owing to the lateness of the hour. Carried.

The meeting then adjourned.

102 Reports of Society Meetings,

NEW JERSEY STATE DENTAL SOCIETY.— (CbncZw^cf.)
Wednesday y July 19, 1889. — Evening Session,

The roll was called, forty-two memberB present.

Dr. Watkins, chairman of the Executive Committee, reported
that that committee had agreed to make an assessment upon mem-
bers, for the purpose of defraying the expense of publishing the
proceedings of the society for the first ^ye years of its existence.
Also, that, as Dr. Sudduth has offered to reprint, free of cost, one
hundred and fifty copies of the proceedings of the society, the
International Dental Journal be made the ofiicial organ of the
society for this year.

On motion the report was received.

Dr. G. Carleton Brown. — Mr. President, in regard to the assess-
ment ordered at the last meeting and made by the Executive Com-
mittee, I would state that it has been found necessary to make this
assessment larger than usual, — four dollars. There are five years'
proceedings included in this publication, and it .brings the literature
of the society up to date. The expense has been met by the officers
of the society ; and we would now ask that the members of the
society make this good to them by the prompt payment of their
jdues and assessments.

Elbert T. Davis, D.D.S., of Bridgeton, was proposed for active
membership ; endorsed by Drs. Kichards and Meeker. Also Dr. A.
Westlake, of Elizabeth, endorsed by Drs. Levy and Gr. Carleton
Brown.

The nominations were ordered to take the usual course.

The secretary announced that he had received the credentials
of Dr. L. Ashley Faught as a delegate from the Philadelphia
County Dental Society, of Pennsylvania.

Dr. Wm. H. Dwindle, of New York, read a paper on the treat-
ment of teeth during pregnancy. (See page 65.)

.»- -«. <c

DISCUSSION OF DR. DWINELLE 8 PAPER ON "TREATMENT OF THE

TEETH DURING PREGNANCY."

Br. E. T. Darby. — Mr. President, there is very much of truth
in what Dr. Dwineile has read to us this evening. We all know
that the period of pregnancy is one peculiarly trying upon a woman.

^ew Jersey State Dental Society, lOS

We also know that during the period of pregnancy the nerroua sys-
tem is wrought up to its highest tension. We know that at this
period there is often a demand in the system for lime salts. This
has been illustrated in various ways, as by the mother craving at
such times food that contains the phosphates in abundance. I think
my friend, Dr. Kirk, some years ago read a paper upon this subject,
stating for illustration several cases in which the women during
this period had craved lime to such an extent that they had even
eaten mortar and lime from the boxes in the street. I have known
instances of pregnant women who ate plaster from the houses, and
also ate chalk in large quantities. This seems proof positive that
there was in the system a craving for lime. It has been questioned
by many scientific men, and by men in our own profession, whether
any change takes place in the teeth in consequence of the introduc-
tion of lime salts into the system. I have heard Professor Black
say that a tooth once soft is always soft ; that no change takes place
in that tooth by the introduction of lime salts into the system. I
differ very materially from Dr. Black upon this point, because I am
positive that I have seen changes take place in teeth for the better ;
teeth that were soft in early life becoming hard and good later in
life. I have also seen in my own practice cases where a diet com-
posed largely of phosphates was introduced, where the diet had.
been of a very different character, containing little phosphates, and
the teeth being in bad condition ; and the favorable results upon
the teeth following that change in diet were truly wonderful. I
think it was Ben Jonson who said that the oatmeal of Scotland
had made good men in England, as it had made good horses. I
think if we could introduce into the system of women during the
period of gestation a greater proportion of the phosphates in their
food, there would be a great improvement in the teeth of their
children. But, unfortunately, these pregnant women do not take
to oatmeal and brown bread and such things, but more frequently
crave those things which Dr. Dwinelle says are inert in the system,
such as lime, which is not assimilated. In the treatment of the
teeth of pregnant women I think we sometimes insist upon too
radical treatment, trying to perform operations which we ought
not to perform under those conditions. My own practice has been,
during the period of pregnancy, to fill the teeth with plastics only,
as much as possible avoiding large operations and the use of
metallic substances. It is not, in acid conditions, perhaps the best
thing to use oxyphosphate or oxychloride ; gutta-percha is prefera-
ble, because the secretions are intensely acid at that time. If we

104 Reporta of Society Meetings,

woald perforin only temporary operations during the period of
gestation the results would be more satisfactory.

I have in my practice a patient whose teeth I have had the care
of from the time she was five or six years old. She has been
married about five years, and has had three children. Previous to
her marriage she had very little dentistry to do, her teeth being of
unusually good character. I saw her a few weeks ago, and her
teeth were in wretched condition. During these three pregnan-
cies she has not had time, or has not been in condition, to give her
teeth the attention she did previously, and the ravages of decay
have been alarming. It' is unquestionably the result of her fre*
quently renewed pregnancy.

It is very difficult to know just what is the best treatment in
these conditions. It has been asserted that the system of the
woman is drawn upon at this period for an unusual quantity of
lime salts to build up the teeth of the foetus, and that the intro-
duction of phosphates would be beneficial.

Dr. Idttig. — Is it the phosphate or phosphite that we want?

Dr. Darby, — I have been under the impression that it was the
phosphate.

Dr. Littig, — I think it is the phosphate that the system throws
off, and the phosphite is used up by the addition of oxygen. When
we have the phosphate, which has an atom of phosphorus and
an atom of oxygen, they take on another atom of oxygen and we
have the phosphite. The phosphite has throe atoms of oxygen
and one of phosphorus. The phosphate has five atoms of oxygen.
As nature uses the phosphite, oxygen is added until it takes on its
full equivalent of oxygen, and then it becomes a phosphate, and
nature throws it off. Am I right?

Dr, Darby. — I cannot say whether you are chemically correct
or not.

Dr. Littig. — I think the craving for chalk and lime is simply on
account of the acid condition. The acidity is corrected by taking
the lime, but it does not really enter into the system. I have an
idea that the thing needed is the phosphite, which is in the grain ;
because, if I wanted to raise a plant I would put phosphate on it.
The plant, in its growth, takes up one atom of oxygen and another
atom of oxygen until it makes up the phosphate and leaves the
phosphite in the grain. I telieve it is the phosphite we want and
not the phosphate ; that the phosphate is inert all the way through.
I do not pretend to be a chemist, but that seems to be the natural
condition of things.

New Jersey State Dental Society, 105

Br. Darby. — I have in mind a case of a woman whose teeth
were going very rapidly during her pregnancy. I said to her
physician one day, "This lady's teeth are decaying very rapidly ;
what is your opinion in regard to the use of hypophosphites ?" He
said, " I have a very good opinion of them, and, if you agree with
me, I will prescribe them for her." He put her upon cod-liver oil
and h3rpophosphites ; and he seemed to think she was very much
better physically, and I do not know but that her teeth were very
much improved by that treatment.

Dr, Littig. — I believe that if you could get phosphite and keep
it pure it would be beneficial ; but as soon' as you open any article
that contains phosphite, the introduction of oxygen disrupts it and
yon have the phosphate again ; so it is of very little service after
it has been opened for any length of time.

Dr. Kirk. — ^Does Dr. Littig understand that the phosphoric com-
pounds to be appropriated by the organism must be necessarily in
the form of phosphites and not phosphates ?

Dr. Littig. — I think it is the phosphites.

Dr. Kirk. — I think that is incorrect. In the outer shell of the
wheat, I think, you will find the lime salts exist as phosphates as
well as phosphites. It is a very interesting point that Dr. Littig
has raised, as to whether the phosphates in the system are pro-
duced by oxidation of the phosphites taken in as food ; but I do
not think there is any evidence to disprove that the phosphates, as
they exist in the various articles of food when taken into the sys-
tem, are directly appropriated. It is quite a new thought to me,
this question, in regard to the assimilation of phosphates. I have
always believed that the phosphates, as they exist in the grain or
muscle or bony tissue taken as food, are directly appropriated by
the organism they are taken into.

Dr. Littig. — I would not undertake to dispute Dr. Kirk on a
question of chemistry. But I wish he would look into this sub-
ject; perhaps he will find I am a little nearer right than he
thinks.

Dr. Kirk, — In relation to Dr. Dwinelle's paper, there are a num-
ber of points in it that have been intensely interesting to me for
many years. One is the question of whether the tooth-structure
in the mother deteriorates during pregnancy, or whether the caries
that runs riot during the period of gestation is produced by con-
ditions dependent upon the local production of acids. I have always
believed, and shall continue to believe as long as I have a tactile
sense sufficiently delicate to distinguish between hard and soft

106 Reports of Society Meetings.

dentine, that the tooth-structure during pregnancy softens. At the
same time there is, apparently, an acid condition of the secretions,
brought about by changes in the systemic condition of the patient
during that time. I have in mind the case of a lady that came to
me about the time of her marriage, her teeth then being in nearly
perfect condition. She has since then given birth to a child almost
annually for the past four or five years ; and the result is excessive
erosion of the surfaces of all the teeth anterior to the molars, on
their labial and buccal aspects. It has been almost impossible to
prevent this destruction of the tooth substance; and I told her
she would have to choose between having babies or teeth, as she
could not have both. I want to say that, in my opinion, the habit
that many women have of giving birth to a baby once a year is a
very bad one, and, from the stand-point of dental prophylaxis
alone, ought to be corrected.

Dr, Dwinelle, — I hope the doctor will give us a remedy.

Dr. Kirk, — If there is any one who absolutely needs a remedy, I
will give it to him.

Dr. W. S. Elliott. — ^Tbe subject before us is one of considerable
interest. The paper suggests this thought, — that the desire for an
antacid lies with the oxide of calcium ; from which we could pre-
sume that it was oxide of calcium, or common lime, that the patient
needed. But I think, as the gentleman from New York has said,
that it is more to correct the acid condition that the system de-
mands lime ; because we know that common lime is nothing more
than oxide of calcium, and is not assimilable as such.

As regards the difference between the bone phosphates and the
inert phosphates of the rocks, I do not know what the chemical
difference is. I do not believe there is really any difference from
this point of consideration, — that all the lime of the earth, as natu-
ralists understand it, has at one time been part of the living animal ;
that all the lime of the earth has really been in solution in the sea,
and has been appropriated by animal life and then deposited in the
rocks. Therefore it has been vitalized. Whether the lapse of ages
has deprived it of that vitality or not is a question I could not
answer; but it is generally understood that all lime has once been
vitalized by passing through a vital medium. I believe the element
which the system really requires in the condition of pregnancy is
that of the hypophosphites. As far as the grain is concerned, there
is a difference between the outer hull, or husk, and that layer which
lies between the centre and the husk, and which contains more of
the phosphites than the outer shell ; and it is the phosphites of the

New Jersey ^ate Dental Society, 107

kernel which is appropriated by the system, and not the phos-
phate.

Dr. Dwinelle, — ^In regard to the comparative potency of animal
phosphates and phosphates derived from the rocks, we have a
splendid illustration in medico-legal history, as derived from a great
fact that was brought to light in England many years ago. I can
not recall the names to enforce what I am about to say. We will
assume that there was once upon a time a certain Jaynes's powder,
that was very potent and efficacious in curing the malignant mala-
rious fevers of the extreme East, where England had her armies by
hundreds of thousands. Annually there broke oiit in that region
occupied by the English troops this malignant fever, which devas-
tated the army more than battles, unless they had a quantity of
Jaynes's powder to combat it and allay its ravages. Jaynes^s powder
was a potent and effective remedy.' Thus matters went on until,
in the course of time, many generations perhaps, the Jayneses be-
came immensely rich; with nches came education, intelligence, and
refinement; and in course of time there was an appeal put by the
country at large to have made known the components of this pow-
der, which was a secret up to that time ; thei*e was an appeal to
the generosity, intelligence, and fairness of the manufacturers of
this powder to make known the secret of its preparation. '^ Cer-
tainly, gentlemen,'' said they to the committee, " we have for a long
period of time derived great advantage, wealth, and power from it,
and it is no more than reasonable that we should do as you request ;
we ought to have done it long ago ; we have not the right to keep
a process secret which belongs to humanity.'* So they published
the recipe to the world ; whereupon there were bids made immedi-
ately for supplying Jaj'nes's powder for the East. Among others
Jaynes was one of the bidders, but ho was underbid by one Jones,
and Jones got the contract. Jaynes came forward and said to
Jones, '^ I congratulate you ; all of my apparatus and plant, my
factories, my stock, ftiy experts, and my men are at your service.''
The offer was accepted, on certain terms, and Jones went to work
to make the Jaynes powder, seeing great success and immense
wealth before him. But his dream was soon ended. The fever
broke out as usual, and the Jaynes-Jones powder was administered
as before, but it had no effect, it was wholly inert, and the soldiers
and others died like sheep with the rot. The result was alarming ;
the army was rapidly reduced, and the whole mother country was
stirred to desperation by the terrible intelligence that came to them
from the East. The matter was brought before Parliament, and

108 Reports of Society ^Meetings.

an investigation was made. Jaynes came forward and rendered
every assistance that he could in the premises, as did others. Jones
was confounded. The old Jaynes experts were put upon the witness-
stand, and questioned closely in reference to any difference between
the two recipes, and they declared them to be the same ; each con-
tained so much phosphate of lime, and so much of this, that, and the
other. They were confounded, and the inquiry arose. What shall
we do to be saved? The investigation went on day after day.
The old exports were put upon the stand again and again ; each
time they declared that the materials used by Jones were precisely
the same in nature and in quantity as those which had been used
by Jaynes. Finally the counsel in the case said, " You say that
Jaynes's powder contained so much phosphate of lime ?'* '^ Yes,
sir.'* ^' And you say that Jones's powder contains precisely the same
quantity of the same material ?" " Yes, sir." " Where did Jaynes
get his phosphate of lime ?" " Why, from the bones of animals."
"Where did Jones get his?" "He got his from the phosphate
rocks ; but they are precisely the same, chemically." The counsel
sprang to his feet and cried, " Eureka ! I have found it.

" In the beginning a nebulous sphere, containing all of the ele-
ments, millions of miles in diameter, transparent as ether, was
floating in space. Suddenly, through the potency of electric force,
this immense area was condensed into the circumference of a few
thousand miles, and hurled into its prescribed orbit in the form of
a ball of flre.

^^ From the elements, air and water took their appropriate place,
upheavals forced elemental rocks above the surface, separating land
from sea, — among them the phosphate rocks.

" It took the phosphate rock unnumbered millions of ages —
passing through the alembic of nature's laboratory, through the
stomach of myriads of animals, through an infinite and ever-ad-
vancing vegetation, devoured and digested by animals, through the
cold-blooded range, ever evolving still higher and higher, up through
the varied types of the warm-blooded mammalia — before its primi-
tive and inert condition had become so far animalized and spiritual"
ized that it would be acceptable as a pap, a pabulum to be assimi-
lated with the human economy in the form of phosphates derived
from the bones of animals.

" Phosphate of lime derived from the phosphate rock has no
affinity with our animal economy ; it is wholly inert, fatally inert,
as proven by the unhappy experience of the Joneses in India, and
established by this court of inquiry. The phosphate of lime ob-

New Jersey State Dental Society, 109

tained from the bones of the mammalia, through the mysterious
processes of untold ages, readily assimilates with our elemental
humanity, and is potent to save, as proven by the record of the
honored Jayneses for generations past, all of which has been amply
verified by this long and laborious investigation.

*' The great lesson of this hour of our solemn victory bids us *
take heed that we recognize the fact that we live in an age where
subtle, potent, and hitherto unknown elements and conditions
challenge our recognition/'

In the course of time Jones adopted the formula of Jaynes, and
his powders were potent ever after.

At the time of the great fatality in India, some of the original
Jaynes powder, that had been left over from the supply of the
year before, was found, which, when administered to the sick,
insured their recovery. This fact, at the time, gave additional
perplexity to the problem, which in the end was so satisfactorily
solved.

Friday^ July 19y 1889. — Afternoon Session.

The President, Dr. Henry A. Hull, in the chair.
The calling of the roll was dispensed with.
The report of the Board of Examiners was read.

The Board of Examiners respectfully submit the following :
We have carefully considered the recommendation of the "Na-
tional Association of Dental Examiners, and fully endorse their
action in omitting the name of the University of Maryland^ Dental
Department^ from the list of reputable colleges whose diplomas
might be accepted instead of an examination, being fully con-
vinced that they have not required a preliminary examination
before matriculation, contrary to the rules required by this board
and recommended by the National Association of Dental Ex-
aminers.

We have also decided to forward the evidence taken in the case
to the National Association of Dental Examiners, and, before pro-
ceeding further, to await their action, as we understand from the
dean of the Maryland University, Dental Department, that he hopes
to have the college admitted to the National Association of Dental
Faculties, and to comply with the rules and regulations governing
that association and approved of by the National Association of
Dental Examiners.

110 Reports of Society Meetings.

We also fully endorse the action of our representative at the
Louisville meeting, August, 1888.

J. Hathurst,
A. R Eaton,

July 19, 1889.

Beport adopted.

The Board of Examiners having reported favorably upon the
application for membership of Dr. J. F. Lomas, of Bridgeton, a
ballot was ordered, and Dr. Lomas was duly elected.

The Committee on President's Address reported as follows :

We heartily commend the excellent address of our president,
and hope all will carefully read it when it shall have been pub-
lished. But, as there is no special recommendation in it, we have
no other report to make concerning it.

James G. Palmbr,

C. S. Stockton, [ (Jommittee.

Geo. E. Adams,

1

The amendment to the by-laws, making the dues of members
three dollars a year, offered at the morning session, was taken up
and adopted.

Dr. Luckey, chairman of the Committee on Dental Medicine,
read a report, as follows :

So far as your committee has been able to learn, the past year
has not been one of remarkable activity in therapeutic progress.
Whilst nearly all dentists feel the need of a better understanding of
the action of drugs, they have been devoting their time to the de-
velopment of those already known rather than to experimenting
with new ones. A good deal of time and thought has been given
to cocaine, but to-day its position in the dental pharmacopodia is not
materially altered from what it occupied a year ago. Iodoform is
still a sheet-anchor with many, and its wonderful properties are
often called into requisition for the benefit of sufferers and the
gratification of operators. lodol, the twin brother of iodoform, is
being quietly but effectively used ; while some have dropped both
and have gone back to the old-time favorite in the treatment of
pulpless and abscessed teeth, — iodide of creosote.

There seems to be a constant and not altogether unnatural

New Jersey State Dental Society, 111

tendency among practitioners for change. Afler a long series of
successful cases with a medicine that has proved a faithful servant,
an unsuccessful case or a series of them persuades the operator that
something else is needed, and forthwith a new remedy is called in.

The discovery of new remedies does not always imply progress,
but the development of the properties of those already known to
their highest and fullest possibilities, the discovery of their proper
combination with other remedies, and the knowledge of the classes
of cases upon which they may be used to as near a certainty as pos-
sible, does signify progress of a most satisfactory kind. The time
was when many dentists thought that medicated cotton or other
material was the proper thing for root-fillings, but progress has
been indicated by the abandonment of such practice and the recog-
nition of the fact that medicines are used to obtain a certain effect,
and when that point has been reached it is time at once to discard
the medicament and insert into the root some material destitute of
active properties, — in other words, something inert. The point of
cure has been reached. All that the tissues need is rest; and if
allowed that rest, they will probably remain quiet and healthy;
but the continued presence of any medicinal agent capable of cor-
recting an abnormal state is likely to result eventually in a return
of the very conditions which it was used to and did correct. Make
a cure when possible, but then cease the use of medicines.

Listerine is growing more and more in favor. The experience
of the chairman of your committeei with it is very gratifying. As
a wash in the treatment of pulpless teeth, during the process of
removing the debris from the canal, it is unsurpassed ; as a mouth-
wash during the removal of tartar it is not only gratifying to the
patient, but is also an excellent application for the gums. Its most
useful and particular sphere, however, seems to be as a general
month-wash in those cases where the teeth are soft, with white
rings appearing at the cervical margins. Those are the cases that
above all others seem most discouraging to the operator, being ap-
parently ready to soften on all surfaces and break down ; where the
only real remedy to stop decay is apparently the application of a
gold crown to keep the oral fluids from the teeth and thus preserve
them. Here listerine ^eems to be the very thing wo need. Marked
improvement has been observed in such cases after a six-months'
course of treatment, and in a year all signs of softening have disap-
peared and the teeth appear strong and healthy. It is used in the
strength of a teaspoonfhl to a half-glass of water, night and morning.

The rage for immediate root-filling still continues, and a word of

112 Reports of Society Meetings,

warning in regard to this matter may not be out of place. If there
are any cases that require our careAil attention and the use of
medicines, it is the treatment of pulpless or abscessed teeth. It
may be justifiable to fill immediately the roots of a tooth the pulp
of which has been recently destroyed or has died, or in cases where
a fistulous opening exists ; but in those cases where pus or other
fluid exudates have no escape, the comfort of the patient and the
successful issue of the case is jeopardized by immediate filling.
Take a little time ; insert your medicinal agent ; give it a week at
least to perform its work. If inflammation and swelling supervene,
— not at all improbable in any case of long standing, — it is easy to
reopen the tooth and search for the seat of the trouble. When
everything is comfortable, fill the root, insert a temporary stopping
in the cavity, and lot the case rest another week, when, if the tooth
is comfortable, it is perfectly safe to fill permanently. This method
of procedure is much safer than the " rushing process," and may pre-
vent the operator from having the mortification of undoing what to
him seems a pretty piece of work. In this connection it is well to
call attention to the fact that where inflammation appears in cases in
which there is no fistulous opening, the use of the lance as a remedy
is often very gratifying. Cut through the gum and process to the
end of the root, including also the pericementum, and cut it from
the apex fully one-half or more the length of the root. In many
cases this is all that is required.

The care and treatment of pulpless teeth forms a large part of
the practice of many dentists ; and if a mistake is made in the treat-
ment, no one can tell what disastrous consequences may follow.
The immediate-root-filler may not hear of the subsequent result for
a long time, but at last the word is likely to reach him that the
tooth he has fondly imagined as successfully treated and saved has
been extracted by some other dentist to afford relief to the afilicted
patient.

A bad or unsuccessful result following immediate root-filling has
a tendency to weaken the confidence of the public in such opera-
tions and operators ; and many valuable teeth wi)l be lost through
dread from the failure of a few such hastily -performed operations.
This warning is not uttered to impede progress, but to point out
and emphasize some of the dangers that lie in the path of imme^
diate-root- fillers.

The thing needed is a thorough understanding of the thera-
peutic value of the remedies we use, conjoined with the same under-
standing of the pathological and physiological condition of the

New Jersey State Dental Society, 113

tissnes and parts we operate npon. Then, with a clear judgment
to guide us, the outcome of any given case is not very doubtful.

Dr, Watkins, — Mr. President) Dr. Adair's paper is in the hands
of the secretary. Its title is " Treatment of Very Sensitive Teeth
when Pulps are nearly exposed.*'

On motion of Br. Meeker, Dr. Adair's paper was read by
title.

On motion of Dr. Meeker, Dr. Land's paper was read by title ;
Dr. Land not being present. Subject, " The Scientific Adaptation
of Artificial Dentures."

On motion of Dr. Meeker, Dr. P. M. Odell's paper was read by title.

The officep-elect for the ensuing year were here formerly
installed.

President Watkins takes the chair.

Dr. Waters, — Mr. President, I want to take this opportunity to
thank the New Jersey State Dental Society for the very pleasant
time, both intellectually and socially, which I have enjoyed at this
meeting. I also desire to compliment this society upon the har-
monious action I have observed in all its work. I have been par-
ticularly struck with your way of managing an election of officers.
There was a good-fellowship and harmony through it all that I
like to see. I have been in societies where there was a good deal
of pulling and hauling on such occasions ; I am glad to see that in
the New Jersey State Dental Society that does not exist.

A vote of thanks was tendered to the gentlemen who read papers ;
to the visitors from a distance who came to take part in the dis-
cussion ; to the exhibitors of dental appliances for their fine exhibits
of things useful to the profession ; and to the proprietors of the
West End Hotel for courtesies extended.
- Adjourned sine die.

OLINICS.

Dr. C. C. Carroll, of New York, filled the root of a pulpless tooth
with an aluminium pin, which subserves the purposes of perfectly
stopping the root and making a retainer for the subsequent crown
filling. In the next sitting the tooth filling will be finished with
aluminium foil, which is claimed to be a superior tooth-saving
material.

Dr. W. H. Pomeroy, of Gloucester, Mass., showed his method of
condensing gold, which has grown out of experiments with the
Herbst method ; using the Pomeroy engine mallet, and soft gold,

8

1 14 Reports of Society Meetings,

without annealing ; the points uBod being smooth, and flattened on

the end.

Dr. Pomeroy claims that his method of packing foil with flat

points, combining the burnishing idea of Herbst with the mallet

blow makes a filling more solid, and more like a gold ingot, than

any other method, and that teeth can be filled as rapidly in that

way as by the Herbst method.

Dr. Wm. E, Truex, of Freehold, filled with gold a crown cavity
in a molar tooth.

Dr. J. W. Canaday, of Albany, N. T., filled a left superior second
molar, grinding surface, with a combination of tin and gold, a
sheet of No. 4 gold and a sheet of No. 4 tin being folded together
in such a way that the tin is completely enclosed by the gold. The
combined material is used as soft gold would be, being burnished
on as in the Herbst method.

Dr. Beading, of Lambertville, filled with crystal gold, and with-
out separation, an approximal cavity in a central incisor; the opera-
tion occupying five minutes.

Dr, J. Marion Edmunds, of New York, filled a very largo cavity
in a left superior second molar, with hand pressure, using only the
foil-carriers, and finishing with a plugger and burnisher ; packing
the gold so thoroughly that it could not be further condensed with
the mallet The gold used was crystalloid.

Dr. C. A. Timme, of New York, filled an approximal cavity in a
superior second bicuspid with Wolrab's gold, in the mouth of Dr.
Adelberg, using the Herbst burnishing method.

Dr. Kimball put in a cement filling, and demonstrated his method
of lining cavities, where the pulp is nearly exposed.

Dr. Edward J. King, of Boonton, N. J., presented a very inter-
esting case, — the removal of a fibrous tumor firom a lad of seven-
teen, the operation having been performed by Dr. J. G. Byerson.
The tumor had distended the cheek very much, and after its removal
a decided deformity presented, which was successfully remedied
by Dr. King, by an ingenious piece of crown- and bridge-work. The
description of the removal of tumor is not necessary here, and we
regret we are unable to illustrate the case, as by that means alone
could a correct idea be formed.

American Academy of Dental Science, . 115

AMERICAN ACADEMY OP DENTAL SCIENCE.

The American Academy of Dental Science held its regular
monthly meeting December 4, 1889, in the Boston Medical Library
Association rooms, President Seabury in the chair.

President Seabury. — Gentlemen, I will now introduce to you Dr.
D. W. Pellows, of Portland, Me., who will read a paper on " Fract-
ure of the Jaws."

Dr. Fellows. — I feel considerably abashed before a body of men
like this ; but such as I have I will give you very briefly. (The
paper will be found on page 77).

There are one or two points which I have not touched upon in
this paper. One is, the time for inserting the splint. I should say,
as soon as possible, but in many cases the swelling would be so
great that it would not be well to attempt it for a few days. In
the cases I referred to it was inserted in about a week ; I think six
days. It may be done any time during the preparatory stages,
any time within a week, if the circumstances are such that it
cannot well be done before, or, in fact, any time before union takes
place.

DISCUSSION OF DR. D. W. FSLL0W8*8 PAPBB ON '^FBAOTUBI Of

THE JAWS."

Dr. PUlebroum. — I suggest that matters of detail are oftentimes
quite as interesting as principles, and I think that the detail of
making the splint would be interesting. Not long since I saw a
splint that was made for a patient with a fractured under jaw,
and the splint was so large that it allowed nearly the full play of
the displacement, so that there was but little gained over the con-
dition which would have existed had there been no splint at all. I
inquired into the matter, and I found that tin foil, tolerably thick,
was moulded over the teeth of the models and wax added to that for
the thickness. Then the models were removed from the pattern and
the pattern inserted into the flask, the plaster poured into that, and
the splint made from the pattern instead of from the model itself.
In consequence of the ill-adjustment of the tin foil in making the
pattern the splint was loose, as I remarked, and the displacement
of the parts allowed. Now, if I understand Dr. Fellows, he used
the models themselves on which to make the splint, and by that
moans he got a more perfect fit. It has always seemed to me in
making splints that it might be reasonable to put a coating of thin
tin foil over the teeth of the model, and thereby insure clean work.

116 Reports of Society Meetings.

just about enough enlargement to allow it to go easily on the teeth,
and still fit closely enough to prevent diaplaocment of the parts.
I would not have thought this worth speaking of had I not seen
within the year past the very condition which I have alluded to,
and I know the patient was in that case very much worse off for
the splint's having been made in that way.

The first case Dr. Fellows reports here to-night, that of the
merchant of Portland, I was quite well acquainted with. I did not
see the case at tl^e time of the accident, but I have seen the gentle-
man since, and certainly it was a bad smash-up. He fell a consid-
erable distance,-*! understood it was from the steps of the cars,
but it seems I am mistaken, — and, striking with full force on the
face, both jaws were badly fractured. After the treatment no one
would know that so severe an accident had happened to any parts
about the face.

Dr. Andrews. — I have had a case that the paper brings to my
mind. It was that of a gentleman connected with Harvard Univer-
sity, who, in trying to stop a vicious, runaway horse, received a
kick, which broke his lower jaw, about an inch to the left of the
symphysis. Besides the fracture there was a loose, Y-shaped piece
of the jaw containing three teeth, the cuspid and two bicuspids, I
think. A few days after the accident the patient was brought to
me by his physician to have a splint made to keep the jaw and
teeth in place. The patient having a close-cut beard, we thought
. it best to cover this with a piece of damp cotton cloth, which was
tied round the head like a bandage, one object being* to keep the
jaws together, and make as perfect an articulation with the upper
teeth as possible ; another, to prevent the modelling composition
from clinging to the beard. A piece of sheet tin, such as we make
air-chambers of, was then rudely fashioned to the form of the lower
jaw, after which modelling composition was heated, placed in this
tin form, carried up in place, and allowed to cool about the jaw.
Another bandage was then tied outside of this and over the head.
We found that the patient could open the mouth to allow an
impression to be made of the teeth, after we had tied the loosened
teeth to the firm ones. From the impression a splint of vulcanized
rubber was made covering the teeth. In three weeks the splint
was removed and the jaw found to be united, the articulation being
nearly perfect.

Dr. Williams. — I would like to ask Dr. Andrews if he would
consider the modelling composition preferable to plaster of Paris?

Dr. Andrews. — In this case it worked quite as well, and was

American Academy of Dental Science. 117

found to be much more convenient. I would say that the plate
held the jaw so well in place that the outer splint of impression
material was soon removed. The only thing being used on the
outside was a simple bandage.

Dr, Smith, — I was called in consultation with a surgeon some
time ago to assist him in holding a double fracture of the lower jaw
that the surgeons of the Massachusetts General Hospital had treated
unsuccessfully with their usual process of wiring teeth together.
The case was that of a gentleman who had been thrown ft*om a
carriage, and, like the person whom Dr. Fellows spoke of, he was
badly smashed up. Not only was the jaw fractured at the right
and left of the symphysis, but the soft parts of the face, especially
about the neck, were severely lacerated. The usual procedure of
using the interdental splint with a bandage passing under the chin
and over the head was prohibited on account of the severe inflamma-
tion of the soft parts, producing two sinuses, in which the surgeon had
placed tubes for the discharge of pus. I was not called until late
in the case, and I found the parts so swollen that it was impossible
to take a full impression at once of the jaw. So I took the impres-
sion of the lower jaw in three sections by taking modelling com-
pound and using my forefinger as a cup. From these impressions
casts were made and put together. A die was then constructed,
and on that was struck up a very stiff gold splint going inside of
the teeth and over the crowns, but not over the outside. Through
this splint, and corresponding to the spaces between the teeth, holes
were made, Airough which passed platinum wire to serve as liga-
tures in securely fixing the splint in position. Everything being in
readiness, the fractures were adjusted, the splint applied and firmly
fastened — by means of the platinum ligature — to the teeth. The
patient wore the splint some twelve weeks with perfect comfort,
and the results were satisfactory to both surgeon and patient.

Dr. Baker.-^Ahout two years ago a case of fhictured jaw came
into my hands. A gentleman fh)m this city was travelling through
the West. I do not know the exact details of the injury, but was
told that he was riding a bicycle, and fell from it on to the side-
walk. The result Was two fhtc'tures of the lower jaw, one in the
vicinity of the condyle on the left side, the other just back of the
mental foramen on the nght side. Travelling as he was, he could
not, of course, remain in any one place for treatment, and therefore
went to several different practitioners for aid. One of the dentists
whom he consulted made for him an interdental splint, and it was
correctly named, but that was all that there was correct about it.

118 Reports of Society Meetings,

When he came to me, he said he thought he had not been properly
treated, and also said, when he reached Chicago, he was in hopes of
receiving proper care, and went immediately to Dr. Harland. On
learning that he could not remain in Chicago a suitable length of
time, Dr. Harland referred him to me. Upon examination, I found
a cartilaginous union on the right side. After removing the splint,
the articulation was seen to be fairly good on the left side, while on
the right there was a space large enough to place a thumb between
the upper and lower teeth in the vicinity of the bicuspids. The
right inferior second bicuspid and first molar were badly fractured,
and the right superior central badly out of position and loose. The
pulps of all these teeth were dead, and there was also a discharging
fistula under the chin, with considerable necrosis.

The treatment I pursued was as follows : Knowing that several
weeks would elapse before the case could be cured, I advised my
patient to procure a room at the hospital, and I called to my assist-
ance a celebrated surgeon. We etherized the patient, after which
we found that, by exerting considerable force, we could spring the
jaw into its proper position.

After removing the necrosed bone, we placed upon the chin a
soft pad of cotton, then over this a plaster splint, and finally passed
a linen bandage over the head and under the chin, covering the
plaster, and drew it tight enough to hold the jaw in its normal
position.

The patient was easily fed through the space made by the fhic-
ture of the bicuspid and molar. After about three weeks the bandages
were removed, and the jaw was found to keep its position so well
that it was unnecessaiy to use the metal shield which had been pre-
pared. The patient merely wore a simple bandage for a few weeks.
I then put the central in place, crowned the lower bicuspid, having
previously treated and filled the roots. The last time I saw the
patient the adhesion was as good as any one could wish, and there
was nothing visible to indicate that he had ever received an injury.

Dr, Pond. — I had a case, a few years ago, which differed from
those already mentioned, in that there were no back teeth on either
jaw. The six front teeth were in place in the lower jaw, and it
fractured on each side just back of the cuspids, the anterior por-
tion of the bone with the teeth being freely movable.

Bandaging proved useless, for, when the front teeth were
brought together, the slightest pressure foreed the parts out of
place ; there being nothing to keep the body of the jaw down, it
would be lifted upward into the mouth. An impression was ob-

♦ American Academy of Dental Science. 119

tained by filling the mouth nearly full of soft modelling composi-
tion, holding the parts in position with the hands under the jaw,
and gently lifting up until the lower front teeth just articulatea
with the upper ones.

A splint was made of vulcanite, which resembled a partial upper
and under plate joined together, — that is, it covered the upper jaw
from the cuspids back to the condyles and the corresponding por-
tion of the lower jaw. Sufficient material was cut away to allow
for the passage of food. It was placed in the mouth and the parts
firmly bandaged, the splint holding the body of the lower jaw in
position, and the front teeth performing the same office for the
anterior portion.

The parts were held in position perfectly for about a week,
when the patient, an ignorant policeman, who was confined to a
hospital bed by some severe bruises received in the same row in
which his jaw was broken, decided that the jaw was all right, and
removed the bandage and splint. The removal was not discovered
until the next day, and as the parts were still in position the splint
was not replaced. The liquid diet was continued, and when dis-
charged from the hospital, where his other injuries kept him some
weeks, his jaw seemed in as good condition as ever.

120 Editorial.

Editorial

. UNSATISPACTORT LAWS.

In an editorial in the September number of this journal Btress
was laid on the necessity of more efficient laws in the various
States for the protection of reputable dentistry. In order to add
emphasis to our remarks, the ruling in a recent case in New Hamp-
shire was cited. This is the sentence in which the reference oc-
curred :

<< In view of the fact that there is some doubt existing in the minds of the
profiassion regarding the oonstitationality of laws goyerning the practice of
dentistry and of medicine, and heoanse of the recent decision of the Supreme
Court of New Hampshire, declaring unconstitutional the law requiring a li-
cense to practise in that State, it behooves the boards of the different States to
support one another, and to adopt such uniform action as not to trust the con-
test of the constitutionality of their laws in the courts, or they may find them-
selves without any law, which would be a serious retrogression.''

A correspondent takes exception to this unadorned statement,
on the ground that it is misleading, and he intimates that when
writing that article we were probably not aware of all the facts in
the case. As the matter is an interesting one and important to
every dentist in the country, it may be well briefly to present the
case.

Two men, a physician and a dentist, were indicted for practising
in a certain county in New Hampshire without a license, contrary
to law.

Here are the important sections of the law of that State, re-
lating to the practice of medicine and of dentistry :

" Sect. 8. It shall not be lawful for any person who is not duly authorised
to practise medicine or surgery to practise dentistry, unless such person has
received a dental degree from some college, university, or medical school au-
thorized to confer the same, or shall have obtained a license from the Kew
Hampshire Dental Society.

'^ Sect. 4. Said dental society shall, at such time and in such manner as
may be prescribed in its charter or by laws, elect a board of censors, consisting

Editorial. 121

of three members, who shall be elected for such term as may be prescribed by
the society, which board shall have authority to examine and license persons to
practise dentistry. The licenses shall be recorded by the clerk of said society.

" Skgt. 6. No person receiving a license as herein provided shall be au-
thorised to practise until he shall have procured the same to be recorded by the
clerk of the court in the county where he resides, if a resident of this State; if
not a resident of this State, in the county where he intends to practise. Such
licenses shall be recorded in a book provided for that purpose, and which shall

bear the title and inscription of tJie medical and dental register of

county, an^ the fee for recording the same shall be fifty cents.

" Sect. 6. Each person receiving a license upon examination shall pay
for the use of the society granting the same the sum of five dollars ; upon
diploma, one dollar.

" SxoT. 7. If any person shall practise medicine, surgery, midwifery, or
dentistry without being duly aulhorized as provided in this chapter, or after
his license is revoked, he shall be punished by fine of not more than three
hundred dollars for each offence.

"Sect. 8. The provisions of the preceding sections shall not apply to
peraons who have resided and practised their profession in the town or city of
their present residence during all the time since January first, eighteen hundred
and seventy-five, nor to physicians residing out of the State, when called into
the State for consultation with duly licensed physicians, or to attend upon
patients in the regular course of business.''

The last clause is the one that gave rise to the troable. The
defendants demurred to the indictment, maintaining that a law was
nnconetitational which required some to undergo an examination,
to obtain a license, and to pay a fee, simply because they had
changed their place of business within an arbitrary fixed period ;
whereas others of the same or less ability were exempted from
these annoyances just because from the accident of circumstances,
they had remained in one place from January 1, 1875, until the
passage of this law.

The judges decided that the law was unconstitutional in that it
unjustly discriminated against certain persons, and they therefore
sustained the demurrer.

Our correspondent says that the eighth section was the only
one concerned in the decision, and that as a whole their laws on
the subject are *^ generally observed ;" but the fact is, that this last
clause is the most important of all, for it exempts fVom the sections
preceding all those who have practised in one place since January
1, 1875, and as the judges, by their ruling, have virtually exempted
those who do come within the ruling of this important section, we
fail to see to whom the law may be applied.

In the course of the judges' opinion the following also oceurs :

122 Editorial.

*< The statute aUo discriminates against citizens of other States. It does
not apply to persons residing and practising their profession in the same town
or State from January 1, 1875, to January 1, 1870, whence persons who have
resided and practised Uieir profession continually since January 1, 1879, in the
same town or city in another State are required upon removing to this State to
procure a license to practise their profession.''

By this it would seem that practitioners from other States can-
not be compelled to procure a license in order to follow their pro-
fession in the State of New Hampshire, and the laws of this State,
therefore, as they are at present, can be bat little more effective
than a dead letter.

Similar suits with various results have occurred in most of the
States that have passed laws of this character, and such has always
been the case after movements of this kind.

The necessity for these laws, and stringent laws, is apparent to
every intelligent person.

Laws are generally made for the protection of society at large,
not for the benefit of individuals ; and the result usually is that
though the welfare of the community may be advanced, yet certain
persons suffer.

Granted, then, that laws protective of reputable dentistry and
medicine are necessary, the organized bodies of these two profes-
sions should see to it that such laws are actually protective, so
firmly made as not to allow of the entering-wedge of a lawyer's
quibble.

ABOUT CORRECT.

It seems as if our remarks regarding the inconsiderate treat-
ment of the published statements of Dr. Brown-Sequard and our
prediction of a change of front in the near fhture upon the part of
the medical press is being realized, for in an editorial in a recent
number of the American Practitioner and News we note the following :

'' That there is a germ of truth in the apparently absurd claims of Brown-
S^uard would seem to he attested by the following item, which is Just now
going the rounds in the medical press : ' Spermine is an alkaloid found in the
ieeOeular juices in the gray matter of the brain, in eggs, oysters, lampreys, fish
ova and milt, also in the products of all atonic mucous membranes. It also
appears in the sputa of senile and acute bronchitis, in the expectoration of
phthisis, and of emphysema with catarrh, and in the spleen and circulation of
anaBmias and of leucocythsmias. The hydroehloraie of apermine, in a dose of
one-fortieth of a grain, injected subcutaneously in a dog of thirteen pounds

Editorial. 123

produced marked mental and phjBical activity, and powerful and prolonged
stimulation of the genital system.'

", We don't know the age of this item, as we have not seen the original
article ttoxa which it was culled, hut take it to he a recent physiologico-chemical
investigation proving the competency of testicular Juice to supply to the de-
vitalised a vitalizing compound, which, if the' alkaloid can he isolated in a pure
state, may prove to he a therapeutic agent of real stimulant or constructive force
and of easy administration.

'* At any rate, it hegins to look as if the great Franco-American physiolo-
gist was ahout to turn the laugh on those who have heen in too great a hurry to
laugh at him."

« Truth crushed to earth will rise again," never fear ; a few more
such articles as the above from which we have quoted, and those
who have made honest investigations with the Brown-S^uard
'^ elixir," will come forward and publish the results of their experi-
mentation in that direction, which have been kept back for fear of
being classed with the quacks and charlatans who rushed into print
in the secular press. Let us hear from others.

THE TENTH INTERNATIONAL MEDICAL CONGRESS.

In our Foreign Correspondence department will be found a com-
munication frx>m Dr. Miller, Berlin, regarding the present status of
the Dental Section of the coming congress. The section Zahnheil-
kunde is placed among the medical specialties as No. 14, and pre-
cedes Hygiene, No. 15. There are eighteen sections in all. While
the dental degree is not recognized in Grermany, yet, by mutual
consent of the general committee, it will for the time of the con-
gress be recognized and placed on the same footing as the others.
Communications in English are to be sent to Dr. Miller, No. 32
Yo08 Street, Berlin. It is to be hoped that there will be a liberal
attendance upon the part of American dentists, and that a number
of good papers will be sent in early. Quite a number have already
signified their intention of attending the meeting. Let all join, as
far as possible, in making our section a grand success.

124 Foreign Correspondence.

Foreign Correspondence.

To THS Editob :

Concerning the Dental Section of the Tenth International Medical
Congress, — ^In response to a call of the Organking Committee (Pro-
fessors Virchow, Ton Bergmann, and Waldeyer), fifty delegates
from the various universities and medical societies of Germany met
in Heidelberg on the 17th of September, 1888, to take steps in the
organization of the congress. At the meeting it was decided that
the congress should be held in Berlin, beginning August 4 and closing
August 10, 1890.

An organizing committee, consisting of Professors Yirchow,
Yon Bergmann, Leyden, and Waldeyer, was elected, and a general
secretary, Dr. Lassar, appointed.

Eighteen sections, including Dental Surgery, were organized,
each with a special committee of nine members.

An international medico-scientific exhibition is to be connected
with the congress. Statutes and a programme were adopted, which
will be given in as far as they particularly concern the Dental
Section.

"Art. II. The congress consists of physicians (approbirten
Aerzten) who have registered their names and obtained their
membership-cards. Other savans, who are interested in the work
of the congress, may be admitted as extraordinary members."

The delegates did not see fit to change this article so as to
include dental surgeons, but decided that the article should be so
interpreted as to admit dentists to membership. Since the meeting
at Heidelberg the question has been raised whether dentists resident
in Germany, but not possessing the Grerman dental approbation
(degree), could be admitted to membership. Begarding this point
the chairman of the committee on organization decided that only
those who possess the recognized degree of that country of which
they are citizens may be admitted to membership.

A German citizen holding only an American or Swiss degree is,
therefore, not entitled to membership, no more is an American or
English citizen not possessing the degree of his own country; on
the other hand, foreign citizens practising in Germany are admitted

Foreign Correspondence, 126

without the German degree, provided they have the degree of their
own conntry.

Members pay a fee of twenty marks ($5.00), and receive a copy
of the transactions.

Art. III. The object of the congress is exclusively scientific.

Art. X. All lectures and communications in the general sittings,
or in those of the sections, must be handed in in writing to the
secretary before the close of the sitting. The Editorial Committee
decides whether, or in what part, such communications shall be
included in the published transactions.

Art. XI. The official languages of all sittings are Grerman, Eng-
lish, and French. Tory short remarks may be made in other lan-
guages, provided some member is prepared to translate them into
one of the official languages.

Art. XII. Sections are, as a rule, to be limited to twenty min-
utes ; discussional remarks to ten minutes.

Art. XIY. Students of medicine and other persons, gentlemen
and ladies who arc not physicians, but are interested in the pro-
ceedings of any particular session, may bo invited by the president
of that session, or, on application, receive permission to attend as
auditors.

There are to be no vice-presidents associated with the congress,
but each section is empowered to elect a limited number of hon-
orary presidents and a secretary for each of the official languages.

The committee of the Dental Section, No. 14, is composed as
follows : Busch, Berlin, chairman ; Calais, Hamburg ; Hesse, Leip-
sic ; Pricke, Kiel ; Hollander, Halle ; Miller, Berlin ; Partsch, Bres-
lau; Saner, Berlin; Weil, Munich.

At a meeting of this committee, held on the 16th of October,
1889, it was decided that the hours from 9 to 12 a.m. should be
devoted to practical demonstrations in the rooms of the dental
institute, the demonstrations to consist of operations in filling, ex-
traction, and Jin mechanical dentistry, — ^in short, operations in all
branches of operative and mechanical dentistry.

Demonstrations in extraction and in artificial work are to be
under the direction of Professor Busch, those in filling under that
of Professor Miller. The theoretical exercises, etc., are to be held
from 2 to 6 p.m. They will consist of the usual essays or lectures
and the accompanying discussions ; besides these, three subjects for
general discussion are to be chosen, one to be introduced in the
German language (on bromide of ethyl, by Professor Hollander),
one in the English, and one in the French languages.

126 Foreign Correspondence,

Those desiring to deliver lectures or read essays on particular
subjects are requested to send in, along with their announcement,
a very short resumd of the contents of the same.

Correspondence in German language to be directed to Professor
Busch, chairman, No. 40 Dorotheen Street, Berlin; in French
language to Dr. Calais, No. 17 Hohenbleichen Street, Hamburg; in
English to Professor Miller, No. 32 Yoss Street, Berlin.

In America, Drs. Barrett and Taft ; in Great Britain, Mr. J. H.
Mummery, M.B.C.S., etc., and Mr. W. Bowman Macleod, F.B.S J!.,
etc., have, on invitation by the committee, expressed their willing-
ness to act in the capacity of honorary presidents.

A fuller report of the steps taken in the organization of the
congress, up to the end of October, is given by Professor Busch in
the Verhandlungen der deutschen odontologischen Gesdlschafi, Heft 2.

W. D, MiLLBR.

Domestic Correspondence. 127

Domestic Correspondence.

To The Editob:

Louisiana State Dental Society, — The Fifth annual meeting of the
Louisiana State Dental Society will be held in New Orleans, on
February, 19, 20, and 21, 1890. The programme will consist of re-
ports from committees, essays, clinics, and display of dental special-
ties. Members of the dental profession are invited.

J. G. MoCULLOOH,

Recording Secretary,

Nxw Oblbaits, January 2, 1890.

To THB EnrroB:

The Seventh Annual Convention of the Maryland State Dental
Association finished its work and adjourned yesterday evening
(December 7), after a lantern exhibit and lecture on " Life from a
Biological Point of View,'* by Dr. W. Xavier Sudduth, of Philadel-
phia. The business sessions in the morning and afternoon were
devoted chiefly to the giving of clinics, the reading of papers, and
the election of officers, a great deal of time being devoted to the
discussion of Dr. Cyrus M. Gingrich's paper on ^' Operative Den-
tistry." In Dr. B. Holly Smith's paper, on " Ddntal Literature,"
he congratulated the society on the high order of merit which the
dental journals have attained. The following officers were elected
and installed : Dr. A. B. Scott, president ; Dr. A. B. King and Dr.
John C. Uhler, vice-presidents ; Dr. W. W. Dunbracco and Dr. J. J.
Williams, secretaries. Dr. T. H. Davy, treasurer, and Dr. Cyrus M.
Gingrich, Dr. A. Price and Dr. A. P. Gore, executive committee.
Dr. W. B. Winder, of the Baltimore Dental College, made a short
speech, urging members of the association to join the National
Dental Protective Association. Dr. A. P. Gore, Dr. A. J. Volk, and
Dr. F. F. Drew were appointed to take notice of any violation of
the code of ethics and report to the chairman in sealed envelopes.
A committee, consisting of Dr. Winder, Dr. Wm. A. Mills, and Dr.
Bernard Meyer, was appointed to look into the affaira of the de-
funct Odontological Society and transfer any funds belonging to it
to the Maryland Association. Clinics were given by Dr. S. H.
Guilford, of Philadelphia, on ^^ Method of Staining and Coloring
of Artificial Teeth ;" by Dr. Wm. H. Gingrich, of Norfolk, on " The
Treatment of Approximal Surface of Molars and Inserting Com-
pound Contour Gold Fillings ;" and by Dr. David Geuese, of Balti-
more, on " The Attachment of Pivotal Crowns of a New Form.''

128 Current New$.

Curreiit News.

Wi are informed that a Dental Anatomy by a well known member
of the profession is now in proeess of pr^aration which, when com-
pleted, will furnish a much-needed text-book upon that subject, and,
coming from the source it does, will be a standard work.

Massaohusetts State Dental Society. — The following officers
were elected in the Massachusetts State Dental Society at its twenty-
fifth annual meeting, held in Boston, December 12 and 13, 1889.
President, Robert R Andrews, D.D.S, Cambridge, Mass.; First
Vice-President, Greo. F. Eames, M.D., D.D.S., Boston ; Second Vice-
President, J. W. Ball, D.D.S.; Secretary, Edgar O. Eansman,
D.D.S., Cambridge, Maas. ; Treasurer, Bdward Page, M.D., D.M.D.,
Gharlestown, Mass. ; Librarian, Jos. King Knight, D.D.S., Boston.

Executive Committee. — ^Drs. D. M. Clapp, Boston ; G. A. Gerry,
Lowell ; E. W. Branigan, Boston ; W. E. Boardman, Boston ; H. S.
Draper, Boston.

The Fiftieth Commencement of the Baltimore College of Dental
Surgery will be held on Thursday, March 20, 1890. All graduates
and friends of the College are invited to be present.

The new Dental Crown of Dr. W. E. Gates, which is just now
attracting marked attention, will appear as the culmination of the
subject of ^^ Crown Mounting" in the forthcoming new edition of
Garretson's Oral Surgery.

Dr. Atkinson says the expression of physical pain has no mean-
ing. We know pain only by the uncomfortable movement of what
we call consciousness, and so, of all that we know, it is simply a
mode of consciousness. If the word physical could be wiped out, it
would do away with much of our misapprehension.

Dr. a. H. Thompson says that his cure for sensitive dentine is
a temporary stopping of ozy phosphate for a week or two. He
has found it reliable and satisfactory for all cavities in sensitive
dentine.

THE

International Dental Jonrnal.

Vol. XI. March, 1890. No. 3.

Original Communications.'

THE EBLATIONS OP DENTISTRY TO MEDICINE, AND

ASEPTIC DENTISTRY.*

BY J. 8. WIGHT, M.D.,
Professor of Operative and Clinical Surgery at the Long Island College Hospital.

As a matter of fact and by common consent medicine is a ge-
neric term. It covers the entire field in which we work to prevent
and cure disease. And it must, in this sense, include the depart-
ment of surgery as well. And in whatever way we deal with sur-
gery, we consider matters that relate to the question of medicine, —
either preventive or curative. Now, it so happens that all of the
specialty which we call dentistry occupies, for the most part, the field
of surgery ; it is a special kind of handwork. But this fact does
not exclude another fact. In dentistry there are many questions
that relate to medicine as distinguished from surgery. Then, we
have this conclusion : Dentistry is both medical and surgical.

Let me say that dentistry is a special practice. It appears to
have started in a small way, — ^as the art of pulling teeth. It has
risen step by step, without the suggestion, the aid, and the support

^ The editor and publishers are not responsible for the views of authors of
papers published in this department, nor for anj claim to novelty, or otherwise,
that may be made by them. No papers will be received for this department
that have appeared in any other Journal published in this country.

* Beai before the Brooklyn Dental Society, January 27, 1890.

9 129

130 Original Communications.

directly of medicine, until it has been built up into a system of
practice, which everywhere confers benefits and improves health.
Other specialties have set out from medicine, and have erected
themselves into a somewhat independent existence. And the more
they keep out of sight the great principles of medicine, the less
their beneficent progress. We may admit at once that special
medicine relates to special organs; and then wo may say that
special organs are related to the general organism. Let the general
organism suffer, and special organs suffer also. And this means
that the specialist who has not general knowledge, and who has
special knowledge, from the very nature of the case, has incomplete,
imperfect, and insufficient knowledge. That is to say, no man can
be a complete specialist who has not acquired a general knowl-
edge of medicine. And I am now going to admit that the dentist
comes very near an exception to this rule: a good dentist may
exist without a knowledge of general medicine. And yet, permit
me to idd that, if he had a knowledge of practical medicine, he
could accomplish, in the main, better results. Not that I would
have dentists become general practitioners, — ^that is not what I
mean. It is this : I would have general medicine throw such light
as it could upon the entire field of dentistry. And so I would
encourage the dentist to move his camp somewhat over into the
field of general medicine.

How shall this relation be arranged ? I am of the opinion that
the dentist might derive much advantage fh>m the attendance on
one course of medical lectures ; two courses of lectures would be
better still. And if he cannot attend regularly, he would derive
much benefit from lectures on anatomy, physiology, general medi-
cine, and the principles of surgery. Ought the dentist to be a
doctor? This is not my point. Under no conditions should he
practise medicine and surgery,— even though he have a medical
degree. My point is this: the dentist could practise the special
surgery and the special medicine relating to the teeth and mouth,
contained under the head of dentistry, if his special knowledge is
supplemented by a reasonable degree of general medical knowledge.

Let us approach this subject from another stand-point. Suppose
a man who never studied medicine comes forward and sets himself
up as a specialist in diseases of the skin, or the eye, or the ear, or
of the uterus, what would be said in regard to the matter? He
may be exceptionally clever, in some respects, in what he professes
and undertakes ; his practice may be followed by a good degree of
success ; and he may be well educated in many directions. Having

Relations of Dentistry to Medicine, etc, — Wight. 131

not the least intention of throwing any imputation or the least
reflection on dentistry, I may say that, by common consent, the
dentist does most admirable work from just this stand-point. In
fact, he is an eminent specialist, without the general knowledge
that should underlie the practice of every specialty.

And then, there is another relation which dentistry bears to
medicine. Does my patient have diseased teeth, I cannot well cure
him until his teeth are attended to. Well, if I doctor them, I am
not sure that everything is all right ; he may improve or he may
not ; but if I send him to the dentist, who knows how to doctor his
teeth, then everything goes well ; my patient improves, not alto-
gether on account of the doctor for the teeth, but because what I
can do for him is not now undone by the irritation of diseased
teeth. You will see that I admit the incomplete knowledge of the
general practitioner in the field of your specialty ; and that you
can co-operate with him not only in curative, but also in preventive
medicine. It is not necessary for the doctor to know all about
dentistry, — and yet he ought to have some general idea about the
subject : then he will be a more competent practitioner. Nor is it
necessary for the dentist to know all about medicine, but he would
be able to do better work if he had a good general knowledge of its
principles. Our meaning is not that the dentist should practise
medicine, nor that the doctor should practise dentistry, — still there
may be an exception to this rule. la some of the rural districts,
it might be important for the doctor to know something about
dentistry. He may know how to extract teeth in a scientific way ;
he may know how to keep teeth clean ; and he may have some idea
as to the necessity of saving and filling teeth : then he can advise
his patients to go to a dentist, who may be found not many miles
away. In fact, this point has been considered by some of the
medical colleges ; and so there is a tendency towards the establish-
ment of a dental specialty in the curriculum of medical teaching, —
much the same as we have other specialties.

In the next place, a subject which has a great interest for me—
and I doubt not for others — comes to my mind for consideration, —
that is, the subject of aseptic dentistry. It is true that dentistry is
more in the line of surgery than of medicine; and if we approach
it from this side, we shall obtain clearer ideas about it. And then
let us set out with facts that will illustrate our subject. When I
speak of infection, I mean the same thing as blood-poisoning. And
it is about certain facts relating to infection that I am going to
speak. A very high death-rate occurred at one time in the College

132 Original Communications.

Hospital from septio fever among the surgical patients. On the
supposition that the infection was local, the beds and the wards
were cleaned in the following way : They were steamed for twenty-
four hours with the vapor of carbolic acid and vinegar ; the walls
were washed with a carbolic acid solution ; the clothing was im-
mersed in boiling water; and then the wards were thoroughly
ventilated. The patients were put into the disinfected ward, and
sepsis went on much the same as before. Evidently the difficulty
had not been reached, nor had the fatal influence been removed.
Had anything been overlooked in the work of disinfection, — that
is, on the ground that there is such a thing as infection? I
found that my own hands had not been duly considered, nor those
of my assistants. And then I asked myself if I had used the best
disinfectant ? My answer to this question was that I had not. Now,
let me tell you what I did. Understand that I was impressed with
the importance of keeping my patients from dying. They were
surgical cases. Then I selected chlorine, as it is found in chlori-
nated soda. After washing off the ordinary dirt, I applied chlori-
nated soda to my hands, sometimes full strength and sometimes
diluted. You know the surgeon operates with his hands, and they
come in contact with the fresh surfaces ; my hands were thus made
surgically clean, so they could not infect the wounds I made with
my knife. And what was the result of this change in practice?
As time went on, more and more infection and sepsis diminished,
while at the outset a very marked change took place for the better.
There were more speedy recoveries, and fewer deaths occurred.
And what was the meaning of this? Simply we had demonstrated
that the surgeon, in trying to save life, had carried the causes of
death on the very hands he put forth to rescue and save. Here
were strange secrets that had defied investigation for centuries.
A new line of practice had been instituted in the field of preventive
medicine, — for such it was, — even though explored by the surgeon.
And so what we mean by surgical cleanliness is to disinfect all
things that come in contact with our wounds, to prevent them from
becoming infected, to permit them to heal in the normal way;
that is, to keep the wounds we make aseptic ; in other words, to
practise antiseptic surgery. So much for our illustration.

Should dentists have clean hands? Should they have clean
instruments ? When one thinks about it at all, there can be only
one way to answer these questions ; indeed, they are of primary
importance. You will permit me to analyze the practical relations.
In the first place, there are two kinds of cleanliness: one ordi-

Relations of Dentistry to Medicine^ etc, — Wight. 133

nary, — that is, the hands are washed clean, so that the eye cannot
detect any dirt on them. This condition does not include that of
surgical cleanliness, in which the hands have been completely dis-
infected, when they are harmless, not having any infecting material
on them. That is, as we have already said, surgical cleanliness
consists in having all infection removed from the hands, in so far as
they are concerned. As surgery is handwork, it is very true that
dentistry is pre-eminently such kind of work, for it is done with
the hand. And the hand should not only be trained, but it should
be clean, — I mean the hand of the dentist. And if this is true of
the dentist's hand, it is also true of his instruments, — that is, they
should be clean ; they should not have any infecting material on
them. Each instrument should be above suspicion. There should
be a reasonable warranty that it is really surgically clean. This is
of much more importance than its general appearance. Infecting
material is not seen by the eye, but it is none the less potential in
all manner of surgical mischief. It shows itself by its works, and
its works are for the most part bad.

We will suppose that the hands and instruments of the dentist
are aseptic, for that is what surgical cleanliness really means. He
begins his professional work for the day, then, when he has made
his hands and instruments aseptic. Well, he extracts a tooth ; he
cleans a tooth ; or he fills a tooth. This is all right for the first
patient. It may be a patient who would be greatly offended if it
were said that his or her mouth is not surgically clean. And yet,
in the light of my argument, who would want this dentist to put
his instruments into his mouth — not to mention his fingers — just as
they come from this first patient's mouth ? Is there a dentist here
to-night who would like to have such an instrument used in his
mouth, or who would use it for one of his patients, before it had
been made aseptic again ?

Does the dentist know the fearful responsibility he incurs in
regard to this question ? Let me illustrate. He extracts a tooth
from a mouth in which there are specific ulcers ; the jaw of the
instrument becomes covered with infecting pus ; he wipes it off, or
he thinks he does; the instrument is ready, like the lancet, for
vaccination ; an innocent lady takes a seat in his dental chair, and
he extracts one of her teeth with this same instrument. It is not
my object to-night to trace and picture the long series of unfortu-
nate consequences that may follow. Only let me say, in the name of
science, humanity, and charity, that these consequences are entirely
avoidable. If this is so, may we suggest where the responsibility

134 Original Communications.

rests? Whose fault is it? Any one can answer this question.
But the dentist replies, Am I to clean my forceps one hundred
times to meet this one possible emergency? Undoubtedly. Which
is better, to wash and clean your forceps so many times, or to incur
the responsibility of causing so much suffering to an innocent
patient who has confidence in your care and skill? Which will
give you more trouble, to take a little time to apply the principles
of aseptic dentistry, or to meet the legal consequences of ordinary
care and skill in your work? For that is indeed what it amounts
to in the light of modern science and recent practice.

Let me further illustrate. Science has shown us that consump-
tion— that is tuberculosis — is an infectious disease ; that it can be
implanted in a perfectly healthy individual; that it can be con-
veyed from one person to another, and that it is caused by a micro-
organism, which is present in the system of those who have it.
This disease attacks the lungs frequently. Expectoration follows.
The bacilli are in the sputa. And they may lodge in decayed
teeth, on the gums, and in other parts of the mouth. Has it
occurred to any one present that these micro-organisms can be
conveyed from the mouth of a consumptive to the mouth of a
healthy person, and cause infection and all the consequences that
result from this dread disease ? Is any one sure that he has never
conveyed the virus of tuberculosis from one person to another by
means of instruments that were unclean? We may allow that,
hitherto, this effect, which we can hardly doubt, has only been
from excusable ignorance; yet, in the future, who can doubt that
its repetition must be set down to the account of criminal negli-
gence. And so, what man among you, now knowing what might
occur, would hesitate to take thought of this matter, and make his
instruments aseptic, as well as his hands, after he has served one
patient, and before he comes to serve another?

And may I suggest, from analogy, the possibility of Bigg's
disease belonging to the same general subject of infection ? The
insidious and progressive nature of this disease, extending from
point to point, indicates phases of resemblance to other infectious
diseases. One cannot explain this disease quite so well on any
other theory ; and yet this does not prove that Bigg's disease is
infectious, — the theory of infection gives us the most reasonable
explanation. Suppose this view to be the true one ; then, what we
have said in regard to syphilis and tuberculosis will indeed be true
in regard to Bigg's disease. More than once have I asked myself,
Can it be possible that this fearful scourge of the human teeth is

Relations of Dentistry to Medicine^ etc. — Wight. 136

infectious? and can it be communicated from one person to an-
other ? This question will have to be asked ; it will have to be the
incentive to investigation ; and the answer will be of moment what-
ever it may be. If the disease is infectious, all may find out a cure ;
if it is the result of senile changes, we may only be able to palliate
it. At all events, there is no reasonable doubt as to the need of
having clean instruments, — in other words, it will be good practice
to act as if this view were true.

