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THE ■
Dental Review.
DEVOTED TO THE ADVANCEMENT OF
DENTAL SCIENCE.
EDITOR ;
A. W. HARLAN, M. D., D. D. S.
Associate Editors:
LOUIS OTTOFY, D. D. S., C. N. JOHNSON, L. D. S., D. D. S.
VOL. VI.
CHICAGO:
Published by H. D. JUSTI AND SON, for the DENTAL REVIEW CO..
60 Madison Street,
1803.
Copyrighted 1892.
LIST OF CONTRIBUTORS TO VOL. VI.
Ames, W. B Chicago, 111.
Angle, E. H Minneapolis, Minn.
Arnold, Otto Columbus, O.
Ball, W. C. C Jacksonville, Fla.
Bennett, O. G Janesville, Wis.
Black, G. V Jacksonville, III.
Blair, E. K Waverly, 111.
Brophy, T. W Chicago, 111.
Brown, E. Parmly .' New York, N. Y.
Brown, G. V. I Duluth, Minn.
Bryan, L. C Basel, Switzerland.
Case, C. S Chicago, 111.
Cattell, D. M Chicago, 111.
Chittenden, C. C Madison, Wis.
Clifford, E. L Chicago, 111.
Cole, H.J Norfolk, Neb.
Cormany, J. W Mt. Carroll, 111.
Cushing. G. H Chicago, 111.
Davis, L. L Chicago, 111.
Dennis, G. J Chicago, 111.
Dennis, S. W La Salle, 111.
DeTrey, E ; Vevey, Switzerland.
Dunn, J. A Chicago, 111
Elliott, A. V Florence, Italy.
FiLLEBROWN, T Bostou, Mass.
Freeman, A. W Chicago, 111.
Freeman, LA Chicago, 111.
French, E. C Eau Claire, Wis.
Gallxe, D. M Chicago, 111.
Gillette, E. A Norfolk, Neb.
Gilmer, T. L Chicago, 111.
Gordon, iL. E Chester, 111.
Green, W. F S. Evanston, 111.
Harlan, A. W Chicago, 111 .
Harned, M. R Rockford, 111.
Haskins, G. W Chicago, 111.
HoDGEN, J. D San Francisco, Cal.
Hugenschmidt, a. C Paris, France.
Jenkins, C. W Zurich, Switzerland.
McCoy, J. C Santa Ana, Cal.
Johnson, C.N Chicago, 111.
Johnson, H. H Atlanta, Ga.
Kester p. J Chicago, 111.
McCandless, a. W Chicago, 111.
McCausey, G. H Janesville, Wis.
Mariner, J. F Chicago. 111.
M.tRCKLEiN, R. E Milwaukee, Wis.
MaWhinney, E Chicago, 111.
Mitchell, L. J London, England.
Mitchell, W London, England.
MoLYNEAUX, G Cincinnati, O.
Morgenthau, G. L Chicago, 111.
Nason, a. W Omaha, Neb.
Nason, G. S Omaha, Neb.
Newkirk, G Chicago, 111.
Noj'es, Edmund Chicago, 111.
Ottofy, Louis Chicago, 111,
Palmer, E La Crosse, Wis.
Perry. E.J Chicago, 111.
Prichett, T. W Whitehall, 111.
Royce, E. a Chicago, 111.
Sage, Frank W Cincinnati, O.
Salomon, G. S Chicago, 111.
ScHiEss, Prof Basel, Switzerland.
Schuhmann, H. H Chicago, 111.
Swain, ED Chicago, III.
SwARTZ, M. W Peoria, 111.
Taggart, W. H Freeport, 111.
TuLLER, R. B Chicago, 111.
Underwood, C.J Elgin, 111.
Warner, E. R Morrison, 111
Warren, G. W Philadelphia, Pa.
Wassall, J. W Chicago, 111.
Weeks, T. E Minneapolis, Minn.
Wilson, I. P Burlington, Iowa.
WooLLEY, J. H Chicago, 111.
Zinn, G . E Chicago, 111.
TABLE OF CONTENTS.
ORIGINAL COMMUNICATIONS.
A Brief Treatise on the Common Diseases of the Maxillary Sinus 200
A Glance at Familiar Characters 703
A Talk About Toothache 790
A Vision of Dead Teeth 847
Abscess of the Antrum, with Cases and Treatment 99
Address to the Odontographic Society of Chicago 214
Aluminum 374
--^Antiseptic Dentistry 5B7
Care of the Deciduous Teeth 032
Combining Amalgam and Gold 765
Copper Amalgam 773
Contour Fillings— What They Should be 458
Crown and Bridgework 630
Dental Legislation 464
Dental Medicines, Their Specific Action and When Indicated 797
Dentists as Hobbyists 928
Electricity in the Operating Room .... 25
Employment of the Post in Anchoring Fillings 945
Enamel, Dentine and Nerve 1
Facial Neuralgia 362
Failures of Dental Operations 280
Fillings 19
Hints on Vision 878
^,,-Hypertrophy of the Oral Mucous Membrane 957
Hypnotism as Applied to Dentistry 688
Improvements in Porcelain Crown and Bridgework 469
Introductory Lectures to Medical Students 354
/^Lingual Ulceration of an Epitheliomatous Appearance, due to an Upper Full
Artificial Denture 218
Local Anaesthetics 917
Making a Name 212
Matriculate Examinations of Dental Students 9
Mechanical Treatment of Congenital Fissures of the Palate 201
Methods, Old and New 93.1
Oral Hygiene 349
Orthodontia — A Practical Case 531
Patients and Patience 867
Plastics 793
Post-Graduate Study 93
President's Address, Illinois State Dental Society 402
President's Address, Nebraska State Dental Society 637
President's Address, Wisconsin State Dental Society 786
Priority in the Use of the Screw for Regulating Teeth 384
Professional Ethics — President's Address 932
Pulpitis 370
Pyorrhoea Alveolaris, or Riggs' Disease of the Gums 778
Pyrophosphate of Zinc versus Copper Amalgam 886
Recent Contributions to the Diagnosis and Treatment of Empyema of the
Maxillary Sinus 284
Recreation and the Conservation of Energy 276
Remarks on Root Canal Filling 23
Report of the Committee on Dental Art and Invention 547
Report of the Committee on Dental Science and Literature 553
Report of the Supervisor of Clinics — Illinois State Dental Society 545
Retention of Entire Artificial Dentures 197
Some Hints on Practice 895
Some Needed Reforms in the Practice of Dentistry 454
-Some Thoughts on Dental Education 16
Some Thoughts on the Manipulation of Gold for Fillings 366
Surface Protection for Plastic Fillings 187
Surgical Treatment of Irregularities 858
The Application and Influence of Force in Orthodontia 015
The Cleansing of Teeth 891
The Enamel at the Gingival Line with Lantern Exhibit 023
The Estimation of the Profession by the Public 4
The First Permanent Molar 681
The Immediate and Painless Extirpation of the Dental Pulp 14
The Interproximate Spaces 441
The Use of Books 83
Thoughts on Dental Education 769
Thoughts on the Density of Dentine 776
Tobacco, its Use and Effects 628
Treatment of the Deciduous Teeth 948
- Ulitis 952
PROCEEDINGS OF SOCIETIES.
American Dental Association 645
American Dental Society of Europe 839
British Dental Association, President's Address 809
Chicago Dental Society 28, 132, 220, 290, 390, 651, 716, 801, 961
Delta Sigma Delta Fraternity 154
Illinois State Dental Society 473, 559
Minnesota State Dental Society 45
National Association of Dental Examiners 713
National Association of Dental Faculties 709
Southern Dental Association and Tennessee Dental Association 038
Southern Illinois Dental Society 234, 814
Antiseptic Dentistry 571
Comparative Anatomy 45
Contour Fillings— What they should be 501
Crown and Bridge Work 509
Dental Art and Invention 582
Dental Legislation 505
Dental Science and Literature 580
Dinner to the Executive Committee of the World's Columbian Dental Con-
gress by the five united Dental Societies of Chicago — The Speeches 106
Diseases of the Antrum 220
Facial Neuralgia 716
Failures of Dental Operations 290
Filling with Crystal Gold on the Surface of Amalgam 801
Interproximate Spaces 473
Matriculate Examination of Dental Students 28
Office Practice 44
Orthodontia 559
Post Graduate Study 132
President's Address, Chicago Dental Society 390
President's Address, Illinois State Dental Society — Discussion 498
Pulpitis and Pulp Capping 716
Some Needed Reforms in the Practice of Dentistry 487
The Enamel at the Gingival Line 5(57
Tobacco and Its Effects 654
University Extension 651
EDITORIAL.
A Blow at Dental Colleges not Located in Michigan 49
A Common Defect in the Insertion of Gold 338
A Correction that Does not Correct 816
A Library 904
Adjourned 591
An Old Idea Useful 50
Caution 396
Chicago Dental Society 396
Clinics 309
Close of the Volume 974
Consistency, Thou Art, etc 395
Corrections 732
Cotton as a Root Filling 394
Delayed 311
Dental Advice Extraordinary 311
Dental Students 815
Does it Pay? 731
Exit Archives of Dentistry 158
Graduates of Dental Colleges 158
Hungarian Dental Journal 158
Illinois State Dental Society 311
Looks Like Success -^l"
Merry Christmas, and A Happy New Year 975
Northern Illinois Dental Society 903
Pyorrhoea Alveolaris ^'3
Specialties 664
The American Dental Association 1"'2
The Annual Meetings '. "I''
The Annual Outflow 239
The Chicago Dental Society -^^y
The Congress, 1893 l^ifi
The Dental Congress 663, 971, 973
The Endowment of Dental Colleges 155
The Herbst Method of Treating Pulps 901
The March of Progress 663
The Medical Congress, 1893 _''>0
The Southern Dental Association '^^\
The Theory of Groups 1'^'
To the Readers of The Dental Review ^'''2
Too Much Matter l^^
University Extension Lecture Course. •'"*
What Next ? 515
Winter Evenings '"'O
World's Columbian Dental Congress 396, 592, 901
World's Columbian Dental Meeting _^^J^
Young Men in Society
:i93
DOMESTIC CORRESPONDENCE.
Dentistry in Guatemala •• ^ "'^
First District Dental Society ^^6, 593
How I Got a Start in Dental Practice 51
Letter from H. H. Johnson 312
Letters from New York 56, 159, 240, 314, 398. 516, 593, 064
Odontological Society of New York 516
Post-Graduate Study 397
Practitioners' Courses 904, 905
FOREIGN CORRESPONDENCE.
Letter from Portage La Prairie, Manitoba 904
Letter from Portage La Prairie, Manitoba, Reply to 905
REVIEWS AND ABSTRACTS.
A Treatise on Dental Jurisprudence 604
Books Received 981
Catching's Compendium of Dentistry for 1891 248, 325
Chart of Typical Forms of Constitutional Irregularities of the Teeth 324
Currents from the Main 323
Dental Law for Washington 602
Dental Questions and Answers 172
Die Orthopedische Behandlung der Sattelnase 601
Extracts from an Address Before the Masssachusetts State Dental Society. . . 816
Histology, Pathology and Bacteriology 980
Lysol, The Cresols as Disinfectants 62
Mercuric Chloride in Alcoholic Solutions 978
New Books for Dental Students (Dental Anatomy and Physiology) 900
Pamphlets Received 06, 173, 325, 415, 510, 606, 906
Post-Graduate Dental Association 739
Resorcin Therapeutically 65
Revue Internationale D'Odontologie 676
Salivary and Sanguinary Calculus 408
Syllabus of Dental Anatomy 739
Syllabus of Crown and Bridge Work 749
The Dental Journal 676
The Essentials of Histology 738
The Student's Quiz Series: Materia Medica and Therapeutics 826
Transactions of the American Dental Association, Thirty-first Annual Session 170
Two Cases of Removal of the Gasserian Ganglion Through the Floor of the
Skull for Trifacial Neuralgia 412
Useful Hints for the Busy Dentist 826
Western Branch British Dental Association , 732
Zene Artzney 173
PRACTICAL NOTES.
Case reported by Dr. W. F. Green, So. Evanston, III. 981
Conductivity of Heat by Filling Materials 181
Dental Education 67
Effect of Electricity on Filled Teeth 827
Matrices 907
Mechanical Dentistry 174
Peculiar Condition of the IS-outh where Plates are Worn 984
Replanting Elongated Teeth 251
Separating Teeth 984
Southern Illinois Dental tiocirt v . Clinics 909
The Management of Pulplcsi Teeth . . 419
DENTAL COLLEGE COMMENCEMENTS.
American College of Dental Surgery 335
Baltimore College of Dental Surgery 334
Boston Dental College 678
Chicago College of Dental Surgery — Dental Department of Lake Forest Uni.
versity 328
Cincinnati College of Medicine and Surgery — Dental Department 606
Dental Department — Columbian University 337
Dental Department — Howard University 337
Dental Department — State University of Iowa 326
Dental Department — Tennessee Medical College 337
Dental Department — University of Maryland 330
Dental Department — Vanderbilt University 336
Department of Dentistry — University of Cincinnati. . . , 326
German-American Dental College 523
Homoeopathic Hospital College — Dental Department 523
Indiana Dental College 249
Kansas City Dental College 248
Louisville College of Dentistry 756
Meharry School of Dentistry 249
Missouri Dental College 332
National University — Dental Department 607
New York College of Dentistry 331
Northwestern College of Dental Surgery 524
Northwestern University — Dental Department 418
Pennsylvania College of Dental Surgery. .... 249
Philadelphia Dental College. .' 320
Royal College of Dental Surgeons of Ontario 419
Southern Medical College — Dental Department 251
United States Dental College 341
University of California— College of Dentistry 173
University of Michigan 607, 677
University of Pennsylvania — Dental Department 523
Western Dental College 333 418
? ? ?
Queries 74, 252, 985
MEMORANDA.
Memoranda 74, 183, 252, 338, 426, 525, 607, 678, 756, 828, 911, 987
, OBITUARY.
Allen, John 837
Bazier, A. J 348
Brownlee, G. E 440
Cooper, Charles 18()
Dunaver, Harry G 530
Emery, J. Grant 440
Garber, S. A 836
Kautsky, E. J 440
Kingsbury, C. A 838
Kirk, Reuben J 440
Mcintosh, L. D 260
Moffett, A. G 440
Morse, Harold Wescott 186
Noyes, Mary S. W 186
Pasedach, Herman 440
Porter, Noah 260
Runkle. D. W 186, 348, 440
Silliman, H. H 916, 990
Suggitt, F. R 915
Swasey, Joseph A 82, 259, 348 440
Ward. E. B 440
Wilkie, C. M 915
Witt, William 440
I^LATlf I.
•^
Fi^. I — Forming Dentine in contact
with Enamel, i 6 inch.
Fig. 2. — Foriniu>^ Dentine zuith colum-
nar cells {odontoblasts) attached ''Nerve''
dissected a~vav. / /■> hom ini.
"^
Fig. ^. — Odontoblasts attached to Den-
tine. A portion of "Nerve" attached to
odontoblasts, i i^ Glvcerine ini
Fig. /. — / ^> inch.
PLATE II.
Fij^. 5. — Trans Sir. Enihryonal Jaw.
/-/5 fiovi im.
FiS- <">. — !-<' ''tell-
Fix'' 7— / ''"'^'■
Fjir, s — /Cmbni'tial tissue devehpin.i:
inlo^idult. tissue. 1 hicli.
THE
DENTAL REVIEW.
Vol. VI. CHICAGO. JANUARY 15, 1892. No. 1.
ORIGINAL COMMUNICATIONS.
Enamel, Dentine and "Nerve."*
By G. H. McCausey, Janesville, Wis.
It is not my intention to treat the subjects of the enamel, den-
tine and " nerve " of the tooth from a standpoint of embryolog^■
purely, but to consider them histologically at different periods of
their development. We will, to a certain extent, watch the
development of both enamel and dentine and at the same time con-
sider the function of that tissue which we have for so long a time
been calling the "nerve" of a tooth. In preparing this short paper
I have felt disposed to call each tissue under consideration bj' its
right name, at the same time making the effort to ascertain so far
as possible what the correct term may be by which it should be
■characterized.
The microscopical anatomy of a tissue often determines its
kind and function. For instance, we recognize voluntary muscle
by the transverse striae of its fibers, while at the same time we
recognize the tissue of involuntary muscle b)^ an absence of the
transverse striae and by the presence of that clear appearance
which distinguishes the connective tissue fibers.
From a histological point of view, we distinguish in osseous
tissue the matri.x as well as the bone corpuscle which represents
the formerly existent osteoblast or bone forming cell.
In a like manner we may study the different varieties of tissue
entering into the structure of the teeth of mammals. The more
dense portions of mammalian tooth consists of three anatomical
divisions, viz : The enamel, the dentine and the cementum.
*Read before the Wisconsin State Dental Society.
2 THE DEXTAL REVIEW.
The enamel is that portion of the tooth which forms a cover-
ing and at the same time a protection for the coronal portion of
the dentine, while the cementum covers that portion of the
dentine included in the root. The enamel is the hardest structure
met with in the human body. It consists of a series of many
sided columns or prisms, and which stand, as a rule, at right
angles to the dentine which the enamel covers. The prisms may
however, at times be found decussating like the fibrous elements
of connective tissues and they may nearly always be found formed
into a number of sections each separated by intervening organic
substance.
The acid treatment to which the adult tooth is necessaril}' sub-
mitted preparatory to making their sections for study with the mi-
croscope, renders it impossible to study the enamel as it is always
destroyed by the acid. It may however be prepared for study by
grinding in thin plates, yet they are generally made of dried spec-
imens which are useless for study as normal specimens.
The better plan is to use specimens in process of development,
and which have not been subjected to either the mineral acids or
alcohol.
I now exhibit a specimen, No. ] , showing the enamel rods as they
appear during the process of development, and as they will appear
when calcified. It shows also the forming dentine in contact with
the enamel. It will be noticed that the portion of each forming
enamel rod is more dense than further away from the dentine. It
indicates for each rod a greater degree of calcification, than where
it appears lighter, and yet further away may be distinguished the
formed matrix . Dissection of the forming rods from the surface
of the dentine would demonstrate the hexagonal form of many of
them.
The developed dentine of the tooth, consists like bone of a cal-
cified glue forming matrix; but unlike bone contains no bone cor-
puscles, and is possessed of much greater density than is bone and
is pierced by numerous passages which pursue a general direction
perpendicular to the surface. These passages contain fibrils which
are apparently protoplasmic processes of certain columnar shaped
cells which envelop that organ, which we have for so many years
been in the habit of calling the " nerve " of the tooth.
No. 2. We now have before us a specimen showing the form-
ing dentine, and which shows the fibrils with the columnar cells
ORIGINAL COMMUNICATIONS. 8
attached, but with the nerve dissected away. As in the case of the
forming enamel there is a difference in the degree of development
of different territories of the forming dentine. That portion in im-
mediate contact with the formed enamel shows the greatest degree
of calcification. That next in contact shows a less degree of calci-
fication while that in contact with the columnar cells of the nerve
represents the formed matrix. It will be noticed that the columnar
cells differ somewhat in their form. The fact has been the occa-
sion for claims on the part of certain histologists, that the form of
the cell determines its function. For instance that the pear-shaped
cell serves to calcify the matrix of the dentine formed by the cell
attached squarely to the forming matrix, but possessing from one
to six processes which penetrate the dentine No. 3.
We now have before us a specimen similar to the previous one,
save that there remains attached to the columnar cells a certain
portion which we yet persist in calling the nerve.
No. 4 is a slide showing the forming enamel and dentine in im-
mediate contact, and the tissue of the "nerve" in contact with the
formative cells of the dentine, and showing at the same time the
enamel forming cells. Up to the present time we have patientl}''
referred to that tissue occupying a position within the forming
dentine as the "nerve." We will now make an effort to ascertain
if we have a right to continue to use the term.
To ascertain our rights in the premises we will be obliged to
return to a very early period in the development of the tooth. A
period soon after the forty-fifth day of intra-uterine life.
No. 5. This slide represents a transverse section of an em-
bryonal jaw at that period. It will be noticed that the tissue rep-
resents nothing which we have before shown, and shows the
presence of two varieties of tissue. The upper portion shows the
development of the epithelium or integument of the jaw at a period
soon after the forty-fifth day. It will be noticed that a portion of
the epithelium is projecting downward in the form of a V into the
embryonal tissue of the jaw.
No. 6 represents the downward projection of the epithelium
only at a later date. It will be seen that it has progressed farther,
and and after a time it will be noticed that a bulb-shaped body
will rise out of the sub-epithelial tissue of the jaw and occu-
py a position beneath it.
That portion projecting downward is to become the enamel
4 THE DENTAL REVIEW.
forming organ, and a bulb-shaped body growing in a direction
upward finally exerts such a pressure against the forming enamel
organ that it finally becomes surrounded by it, and itself becomes
the organ of dentinal formation. In slide No. *? we see it engaged
in the formation of dentine, and although photographed with a
lens of low power, it serves admirably to show the function of the
bulb arising from the sub-epithelial portion of the jaw, and which
is that of dentinal formation. An examination by high powers of
the microscope shows it to consist of that variet}' of tissue which
constitutes the embryonal jaw. At first it contains within itself
veins and capillaries for the purpose of furnishing nutrition for the
developing tissues, and at a later date it contains within itself
meduUated nerve fibers, and branches of which have their terminus
near the dentinal forming cells as non-medullated nerve fibers.
We can only conclude that while it contains nerves, it is not a
nerve because it does not itself consist of nerve tissue, but is a
modified form of embryonal tissue, a characteristic specimen of
which is seen in No. 8.
The Estimation of the Profession by the Public*
By C. N. Johnson, L. D. S., D. D. S., Chicago. III.
The President's address a year ago dealt so earnestly and forc-
ibly with the workings of this society, and pointed out so plainly
its needs that our members were aroused to renewed effort resulting
in an awakening which has made the year a successful one. It
therefore remains for me to make little suggestion as to change
during the coming year. One feature, however, I think needs re-
forming, and to that I shall briefly call your attention.
I refer to the reluctance with which many of our members give
their consent to prepare papers for the societ3^ The programme
committee invariably have a difficult task to secure essayists for
the coming year unless they go to those whose known loyalty to the
society prevents them from ever declining. Thus it is that we of-
ten see year after year nearly the same names occurring on the
programme, and this fact of itself has often led to censure of the
committee and toachargeof favoritism in the selection of essayists,
I wish here to emphasize the fact that it is not so much a desire of
the committee to have the same names continually appearing as it
* President's Annaal Address, Chicago Dental Society, April, 1891.
ORIGINAL COMMUNICATIONS. 5
is the necessity which forces them to aproach men who will accept,
by the persistent excuses and declinations of a large majority of our
members.
Every man owes it to his societ}' to do something toward its
progress, and it is safe to say that in an organization like ours
there are very few who are deterred from a duty like this through
lack of ability. We are always disposed to admire modesty in a
man, and yet even so great a virtue as modesty should not be en-
couraged to the point of proving a drawback to the best interests
of the society. We trust that future committees will meet with
more encouragemeut than those in the past, and we also hope that
future presidents will have less trouble in obtaining men to act on
these committees.