The extent of the field beyond these illustrations is at present
unknown, — that is, we do not now know how many pathogenic
micro-organisms may be likely to affect the mouth, in one way or
another, by means of dental instruments. Let it suffice that we
have directed the attention to this important subject ; a subject in
which lies immense possibilities of harm and peril ; a subject which
belongs to the field of preventive medicine, in which we find the
greatest advancements and the noblest benefactions.

I will try to tell you how to keep your hands and instruments
clean ; by this, I mean surgically clean, — ^that is, aseptic. In the
first place, the hands should be scrubbed with soap and water, using
a large nail-brush. At the same time the nails must be kept
thoroughly clean. Then they should be washed with a solution
(1 to 5000) of mercuric chloride. Subsequently let them be
washed in alcohol from time to time. Or, make a solution as
follows : First, mix glycerin and carbolic acid, equal parts ; and
then make a one-per-cent. solution of this mixture in water, and
have it ready for bathing the hands, when required. Other
methods need not now be described, since these are sufficient. In
the second place, it would be very easy for the dentist to have a
small vessel containing water over a gas-jet, burning so as to keep
the water at a boiling temperature; in this boiling water the
instruments can be immersed after being used in the mouth of one
patient, and before being used in the mouth of another. This
would insure the destruction of pathogenic micro-organisms, and
prevent infection. A plan so simple, and so easy of execution,
can be adopted by any operator. One now submits to the true
teaching of science; one puts to the best use the principles of
asepsis for the benefit of those who suffer ; one may not neglect to
apply new facts, and so permit harm to come to others who depend
on him for aid, and pay him liberally for his assistance. In fine,
the law of asepsis rules every part of the great territory of anti-
septic work, and in no department more than in dentistry.

136 Original Communications,

EAPID METHOD OF INSERTING AND FINISHING CON-
TOUR FILLINGS WITHOUT THE AID OF A MATRIX.*

BY J. E. WAITT, D.M.D.

Fob years, science and skill have been coming to that place where
each and every department of life is being forced to that point where
its work may be accomplished with the greatest ease and in the
shortest time. The department which we represent has been
among the foremost in devising ways and means for the accomplish-
ment of our daily work with the least inconvenience both to our-
selves and our patients. It shall be the aim of this paper to present
you, in a few words, a few (possibly new) ideas, and thereby assist
you in the labors of the day, and the rapid and satisfactory com-
pletion of those large or difficult contour fillings with which we
have to deal.

By the use of Dr. Jack's and other matrices very many of the
difficult operations in contour filling have become, under the skilful
hand, very simple operations ; and operations once requiring hours
for their completion are now accomplished in minutes.

The impossibility of having the walls of a cavity in full view,
and the inconvenience of easily adjusting a matrix, led me to dis-
card all forms of matrices, and look about for a method of quickly
reaching the same or a better result. After some years of experi-
menting with methods, foils, and preparation of cavities, I am
pleased to present you a method which you will find to answer the
requirements of the case, thereby making operations, formerly long
and difficult, so short that they become a pleasure both to the
patient and the operator.

First, space by a separator or tape, to the width of a No. 3 or 4
separating file. Apply the dam in the usual or the following man-
ner : In the case of a right superior second bicuspid, lay the dam
over the face, and apply it to the mouth in the position it is to
occupy, then with a pencil mark the centre of each tooth from the
right superior lateral to and over the first molar. Punch out a
hole for each tooth, and then apply the dam, beginning at the

^ Read before the American Academy of Dental Science, December 4, 1889.

Inserting and Finishing Contour Fillings, etc, — Waitt. 137

lateral and working backwards. Over the molar slip a clamp, or, if
close to the second molar, pass a ligature up between, and leave it.
Then, with, a thin and flat burnisher, turn the dam up on itself
around each tooth, and dry with cotton.

The dam applied in this manner obviates the tying of a ligature
about each tooth, which is a nerve-trying experience. This method
allows greater freedom for working, because the dam is out of the
way, and also affords better light. It will be found to answer the
purpose for large cervical cavities when properly applied.

Next, prepare the cavity as usual, except do not cut any retain-
ing points, but in their place cut a fine groove across the cervical
wall and down the buccal and palatal or lingual walls with a fine
burr, and make the opening on the crown surface when possible,
slightly dovetailing towards the body of the tooth ; then, with a
sand-paper disk, smooth the mesial or distal surface, as the case
may be.

The gold to be used becomes the next feature, and must be a
soft gold, easily moulded under a burnisher. I use the new gold of
the Boston Dental Manufacturing Company, ropes No. }. These
may be flattened and made into cylinders with great convenience.

In using soft foil, take No. 4 soft, cut in one-half sheets, and
roll to about the size of three-sixteenths of an inch diameter, and
flatten. Each cylinder to be of a length slightly exceeding the
depth of the cavity from front to back, and its size in the square
to depend upon the width of the cavity and the method of con-
densation.

I prefer the No. } ropes to any other, for the ease with which
cylinders may be made from it. For the intermediate layers, of
which I will explain later, the Boston Dental Manufacturing Com-
panj^s No. 4 foil is the form used.

In preparing the cylinders, take a strip full length of soft gold,
grasp it with a pair of pliers, and fold over and over until the size
wanted is rolled ; then condense easily endways, then sideways, and
repeat until it is of the desired square.

Never cut a strip in two lengthways to get a short cylinder, but
rather fold it upon itself lengthwise, and proceed to roll as in the
usual manner. With many of these cylinders of various sizes
rolled during leisure-hours, or by an assistant, considerable time
may be saved at the moment of greatest strain to yourself and
patient.

Now place a floor of these squared cylinders across the bottom
of the cavity, allowing the ends to extend slightly over the edge,

188 Original Communications.

and with a large round or foot-shaped plugger partially condense
this layer; then, with a couple of pieces of No. 4 foil made cohesive
and single thickness^ placed over the partially condensed surface, the
whole is thoroughly condensed with a smaller, round plugger, care
being taken not to allow the plugger to enter the gold extending
over the edge.

When thoroughly condensed, pass a thin, flat burnisher up by
the ends, and, with a slight pressure, force them over the edges of
the cavity in each direction, making the burnishing carry the gold
over the edges, thereby locking it and preventing tearing it out.
Increase the pressure upon the burnisher until the ends are well
condensed, and shaped to the desired contour.

When this point is reached, place a couple of thin layers of
cohesive gold over the whole, and condense well. This is done for
the purpose of locking each layer and giving edge-strength to the
contour. Burnish this edge well, and then proceed with your second
layer of soft cylinders, as you have done with your first, with the
exception that the middle cylinders are to be slightly longer than
the side ones, to allow for the swell of the contour. Burnish, and
proceed as before.

The crown surface can be finished by building up to the desired
shape with cohesive gold, which can always be made to unite with
the soft gold, if the first union is made with pieces of a single
thickness, well united by mechanical force, and condensed with the
soft gold.

Contour fillings, built in this manner, do not need any finishing
with a file or sand-paper, as the whole surface is left finished at
each stage, and any amount of overlapping gold is burnished off,
leaving a clean, smooth edge, and highly polished.

By this method the entire wall edge is constantly in view, and
one point is not left for another until the former has been com-
pletely filled and finished, which alone is enough to commend this
method to our careful consideration.

Oral Surgery Clinic. — Marshall. 139

^ ORAL SURGERY CLINIC.^

8EBVI0E OF PR0F1S880B JOHN 8. MARSHALL, M.D.

The patient before you, gentlemen, is a railroad engineer, thirty
years of age, who has recently been in a collision, and came out
rather badly battered up. He is suffering from a broken wrist,
contusions and lacerations about the head and face, and a compound
comminuted fracture of the lower jaw. The accident occurred
about two weeks ago. The broken wrist, contusions and lacera-
tions about the head and face have been cared for ; he is now re-
ferred to us for treatment of the fractured lower jaw. The broken
bone has been treated since the injury by the ordinary occipito-
mental bandage and wiring the teeth, but these fail to hold the
ends of the fractured bone in apposition.

Let us now proceed to a critical examination of the mouth and
the fractured jaw. First, we notice the crowns of the superior,
central, and lateral incisors are fractured obliquely outward and
upward, the centrals losing about one-half and the laterals about
one-third of their crowns. This indicates a blow upon the lower
jaw, near the chin, the direction of the force being upward. The
lower jaw is fractured through the alveolus of the right lateral
incisor (this tooth is missing, having been knocked out in the
accident), and then extends obliquely backward and downward
through the body of the bone. The six teeth to the lefl of this, —
viz., three incisors, the cuspid, and the first and second bicuspids,
together with their alveolar process, are broken loose from the
body of the bone, so that they are freely movable in all directions.

The gum is intact along the line of this horizontal fracture upon
the labial surface, but upon the lingual surface it is considerably
lacerated, and the bone is here, and at the ends of the fracture,
exposed to the secretions of the mouth. Suppuration has taken
place, as generally happens in compound fractures opening into the
mouth, owing to the fact of the great difficulty in maintaining
an aseptic condition of the parts.

Until the introduction of the antiseptic method of treating
wounds, compound fractures, in any location of the body, were

^ DeliTered before the students of the Medical and Dental Departments of
the Northwestern University, at St. Luke's Free Hospital, Chicago, 111.

140 Original Communications,

generally followed by Buppnration. Vigorous efforts should be
made, however, to combat these conditions by the free use of an-
tiseptic mouth-washes, and if this treatment is faithfully carried
out, in many cases it will prove successful. The mouths of the
most cleanly peraons are the habitat of great numbers and various
forms of micro-organisms, while the food and the fluids of the mouth,
loaded with these organisms, cannot be prevented from entering
the wounds ; consequently, fermentative processes are set up, and
pathogenic bacteria readily find access to the tissues.

This fracture is a somewhat peculiar one, and may result in loss,
from necrosis, of that portion of the alveolar process, and the teeth
contained in it, which are broken loose from the body of the jaw.
Injuries to the bones of the face, however, are less likely to result
in necrosis than like injuries in other portions of the body, which
is due to the greater vascularity of the tissues of the face. You will
notice that the teeth occlude only upon the right side, posterior to
the line of fracture, through the body of the bone, the space be-
tween the upper and lower teeth of the left side is fully three-
eighths of an inch, while the movable fragment is carried inward
and to the right fully one-half of an inch.

In order to treat this case successfully, it will be necessary to
construct an interdental splint, with metal arms passing out at the
corners of the mouth, and turned backward on a line with the
lower jaw, and outside the cheeks. This form of splint is known
as the Kingsley.

After plaster casts have been made from impressions taken, we
saw through the lower one upon a line with the fractures, and
adjust the fragments of the cast to their normal position by the
aid of the cast of the upper jaw. If the occlusion of the teeth of
the casts is made properly, and the fragments of the cast of the
lower jaw united with plaster of Paris, in their new position it will
represent the shape and position of the jaw before the fractures
occurred ; and a splint constructed to fit this will bring the frag-
ments of bone into their normal position. It is made secure by
placing a compress under the chin at the most depressed portion of
the jaw, and passing a bandage back and forth over the arms of the
splint and under the chin.

[The splint was constructed of hard rubber with soft steel arms,
and inserted two days later. At the end of two months, union of
the bone had taken place in each of the fhictures and the occlusion
was perfect.]

American Academy of Dental Science. 141

Reports of Society Meetings.

AMERICAN ACADEMY OF DENTAL SCIENCE.

(Continued from February number.)

President Seabury. — The next matter in order is a paper entitled
" Bapid Method of Inserting and Finishing Contour Fillings with-
out the Aid of a Matrix," by Dr. Joseph E. Waitt, Boston.

Dr, Waitt. — Gentlemen of the American Academy of Dental
Science, the method that I present to you is not new, neither is it
entirely my own ; it is a chip from here and a chip from there, and
putting them all together, I reached the result of which I will show
you a specimen, and tell you how I accomplished it. (For paper,
see page 136.)

Dr, Andrews, — The subject is so interesting that I wish we had
a black-board here, so that Dr. Waitt might demonstrate his method
more clearly ; and I move you, sir, that we have one hereafter for
the use of the members.

Dr, Ames, — I should like to ask Dr. Waitt how long it would
take to fill a cavity of the size shown in specimen No. 2. Could you
do it in half an hour?

Dr, Waitt, — ^You could finish the filling in about half an hour.
The filling, as far as you see it there, or with one more layer, can
be done in about ten or twelve minutes. It will take as long to
build that top as it does the three-quarters or seven-eighths of the
filling up to that point.

In making these squared pellets, or squared cylinders, I take
these ropes, if I want to make a very long cylinder, No. i, and fold
this rope on itself lengthwise, then over and over. If I want to
make a large cylinder, I start with full width of rope and fold it on
itself and roll it somewhat larger than the cylinder is to be when
squared.

Dr, Barker. — So far as I was able to comprehend the doctor, the
method he describes is not dissimilar to the one I have been using

142 Reports of Society Meetings.

for several years, and doubtless many others employ it. In regard
to the preparation of the cavity, he made a remark that attracted
my attention. It was this : '^ There are no retaining pits used." I
apprehend that by far the larger portion of good operators have
practically abandoned retaining pits.

The preparation of the doctor's cavity is almost identical with the
method that is described in nearly all the standard works on opera-
tive dentistry. Without the use of a diagram, or a black-board, I
confess my inability to grasp the minutisa of the locking and inter-
locking he describes.

The method consists simply, as I understand it, in laying a mat,
a flattened cylinder, or a block of unannealed foil on the floor of
the cavity and condensing it. The floor may be thus formed of
one block, if it be sufficiently large ; place now a flattened cylinder
at each border, condensing them laterally against the walls ; lay
on the bottom one large or three smaller blocks, which, when
condensed, expand laterally, thus fastening the side-pieces in posi-
tion ; more blocks may be introduced at the bottom and be treated
in the same way. When the cavity is two-thirds or more full,
begin to work on cohesive foil. It will readily cohere by the joint
effects of molecular and mechanical cohesion, if good serrations
are employed; complete the fllling with cohesive foil. The bur-
nisher should be employed on the proximal aspect of the unan-
nealed foil during the various steps of the operation.

Br. E. G. Trucker. — ^Mr. President and Fellows, I have never used
gold foil in any other form but pellets of different sizes, the small,
delicate ones in front teeth, large ones in large cavities (grinding
surfaces), where great packing pressure could be given. By carry-
ing out the filling to the edges with these small pellets and sharp-
pointed pluggers, you can get as perfect a filling — ^polished and dura-
ble— with No. 4 soft gold and hand pressure as can be made with
automatic mallet and hard gold. I have tested this mode of filling
fifty-four years, and have used no other to the present day. I will
show the Academy four front teeth that I filled for a young man
in Harvard College, which were used thirty-six years afler being
filled, and then were extracted on account of general disease of
the sockets of all his teeth, from the effects of which they became
loosened. As you will see, the fillings are still in excellent condition
and preserved those teeth during that long period.

Dr. Williams. — In regard to mats, or pellets, as they used to be
called in Dr. Tucker's early days, this method reminds me of the
way his brother and he used to make fillings that made such a repu-

American Academy of Dental Science. 143

tation for American dentists. I think it was similar to the manner,
described by Dr. Waitt.

Dr. Briggs. — I do not perfectly understand Dr. Waitt's paper. I
wish I could have it explained, as Dr. Andrews suggersts, with a
black-board. I think he has given us something new, whereas I am
quite sure that Dr. Barker has given us something old. His is the
ordinary soft filling; but I think that Dr. Waitt's method may
have something more in the finishing, perhaps, than any mere
question of using soft or cohesive gold. I do not know, perhaps
some of the members understand it better than I do, but it seems
to me that the other methods spoken of are very old, and I hope
that Dr. Waitt will endeavor to explain his process more fully by
the use of a diagram.

Dr. Andrews. — I want to say a few words criticising the shape
of the cavity formed by Dr. Waitt. We understand that the ^hape
of the cavity is exaggerated, but you will find the cervical wall to
be the weakest part of the whole cavity. We know that if we cut
across the tubuli, at the cervical wall, there is dead tissue there, and
I should think that the filling could be quite as well made if the floor
of the cavity was cut square across or made to slant outward
rather than inward.

Dr. Waitt.'^I said in the first place that it was an exaggerated
case. I expect that each one will use his own judgment. The
filling can be practically put in as well on a fiat fioor as it can on a
floor that has a groove cut across it, but where the tissue is com-
paratively hard, a slight groove can be made. I use the flnest in-
verted cone that the S. S. White Company makes. The filling is a
soft gold filling, with the exception that a layer of cohesive gold is
placed between the layers of soft foil. The contour is made
entirely by burnishing. The pellets are put into the cavity with
the ends standing out, somewhat longer than the cavity is deep.
It is the length of these out-standing ends that makes the contour.
Then again, where each layer is looked, that makes it a little
stronger, and you have a hard edge to burnish on to.

Dr. H. A. Baker. — I thought that when Dr. Andrews began to
speak he was going to bring up just what I had in my mind,
only my exceptions are at the other end of the cavity. What I
wish to call attention to is the way in which the essayist forms his
grooves. It seems to me that if he brings his grooves clear up
through the enamel of the crown, he leaves a sharp comer which
necessarily must be very weak, and in my patients' mouths that
comer would break off just as sure as the world. To avoid this, I

144 Reports of 'Society Meetings.

should bring the groove up under the enamel and not cut through
it, and leave the corner on a bevel, and protect it by a covering of
gold, which would resist the occlusion. Another point in regard to
his cylinders : Tou make a cylinder of rope, and one gets into an
elliptical shape, and you cannot avoid it ; the result is, your cylin-
der is thicker in the middle than it is at the ends. Now, in the
place of ropes, I would take non-cohesive pellets and flatten them
out, lay the fiat sides one upon another until you get the desired
thickness ; then, bending the ends towards each other, the result is,
one gets a cylinder in the cavity like so many leaves in a book, one
upon another, with one end against the wall of the cavity, the
other against the matrix; and thus you have an even thickness
throughout. This should fill the cavity about one-third full, then
forming an anchorage above this, and finishing out with cohesive
gold, protecting your corners as I described before, and you will
have a filling which will stand the test of severe usage.

Dr. Briggs. — As I understand it, it is not so much the shape of
the cavity as it is the filling. It may be, it is boring the others,
but I wish that Dr. Waitt would give us a resume of his process of
putting in the filling.

Dr. Waitt. — Perhaps you are getting too much, gentlemen. I
told you in the first place that it was not entirely my own, but a
chip from here and a chip from there, and putting these together I
got this out of it, and this I can do. Now, the preparation of the
cavity or the making of the cylinder is immaterial. I do know
that I can take a patient in my chair and fill a cavity in one-quarter
of the time that I can do it with cohesive gold, or any other
method that I have ever seen. It is my way, and yet it is not my
way entirely, because it is a combination of the parts of several
other methods.

In the first place, if we look at the end of the cavity from front
to back, we see here these squares laid side by side. First, place
these squares across the bottom and only partially condense them
with a large plugger. Cohesive gold is then placed over this in
shreds, as it were, of the thickness of one single sheet at a time,
and with a plugger, the serrations of which are sharper than for
ordinary condensing, make a thorough mechanical union with the
soft gold. I put on perhaps three or four thicknesses of this single
foil and carry them right straight down, as hard as I can condense
it by hand pressure. Now, I do not condense beyond what is to be
the contour of the tooth, for by so doing you are likely to push the
plugger through that portion. After the first layer is put in, locked,

American Academy of Dental Science. 146

and condensed, I take a burnisher and carry it up and about the
extending ends and form the contour, and burnish away the small
amount of overlapping gold. That layer is then practically finished.
I claim that after that layer has been put in, you could leave it for
weeks, and then take out the filling, and the bottom of your cavity
will be-perfectly dry.

Dr, Clapp. — I would like to ask Dr. Waitt if he uses a mallet at
all?

Dr. Waitt. — When I get clear up to the surface, which would
become the grinding edge, I then use a mallet. I have seen soft gold
fillings put in by hand-pressure where the patient has ground and
articulated on the filling, and it was not broken. I cannot do it. I
would be very happy to learn how to condense soft gold by hand-
pressure to stand such a strain.

Dr. Andrews. — ^May I ask Dr. Waitt the object of the cohesive
gold?

Dr. Waitt. — The cohesive gold, as you see it in this layer, ex-
tends clear out to what would be the edge of the contour of the
tooth. It acts as a face or a resistance to burnish against.
Subject passed.

President Seabury. — Dr. F. G. Eddy will present a new mouth-
piece for saliva-ejectors.

Dr. Eddy. — There is a mistake in the announcement on the card
that I was to present a new mouth-piece. I do not know how it
happened. There is nothing new in regard to this mouth-piece.
It is simply the old mouth-piece with lengthened shank, and with a
stop-cock put a little lower down, so as to be under the control of
the patient.

As I was leaving the office to-day. Dr. G. W. Porter, a surgeon
of Providence, handed me this box, part of the contents of a der-
moid tumor, removed a few days before, and within that, among
some hair and some fatty substances, he found these teeth, and also
these pieces of bone. Out of sixty ovarian tumors he has found
but twelve dermoid cysts. This is the only one in which he has
found any teeth. With them he also found the left half of a lower
maxillary bone.

Dr. Andrews. — The little stop-cock in Dr. Eddy's ejector is cer-
tainly an improvement, but I had hoped that we were going to get
something that would not suck in the soft tissues.

President Seabury. — I have an old ejector, the holes of which are
on top.

10

146 Seports of Society Meetings.

Dr. Briggs.—^I like this ejector very much. I would like to ask
Dr. Eddy if, in using it in ordinary operations, debris would be
likely to get into the cracks and stop them up very easily ?

Dr. Eddy. — I think not. I use it daily.

Dr. Waitt. — I think the best mouth-piece I ever saw was one
shaped something similar to this, but the end of the tube came down
nearly to the bottom of a little cylinder made of perforated metal
and surrounding it. The saliva can come up in it three-fourths of
its length, then pass down and go into the tube. I have used one
of them five years, and I never had any trouble with it. I would
like to ask Dr. Eddy, Will these fine slits let thick, stringy saliva
pass through them ?

Dr. Eddy. — ^Yes, sir.

Dr. Williams. — I have an impression that this plan of Dr. Eddy's,
of having slits instead of holes, will be an improvement. There is
a chance for a slit to clear itself, while a hole blocks up. There is
an objection to the weight of this ejector. I have a short one, not
more than five inches at the most. I put in the lightest rubber
tubing that I can find that will not collapse by suction, so as to
avoid any sense of weight in the mouth. I find the patients feel
relieved, and consider it somewhat of a luxury.

Dr. Andrews- — One of the advantages of this saliva-ejector is
that the patient can hold it in the mouth ; but what I wanted to
suggest was that the mouth-piece might be difficult to cleanse. Any
one of you who has tried to clean a saliva-ejector must have been
surprised at the amount of filth that can get into an instrument
of this kind.

Dr. Codman. — I have noticed among practitioners a growing
tendency to make dental operations complicated. I think that has
been so very largely in the use of the saliva-pump. I think, in a
great many cases, it is entirely unnecessary, and should be dispensed
with. The drawing out of a person's system of a pint to a quart
of saliva must certainly be very exhausting, and this is done in
many cases where the saliva-pump is not needed at all. I don't
think I have used one in six months, for I find by a proper adjust-
ment of the rubber dam with ligatures my patients get along much
easier than they would by the use of the saliva-pump.

Dr. Meriam. — I should like to present, Mr. President, as chair-
man of the Executive Committee of the Massachusetts Dental
Society, a cordial invitation to the Academy to our next meeting,
to be held on Thursday next. In addition to our usual programme
we shall have a small exhibit, not as extensive as last summer. The

American Academy of Dental Science. 147

annual address will be delivered by Bev. Alexander McKenzie, D.D.,
secretary of the Board of Overseers of Harvard University. The
address will be given at 4.30 o'clock in the aflemoon, and we hope
there will be a large attendance. It will be given in the large hall
of the Young Men's Christian Association. We have sent an invi-
tation to the faculty and students of the Harvard Dental School,
and also to the faculty and students of the Boston Dental College,
and we trust that the attendance will be large, to do justice to our
orator.

Dr, FiUebroum. — Mr. President, I move the invitation be accepted
and placed on file by this society.

Dr. Waitt exhibited a nitrous oxide light for photo-microscopic
purposes with the following description :

The principle is old in that it is a combination of the Knapp
blow-pipe simply adapted to a burner which carries a piece of lime.
It is after the principle of the oxyhydrogen light, with the excep-
tion that we use ordinary illuminating gas and nitrous oxide gas.
By this I get, as you see, a very powerful white light. In my
first experiments it would spit and sputter, but I finally found that
the trouble was in getting the gas out of the cylinder. It would
persist in freezing. If I blow off about twenty-five gallons, or use
a seventy-five- or fifty-gallon cylinder, I get the result which you
see here. A light, as Dr. Andrews knows, for photographic pur-
poses, needs to be an intense white light. This light can be used
for the projection of pictures on a screen, and for a picture up to
twelve or fifteen feet in diameter it is perfect. In a course of
lectures by Dr. Dearborn I illuminated a circle of twelve feet
diameter, and he said the pictures were fully as well illuminated
as if they were shown by his regular operator with the oxyhydrogen
light. The plates were the ordinary three and one-fourth by four.

In the illuminating of stereopticon pictures all that is required
is a bright spot or line of light ; in other words, the whole thing to
be reached is to get the most intense white light into the smallest
possible spot. After I once get this light in this way, and the
cylinder of gas down to where it will blow readily, we can regulate
the light by a stop-oock in this cylinder.

William H. Pottkb, D.M.D.,
Editor American Academy Dental Science.

148 Beports of Society Meetings.

UNION MEETING OP THE CONNECTICUT VALLEY
DENTAL SOCIETY, THE NEW ENGLAND DENTAL
SOCIETY, AND THE CONNECTICUT STATE DENTAL
ASSOCIATION, AT SPEINGFIELD, MASS., OCTOBER
23, 24, AND 26, 1889.»

The meeting was called to order at 2.30 p.h. by Dr. E. S. Gaylord,
chairman Executive Committee.

Dr, Gaylord. — Gentleman, the hour has arrived for calling this
meeting to order. I now have the pleasure of introducing the
president of the Connecticut Yalley Dental Society, Dr. S. B. Bar-
tholomew.

DB. Bartholomew's addbess of wbloomb.

Gentlemen and Professional Brethren, — Through the cour-
tesy extended by your Executive Committee I have the honor, as
well as the great privilege, of welcoming, from all parts of New
England and the Canadas, the members of the Connecticut Yalley,
the New England, and Connecticut State Dental Associations, to-
gether with our invited guests from different sections of the
country, to the autumnal beauties of Springfield as well as to this
dental gathering.

Our good mayor, a few weeks ago, placed a pot of red paint in
the hands of the members of a section of the Grand Army of the
Bepublic, who chanced to hold their annual reunion in this city.
He bade them enjoy themselves to the utmost. Although I cannot
speak with municipal authority, I will say this much, that, if you
find less leniency shown you than was shown on that occasion, woe
be to any one of our present municipal authorities who shall here-
after demand the professional services of any of the local dental
committee who has assisted in completing the arrangements for
this convention, for he will proceed to square the account by in-
flicting the full pains and penalties known to dental science.

It affords me great pleasure to stand in this place as a sort of
link between the past and the brilliant future that is before us, and
open the door to the work of this dental convention. I am now
in my fifth dental decade. It covers a period of the world's his-

^ Reported for the Imtxrnatiokal Dsntal Journal by Geo. A. Maxfield,
D.D.S., Holyoke, Mass.

Union Meeting of Dental Societies. 149

tory in which the arts of peace have attained their greatest tri-
umphs. The impartial historian will place the art and science of
dentistry as one among the new births or revelations to man's con-
sciousness during this period, out of which is coming the greatest
possible good to mankind. Little by little we have seen the flame
of incense ascending from our dental altar, representing the full
vigor of early manhood, the science of investigation, the restless
genius of invention, the spirit of refinement and culture, until the
whole world pays tribute to American dentistry. And in this con-
vention I am proud to recognize men who have accomplished their
proportional share in this great work. In the fall of 1848 I en-
tered, as a student, one of the best dental offices in Massachusetts.
At that time, I believe, there were but four dental graduates in all
New England. We were like travellers in a wilderness, with here
and there a blazed tree to guide us. It was fortunate for us that
there was then no law against any man's experimenting on the
dear public to his heart's content. But, notwithstanding all that
has been done to reduce dentistry to an art and a science, it has as
yet no clearly recognized place in the field of M.D.ism, and will not
until the curriculum of study shall be such as to place the graduate
in dental medicine and dental surgery upon an equality with the
graduate in any department of medical and surgical science.

The tendency is towards the highest possible attainment in all
professional life, and the man who stops at the attainment of his
D.D.S. will find himself, ere long, barred against associating on
terms of equality with the constantly increasing number of M.D.,
D.D.S.'s.

A calling that would attain to the grand and the great rises
above the every-day grad-grind for subsistence, and carries its clan
into the realms where work is transformed into the intensest
pleasure under the stimulus that comes from the pursuit of the un-
attained, and draws towards it a constantly ascending grade of
mental force and power. Then we may look for a realization, in
the near future, of the dream of our advanced brethren who are
bearing the heat and burthen of the day, not the dream of Long-
fellow's alpine youth, whose burthen of strange desire was lost to
sight and realization, as he seemed transformed into a lunatic above
the clouds, leaving behind him his mortal vehicle stuck fast in snow
and ice ; not the Utopian dream of Sir Thomas More, whose ideal
was beyond mortal attainment, but the dream of an educated and
scientific art that shall move by the side of and be classed with the
learned professions. I expect to live to see the day when the Har-

150 Reports of Society Meetings.

vard school will, in obedience to a demand, require the M.I>. as a
foundation upon which to lay the D.M.D.

Grentlemen, may your stay in our city be agreeable to you, and
may the sessions of this convention be profitable to us all.

Dr, Gaylord, — Gentleman, Dr. G. A. Brackett, president of the
New England Dental Society.

Mb. President and Members of this Convention, — It gives
me pleasure to appear before you and utter a few words in the
capacity in which I am permitted to speak. As it was my privi-
lege to say on a former occasion, the occasion of my accession
to the presidential position which you now so capably fill, the
Connecticut Yalley Dental Society is like a home to me. It was
the first dental organization to enroll me as a member. Among the
members of this society are men who have been to me most help-
ful as a student of dentistry. From the men whom I now see before
me, I think I have gained, in a sense, more courage and help than
from any men in the world. So it was a pleasure to come back to
its society meetings. It has not been convenient or possible for me
to be a regular attendant at the meeting of late years, and I come
back as the '* prodigal son," not as one having engaged in riotous
living, — for dieting on clams is not to be called riotous living, — but
I come back in the sense of the prodigal son who has been away
for a time from his father's house. If you will kindly let me in-
dulge in a few personalities, I will speak of the way in which I
was impressed on my arrival in your city afler dark. There was
a sense of bewilderment, due to the change of the railroad station.
I needed guidance and direction to get out on the main street.
Since my last visit, great changes, I find, have taken place ; new
hotels, new stores, the enlargement of buildings, etc., and enter-
prise, vigor, and energy appear on every hand. In the morning I
rose early and went eight miles to Holyoke, which, only a few
years ago, had a population of but ten thousand, and now has
over thirty-three thousand, and with positive evidence of life and
energy or push and progress that, to a person who has been
living in a place where nothing is done in business, was inspiring.
The Connecticut Biver I studied about in school, as a matter of
geography, rises in Connecticut Lake, and flows south through
Massachusetts and Connecticut, and empties into Long Island
Sound. The Connecticut Biver is a great institution in itself, yet,
compared to the Connecticut Yalley, is a small thing. The Con-

Union Meeting of Dental Societies. 151

necticut Yalley, with the accompaniment of the Connecticut
Yalley Dental Society, is a thing of wide extent. We might then
bring in a little more geography, and Bay, the Connecticut Yalley
is bounded on the north by Montreal; and speaking of this, it
reminds me that the society is always glad that it has such a good,
big " Bazin." The Connecticut Yalley is bounded on the east by
Uncle *^ Dudley," and he spreads over a good deal of territory him-
self, and will doubtless do so to-day. On the south, by salt water,
— let us hope it will never be '^ Salt Biver." On the west, by the set-
ting sun. We see no indications that the sun ever will set in this
valley. The Connecticut Yalley has large dimensions in height,
especially here in Springfield, and has always been so. In Boston
we have deep water, that, whatever the " Weatherby," we are not
likely to have its "Niles" "Leach" away; but here in Springfield
you go below water into profound "Mayr." Yet let any man
" Hurlbut" a bottle at the fair fame of your society, and we shall
all rise in its defence. It is a society we know full well, for
you always keep its "Stockwell" up to par. When it comes to
largeness of heart and helpfulness of hand, I tell you. Mack, there
is no one who can beat "McManus." The Connecticut Yalley
Dental Society, in times past, has reached some new ideas, and
they are ideas that are not likely to become " Snow"d under. Its
members have in their time run against a good many snags, and
still succeeded in living, but whenever we go to Brattleboro', we
are always glad to run against a " Post." The old saying, " it takes
nine tailors to make a man," we have heard, but it is demonstrated
to us that when it comes to a matter of working on committees or
to engineer a steamboat excursion, one " Taylor" is equal to nine
ordinary men. Our societies are, in a sense, cosmopolitan. New
York can match our " Smith'* and " Jones" with their " Bobinson."
In all the push and enterprise in Holyoke, I could not help
thinking, with all its " Hastings,'* it is building solidly, and with all
its material with which to build, it needs to be to complete the
culture of its fields, and the most satisfactory one to meet is its
" Maxfield." You know the reason given for giving up the reading
of the Bible in the public schools of Minnesota was because it made
BO much more mention of St. Paul than of the other cities ; yet I
have never heard any one make any opposition to St. "Barthol-
omew." Our bishop may be absent, but our " Shepard" is always
here. If we could only have our friends from Buffalo with us, we
would tiy to " Barrett." I should not, however, forget that we
came here for something else than such things as we have been

152 Reports of Society Meetings.

speaking about, and I wish to make mention of how much we owe
to this society, the Connecticut Valley, and the New England
Dental Society, for which latter it is ray honorable privilege
to speak. Seriously, a very large part of the progress in our
art and science that has been made in New England has been
accomplished through the pioneers who have kept up their
active work in both societies, and have greatly contributed
to the advancement of the cause in which we labor. Notwith-
standing the time and manner of our calling, a very large pro-
portion of the members of these societies are in good health and
in the active pursuit of their calling. I was noticing just before
leaving home — and this may be stated as a fact — ^that the dentists
are, as a class, men of good health that bid fair to attain longevity,
and are a model of perfect development.

We are very glad to be with you on all occasions, and if we do
not come, it is because we are creatures who cannot control all our
ways. I thank you for the courtesy of the introduction and for
your listening to me. I look for much profit from these sessions in
the days to come.

Dr. Gaylord, — Gentlemen, Dr. W. J. Bider, president of the
Connecticut State Dental Association.

response of president rider.

Mr. President and Gentlemen of the Connectiout Valley
AND New England Dental Societies, — It is my privilege, in behalf
of the Connecticut State Society, to thank you for the warm wel-
come we have received from you, to express the pleasure we have of
meeting with our professional brethren, and to discuss some of the
great questions pertaining to our specialty. I say brethren, for we
are brothers working together to do what we can to ameliorate some
of the conditions of life in our fellow-men. And we may congratu-
late ourselves that the day has long gone by, never to return, when
the secrets of the laboratory and the operating-room never went
outside the office-door ; when what a man knew he kept to himself,
jealously guarding from his brother practitioner his own mode of
operating. The opposite of this is the rule now, for as soon as a
man arrives at any new mode of treating a case, he at once, by a
paper read before his society or by an article in some one of the
many dental magazines of the day, gives to the profession the
results of his researches, — anxious to add his brick to the pile
of knowledge.

Union Meeting of Dental Societies, 163

And this leads me to say that dentistry is fast becoming a
liberal profession ; no longer narrow or contracted, but bestowing
with a free hand the exertions of the mind, as well as the results
of the labor of the hands.

I envy the young men coming into practice now; they are
starting in life where the older ones are leaving off; they have the
benefit of all their researches and experiments; the accumulated
knowledge of the past is at their command, and they have but to
go on to still higher attainments. They little know the difficulties
and discouragements that the student had to overcome in the days
when your speaker commenced practising. In the larger cities
were some educated men, but the mass of the profession through-
out the country was very ignorant. We had but few works on
dentistry. I think but two dental journals were published in the
country, and they were very crude. No dental societies; and every-
thing that a man knew he kept to himself, so that there was no
general dissemination of knowledge on the subject.

And this reminds me of an incident that occurred, one day,
while pursuing my studies. I was reading Harris's "Principles
and Practice of Dentistry," when I came across the word peri-
osteum. Says I, " Doc, what's the periosteum?" " It's aw — aw —
it's ; well, it's — ^you know if you drive a nail in a board, it stands in
the board so ?" " Yes." " Well, that's it." That was just as lucid as
mud. Of course, I knew all about the periosteum and its office in
connection with the teeth after that explanation. I am happy to
say that that gentleman has kept up with the growth of dentistry.
He has enjoyed a large practice in the city of Brooklyn ; he had
the honor of calling to order the first meeting called to organize
the Odontological Society ; and was at one time a member of the
board of censors that meets at Albany to examine candidates for
the title of M.D.S.

The higher ethics of all liberal professions require that each
member shall give in full the results of his investigations for the
benefit of the profession at large. It condemns the man that takes
out a patent on any new method of operating, or instrument, or
sells to any one instrument-maker the right to make and vend the
same, thereby depriving the profession of the full right to make and
use them. It requires that the little that any one man may learn
in a lifetime should be given freely in return for the great stock
of knowledge he is at full liberty to draw from. Or, as the good
book puts it, " Freely ye have received, freely give." When every
member of the profession learns this, and lives up to it, then shall

154 Reports of Society Meetings,

we be truly — and not until then — what we claim to be, a liberal
profession. Those of us who paid tribute so long to the rubber
company, and fear the rod that the tooth company holds over us,
feel the force of what I say.

Mr. Chairman, the future of dentistry looks very bright. Look-
ing back over a practice of forty years, I am impressed with the
strides that it has taken.

The advent of the rubber dam, the dental engine, the mallet in
its various forms, cohesive gold, and the many other appliances of
the day, have revolutionized our methods of operating, and enabled
us to arrive at results that the fathers never dreamed of. Review-
ing what has been done in the last twenty-five years, who dares
prophesy what are the possibilities of dentistry in the next quarter
of a century, or what will be the modes of operating? We may
congratulate ourselves that there is so much working together for
good for the advancement of our profession, — the many dental
colleges, where, under competent instructors, a young man may get
a good education ; the many periodicals, filled with valuable papers,
and discussions upon every new thought and thing; the many
dental societies, where our best men get together to compare
results ; and last, but not least, the laws regulating the practice of
dentistry in the different States, keeping out the quacks and illiter-
ates, requiring a higher standard of education in the practitioner,
— thereby protecting the profession, and insuring to the public a
better class of operators. All these things are tending towards a
higher standard in the future, and are hastening the day when oral
surgery will be fully recognized as a specialty of the healing art.

Thanking you for the cordial welcome we have received, I close
with the wish that the auspices of the present moment may con-
tinue, insuring the success of this our first union meeting in order
that it may be an enjoyable one, and of great profit to all.

Dr. W. G. Barrett, of Buffalo, being called upon, responded as
follows :

I can only say it affords me great pleasure to meet with you.
It is not the first time, and I hope it is not the last. I shall not
attempt to imitate the purpose of my friend who was speaking
when I entered the hall, for you know little sayings are always put
in '^ Bracketts." I will only say this, I have come once more to
meet with you here, and I only hope you will receive as much
benefit from me as I shall from you. I know I shall carry away

Union Meeting of Dental Societies, 165

from here a great deal more than I bring. I have always carried
awaj my head f\ill and sometimes my pockets. It affords me
pleasure to meet these friends and to attend these meetings, which
have always been profitable, and I am sure will be now.
Addresses closed.

President Bartholomew. — We will now proceed with the regular
order of the programme. The first on the list is a paper by Dr.
E. S. Niles, of Boston, on " The Inference of Adenoid Growths in
Oral Deformation."

President Bartholomew. — ^Gentlemen, the paper just read is now
before you for discussion.

Dr, Porter. — Are we to understand that these specimens shown
came from a single mouth or from a number of mouths ?

Dr. Niles. — From a number of mouths. They are specimens
borrowed from Dr. Hooper. Each bottle contains what was re-
moved from one mouth.

Dr. Morgan. — Do you consider the high-arched mouth or
palate the cause of this condition, or is this condition the result of
a high-arched mouth ?

Dr. Niles. — Of course the stoppage of the passage through the
nose, causing mouth breaking, exerts an influence on the palate.

Dr. 0. A. Brackett. — This subject, which Dr. Niles has brought
before us to-day, I have been led to give some attention to, through
a previous effort of dentistry in another place. It has seemed to
me a matter of very considerable consequence. My own idea about
it — and I make no pretence as to correctness — is that the varying
of the upper arch at the sides and the bulging up of the hard palate
is in consequence of the deviation of the muscles, through keeping
the mouth open. It seems to me, with the very limited attention
given to the subject, that I should endeavor to stop this difficulty.
As, for instance, in a case of a child breathing with difficulty or
noisily, especially at night. In some of these cases that have been
operated on he makes mention of very great alarm being excited
because the child slept with perfect quietness after the operation.
The child was a noisy sleeper, and immediately upon removal of
these growths the breathing became so quiet that there was anx-
iety on the part of the parents, thinking it of some grave con-
sequence. Dr. Hooper says he removes many of these growths
with his finger-nail. I think that a dentist is as capable as any
person to make the examination. If a case came to me, I should
feel justified in making the examination, and under the influence

156 Reports of Society Meetings.

of nitrous oxide, if the age of the patient made it advisable. I
cannot see any harm in niaking the examination. If I did not feel
like doing that, I should refer the patient to some one who had had
practical experience with the treatment of this affection.

Dr. Maxfidd, — Since reading the paper of Dr. Hooper, referred
to by Dr. Niles, which I first saw a few months ago, I have been
very much interested in this subject. One thing that Dr. Niles
did not mention was that Dr. Hooper says that it was in 1885 that
he first removed these growths, and thinks he was the first one
to perform this operation in New England. I refer to this be-
cause it shows that there is not much known about this affection in
the medical profession. A few weeks ago a child was brought to
me by her parents to have its teeth straightened. As the child had
many of the characteristics that Dr. Hooper attributes to this affec-
tion, I advised the parents to have a specialist make an examina-
tion of the throat and nose. They did so, and reported that the
examination had been a very thorough one, and that nothing of the
nature I had alluded to had been discovered, and that the specialist
attributed the mouth-breathing to catarrh. I asked how the ex-
amination had been made, and they answered, by passing an instru-
ment into the front of the nose. While this examination satisfied
the parents, it was far from being satisfactory to me.

Dr. 2/. D. Shepard, — I have seen a considerable number of the
patients that have been spoken of, and quite a number of my patients
have been operated upon by Dr. Hooper. I have no question, from
what little thought I have given to the subject, that the collapse of
the upper jaw is caused or helped by this growth. I have not
given any special study to this subject in a proper scientific manner,
but almost all the patients with whom I have been familiar, that
had this trouble, have also had accompanying it the peculiar con-
ditions of the mouth already spoken of. The essayist did not speak
of what has always seemed to me a very interesting circumstance
connected with the operation which we have the impression of as
being original with Dr. Hooper. You well know, in all bloody
operations in the mouth, the difficulty occasioned by the blood
passing down the throat into the oesophagus. Dr. Hooper in these
operations places the patient prone upon the face, so that the blood
comes out of the mouth. All patients, young or old, when ether-
ized, are placed upon the table, face down, head hanging over, and
the operation performed by sense of touch ; there is no trouble from
blood as it drips out into a basin. This has solved with him the
whole difficulty of giving ether with a bloody operation in the

Union Meeting of Dental Societies. 157

mouth. I think this subject a very interesting one, and am glad
it has been brought before this meeting. The evidenpe of this
condition is most marked in the patient, and you can recognize the
patient the moment you put eyes upon her or him. I have in that
way noticed several of my patients, and have sent them to Dr.
Hooper, and my diagnosis has been confirmed by him. We all
know that mouth-breathing and irregularities of the teeth go
together, and we have both in this disease. It is of so recent dis-
covery, it has escaped notice until now. Another feature, and a
very prominent fact, in regard to this subject is, it is a self-limited
disease. As a rule, it is a disease of youth and not of adult age ; my
impression is it is very rare to find such a case in an adult.

Dr. Wm. H. Atkinson. — It is useless for me to improvise and talk
of principles and facts that we have not been made acquainted
with. There is knowledge on this subject which acts without
saying. Most of the remarks that have been made are simply
surmises. The man who handles the mouth must and will be
an expert at it. As to the cause of this trouble we know
absolutely nothing. We know indications, and yet every indi-
cation, as noted, we do not know, for we cannot pursue it beyond
the reach of mental grasp. These pathological growths cannot
be because of food formation, but must be from the need of
nutrition of the part; they are evidently hard and epithelial-
like ; the myxomatous matter of the gum is here involved out-
side of its immediate condition. There is a need of considerably
enlarged vessels here, and until these vessels have been enlarged
the growths continue. We know so little of it that I only care
to emphasize our ignorance, and call for a ratiocination of our
voice and mind until, with the inspiration of the moment to guide
us, we can retain what we know ; until then it will be useless to
talk about it. One remarkable case I wish to speak of, where I
have made fourteen or fifteen operations to remove the abnormal
growths which filled the entire buccal cavity and covered the cheek
in folds like the pouches of a chipmunk. If I ever get my saddle-
legs on, I will write this case up ; it is of too much importance and
interest to let go. It was entirely of epithelial growth. I applied
a solution of salicylic acid in alcohol, and just cooked the abnormal
growth, and was thus enabled to remove it. It had not involved
the blood tracts. My place is so much in the possession of my
dental friends that I am not always able to put my hands on th&
specimens I wish to, so was unable to bring them with me. We
have not enough to indicate what this pathological growth is.

158 Reports of Society Meetings.

What this term adenoid means we do not know. It is in this
mixture of terms where we shall get into diffieultj, and if we are
not careful we shall get into greater difficulties from them. We
shall be pushed from one supposition to another, until at last we
hope to take such a grip that it will be understood by all.

Dr. Shepard. — I think the essayist gave the definition of adenoid,
and with sufficient emphasis for all to recognize it. It is a mere name
and means gland-like, which, however, does not fully describe it.

Dr. Atkinson, — It is a pouch in contact with the tissue, is lined
with epithelial cells, and depends upon them for activity.

Dr. Niles, — As I understand it, this adenoid growth belongs to
the glandular growths of the throat, and they are located in the
region of the pharynx. They are simply a hypertrophy of the
cells of the pharynx. Dr. Hooper says the old fashioned polypus
is not the same as the adenoid growth ; but, of course, a man who
has a specialty of this kind is liable to go to extremes, the same as
in other specialties. A young man of my acquaintance says his
grandfather died of polypus. This young man goes about with his
mouth open, and respiration would be entirely shut out if it were
not for the mouth. His parents are very much prejudiced against
having anything done. Another case : a gentleman from Chicago
came on to me with his two boys to have their teeth straightened.
These boys have these adenoid growths, and their father intended
to have an operation performed. I succeeded in getting a very
good arch, but their parents then refused to have anything done.
I was well convinced that nothing permanent would result till this
operation was performed. Dr. Young treated them with escha-
rotics. Most of the information we have is mainly from Dr. Hooper,
though Dr. Bradbury has made some study of the trouble, and one
of the specimens that are being passed around was taken from the
mouth of one of Dr. Bradbury's children. I myself have four chil-
dren which I am going to have examined very soon. I believe
they have this growth ; they all show indications of it, having the
hacking cough. The youngest is about one year old.

Subject passed.

NBW APPLIANCES AND DISCUSSIONS.

Dr. N. Morgan, — I have here a little broach-holder I made for
my own use. I was so much troubled with my broaches slipping.
This is made from one of the cone-socket instruments, — an exca-
vator. It was screwed into the handle and cut off within one*
fourth inch of the handle, then taken out and a hole drilled through,

Union Meeting of Dental Societies. 159

the size of the broach ; next, with a saw a slot was cut half the
length of the hole. As you screw it into the handle it squeezes the
sides together, thus holding the broach very firmly. I also have
here some exploring points that are made from piano wire, simply
filed down and bent into the shapes desired. These bone handles
are simply needles — such as ladies use for knitting worsteds — cut
in two and holes drilled in them, and the wire is cemented in with
shellac. These needles can be obtained at any fancy-goods store,
and only cost from fifteen to twenty cents a pair, — enough to make
four handles.

Dr, J. F. Adams, — I have here a modification of the McLean
disk ; it is simply a metal disk soldered to the mandrel instead of
fastening it on with a screw. This disk is made of brass, and, after
it is shaped to run true, the emery paper is glued on, using a solu-
tion of dextrine. When the paper is worn out, it is dipped into a
glass of water, when the paper will come off. The advantage of not
using a screw is that you can use them for sharpening knives.

I also have a syringe here that is home-made. A short time ago
I was treating a case of pyorrhoea alveolaris, and I wanted the
patient to use a syringe at home to wash out the pockets. I went
to a rubber-store and bought a small rubber ball that cost three
cents, then took a glass tube from a medicine dropper, inserted
it into the ball after enlarging the air-hole, and you see I have a
perfect syringe.

I also have here a method for removing roots of teeth. The idea
is not original with me, but there are some here who perhaps have
never used it. I had a patient where the roots of the teeth that
were broken were more or less covered with the gum, which was
very sensitive. I took the engine and drilled into each root, then
put in a wood screw, and removed all the roots without touching
the gum.

Dr. E, A. Stebbins, — In taking impressions, especially of upper
oases, I always found, when putting the finger up to hold the cup,
that the cup would slip forward. To obviate this, I have had a
piece of tin soldered on to the under part of the cup so that my
finger rests against it, and the tendency is to press the cup back
all the time.

Dr. L. C. Taylor. — A few weeks ago, looking around, I came
across a practical little thing for holding the rubber dam, instead
of using weights, which are very tiresome to the patient when
sitting for a long operation. This holder is made of piano wire
bent in the shape of a bow. On the ends are fiMtened large beads.

160 Reports of Society Meetings.

A weight is fastened to the bow. The dam is stretched over the
ends of the bow, and the spring of the bow keeps the dam stretched
out of the way. If small balls are not used on the ends, they will
punch a hole through the dam. This is the invention of a
Hartford man, and has been placed on the market, and sells
for fifty cents.

Dr. E. S. Gaylord. — What I have to present is a little device I
have enjoyed using very much. One is a rubber dam clamp and
separator combined, the invention of Dr. Glough, of Boston.
Another thing I find serviceable in the laboratory or elsewhere is
an appliance in the form of a bench-block. It is not my invention,
but I have used it several years. It is simply a cork. A hole is
bored in the block and the cork is glued in. It is valuable for
filing a screw or small article, as they embed themselves into the
cork. I have here a band that I have had manufactured for my
own use. I use the Bon will engine. This band is a hard-finished
linen thread band and has a core; this does not have any lint,
which those who use the Bonwill engine will appreciate. All those
of my friends to whom I have sent this band endorse it Some
weeks since, my friend here, Dr. Maxfield, instructed me how to
make a splice, and until then I had been greatly troubled, for there
is a constant breaking of bands, and the old method of splicing,
which must be done with needle and thread, consumed so much
time and was so troublesome to keep in order. So, not to be de-
tained when a band broke, I have kept two engines. This now is
not necessary since Dr. Maxfield has given me this splice, for there
will be no more such trouble with splicing bands. It is a perfect
success. I have tried to get the S. S. White Company to put
this band on the market, but as yet they have not done anything
about it.

Dr. G. F. Harwood. — I have here a vertical jack. All of you,
doubtless, know what a jack is. This is made for carrying emery
wheels, which will enable you to grind with the wheel horizontal.
You can grind either on the top of the wheel or on the edge.
These emery wheels are made in Worcester, and you can get them
of any diameter. The diameter of this spindle varies about two-
hundredths of an inch, so that the wear can be taken up by
the screw which it rests upon at the bottom. This jack can be
placed on the front edge of the bench and can be connected to a
motor or a foot-wheel. I have also drilled a hole in the top of the
spindle so as to carry a mandrel such as we use in the engine, and
so run the McLean disks. You can do your rough grinding on

Union Meeting of Dental Societies. 161

the wheel and finish on the disks. The emeiy wheels are made
solid with a soft metal centre so as to fit your mandrels. They
come in varying grades, both as to hardness and fineness, running
from "No, 80 to 150. These grades, which are coarse and soft, are
best designed for quick cutting. An instrument, after it has been
tempered, should be sharpened on a wheel that is soft, such as will
readily give way to the instrument. You, of course, want a coarse
one to start with and a fine one to finish with.

Dr. J. K, Wiley, — ^I have here what are called plate screws, and
I use them for regulating, for drawing in and pushing out the
teeth. They are steel screws, and can be obtained at any watch
factory or of any jeweller. They do the work for me better than
anything I have ever used.

Dr. Gaylord. — I had the pleasure of seeing, the other day, some-
thing which seems to me to be very promising to future new engines.
It is the invention of Dr. Campbell, of New York. You will re-
member him as the dentist who used to do celluloid work. This
is an engine whf^h has a horizontal driving-wheel. It can be placed
under your chair out of sight. The foot-piece can be moved around
anywhere, — if the legs of the chair are not in the way, — into any
position you may wish. The rod comes up back of the chair, and
you can attach any of the arms you may wish to it. It works
very beautifully. The principle of the engine is the same as in
the Bonwill, and you can get the same power and speed. Another
very nice feature is that jovt can fold it up and put it in a case, the
size of a violin case, and carry it anywhere. Dr. Campbell will soon
put the engine on the market. I think we have something in this
new engine which will be a great improvement over any engine
now in use. It is out of the way and runs very smoothly. One of
the English dentists, to whom Dr. Campbell had loaned this engine
for a month for him to experiment with, declined to give it up
when Dr. Campbell sent for it, and sent him instead his check for
two hundred and fifty dollars. The appreciation of those who have
seen it is very great, they are all very enthusiastic about it. It is
a valuable acquisition, which we shall probably have, provided it
gets into the proper hands.

Dr, W, C. Barrett. — I want to say a few words, and it is simply
this, the dentist who attempts to stand on one leg and run an
engine with the other is going to be at a* disadvantage. For a
number of years I have had the most simple contrivance and it has
given me more satisfaction than anything else I have ever had.
It is a water motor. It is one that does not require more than ten

11

162 Seports of Society Meetings.

pounds pressure to run. The motor I have I can cover with my
hat. It can be placed beside the chair and makes no noise. I have
used it for a good many years. The cord from the small pulley of
the engine is carried down and around the chair to the water
motor. The valve of course is controlled by the foot, this turns the
water on and off; just the slightest amount of pressure by the foot
gives more or less speed, and it can be stopped instantly. Hy
advice is to got a water motor and be relieved from all the trouble
you ever had in regard to the running of the dental engine.

DISCUSSION.— DENTAL PBOTECTIYS ASSOCIATION.

Br. Shepard. — ^My appointment to open the discussion on this
subject was made without consulting me, but I will try to discharge
the duty. All the dentists here present have received one or more
of the circulars of the Dental Protective Association. The majority
have doubtless laid the circulars to one side without reading them.
Some have responded favorably, and others have said to themselves
that they would do so at a convenient (future) tidLe. Both those
who have not read the circulars and those who have not already
joined the Association have made a great mistake.

The impression prevails that the Protective Association was
gotten up to resist the claims of the International Tooth Crown
Company, and for that only. While it is true that the demands of
this company was the incentive as the most important present
question to be inquired into and determined, those who have in-
augurated this movement have broader and more far-reaching ends
in view. It is hoped that a fund of large amount can be raised,
which shall be safely invested, and produce an income which may
be used now and in years to come in any legitimate and proper
manner for the benefit of the profession. At present the profession
is menaced by what many feel to be unjust claims from patentees.
If we use what rightfully belongs to another we should pay for it.
It is universally, at this time, regarded as no proof of right that
the Patent-Office has granted a patent. It is the universal practice
to test in the courts all patents which are found valuable enough,
and not until any patent has had a full and fair trial is it considered
to be established and valuable.

Fair and honorable men would not enter into combination and
raise a fund to enable them to resist a just claim or freely to use
what was not theirs. But fair and honorable men may with pro-
priety combine to raise a fund to secure a full and thorough investi-
gation of the justice of any claim, which may now or in the future

Union Meeting of Dental Societies. . 163

be made for anything about which there may be doubt. The neces-
sity for this and the justice of it rest upon the fact that no indi-
vidual has himself enough at stake to justify the expense of testing
a claim single-handed or the time and financial ability to do this
fhlly and thoroughly.

We live in communities where each man is dependent for his
safety and success upon others. No man can be independent. A
member of a community has duties and obligations beyond himself.
He should pay his debts and support his family as his first duty,
but he cannot be absolved from the moral obligation to give of his
means, in proportion to his success, for objects outside of his im-
mediate surroundings. All movements for the good of society should
not only enlist his sympathy but be helped by him in more sub-
stantial ways. He cannot do his whole duty and be clean through
and through if he lends his aid only to those objects in which he
has a particular and selfish interest.

If these principles are correct, it makes no difference to any one
of us whether we use a method which is to be investigated or not,
provided that the question is of importance to others of our co-
laborers or to the profession at large. Our duty is to assist in
every good movement so far as our means will permit. We cannot
shirk our duty and let a few do the work for the good of all and
retain our self-respect.

In regard to the Protective Association, if you will carefully
read the circular and by-laws I need say no more. It is all fblly
stated.

The object is mutual assistance and mutual protection, — not of
every one, but of the members only. If you, while a non-member,
get into trouble, the Association will not help you nor even receive
you as a member. Tou are an outsider and must so remain. But
if a member be assailed, the Association will take upon itself the
investigation of the justice of the claim against him, and, if it is
an open question, will assume all the work and expense of his
defence. »

The ultimate object of the association is that truth, fair dealing,
and justice may prevail, and that wrong, bulldosing, intimidation
of the weak, and injustice may be met by an efScient defence and
overthrown.

While certain claims assume great prominence at present, no
one can foretell what other claims may arise in the near future.
If we are to judge by the past, there will be many such claims and
of a nature little dreamed of now.

164 Reports of Society Meetings.

I urge this object upon you now, not because we are face to
face with a certain company's claims, but because I solemnly believe
that if the present movement fails to enlist the full co-operation of
the profession throughout the country, it is extremely doubtful
whether it will ever be attempted again. I have perfect confidence
in the uprightness, steadfastness, honesty, and grit of the gentle-
man who is at the head of this movement, who is giving his
valuable time, working day and night, and for what? That some
stranger, a fellow-member in Boston, Springfield, or Hartford, with
little business ability or pecuniary means, can be protected in his
rights.

I have confidence that the money of the members is in safe
hands, as each member has a receipt from the vice-president of the
First National Bank of Chicago, a bank of good reputation.

I have confidence that the management of the association is
judicious and wise and that the legal talent is able and honest.

I am happy that there are some who are willing to do the work
while I have only to pay my paltry ten dollars.

The question has been put to me, as a personal one, whether I
have any right, being a licensee of a certain patent company, to
join the Protective Association and urge others to become members.

I have carefully considered this question in its legal and moral
aspects, and am satisfied that I have the right legally and morally.
To establish this position to your satisfaction I must tell the story
at some length. A method of practice is invented and comes into
quite general use. I use it, thinking it public property. Tears
ailerwards it is patented, and the patent becomes the property by
assignment of a company. The agent of the company visits me
and asks me to settle for infringement. While I may have in-
fringed legally, I have not done so morally. I offer to settle
with him, but he will do so only on condition that I take out a
license for future use of the invention, so worded as to be, to my
apprehension, untrue, insulting, and degrading. I decline to take
the license, and he threatens me that he will immediately apply to
the court for an injunction to issue against me. He offers me one of
two alternatives, a license or an injunction, a humiliation or a public
injury to my business, and wants an immediate answer. After par-
leying, he agrees to a modification of the license so as to obviate
my objection, and says he will send the modified license to head-
quarters for approval. In a few days he reappears and reads me a
letter from head-quarters saying he is authorised to execute the
license as modified by me. I have witness to the reading by the

Union Meeting of Dental Societies. 166

agent of ibis letter. I then execute the license, pay my money for
the license, and for past infringement. The agent then says he
must send the license to New York to be countersigned at head-
quarters. In a few weeks the manager of the company calls upon
me, tells me the agent^s act was unauthorized, tenders me back my
check and the license I had signed, and presents me a new license
with the objectiouable features, and threatens me with an injunc-
tion if I refuse. I find I am caught in a trap ; that I have given
myself away, and must either sign or fight the company single-
handed, and at a disadvantage from having made returns of cases
of the use of the invention. This came also, at a time when, from
family sickness and sore distress, I had no time, energy, or leisure
for a legal contest. I did what I should do again and always under
similar circumstances. I signed the license, pocketed the imposi-
tion, and was at peace. There was then no Protective Association.
What I did I did under intimidation and falsehood. It was as if,
on a lonely road on a dark night, a voice cries, *' Money or your life f*
and life is saved at any expense. The offer to pay for what one
had innocently taken of what was claimed as another's property
was insultingly spurned and the threat made to blight one*s busi-
ness reputation by a judicial decision that ho was an infringer or a
thief. It has been universally declared by our courts that a check
or note signed under duress or intimidation was void. The obtain-
ing of this license from me was analogous. There is, notwithstand-
ing any expression in it, no abridgment of my full and perfect legal
liberty to assail it as though it had never been signed. Bver since
that time my resentment at the deception, falsehood, intimidation,
and brow-beating has been increasing until now my whole moral
nature rises in rebellion against a company which prefers " ways
that are dark and tricks that are vain" instead of fair, square, and
honorable dealing.

Dr. S. O. Stevens. — If you had at that time gone to head-quarters
and made 'them a tender of legal money enough to cover all their
claims against you, would they not have been obliged to receive it
in settlement without your taking a license ?

Dr. Shepard. — I cannot answer positively. I have understood
that some have successfully done this, but I do not know it. It
would seem to be a fair way of settling for all that was past. It
would also seem to be fair for a man or company that has anything
to sell to put a price on it, and the party desiring to buy can decide
whether the price or terms are satisfactory, and buy or not as may
seem judicious. The acceptance of pay for the past should not be

166 Beports of Society Meetings.

contingent upon an agreement to buy for the future. Dr. Grouse
has had a personal suit brought against him by this company,
damages being set at sixty thousand dollars for conspiring to injure
its business.

Dr, B, JR. Andrews. — Will the money of the Protective Associa-
tion be used to defend him in this suit?

Dr. Shepard. — Not one cent of the Association's money. At
Saratoga, last summer, two thousand six hundred dollars was sub-
scribed for this purpose by gentlemen of the profession, and the
American Denial Association, by vote, appropriated one thousand
dollars for the same purpose. The suit against him is personal and
entirely separate from the work of the Protective Association.

Dr, R. R. Andrews. — Can you toll us who are members of the
Protective Association ?

Dr. Shepard. — I cannot, and I have understood that it is deemed
not desirable that the names or number of members shall be pub-
licly known. Any man can say whether he is a member, if he
pleases, but it is considered advisable by the managers of the as-
sociation that they should keep to themselves the list of members.

It may be of interest to know that the Pope Manufacturing
Company have so many patents upon bicycles that they have for
years controlled the manufacture throughout the whole country,
and that no one could manufacture a bicycle without taking a license
from them and paying them a royalty. They have managed the
business with a very high hand it is said. One of their licensees,
who has paid tbem about twenty thousand doliara in royalties, re-
sisted their claims and was sued. Mr. Offleld, the same gentleman
who is the attorney for the Protective Association, defended the
case, and got a favorable verdict. The ground of successful defence
was that no holder of a patent had a right so to manage the busi-
ness as to cripple, retard, hamper, or paralyze the business of the
country ; such a means of managing a patent was declared by the
court as contrary to public policy. I have understood that the
Pope Company has appealed from this decision. The decision is
interesting as showing the drift of patent litigation.

Dr. Bartholomew. — I wish to ask Dr. Shepard if he intends to
take out a license for the coming year ?

Dr. Shepard. — I do not expect to do so. I am not yet advised as
to whether those who have been licensees occupy any different posi-
tion, legally, from those who have not. It is my intention to act in
harmony with the profession, and, now that we have an association
for mutual assistance, to do exactly as my attorney, the counsel of

Union Meeting of Dental Societies. 167

the Protective Association, shall advise. In conclusion, let me urge
you all to assist in this movement. There are gentlemen here who
have the by-laws for you to sign, and who will be pleased to take
your names and money and forward them to Dr. Crouse.

Dr, Stevens. — Perhaps there are some here who have never read
the circulars of the Dental Protective Association, and I would like
to ask Dr. Bartholomew if he will please read the list of patents
now held by the Tooth Crown Company ?

Dr. Bartholomew read from the circular.

Dr. A. M. Dudley. — I understand this Protective Association to
be somewhat similar to the Association we formerly had here in
New England, when some other patents were being tested. We
had then what was known as the New England Dental Association.
I was the secretary and treasurer, and I can therefore give some
information as to what it will cost one if he attempts to do his own
fighting on these cases. Some of you remember that every quarter
you would receive a notice fh>m me calling for your dollar, and the
average cost to each member was eight dollars. Tou remember, it
was a member of this society whose case was made a test case, and
the cost of this case in the Circuit Court was paid by myself.
You remember our generous friend, the late S. S. White, assumed
the liability of this case. After it had gone through the Circuit
Court it was again reopened and begun all over, and was again
carried through the Circuit Court and decided against us. It
was then carried to the Superior Court, and finally was decided
against us, and all the costs and expenses were paid by Dr. White.
All other cases pending, when this was tried, were kept on file. In
the New England Circuit the average expense for each case was
sixty-five dollars. So each member of the New England Associa-
tion, who had paid in only eight dollars, had their costs paid by the
association. Now if one attempts to carry his own case through
the court he will have, in addition to the expenses of the court, that
of the lawyer, who conducts his case for him. Now whichever
way you look at it, it is a good investment to put ten dollars into
this Dental Protective Association. For by putting in only ten
dollars the whole costs of your suit and the lawyer who defends
your case will be met from the funds of the association.

Discussion closed.

168 Reports of Society Meeiings.

SEVENTH ANNUAL SESSION OP THE MARrLAND

STATE DENTAL ASSOCIATION.

The annual session was held on December 5 and 6, 1889, at the
St. James Hotel, Baltimore, the president, E. P. Keech, M.D.,
D.D.S., in the chair.

Thursday^ December S, 1889, — Morning Session,

presidsnt's address.

Gentlemen or the Maryland Odontolooioal Society and the
Maryland State Dental Association, — Before proceeding to the
business which has called us together, I beg to trespass for a few
moments upon your time and patience by giving expression to some
thoughts which have suggested themselves to my mind as not in-
appropriate to the occasion.. We have met to consolidate a union
between two scientific bodies of this State, — the Odontological
Society and the Maryland State Dental Association, — with a view
of stimulating the members of each to renewed interest in the
pursuit of the truths of science, and of adding force and strength
to such pursuit by concentration and harmony of action. To the
lay world we are only dentists, whose office it is to minister to
the human teeth, or to supply their want by artificial appliances.
This superficial and erroneous limitation of our professional entity
is doubtless due to a defective nomenclature. So, too, the student
who has burnt the midnight oil in acquiring a knowledge of the
intricate truths of anatomy, physiology, and pathology is a mere
surgeon,— ^chirurgcon, — handworker, because the visible demonstra-
tion of his knowledge is the skilful excision of a leg or a finger;
the theologian, who in the pursuit of his divine science, has grasped
the sublime relations existing between God, the Creator, and man,
the creature, with all their obligations and responsibilities, degen-
erates into a mere preacher, whose principal office is to relieve the
tedium of a Sabbath evening, or to lull into blissful repose the un-
comfortable suggestions of a too sensitive conscience. After all,
there is much in a name, even if a rose would smell as sweet if
called a turnip. Our profession is a specialty ; but this fact, while
it certainly enhances its efficiency and usefulness, should not detract

Maryland State Dental Association, 169

from its dignity. In our day, throughout the ^hole world, the
tendency of all thought and action, both in science and art, is to
specialties. So enormous is the multiplication of human knowl-
edge that the average life of man is too short to even grasp, let
alone master, it in all its essential details. Hence has arisen the
necessity for a division of labor, mental as well as physical. The
study of the telescope and the microscope alone, which, as has been
well said, " enables the vision of man, far less acute than the eagle's,
to range fW>m the fixed stars to the twenty-thousandth of an inch
bacteria," would compass an ordinary lifetime. In the mechanical
and in the fine arts, — from the building of the Eiffel tower, the con-
struction of the Brooklyn bridge, the breathing of almost life into
the dead marble of a dying gladiator or a Venus of Milo, to the
fashioning of a lady's slipper or the production of the pin and
needle for domestic use, — ^all are the result of the skill and aptitude
of the specialist. So in the science which has for its object the
prevention or cure of those ills to which flesh is heir. The eye,
the ear, the lungs, the heart, the nerves, the skin, every organ and
function of the body, has its specialist. Why not the mouth, the
most important of all, if any comparison be admissible between
organs, each of which is necessary for the healthflil and perfect
operation of the whole ? No one of those specialties is in itself a
science. Ooulism is no more a science than dentistry ; dentistry no
more than orthopedy. The proper understanding and practice of
each do not depend upon its exclusive study, — as well expect to
learn to swim in a bath-tub. The mental vision of the student
must take a wider range. The would-be swimmer must strike out
boldly into the wide lake or wider ocean. The vital phenomena of
organized bodies, the composition and certain properties of material
substances, the structure of organized bodies as learned from dis-
section,— ^physiology, pathology, chemistry, and anatomy, — ^these
are the four great streams of science, separate and distinct, but
together forming the one pure fountain from which every one who
aspires to real eminence in any one specialty must drink deeply, or
fail in his aspirations. We of the dental profession, gentlemen,
have reason to congratulate ourselves upon the progress which, as
a scientific calling, we have made. But yesterday we were sneered
at as artisans, — hand-workers ; to-day this curriculum of no respec-
table medical school is considered complete without a chair of den-
tistry. Perhaps no branch of the healing science has made such
great progress and bestowed upon mankind such lasting benefits in
so short a time as ours. The one discovery alone of the unfortu-

170 Meports of Society Meetings.

nate Morton, the application of chloric ether to the operations of
eargery, caused the groat philosopher Leokj to assert that *'tbe
American inventor of the first ansBsthetic has done more for the
real happiness of mankind than all the moral philosophers firom
Socrates to Mill." True it is that we have not yet weeded oat the
ignorant charlatans, whose flaming advertisements and huge signs,
hideous with grinning teeth and blood-curdling instruments of tor-
ture, still greet us in the thoroughfares. But let us hope that their
day of darkness is short and will soon come to an end, to be suc-
ceeded by a race of practitioners to whom the steady beam of the
pure rays of science will be more precious than the meretricious
glitter of the vulgar shekel. The union which we are about to
form can accomplish much in this direction. Science is not art,
nor is art science. Tet each is necessary to the other, and should
be inseparably blended. The former without the latter is a tree
without fruit; the latter without the former is fruit, but dead-
sea Aruit, which turns to ashes on the lips. The practice of the
healing art, in all its various specialties must mean, and in truth
be, the application of the knowledge derived from the study of the
four pure sciences which I have named, or it must be mere handi-
craft applied haphazard, without certain and known results. As
tending directly to this much-to-be-desired consummation, it is grati-
fying to note the action of the National Association of Dental
Faculties in the adoption of resolutions requiring the colleges to
exact an examination preliminary to matriculation, and compelliog
students to attend a three years' graded course. This is an up-
ward step in the right direction ; and, in connection with two other
great reforms, — the exclusion from the graduating class of mere
practitioners of five years' standing, and the establishment of the
graded course with preliminary and junior examinations, to both
of which we are indebted to this same admirable association, — ^will
at no distant day entitle the dental profession to an equal rank
with any other body of scientific men, in dignity, in usefulness, and
in education. The theme, gentlemen, as it unfolds itself before me
is an inviting one, but I must kindly forbear and permit you to go
on with your work. My purpose is to stimulate the thought, and to
help the effort which is now happily reaching out eveiywhere for
the higher and better education of our useful profession, in which,
I am sure, I have the sympathy of every one of you, and which, I
feel very certain, will be greatly promoted by the union which we
are about to form.

Many thanks for your kind attention.

Maryland State Dental AeBociation. 171

■

DI80U8SION OF THI PRBSIDINT's ADDRESS.

Dr. A. J. Volck. — ^Among the subjects presented by the presi-
dent there is one which, I think, ought not to be allowed to pass
without some special reference to it, and I desire to say a few words
upon it. I refer to the allusion to the fact that, with but one ex-
ception, no dental society in the city of Baltimore or in the State
of Maryland has ever succeeded.

Mr. President, you have handled that subject very tenderly,
veiy daintily, and, I may say, with kid gloves. It is therefore
right that somebody should handle it with the bare knuckles. The
cause is not properly attributable to the fact to which you have
referred. The cause lies in the difficulty between the two dental
colleges in this city. And the sooner these colleges arrange the
difficulty the better it will be for themselves and for the profession.
Both are marshalled under the same banner ; both are laboring to
promote the same good purpose and the same great object ; and I
undertake to say hero that the man who, as president of this as-
sociation, will take this matter in hand, and will bring these two
colleges together and have them join hands (and it may be your
duty, Mr. President, to do it ; and if so, may you succeed), that man
will deserve the thanks of the profession of the whole State, and
not only of the profession of this State, but of the profession at
large. We have in this city the first dental college ever estab-
lished in the world, and this fact should stimulate us to assist in
any effort to remove the difficulty referred to. We are, as the
president has well said, a body of men perfectly able to make a den-
tal society successful, to undertake all the business and to perform
ail the duties of such an organization, but this same difficulty has
constantly confronted us. If the members of the faculty, or the
graduates of one college, are seen two or three times in a meeting
of a State society, or in any other society, those of the other college
uniformly stay away from such meetings. When we propose to
elect an officer, we have to be veiy careful not to select a gentle-
man who has any connection with either one of the colleges, lest
one of them should be given advantage over the other.

That is the cause, the only cause, why no dental society, with
one exception, has succeeded here. I wish to call particular atten-
tion to that one exception. There is one dental society that has
succeeded. It has not been in existence for more than a year and
a half, but it meets monthly, and is a source of great benefit to its
members. Its membership is made up of men who do not tolerate

172 Reports of Society Meetings.

any jealousies of one another, who entertain the Bincerest feelings of
good fellowship, who come together for mutual improvement, and
to have a good time. I make this statement because I do not
want it to go upon record that no dental society in Baltimore has
ever succeeded. The Association of Dental Surgeons of the city
of Baltimore has been eminently successful, and it is a society in
which there is not a speck of decay.

Afternoon Session.
H. B. Noble, D.D.S., Washington, D. C ', road a paper on

DENTAL HYQISNS.

Health being the corner-stone of all good work, either of body
or mind, it should be the aim of every one to study and work for it.
Our body is governed by fixed laws, which, if violated, will bring
trouble just in proportion to the extent that the laws of hygiene
are disregarded. The dentist, of all men, cannot afford to be care-
less of his health or of the laws of hygiene so nearly allied to it.
.A good dentist means a healthy, clean man; his personal habits
must be those of a gentleman. Out-door exercise, in the pure air
of heaven, should be regularly had by walking or riding.

In choosing an office, its hygienic surroundings should always
bo considered. Light and ventilation are two of the essentials.
Light is of the fii*st i importance ; north, south, and east, each has
its advocates, and each has its advantages and disadvantages.
From experience and observation we believe a southern exposure
and south light the best; there ai*e health-giving properties in
every ray of the sun ; it is the strongest and longest, and if properly
regulated by white curtains In the middle of the day, you have an
all-day light, and a friendly assistant, giving health and cheerful-
ness to all. In the middle of the day, in the summer months, when
the direct rays of the sun are oppressive, before it reaches the south
window it is so high it does not give you its direct rays. Our
hottest weather is almost invariably accompanied with southern
b/eezes, giving us good air as well as light.

The east is a good morning light, but is weakest at the closing
hours of the day, just when one is tired and wants the best light
possible. The north is a steady light, is not as changeable as a
south light, and is claimed, by artists, to hiring out the difference
of shades of color with more distinctness than any other; but for
our work, where strength is the element^most needed, it is not
equal to a southern light. A west light should never be chosen if

Maryland State Dental Association, 173

either of the others can bo had, as it is weak in the morning, and
the direct rays of the afternoon sun must be shaded from a patient's
face, making it unpleasant and weak when you get it.

Plenty of air and good ventilation should always be in order.
The operating-room should be large and airy, and the best and
brightest, not a little back comer, poor light, worse ventilation ]
privacy is all very well in its way, but not to the exclusion of light
and good ventilation. Pure air and plenty of it is of prime im-
portance to health ; yet how little regard seems to be given to it,
judging from the close medicinal odors that greet our olfactories in
many of our dental operating-rooms, charged with the concentrated
odors of creosote, carbolic acid, iodoform, and half a dozen other
vile-smelling compounds, sweetened, perchance, with the odors of
dead pulps, foul teeth, and sour stomachs. We get so accustomed
to these vile, unhealthy odors that no effort is made to correct or
remove them, requiring both patient and operator to exist, not live,
in them day by day, until insulted nature rebels at this foul treat-
ment, and enters her protest through headaches, backaches, weak
eyes, and the last more fashionable trouble, '' nervous prostration ;"
if he dies, they call it " heart failure," the last undoubtedly correct
in all cases of death ; but which gives not the slightest hint or indi-
cation of the primary cause of the disease.

Have all odorous medicines in glass-stoppered bottles, and in a
closed case.

It is not necessary to smear your instruments with creosote
and iodoform, and so inoculate your person and clothes as to ad-
vertise your calling. I have little doubt that disease has been
communicated by foul, unclean nerve broaches, which always
should be disinfected after using. No instrument that has been
used should be put into another mouth until carefully cleansed.

The laboratory should, if possible, be a large, light, sunny room,
with good draughts and ventilation ; not the little back closet or
dark cellar, so pflen seen ; light and air must be had if good work
is to be done.

There is no profession so likely to neglect exercise in the open
air as the dentist, with a tired back to call and urge him to the
lounge or easy-chair, when he should be filling his lungs with pure
air by riding, driving, or walking.

The dentist has duties in hygiene outside his own health that
should engage his attention ; children and parents need advice, as
well as professional work. How few persons, especially children,
do we find who take proper care of their teeth ? It should be our

^

174 Beports of Society Meetings.

duty to instruct our patients in the duty of properly cleaning their
teeth, and to give careful, minute instructions as to the manner of
using the brush, so that there shall be no food for the bacteria to
build nests for work on the pearls we are to watch and preserve.
Instruct your patients that it is not the sweet things but the acid
produced by fermentation in the mouth that decay's their teeth.

Study the general health of your patient; it will often give you
a clue to some hitherto misunderstood trouble. No part of our
body can be diseased but it affects, more or less, every organ and
tissue.

Nothing but a constant study of the laws of hygiene will enable
us to ward off disease, especially that of the oral cavity, which we,
as dentists, are called to look after and to treat; and as prevention
of disease is better than cure, it becomes us to see that we are com-
petent instructors in the laws of hygiene in its relation to the oral
cavity.

We should educate our patients to greater care in the sick-room,
that some antacid or mild germicide like listerine be used to rinse
the mouth, as nearly all conditions of the sick are favorable to
active bacterial growth, especially so in fevers, and many a bad
decay dates its beginning from the sick-room, and we should im-
prove every opportunity to urge our medical friends to greater care
in this direction.

We should instruct children in the use of the tooth-brush, and
oftentimes the parent needs the instruction and advice quite as
much as the child.

Let us emphasize the mouth as a hygienic organ, whose ftmc-
tions, I fear, have never been properly appreciated by the medical
profession, or overestimated by the dental. Health depends on
good blood; unhealthy food, whether from inherent defect, bad
cooking, or imperfect mastication, will not make good blood. The
caterer of the stomach is the mouth, and disease there will tend to
vitiate all the supplies of the stomach. How much of our food
reaches the stomach through the portal of a diseased, and often a
filthy mouth that is not in condition for proper mastication and
insalivation in this active office of preparation, and thus is im-
properly prepared for passage into the alimentary canaL

Nature, in her prodigal care for the health of all her creatures,
has placed at the portal of this great alimentary highway the teeth,
which, for fitness for their functions, cannot be surpassed by any
other organ of the body.

All healthy food must have its wedding-garment on, and this

Maryland State Dental Association. 175

can be obtained only in the month, where a semicircular band of
trained soldiers stand shoulder to shoulder to give welcome to the
guests of the body.

Dr. J. Y. Crawford, in his address to the Southern Dental
Association, at Gralreston, last August, gave a vivid description
of these guardians of health when ho said, —

"The first effect is upon the nervous system. The grateful
smell, as the food passes the lips, salutes the plexus of nerves that
engrave with rich tracery the nasal arch and is conveyed to the
sensorium. The lips open and the teeth seize the delicious morsel
that comes thus heralded. Every nerve of taste tingles with gus-
tatory pleasure, and summons, as with an electric bell, the liveried
servitors who wait in this banqueting house of the gods. From lip
to pharynx, floor, wall, and arch pour out their welcome. The
nerves of taste carry joyous messages to the brain, and throughout
the whole system glands — labial, buccal, palatine, molar, and
lingual— open mouths of welcome on the free surface of the mucous
membrane, and pour libations along the margin and dorsum of
God's banqueting-table, the tongue. The niajor dome, the steward
and the butler, the parotid, the submaxillary, and the sublingual
glands send up from the cellarage salivary nectar through the ducts
of Steno, Wharton, and Bivinus. The incisors carve, cuspids pierce,
bicuspids tear, and molars grind around the whole royal arch from
condyle to symphysis, — divine cutlery and plate, not of steel nor
of silver nor gold, but of peerless enamel, — till at last the precious
mouthful is delivered to the constrictor, stylo-, palato-, and salpingo-
pharyngei to be safely conveyed through the oesophagus to the
stomach, where it is taken up by the systemic economy and the
digestible converted into chyle and blood to nourish the body, and
the indigestible rejected and excreted."

This intricate machinery, so graphically described by our South-
ern brother, requires to be kept clean, if we would not poison the
body, at every meal, by mingling with the food particles of decayed
animal or vegetable matter.

Mingled with such carrion juices and micro-organisms, the
most delicious food reaches the stomach in a condition destructive
to health.

Scientific investigations have demonstrated that micro-organ-
isms are potent disturbers of the normal conditions of the body,
and are prime originators of many diseases, and the continual
swallowing of these fungi in great numbers may produce serious
disease.

176 ReporU of Hociety Meetings.

Many of the diseases incident to childhood are now believed to
be aggravated, if not induced, by these bacteria, and in many cases
can be mitigated, if not prevented, by maintaining clean and healthy
surroundings, especially that of the mouth.

Dental art and science is, we affirm, a most important branch
of the healing art, and should be taught in all our schools, not in
the cursory, indifiPerent manner natural to those who have not
given it special study, but should be taught by those trained in
dental schools, and who feel and know its importance.

The lack of proper care of the teeth in early youth often causes
ill health and suffering, and this because the child, or parent, had
not been properly instructed in the care, or importance to health,
of good teeth properly articulated.

The dental surgeon who has preserved the teeth from decay
has preserved the health, and rendered life more comfortable.

Let us as watchmen and guardians of the portal of this sacred
temple see that nothing enters to deface any of the pillars that
adorn the oral cavity, or that shall detract from their beauty;
thus our patients' teeth will be like those described by the prophet
Solomon, —

<'His teeth will be like a flock of sheep that are all even
shorn.*'

DISCUSSION OF DR. NOBLX'S PAPKB ON << DENTAL HTOIKNS."

Dr, JB. B. Winder* — ^A valuable paper such as that which we
have heard ought not to pass without due acknowledgment and
the discussion to which it is entitled. We shall doubtless all agree
as to the necessity for special education in this direction. There
is nothing in the paper that can be harshly criticised, all its, points
being well taken, so far as I can see. The want of proper hygiene
is very clearly indicated by the secretions of the mouth becoming
vitiated, especially in low forms of fever. Under these circum-
stances decay in the teeth takes place rapidly. We all know now
that caries of the teeth is caused by the presence of bacteria, and
that these are generated in vitiated secretions. Since it has been
demonstrated (and I consider that the fact has been clearly and
absolutely demonstrated) that the health of the teeth depends
on the chemistry of the mouth, it is obviously of the utmost
importance to keep the mouth as clean as possible under all
circumstances.

I regret to say that I am compelled to concede the truthfulness
of all that has been said by the essayist in regard to what I may

Maryland State Dental Association. 177

term the almost crimiDal neglect on the part of medical men per se
in the matter of dental hygiene. This is so apparent that it might
well be inferred that the teeth are ignored by them, or are regarded
as undeserving of their attention. I do not say this in any unkind
spirit, because I entertain the highest respect for the medical pro-
fession, but I mention it as showing that dentistry has not been
incorporated in the curriculum of the medical student, and that the
text-books practically ignore education in this direction. It is for
this reason that dentistry is to-day a profession separate and dis-
tinct from that of medicine. The attempt was made in the early
history of our profession to secure the co-operation of medical men
in our work, but it proved ineffectual. I can give you no more
striking illustration of the consequences which follow from this
condition of things than that which was shown in a case in my
own practice a few years ago. The case was that of a lady in
feeble health, who applied to me to have her front teeth extracted.
Her physical condition was not, in my judgment, such as to war-
rant the operation, and I suggested a preparatory method of treat-
ment, to which she assented. I then inserted plastic fillings for
temporary service until gold fillings could be put in. This was in
the month of February. About the last of the following May she
sent for me to come to her house, and, upon visiting her, I found
that nearly all of the oxyphosphate fillings which I had inserted
had been dissolved or washed out, this being due to an alkaline
reaction from the saliva or secretions of the mouth. The decay
had reached close to the pulp at certain points, and the sufferings
of the patient were consequently quite severe. While it was ap-
parent to me that the secretions wore strongly alkaline, she in-
formed me that she had been required, by her physician, to abstain
from the use of acids because they would aggravate the indigestion
from which she was suffering. I had said to her, in a humorous way,
" You have been indulging in too many pickles, too much acid ;"
when, throwing up her hands in alarm, she assured me that her
physician had strictly prohibited acids, although she had a most
intense longing for them. Upon learning that her physician was a
gentleman with whom I am well acquainted, one whom I knew to
be a progressive and intelligent member of his profession, I took
the liberty of preparing for her a lemonade, and advising her to
make use of acids; in other words, I suggested an acid treatment.
When her physician, in compliance with the request I made to her,
called upon me, he assured me that my diagnosis of the case was

absolutely correct, and, instead of objecting to what I had done,

12

178 Reports of Society Meetings,

expressed his obligation to me for it. I had been fully confident,
however, that in what I did I was not acting upon any uncertainty
as to the kind of treatment the patient needed. I knew that oxy-
phosphate fillings would resist the action of all acids, but were
easily dissolved by alkalies, and particularly by ammonia. I real-
ized at the outset that the diagnosis of her physician was faulty,
for the reason that, instead of making a test of the secretions of the
mouth to ascertain whether they were alkaline or acid, he had
arbitrarily assumed that her condition was acid. The result was
that, after the patient had been placed on an acid treatment for
a couple of months, her condition showed marked improvement;
indeed, I have rarely seen more decided evidences of rapid recuper-
ation than were shown in the case of that patient.

That was one instance corroborative of what Dr. Noble has said
in regard to the condition of the mouth being absolutely overlooked
by the attending physician, and the duty which is sometimes im-
posed upon us in forcing the matter upon the attention of the physi-
cian. In ill health the secretions of the glands become vit^iated,
and decay in the teeth results ; and it often happens that when a
patient whose teeth we have preserved in good condition returns
to us, after a spell of sickness, we find that our work is a wreck,
and that previous operations must be repeated, when a little care
and attention on the part of the physician would probably have
prevented this.

In the case of which I have spoken the use of litmus paper would
have enabled the physician accurately to diagnosticate the con-
dition of the mouth. This paper is blue and red. The blue, when
applied to an acid, turns red ; and the red, upon touching anything
that is even slightly alkaline, turns blue, thereby furnishing a very
delicate means of testing the mouth. If tested by this means, the
physician would have found that the condition of the mouth was
alkaline, not acid, and he would have prescribed acids instead of
restraining the patient from the use of them. The symptoms, in
sickness, which are indicated by a furrowed tongue and a constant
bad taste in the mouth, are well known; and if the physicians
would devote the requisite attention to these and kindred symptoms,
their treatment would prove more effectual and salutary.

In regard to what has been said in the essay about the arrange-
ment of an operating-room, with reference to light and in other
respects, I desire to say a word, as the subject is one of general
interest to the profession. I have never yet seen an operating-
room the arrangement of which was, in my opinion, based on

Maryland State Dental Association, 179

scientific principles. I agree with Dr. Noble in all he has said
concerning the necessity for ventilation, the ingress and egress of
pure air, and the avoidance of all disagreeable odors. Some prac-
titioners would have in the office all the light that they could pos-
sibly get. I suggest that what we want are direct rays of light,
and that we do not need to have a reflecting surface from which
those rays may be returned or reflected back as from a looking-
glass. I think that which is most desirable is an arrangement
similar to a photographer's, with a background, and so arranged
that, when they have passed beyond your head-rest, the rays may
stop and be absorbed. I repeat that the best arrangement seems
to be one by which you have a direct light upon an objective point,
without any returning or interfering rays.

With regard to the color to be used in the papering of the walls
of an operating-room or office, I suggest that if our preference is
to be determined by the fact that nature has clothed the earth in a
certain color, we should of course select green. An additional con-
sideration in favor of this color is to be found in the generally-
admitted fact of the beneficial effect of green in resting the eyes.
The shades usually worn over the eyes of students are of a green
color. I can say, from my own experience, that, having at one
time had a laboratory commanding a view of surrounding foliage,
I often experienced a sense- of relief, when engaged on critical
work, in looking out upon the green fields and trees within range
of my vision. There is, however, a consideration that may be
urged as an objection to this color, and that is, that green-colored
wall-papers, as I have learned from manufacturers, are made by an
arsenical preparation, and therefore may contain poisonous sub-
stances which would have a deleterious effect upon the atmosphere
of a room or in some other way prove prejudicial to health.

Dr. Wm. A, Mills. — ^Mr. President, I was glad to hear Dr. Noble
call attention to the character of some of the colored papers on the
walls of our offices, and particularly in the rooms in which we
operate, and in our sleeping-apartments. I regard this as one of
the greatest sources of danger to which members of our profession
could expose their lives. I know of an instance in which a family
was poisoned (though the cause of the trouble could not be ascer-
tained at the time), where it was afterwards discovered that the
curtains or hangings in their apartments had been prepared with
arsenical compounds of some kind. I think that in advocating
hygienic laws, and seeking to make a practical application of them
in the arrangement of our dwellings and offices, we ought to be

180 Beports of Society Meetings.

very careful in the selection of paper-hangings, and that we ought
never to prefer green as a color.

Dr, A. J, Volck, — Mr. President, why not follow the rule which
is followed by the artist in a matter like this? The artist wants a
concentrated light upon his easel just as we want it upon our
patients. He papers his operating*room with colors which are
absorbents of light. Therefore he prefers, generally, a maroon or
some dark*gray or broken color such as you find in gray wrapping-
paper. I know of one studio in New York which is covered with
hemp cloth, which material not only makes a very good appearance,
but an exceedingly pleasant appearance to the eye.

Green is a very good color when looked at in the open air ; the
effect presented by green woods or green fields is very pleasant ;
but a room, the covering of which is wholly of green, is one that
affords no relief to the eye, and is anything but a relief to it,
because the green reflects the light more than does maroon, gray,
or other colors. It does not absorb the light as those colors do.
Green is a secondary color, while the others are tertiary. Being
less positive, the other colors are more pleasant to the eye.

Dr. Charles JD. Cook. — Mr. President, having come in late and
beard only a portion of the paper, I do not think I can add
anything to what has already been said. If I may be allowed,
I will make one suggestion, and that is, it is customary for
dentists to speak of dentistry as though it were a profession
separate from and independent of the medical profession ; those
who hold the degrees of M.D. and D.D.S. are in the habit of speak-
ing of it as a profession ; whereas they should recognize dentistry
as a specialty. I think we ought to treat the general practitioner
and the dentist alike as medical men ; that the general practitioner
should be known as such in contradistinction from the dental
specialist ; and that we ought not to assume that our art or our
practice is fundamentally different from that of the general prac-
titioner.

In our code of ethics we almost invariably start out with the
proposition that dentistry is a specialty of medicine, and that
we are medical men. The tendency now, among teachers and
among the more advanced of our brethren, is to train dental
students not only as specialists but as medical men. In our col-
leges such students are, I think, being trained from a medical
stand-point, as they have been in England for the last twenty-five
years. In London, the dental student receives the same training
in anatomy, physiology, therapeutics, etc., that the medical student

Maryland State Dental Association, 181

reoeives; the teachers being the same for eabh. At the examina-
tion in the Boyal College of Surgeons, where the degree of L.D.S.
is conferred, there are two special examiners on the specialty of
dentistry, who are also members of the Examining Board of the
Boyal College of Surgeons. The only difference between the two
classes is that the dental students receive a special training for their
work, in the filling of teeth, in making obturators, etc., and have
a special school just as the oculists have. So that, practically, all
the graduates are medical men, but the dental students receive
this special degree. I think we owe it to ourselves to speak of our
practice as a specialty, and to drop the term " profession" except so
far as it applies to the general profession.of medicine.

Dr. JET. B. Noble. — Mr. President, I have but a few words to
say. One of the positions which I have taken has been freely
criticised, but all the speakers have agreed upon the main point.
In regard -to the papering of our rooms, much that has been said
may be found to be of value. I think that the question as to the
most advisable color to be made use of should receive more atten-
tion than it has yet received. I am not prepared to say what color
I regard as the best, but undoubtedly there are certain colors which
are preferable to others. I think that the subject has been suffi-
ciently ventilated to lead the members to consider it thoroughly,
and that the result of their deliberations may eventually enable us
to get our offices in as perfect order and condition as is possible.

Subject passed.

182 Editorial.

Editorial.

THE NATIONAL ASSOCIATION OP DENTAL FACUL-
TIES.

The question has been raised as to the propriety of changing
the time and place of meeting of the Association. It is argued that
those members desiring to go abroad the coming summer cannot
defer their departure later than the 15th of July, and that, even if
they could, the meeting of the American Dental Association, if held
at Excelsior Springs, is out of their way. Unless a change is
made in the time and place of meeting of the American Dental
Association, then it seems that a movement to change the time
and place of meeting of the Association of Faculties in order to
accommodate those members who desire to attend and also go
abroad might well be taken. It is essential that a full repre-
sentation of the colleges belonging to the association shall be had
this year on account of the important measures which will un-
doubtedly come up to be acted upon, and if the meeting is held in
the extreme West, and at the time of the meeting of the American
Association, we fear that the attendance will be small, a result
very much to be deprecated. The Association did not complete
its labors when it voted to establish a three-years* course of instruc-
tion. It only entered upon its real work, and it must now see to it
that this step in advance is carried out. There are a number of
questions yet to be settled in order to set the machinery in motion,
and get it to running smoothly.

It is barely possible that some changes may yet have to be made
before the measure is accepted by all the colleges connected with
the Association. The question has been before the members for a
year, and time has been had fully to consider the movement in all
its bearings, and there will undoubtedly be some honest objections
^lade to its adoption as it stands which will have to be met and eon-
sidered, and which will possibly modify the standing resolutions.
It is a movement of great importance, and wants to be entered
into with caution. We do not desire to be understood as indicating

Editorial. 183

that there will be any backward steps in the matter, but there may
need to be certain modifications so as not to work a hardship npon
any institution connected with the Association. Great care must
be exercised in drawing the lines so as not to force any institution
out of the Association. Unanimity of action is absolutely essential
for the iull success of the measure. The question of the equalisa-
tion of the fees will come up at this meeting, and is going to require
careful consideration not to work an injury. This does not affect
the weaker institutions so much as the stronger ones, and they may
be the ones to object, especially the State institutions, which, by
reason of being connected with State universities and receiving
State aid, are not able to control the question of fees. Then, again,
the question of time service must needs be considered.

Those institutions which have already adopted a lengthened
course, if they are compelled to establish a three-years* course, will
labor at a considerable disadvantage. For instance, a college having
a two-years' course of nine months each is already giving more
actual time to their students than an institution which may adopt
the prescribed course of three years of five months each. It seems
that it would be more equitable for the Association to establish the
time actually to be spent in attendance upon lectures, and allow
the different institutions to elect how they will apportion the time.
Let the minimum time be set at eighteen months actual attendance,
and let that time be divided into three years of six months each, or
two years of nine months each. This question will undoubtedly be
brought before the Association, and presents features that are to be
commended. If a nine-months' course should be adopted, the col-
lege year could be divided into three terms, of three months each,
and students could matriculate at the beginning of any one of these
terms, and receive credit for the actual time spent in attendance.
A graded course could be established, and an examination made
upon the work done, and, if successful, a certificate given which
could be presented at any other institution for just what it called
for, and credit be given therefor ; and when a student could show
certificates for eighteen months' attendance, he could come up for
final examination, and receive his diploma at the next regular com-
mencement. Such a plan would work a special benefit for those
institutions that are short of clinical material, by extending the
course over a greater length of time, and thus distributing the
year's work more evenly. When the course is limited to five or
six months, it draws heavily upon the material at command to
supply the needed demand. It would operate also to lessen the

184 Editorial

number of demonstrators employed, as the class could be divided
into smaller sections. Better demonstrators could thus be engaged
by employing a less number and extending the time of service to
the entire year. Such is, however, only a few of the questions that
have been presented to us. The different institutions have their own
peculiar difficulties to contend with, and these ai*e more or less
aggravated by the proposed compulsory change in the established
course, and there will, no doubt, be several knotty questions brought
before the Association for its deliberation which will require time
and a full attendance wisely to consider and pass upon.

The meeting of the Association of Faculties seriously interfered
with the success of the American Dental Association last year by
taking fVom the latter many of its active members, and as there
is not the same need of itinerancy upon the part of the Association
of Faculties as there is on that of the American Dental Association,
would it not be well to call a meeting of the Association of Faculties *
the first week of July, at some more central point than Excelsior
Springs, say at Niagara Falls? This would accommodate those
members who desire to go abroad, and insure a f\ill attendance,
and not in the least interfere with the meeting of the American
Dental Association.

AMERICAN DENTAL ASSOCIATION.

There seems to be a strong feeling still existing in the minds
of the profession that the American Dental Association should meet
in the East this year, and at an earlier date than usual, notwith-
standing the fact that the question has been once voted upon by
the Executive Committee and the officers of the Association. There
is a movement on foot to petition the powers that be to make the
change. The ground taken by those who are foremost in the
movement is that a large number of the members of theAssocia-
tion desire to go abroad, and that if the meeting is held in August,
and at Excelsior Springs, they will be unable to attend. There
can bo no reasonable objection raised against the change in the
time and place of meeting of the Association, except that of fickle-
ness, and the evident willingness, on the part of some, to make the
American Dental Association secondary to other meetings. It was
known last year that, in all probability, the International Medical
Congress would be held at its usual time, and the question of

Editorial. 185

oonfliot in the two dates was discussed, and the time and place of
meeting decided upon in the light of that knowledge. It seems to
us that then was the time to have raised objections, and not at this
late date. Then, again, the Association has been promising for a
long time to go to the Southwest, and now that the promise is on
the verge of fulfilment, it does not seem just right to vote to go
elsewhere. At any rate, if the change is made, it should be with
the explicit understanding that it is to return next year to Excel-
sior Springs, and thus f\ilfil the promise made to the Western
members ; and then it can go to Chicago the following year, when
the grand memorial meeting is to be held. The Southwest has
waited patiently for an opportunity to show its hospitality, and it
should not now be deprived of the privilege. Under the circum-
stances, however, it seems best to make the change asked, as all
are, or at least should be, anxious to see the section on dentistry
in the Tenth International Medical Congress made as great a suc-
cess as possible ; and if the Western members will allow the change
to be made, their magnanimity will be fully appreciated, and the
return meeting, next year, will be all the greater success. The
meeting could be called for Niagara for the second week in July,
immediately following the meeting of the Association of Dental
Faculties. The coming meeting of the association will be an im-
portant one, as arrangements should be started looking towards a
grand meeting in Chicago in 1892. Committees should be ap-
pointed and a plan adopted in order to insure that that meeting
shall be a success commensurate with the importance of the
occasion.

A CALL FOE AN INTERNATIONAL DENTAL CONGRESS.

On another page may be found a circular issued by the New
Jersey State Dental Society, for a meeting of delegates from the
different dental societies of the United States, looking to the issu-
ing of a call for an international dental congress, to be held in
1892. When the circular was sent out, the location of the World's
Fair was still in doubt, and the doubt seemed to be in favor of
New York; but now that the Queen City of the West has captured
the prize, it is barely possible that the New Jersey State Dental
Society may not be so anxious to inaugurate the movement as
it was.

186 Foreign Correspondence.

The Archives has expressed itself as opposed to the calling of a
meeting as proposed by the cirealar, and so mast we. If saoh a
meeting is called and a movement started to establish a congress,
it will not represent the profession in America, but a small faction
in the East, and will not meet with hearty, support. Any move-
ment that looks towards taking the control of the World's Fair
meeting out of the hands of the American Dental Association will
meet with sharp opposition. There is a fixed sentiment in the
profession that any credit or benefit to be obtained from such a
meeting should accrue to our already existing associations. The
loading journals have expressed themselves in that way, and any
attempt to use the occasion or the meeting for individual ends will
meet with strong opposition from this journal. Let us throw aside
all politics in the matter and make the meeting one of the grandest
in the history of the American Dental Association, one noticeable
for its high scientific value.

Let us not have a repetition of the difSculties which arose in
the organization of the Ninth International Medical Congress,
when a small faction tried to take the control of the congress out
of the hands of the American Medical Association. The American
Dental Association bears the same relation to the present move-
ment that the American Medical Association did to the congress.
All such movements should be under the control of delegate bodies
in order to insure success, and that is the reason we have so
strongly favored placing the whole matter in the hands of the
American Dental Association.

Foreign Correspondence.

To THB Editor:

Thinking that cocaine notes may still be interesting, I send you
those of three cases that with me lately have deviated from the
ordinary run of success.

For a lady patient, twenty-two years of age, I injected ten
minims containing in solution one-half grain of cocaine, intending
to extract the roots of a lower first molar. The part was entirely
insensible, but she, fearing great pain and knowing the instrument
about to be applied, made it impossible to operate without force,
which I did not attempt. I tried to pereuade her, but after five

Foreign Correspondence, 187

minates I saw she was getting uneasy and commenced convnlsive
movements with her hands. They were not cold, neither were the
lips or face blanched ; the pulse was good, but the breathing rather
troubled. After all tight clothing had been loosened and strong
smelling-salts used, everything seemed to get natural, and her
mother fixed her for leaving ; but no sooner had her corsets been
fastened than the old trouble reappeared increased. She was again
relieved and aroused firom a iieiint, and brandy was given ; and I
found the best thing was to get her on the floor, where she lay
for about an hour in an hysterical fit, breathing jerkily. I called
in a doctor, as I had never met with such symptoms before with
cocaine, but he pronounced it only hysteria. She awoke all right
and left for home.

The second case was a gentleman about fifty years of age. He
had been suffering all night from an exposed nerve in an almost
invisible distal cavity of a second upper molar, and a doctor, to re-
lieve him, had at different times given him two weak injections of
morphia over the mastoid process ; but as he got no relief, I was
summoned in the morning. I injected half a grain of cocaine,
having told him before that I could save the tooth ; but no, he
wanted it out. However, no sooner did he feel the pain gone than
he changed his mind and asked me to treat it. So I put in a dress-
ing of carbolized resin, and was about to leave him, when he com-
plained of sickness, and his face looked distressed and his lips
blanched. I had no ammonia with me, as we were in a hotel, so
I bathed his face and opened the windows ; he seemed set against
brandy, so we tried some Chartreuse, which, acting like a charm,
speedily relieved him.

The last was a boy of seventeen years. I was injecting cocaine
slowly, but no sooner had three minims disappeared, when I found
him fainting. He was very ansBmic and weak. Later on for him
I operated without an ansesthetic.

Looking back over three years' experience with cocaine, I think
that where it has been injected, and for some reason no extraction
has taken place, and therefore no bleeding, uneasiness may be
caused. I find a minute and a half to two minutes ample time to
wait, and, used with care and common sense, it has ever proved
to me a valuable help.

Henry L Moore, D.D.S., L.D.S.B.

24 Hue Skryixz, Pau, S. France.

188 Domestic Correspondence.

Domestic Correspondence.

To THE Editor:

First District Dental Society, State of New York,— The Twenty-
first Anniversary of this Society took place in New York City
during the third week in January. Clinics were given in the
rooms of the New York College of Dentistry on Tuesday, Wednes-
day, and Thursday, and a large number of dentists performed
operations on each day of the session, which were witnessed by
crowds of interested spectators. Meetings of the Society were also
held in the spacious hall of the Masonic Temple, where a number
of interesting papers were read and ably discussed, and where
various specimens were exhibited to aid in demonstrating theories
advanced by some of the speakers.

According to reports in the New York daily papers, several
hundred dentists were in attendance. Among the guests present
were Dr. J. S. Campbell, of London, Eng. ; Dr. J. H. McEellops,
of St. Louis ; Drs. J. L. 6ish and C. M. Chase, of Michigan ; Drs.
M. W. Poster, T. S. Waters, and W. Finney, of Baltimore ; Dr. Geo.
H. Wells, of Augusta, Ga. ; Drs. E. S. Talbot, J. N. Crouse, A. W.
Harlan, and W. B. Amos, of Chicago ; Drs. L. D. Shepard, H. E.
Stoddard, J. E. Waitt, and P. M. Dowsley, of Boston ; Drs. W. C.
Barrett and P. E. Howard, of Buffalo ; Drs. Jas. Truman, C. N.
Peirce, and L. A. Paught, of Philadelphia ; Drs. S. B. Palmer and
G. L. Curtis, of Syracuse; Drs. E. C. Baxter, of Albany; P. B,
Darby, of Elmira ; Prod. H. Lee, of Auburn, N. Y. ; Dr. B. V.
McLeod, of New Bedford, Mass. ; Drs. C. S. Stockton, J. B. Palmer,
G. E. Adams, P. A. Levy, A. B. Eaton, Oscar Adelberg, B. P.
Lucky, C. A. Meeker, C. S. G. Watkins, P. C. Barlow, C. P. Hol-
brook, and W. Pinney, all of New Jersey ; Drs. E. S. Gtiylord and
Jos. H. Smith, of New Haven, Conn. ; Drs. O. E. Hill and N. Jarvie,
of Brooklyn, and Dr. Carl Heitzmann, of Now York. Many other
visiting dentists were present whose names could not be secured
for this report.

A dinner was given by the Society to the invited guests on
Thursday evening at Clark's famous Cafe, in Twenty-third Street,
near Pifth Avenue. Unfortunately many of the visitors had led
the city for their homes, as is apt to be the case where the banquet
is deferred until the last evening of a session ; however, over one

Domestic Correspondence, 189

hundred gentlemen occupied chairs at the tables. The dinner was
becoming the occasion and was well served. Everybody present
looked happy and all were apparently engaged in cheerful con-
versation, yet doing good service in disposing of the tempting
viands placed before them.

The Brooklyn and Jersey delegations were particularly jovial,
as is the usual way with them on such occasions. Hill was in his
best mood; Stockton was aglow with wit and humor; Meeker
became decidedly hilarious; Levy was all radiant with smiles;
Finney was almost boisterous, and even Adams, who is usually
so meek and gentle, looked as though he felt somewhat the influ-
ence of the " spirit'* of the hour.

Chicago was not much behind them in enthusiasm. There was
Grouse, the inevitable, who cannot be crushed, — the indefatigable
worker and champion of his profession, who is bound to have his
fellow-dentists protected from unjust extortions of wolves and
sharks in human attire. Harlan occupied a position just opposite,
drinking it all in and rolling up ideas which may appear in a future
number of the Review. Beyond him sat Talbot, who has the
reputation of being exceedingly regular in all his habits and
individual ways, but who is ever on the alert to pry into and study
up " irregularities" in others. Foster, of Baltimore, secured a seat
at the president's elbow, presumably in order to be fully served, and
evidently succeeded. McKellops, of St. Louis, known everywhere,
as "Mac," was "around," and held his own in his accustomed
genial way.

In due time, the order of "menu" being completed, Fresident
Northrop sounded the signal for order, and, after a brief address,
introduced Dr. Wm. Jarvie, of Brooklyn, to respond to the toast,
"The Dental Frofession." Dr. Jarvie spoke of the present ad-
vanced condition of dentistry ; also of the successful professional
career of prominent dentists in this country and Europe, and of
the high social position they had attained. In referring to exami-
nations of students, or applicants for diplomas, he stated that, in
his opinion, " true merit and ability," if satisfactorily demonstrated,
should have greater weight in the deliberations of the examining
board than the length of time spent in a dental college.

Dr. A. W. Harlan, of Chicago, was called upon to respond to
the sentiment ofifered for " Our Guests." The doctor believed that
the guests had greatly enjoyed the hospitality of their New York
friends, and had been . much interested in the meetings of the
society.

190 Domestic Correspondence,

To the next toast, " The First District Dental Society," Dr. N.
W. Kingsley was called upon to speak. In the order of travesty,
Dr. Kingsley gave an amusing account of the life and workings of
the society from the time of its organization, or " birth," to the
present period of its maturescent loveliness. The audience was
kept in a state of continuous laughter throughout the narrative.

To the fourth toast, '' The Jersey Boys," Dr. C. S. Stockton, of
Newark, was requested to respond. The doctor spoke well for the
'< boys," and thinks them equal to any occasion like the present
one. They, too, know how to get up excellent meetings and how
to entertain their visiting friends. Ho hopes to welcome them all
in Jersey in 1892, if the World's Fair Committee decide to have
the fair held on Jersey territory. The doctor complimented the
New York society on the success of its recent meetifags, and the
splendid entertainment which supplemented it.

When the last toast, << The Dental Protective Association of the
United States," was announced. Dr. J. H. Crouse, of Chicago, was
loaded for a response which he fired off with telling effect, fie re-
ferred to the immense amount of work done by the officers of the
Protective Association without fee or reward, and asked of each
dentist only the small sum of ten dollars to make up a fund suffi-
cient to protect them in the practice of their specialty and to de-
fend them from unjust exactions.

Mr. J. Kimberly Beach, of New Haven, Conn., was called upon
for a speech. He is a member of the legal profession, and envies
the dentists for the high position they have gained. He compli*
mented them for the many achievements they had won, and be-
lieves that in the great future before them dentistry will be gen-
erally recognized as a most useful, benign, and respected specialty
of medicine. He thinks that dentists should be protected from
unjust claims of pretenders, and in order to be protected should
support the association.

Dr. W. H. Dwinelle made a few remarks complimentaxy to the
efforts of Dr. Crouse ; after which Dr. C. E. Francis called the atten-
tion of the gentlemen present to the arduous labors of Dr. Crouse,
and to the valuable time gratuitously given by him for the benefit
of dentists generally. Dr. Francis also offered a resolution of thanks
to Dr. Crouse for his efforts in behalf of his specialty, which by
vote was unanimously carried.

After a song by Dr. B. C. Nash, in which the entire assembly
heartily joined, the happy party adjourned.

Ourrent News. 191

Current News.

CHICAGO AND VICINITY.

Pbofsssob Truman W. Brophy has returned from the Pacific
Slope very much improved in health.

The annual meeting of the Chicago Dental Society was held on
February 4. The entire day was devoted to scientific work, — the
forenoon to clinics, the afternoon to the reading of papers and
discussions; and the evening to a banquet at the Leland Hotel.
Between fifty and sixty were present, including the guests of the
society. A marked and unmarked feature of the banquet was the
absence of all forms of intoxicating liquors.

La Grippe has seemed to have a special spite against the
teachers in our medical and dental schools, and many of them
have been obliged to find substitutes to fill their places for longer
or shorter periods. Five of the professors in one of the dental
colleges were laid off at the same time.

The annual dinner of the Chicago Dental Club occurred on the
evening of February 24, at the Tremont House, at which Dr. W.
X. Sudduth, of the International Dental Journal, Dr. F. H.
Berry, of Milwaukee, Dr. C. R £. Koch, of the Illinois State Board
of Dental Examiners, and Dr. P. J. Kester, president of the Chicago
Dental Society, were the honored guests.

After the dinner Dr. Sudduth delivered a lecture on "Cel-
lular Morphology," illustrated by numerous photo-micrographs.
He was assisted by Dr. L. D. Mcintosh, of Chicago, who furnished
for the occasion one of his new and improved lanterns.

Dr. Berry, of Milwaukee, demonstrated the "Construction of
Appliances for Cleft Palate by a New and Improved Method."
Forty-five were present at the dinner.

The Chicago Dental Society and the Chicago Dental Club in-
augurated this year a new departure in the line of banquets. In-
stead of ordering an expensive dinner, at a late hour of the night,
the societies sit down to the regular six o'clock dinner, served in a
private room. This gives plenty of time for speech-making or
literary and scientific work without robbing the next day, and
saves a large item in expense, which can be spent to better advan-
tage in other directions.

192 Current News.

The World's Fair ? Why, of course. Where should it go but
to Chicago ? What other city could make a success of it in such
a limited space of time ? This is what we hear on the street every-
where. Come and see, in 1892, if Chicago does not fulfil her promise.

At a mass meeting of over one hundred dentists, gathered from
various parts of the United States, held in the city of New York,
January 16, 1890, of which Dr. O. E. Hill was chairman, it was,
on motion, unanimously

Beaolvedj That we thoroughly endorse the Dental Protective
Association of the United States, and urge upon every member of
the dental profession to join the association, and send to Dr. J. N.
Crouse, of Chicago, its president, the initiation fee of ten dollars.

Nbw York, Janaarj 16, 1890.

Call fob an International Dental Congress in 1892. — ^At
the Nineteenth Semi-annual Meeting of the New Jersey State
Dental Society, held at the office of Dr. S. C. G. Watkins, Mont-
clair, N. J., Saturday, January 11, 1890, the following resolution
was passed :

" Deeming it fitting, and the proper time for holding an Inter-
national Dental Congress in the year 1892, the New Jersey State
Dental Society has appointed a committee to act in co-operation
with like committees from all other dental societies throughout the
United States. They would request your society to appoint a com-
mittee to meet with them at the Hoffman House, New York, on
Tuesday afternoon, April 8, to formulate plans for the holding of
the First International Dental Congress."

Trusting that this will meet- with the approval of all Dental
Societies and that your executive committees will appoint delegates
at once.

Yours very respectfully,

S. C. G. Watkins, President.
Geo. Emery Adams, Vice-President,
Charles A. Meeker, Secretary.
Geo. C. Brown, Treasurer.
Fred A. Levy, Oscar Adelberg,

A. R Eaton, . B. F. Luckey,

G. Carleton Brown, C. F. W. Holbrook,

James G. Palmer, E. M. Beesley,

C. S. Stockton, Henry A. Hull,

WORTHINGTON PiNNEY.

THK

International Dental Journal.

Vol.. XI. April, 1890. No. 4.

Original Communications/

THE RELATIONS OF THE TOOTH-PULP TO THE

OTHEE TOOTH TISSUES.'

BT OBOSQE H. H'OAUSKT, JANKSVILLI, WIS.

Our imagination is never at rest. During the hours of sleeping
it may run riot. During the hours of waking it may be controlled
or modified by judgment. ^

The judgment, controlling the imagination, may have been
perfected through a knowledge of facts, and the extent of that
knowledge will determine to how great an extent the imagination
may be controlled by judgment.

If we neglect the means of acquiring knowledge, we neglect
the very means of perfecting our judgment, and we may find that
which we consider reason to be merely a grade of imagination.

The human animal acquires knowledge through the medium of
the five organs of sense, either of which is created for its own
special function. Certain varieties of wine, for instance, can hardly
be distinguished apart when presented to the sight, but experts
readily determine a variety by placing it in contact with the taste-
buds of the tongue.

^ The editor and publisheri are not responsible for the views of authors of
papers published in this department, nor for any claim to novelty, or otlierwise,
that may be made by them. No papers will be received for this department
that have appeared in any other Journal published in this country.

> Bead before the New York Odontological Society, January 21, 1890.

18 198

194 Original Communications.

The sabtile perAime floating in the atmosphere can be smelled,
but who ever felt or saw it? Yet the use of more than one sense
may be necessary, at times, to determine certain truths. The
interpretation placed upon the impressions conveyed to the brain,
through either one or all of the human senses, may and does often
differ, yet that does not excuse a refusal to employ the senses in
the effort to arrive at or approximate truth.

The unassisted organs of sense are, however, limited in the
extent to which they may serve us, and the inventive genius of
mankind is being continually exerted in an effort to aid them in
the performance of their function. As the Creator has created in
the human organism certain organs with special functions, so
the necessities of the human family have led to the invention of
mechanism for special uses. The necessities of the astronomer led
to the invention of the telescope, without the aid of which his occu-
pation would be gone ; and instead of a knowledge of facts, so far
as facts can be determined through its use, he would be engaged in
speculations, which amounV simply to Scotch verdicts, or, in other
words, not proven. Tf astronomical facts are arHved at through
the use of the telescope, a theory formulated by an astronomer who
mhU use it may approximate the truth. But what shall we say of
a theory founded on nothing, which, through the aid of the tele-
scope, has been demonstrated as a fact ? If he will use it, he may
learn much ; if not, can he learn anything definite ? If the prin-
ciple is true, in case of the astronomer, it is no less so in case of
the histologist.

There is a limit to the function of the eye, and beyond which
the sight cannot penetrate, unless aided by the microscope, which
to the eye of the histologist is an annex through which he arrives
at truths, which can be arrived at by no other means at present
known; and it is therefore safe to assume that any histological
theory may be questioned, if not based upon facts ascertained to
be such through its use ; and any histological theory which cannot
at present be demonstrated through its use may be considered as
not proven, and as yet an open question.

In a consideration of the relations of the tooth-pulp to the other
tooth tissues, the writer assumes that the microscope is the only
medium through which we can arrive at facts regarding that
important organ, and while awaiting the result of the future effort
of the makers of microscope objectives, we can only pursue our
studies by aid of the best productions of the present time, and
which, like the unaided eye, have a limit to their performance.

Relations of the Tooth-Pidp, etc. — Mc Causey. 196

A knowledge of the relations of the tooth-pulp to the other
tooth tissues involyes a study of the developing tooth, and is a
question of histology and function.

Sections of teeth and jaw of the lower animals, at about the
time of birth, enable us to study the relations of the tooth-pulp to
the other tooth tissues sufficiently near, to determine regarding the
commencement of the relation, and which can afterwards be pur-
sued by sections yet older, and up to the time of full development.
It is a recognized fact that all tissues to be examined under the
microscope should be subjected as little as possible to the action of
any agent which has a tendency to shrivel the elements, and, in the
treatment of embryonal tissues particularly, it should be avoided.
Therefore such sections should never be mounted in balsam, which
involves thdnise of alcohol for dehydration. The method described
by Dr. Andrews, of Cambridge, Mass., has been found by the writer
best to preserve the structure in its original form as a permanent
mount. Sections are examined best while resting in a medium
which possesses as nearly as possible the same refractive power as
do the fluids of the body, and the writer has found iodized amniotic
liquor to answer the purpose admirably. The sections may be ex>
amined under objectives ranging from a one-eighth upward. They
should be of high angle, and, if possible, either oil or homogeneous
immersion.

Objections have been raised against the use of the term " tooth*
pulp," but, in the opinion of the writer, it is better to use a term
which, while it falls short of conveying a full idea of structure and
function, is not positively misleading as to facts ; and until some
better term can, in accordance with a knowledge of facts, be devised,
it is, in my opinion, better to retain and for the time make use of
the term tooth-pulp. At the instant of the commencement of pro*
liferation of the bud of embryonal subepithelial tissue (and which
becomes the future organ of dentinal formation) there begins a
series of changes which are to determine the relations of the tooth-
pulp to the other tooth tissues.

The growth of the bud continues in an upward direction against
the epithelial elements of the enamel organ, until, through the
resistant pressure of the enamel organ, it becomes nearly enclosed
by the enamel organ. At this particular epoch we can commence
advantageously a study of that tissue which constitutes the dental
pulp. If we focus upon the tissue (prepared as before recom-
mended) an objective of first class definition and sufficient power
of amplification we shall find the central portion to be composed of

196 Original Communications.

the simplest kind of tissue, that known as mucous, or myxomatous.
Certain of the cells will be found to contain homogeneous proto-
plasm only. Others show finely granular bodies within the proto-
plasm, while others, in addition to the granules, exhibit nuclei.
Other cells can be found of the form which we know as bipolar,
and are those from which arise the connective-tissue fibres which
are found embedded in the pulp at its maturity.

At its periphery we find yet other forms of protoplasmic bodies,
and which stand like columns, perpendicular to its surface. One
form at its outward extremity is found to be square, or nearly
so. Others are of a pear-shaped form, the smaller extremity point-
ing outward. Both forms will at their outward extremities be
fotind to show processes which, apparently, are a continuation of
the protoplasmic contents of the cells of which they are processes.
At this time there will be found surrounding the tissue, which we
have examined, a layer of formed dentine, and into which we
readily trace the processes of the peripheral cells of the pulp.

The fact that the peripheral cells form the only portion of tissue
in immediate contact with the forming dentine, justly leads to the
conclusion that these cells are the only medium through which the
cartilaginous matrix of the dentine is formed and its subsequent
calcification is effected.

Observation of sections yet older in development shows that in-
crease in thickness of the dentine is accompanied by a correspond-
ing decrease in the diameter of the pulp.

If we next examine our first section of embryonal pulp tissue
under a higher power we will find the cell walls to be penetrated
by most delicate filaments, which are cohnected with the gran-
ules of the protoplasm of the cells, the granules themselves being
connected with each other by the same delicate filaments. These
filaments which penetrate the cell wall are continued through the
walls of the adjoining cells, thus forming a delicate net-work
throughout the tissue of the entire pulp, including its columnar and
pear-shaped cells. Blood-vessels will be found penetrating the
tissue of the pulp, the significance of which, as in all tissues, is
that of nutrition.

The blood furnished through the developed and developing
vessels nourishes the tissues of the pulp, at the same time furnish-
ing the pabulum fVom which is elaborated the materials for the
structure of the forming dentine, through the medium of the
peripheral cells.

As all mature tissue has arisen primarily from the mucoid tissue

JRelations of the Tooth-Fulp^ etc, — McCausey, 197

of the embryo, so does the dentine arise through the formative
action of the pulp which, having performed its function, yet con-
tinues as an organ of repair, when necessity calls for such action.
Unlike most tissues, the thoroughly developed pulp consists largely
of its embryonal elements, the only change being in the elements
contained within it. Thus far no allusion has been made to the
nerves of the pulp, but which we will now consider as we see them
through the microscope objective.

We will try and ascertain if we have the right to call a part
the whole or the whole a part. An old theory — which is so very
old that to most of us it has become new — is that the pulp of a
tooth is a nerve. It is an idea which, in the dim past, was com-
municated by the physician to the patient, and from parent to child
among the laity, and it is through the admirable performance of
the modern objective that we are to prove the theory a truth or a
fallacy.

Later on, we have been told that the function of the pulp is
that of a ganglion or nerve-centre. If the tooth-pulp is a nerve
we shall expect to find it to be composed wholly of the elements
which enter into the structure of nerve tissue. If it be a nerve, it
must be morphologically of one or another of the forms of neural
tissue. If its function is that of conduction of nervous influence,
we will find it composed entirely of nerve fibres. But we have
already found it to be composed of mucoid tissue. Microscopical
examination reveals the fact that it, like other tissues, contains
within its substance neural tissue of that form known as tubular
neurine, which enters into the structure of nerves whose function
is the conduction of nervous influence.

If the pulp is a ganglion, we may expect to find it consisting of
neural tissue in the form of cells.

But as mucoid tissue cannot consist of other elements than mu-
coid elements, and at the same time retain its identity as mucoid
tissue, we will not expect to find it consisting of vesicular neurine,
as elements entering into the structure of ganglia. Being formed
by the union of nerves, ganglia may be expected to be found con-
nected with axis cylinders, as poles of their cells. We find nothing
of the kind, however, unless, by a long stretch of the imagination,
we assume that ^the processes of the peripheral cells are nerve
terminals. That assumption is very hard to prove, as their be-
havior, under the action of reagents and stains, is very different
from that which we know to be nerve tissue, when submitted to
the same treatment.

198 Original Communications.

Instead of the*tooth-palp showing any of the characteristics
of a ganglion, or other nerve tissue, we find that, like other tissues,
it contains neural tissue within itself, and of that form which the
histologist recognizes as meduUated.

The fibres traverse the structure of the pulp mostly in a direc-
tion parallel with its long axis, but, at times, approach its periph-
ery, where they terminate as exceedingiy small non-meduUated
fibrils, which may rest near to or between the formative cells of the
dentine. That, during the excavation of a cavity of decay id den-
tine, contact of the instrument with the processes of the formative
cells produces a sense of pain in greater or less degi*ee, every den
tist well knows ; but that it is caused by direct contact of the in-
strument with nerve tissue, the writer is not at the present time
prepared to admit. He has been quoted as denying that the den-
tinal tubules contain nerve tissue. That assertion is a ipiistake, but
he takes the present opportunity to say that he does not believe
that they contain nerve tissue, but is open to conviction.

At the present time it is with him an open question, and the
only theory which he has to advance to account for the existence
of pain in excavation is through the contractility of the protoplas-
mic processes of the peripheral cells of the pulp, and the impression
of which may be received by the nerve terminals through the
medium of the protoplasmic net-work, which extends through and
connects the cellular elements of the entire pulp ; and it is with
him simply a theory which he has as yet been unable to demon-
strate to his entire satisfaction as the truth. If we admit that the
tooth-pulp is either histologically or functionally a ganglion, we
must, in order to be consistent, admit that each and every papilla
of the corium which contains nerve terminals is a ganglion, the
fact that one is surrounded by a wall of calcified tissue, and the
other not so surrounded, having no particular significance. If we
admit that the tooth-pulp is a ganglion, we seek in vain for the
organ which forms the cartilaginous matrix of the dentine, and
afterwards plays an important part in its calcification, and we are
compelled to admit, at the same time, that the science of histology is
a rope of sand and the results of the continued studies and patient
plodding of Yirchow, Bilroth, Strieker, Schultze, Heitzman, Black,
et al,y have gone for naught. The patient investigations of Legros
and Magitot have no practical significance, so far as* their conclu-
sions are concerned. We are forced to the conclusion that antiseptic
treatment of a tooth containing a dead " ganglion*' is a myth, and
the almost marvellous performance of objectives made by Spencer,

Appliances for Correcting Irregularities, etc, — Jackson. 199

Bansch and Lomb, Tolles, Zeiss, et al., representing the result of the
highest grade of patience and skill, absolutely wasted. The years
of toiling by skilful manipulators of such wonderful lenses have
been worse than thrown away. But the honest seeker after truth
may take renewed courage in the thought that, the theory that
the tooth-pulp is a ganglion, fW>m either a histological or functional
stand-point, would never have been formulated by even a mediocre
manipulator of the microscope.

SOME METHODS OP MAKING AND EBTAINING BB-
MOVABLB APPLIANCBS FOE COBRBCTING IBBBGU-
LABITIES OP THB TBBTH.»

BT y. H. JACKSON, D.D.S., NEW TOBK.

Gbntlbmen of the Union Meeting, — May I have your attention
to consider some methods of making and retaining appliances for
moving teeth and how to make additions to apparatus already in
use, which have been used satisfactorily in my practice.

As bands of gold and gold and platinum are being used generally
for attaching and retaining appliances to the teeth, and also for re-
taining teeth in position after regulating, a few remarks may be
appropriate first, as to the best method of making and retaining
them.

The metal should be as thin as can be used, and still have suffi-
cient rigidity so that when driven it will conform readily to the
tooth.

Gold meets the requirements better than gold and platinum in
most cases, as the latter is not sufficiently yielding, and is more
liable to discolor when used in contact with piano wire. Better
results are obtained by forming the band on the natural tooth than
on a model, and much depends on its adaptation.

If there is to be much strain on the band it should be rather
broad, and burnished to the tooth with the ends lapping on the
lingual side in most cases, at an angle best suited to make a good
adaptation. Por the incisors or cuspids, a broad piece of gold may
have a Y-shaped piece cut out of either end, and then burnished to

* Bead before the Union meeting held at Springfield, Mass., October 24, 1880.

200 Original Communications,

the tooth with the ends drawn together on the lingaal aurfiice and
soldered, thus adapting it perfectly to the tooth.

A very strong band can be made by fitting two narrow bands
to the tooth, having them close together on the lingaal and sepa-
rated on the labial side, and make an impression with mouldine of
the front of the tooth and bands, then remove the bands and place
them in the impression and solder the parts to be united.

The bands can be used in this way, or a thin piece of gold can
be burnished to the labial side of the band and soldered.

To assist in retaining, the inside of the band should, be rough-
ened by raising ridges with a sharp instrument, and the tooth pol-
ished with a fine grade of pumice-stone so the cement will adhere
more readily to it. The cement is used rather thin, and kept dry
by rubber dam or spunk.