One word more in this connection. When a member gives his
consent to read a paper he should look upon the matter as an obli-
gation not easily to be set aside. He owes it to the committee, to
the officer of the society, and to the society itself that he makes
good his promise. It is a matter of much inconvenience to the
Secretary to receive from a member who is expected to read a
paper at the next meeting, a note simply stating that it will be im-
possible to be on hand and sometimes coupling an excuse which
nine times out of ten only serves to prove how lightly he holds his
pledge given to the committee. The essaj'ist always has from one
to twelve months' notice of the time he is expected to appear and
there is seldom any excuse which will warrant his failure. He
should hold himself personally responsible for the entertainment of
the society on the night for which his paper is set, and if from any
cause he is unable to be present he should prepare his paper in
advance and place it in the hands of the Secretary or some friend
whose confidence he can claim to properly present it. If this were
done it would prove his good will, and from past experience in
these matters we feel sure it would be appreciated by the society
and more especially by the Secretary on whose hands falls the bur-
den of procuring a substitute.
It is exceedingly embarrassing for the Secretary to be obliged to
impose on the good nature of some of our members and solicit a
paper at the last moment on account of the negligence of a delin-
quent. In common justice to the society it is only reasonable to
expect of a man whose name is on the programme that in case of a
failure on his part to prepare a paper, he will himself provide a sub-
6 THE DENTAL REVIEW.
stitute and relieve the Secretary of a service which does not right-
fully belong to him.
It is probably more often thoughtlessness and carelessness
than willful neglect which leads to this wrong, and it is hoped
that now since attention has been called to it we will have fewer
delinquents than in the past. Your retiring President bespeaks for
the coming year a most successful era in the history of the society.
The subject selected for our brief consideration this evening is
THE ESTIMATION OF THE PROFESSION I!V THE PUBLIC.
The question must often arise in the minds of the thinking men
of the profession whether or not we are appreciated by the public
in due relation to the amount of good we are doing in the world ?
A professional man is usually supposed to have some prestige in
society not ordinarily accorded those in humbler walks of life. The
lawyer and the clergyman for instance are better received — other
things being equal — than the mere mechanic. No reflection is
meant in this connection on the mechanic. He may be a man as
proficient in his way as the professional man and yet the world has
grown to expect a higher development of intellect from the latter,
and treats him with the increased respect which advanced intel-
ligence demands.
Now the question arises : Do dentists, as a class, stand upon
the footing of professional men when judged by the estimate which
the world places upon them? In our limited way we do as much
good to humanity as any of the other professions. We relieve
human suffering, and we add our share to the sum of human happi-
ness. But we have not yet succeeded in gaining from the world that
kind of recognition which places us on an equality with the learned
professions. Reference is not here intended to individual members
of the profession. It is freely admitted — and with pride — that
individuals practicing dentistry have been honored by the
world and have been looked upon as worthy of a name beside the
greatest, and yet the few who have claimed distinction in this way
only demonstrate more forcibly the fact that the rank and file of the
profession are considered lacking in those qualities which demand
recognition.
We cannot any longer content ourselves with accounting for
this by the extreme youth of our profession. When a profession
increases to the extent that it has between 18,000 and 20,000 mem-
ORIGINAL COMMUNICATIONS. 7
bers in a single countr}' it has reached a point where it can no
longer shirk responsibiHty with the claim of minority. We have
been long enough in the field now to have made an impression on
the world, and it is time we began to examine ourselves for the
cause of our present condition. Let us see if the fault does not
lie within our own ranks.
It is generally supposed to be a requirement of a member of a
learned profession that he shall be possessed of learning. We are not
quite sure that members of other professions invariably fulfill this re-
quirement. In fact it is probable that many of them do not, but when
it comes to dentistry there cannot be the shadow of a doubt that a
very large per cent of the profession are utterly devoid of the first
principles qualifjdng an individual to recognition as being learned.
Dentists ma}^ be skilled in manipulative measures, but they are
not as a class well developed mentally. By this we mean that they
do not take as comprehensive a view of life and its possibilities as
they should. They dedicate themselves heart and hand to the den-
tal rut, and they ignore the fact that there is anything outside of
that rut worthy of serious consideration.
It is well to be devoted to one's profession, it is perfectly prop-
er that it should be the mainspring of one's best endeavor, but to
confine oneself constantly to the environments of a profession like
dentistry where strict attention must be paid to the minutiae where
the little things are the things which count, where a broad, com-
prehensive grasp of the great questions agitating the mass of hu-
manity is seldom called for, will in time produce in the individual
a narrow, illiberal spirit which influences him in his intercourse
with the world. He cannot avoid making an impression on those
he meets as a narrow-minded man. His mental vision is limited,
and he sees nothing on either side of the restricted groove into
which his destin}' has placed him.
When we as dentists are called upon to encounter the world in
any capacity outside of that related to the profession, we make an
indifferent showing. We are at sea on questions of national or in-
ternational importance. We cannot for a moment speak intelli-
gently on the trade relations between our own and other countries.
We apparently ignore the import of the wonderful advances made
in the industrial world around us. We fail to keep properly in
touch with the revolution of thought and theory which forms the
most distinctive feature of our age.
8 THE DEXTAL REVIEW.
And what must be the estimate placed upon us by the world
when these facts are so manifest? I am willing to admit that to
follow the practice of dentistry so closely, as most of us are obliged
to do in order to obtain a livelihood, precludes the possibility of
looking deeply into the questions just enumerated. For instance,
the associations of a man absorbed in filling teeth are not favorable
to a close study of the great railway interests of the country. There
is little in common between a pulp canal and politics (unless they
are both putrescent) and we may not hope that a man whose mind
is occupied with the study of erosion can successfully cope with a
question such as that of the fisheries dispute between the United
States and England. But dentists should at least know enough of
these matters to be able to discuss them intelligently, if not deeply.
They should show the world that they are readers and thinkers,
and not mere mechanics.
And even if we give over entirely the consideration of questions
such as I have just mentioned, if we feel inadequate to follow the
workings of the political and industrial worlds, we have yet before
us another world which, if developed by us as a profession, will
give us standing beside the culture and learning of our generation.
It is one not at all incompatible with our calling as dentists, and
one which is as broadening in its influence as its possibilities are
unlimited. I refer to the literary world. The study of the best
literature inspires, broadens and ennobles a man as nothing else
will. If we are properly equipped with a knowledge of the litera-
ture of the world we need not fear to pull a conversational oar with
the best men we meet. We may hold up our heads and assume a
place in the community fitting the members of what would then be
a learned profession. And this development of the literary taste is
within the reach of all dentists who have in them the elements of
progressive men. There is little monetary expense attached to
the accumulation of this kind of knowledge, and the poor dentist
may advance as rapidly as the rich. It is not necessary to neglect
the duties of practice, and in truth these duties are rendered less
monotonous and irksome by the diversion which comes from a well-
balanced brain filled with something to think about. An evening
with some of our best authors is conducive to rest and sleep, and
the reflections and inspirations resulting from the discovery of a
new thought or a beautiful sentiment from some great poem sends
a man to his office the next morning refreshed in mind and spirit.
ORIGINAL COMMUNICATIONS. 9
He has something to think about other than the petty failures and
vexations of his daily practice, and he is more in the mood to im-
press favorably those he meets than if he had idled away his time
or spent it fruitlessly in the endeavor to hold a better hand than
his opponent in a game of draw.
The truth is becoming more and more apparent that if we are
to gain a reputation as broad and liberal men we must do it by vir-
tue of development in lines other than those strictly relating to the
practice of our profession. We must get outside the dental rut oc-
casionally and in doing so we shall not only broaden our percep-
tions of life in general, but we shall be better equipped to view our
owti profession from every side and raise its standard more rap-
idly than if we confine ourselves at all times to the details de-
manded by our every day experience.
As it is to-day we are controlled altogether too much by the lit-
tle things. We are pleased by trifles, and what is worse yet, we
are annoyed by trifles. Ignorance is our greatest enemy, and the
world cannot be expected to look with respect upon a profession
which contains within its ranks so many men who are lacking in
the elements of ordinary education. In this connection I wish to
emphasize the fact that unless we exercise more care in the
future than we have in the past in discriminating between educated
and ignorant men who apply for admission to the profession, we
shall advance very slowly in the estimation of the world. We
must seek not only to elevate the men who are in the profession, but
to keep out men who are not fitted to do it credit.
But for ourselves I am convinced that there is no other one ele-
ment which will work so favorably toward making us more expan-
sive and receptive, no other influence so well calculated to improve
our mental caliber and place us in a position where we may ad-
vance our reputation before the world, no other diverting pursuit
so congenial and convenient for us as dentists, as the consideration
and study of the various phases of human thought and experience
which comes under the general head of literature.
M.-^TRICULATE Ex.AMINATIONS OF DeNTAL StUDSNTS.*
By Edmund Noyes, D. D. S., Chicago, III.
Will the time ever come when dentistry will be entitled to rank
as one of the "learned professions ? " Will the large majority of
* Read before the Chicago Dental Society.
10 THE DENTAL REVIEW.
the dental profession at some time in the future deserve to be char-
acterized as well educated or liberally educated men? If we may hope
for such a condition of things, what are the forces and motives in
operation to produce that result and what efforts are necessary
on the part of the profession and the colleges to accomplish
it or to hasten it ? The surest ground of confidence that the
future will be better than the past in some of these respects
is in the general tendency of this age and generation toward
a better education of j'oung people in the schools and a longer and
more careful special training for the work of life. Dentistry is be-
ginning to feel the benefit of this general impulse, and will do so
more in the future, probably, though it seems to me that for some
reason, which I cannot understand, it does not yet feel this progres-
sive movement to so great a degree as some other occupations. I
mean that the boj's appear to me to be more willing to patiently
complete a high school or manual training school course of four
years and then, perhaps, add two or four years in colleges or
schools of technology, if they intend to be architects, engineers,
chemists, electricians, lawyers, doctors, journalists or clergymen,
than if they intend to be dentists. Whether or not this supposition
is correct it is evident enough that very few of the boys applying
for matriculation in the dental colleges have had anything that can
possibly be called a liberal education, and ver)' few, indeed, of the
boys who are obtaining a collegiate education have any intention of
studying dentistr}' afterward. I shall not spend much time to
argue the desirability of a better educated class of men, for though
there are instances of college graduates who appear less intelli-
gent, show less vigor and breadth of understanding and less ability
and success every way than numerous others who had very indif-
ferent advantages in their youth, I judge it to be evident enough
that the average standing, ability, influence and professional success
and usefulness of men well educated previous to their professional
studies are abundant compensation for the time and expense re-
quired to educate the boys.
What can be done to raise the standard of qualifications for
entrance to the dental colleges ? From the public little can be ex-
pected directly, though the general tendencies and influences
operating in most communities, which have been referred to, are
likely to be important in the end. Much ought to be done by the
profession generally. Boys who are thinking of studying den-
ORIGINAL COMMUNICATIONS. 11
tistry are apt to consult the dentists of their acquaintance, and
though they may think that they do not need any more schooling
than those who have preceded them, and though many dentists
may feel inclined to advise that what has answered for them will
answer for a new generation, the most of those in practice should
appreciate the importance of their calling and the limitations
caused by their own deficiencies, with sufficient clearness to cause
them to urge the best attainable education upon all young men who
consult them with reference to a preparation for entrance to den-
tal colleges. This is where work is most needed, and though it
must be done quietly, and without system or organization, by the
power of individual influence and opinion, it ought to be so con-
stant and universal as to prove very effective in time.
That the colleges have an important work to do in this regard
is apparent enough to everybody, and they should be made to feel
such a wise and constant pressure from the profession as will in-
duce them to make steady progress toward the most desirable
standard. Advancement must be slow, for the colleges must have
students and the profession must have recruits. If the standard
were raised at once to what we should like to have it, a ver}' large
proportion of those who are now applying would be rejected. All
we can expect is that the requirements may be made stringent
enough to weed out the most undesirable, and be advanced as
rapidly as the attainments of the better class of applicants will per-
mit. It is to be feared that hitherto a great many of the colleges
have allowed very few to escape them, whether well or ill qualified.
The Association of Dental College Faculties requires, in the
absence of diplomas from high schools or colleges, or teachers'
certificates, a preliminary examination the requirements of which
include a good English education. This is perhaps rather indefi-
nite, and as interpreted by many of the colleges appears to mean
no more than could be successfully attempted by ordinary bright
boys of fourteen or fifteen at the time they leave the public gram-
mar schools to enter the high school. Some of the colleges have'
announced a little higher standard than this, equivalent to, possi-
bly, one year's work in a high school or academy having fairly good
entrance requirements. One of them has announced that its stand-
ard will be raised after next July, when what appears to be a
little more than one year of high school work will be required.
Now if by a liberal education, we mean a college course with
12 THE DENTAL REVIEW.
its degree of bachelor of arts, or science, it is evident enough that
we are not in sight of the time when we can hope to have a Hber-
ally educated profession. We are not even near enough to conjec-
ture whether the progress and developments of the future will be
toward that end, or upon other lines, perhaps more closely special-
ized to our requirements.
Much has been done to improve the quality and duration of
professional teaching, and we are just entering upon the new plan
of requiring three years of college work instead of two years in col-
lege and one year of uncertain and easily evaded work in a
dental office, and there is a resolution pending before the Associa-
tion of Faculties to require four years of study, including three
winter courses of lectures. Would it not be better now to wait
awhile before increasing the length of time required for professional
studies and devote ourselves to efforts for improvement in the
quality of the teaching in our three j'^ears course, and especially to
an effort to lengthen the time spent in high school or college before
matriculation. Are the profession, and a few of the best colleges,
ready for a positive step in advance at this point, which has made
little or no progress for twenty-five years?
If it is conceded as desirable that our profession should be com-
posed of fairly well educated men, generally as well as profession-
all)', it must be admitted as more necessary that boys should have
well trained minds, studious habits and a fair amount of general
information such as is obtained in school, before entering upon pro-
fessional studies, than is the case with most other professions, for
the reason that the daily practice of dentistry does not necessarily
require nor tend to promote studious habits as is the case with the
practice of medicine, law, or journalism, or teaching of any sort.
Professional studies have so definite an object, and the attention is
so constantly and closely fixed upon the goal to be reached that
the enjoyment of study and investigation is not usually great
enough to insure the continuance of studious habits very much
after graduation, while in other professions the necessities of suc-
cessful practice more surely compel it. It is necessary therefore
that the foundation be laid, the impulse given, and the disposition
and habit acquired before coming to the dental colleges, if we ex-
pect our men to show the studious habits and thirst for knowledge
which will entitle them in middle life to be called educated men.
It is about time to begin asking that applicants for matricula-
ORIGINAL COMMUNICATIONS. 13
tion shall be required to present diplomas from first class high
schools, or otherwise show fitness to enter the freshman class in
first-rate colleges. This would be an advance of two or three years
of study over present requirements, and may be thought too much
to ask at once. (Though it is to be remarked with satisfaction
that a considerable number of students voluntarily take this
amount of schooling now.)
It will be easier to advance to that point than to take a shorter
step, because it is a standard of requirements easil}^ defined and
universally understood, and is the least that is reasonable in view
of the character and requirements of the profession. In the case
of all the schools connected with universities it would be practica-
ble, and probably desirable, to relieve the dental schools entirely
of the trouble and responsibility of examining students, who could
be sent to the college authorities with the candidates for entrance
to the freshman class. It might be necessary to allow a greater
number of substitutions (a wider range of choice) than is allowed
by some colleges, and to insist upon somewhat different studies as
indispensable; for instance, piiysics and chemistry instead of an
equivalent amount of Greek or the higher mathematics. Excep-
tion ought to be made in case of students more than twenty-one
3'ears of age, who ought to receive individual consideration as to
whether their maturity and the particular training each may have
received in some previous occupation, together with his ability and
character, should be accepted as a fair equivalent for the schooling
otherwise required.
Experience has shown that very many of those whose special
aptitude and inclination are so strong as to induce them to leave
other occupations and begin the study of dentistry rather late in
life, make excellent students and successful practitioners, though
it is also true that a good many of this class who wish to tr}- den-
tistry because they have failed in everything else, ought to be
turned away. If a boy less than twenty-one years old cannot com-
ply with the requirements, he cannot do better than to spend the
time till his majority, if necessary, in an effort to complete them.
We must not depend too much upon associations with consti-
tutions and b5'-laws, for the taking of advanced positions, and en-
forcing their maintenance, though valuable help can be had from
this source and it will all be needed, but we shall make slow and un-
satisfactory progress except as we have colleges tliat will establish
14 THE DENTAL REVIEW.
a high standard and maintain it because they want to, and not be-
cause the}' are obliged to, just as all our great colleges and uni-
versities have maintained their high standard of scholarship
because they desired to, taking pride in doing such thorough work
as will fit their graduates for honor and usefulness, and not be-
cause of any outside compulsion.
The Immediate and Painless Extirpation of the Dental Pulp.*
By John C. McCoy, D. D. S., Santa Ana, California.
Only a few of you know of my experiments relative to the sub-
ject of this paper. My first successful case was more than five
years ago, and was the result of accident or necessity rather than
investigation. An operation had to be finished at one sitting, and
yet a living, extremely sensitive pulp must be extirpated for a ner-
vous patient, before even the foundation of the work could be laid.
After trying all ordinary heroic methods to extirpate, both the pa-
tient and myself were despairing, when I determined to try cocaine,
injected. So filling my hypodermic with a ten per cent solution of
cocaine I placed the point in the small exposure and rapidly forced
the contents into the exposed pulp surface. Of course the patient
jumped, but said the pain was only momentary. The haemorrhage
from the pulp was immediate and profuse. On examination I found
the point of exposure insensible to the touch of the excavator. En-
larging the cavity I probed carefully, and to my delight I found the
effect of the cocaine was complete. The entire pulp was quickly re-
moved, and without pain to the patient. The haemorrhage ceased
after syringing the cavitj' with cold water. The root was dried
and immediately filled, and crowned, and is doing good service to-
day.
After a few days three more pulps were treated in a similar
manner, with a like result. My next few cases did not terminate so
successfully. The trouble was with the haemorrhage which was
copious and uncontrollable. At least I could find nothing that
would check it sufficiently so that I might properly fill the root ca-
nals. After spending much valuable time in a vain effort to stop
the bleeding, in each case a styptic was applied far up in the canal.
*Read at the Seventh Annual Meeting of the Southern California Odontolog-
ical Society, convened in Los Angeles, California, November 19, 1891.
ORIGINAL COMMUNICATIONS. 15
and the patient given another appointment. In nearly every such
case pericemental inflammation supervened, and it required con-
siderable treatment to save the tooth. So man}' cases were of this
nature, and being unable to find a styptic that answered in all cases,
I ceased to use the method except experimentally on supposed fa-
vorable cases. So it went on for years, until I found the long
looked for styptic in tinct. of hamamelis or Pond's Extract. I would
have published the result of my experiments sooner, but thought it
wiser to wait and test it thoroughly. More than two hundred suc-
cessful cases have now been treated, most of them in the past fif-
teen months. So much for the history, now for my present method,
and I will be brief as possible.
First, a suitable case. The pulp must be exposed and the open-
ing large enough to admit a large sized hypodermic point. The
larger the exposure, the less pain you will inflict. The application
to the cavity of a twenty per cent solution of cocaine in eugenol for
five minutes will generally relieve most of the pain in removing the
decayed dentine from the surface of the pulp.
Second, a first-class h3'podermic syringe and in perfect working
order, with both straight and curved points, with points cut square
at the end. Not the smallest points, medium sized to large points
produce best results.
Third, A wide-mouthed bottle containing a ten per cent solu-
tion of cocaine, fifty grs. to an oz. of water.
Fourth, Wide-mouthed bottle of tincture of hamamelis.
Fifth, Rubber dam being applied or napkin in place, remove
all debris from the cavity, exposing the pulp as much as possible
without inflicting pain. Fill the hypodermic with the solution of
cocaine, place the point in the opening of the pulp cavity and
steadily and rapidly force the contents of the syringe against and
around the pulp. The pain, if there is any, is onl)' for a moment.
Haemorrhage from the pulp is the best indication that the applica-
tion has been efficient. In three minutes you can enlarge the
opening, and if the pulp is still sensitive, repeat the dose, using
only half the amount of the solution. Before attempting the re-
moval of the pulp, the dentine around and above it should be cut
away with the engine bur. You can now remove the entire pulp
with slight pain and in most cases with none at all. In molars
each root should be treated separately after the "pulp mass " is
removed.
16 THE DEXTAL REVIEW.
The force used in injecting the cocaine is an important factor in
successfully performing the operation, and the syringe should be
directed in such a way as to cause the cocaine solution to penetrate
the fang as far as possible. The anaesthetic effect is temporary,
but is sufficient for practical purposes. If, however, the pulp is
not removed at first sitting, sensation returns in an intensified form.
When the pulp has been removed, fill the hypodermic with tinc-
ture hamamelis and force it into the pulp cavity as before. This
will not only wash out the loose fragments, but will control the
hsemorrhage. You may have to syringe out the cavity several
times, but I have never had a case where hamamelis failed to stop
the haemorrhage immediately.
When I am satisfied that the pulp is all removed from the fangs,
I syringe the same as before, then dry with absorbents and hot air
(under pressure), drying thoroughly. Use no medicaments ; I fill
roots usually with chloro-percha and gutta-percha cones. If con-
venient, fill crowns at the same sitting. Every case so treated has
been a success. This plan recommends itself for crown work. It
is especially adapted to work on front teeth, where it is of great
importance to retain the natural color. Teeth treated in this way
retain a lifelike appearance and I am sure are stronger and in a
better condition than when arsenical preparations are used. The
proper cases on which to use the method will, of course, be left to
the judgment of each operator. A little practice will enable any
intelligent operator to succeed. In the use of this method you will
be saved much valuable time and annoyance; and, better still,
you will alleviate much pain. The teeth so treated will present a
more natural appearance and the work will be more permanent.
Thus you will reflect credit upon our noble and philanthropic pro-
fession.
Some Thoughts on Dent.al Education.
By E. MaWhinney. D. D. S., Chicago, III.
Dental education consists, of all that series of instruction and
discipline which enlightens the understanding, corrects and forms the
manners and habits of individuals, and prepares them for the great-
est possible usefulness in their future profession. The great requi-
site of the student before entering his professional studies is a
broad, solid, true foundation upon which to raise his superstructure.
ORIGINAL COMMUNICATIONS. 17
Such a foundation consists of a knowledge of the great under-
lying principles of all science, truth and culture.
His mind should be so drawn out to a point of self reasoning
that he is able to arrive at reasonably correct conclusions and capa-
ble of ascertaining the great lessons and facts from the many con-
jectures, suppositions and demonstrations of advanced thinkers in
general science and literature.
His finer nature should be so cultivated as to for7n a basis for a true,
noble, well rounded character.
Upon such a foundation he may rear a structure that will be an
honor to the profession and himself, and a harbor for the suffering
around him and a blessing to mankind in general. Without such
a foundation his future labors will almost certainly come to naught.
It is true that upon poor foundations the frame work of many
structures are reared, and this even enclosed and covered with
shining colors of paint which glitter and decieve many of us, but
rarely ever does such a structure reach completion before the trials
of professional life come and carry it away to give place to one
grounded and reared upon the true principles of success, perchance
here and there one may stand and make what men call a success,
but that success is more caused by the ignorance of the masses
around him than his own merits.