Where there is a great downward pressure on the band, as when
superior incisors and cuspids are being forced forward, it can be
sustained in many cases by passing a small platinum wire around
the neck of the tooth one or more times, then passing the ends either
way below the band, and then twisting together before the cement
hardens. If well adjusted this will in most cases resist the most
severe strain on the band.

There is also a method of putting a screw through the band and
adjusting with zinc phosphate, at the same time tightening the
screw.

If there is to be a projection from the band on the distal or
mesial surface, for the purpose of retaining a tooth once rotated, or
to hold an appliance from slipping from the lingual surface of the
incisors, it can be most easily made by bending the ends. at a right
angle with the bands and then soldering.

The projecting end can be ground or filed to any desired shape,
or a lug, or tube, may be soldered to the band for similar purposes.

Bands can be removed usually without cutting, by forcing a
thin straight burnisher between the band and tooth.

It frequently occurs, when regulating with rubber plates, that
an extra spring is needed to complete the regulating. The writer
has often attached a piece of piano wire for that purpose, by pass-
ing it through a hole in the plate a quarter or half an inch, with
the end flattened and formed to fit the surface, and fastened by
drawing a binding wire through holes in the plate either side of the
fiattened wire, and twisting the ends together.

Doubtless a number of the gentlemen present heard a paper
read before the American Dental Association in August last, in

Appliances for Correcting Irregidaritiee, etc, — Jackson. 201

which I described a method of uniting piano wire to form inde-
pendent appliances for the purpose of moving teeth.

Two or more pieces of piano wire are joined in any desired posi-
tion, and held temporarily with cord, then bound with fine binding
wire of copper or iron, wound close together usually, and soldered
with soft solder or tin, by holding the parts over a spirit lamp and
applying small pieces of solder, the surface having been covered
with muriate of zinc ; the zinc solution should be very much diluted.

The method of attaching springs to a rubber plate is accom-
plished in a similar manner by soldering a piece of metal to the
end of a piano wire, to be used as a spring for moving teeth, and
for retaining the plate in position in the mouth, etc. (See Fig. 1.)

Fig. 1.

u^f

Beduoed one-half.

The spring or piano wire is flattened on the end, without draw-
ing the temper, and a thin piece of coin silver, German silver or
tinned copper, about one-fourth by half an inch in size, is made in
form something like the bowl of a spoon. The flattened end of the
wire is then fastened into the depression of the metal by drawing
binding wire through holes made with the plate punch, either side
of the piano wire, and twisted as close as practicable, with the ends
left long, and coiled up in the depression to assist the solder in
flowing.

It is then heated ovex ft spirit lamp and soldered by applying
pieces of solder or tin, as before described, until the bowl part is
filled, when the surface of the solder may be filed, or fiattened by
turning it down on an anvil and cover with a thick piece of lead
and hammered until it is level ; the latter will be found the quicker
method.

The edge of the silver is trimmed to the desired form, and holes
punched with the plate punch in the corners for the rivets.

202 Original Onnmviiieatums,

Gold can be uned in place of other metals, If soft solder is used,
but, owiDg to the great affinity of tin and gold, tin is not prao-
tioable.

A piece of watob- or clock-spring can be used to advantage in
some cases in place of piano vire.

The common brass pin with the temper drawn fs a convenient
rivet to fiuten springs to rabber plates.

The whole appliance can be immersed in molten tin, if it is de-
sired, soldering and plating it at once, or the wire can be tinned
before soldering.

In this manner bands or olaspe of silrer or most any metal can
be Kttached to the end of spring wire to hold it in place on any
tooth it is desired to move.

A method of keeping the end of the spring wire from pressing
on the gum, or slipping off of the teeth when regulating molars or
bicuspida, is accomplished by twisting a copper wire around the
piano wire one or more times, and soldering with soft solder. Apply
by allowing one end to project into the space between the teeth, and
the other end to rest on the grinding sur&ce.

For the same purpose a bow of copper wire may extend up over
any prominence on the surface of a tooth with the ends united to
the piano wire opposite the space between the teeth, as before, or
a very thin piece of tinned copper may be burnished to the model
of the tooth and soldered to the spring wire in the manner deeoribod
for soldering metal to piano wire.

Applianceafor Oorrecttng Irregalarities, etc. — Jackson. 203

The pnotioability of spring wire being used independently of
plates or fixed appliannes I have demonstrated in many casea, as
^m my experience I hare found but few irregularities of the teeth
that caonot be corrected by the use of the hand and spring, which,
as a rule, is more easily made and adjusted than other applianoos.

Via. H.

A simple method adopted to force a superior incisor into proper
position that stood inside the normal line of the arch was to cement
a band to the tooth, with a U-shaped piece of metal attached to the
lingoal side. A piano wire of about No. 20 gauge was formed to
fbllow the curve of the arch back of the incisors with the ends in
form of a letter 8 and -allowed to project into anterior proximal
cavities of the temporary molars. (See Figs. 2 and 3.)

The pressure was increased by removing the wire and straight-
ening the ends. The regulation of the tooth was accomplished in
thirty-four days, with perfect comfort to the patient, a very desira-
ble feature, especially in the case of children.

204 Original Communications.

DESCRIPTION OP A SPECIMEN OP CLEPT PALATE.^

BY JOHNSON SYMINQTON, M.D^ F.B.8.B.,

Leotarer on AnAtomy, Minto House, Edinbargh ; Szaminer in Anatomy in

Uniyenity of Edinburgh.

This specimen was met with in a male subject, aged seventy,
dissected in my rooms last summer session. The cleft was ob-
viously congenital, and extended through both the hard and the
soft palates and the right alveolar arch. It opened above into the
right nasal cavity.

The upper jaw was practically edentulous, so that it was not
possible to determine the relation. of the cleft to the incisor teeth.
It may be noticed, however, that the cleft passed through the alveo-
lar arch barely a quarter of an inch external to the fr»num of the
upper lip, so that on the right side there was obviously not room
internal to the deft for more than the central incisor tooth.

Mr. Bowman Macleod kindly made a cast of the deformity for
me, and I then froze the specimen, and made a series of transverse
vertical sections through the palate, nasal cavities, and maxillary
sinuses. Sections of this kind are very useful for the demonstration
of the relation of the palate and nasal cavities, and Zuckerkandl'
has employed this method very extensively for the illustration of
diseased conditions of the nasal cavities. I have, however, been
unable to find any published drawings of similar sections in cases
of cleft palate. Indeed, the illustrations of this condition appear
to be practically confined to representatives of the cleft as seen
from the mouth. These figures, which are generally diagrammatic,
merely represent what can be readily seen on an examination of
the deformity in the living body, and give a very incomplete view
of the condition of the palate and nasal cavities.

Pig. 1 is a drawing of the cleft in my specimen, as seen from the
oral aspect. There is a cicatrix in the upper lip below the right
nostril, and it looks as though there had been a hare-li|) on that side

^ Bead before the Odonto-Chirurgical Society of Scotland, December 12, 1889.
* Kormale und Pathologische Anatomic der Nasenhohle. Wien. 1882.

Description of a Specimen of Cleft Palate. — Symington. 205

'which had been operated oq. The anterior part of the alveolar
arch to the left of the ctell projects lower down and overlaps aome-
what the thickened and warty-like mucous membrane attached to

the alveolar arch on the right «de of the cleft. The left alveolar
arch gradually becomes less prominent as it passes backward. The
fissure extends through both hard and soft palates, and there are
two distinct uvolce.

Four transverse vertical cuta were made with a saw, so as to
divide the specimen into Ave pieces. The two anterior cuts went
through the nasal cavities, and the two posterior ones through the
naso-pharynx. The traosverse lines on Fig. 1, numbered 1, 2, 3,
and 4, indicate the position in which tbe sections were made.

Fig. 2 is from a tracing of the posterior out surface of the
anterior slab. The ethmoidal sinuses and superior and middle
tarbinated processes are fairly symmetrical, except that the right
middle turbinated process is distinctly smaller than that of tbe left.
The septum nasi passes downward, and slightly to the right, for
one and one-fourth inches. At this point it is thickened, and then
makes a very marked bend downward and to the left, to join the
left palatine process.

It will be seen that the fissure, although opening into the right
nostril, is situated to the left of tbe mesial plane, and the closure of

206 Original Qmimttnicatioiu.

tbe left nasal oarity is not astooiatod with «iy mailed development
of the palatine prooMB on that Bide, bnt depends upon the defiecti<Hi
of the aeptam nasi to the left. The vertical thiokness of the left

alveolar arob ie decidedly greater than that of the right, hut it lies
farther from the mesial plane. The antrum is larger on the left,
LA, than on the right, BA, side. The openings trora the antra
into the infUndibula are anterior to the section, and there are no
apertures leading directly from the antra into the middle meatuses.

Fig. 3 shows the posterior surface of the second slab. It will
be observed that in this plane the septum has a very prominent
ridge projecting iW>m its right side into the space between the
superior and middle turbinated prooesses. Below this ridge the
septum inclines downward and slightly to the left. The antrum
extends much lower down on the left side than on the right.

Fig. 4 is taken tVom the posterior surface of the fourth slab.
The body of the sphenoid is divided nearly half an inch behind the
posterior dinoid processes. The left sphenoidal slniis is opened, bnt
the right one does not extend so far back. The section is a little
behind the pterygoid processes, and corresponds to the pharyngeal
ends of the Eustachian tubes. Bach Eustachian tube is hounded
internally and above by its cartilage, the outer wall being mem-
branous. The two halves of the soft palato are of about the aama

JDescription of a ^tecimen of Cleft Palate. — Symington. 807

UuckneBS. Below the Eustachian orifices they are about tbree-
qnarters of an inch thick, bat become rather thinner as they

approach the meaial pUne. This section shows extremely well the
relations of the palatal muBcles. The levator palati forms a well-

defined mass of moscnlar tissues, which lies just beneath the macous
membrane, covering the tipper surface of the soft palate. The

208 Original Communications.

tensor palati appears as a thin sheet of fibres lying external to the
Eustachian tube. On the right side, after removing a little fat, its
tendon was easily traced to the hamular process of the internal
pterygoid plate. A small bundle of fibres connected internally with
the lower part of the levator palati, and passing outward and down-
ward, belongs to the palato-glossus. The section is immediately
in front of the tonsils, and consequently anterior to the palato-
phaiyngeus.

The muscles of the soft palate are separated from the mucous
membrane on the oral surface of the palate, by a thick layer of
glandular tissue and fat. It is' scarcely necessary to poin|^ out how
clearly this specimen demonstrates the relations of the muscles of
the soft palate, as described by Sir William Ferguson. It also shows
that the levator palati lies much nearer the upper than the lower
surfitce of the soft palate, and, therefore, can be most readily divided
by Ferguson's method.

Tomato-Poisoning, 209

TOMATO-POISONING.i

BT WILLIAM A. MILLS, D.D.8., BALTIMORE, MD.

Gentlemen, — I desire in this paper to call the attention of
the profession to a new disease, which, after many years of experi-
ence, I have discovered to be and have named tomato-poisoning.

Of necessity I shall be brief in details, leaving the history of
its discovery for some future paper; nor will I attempt any ex-
planation of its pathology, but will leave it to others to philoso-
phize upon its phenomena.

Symptoms. — At first the pain is rather indistinct, only manifest-
ing itself in an uneasy discomfortable feeling, being more pro-
nounced as evening approaches, and most acute at night. These
symptoms may continue for days or weeks before the patient seeks
relief from the agonizing pain which follows. Pain is rarely ever
localized, but is made manifest by all kinds of reflex conditions.
Patient cannot take anything sweet, even moderately warm or
cold, into the mouth without causing the most intense agony.
Going from the house into the open air, or from one room to an-
other, where there is but a slight difference of temperature, pro-
duces the most acute paroxysm; sometimes seeming to proceed
from an exposed or inflamed nerve, centring in one or more teeth
in the same maxilla, or both ; then apparently jumping from tooth
to tooth, and then, by reflex action, causing neuralgia of the neck,
head, ear, or angles of the jaws, alternating from point to point
with the swiftness of the electric current. The duration and
intensity are governed by age and temperament of the patient.

Diagnosis, — ^Upon the most careful examination of the oral
cavity we fail to find any decay in the tooth the patient complains
of, nor in any others in which reflex action could be supposed to
play any part in the distressing symptoms. No response to con-
cussion, no deposit of any kind, on any part of the teeth. All in-
dications of pyorrhoea alveolaris absent, rarely any devitalized
teeth ; in general, the gums and associated parts apparently
normal ; mouth clean and properly attended.

^ Bead before the Maryland State Dental Association, December 5, 1889.

14

210 Original Communications.

But, on very close examination, we discover around the necks
of the superior molars (but rarely the inferior), particularly mani-
fest on the palatine surfaces, — ^and even recession of the gums,
about an eighth of an inch wide, as even and clean cut as though
done with the most accurate mathematical precision, — ^the denuded
surfaces are clean and white, in striking contrast, with the surfaces
above the line of original attachment of the gums.

If we place a steel instrument anywhere along the line of the
recession, touch it with the finger-nail, or blow air upon it from the
syringe, the patient exclaims in agony. So far all remedies have
failed to effect a cure except the absolute prohibition of tomatoes
as an article of food. All the foregoing pertains only to patients
from eighteen to twenty-five years of age. With older patients the
disease proves more serious. In its first stages all the symptoms of
the younger are manifest, lasting about two or three weeks, when
the tissue surrounding the tooth or teeth affected shrink again to
their normal position, but do not become attached to the teeth as
in the case of the younger. About the fourth week the gums
surrounding the necks of the teeth show a slight thickening of
tissue, the color of which resembles the line of lead-poisoning.
The slightest pressure of the tongue causes great pain, apparently
deep-seated in the maxilla; the sensation imparted to the tongue,
when touched by it, is that of something foreign and glassy. About
the fifth week the teeth begin to loosen, the alveolar wall is ab-
sorbed, and in some cases caries of the roots takes place. About
the sixth week the tissues collapse, when we have a condition
resembling that of cancrum oris or arsenious-acid poisoning.

At this point the disease has reached its climax. If the tooth
does not fall out from lost attachment, it must be extracted to
give relief, which will be but slight, as all pain does not cease
for days afterwards. Prohibition of tomatoes gives no relief in
these cases ; all remedies have failed to give even temporary relief
nothing but extraction effecting a cure.

Patients rarely lose more than one tooth the same year. The
disease is most prevalent during the wet seasons. This is no doubt
due to the greater amount of acid contained in the tomatoes. The
disease never attacks a devitalized tooth. One great peculiarity
about the disease is that, during the whole process of absorption,
there is almost a total absence of fcetor. In diagnosticating this
disease do not confound its symptoms with that produced by grape
and tomato sore mouth ; always hunt for the recession of the gums
on the palatine surfaces of the superior molars.

Nw York Odontological Society. 21T

Reports of Society Meetings.

NEW YORK ODONTOLOGICAL SOCIETY.

The New York Odontological Society held its regular monthly
meeting, Tuesday evening, January 21, 1890, in the New York
Academy of Medicine, No. 12 West Thirty-first Street.

The president, Dr. J. Morgan Howe, in the chair.

INCIDENTS OF OFFICE PBAOTIOE.

Dr. Geo, S. Allan. — Mr. President, I have here an amalgam
carrier that I would like to show the gentlemen present. I do not
know of any instrument in the market that will meet the good
points of this one. A slight pressure opens the nibs to receive the
amalgam, and when it is carried to the cavity the nibs are pressed
apart and the amalgam placed wherever desirable with the other
hand. There is no danger of dropping the amalgam on the way
from the desk to the cavity, and the instrument works well in
every way. The spring is very light, just enough to hold the
amalgam without pinching; it, and the beaks are a little serrated
inside, so that the amalgam does not drop off when the nibs are
separated.

I have long wanted a syringe for general work in the mouth
that would be free from many of the objectionable features of those
we ordinarily purchase. The inibber syringe never works well
after it has been used a short time ; the piston soon wears in the
barrel and the suction becomes imperfect. This one, which I now
exhibit, is a glass syringe, and it holds about the requisite quantity.
When it is being filled there is no loss whatever ; no air follows the
fluid; and it works smoothly as only a syringe with a glass or
metal barrel will. I have two or three nozzles here ; two for reach-
ing into the antrum. One of these is something on the principle of
Dr. Farrar's spray syringe. It throws the fluid in all directions,
and there is no difficulty in treating diseases of the antrum with
any medicine that it is desirable to use. Then I have a third
nosole for ordinary work in the mouth, for pus pockets, or cavities

212 . BeporU of Society Meetings

where teeth have been extracted and there are indications of blood-
poisoning. Take it as a whole, it is one of the handiest little
instruments that I have ever had for such purposes.

When syringes are used only occasionally and are then laid
away, the plunger soon becomes dry, and has to be soaked before
it will work. That difficulty can be obviated by taking off the
nozzles and placing the syringe in a glass jar or bottle with a little
water in it. They are then ready for use at any moment. The
Farrar syringe is a most useful little instrument, but I have heard
complaints about its becoming contrary and refusing to work ; but
if it be put into a bottle after using, as I have suggested, it will
always be ready to do its work.

A Fotc^.— rWhere can this syringe be purchased.

Dr, Allan. — This I bought of a surgical instrument-maker on
Sixth Avenue, just below Thirty-fifth Street, east side, next to
Cherry's trunk store. He made these nozzles to order.

With the consent of the president, I would like to read from
the Dental Review^ of January 15, a few paragraphs from an article
headed " Ethics, Professional and Otherwise," and signed " Nemo."
This article attempts, in a very naive way, the defence, as I take
it, of the Dental Trade Association, and indirectly raps the pro-
fession over the knuckles for intermeddling with the business of
others. After I have read the paragraphs I will tell you why I
read them.

*^ Much has been said and written in regard to the impropriety
of dental patents secured by dentists, and, by sale or otherwise,
made a source of revenue to the inventor. It would seem to be
not difficult to defend the rights of the individual in this matter.
If he has voluntarily become a member of a dental society, he is
in honor bound to abide by its rules or to withdraw from its
membership ; and, on the other hand, members of the society may
properly refuse to recognize professionally those they believe to be
acting in a manner adverse to the interests of the profession. But
when dentists go beyond this, and practically claim the right to
establish a code of ethics for those engaged in an entirely different
occupation, they invite the like interference with, or at least criti-
cism of, their own acts. There has been much sharp denunciation
of dealers in dental goods because of an association formed by them,
also of certain manufacturers, because of their purchasing patents,
and in various ways so managing their business as to make it most
profitable to themselves. While trusts are multiplying and are
made for the acknowledged purpose of preventing competition, con-

New York Odontological Society. 213

trolling production, and advancing prices, it is gratifying to know
that this Dental Trade Association has no power to prevent com-
petition, limit production, or fix prices ; and without such power it
is certainly not much to be feared by the public.

<* Manufacturers and dealers in goods of all kinds do business for
profit in hard cash, and the struggle for success is always sharp
and often unsuccessful. Much work in every branch of business is
done without profit, and yet this part cannot be rejected, as it is
essential to retain the other. The grocer who should refuse to sell
sugar because there is no profit in it would soon find his customers
going elsewhere for other goods besides sugar."

Now I want to say that there has seldom been put in a few
lines a stronger argument in favor of independent journalism than
that contained here. It is because dentists acknowledge openly,
and assert openly, that this Trade Association is governed by dif-
ferent rules and a different code of ethics from others, that they
want to have their journals independent. They do not want their
journals dictated to by an association or a business concern that is
antagonistic to the principles that they wish to adopt, and that they
do adopt in their daily professional life. It is for the interest, as
this writer plainly says, of the Trade Association to deal in patents,
to purchase patents, and to obtain the control of patents, and this
for the sake of making money. Now, the ground taken by the
dental profession is that we dentists ought not to patent articles
ourselves or allow a product of our brains to be made merchandise
of by others. I do not think there is any question about that ;
therefore this plain, unvarnished statement of a defender of the
Trade Association, I think, calls for a slight notice. He says there
that the association has not the power to prevent competition, limit
production, or fix prices ; and that without such power it is not
much to be feared by the public. I do not pretend to know what
the rules that govern that association are, but I do know this as a
fact: that no dental dealer or manufacturer can start in business
anywhere in these United States and be successful unless he joins
that association. That is a simple fact which men here present
know to be such ; and that certainly indicates that the profession,
as a whole, are right in their position of antagonizing this associa-
tion, because it does not allow of free trade in the necessities which
we daily require in practice.

Dr. 8. B, Davenport. — It may not be out of place at this time
for me to give favorable testimony concerning Mr. B. S. Williams's
crystalloid gold. No. 3, which I have been using several months.

214 BeporU of Society Meetings.

I ani surprised, when thinking the matter over, that I have come
to value it so highly, for I was not at all pleased with the previous
numbers of the same gold, although I gave them, as I thought, a
fair trial. The No. 3 oan be placed in a cavity without crumbling,
is easily pressed into an undercut or other inequality, and it seldom
tips up when starting a filling, though the unevenness of the cavity
be veiy slight. This gold never seems harsh ; on the contrary, it
possesses a lead-like quality fully equal to the combination of tin
and gold, is sufficiently cohesive without annealing for all ordinary
work, and even when heated to a red heat to anneal for large con-
tours it does not become stiff. While experimenting with this gold
I have been led to use it from the foundation, in a number of large
fillings, where considerable masses of gold were necessary for con-
tours and new biting surfaces, and the result has been very satis-
factory. The surfaces are very hard, about the same, I should say,
as crystal gold, and I expect those fillings to be durable, if the
cavities have been properly prepared. While the question of time
is less important than many others, it yet means much to all busy
men, and therefore it is only fair to state that with the Ko. 3
crystalloid a filling can probably be made more rapidly than with
any other cohesive gold.

Following the method which was so ably introduced last year
before this Society by Dr. Dwight M. Glapp, of Boston, namely,
the combination of amalgam and gold in the same cavity at one
sitting, I have found that No. 4 crystalloid gold — ^which is, I think,
prepared especially for work of that character — ^is in my hands
superior to Steurer's gold, which Dr. Glapp was using at that time.
It is not so crumbly, the parts being held together by a layer of
foil on each side, and it can therefore be carried to place and con-
densed without breaking to pieces; and that I never could do with
I Steurer's gold, unless the cavity was in the lower jaw, when gravi-

tation would assist. Dr. Kingsley being present, I hope he will say
i a few words in explanation of his early efforts to combine gold and

I amalgam. He succeeded, I know, but although I have tried to find

a fiill description of that success, the effort has been in vain.
i Dr. N. W. Kingsley. — It does not seem to require many words.

I remembered while the gentleman was speaking on the subject
i that I, with some timidity, brought it to the attention of the State

> Society the firat time I ever mentioned it publicly. I say with

timidity, because I knew the prejudice there was against amalgam.
I remember especially one gentleman making comments upon it of
this nature : he never used anything but gold, and never had any

New York Odontological iSociety. . 216

difSculty whatever in using it ; any man who could not use gold
successfully proved his inability to do work properly ; and to fall
back upon amalgam for a substitute in the way which I described
proved great lack of skill. But the mills of the gods grind slowly,
as do some other miAs ; and I knew if it was worth anything it
would be accepted in time ; and, perhaps, if it was not worth any-
thing. My experience has been that, whether a thing is good or
bad, sooner or later many of the profession will be found adopting
it and lauding it to the skies; the professional pendulum will sooner
or later swing from one extreme to the other. I never had any
serious difficulty in combining gold and amalgam; but to say I
never had any difficulty would not be stating a fact. I do not
know of anything in dentistry that I have not had some difficulty
in doing at first. I used amalgam in that way because I was
forced to. I felt compelled to use something against the cervical
edges of approximal cavities of molars and bicuspids where they
were not easily reached, cavities where the space between the
teeth was somewhat narrow. It seemed to me that if amalgam
was good under any circumstances, there was no objection to
putting it there; particularly as I had seen many of the best
operators, when good gold fillings in such places as that had given
out, repair them with amalgam ; and I did not know why it would
not be as well to use amalgam in the begiqning. I used a small
quantity of amalgam, and packed the gold against it. In some
oases the gold would continue to absorb the mercury from the
amalgam until the cavity was one-half or two-thirds full, but I
would keep on with the work and subsequently the gold would
unite.

Fillings made in that way stand. That is my experience, and
I think it is also the experience of others. They are not as liable
to give out along the border as fillings made entirely of gold.
I do not think there is anything especial in my experience or
method of doing that kind of work.

Dr. Davenport. — The question in my mind was not as to the
advisability of combining amalgam and gold in that class of
cavities, for I think the profession has grown sufficiently to
recognize the value of such fillings. The point was whether Dr.
Eangsley used a special gold and succeeded in getting a chemical
union. I have been able to get a definite union of gold and
amalgam with but two preparations of gold ; those preparations
are Steurer's gold and E. S. Williams's crystalloid, No. 4. Of
course, if Dr. Kingsley filled only one-third to one-half the cavity

216 Reports of Society Meetings.

with amalgam and then began with the gold, packing it into
undercuts, he would not need a definite union ; but, if he recollects
Dr. Clapp's paper on that subject, it was stated that most of the
filling, including the knuckle, was made of amalgam with only a
thin capping of gold which did not extend into undercuts, but
depended entirely upon its union with the amalgam.

Dr. George A. Mills, — ^Dr. Kingsley's idea of combining gold and
amalgam was probably first suggested by the necessity for repair-
ing large gold fillings. I remember performing some very ezten*
siye operations with No. 60 and No. 120 gold for one patient who
was undergoing a good many constitutional changes, and these
conditions manifested themselves in the teeth. He came to me in
1880 or 1881 with gold fillings on the buccal surfaces of the teeth
and decay had recurred. I thought the best thing I could do was
to cut out and fill with amalgam. I did so. After a year I found
extensive decay on the approximate surfaces and lingual surfaces.
I cut that out and filled in the same way, following right around
at different times, until now I have gone entirely around the teeth.
I saw the gentleman four or five weeks ago, and he spoke particu-
larly of the manner in which I had saved his teeth. I consider it
was due to the combination of metals. I have seen an immense
amount of mischief done in filling teeth with amalgam, especially
approximate cavities. Extensive fillings are found where, although
the cavities were large in the first place, the decay dips in under
the edges of the' fillings. I have come to the definite conclusion^
in treating those cases, that the amalgam was placed in the teeth
because the dentist could not do anything better. In many cases
I have cut out the fillings and filled with amalgam, restoring the
contour with gold. I have come to be a believer in the general
characteristics of Dr. Palmer's theory in regard to the Combination
of metals, and am a strong advocate of the combination of tin and
gold. I have had several years experience in it, and have talked
with a good many intelligent dentists who believe with me that
teeth can be saved by a combination of metals when perhaps they
could not be saved in any other way.

Dr. Lord, — ^Mr. President, we have Dr. Palmer, of Syracuse, here
this evening.

The President, — ^We shall be pleased to hear from Dr. Palmer.

Dr. 8. B, Palmer. — ^Mr. President, I think all has been said on
the subject that is necessary. I remember very distinctly being
present when Dr. Kingsley made his first announcement in regard
to the combination of gold and amalgam. I was meeting with so

New York Odontological Society. 217

muoh oppositioD at that time for having advocated the ase of tin
and gold in contact that I did not dare to include amalgam, and did
not for several years after because of the prejudice against it.
When Dr. Kingsley was about to make his announcement to the
State Society, he came to me and asked what I thought of the
practice he was going to introduce. I told him to go on, that the
principle was right and he was safe in advocating it.

In regard to the combination of tin and gold, unless the two
metals are properly mixed, as I have previously described, so that
the tin and gold form an alloy which resists oxidation, I have found
that the tin portion of the filling was affected by galvanic action,
becoming a soft black mass. Seldom is there any decay, but an
instrument can be inserted through the tin portion of the filling.
No doubt others, who have used tin and gold in combination,
have noticed like conditions. Experience teaches that amalgam is
more reliable than tin at the cervical border as a guard material
under gold. Some operators seem to have difSculty in anchoring
the gold to a freshly-inserted amalgam base. Alloy for this purpose
should be kept in the ingot, and be cut for each operation, and not
amalgamated till after the cavity has been dried ready for filling.
Amalgam thus prepared, unless there is more than the right pro-
portion of mercury, will become firm while packing the first layers
of gold, and will not cause the gold to slide upon the surface, be-
cause of the presence of free mercury. Occasionally it occurs that
« gold must be added to or built over amalgam pr^iously inserted.
It is very important that all surfaces which come in contact with
gold be touched with mercury, so that the gold may be soldered to
the amalgam ; the two metals, thus united, never show the joint
by wear or chemical action, because the mercury, thin as the coat-
ing is, becomes an amalgam containing gold of higher potential or
finer than the body of the plug. Practically, the gold element
passes over the line of union into the body of the amalgam.

Quite the reverse of this occurs when amalgam is added to
amalgam, even though the potential may be nearly the same be-
tween the plugs. Of course, the joint is made perfect by the
newly-inserted material being soldered to the old, but the alloy or
solder which joins the two is not as fine as either other element,
containing, as it does, more mercury. The result is, chemical ac-
tion works upon the joint ; a slight seam or hair-line is first noticed,
and after a few years the pieces separate. A single thickness of gold
foil, placed between the two plugs, would secure a perfect joint, the
connecting element would be negative or finer than the body of

218 BeporU of Society Meetings.

the filling. ThoRO who have made temporaiy plates of silver,
where the backings of the teeth were fastened to the plate with soft
solder, know that the teeth with the rim of solder would separate
from the plate in a few months. Certainly was this the case where
the tinning of the plate was done with chloride of zinc, because
the tinning became an alloy of silver, zinc, tin, and lead, and was
decomposed by galvanic action.

The President, — ^Dr. Merriam has sent for exhibition fourteen
samples of files for finishing fillings and filing enamel edges.
They are curved on the edge, and are all different. I will pass
them around, so that the gentlemen may see what excellent and
practical ideas Dr. Merriam has had in devising files for these
purposes.

The secretary being absent, I will ask Dr. Davenport to favor
us by reading the paper of the evening, by Dr. George H. Mc-
Causey, of Janesville, Wis., on " The Relations of the Tooth-Pulp
to the other Tooth Tissues.*' (For paper see page 193.)

The President. — Gentlemen, you have heard Dr. MoOauseVs
interesting paper; the subject is now open for discussion.

Dr, Carl Heitzmann. — Mr. President, you have been kind enough
to invite me here to-night, and I feel that I am amply repaid for
coming. Last year I listened to a paper by Dr. IngersoU on this
subject. Dr. IngersoU maintained that the whole pulp is nerve
tissue, and that the pulp itself is a ganglion. I have fought that
theory as much as I could, and now I am really delighted that a
gentleman, whom I do not know personally, takes exactly the same
ground that I took last year, and have taken since I began study-
ing the histology of the teeth, more than thirty years ago.

The gentleman exhibits a familiarity with certain minute
anatomical features of the pulp which both delights and surprises
me. He speaks of the delicate fibrillsd passing through the proto-
plasm and connecting the granules with one another, going from
one cell to another, and making the whole a continuous tissue.
I am sure Dr. Allan, who is present to-night, will be delighted to
hear that. He denies it. But here is a gentleman, who has never
studied in my laboratory, and never drew the reticulum in my
laboratory, and, nevertheless, describes it as existing throughout
the protoplasm which builds up the pulp tissue. After all, gentle-
men, if one does not get his reward quickly, when working hard
and earnestly, he does get it sooner or later. This is a reward to
me, for the gentleman seems to corroborate my own statements ;
and, with the exception of some slight discrepancies of no impor-

New York Odontological Society, 219

tance, I can agree with what he has said. Although he does not
mention Dr. IngersoU he evidently refers to his views. He per-
haps does not want to personally attack Dr. IngersoU ; but as far
as I am concerned, I have no such objections. The essayist says
that the basis substance of the dentine is cartilaginous. That is a
slight mistake. It is a glue-yielding substance, but not cartilagi-
nous. When boiled, it yields a cloudy liquid smelling like glue,
but not viscid. He maintains that the odontoblasts, which he does
not exactly nominate as such, though giving an accurate descrip-
tion of them, send offshoots into the dentine, and he claims that
these offshoots are not nerves. We all of us know that John
Tomes allud^ to the possibility that the tenants of the dentinal
canaliculi might be nerves. It is perfectly surprising, gentlemen,
how near this excellent investigator, who is still living, approached
the truth. If the essayist had used, instead of protoplasmic threads,
the term that Dr. Boedeoker and myself have chosen, — ^living
matter, — he would have pretty nearly stated the facts correctly.
The nerves, as such, are undoubtedly forms of living matter, in
contradistinction to what Lionel Beale says of the basis substance
of connective tissue being << forming material." How is it possible
that an almost inert mass, such as the basis substance of connective
tissue is, should be compared, as Beale does, with the most active
tissue that we have in our bodies, — ^the nerve and muscle tissue.
This mistake was demonstrated by Bastian, and I have simply
upheld his theory. What we call nerve is not formed material,
neither is what we call muscle ; but both are living matter. If we
take this ground and say that living matter pierces the dentine in
all possible directions, being merely stored up in the shape of
filaments that are able to conduct sensation, and that are able to
supply the whole dentine with what we call the properties of life,
nutrition and growth included, then we have said pretty nearly
everything. Then we have asserted that the living matter, being
within the canaliculi of the dentine, is in one essential point identical
with the living matter building up the nerves. This is the ground
taken by Dr. Boedecker and myself. We have looked a long time
for the immediate connections between the dentinal fibres and the
non-medullated nerves, and I can say that we have failed to see
such direct connections. Some very sensible dentists assume that
such a connection must exist. In cutting a tooth we know that as
soon as we have reached the boundary zone — ^the interzonal layer
of Dr. Atkinson, between the enamel and the dentine-^there is a
keen sensation of pain ; and another point where there is marked

220 Reports of Society Meetings.

soDsibility is the neck of the tooth. How shall we explain the
carrying of what we call sensation from far up at the boandary
.of the dentine to the tips of the nerves, unless there is something
living within the dentine? Therefore we have to admit that a
connection exists between the dentinal fibres and the non-medul*
lated nerve fibres ; but this connection is not a direct one. In other
words, the dentinal fibres do not directly inosculate with the nerve
fibres, but there is an indirect connection existing. That means
that this very reticulum, which the essayist described, and which
unquestionably exists, furnishes the material by means of which
the dentinal fibres are connected indirectly with the nerves. If we
say that this reticulum, which the gentleman calls the protoplasmic
reticulum, — we prefer the term living reticulum, — ^if we say that
from the top of the crown down to the pulp-chamber there is such
a continuity of a living reticulum, we have said pretty nearly every*
thing that we understand of the dentine and its marked sensibility.
Besides, it explains a fact which Dr. Boedecker first demonstrated,
— ^that the points of greatest sensibility are at the interzonal layer
between the dentine and the enamel, and at the neck of the tooth
between the dentine and the cement ; for at those points there is
more living matter and a coarser reticulum than is found through-
out the rest of the dentine or of the cementum.

I can say that, with a few exceptions, I concur with the gentle-
man who wrote this paper. Evidently he has really studied with
the microscope, in contradistinction to Dr. IngersoU, who admits
that he did not ; and in contradistinction to some other men who
claim to know something about the microscope and who do not
know even the elementary principles of microscopy. This gentle-
man truly says it is bad practice to mount sections of teeth in
Canada balsam. He is right. We have demonstrated years ago
that it is a blunder to mount specimens in Canada balsam. I
heartily and cordially agree with the essayist in every essential
point.

Dr. Allan, — The old Scotch verdict, not proven, which the
author of that paper alludes to, certainly is the verdict not only of
the writer of the paper, but is the verdict of the histologists of the
present day, so far as any direct relationship can be shown between
the contents of the dentinal tubuli and the pulp tissue. But it is
not necessary that the contents of the dentinal tubuli should be
nerve tissue in order to convey sensation. Protoplasm itself con-
veys sensation most decidedly. Any one who has studied under
the microscope the lower forms of animal life, such as the protista

New York Odantological Society. 221

and the monads, will have direct evidence that protoplasm, long be-
fore there has been any differentiation that can be demonstrated by
any microscope, possesses what we woald call sensatory power.
In other words, it seems to manifest life to a certain extent, in ac-
tion, motion, and direction in avoiding obstacles, and in many other
ways ; therefore it is not at all necessary to sappose that these con-
tents of the dentinal tubuli are directly or indirectly nerve tissae,
because in some way they do convey sensation, for that sensation
is a property of protoplasm is a traism that cannot be questioned.

In regard to the reticulum, it is barely possible that, as Dr.
Heitzmann claims, this paper upholds his theory. It is a theory
that I have often invited Dr. Heitzmann to put in my hands
specimens to prove and in which I do not believe.

Dr. George Evans. — ^I have been in Dr. Heitzmann*s laboratory,
and have studied with him. The reticulum that has been discussed
here this evening I have seen distinctly, both in the dentine and
in the enamel, as represented by Dr. Boedecker and Dr. Heitz-
mann.

Dr. Allan, — I know of several besides myself who are exceed-
ingly interested in this subject, men of character and of acknowl-
edged technique; histologists, who are very anxious to obtain
specimens to prove whether this marvellous reticulum exists or
not/ If any gentleman here can put me in the way of obtaining
such a slide I will be very much obliged to him, and will put it to
a good use.

Dr. Atkinson, — In my acquaintance with scientific men I have
met with no one who so entirely captivated me in the demonstra-
tion of what he really sees in the microscope as Dr. Heitzmann.

The point of interest in this paper is to find out what function
is. I think we are nearing it. I was inspired by some pupils that
I had to undertake to show that embryonal tissue made its first
appearance in a neural mass, so that it included all possibilities of
function within it, and the differentiation of that material after-
wards gave us the lay-out of the five tissues that we are so well
acquainted with. I think that little key will unlock the whole dif-
ficulty of the conductivity of protoplasm, and the conductivity of
the same thing when it is in shape of a nerve mass called neurine,
which is nothing less than protoplasm. I think it merely a matter
of difference in verbiage.

Adjourned.

S. B. Davenport, D.D.S., M.D.S.,
Editor New York Odontological Society.

222 BepcrU of Society Meetings,

SEVENTH ANNUAL SESSION OP THE MAEYLAND

STATE DENTAL ASSOCIATION,

(Continued from page 181.)

Ths annual session was held on December 6 and 6, 1889, at the
St. James Hotel, Baltimore, the president, E. P. Keech, ]I.D.y
D.D.S., in the chair.

Thursday, December 5, 1889. — Evening Session.

DIS0U88I0N OF DB. WM. A. MILLS'S PAPER ON ''TOMATO-POISONING.''

Dr. GrindcUl. — Mr. President, I think our friend, Dr. Mills, is
mistaken in ascribing the cause of the trouble to which he refers as
being due to the tomato. It will probably be found that it was due
to calomel, though the difficulty may have been aggravated by the
acid of the tomato. I have known of cases in which patients have
been afflicted in the way spoken of by Dr. Mills, but the cause in
those cases was properly attributable to calomel.

Dr. E. Nelson. — ^I desire to ask Dr. Mills whether he has deter-
mined, by chemical analysis, the peculiar acid in the tomato which
afTected the teeth in the manner he has described, and why it is
that only the teeth of which he has spoken and not the teeth of
other persons were affected ?

Dr. Mills. — That is a conundrum to which I can only answer,
'' I give it up." In the statement I have made I have endeavored
simply to state actual facts. I anticipate, at some future day, to
give a history of the discovery of this disease. I may add here
that the conditions of which I have spoken have, for years, been
very marked in cases among young people. I have treated patients
for the trouble, but did not know at the time what the exact cause
was, and I only discovered it by accident. I have myself lost teeth
from this very disease ; the specimen I have exhibited here being a
tooth from my own mouth. I assume that for that reason I am better
able to judge of the cause of the trouble than are others who have
not had personal experience with it. I lost two teeth in experi-
ments upon myself, and that is why I claim to speak with some
authority. Possibly every member present has had more or less

Maryland State Dental Association^ 223

experience in contending with oases of this kind, without supposing
that the cause was to be found in the tomato. I have watched
very closely the developments in my own case. While on the floor,
I may say that this is only one of many cases of a like character
to which my attention has been called. I propose to detail, at some
future day, the results of my observations in other directions, —
vis., quinine and other poisons.

As I intimated at the outset, I do not propose at this time to
pronounce any decision upon the phenomena, but simply to throw
out the suggestions that have occurred to me, with a view to the
matter being taken up later by some one more capable than myself
of reaching a determination upon it.

Dr. T. S. Waters. — I do not rise to discuss this subject, but merely
to refer Dr. Mills to our friend, Dr. Bawlings, of Lexington, Ky.,
who has written considerable on , the disease, claiming that the
original cause of it is pyorrhoea alveolaris. By corresponding with
Dr. Bawlings, I suggest that Dr. Mills may acquire more scientific
data than he has now to enable him to reach the bottom of the
trouble in what he has spoken of as the tomato disease.

Dr. D. Genese. — The statement of Dr. Mills and the condition of
the tooth exhibited by him, which shows a speck upon it, leaves
the matter plain to my mind as to the cause of the disease being
other than the one he has stated. I happened to come from a
country in which the tomato is a rarity, being almost as rare as the
peach, and yet I found there evidences of the same action on the
teeth which I have seen here. Since residing in this country I
have known people who were accustomed to eat the tomato in its
raw state, as taken from the vine during the season after ripening,
instances of that kind coming under my notice throughout a period
of twelve years, and yet I have not observed any erosion of the
teeth from that cause. In a district which I have been visiting
occasionally for the last year or so, and which is a great tomato-
growing district, there has been serious trouble with the teeth, but
the cause of it has not been attributed to tomato-eating. I visited
some of the cottages there on matters of business other than den-
tistry, and, while there, I found that the attending physician had
prescribed for the trouble with the teeth from three to ten grains
of calomel, to be taken several times a day. You may imagine the
effect of this upon the teeth.

I think that Dr. Mills will find, on close investigation, that the
tomato, as an article of food, is one of the most healthfUl vegetables
we have, and that, if eaten when ripe and in proper condition, the

224 BeporU of Society Meetings.

acid from it is no more deetruotive to the teeth than is the juice of
an apple, the pear, or any other fruit in ordinary use. It is well
known that the strawberry has a very acrid, pungent juice ; and its
effect on the teeth is somewhat peculiar. It will whiten the teeth,
but if yon insert in the mouth a paper test, five or ten minutes
after a quantity of strawberries have been eaten, you will not find
any acid remaining. The same thing may be said of other fruits
from which considerable acid is derived and from which no injurious
effect upon the mouth is apparent.

Before reaching any conclusion on the subject, I suggest that
we await the results of further investigations, made on a more
scientific basis than were those which have been stated ; and the
results we may possibly receive at our next meeting.

Dr. Mills. — I simply wish to put on record the actual facts in
regard to the remarkable conditions to which I have called attention,
60 that, in the course of time, when the matter is again brought up,
it may be known that these facts have been ascertained and stated.
In doing this, I would say that I am not surprised that the theoiy
I have advanced has met with a good deal of criticism. Indeed, I
almost expected to hear it said, after what I have alleged as having
happened in my own experience, that I bad filled myself with
calomel from the crown of my head to the soles of my feet. I know
that such an inference may be drawn from what has been said.
But I also know that there are medical authorities who state that
the action of the tomato on the teeth is exactly the same as that of
calomel. I also know, from what I have read on the subject, that
certain facts have been demonstrated in regard to the effects pro-
duced by tomato eating. It is stated that, since the introduction
of canned tomatoes into the empire of China (about two-thirds of
all the tomatoes put up in the United States are consumed there),
cancer, a disease that was comparatively little known there, has
increased to an extent of from forty to fifty per cent. This is all
attributed to the eating of canned tomatoes. By some it is at-
tributed to the action of the muriatic acid on the solder, forming a
lead salt. Nevertheless, it is our duty to meet facts as we find them.
We have a practical one here. We should keep our eyes open and
deal with these facts fairly and without any preconceived notions
of our own. If the cause of the trouble is in the tomato, let us say
so ; if it is not, let us ascertain that fact.

Dr. B. Orady. — I understand Dr. Mills to state that he wants to
go on record as having discovered the disease known as tomato-
poisoning.

Maryland State Dented Association, 225

Dr. Mills. — Yes, sir.

Dr. Grady. — Bat Dr. Waters has stated that this matter is
already on record ; that it has already been written upon by Dr.
Bawlings.

Dr, MiUs. — With the permission of Dr. Grady, I would like to
ask, Airough the chair, if Dr. Waters can inform me as to the date
at which the writings referred to make their appearance.

Dr. Waters. — They appeared in the Southern Dental Journal
some five or six years ago, and were in reply to articles written by
Dr. Eiggs, of Hartford, Conn., in connection with pyorrhoea areo-
laris. Dr. Bawlings took very strong grounds in support of the
theory that tomatoes were the original cause of pyorrhoea.

Dr. Qenese. — ^The theory of tomatoes causing pyorrhoea must
be regarded as exploded, because pyorrhoea existed in Europe, par-
ticularly in England, long before the tomato was introduced there.

Dr. Mills. — ^AUow me one moment. My statement was that I
simply wished to go on record as to what I say. Of course, if the
gentleman named has written on this subject, he antedates my
statement by two years.

Dr. Ghrady. — By five years.

Dr. Mills. — If it is claimed that he antedates me by five years^
I would call attention to the fact that I have been talking on this
question and speaking to my friends upon it for three years. Now,
I would like to speak upon the treatment of pyorrhoea alveolaris in
general.

Some eight or nine years ago I had a case of a female patient
who was troubled with what is now known as pyorrhoea alveolaris.
The treatment of the patient embraced the usual remedies, — viz.,
Bobinson's remedy, iodine and carbolic acid, the chisel, the gouge,
and chemical compounds. The success of this treatment seemed
to be uncertain, as the patient returned year after year, and I
was almost ready to abandon my efforts in despair of effecting a
cure in the case, which was only one of many like cases. For a
period of twelve months all traces of her were lost. At the expira-
tion of that interval she returned to have a tooth filled. Bemem-
bering the young lady's case, I examined her mouth to ascertftin
what ravages the disease had made, when, to my surprise, I
found that all symptoms of pyorrhoea alveolaris had disappeared.
I questioned her closely as to the remedy she had been using.
She informed me that, having noticed that a cousin of hers in
Washington, whom she was visiting, had beautiful teeth and
healthy gums, she learned that her relative, and the sisters of

16

226 Reports of Society Meetings.

her relative also, had healthy moaths; they for years had been
using as a tooth-powder carbonate of magnesium. Upon their
advice she had, for twelve months, been using the same. She
was conscious of the fact that her gums had become healthy and
her teeth firm in their sockets, but her improved condition did not
specially attract her attention as it did mine. I reflected upon the
case and concluded that, if the fact was as she stated it, the carbo-
nate of magnesium must have made the cure. I then began to ex-
periment with the drug and continued my experiments for several
years. First I used it as a dentifrice, and directed patients to rub
their gums with it at night, before retiring. Observation showed
that from six to twelve months wore required to effect anything
like a change for the better except in some few cases, which re-
sponded promptly in six or eight months. Even in cases in which
a patient would not submit to the operation of having the deposits
removed from around the necks of the teeth it acted promptly.
After further reflection upon a method of improving the prepara-
tion for use as a dentifrice, I tried boric acid in combination with
carbonate of magnesium in the proportion of from one-half to one
drachm of the acid to one ounce of the carbonate of magnesium,
with sufficient winter-green to flavor. This was intended to act as
a powerful germicide and to prevent fermentation. And the prep-
aration has invariably given the utmost satisfaction, my patients
returning after an interval of forty-eight hours and assuring me that
they had experienced the greatest relief.

While I do not assert positively that the application of these
remedies has, in every instance, effected a perfect cure, I am able
to say, upon the assurances of friends to whom I have given the
formula, and who have personally witnessed the results of its applica-
tion, that the action of it has been almost miraculous in producing
a cure. Dr. McDonald told me that with him the remedy worked
most satisfactorily. He did not strictly follow my directions, but
used the formula for injections into the pockets while patients were
at his office, and he expressed himself as being astounded by the
improvement which resulted. So far as my own experience has
gone, I can say that I think we have in these chemicals that which,
if it does not effect a thorough cure, will certainly ameliorate the
disease.

• Dr. Qenese. — ^Mr. President, I had the pleasure of listening to
to Dr. Mills on this same subject some three or four years ago ; and
I am able to say that I have given the preparation referred to by
him a thorough trial in every sense of the term, and have found it

Maryland State Dental Association. 227

wanting. It has no effect upon teeth affected by pyorrhoea other
than that which plain water would have. The carbonate of mag-
nesium is insoluble. It will glide over the deposits upon the teeth
and leave them just as they were before. In pyorrhoea we have
an insidious disease that lies far below the surface. The prepara-
tion produced by Dr. Mills will not cure that disease, for the reason
that the disease lies at a point beyond that which the preparation
reaches.

I am indebted to Dr. Adair of the Southern Dental Association
for an idea contained in an article in one of the numbers of the
Southern Dental Journal, and which I have put in practical opera-
tion and have found to be exceedingly valuable in practice. I
cannot remember the date when it appeared, but the substance
of the article is that he advises, in these cases of pyorrhoea,
and particularly where we have that condition in which pus is
oozing around the gum margin, to flatten a piece of platinum,
bringing it to a nice shape, then taking away all but the point, and
leaving the shaft so fine that it will not injure any part with which
it comes in contact. This is then heated somewhat, but not
too hot. It is then dipped down around the teeth, between the
cementum and the gum-lining. You thus cause the destruction of
the tissue, though only to a very slight extent. Dr. Adair claims
that the reaction in the deposit, the fresh tissue in the place of that
which is destroyed by the cautery, will cure the pyorrhoea. Not
very long ago I saw a practical demonstration of this. I have
tried it in two cases, and they have succumbed entirely to the treat-
ment. One of them was that of a long-standing fistula of the
superior maxilla, with pyorrhoea extending fh>m the central incisor
to the first bicuspid. All the other teeth were gone. The entire
treatment was confined within a period of about three weeks, when
the patient reported himself as cured.

Dr. Mills. — I am rather surprised to hear Dr. Genese make the
statement which he has just made. He is on record as having, on
several occasions, recommended carbonate of magnesium for pyor-
rhoea alveolaris. In another place he is on record as recommending
boric acid, carbonate of magnesium, and chalk. As this preparation
was originally suggested by myself, and as I have heretofore spoken
about it, I thought that Dr. Genese would give me the eredit for it,
just as he has given credit to Dr. Adair for his preparation for the
tr^tment of pyorrhoea. I am surprised that he should come here
to-night and say that he had found it to be unsuccessful and of non-
effect, particularly as I stated at the outset of my remarks that,

228 Reports of Society Meetings.

with the magnesia alone, an interval of from six to twelve months
was required before any decided effect or improvement would be
shown.

I believe that magnesia is a splendid thing to use in these cases,
and my belief has been strengthened since I have been reading on
the subject. I believe, too, that pyorrhoea alveolaris, so called, is
nothing more nor less than an anemic condition of the tissues sur-
rounding the teeth, and that magnesia (having an affinity for iron in
the blood) carries the blood corpuscles to the parts and the surround-
ing tissues and builds them up, producing a healthy action and flow
of blood. Boric acid, being a germicide and an antifermentative
as well as the winter-green, simply adds more strength to the
compound.

Dr, Qenese. — I wish to say l^hat I may have mentioned these
preparations at the meeting of the Southern Association, or at one
of the Northern meetings, simply as remedies untried. If my
memory serves me, I made that statement shortly after the meeting
at which Dr. Mills had recommended these preparations. As I
have now tried them for three years, I am able to speak experi-
mentally. I believe you all know the action of magnesia, and I
will ask you, as scientific men, whether, in your opinion, magnesia
is going to have any effect upon the lining membrane of the gum
tissues or on the teeth when they are attacked by pyorrhoea, as
claimed by Dr. Mills. It is known to you that we must first have
mechanical action to remove the deposit, and then we must have
some pungent preparation or antiseptic to do away with the pus
formation.

Dr. A. J. Vokk, — ^I desire to mention a case of a lady, a native
of Bermuda, who was in this city on a visit during the summer
and remained during the following winter. She came to my office
some time in September. Hers was one of the most pronounced
cases of what is called pyorrhoea alveolaris. It occurred to me at
the time to try the remedy which Dr. Mills had spoken of once in
our meeting. I sent to that gentleman for tlie prescription, and he
very kindly gave me a copy. I applied that remedy in the case of
this lady, and continued to apply it for about seven weeks, when
the treatment proved to be entirely successful. I was profoundly
impressed with what I saw of the promptness with which the
disease yielded to this treatment. That case is the only one in
which I have seen this treatment made use of. I have no doubt
there are cases in which it may be used successfully.

The lady remained here for some three or four weeks after the

Union Meeting of Dental Societies. 229

use of the remedy was discontinued, and I saw no unfavorable
change in her condition and no indication of a relapse. She sup-
plied herself with the preparation for her future use in the event
of a return of the trouble. I directed the patient to rub it into
the gums and around the teeth, particularly in the evening, before
she retired, and to allow it to remain there. I also instructed her
to use it as a tooth-powder during the day, as she had opportunity.

The President — Is the formula for that powder the one that has
been stated by Dr. Mills ?

Dr. Volck. — The formula is the same.

The discussion of the subject here closed.

UNION MEETING OP THE CONNECTICUT VALLEY
DENTAL SOCIETY, THE NEW ENGLAND DENTAL
SOCIETY, AND THE CONNECTICUT STATE DENTAL
ASSOCIATION, AT SPRINGFIELD, MASS., OCTOBER
23, 24, AND 25, 1889.»

(Continued from page 167.)

DISCUSSION OF ''PRACTIGAL POINTS IN DENTAL PATHOLOQT AND

THEBAPEUTI08."

Dr. 0. A. Brackett. — In opening the discussion of this subject,
it was my purpose to speak briefly of one or two classes of
cases that are not the most satisfactory of those that come into
our hands for treatment. Most of us have patients fh)m the
higher walks in life, patients of abundant means and of best dis-
positions in caring for their dental organs themselves. We also
have patients that are the reverse of this; and then we have
all grades of character between these two extremes. Probably
very few of us escape having patients for whom sacrifices are
made of organs that ought to have been attended to. The patients
regret these sacrifices, and we regret them, and would gladly
change the circumstances that decide these things, if we could. It
may be of frequent occurrence for a patient to say, '^ I have teeth
which I would like your advice on. They have given me a good

^ Reported for the Intxbkational Dental Joubkal by G^. A. Maxfleld,
D.D.S., Holyoke, Mass.

230 Reports of Society Meetings.

deal of trouble, but I would like to have them filled and saved."
The patient is not abundantly blessed with means, or has not had
time ; and these are the difficulties of the situation. It seems to
me that here is an opportunity to do some of the most profitable
work. If not with that tooth, then with reference to the other
teeth ; and if not for that patient, then for the friends and family
who will be influenced by that patient to come to you. We then
can say to this patient to this effect: "These teeth have been
neglected most sadly, permitted to ache, to ache repeatedly, to
ache until you could no longer tolerate it, and you are forced to
ask my assistance in saving them for you. It is most desirable
for you to save these organs. I shall be happy to use my very
best efforts possible to restore them to usefulness ; but you should
clearly unde^tand these facts : that every hour's pain, of suffer-
ing endured with exposed pulp, in its present pathological state,
which adds to the uncertainty of the results of my efforts, and
to the lessened usefulness of the teeth to you in the fiitare, has
placed certain difficulties in the way. In order to get the teeth
back to their normal condition you have got to retrace all the steps
that have been taken. If they have been aching only a few hours,
my work is comparatively easy; if at intervals of weeks or of
months, my work is complicated, and it will consume a great deal
of your time and be of greater trouble to me."

This can be explained to the comprehension of the intelligent
patient who has the disposition to do the right thing ; and is an
opportunity for us to be very useAil, to explain to patients the de-
sirability of giving the dentist an opportunity to exercise his skill
under the most favorable circumstances. The patients are not to
blame for doing as they do. The judicious saving of the natural
teeth is of the greatest importance. We do see instances in which
the patient comes to us and asks to have a molar extracted; that
is the only substantial bulwark they have in holding the jaws to-
gether correctly. We see the unfortunate disregard that has led to
the extraction of all the molars on the upper and lower sides of
the mouth. It seems a matter of the greatest importance.

Another class of unsatisfactory patients that comes to us consists
of children with aching deciduous teeth, and on this subject I would
be glad to be instructed myself. There is hardly a patient who
comes in my office that I have more dissatisfaction with than chil-
dren from poor, ignorant families who are suffering pain from
exposed pulps. The child is suffering, and there is not the under-
standing, time, money, or disposition to make conservative opera-

Union Meeting of Dental Societies. 231

tions. In some familieB, if the temporary teeth were cared for in the
best possible way, it would absorb all the bread earnings of the family.
In these cases I know no other way than to pursue the one that
does the least harm. If I can keep the temporary tooth in its
place, I like to do it. If I can make applications myself, I will do
BO. It may be a case that needs local depletion, or if an extreme
case, it may need the application of caustics. If I could not do
better, and feeling especially that the second set of teeth would
have no more care than the first set was having, and that the
molars would be sacrificed at an early age, as the easiest way out
of difficulties, — the children need rest from pain and the parents
need their sleep, — I should feel justified in extracting the tooth.
It would be a matter of choice of evils. If there are other ways to
.get out of these difficulties, and if any others have suggeeticms to
make, I shall be glad to learn about them.

Dr, E, A. Stebbins. — Is there any objection to putting arsenic in
a temporary tooth ?

Dr. Brackett — ^I have not the fear of arsenic that many men
have. If I were sure I was applying it to an exposed pulp and not
to a perforation in the division of the roots, and have s^ed it in
to my satisfaction so as not to come in contact with the gum, I
should have no fear whatever. , In such cases as ordinarily exist, I
should make the time of application as short as possible. I have
no hesitancy whatever in using arsenical paste. We know that
in nineteen out of twenty of these cases the pain is inside of the
cavity in the temporary molar. Very likely the gum is growing
into the cavity. The sealing of the destructive paste in these
cavities must be done very carefully. I seal it with that which
I think will make the sealing most secure, — gutta-percha or
whatever else will do it In regard to the pain, it depends on
when the arsenic is applied; and the way in which that treat-
ment is received will depend upon the state in which the pulp
has been. In a pulp that has been exposed for months to all
manner of irritation, no ordinary means of relieving pain will at
all suffice. '^ There is no peace for the wicked" until destruction
has been accomplished. All means will fail ; you may keep your
patient for hours, and yet the pain does not cease. In an instance
of that kind you may apply arsenic and have everything comfort-
able quickly. That pulp is in a state of low vitality, and to my
mind the arsenic just pushes it over. On the other hand, if you
apply the arsenic to a recently exposed pulp in a large molar of a
vigorous person, you get an entirely different result.

232 Reports of Society Meetings.

Dr. Maxfield. — What would be your treatment of temporary
teeth after applying the arsenic ?

Dr. Brackett, — That must depend on all the circamBtances of
which I have been speaking. Try to d6 the best under existing
circumstances. In many cases, after removing the arsenic, that is
all we can do for the teeth. The parents who would do nothing
for the care of their own permanent teeth will do nothing for the
children's temporary teeth. If you can make everything clean and
wholesome, and fill them, by all means do it ; and if you cannot,
then do as well as you can. If we are to speak of the best thing
to do for temporary teeth, in cases of this kind, it would be the
removal of the destroyed pulp, and thoroughly to disinfect the
canals and cavities. We may be justified in filling the cavity and
providing an exit, which is an objectionable thing to do with perma*
nent teeth. The circumstances may be such that we may think
this is the best way out of the difficulty.

Dr. N. Morgan. — What do you fill the canals of temporary
teeth with ?

Dr. Brackett. — If I can clean them to my satisfaction, and have
everything in a healthy state, I fill with a solution of gutta-percha
in chloroform.

Dr. Stebbins. — Between what ages would you apply arsenic to
the temporary teeth, — or does age make any difference?

Dr. Brackett. — It does make a difference. If the age approachee
the time for these teeth to be lost, there is less occasion for using
anything in the roots, whose absorption has already commenced.

Dr. W. F. Andrews. — I would like to know whether a tooth is
more liable to pain if the arsenic is put in without uncovering the
pulp or less liable by freely uncovering it ?

Dr. Brackett. — The instance must be very rare where it is neces-
sary to place arsenic in a tooth when there is no exposure. I
should say it is best always to uncover the pulp.

Dr. Stebbins. — ^Did you ever see any difficulty in the develop-
ment of the permanent bicuspid where arsenic has been placed
in the temporary molar?

Dr. Brackett. — Never saw or heard of such an instance.

Dr. St^bins. — When a person comes to you with a permanent
tooth aching, what are the indications warranting you to devitalize
the pulp ?

Dr. Brackett. — I am guided first by the history of the case.
The longer the tooth has been a source of offence, the less the
chances are for successful capping. Besides the history of the case

Union Meeting of Dental Societies. 233

that the patient gives me is the appearance of the pulp as I investi-
gate. A great failnre in our treatment of exposed pulps has been
in not discriminating as to its condition in the great range of the
pathological state in whicfh the exposed pulp may be. If the pulp
were as large as the finger, and we could see the extent of the
inflammation, — and ninety-nine out of every hundred commence
in this pathological state, — we would not treat them so indis-
criminately as we have in the past. There are individuals for
.whom you may cap an exposed pulp with about as much certainty
of success as you fill an ordinary simple cavity. There are, we
may say, governing circumstances that almost in themselves guar-
antee any pulp-capping, if the right conditions are observed.
There are patients for whom any attempt at pulp-capping will be
sure to result disastrously.

Dr. A. H. Gilaon. — ^I am particularly interested at this time in
what Dr. Brackett has said, as he has given us very good advice
aboitt how to treat these cases. I have a case which I would like
to speak of. A patient recently came to me, and on examination
I found a pulp which was very nearly dead. I treated this tooth
to the best of my ability, and she came back the next day for me
to finish filling the tooth, and in the mean time the tooth had not
given her any trouble. When she left me I cautioned her not to eat
any ice-cream or drink any ice-water; I afterwards found out that
she went directly from my office and had a sherbet. On Sunday,
which was two days after, she came out to my house, her face
being badly swollen, and, as I had nothing at my house to treat
teeth with, I tried to get her to go to a dentist up-town who would
relieve her. She would not do this, but insisted on my going in to
Boston, to my office, to attend to her. This I positively refused to
do. She went off quite in a huff, and the next day I received a
letter from a lawyer saying I was to be sued for malpractice, and
I expect the sheriff at my house when I return to serve the writ.

To protect myself, I have had to place all my office fixtures,
etc., out of my hands so as not to have a keeper placed there.
This case will be tried before a jury, and if they defeat me, I can
appeal to a higher court.

This is a question that concerns us all, as we are all liable to be
tripped up in this manner. She says I caused the pain. What is
there that we do that does not cause pain ?

I would like to ask Dr. Brackett if he has noticed any differ-
ence in the development of the enamel of the bicuspids caused by
the application of arsenic to a temporary tooth ?

234 Reports of Society Meetings.

Dr. Brackett. — I, of course, shall admit that this may be pos-
sible. I have heard of half of the tongue being destroyed from
the same cause ; but I have never known of any instance of the
kind.

Dr. Stebbina. — Will you give us your formula of arsenical paste?

Dr. Brackett. — I modify it in all manner of ways. Ordinarily, I
use the preparation that White sells. Sometimes I use the dear
arsenic, modifying it with the addition of acetate of morphia, oil
of cloves, and various modifications that seem to me most likely to
make the application with as little affliction to the patient as
possible.

Dr. S. 8. &ou)ea.—I would like to ask Dr. Brackett if he would
make any distinction in applying the arsenic, whether the pulp was
in a state of inflammation or in a state of rest? When it is in the
state of inflammation, as we understand it, it is not capable then
of absorbing the drug, and great pain is caused if applied at that
time.

Dr. Brackett. — In any case where it is decided to destroy the
pulp, I should first endeavor to relieve the pain ; and to do this I
would first treat with anodynes. If that failed, I would apply the
arsenical paste. This condition, I apprehend, to be a condition of
acute inflammation, accompanied with severe pain. In such a case
as this, if I did not deem it advisable to apply the arsenic, I would
try agents that would lessen the pain, to give opportunity for the
inflammation to subside. If I deemed it best to apply the afsenic,
and this being seriously painful, I would ask the patient to endure
it only for a limited time. I would tell the patient to come back,
if the pain was so severe he could not bear it, and I would take
out the arsenic, and try the effect of an anodyne. An application
for a limited time in this way will relieve the pain. It may not be
successful immediately, but in a short time jthe pain will subside.
So within an hour after you take out the arsenic your patient will
be comparatively comfortable, and you can then r^lace the arsenic
without having much more suffering.

Dr. Miller. — How long before the pulp will die?

Dr. Brackett. — I know of no therapeutic circumstance more
uncertain than this. The pulp may be dead in a few hours and
perhaps not in six months. I knew of an instance that came under
the hands of one of Boston's best practitioners, for whom I have
the highest respect, and one whom you all know. He tried most
determinedly for two years before being successful in destroying
a pulp. I have no hesitancy in leaving the arsenic in the tooth.

Itcdian Odontological Society. 235

provided it i« properly sealed in. SomettmeB we meet oases where
a large portion of the pulp is dead, yet portions remain in the i^ex
of the root that are a source of pain to the patient. This sBiall
fragment is a cause of dissatisfaction and discomfort so long as it
exists. I would in such a case as this place the arsenic in the
canals. I have, in teeth of a dense, hard structure, made applica-
tions for nine months before being able to destroy the pulp. It is
a principle with me to carry the destructive agent against the tissue
which it is intended to destroy.

Dr. Stebbins, — How long a time between the applications in the
nine months ?

Dr. Brackett, — I should be guided by the case. If a greater
portion of the pulp has been destroyed with a great deal of dif-
floulty and had extended over considerable time, and I have to
make an application to destroy the remainder, after a week take
oat the dressing. If no progress has been made, try again ; and
after two or three weeks the progress has been slight, the next
time leave it a longer interval. If my sealing is secure, I am sat-
isfied to leave it for a long period. Another poiftt is, the palp may
seem to have vitality left, as you first attempt to remove it, but
-oftMi with a little persistence you can get it all away and avoid a
second application.

(To be continued.)

CONGRESS OP THE ITALIAN ODONTOLOGICAL

SOCIETY.*

Aftxb a lapse of five years the Sixth Congress of the Italian
Odontological Society, that was to have been held in Bome in 1884,
was held in Genoa, in the rooms of the ^' Societa di Conversazioni
Scientifiche/' on the 1st and 2d of November of last year.

Two meetings were arranged for each day, — ^from 10 ▲.x. until
12 m. and from 2 to 4 p.m. The president, Dr. Campani, being
absent, the vice-president, Mr. C. W. Dunn, senior, of Florence,
took the chair. With the usual formalities the Congress was de-
clared open, and the vice-president pronounced the inaugural
address, expressing at the same time a vote of regret for the
president's absence on account of ill health. Twelve new members

* Beported by William ]>unn, Jr., D.D.S., Florence, Italy.

236 Reports of Society Meetings,

were proposed and accepted, after which the Hon. Secretary, Mr.
C. S. Bright, of Genoa, proposed some modifications of the then
existing statute, — that the Congresses should be h^d yearly, and
that the officers should be appointed from among those present ; the
modifications were passed after some discussion.

The first thesis was read by Signer Ballerio, of Milan, "On
Secondary Dentine and Nodular Calcification." Signor Ballerio
finds that in each case the calcific deposit is due to a slow and
constant irritation, but whereas it is physiological in the formation
of secondary dentine, the process is pathological when it results in
nodular calcification.

Dr. Schaffner, of Florence, concurred in Signor Ballerio's ideas.
He thinks that if it were possible, by extremely delieate manipula-
tion, to remove the odontoliths from the pulp, the pulp would
return to its normal condition. He agrees that such an operation
is, for the present, purely theoretical, never having been accom-
plished. The safer way is slowly to devitalize and extirpate the pulp.

The next paper, by Mr. C. S. Bright, " Whether it be Well to
leave Decalcified t>entine or not," was ably handled by the gentle-
man. He recognizes the advisability of preserving the pulp, even
if only a few filaments are left, and therefore would leave decalci-
fied dentine in a cavity if it were protecting a pulp. The decalcified
dentine can be well disinfected and often is recalcified later on by
the pulp.

Signor Damiano Mela, of Genoa, would make a difference be-
tween cases. In some cases decalcified dentine, well disinfected, is
the best protection for the pulp, which recalcifies it in time ; but in
some cases the pulp dies under the decalcified dentine, and an
abscess may be established. He does not think disinfection neces-
sary if the cavity be perfectly dry.

Dr. Schaffner thinks that, once a tooth is well formed and
calcified, its pulp is not of such great importance to it. He recounts
a case of one of his own teeth which, under a nitrophosphate filling,
was quiet for seventeen years ; later on he suffered from an irrita-
tion of the ciliary nerve, which passed away when the tooth was
unstopped ; refilling the tooth brought on the trouble again, and
finally the pulp was devitalized. He is now circumspect in pre-
serving pulps, and prefers to destroy in dubious cases rather than
run the risk of a chronic irritation or neuralgia. He mentioned
how, according to Miller's latest researches, micrococci precede
decay, almost into the healthy dentine, and that therefore it would
be extremely difficult to sterilize perfectly any sofbened dentine.

Italian OdontologicaX Society, 237

The meeting was adjourned till the afternoon.

Signor Ballerio, of Milan, presented the next thesis, — ^^ Ortho-
dontia." The greatest number of irregularities treated are in the
upper incisors and cuspids, the difficulty was to find a fVilcrum from
which the force could be exerted, and to find a fixed point on the
tooth to be moved on which to exert the force. Complications
arose in the shape of the arch and teeth, the articulation, the
crowding of teeth, and the state of the gums and mouth; this
opened the discussion, which was animated ; special cases were
described by Dr. Carreras, of Leghorn, and Signor Solari, of
Sologna.

The rest of the afternoon was occupied by discussions on the
new dental law to be proposed, — that all those desiring to practise
dental surgery in Italy must be doctors of medicine. It was decided
to telegraph to His Excellency, the Minister of Public Instruction,
to thank him for the interest he had taken in raising the standard
of the profession in Italy, but to beg that he would consider the
modifications the society would offer, — that is to say, to restrict the
time of education from seven to three years.

At half-past six the forty and more members met for the social
dinner at the Restaurant della Concordia, where good humor
reigned throughout. The king, queen, prince, ministers, and
president were toasted.

The next morning was occupied by theses, — "Disinfection," by
Signor Ballerio, and " PyorrhoBa Alveolaris," by Mr. Bright. Both
were discussed ; much was said about Signor Damiano Mela's
treatment of pyorrhsea alveolaris with finely pulverized sulphate
of copper, which seems to be very successful.

A very interesting communication from Professor Miller, of
Berlin, was read, on "The Antiseptic Properties of Filling-Ma-
terials."

Dr. Miller fully explained two methods of testing the antiseptic
property of filling-materials ; one by dropping pieces of the filling
in a growth of fungi, and the other by using decayed dentine that
had been under fillings for some days. As the result of these ex-
periments he comes to the conclusion that copper amalgam has the
most marked antiseptic effect of all fillings ; and that amalgams are
more or less antiseptic in their action according to the proportion
of copper that they contain. Some preparations of non-cohesive
gold are markedly antiseptic in their action ; this action disappeared
as soon as the gold was annealed, and for this phenomenon Dr.
Miller can as yet find no explanation.

238 Beports of Society Meetings.

The afternoon was passed in demonstrations. Mr. Dunn showed
his adaptation of the ether spray and compressed air for painless
operations on and about the teeth.

Dr. SchaiTner showed a new saliva-ejector, of his own invention,
and an automatic mallet to be worked by compressed air, which
acted beantifally.

Signer Mela showed casts of irregularities, most noticeable
among which was the model of upper maxilles with five permanent
molars on each side.

Dr. Herbst, of Bremen, sent some very interesting specimens of
his fillings by the rotary method, and other specimens of his
system of glass crowns and inlays.

Enamel and porcelain inlays were shown by Mr. Dunn, of
Florence, and several samples of mechanical work were contributed
by Signer Solari and Signer Casotti, of Leghorn.

Drs. Miller and Herbst were unanimously elected honorary
members.

The next Congress will be held at Turin.

THE AMEEICAN DENTAL SOCIETY OP EUROPE.—
SEVENTEENTH ANNUAL MEETING, PARIS, AUGUST
6 AND 7, 1889.

First Day's Proceedings. — Morning Session.

The chair was taken, at ten o'clock, by Dr. W. St. G^rge
Elliott, president.

BEPORT OF THE MEMBERSHIP COMMITTEE.

Dr, Elliott, — Gentlemen, I want to apologise for the delay this
morning. I came here at 9.30, but as I left the minutes of the
last meeting at my boarding-house, which is near the Arc de Tri-
omphe, I was obliged to return there and get them. We will com-
mence the meeting by calling the roll, when Dr. Patton, the secre-
tary, will read the minutes of the last meeting, which he proposes
to do in a condensed form. I should like to have your opinion on
the matter, if that proceeding will be agreeable to you ? Our last
secretary took the minutes in detail, but he had not apparently
the time nor the inclination to write them out afterwards.

American Dental Society of Mirope, 239

It was agreed that the minutes should be read in a condensed
form as suggested.

The call of the roll.

Members Present, — Br. L. C. Bryan, Basel; Dr. J. W. Crane,
Paris ; Dr. I. B. Davenport, Paris ; Dr. C. V. Du Bouchet, Paris ;
Dr. W. St. Geo. Elliott, London ; Dr. P. Porster, Berlin ; Dr. N. S.
Jenkins, Dresden ; Dr. W. D. Miller, Berlin ; Dr. W. E.' Patton,
Cologne ; Dr. Ed. Bosenthal, Brussels ; Dr. W. Sachs, Breslau ; Dr.
Hoffmann, Wiesbaden ; Dr. Schaffner, Florence ; Dr. I. H. Spauld-
ing, Paris ; Dr. A. Wetzel, Basel ; Dr. N. W. Williams, Greneva ;, Dr.
Chas. Adams, Leipsic ; Dr. Fred. Merrill, Milan.

Ghuests Present, — Dr. Bonwill, delegate of Odontological Society
of Pennsylvania ; Dr. Warrington Evans, Washington ; Dr. Bosen-
thal, Sr., Liege, Belgium ; Dr. Thomas, Yilbon, Spain ; Dr. W. E.
Boyce, Tunbridge Wells, England ; Dr. Mitchell, London ; Dr. A.
C. Hugenschmidt, Paris ; Dr. C. Agabey, Athens, Greece ; Dr. F.
Du Bouchet, Paris ; Dr. Theo. Frick, Paris ; Dr. G. C. Daboel, Paris ;
Dr. C. P. Terry, Milan ; Dr. L. A. Obrian, Jr. ; Paris ; Dr. W. F.
Kelsey, Marseilles; Dr. E. A. Bpgue, New York; Dr. F. C. CoUett,
New York.

Dr. Elliott then greeted the guests, thanking them for their
presence, etc.

The guests then retired, while the members attended to the
official duties of the society. On conclusion of the same. Dr.
Elliott opened the professional duties of the meeting.

Dr. Mliott. — Dr. Miller has some preparations with him, and it
is very desirable that we should have them at once. I would also
say that Dr. Bonwill is here, and he and Dr. Mitchell have pro-
posed giving clinics. Dr. Du Bouchet has been kind enough to
offer facilities for doing so. Most of us, of course, are interested
in the exhibition ; but still there may be some members who
may perhaps be sufficiently interested to stay for the clinics.
Dr. Mitchell proposes to put on a crown, and Dr. Bonwill, par-
ticularly, wishes to speak about his articulator and to exhibit his
instruments.

Dr, Miller. — I think he has already been invited by the Execu-
tive Committee.

Dr. Crane, — ^I spoke to him personally about it, as being the
only member here.

Dr, Elliott, — ^He wished to give a clinic in London, but I rather
dissuaded him from it, as I knew there would not be sufficient
general interest to get an audience.

240 Reports of Society Meetings,

Dr. Miller, — He gave us a clinic in Berlin, and I think we bad
one hundred persona present, mostly students.

Dr. Elliott. — I will ask Dr. Miller to give us his communication
on the antiseptic action of filling-materials.

Dr. Miller. — Grentlemen, I wish to demonstrate some culture
experiments, showing the antiseptic action of different filling-ma-
terials. It will scarcely be questioned by any one that, in a great
many cases, if not in all, the probability of success in filling teeth
would be greatly heightened if the filling-material could be made to
exert a permanent antiseptic action upon the walls and margin of
the cavity. I have tested a great number of different filling-ma-
terials, in order to ascertain whether they exert any antiseptic
effect ; and I have found one material which possesses this action
in a high degree, — that is, copper amalgam.

I have employed two different methods for testing the antiseptic
action of filling-materials. By the first method I inoculate a tube
of ordinary nutritive gelatine with a fungus which grows rapidly
at room temperature without melting the gelatine. I liquefy the
gelatine and pour it upon a horizontal glass plate. While it is still
soft, I drop into it pieces of the filling-material whose antiseptic
action is to be tested. A plate so prepared usually becomes cloudy
in about twenty-four hours through the development of innumerable
colonies of bacteria. If, however, the material possesses an anti-
septic action, no fungi will develop in its vicinity, and it will con-
sequently appear surrounded by a zone of transparent gelatine.

In this manner I have tested nearly all the filling-materials now
in use. I have found that copper amalgam possesses considerable
antiseptic action. Not only freshly mixed amalgam, but even very
old fillings and pieces of dentine from teeth which had been filled
with copper amalgam, show strong antiseptic action. Gold amal-
gam possesses very little, and in most cases no action whatever.
Phosphate cement, freshly mixed, is very slightly antiseptic ; old
fillings have no action. Gutta-percha, as naturally suspected, is
inactive.

These facts you will see clearly demonstrated on the plates
which I now show you. You will also notice that I have strown
some iodoform on one of the plates, and that the growth of bacteria
has not thereby been interfered with in the least. It is a very re-
markable phenomenon, which I am not able to explain, that certain
preparations of gold also appear to be antiseptic. Pack's pellets,
quarter-century gold foil. Abbey's foil, are all of this character,
whereas other preparations which I have examined exhibit no anti-

American Dental Society of Europe. 241

septic action. All preparations of gold lose their action on anneal-
ing. It has been supposed that this property of the gold is brought
about by something added to it during the manufacture, or that the
gold accumulates oxygen upon its surface, which, as we know,
sometimes exerts an antibacterial action.

Another, perhaps more instructive, method of showing the anti-
septic action of filling-materials is the following : Take a number
of teeth extensively decayed, in which the pulp is, however, pot
exposed, excavate partially so as to leave a considerable quantity
of carious dentine in each cavity ; fill the cavities with the different
materials to be tested, and put the teeth in a mixture of saliva and
bread, where they should remain for some three days ; then remove
the teeth from the mixture, wash them and dry them and remove
the fillings. The filling is most easily taken out by placing the
orown of the tooth upon an anvil and giving it a short tap with a
hammer ; the filling usually flies out, exposing the untouched sur-
face of dentine. Now remove a small particle of the carious den-
tine with a sterilized instrument, place it upon a sterile plate of
nutritive agar-agar, then put the plate in a moist chamber at a
temperature of about 38° C. In the course of two or three days
the piece of dentine will be found to be surrounded by a whitish
growth of fungi. If, however, the filling-material has exerted such
an antiseptic action upon the dentine as to devitalize the fungi, or
if the dentine has taken up a sufficient quantity of the antiseptic
agent in the filling-material to become itself antiseptic, then no
growth of fungi will form around the piece of dentine.

Having tested nearly all of the ordinary filling-materials by this
method, I have found that pieces of dentine, taken from a tooth
which had been filled with copper amalgam, never show any de-
velopment of bacteria when brought upon the culture-plate, whereas
pieces taken from teeth which had been filled with gold amalgam
have invariably shown a fine growth of bacteria. The same is
also the case with teeth filled with gutta-percha, with phosphate
cement, and with tin-gold. In nearly all cases pieces of dentine
from teeth filled with oxychloride of zinc have also given rise to a
development of fungi, much less profuse, however, than that which
forms around most other filling-materials.

From these results, it is very clear that copper amalgam exerts
a very powerful antiseptic action upon the walls of the cavity con-
taining it, and that there is no doubt that it thereby contributes
greatly to prevent the recurrence of caries under the filling.

The idea that the combination of tin and gold is antiseptic is

16

242 BeporU of Society Meetings.

utterly fallacious, and the recommendation of this combination for
filling root-canals, on the ground that it destroys micro-organismB
by galvanic action, is unscientific and unfounded. It is a well-
known fact that strong currents of electricity are required to exert
any marked action upon the development of bacteAa. We might,
for instance, kill an oz by means of a shock of electricity, without
doing any harm to the bacteria, which might be in him. I speak
of this in particular because I know of more than one gentleman
who has adopted the practice of filling root-canals with tin and
gold, with this object in view.

DISCUSSION.

Dr. Elliott.-^l would like to ask Dr. Miller whether these experi-
ments do not go to prove that bacteria are the sole cause of the
decomposition of the root-canals; generally speaking, we only
consider it one of the causes ; those who have had much to do with
copper amalgam know that it does not stop decay.

Dr. Miller. — The antiseptic action of copper amalgam may
diminish or cease altogether in the course of time. I only mean to
say that, other things being equal, copper amalgam will prevent
decay longer than the ordinary amalgams. There is no means by
which a pulp can be decomposed except by bacteria. In caries the
decomposition of the softened dentine is caused by bacteria; being
an albuminoid substance, it is dissolved by the bacteria, just as
an egg is dissolved in the stomach by the pepsin.

Dr. Elliott. — I think the most important factor is in the defect
of the teeth, in construction, and has nothing to do with bacteria;
otherwise, how could people who are not cleanly go through their
lives without decay ?

Dr. Jenkins. — I should like to state that what Dr. Miller has ar-
rived at, we, many of us, have also arrived at in a practical way.
Most gentlemen have had very similar experience in regard to the
untrustworthy nature of iodoform, and I am glad to hear Dr. Mil-
ler make this statement in regard to tin and gold ; for he is one
of those who thoroughly advocates the proper use of it. I believe
those who have had the widest experience, claim for it only its ad-
vantages as a mechanical stopping. I should like to ask Dr. Miller
if he has made use of the experiments which he has shown us, with
oxychloride of zinc ?

Dr. Elliott.— There is a general impression in the profession that'
the iodoform is decomposed.

Dr. Mitchell. — Mr. President, I don't know, but I must rather

American Dental Society of Europe. 243

correot our president in regard to the decomposition of iodoform ;
that can be very easily established by using a hot-air syringe. The
iodine can thus be liberated, and the reaction found there by the
starch test. I have given my method of using it, placing a pledget
of cotton saturated in alcohol and iodoform, and then throwing the
hot air from the large bulb syringe through the cotton ; this liberates
free iodine.

Dr. Mliott. — Of course the only inference is, why not use iodine
direct ? The strongest tincture of iodine is the " Dental Tincture,"
recommended by Dr. Fiagg, of Philadelphia.

Dr. Miller. — In answer to Dr. Elliott, let me say that we know
by experience that caries does not take place on the exposed sur-
faces of the t^eth, but we find caries appear in fissures and secluded
spaces in teeth where the food lodges and where the fluids of the
mouth do not circulate ; consequently, the acids most active in caries
cannot be those introduced into the mouth with foods, etc., but
those formed within the mouth by fermentation.

Dr. Elliott speaks of the fissures in enamel and defects in de-
velopments of the teeth, etc. ; these are what we call t\iQ predisposing
causes of caries ; they play a great part, and improperly developed
teeth will become carious much sooner than teeth which are of good
structure. We know very well, however, that cracks and fissures
can never act as exciting causes of caries.

Dr. Elliott also mentioned that people who never cleaned their
teeth are frequently exempt from decay. This, however, cannot be
taken as proof that it is not advisable to keep the teeth properly
clean, because in some cases the teeth are of such perfect structure
that they do not become carious in spite of the uncleanliness.
Moreover, it is a fact, especially with people who consume an excess
of nitrogenous food, that, when the uncleanliness goes so far that
putrefaction of the remains of food takes place, then we do not
obtain an acid, but an alkaline reaction ; and in this case, of course,
we could not expect the occurrence of caries. It is for this reason
that fiesh-eating tribes — for instance, the Esquimaux — ^very rarely
suffer from caries, because the food which they consume is such
as does not give rise to acid reaction by fermentation. These
flesh-eating tribes are less troubled with caries than the common
house-dog.

In considering the subject of caries there are, of course, a vast
number of different factors, predisposing as well as exciting, which
must be taken into consideration, before we can come to a proper
conclusion as regards the nature of dental caries. It would, how-

244 JReports of Society Meetings.

ever, lead us too far to enter into a discuBsion of this question at
present. In regard to the question of Dr. Jenkins, I have tested
oxychloride of zinc, and have found that in the fresh state it
possesses considerable antiseptic action ; it ceases to be antiseptic,
however, soon after it has thoroughly hardened.

Dr. Mitchell. — I would like to ask Dr. Miller how he accounts
for the preservation of teeth by gutta-percha ?

Dr. Miller. — Gutta-percha fillings, if properly made, will exclude
all particles of food from entering. Spaces do not form between
the filling and the wall of the tooth where gutta-percha has been
used, consequently fermentable substances cannot enter.' We do
not get the acid which must be there always before the dentine can
be decalcified.

Dr. Elliott. — There is a peculiarity in regard to that. We know
that an infinitesimal defect in a gold filling is fatal.

Dr. Miller. — If we have a small leakage in a gold filling, there
is a tendency for the enamel to break away, and in the course of
time the defect will get gradually greater. This tendency to
crumble away does not exist around gutta-percha fillings; and
herein lies their chief preservative power. The reason is not hard
to find. Every time we bite on a large solid gold filling a shock or
blow is thereby communicated to the walls of the cavity ; and if
these are not perfectly solid and intact, they will, in the course of
time, suffer from these repeated blows. Gutta-percha fillings do not
receive such blows, because they are not contoured, and the lighter
blows which they do receive are not transmitted to the walls of the
tooth.

Dr. Mitchell. — I should like to ask Dr. Miller how it is that, in
removing a gutta-percha filling, provided the rubber dam has been
applied, there is always a trace of moisture ? That has been my
experience with gutta-percha as a filling.

Dr. Miller. — I think I can make a gutta-percha filling which
will seal the cavity thoroughly ; besides, in case of an imperfect gold
filling, you can insert an excavator between the filling and the walls
of the cavity. This you cannot do in case of a gutta-percha filling.

Dr. MitcheU. — I cannot understand why this infinitesimal amount
of moisture should not act in a detrimental manner to the teeth.

Dr. Miller. — I have an experiment which has been going on since
1882, which shows that saliva, when it putrefies or ferments, does not
have any action upon the tooth structure ; if your fluid, which ap-
pears between the filling of the teeth, can be renewed from time to
time, and if the fiuid contains sugar, which should ferment, then you

American Dental Society of Europe, 245

would undoubtedly have, in the course of time, a detrimental action
on the teeth. The very fact that it cannot be renewed would limit
its action.

Dr. D. Kelsey, — I would like to ask the doctor, if it is meat which
preserves the teeth of Esquimaux, what preserves the teeth of
Hindoos, who never eat meat ?

Dr. Miller. — ^Perhaps the healthy mode of life helps to prevent
the caries ; perhaps the physical character of the food ; some kinds
of food clean the teeth themselves. Wild races suffer much less
from caries than we, because we have all our things cooked, and
our teeth do not have the necessary gymnastic action. Finally,
the chief answer that I have to give to the question is that the
doctor is not quite right in his statement. Hindoo races are by no
means exempt from caries, some of them suffering to a very great
extent.

Dr. Elliott. — I can corroborate the statement. I find that in
China there is a great deal of caries ; not so much as in Europe ;
but were you to ask any foreigner if the Japanese have good teeth,
he would say yes. I would like to add that, of all nations in the
world, — and I have been in all countries, — the Japanese are &r the
Worst in the matter of irregularities.

Dr. Mitchell. — Can our president give us any reason for this
condition ?

Dr. Elliott. — I could not say ; at the time I went to Japan, there
were a large number of dentists ; they usually had their stands on
the street, and, as a rule, they would make you a set of teeth in a
very short time. It is to me a very remarkable thing that the
Japanese get their knowledge of science from the Chinese, and
have no artificial teeth whatever, except that they make two or
three incisors merely for appearance. The Japanese are the in-
ventors of the suction principle of plates. They are made of wood,
very accurately, and the mastication, which is done on the back of
the plate, which is covered with copper nails, is exceedingly useful.
In regard to the amount of caries, we have no statistics to guide
us in the matter. My student was the first Japanese who took up
dentistry in Tokio, and he established a practice there.

Dr. Jenkins. — Is there not reason to believe that the Japanese
are a mixed race, which may account for the irregularities ?

Dr. Elliott. — I do not think that that is sufficient reason to
account for it.

Subject passed.

(To be continued.)

246 Editorial.

Editorial.

DENTAL HYGIENE.

The past decade has marked an era of advance in our knowledge
regarding the etiology of dental diseases, until now the terms sepsis,
antisepsis, infection, and disinfection are as common in our litera-
ture as pulp conservation and mechanical dentistry formerly were,
and yet how many of us use the terms intelligently ? How many
can explain the pathology of alveolai' dental abscess, pyorrhosa
alveolaris, etc., according to the new school of dentistry?

The rapid advance made in our knowledge of the etiology of
dental diseases makes it necessary to revise the teachings which
have largely held up to the present day.

When it is understood that nearly if not all the diseases per-
taining to the oral cavity are the result of unhygienic conditions,
then the importance of the subject will be better appreciated. The
mouth is known to be a hot-bed in which nearly all forms of micro-
organisms find a suitable habitat and culture media. It is true that
all are not pathogenic, that is, disease-generating, but many such do
find their way into the oral cavity, and fh>m thence into the ali-
mentary canal, the lungs, and through the mucous membrane into
the tissues of the body, thereby producing local or general infection.
Nearly all the diseases of the mouth sooner or later become com-
plicated by the presence, if not the direct action, of germ- life. Not
a few owe their origin to micro-organisms. Suppuration of the
gums and the pulp, as also alveolar abscess, is due in most cases to
direct infection from the oral cavity. That stage of Biggs's disease
which is known as pyorrhosa alveolaris is undoubtedly caused by
infection. The disease may, and probably does, begin as a catarrhal
process, but the stage where pus is formed indicates the presence of
some one of the pus-forming micro-organisms : as it is now gener-
ally admitted that pus is formed through the action of certain
well-known germs. Then decay of the teeth themselves, as has
been so ably demonstrated by Br. Miller, is caused by acid fermen-
tation in contact with unexposed surfaces of the teeth.

The mouth forms the open portal to the system. The teeth

EditonaL 247

stand as sentinels to guard the entrance, and their care should form
the most important subject for discussion in our literature. It is
true that we do devote most of our time to their conservation after
they have been to a greater or loss extent destroyed by the influ-
ence of unhygienic conditions, but knowing as we now do the eti-
ology of so many of the diseases pertaining to the mouth and teeth,
it becomes our bounden duty to give more attention to informing
ourselves and patiebts regarding the prophylactic measures neces-
sary to prevent their inception. The loss of a tooth, in the light of
our present knowledge,. should be looked upon as an evidence of
incapacity upon the part of the operator, provided he has the full
confidence and co-operation of the patient. Children should be sent
to the dentist from early childhood and all irregularities corrected
and all pits and fissures filled to prevent decay and full directions
given as to the care of the teeth. If the patient implicitly follows
these we can pron^se him that he will be able to retain his teeth
throughout his natural life with only now and then a filling, a
desideratum not to be despised.

In view of the fact that the subject of oral hygiene has not been
as fully treated in our dental literature as its importance demands,
it seems that there is room for some elementary work in this di-
rection, so that the busy practitioner may acquire the needed in-
struction which will enable him to understand the phenomena with
which he daily comes in contact, so as to intelligently explain the
same to his patients without having to spend his leisure hours in
painstaking experiments.

SOUTHERN DENTAL JOUENAL.

Da. Catohino, editor of the Southern Dental Journal since its
inception, has resigned in favor of Dr. H. H. Johnson, who, in as-
suming the editorial position, says, in answer to a query from the
Archives^ —

" It is true there has been a change in the editorial department,
but its present management is determined that it shall not fall be-
low its former high standard of excellence thereby, and by diligence
Mid care we hope to see it improve as it grows in age, and to keep
apace with the profession as it advances to a higher standard of
perfection."

248 Editorial.

Dr. Catching does not intend to retire fh)m journalistic work
entirely, but will issue an annual review of dentistry in the form of
a compendium which will be sold on subscription only. There seems
to be a field for such a work, and Dr. Catching will undoubtedly
make it a success. We wish both the fullest success in their new
fields.

BIBLIOGRAPHY.

Transaotionb of the American Dental Association, at the Twenty-
ninth Annual Session, — Held at Saratoga Springs, N. T.,
August, 1889. Philadelphia : S. S. White Dental Manufactur-
ing Company, 1889.

Dental Chemistry and Metallurot. By Clifford Mitchell, M.D.
Chicago : W. T. Keener, 1890.

This is the second edition of the Dentist's Manual of Special
Chemistry, revised, rewritten, and including the following parts:
1. Essentials of Chemistry for Dental Students. 2. Greneral Chem-
istry for Dental Practitioners. 3. Laboratory Course in Elementary
Chemistry for Dental Students. 4. Laboratory Course in Dental
Chemistry and Metallurgy.

The author rightly claims that a knowledge of chemistry is of
the greatest value to the dental practitioner, and he predicts that,
as the special requirements of the dentist are different from those of
the medical man, in time the dental student will have a distinct
course in this branch. The work is well written, the matter neatly
arranged, and printed in good large type.

Artificial Crown- and Bridoe-work. By George Evans. Second
Edition, Bevised and Enlarged. 547 illustrations. Philadel-
phia : S. S. White Dental Manufacturing Company, 1889.
The rapidity of growth of this kind of work, and the consequent
changes it has undergone, may be judged by the fact that in less
than a year after the publication of the first edition of his work
the author has deemed a second necessary. It is fully up to date,
and embracing, as it does, the methods invented by, and the prao*
tice in vogue among, the most advanced dentists, it must prove of
much value to the progressive practitioner.

Foreign Oorrespondence. 249

Foreign Correspondence.

LETTER FROM PARIS.

To THB Editor:

Although it is rather late to speak to the readers of the Inter-
national Dental Journal of the International Dental Congress of
Paris, yet it may not be without interest to them to learn in brief
of the most important communications received.

In the section of anatomy and physiology, normal and pathologi-
cal, I would mention a learned paper by M. Bothmann, of Buda-
Pesth, on the '' Patho-Histology of the Pulp and Periosteum." He
brought to the support of his conclusions a beautiful series of micro-
scopic specimens which give great credit to M. Bothmann as a
microscopist.

Permit me also to call your attention to two communications of
your correspondent, one, " The Teeth of the French,'* and the other
an " Essay on the Terminology of the Principal Diseases of the
Teeth and Mouth." I consider that it would be of great advantage
in the study and discussion of obscure points in the science of odon-
tology, if dentists would unite on one common nomenclature. On
account of the general familiarity with the pathological anatomy
of the mouth and dental organs, it seems to me best to make this
the foundation or beginning for our classification. Any of our
readers interested in this matter will find it treated at length, and
the classification proposed, in the October number ot Jj Odontologie.

In the section of therapeutics the subject of diseased pulps re-
ceived a long and exhaustive discussion. We are not convinced of
the wisdom of filling-root canals immediately on opening. Per^
sonally I treat the canals and fill temporarily with gutta-percha,
filling permanently after the second, third, and fourth sitting, ac-
cording to the conditions of the case. By this method I claim to
have only from three to five failures in a thousand. Dr. Cunning*
ham's statistics give four cases of periostitis out of forty-five
treated.

H. Heide, of Paris, gave his method of filling cavities with in-
lays cut from natural teeth, and M. OuMni, of Naples, with coral
of whitish color.

Cocaine and nitrous oxide are used to a great extent in France,

250 Foreign Chrrespondenee.

owing somewhat, probably, to legislation, which prohibits general
anflBsthesia by those who do not have the degree of M.J>.

M. Bleischsteiner, of Oratz, always uses the aqueous solution of
cocaine, first sterilizing the water with a weak solution of corrosive
sublimate. His method is to inject at several places, but only a
little in each place. M. Poinsot, of Paris, advises a solution in oil
of vaseline, medicinal,^ or oil.

His formula is, —

B Pure cocaine, 6 centigrammeB ;

Liquid vaseline, 60 *'

Pea-nut (or pistachio) oil, 60 "

This solution is not toxic. I have given the reason in the '' Aid
to Memory of .the Surgeon Dentist." The aqueous solution is
quickly absorbed by the blood-vessels and carried to the nerve-
centres, while the oily solution remains longer where it was injected
and has more of a local effect. During the three years that I have
used this formula I have had no accidents whatever, whereas with
the aqueous solution I have seen alarming symptoms of syncope,
lasting for houro, and in some cases for days. The inconvenience
of this preparation is its lack of fluidity and consequent difficulty
of injecting it, and more especially if low temperature has caused
a recrystallization. For this reason I have modified the formula of
H. Poinsot a little. My method is as follows: Into a tube (or
phial), of a capacity of two cubic centimetres, put from three to
five centigrammes of cocaine (my cocaine is not the hydrochlorate
but the pure alkaloid) ; to the crystals add two drops of chloroform,
then equal parts of pea-nut oil and vaseline oil to make a quantity
sufficient to fill a hypodermic syringe ; that is to say, one gramme
or one cubic centimetre. To avoid rapid recrystallization of the
cocaine, it is well to warm slightly the phial and also the syringe.
Like M. Bleischsteiner, I inject at several points and put the point
of the syringe into the tissue but a short distance. By this method
there is no fear of accident, and the operation is less dreaded by
nervous patients. It is a good idea, after the extraction is completed,
to force out, if possible, the injected liquid by pressing the gum
hard between the fingers.

In prosthetic dentistry I will mention the interesting presentation
of M. Michaels, of Paris. In making metal plates, he treats the
mould so that the die will give the plate a slightly wrinkled ap-

^ Not to be confounded with mineral yaseline.

Foreign Gorrespond&nce, # 251

pearance ; on the lingual side he flows solder into the depressions
(stri»), thus making the plate ridged enough to withstand the
strain of mastication.

M. Michaels made before the members of the Congress a plate
having four teeth in forty minutes. The process, I believe, has a
great fhture.

The restoration of the face and maxiilsB has been entirely trans-
formed in France, thanks to the good work of M. Martin, of Lyons.
The most startling and at the same time the happiest idea of our
eminent confrere is the immediate application of the appliance. The
readers of the International Dental Journal, who are engaged
in facial restoration, know how difficult it is to successfully put in
position an appliance where there has been resection of the jaw,
and the consequent falling away and retraction of the soft tissues
left without osseous support. M. Martin's remedy is to make in
advance a reproduction in black rubber of the bone to be removed.
As soon as the operation is completed, the rubber is fitted into the
place where the bone has been removed, and is then held in position
by a platinum screw. Over this artificial maxilla the surgeon
fastens the flaps of soft tissue with sutures, and the appliance is left
in place until the healing is complete. My readers will be aston-
ished, as I myself was, to learn that the false maxilla will be toler-
ated in contact with so large a wound. The surgeon, M. Olier,
who has often employed M. Martin's appliance, makes the following
statement : '' Is it prudent to disturb, or at least fill, a fresh and
irregular wound with a foreign body that may become a permanent
aource of irritation, and of whose retention there may be doubt?
It is remarkable to see how the healthy bone will tolerate the
platinum screws used to hold the appliance (hard rubber) in place.
It is always, without doubt, a question of antisepsis and the
property of heat that are necessary to success. By the manner in
which the piece is constructed it is easy to keep it in place. It is
sufficient to frequently and methodically irrigate the parts."

It seems to be quite probable that it is on account of the frequent
irrigation that the piece is tolerated. M. Martin has made this
easy by having the appliance furnished with grooves or canals of
irrigation to which a rubber tube can be applied.

I cannot describe here minutely the method of construction and
procedure of this class of operations, but will refer the reader to M.
Martin's excellent book on the subject.^ In this book may be found,

^ "De la Frothtee immMiate appliquir A la Bisection des Maxillaires/'
Par G. Martin, Chez Maison, Paris, 1889.

262 • Foreign Correspondence.

also, other important information in regard to facial restoration, to
which your eminent co-laborer, M. Bonwill, and dentists who wit-
nessed the demonstration by M. Hartin at the Exposition UniverseUe^
will bear testimony.

The clinical sessions were of great interest. M. Bonwill demon*
strated his method of gold filling. M. Chauvin transplanted a root
on which had been placed an artificial crown. MM. Bleischsteiner,
Michaels, and Eothmann exhibited their work and microscopic
slides, which have already been mentioned. M. Cunningham, of
Cambridge, showed his diagrams used in teaching at the National
Hospital, London. M. Telschow exhibited a dental engine worked
by compressed air, also a mallet and saliva-pump attached to the
same. He also showed ^n improved clamp.

MM. Michaels and Kuhn showed their operating rooms where
compressed air is used for the engine and also for running the
dynamo.

In regard to the fears expressed by the International Dental
Journal and many other American journals that it was our wish
to injure the Congress to be held in Berlin, we have proved that
this was not our end. Before adjournment, the Congress gave ex*
pression to the wish for another reunion whenever such favorable
circumstances should present themselves as was the case with the
Congress of Paris.

I hold in grateful remembrance the cordial reception given us
by our American confreres at Washington. My colleagues of T^cole
Dentaire, of Paris, and myself have done our best to give a fitting
reception to those dentists who have honored us with their presence*
We were particularly happy to have had with us our American
friends, Bonwill and Harlan, to whom we wish to renew our ex-
pressions of regard.

You will see, my dear Editor, that the Congress of Paris has
been most useful and happy in its results. It has assisted the prog*
ress of dentistry, and strengthened the bond of friendship between
the members of the profession throughout the world.

P. Dubois,
• President of the Odontological Society of Paris,
Translated by Dwight M. Clapp, Boston,

Foreign correspondent L' Odontologie.

Domestic Correspondence. 253

Domestic Correspondence.

To THB Editor:

Society ^^ Incident" — ^At a recent meeting of the New York
Odontological Society, a gentleman present (not a member), in re-
sponse to a general invitation by the president to relate " incidents
of office practice," took advantage of the occasion for the purpose
of reporting a case under his observation, which, in substance, was
as follows :

"A lady was under his care for treatment. In her teeth were,
upward of forty fillings. Six of the teeth were devoid of vitality.
Her teeth were also exceedingly loose, — a marked case of pyorrhoea
alveolaris, — and both teeth and gums were causing much pain.
Indeed, it was a bad case all around. The lady's former dentist was
reported as a * prominent' member of our specialty; prominent
through his writings and teachings ; a professor of operative den-
tistry in one of our ' prominent' dental colleges, located in one of
our prominent cities, yet his name was modestly withheld.

<' This prominent professor had permitted this lady's teeth to get
into this deplorable condition, and the fact must be widely known
and published, to the discredit and shame of this unworthy, yet
'prominent' professor, who, instead of occupying the professor's
chair, might better take a seat on a bench with the ' boys' and
learn how to do what he was pretending to teach to the youthful
aspirants for diplomatic honors."

This prominent professor of the prominent college was certainly
unworthy of his high calling, — at least was so pictured to the mem-
bers of the Odontological Society, who patiently listened to the
rehearsal of these woes. They could imagine this prominent pro-
fessor as simply a fraud, a botch, a humbug ; careless, remiss, in-
competent, and totally unfit to practise dentistry. And yet he
holds a position as a professor of operative dentistry in a prominent
dental college I " Human impudence — to what a height hast thou
arisen I" Why are such things permitted ?

But, to be serious, why should such a case have been thus stated

at a society meeting? What does it signify, except to traduce in a

semi-blind manner a fellow-member of our calling ? Who knows

. anything of the circumstances connected with the case referred to?

Are dentists responsible for all the cavities that form in human

254 Domestic Correspondence.

teeth ? Are they responsible for the neglect of individuals to have
them timely attended to ? Are they to be blamed because teeth
are allowed to become incrusted with scales of salivary calculus
and loaded with other filthy deposits ? And are they to be blamed
for all the dead teeth that exist ? Is it not possible for an individ-
ual to have " six teeth with dead pulps" without being a victim of
malpractice ? Thousands upon thousands of dentures are covered
with unsightly stains and their interstices filled with mischievous
accumulations. Many mouths can make an exhibit of rows of
pulpless teeth or Crownless roots. Must the dentist, who, perhaps,
has had but a semi-occasional opportunity afforded him by a care-
less patient to keep his or her teeth in order, and who visits him
only when driven by desperate pain, or when mastication has be-
come almost a '' lost art," be blamed for not staying the inevitable
results of carelessness or indifference ?

Beally, it is not a nice thing to do to bring up this sort of (so-
called) " Incidents of office practice" before society gatherings. It
is a decided breach of courtesy, and should be severely rebuked.
Beports brought by patients should be taken with many grains of
allowance. Few individuals are willing to blame themselves for
their sins of omission, and especially is this the case if they can
make a pack-horse of some unfortunate dentist on whom they can
saddle the responsibility for the condition of their shocking bad den-
tures. Circumstances and conditions must be taken into account
before judgment can be fairly passed. Who can get at the exact
truth in such matters? One might as well try to correctly picture
the life, character, habits, and disposition of a deceased stranger by
viewing the corpse I

Be charitable, ye who dwell in glass houses, and let him only
who is proof against criticism hurl the damaging missiles.

" X."

To THE Editor:

A NEW organization has been formed among the dental students
of the University of Pennsylvania under the name of the James
Truman Dental Society. The first regular meeting was held on
Thursday evening, March 13, 1890, in the college building. The fol-
lowing officers were elected for the ensuing year : J. A. McKee, Jr.,
president; Louis Stephan, vice-president; W. T. Arrington, Jr.,
secretary; Greorge J. Frey, treasurer. The society offers to its
members a field for discussion and active investigation of all such
subjects and questions that may be suggested in their course of study*

W. T. Arrinqton Jr., Secretary.

Ourreni News. 256

Current News.

CHICAGO AND VICINITY.

Dr. E. S. Talbot, whose labors in the field of Dental Irregulari-
ties are well known, has made a thorough and scientific examina-
tion of the mouths of the '< cave and cliff dwellers," who have been
on exhibition under the charge of Lieutenant Schwatka, and states
that the results were interesting and instructive. They will be
given to the profession later on.

Mb. E. E. Clabk, of Newark, N. J., has been in the city, ar-
ranging matters with a view of establishing a plant for the manu-
facture of his deposited plates in this city. A number of prominent
dentists appear to have taken an interest in the matter.

Thb Chicago Dental Club appears to be in a flourishiug and
growing condition, and arrangements have been made for publish-
ing its proceedings, in future, in the International Dental

JOUBNAL.

Dr. Custer, Dayton Ohio, says too much value cannot be
placed upon the power of personal magnetism in the dental oper-
ator. The exhibition of tender sympathy in a painful operation
does much to mitigate its severity. Everything lies in obtaining
the absolute confidence of the patient. If the operator shows that
he is perfectly familiar with the operation, that he knows exactly
what to do, giving no evidence of bungling or embarrassment, no
hesitation in the choice of instrument or remedy, there will be less
dread and apprehension, the imagination will not be roused, and,
the subjective image not being formed, the actual will not be
realized.

Dr. Green, New Albany, suggests that, in setting a porcelain
inlay in cement, the piece of tooth be made as hot as can be held
in the fingers before pressing home in the cement. The cement
will set much harder.

266 Current News.

Chlobidb of zinc stands at the head of the list as an obtundant
of sensitive dentine. It both coagulates and dehydrates, but its
action is painful, and, as it is not self-limiting, it must be used with

caution.

■

Db. a. E. Baldwin, Chicago, overcomes sensitive dentine by
the use of sure, sharp instruments, with rapid motion and light
touch.

SOCIETY NOTICES.

Thb Iowa State Dental Society will hold its Twenty-eighth
Annual Meeting at Dubuque, Iowa, May 6 to 9, 1890. All are
invited to attend.

PEOGRAMME OP DENTAL SECTION OP THE AMEEI-

CAN MEDICAL ASSOCIATION.

Addbsbs. By J. L. Williams,

Belation of Tropho-Neuroses to Diseases of the Mouth and
Jaws, with Special Beference to Syphilitic Necrosis.

By G. Frank Lydston,
How the Vascular Supply is connected with the Teeth.

By A. 0. Hunt,
Vascular Tumors of the Mouth, and Treatment by Injection.

By John Marshall,
Electro-Therapeutics. By John L. GHsh.

The Value of Illustration in the Lecture-Boom.

By L. D. Mcintosh,
Adenoid Growths and their Effect on the Mouth.

By E. E. Briggs,

Cure for Cleft Palate by a Double-Plap Operation and Closure

with the buried Tendon Suture. By H. O. Marcy,

Diseases of the Gums and their Treatment. By J. Taft.

Irregularities of the Teeth connected with Neurotic Conditions.

By E. S, Talbot
Hereditary Dental Anomalies. By William 8. Sherman,

:K-

p.

THB DENTAL CROWN.

THE

International Dental Journal.

Vol. XI. May, 1890. No. 5.

Original Communications.'

THE DENTAL CROWN AND ITS ENABLING METHOD

OF REMOVABLE BRIDGE-WORK.'

BY WILLIAM H. OATXS, D.D.8., PHILADELPHIA.

Advanos in the art of dentistry, while bo pronounced and
gratifying in most respects, has been singularly slow in producing
a satisfactory substitute for the natural crown.

When carefully examined, in fact, it will seem not a little re-
markable that the radical errors and absurdities of that old-time
method known as '' pivoting^' are the actual basis of the prevailing
method of to-day. These absurdities arose from the anatomical
mistake of supposing that a through and through cut, from the
labial to the lingual curve of the gum, was the proper line of divi-
sion between the crown and the root. This mistake was manifestly
excusable coming at a period of dental science when such crude
devices were its exponents in art ; but we must no longer overlook
this anatomical relation, as the natural outline of the end of the
root is suggestive of the best possible form for the crown.

^ The editor and publishers are not responsible for the views of authors of
papers published in this department, nor for any claim to noTelty, or otherwise,
that may be made by them. No papers will be received for this department
that have appeared in any other journal published in this country.

' Bead before the Odontological Society of Pennsylvania, Saturday, Feb-
ruary 1, 1890.

17 257

258 Original Communications.

The distinctive features of pivoting were the concave foundation
in the end of the root and the tooth rudely joined therein by the
dowel, or " pivot/' as it came to be called from its tendency to turn ;
but these are likewise the basal features of the so-called porcelain
crowns. In both — the Gates-Bonwill and the Logan — ^the change
relates only to the muke-up of the so-called crown and its pivot, the
outer part being of porcelain, while the basal portion of both alike
is of plastic materisJ added thereto because of its adaptability to
the pivot joint in the end of the root. To have termed either of
them a crown was incorrect, as no crown has a convex base. They
are simply composite pivot-teeth, and the post of each is the core
of its pivot.

An objection to the existing pivoting method is, that it cuts
away the natural base susceptible of being clasped like a rook and
interposes in its place a base that throws the entire support upon
the post-pivot, and thereby forms an adverse leverage within the
end of the root, the extreme length of the composite pivot-tooth
being the long arm, and the radius of the end of the root the short
arm of the lever. This tendency to split the root becomes still greater
through the vertical diameter, as the tooth, confined by the poet
between the lateral inclined planes, acts as a positive wedge. In
view of these facts, which are witnessed also by the immense
strength required in the platinum posts, we must certainly have
increased respect for the stanch qualities of root material that has
so rarely given way under such adverse conditions.

A fhrther objection to this pivoting method arises from the
impossibility of making a proper joint where there is no guide but
guesswork ; no opportunity to see or know the relation of the two
surfiioes when applied ; no guide for the proper occlusion with the
opposite jaw ; no recourse, indeed, but to cut and try for some sort
of makeshift.

Because of these difficulties the suggestion of the amalgam base
was thought to be a great boon, and the porcelain was countersunk
to receive it. There was a grievous disappointment, however, be-
cause of the mechanical impossibility of getting the amalgam to a
proper ppsiUon in so large a single quantity, which soon became
apparent. Besort was then had to the perishable plastics, because
less rigid before setting, a gold band being employed to protect
them, and likewise act as a bandage for the ever-threatened root.

But why must we infringe on the pericementum, establish bac-
teria nests, and disfigure the tooth with this bandage of gold ?

If we take nature's*Buggestion we will replace the nfitural crown

The Dental Crown, etc.— Gates. ' 259

with a Babstitute that presents a true roeohanioal joint, into which
the end of the root projects, and which is therefore properly called
a crown. Such a crown I have provided, and hence have termed it
the dental crown.

Beferring to the drawings for its illustration (see plate), the line
a a, Fig. 1, shows the anatomical outline and the strong defensive
angle of the end of the root, while the dotted line b b indicates the
slight modification necessary to make this angle available as a per-
fect crown-seat, a ledge, c. Figs. 1 and 2, being formed at the outer
base against which the crown may solidly abut. This ledge neutral-
ices the inclined plane which would imperil the crown, and as the
crown seat represents a trifle less than a right angle, the plane d
supplements in the most ample and positive manner the support
afforded by the ledge, with the result that we have here a mechani-
cal crown-seat of the very highest order, affording permanent
protection both to the root and to the crown.

To make this crown-seat, a facing-wheel, Fig. 3, and a gauge,
Figs. 4 and 5, are provided, which are very exact and practical in
application, because each has a supplemental form that allows one
plane to be finished before the other is begun. The facing-wheel is
file-cut on its front face. Its diameter covers one face of the crown-
seat, which it quickly and definitely forms while firmly sustained
by a self-centring point, e. Fig. 3, which, separately made, has been
hermetically sealed into its mandrel; and as this centring point
cuts only on its front face, /, Fig. 3, which is also its largest diam-
eter, the wheel is thereby confined to the selected position while
free to adjust the plane of the crown-seat to any inclination
desired.

The gauge, made of sheet metal, represents a kind of skeleton
of the body and the outer lobe only of the crown, the body of the
lobe being represented by a circular crib, g, Figs. 4 and 5, over
which its outer face, A, rests as a hinged cover. The natural crown
having been reduced to the line of the gum, and the enamel re-
moved, this gauge is simply applied against the end and labial face
of the root while forming the outer face of the crown-seat by the
fikcing-wheeL The occlusion with the opposite jaw, the mouth
being closed, determines at once the length of the crown required ;
and by uncovering the crib in testing, to be sure of its proper con-
tacty this outer and determining face of the crown-seat is carefully
formed, the contour of the gauge proving the position correct.
Thus we have an .unfailing guide, a direct open view, and a thor-
oughly-controlled, painless, and effective instrument for overcoming.

260 Original (kmmunicatioM,

right at the start, the paramount and, by the old method, moet
formidable difficulties of orown-setting, — ^viz., obtaining the correct
position and the proper adaptation.

The supplemental or face-extension wheel, Fig. 6, is of similar
diameter to the facing-wheel, but cuts only on its peripheral face.
Besting flat on the plane already formed, it simply extends that
face of the crown-seat as far up under the free edge of the gum as
the selected crown requires. Of this form there may be a pair,
cutting right and left.

The supplemental gauge. Fig. 7, is an oval band or crib bent
edgewise to the standard angle. Guided by the outer face, this
quickly determines the eorrect position of the inner face of the
crown-seat, which is formed by a facing-wheel in the right angle
attachment.

It will be observed that the coronal end of the crown-seat ex-
tends beyond the enamel line at the ridge. This, like that at the
ledge, is a useful variation from the saddle-shaped, anatomical out-
line of the root, as it projects a solid line of support of unexampled
height into the centre of the crown. It is slightly trimmed at each
end to admit its reception between the lateral wings a' of the crown
so provided.

The crown itself requires no trimming. It represents the
standard of joint as suited to the crown-seat. The special advan-
tage, in an economic as well as an artistic sense, in having at hand
perfectly-adjusted crowns in porcelain, need not be enlarged upon.
It may be mentioned here that in the manufacture of this crown it is
contemplated to embed into the porcelain just within the peripheral
border of the angle a slight rib, or a perforated mat of platinum, in
order always to have exact uniformity of the gauge. .

An important feature also embodied in this crown consists in
employing a staple as the bond between the crown and the root.
Entering the inner face of the crown, its loop is bent backward and
embedded in the porcelain towards the outer face as shown at t,
Fig. 8, thus securing the most powerful combination with the crown-
seat. This arrangement provides an open passage directly through
the crown and the pulp-canal while the crown is in place upon the
root, and affords facilities for the attainment of highly-important
purposes.

Instead of having the approach to the canal sealed with impen-
etrable porcelain, it is a manifest advantage to have an opportunity
to reopen in case of pathological conditions not apparent at the
time of closing ; and the open passage is of still greater importance

The Dental Crown, etc.— Gates, 261

at the time of setting the crown, for it permits the centre of the
crown to remain open and undisturbed until the treatment can be
made ander favorable circumstances. Thus, instead of wasting
time at the start in a dificult diagnosis of the case, the crown-seat
is at once formed, the canal enlarged, and the crown set with gutta-
percha; the presence of a slender pin embedded there leaves
the canal open when withdrawn; and on removing the crown
at a subsequent sitting, the treatment is made with every advan-
tage of free access, an open view, and the opportunity to make
make deliberately whatever tests may be necessary.

This open passage also makes available an important discovery
touching the material employed in the setting. Gutta-percha,
having shown unusual tenacity and power of resistance as a thin
layer between this crown and its crown-seat, requires only the as-
sistance of a firmly-embedded staple to make it serve as a permanent
setting. But this direct access is essential in order to embed the
staple properly.

The convenience and simplicity of such an adjustment is in-
stantly apparent. A thin layer of gutta-percha, adapted to the base
of the crown, is warmed and impressed upon the crown-seat, which,
being moist, allows the crown to withdraw the gutta-percha as an
impression. The excess at the border and immediately around the
staple being trimmed away, it is warmed and replaced until the
crown practically rests against the crown-seat. At this point, if
the mounting is to be temporary, two slender sticks of gutta-percha
are warmed and pressed within and upon the opposite edges of the
staple, and embedding also a small ordinary pin between them. The
point of this pin, made blunt, will be slightly in advance of the
gutta-percha when inserted into the canal, and the gutta-percha
should be at least an eighth of an inch in advance of the ends of
the staple, so that in condensing it may obtain firm contact with
the sides and retaining-points of the canal. The canal and root
having been well dried, the loosening and withdrawal of the pin
will leave the case in a safe and successful condition. But the per-
manent placing is still more simple, as, when the gutta-purcha set-
ting has been adjusted to the base of the crown and the root dried»
nothing remains but to partly fill the canal with a soft mix of
amalgam, carry the crown to place after warming, and finish by
thoroughly introducing very dry amalgam until mercury will no
longer appear.

In making this permanent closing of the canal the insertion and
withdrawal of a slender steel pin, reaching almost to the foramen,

262 Original Communications,

will leave a closed tabe in the amalgam fbr more convenieDt ap-:
proachin oase of necessity*

It should here be stated that amalgam itself is perfectly adapted
for setting this crown, as a soft mix, placed between the crown and'
crown-seat, permits the crown to go fully and easily to place, leaving
only a mere film of amalgam between, the excess of mercury
being withdrawn at the same time with that in the canal; and
the only part of the joint facing outward, namely, the ledge, is
easily provided with a fender excluding the amalgam, so as to ap-
pear, if at all, only as a fine line of gold. But the extraordinary
convenience, entire concealment, and stanch character of gutta-
percha as a cement between two solid surfaces, otherwise sustained
in close apposition, make amalgam unnecessary, and add to the
laurels of this invaluable material, gutta-percba.

The reaming of the canal is preferably deferred until the crown-
seat is formed, as any improved position desirable to be given to the
crown will require ordinarily only a slight corresponding change in
the position of the staple at the mouth of the canal without resort
to bending; and since the dislodging force against the crown,
hitherto bom by the post, is here sustained by the crown-seat with
its immense reserve of force, we can widen laterally, or make such
other shaping of the pulp-canal as suits any purpose of advanced
ideas.

But the question will be asked, How shall the position of the
crown-seat be determined when the end of the root is far decayed
or already cut into concave shape ? Simply by inserting into the
pulp-canal, temporarily, a pivot of orange wood, the outer end of
which, cut to a wedge-shape, will give support to the centring bar
of the facing-wheel. In such cases, after the crown, set for a few
days upon these partial outlines with a slight excess of gutta-
percha, has pressed the morbid gum back to its normal condition,
a section of corrugated tubing, having its outer end likewise cut to
wedge-shape, is to be permanently set into the enlarged canal by
means of amalgam, which is then simply built out far enough to
restore the crown-seat. As all tendency to split the root is inter-
rupted by this simple arrangement, it is obvious that roots other-
wise impossible of preservation may in this manner be saved. Boxes
of these wedge-pointed pivots and sections of corrugated tubing
may be kept at hand.

Lastly, the facility of the open canal offers a unique advantage
for bridge-work. All banding is set aside and a strong, simple, and
removable attachment is made to this crown. A lingual gold &ce

Correcting Irregularities^ etc-r-Bymes, 263-

Bet into the crown its own thickness, j, Fig. 8, including a short
hood at the cutting end, is easily secured by a suitable screw, li
Fig. 8, provided with a platinum counterpart previously embedded*
in amalgam in the pulp-canal.

In condvision, it gives me pleasure to say that I have this
method of mounting bridge-work protected in the United States
Patent Office for the profession, and that they shall not be subject
to the payment of office rights for the use thereof.

COERBCTING IRREGULARITIES BY THE SPRING OF

GOLD BANDS.*

BY B. S. BYRNES, D.D.S., MEMPHIS, TENN.

I REGRET to say this mode is yet comparatively new in the
profession, although demonstrated thoroughly at the Southern
Dental Association, held in New Orleans in the spring of 1885,
and published in the Dental Cosmos for May, 1886. To-day I
know of but few dentists who faWy appreciate the merits of the
principle.

Dr. Kingsley, in answer to the query as to what kind of fixture
he used for regulating teeth, says, '* Some variation of an old appli-
ance must be invented for almost every new case." I will go
further, for in all of my complicated cases I find that I use one,
two, three, and sometimes four variations from my first invention
for a certain case, and after passing certain stages will go back to
the original appliance;, not that the others were failures, for they
did their duty as far as they could, but the original would do more,
taken from that point, than its substitutes would do if retained ;
the substitutes did better to pass the work over certain stages than
the original could do. To quote Dr. Clark on failures, I will say that
t have been unable to obtain the retainer by demanding half of the
fee in advance ; but will say this much in favor of the principle
which I advocate : that all of my patients claim that after wearing the
fixture the first day they find their teeth are much more comfort-
able while the fixtures are on than when they are taken off; for I
too ''have had them to bring fixtures to me in their pockets,
having taken them off the night before to attend a ball."

^ Bead at the Union meeting held at Springfield, Mass., October 24, 1889.

264 Original Communications.

Id eomcCiDg imgnlBritieB there ar« three important pmnts
which I keep constantly in mind and labor for faithftiUy, to ao-
complish the objects I have in view. First, the more even arrange-
ment of the teeth in the arch ; aecond, the physiognomy, so bb
to have the featnres harmonize well ; third, and last thongb not
least, the oocluaion of the teeth, for tbereon depends the sncoesB
of the case. In following tbia last point we are simply Mding
nature to do a woHc which she was too feeble to perform when
called apon. These three points are likened unto the Holy Trinity,
for they are, properly speaking, three in one.

I practise no part of my profession by a fixed rule. I condemn
none of the materials used by dentists; neither do I say I nerer
extract s tooth. I study well the nature of each indivldaal case
as it presents itself, then follow the dictates of my judgment
towards correcting its abnormity.

For illustration, I will give my reasons for treating two cases
so entirely different that presented similar appearances of irregu-
larities. The first case, published in the Cosmos for Hay, 1686
(see Fig. 1), shows a prominence of the inferior cuspidata, patient

twenty-seven years of age, with wisdom teeth well erupted and
crowding all the teeth forward, making tbo inferior maxillary
square and angular at the chin. I at once without hesitancy
extracted tbe first bicuspids, which were perfectly sound, and with
simple gold band, on either side embracing fint molar, bicuspid, and
cuspid, drew the cuspidata back into place until tbey occluded on
the distal surfaces of the superior cuspidata; having reached this
stage I bad my patient discard tbe bands. I then propped the
teeth apart until the occluding cusps passed each other. (See
Kg. 2).

Correcting Irregidaritia, etc. — Bymea. 26S

yatnre oame in and did her work, reducing the angalar, pro-
truding ohin, and the features are now in perfect harmoiiy ; befiideB

overcoming the threatened triamus, the orowded arch has entirely
disappeared.

Having treated the first case, I will now introdnoe the parallel
case, which received entirely different treatment. I would not have
dreamed of extracting teeth in this case, and why? Because
broad, flat features, depressed lips, and a retreating chin presented
themselves for treatment as well as irregular teeth. Patient
fourteen years of age. I first used a fixture embracing the two

Natiinl width ot uch.

bionspids on either side with a continuoos band aroand the front of
the cuspidata and behind the incisors. (See Fig. 3.) The object
was to crowd the incisors more together and force them forward.
Work progressed well to a certain stage, when my patient com-
plained of the soreness being altogether in the bicospids. This
necessitated another invention.

266 Original Commwiicatioiu.

I at once snbBtituted for the tint fixture the following one,
vbioh 18 a Bimple long strip of gold with tbo two eoda soldered

c3ro

togetherand wOTenaroundtheteetb. (See Pig. 4, a.) Itwasaronnd
the first bicuspids on either side, which doabled the strips in a
parallel line on the anterior sarface of the cuspids ; the inner strip
was passed behind the incisors and the outer strip was continued
on their anterior surface. This simple fixture bad a threefold
object, — to force the bicuspid outward, to force the incisors forward,
and to bold them in line at the same time.

Fixture No. 2 was discarded for two somewhat similar ones.
(See Fig. 4, b and o.) The left central being very prominent, I oon-
cluded to leave it fVee ; bo I placed a small loop around the left lateral,
doubling over the cuspid and embracing the first bicuspid on the
right side, enclosing lateral and central in the loop. While these two

. Tb« gkln of afzij one-faoith el ui Inch wu obuined by the

bands were on I found it necessary to weave a band in like manner
over the left central, looped from left lateral to right central, which

Same Practical Points^ etc, — Ottolengui, 267

was to bring the inciBors in line. (See Fig. 4, d.) Having brought
the incisors in line and spread the superior arch by means of occlu-
sion, inasmuch as the bite was very close, I now go back to first
principles and make a retaining fixture, which is formed of a simple
band embracing the first bicuspid on either side instead of both
bicuspids, with a continuous strip passing in front of cuspids and
behind incisors. I am only able to pronounce this case a success
from the simplicity, ease, and comfort with which the fixtures were
worn, as sheer indifference caused my patient to absent herself on
one or two occasions for as long a time as two weeks during the
process of straightening her teeth.

By way of summary, I will add that the most important point
in this case is the improvement of the features, and because it
proves a contradiction of my own statement made in New Orleans.
When asked what I would do to gain space to bring the teeth into
line, I said in such a case I would have to use .the jack-screw or
coffin-plate, but here I have spread both arches without the screw
or plate, and confined my fixtures to the lower teeth exclusively.
The patient would not tolerate the rubbers between her teeth that
I put in for assistance, knowing they would give less resistance in
occluding if I could gain some by that means, yet she wore the
bands without complaining.

SOME PRACTICAL POINTS LEARNED AT SOCIETY

MEETINGS AND CLINICS.*

BT DB. B. A. B. OTTOL|BNani, NEW YOBK OITY.

ExPEBiSNOi is the best teacher. However thorough the college
training may be, or become, no man will ever graduate with as
much practical knowledge as will come to him by actual work at
the chair. If experience, therefore, is a great teacher, and ^ach
man is taught by different experiences, it must be a fact that dif-
ferent men learn different methods of accomplishing the same
thing, and also learn to do different things. What then can be
better than meetings and clinics where these differing methods may
be exhibited and discussed ? Suppose we read on a programme,
" Dr. A — p- will fill a tooth with gold ;" must we say, " We can learn

* Read before the Brooklyn Dental Society, December 26, 1889.

268 Original Chmmunicatums.

nothing there, we all know how to fill teeth with goldf That
would be a great error. We may learn nothing, bat then we may
learn something, and that possibility makes it to oor advantage,
if not our duty, to attend that clinic. It is almost impossible to go
into the worst-appointed dental office without seeing something
new, or at least difTerent from our own methods. We are all stu-
dents, and at the same time we are all teachers. We should be
willing in both parts.

To-night I have to oifer you a brief but practical paper. I
think nothing in it is entirely original with myself. I suppose that
there is -not any idea in it which some of you have not heard be-
fore, but I doubt if there is any one who can say, '^ I knew them
all ;*' and if each man gets but one new idea to-night he will be re-
paid. These little methods have been extremely valuable to me,
and I could not dispense with any one of them.