Some of the fathers of our profession began on poor founda-
tions, but during practice they were continually repairing their
beginnings. Remember that but little was required of them as
compared with the demands of our day. Under the influence of
our wide spread literature, the public are becoming more familiar
with the achievements of our profession, and of the fact of its con-
stant advancement, so that each succeeding year our patients de-
mand more at our hands, and only those who keep apace with the
profession can expect to gain their friendship, confidence and
patronage.
A student may graduate with highest honors but if while in
practice he stands still — if this were possible — or goes backward
and does not continually improve, he is soon left far behind and
trampled in the dust by the progressive throng. How important
then the duty of colleges and instructors, of cultivating in the stu-
dent this spirit of advancement.
We frequently have nongraduate practitioners complaining be-
cause they are not allowed to begin with advanced classes in our
18 THE DENTAL REVIEW.
colleges and accredited with one or two courses on account of pre-
vious practice. The reason they are not allowed this advanced
standing comes out of the fact that the majority of such applicants
have nearly as much to unlearn as to learn. There are however
some who apply for admission who are doubtless qualified to re-
ceive advanced standing, and I regret that the}' cannot be so ac-
commodated. Our colleges must have some fixed rule and past
experience teaches that the present one is most certain of good re-
sults for the present at least.
It is almost impossible for an individual to enter upon a career
of usefulness unless he first undergo a system of instruction and
training such as is imparted by our good colleges; indeed beyond
doubt, our dental schools are the best means of acquiring the de-
sired end but that the individual can only get such instruction and
discipline in our colleges is, I believe, a mistake. The idea that
otily graduates of reputable dental colleges shall be allowed to
practice is too old and narrow for our time, and the principle that
because I hold a diploma from a reputable college I shall be
allowed to practice so long as I desire is an outrage on hu-
manity.
It is a thorough knowledge of the advancing science and art of
dentistry, skilled in the art of manipulation together with a mind
and character capable of advancing as fast as does the profession,
that we should desire in the practitioner and it should not matter
where, when or how he reaches such attainments.
The time is coming when all who are not properly qualified to
practice, whether in possession of a diploma or not, shall have to
enter some other field of labor and give place to those that are.
Because an individual was well qualified ten years ago does not
prove that he is now, and in justice to the good name of the pro-,
fession, as well as humanity, there should be som^e way of deter-
mining every few years who are qualified and who are not, and
compelling those who are not to prepare themselves or leave the
profession. It is pleasant to notice the stress many colleges are
placing upon "a good moral character" as a requirement for grad-
uation. They cannot be too strict in this regard, for without such
a character few succeed. Had our colleges been more strict in
this requirement during the past years we would not now be
troubled and disgraced by so many unprincipled cheats and
quacks.
ORIGINAL COMMUNICATIONS. 19
Fillings.*
By O. G. Bennett, D. D. S., Janesville, Wis.
The object of filling is simply to close up a hole. Substituting
a foreign substance for that which was lost. A mechanical means
of restoring continuity and preventing further destruction of re-
maining tooth substance.
To attain results in any degree satisfactory, requires the skilled
dentist who has both application and a conscience that he is operat-
ing upon living tissue, and upon organs of the human S3'stem on
which health, happiness and life depends. He impresses his pa-
tients with the fact that good results do not depend on him alone,
but with their cooperation. That cleanliness and correct habits
are indispensable and that care and judgment must be exercised in
the use of their masticating organs. The desirable patient will profit
by your advice and will be a stimulus to his faithful dentist to
work with higher and far better results.
It is the duty of each of us to provide ourselves with all neces-
sary appliances, instruments and materials, and with a well venti-
lated, comfortable and convenient operating room where plenty of
good daylight is admitted.
The necessary requisites of a filling material are indestructibilit}'',
adaptability, hardness, tenacity, nonconductibility and color.
Gold possesses the greatest number of desirable qualities and
the least number of objectionable ones as a permanent filling ma-
terial. As used by the dentist it is in its pure state and cannot be
affected by the oral secretions to which it may be subjected. It is
capable of being accurately fitted to all portions of the walls of a cav-
ity. It can be used in the cohesive or noncohesive state or in combi-
nation, as the different cases may indicate. It is capable of being
thoroughly condensed and finished, producing a filling that is
sightly and serviceable, having good edge strength, tough enough
and hard enough to stand any ordinary service. It is nonshrinka-
ble and nonexpansive. Gold is a good conductor of heat and cold,
which in some cases is a serious objection. This can be overcome in
the majority of cases by the judicious use of a nonconducting ma-
terial nearest the pulp, where it is possible to use it.
If we prepare the ordinary cavity properly, take the necessary
precaution against the transmission of heat and cold, insert the
* Read before the Northern Illinois Dental Society.
20 THE DENTAL REVIEW.
gold carefully and thoroughly, and finish so that it will have no
overhanging edges of gold and of such shape that will not invite
the lodgment of food but be accessible to cleanse, we will not
have to depend on the oxide or microbe to complete the oper-
ation.
Amalgam is made by mixing mercury with an alloy of various
metals of which there is endless variet)^ of formulas. Some of
these alloys have a considerable merit and many of them none.
It requires no small amount of skill to make a good amalgam
filling and no skill at all when used as far too great a number of
those who bear our honorable name use it, i. e.: To plaster holes
in teeth so that they can get that punched fifty cent piece in their
trousers pocket and yet not be guilty of larceny under the State
laws.
On account of the plastic working qualities of amalgam and the
ease of its manipulation it is sometimes a desirable material to use
especially in posterior teeth where the cavity is not accessible or
where rubber dam cannot be adjusted so as to exclude all mois-
ture. We may have some faith in copper amalgam in these cases.
A good amalgam filling is preferable to a poor gold one, as that
oxide is so handy to cover up some of the defects resulting from
the use of amalgam. The cavity should be just as carefully pre-
pared and protected as for gold, only we should remember that in
gold we have the edge strength to protect the enamel margin while
in amalgam the edge strength is not its equal. Therefore we
should prepare the margins of cavities in accordance with this fact.
For badly broken down molars and bicuspids the serviceable crown
is preferable; but we are not always permitted tt) do the best way,
so we are compelled to do otherwise from the force of circum-
stances. When we do use amalgam we should use it to the best
of our ability for it admits of no carelessness in its use.
The reasons for discouraging the general use of amalgam are
these : — that the molecular changes undergone in the pro-
cess of crystallization, the action of the various conditions of
the oral secretions, and galvanic action make its results very-
uncertain. It is shrinkable, expansive, and has a tendency to as-
sume the spheroidal shape and has poor edge strength. Great
pains should be taken to prepare the cavity, to fill thoroughly, and
after a few days finish perfectly, having a very nice looking opera-
tion, but after a few months or a year's wear we examine it and find
ORIGINAL COMMUNICATIONS. 31
an unsightly filling with defective margins. It has shrunk or
bulged, defeating the very object for which it was inserted.
We have in Wisconsin a few dentists, so called by their victims,
and who advocate nothing but amalgam for bicuspids and mo-
lars, and even rascally insert it in the anterior teeth. They
are incapable of using gold, likewise amalgam, much less are they
competent to educate their patients to a better care of their dental
organs, or to appreciate and pay for high grade dental services when
it is simply throwing their money away, sacrificing time and patience
and submitting themselves to a wrong unless they receive honest
attention.
Oxyphosphate of zinc is useful and effective as a temporary fill-
ing, and also for preventing the effect of thermal changes in the
pulp. It being more soluble in some mouths than in others makes
it unreliable as a permanent filling. Teeth of poor structure can
be made useful for an indefinite length of time by its use, if the
patient is under control and understands that it must be given fre-
quent attention.
Gutta-percha is too soft a substance for a permanent filling but
makes a very good temporar}^ stopping. Its admirable qualities are
that it is a nonirritating and nonconductive substance, yet it ap-
pears to have little effect as an obtunder.
In the preparation of a cavity for filling the first step is to care-
fully examine it and the surrounding parts, and to adjust the rubber
dam. If an approximal cavity and space is needed, secure it by sepa-
rating. It may have been necessary in rare cases to have previously
separated, i. e., by means of wooden wedges or rubber strips placed
between the teeth several days previous to operating. In most in-
stances this mode is very annoying to the patient and is very liable to
induce peridental inflammation, which may mave a serious termina-
tion unless care and judgment be used throughout the operation.
Immediate separation is preferable by use of the mechanical sepa-
rator or the wedge. The former preferred where possible to use it.
The separator admits of no carelessness in its use on account of its
great power.
The opening of a cavity is an important step, especially in deep-
seated caries.
Break down the frail walls of enamel with a keen edged chisel
or some other appropriate instrument, dry, render aseptic the con-
tents, remove the decalcified dentine with a sharp excavator. If
22 THE DENTAL REVIEW.
pulp is alive and has not previously shown inflammatory symptoms,
but is nearly exposed, work ver}^ cautiously indeed. Better leave
a portion of decalcified dentine than to expose pulp as we can sub-
stitute a no better protector. Dr)' with warm air and saturate with
creosote what is advisable to leave. Cover with a thin coating of
gutta-percha solution, or what is better a kind of gutta-percha film
such as tailors use and which is about the thickness of ordinary
writing paper. Cut a piece about the size of portion that you wish
to cover. Place in cavity and spray with chloroform. It will adapt
itself very nicely, then after chloroform has evaporated sufficiently,
cover with oxyphosphate of zinc, avoiding all unnecessary pressure.
After cement has set proceed to preparing, as any ordinary cavity.
If the pulp has previously caused trouble, we find an exposure
and the patient is more than twenty-five years of age, we have rea-
son enough to devitalize it as it will most certainly cause trouble
should we tr}' to save it.
If the patient is young and health}^ and has given a favorable
history of the case and we find conditions favorable, preserve if
possible.
When doubts exist as to results it is best to fill with cement and
let the matter remain in abej'ance until satisfied that the prospects
are good, then fill with a permanent filling, leaving a portion of ce-
ment as a protector.
There can be no general rule in regard to shaping a cavity.
Good common sense must be the guide in every step. How much
or how little to cut away cannot be written with propriety, as there
are different circumstances in every case.
A knowledge of the kind and also the amount of force that both
metal and tooth structure will be subjected to, the direction in which
force is applied and the relative strength of metal and tooth sub-
stance is necessary.
Cut until good healthy tissue has been reached. Be suspicious
of all fissures and lines terminating in margin of cavity. Leave no
sharp angles, no ragged edges, but a well defined, polished margin.
Cut away no more healthy dentine than is necessary. Cut
grooves and retaining points in dentine where they will do the
least harm and the most good. Make all portions of cavity access-
ible.
The use of the matrix greatly simplifies the filling of posterior
approximal cavities.
ORIGINAL COMMUNICATIONS. 23
Soft gold must be used for the greater part of the filhng, giving
special care to cervical margin, complete with cohesive gold.
Every step should be made carefully, intelligently, and with suit-
able instruments.
The lateral expansion of soft gold after finishing filling will
be found to have given a perfect margin, and it cannot be told where
the cohesive gold commenced and where the soft gold ends, so
completely is the whole mass condensed.
In using gold, especiall}^ cohesive, the operator should bear in
mind that it only goes where it is directed, also that pluggers are
made of steel and that we should always have gold between the
points and the tooth structure when force is applied, and that force
does not follow the curves of corkscrew plugger points.
We should try to imitate nature in the shaping of a filling,
whether it be in the central incisor or in the second molar.
Preserve the bellshaped tooth when possible. Fillings should
be contoured if possible. Let no two flat surfaces come
in contact with each other unless unavoidable. Finish
fillings thoroughly. Leave no overhanging edges of gold. Do
not cut a shoulder at cervical margin in finishing. Have cavit)^
properly filled before dressing down to tooth structure, but do not try
to dress the tooth structure down to an incomplete plug. Let me
again tell you to be careful in filling and finishing at cervical mar-
gin and to have gold burnished to entire margin of cavity, having
a perfect plug at the completion of the operation.
Be honest with yourselves, be honest with your patients. Profit
by your failure of to-day that you may do better to-morrow.
Remarks on Root Canal Filling.*
By E. R. Warner, D. D. S., Morrison, III.
The subject, "The filling of pulp canals," is an old one, yet it
is one which rarely escapes, in some form or other, the programme
of a dental society meeting.
As to the importance of this branch of our practice none of us
will raise a question ; we see it daily manifested in the office and
infirmary. Upon the successful treatment and preservation of the
root depends the usefulness and durability of our present crown
and bridge work ; upon it lies the only means of escape for the
* Read before the Northern Illinois Dental Society.
24 THE DEXTAL REVIEW.
practitioner who never has occasion to extract tooth or root but
preserves everything.
I will not give an extended account of the prevailing methods
of treatment, neither will I advance any new theories of m3' own,
but call to your minds manj' of those now in use. We have on the
one hand the extremist who fills the root immediately, no matter
in what condition he finds it, whether it be a recent devitalization
or an abscess of long standing, while on the other haud the timid
operator who occupies many days and weeks in simple cases fear-
ful that some catastrophe might happen. Again there are those
who take a more liberal view of the case preferring to allow nature
to heal the parts before a permanent stopping is inserted, taking
only as much time as the necessity of the case demands.
I do not wish to censure immediate root filling for I think there
are many cases in which that is the shortest, safest and most satis-
factory wa)' of treating, but there are times when it would be a very
unwise thing to do and would result unfavorably both to patient
and operator.
The important point I would call your attention to is that of
principle, not that we should proceed in a certain way to treat all
cases, but let our better judgment dictate the proper method.
A prominent surgeon giving advice to a student, stated, that in
the foundation of any great profession there were three things the
acquirement of which were an essential : principle ! principle ! !
principle I I I
I see no reason why we cannot apply principle in the treatment
of pulp canals as elsewhere. One dentist claims that gutta-percha
is the only true root canal filling ; another claims that cotton has
far superior advantages, and another thatoxychloride of zinc should
be used in preference to all others. By constant study in certain
lines men become proficient in those. Whatever works best in
your hands use it, but do not condemn other methods too severely
from the fact that you are not successful with them, for your skill
may not lie in that direction.
What then are the essentials in the treatment of cases present-
ed ? What are the principles to be observed ? I would say first
of all is the thorough removal of the cause of irritation. Second a
complete asepsis of the parts, and lastly the closure of the apical
foramen with a material which is nonshrinking and nonabsorba-
ble.
ORIGINAL COMMUNICATIONS. 35
If we can be sure we have accomplished all of these we need
have but little fear of trouble. But how uncertain we are at times.
How often we feel that we have not removed every particle of
dead pulp, or from the persisent discharge that we have not yet de-
stroyed the germs of disease. Each one of the many materials now
in use has its advantages and disadvantages. Can we insert med-
icated cotton to the end of a small or tortuous canal and be sure
we have it thoroughly filled or a certainty that in fifteen years the
cotton could be removed without the presence of a foul odor?
On the other hand, how many an operator, when one of his
cases presents itself with peridental trouble, where the canal has
been filled with either gold, gutta-percha or oxychloride of zinc,
wishes to himself that in this particular case that cotton had been
used, for it means that if he cannot control the inflammation locally
he will be obliged to go through the alveolar process or extract the
tooth.
Any hard, unremovable substance in a case of this kind causes
the same chilly feeling to come over him that he has when he
breaks off a nerve broach in the upper third of a canal.
The many difficulties encountered in canals of various sizes and
shapes in persons of different temperaments makes it impossible
to use any one material exclusively and have it work effectuall}'.
Therefore I say that according as the condition before us permits
of or calls for an insoluble resisting material or one of a removable
nature, let us abide by the demands of the case.
Electricity in the Operating Room.*
By G. S. Salomon, D. D. S., Chicago, III.
Some twelve years ago your essayist had the pleasure of attending
a meeting of the most prominent dentists of Philadelphia and the
surrounding country. At that time electricity was in its infancy.
One of the remarks made was as follows : "We do not want elec-
tricity in our offices \ we do not want any power that we know
nothing about." Not being a member of that society, nor even a
graduate, your essayist was compelled to hold his tongue, but the
question arose in his mind : If the speaker does not understand
electricity and for this reason is afraid to make use of it, why does
he not make a study of it and find out what it is ? At that time your
*Read before the Northern Illinois Dental Society.
26 THE DENTAL REVIEW.
humble servant resolved to make it a stud}^ as far as it should relate
to dentistry, and neither the meeting spoken of nor the remarks made
have ever at any time been forgotten by him. Marshall H. Webb
answered this question as best he could, but since that time a great
deal has been learned in this line so that to-day this same question
might be argued to much better advantage. Ten 5'ears ago elec-
tricity was used in the dental office in connection with an instru-
ment called the electro-magnetic mallet, invented by Dr. Bonwill,
of Philadelphia. This instrument was the first to call this new
power into play, and although a very good instrument, it has never
become universal, as was predicted by Dr. Webb, who brought
it into use and performed with it some of the finest operations
that have ever been performed in the dental profession. At
that time every dentist had to generate his own electricity. To-
day it is different, we can use it for a dozen different purposes in
practicing our profession and have our offices wired and use the
electric fluid as we are using gas for illuminating purposes.
On entering the operating room the first object presented to our
view is the operating chair, which is probably the most essential
in it. The next in point of interest, utility, etc., is the dental en-
gine, in fact one is hardly to be found without the other, and until
lately it was invariably a foot engine. Since electricity has come
into use, however, we are not obliged to have one of these instru-
ments on the floor, although we may attach a motor of some sort to
it and in this way dispense with the formerly indispensable treadle.
On entering my operating room one beholds a dental chair, the
only object which would suggest a dental office. T^he dental en-
gine of former days has disappeared and in its stead we have a neat
little arrangement to the left of the chair, fastened to the window
casing. This arrangement consists of an extension bracket, which
when closed is hardly perceptible. Upon the end of this bracket
is fastened a small electric motor about four inches high and five
inches wide, not very much larger than the head of an ordinary
dental engine. This motor has a hollow spindle, through which
the end of the engine cable runs and this about completes my den-
tal engine. Of course the sheath and handpiece are part of the ap-
paratus. Under my instrument table is fastened a small switch,
which takes up no room to speak of. This switch has as an end-
piece a round handle the size of a 50 cent piece. A slight turn to
the right and the motor is in motion, turning a little further, the
ORIGINAL COMMUNICATIONS. 27
speed is increased to any degree desired. In conversation the
question is invariably put, what are the advantages over the old
style engine. Now these are so enormous that they can hardly be
compared. In the first place it is always ready for use, the elec-
tricity being furnished by a company which supplies hundreds of
consumers, will see that its works will not get out of order. Then
it takes up no room. The work can be done in so much less time
and with no exertion on the part of the operator. No one perhaps
finds fault with the treadle until he learned to do without it; then
its disadvantage will manifest itself. Then only do we learn how
much more secure we stand on our feet and how little exertion it
requires to prepare a cavit)^ in a tooth when the foot is not called
upon to do half of the work. In using a corundum or rubber disk
while the rubber dam is applied, it may be annoying to have the
disk tear the rubber, but it will do this in using the foot engine
when handled carelessly. Now this electric engine is such a boon
to the operator that after using it for a short time only he will find
it impossible to go back to the old style foot engine. This much
about the engine. The next arrangement of interest in m}' office is
fastened above the motor and this is an electric fan. It is placed
in such a position as to throw the air in a constant stream above
the patient's head and right through the office, keeping it at a com-
fortable temperature and also keeping the office free from odors
and obnoxious gases which are liable to collect in any closed place.
The fan is such a blessing in warm weather that it is now an in-
dispensable article in my office at least.
At the right of my chair, fastened to the window casing, is a
fifty-candle light which is attached by a small rheostat consisting
of a glass jar which contains a solution of sulphuric acid and two
carbons. This supplies the electric mallet with its power and its
work is done more complete than any assistant could possibly do
with any hand mallet. The amount of electricity can be regulated
by raising or lowering these carbons in the glass jar. The mallet
is another indispensable article in my office and the objection to it
in the shape of a battery which has always been mentioned as an
objection, although none to speak of, has been overcome in this
rheostat. Wherever the Edison light can be had the electric mallet
can now be used without any trouble whatsoever. This may not be
a generally known fact, and it is about time that it should be made
known. The electric mallet will do work that cannot be accomplished
38 THE DENTAL REVIEW.
with any other instrument, no matter how carefully handled. Gold
cannot be impacted in frail teeth as it can be done by the aid of
the electric mallet in the hands of a careful operator.
The next appliance we lay our hands on is a two-candle lights
which is placed in the mouth when we wish to ascertain whether
the pulp in a tooth is alive or not. There is no better test known
than this one. It is absolute proof whether the pulp is in good
condition or not, and I have never yet seen a failure to detect a
dead pulp.
Beside these several appliances we can also light our operating
room with the electric light and have probably a swinging lamp in
front of the chair to enable us to work even in dark days where
otherwise we should be obliged to send our patient home.
There are certainly many more ways of utilizing the electric
current, such as drying pulp chambers before inserting our fillings^
disinfecting our cavities when ready for falling, not to mention
the different methods for bleaching dark teeth, as illustrated by
some of our operators.
The electric current may also be used for cauterizing purposes,
and is so employed by medical men, why not by the dentist?
Gentlemen, the different purposes to which electricity may be
utilized in the operating room are so many that it would require
a good long while to enumerate them and each one would furnish
a good theme for an essay by itself.
May this article, short as it is, be the means of inviting a long
and healthy discussion of benefit to all present.
PROCEEDINGS OF SOCIETIES.
Chicago Dental Society.
Regular meeting, December 1, 1891, President, Dr. D. M. Cat-
tell, in the Chair.
Dr. Edmund Noyes read a paper, entitled "Matriculate Exam-
ination of Dental Students."
Discussion.
Dk. C. N. Johnson : Mr. President and gentlemen, I am es-
pecially pleased to listen to a paper so ably treating a subject in
which I have been interested a long time. Dr. Noyes has gone
PROCEEDINGS OF SOCIETIES. 29
over the question quite thoroughly, and I simply wish to empha-
size several of the points he has made. The essayist makes a
query in the beginning of his paper as to whether dentistry shall
ever be recognized as a learned profession. It will be recognized,
as a learned profession just as soon as dentists are learned men
and impress that fact upon the public mind. The essayist also
says in one place that boys seem more wiUing to put in an extended
studentship in preparing for other callings than for dentistry.
They are simply willing to do that for this reason : because other
callings demand it of them and dentistry does not. Tust so soon
as colleges demand a high standing of matriculation, so soon
will students prepare themselves for that standard before applying
to the college, but so long as we leave the standard low, we will
have our colleges filled with a class of men who have no ambition
to get up to a high standard. An argument is sometimes made
that uneducated students who enter colleges often turn out the best
students in the end and the best practitioners ; that sometimes a
student who is not well educated on entrance to the college will
make a better practitioner than another student who entered at the
same time with a good education, but that is no argument in favor
of a low standard. It simplj^ proves this one thing, that the man
who went in without education was a better man than the other
one to begin with. The fact remains that the man who matricu-
lated without education would have been infinitely better had he
gone in with an education.
Now we must change the sentiment of the whole profession be-
fore we can advance materiall}^ without causing almost a revolu-
tion. The deplorable fact is this, that to-day the rank and file of
the dental profession are not in favor of advanced standards of ma-
triculation. That may seem a strong statement, but 3'ou go out
among country practitioners — without intending to cast any reflec-
tion on them — many of whom have become dentists by registration,
and you will find that if one of them has a friend who wants to be-
come a dentist, he is desirous of getting him into a college just as
easily as possible and he will resent almost as a usurpation of indi-
vidual rights any demand asking for an education to begin with for
that student. Now that is a great drawback and those who are in
earnest and who desire advanced matriculation must make everj'
effort to raise the standard by changing the sentiment of those
men.