I will begin with the rubber dam. Probably no dentist will
admit that he is not master of so simple a thing as the rubber dam ;
and yet how often does the dam become the master of the dentist
merely because some unforeseen accident occurs in the midst of an
operation. There is the tiniest tear through which mucous will
oose ; the dam did not pass entirely down between the teeth, and
moisture is creeping towards our work ,- the clamp slips ; we have
not allowed quite enough margin to the rubber to cover the mouth ;
we thought we had, but when we applied the clamp we discovered
our errot, and so on ad infinitum; through some little oversight we
have failed in that seemingly simple operation the application of
the dam. So much annoyance has occurred in this manner that
perhaps you will pardon me if I think it important enough to tell
you all the little tricks which I have learned in this connection.

For comfortable work, the rubber, when in position, should em-
brace at least four teeth ; on dark days it is not amiss to take in
twice as many. It should lay over the face without a wrinkle, and
should not cover the nostrils ; it should, however, completely cover
a moustache, as the hairs often intervene between our eyes and
work. To accomplish this a piece of dam of sufficient sice should
be stretched over the parts which it is intended to cover, so that
the proper position for the holes may be ascertained, allowance
being made for the stretching which will be made by the clamp.
Jn this position the cusps of the teeth will show through the
rubber, and a mark over each may be best made with an excavator,
a pencil not answering as well. If because of the loss of a tooth a
space must be spanned, the rubber should not be stretched at that

Some Practical PoinUy etc. — Ottolengui. 269

point ; if this is not considered it will be found that when the dam
is stretched over the teeth it will not hug the necks of the teeth at
this point. In fact, this rale holds for all spaces great or small ; the
rubber should be wide enough. In cutting the holes use a device
which makes a perfectly round hole, this being the least likely to
tear. Make the holes sufficiently large ; don't force a molar through
a hole which would be just right for a bicuspid. Where the teeth
are in close contact, soap a bit of waxed floss silk and pass it be-
tween all the teeth first ; then soap the edges of the holes in the
dam ; in this manner there is seldom any difficulty about forcing the
rubber between the teeth. Occasionally, even this will not serve.
Your predecessor (of course not yourself) has left a filling with
ragged edges, which tear the rubber. In this case the teeth in
question should be wedged with soaped wood, as will be described
later. The least spreading allows the rubber to pass between,
when the wedges may be removed. This is better than trying to
force the dam between the teeth with silk. That method not un-
frequently tears the rubber, and accounts for the mysterious oozing
which occurs whilst the filling is in progress, and is largely respon-
sible for the failure so often reported at the cervical border. If
the dam has been propeil7 adjusted, it can be removed in perfect
condition. How often have you noticed, after removal, that in ad-
dition to the holes made by your punch there are several others,
satellites, as it were, about the greater orbs.

Next comes the clamp. In the first place select the one to be
used before applying the dam. Choose one which will grip the
tooth tightly. Throw away all clamps which would not hurt you
if put on your finger. A clamp without a spring is no better than
a clock in the same condition. In applying the clamp to a molar
in the upper jaw a little trick is found to be most valuable. Wo
begin by slipping the rubber over a central incisor, then over the
lateral cuspid and bicuspid, and finally over the first molar, let us
say. We endeavor to apply the clamp and find little room, and the
patient fiinches. The cause is this : The middle finger is the one
we use to adjust the dam ; it protrudes into the mouth, and as we
work towards the molar region we gradually fold the angle of the
mouth inward so that at last it is held back by the tip of the
finger, and it is difficult to find room for the clamp. Just at this
point, take the handle of a burnisher or other instrument and free
the check so that the finger passes into the mouth, the check slip-
ping forward ; then it will be found that, not being crowded back,
its elasticity gives us sufficient room to apply the clamp without

270 Original OommuniccUions.

pain. This one point has been of inestimable value to me, and to
my patients in saving pain.

Before passing to ligatures there is a special case to be alluded
to. Where the gum has receded and a large festooned cavity is
present, the space on either side of the hole which is to embrace
the tooth to be filled should be wider than ordinarily made ; other-
wise, when stretched so far up on the gum, there will be leaking
about the edges. Ligatures should be dispensed with as much as
possible. They are frequently the cause of more pain than any
other part of an opei*ation. It is rarely necessary to ligate more
than two teeth, and frequently no ligature at all is needed. The
trick is done by inverting the edge of the rubber so that it slips
under the margin of the gum ; if the root is at all conical, the elas-
ticity will cause the rubber to crawl up and tuck itself under nicely.
If a ligature must be used, a little cocaine is useful. There will
come to us cases where the ligature is absolutely necessary, and
where it seems almost impossible to place it so that it will not ride
up around the crown rather than remain at the gum margin. Let
us suppose such a case in connection with an upper lateral incisor.
The cavity is in the palatal sulcus, therefore the ligature must be
forced up. The trick is to tie a good knot in your silk first ; placed
about the tooth, this knot must come at the centre on the palatal
side ; it makes a good point of resistance for the instrument, and is
pressed up lender the margin of the gum, carrying the rubber with
it; the gum contracting holds it, and when tightly tied on the
labial side holds securely. This is the first point I ever picked up
at a clinic, and, as I have never seen it at one since, I would have
lost a great deal of satisfaction which it has brought me had I been
absent from that clinic.

I alluded to leaking. In a very wet mouth, after the best
precautions, ligatures well placed, it will sometimes happen that
moisture will creep in around the neck of the tooth. Take a piece
of spunk, dip it in gum sandarach, being careful not to get an excess,
and pack it in a rope around the neck of the offender. Then apply
a second ligature which shall tie the spunk in place. The leak will
be stopped. If an instrument has slipped and torn a small hole, it
may be stopped with a bit of sponge dipped in sandarach. Where
the leak is about a clamp, the clamp should be taken off carefully,
a fairly large piece of spunk, treated as described, placed along the
edge of the rubber, and the clamp reapplied so that it bites the
middle of the spunk holding it in place. As to the slipping of a
clamp, it sometimes occurs because the dam is held too tight by

Some Practical Points, etc.^^Ottolengui, 271

the rubber Btrap which passes around the head, or there is a strain
from the dam weights.

In some eases it will be found impossible to apply the dam at
all. There is a way of using the napkin which may not have
occurred to all. A small mouth napkin is rolled into a narrow
fold, and placed about the tooth in the shape of the letter << XT," the
ends forward. It is so arranged that the folds extend slightly upon
the sides of the tooth where it is firmly held in place with a clamp.
There is a special clamp made for this purpose by Dr. Ivory, but
any clamp of suitable form will answer.

There are a few points about ozyphosphate fillings worthy of
note. We have all noticed that what is left on the mixing dish is
usuaUy more adherent and harder than what we put into a cavity.
Both these facts depend on circumstances which are usually absent
in the mouth. To make a dense filling it should be allowed to set
thoroughly before the dam is removed, and moisture should be ex-
cluded for at least twenty-four hours. This may be accomplished
by using a coating of chlora^percha over the finished surface of the
filling. If the dam is left on until this varnish has hardened by
the evaporation of the chloroform it will not wear off for a week,
and I have known it to last two months. Such fillings are com-
paratively permanent. Where we wish to utilize the sticking or
cement quality of this material, the best result .is obtained by first
lightly coating the surfaces with the liquid. This is why the
material is so adherent to the slab. I have thus cemented regu-
lating fixtures to teeth, and at the completion of the work found it
troublesome to detach the cement from the enamel after the fixture
had been forced off.

In teeth which ure sensitive, and where a good general shape
to the cavity is present, do not make a retaining pit or groove for
starting the filling. I am aware that some of you will say. Never
do so under any circumstances. But possibly you preach better
than you practise, and you may make such a pit or groove to-
morrow if you find it more convenient. In sensitive teeth, whether
the pulp be nearly approached or not, a coating of oxyphosphate
between the filling and tooth is an advantage; place it there and
then press gently two or three pellets of gold into it, without
attempting to condense them. When the cement has set, carefully
chip away such portions as have crept over the edges, and the gold
thus cemented to the tooth forms the very best starting-point.
Of course amalgam may be used similarly.

Gilbert's temporary stopping is furnished us in two colors, red

272 Original CommunicatianB.

«

and white. At the first glance it would seem that the white is to
be used in the front of the mouth and the red out of sight. The
difference in color can be better utilized than that. Use the red
to cover arsenic dressings or in any place where immediate con-
tinuance of treatment at the next sitting is imperative. Use the
white for teeth in a comparatively safe condition. In this nuinner,
as soon as the mouth is examined, the observance of the red filling
is as. a danger signal, and calls our attention to the fact that there
is something which may not be postponed.

A gentleman said at one of our meetings recently, *'I have
several kinds of separators ; I could not get along with only one.''
I made a mental note at the time that this was odd, because I get
along without any. I think the separator is a dangerous instru-
ment. It is in rare cases only, where good and sufficient space
may be thus acquired, and in unskilful hands, especially young
practitioners, the probability of failure at the cervical border is, in
my opinion, increased tenfold. If a tooth is to be filled, the first
and most important point is that the completed filling shall be
perfect. There are few men who can put in as good a filling in a
space barely admitting an instrument, and there are fewer still
conscientious enough to do it, even granting them the skilL The
best teaching then for the young, and I think for the old as well,
is to depend on the rubber or wooden wedge. There is a trick in
the application of each. When using rubber allow a bit of it to
protrude below the cutting ends of the teeth. This part, by con-
traction as the teeth move, will swell, and the rubber is prevented
from pressing up against the gum. To apply the wooden wedge,
proceed thus: The wedge is trimmed to the proper width and
should approach a taper very gradually. If it is then made smooth
with a bit of sand-paper it will be less likely to split. Lastly, it
should be soaped. A second wedge should be made quite thin, and
have a shoulder which will prevent it from passing between the
teeth beyond that point. This, also soaped, is placed between the
teeth next to the gum temporarily. Now, when the permanent
wedge is forced into position, this one first placed prevents it from
hurting the gum and offers a slippery surface for it to slide against.
The wedge in place and trimmed to suit, the temporary slip is
removed, and this relief of pressure against the gum is gratefully
acknowledged by the patient. At the next sitting, supposing the
teeth separated but quite sore, gutta-percha should be placed be-
tween them and worn for several days. There is a neat trick
about this. If the material is softened it is frequently difficult

Some Practical Points, etc. — Ottolengui. 273

to fix it tightly in place. Cut a piece from a sheet and press
it into place cold, then smooth and trim into shape with warm
bamishers.

Occasionally, in soldering, a portion of our investment breaks
ofP, exposing a part of a tooth. We can ill afford the time to patch
the break and wait for the plaster to harden again. The exposed
portion of the porcelain may be perfectly protected by covering
it with a thick paste of chalk and water. This mixture may also
be used to fasten small pieces of gold to the solder-block while
soldering.

You all have seen artificial dentures where, after brief wearing,
the front blocks separate, the plate finally breaking in half. To
avoid this, permanently unite the blocks by soldering a platinum
bar to the pins. To do this, after the teeth are ground to proper
position, make a guide with plaster along the outer surfaces and
then take off the front blocks. They are set into position in this
guide, waxed together and invested, when the soldering may be
done, the blocks dropping back into proper place.

There is nothing better than the pins from old teeth, soldered
to a gold plate, for securing rubber attachments. The graving of
a plate or even punching holes is a delusion and a snare. The
rubber will separate from the plate some day. The prettiest and
strongest plate is made with what we know as " celluloid " teeth,
soldered to a gold plate and then rubber vulcanized around them.
The plate teeth are not made in as good moulds.

Don't varnish plaster impressions. Soap the surfaces with a
shaving brush. Be careful to wash off the suds, or the model will
be pitted. Put a little red paint in the water when pouring your
model, and in separating, the model is easily detected, by its color,
from the impression.

Occasionally a gold plate is brought to us with a tooth broken
off, the pins of course remaining in the backing. It may be that a
good match cannot be found, or you may be in a hurry, so that you
wish the same tooth could be used. Proceed as follows: Boil the
tooth in acid to get the stump of the pins remaining as clean as
possible. Invest it as for a backing. Lay a bit of pure gold over
each broken pin and point a fine flame with the blowrpipe till a
tiny gold ball is made on each broken pin. These may be filed
up and will be sufficiently long to allow backing the teeth, using
platinum foil and gold of a lower carat.

18

274 Reports of Society Meetings.

Reports of Society Meetings.

MONTHLY MEETING OP THE AMEEICAN ACADEMY OP
DENTAL SCIENCE, HELD AT THE BOSTON MEDICAL
LIBRAEY ASSOCIATION EOOMS, PEBEUAEY 5, 1890.

A PAPia on "Advantages of Using Celluloid as a Base for
Prosthetic Dentures" was read by Frederick W. Seabury, Provi-
dence, B. I., as follows :

Mb. President and Gentlemen, — I shall take pleasure this
eveniDg in telling you a few of the good points that I know aboat
celluloid dentures ; and get in a few clips at our old enemy, igno-
rance,— ^politely called conservatism. I have been wrestling with
this subject for the past nine years, with varying success. I guess
that I have been on top half the time. Why the Celluloid Manu-
facturing Company, of all people, should have made machines and
published instructions which, when used and followed, reduced
celluloid to a soft, porous, colorless mass is beyond my compre-
hension, but that is exactly what they did. A dentist who could
discover the few good points on working celluloid which are
buried in the thirty-six pages of matter on that subject in Bichard-
son's *' Mechanical Dentistry," fourth edition, would have no use for
them when found. This observation applies with equal force to
dental literature in general.

The amount of reliable data on all subjects connected with
dentistry, to be found distributed in fragments and buried in dental
journals, books, and essays, will astound any one who will take the
trouble to investigate. What dentistry most needs to-day is some
one capable of condensing and amalgamating facts already re-
corded. Celluloid as a base for artificial teeth came into general
use about 1871, and in 1876 we replaced the last plates we had
made with rubber free of charge. There are a few dentists who
have worked celluloid successfully ever since it was introduced,
but the large majority of dentists discarded it entirely as soon as

American Academy of Dental Science, 275

the Groodyear rubber patent expired, in 1881. The advent of the
New Mode Heater and celluloid dentures made in it at the Ameri-
can Dental Association meeting, held in Boston August 3, 1880,
revived interest in celluloid. Of course I ordered a New Mode
Heater, which I received the following spring. I worked a month
day and night without producing a celluloid plate. I did make a
black rubber plate with celluloid gum. Then I started for New
York City to see the inventor, John S. Campbell. He agreed to
come to Providence and teach me what he knew about celluloid for
one hundred dollars and expenses, which amounted to another
hundred dollars. I have four plates here, two black rubber with
celluloid gum, and two celluloid. Campbell made one of each, and
I made the others at that time ; my celluloid plate has the vitreous
surface, his was polished. I then worked a month before I pro-
duced another perfect celluloid plate, after that the percentage of
perfect plates increased steadily.

I have labored constantly to reduce the process to a mechanical
certainty for every dentist who may wish to work celluloid, and
I believe that I have succeeded. The greatest difficulty has been
to discover the length of time required to heat the plaster invest-
ment up to 315^ 7. I probably burned and exploded one hundred
celluloid blanks, and invested one hundred days' work before that
was accomplished. I invented the inclined guide-pin to obviate
the breaking of the plaster investment, over the projecting alveolar
ridge in front, when opening the flask and when moulding. I made
a flask with removable guide-pins to supply the need' of a lateral
movement which was found necessary when opening the flask.
The dovetail lock was invented because plates were liable to bum
or become porous if left in the heater afber moulding. I journeyed
to Philadelphia to inquire if the form of the celluloid blanks could be
changed to resemble dental plates and the color varied. The S. S.
White Dental Manufacturing Company, which desired the change as
much as I did, gave me a letter of introduction to the president
of the Celluloid Manufacturing Company, upon whom I waited in
Newark, N. J. He told me that the plates could be made any and
every shape and color desired, but as they had one hundred thou-
sand plates on hand they did not intend to make any more. I then
visited the Zylonite Company, in New York City. I was cordially
received, and they regretted very much that we had not met before,
for they had hired the same bungling dentist whom the Celluloid
Company had employed, and of course they had a large stock
of Zylonite blanks which they could not sell. Blanks such as I

276 ReporU of Society Meetings.

wanted oonld be made with ono-half of the material, and they felt
badly when they realized the mistake they had made.

Neariy all of the failures to make celluloid dentures can be
attributed to the form of the blanks. The size, shape, and unequal
absorption of the alveolar process, in nearly aU cases, centres the
whole pressure, when closing the flasks, on the teeth where least
material is required, thereby cracking the teeth and investment.
Celluloid is so unyielding that the blank before moulding must be
formed so as to exert an equal pressure on each tooth at the same
time. As no outlet can be made for the surplus celluloid in the
centre or roof of the plate, blanks must be reduced to the thickness
required by the denture when finished, otherwise the flask' cannot
be closed. I now first mould an exact duplicate of the plate desired,
so when moulding the second time with the teeth in place the
pressure will be equally distributed.

The next point is the amount of pressure required to produce a
dense tough plate. After locking the flask, remove it from the
press as quickly as possible and place it in a large bench vice, close
as tight as possible, and leave it there to become cold. You can
easily understand that I was not long in crushing a half-bushel of
cast-iron flasks ; then I experimented with malleable-iron flasks to
the tune of four hundred dollars, — they proved unsatisfactory ; brass
was too soft, bell metal too hard and brittle. My flasks are now
made of bronze a little softer than bell metal.

To make a perfect plate requires a perfect flask. The vitreous
surface is dependent- on a temperature of not less than 300^ when
moulding, and contact of the celluloid with metal at that time.
The artistic possibilities of celluloid and plain teeth are too evident
to need comment.

The advantages of celluloid as a base plate are :

1. The part of the plate covering the hard palate is ^ of an
inch or less thick, and the labial portion only thick enough to re-
store the contour of the face, which with plain teeth makes probably
the lightest denture in use.

2. It is tough and rigid. I have never seen a broken
plate.

3. The vitreous surface protects the plate from the fluids of the
mouth, so they are cleaner even than continuous-gum work.

4. Practically the perfect fit of the celluloid plate counterbal-
ances the conductivity of metal plate so far as inflammation is
concerned.

5. In color the carved stippled surface, afler the tin-foil is

American Academy of Dental Science, 277

stripped off, resembles mucous membrane more than any material
now in use.

6. They are easily adjusted to fit inflamed tissues by dipping in
boiling water.

7. It is easily repaired without changing the fit.

8. Celluloid moulded by dry heat does not deteriorate or change
color.

DISCUSSION.

President Seabury. — ^The subject is now open for discussion.

Dr. Sam. — Mr. President, I cannot say that I have investigated
this matter, or proved it so thoroughly as Dr. Seabury, as I have
not given it the time nor spent the money on it that he has, but
I can say that I have used celluloid since 1871, and have pre-
pared my cases in both ways, — with the metal dies an.d by the old
method. I think that the method of making it between the metal
dies is very much preferable to the old method, as it produces much
better results. The old method in many instances left the case
somewhat porous, and it would absorb moisture and discolor. But
taking it all in all, in the use of both methods, I have never had to
make over any more plates with celluloid than I have with rubber,
and those plates that I have seen, in after years look very well.
I first begun to use celluloid in temporary cases, but I found that
my patients never came back. I never got any permanent work
to do, for the celluloid worked so well that they had no desire to
change. I have a patient who is wearing a temporary celluloid
plate which I made in 1871, and five or six years ago, while I was
doing some other work, the patient was talking of having a per-
manent set, but I have not had the opportunity to make it yet.
It makes a very durable and light denture, and I think second to
none when taking into consideration its cost and the artistic result
that can be produced in all cases. Tou can make just as thin a
plate over the gum as you choose, and still it will look very natural
and it will be very tough and very durable. Now, in order to
produce the same effect with block teeth it would be necessary to
grind them so much that they would be very thin and fragile.
There is another thing I consider of very great value, and that is,
the adaptability of the material to the mouth.

I never have to depress the arch of the plate to make it fit the
roof of the mouth, as I have frequently to do with rubber. Cellu-
loid, if exposed to a dry atmosphere, will warp when made in the old
way, but with the new process the tendency to come together does

278 Beports of Society Meetings.

I

not follow ; the plate will remain very much as when taken from
the metal die no matter how long the exposure, and I have brought
here to-night a case which was made for a patient six months ago.
The arch was high and it was very hard to remove the case from
the die. I do not know whether these three front teeth were
broken in removing the plate from the die or not, and my workman
did not know, but they were broken off in some way, and so the
case was worthless, and I thought I would bring it here, it being
a good one to illustrate this matter. You can see that it was
a difficult case, on account of the overhanging of the mouth.
The plate has been off the die now since it was made, though I
have put it on there once to test it. The case was a difficult one
to handle, and it would be considered such were it a gold plate, bat
when I replaced it upon the die it fitted as perfectly as the day it
was made, and I think it would now go into the patient's mouth
without any trouble. And then the color ; even if it does not
retain it for any great length of time, it cannot be gainsaid that it
is superior to rubber in this respect, as it is certainly very flesh-
like. I am not able to compare it with the continuous-gum work,
as I have never used any in my practice. My experience in repair-
ing it deterred me from ever introducing it in my practice.

The color of celluloid is good, the texture is not as dense as
rubber, but it is fibrous and exceedingly tough. I remember a
partial case of about six teeth, scattered around in various portions
of the mouth, which for some reason did not answer. I have re-
peatedly put my whole weight on that partial set without break-
ing the plate. I think if I have done so once, I have done so a
hundred times. I did finally succeed in bending it with about two
hundred pounds pressure.

And then the artistic effect that can be produced with this
material, I think, is a very desiitible point. The teeth can be
arranged to your liking, with the assurance that a satisfactory
result will follow in the completed plate. If .you employ blocks,
the arrangement is too regular, — too mechanical, the teeth are too
nice. I could not with carved blocks seem to adapt each case to
the individual, but now with these celluloid plates, and being able
to use the plain teeth, it is a very easy matter to move a tooth in
any direction, and you may be sure it will be just where you placed
it, if everything is well done in the laboratory.

Now, there is another point. Dr. Seabury tells me that he does
not stipple the gum, because the smooth surface can be kept cleaner
and neater than the stippled gum. I have seen but very few of

American Academy of Dental Science, 279

them, however, but what looked as good as new and had nothing
upon them but what could be easily removed with a common tooth-
brush, a little prepared chalk, or something of that kind.

On the whole, I am persuaded that celluloid is about as good a
material as we have to use in our laboratories.

Dr, Eddy, — ^I have used celluloid for some years, and, being a
competitor of Dr. Seabury, I have had opportunity to see a great
many celluloid plates which he has made, and I know what he has
said is true. But plates made by the old method, not having a
vitrified surface, do not hold their color, and are not as durable as
those made by Dr. Seabury.

Dr. Chandler. — I would like to ask Dr. Seabury if he uses a
metal die or a hardened plaster cast ?

Dr. Seabury. — A metal die, always.

Dr. PiLlebrown. — What metal do you use ?

Dr. Seabury. — ^I use tin mostly.

Dr. Chandler. — Did you find any trouble in the use of tin in
filling the mould ? Tou cannot make a sharp casting with it.

Dr. Seabury. — I have not experienced any trouble of that kind.
We mould them in sand the same as we do zinc.

Dr. Pillebroum. — I have been much impressed with the remarks
of Dr. Seabury, and am much more interested in the subject than
I expected to be. The excellence of the work shown here is very
marked. I used celluloid considerably in former years, but re-
turned to the use of rubber, as that seemed to serve me better.
I used tin dies for the palatal and lingual surfaces of the plates and
got a very fine hard finish, but I did not coat the labial gum sur-
face with tin as has since been done, and probably that was the
great reason why I laid celluloid aside. There is one other point
brought out in this discussion worthy of consideration,-— that is, the
merits of plain teeth over gum sections for artificial substitutes for
natural teeth. I consider them very much superior in every way.
For nearly twenty years I have used scarcely a set of gum teeth
unless by command of my patient. I agree with Dr. Ham that
plain teeth are best because more easily arranged in the mouth
according to the artistic requirements of the case. Or, to state it
stronger, plain teeth can be arranged artistically, while gum teeth
cannot, but must submit to predestined rigidity. As each plain
tooth can be moved separately, the personality of the patient will
assert itself, and an individuality will be obtained not possible with
gum sections. At one time I was in the habit of carving models
for teeth in wax, arranging them in the mouth and having gum

280 Beports of Society Meetings.

Bets carved for cases. But though the carved sets were far better
than the moulded gum sections, they all came back with a monoto-
nous sameness, very objectionable. The plain teeth with pink
rubber for gum afford myself and my patients great satis&otion.
By using teeth a little longer than natural, but not enough so as
to be noticeable, the gum will show but little if any, and the case
will look a thousand times better than if made with the rigid
sets of gum teeth.

Dr, Banfield. — Mr. President, I had occasion to make a set of
teeth a few days ago where the upper jaw was very prominent,
and finding that if gum teeth were used the lip would be thrown
too far out, I decided to use celluloid made by the Seabury process.
It was particularly advantageous to use celluloid in this case, be-
cause the labial surface of the plate required to be very thin, and
the use of celluloid assisted in arranging the teeth to look more
natural. When the plate was finished the material looked good
and firm and I was well pleased with it.

Dr, Codman. — I would like to ask Dr. Seabury what blanks he uses ?

Dr, Seabury, — They are all White's.

Dr, Ham. — ^If you remember, soon after the introduction of this
material, the works of the Celluloid Company were destroyed by
fire, and the stock they had on hand was either burned up or ruined.
Then there was quite a demand for it, and the company was in-
duced to immediately enter upon the manufacture of it again, and
the consequence was they placed upon the market a material that
had not been thoroughly seasoned. What we are getting now is
very much better.

Dr. Williams. — I wish to ask Dr. Seabury in regard to the non-
warping qualities, — ^whether it is liable to warp ?

Dr, Seabury. — This set of teeth has been lying on the bench and
has been exhibited for nine years. There has been no shrinkage
or warping. They are moulded at such a high degree of heat,
315^ F., that the tendency to warp is overcome.

Dr. Andrews, — I would like to ask Dr. Seabury if the blanks are
any better now than they were before in regard to the shape ?

Dr, Seabury, — They have not been changed. Celluloid has al-
most gone out of use nowadays, and they had such a large stock
of blanks left on their hands that they refused to make new dies.
They realized that they were two or three times as thick as they
need to have been, and of course it would have been a great saving
to them if they had been made the right thickness. As they are,
they have to be scraped to the required thickness.

American Academy of Dental Science. 281

Dr. FUlebroum. — ^Do you make new moulds each time?

Dr. Seabury. — ^We mould a plate every time. First scrape the
roofy-^crape it down to the thickness you want it, — ^then mould it.
and then it is ready to put the teeth on, all of which could have
been avoided if the blanks had been made the right shape.

Dr. Banfidd. — ^There was one thing which I wanted to ask Br.
Seabury, and that is, if he had seen any plates that had been worn
for a year or two and then laid aside ?

Dr. F. N. Seabury. — I can answer that question. About a year
or so ago a lady came to our office who had been wearing a cellu-
loid plate for five or six years. The plate was all right in every
respect, but she wanted to have a gold one made. We have that
plate now, and it is just as perfect as it was then.

Dr. Banfidd. — Have you ever tried it in the mouth ?

Dr. F. N. Seabury, — ^We have never had the opportunity, but
Dr. Ham's demonstration is pretty conclusive on that matter. I
think it does not change.

Dr. Baker. — I should like to ask Dr. Seabury if he has ever had
any difficulty in removing the plate from the metal die ?

Dr. Seabury. — No, sir. You can do that every time by immers-
ing the plate with the tin die in a basin of cold water ; then hold the
basin over a gas-burner, and the flame striking the bottom of the
basin will heat the die ; before the water boils, the plate can be easily
removed. In this machine (the Seabury celluloid machine) a cellu-
loid press and heater are reduced to the simplest form. The ad-
vantage of this little press is that the operator has perfect control
of the case through each stage of the process. I can tell by touch-
ing my finger to the tin die how hot the plaster is. It is the heat
firom the plaster that moulds the celluloid. The flask should be put
in bottom side up, turn the gas on, and leave it in there an hour and
a quarter at a temperature of 320^ F. Then mould. The flask will
close in fh>m four to five minutes. Then remove it from the press
as soon as possible, so that it will not bum or become porous. This
can be done very readily. The flask when it is heated up to that
degree of heat is pretty hard to handle, but the door is large enough
so that you can get the flask in and out quickly without burning
yourself. I have not had an imperfect case since I have used the
heater. I am more sure of the product than I would be with
rubber.

Dr. Bdker^ — ^Do you use the metal always ?

Dr. Seabury. — The metal must come in contact with the cellu-
loid or you don't get a finished surface. You get the same efl^ect

282 Beparts of Socieh/ Meetings.

by covering your plaster with tin foil. The only way yoa can tell
how hot your investment is, is by the siss of the tin die.

Dr. Chandler. — Tin is a very soft metal, and when it is heated
to something like 300^, it will take the impression of almost any-
thing. In the manufacture of vulcanite plates, it will take eveiy
impression of the mould.

Dr. Seabury. — I have never seen more than one or two softened
in nine years. In the case of a very narrow alveolar ridge, I would
not trust the tin, I would use bronze.

Dr. FiUebrown, — How would Babbitt metal do ?

Dr. Seabury. — I don't know. I have never used it.

Dr. FUlebrown. — ^I think that Babbitt metal melts at a lower
degree than tin.

Dr. Chandler. — Oh, no ; between tin and zinc.

Dr. Williams. — ^I would like to ask Dr. Seabury why he does
not use zinc ?

Dr. Seabury. — I do use it occasionally, but it is more apt to
shrink. We mould these tin dies very thin, and it is hard work to
get a suitable mould from zinc. The shrinkage takes place right
in the centre of the roof and you get a hole there.

Dr. FiUebrown. — I would like to ask if there is considerable
celluloid used ?

Dr. Seabury. — I should judge there were about half a dozen
dentists who use it in New England, but I should say that in com-
parison with the number of dentists in the United States they do
not make much of a showing.

Subject passed.

«

President Seabury. — Dr. William Y. Allen will present a new
method of obtunding sensitive dentine.

Dr. Cooke. — Mr. President, Dr. Allen was not able to be here to-
night, so he left the machine at my office, and I will endeavor to
tell you all I know about it.

I understand, Mr. President, that this appliance is not new to
Providence dentists. It has been used there for some time, and it
consists of three parts, — a little alcohol lamp, a little boiler in which
steam is generated, either from water or alcohol, and a little tube,
about ten inches long, to convey the steam to the desired point
The amount of the steam is regulated by a stopcock. I tried the
device on a brother dentist with pretty fair success. Also upon
another case in which the secretions were in a very acid condition,
and where I had had some difficulty in excavating. I started this

American Academy of Dental Science, 283

flame, — ^the steam gets up in a few moments, — ^and, canying this
tube into the cavity, and allowing it to remain there a few seconds,
I took an excavator and out the decay out without pain.

I presume, Mr. President, that some of the Providence gentle-
men can tell more about it than I can.

Dr. Eddy. — I suggest that Dr. Cooke light the lamp. All I
know about it is that it was invented by a gentleman by the name
of Small, and a dentist of the same name has been using it since
last February. Dr. Cummings, I know, has personally used it.

Dr. Cooke. — This is alcohol in the boiler here. When first used
I believe they put in water.

Dr. Williams. — Do you suppose that alcohol is better than
water?

Dr. Cooke. — ^Yes ; steam can be produced at a lower degree of
temperature.

Dr. FiUebroum. — ^I would like to ask Dr. Eddy if he has seen any
cases in which the use of it has been injurious?

Dr. Eddy. — ^Not at «11. I have talked with one of Dr. Small's
patients, — an intelligent gentleman, who has a very sensitive or-
ganism. He was very enthusiastic; having had buccal cavities
filled with little discomfort, when formerly the pain was unbearable.

Dr. Potter. — ^What is the temperature of the steam ?

Dr. Chandler.^-Jf water is used, the boiling point would be
212^ F.; if alcohol, about 174*> F.

Dr. Potter. — ^What would be the effect if the hot steam were to
come in contact with the pulp of the tooth ?

Dr. Eddy. — ^Mr. Lippitt, the gentleman who spoke to me about
it said that it could be put right onto an exposed pulp without any
discomfort.

Dr. Pond. — ^Have you got to put the point of the tube right onto
the dentine ?

Dr. Cooke.— 1 understand it has got to be very close.

Dr. Williams — ^Is the operation done while the tube is in the
cavity, or immediately after ?

Dr. Cooke. — ^You hold it there fifteen or twenty seconds, remove
it, and commence excavating.

Dr. Tafl.—1 would like to ask Dr. Cooke if he considered it
worked successflilly on the two patients at the meeting of the
Harvard Odontological Society ?

Dr. Cooke. — In those cases the success was not marked, but that
proves nothing. Clinics are not always successful.

Dr. Fillebrown. — I would like to ask Dr. Eddy, or some one who

284 * Reports of Society Meetings.

has had experience, if he thinks the sensitiveness is obtunded by
the resorption of the moisture from the tabules of the teeth?

Dr. Eddy. — ^I would say, Mr. President, that I have had no
experience whatever. Dr. Cooke has used it personally and can
tell you more about it than I.

Br, Cooke. — I should hardly think it was caused by the resorp-
tion of moisture, as, after using the steam, we must dry oat the
moisture which is condensed in the cavity before excavating.
This is not so when alcohol is used.

Df. Niles. — ^I want to say a word in regard to this steam ob-
tundent. It was called to my attention a month or six weeks ago,
and from my knowledge of its use in Dr. Allen's hands and my own
experience with it, I am inclined to think there is some merit in it.
I had yesterday a very good chance to test it, and I sent to Dr.
Alien's office and obtained the use of it. The case in hand was the
fracture of a superior central incisor of a young lad about twelve
years of age. The tooth was broken about one-third the way up,
and, in order to piece it with porcelain, it wto necessary to smooth
down considerable of the dentine. I used the steam and it certainly
worked very well indeed. I found that after grinding off a little
dentine, it was necessary to apply it again, and so by alternately
grinding and applying the obtundent I was enabled to complete
the operation, giving the patient little pain. In that operation it
was certainly successful, and I for one do not feel like passing this
matter over so lightly.

Dr. Eddy. — ^Dr. Allen has used it a great deal, and says that
his patients would not think of having an operation performed
without it.

Dr. FiUebrown. — ^The principle is good and there is no doubt it
can be improved on. The boiler can be made to throw medicated
solutions for various purposes, as is now done by the steam
atomizer in throat diseases.

Dr. Cooke. — Dr. Allen made a step in advance by using alcohol
instead of water.

Dr. Taft. — Isn't it liable to destroy the pulp ?

Dr. Cooke. — ^It struck me in rather a ridiculous light when I
first saw the machine, as it seemed as if it would surely cook the
pulp, but by judicious use I do not believe this objection will be
a serious one.

Dr. Taft. — How much of the tooth does it affect?

Dr. Cooke. — ^I find that two thicknesses of common note paper is
about the depth that the dentine is obtunded.

American AccuUmy of Dental Science. 285

Dr, FiUebroum, — ^I should say that if it was obtunded half the
thickness of one sheet of note paper, it was a perfect success.

Dr. Baker. — I think myself this thing is worth investigating if
nothing more, and I for one would like to try it. My attention
has been called to it several times lately through my patients ; if it
has merit we have got to have it ; if it has not, it will die a natural
death.

Dr. Codman. — I saw the explosion here this evening, and I would
not have such a thing as that happen in my office for five hundred
dollars. I don't think any dentist here would. We all know how
unwisely people will act when they come into a dentist's office, —
how they will do the most extraordinary and unexpected things,
and how careful we have to be so as not to shake their confidence
in us. I do not see the necessity of having the lamp placed near
the patient's mouth, for accidents in its use would be fatal to the
confidence of our patients.

Dr. Niles. — I think Dr. Pillebrown is in a position — ^being at
the school — to make a thorough test of this apparatus, and I am
sure the inventor will be very glad to loan one to the Academy for
the purpose of investigation. It seems to be a risky thing to be
experimenting with in ordinary practice until we have had some
instruction in the use of it from some one who has had experience,
and in the clinic there are plenty of exposed pulps and oppor-
tunities for experimenting that we would not have in our offices.

Dr. Banfield, — I will ask one question which I think might be
very interesting, if those gentlemen who have used it can answer
it, and that is, if they have themselves, or any one else, tried to
destroy a pulp that they wished to remove, with this instrument.

Dr. Eddy, — I have never heard it spoken of as used for that
purpose.

Subject passed.

Dr. Banfield, — The S. S. White Dental Manufacturing Company
have kindly sent me their Howe Fissure Chisels to be exhibited to
the society. Also, the Perry Dental Engine, which you will please
examine.

Dr. Mam. — If there is no other business to come before the
society, and the exhibition of dental appliances is now in order,
Mr. President, I would like to exhibit a method of adjusting a
rubber ligature to a regulating case. I have never seen it used by
any one else, and I think it is original, — still it may be very old.
Moat of us are accustomed to using buttons, hooks, etc. I simply

286 Beports of Society Meetings.

make a hole of proper size throagh the rabber plate, and on the

palatal surface I countersink with a square ended bur. I then

take a silk string and pass it through the loop and pull the end of

the rubber ring through the rubber plate, and the resilience of the

rubber will fill the countersink in the plate and hold the ligature

firmly, I then clip the string off even with the plate and leave it

in the loop.

William H. Potter, D.M.D., Editor^

American Academy of Dental Science,

SEVENTH ANNUAL SESSION OF THE MARYLAND

STATE DENTAL ASSOCIATION,

(Continued from page 229.)

The annual seesion was held on December 5 and 6, 1889, at the
St James Hotel, Baltimore, the president, B. P. Keech, M.D.,
D.D.S., in the chair.

Friday^ December 6, 1889, — Afternoon Session.

Beport from Committee on Anatomy, Physiology, and Histology,
consisting of Drs. R. B. Winder, chairman, Bicbard Grady, and W.
H. Montell.

Dr. B. B. Winder. — ^As chairman of the committee of the Section
on Physiology, Surgery, Histology, and Microscopy, I will have to
report that, by some means or other, the impression was made on our
minds that anatomy was included and placed at the head of the list
of subjects for our consideration. So it was thought wise to com-
mence with this fundamental branch of all medical studies, and
offer a paper, this year, on anatomy as a starting-point, to be fol-
lowed next year by one on physiology ; the year after, by one on
surgery ; and later still, by one on histology and microscopy. We
beg leave to apologize for our misconceptions, but, in all due defer-
ence, would suggest that anatomy properly belongs to this section,
and should be added thereto. At the committee meeting a general
plan of dealing with this subject was agreed upon, and Dr. Bichard
Grady generously consented to work up the matter, and present
what your committee have to report, and to him belongs the credit
of preparing this essay, which to him, no doubt, has been a very
laborious pleasure. We sincerly hope that his efforts will be duly
appreciated.

Maryland State Dental Association. 287

Bichard Grady, M.D., D.D.S., then read the following paper on
Anatomy.

The Committee on Anatomy, Physiology, and Histology, as now
constitnted, in order to fill an important gap which has existed
since the Association was founded, has confided to me the difficult
task of preparing the report for this year, it being understood that
the other members will, if reappointed, severally speak on Physi-
ology and Histology at future meetings. A twenty-minute paper
on anatomy must of necessity be rigidly eclectic, when many vol-
umes are given to its full exposition. I have intentionally ab-
stained from burdening the text with references, and have freely
used the works at my command ; in some cases paraphrasing, or
even adopting verbatim^ the author's language, when it suited my
purpose.

The dental organs, through the digestive function, hold an im-
portant relation to the whole body. Dentistry, therefore, includes
the sciences which lie at the foundation of all medical art. The
anatomy, physiology, and pathology of dentistry should, therefore,
differ in no respect from that of medicine ; in fact, human anatomy
is a distinct branch of study in connection with physiology, pathol-
ogy> surgery, and therapeutics ; and a dentist's knowledge of these
fundamental sciences admits of no limitation; in most cases his
knowledge is insufficient to give full value to the subsequent lessons
of experience.

During the primitive ages of the world anatomy, which is now
one of the most important branches of natural science, was little
cultivated as a science, and hence the art of surgery was unde-
veloped. The ancients, ignorant alike of the anatomy and diseases
of the human body, supposed that manual dexterity was all that
the surgeon required; and the well-known etymology of the
word surgery — "hand-work" — conveys that idea. In our own
day, in our own city, a like sentiment has been expressed, it be-
ing claimed that dentistry is ninety-nine and a half per cent, me-
chanical. The surgeon, during the last half of the century, has
not been considered inferior to the physician. He must be his
equal in medicine to become eminent; and besides possessing a
knowledge of anatomy, the M.D., for his major operations, and the
D.D.S., for his minor operations, should have, to use the language
of Celsus, " a hand steady, expert, and never tremulous, and an
intrepid mind." To guide them in their delicate and difficult opera-
tions, a proper knowledge of the relations of organs to each other,
such as the positions, forms, dimensions, structure, and peculiari-

288 Beports of Society Meetings.

ties of nerves, vessels, muscles, glands, and membranes is necessary.
They must know where to cut and what to avoid in operating on the
living body, for the life of the patient might be jeopardized if
they were not well acquainted with the anatomy of the vital organs.
It is difficult to determine the date at which the science of
anatomy began to be cultivated.- It is probable, says Gralen, that
JBsculapius, who excelled in the treatment of wounds, dissected
animals for the instruction of his pupils. Although among the
Jews the touching of a dead body involved ceremonial uncleanness,
they did not entirely neglect anatomy.^ They counted two hun-
dred and forty-eight bones and three hundred and sixty-five veins
and ligaments, which division, it is said, has relation to the two
hundred and forty-eight precepts of the Mosaic law that comjnand
and the three hundred and sixty-five that forbid. Hippocrates
was the first author who treated anatomy as a science. He caused
a skeleton of brass to be cast, which he consecrated to the Delphian
Apollo, with a view of transmitting to posterity proofs of the prog-
ress he had made and stimulating others to the study of anatomy.
Aristotle possessed nothing certain on the subject beyond what
could be drawn from the probable resemblance of the correspond-
ing parts of other animals. He first gave the name aorta to the
great artery. Human bodies were first dissected b.o. 300, and it is
said that some condemned to death were dissected while they were
still alive. Galen (a.d. 131) dissected apes, as being most like
human subjects, though he occasionally obtained bodies of children
exposed in the fields, or of persons found murdered, which, how-

1 1. That the Jews paid attention to anatomy is shown by the fact that Hebrew
possesses names for all the organs and their parts. Cf. '* Das Arabiache und
Hebraische in der Anatomie," Yon Dr. Joseph HyrtI, Emeritus Professor of
Anatomy at the University of Vienna (Vienna, 1879). 2. There is recorded in
the Talmud a case of dissection. In ** Bechoroth/' 45, a, it is related that a
certain disreputable woman was condemned to be burned, but that her body
was given to the pupils of Eabbi Ishmael, who discovered that a woman's body
contains two hundred and fifty-two, and not two hundred and forty-eigbt,
bones. 8. The ancient Jews had simple and effective remedies for diseases,
which contrasted strongly with the almost universal use of magical formula
employed by other nations. Cf. Dr. Joseph Bergel, " Die Hedizin der Tal-
mudisten nebst einer Anhange die Anthropologic der alter Hebraer'' (Leipsic,
1886). 4. The sanitary regulations concerning the food drew the attention of
the Hebrews to anatomy. Thus a cow must not only be slaughtered according
to certain regulations, but its lungs must afterwards be examined, and if any
trace of pleuro-pneumonia be found, the flesh of the animal w,as considered
unfit to be eaten.

Maryland State Dental Association. 289

eyer, he was obliged to dissect in secret. There was at this time
no regularly prepared skeleton, as there was a Boman law forbid-
ding the use of dead bodies. Galen also collected the works of his
predecessors. He first showed that arteries in the living animal
contain blood, not air alone ; but it did not occur to him to notice
the circulatory movement of the blood; that was reserved for
Harvey -fifteen centuries later. As you know, the ancients sup-
posed the arteries to contain '* spirits" or air, because, when cut
open in the dead body, these vessels do not collapse, as a vein
would, but stand open, allowing the air to pass in. It was this cir-
cumstance which led the old anatomists to believe that the arteries
also contained air during life.

Anatomy made small progress among the Arabs, which is ac-
counted for by the Mohammedan religion prohibiting contact with
dead bodies ; but the Arabians cultivated the .natural sciences in the
Middle Ages when they were neglected by the Christians. When
a great Arabian physician (Bhases, 852) was about to be oper-
ated on for cataract, he discovered that the surgeon was ignorant
of the structure of the eye, and refused to submit to the operation.

Anatomy was now neglected for a long period, till the £ing of
Sicily, in the thirteenth century made a law forbidding any one to
practise surgery without having first acquired some knowledge of
anatomy. He founded a chair, at the solicitation of his chief
physician, where the science was demonstrated for ^ve years.
Students from all parts crowded to it, and some time after a similar
school was established at Bologna, where one of the surgeons
(Yigo) boasted of having dissected more than one hundred subjects.
Beports were circulated that he had dissected living Spaniards, and
he fled or was exiled. Another surgeon (Yesalius, 1514) had the
misfortune to open the body of a young Spanish nobleman whose
heart was found beating, and he was obliged to make a pilgrimage
to Jerusalem. The first work in English on anatomy was published
in 1548.

In the seventeenth century progress was rapid. Harvey, in
1619, discovered the circulation of the blood, and the microscope
was employed to detect the structure of minute vessels. In 1622
the existence of lymph-vessels was discovered and demonstrated.
The glandular vessels were investigated by Wharton, while Mal-
pighii and (in the following century) the illustrious Buysch, by the
use of injections and the aid. of the microscope, gave a new impulse
to the research in minute structures. Eminent names in the history
of anatomy are numerous in the eighteenth century. We find them

19

290 Beparts of Society Meetings.

in Italy, which still retained its former pre-eminenoe; in France,
including Biohat, the founder of general anatomy ; in Germany,
Haller and Meckel prepared the way for greater aohievementa in
the nineteenth century ; in Great Britain, Hunter and Charles Bell
contributed to the progress of the science. On the boundaries of
the two centuries we find names nearly all connected with practical
medicine, which was benefited by the studies in anatomy. Many
of the great discoveries of comparative anatomy and general
anatomy have been made in the present age ; and the systematic
study and development of minute anatomy dates from the improved
construction of the compound microscope. The necessity of a
union of theory and practice has led to the zealous study of patho-
logical anatomy by modem scholars. Eminent contributors to
comparative anatomy are familiar to you, as are also the names of
those who have studi.ed it with especial reference to physiology.
First Italy, then Holland, Denmark, Sweden, Grermany, France,
England, and America have furnished them, but popular prejudices
have hindered free dissection of human bodies in medi<»l schools
until a very recent date.

The word '' anatomy" is still commonly used to signify *' human
anatomy." Almost all begin the study of the science as medical
and dental students with the dissection of the human body, aid
most end there; but no special anatomy can be rightly and folly
understood save on the basis of general science, of which it is an
integral part. The reason lies in the diversities of organic strac-
ture being subordinated to a principle of unity.

Without some knowledge of comparative anatomy it is im-
possible to understand the beautifblly progressive development of
organisation. It is necessary even for the fiiU comprehension of
the uses of many parts of the human body, which, apparently mdi-
mentary and useless in man, are highly developed in other animals.
This science is also the basis of physiology and the natural classi-
fication of animals. On a subject so vast as this, comprehending
the whole range of animal life, it will be impossible here to gi^e
anything but the briefest sketch, making it referable to the organs
of alimentation and digestion, and especially to the teeth.

In man the upper jaw-bones contain all the upper teeth; but in
the lower animals the incisors are contained in the intermaxillary,
a persistence of separation which may be detected in the human
foetus. Ko animal but man has a chin. In all below him the
interior arch of the lower jaw is convex vertically and retreating
at its lower margin.

J

Maryland State Dental Association^ 291

The range of the subject of dental anatomy turns upon the
meaning which is attached to the word " tooth." Most vertebrates
and a great many invertebrates have certain hard masses in or
near to the orifice of the alimentary canal, — i.e,<^ the month* By
these hard masses, sometimes of bony and sometimes of homy
nature, various offices in connection with the prehension and
comminution of food ^re performed, and to them the term ^* teeth"
is applied. In many animals teeth have come to be used for other
purposes, such as for sexual warfare ; but it can hardly be doubted
that teeth have primarily to do with the nourishment of their
possessor. No one can doubt, whether from the comparison of
adult forms, or from a study of the development of the parts,
that the teeth of the shark correspond to the teeth of other fish,
and these again to those of reptiles and mammals. It may be
clearly demonstrated that the teeth of the shark are nothing more
than highly-developed spines of the skin, and therefore it is inferred
that all teeth bear a similar relation to the skin. This is what is
meant when teeth are called " dermal appendages," and are said to
be perfectly distinct from the internal bony skeleton of the animal.
The teeth of the shark, and of many other creatures, remain em-
bedded in tough, mucous membrane, and never acquire any con-
nection with the bone. Indeed, all teeth are developed from a part
of the mucous membrane, and any connection which they may
ultimately get with the bone is a secondary matter. It has been
well expressed by Dr. Harrison Allen, in his '' Anatomy of the
Facial Begion," that '* if the hairs of the scalp were to be inserted
into the skull, or of the moustache into the upper jaw, we should
express great astonishment, yet such an extreme proposition is no
more remarkable than what is seen to take place in the jaws."
Again, "the feathers of certain birds making impressions on the
radius, the whalebone pendent from the roof of the mouth, are
examples of this same association of tegumentary appendages with
the bones." In their simpler forms, then, the teeth are met with
as very numerous spines. In many fish the teeth, though more
specialised, are scattered over almost every one of the numerous
bones which form part of the walls of the mouth and pharynx ; in
reptiles they are much more limited in position, and in mammals
are absolutely confined to the intermaxillary, superior maxillary,
and lower maxillary bones. In fish and reptiles it is the exception
for the teeth in different parts of the mouth to differ markedly from
each other; in mammals it is the rule.

There is no organ so characteristic of the animal, as distin-*

892' fieporto of Society Meetingt.

guiflhed from the vegetable, as ui internal digestive cavity for the
conversion of organio snbstanoes into nntritive material. In the
sac-lilce polyps (e.g., the animals that form coral) the food U intro-
duced into the simple stomach and dissolved vithoat any mechani-
cal division ; in the higher invertebrates, and all the vertebrates,
there is a distinct mouth, an apparatus for mastication, a stomacb
for digestion, and an intestine from which the nutrient matters an
absorbed and the useless materials are expelled. In vertebratefl the
teeth are confined to the cavity of tbe month, and generally to the
jaws, none being found in the stomach. In serpents, which feed on
living prey, the sharp, conical teeth are directed backward and the
booea to wbiob they are attached are freely movable, enabling
them to swallow animals considerably larger than themseivea; tbe
venomous class have in the fW)nt of tbe upper jaw two (Professor
Winder has seen more) long, curved fangs, commonicating by
a oanal or a groove with the poison-gland behind and below the
orbit; the masoles which close the jawa press the venom into the
wound made by the teeth ; in the rattJeenake tbeee fangs are
movable, and may be bent backward in a fold of the gum when not
in ose; behind the ones actually employed, there are rudimenu
of others which soon complete tbe terrible armature, if one &ng
happens to get broken.*

A. Tb» polioii-b*s. S. A (kng, nmored.
The bill flimishes to the zoologist as good characters for the
classification of birds as do the teeth for that of mammals; its
exterior and the sharp edges are covered with solid bom, but it
never has any true teeth, so that there is no proper mastication
in this class.

■ Tbe cut ftffords a Ti«w of the poiton-gland, and the backwud pgtltion
of tho fkDgs. Tbe initant tbe wound la Inflicted, tbe roott of tbe fooga pma
heblud on the Tenom-bkg, cftualng tbe fluid to run doirn a groove or chancel
in «toh Cing, bj which mean* the vinu ii carried directly into tbe puncturei

Maryland State Dental Association. 293

The existing kinds of vertebrates oonstitnte part only, perhaps
but a small proportion, of those which have lived. More than one-
half the groups of the class indicated by osteal and dental charac-
ters have perished ; and it is only by petrified fasces or casts of the
intestinal canal, by casts of the brain-case, or by correlative deduc-
tions from characters of the petrified remains, that we are enabled
to gain any glimpses of the anatomical conditions of the soft parts
of such extinct species: by such light some of the perishable
structures of these animals are indicated in works of comparative
anatomy.

As vertebrates rise in the scale, and the adaptive principle pre-
dominates, the law of correlation, as enunciated by Cuvier, becomes
more operative. In the jaws of the lion, for example, there are
large canines, formed to pierce, lacerate, and retain its prey. There
are also compressed, trenchant, flesh-cutting teeth which play upon
each other like scissor-blades in the movement of the lower upon
the upper jaw. The lower jaw is short and strong ; it articulates
with the skull by a condyle received into a corresponding concavity,
forming a close-fitting joint which gives a firm attachment to the
jaw, but almost restricts it to the movements of opening and closing
the mouth.

The jaw of the carnivora develops a plate of bone of breadth
and height adequate for the implantation of muscles with power to
inflict a deadly bite. These muscles require a large extent of sur-
face for their origin from the cranium with concomitant strength
and curvature of the zygomatic arch, and are associated with a
strong, occipital crest and lofty dorsal spines for vigorous uplifting
and retraction of the head when the prey has been gripped. The
limbs are armed with short claws and endued with the requisite
power, extent, and freedom of motion for the wielding of these
weapons. These and other structures of the highly-organized
carnivora are so co-ordinated as to justify Cuvier in asserting that
the '' form of a tooth gives that of the condyle, of the bladebone,
and of the claws, just as the equation of a curve evolves all its
properties ; and exactly as, in taking each property by itself as the
base of a particular equation, one discovers both the ordinary
equation and all its properties, so the claw, the bladebone, the
condyle, and all the other bones individually give the teeth or are
given, thereby reciprocally ; and in commencing by any of these,
whoever possesses rationally, the laws of the organic economy will
be able to reconstruct the entire animal. The law of correlation
receives as striking illustrations from the structures of the herbiv-

294 BeportB of Society Meetings.

oroas mammaL A limb may terminate in a thick, homy hoof;
Bach a foot eerres chiefly, almost ezclosiyely, for locomotion. It
may paw the ground, it may rub a part of the animaVs hide, it may
strike or kick ; but it cannot grasp, seize, or tear another animal.
The terminal ungulate phalanx gives, so Cuvier declares, the modi-
fications of all the bones that relate to the absence of a rotation of
the foreleg, and those of the jaw and skull that relate to the masti-
cation offered by broad-crowned complex molars.

DISCUSSION OF BXPOBT OF COMMITTEE ON ANATOMY, PHTSIOLOQT, AND

HISTOLOGY, PBB8BNTED BY DB. OBADY.

Dr, B. SoUy Smith, — I think that Dr. Grady deserves much
credit for the able, clear, and concise paper which has just been
road. It is customary in our schools to impart a knowledge of
special anatomy or of those branches of it that may be of special
interest to the dentist; but being of an intricate nature, the stady
is one that requires a student to devote his whole time to it if he
would become proficient in it. This it is not always possible for
him to do, and the consequence is that, as a rule, the members of
our profession, while possessing a general knowledge of anatomy,
do not make any great pretensions as surgical or anatomiMl
experts* Therefore, when an operation is to be performed requir-
ing the location of an important artery or nerve, an appointment
is made and sufficient opportunity is afforded meanwhile for the
operator to brush up his knowledge and prepare himself for the
special operation.

Unless afforded opportunity to mature our thoughts upon the
subject, I do not think we are capable of adding anything to the
anatomical history which has been detailed, and which could have
been prepared only after the most laborious and patient investigation.
I can only say that the study of anatomy is an absorbing and fas-
cinating one. Certainly mathematics cannot be more attractive to
its devotee than is anatomy to one who persistently and patiently
devotes himself to acquiring a knowledge of it. I have only to
say, as an apology for my inability to lead the discussion in a direc-
tion so interesting as the one here indicated, that we as specialists,
while having a knowledge of anatomy, do not possess any special
qualification for an intelligent discussion of the subject.

Dr> B. B. Winder. — Anatomy, as is well known, is like mathe-
matics or the multiplication table in that it is a subject that does
not admit of much difference of opinion or controversy. The paper

Maryland State JDental Association. 295

just presented received my eDdorsement as the chairman of the com-
mittee on the subject, and I have nothing to add to it. It is an
accumulation of facts that have been compiled by anatomists, and
I believe its statements to be absolutely correct. There are many
interesting points connected with anatomy which are not embraced
within the scope of the paper and which would not be fit subjects
for discussion here.

Dr* A. J. Volck. — ^A paper like the one just presented is under-
stood to be literally accurate in its statements. I therefore beg
pardon of my friend (Dr. Orady) to allow me to correct what I
consider to be one error in it. I refer to the statement in regard
to the rattlesnake. The paper speaks of the rattlesnake as shut-
ting its mouth when it bites. The doctor is mistaken in regard to
that. The rattlesnake does not shut its mouth when it strikes;
and what is true of the rattlesnake, in this respect, is equally true
as to other poisonous snakes. The teeth lie flat in the mouth dur-
ing quiescence, and are only erect when the snake strikes* This is
a peculiarity not of the rattlesnake alone but of all venomous snakes.

Dr, B. Ghrady. — If the statement of the paper is not accurate, I
am grateful for the correction.

Dr. B. &. Winder. — ^I do not think that Dr. Yolck is correct in
assuming that the language of the paper is as he has stated it.
That the rattlesnake strikes and does not bite, so far as the use of
its poisonous fangs are concerned, is well known. If the paper
contains a statement to the contrary, the error escaped not only my
notice, but that of the other members of the committee.

Dr. B, Orady. — The statement was based not upon any personal
knowledge of my own, but simply upon what I regarded as a mat-
ter of record. I have not here the authorities with which to sup-
port the statement, but I have preserved the original extracts
which I made and will refer to them later. Upon consulting one
of our members who, I thought, was familiar with the peculiarities
of the rattlesnake, he was unable to give me sufScient light on the
point, and I was obliged to rely upon the books. I will either
verify the statement or, if it is not correct, expunge it.

Dr. A. J. Volck. — That part of the report to which I refer states
that 'Hhe venomous class of serpents have in the front of the
upper jaw two or more long, curved fangp, communicating by a
canal or a groove with the poison-gland behind and below the orbit;
the muscles which close the jaws press the venom into the wound
made by the teeth ; in the rattlesnake these fangs are movable, and
may be bent backward in a fold of the gum when not in use."

296 Reports of Society Meetings.

That is what I say. They are bent backward in all poisonona
snakes. In the rattlesnake these fangs are movable.

My object is to show that it made an exception in &yor of the
rattlesnake as the only snake whose teeth are movable and lie back
in the mouth daring quiescence; my own contention being that
this peculiarity is applied alike to all poisonous snakes.

Dr, Edward Nelson, — I endorse the general scope of the paper,
inasmuch as, instead of being confined to the extraction of teeth
and the making of artificial teeth, it has taken a wider range upon
the theory that dentists should be educated in all the branches
pertaining to their specialty. Begarding it in that light, I think
the paper is ably written and is worthy of the endorsement of the
Association.

Dr. W. A. Mills. — I must take exception to the statement of the
paper in reference to the embalming of the dead by the Jews. I
believe that the Jews are stric^y opposed to embalming, though
there was an exception in their case, as we learn from biblical
sources, and that was when Jacob was embalmed and carried from
Egypt.

Dr. Volck, — He was embalmed by the Egyptians.

(To be continued.)

ODONTOLOGICAL SOCIETY OP PENNSYLVANIA.

The regular meeting of the Odontological Society of Pennsyl-
vania was held Saturday evening, January 4, 1890, at the hall,
Thirteenth and Arch Streets. President Truman in the chair.
A paper was road on " The Dental Crown,"* by W. H. Gates, D.D.S.,
Philadelphia (see page 257) ; also one by C. H. Littleton, D.D.S.,
Philadelphia, on ''A New Beamer for Pulp-Canals," as follows:

There is no operation in dentistry which requires more skill
and care than the treatment of the roots of devitalized teeth, and
yet, judging from the various methods advocated, the dental pro*
fession is far from a satisfactory solution of the problem.

It is not the intention of this paper to discuss the different
conditions requiring root treatment, but only to present some new
facilities for the preparation of the canal and hermetical sealing of
the apical foramen.

^ The diflcuBiion of thig paper was deferred until Dr. Littleton's paper had
been read, and both papers were then discussed together.

OdorUdogical Society of Pennsylvania. 297

To insure permanent Baocess, it is neoessary, first, to carefhlly
remove the entire contents of the canal without forcing any sub-
stance whatever through the foramen ; secondly, the canal must be
sufficiently enlarged at the apex to enable the operator to make
a filling at that point with a strictly impervious, non«absorbing
material.

To accomplish this an instrument is necessary that will cut
smoothly, clearing itself as it advances, without any piston-like
effect. The instruments I use for this purpose are self-centring in
the canal without the usual guide-point. The ordinary point on
a canal reamer has a tendency to force material in advance instead
of withdrawing it, and it also retards the cutting. The only
bearing of this reamer is its rounded front, which, by being short,
enables it to centre itself in the canal without interfering with the
fiezibility of the stem. This front is cut into very definite blades
for rapid cutting and self-clearing ; and the general form of the
reamer, being a fiattened globe, serves to withdraw the cuttings.

The longest diameter of a pulp-canal reamer should be at right
angles to the stem, in order to permit the flexible stem to control
it from its front instead of from the rear. Thus it is always free
from the cramped position of a long bodied reamer and the con-
sequent danger of breakage.

The stem should have a fine spring temper, so as to operate
easily at any required angle, — its flexibility vaiying according to
the directness of the canal. For the more crooked canals it should
have a uniform flexibility extending two inches from the cutting
end.

The handle is octagon in shape, which, in connection with the
flexible stem and cutting front of the reamer, makes this hand
instrument so delicately sensitive to the touch of the operator that
he is enabled to feel its advance in the canal, and, by the greater
resistance, judge of. its approach to the end of the root. I have
them made in sizes varying from 1 to 4.

To hold the flexible stem at the necessary curve, and thus
relieve the reamer from side-pressure when operating in the roots
of posterior teeth, I have a hole made through the centre of a
mouth-mirror ; the stem passing through from the back can thus be
controlled by the handle of the mirror.

For convenience in placing the flexible stem in this position
a narrow slot is cut in the mirror from the side opposite the handle.
Hooks soldered to the rim of the mirror will also further assist in
guiding the instrument.

298 ReporU of Society Meetings.

In reaming, or in any operation in a pulp-oanal, it is of the
first importance never to produce a pneumatic or piston-like effect.
Periodontitis is often produced from this cause alone*, as a babble
of air, charged as it is apt to be with septic matter, is highly irri-
tating, and its imprisoned elastic force, if maintained, is more hurt-
All to the peridental membrane than a puncture by an instrument.
It is, therefore, obvious that thorough desiccation of the canal
is an essential prerequisite. With perfect dryness and the self-
clearing action of this instrument no material whatever will be
forced through the foramen.

In operating in a small and crooked canal, as, for instance, in
an anterior lower molar, the approach at the mouth of the canal
should be straightened with the engine-bur, cutting in that case
very freely towards the front walls.

To ream a canal with safety and facility the reamer must be
proportioned to the size of the canal. Having followed a veiy fine
canal with reamer No. 1 a short distance, — ^thus obtaining greater
freedom for the flexible stem, — it is easily enlarged with No. 2.

When the end of the root has been reached with this reamer,
there is a definite shoulder formed at that point, against which an
amalgam filling not larger than a small pin-head can be easily
made. The amalgam should have such plasticity that a small
portion may be carried on one of these reamers and tamped gently
to place. Amalgam is well adapted for this purpose because so
little force is needed to make it an hermetical stopping, and, being
noD-porous, it cannot become charged with septic matter. As cot-
ton, the cements, and especially gutta-percha absorb the matter
that remains more or less present in all cases, the necessity of im-
pervious sealing at the apex is clearly indicated. The apical fora-
men being sealed with amalgam, the remainder of the canal can be
filled with cotton covered with gutta-percha, or other material easy
of removal, if future operations in the canal be found necessary.
Should it ever be necessary to reopen the foramen, the small
amalgam filling can be readily cut away with one of these
reamers.

In case of an enlarged foramen, from whatever cause, the
softened dentine and cementum can be removed with one of these
instruments, and a shoulder formed near the end of the root with
the next in size, against which a plug of platinized silver wire
covered with amalgam may be adjusted.

The amalgam filling, made at the end of the root, affords great
advantage when the root is used for crown- and bridge-work, en-

Odontohgicdl Society of Penngylvania. 299

abling the deeper anchorage of the pin and preventing any distarb-
ance of the peridental membrane daring insertion or removal.

DIS0V88I0N.

Dr, J. A. Woodtoard. — The reaming of root-canals has been as
strongly advocated as objected to by many competent operators.
The practice of those who do not ream is largely the result of the
use of defective instruments. After a straggle to remove the tem-
pered point of a drill firom a canal difficult of approach, most of us
are carefbl not to have that experience repeated, and, to avoid it,
only ream or enlarge a canal as &r as we can perfectly control the
instrument used.

The set of reamers presented to us to-night is a decided ad-
vance. The slender, flexible shank permits the cutting blades to
follow a canal, when the reamer is of proper size in relation to the
diameter of the canal, and should give us the means of safely ream-
ing where we would not venture with the older drills. The per-
forated mirror is an ingenious assistant. As to reaming to the
apex of all roots, I have been led by experience not to try it. Gen-
erally I ream sufficiently to gain access near to the apex. I have
found that the less the canal at the apex is interfered with the
better has been my success.

My experience with crown- and bridge-work has been quite
limited, but if for an abutment for a bridge or not I think all roots,
with few exceptions, should be so treated that the canal-filling
should not need to be removed, as removable root-fillings appear to
invite the very conditions we wish most to avoid. The use of
gutta-percha to make the joint between the new crown of Dr.
Grates and the root I can unreservedly endorse, as it has proved
with me the best material for that purpose.

Dr. Register, — I do not think it matters much whether you
ream or not. In reference to root-fillings we are not able yet to
distinguish just which roots should be filled with cotton, which
with gutta-percha, and which with amalgam at the apex. If the
pulp has been removed, I prefer to fill the tooth with amalgam even
to the apex. I am much pleased with the instrument and think it
a very good idea.

Dr. Boberts. — If I understand it right, the doctor claims that by
the flexibility of the stem of his instrument he gets a delicacy of
touch &r greater than with the ordinary instrument, and which
enables him to follow any canal and prevents any mistake.

300 Reports of Society Meetings.

Dr. Littleton. — Dr. Roberts grasps the idea. If there is any
canal, that instminent will follow it, and follow it to the apex. The
instrument is very delicate to the toach. Then, the great advantage
is that it does not push matter ahead of it and carries no septic
matter into the canal. If we have to reach the apex of a bad root
in a tortaoos canal, while this reamer will follow the canal it will
not push matter in advance of it.

Dr. Jamison. — When I first began to practise dentistry I used
to feel along with a flexible instrument which would cut the canal
open ; but now I have no use for it. From the instrument ex-
hibited it looks very much to me that it cannot but force matter
ahead of it from the twist which it has.

Dr. Littleton, — If the doctor will take my instrument and try
it awhile I think he will change his mind and will find it quite
different from what he anticipates.

Dr. Faught. — Some six weeks ago I had the pleasure of giving
some statistics to a society in New York on '' whether to ream or
not to ream," and I can assure you it is a moot question, and not
at all decided that we should always ream. I would like to know
the practice of each, and hope all present will state in their discus-
sion whether they are in the habit of reaming. I let the apex
alone after I have cleaned out the root-canal. It may be some ad-
vantage to the teeth to fill the apex with cotton, gutta-percha, or
what not, but I fail to see it. When I wish to ream a canal I
can feel with a fiexible instrument as well as I can with a flexible
point.

Dr. Tees. — I am pleased with Dr. Littleton's reamer and think
it is a good instrument. The fault of Dr. Grates's crown is that the
post comes to the labial and not the palatal surface of the tooth.
I think an offset of ^ to -j^^ of an inch on the next tooth will serve
very little to hold it in place.

Dr. Gkites. — The anatomy of the tooth will determine the direc*
tion of the post.

Dr. Tees. — This crown is some advance upon posts for the
teeth.

Dr. BonwUL — It is so seldom that we hear of a new thing with
any real merit in it that we are always inclined to doubt the use-
fulness of it. But I am inclined to think well of Dr. Grates's crown.
I have crowned teeth which were used for five years, and no trouble
was experienced with them.

Dr. Truman. — In regard to Dr. Gkitos's crown it is evidently an
advantage to have the post or pivot on the concave side of the root.

Union Meeting of Dental Societies, 301

When properly applied with the instruinent which Dr. Chitee has
described it is undoubtedly a great improvement. I regard it as a
usefbl addition to prosthetic dentistry.

INCIDENTS OF OFFICS PBACTIOK.

Dr, Head. — ^I have been noticing for a year or two past that
something has been making fearful ravages in the teeth of my
patients. I found that on every occasion of this my patient was
an ardent lover of " acid phosphate.*' I felt there must be some
connection between this drug and the trouble with the teeth, so I
determined to investigate the matter. To do this I got a supply
from a druggist and dropped a tooth into it, and found that in thirty
minutes it had formed a thin film on the outside of the tooth and
the whole enamel was softened. In two days the enamel was as
soft as the other part of the tooth, and the whole tooth could be
crumbled away.

Such being the case, I thought it best to report it to this society,
that others having patients using this drink might warn them of
its deleterious effects.

Dr. Truman. — ^I have heard the same complaints made against
this drug, and feel that we all should warn our patients against
its use.

UNION MEETING OP THE CONNECTICUT VALLEY
DENTAL SOCIETY, THE NEW ENGLAND DENTAL
SOCIETY, AND THE CONNECTICUT STATE DENTAL
ASSOCIATION, AT SPRINGFIELD, MASS., OCTOBER
23, 24, and 25, 1889.'

(Gontinaed from page 285.)
DENTAL EDUCATION.

BT N. MORGAN, D.D.S., SP&INQFISLI), MASS.

Much has been and is constantly being written on the subject
of dental education. Is the profession as a whole even reasonably
well educated ? A few have been fortunate in acquiring an ad-
vanced professional education, and are qualified to associate with

^ Beported for the Intsrvatiokal Dxntal Joubnal by Geo. A. Maxfield,
D.D.S., Holyoke, Masi.

302 Reports of Society Meetings,

members of any learned profession, and many of these men are
endeavoring to lift the laggards into the light and, after revealing
to them their need, to hold up high standards of attainment. That
which was the peculiar privilege of the few may become, to a large
degree, the possession of many. Are we satisfied with the sordid
element in our nature which looks only to the return of dolhurs for
our work ? or, shall we cultivate the humanitarian element which
is a blessing to the sufferers who come to us for relief?

To claim that wonderfhl advancement has not been made would
be libellous ; dentistry is moving forward, but we are not satisfied
with the return for the efforts put forth, — ^it is not all that could be
desired or reasonably expected.

If this statement is accepted as correct there must be some
reason for our present condition. Would it • not be well to try to
analyze our situation to some extent? Perhaps we may arrive at
more efiScient methods for its improvement.

First let us glance at our present educational facilities, — ^their
advantages and failures. For those who can avail themselves of
them, — and every individual who now enters the profession should
do so, — ^there are the dental colleges with their corps of earnest and
efiftcient workers. They furnish facilities for the acquisition of
education, both of mind and th^ equally essential one of hands
skilled to work out the suggestions of the mind. That the colleges
are to be praised for such efficient work we all agree. At the same
time they do not claim to educate a student so that he will have
no further need of increasing fitness for work, but rather an adapta-
tion of the individual for additional study and research.

A second class to consider is made up of many practitioners who
either could not or would not take advantage of these privileges.
These have, however, the same educational facilities at hand
common to us all. I refer to the dental literature which includes
some journals of great excellence; dental societies, clubs, etc
These organizations are usually open to all who have a desire for
improvement, at the same time being of slight expense, compared
with most social clubs.

This, then, seems to be our condition as a profession ; there are a
multitude of men of various ages, — many with slight early educa-
tional advantages and at present without the perception of how to
study, or the ability, so to speak, of knowing how to set themselves
to work in a practical and productive way. " But," remarks some
one, <* we have known all this for years, and have we not been
striving to bring about a more desirable condition? and are we

Union Meeting of Dental Sodetiee, 303

not almost disooaraged in the attempt to make oar profeBsion an
honored one, and to place it on a plane with the medical profeesion,
aspiring to have oar vocation recognized by the world as a branch
of the healing art ?" What is the result ? We are forced to confess
ourselves still in bonds to our surroundings, but not in the way
of permitting them to cause discouragement. We have not the
history of the medical profession, it is true, but we are capable of
making history. To-day we are not so proud of our ancestry as
our deeds. It is the apostolic ^'forgetting that which is behind
and reaching out to that which is before" which is to make our
personal or professional success. Betrospection may be productive
of good, if our mistakes and failures lead us to change our ways so
as to avoid the evils of the past.

We believe that there is a still better outlook, if not throagb
one avenue, perhaps another will be opened. Unforeseen excep-
tional advancement may be made in the coming year or years, and
the object of presenting this paper is to offer possible suggestions
in the way of its achievement.

For a long time we have been convinced that our present
desultory method should give place to a systematic course of study
outside the college walls. We read many essays and articles, good
enoagh in themselves, but without collateral study they lose much
of their power. How different would have been the effect of Pro-
fessors Andrews's and Sudduth's lectures of last evening if the hear-
ers had previously read something relative to the subject? Some,
if they study at all, prefer special lines of study, which in our opin-
ion should /oKoto a course having a general outlook. One apparent
need in this direction is an element which shall draw us together,
a uniting of interests, " a brotherhood," if you choose to call it so.
Cannot the '' Chautauqua" system be so modified as to meet our
demands ? Most of us are somewhat familiar with the workings
of that system, and know of the wonderful educational and moral
influence it has and is yet exerting. There are now circles in
almost every civilized portion of the world, over one hundred
thousand persons having been allied to the movement. This result
has not come by chance but by natural laws.

President Garfield, in a speech at Chautauqua, said, <<It has
been the struggle of the world to get more leisure, but it was left
to Chautauqua to show how to use it ;" the real Chautauqua idea
being the saving of time, the gathering up the moments which are
ordinarily wasted, and so employing them as to bring rich returns.
The student is encouraged to study because, virtually, he has a

304 Reports of Society Meetings.

tutor; becauBe a well-defined coarse of stady is prepared for him ;
because a multitude of associates are pursuing the same, and a
feeling of sympathy is common among them.

Besides the study, there are the *' Local Circles,** which bold
regular meetings in the interests of their work, whereby great
enthusiasm is aroused. At the end of each year comes a test to
be answered in writing, and to those who persevere and pass suc-
cessful examinations for four years a diploma is awarded. After
this general course, special courses may be pursued, which are
increasingly interesting and instructive and may be continued
indefinitely.

The query now is. Can we not adapt to our own need a system
similar to this? If we have not already such text-books as we
need, can they not be prepared, — books concisely written and suited
to such a purpose? We have sometimes overlooked the best in our
lack of time to discriminate carefully, and the inferior on which we
often stumble discourages us from perusing further, but we may
have a systematic pursuit of such knowledge as will in some way
or degree fit us to become more of a power in every feature of cor
profession. Is not that method which *< reaches down and lifts
men up" one by which we may bring the greatest number into
line? The greatest difficulty in leading men into the student life
is the first step ; for after the taste is formed the difficulties begin
to vanish.

A thirst for knowledge is a law of our being given for good of
self and that of the whole world. If the desire is dormant it may
be revived by suitable influences. Our particular branch of science
is as distinguished as any for the demand it makes upon skill In
manipulation, and although the laboratory and chair fhmish the
best school for our handicraft, yet we need as much knowledge as
we can assimilate and organize into a basis for our work, — ^not
thinking of our own pleasure alone, but as an obligation to those
who put themselves under our care.

If such courses of study were presented to oui; profession to-
day, the needed requisites being at hand, how many would rejoice
and take advantage of the privilege ? How many Jiere present would
be glad of the opportunity? How many would form clubs or
^ circles" of two, six, a dozen, or more, meeting from time to time
for discussions of subjects gone over, for experiments, or anything
which would help to make study a pleasure and our life brighter
and better worth the living.

I am sure members of the old <^ Springfield Dental Club" will

Union Meeting of Dented Societies. 806

•
agree with me that pleasure and frieDdly intereets are promoted
and the wearinesB of many an hour lightened by such intercouTBe.
How much stronger the bond of sympathy if there were clubs in
Boston, Hartford, Providence, and every other place where a club
could be organised, all using the same course of study, — or some
perhaps taking the advance courses, but all in the same general
organization. Some will make excuses, — want of time, want of
opportunity, want of talent or of cleverness. Are we making the
best use of all our time? Are we improving the one or more
talents given us ? Are we as clever as we might be if we sought
to know what another's cleverness has done? Great and good
thoughts may lie in the mind of an individual brother for his
personal good ; he may not be able to write an acceptable article
for a journal, but meeting another who possesses the gift of clear
and forcible speech without the power of originality, they can
conjointly benefit the brotherhood. There is a vast amount of
thinking that ought to be in the market, bringing in great returns.
It might surprise us to learn that while on change, our idea, ex-
pressed faultily though it may have been, was taken possession of
by one who so transformed it with beauty and strength that when
it returns to us and others, it may aid us in our work, or, warming
and refining our hearts, help us to be more perfect in character
and life.

How such an organization can be brought about is hardly
possible for one single-handed to determine. Perhaps a committee
might bring the subject before the American Association.

Some journal might be published in its interests. Possibly Pro-
fessor Sudduth and the managers of the International Joubnal
might use its pages for the purpose, and the enterprise be managed
by them and an associate committee from the American Association
combined, the courses of study and text-books to be selected and
arranged under their supervision. It would be necessary for every
person to become a regular matriculant and pay the nominal fee
therefor, in order to enjoy<the privileges of such an organization
and become eligible to receive a diploma at graduation. The
matriculation fee should be as low as possible and books furnished
at reasonable rates. The whole expense need not be so great as to
prevent any one from entering the ranks. Probably there are few
among us who do not squander more each year than would cover
the necessary expense for the course.

Moreover, the increased respect in which each member would
be held by the community would tend to increase and improve his

20

30Q Beports of Society Meetings.

praotice, thus bringing a material return for all investment in the
cause.

It is to be emphatically stated that this method is in no sense
suggested to take the place of the present college course, but is
subsidiary to it. Rather is it to precede and follow the college
course, and for those already in the profession who are debarred
from its advantages. As long as we live we may learn if we will.

DISOUSSION.

Dr. Barrett, — The subject is one that should appeal to the in-
most professional heart of every dentist who loves his calling.
What has the future in store for us ? Are we to sit still, to rest
content with what we are, or shall we make an advance that will
be commensurate with our past history ? This matter is not now
presented for the first time. The West has had it under considera-
tion, and Dr. J. D. Moody, of Illinois, has written some very
thoughtful papers in advocacy of a system of post-graduate study,
somewhat upon the Chautauqua plan, which commends itself to
every thoughtful dentist. In this new and aggressive department
of medicine there is a hope found nowhere else. We are opening
up new fields. We are free and untrammelled, and are not held
down by the bonds of precedent and established custom, as are all
the old professions. We have not to look back and guide our foot-
steps by the past, but need gaze only ahead. There are no narrow^
prejudices to hamper us, no old traditions to keep inviolate, but we
are like children upon the virgin prairie, and may stray where we
will. Divinity is held down by iron creeds which forbid free
thought, and which prescribe a narrow path beyond which the
members of that profession may not stray, nor even look. Law ia
more a matter of precedent than of prescribed rule, and courts in
their interpretation, even of written statutes, are governed by the
opinions of those who have gone before, and into the merits of
which they may not inquire. Medicine is largely a system of
empiricism, and it is necessarily the most conservative of pro-
fessions. Consider what has been the fate of those in that pro-
fession who have advanced new theories and ideas. Think bow
the grand discoveries of Harvey and Jenner were received; re-
member the inertia of medicine and its intolerance of new prin-
ciples, and then ask yourselves what hope the world of science has
there. But we have no creeds, no precedents, no past by which
we must be governed. Dentistry has such a chance as has never

Union Meeting of Dental Societits, 307;

been granted the older professions, which have existed since man
emerged from a state of barbarism and have not had our oppor-
tunities to start on a career guided only by nineteenth-century,
enlightenment. There is nothing to hinder an advance such as the
world has never seen. Shall we make a record for the fUture, or
shall we be content to rest where we are, thinking ourselves as
large as we ever can be.

I have never seen a December in which I did not think I could
view a manifest advance from the preceding January. All my life
I have been climbing, climbing, standing on tiptoe, watching for
the dawn of a yet earlier sun. I hope to continue thus until I shall
for the last time hail the dawning of a new professional advance-
ment. Dentistry is very largely made up of men who are neces-
sarily earnestly looking towards the future, because they have no
past to rest content in. It is in this that its hope lies. What shall
the future bring forth ?

Our colleges are continually taking advanced ground. But they
do not yet represent the highest type of thought. They are not
sufficiently ahead of the body of the profession. If they do not
set a step that is sufficiently quick, if the rank and file are to tread
upon their heels all the time, let the societies take the advance and
give a new pace. We need a higher education, a deeper erudition.
If this is not to bo found^in the schools, let the private offices
furnish it. There is no reason why we should not blaze a path for
the world through certain sections of the great forest of ignorance.
There is an opportunity for dentistry to make for itself the very
highest expression of scientific knowledge. All that is needful is
that we should earnestly put our hands to the work and unitedly,
shoulder to shoulder, take up the line of march for higher acquisi-
tions. What could resist the impulse of a united profession, earnest
for the right?

I am anxious to see the Bast take the lead in this great work.
I want to see the sun of intelligence rise here and illumine the
whole world. But this is not to be done by one man or one society.
There must be united e£fbrt. The East and the West must be in
accord, and all our societies must strike hands together. There-
fore, I suggest co-operative committees from every society, which,
acting together, shall thoroughly organize all earnest dentists into
a compact body that shall lift a standard to which all must bow,
and set a pace into which all the progressive men of the world
must fall.

Dr. W. H, Atkinson, — The remarks we have just listened to

308 BeparU of Society Meetings.

coincide with what I think most about when I am alone. I have
feared that we had come to' a point in our ambition where we were
about to take a permanent rest. It will be necessary to have some
revival, at least of our ambition, to enable us practically to formu-
late and push forward the very desirable course suggested by the
last speaker. I think his reference to the so-called profeadons
being confined to iron creeds is fast being removed. For you
scarcely find old fogies among old .graduates of divinity or den-
tistry. They are not following out the old leads. Med.icine es-
pecially has become so imbued with the spirit of progress under
the hands of impatient young men that they have about discarded
the old way of writing prescriptions. As far as divinity is con-
cerned, you can scarcely find a man who has cheek enough to
preach eternal hell any longer. As to the other profession, I do not
feel there is much to encourage us, for they go by precedent. They
•esteem it a breach of brotherly feeling and respect to file a decision
that has not been rendered before in some of the courts, irrespective
of the testimony before the court, or of the facts of the case, and
so they decide more frequently against truth and innocence. It
looks foolish to have a set of boys — as we may call them — ^who
have discovered a better way to instruct human beings, and
learn from them how to deal with an adverse environment of the
human mind. But we must go to them if we progress.

There is no such thing as getting a formulative syllabus, that
will reveal to us all the pathological changes. I defy any man to
so state the history of any case of disease as to make it cognate
with any disease he or anybody else will ever see afterwards.
Could we get a little more familiar with a few established basal
principles, then we might have something like what I suggested at
the last meeting of the American Dental Association.

The time to do something in the direction of the suggestions in
the paper is now, when our minds are drawn to it and we see the
necessity of it.

It will be the bappiest day of my life when I can rise above my
ignorance and prejudice and sincerely investigate a case, and it will
intensify my joy if I could find my brethren following in that same
journey.

Dr. Miller. — I feel that this is a subject of very great impor-
tance, and I hope some means will be taken to follow out the sug-
gestions in the paper. It seems to me a committee should take
this into further consideration and carry it forward and not let it
drop here. I therefore move you, that a committee of three be

Union Meeting of Dental Societies. 309

appointed to bring in a list of five or more that shall be a committee
to take charge of this subject and to* report some plan — ^that will
be practical — ^at some future meeting.

Dr. Wiepard. — ^If any action is taken, it should be by the
whole profession, not by a few societies. Now, if these societies
could take the initiative, and appoint a committee which would
bring other societies to work in the same direction, you will finally
secure a congress that would act for the whole country.

Dr. Bhein. — I agree with Dr. Barrett's sentiment on this ques-
tion, and I would like to amend the motion. It is not to give a
course of instruction in any particular school. I therefore move
the following amendment: That a committee of three be appointed
to try and secure co-operation of various dental societies in the
United States, to further some plan of this kind, and such com-
mittee to confer with similarly appointed committees from other
societies and report at some future meeting.

Dr, Maxfield, — The suggestions made by Dr. Morgan in his
paper are too good to be lost, and that they may take some practi-
cal shape, I would urge the original motion.

Dr. McManas. — A large committee will be better than the one
suggested by Dr. Rhein. I think the chairman would like to be
relieved, and therefore I think it might be well for the chairman
to name a committee to report a committee for adoption by this
meeting. I think the subject suggested is practical, and if carried
out, future generations will rise and call the men of this day
blessed.

The president then put the motion and it was carried, and
Drs. Morgan, Brackett, and McManus were appointed.

After a conference, this committee reported the following names,

which were adopted as the permanent committee to take this

subject in charge: Dr. N. Morgan, of Springfield, Mass. ; Dr. G«orge

A. Maxfield, of Holyoke, Mass. ; Dr. William J. Bider, of Danbury,

Conn. ; Dr. George L. Parmele, of Hartford, Conn. ; Dr. W. B. Page,

of Boston, Mass. ; Dr. A. M. Dudley, of Salem, Mass.'

Subject passed.

(To be continued.)

810 EdUoriaL

Editorial

DENTAL SOCIETIES.

The past fow years have been eventful ones in the history of
dentistry. No one thing has contributed more towards the de-
velopment of this specialty into a science — and a recognized place
among the medical specialties — than the excellent work done by
the dental societies.

The society has, in the highest degree, been the birthplace and
main-stay of dental literature. Had it not been for its fostering
care, our literature never would have reached the high plane upon
which it rests to-day. The emulation between the different societies
has been the most powerful lever to draw out the busy practitioner
and secure from him literary efforts which have tended to better
the individual and elevate his fellows. Dentists as a class are not
inclined to literary work. They labor at the chair all day, and
when the evening comes they much prefer the intercourse of the
family circle to the solitude of the study ; and it is only the promise
to prepare a paper for some association, which is made in most
instances under great pressure, that spurs the physically weary
man to exert himself mentally for the benefit of his brother
specialists.

There is a small class of dentists, however, who write articles
for publication from other motives, but they are not the ones who
are best prepared to instruct, for, as a rule, they are not practical or
successful men ; and the very fact that they have the time to write,
in many instances is proof of their unfitness to do so. In every com-
munity are to be found busy men who are most thoroughly prepared
to furnish the very best literature, but who seldom or never write
anything. Their time is too valuable to spend in putting thoughts
on paper when they are coining their efforts into gold. If they are
ever induced to present anything to the profession, it is through the
earnest solicitations and sometimes importunities of the executive
committee of some society. Theirs is seldom, if ever, a voluntary
effort ; and if estimated by the actual loss of time would come high
in dollars and cents, so high, indeed, that no journal in this country
could afford to pay for it; nevertheless, it is given without cost
to some society and appears in its published proceedings. These

Editorial, 311

papers represent the very cream of our dental literature, for they
bristle all over with practical points that could not be obtained in
any other way. Their value is always in the inverse ratio to their
production. The society, therefore, deserves the fullest praise for
its success in bringing out the very class of men who are best fitted
by experience and ability to furnish our literature.

Not only does the society give us our leading papers, but it also
furnishes an opportunity for the exchange of opinions under the
head of '' Discussions." It is there that the dentist is most at home,
and the ideas that are drawn out under the inspiration of the
favorable surroundings are most valuable contributions to our
knowledge. It is true that drift-wood and repetition sometimes
creep into discussions, but if well edited, they form the most valu-
able portion of our literature ; little bits, practical points, and com-
parisons of methods are put in close space. The paper in this issue,
on '^ Some Practical Points learned at Society Meetings,'' is proof
of the truth of these statements.

POST-QRADUATB COURSES.

The society forms a post-graduate course of instruction for the
busy practitioner, in which he may-secure many advantages, and
add to his knowledge of methods of practice. Too much stress can-
not be laid upon the value of society meetings, and it has been with
the full knowledge of their importance that this journal has stead-
fastly worked to secure the exclusive control of the proceedings of
the leading dental societies of this country and Europe. How well
it has succeeded may be known by the fact that the International
stands to-day as the official organ of the Academy of Dental Science
of Boston, the New York Odontological Society, the Odontological
Society of Pennsylvania, the Chicago Dental Club, and the American
Dental Society of Europe. In addition it contains the exclusive
reports of the meetings of the New Jersey State Dental Society, the
Massachusetts State Dental Society, the Union Meeting of the New
England Dental Society, the Connecticut State Dental Association,
and the Connecticut Yalley Dental Society ; the Pennsylvania State
Dental Society, and th*e Maryland State Dental Society. It has
also received reports through its numerous foreign correspondents
from several foreign dental societies. To give some idea of the
amount of matter presented at these meetings during the past
year we will refer to Volume X. of the International Dental
Journal, 1889, which contains 766 pages of original matter and a
topical index of 52 pages. By reference to the latter, it will be

812 JSdUorial.

seen that during the year four thousand two hundred and thirty
Bubjeots were discuaeed by nearly two hundred dentiatB,— 4tn aver-
age of over three pages to each person. The volume also contains
eighty-one illustrations, including three photogravure plates, all the
efforts of dentists in dental meetings, and, altogether, it forms a last-
ing record of the good work done in the leading dental societies in
this country and Europe during the year.

In this review of our dental societies we do not desire to over-
look the work of the several district societies of New York State,
especially that of the First District Society of New York City and
of the American Dental Association, reported in the Oosmos^ nor
of the Illinois State and the Chicago Dental Societies, the reports
of which form the basis of matter for the Dental Review,

DENTAL BSOTION OF THE AMSBIOAN MEDICAL A880GDLTI0N.

Then, again, within the last few years there has been a steady
growth in the direction of the Dental Section of the American
Medical Association. The meeting last year, at Newport, was a
most successful one, and the meeting this year, to be held at
Nashville in May, promises to be the most brilliant one yet. The
programme, as published in the April number of this journal, con-
tains a splendid array of talent. The report of this meeting belongs
exclusively to the journal of the American Medical Association,
which has a circulation of over five thousand. It is needless to say
that the papers of the Dental Section hold their own in importance
and scientific interest with those of the other sections. The paper
by Dr. Andrews, in the journal of the Association of April \%
illustrated by a full-page plate showing the predisposing causes that
lead to decay, and the other able papers read before this section,
and which have appeared during the year, cannot help but have an
influence upon the status of dentistry, and tend to interest medical
men in dental science, and instruct them in a specialty in medicine,
of which general practitioners have heretofore known but little.

No single movement that has been undertaken in late years by
dentists has promised more towards bringing together what has
heretofore been considered two separate professions .than this sec-
tion in the American Medical Association. Medical men are begin-
ning to learn that dentistry is something more than a mere trade,
and dentists are really finding out that dentistry has many things
in common with medicine, while all are willing to admit that den-
tistry, practised as a specialty in medicine, is one of the nicest
specialties in existence.

BiUarial 318

BIBLIOGRAPHY.

Man and His World. By John Darby. Philadelphia: J. B.
Lippinoott Company, 1889.

The pseudoDyme of '^ John Darby" belongs, as is well known, to
the distinguished philosopher and surgeon, Professor James B. Gar-
retson, A.M., M.D., of Philadelphia. Amidst the exactions of a busy
city physician's life, and the demands upon his time as a teacher in
a leading school, he has yet found leisure to give to the world, by
means of his various works, many thoughts of a character so pro-
found and comprehensive as is seldom met with in this age.

The first part of the book, << Two Thousand Years After," was
published some years since ; but with the addition now of a second
part, " The Philosophy of the Eternal Now," the author has given
the volume the more suggestive title of " Man and his World." The
groundwork of the book is the pleasing conceit that Socrates and
his friends resumed, two thousand years after his tragical end at
Athens, the fascinating conversation as reported by Plato ; but now
with its scope enlarged by reason of an acquaintanceship with
modem Positivism. All those who have a mind above the merely
practical affairs of life, whose thoughts love to soar into the realms
of the recondite, and to grapple with what is hidden from the ma-
terial eye, who find the mysteries of matter, man, mind, and soul
ever interesting and enticing subjects for reflection, will discover
much in this little volume that will give them pleasure and mayhap
enlightenment.

Philadslphia and Its Bnyirons. J. B. Lippincott Company, Phil-
adelphia, 1889, pp. 232.
This little book is prepared with the same neatness and elegance
that marks all the publications of this firm. Every place of interest
is mentioned, copious illustrations are given, along with a good map
of the city, all making a volume of so much value that visitors
here and even residents can hardly afford to be without it.

Thrbb Introduotort Leotures on the Science of Thought. By
F. Max MI^ller. Chicago : Open Court Publishing Company,
1888.
These lectures were delivered at the Boyal Institution, London,
and first published by the Open Court Company. The illustrious
name of the author is a sufficient guarantee as to the quality of the
matter, and the name of the publishing company as to the mechani-
cal 'character of the book.

314 Foreign Correspondence.

Foreign Correspondence.

To THB Editob:

Having just returued from a trip through Kew Zealand, I enclose
a report of the first annual meeting of the New Zealand Dental
ABSOciation, which was formed at a conference of delegates held in
Wellington last July.

'< The sittings were held at the Criterion, and occupied two dajB.
The following gentlemen were present: Messrs. Boot, Hunter,
Throp, J. P. Armstrong, P. Armstrong, Bobinson, and Hewitt, of
Dunedin ; Messrs. Thomas and Merewether, Christchurch ; E. Cox,
Auckland ; J. Goodwin Cox, Tiraaru ] and Thompson, Ipvercargill.
Apologies were read from Messrs. Bawson, Hoby, and others unable
to attend.

<^ Mr. Boot (president of the Association) occupied the chair, and
welcomed the members to Dunedin.

'' At the sittings of Thursday, after receiving reports from branch
representatives, the by-laws of the Association were reconsidered
and confirmed, the first only of these evoking prolonged discussion.
The question as to whether membership should be thrown open
to all registered dentists, without any condition to the mode of
conducting practice, was fully discussed.

'< The sitting of Friday morning was devoted to the considera-
tion of the ' code of dental ethics.* In compliance with the requeet
of the Wellington Conference, Mr. E. Cox submitted to the meeting
a paper upon this subject, dealing with the obligations of the den-
tal practitioner in relation to his profbssion, to his patients, to his
confrireSy to the medical profession, and to the general public. With
the vote of thanks Mr. Cox was desired to revise his paper for
publication with the report of the proceedings of the meeting. The
afternoon sittings considered the legal opinions received from Sir
Bobert Stout, and the cases of alleged violation of provisions of the
Dentist's Act already open to litigation.

'^ A vote of thanks to the president and secretary, and the deci-
sion to hold the next annual meeting at Christchurch, closed a very

cordial and successful conference.

<< Alfred Burne.

" Stdkky, Australia.*'

Domestic Correspondence, 316

Domestic Correspondence.

To THE Editor :

A question ofprofessional ethics, — I have never been of those who
felt particularly solicitous concerning the source of dental litera-
ture, so long as the quality was satisfactory. Particularly in our
journalism have I felt indifferent, provided it be good journalism,
and such as will add to the dignity and subserve the best interests
of dentistry. Perhaps I have at times thought that I recognized
a tendency in the mercantile and trade element to dictate to and
antagonize the professional, but I have clung to the idea that these
matters will regulate themselves. I have thought that only fair
play was demanded, and the good sense of dentistry would settle
the rest.

Our calling is not strictly amenable to the rules which govern
any other, because, while, as I believe, it is professional in its main
aspect, it has a mechanical and artisan-like side. Every thinking
man knows that the laws which govern trade and mechanics are
not applicable to a profession. The methods which are entirely
legitimate in mercantile ethics are inadmissible where a liberal pro-
fession is concerned. Advertising, for instance, which is the life of
trade, all men agree is quite beyond the bounds of professional
ethics.

The dividing line between that which is '^ professional" and that
which is ^' unprofessional is exceedingly difficult to make manifest
to the eye of a layman, but it is as obvious as one's nose to him
who, having been regularly admitted within the pale, is animated
by true professional feeling. To men engaged in trade, and whose
minds are pervaded by mercantile ideas, the laws ofprofessional ethics
are quite incomprehensible. An American or a Frenchman cannot
understand the admiration of the Welchman for the odorous leek ;
but to him who has been trained in Welch lore and tradition the
leek stands for all that is honorable and heroic in his national his-
tory. To the Indian our national flag is but a piece of gaudy
patchwork ; but to the American patriot it is the symbol of his
nationality. So to the real professional man the spirit of the code

316 Ihmettic Carrtspandence.

of ethics, although it may be foolishness to the unprofessional Greek,
is that which marks his professionality.

I recognise in dentistry two elements ; the one strictly profes-
sional according to the code of oar mother profession, medicine ;
the other more nearly allied to mechanics and trade. Although in
a measure antagonistic in certain aspects, it does not follow that
they should make war upon each other. Their mutual relations
may, and should be, discussed in a spirit of temperance and candor.
Grood men on each side are doubtless swayed by their interests and
their associations, but that gives no excuse for recrimination. The
man who has, perhaps, gone through a professional course of study
and then left the professional ranks and gone into trade, or who has
introduced some manufacturing interest into his professional life,
cannot but be imbued with the spirit of trade. AnotUbr may have
devoted himself to the mechanical part of his calling and drifted
out of professional associations and sympathies. He may have an
inventive talent, and have devised some ingenious appliance from
which he desires to reap a benefit. There is no reason why he
should not do this, so long as it is done decently and in order, but
he should not insist that the man who has kept strictly within
ethical lines should adopt his views and methods. He should be
prompt to recognize the fact that just to the extent to which he
has gone into trade has he abandoned a professional life, for a man
cannot follow both. Who will claim that the dentist who has com-
menced the manufacture and sale of some vendible article, or who
has gone into mechanics, is any better judge of ethical matters
than he who has kept within the line of medical ethics? More
than this, who will deny that the mind of such a man is not, to a
greater or less degree, imbued with those trade methods and ideas
which are antagonistic to professional life? Such a man maybe
quite as conscientious as another, but he is scarcely qualified to sit in
judgment upon professional matters. Trade is quite as honorable
as a profession, but it is not identical with it, and is not amenable
to the same laws. If a man is imbued with the spirit of the one,
he cannot enter into the feelings of the other.

The most of our dental journals are edited by men engaged in
active professional life. Their sympathies are with dentistry and
not with that which is antagonistic to it. They are legitimate
members of the profession, and not outside of it, engaged in trade.
So when a question of ethics arises, they are qualified to speak upon
it without being liable to the charge of impertinent intermeddling
with that with which they have nothing to do, and which, from the

Domestic Correspondence. 317

very drcamstunoeB of the case, they cannot comprehend. Yet some,
even of these, it seems to me, have not been professionally just in
certain instances.

Nearly a year ago, Dr. H. G. Merriam presented before a well-
known dental society his views upon certain matters of profes-
sional ethics. No one could question his right to do this, for he
occupies at least a respectable position among dentists, is known as
a candid and honorable man, while his intelligence is undisputed.
Certainly no one will deny his devotion to what he believes to be
the best interests of dentistry, nor the purity of his motives. He
viewed nuitters, as might naturally be expected, from an exalted
professional stand-point. He thought he saw certain tendencies
which were inimical to professional advancement, and he pointed
these out, clearly but dispassionately. There was no tinge of per-
sonal malice, no bitterness of disappointed ambition manifest, but
from his high position he argued against what he thought were de-
basing tendencies. What was the consequence ? The journal in
which his article was published as a part of the transactions of the
society made answer to it from the mercantile view, as of course
was to be expected, but it also took him personally to task for
openly discussing general principles. The very party which is
least qualified to speak upon a question of ethics severely con-
demned the writer for discussing professional relations. An advo-
cate who has no standing whatever in court assumed to sit as a
judge in a strictly professional matter, and this was echoed not
only by every editor who is in trade, but by some from whom
might have been expected different sentiments. '* Tray, Blanche,
and Sweetheart" all opened upon the trail of a professional man
who had only spoken of professional matters before a professional
audience. There seemed a determination to make an example of
him ; to so hold him up to personal ridicule and disparagement as
to make of him a solemn warning. A distinct opposition to the
commonly accepted ethical spirit was shadowed forth, and a de-
termination to deter others from resisting what they might hon-
estly believe to be an encroachment of the mercantile upon the pro-
fessional spirit. Granted that the writer was utterly mistaken in
his views of professional matters ; had he no right to express his
opinions before his professional brethren and invite discussion of
the subject? Perhaps he was incompetent to judge what was for
the best interests of dentistry ; but were those who had nothing in
common with professional life any better qualified ? If he mis-
represented the real feelings of true professional men, did he not

318 Current A'evcs.

appear before a tribunal which is an acknowledged authorily upon
Buch questions ?

The treatment which he received stirred the blood of more than
one dentist who had not recognised a possible danger, and instead
of repressing a professional spirit it has stimulated it as nothing
else could have done. It seems time that some voice should be
raised in behalf of fair play. If professional men are to be throttled
because they express views which may not tend to the profit of
trade, we all should know it. We have seen dentistry bound hand
and foot, by patent rights and sordid monopolistic aggression, in a
vulcanite web from which nothing but death reliev<vi it. We are
even now threatened by another exhibition of this same tendency,
and nothing but a bold, determined, united action will protect us.
That same patent-right element has endeavored to strike down the
man who stands as our representative in resistance. In his defence
every professional arm has been raised. Why should not the same
desire for fair play be guaranteed another who honestly endeavors
to strike a blow for what he deems to be professional honor? If
he be mistaken, we ourselves should be the judges of the fact. If
he be right, surely it is time that somebody sounded the trumpet
and raised the cry, " To your tents, O Israel I" We have no quarrel
with trade, but we do protest against its assuming to sit as a judge
in matters of professional ethics.

W. C. Barrstt.

Current News.

At the March meeting of the Chicago Dental Club it was voted
to engage Dr. W. X. Sudduth to deliver a course of lantern lectures
upon Biology during the first and second weeks of June.

On March 25 the Chicago College of Dental Surgery graduated
a class of sixty. The whole class numbered seventy-one, but eleven
of these failed to pass satisfactory examinations and conseqaently
did not receive the much coveted diplomas. This is an indication
of more thorough work on the part of the college and a determina-
tion not to graduate incompetent men.

Current News, 319

Dental Education was the theme for disoussion at the last
meeting of the Chicago Dental Club. The paper of the evening
was prepared by Dr. C. Stoddard Smith, of the Illinois State Board
of Dental Examiners. The discussion was opened by Professor
E. L. CliflFord and Dr. B. S. Talbot.

The Faculty of the Chicago College of Dental Surgery are
determined to have the '^second" International Dental Congress
held in Chicago in 1892 or 1893, and secure its control ; at least it
would seem so from the speeches made at their late commence-
ment banquet.

Dr. Cbouse has been invited by the Chicago Dental Club to
present the interests of the ^'Dental Protective Association'' at
the April meeting. He is doing an unselfish work and should be
encouraged to go on. The very least that the members of the pro;
fession can do is to join the Association. Mail him that ten dollars
at once and save yourself from the clutches of a worse enemy than
Josiah Bacon.

The commencement exercises of the American College of
Dental Surgery, Chicago, were held on March 25, and a class of
twenty-nine were launched upon the troubled sea of professional life.

The University Dental College, Chicago, held its commencement
exercises April 29.

This college has inaugurated an advance step in the State of
Illinois in the matter of final examinations.

By a vote of its Faculty and also of the graduating class, the
Illinois State Board of Dental Examiners was requested to
conduct the final examinations of the graduating classes. The
examinations of the State Board were an oral in addition to
the regular written examinations conducted by the Faculty.

Dr. W. C. Wabdlaw says that dentists are too often remiss in
ability to satisfactorily answer the unwelcome questions of intelli-
gent patients as to " why" the teeth decay, but whip the devil
around the stump with indefinite generalities, or cover up an in-
glorious retreat with a flow of technical terms.

320 Ourrent News.

Whxrb a cavity extends both ap the neck of the tooth and on
the Ubial surface of the crown, Dr. A. H. Thompson selects a piece
of gnm tooth having the proper color for both gam and erowc
portion, and inserts an inlay, restoring the whole to a perfecUj
natural appearance. If the color of both gum and tooth cannot
be matched from a single tooth, each can be matched separately
and dovetailed together, the joint being imperceptible if accurately
ground.

De. T. E. Wsiks says that at thirteen, if injury is inflicted at
the distal ends of the dentinal fibrils, the nerve-endings, it is trans-
mitted along the fibrils to the sensorium. The water in the tuboii,
which is a constituent of the fibril, and which also surrounds it, is
essential to this transmission of sensation. In proportion as the
water is removed sensation is modified. Hence the adoption of
different methods of dehydration for the control of sensiUvenees
of dentine, either by raising the temperature by means of hot air
etc., or lowering it through cold applications. The rapid motion of
a keen instrument on sensitive dentine is painless, but the instru-
ment should be one that will free itself of chips, and be small, thus
having less friction.

Dr. Pstbbson, Iowa, has, with the greatest satisfaction to him-
self, replaced unsightly, glaring gold fillings, in the neck of the
anterior teeth of his wife, with porcelain inlays made fiom good
English teeth, in which he was fortunate in finding exactly the right
shade. He had inserted the gold fillings as the only thing to be done
in the case, but deplored them as '* a vulgar advertisement of hk
own work." He thought it much easier to grind a piece of ready-
made tooth than to fire up a furnace and bake a small filling.

Thb Fourteenth Annual Meeting of the New Hampshire Dental
Society will be held in Concord, commencing Monday evening,
June 16, and continuing till Wednesday noon of the 18th. An inter-
esting programme will be issued to members of the profession in
this State in due time, and all are cordially invited to attend.

The Board of Censors will meet on Monday evening, June U,
in connection with the Society.

Edwabd B. Davis, Secretary*

International Dental Journal.

Vol. XI. June, 1890. No. 6.

Original Communications/

EBPLEX OCULAE AND FACIAL SYMPTOMS OP NASAL

DISEASE.'

BT EDWARD 8. PEOK, A.M., M.D.,

Visiting Surgeon to Charity Hospital ; Consulting Surgeon to Belleyue Hos-
pital, Out-Door Poor Department ; Ophthalmic Surgeon to the Monteflore
Home for Chronic Invalids ; Member of the Kew York Pathological Society ;
Fellow of the Kew York Academy of Medicine, etc.

The subject of reflex nearoses or of distant reflexes of the
nervous system, has always been an interesting one ; and it will
so continue, as long as there remains any region of disease which
fails of coming under the law of localized areas of nervous force,
or of being subordinated to distinct nervous impulse. To be able
to discuss intelligently the fons et origo of symptoms of disturbances
of one organ, by means of disease located in another organ, possibly
quite remote, is quite in the scope of the topic under consideration.
It rather disarms our faith in the old physiological law of direct
nerve-irritation to be told of pathological phenomena appearing
in a part remote from the source of irritation ; but you will agree

^ The editor and publishers are not responsible for the views of authors of
papers published in this department, nor for any claim to novelty, or otherwise,
that may be made by them. No papers will be received for this department
that have appeared in any other Journal published in this country.

' Read at the stated meeting of the New York Odontological Society,
February 18, 1890.

21 821

322 Original Communications.

with me in the truth of this possibility by multiple illustrations
taken from symptoms in the face and mouth of disease that is
purely, and without question, dental. On this subject the litera-
ture is quite meagre. I am astonished to find that twenty years
ago a most able authority' in dental literature hinted at dental
reflexes, when he said that neuralgia is not a disease, but simply
a phenomenon, or the expression of an immediate or distant
lesion.

The first inquiry in neuralgia, he writes, is to search for the
cause, which is by no means evident ; it exists, and in many in-
stances nothing short of a thorough search will reveal it ; when,
to argue effect from cause, we will find that principles must be
deserted, physiological theories must be abandoned, even anatomi-
cal relations and connections must be forgotten ; and the neuralgic
expression must be treated "with the hope of an accidental
success."

As graphic examples of the phenomena of distant and periph-
eral neuralgia's, there may be cited otalgia, hemicrania, or even
sciatica, as a result of an exposed tooth-pulp, or of pressure from
an exostosis. It is undoubtedly a fkmiliar fact that the extraction
of a canine, or bicuspid, or molar tooth, relieves, as with this author,
neuralgia of the face, odontalgia occurring in consequence of men-
strual irregularities, megrim, and even neuralgia of the nates and
thighs. As further instances of dental reflexes, and more pertinent
to the scope of this paper, may be mentioned the neuralgias found
in the infra- and supraorbital nerves, the globe of the eye, the
temples, and particularly in a spot near the vertex, a little to that
side of the median line on which the affected tooth is found.
Catarrhal affection of the middle ear has been caused by carious
teeth ; so, too, amaurosis by the crowding of teeth. All these and
more are cited as examples of dental reflexes.

There are, however, as every dental surgeon knows, many in-
stances of distant neuralgias, which neither extraction nor filling
of the properly-selected tooth will alleviate.' These instances can
only be explained, according to Yon Becklingbausen, by the irrita-
tion of the sphene-palatine ganglion and superior maxillary nerve.
The alveolar border of the teeth possesses a rich kingdom of nerves,

1 GNirretson, ** Diseases and Surgery of the Mouth, Jaws, etc." Philadel-
phia: Lippincott is Oo., 1869.

' Ziem, "Bedeutungd. Zabnkrankheiten far d. EntstehungT. Kasenleidea."
Allg. Med. Centr. Zeitung, September 2, 1886, p. 1117.

Beflex Ocular and Facial Symptoms^ etc, — Peck, 323

«— the anastomosing filaments of the anterior and posterior dental
nerves. How often do we see teething children, and children
suffering from caries of the upper back teeth, who have at the same
time discharges from the nasal mucous membrane, with swelling of
the inferior turbinated bones and adjacent parts of the septum
nasi, and with possible elevation of temperature ?

In isolated cases the same connection is found between dental
cysts, alveolar swellings, pathological growths from the teeth into
the buccal cavity or into Highmore's antrum, abscess-formations
of tooth-roots, etc., with swellings of the nasal mucous membrane,
of the lips, or cheeks. In some of these isolated cases the only way
to destroy the persistent neuralgias, or to prevent their insidious
recurrence, is by means of the galvano-cautery, or chemical caustic
to the nasal mucous membrane.

So far as I know, the first one to call the marked attention of
specialists to the dependence of conjunctival catarrh upon nasal and
pharyngeal catarrh was Bresgen,^ in 1881. Arlt, of Yienna, had
dwelt upon the close connection between stricture and chronic inflam-
mation of the lachrymal duct and diseases of the mucous membrane
of the nose for many years in his admirable clinical hours with his
students. From earliest time it has been known that, if an eye
were injured, or suffered from the lodgment of a foreign body upon
any of its coats, more especially upon the cornea, the first phe-
nomenon is a one-sided " snuffle," or a sudden rhinorrhsBa. This is
not merely an increase of tears, because a sudden hypersdmia of the
nasal mucous membrane of the same side follows. The introduc-
tion of a Eustachian catheter, in its passage over the floor of the
nostril, and opposite the anterior and middle parts of the inferior
turbinated bone, is immediately followed by a flow of tears from
the corresponding eye; after the catheter has passed this short
tract, the sensation produced by it is confined to the posterior part
of the nasal strait, and is not accompanied by any ocular symptoms.
This gush of tears cannot be explained by a stoppage of the nasal
end of the lachrymal duct, for the tears are not conveyed with
such rapidity into the duct; and, moreover, the overflow on the
side of the catheter-introduction is immediately succeeded by a
flow of tears f^om the other eye.

These and similar physiological phenomena led Bresgen, Hack,
Ziem, and later, Gruening, Bumbold, Bothholz, Bosworth, etc., to
obsei*ve certain ocular symptoms consequent upon nasal disease.

* Der Chronische Kasen u. Bachen Katarrb, 1881, Band I.

324 Original Communications.

Hack's paper attracted universal attention, and, while it was at first
received with quiet favor on account of its source, soon invited
unsparing criticism and strong opposition from the Berlin Medical
Society, where it was first presented. Hack found a large number
of ocular disturbances that would not yield to proper local treat-
ment ; and, in looking about for a definite cause, found not infine-
quently a series of nasal symptoms, which one author^ has grouped
together under the homely phrase of "irritable nose." These
symptoms were stuflSness of one or both nostrils, usually of the one
corresponding to the affected eye ; a catarrhal discharge ; local nasal
irritation, usually described as in the lower and middle parts of the
nasal fossa, and inability to breathe freely through the nostril.
Bxploration with the nasal probe produced an engorgement of the
mucous membrane of the anterior extremity of the inferior turbi-
nated bone, and sometimes a puffing of the corresponding portion of
the septum. This touching with the probe was like touching a
puff-ball. It was found that the submucous cavernous tissue had
undergone irritation, had become spongy, enlarged, and erectile.

The ocular disturbances physiologically produced by this
manoBuvre were lachrymation, fear of light, known by the term
photophobia, itching of the lids, a more or less bloodshot appear-
ance of the conjunctiva of both lid and ball, and sometimes an
injection around the cornea ; more or less pain accompanied these
symptoms. Hack regarded these disturbances as paroxysmal and
reflex. The question of reflex irritation, therefore, was not so
much one of enlargement and engorgement of nasal tissue and of
obstruction of the nostril, as of the remote effect upon the eye.
This is also illustrated by the familiar effect of sneezing, of the
sudden entrance of foreign bodies into the nose, of twitching out
hairs from the nostril, etc., whose prompt effect is to suffuse the
eyes with tears, and to produce ocular congestion.

It would be improper to consider the pathological disturbances
of the eye, as the possible result of nasal disease, without excluding
certain groups of diseases which must be regarded as determining
their own manifestations ; as, for instance, all forms of direct trau-
matism; all scrofulous and syphilitic diseases, whose import is
shown quite as much in the skin, glands, teeth, etc., as in the nose
or eye, and which may be expressed in one or all of these different
systems simultaneously, or consecutively, without any reflex element •
whatever. For instance, the occurrence of a one-sided ophthalmia,

^ Qradle, Archives of Ophthalmology^ December, 1887| p. 891.

Reflex Ocular and Facial Symptoms, etc, — Peck, 325

of necrotic ulcers of the cornea, or of an iritis, during an attack
of Bcrofhlous rhinitis, or of oz»na, or of nasal ulcers and eczema,
cannot be regarded as reflex; it is also a well-known fact' that
wounds of the cornea of the eye are very apt to become suppura-
tive, necrotic, and perforating during the contemporary existence of
an OE»na, but it is not reflex. A more intelligent view of such
coincidences is that they are mutually dependent upon a central
systematic cause, and their removal depends upon a persistent fight
with this central lesion. It is doubtfUl, in such coincidences, which
disease is the starting-point of the other ; in fact, it is best to regard
them as independent of each other, and to treat them simulta-
neously as symptoms of a general cause. Every physician has
cases in which such a connection or coincidence exists ; and in the
elimination of those that have no connection with each other lie
the genius of diagnosis and the success of treatment.

The pathological disturbances of the eye and face which may be
regarded as belonging to the category of reflex symptoms, due to
nasal disease, are as follow : lachrymation ; congestion of the eye-
ball and lids; floating bodies in the vitreous humor of the eye;
phosphorescences in the eye; itching and scratching of the inner
surface of the lids; eczema at the margin of the lids; a flilness of
the lids just behind the bases of the cilia, and to be contradistin-
guished from the puffy oedema of albuminuria ; eye-strain, or eye-
tension, described by patients a9 if a tight band, all too short, held
both eyes together, or as if a band fixed the eye in the orbit, making
its motions painAil ; weakness of sight, known by the term asthe-
nopia, the result either of a weak muscular apparatus, or of imperfect
accommodation for near objects ; headache, either temporal, vertical,
frontal, or cervical, chiefly the two last varieties; spasm of the lids ;
choreic movements of the lids and eyeballs ; neuralgia of the supra-
orbital, infraorbital, and canine regions of the face ; pain, tender-
ness on pressure, and swelling over the region of Highmore's fossa ;
functional epilepsy, manifestly due to reflex influence ;' nausea and
gastric disturbances; a diseased condition of the upper digestive
tract; uterine disorders; genito-urinary affections; perversions of
smell, taste, and hearing, as well as of sight; laryngeal cough;
bronchial asthma ; megrim ; melancholy, etc. Since Yoltolini first
observed the reflex connection between nasal polypi and asthma,

^ Bothholz, Deutsche Medieiniaehe Woehenachrifi, December 29, 1887, p.
1128: " Ueber die Beziehungen von Augenkrankh. zur Nasen-affectionen.''
' Elsberg, Archives of Laryngology , 1888, iv. p. 258.

326 Original Oommunicationa.

between sneezing and asthma, between sneeesing and spasmodic
cough, a great deal of attention has been paid to laryngeal and
nasal reflexes* In 1880, Zuokerkandl, of Vienna, made a carefal
examination of one hundred and fifty skulls, with reference to the
existence of catarrhal inflammation in the cranial sinuses. He
found that the sinus, or antrum, of Highmore, is most frequently
affected with catarrhal processes ; after that the sphenoidal sinnses;
and least frequently of aU, the frontal sinuses.

The following cases will serve as illustrations of some of the
reflexes named. They are selected from a varied array, for the
emphasis of special symptoms.

A married lady of thirty years, mother of one child by a normal
delivery, succeeding to a miscarriage by two years, occupation that
of care of an easily-managed household, with time and inclination
to cultivate herself, to a limited extent, in music and literature,
enjoying otherwise good health, came to me in October, 1888, com-
plaining of blurred vision, and floating specks chiefly in the left
eye; itching and scratching of left lower lid; pain between the
eyes ; a cincture-band around the forehead ; headache after using
the eyes for sewing and reading, and on the following nights an
aggravating insomnia. Correction of a hyperopic astigmatism
with proper glasses brought vision to the normal, and an eye-drop
of one-half per cent, of cocaine-hydrochlorate and one grain of
zinc-sulphate improved the congested and granular condition of the
lids. The remedies were sufficient for a time. Soon, however, the
frontal ache and cincture-band, with the insomnia, asserted them-
selves more strongly, and my attention being directed to her nose
and throat, I found a catarrhal rhinitis, chiefly of the right nostril;
a deviation of the septum, partly of osseous and partly of carti-
laginous tissue, into the same nostril; a puffing of the mucous
membrane of the right wing of the nostril, opposite the septal
malformation : the two entirely filled up the middle and superior
meatuses of the nostril, but the nasal probe could be easily passed
between them to the post-pharyngeal wall ; the puffy alar hyper-
trophy was very sensitive to the touch, and fairly rough usage of
the probe immediately produced a flow of tears, with a pericorneal
injection of the same eye. Under the belief that cocaine ought to
assist in establishing a connection between the nasal disturbances
and the ocular symptoms, a four-per-cent. solution of cocaine was
freely used, with the effect of a partial retraction of the alar hyper-
trophy, but with only slight abatement of the ocular symptoms.
A systematic treatment of cocaine-spraying and pencilling was

Beflex Oc\dar and Facial Symptoms^ etc, — Pech 327

then used, together with Dobell's solution of borax, bicarbonate
of soda, carbolic acid, and glycerin, with considerable relief of the
nasal sensitiveness and of the ocular symptoms. It was not, how-
ever, until the osseo-cartilaginous spur was freely removed with a
saw, that freedom from distressing symptoms could be asserted.
This was done with a ten-per-cent. solution of cocaine, applied for
fifteen minutes with a cameFs-hair pencil, and on a cotton probe.
The sawing was with an upward movement, and brought away
quite a large triangular spur of the septum. Frontal and ocular
symptoms disappeared, followed by complete absence of insomnia.

This case may be regarded as a fair example of distinct nasal
and ocular diseases, at once dependent upon, and independent of,
each other. The refractive error of hyperopia was certainly dis-
tinct from the nasal disease ; and, following the law of such optical
anomalies, it was due to an anatomical defect of the eyes. But its
careful correction did not relieve the patient of the reflex ocular
symptoms, whose origin was in the nose, and which finally dis-
appeared with a removal of the offending nasal obstructions. In
the simpler forms of nasal mucous-membrane hypertrophy a resort
to operative procedures is usually unnecessary. Cocaine, in a two-
or four-per-cent. solution, when well borne, with Dobell's spray, or
Seiler's antiseptic pastilles, and, if necessary, chromic acid as a
caustic application, will in a large number of cases sufSce to effect
a cure. As to operative procedures, it is to be remembered that
the nostrils are not symmetrical in two-thirds of all the cases, and
that not every deviated septum is to be " shaved off," or " sawn off."
The practice of *^ rifle-boring" a nostril, or making it as " clean as a
gun-barrel," is to be condemned. It is to be borne in mind that the
nose receives the first air that is destined to pass into the lower
respirator}^ organs ; and sufficient area is needed in either nostril
to allow of its free passage, otherwise the mouth must be opened
to assist in respiration, and thereby the faulty habit of mouth-
breathing will be acquired ; it is also to be borne in mind that the
nose is the organ of smell, and destruction of excessive nasal tissue,
especially of that of the bony septum, is not in the line of good
surgery, on account of its interference with this function.

Another case is as follows: A man of forty years, of large
physique and bony frame, never having had syphilis, and appar-
ently in perfect health, by occupation a teller in a bank in the
northern part of this State, had suffered for some years from con-
junctival catarrh of both eyes, and had worn glasses with the idea of
relieving eye-strain while at work upon the books. He was a

328 Original Communications.

mouth-breather, with enlarged tonulB, chronic follicular pharyngitis,
false noises heard in both ears, slightly but not noticeably deaf, had
central frontal headache, especially at the dose of the day's work;
in addition, he had hay fever for a limited time during the summer.
Cocaine in weak solution had been used upon his eyes, giving tem-
porary relief. Having fallen into good hands, he found himsdf the
unfortunate possessor of <' sensitive areas" in each nostril, which
had been touched with the red-hot platinum wire. I found that,
though there was an improvement in the size of the nasal straits
by the removal of the alar hypertrophies, there remained a large
deviated septum into the left nostril, which, at its middle and pos-
terior parts, was sensitive to the touch of the probe, and somewhat
puffy. Under thorough local anaesthesia this was sawn from below
upward with some difficulty, and the major part of the obstruction
was removed. The result has been a return to normal breathing
by the nose, an abeyance of the false aural sounds and of the stuffy
fooling of the ear, eye-tension and discomfort have disappeared,
and glasses have been laid aside.

I shall cite one more case of perhaps greater dental interest,
wherein relief failed to come by means of the methods heretofore
indicated, and then close these observations upon this interesting
topic.

A New York merchant of nearly thirty years of age, whose
father is engaged in large manufacturing interests, and who him-
self was engaged in buying raw materials, in office-work, and in
shaping national legislation in regard to import duties, whose
duties, therefore, were varied and responsible, but not specially
trying to his eyes, was sent to me in January, 1887, by a dentist,
with a history, concisely stated, as follows: Patient had had inter-
mittent pain in the fifth pair of nerves, chiefly over the superior
dental nerve, and in the canine fossa, running up through the
superior lateral incisor teeth ; this pain was now on one side and
now on the other; bilateral temporal pain and discomfort, chiefly
over the right temple, on which side was chiefly located the canine
pain ; pain behind both eyeballs. In March, 1886, he fell twenty
feet in the gymnasium of one of the athletic clubs of the city, and
broke off both lateral incisors of the upper right side, and injured
the nose, though no fracture, not even of a cartilage, of the nose was
found. The teeth were beautifully crowned with porcelain, backed
by gold, so that the fractures were not perceptible to ordinary
observation; he had a catarrhal conjunctivitis, granular and dry;
asthenopia, with the slightest use of his eyes for the near; occa-

Reflex Ocular and Facial SymptamSt etc. — Peck. 329

Bionai insomnia; ftontal headache; no -appetite for breakfast, and
was melancholy ; he had never had rheumatism nor syphilis ; did
not drink, and retired early. He had been nnder treatment by
several oculists, and had been observed by several dentists. Just
before coming to me he had been under the care of a skilful oculist,
who found occasion to interfere with the nares by repeated cauter-
ization of the nasal mucous membrane. A weak lens had been
worn, but the patient complained of its interference, and that it
gave him no relief. Early in 1886, nausea and gastric disturbances
were relieved by an astigmatic lens, but the astigmatism had dis-
appeared, while the headaches had grown worse. On examination,
I found the chief objective symptom to be the conjunctivitis ; the
nasal fossad were amply large, and had no unusual discharge ; the
canine reflexes were intermittent, and shifting from one side to the
other; and the teeth were, without exception, in perfect order.
No glasses improved the vision, which for distance was perfect, and
I looked upon the patient as suffering from invalidism, due to
nervous reflexes, and treated him chiefly on general principles.
Aside from a mild local astringent to the lids, his regime was a
change in diet, more devotion to social pleasures, a trip to Wash-
ington, followed by ten days at the carnival in Montreal, etc.
During these diversions he was much better as to the ocular
symptoms, especially as to the bulbar pain, and his appetite
relumed. This improvement lasted for about two months, when
the symptoms above mentioned recurred, and he sought other
sources of relief. I have authentically learned since that a dis-
tinguished oculist had made a partial tenotomy of the internal
rectus muscle of each eye, and that the patient was free from
the incubus of nervous reflexes and had gained thirty pounds in
weight.

Thi^case is introduced to show the possibility of dental, nasal,
and ocular reflexes concurring, and the elements in doubt in
making an eliminative diagnosis. It further affords an illustration
of the doctrine of the " survival of the fittest.''

Before closing this paper, I desire to call attention to the
dangers of overestimating reflex disturbances. That they exist,
and that they are local expressions of a nerve disturbance, as
suggested here of the fifth pair of nerves, cannot be denied. But
that they are the necessary initial step of a future neurosis, such
as chorea, epilepsy, or paralysis, is not true. It is always easy for
the specialist to find symptoms that conform to a new and attrac-
tive theory of pathological phenomena; for new theories present

330 Original Communicationa.

an air of diversion and relief that is always refreshing. In the
special subject under consideration, as in all references to nervous
phenomena, it is a safe rule to keep before us the necessity of tbe
healthy nutrition, both physical and moral, of the nervous system
of our patients.

A NEW METHOD FOR THE TREATMENT OP FRAC-
TURES OP THE MAXILLiE.

BT EDWARD H. ANGLE, D.D.S., MINNEAPOLIS.

MusouLAR contraction is a most difficult obstacle to overcome
iti reducing and maintaining in proper apposition most fractured
bones. This force, especially in the femur and patella, is so diffi-
cult to antagonize that probably the ideal or normal result is
never attained.

In fractures of the inferior maxilla it is also a most difficult
obstacle in the way of maintaining perfect apposition of the parts,
and should always be carefully considered in the construction of
an appliance for this purpose. This difficulty is intensified by tbe
large number of movements to which the human jaw is susceptible,
and the great number of causes which contribute to their produc-
tion. That others have recognized the difficulties to be overcome
in the treatment of fractures is evinced by the large number of
devices and appliances which have been recommended for the
purpose.

The methods used by myself in treating fractures of the mazills
have been so successful and so gratifying that it would seem they
approach for efficiency and simplicity more nearly the ideal than
any yet devised.

In order that this system of treating fractures of the maxillary
bones may be more easily understood, I will divide them into three
classes. The first class comprises all simple fractures in whicb
the teeth are good and sufficiently firm in their attachments (espe-
cially on each side of the fracture) to afford anchorage for the
appliance.

The second class comprises all fractures where the teeth are
unsuited, from disease or any other cause, for anchorage, but yet
sufficient to give the correct articulation of the jaws.

The third class comprises all fractures where the jaws are

Treattnent of Fractures of the Maxillte.— Angle. 331

edentaloua. The following cases treated by myself will enable
the reader to oomprahend the method peculiar to each clam :

Caee No. 1 will illuatrate Class No. 1. Hay 29, 1889, Nels Parsons,
aged twenty-one, was admitted to the Saint Anthony Hospital of
this city. He had fallen from a pile of lumber, a distance of fifteen
or twenty feet, and, besides severe bruises, suffered a simple fracture
through the symphysis, torminatiog, however, in front between the
central and lateral on the left side, as shown by the line in the
engraving. Fig. 1. Upon examination, I found the fractared bone

Flo. 1.

was quite widely separated at the top, and the left central incisor
was loosened. The following treatment was adopted : The ends of
the fhictured bones were placed in their proper position and tem-
porarily &Blened by lacing the teeth with silk ligatures.

Bands of very thin German silver were made to encircle and
accarately fit the cuspid teeth. A small tube of German silver,
one-half inch in length, was soldered to each band and in exact
alignment ; a piece of wire accurately fitting the bore of these tubes,
bent at right angles at one end and having a screw cut upon the
other end, was slipped through each tube and secured therein by
adjusting a nut on the screw. The bands were cemented in posi-
tion upon the teeth by means of oxyphosphate cement, as shown
in Fig. 1.

After the cement had become thoroughly set, the nut was then
tightened until the fractured ends of the bone were drawn snugly
together.