30 THE DEXTAL REVIEW.
The essayist intimated in one place I think that we must not
advance the standard so rapidly as to prevent students from study-
ing dentistry and shut out recruits from the profession. I was
talking with my friend, Dr. Beers, on the subject while he was
visiting here a short time since, and he took this ground, and I am
inclined to believe it is true. Said he: "So long as you keep the
standard of matriculation down, you will have a certain class of
young men entering the dental college, young men who are not
ambitious enough to enter a learned profession. The moment you
raise the standard you shut out that class, but you get enough of
a better class of men, and you will have your colleges as full as
they are to-day. The only difference is you will have a class of
men who appreciate a learned profession and who will enter a
learned profession from the very fact that it is learned, "not that
it is easier to get into." I believe in the end we will have just as
many students in our colleges as we have today. We certainly
will have just as many recruits as the profession requires, no mat-
ter how high the standard will be; it will simply be a different
class of men that we get in.
The essayist claims that there has been little advance in ma-
triculation for twenty-fiive years. I am only sorry that he qualified
that at all. I do not believe the profession has advanced one iota
in relation to matriculation in twenty-live years. We have ad-
vanced in a wonderful degree after we get the students into the
college; there is no comparison with the education that we gave to
students in colleges then and now, but so far as matriculation is
concerned, we are just as far from the mark to-day as we were
twenty-five years ago.
I will not attempt to lay down any special requirements which
I think should be lived up to in matriculation. The essayist has
arranged for that and I certainly think he has not been too steep
in his demands. But whatever standard is required, it must be
made uniform in all the colleges of this country. Just so sure as
you have a few colleges asking for the higher requirements, and a
few other colleges that take students with lower requirements,
those colleges that admit students with low requirements will de-
moralize all the other colleges. Whatever system is devised must
be uniform, and the colleges must all live up to it, or the standard
will not be of any use.
Dk. p. J. Kester: I am inclined to believe that Dr. Johnson
PROCEEDINGS OF SOCIETIES. 31
and the essayist are rather over stating the matter when they say
that there has been no progress made during the last twenty-five
years in requirements for matriculation. It seems to me that the
advance has been considerable. That is not the point I wish to
make. The point I wish to make is that the examination or the
necessary amount of knowledge requisite for a student entering a
dental college depends on the amount of knowledge which the in-
stitution itself requires. I do not believe that it is absolutely nec-
essary for a student to understand the latin language, for instance,
when he is to come before professors who have never read a word
of Latin. I do not believe it is necessary for a student in entering
the study of medicine to be educated in the higher mathematics
when the professor himself has never been further than the district
school arithmetic. I believe, gentlemen, that just as soon as all of
our dental colleges place their standard where it is necessary that
the student shall acquire a certain amount of knowledge, the stu-
dent will of necessity acquire it. I believe in order to raise the
standard of dentistry, you have got to raise it at the college. I be-
lieve the curriculum of the denial college he attends should make
it absolutely necessary that he shall be qualified to enter the fresh-
man class of a first-class university before it should be required of
him to be so prepared. We have heard a great deal of the prelim-
inary requirements of the student, and I do not believe to-day that
the average dental college of this country has got to that point
where they can absolutely demand that standard. The fact
remains, however, that in all our professional schools, perhaps in
medicine the same as in dentistry, that a large portion of the pro-
fession stand low in a literary sense, but I believe the same law
will apply. That there is nothing taught in the medical or dental
professional schools which cannot be thoroughly understood by the
average student from the average public school of our country to-
day.
Dr. J. G. Reid: Mr. President, I believe the preliminar}^ ex-
amination of dental students as conducted in dental colleges, is
simply a farce. They matriculate and get in; there are very few
that are refused. I never heard of one that was refused admission.
If they fail in one place, they seek some other college and gain ad-
mission.
I am satisfied that it the preliminary examination of students
were conducted under the auspices of a disinterested board of ex-
32 THE DENTAL KEl'IEW.
aminers appointed from local educational institutions, fewer ad-
missions would be noticeable, and criticism would be allayed in so
far as the dental college is concerned.
Dr. Sw.\in: I believe that the gentleman who has opened this
discussion has overdrawn the matter considerably. I am too young
of course, to go back twent3'-five years, or very many years, in fact,
in this matter of education, but it is my impression that there has
been a decided advance inside of twenty-five j^ears. Dr. Raid has
stated some truth. Dr. Kester has pretty nearly got on to the rock
bottom of this matter, but unfortunately I represent fifty-four stu-
dents now who within a few months have presented themselves for
admission to dental colleges; only four of that number were com-
pelled to pass an examination because they presented the creden-
tials which admitted them, either certificates as teachers, diplomas
from high schools, diplomas from academies or colleges. Now I
think that is a pretty good showing and I don't believe that twen-
ty-five years ago any demagogues in this countr}- could have made
the same statement. Now it seems to me that this is a decided
improvement upon anything that I know about from reading or
hearsay. The gentlemen who are teaching these fifty-four men, so
far as I have conversed with them, and that is to some considerable
extent, have no fault to find with their intelligence. In fact, some
of the teachers think they know a little too much. Think the stu-
dents are a little bit too wise. I have no doubt that is the truth,
because it is usual, I think, in all such instances.
This simply means that a more intelligent class of men are en-
tering our schools of Dentistry, and that the necessities for a severe
preliminary examination are growing proportionately less, with
the masses of students applying for admission to our schools.
Now with this statement I am going to sit down and see what
develops hereafter. I may have a word to say a little later on.
Dr. Ai.i.port : Mr. President, I cannot agree with the state-
ment in the essay, nor with the remarks of Dr. Johnson, that there
has been no advance in the matriculate examination of dental stu-
dents during the last twenty-five years, and I must agree with the
statement of Dr. Swain, that in some of our schools at least there
has been a marked improvement during the time named. In fact,
nearly all of the advance made has taken place within the period
stated, and, as it has been nearly forty years since I graduated in
dentistry, it is not unreasonable to suppose that I am as well in-
PROCEEDINGS OF SOCIETIES. 33
formed on this Subject as is any one present. I do not guess in
this matter, but simply state what I know to be a fact ; it is not
just to class such of our colleges as have tried to do their duty in
this respect with those that have not ; they should receive credit
for what they have done.
Dr. Noj^es states in his essay that our colleges must have stu-
dents. Had he said " some of our colleges ze//// have students " I
should agree with him. The trouble is we have too many dental
colleges and that some of them, regardless of the good name of
dentistry, as well as of the interest of the public, are determined to
have as large a number of students as they can get in order to
swell their annual dividends. This class of colleges is organized
and run for the sole purpose of making mone}^ ; their managers
care not a rap as to the qualifications of their matriculates or grad-
uates, so long as profit is made out of them. Should any one ques-
tion the correctness of what I say, let him look about him in our
own city and see if m}^ statement is not true; he will find colleges
here conducted by men who never practiced dentistry a day in
their lives, who care nothing for the good repute of our calling and
•who are entirely ignorant of the qualifications that a competent
dentist should possess. They hire their journeymen teachers,
many of whom ought to be attending lectures, and then matriculate
and graduate, without regard to their qualifications, all the stu-
dents they are able to entice into their institutes. The turning out
of dentists is with them a purely manufacturing enterprise, con-
ducted upon business principles : the greater the number of stu-
dents they can secure and graduate at fixed fees, the greater will
be their profits at the end of the year. Their chief concern being
to do as large a business as possible and make all the money they
can.
The essayists ask if dentistry will ever become a learned pro-
fession. The asking of the question is an implied acknowledg-
ment that it is not. He then, in behalf of our schools, attempts to
shirk the responsibility in this matter, and to place it upon the
community, the profession, or somewhere else, rather than upon
our colleges, where it properly belongs. Dentistry will become a
learned calling or profession just as soon as those who educate
dentists demand a proper degree of learning as a requisite for ma-
triculation, and of professional science for graduation; and not be-
fore.
34 THE DENTAL REVIEW.
It is of no use, therefore, for those who are m'anaging our col-
leges to endeavor to shirk this responsibility, for professional sen-
timent upon this question depends upon the quality of the educa-
tion possessed by the graduates they send out.
A " learned profession " is a calling requiring knowledge and
skill. When applied to dentistry it means a thorough knowledge
of the nature and causes of all the diseases, the treatment of which
comes within the province of the dentist, as well as skill in adapt-
ing the most improved methods of science and art in treating them.
It makes no difference in this matter whether the diseases are pro-
duced by local or by constitutional causes, or whether they require
local or constitutional treatment. By professional learning does
Dr. Noyes mean skillful manipulation in filling teeth, the making
of artificial crowns and of sets of artificial dentures, and the appli-
cation of local remedies for the cure of diseases of the oral cavity?
Or does he mean the broad medical knowledge that would enable
a dentist to diagnose the causes and tendencies of the manifesta-
tions of all of the diseases of the mouth, and to prescribe, when
necessary, not only local, but constitutional treatment for its relief,
with the same degree of medical intelligence as that with which
other specialists treat the diseases that come within the provinces
of their respective departments of the learned profession of medi-
cine? If he means the latter, dental students will be obliged to
gain their education elsewhere than in the ordinary independent
dental colleges of to-day, for in them they do not teach it.
I may be wrong in my opinion, but it is my belief that dentistry
will never be classed as a learned profession, or even as a part of
a learned profession, until all of our dental schools are so connected
with medical colleges or universities that these institutions will be
held responsible for the general medical instruction of dentists.
You will naturally ask why I make this statement. In the first
place, there are very few teachers in our regular dental colleges who
think it essential that dentistsshould be as well educated in the fun-
damental principles as those should be who make a specialty of the
treatment of other diseases; and so long as teachers do not think
this knowledge important to their students, they will neither teach
it to them nor exact it of them, for they will not teach knowledge
which, in their opinion, is not essential for graduates to possess.
That this degree of medical knowledge has not been imparted to
most of our dental students is apparent from the well-known and
PROCEEDINGS OF SOCIETIES. 35
humiliating fact that dental graduates are not as well qualified to
treat constitutionally diseases of the oral cavity as are other spe-
cialists to so treat the diseases that come within the scope of their
practice in other parts of the body.
Dr. J. N. Grouse. Mr. President and gentlemen, this is a lit-
tle out of my line. I think I am the only man in Chicago that
don't run a college, consequently I don't know much about it.
Still I am one of those that favor education, and I consider that
an education should be a discipline of mind, and that the dental
profession ought to have the best disciplined minds of any pro-
fession. It requires greater ability to be a first class dentist, to
practice right and well, than any other profession. Now let us
see if that is true. What do we require from a dentist? Skill —
he certainly must have it, cannot get along without it. Integrity —
he might get along without it, but it would be kind of a rough road
for himself if not any body else. He ought to have good judgment
and without good judgment he is unfit to practice dentistry. In
order to have good judgment he ought to have a mind that can
reason from cause to effect, can take the subject and think it over
systematically. Now education is to learn to think logically, A
dentist ought also to be a gentleman. So if there are any young
men here who have just started dentistry and think they have an
easy task before them, they are certainly greatly mistaken. A
young man asked me not long ago if I would recommend him to
take up dentistry. I said to him, a man that has mind enough to
practice dentistry, that has good judgment, perseverence, strict
integrity, ingenuity and power to reason, can do better at some-
thing else. He said if that was the case he would be a big fool to
go into it. I told him to take up something else. Now strict in-
tegrity and the power to think logically are not found in every in-
dividual, and so if you are gomg to bring the matter down to a
test, we cannot recommend others to go into it because they can
do better elsewhere. I mean so far as money making is concerned.
Now as to the pleasure of it, I like to practice dentistry and prob-
ably would have gone out of it ten years ago, when an opportunity
was presented to me to go into another business, if I had not grown
up to this and had become so infatuated with dentistry that I did
not want to leave it. But had I started twenty years ago in an-
other profession, it would have been better for me financially.
What is the dental profession made up of to-day? I hold to-day
36 THE DENTAL REVIEW.
over a thousand notes for ten dollars each of men who are not at
this time able to pay. They want to get along and pay their pro-
portion in a good cause, and 3'et are not able to. Does it mean
that dentistry as a means of livelihood is well compensated? I
think not. I do not think the field is enticing enough for that grand
display of intellect that j'ou are going to try to lay out for the col-
leges. It is not a good paying business, and a man who has abil-
ity enough to do something else, and knows it, won't go into it. I
have not induced any one in the last twenty years to take it up as
a lifetime work. I have had a great many applications and have
talked on the subject with a good many people, and with very few
exceptions by the time I am through discussing the subject with
the young man he decides to take up something else. It requires
more years and ability to practice dentistry successfully than any
other profession, and life is too short to make it a desirable pro-
fession.
As to the colleges, I think that what Dr. Allport has said here is
true, that colleges, many of them, are run too much for making
money. But you take Harvard School, which raised its standard
high a number of years ago, what is the result? Their classes
have been small right straight through^ and where they required a
three years' course, and a rigid course, their classes have been so
small that, I have been told, they are letting up on that high grade
and are trying to even up a little more with the other schools.
Now I think it is within the power of one body of men to raise
the standard of the profession — I mean the National Board of Den-
tal Examiners, composed of representatives of the different States.
The laws will sustain them, they have the power to do it, and I
should be very greatly surprised if within ten years this organiza-
tion does not bring the professional education of those coming into
the profession somewhere near the position it ought to take.
Dr. C. F. Hartt : I wish to make a plea for the country den-
tists. I have seen quite a number of country dental offices, and
after visiting a few I find their libraries as a rule are larger and better
equipped, their instruments are fully as good and they are quite as
intelligent as city dentists, also from what I have seen of their work,
theycomparefavorably with their city brothers. A man in the country
towns generally has got to be a pretty good dentist, if he is not he can-
not stay there, and because some come in under registration it does
not necessarily imply that they come in with little or no education.
PROCEEDINGS OF SOCIETIES. Z1
So far as I am able to judge the countr}' dentist is fully equal to
the city practitioner. Of course there may be some few exceptions.
But as a whole, both in city and country, I honestly and firmly
believe that the dental profession is not surpassed by any body pf
men in point of usefulness, nor in unselfish and patient devotion,
with which many sacrifice themselves to their noble calling, some
of whom will never receive their full reward here, yet are willing
to work on till the day when they shall receive their reward openly
for that which was done in secret.
Dr. Johnson : It appears that I dropped into several errors.
I made the one error of speaking about the state of affairs twenty-
five years ago. About that, Mr. President, my extreme youth
should have prevented me from saying anything, I am willing to
admit that I do not know anything about, except from ni}^ read-
ing. I emphasized what Dr. Noyes said in regard to the require-
ments, not to the present state of affairs, but what is required. As
I understood the essayist, he said that requirements for matricula-
tion twenty-five years ago were practically the same as they are to-
day, that is that there had not been much advance in the matter.
I do not undertake to say that the class of men we get to-day are
as uneducated as the class of men that they got twenty-five years
ago, but I do wish to say that if it was any easier to get into a
dental college then than now, God help the state of affairs twenty-
five years ago. I am glad that we are getting a better class of men,
but what I refer to is the requirements. I have not seen the man
yet but who could get into some dental college if he wanted to. It
seems to me that our matriculation methods are just as low as they
possibly can be and exist at all.
What I said in regard to the country dentist was meant for no
slur on that class of men at all ; not in the least. There are a great
many good men among the country dentists, but I said that strong
opposition to any great advance in matriculation would come from
country dentists — not from all, but from many of them.
Dr. a. W. Harlan : After listening to the remarks of the vari-
ous speakers and the paper of the essayist, I feel that I cannot re-
main quiet, because I want to make some supplemental remarks to
fill out those of Doctors Noyes, Crouse and Allport. Dr. Crouse
says that a dentist must be a man of integrity and he must be wise
and capable of thinking. Now if he is capable of thinking, he must
have a decent education before he begins the study of dentistry.
38 THE DEXTAL REVIEW.
That is the point that Dr. Noyes is trying to make. Dr. Allport
says that eventually, in order to raise the status professionally the
dentists must be specialists in medicine. Well, a great many den-
tists think that they are specialists in medicine now, but they are
not, even though they have M. D. degrees. There is nothing that
will make a dentist a specialist in medicine except knowledge, and
all the knowledge attainable in this world is not covered by the
M. D. degree. It appears to me from my experience of twenty-five
years — it has been a little over twenty-five years since I began the
stud}' of dentistry, I am not too modest to admit that, — it has been
my observation during those twenty-five years that in many of the
States of the United States there were no laws regulating the prac-
tice of dentistry and consequently those who did enter upon the
practice never went to college at all, and I believe there was a bet-
ter class of men all round entering the dental colleges twenty-five
years ago than are entering to-day, because all those who entered
then, did so because they wanted knowledge, and now they are
compelled to do so, and just at the present time we have a glut of
that sort of material. But ver}' soon it will come out all right, be-
cause the three years that is now required of the student before he
can come up for graduation will shut such people out and they will
go into other occupations.
Dr. Crouse said another thing this evening that was very good
and that was this — he didn't say it exactly this way, but it was to
this effect: What are the inducements for a man of education to
undertake the study of dentistry? Are the large emoluments from
the practice so great that everybody is seeking for them, reaching
out for them, because there are no other avenues where an exist-
ence can be secured and wealth acquired in a short time? There
are plenty of avenues that afford a much better income, generally
speaking, than are secured by the men who are in this room.
Probably there is not a man here who earns $25,000 a year, and I
feel sure if I were practicing as lawyer that I would earn double
that, and if I were practicing general medicine, I know that I
would earn as much as that. I do not believe there is a man in the
room that ever did earn $25,000 a year, but I know of an eminent
surgeon in this city who made $75,000 in one year. Probably there
are a dozen men in this room whose acquirements and general in-
telligence make them equals of the eminent surgeon whose name I
will not mention. Probably one of the reasons why educated men
PROCEEDINGS OF SOCIETIES. 39
do not enter upon the study of dentistry is, because the emolu-
ments are small. There are too many mediocre intellects engaged
in this occupation. And if men are content to live along on incomes
of $2,000 a year, or $3,000 a year, and our profession is filled up
with that kind of men, it is very hard for those who have high
ideals, to reach a high standard. But I say, God speed the time
when the matriculate examination will be so high that it will attract
men of talent who will be self-respecting and have ideas that will
be so large that they can have fees commensurate with those
ideas.
Dr. Allport: I am glad that Drs. Harlan and Grouse have
spoken of the emoluments of dentistry. I quite agree with them
that there is a very erroneous impression in the public mind in re-
gard to this matter, for generally, after all expenses are paid, den-
tistry is not the lucrative calling that many suppose it to be. I
have been, and still am, very fond of the practice of dentistry, and
am anxious to see both its science and its practice advanced in the
highest degree possible. The time was when there was no wish
nearer m}^ heart than to see at least one of my sons engage in the
practice of dentistry, but I can now say that I am truly thankful
that none of them have done so; for such a great hoard of improp-
erly educated graduates are turned out from our dental colleges
that the profits of the profession are no longer tempting, and, to
say the least, its respectability is not now what it should be. While
a few of these graduates may be considered as well qualified to
practice, a large majority are not, nor are they making respectable
livings. Dr. Harlan says that there are very few of the dentists in
our city doing a business of $25,000 per year, and many of them
not over $2,000. This estimate is too high and I challenge an}- one
to show that, out of nearly seven hundred dentists in Chicago, we
have five who are doing a business of over $15,000 per year, and
that there are ten more who are doing over $10,000 or twenty more
who are doing over $5,000 a year, (while there are large numbers
whose net income will not reach $1,000;) and that there are not
more dentists in the city whose net income is not over $1,500, than
there are of those who earn $3,000 per year, and yet in their cram-
ble for money, our colleges will have students; and to get them the
entrance examination is made easy, as their graduation is as good
as assured, and they are encouraged to believe that a lucrative prac-
tice awaits them as soon as their course is finished; notwithstanding
40 THE DENTAL REVIEW.
the fact that, with a very large majority of the practitioners of den-
tistry, the profession is fast becoming a beggarly calling.
Dr. Crouse : I want to ask you a question. How is it with
the medical profession ? I want to know which is the easier to go
through, a medical school or dental school? Who is turning out
the biggest lot of quacks to-day? It is true that the medical pro-
fession to-day are turning out more uneducated men, more men
unfit to practice medicine and take life into their hands, than the
dental profession. It is true that the medical profession to-day are
not able to control that matter half as easilj^ as we are, and a very
large per cent of the men that go through medical schools and start
medical careers find out that they are not fit for it and drop into some-
thing else. A physician riding through the country sees opportuni-
ties for getting out of it and going into something else, but when
you are shut up in your office all day you cannot look around for
another opening. I have sat for six months in the medical college
with a class and I know what the average ability of medical stu-
dents is. Any man who will sit in a medical school and watch the
students right through will find their average is not as good as that
of the dental colleges. The compensation for the medical profes-
sion is not any better ; the beginners in the medical profession are
starving to death. The medical profession to-day are having the
hardest kind of a time to get their bread. I am only holding this
up to show that the evil is there as well as here with us. It is a
great evil ; it is a great wrong for men to make that mistake, to go
in and spend the best part of their lives on a thing that is going to
be a failure. It makes me tired to have men stand up here and
hold up the medical profession to me. Every man that observes
this thing must know that that is a very poor example to hold up.
Law seems to be better, but the men have got to study for it.
There is not a boy who cannot start in an office to read law, but
when he gets to the examination is where the test comes in. I
would not teach in a dental college, not if you would give me $50,-
000 a year, I would not burden my conscience with encouraging
young men to take up an occupation for a lifetime work that was
not the best thing for them.
Dr. Hartt: We have got to go back further than the dental
colleges and medical colleges, gentlemen. I stated here before,
and I say it this evening, that the poor man is getting poorer every
day and the rich are getting richer. That is where the trouble
PROCEEDINGS OF SOCIETIES. 41
lies; they have not got the money. There is work enough for
every dentist in this country, and more than enough to keep him
busy and have a bank account at the end of the year, but the peo-
ple have not got the money. I can refer you to some of the most
prominent men in this city, and you will hear it from the best pul-
pits that the people are getting poorer. Gentlemen, there are a
great many other people besides dentists who do not have enough
to eat, who cannot make from ^5,000 to ^15,000 a year. This is a
great rich country and it is full of everything and it is all in the
hands of a few and it is going into the hands of still fewer. It is
not essential and perhaps not best for a man that he should drive
fast horses and give champagne suppers and use up an income of
$15,000 to $20,000 a year. If I wished any work done on my teeth,
I should sooner have a man attend to them that was not quite so
flush.
Dr. G. J. Dennis: I would like to say something this evening
on behalf of the young men in the dental profession. It seems to
me that it is rather a discouraging outlook for j^oung men in the
dental profession, because theyfirst learn that the standard of edu-
cation for the dentist is extremely low, that their ability is Ioav, and
they next learn that the compensation is low, that it does not afford
them a compensation in proportion to their efforts and in propor-
tion to their ability, and then they next learn that their social posi-
tion is on a rather low scale. I am sorry to hear that, because I
think that there is a great deal gained by having respect for one's
own self, and I think if the dental profession is self-respecting, it
will have a great deal to do with the standard of education and the
amount of compensation and social position of its members. If
men like Dr. Grouse, Dr. Allport and Dr. Harlan, when young men
of ability come to them, would encourage such young men to go
into the dental profession, instead of stating the facts as they are
with regard to their ability in commercial pursuits, we would have
a better class of young men. The young men who have no ability
would not flock to the profession, because they would find their at-
tainments were not sufficient to compete with men of better ability.
In looking over the different professions and inquiring why certain
men are successful, we find it is due in most cases to the prelimi-
nary foundation that they have laid for their success, in their pre-
vious studies and in the early work that they have done in their
particular line. Those men who have attained eminence as law-
43 THE DENTAL REVIEW.
yers, as ministers, or as doctors, will be found, as a rule, possess-
ing a fine education. If they have not received it in the school or
in the college, they have gotten it by a systematic kind of work, under
systematic direction of some kind, which has prepared them for
later successes. It is these first principles that help a man along in
later years.
1 have in mind a gentleman in this city who stands very high
in his profession, I have been brought into contact with him in various
ways and I have wondered at his success. It seemed to be so spon-
taneous and it gathered people to him in a certain way that was re-
markable. His fund of knowledge seemed inexhaustible, I wondered
how he was able, as young a man as he was, to have that fund
of knowledge. I found that it was due to the fact that in his early
years his training had been such that it was done without difficulty,
a knowledge of his early work was retained and his present work was
carried on in his present position so that it was hardly any work at
all. If any man had filled that position without that preliminary
training he would have been a failure. I think that in dentistry we
can have such men as that by offering to them the example of men
who have gone before. A gentleman in speaking to the Alumni
Association of one of the medical colleges of this city spoke of the
advantages or inducements there were for a medical student to take
up the study of medicine. He said that a man could make some
money ; he had a chance for some social position and he had a
chance to cure some people, and he asked if that was all. He said
there was precious little in the study of medicine to a student if he
did not become more of a man and did not grow larger in every
way, intellectually, morally, and so on. It seems to me that
that can be applied to dentistry just as well. I think Doctors
Crouse, Allport and Harlan could induce better men to go into the
profession if they would do so.
Dr. Noyes. I do not think much more will have to be said.
This discussion has taken a wider range than I expected it would,
and I feel a little disappointed, as perhaps most members do, that
the particular subject of the essay has not received a little more
attention. I really hoped that something would be said upon the
practical side of this question, as to the feasibility and the means
to be adopted for some definite steps of progress, which it seems
to me the time is about ripe to undertake.
Perhaps the statement which has been criticised by one or two
PROCEEDINGS OF SOCIETIES. 43
in regard to the lack of progress in the entrance requirements dur-
ing twenty-five years ought to have been a little more elaborated
and perhaps somewhat qualified. I think it is a little difficult to
determine the question with accuracy. The thought in my mind
was that the minimum requirement had not much changed in that
time. I grant very gladly that the average attainments of the
students who actually enter colleges is greater than it was then,
and that a few of the colleges have a better standard than they had
some years ago, especially within the last few years. In respect to
the better training of the students who come into the colleges, it is
due more to the first consideration claimed in the paper, the gen-
eral increase of schooling that children throughout the communi-
ties receive as compared with twenty-five years ago, than to any
higher positive requirement on the part of professional schools.
The closing sentiment of the paper that the colleges cannot
make a higher standard than they can find students willing to com-
ply with, is perhaps not exactly the ground which we want to
stand upon, and Dr. Johnson's statement is probably truer, that a
sufficient number of men will be ready to prepare themselves in
any way that the colleges will absolutely require. There is a sin-
gular difference which I do not quite understand, though perhaps
some of the reasons for it are plain enough, between the powers
and motives which we rel}^ upon and which experience has shown
to be effective in other departments. It was said in the discussion
that we cannot hope for much progress unless all the colleges in
the country agree upon a definite standard and hold up to it, be-
cause if only a few of them advance the standard they will be
broken down by those who will not advance it. Now in respect to
ordinar}'- literary college education it has not been that way, it has
not worked that way at all. The colleges in this country which
require the highest standard of matriculation and enforce their
rules most rigidly are the ones that have the largest number of
students. It is only necessary to mention such institutions as
Harvard and Yale and Johns Hopkins without going any further.
Now there are colleges in this State, one I know whose degree of
A. B. is not much better in respect to scholarship, does not repre-
sent more work or actual attainments of studies gone over than
the entrance examination of Harvard college, but it has not one
student for twenty that Harvard has, and it is not a prosperous
college and the other is. It is evident enough that we cannot do
44 THE DENTAL REVIEW.
that now. Whether perseverance and generosit}- in carrying on
dental colleges with strict requirements and a high quality of
teaching whould bring the time when the college with the highest
standard most rigidly enforced would be the one to which the
students would flock, I cannot tell, but I would like to see the
time come.
OFFICE PRACTICE.
Dr. Crouse : I have to report a very peculiar case of exosto-
sis, which has developed to such an extent as to throw the jaw
open. The gentleman who is suffering with this affliction is an in-
valid. He was once a lawyer of prominence here and an old pa-
tient of mine. He came to me a few weeks ago, and I was amazed
at the enlargement ; he could hardly talk. An examination showed
a very great enlargement of the alveolar process and to such an
extent that I think I could pass my thumb in between the teeth.
He has been somewhat mentally deranged at times, and I do not
think he is altogether himself, and the matter that interests me
very much is the question of whether this ossification will take
place all over the body. I am inclined to think that such may be
the case. I have had one or two talks with his physician and he
talked about, his dying of softening of the brain ; I told him I
thought he would die of hardening of the brain. His trouble has in-
creased very rapidly indeed within a few months. He is a man of from
forty to fifty years of age and has been a very temperate and indus-
trious man ; I have known him for twenty j'^ears ; he has had to
give up his practice and has had to give up everything on account
of his health. Some two or three years ago he came to me with
this mal-articulation to a less extent, and I helped it some by
cutting down one or two of the molars that seemed elongated. In
order to do that I had to kill the pulp. It is a matter that I shall
watch carefully and will be glad to report to the society the result.
He is suffering in general with his teeth ; can hardly get his
mouth shut enough to enunciate his words properly. It is a very
serious question to know what to do with him even for temporary
relief, whether to cut down the teeth or extract them. It is not
an exostosis of the roots in the alveolus alone, but apparently the
whole jaw is enlarging around the teeth. It is a bony deposit
which is elongating the teeth. The exostosis is very much less
above than it is below.
PROCEEDINGS OF SOCIETIES. 45
A Member : I think we would find exostosis of the root, prob-
ably.
Dr. Crouse : There is certainly a large deposit of bony matter
around the teeth. It is a matter that has given me a great deal of
concern, because I have not known what to do with it. It is very
nearly alike on both sides, the two back molars seem to have more
than the others. I can see an enlargement of the alveolar process
all around.
Dr. Allport : I have a case not just like that, but somewhat
similar. It came to me nearly a year ago from a Western city. It
was a lady who had been considerably out of health and she was
under the care of a physician here, and her back teeth were thrown
out so she could hardly get her jaw together. Most of her teeth
were decayed so that I had to take them out. It puzzled me at
first, but being obliged to take out some of her teeth, I found very
large exostoses on the roots, so that I just split the jaw right open,
the lower jaw, and a number of her upper teeth were the same way,
and I have taken out all of her teeth except six lower teeth.
Almost every one of her teeth that I removed had this addition,
both above and below. I have some of those teeth in my office
now, and some of them are as large as my finger.
Minnesota Dental Society
Comparative Anatomy.
discussion.
Dr. E. H. Angle : Mr. President, Ladies and Gentlemen :
I have listened with pleasure to the reading of Dr. Thompson's
paper, and, as a rule, I do not believe in devoting much time to the
complimenting of papers. Yet I do feel this paper is excep-
tionally good, and I am glad that we occasionally find a man in our
profession who can write so broad, deep and comprehensible a
paper, the tendency of which is to give us a greater appreciation of
dentistry and to lift us out of the narrow rut into which we as
specialists are so prone to fall.
In the paper I find much to admire and but little to criticise. I
suppose if I were a believer in the old forms of orthodoxy, I would
then, doubtless, have found much to disagree with ; but as I am a
firm believer in the main principles of evolution, I can fully agree
46 THE DEXTAL REVIEW.
with the essayist, for he has elucidated only well-known principles
of the well-known doctrine, so that in attempting to discuss the
paper I can do little more than intensify some of the points which
he has brought out.
First, in regard to the value of the comparative method of
studying, I fully agree with the essayist. I believe it to be the
true and most natural way of studying. Indeed, the most of our
knowledge from youth to old age is gained by comparison. For
instance, our ideas of size, color, weight, height, distance, etc., are
nearly all gained by comparison. We gradually gain these ideas
from the earliest development of the human mind, and they so
grow to be a part of our being that we hardly recognize how we
came by them, but if we reflect we will see we obtain them almost
entirely by comparison.
Those of you who were fortunate enough to have heard Dr.
Sudduth's lecture on the morphology of the blood, in this room, a
few weeks ago, will remember what a flood of interest and instruc-
tion was turned on the subject, with the slides showing the com-
parative anatomy of the blood. And so it is throughout the study
of anatomy. The comparative method is invaluable.
Now, to attempt to gain a knowledge of so complicated a sub-
ject as our teeth, without studying their comparative anatomy,
seems to me to be utterly absurd. And I have long wondered why
members of our profession, occupying prominent positions, could
be contented in knowing or caring so little about the wonderfully
instructive and exceedingly fascinating study of comparative anat-
omy of the dental apparatus.
When the time comes, as it surely will, when colleges are con-
ducted for the purpose of thoroughly educating our young men, in-
stead of for the purpose of increasing the income of a few selfish
and unscrupulous stockholders, then will the great importance of
this subject be recognized and its bearing upon all departments of
dental science be understood and appreciated.
Not until more attention is given to the minute anatomy of the
teeth throughout their process of development and in their matur-
ity will the vexed questions regarding their structure and nourish-
ment be understood.
In regard to the complicated subject of dental irregularities and
abnormalties and their causes, I have learned more by comparative
study than by any other method, and I believe we will never reach
PROCEEDINGS OF SOCIETIES. 47
the true solution of many of these problems until a closer study of
this subject is instituted.
The study of the histology of the human teeth — the structure
of enamel, the direction of enamel rods, the dentinal tubules with
their primary and secondary curvatures and their contents, the
processes of the odontoblasts, the interzonal layer, the nerve and
blood supplies of the pulp — are all hard for the young student to
understand, but by comparative stud}', taking up first the simpler
forms of dental tissues, and gradually working up to the higher and
more complex, the process becomes easy, and the knowledge gained
is never forgotten, it is so firmly fixed in the mind.
The portion of the paper relating to the law of atavism or re-
version to original types is instructive and interesting, but I can-
not understand how Dr. Thompson can so clearl}'^ draw the line be-
tween reversion of type and variation of a type to a new form.
For example: I have a model of a jaw showing some twenty-five
teeth, and I understand from the histor}-, that they are all permanent.
Surely we would find difficulty in pointing to an}' of the mammalia to
which we could refer this exceedingly large number by reversion.
There is a similar model in a Pennsylvania college which con-
tains twenty-three well developed teeth, while cases of four and
even five molars on a side are reported.
The typical number is but three in the mammalia, imless it
be some of the marsupialia. One of the most common regions of
the mouth for the supernumerary is on the buccal surface of the
second molar superior.
Can we with such certainty account for these digressions by
atavism ?
The Dental Review.
De\oted to the Advancement of Dental Science.
Published Monthly.
Editor: A. W. HARLAN, M. D, D.D. S.
ASSOCIATE EDITORS:
Louis Ottofy, D. D. S. C. N. Johnson, L. D. S., D. D. S.
World's Columbian Dental Congress.
Obscurity will not be considered a good reason for failure to
attend the great meeting of 1893, as it is the purpose of the pro-
moters of this international gathering to invite all dentists of re-
spectable lineage and antecedents, from every clime, to participate
in the grandest meeting the world has ever seen. It is not too
soon to begin preparing and gathering specimens of all sorts, and-
mechanical devices of every variety to be exhibited in Chicago.
Our best thinkers and authors are already beginning to arouse
themselves to make this an event worthy of the cordial effort
of every progressive dentist in the world. Success to the under-
taking is already assured, as the journals everywhere have given
it great publicity. The World's Congress Auxiliary is giving it
support unlooked for in the inception, and now it remains for the
journals to stimulate their readers to help in every way possible to
fulfill the promise made when the movement was inaugurated — to
constitute it the memorable scientific event of the year 1893.
Very soon the list of committees will be made public, so that the
mass of material to be presented can be so arranged as to be pre-
sented in a systematic manner. There will be no confusion, and
every one invited to take a part will have time allotted him and an
audience that will thrill him with an eagerness to surpass himself
at this meeting. Make a note of the time in your book for
1893.
EDITORIAL. 49
A Blow at Dental Colleges Not Located in Michigan.
The amended dental law of Michigan reads in section 1, as
follows :
"It shall hereafter be unlawful for any person to practice dentis-
try in this State unless such person has received a diploma from
the faculty of a reputable dental college, duly incorporated under
the laws of this, or some other State of the United States, with a
course of instruction and practice fully equal or equivalent to that
of the college of Dental Surgery of the University of Michigan, or a
certificate of qualification from the Board of Examiners provided
for by this act."
If a partisan Board of Examiners were by chance to come into
office there would be little difficulty in refusing to recognize the
diploma of any and every school not located in Michigan. It is a
very uncertain power to place in the hands of any Board of Exami-
ners as it will lead to favoritism and may compel persons residing
in Michigan or those who contemplate a residence there to first
attend the dental college at Ann Arbor and take its degree before
entering upon practice. A few years ago this sort of legislation was
passed in Maryland but the law was soon amended so that the col-
leges in that State were placed on an equal footing with those in
other States, that is, graduates from other reputable colleges were
admitted to practice without examination. As long as a diploma is
recognized as prima facia evidence of the right to practice, repu-
table colleges should be allowed a fair field for their graduates as
there is no evidence that a student who graduates after three years
attendance upon the courses in a reputable dental school is defi-
cient in any sense or the inferior of the one who graduates in Mich-
igan, Pennsylvania, Ohio or elsewhere. As it now stands all the
schools belonging to the Association of Faculties have adopted and
are living up to the three year rule ; some, it is true, have not a
continuous nine months' term, but. all have, and give about seven to
eight months of instruction during the year, and none of them
absolutely close their clinic rooms during the year, so that a student
who so desires may spend the whole three years in the school. We
do not insinuate that the Board of Examiners in Michigan will dis-
criminate against the graduates of other schools, but its complexion
may change by act of the Governor of the State who has the
power to appoint, and if the executive should appoint a Board
50 THE DENTAL REVIEW.
not friendly to any school of dentistry not located in Michigan,
there woud be unjust discrimination. For ourselves we believe
that all graduates should be examined by examiners not con-
nected with any school and no person should be examined who
had not obtained a diploma from a reputable school showing
that he or she had taken a prescribed course of study previous
to an application for license to practice.
An Old Idea Useful.
We believe it was Dr. W. H. Eames who said "if you wish to
remove a deciduous tooth, and through fear the child will not per-
mit it, slip a piece of rubber tubing over the crown down to the
neck of the tooth, and in a few days the tooth will be so loose that
it can be extracted with the fingers." If you have such a case try
it and see the exact result.
Thk Medical Congress, 1893.
Our esteemed friend, the editor of the Dental Practitioner and
Advertiser, in the January number makes haste to place a wrong
construction on the note in our December issue concerning the In-
ternational Medical Congress, 1893. What we inferred and what
we meant was this: There is a look of sincerity about the estab-
lishment of the dental section in the Medical Congress. If we have
a place there it is because we are entitled to it, and preliminary
programmes should not be issued leaving out a section which could
be larger, numerically, than any other section in a Congress. We
are not opposed to a section in a Medical Congress, but we are
opposed to begging for a place in the Congress every three or six
years. It is not probable that the question of dentistry being a
specialty in medicine will be settled for some time to come; in the
meantime we are not in favor of dentists being used to fill a gap
when it suits the managers of a Medical Congress to invite them
to come in.
Dentistry is not a newfangled invention or discovery, it has
been practiced for centuries, and if the authorities at the head of
proposed Medical Congresses are not alive to the aims and impor-
tance of the field of dental surgery without being continually re-
minded of it, it is high time that dentists should stand on their
DOMESTIC CORRESPONDENCE. 51
dignity and not thrust themselves into a place where it is evident
they are considered as intruders.
Sections in Medical Congresses are made up by those who are
appointed by the organizing committee; they do not originate de'
novo. It is the custom for such a committee to designate one or
more gentlemen to be responsible for the organization of a section,
and in the announcement made there is no hint of a section on
odontology. This is all the more regrettable at this time, because
dentists are looking for opportunities to display before practition-
ers of medicine the benefits that the public receive at the hands of
those engaged in daily practice, as well as to show the advance-
ment of dentistry as a science.
DOMESTIC CORRESPONDENCE.
How I Got a Start in Dental Practice.
Cincinnati, Dec, 1891.
To the Editor of the Dental Review: Dear Sir — In the current
number of your journal appears an article estimating the expense of
fitting up an office in city and country. The figures are so extravagant
that I feel impelled to recount the early experience of a very poor
young man, to wit myself, in renting an office and working up a
practice. This I do, not with any feeling of vanity in the opportunity
of relating my struggle at the time, but by way of encouragement to
the army of young men preparing to enter the profession, who are
without means or definite prospects. That a majority of the students
now in our colleges are of this description I need not undertake to
demonstrate. That many of them would be virtually debarred
from practice if such an outlay as the anon5'mous writer of the
article to which I have referred has indicated as a prerequisite
were required of them, is probably true. I shall then for the pur-
pose of showing what may be done with scanty means, tell what
befell me early in my career.
As I anticipate a rather florid display of my ignorance at that
time, I beg to preface my story with a statement or two. I went
directly from the counting room of a mercantile house in Cincin-
nati to the dental college, having had no practical experience
whatever of dentistry. I had become so imbued with the idea that
the stud}^ of the theory of a profession is of paramount importance,
that while attending lectures I almost wholly neglected practical
52 THE DENTAL REVIEW.
work, innocentl}' assuming that the trifling details of fiUing teeth,
extracting, and making plates could be easily picked up later.
When at the end of the term I received an offer to assist as a "rub-
ber boiler" in a western office, I joyfully accepted with little or no
misgivings as to my ability to fill the position. Up to that time I
had made two full upper gold plates out of brass, in the college
laboratory, three partial rubber plates, and a full rubber denture
for an aged negress. The latter case taxed my ingenuity. I re-
member. I must have forgotten to take a "bite," for when I in-
serted the teeth the under set projected unduly about an inch and
a quarter, presenting a curious appearance of prognathism not
commonly found in the African subject. Then in the upper set
the bicuspids on one side were abnormally elongated, while on the
other side they were "out of sight." Otherwise the fit was unex-
ceptionable, and as the old lady was anxious to attend a lawn fete
that afternoon, she was easily persuaded that by perseverance she
could readily master any trifling annoyance she might experience
in the first wearing. In accordance with her request I had se-
lected narrow, white teeth, so that the effect when she smiled sug-
gested a white picket fence closing the entrance to a coal mine.
Encouraged by my success, I prepared with a glad heart for the
five hundred miles' journey to my new field of usefulness, by bor-
rowing $25 from a brother, who had implicit faith in my mechanical
genius, and in my assurance that when it came to the matter of
salary, as yet unsettled between my employer and myself, I would
be able to name my own figure. I haven't the slightest idea what
he ever did with the sixty days' note I gave him.
But I must get at the pith of my story. My new employer
proved to be an affable, good-natured man, who adhered so strictly
to the scripture injunctions to take no thought for the morrow, that
his reputation for piety and for inability to pay his debts extended
far and wide. On the second day of my service he so far took me
into his confidence, as to borrow all the money I had. At the end
of the month I concluded to quit. I might have "resigned"
earlier, without encountering very serious opposition, I presume.
I recovered the money I had lent, and saying nothing about the
amount of my salary due me, took the first train in quest of an
uncle who lived a hundred miles away. I wanted to get as far
away as possible from my employer, for while he had not once re-
ferred to the matter, I could see that it embarrassed him whenever
DOMESTIC CORRESPONDENCE. 53
he thought of the $'75 worth of plate work I had spoiled for him.
My uncle, a farmer, had never seen or ever heard of me. On TC\y
satisfying him of my identity, he consented to my staying at his
house until I could pull myself together and decide what to do.
The latter question he kindly undertook to decide for me a day or
two later ; he lent me four rusty forceps of an antique pattern (he
had been a physician, years before), mounted me on an old lame
horse, and started me off to seek my fortune. I had never so much
as extracted a tooth, and I think my first effort hurt me quite as
badly as it did my patient, a stout country girl. As the tooth
came out she fell down in a heap on the floor. I thought for an in-
stant that I had extracted with the tooth the girl's vital principle.
But she got up presently, unwound about two yards of blue yarn
stocking which she took from a bureau drawer, and handed me
half a dollar. Then I hurried away to my horse, pale but exultant.
For two weeks I traversed the highways and crossroads of that
benighted country, and then I returned to my uncle's house with
^44 in dirty scrip, money honestly earned by extracting and break-
ing off teeth. The sight of the roll immediately made me "solid "
with my uncle. I suspected, however, that he felt somewhat
chagrined because of his having himself overlooked the mine of
wealth I had tapped. Within a day or two several persons with
badly swollen jaws appeared at his door, which circumstance
prompted me to act without delay upon a suggestion my
uncle had offered, that I retire on my laurels to a small town
twenty miles distant, and open an office. I had never, until the
morning of my arrival at the place, so much as heard its name, and
of course did not know a soul there. I introduced myself to a
physician, and before night had made an arrangement with a law-
yer— the only one in the place — to share his office, paying him three
dollars rent in advance. He had two rooms over a general store,
on the public square. The rooms were separated by a pine board
partition, unpainted and unpapered. They were unpretentiously
furnished with a rusty box stove, two chairs, a settee and the law-
yer's bookcase. The lioor was carpeted with coffeesacking stitched
together. The approach to this cozy retreat was by means of an
outside stairway which ushered the caller into a large store-room
filled with boxes and barrels, between which a passage was usually
to be found leading to our double office. Among the rafters over-
head a varied assortment of mud and paper wasps' nests supplied
the lack of any express effort at ornamentation.
54 THE DENTAL REVIEW.
By way of fitting up, I bought a lounge-bed (second-hand), a
lamp, two or three chairs, and a tin hand basin. I also rented for
$0.75 a month a new barber's chair, the barber having died the
week before. For instruments I had half a dozen cheap pluggers,
half an ounce of amalgam, a few drills and excavators, and my
uncle's forceps. With the ingenuousness of youth I wrote to a
western dealer ordering $25 worth of instruments, foil,&c., prom-
ising to pay in the indefinite future. The goods came promptly by
the first mail, and with it a kind note wishing me success. And
that dealer of course knew nothing about me! You needn't say
you don't believe this. It is literally true. I paid him as I was
able, and years afterward, when I had removed to a remote field, I
continued to deal with him until he went out of business, for I
never forgot his kindness.
My first patient was the barber's widow. She came on the
first day. I filled for her four cavities, with amalgam, and got the
St) fee I charged, on the spot. The lawyer who had been sitting
at his desk furtively watching the procedure, turned green with envy.