The appliance was worn without displacement or trouble for
twenty-one days, when it was removed, the bone having become
firmly united. I may add that, during the time the appliance was
worn, so firmly was the jaw supported, the patient suffered little if
any inconvenience, and after the third day partook regularly of
his meals, using his jaw fVeely, but of course avoided tbe hardest

332

Original Communications,

particles of food. After removing the appliance a careful impreadon
of the Jaw was taken, a model made, and the appliance transferred
to the model, exactly as shown in the engraving. The lofver part
of the jaw is, of course, diagrammatic, and was added hy the en-
graver to show the line of fhtctuie.

It should be borne in mind that the principle upon which this
appliance is based is not the same as when the teeth are simply
wired together, but very different ; for, in wiring, the upper parts
of the fracture only are tipped or drawn together, and no pressure
or support is given to the lower parts ; while in the method here
shown it will be seen that, by reason of the bands and pipes being
rigidly attached to the anchor teeth, tipping is impossible, and
pressure is exerted equally upon both parts (upper and lower) of
the fracture as they are drawn together by the screw ; or, as my
friend, Dr. Charles G. Brown (who first suggested to me this use
of the screw), puts it, ** It is a Malgaigne splint, if you please,
except that the hooks are not foreign bodies."

Fio. 2.1

This device may be applied in any locality in either jaw, pro-
vided suitable teeth for anchorage be not too remote from line of
fracture. The screw may be bent to accommodate the curve in the
arch, should the fracture occur in the region of the cuspid.

The treatment for cases of the second class is illustrated in Case
No. 2. On July 4, 1889, William Fraley, aged forty-five, was ad-

1 These bandi, tubes, wires, screws, and nuts are some of the appliances
known as " Angle's Regulating and Betaining Appliances," devised and used
for the purpose of correcting irregularities of the teeth. They may be made
by any ingenious dentist, or procured from any dealer in dental goods.

Treatment of Fractures of the Maxilla.— Angle. 333

initt«d to the Kinneapolie City Hospital. A blow from a police-
man's clab had produoed two simpie fraoturee of the iDferior maxilla.
The flret wa§ an oblique tVacture of the right side, beginning with
the socket of the second bicuspid, extending downward and back-
ward, involving the socket of the first molar, breaking out the
second bicuspid and greatly loosening the first molar. The second
molar had been lost years before, while the third, as well as the
remaining teeth, were much abraded and loosened by eslivary
calculus, thus making the application of the appliance described in
Case No. I impossible. The second fracture was situated on the
opposite side, high op in the ramus. Because of swollen condition
of tbe parts, I could -not detect the exact line of fracture, but the
grinding of the ends of the bone and the great pain occasioned
thereby were unmistakable evidences of a fracture. The patient,
as in all such cases, was unable to close the jaws. The fracture on
the right side was widely separated, and the anterior piece much
depressed by reason of the contraction of the depressor muscles,
while the posterior piece of bone was drawn firmly up, the molar

teeth occluding. (See Fig. 3.*) The following treatment was used :
Bands were made to encircle all four of the cuspid teeth, they being
tbe most firmly attached in their sockets. The fVactured ends of
tbe bones were placed in apposition, the lower jaw closed carefblly.
The occlusion of the lower teeth upon the upper reqnired so con-
siderable force and occasioned so much pain that it became necessary
to annstbetise the patient. Points on the bands for tbe necessary
attachments were carefully noted. The bands were then slipped
off the teeth, and little pipes (shown at c, Pig. 2) soldered at the
necessary points, after which the bands were cemented in their

334 Original Communications.

»

proper poBitions upon the teeth, and two small traction screw-wires,
the same as shown at b, Fig. 2, were slipped into the pipes. The
jaws were closed and the nuts tightened on the screws, until the
jaws were drawn firmly together, and each tooth occupied its exaet
position in occluding upon its fellow of the opposite jtL'w. Both
fractures were then carefully examined and found to be in perfect
apposition, and presented the appearance shown in Fig. 3. The
most natural position* for the jaw and the muscles had been secured,
thus placing the parts in their natural position of relaxation and
rest.

During an attack of coughing in the night following, one of the
bands was wrenched loose, but was replaced the next day with-
out trouble. No further accidents occurred. The patient readilj
took nourishment through the spaces between the teeth. Thus the
fV'actured jaw was firmly supported without the least motion for
twenty-two days, when the appliance was removed, showin^^ most
excellent results.

The patient was a great lover of the clay pipe, which accounts
for the much-worn condition of the incisors.

The following case possesses several points of special interest,
although the fractures occurred in regions similar to the case just
described, and the appliances, though involving similar mechanical
principles, will be found to bo greatly simplified.

December 28, Thomas Brennan was admitted to the Dental
Infirmary of the University of Minnesota, suffering from the efifects
of a blow received on the left side of the jaw fVom a cant hook
while working in a lumber camp in Wisconsin, which produced
fracture of the jaw in two places. The first fracture was on the
lefl side, beginning between the first and second bicuspids, and ex-
tending downward and backward, and involving the lower part of
the anterior root of the first molar. The second fracture was on
the right side directly through the angle of the jaw. The fractures
had occurred thirty-two days previous to his admission to the
infirmary, during which time nothing had been done to reduce
tbem. He reported that he had called upon a physician, who sup-
posed the trouble was merely an abscessed tooth, and had lanced
the gum with the view of reducing the swelling. Later the patient
had ^called upon a dentist in one of the smaller towns, who also
failed to diagnosticate the fracture, and extracted both bicuspids in
the hope of giving relief

Upon examination, I found considerable swelling in the region
of this fracture, with the usual result : the patient being unable to

Treatment of Fractures of the MaaM<e.~-Angle. 336

close bis mouth by reason of tbe anterior piece of tbe fisctared
bone being drawn down by the contraction of the depressor mascles.
A false joint bad also become established, and tbe bones could be
easily worked without causing pain.

At the point of ftvcture, on the right aide, there was little or no
displacement; tbe swelling was also slight. With the assistance of

^^^

Professor Leonard the patient was annstbetiEed ; the ends of the
bones were then rubbed forcibly together with tbe view of break-
ing up the false attachments and stimulating activity in repair.

The ends of the bones were now placed in perfect apposition,
and the jaw closed, taking great care to articalate tbe teeth in
their correct position against the upper ones.

The jaw was now firmly bound in this position to tbe upper
teeth, in tbe same manner as described in Case Ko. 2, with this

difference, that the method was improved upon and simplified by
using clasp bands, aa shown in Fig. 4.

No cement was used, and, instead of the screws, small metallic
buttons were soldered to tbe eides of tbe bands (as shown in the
cut), around which fine binding wire was wrapt in the form of a
figure 8. (See Fig. 5.)

The bands seen upon tbe molar teeth in the engraving were

836 Original Communicaticns.

not used in this case, bnt are shown for the purpose of illnstntlDg
how they maj be used in cases of comminuted fracture. At the
end of seventeen days the bands were removed and the pstient
discharged, the bone having been firmly united.

It might be urged as an argument against this method that^the
teeth being closed and the jaws being firmly bound together, the
patient would be unf\J[>le to take sufficient nourishment. It, how-
ever, rarely happens that a patient is found without some teeth
missing, thereby leaving abundance of space for the passage of the
liquid foods, and even if all the teeth are sound and in perfect
position, it has been proved that there is plenty of space between
the teeth and behind the molars and between the upper and lower
incisors for taking all nourishment necessary. In such cases more
time would be consumed in taking nourishment, but this obBtacIe
is compensated for by the main points of advantage in its fkvor,
such as cleanliness and greater comfort to the patient, as compared
with the many bulky and awkward appliances in use.

Third, its extreme simplicity enables any one with ordinair
mechanical ability, when provided with a set of clamp bands, to
easily and quickly set all ordinary cases of lecture.

And, lastly, the certainty of correct results will, I think, be
sufficient reasons for all those who are interested in this branch of
surgery to give it a trial.

Class No. 3, comprising fractures of edentulous jaws, are fortu-
nately very rare. The method of treatment I propose is similar in
principle to that already described in Class No. 1, except that in
place of the teeth small bone hooks are used, drilling for their re-
ception a suitable cavity on each side of the fracture comparing
in position to the original sockets of the teeth, the same as if the
operation of implanting teeth was intended ; the cavities thus made
need not be nearly so large or deep. They should also be drilled
obliquely to correspond to the course taken by the hooks. The
hooks before insertion should of course be made antiseptic.

Oral Surgery Clinic, — Marshall, 337

ORAL SURGERY CLINIC— MERCY HOSPITAL, CHICAGO.

SE&yiOE OF PROFESSOR JOHN S. MARSHALL, M.D., BEFORE THE GLASS

OF THE UNIVERSITY DENTAL COLLEGE.^

The patient before you, gentlemen, is thirty-eight years old, and
the mother of five little children. She is here for treatment of ex-
•tensive necrosis of the inferior maxillary bone. The odor emitted
from the dead bone is almost intolerable, as no doubt your olfac-
tories have already discovered. The patient brings a letter from
her doctor, which details briefly the history of the case, and is as
follows :

Eleven months ago patient was suffering from an abscessed bi-
cuspid tooth in the inferior maxilla of the right side, which had
progressed so far as to open externally under the jaw. Poultices
were applied, and later the tooth was extracted. Patient was at
this time in the eighth month of gestation.

The external opening soon after closed and remained so for a
few weeks, when it again began to discharge. Necrosis of the jaw
was then diagnosticated and seveftil loose teeth upon the right side
were extracted. The disease has steadily progressed until it is
feared the entire bone is involved from the temporo-maxillary
articulation of the right side to a corresponding point upon the
other. No operation had been permitted by the patient save the
extraction of the teeth as they became loosened ; the only one now
remaining is the wisdom tooth of the right side. The patient is
now well anesthetized, but we shall have to proceed carefully on
account of her extreme weakness. Her pulse yesterday was 130 ;
temperature, 100° ; respiration, 24.

Stimulants have been administered to brace her for the opera-
tion.

The bandages are now removed, and you will discover that the
soft tissues, including the chin and anterior portion of the floor of
the mouth, the skin of the neck from the angle of the jaw upon
one side to a like point upon the other and downward to the cri-
coid cartilage, and all the muscles having attachment to the inner
surface and lower border of the jaw, have sloughed from the bone,
so that nearly the entire hand can be passed through the opening

> Keported for the International Dental Journal.

22

338 Original Communications.

into the moutb. 'The Bubmaxillary glands are also ezposecL Ar-
ticulate speech is impossible, and all her communications have been
made for some weeks by writing.

We will now proceed to examine the extent of the necrosed
bone. On the right side it has progressed seemingly to about half
an inch above the angle and extends to the temporo-maxillary ar-
ticulation of the left side. The body of the bone is fractured on a
line with the first molar tooth, and it is reasonable to presume this
was a natural separation of the sequestrium.

The removal of the inferior maxillary bone, entire or in great
part, is not a common operation, and is rarely justifiable except in
cases of malignant disease, large tumors, or when the bone has died
en masse, as in the case before you. The operation will cause great
disfigurement, but when the life of the individual is at stake, this
becomes a matter of minor importance.

We are by no means confident of a favorable prognosis in the
case, as the patient is very weak and ansBmic. The possibility of a
fatal issue has been explained to her and to her husband, but, as it
is certain that she cannot live long in this condition, they are both
anxious for the chance of life which may come from the removal of
the diseased jaw.

The usual method for an opeiiation of this magnitude is to make
an incision along the lower margin of the jaw and chin and divide
the lower lip upon the median line. The first incision is not neces-
sary, on account of the loss of so much tissue beneath the jaw.
We therefore divide the lip and secure the vessels ; we find no con-
nection of the soft tissues with the bone as far back as the angle
upon the right side, and well up on the ramus of the left side ;
with the periosteotome we strip the remaining portions of the peri-
osteum from the ramus and coronoid process, and the bone is now
ready to be disarticulated. We seize the ramus with strong forceps
and carry the bone backward and outward, the capsular ligament
gives way, and the bone is removed. Hemorrhage is very slight,
not a single vessel requiring to be ligatured. This is very fortunate,
and quite difi'erent from what we anticipated.

Examination of the remaining portion of the jaw of the right
side makes it necessary to remove a considerable piece of the ramus;
this we will do by dissecting the periosteum fh)m the bone, and
with the chain-saw and bone-cutting forceps cut it away. It will
be necessary, however, to wait a little before proceeding with the
operation, as the pulse and respirations indicate the need of stimu-
lants.

Dental Education, — Smith, 339

The patient having sufficiently rallied to permit the progress of
the operation, we proceed, and find, on cutting away this portion of
the ramus, that a large pus-pocket has formed in the cancellated
structure of the bone. We will, therefore, scrape away with the
curette all diseased bone ; this being accomplished, and the wound
thoroughly irrigated with a five-per-cent. carbolic-acid solution, we
will clip away all gangrenous-looking tissue from the edges of the
ulcer and scrape away all necrotic material fh)m the deeper por-
tions, and again thoroughly irrigate the parts. The lower lip must
now be united; this we will do by two deep sutures, one at the
upper margin and the other at the lower, and two superficial ones
in the vermillion border.

A suture must now be passed through the tip of the tongue, and
this organ drawn well forward and secured by tying the ends of the
suture around the neck to prevent the tongue from falling back-
ward into the fauces and causing suffocation. The wound will now
be dressed with iodoform and antiseptic gauze and changed every
few hours.

Stimulants and nourishing liquid food will be the afber-treat-
ment, and if she is unable to swallow food it must bo given by .the
oesophageal tube. The patient has passed through the operation
with less shock than we expected, which leads us to hope that if no
complications arise she may possibly recover.

DENTAL EDUCATION.*

BY 0. STODDARD SMITH, D.D.S.

Tims was when the seeker after dental knowledge, upon the
payment in lawful money of one hundred or two hundred dollars
to a so-called preceptor, could be assured of a complete initiation
into the mechanisms, mysteries, and secrets of the dental art in
the space of a few short weeks, or months at furthest. Peeping
through the crack of the laboratory door, he watched his preceptor
as he mixed and inserted the *' royal mineral succedaneum'^ (as the
quacks of that day denominated amalgam), or '' plugged'' the carious
molar with " gold leaf," introduced by smooth-bore instruments, or

^ Bead before the Chicago Dental Club, March 24, 1890.

340 Original Communications.

•
fixed the key on the dental organ which had ached. Secure in

the private receeees of the laboratory, with doors dosed bo that tbe

prying and non-paying world shonld not share in his good fortune.

he became acquainted with the mysteries of wax impreasiona, cast^

dies, and soldering lamps. It was generally believed that the

greatest effort and skill was required to master the secret processef

of what is now somewhat pedantically denominated prothetic or

prosthetic dentistry, while the art of saving the natural teeth wa#

very easily acquired. To be sure, the student had to absorb and

assimilate the fact that arsenic would ^^pizen" nerves; but cou-

tour fillings were an unknown quantity, and ''gum-biles" were

a pathological condition beyond the reach of the therapeutical

knowledge of those by-gone days. A few plain excavators and

pluggers, a key, a pair or two of clumsy forceps, a book of gold.

and a pound or so of amalgam, with a scant outfit for making metal

plates, and possibly a rolling-mill^ comprised the stock in trade of

the most progressive dentist. Yet I have seen gold plates made

by a dentist of that period that for fit and workmanship would

equal any, and far surpass nineteen-twentieths of the work of

later years.

But that day has long since passed. Dentistry has outgrown
and cast off its swaddling-clothes, passed through the period of
adolescence, and emerged into the arena of a recognised pro-
fession.

Dental education in its modern phases is the subject we have
before us for consideration this evening. What should it be, and
how should it best be accomplished ?

The dental student of to-day is easily resolvable, in origin, to
one of two classes. The country youth, to whom a dollar re-
sembles a cart-wheel in size, having discovered that he has just a
little hole in one of his teeth, .visits the village dentist, and is in-
formed that there are a dozen cavities ; and the amount of the bill
and the apparent ease with which the money is secured by tbe
dentist, lead the patient to believe that a dental office is a " heap
better than a farm,'' or <' tending store," and is, in fact, a veritable
bonanza, a soft snap, a philosopher's stone, or a Midas touch, which
shall literally turn base metal to gold, and gold into greenbacks
with about one thousand per cent, profit. He casts longing eyes
on the environment of the practitioner, wonders how long it would
take him to "learn the trade," and soon determines to reach tbe
wished-for goal, or die in the attempt. Another class is composed
of the sons of well-to-do and ambitious parents, who, like the

Dented Education. — Smith. 341

coantiy youth, have been led to believe that the main work of the
dentist is to take care of the money as it comes in ; that the busi-
ness is genteel as well as lucrative ; and that it requires little time
to loam it or capital to set up in it. The aspiring father sees in
dentistry the short line to success, position, emolument, and most
likely affluence for his offspring.

From both of these classes, as well as from other sources, come
the rank and file of dental students to-day. But from whatever
source they come, whatever motives actuate them, they one and
all utter and re-utter the self-same query, *^ What is the least possi-
ble time and the smallest amount of money which it is necessary
for me to devote before I can emerge a legitimate practitioner,
and share in these golden rewards ?"

Dental laws in nearly all the States have made it necessary that
some sort of education shall be obtained ; at least, that a diploma
must be secured. These laws might with propriety have been
entitled laws to promote the organization and operation of dental
colleges. Certainly their effect has been to vastly multiply the
number at least of these institutions. Armed with a diploma from
one of them, the student possesses the '^ open sesame'' to the mine
of wealth he thinks he is about to put his pick into. He can defy
examining boards, and by putting out his shingle with a D.D.S.
attachment easily secure the prize.

Though the mallet has done much in private practice to bring
the student from behind the laboratory door, and enable him to view
the actual operation of filling, yet the patient objects to his presence
as a rule, and the various pathological conditions, the proper forma-
tion of cavities, and many other matters are nearly as far from his
reach and observation as ever. Few patients will allow him to
operate, even in the simplest cases. Further, few preceptors have
the ability, the gift, or the time to teach the student,- even had they
the desire ; and in many cases their main idea is to obtain as much
in the way of service as is possible, with as little of effort on their
pari as may be. The dental college, properly officered, equipped,
and conducted, changes all this. From the moment the student
enters its doors he is in possession of facilities and advantages
which years of private pupilage could never afford him. He has
systematic and thorough instruction by didactic lectures ; he has
skilled instructors ever ready to encourage and aid his efforts, and
to show him what to do and how to do it ; he has patients awaiting
his manipulations, who come with the expectation of such com-
paratively unskilled service. If studious, industrious, and energetic

342 Original Communications,

in uBing his opportunities, he can learn more in six months than
he possibly could in two years under any preceptor, no matter
how willing or competent to teach.

The dental college, then, must be regarded as the chief educa-
tional agency of the dental profession. It must, of course, be sup-
plemented by text-books, and if then is added the advantage of a
private preceptorship, so much the better. When a man starU
out in business of any kind, he naturally seeks to secure that which
he must have as his stock in trade where he can obtain it to the
best advantage. The dental student, whose dental knowledge b
to be his stock in trade, is no exception, and, recognizing the sound-
ness of the above conclusions, he seeks the dental college naturallj
and unavoidably. If we trace his career through these inetitutions,
see what he actually does, or tries to do, what he accomplishes, and
how he is equipped for his chosen profession when he emerges,
we may, by comparing the actual process with an ideal one, be
able to arrive at a conclusion as to whether dental edacation, as
now conducted, is what it ought to be or what it might be.

All dental colleges of repute profess to require a preliminary
examination in English branches. In other words, it is assumed
that a man who is to occupy a professional position should be
possessed of a common-school education at least, and have an
intelligent knowledge of common branches. It ought, at least, to
be understood that he will be required to show a decent knowledge
of what the backwoods school-director termed '' the three R%'' to
wit, '< readin' 'ritin', and 'rithmetic," and it might not be too much
to require a rudimentary knowledge of " spellin' " as well. But in
how many colleges may we suppose this requirement to be anj-
thiug more than a hollow mockery? Since this paper was began
the writer had it direct from a matriculate of a college which
claims to stand high, that no examination whatever was required
of him. It is probably the case, in at least a great many instances,
that the process of matriculation consists of the transferring of a
*< Y" from the pocket of the candidate to that of the dean, and the
inscribing of the name of the applicant upon the roll of matricu-
lates, unaccompanied by any such formalities as finding out
whether the student knows anything whatever.

We will suppose that the student is <^ green," and enters at the
fall term. He is at once plunged into an atmosphere entirely
unknown to him. He hears terms of which he knows not the
meaning, allusions and descriptions which be does not understand ;
he gets a dose of one or two subjects in the morning and of one

Dental Education, — Smith. 343

or two more in the evening, with an intermediate admixture of
practical operations of some sort. What wonder, then, if at the
end of three months he becomes confused and bewildered? Educa-
tion, in its literal and proper sense, means a drawing out, — an
attempt to evolve or bring out the capacities of the individual.
Dental education, as now conducted, seems to be largely a pouring
in or a filling up process. It begins in this manner and it con-
tinues on this line to the end, and too often, we fear, the attempt
is made to pour in too fast, if not too much. The two terms of
five or six months each is far too short a time to teach thoroughly
all that is attempted in the curriculum of the principal dental
colleges of to-day. It is not possible that the average student
should in that brief time obtain more than a smattering of the
many branches. It is well, therefore, and we regard it as a great
step in advance, that this time is to be lengthened to three years.
And when we say three years, we mean thirty-six months of solar
time, and not three years of five or. six months each. That surely
is none too long to gain even a superficial knowledge of all these
subjects. All honor to those men who have worked to effect this
end, whose efforts have at last set the date when this reform is to
go into effect ; and now lot every individual member of the pro-
fession endorse and sustain it by refusing to receive any student
who will not pledge himself to spend this length of time ; and let
every State Board enforce it — as they have the power to do — ^by
refusing to recognize any college as reputable which does not
require it, or to admit to an examination any candidate who can-
not show satisfactory proofs that he has studied for three years.
Both of these things the Illinois State Board has done, but, sq far
as we know, no other Board has done so.

This is, however, a digression ; we were discussing dental educa-*
tion as it is. The attempt to teach all branches during a six-months'
term is a baneful effort to cram the student. The graded course,
in which the studies of the first and second year are separated, is a
great advantage, and should be generally adopted, as it is now by
many or perhaps most of the better colleges. But, notwithstanding
this, there is, we fear, a constant attempt to do too much. It is
quite impossible to make a pint measure hold a quart. It is equally
impossible to make complete anatomists and chemists and thera-
peutists and metallurgists and physiologists and microscopists
out of a class of average students, — ^that is, to make all of them
thorough in all these branches. Yet each professor goes to work
as if his object was to make a specialist in his particular line. He

344 Original Communications.

Beoms to forget that he is but the part of a whole. Wl^ther den-
tistry is a specialty of medicine or not, is a question foreign to this
paper. The attempt to make it such by first demanding an MJ).
decree has not been successful, and is not likely to be. ^or is th«
attempt to carry the instruction in purely medical and theoretical
branches to an extreme, as it is my opinion is too often done, likely
to be any more of a success. The student enters upon his second
year face to face with the fact that he must master the remaining
branches, or fail to secure his coveted prize. He must fit himself
for the dreaded examinations. To this all his efforts are bent. He
plunges into the vortex overwhelmed by misgivings, and it is then
that the cramming process begins in earnest. As the time for the
dread ordeal approaches, he is treated like the Christmas turkey,
whose neck is stretched to stuff his crop with grain by the forcing
process, rammed down with a ramrod, irrespective of the fact that
the pabulum of the previous day or week lies undigested and un-
assimilated. He finds that he cannot possibly do all that is re-
quired of him. He must neglect something. He manages to get
in the required fillings, and his practical artificial case, in some
way, but that examination ever haunts him as a spectre. Unless
he shall succeed in passing it, he cannot go forth with his degree.
The result is that he emerges accredited to the world as skilled
and competent, when really his practical knowledge is that of the
merest tyro. He bears the insignia of competency, but really he is
entirely unprepared to grapple with the actual demands of practice.
Ho begins at once to learn at the expense of the unfortunate public
who may fall into his hands what he should have been taught
while in college. He has learned imperfectly, and in many cases
very indifferently, how to master the ordinary office practice ; how
to make a good gold filling, the sine qua non of successful practice ;
and as to the so-called prosthetic dentistry, he is in very many
cases an utter failure, especially as to the despised but mnch-
called-for rubber plates. In extracting teeth he is probably a
butcher. In the very essential matter of dealing with the public,
of conducting a practice, he has most likely never had any instruc-
tion whatever. He has to pay well in time and money for teach-
ing which he supposed was to make him a dentist, but the
tendency of which has all the time been to make a specialist of
him. In this attempt there is no probability of any considerable
success. If a man is to be a chemist or a microscopist, he will find
that what he learns in the dental college is merely rudimentary
after all.

Dental Education. — Smith. 345

This tendency of the teaching of the day is not peculiar to
dental education. It is found in our common schools and literary
colleges as well. The pupil in our common schools is taught a little
English, a little German, a little music, a little day-modelling, a
little of this, and a little of that, with the result that of any of these
branches only the merest smattering is obtained ; not enough to be
of the least practical' use in the business of life, and meantime the
time which should have been spent in developing the powers and
making progress in the common English branches is frittered away,
and the pupil ends his school-days with no specialty at all mastered,
and with a painfully imperfect knowledge of reading, spelling,
grammar, arithmetic, and the common and practical things he will
need to know and to use in order to fill his place in life. If he
aspires to a higher education, he perhaps spends his time on Greek
and Latin and Calculus, the result being that, although bearing the
degree of A.M., he is forced to earn his living by some ordinary
and perhaps subordinate occupation.

*' For many a man comes home from school,
A Oreek and Latin, Hebrew fool."

Let us not be misunderstood. We do not decry or belittle
education. We respect and admire it. We wish to have every
man who is attempting to get it get all that he possibly can, on all
subjects. Let him imbibe fVom the fountain of knowledge to his
full capacity. But what we are contending for is that an education
looking towards an object should be practical in its relation to that
object. It is supposed that the object of dental education is to
make dentists ; not specialists of some sort or other. Therefore all
hi.s teaching should be mainly directed towards making a dentist of
him. Let him learn as much more as his capacities, time, and
opportunities will admit ; but unless he succeeds in making a dentist
of himself, his dental education must be a failure, no matter how
much he may know of special branches. Much as we may magnify
the profession of dentistry, the fact remains that nine-tenths of its
practice is almost wholly mechanical. Anatomy and pathology
and therapeutics, of course, are necessary branches ; but dentists,
as such, do not need to spend time on more than their main prin-
ciples and the details which are connected with dental practice ;
when we come to simmer it down, the pathological conditions with
which the dentist ordinarily has to deal are comparatively simple,
and their treatment is equally so. The polychrests which he really
needs in his materia medica are quite few in number, and all the

346 Original Communications.

multiplication of new remedies seems to amount practically to very
little. If the specialists in dental therapeutics and materia medica
will bring forth a certain and unobjectionable remedy for sensitive
dentine, and inaugurate an era of really painless dentistry, they
will accomplish more for the dentist and the public than in fifty
years of research to secure some new and original and probably
expensive substance with which to do what has for decades been
as well and successfully done with old and tried remedies as it can
well be.

Then, again, microscopy is a very interesting and instructive
science. It should be taught in every dental college. But can a
dental student profitably spend days or weeks of the precious time
of his course in making sections of liver and lung and vegetables?
A dozen illustrated lectures (such as Dr. Sudduth can give) will
teach him more that he really needs to know, and in a more effbctive
manner, very likely, than he could be taught by making sections
without number.

Our main plea is, therefore, that dental education should consist
more of practical teaching and practical work. More of this, and
no less of theory than heretofore, we would gladly say. But life is
short, and so is the time allotted to preparing for the great ^ork
of life. The struggle for existence is ever present. Capacity, time,
and means, all are often limited, and if the result is that one or the
other must be sacrificed, let us cut off the theoretical and stick to
the practical.

As it appears to us, one great defect of even the most pre-
tentious of dental colleges is a lack of a proper number of chairs,
and also of demonstrators. In one college which professes to have
considerably over two hundred students there are fifty chairs, and
hardly six demonstrators. If the two hundred students are study-
ing dentistry, it is to be supposed that they should have the uso of
chairs. The proportion of cbaii*s to students named would give
each student a chair once in three to four days, or an opportunity
to perform thirty to thirty-five operations in a term. K some of
them were juniors and not allowed to operate, the number might
be increased to fifty or possibly sixty. But we submit that this is
far too small a portion of the time to be devoted to practical opera-
tions. And as to demonstrators, it is perfectly plain to any one
that knows anything about it that eight chaira are more than the
average demonstrator can attend to properly. Yet it is believed
that the facilities named are as good as any, and very likely ex-
ceptionally good. This is all wrong. If the college desires to do

Dental Education, — Smith, 347

its duty by the student, it will provide such clinical facilities as will
enable him to properly acquire the skill which he must have to
sustain himself in practice.

But time would fail were we to enumerate the defects of the
actual and the requirements of the ideal dental education. The
subject is only outlined here.

In conclusion, let us utter one more word of caution, lest the
purport of this paper be misunderstood. It is the attainment of
but few to become eminent in more than one department of life.
To develop all that there is in a man, and direct it in one line of
action, is all that can ordinarily be hoped for. Let those who
control the educational institutions of the profession ever remember
that their object should be to make dentists ; to send out men com-
petent in diagnosis, thorough and skilful in manipulation, kind
and sympathetic in their bearing towards their patients, able to
command the respect and confidence of the community. Let this
be theii^ object, and not the inculcation of some special fad ; and let
the student be made to feel that this is the case, and not that he is
liable to be despoiled of his time and money and then either plucked
and cast adrift because he fails to grasp some technicality, or else
turned loose with, a meagre equipment for the struggle which in
most cases will confront him. He will then, if he has the right
stuff in him, feel encouraged to put forth his best efforts, and be
far more likely to succeed. Let the standard be never so high,«but
let it not be the case that the real and the practical is lost sight of
in a fruitless effort to grasp the ideal.

348 Reports of Society Meetings.

Reports of Society Meetings.

CHICAGO DENTAL CLUB.^

Ths monthly meeting of the Chicago Dental Club was held on
Monday evening, March 24, 1890, the Preeident, Dr. A. E. Hatte-
son, in the chair.

Dm. J. H. Martin, J. W. Slonaker, Marvin E. Smith, and U. A
Newman were elected members, and, after some miscellaneous and
routine business, the subject of the evening was opened by the
reading of a paper, by Dr. C. Stoddard Smith, on " Dental Educa-
tion." (For paper, see page 339).

The subject being declared open for discussion, Dr. E. L. Clifford
said, —

Mb. President and Gtentlemen, — It has been our privilege,
this evening, to listen to one of the most practical, most substan*
tial, and, I may say, one of the most instructive papers that has
been placed on the programme of our monthly meetings for some
time. It is not necessary to say interesting, in speaking of such
an effort upon such a subject, for does it not 'constitute the very
foundation of our professional, standing and progress, and would
it be possible to conceive of ''a man with soul so dead" in oar
rapidly-increasing roll of membership that could not, or would not,
appreciate the importance of flill and free discussion upon such a
topic.

Discussion ! May I be pardoned for digressing just one moment,
to allude to the true meaning and importance of discussion. Usage
adds to our programme the discussion of papers read before oar
club, and by discussion, I take it, the fact is not meant that your
time and mine shall be taxed to listen to deserved or undeserved
eulogy, praise, and compliment. Our papers are presented to ob
for mutual, scientific instruction, and the discussion upon these

^ Reported for the Ivtkbkatiokal Dental JoxrBifAL, by C. Stoddard
Smith, D.D.S.

Chicago Dental Club. 349

papers is for the purpose of giving to the club the individual ideas
of its membership upon the subjects presented. Neoessarily, such
discussions may be critical, but I ask you to bear in mind that
criticism, pure and simple, is not fault finding or blaming. It is a
privilege accorded the humblest member of this club to express his
views and opinions upon any paper, and should these opinions or
remarks differ or agree with the statements of any essayist, the
reception should be the same and the speaker accredited with at
least being conscientious. Though we work, and even fight, for the
promulgation of such ideas as we deem correct, let it be determined
that, when the portals of our club-room close behind us, the mantle
of charity shall enshrine and embrace each individual member.

Should I, therefore, see fit to exercise my prerogative of taking
issue with some of the points made by the essayist, do me the
justice of ascribing honesty of motive.

The essayist gives us, in brief, a history of the advancement of
dental education. He takes us back to the time when all knowl-
edge, all education in our specialty, was practical ; when the em-
bryonic state of our profession did not call for theory, and all the
advantages which he has depicted as arising from a theoretical
training, and leads us step by step through what might be termed
the seven stages of man*s development. With this idea, in the
abstract, that manual, practical training is all-important and es-
sential, I would not ask to differ. Apprenticeships I believe to be
absolutely necessary, and only regret that, in addition to the pre-
liminary examinations required by the colleges, one year's tutelage
in an office is not also obligatory. It is true, as the essayist says,
that if we take a greenhorn from the average walks of life and
place him under the task of imbibing from didactic lectures, much
time must necessarily be lost in his trying to familiarize himself
with the technicalities of his selection. In this, I believe, I can
speak from experience, having watched the comparative advance-
ment of such students in the college. The essayist suggests that
the object of dental education is to make dentists. With this
suggestion I am in full accord, but acknowledge the fact and must
claim the belief that the dental office should be the starting-point
for practical training. No man can appreciate more than I do the
value of office tutelage. When I entered college for the purpose of
gaining the finishing touches to a professional life, had I been com-
pelled to depend upon the practical training there received (and
the advantages were as good as the best), I certainly think I should
still be working for the longed-for diploma. But the question

350 Reports of Society Meetings,

arises, What prompted me to covet this diploma and to attend
college ? The fact that my profession had advanced to that state
where theory and theoretical training was absolutely eeaeotiaL
Now, what caused this advancement ? The realization by the older
heads and brightest lights of dentistry that our specialty was no
less than a branch of the healing art, and, being such, must need the
accompaniment of a thorough education to place it alongside of
other professional vocations. Does the essayist think that, had
Chapin A. Harris remained in his laboratory and at his chair,
carefully hiding and cherishing the light of the lamp his bashel
contained, totally ignoring the instincts his nature had developed,
to '^ go teach all nations" what he had learned, that he could have
benefited the profession and the public to any extent to be com-
pared with the fruits of bis self-sacrificing, industrious, all-inspiring,
ambitions life ? Does he think that the time and skill of our fully-
appreciated Sudduth could have borne fVuit of value and impor-
tance to the standing of our profession in any way comparable with
its acknowledged worth, had he confined himself to the chair and
the bench ? And although not all of us, indeed, extremely few, can
have our names inscribed upon the professional escutcheon along-
side of Miller, of Allen, and of Atkinson, will he not be sufficiently
magnanimous to confess our debt is due to their theory and their
research, and not to their ability to make a gold plate or contour a
defective molar? Dental education, he asserts, is to make dentists,
and with this I have agreed. But let us not forget the new mean-
ing advance has placed upon that word. Mechanics, nowadays,
are not dentists, and no one gift is more essential and important to
the aspirant for our degree, but I am convinced that while dentists
may be produced by education, mechanics are born, not made.
And what must be the result of this phenomenal advance and
spread? Simply that the dental profession, following in the foot-
steps again of its brother medicine, must divide itself into branches
of special practice. Taken in its entirety to-day, one head wishing
to contain, to master, and to appreciate all that is implied by
doctor of dental surgery must indeed be a paragon or a prodigy.
Indebted as we are to the different sciences, — anatomy, physiology,
chemistry, physics, materia medica, therapeutics, biology, mycology,
etc. ; called upon to advise and expected to treat almost any and
every pathological condition hidden behind the orbicularis oris,
does it strike you as consistent to believe that a smattering of a
knowledge of any of our collateral sciences, such as might be gained
by listening to a few short lectures prepai*cd, culled, and condensed

Chicago Dental Club. 351

by our most emioent Bpecialists, will fit the average candidate to
occupy a foremost place before bis clientele and the public ? No ;
while dental colleges have multiplied to an undesirable extent, and
while it is true that many of them are mills for grinding profes-
sional grist, simply and only as a secondary consideration, their
first being financial greed and imaginary professional promotion
and standing to its corps of professors, I must claim that from
oven this state of affairs has arisen an upward and an onward
march towards our professional Utopia paralleled by the strides and
accomplishments of no other vocation. I am glad that the essayist
has noticed and appreciated the value of this corrected system of
education. I only regret the paradox of his conclusions, and fear
the result upon the careless observers, and this, if any be necessary,
I offer as my apology for what might at first glance appear as an
attack or antagonism.

It appeared to me, while listening to the paper, that I could
discern a tendency on the part of the writer to give little credit to,
and place small importance upon, three important branches of the
required course, — viz., materia medica, therapeutics, and pathology.
I hope I do not do him an injustice in this conclusion, but if I am
correct I also hope he will not misconstrue my motives in the great
stress I wish to place upon their importance. I want to be placed
upon record as avowing that to no branch of dental education are
we so much indebted for our progress, and whatever standing we
may have attained, as to those mentioned. What is it that enables the
progressive dentist of to-day to bid defiance to that host of patho-
logical conditions so often brought to his notice, and upon the
eradication of which depends the saving of those priceless organs,
in the past relegated to the forceps, but at present known to be
essential to a proper performance of true physiological function ?
Certainly I do not believe it will be the verdict of our profes-
sion that the work so ably done in the past by Black, Gorgas, Har-
lan, Miller, and a host of co-workers in this field amounts to nil.
To the results of pathology we certainly owe our present under-
standing of the conditions existing. To the results of therapeutics
we certainly owe our ability to combat and overcome those con-
ditions ; and to the results of analytical and synthetical chemistry,
as applied to the field of materia medica, we certainly have placed
within our reach the agencies necessary for this advanced work.
Then, taking the debts we owe to these branches collectively,
recognizing that through their agency we hold the power I have
suggested, who will doubt the importance to be placed upon these

352 Seports of Society Meetings.

studies to still further promote a proper recognition of oar pro-
fessional standing? -Truly, a little learning is a dangerous thing,
and the idea advanced by the essayist, that a smattering of any
scientific branch is all a practitioner needs to know, I feel honestly
called upon to refute. It is just this slipshod method of teaching
that has so often brought some institutions of learning into bad
repute, no less than the consciousness on the part of the recent
graduate, that his education has not been sufficient to enable him
to cope with more searching and progressive confreres, Ko; I
would hold and verily believe we cannot know too much. Espe-
cially is this so of any and all branches which go to make the sum
total of those sciences which form the foundation of general medi-
cal practice. I do not believe the essayist will deny that even a
chief in the culinary department of any hotel, an ordinary cook,
whose special education in his art had been supplemented by a
general knowledge of chemistry, would be in possession of secretA
and powers entirely unknown to his ignorant associate. Woaid
not the possession of this knowledge render his services more valu-
able to his employer? would it not have a tendency to throw a cer-
tain amount of respect around his calling and a value upon his time
not to be hoped for by others ? If such would be the case in 80
menial a position, does it not multiply many times in importance
as it rises upon the scale of vocations until professional mission is
reached ? True education is defined as educing, leading, or drawing
out the latent powers of an individual. Let us not forget, bow-
ever, that while this definition is philosophic, a more specific sense
would lead us to the fact that technical training is necessary to fit
the scholar, or the student, for the occupation by which he desires
not only to earn his daily bread, but to ornament society. This
necessitates elementary schools for the multitude, secondary schools
for a smaller number, and universities for the highly-favored few.
We want to remember that education embraces not only the facts
of instruction and good breeding, but that it comprehends the for-
mation of mind, the regulation of the heart, and the establishment
of principles. A want of education will always be to the injury, if
not the ruin, of the sufferer. And a want of proper instruction will
always unfit a man for the society of the cultivated.

I feel so enthused, gentlemen, upon this subject, that it seems
to me this discussion might be indefinitely prolonged, and that, too,
to the advantage of those who would in the slightest degree
diminish or underrate the advantages of any amount of education.
Jealous though I am of personal and individual reputation, not

Chicago Dental Club, 353

less so am I of the repute of the calling I have selected. Frame
such laws and place such restrictions at the entrance of our doors
as will give us an aggregate of educated, accomplished, and com-
petent members, and soon the dental profession will be looked to
as an equal of the most learned. I trust each and every member
present will contribute his quota to this discussion. I ask the
indulgence of the club and the forbearance of the essayist for the
time I have consumed and for some of the extreme views I may
have advanced, but I am of the opinion that in this audience I
can hardly stand alone in my desire to give full and adequate
importance to scientific education.

Dr. E. 8. Talbott. — The essayist has portrayed the longings and
ambition of both rich and poor young men who study dentistry for
pecuniary gain.

It is not only excusable, but even the duty of a man to think of
the support that a calling will yield him and those depending on
him. He should therefore consider all before he decides upon
entering a vocation that requires several years of preparation and
considerable expenditure of money. A mistake made early in life
may prove disastrous in the end and force him to try some other
mode of making a living.

The student, having decided to make dentistry his life-work,
selects his college and pays his fees. Up to this point he is re-
sponsible for his own actions, but as soon as he has secured his
tickets the college is responsible in a measure for his success or
defeat in life.

How great this responsibility ! Does he receive a preliminary
examination to test his ability to understand the lectures and
pursue his studies intelligently ? We have known students visiting
this country, attending college, and returning to their homes with-
out understanding simple English, and yet they took a diploma
with them. We know of others that graduated lately and cannot
read or spell correctly.

These are the criticisfns made by the public.

To my mind there is another preliminary examination far more
important to the student than this. I allude to the student's
capacity for acquiring mechanical and manipulative skill. Without
this no student can become successful, whatever his training may
be otherwise. His ability should be tested, and only when found
fair should he be admitted to the college with a view to graduating.
The college having selected the proper material should have a uni-
form standard by which to gauge each student as he progresses

28

354 Reports of Society Meetings.

from year to year. This can only be accomplished by a graded
course. Uniform methods can be followed in dental colleges be-
cause dentistry is a positive art, unlike medicine and surgery, which
still involve questions that are unsettled. With three courses of
lectures in separate years the student should be qualified to pass a
rigid examination. Mental training and manipulative skill are not
enough to make an efficient dentist. The student should learn
honesty in his business relations, cleanliness in his habits, and tact
in handling patients, all of which are essential to success. At the
age the average student enters college the mind and character are
plastic, receiving impressions readily ; he looks upon the lecturer
as a model to copy.

Flaming advertisements in the daily papers, flattering notices
of colleges and members of the faculties one or two columns in
length, and notices to do dental work at cost, which students know
to be untrue, all tend to demoralise him and lower his standard.
Is it to be wondered at that our city is full of advertising dentiBts
offering their services cheap to the public ? Will not men following
these practices injure the college from which they are graduated ?

The essayist advocates that the student shall confine himself to
such branches as have direct bearing on the practice of dentistry.
This, though more practicable, is not conducive to the advance-
ment of the profession. It is owing to the prevalence of this
opinion that such statements as ^'the profession of dentistry is
largely written out" are made in perfect good faith.

To this view the editor of the Cosmos answers by giving a
long list of subjects for papers or books, all of which require prepa-
ration and study for which the student turned out in the way
suggested above is unfitted. Should his ambition rise high enough
to make observations and experiments, his efforts would be con-
stantly frustrated by his ignorance of the studies that form the
basis of these subjects and his lack of mental discipline.

There are two ways iii which many of the existing evils can be
corrected. The first is suggested by Dr. Ottolengui, of New York.
He suggests the establishment of a National University. The
student would attend a three years' course at the ordinary college
and pass his examination. The college would give him a certificate
which would entitle him to an examination at the university.
The degree of Doctor of Oral Surgery is conferred upon him after
having passed this examination. If he should fail he would be
returned to his college for another course. This method would
stimulate the colleges to do better work, for their existence

Chicago DentAl Club, 355

would depend upon it. All students would graduate on the same
basis.

A second way is the adoption of laws similar to those of Minne-
sota and Massachusetts, on the part of all States giving boards
power not only to establish a standard for the different practi-
tioners but also for the colleges. The State Boards should then
appoint a National Board whose duty it shall be to examine into
the workings of the colleges. This would force them to do better
work when below the standard, for if they should fail to do this
they would be ruled out. The National Board, not being a legal-
ized body, could only act as an agent for the State Boards.

The State Boards, being legalized, could rule out such colleges
as are not up to the standard. This is a mere suggestion of plans
that might be pursued.

Dr. W. W. AUport, — There are many things in Dr. Smith's paper
to commend, and with which I agree, but there are some ideas in
it with which I cannot agree, and think it will do harm to let
the paper be published and go forth in its entirety with the appar-
ent sanction of all the members of the club. In addition to the
criticisms that have already been made, I wish particularly to
express myself as being opposed to the idea that we should have
more of the practical, at the expense of the scientific, taught in our
dental colleges, or that there should be relatively more of the
practical than of the science of dentistry taught than we now
have, for it is only upon the science that an intelligent practice of
dental surgery can be pursued.

When I commenced the study of dentistry, with a few excep-
tions, the teaching was almost wholly practical. Dentists were
not expected to understand anything except the manipulation
necessary to clean, fill, and extract teeth, and put in sets of arti-
ficial teeth, and this was usually taught in private offices in about
six months, there being but one dental college then in existence.
Since then great improvements have been made in the instruments
and materials used, as well as in manipulation, but it is the de-
velopment of the science of our calling that marks the great
difference between dentists of forty-five and fifty years ago and
those who are now educated in accordance with the highest grade
of modem teaching. Then the highest skill of the dentist was
reckoned to be in the handicraft of the artisan ; to-day his greatest
skill has its foundation in his knowledge of the nature and
scientific-medical treatment of dental diseases. Say what you will,
the main object in learning any business is to make money at it,

366 Reports of Society Meetings,

and, in most cases, when a young man enters ^on business on bis
own account, his first and leading object is to this end. If a dentist
has not acquired the habit of study, and become versed in the
science of his calling while a student, the chances are that, when
he enters practice, his thoughts and energies will be mainly directed
to that which most readily brings money, — the ^'practical," the
manipulative part, at the expense of the scientific, upon which
only an intelligent practice can be based. But let a young man
go forth fully equipped in the science, and with but a moderate
amount of technical teaching or acquirements, the incentive of
money-making will readily prompt him to make up the technique
that he may have failed to learn while in college. By this let it
not be understood that I would have the student learn less of the
technique than is now being taught in our dental colleges, bat
rather that I would have more science, more of what might be
called medicine, taught to dental students than most of them now
get. If either is abridged, let it be the practical, for that, as I have
before said, would be more apt to be made up in after life.

For the proper scientific teaching of dental students, I regard
the joint teaching in medical colleges and dental schools far pref-
erable to the teaching in what is known as independent dental
colleges, — better calculated to make intelligent and broad-minded
practitioners. It is a common remark among dentists that medi-
cal men know nothing, or are exceedingly ignorant of the diseases
of the teeth, and that therefore it is a waste of much valuable time
to attend medical lectures in a medical college ; and it is a common
remark for medical men to say that dentists know but very little
of what medical men know; that dentistry is almost entirely
mechanical, or manipulative. The unfortunate thing about these
two statements is, they are both too true. The ordinary medical
man knows but very little of the special pathology that should be
possessed by every practitioner of dentistry, and yet he possesses
that broad scientific, medical knowledge upon which all special
pathology must be based, without which foundation no man can
become even an intelligent student of a specialty, to say nothing of
an intelligent practitioner of it. But let anything be said to an
independent dental college-man about this broad medical teaching
for a dental student, and his reply will be. There is no need for it,
and besides that, we have medical men in our fieicnlty to teach
dental students all they need to know of the science of medicine ;
and they will make this statement in the face of the fact that they
say physicians know very little about the diseases of the teeth, or

Chicago Dental Club. 357

what dentists should know, as well as that the physicians feel that
dentists need but very little medical knowledge.

Between the fact that medical men possess but little of the
special knowledge that dentists should understand and the fact
that medical men think that dentists need but little medical knowl-
edge, it is evident that the dental student gets but a very limited
amount of the latter by the teaching of medical men in these in-
dependent dental colleges, for they certainly would not teach them
more than they feel or think they need.

To illustrate what is meant: Within the last three years, I
happened to be present at a lecture upon the physiology of diges-
tion and assimilation, by a medical man in one of these colleges.
After it was over, occasion was taken to compliment him on his
lecture, to which he replied, " It was not very full, or in detail what
I would have given to a medical class." ** Why," said I, " should
not a dentist have just as perfect a knowledge of the physiology of
digestion as a regular physician ?" " Oh," said he, " it would do no
harm, but it is not usually supposed to be necessary." At a later
time I was in another dental college when a physician was giving
a lecture on sarcomatous growths. In talking to him after the
lecture was over, he said, " I hope you were interested in my lec-
ture, but," said he, '< it would have been very different had I been
delivering it to a class of medical students." "Why so?" said I;
" such growths are not infrequent in the mouth, and dentists should
certainly be able to diagnosticate them when they see them, if not
to operate upon them, when operations are indicated." " Oh," said
he, " we have surgeons for that purpose, and it is not necessary for
dentists to know much about such matters." And this is about
the extent of medical teaching that dentists usually get in this
class of colleges from medical men.

It is just as important that the dentist be well grounded in the
fundamental sciences that go to make up a medical education as it
is that the oculists or the gynsdcologists should be, and in no place
are these as well taught as in medical colleges, except in the uni-
versity system of teaching ; but a dental department in a university,
where its teaching is all independent of the scientific departments
of those universities, is in no way any better than the ordinary
independent dental college, for they derive no benefit from the
well known State university system of teaching. If I could have
my way, no student should be graduated in dentistry until after he
had received a general medical education ; but next to this he should
receive jointly with medical students all that goes to make up the

358 Reports of Society Meetings.

fundamentals of a medical education. He should recite from the
same books, attend the same lectures, and submit to the same
examinations in anatomy, physiology, chemistry, materia medica,
and therapeutics, as well as in the general principles of pathology
and surgery, as do those who expect to graduate in medicine, and
then take up the practice of any of its specialties, pursuing his
special studies in dentistry in a department devoted to that purpose,
and nothing less than this will ever make the dental practitioner
as intelligent in the treatment of the diseases that come within the
scope of his practice as are those who are specialists in the treat-
ment of other diseases.

But, say those who are opposed to this thorough teaching, why
is it necessary for a dentist to understand the size of the pelvis, or
of the surgery of parts remote from the mouth ? As well might it be
asked. Why should the oculist understand the size of the pelvis, or
the bones of the leg and feet? and yet, who would want to employ
an oculist who had not this general medical intelligence ? And there
is not a principle in surgical pathology or therapeutics but what is
applicable in the treatment of the diseases that come within the
scope of the practice of the true dental and oral surgeon. And
without a knowledge of these principles, supplemented by necessary
special knowledge, he cannot meet the highest requirements of his
calling. Instead of the scientific or medical portion of a dental
student's education being doled out to him in such stinted portions
as medical teachers in dental colleges think he needs, it would be
far better for him to occupy his time in the study, and enjoy the
broader teaching in his medical studies that is laid down and
exacted in our best medical colleges, that he may pass without
favor the same examinations by the chairs that is required of those
who expect to take the medical degree, as is now required by some,
at least, of these joint schools, — the dental students scorning to ask
or receive any favors in their medical examinations. A dentist
thus grounded in his knowledge of the principles of general medi-
cine would himself be able to prescribe such remedies in the treat-
ment of diseases, and make use of such means as his judgment
might suggest to him, as being best adapted to the case in hand, as
other specialists do, rather than to shape his treatment in accord-
ance with the very limited medical teaching of men who have but
a faint conception of the requirements essential to the proper treat-
ment of dental diseases.

Dr, C, F, Hartt, — ^A middle course is generally the safest. A
well-rounded dentist is a safe man, and should be reasonably well

Chicago Dental Club, 359

educated. As much depends on the student as on the college. If
there is a hungering and thirsting for knowledge, colleges will
afford the means of supplying the want.

Dr. C. N. Johnson, — I am heartily in accord with the spirit of
the paper, and also agree with much that has been said in appar-
ent criticism of it. In fact, I think the two sides are not so far
apart in belief as would appear, and that some things said in the
discussion are due to a misconception of the paper. I do not
believe that the essayist meant to maintain that nothing but
practical branches shall be taught. The argument of the paper, as
I understand it, was that in the time given for studentship it was
not possible for the average student to gain a thorough scientific
knowledge and also a perfect practical training, and that where it
was obviously necessary to slight something, it was better to lessen
the theory and devote more time to practice. This I consider was
a good argument. A student armed only with scientific knowledge
is not a proper person to send out to practise dentistry. The
principal fault with dental education to-day is that we do not get
the right kind of students into the colleges to begin with. It is
impossible to pour a quart of material into a pint measure and
make it stay there. Our methods of matriculation are too lax.
If we, as a profession, are to make an impression on the world, we
must be intellectual men, and we cannot, in a short course in the
dental college, gain sufficient knowledge to entitle us to that dis-
tinction. A man should bo educated before he enters a college, — he
should know how to study. A young man just from the plough with
mind untrained loses half his first term before he can begin to learn-
anything. A uniform standard of requirements for matriculation
should be adopted and adhered to by all colleges. It is too mani-
fest that students without an education are often allowed to
matriculate on the theory that if one college does not admit them
another will.

In Canada the law governing applicants is far in advance of
present methods here. The college holds no matriculation ex-
amination whatever, but requires the applicant to show at least a
provincial third-class teacher's certificate, including a knowledge of
Latin, and in Canada this means something. Examinations are
held with great strictness, and the applicant who presents such a
certificate has at least the foundation for a good education. This
question of matriculation should be carefully considered, and con-
certed action taken on it by all our colleges.

Dr, E. M, S, Fernandez, — One thing that would be a great im-

360 Reports of Society Meetings.

provement in dental teaching is that the student should know
something about drawing. Drawing should be used in every effort
to teach. He would require lineal and mechanical dramng to be
included in a preliminary examination. Another improvement
needed is that the professors should be made such by some
authority. Professors are now self-styled as such. We need a
place to teach men how to teach.

Dr. E. J. Perry. — ^With some noble exceptions, colleges have
degenerated into a business; the commercial idea has crowded out
the idea of teaching. Colleges profess to teach ethics, and in the
infirmary they teach the most improved methods of quackeiy.
Professorships have grown cheap. The commercial idea in colleges
prevents the proper teaching as to the construction of metal plates.
This idea is ruining the colleges. Colleges graduate men and send
them out to compete with the infirmaries of the same institution.
Think of a theological seminary organized for profit, or of any
educational institution run for money 1

Dr. C. B, Baker. — ^The idea of profit was not first established or
practised in colleges. Students were taken into private offices for
profit, and the mistake was in asking them two hundred or three
hundred dollars /or what they would get there, which would not
be one-tenth of what he would give. Students were taken in for a
profit, and how much were they taught ? It is a mistake to advise
students to go first to a dental college. They should first go into a
private office. The first thing they should see is the refinement of
a private office ; in a college only slip-shod methods obtain, and
the object is to get in as many fillings as possible. If they first go
to a college, they know nothing of the terms used. They may go
to a university with students who have studied for some months,
yet they are expected to know as much as they da. They take
lectures the same as the medical student, but they are cut off from
laboratory or hospital practice. He regrets every day that be
knows so little about drugs and therapeutics. It is impossible to
know too much of science, yet we want all the practical knowledge
we can get. We want to get at principles, yet we cannot go all
through the materia medica. To lay a foundation is all we can
do ; but what we do take up should be thoroughly mastered ; go
to the bottom.

Dr. J. JET. Woolley. — The ethical side of dental education will
have its influence in the profession at large. When the dis-
cussions on these subjects are read, more thought on them will
be aroused.

Chicago Dental Club, 361

Br, A. E, Baldwin, — ^It is probable that the two sides of this
discussion are not so far apart as they appear. A profession is
adopted from self-love and self-interest : therefore, when beginning
it, the person should be competent, and not learn it afterwards.
First, the dental student should be capable of understanding the
principles brought before him. Honesty should be taught him.
He is now taught lies from the day he enters a college, not as lies,
but as profits. Dental work is advertised to be done <' at cost."
A student asked the cost of an oxyphosphate filling, which was
about one cent, but when put in by a professor "at cost," the
amount was three dollars and seventy -five cents. Professional life
is begun in iniquity. Can a student put confidence in such pro-
fessors ? On the contrary, he looks with suspicion on the man who
deceives him. The students do as do the professors. The pre-
liminary examination should be thorough and should be insisted
on. If a dental college is properly arranged and officered by those
who have ostracized profit, there is no place where a student may
BO well begin. The first impressions are lasting ones ; it is easier
to learn right than to unlearn. It is impossible to teach all sub-
jects thoroughly ; the elements should be fully taught, and the rest
may be elaborated afterwards. Half the task is accomplished when
the student has learned how to study. When I first entered a
dental college they had no demonstrator at all. There are not
demonstrators enough in the colleges. Some students require a
demonstrator all to themselves. The medical profession is spoken
of in raillery by dentists, but it is never the case that medical men
speak so about dentists. Medical men are lamentably ignorant of
'* gum-biles," but they are glad to have their attention called to
anything that helps them. We are apt to glorify ourselves too
much. If we realized how little we know, we would study
more.

Br, A, J, Nichols, — ^If we are members of a profession, why
should we not qualify as general practitioners? We treat too
much locally; we do not look beyond a filling. What per cent,
of the dental profession is capable of prescribing for a patient.
A thorough medical course should be required in a dental college.
A student should go to a private office first.

Br, C, S, Smithy in closing the discussion, said : It is plain that
the real purport of the paper has been misapprehended, as was
perhaps to have been expected. It was not the intention to belittle
education ; but quite the contrary. What is contended for is that
if the amount must be limited, what is obtained should be of the

362 Reports of Society Meetings.

right kind. Id all the talk about the necessity of a complete medi-
cal education for dentists, the fact is lost sight of that the object of
dentistry is to save teeth, — ^and from what? From dental caries,
which it is not at all certain is a disease ; the treatment of it, when
simple, is, aside from sensitive dentine, purely mechanical. We talk
of educating the people up to an appreciation of their teeth, and
taking proper care of them ; if the day ever comes when this is
done, there will be no need for any medical knowledge whatever,
aside from oral surgery and the treatment of irregularities, for
dexterous manipulation will then be about the only thing required
for success.

Monday ^ April 28^ 1890, — Evening Session.

The Chicago Dental Club met as usual, and the evening, aside
from routine business, ^vas mainly consumed in hearing from
Dr. J. N. Crouse, who had been given the floor to explain the
objects of the Dental Protective Union, and in remarks by members
on this subject.

At the close of the discussion the following resolution was
unanimously carried :

<' Resolved, That the Chicago Dental Club endorse the Dental
Protective Association as being worthy of the confidence and
support of the profession."

Adjourned.

C. Stoddard Smith, Secretary.

NEW YORK ODONTOLOGICAL SOCIETY.

The New York Odontological Society held its regular monthly
meeting, Tuesday evening, February 18, 1890, in the New York
Academy of Medicine, No. 12 West Thirty-first Street.

The president, Dr. J. Morgan Howe, in the chair.

Dr, Benjamin Lord. — We were all so interested in the discus-
sion of the paper at the last meeting that we entirely forgot to
express our thanks to the essayist for his kindness ; and I move
you, sir, that a vote of thanks be tendered to Dr. McCausey, of
Janesville, Wis., for his very interesting and able paper.

Dr. Lord's motion was carried, and the secretary was instructed
to communicate the Bame to Dr. McCausey.

New York Odontological Society, 363

Dr, Lord, — It will be remembored also that Dr. H. C. Meriam
sent here quite a number of files, of a new and improved pattern,
for finishing fillings, and there was no mention made of his kind-
ness ; I move you that a vote of thanks be given to Dr. Meriam for
the presentation of the files at the last meeting, and that the secre-
tary be directed to report tbe same to Dr. Meriam.

Dr. Lord's motion prevailed.

INCIDENTS OF OFFICE PRACTICE.

Dr, William Jarvie. — Mr. President, I met with a case the other
day that was so peculiar to me that I thought I would take a model
of the teeth and present it to the society. The patient is a lady from
fifty to fifty-five years of age, with all the upper teeth in good con-
dition, and of hard, dense structure. The left central, for several
years, has been gradually receding ; not by erosion or attrition, but
simply settling into the jaw. Some five years ago, it being then some-
what shorter than its fellow, the longer tooth was ground away and
they were made both of the same length. Since that time there has
been a very marked recession or shortening of the left central. It
is the first case of the kind that has ever come under my notice, and I
do not think it is a common occurrence. It is not caused by the
occlusion of the lower teeth, as the lower centrals do not touch the
upper centrals.

Dr. N. W. Kingsley. — How does Dr. Jarvie know that the other
teeth have not elongated ?

Dr, Jarvie, — That is a very pertinent question. I had never
seen the lady until within the last month or so. If it is an elonga-
tion of the other teeth it is an elongation of the whole upper
denture. It may be that the other teeth have elongated and this
tooth alone remained in place. The other teeth are all firm.

Dr, C, E, Francis. — It would seem to be an elongation of the
other teeth.

Dr, C. F, W. Bodecker. — Mr. President, among several cases of
antrum disease that I have had lately there is onl exceptional case
which I would like to report. The patient is a lady between
twenty-five and thirty years of age. She tells me that about six
or eight years ago she had the left upper lateral incisor filled witli
gold, and that some weeks after the tooth began to ache. She
went back to her dentist, then in the country, who advised her not
to do anything with it. About two years ago there was a swelling
about that tooth, which swelling extended back almost to her ear
and up under the eye. She again applied to her dentist, who told

n

364 Reports of Society Meetings.

her that he could not find anything the matter with her teeth ; that
they were sound and in good condition. Last May she was sent to
me. I found none of the teeth decayed, but upon examining the
parts above the first and second left upper bicuspids and the first
molar, I found that the external plate of the antrum had been
entirely dissolved. I made an incision a little above the fint
bicuspid root, into which I inserted a drainage-tube. One peculiar-
ity was that I could not find any opening between the antrum and
the nose, and on further examination I found that the antrum was
a very abnormal one. Measuring from the front backward it was
only about three-quarters of an inch long. It begins between the
roots of the first bicuspid and the eye-tooth and goes back about
as far as the root of the first molar ; no farther. I sent the patient
back to the gentleman who sent her to me, a physician of Hoboken,
to see what he could do with the case. He sent her to Dr. Lange,
the well-known surgeon, who examined the case, and was at fiist
under the impression that the trouble was not in the antrum at all,
but that it was some cyst which had developed between the two
plates of bone, and that one of the plates had projected itself into
the antrum. There are such oases on record. But against this
theory there was the fact that the cavity was lined by a mncoos
membrane, which, with a cyst in such a position, is hardly probable.
The patient was then sent to Dr. Delevan, an eminent specialist of
diseases of the nose and throat, who tried to re-establish the ostenm
maxilla (opening between the antrum and the nose) by forcing a
galvanic cautery needle through. Tou will remember that in the
normal condition this wall is exceedingly thin, and can very easily
be perforated by the galvanic cautery ; but in this case Dr. Delevan
could not get through. If there had been a cyst lying just within
the antrum, this wall would not have been any thicker than nsoal,
I should suppose. We do not know what to do with it ,- whether
to take out the drainage-tube on the buccal surface, and leave it to
nature to heal, or whether to go through in spite of the thickness of
the wall of the antrum. I would like to have Dr. Atkinson, or any
one, give mo some advice. The antrum is now in an absolutely
healthy condition, except that the osteum maxilla is closed.

Dr. Jarvie. — Why don't you let it alone ?

Dr. Bodecker. — ^It is necessary to have an air-passage through
the nasal cavities. I have a case similar to that, which has been in
that condition for about nine years, which was also examined by
Dr. Abbott. I proposed an operation, but the patient's &mily
physician objected to it, and the case remains as it was.

New York Odontological Society. 366

Dr. George 8. Allan. — ^Mr. President, if there is nothing else to
be presented, I would like to read a short preamble and resolution,
after which, I will, in a few words, give my reasons for offering
them to the society.

Whbbeas, Drs. Heitzmann, Abbott, and Bodecker have promul-
gated certain theories as to the histological characteristics of the
teeth, claiming the demonstration of the presence of a protoplasmic
reticulum in both enamel and dentine, and as said theories are not
generally accepted, and the demonstrations are questioned or
doubted by other gentlemen of lOur profession who have devoted
much time to histological investigation ; therefore, be it

Besolvedj That Drs. Heitzmann, Abbott, and Bodecker be in-
quired of, by the secretary of this society, whether they will
co-operate with this society in an effort to have the truth known
in regard to these disputed points, by obtaining the consent of
three experts, to be chosen in a manner satisfactory to themselves
and to the officers of this society, which committee shall have the
right to examine specimens (slides) submitted, and be requested to
report to the society at as early a day as practicable.

You all know how much interested I have been in this subject,
and also how much interested the