I saw that in his face which suggested a determination to raise my
rent, and sure enough, he did promptly, at the earliest opportunity.
However, I didn't say much by way of protest. We had no other
expenses, as we kept no office boy, and never swept or dusted.
The first month I made $32, all by amalgam filling and extract-
ing. My associate in the office was by this time saying less about
the dignity of the legal calling, and more about the advantages of
professions which yield prompt money returns. What that man
lived on I am at a loss to say. During the twenty months of my
stay with him, he had only two paying clients, and his receipts
were just $10. I heard afterward that he learned the cooper's
trade, which in that town paid from $2 to $4 a day.
During mv second month a young man came in who wanted
four incisor cavities filled with gold. I had filled several teeth
with gold while in college, that is to say I had assisted one of the
seniors to adjust the dam, and had malleted for him. It seemed to
me then that he made a stupendous fuss about filling those teeth,
and I felt sure I could have done it in one-tenth of the time. So
with a profound contempt for those fellows who can't do a little
trick like filling a tooth, without straining their flexor-carpi-radialis
muscles, and going to bed with a fit of nervous prostration, I set to
work. I cut four slits in my dam and tied it on with thread.
DOMESTIC CORjRESPON'DENCE. 55
Every time the man coughed a bubble as big as a hickory nut was
liable to bulge out through one or another of the slits.
I wasn't to be disturbed by trifles, however, so I let them bulge.
They interfered only slightly with my view of the cavities and I
had other more important details to look after. After several fail-
ures to make the gold cohere (I had forgotton to anneal it), I got
out the only book I had, Taft's Operative Dentistry, opened to the
chapter on filling teeth and proceeded at one and the same time to
imbibe and practice its precepts. I also lighted my coal- oil lamp
and carefull)' annealed my gold by holding it over the chimney.
You needn't laugh. I saw a city dentist annealing foil in a gas
flame, recently. But in his case, as in n\y own, the gold wouldn't
cohere worth a co-huss."*" By dint of seven hours of pounding,
punching, wedging and sweating (during which I am not sure that
I succeeded in refraining from heterodox expressions occasionally,
for some very good men in moments of trial use extravagant lan-
guage merely as a form of protest against Pharisaism), I say, then,
that I at last got the cavities filled. To be sure, the fillings pre-
sented a somewhat scooped appearance, as also did the patient.
But I concluded that they would probably stay until I got ready to
move. The young man paid me the ten dollars previously agreed
upon, and, after having expressed himself in fervent terms respect-
ing my manner of handling his person, went away. Then I charged
up $700 in my ledger, representing the value of my day's service,
and $10 on my cash book. The first memorandum was to assist
memory and imagination when I should find time to write home
and report progress in acquiring business ; the second record was
for strictly private reference. I have always, since that time, ad-
hered to the practice of keeping my ledger and cash accounts
widely separated in case any over-inquisitive professional friend
should demand substantial confirmation of statements I may see
fit to make about the growth of my business.
In the course of three or four months I found myself in receipt
of a monthly income running from $40 to $75. One month I made
$130 nearly. I had to buy a pocket book. The railroad telegraph
operator and express agent, who in summer wore white flannel
suits and was quite a swell, began to nod to me. I bought a horse
and when business slackened, as it frequently did, I mounted him
and rode about the country filling teeth, making plates, and spread-
* Copyright on this joke applied for.
56 THE DENTAL REVIEW.
ing far and wide the infamy of dentists who travel about extract-
ing teeth. For by dint of perseverance and study I had become a
tolerably fair dentist. I now annealed my gold by means of an
alcohol lamp made out of an ink bottle with a pen barrel driven
through the cork. It served my purpose quite as well as any two
dollar lamp would have done, though it was not very pretty.
But I was not to remain in undisturbed possession of this rich
and productive field. A graduate of a western college located not
far from me, a man whose articles I have frequently of late seen in
print in the Review. He denounced me to my face for using
amalgam. I think we must have swapped opinions of late years,
for recently I saw an article from his pen advocating the use of
this material.
And now in conclusion: as I look back to those days of unutter-
able wretchedness, everything about them appears rose-tinted. I
smile when I think how many bridges I crossed before I came to
them. And I realize now how invaluable was the lesson of self-re-
liance I learned. And when I came away I left behind me a circle
of warm-hearted friends, some of whom had lent me a helping
hand when I needed it. But ultimately I paid my way in full, sav-
ing enough besides to carry me through the dental college. Den-
tistry is not usually a fortune-making profession, but it stands in
the front ranks of the callings in which he who engages may go off
among strangers and make his way with more than the average
degree of certainty. And now as I look down from the dizzy heights
of my present position and recall those hours of distress and anxi-
ety, when as a stranger among strangers I frequently found myself
WMth only $1.35 between myself and poo — that is to say — reduced
circumstances, I am inclined to disdain the fear of adverse com-
ment by which some might be lead to sign a fictitious name to such
a production as this, and subscribe myself.
Yours very faithfully,
Frank W. Sage.
Letter From New York.
To the Editor of The Dental Review:
Dear Sir — To say that enthusiasm was at high-water mark at
the monthly meeting of the First District Society would not be an
DOMESTIC CORRESPONDENCE. 57
overstatement. It came out of the report of the executive com-
mittee, calling the society's attention to the editorial in the Decem-
ber number of the Cosmos. The}' inferred that it directly aimed at
what might be a violation of the code of ethics by the society in
that they had unthinkingly endorsed in their clinical reports a pat-
ented article, called "Dorsenia," and the company controlling
this article had copied it from the published report and placed it
in their circular, which circulates an inaccurac}', for in this circular
it is stated that this article can be used indiscriminately, by any
and all, with safety. In fact, all the society report did conclude
was this, that it proved a success in this individual trial at the
clinic. Simultaneously with this discussion, which had put all on
the qui vive, Dr. Carr offered an amendment to the by-laws which
took an additional turn of the already tense strain of codified eth-
ics. It was in letter and spirit to this effect — viz., a direct aim to dis-
count any and all that have anything to do with the taking out of
patents as ineligible to membership.
It is plainl}^ indicated b}' conversations since the meeting that
this step will not be taken without a good deal of thoughtful con-
sideration, for it is a question on which the profession is largely
divided. This is also said in the editorial of Dr. Kirk. We
are not sure that the new by-law was brought up in the interest of
a test at this particular time. It is matter that thoughtful men
who have the true interest of the profession at heart can afford to
let go into legislative action without protecting themselves from
the aspersion of establishing a surveillance. In the future our
legislation must try to keep a healthy organization and make laws
that have in them the principles of health. We say that this edi-
torial sounds a note of attention, and we agree that the point mak-
ing a distinctive difference between those who secure legiti-
mate patents and those who secure themselves by law in their
protection of nostrums, as a good point taken. We are sure, by a
known feeling which does exist, that associations will not rest on a
sound basis until this internal question is fairly settled, so we pre-
dict that the action of the First District Societ}' will be waited for
with much solicitude.
This society ought not, in view of its large influence, and can-
not afford to give a note of uncertain sound.
The subject of the evening was Plastic Fillings. Although the
author was Dr. Line, of Rochester, it was not conceded to be a
58 THE DEXTAL REVIEW.
very commendable effort, possibly it was in purpose, but not in
value. Yet there may be those who will see something worthy of
larger attention than it seemed to attract when read.
No one discussed it but Dr. Keese, of Williamsburg, Brooklyn.
E. D. Keese of metal fame. The doctor has given much attention
to the mixture of gold and amalgam with phosphate fillings and has
claimed that they had a degree of virtue worthy of attention. He
has pursued this method over a period of six years. It has been
denominated as an amendment of the "New Departure System."
The clinic was attended by 108, visitors included. We met Dr.
Chambers, formerly of Delphos, Ohio, who is to settle in Chicago
in January. If we do not misjudge his looks, he will be a credi-
table addition. He has been spending a few weeks in New York
getting all the good points, particularly in porcelain bridges. His
work, which he exhibited to us, speaks for itself. He is about
thirty years of age and has a young, wife with him. It is our opin-
ion he will be heard from later. From personal acquaintance and
hearsay, we think Chicago is attracting a wide awake class of prac-
titioners. Why not? Chicago is, in our estimation, more like
New York than any other cit}'.
We have exhibitions of a fine demonstration of bridge work,
twenty teeth in both the lower and upper pieces. It had been in
active use for a period of eighteen months. It was commended on
all sides for its beauty of fine workmanship and the extreme health
and cleanliness. It was a credit to the operator. We saw alsO'
some fine crown and proximal fillings of Wolrab gold, placing un-
annealed gold at all the borders and cohesive in the remainder,
also a new preparation of sponge gold, both in method of prepara-
tion and form.
Dr. Oliver exhibited a new invention for blast air force, both for
soldering and chip blowing. A fully equipped apparatus with elec-
trical power for offices.
An exhibit of mat sponge gold was a new article. Also another
invention of a cervix clamp. We are certain that nothing has
struck us so favorably. It is truly a time saver; humane and quickly
adapted. Cut a hole about one-third the diameter of the tooth and
sheath without the least difficulty over the clamp pins and the op-
posite end and it will adjust itself to the lateral form of the tooth
and without any necessity of placing it between the teeth. The
whole time in applying need not exceed one-half of a minute, and
DOMESTIC CORRESPONDENCE. 59
all with absolute comfort. The latter feature is an invaluable
one.
The bimonthly Jersey meeting, at Newark, met with a liberal
attendance this month. The supper's alvva3'S good, and music,
ditto.
Jersey is ahead once more. A new thing in the scientific world
was brought before the body. Dr. Watkins took the first bottle as a
test and if it is a success with him, that settles it. It is claimed a
complete renovator and removes all the ills of the body, and indi-
rectl)'^ the immoral tendencies will change. At this juncture we
saw some significant books. "Biozone" is the term as it now
stands. It is formed of a new invention called the "Liberator;" to
this is added a preparation of peroxide of hydrogen, raised to a
temperature which can readily be inhaled by the aid of an inhaler
shown, simple and new. In the process of inhalation, atmospheric
air is added through the lungs and the bodily conditions are met
by the tonic effect formed by the combination.
The Professor's language was exceedingly scholarly and given in
an unusually understandable manner. The lecture was very in-
structive. The speaker guaranteed that he has a peroxide of hydro-
gen which will not deteriorate from one year's end to another.
The Jersey boys showed some smoky legislation. The}^ brought
in a report from the executive committee abolishing cigarettes from
their menu, which was carried with an amendment to have cigars.
This does not seem to meet with the wishes of those who demur
against smoke in any form from tobacco. More harmony is better
than more smoke and more profitable we think. They don't want
to end in smoke. Dr. Stockton being absent that evening, was
present in spirit by sending one of his persuasive orations in behalf
of the nonsmokers.
The annual meeting of the Odontological Society selected Dr.
C. A. Woodward for President, and Dr. A. H. Brockway, of Brook-
lyn, for Vice-President, the latter a reelection from last year.
Here, as elsewhere, the identity of the noted dynamiter of finan-
cier Sage, b}' the record of dental operations has emphasized the
importance of keeping such means of identity. The record of
nine fillings, by the Boston practitioner, virtually settled the ques-
tion of doubt. It may be recalled, also, that by the same means
Mr. Robert Ray Hamilton's remains were recognized, by fillings
placed by a New York dentist, and if possible to make it more
60 THE DENTAL REVIEW.
fully definite, a memoranda of the bill and date of work was found
on the person of Mr. Hamilton, which corresponded with the den-
tist's record. It would be hardly probable that any operations of
a skillful operator would fail of recognition.
La grippe is paying its respects among us again. The author
of this letter is writing under reduced energy, because of its hold
on him for ten days ; we thought, for some time it was one of our
occasional bilious headaches ; for four days our appetite dropped
off and then gradually returned and finally we were forced to ack-
nowledge the grippe, because of the loss of the strength which did
not come with the returning appetite. Thus absence from the of-
fice was of but two days' duration, but we have stood at the chair
when not able to. We have taken no medicines, but have slept
much and have clothed ourself warmly and carefully, avoiding
all violent exposures. Being organically sound we trust ultimately
to pull up to the basis of sound health. This calling is not neces-
sarily a dangerous one for health, although at twenty-three years of
age were counselled not to choose the avocation because of a sup-
posed tendency to pulmonary troubles, but here we are in our
thirty-eighth year of practice, yet the last surviving member of a
famih' of eleven, and with a family of our own numbering eleven —
only five living. We feel a little shaky now and then, yet our
desire and belief is that we will pull up to our 50th anniversary of
practice, for let it be known that, not until then, does one get an
honorary banquet — "a good square meal " — and listening to one's
obituary, is of more uniqueness than the usual occurrences of this
checkered career of a " down in the mouth pilgrimage."
This will do for Christmas Eve, and we will only add that we
had a full stocking and a few presents from G. P.'s grateful pa-
tients. All has been merry with us and we trust it has been the
same with all the readers of the Review.
The serious illness of Mr. Lyman Gage, at the Holland House,
has enlisted much interest among our fraternity in this city, yet at
this writing, we are informed by the press, that his return to health
is assured. I may not need to tell the readers of the Review that
Mr. Gage is the treasurer of the Dental Protective Association funds.
Mr. Gage came on to New York to attend the dinner of good will
given by New Yorkers, in evidence of the World's Fair interest.
Mr. Gage was taken ill en route and reached New York in a serious
condition and was soon compelled to undergo an operation for
DOMESTIC CORRESPOh^DENCE. 61
appendicitis. Hearty congratulations will be most cordially ac-
corded Mr. Gage when he is up and out again. Our daily press
has been fertile in high enconiums of his unblemished character.
We trow that our Columbian Congress committee will forge a link
of good will during their visit to Chicago, in January. It is ex-
pected that after this, the second session of this body, things will
begin to take shape. We hear the soughing of breezes about us
and not all are musical in tunes. We have thought of suggesting
a " loving grip" in that part of the country for we are far from be-
ing harmonious.
The editorial on pyorrhoea alveolaris is accorded a timely and
common sense view of the subject. Is it not strange that the very
frequent question is asked: "Do you think this disease curable ? "
The answer in the editorial is so pat we do not need to repeat it,
and we only emphasize it and say that such questions are evidences
of a prevailing lack of knowledge of the subject. Eleven years of
continued enthusiastic experience in treating a large variety of
cases leads us to say this of the editorial. We could add much
testimony in favor of this all important branch of practice, which is
so largely neglected and what is far worse, the public are informed
that the disorder is not amenable to remedy. I say this, based on
personal information which is spoken in our office daily. What do
these facts suggest ?
How shall the public be educated ? is a question that is hardly
being answered.
In reference to the direct question, asking for discrimination
between the suppurating conditions versus nonsuppurating, our an-
swer would be — the first is associated with hypertrophied condi-
tions or of excessive nutrition ; the second, with atrophied or lack
of nutrition. This to us seems plain and we give it as a nutshell
expression. For further delineation it would require an article.
What is that joint committee on publication doing ? We think
the public are ready for the truth certainly as soon as they will get
it by such means, although we are heart and hand with this com-
mittee in all they may be able to do.
New Year's day passed very pleasantly, judging from the unus-
ual numbers of promenaders on the avenue. The day was fine and
all classes were out in their gayest attire. It was noticeable by
one familiar with New Year's day for many years. The procession
has changed from the highly decorated gents bent on a full list of
62 THE DENTAL REVIEW.
calls. This year it was in every sense a gala day for any and all.
The earlier customs of open house and fine feed are but in remem-
brance. 1892 has opened to us an avenue of opportunity, and by
the time the knell of '92 has sounded it will have appeared what
our contribution promises to be for the great Columbian Dental
Congress of '93.
We wish the readers of the Review all a Happy New Year.
" May they all live and prosper." Ex.
REVIEWS AND ABSTRACTS.
LVSOL THE CrESOLS AS DISINFECTANTS.
The first question suggested by such a title is naturally, what
are the cresols exactly? In order to answer this it is best to go
back to the beginning and to start with coal tar, the product (with
coke and illuminant gas) of the dry distillation of coal. By frac-
tional distillation this coal tar is separated into parts, having vari-
ous boiling points, principally as below :
1. A small fraction (amounting to two or four per cent, of the
tar) containing what passes over at 80° C, namely; — ammonia,
carbon bisulphide, methyl cyanide, alcohol, amylene, benzene and
its homologues.
2. The light oil; forms six to eight per cent of the tar, and in-
cludes the constituents boiling between 80° and 210° C, chiefly
made up of benzene and its homologues, with some naphthalene,
phenols, and bases.
3. The heavy oil; thirty-two to forty per cent of the tar, this is
made up of what goes over between 210° to 400° C, and consists
of naphthalene, phenols, high boiling bases, anthracene, phenan-
threne, fluorene, and other hydrocarbons.
The residue in the retorts represents —
5. The pitch; in quantity of from fifty to fifty-five per cent.
The heavy or creosote oil on cooling deposits solid naphtha-
lene; the separated oil is treated with concentrated soda lye, the
insoluble part separated from the dissolved sodium phenol, and
the latter decomposed by sulphuric, carbonic or sulphurous acid.
Crude carbolic acid rises to the surface of the solution of sodium
sulphate, carbonate, or sulphite. By fractional distillation of this
crude acid between 185° and 20.3° C. cresols are obtained, which
REVIEWS AND ABSTRACTS. 63
appear to consist of a mixture of the so-called ortho- and para-
■cresol, and have the general formula C,.H^CH30H, from which it
will be seen that they are carbolic acid, or phenol (C,.H.OH), in
which one hydrogen atom is replaced by a methyl group, CH .
What a difference in some physical properties this replacement of
an atom by a group makes we shall see presently.
Orthocresol, or orthotoluidine, melts at 31° C. and boils at
185° to 186° C; metacresol is a thick liquid that even at 80° does
not solidify, and boils at 195° to 200° C; para-cresol occurs in
colorless prisms, melting at 36° C. and boiling at 198° C. They
are all practically insoluble in water.
Lysol, which is obtained by dissolving in fat, and subsequently
saponifying with the addition of alcohol the fraction of tar oil
which boils between 190° and 200° C, is a brown, oily-looking,
clear liquid, with a feebly aromatic creosote-like odor. It contains
fifty per cent of cresols and is miscible with water to a clear sapo-
naceous, frothing liquid; it also forms clear solutions with alcohol,
petroleum or benzene, chloroform, carbon bisulphide, and gl)'-
-cerin.
The essentials of a perfect ideal antiseptic maybe briefly stated
as follows:
1. It must be soluble in water, and ought to be clearly so.
2. It must arrest the development of pathogenic bacteria, even
in very dilute solutions, and after a comparatively brief period of
action.
3. It must be harmless — that is, nonpoisonous and noncorro-
sive.
4. It must not be too expensive.
Lysol meets these requirements.
It forms clear mixtures at once, in every proportion and at all
temperatures, with distilled water or ordinary well water.
The mixture possesses — and therein lies a prominent advantage
of lysol — the property of a saponaceous solution, which renders
the use of a special soap in surgery quite unnecessary. The gen-
erally complicated processes of cleaning and disinfecting the area
of operation are completed in a single act, — viz., an energetic
brushing with the solution of lysol. It acts in a manner equal to
the best soap as an excellent cleaning agent, which removes all
dirt, fatty or resinous spots, etc., from the skin as well as from the
surroundings, linen, instruments, and the like.
64 THE DENTAL REVIEW.
Lysol is superior in bactericidal power to carbolic acid and
other preparations of the higher homologues of phenol, and is pos-
sessed of powerful deodorizing properties.
Lysol is neutral. In alcoholic solution phenol-phthalein pro-
duces no change. In aqueous solution a reddening appears, but
this is traceable to the recognized dissociation of neutral soaps
under such circumstances into acid salt and alkali. It is also free
from poisonous properties — the relative harmlessness of the cresols
even when taken internally in large quantities has been often dem-
onstrated— and is noncaustic. The mucous membrane is unaffect-
ed by the application of a one-half per cent solution, and though
stronger concentrations produce a more or less pronounced sensa-
tion of burning, this disappears on the application of a little plain
water.
Lysol has been introduced into a number of surgical, and par-
ticularly in lying-in clinics, from the experiences of which it has
been concluded —
1. That through its simultaneous cleansing and disinfectant
action, in conjunction with its relative nonpoisonousness, lysol is
superior to the disinfectants commonly in use.
2. That its application is more convenient and less dangerous
than that of any of the other agents of the same class.
As has been already intimated, lysol has been largely and satis-
factorily used in midwifery, for irrigation of the uterus and vagina,
and in gynsecology generally, where its powerful deodorizing prop-
erties prove of the greatest value.
In surgery generally it is being extensively adopted in one and
two per cent solution for the disinfection of the operator's
hands, of the field of operation, of instruments, sutures, etc., and
for irrigation of wound surfaces. Amputations, extirpations of va-
rious tumors, operations for hydrocele and hernia healed in the most
satisfactory manner, and partly by first intention.
Dr. Unna has used lysol in various skin diseases in the form of
a plaster mull, and was favorably impressed with it; he classed it
among substances which do not produce pain. It will prove valu-
able in the treatment of rhino-pharyngeal and laryngeal diseases, as
well as in affections of the middle and external ear. In short, the
application of lysol is indicated wherever any morbid processes as-
sociated with the formation of pus and other disintegration pro-
ducts are going forward. It should also be tried in skin affections,.
REVIEWS AND ABSTRACTS. 65
especially eczema, or such as are of parasitic nature, and in the
treatment of burns and wounds generally.
Lysol forms an efficient general disinfectant. The walls of a
room, and the dwelling generally, may be freed from germs by the
intelligent and thorough use of a spray containing a one to three
per cent solution. It seems likely that lysol may become a perma-
nent institution in the household for the purpose of domestic clean-
ing, the disinfectant of sputa, etc. For such uses its saponaceous
character and perfect solubility in water again manifest themselves
as not the least important among its many advantages over other
substances of the same class. — Pharmaceutical Record, November
12, 1891.
Resorcin Therapeutically. — By Alfred Eichler, M. D., San
Francisco. Medical and Surgical Reporter, 1891 ; No. 5. — Resor-
cin, if exposed to light or kept in a moist place, will soon acquire
a reddish tinge, but it does not lose its activity. It is soluble in
water and alcohol, also in ether. Solutions assume on standing a
darker, whiskey-like co\or, without any ijnpairnient of their activity.
In very concentrated solutions it acts as a mild caustic, if applied to
mucous membranes ; it does not irritate sound skin, however.
When sufficiently diluted it seems to have a soothing effect on in-
flamed surfaces and also on the mucous membranes. Internally it
may be administered in doses ranging from two to fifteen grains.
Resorcin is to be preferred to carbolic acid in all instances when
the latter proves too irritating. Consequently it is especially use-
ful in all affections of the mucous membranes ; it is then used in
aqueous solution, largely diluted. A three to five per cent solution
is mostly preferred. In catarrh of the posterior nares and of the
pharynx it is found to be an' excellent application ; it is also useful
in all affections of the upper air passages. A good formula is pre-
sented by the following :
Resorcin 2 drams.
Sodium salicylate 1 dram.
Sodium biborate 1 dram.
Glycerin 2 fl. oz.
Water enough to make 8 fl. oz.
Use freely three times daily.
This solution will soften and bring away all hardened secretion,
relieve the congestion and lessen the usual discharge. For thus
66 THE DEXTAL REVIEW.
cleansing the naso-pharynx a posterior nares syringe should be
be used instead of a nasal douche^ which, in unskilled hands, is
very likely to create mischief, that is, inflammation of the middle
ear. In many other affections of the air passages does resorcin
give great relief. Whooping-cough, asthma, bronchitis and laryn-
geal ulcers are benefited b)^ it. It is especially valuable in chronic
ailments of this kind ; it is of less use, however, in the acute affec-
tions—like croup and diphtheria. It should be applied in diseases
of the throat with an atomizer or inhaling apparatus. A five to
ten per cent solution will serve all purposes.
Resorcin sometimes acts charmingly in other diseases of the
mucous surfaces ; it is an excellent injection in all stages of gonor-
rhoea, although it here also produces more benefit during the latter
stages ; in inflammation of the neck of the bladder it may also be
employed. From two to five per cent solutions will be the proper
strength to use.
The intertial use of resorcin is chiefly limited to producing its
antifermentative action. In gastric and intestinal catarrh, dilata-
tion and ulcer of the stomach, and in all those diseases where
gases are produced in the alimentary canal, its use is indicated.
Impure resorcin is said to occasion vomiting ; but, according to An-
deer, pure resorcin is one of the very best and most certain remedies
against vomiting, and he says that it will prove efficient in all possible
forms of vomiting — as in those caused by pregnancy, kidney and
liver diseases, also by sea-sickness and after excessive eating and
drinking of alcoholic liquors. The doses as applied by him range
from five to forty grains. It is most conveniently administered in
capsules. — Merck's Bulletin.
Pamphlets Received.
Annual report of the Postmaster-General of the United States,
for the fiscal year ending June 30, 181)1. Washington; John
Wanamaker, Postmaster-General, Government Printing Office,
1891.
PRACTICAL NOTES.
PRACTICAL NOTES.
Dental Education.
SYMPOSIUM THREE.
By a. C. E. and F. (B. and D. Left Out),
A. — From a somewhat lenghthy editorial in the Southerti Dental
Journal for November, we extract the following: "The dental
profession is fast becoming great, and we need men to work in
various capacities. We need leaders, teachers, writers, inventors,
investigators, and so on, until the list could be extended inimitably.
But if I were asked who of all the different classes named or un-
named was doing the most good from a philanthropic standpoint,
the answer would be the modest practitioner who is seldom heard
from, reads one or two journals, attends his State society, and qui-
etly pursues the even tenor of his way, relieving suffering human-
ity by practicing his profession intelligently and conscientiously,"
The exception I make to this, is that there would not be a mod-
est, unassuming practitioner pursuing "the even tenor of his way''
if there were no teachers, inventors and investigators, and it is no
great credit to him to be pursuing "the even tenor of his waj' "
by absorbing everything and giving out nothing.
F. — Almost any one can absorb the thoughts and ideas of oth-
ers, and such a man is simply an absorber, and not a producer.
A. — What is the particular influence that such a practitioner
exerts upon society ? What standing does he give to the profes-
sion ? In what way is he doing more good than the men who are
engaged in reforms and in the establishing of higher standards of
education ?
E. — Such a man is simply a sponge. He is absorbing, and giv-
ing nothing out. The influence he exerts is simply for the laity.
He may perhaps benefit the standing of dentistry somewhat by
the influence that he exerts over his patients and the people he
comes in contact with, but he certainly does not contribute any-
thing to the profession itself. No good comes back to our socie-
ties from him. He is simply a parasite and his growth is parasi-
tical.
F. — It would seem to me that the influence that such a man
exerts on either general society or the profession is very little.
68 THE DENTAL REVIEW.
C. — A. means the value of the man to the community in which
he lives and the influence he exerts upon the people with whom he
associates, whether it is superior or inferior.
A. — This is only one phase of dental education, which is really
the topic we want to touch upon. But the whole tenor of the edi-
torial is to this effect, that there is now and must always be a field
for what the writer calls "medium capacitated men." We must
recognize, of course, that in all professions there are the rank and
file who give respectability or cast disrespect upon the profession,
and if the "medium capacitated men" so largely outnumber those
of talent or habits of study, or industry, or great intelligence, the
whole profession must be judged by the " medium capacitated
men " instead of the others.
C. — Let us take a practical view of it. We see men go to the
State societies who probably never throughout the year associate
with any other dentists, and if they read a dental journal or two
you may depend upon it that the journals are of the inferior kind.
They do not have enough friction or association with other dentists
to comprehend a good article. They can read little articles on how
to prevent the teeth and joints from discoloring and grasp those
things, but they cannot go beyond them. It is simply impossible
for a man to limit himself within such bounds and be able to do
good work in the community in which he lives. There are notable
exceptions to this rule. For instance, I know of a man who per-
haps does not read a dental journal ; I know he does not attend
any society, yet he is a fine operator. He is a mechanical genius.
He cannot do anything beyond absolute mechanical work. He is
not doing as much good to his patients as he could if he were to
take a more active interest in reading dental journals and attend-
ing society meetings. He is doing no good to his professional
brethren whatever. I think a man whose aims are mediocre never
reaches the position he thinks he occupies.
E. — Very many men deceive themselves. They are honest in
their opinion, and they think they are good professional men, when
they are badly mistaken. The reason for their belief is simply
that they have nothing to compare themselves with. They do not
come sufficiently in contact with any one else who could possibly
enlighten them regarding certain subjects.
A. — That is true, and they are the men who skip an article in
a dental journal that has the appearance of being scientific or is
PRACTICAL NOTES. 69
based upon experiments or anything of that sort. They turn to the
advertisements first, if they ever happen to see a journal.
E. — The reason why low grade journals are so popular is be-
cause they contain little short articles and bits of news that are-
oftentimes far from being scientific. They are simply little squibs
and cuttings.
C. — Yes, and they are oftentimes incorrect.
E. — There are a few bright men in our smaller towns. They
read, but oftentimes are not heard from in our societies because of
diffidence. They have not come in contact with dentists often
enough to be able to trust themselves on their feet to take part in dis-
cussions. It is true that some men have very good ideas, perhaps
better ideas than those wordy speakers who are universally on the
floor, but on account of diffidence they are incapable of giving ex-
pression to the thoughts and knowledge that they possess, which
would prove of value to others. The city dentist who comes in
contact with other dentists, who attends societies frequently, has a
wonderful advantage over those practitioners in the country who
perhaps attend a society only once a year or not at all.
A. — Yes, that is true, but there is nothing to prevent such men
from writing if they have good thoughts or knowledge to impart to
their fellowmen.
E. — Some men write a good deal, but they do not do much
talking.
A. — But they do not write such matter as will show that the}'
are profound thinkers. Their articles are too brief and are lacking
in original thoughts or ideas. They write too many text book
short articles. Half of the articles we read on the development of
the teeth, and on the care and treatment of deciduous teeth, etc.,
are borrowed or taken from the productions of other writers and
simply recast, and whenever I see an article of that kind, unless
there are illustrations or tables accompying it, it does not appeal
to me. It is some old stock article that has been going the rounds
of the dental journals for years.
C.^ — Do you know of any men within the last twenty years who
have made themselves prominent in dentistry, except as teachers,
investigators, inventors, industrious writers connected with den-
tal journals or societies?
E. — Very little good can come from a man who is not engaged
either in teaching, experimenting, writing, or who does not attend
70 THE DEXTAL REVIEW.
dental societies. These are the only avenues through which he
can make himself useful. If he does any good at all, he must do it
through one or the other channel referred to.
A. — If he pursues "the even tenor of his way," he is lost to
sight.
E. — He certainly knows very little about what is going on in
the profession.
A. — It is simply a little circle that he impresses himself upon
according to the performance of his daily operations ; and when he
dies they simply say requiescat in pace.
F. — This is a new phase of dental education for me, and a very
important one. A large majority of dentists are vegetating, they
are neither giving nor taking, simply because they do not have such
opportunities as we have in cities of getting together. If they
could organize societies, read papers and discuss them, it would be
the means of doing a great deal of good not only to themselves, but
to the profession.
C. — Let us take the West as an example. Most of you have
attended Western dental societies, and you will find how many
men there are who read dental journals and attend meetings. Only
a few seem to be interested in society proceedings, and those
gentlemen are the ones who have written for our dental journals,
and we hear of them in that way. Take, for instance, certain
States, and I do not believe there are more than a dozen men in
them that amount to anything in so far as they have added to the
stock of knowledge of the profession.
A. — It is not permitted for all men to be great. Every man
however, is permitted to do something toward the betterment of
his profession to compensate in a slight way for the knowledge
that has been gathered by others in times past, which he has ac-
quired in such a short time during his college education, for
instance, and if he does not compile, invent or investigate some-
thing, or present a new thought or do something to keep up socie-
ties, or become a teacher or editor, just the mere fact that he is
performing operations on the teeth from day to day is not a suffi-
cient excuse for his existence. That is the way I look at it. If he
does rise above a mere money making machine, who goes to work
at 8 o'clock in the morning and keeps it up until 5 or 0 at night,
year in and year out, he is just like any ordinary mechanic. He is
not a professional man at all, because to be considered one he has
PRACTICAL NOTES. 71
to contribute something in some way that will show that he is not
inappreciative of the facts, discoveries, and great labors of all the
men who have preceded him.
C. — You think then, that there is not a man practicing dentistry
in the smallest village but what can in some way do some good to
the profession through one of the channels mentioned.
A. — I think it is the duty of every man to do something. He
must keep himself in touch with the inventions and discoveries,
otherwise he is not fulfilling his duty to the community in which
he practices, whether he lives in a great or small city, a town or a
hamlet.
E. — We have a great many men who make considerable noise.'
They attend societies, they do the greater part ot the talking, but
contribute no more than those men of whom you are speaking.
They are not dental educators in the smallest sense.
A. — That may be so, but they help to keep up society organiza-
tions, and these are good things for the dental profession at large.
If we do not have an organized dental profession in ever}^ state,
city and district where a sufficient number reside, they become
apathetic, and the practice in that community will be of a low or-
der. Is it not a fact that there are more unheard of operations,
and particularly well performed operations of various kinds in com-
munities where the people have been educated up to feel the need
of such work — artistic dentures and beautiful crowns made in the
most substantial manner, the kind of bridge work that will not spoil
the teeth in a few m.onths, and the kind of root filling and various
other operations I need not mention that become a necessit}-? But
if the men who are located in that community are all asleep, do
not attend societies, do not contribute in any way of their stock
of acquired knowledge, they do low grade operations from day to
day, and so they get the credit of being in the rear guard, and that
is where they belong.
F. — What do you propose as a remedy?
A. — I had not thought of the particular form of remedy, except
this, that in the dental schools where there are so many students,
it is the duty of every dental teacher to impress upon them the ne-
cessity of allying themselves in some way with a dental society and
becoming subscribers to dental journals, and possibly a medical
journal or two, so as to keep themselves informed in a professional
way. Get them started, and then if it happens that there are tea
72 THE DENTAL REVIEW.
or a dozen men residing in a region where it is not thickly popu-
lated, say ten, twenty, thirty or forty miles apart, it is a good thing
to have a local society that meets once in three months for the pur-
pose of showing the members what they are in the habit of doing.
If they do not do that, they inevitably fall to the rear. They must
do it.
F. — If such men were encouraged and stimulated to take hold,
I think we would be surprised at the good that could be done, not
only to individual dentists, but in other ways.
A. — Look at Chicago. For many years there was but a single
dental society, and the membership did not exceed fifty or sixty up
to probably 1880. Since that time there have been four other soci-
eties organized, and they have pretty generally full meetings and
have succeeded in drawing a great many dentists into them that a
single one could not do. If one society is not sufficient in a large
city, there ought to be two, or three or four, and they ought to be
rivals in the sense of doing the very best kind of work. That is the
only kind of rivalry that should be acknowledged or fought for or
obtained. Every society has to live on its own merits, and if it
does not produce good papers and good discussions the publishers
of dental journals do not care to publish its proceedings. If that
sort of generous and friendly rivalry exists, we will have such a
mass of valuable material that our pages will not be large enough
to hold them.
E. — I think the value of local societies is underestimated for
the good they have done. I have associated with them consider-
ably, and have known them since their birth.
A. — You were on a committee that first organized the district
society of the State, were you not ?
E. — In the annual address as President, I recommended that it
be done, and a motion was made to that effect, but whether I was
on that committee, I do not know. I have seen when I have at-
tended these district meetings ability exhibited by men from small
towns that surprised me; which shows the good that is coming from
the schools. We do not find such dentists in the little hamlets.
There were no dentists in those places in years gone by, but now
nearly every town in this State and adjoining States of 500 or 1,000
inhabitants has a regular dentist, and many of them are graduates
of schools, and many of them subscribe to journals who read them.
Many of them have not gotten into the State societies for some rea-
PRACTICAL NOTES. 73
son, I do not know just why. Probably they will join the State
societies later.
A. — They can grow up to that though.
E. — Within the past two or three years men who are members-
of the district dental societies have been coming into the State soci-
eties; and men who have never attended State societies, who have
been practicing for years, have become members of local societies
and gradually worked themselves up. We see this from year to
to year. We are discovering men of intellect in the countrj^ who
are fairly good educators.
F. — Is there any better way than for the State societies to take
hold of this matter? The States should be organized. Of course it
takes time and money to do it, as well as energy and push; but if
each State was organized so as to reach nearly all the dentists in
the State, it would result in incalculable good.
E. — It has been done.
A. — It is being done in a good many States. It is a good thing,
but the way in which to do that is to let men run their own socie-
.ties instead of importing talent from other districts. It is much
better for them to get started and rely upon themselves, then they
take a personal interest in their work; if they have a protecting
arm around around them, they begin to feel as though they did not
have proprietorship in the society, consequently they lose their in-
terest in it. When you put the responsibility on a number of men,
if in earnest, they are generally equal to the emergency.
F. — My idea was to have local and district societies organized,
and then see that they were kept going. I think they have organ-
ized the State of Ohio on this plan.
A. — They have several district dental societies in Ohio, and in
New York, by an act of the legislature, there are eight district so-
cieties. In Iowa they have district societies, and also in Indiana.
In Illinois there are four at the present time, the central and west-
ern having united.
C. — It is strange, that out of 1-200 dentists in Illinois only IGO
are members of the State Society.
A. — That brings us back to the original proposition, that if
there are only IGO, or say 260, men interested in dental societies in
the State of Illinois, the vast majority of those remaining must be
absorbers, not contributors, and to be an absorber is not the best
position for a man to be placed in. What we desire and what we
74 THE DENTAL REVIEW.
hope for, is that the absorbers will begin to contribute through
some one of the channels that have been previously mentioned. —
Exeunt Reporter.
To the Editor of the Dental Rezde'u :
Dear Sir. — In filling two adjoining approximal cavities with gold it has
been my custom for years to fill the posterior approximal cavity of the anterior
tooth first and then the other. For instance, if I have to fill a posterior approxi-
mal cavity in an upper first molar and an anterior approximal cavity in the sec"
ond molar adjoining, I always fill the cavity in the first molar first and the cavity
in the second molar afterward. In conversation with a number of professional
friends, I learned that the universal custom among them was just the reverse of
this procedure. What is the usual practice in this particular, and why is one
method preferable to the other ? Will some reader of the Review please reply
and oblige one who after knowlege is A Seeker.
January 5, 1892.
MEMORANDA.
The Michigan Dental Law was amended in 1891.
Chloroform water may be used to disinfect instruments.
Dr. J. D. Patterson took a look at the World's Fair city recently.
Dr. W. X. Sudduth, of Minneapolis, paid a flying visit to Chicago this
month.
Dr. Joseph Head is to be Associate Editor of the International Dental
fourtuil.
The British Journal af Dental Science ^MhWiihed. 1,149 pages of reading mat-
ter in 1891.
Do you use amalgam dies for inlay work ? If not, try copper amalgam or
some other variety.
Look out for the impecuneous dentist who wants to borrow a dollar or two
about this season of the year.
The Mississippi Valley Association of Dental Surgeons will meet in Cincin-
nati the second Tuesday in March.
A GRIM PLEASANTRY.
A London dentist about the middle of December hung out the sign, "Have
your teeth pulled out for a Christmas present."
MEMORANDA. 75
Dr. H. A. Smith, dean of the Ohio College of Dental Surgery, spent a few
days in Chicago during the holidays.
Oil of wintergreen is again recommended in acute rheumatism ; five drops on
a lump of sugar four or five times a day,
"Teeth filled while you wait " is a sign displayed in an American city. Won-
der if the dentist "waits" for his fee ?
Clinical teaching, wherever practicable, must take the place of didactic
instruction, preferably in division of classes.
Dr. W. H. Whitslar, of Cleveland, Ohio, was a recent visitor in Chicago
Dr. Whitslar is the Dean of the new dental college in Cleveland.
From recent investigations, eugenol takes high rank as a local anaesthetic
and disinfectant. It cannot be discarded from the dental medicine case.
James Charles, for many years a dentist of Omaha, Neb., committed suicide
at the Hotel Brewster, in Chicago, January 6th. No cause for the deed is known.
M. E. Lecaudey has been named an officer of the Academy in France. M.
Lecaudey was the honorary President of the First International Dental Congress.
II Frogfc'sso DentisliiO is a new dental journal just issued in Italy. Editor
Dr. Platlchrick. Monthly organ of the chair of odontology in the University of
Pavia.
Dr. John H. Spaulding, formerly of Minneapolis, who is practicing dentis-
try in Paris, has been appointed one of the professors of operative dentistry in the
Dental School of France.
Dr. W. C. Barrett assumes the editorial mantle this month. He will act as
editor of the Dental Practitioner and Advertiser, of Buffalo, one of our valuable
quarterlies, price one dollar per annum.
The Illinois State Dental Society will meet in Springfield the second Tuesday
in May, 1893. It is not too early to begin preparations for this meeting, as Pres-
ident Taggart expects a large meeting of his fellow countrymen.
It is unprofessional to endorse nostrums, especially secret local anaesthetics.
How dare you inject even a minim of a secret pain obtunder, or use a poisonous
preparation the ingredients of which you do not know nor the quantity of each?
SERVED HIM RIGHT.
A dentist in Ai.x-la-Chapelle has been sentenced to nine months' imprisonment
for pulling out all a woman's teeth while she was under anaesthesia. She wanted
only one pulled.
Very recently we discovered a cavity on the root of a living cuspid tooth
about midway between the gingival margin and the apex of the root. The gum
was not receded and there was no disease of the peridental membrane. After
vainly searching for the cause of pain, a fine probe was passed between the ce-
mentum and the pericementum on the labial aspect and the cause of the pain was
discovered. The tooth had been giving trouble for three weeks. What caused
the cavity ?
76 THE DENTAL REVIEW.
Three new phosphate companies have recenlly been organized to develop and
work the phosphate beds in Florida. The capital stock of these companies aggre-
gate over $4,000,000. Many plants are now in operation and will turn out 250,000
tons, nearly one-fourth of the world's product. — N^. Y. Globe.
The influence of food upon the rate of formation of carbonic acid has been
made a matter of study in France, and it has been found out that during the first
hour after a meal the quantity of carbonic acid exhaled increases till it reaches a
maximum, three or four hours after the meal, when it falls off again. Plenty of
fresh air is desirable from one to three hours after a meal.
Dr. L. P. Haskell, who established the first post graduate school of prosthetic
dentistry, has removed to 211 Wabash Avenue, Chicago. Dr. Haskell's school is
open the entire year and students may enter at any time and receive personal
instructions in crown and bridge work, continuous gum and metal plate work,
and in fact in any department of prosthetic dentistry.
Ghostly Dentists. A man in Ohio who was suffering from a severe case of
toothache, consulted a spiritist medium for relief. He was told to go to bed and
the relief would come. He obeyed, and upon recovering consciousness he found
a blood stained pillow and the offending molar on the sheet. He is deliberating
whether it was nitrous oxide or spiritism, but he is glad the tooth is out anyway.
— Medical Record.
POST-GRADUATE DENTAL ASSOCIATION, OF THE UNITED STATES.
To THE Editor of the Dental Review :
Dear Sir : — Will you kindly announce in the next issue of the Review that
the annual meeting of the Post-Graduate Dental Association of the United States
will be held in April, date to be announced later.
Very truly,
L. S. Tenney, Sec'y.
Bathing the face and neck in hot water in acute pericementitis will prove
very soothing in conjunction with counterirritation and constitutional treatment.
Use a large napkin dipped in water about 180 F., do not wring it completely dry,
continue this for ten minutes, and give internally teaspoonful doses of fl. ext. gel-
semium, minims x., water ^i-. every fiften minutes until four doses have been
taken, then every half hour for two hours. Or, use calcium sulphide in '/lo gr.
pill until eight have been taken in two hours, then one every half hour for two
hours. Relief will follow in a very short time if the treatment is followed faith-
fully, Try it.
A good plan.
In Cincinnati, the Ohio College has undertaken the care of the teeth of or-
phan children housed in the orphan asylums. The plan is to have the children
come a dozen at a time and such services as are needed — filling, regulating and
extracting are rendered gratuitously. This is not only a benefit to the children,
worthily donated by the college, but it is of still greater utility to the students as
it will be helpful to them in learning to diagnose disease in its incipiency and teach
them something of the methods of managing children when they begin practice
on their own account. Other colleges can follow after this idea with good results.
MEMORANDA. 77
MUMMY WITH FALSE TEETH.
There was a good deal of interest felt among dentists some years ago when
one of the royal mummies taken from the Egyptian catacombs was found to be
fitted out with an upper set of artificial teeth. The plate was of wood, carved to.
fit the roof of the mouth, and the teeth were of brass, the natural shape of the
tooth being quite closely imitated. It shows that some one of the Pharaohs felt
the loss of his incisors and grinders and had the court tooth doctor to do the best
that could be done for him. Before this discovery it was commonly supposed
that artificial teeth were a modern contrivance, but false teeth in ancient Egypt
furnish convincing proof that there is nothing new under the sun. — St. Louis
Globe-Democrat.
SHE WAS FALSE.
"No brighter eyes did ever glow
Such lovely brows beneath.
And never opened lips to show
Such rows of pearly teeth."
Thus said I to myself as there
I stood with hat in hand
To bid "good night" to maiden fair
That did my love command.
She smiled ; I was about to speak,
When horrors ! came a wheeze,
A crinkling of her nose and cheek
And then a giant sneeze !
A sneeze that jarred the earth, and at
Whose winding up I found
Those pearly teeth within my hat.
Her left eye on the ground,
- 'Boston Courier.
SECOND HAND TEETH.
Of all the odd trades in New York City that unearthed by a Telegram report-
er the other day is the most peculiar. On a sidewalk stand on Vesey street, be-
low Church, a shrewd dealer had displayed a heap of second hand artificial teeth.
In reply to an inquiry he said ; " ' Yes ; at times I sell a great many sets of these
teeth. Where I mostly get them is at pawnbrokers' sales. I buy them for 10, 30
or 30 cents, and sell them sometimes for $3. I have had old men and old women
— poor people, of course — walk up to my stand, pick out a set, examine them, try
them, and immediately purchase, saying that they were fitted better, than a den-
tist could suit them. An old man purchased an upper set from me last winter, and
he was so well pleased with them that he brought his wife here last week to get a
set. I had none at the time, and he promised to call this week. A person might
as well save a few dollars in buying teeth as in any other way. Take them home,
wash them, and they are just as good as new — in fact, better, for they have been
'broken in.' " — Excliamre.
78 THE DENTAL REVIEW.
ST. LOUIS DENTAL SOCIETY. OFFICERS FOR 1892.
The St. Louis Dental Society met at the residence of Dr. Conrad, on January
5, 1S92, and elected the following officers for the ensuing year :
President, Dr. Geo. Robitoy ; Vice-President, Dr. Walter M. Bartlett ; Re-
cording Secretary, Dr. J. B. Vernon; Corresponding Secretary, Dr. John G. Har-
per; Treasurer, Dr. Henry Fisher.
Committee on Publication, Drs. Helmuth, Lindsley and Keith.
Committee on Membership, Drs. Morrison, Hickman and Spaulding.
Committee on Ethics, Drs. Baird, Prosser and McNamara.
The Executive Committee consists of the officers of the society.
Regular meetings are held on the first Tuesday of each month, excepting
July, August and September. John G. Harper, Cor. Sec,
800 Pine Street, St. Louis, Mo.
NECROLOGY — MEDICINE — 1891.
Dr. Jacob Regensburger, San Francisco, Cal.; Dr. Henry Olin, Chicago, 111.;
Dr. Edward C. Harmond, New York; Dr. J. M. Quigley, Pres. Southwestern
Med. Assoc, Pierce City, Mo.; Dr. Sullivan Whiting, homoeopathist, Boston,
Mass.; Dr. S. S. Strong, Saratoga, N. Y. ; Dr. Frederick W. Beard, Vincennes,
Ind. ; Dr. Jennings Price, Lancaster, Ky.; Dr. John S. Messersmith, Med. Direc.
U. S. N., Lancaster, Pa.; Dr. H. A. Johnson, Chicago, 111.; Dr. Stephen G.
Cowdrey, Surgeon, U. S. A.; Dr. Joseph H. Warren, Boston, Mass.; Dr. Charles
T. Parkes, Treas. Rush Medical College, Chicago, 111.; Dr. W. W. Baxter, Mount
Sterling, 111.; Dr. Ransom Dexter, Chicago, 111.; Dr. Richard Gundry, Supt.
Maryland Hospital for Insane, Spring Grove, Md. ; Dr. Daniel S. Smith, homoeo-
pathist, Chicago, 111.. Dr. Philip Leidy, Philadelphia, Pa.; Jesse P. Bancroft, ex-
Supt. New Hampshire Insane Asylum; Dr. W. H. Boling, dean, Louisville (Ky,)
Med. University; Dr. David McDill, Burlington, la.; Dr. Alfred Hosmer, Water-
town, Mass. ; Dr. W. Nashua, Burlington, la. ; Dr. Fordyce Barker, New York;
Dr. Willis Danforth, Pres. Wisconsin Homceop. Society, Milwaukee, Wis. ; Dr.
Thomas P. Gary, Pres. Florida Med. Society; Dr. James H. Thompson, Milwau-
kee, Wis.; Sir Prescott G. Hewett, surgeon, England; Dr. William Mottram, Kal-
amazoo, Mich.; Dr. John F. Groenevelt, surgeon, New Orleans, La.; Dr. O. P.
Mills, New York; Dr. William Coggswell, Bradford, Mass.; Dr. Horace Duper,
Boston, Mass,; Dr. George H. Lyman, Boston, Mass.; Dr. Daniel Pardee, Ful-
ton. New York; Dr. Abraham Dubois, New York; Dr. Thomas T. Pratt, Ameri-
can physician, London, Eng. ; Dr. Benjamin S. Woodworth, Fort Wayne, Ind.;
Dr. Peter Pineo, ex-Medical Inspector, U. S. A.; Dr. David H. Storer, Boston,
Mass.; Dr. Prince Page, Boston, Mass.; Dr. William O. Emerson, Harvard
School of Medicine; Prof. Christopher Johnston, surgeon, Baltimore, Md.; Dr.
William A. Galpin, Goshen, Ind.; Prof. Thomas B. Evans, Dean of Baltimore
School of Medicine; Dr. John Clarkson Jay, Rye, New York; Dr. Phineas P.
Wells, homoeopathist, Brooklyn, New York; Dr. Levi Ives, New Haven, Conn.;
Dr. Francis Donaldson, Baltimore, Md.; Dr. W. F. Peck, Med. Dep. Iowa State
University.; Dr. Henry F. Campbell, Augusta, Ga.; Dr. R. A. Kinloch, surgeon.
Charleston, S. C; Dr. Fred L. Matthews, Springfield, III.; Dr. Simon T. Clark,
Lockport, N. Y.
MEMORANDA. 79
ODONTOLOGICAL SOCIETY OF PENNSYLVANIA.
President, Dr. Louis Jack; Vice-President, Dr. James Truman, 3249 Chest-
nut Street; Recording Secretary, Dr. A. W. Deane, 1228 Walnut Street; Treasur-
er, Dr. L. Ashley Faught, 1331 Arch Street; Corresponding Secretary, Dr. H. K.
Leech, 16 S. 37th Street; Chairman Executive Committee, Dr. D. N. McQuillen,
1(538 Chestnut Street, Chairman Clinic Committee, Dr. Frank L. Bassett, 418
Girard Building.
The stated meeting of the Society was held Saturday, January 9, at 8 o'clock,
at 1228 Walnut Street.
A paper was read by Dr. Geo. W. Weld, of New York City. Subject:
I. " Syrup of Iron Chloride." (A new form of iron considered from a ther-
apeutical point of view.)
II. " The Tincture of the Chloride of Iron — its merits and demerits."
III. "The Direct Action (if any) of weak Hydrochloric Acid upon the
Enamel of Teeth."
IV. "The Ingestion of Acids, considered in connection with the so-called
Secondary Effects upon the Fluids of the Oral Cavity, and the Enamel of the
Teeth."
All who are desirous of reading Papers before this Society, or presenting
anything of a literary nature, apply to Chairman of the Executive Committee,
Dr. D. N. McQuillen, 1628 Chestnut Street.
Parties wishing to give Clinics, exhibit casts or models, or introduce new de-
vices, apply to Chairman of Clinic Committee, Dr. Frank L. Bassett, 418 Girard
Building, Broad and Chestnut streets.
H. K. Leech, D. D. S., Corresponding Sec'y,
No. 16 South 37th street.
TESTING OIL OF CASSIA.
The best criterion of the purity or genuineness of oil of cassia is the amount
■of cinnamyl aldehyde it contains. It is the merit of Schimmel & Co., of Leipzig,
to have first pointed out the nature of the adulteration so long practiced by the
the Chinese, and also to have communicated a method of testing by which the
adulteration can be detected without difficulty. We published this method last
year {A»ter. Drugg., 1890, 135), but Schimmel & Co. have recently improved the
process so that it takes a much shorter time. We therefore republish it here, in-
corporating therein the new features, after their October report.
Requisites. — A solution of sodium bisulphite containing about 30 per cent,
such as is usually sold in the market, but it must be perfectly clear ; a pipette
marked at 10 Cc; a water bath; and a special small glass flask of the capacity of
about 100 Cc, having a neck about 13 Cm. [5% inches) long and 8 Mm. (\\ inch)
in diameter, upon which is a graduated scale beginning with 0 below, extending
to 6 Cc, and divided into j^ Cc.
Method of Testing. — Transfer 10 Cc. of the oil to be tested, by means of a
pipette, into the flask, allow the pipette to drain, and empty it as completely as
possible by blowing through it. Now warm the flask on the water bath and then
80 THE DENTAL REVIEW.
add to it the solution of sodium bisulphite, in small portions at a time, waiting
after each addition until the solid mass produced by it has become completely
liquid again. When a further addition of the solution produces no solidification,
the whole of the aldehyde has entered into a liquid combination with the bisul-
phite. About tenor fifteen minutes will be required for this reaction, provided
the percentage of the aldehyde was high. If only a small quantity of aldehyde
was present, a longer time is required to complete the reaction. The completion
of the latter is recognized by the contents forming two distinct and sharply de-
fined layers--one, a lower aqueous one, containing in solution the bisulphite
compound of the cinnamyl aldehyde; and an upper, oily layer, consisting of the
other constituents of the oil. Now take the flask from the water bath and cool it
to the ordinary temperature [at which the original oil was measured]. Next add
more bisulphite solution until the oily layer has been driven up into the narrow
neck of the flask, and its lower margin corresponds with the mark 0. Read off
the number of cubic centimeters of this layer and deduct it from 10. Supposing
the oilv layer measured 2.7 Cc, then the original oil contained 7.3 Cc. of cinnamyl
aldehyde and 2.7 Cc. of nonaldehydes, or 73 per cent of the former and 27 per
cent of the latter. Of course these are percentages by volume. Yet, since the
specific gravity of the nonaldehydes of oil of cassia (1.060 at 20- C.) is almost
identical with that of cassia oil itself, the difference between percentage by vol-
ume or by weight is insignificant.
In making the test it is necessary to insure one's self that the 'vhole of the
cinnamyl aldehyde has been acted upon. No sign of any coagulum must be re-
maining, either in the oily layer or adhering to the flask.
If the oil is adulterated with much resin, the coagulum produced by the bi-
sulphite will dissolve only with difficulty. If protracted heating does not cause
solution, the above test is inapplicable.
Instead of using an additional quantity of solution of sodium bisulphite to
cause the oily layer to ascend into the neck of the flask, a filtered solution of
chloride of sodium may be used. — American Druggist.
O'DONTOGRAPHIC society of CHICAGO.
To THE Editor of the Dental Review:
Dear Sir:— At the annual meeting of the Odontographic Society of Chicago,
held Dec. 14, 1891, the following officers were elected for the ensuing year;
President, E. L. Clifford.
Vice-President, Geo. J. Dennis.
Recording Secretary, U. G. Poyer.
Corresponding Secretary, T. A. Broadbent,
Treasurer, E. Noyes.
Board of Directors.— E. L. Clifford, U. G. Poyer, R. B. Tuller, Geo. J. Den-
nis, C. E. Bentley.
Board of Censors.— D. C. Bacon, Louis Ottofy, D. M. Gallie.
Very truly yours, T. A. Broadbent, Cor. Secy.
MEMORANDA. 81
DENTES SAPIENTIA.
Away! away! thou hateful fang,
Begone! avaunt! and get thee hence;
Thou'st cost me many a twinge and pang,
And now thou'st cost me fifty cents.
And thou art called the "wisdom tooth"
The just fulfillment of a law!
Then ignorance were bliss, forsooth.
When thou are absent from my jaw.
And thou the "star of manhood's dawn!"
The ivory crown of womanhood!
Daylight comes when thou art dratvn.
And "stars" appear to say " 'tis good."
If wisdom thou dost symbolize —
A type of logic and of love,
A martyr then thou shall comprise,
To be a sign forevermore. >
So now begone on swiftest wings,
And gums heal up in ignorance;
Thou'st cost me all that wisdom brings.
And now thou'st cost me fifty cents!
Elgin, III. — C. J. Underwood, D. D. S.
ANNIVERSARY MEETING OF FIRST DISTRICT DENTAL SOCIETY.
The following is the programme of the anniversary meeting of the First Dis-
trict Dental Society of New York, to be held January 18, 19, 20, 1892, at the
Academy of Medicine, New York city.
The essays to be read are:
"Pus Formation — Revived," by Professor D. R. Stubblefield, Nashville.
"A Plea for Replantation as a Cure for Chronic Alveolar Abscess," by Profes-
sor John S. Marshall, Chicago.
"Some Thoughts on Transformism," by Professor C. N. Pierce, Philadel-
phia.
"Borders between the Natural and the Artificial in Bridgeand Crown Work,"
by Dr. Calvin S. Case, Jackson, Mich.
"Adenoid Growths, Mouth-Breathing, and Thumb-Sucking, and their Rela-
tion to Irregularities of the Teeth," by Dr. Norman W, Kingsley, New York.
Dr. Kingsley 's paper will be illustrated by a number of casts of faces, mod-
els of jaws, and regulating appliances.
The following distinguished gentlemen have agreed to discuss the above
papers: Dr. J. E. Garretson, Dr. C. N. Pierce, Dr. James Truman, Dr. S. H.
Guilford, Dr. E. C. Kirk, and Dr. Chas. J. Essig, Philadelphia; Dr. J. Taft, Cin-
cinnati; Dr. John S. Marshall, Chicago; Dr. D. R. Stubblefield, and Dr. J. Y.
Crawford, Nashville: Dr. C. S. Stockton and Dr. S. C. G. Watkins, New Jersey;
Dr. Thos. Fillebrown, Boston; Dr. G. L. Curtis, Syracuse; Professor Chas. Mayr,
Springfield; Dr. Frank Bliven, Worcester; Dr. F. T. Van Woert, Brooklyn; and
Drs. J. N. Farrar, Geo. S. Allan, and Carl Heitzmann, New York.
The following gentlemen will give new and interesting clinics: Dr. J. Y.
82 THE DEiVTAL REVIEW.
Crawford, Nashville; Dr. Geo. V. I. Brown, Duluth; Dr. Sydney S. Stowell,
Pittsfield; Dr. F. T. Van Woert, Brooklyn; Dr. A. H. Gilson. Boston; Dr. John
L. Gish. Jackson, Mich : Dr. S. C. G. Watkins, New Jersey; Dr. W. F. Rehfuss,
Philadelphia; Dr. W. F. Davenport, New York, and a number of others with
whom we are still in correspondence. In addition, there will be a number of
new instruments, devices, etc., shown by various manufacturers. The clinic will
be held in the large clinic room of the Academy, where there will be space enough
for everything to be seen by all who attend.
The Wednesday morning's session will be devoted to a mass meeting of all
interested in the Dental Protective Association. Dr. Grouse will preside, and
several prominent men will make addresses.
The Trunk Line Association have agreed to sell tickets from points on their
road for one and a third fare.
The profession are cordially invited to attend.
RODRIGUES Ottolengui, Chairman Executive Committee,
115 Madison avenue, New York.
Springville, Iowa, Jan. 8, 1892.
Dr. a. W. Harlan.
My Dear Doctor: — Will you allow me space in the Review to make the fol-
lowing statements:
First. I resigned as editor of the American Jaurnal of Dental Surgery prior
to the last issue, Oct., 1891.
Second. I have no evil feelings toward any Dental College.
Third. I have full sympathy with the Association of Dental Faculties.
Yours respectfully, Gustavus North.
True Copy " Chicago, III., Jan. 2, 1892.
This is to certify that Dr. Gustavus North, former editor of the American
Journal of Dental Surgery, sent in part of the Journal matter for publication in
September for the October number, 1891. The Journal was delayed for other
matter ano before it was published. Dr. North resigned as editor, and his name
was retained by mistake as I was out of the city. G. A. Stevenson,
Managing Editor."
True Copy. "Chicago, III., Dec. 29, 1891.
I hereby certify that Dr. G. North resigned from the editorship of the Amer-
ican Journal of Dental Surgery prior to last issue of same and that his name was
kept on as editor by mistake. I. Clendenen.
DIED.
At the age of twenty-five years. Dr. Joseph A. Swasey, only son of Dr. James
A. Swasey.
We tender our deepest sympathy to the bereaved family in their sad affliction.
It is particularly sad to see a young life cut down just on the threshold of man-
hood, with all the brightness of life and a career of usefulness before it.
Dr. Swasey studied dentistry with his father, and graduated from the Chica-
go College of Dental Surgery in 1889. Since that time he has practiced his pro-
fession with his father, where his many genial qualities have won for him many
friends, who mourn with us his early demise.
THE
DENTAL REVIEW.
Vol. VI. CHICAGO, FEBRUARY 15, 1892. No. 2.
ORIGINAL COMMUNICATIONS.
The Use of Books.*
By G. V. Black, M, D., D. D. S., Jacksonville, III.
In literary schools the use of books is given the place of first im-
portance. The child when taught its A B C's is given a book that
it may study the forms of the characters used. When these have
been mastered comes the study of the thought that has been trans-
ferred to the printed page. At first the pages are divided into les-
sons and the pupil is examined from time to time as to his under-
standing of the contents of the lessons. In this wa)' the teacher
learns whether or not the pupil succeeds in grasping the ideas ex-
pressed in the written words, and by supplementing them with
oral explanations, corrects and amplifies the thought obtained by
the pupil. The general idea of teachers in pursuing this form of
instruction is the transmission to the pupil of correct ideas of lit-
erature and science, and particularly to develop his power to com-
prehend written language. It also deals with the use of language
by the pupil, and to this end he is put to writing early in the course.
This course of instruction furnislies an extended training in the use
of the books which have been selected for this primary education.
This plan of study, when extended through the college currici •
lum, is intended to be sufficient to give the pupil such a mastery of
the use of books on general literary subjects that he will be able to
continue his studies independently of his teachers. That is to say,
his instruction has been such that he is able to take up new books
on literary subjects and obtain the thought of the authors. He is
* Read before the Odontographic Society of Chicago, February 8, 1892.
84 THE DENTAL REVIEW.
also supposed to be able to judge fairly well of the correctness and
of the value of the thought expressed in books of this class, and to
be able to select such books as may be best for his continued
mental development. His course of instruction has, indeed, in-
cluded a general knowledge of the important books in literature,
though his allotted time of school work has been only sufficient for
him to study a few in detail.
Such a course is supposed to be the best to fit the pupil for the
beginning of professional studies. He has gained an extended
knowledge of language, has become intelligent in several depart-
ments of natural science and is able to read to advantage in these
fields of thought. But this has given him no knowledge of medical
or dental literature. He has had no instruction as to the character
or scope of the books in dentistry or medicine. Though he may
have made an extended study of language, he meets strange terms
at once. Many familiar words are used in a technical sense, and
he finds many new words and special compounds of old words, the
meaning of which must be learned before he can understand what
he reads. In entering a new field of thought the pupil has entered
a new field of technical language in which that thought is ex-
pressed. He must learn to read his new literature understandingly
and effectively if he would master the thought it contains. In fol-
lowing out the general idea of educators it seems to be supposed
that when a pupil has passed the school he has become sufficiently
acquainted with the literature of the subjects taught to be able to
read that literature effectively.
Now when a student enters a medical or dental school a radical
departure is made from this general plan of instruction. The lec-
ture takes the place of the books. When we look over the cata-
logues of medical and dental schools we generally find a list of
hooV^ recommended hy \.\\^ faculty. With this recommendation in
the catalogue all reference to books by the faculty usually ends ;
and the use of books by the student, if used at all, is by his own
motion. Those who have passed through the curriculum of liter-
ary institutions are not the only ones admitted to medical and den-
tal schools. Perhaps a majority have had but a part of this train-
ing, and, presumably, have not had the advantages in the use of
books enjoyed by their more fortunate comrades. No distinction
between these can be made in professional schools. If admitted
at all they are on equal terms.
ORIGINAL COMMUNICATIONS. 85
Recently I was in company with a half dozen young physicians,
all of whom were graduates of literary schools. I questioned them
as to the use they made of books while at their several medical
schools. All said that no one of their professors had mentioned
the subject of their reading, or the books they should use during
their pupilage. In answer to the question whether they used books,
they all said that they did. One said that about the only attention
he gave the lectures was to know the subject. He then read from
three to five authors on that subject. Another said he took notes
of the lectures and compared them with from one to three or four
authors. Thus I found that these young men had depended on
the lectures as their guide in study, but had done the real work
from books. Among another' group of young physicians the case
stood differently. They were not graduates of literary institutions
and therefore had not had the same training in the use of books.
Like the others they had not been questioned as to the matter of
reading. Most of them had depended entirely on the lectures ex-
cept in anatomy and one or two other subjects. They had found
the study of books hard work. Now which of these groups of young
men were best prepared for continuous advancement in medical
knowledge after entering practice, those who had made use of med-
ical books or those who had depended entirely on lectures ? There
can be but one answer to this question. Skill gained in the use of
medical books equips the man for future study and advancement
which the sole dependence upon lectures while at school can never
do.
It has happened that in these two interviews it was the college-
men who had taken to books in the study of medicine. But other
interviews have shown that while this is the most general rule, it
is by no means universal. Some men who have had but a common
school education have become the most persistent users of books
and masters in the art of effective reading. On the other hand many
who pass the literary school throw aside their books as soon as
they receive their diplomas. It is the man that wins knowledge.
But the man must adopt means to that end. What other means
equals the skillful use of books? In the medical or dental college
lectures are well enough; but what of the student in after years
who depends only upon the lectures? What skill has he attained
in the use of his professional books? What is his equipment for
continued progress ? If he has not become an efficient reader of
86 THE DENTAL REVIEW.
professional literature he is at a great disadvantage. In order that
he ma}' continue his studies he must learn a new art, that of read-
ing effectively. It is an art that is often difficult to acquire, but is
acquired easiest and most certainly under the stimulus of college
work. I hear the suggestion that any one admitted to a medical or
dental school has learned to read. Certainly they can read, all of
them. But there is reading — and reading. It is one thing to read
words, it is another thing to read thoughts effectively. It is the
thought we wish to acquire. A person may have learned to read
one class of books fairly well but will require months of effort be-
fore he can read another class of books effectively. While I should
not urge a change of the lecture system now in vogue, I insist that
dental students should be put to systematic reading while in school,
and time provided for this work. They will be better students;
but more than all else, they will be prepared to go forward with
their professional studies after they leave school to enter practice.
There is a great difference between the medical and dental pro-
fessions as to the use of books. The medical profession is older
and more mature. It has a much more extensive library for its
students to draw from. Its membership is much more habituated
to the use of books. The more successful medical men are gener-
ally found to have collected extensive libraries. We cannot say
this of the dental profession. There are individual dentists who
have large libraries; but we generally find dentists with but few
books and not given to extensive reading. Many dentists who
have long held a lucrative practice have but few books.
It may be said that the dental literature is scanty. Is it not
equal to the demand? Sometime ago a very able dentist com-
plained of the lack of books, and I said to him, •' Why don't you
write a book on operative dentistry?" "Who would buy it?" was
the rejoinder. 1 will venture to say that when there is sufficient
demand for books on any subject relating to dentistry to justify
their preparation and publication they will be placed before the
profession. The difficulty is with the demand. Dentists do not
use the books now on hand.
There is a general complaint that the books now extant in im-
portant departments are not suited to the needs of the profession.
This plea is made particularly as to operative dentistry and is
probably more nearly correct in this than in any other field. To
me this is very curious. Suppose I wished to start an office pupil
ORIGINAL COMMUNICATIONS. 87
in operative dentistry to-day, what book would I give him ? I
would have to fall back on the articles in the American System of
Dentistry, not having any book devoted exclusively to operative
dentistry that is suitable for a beginner to read. This is not the
most popular work however. Another is found recommended in
nearly all of the college announcements and I believe is found in
more offices than any other. This is Harris' Principles and Prac-
tice of Dentistry. It is a book that has descended to us from a
past age and has been patched out time and again until it reminds
one of the rubbish loft of some old family who have lived in the
same hoiise for several generations without having had a fire. The
original was a splendid work, and it bore good fruit. But oh, the
dust of the ages have gathered on its pages now. I know of no
other good book that has run such a gauntlet of revision and lived.
This could not be but for the wonderful vitality of the original work
and the reverence of the dental profession for the author.
In operative dentistry we have the poorest equipment in books,
and in this particular field there is the greatest diversity of opinion
and practice among dentists. It is probably to this that the poor
equipment in books is due. There are very few men who feel that
they could produce a book on this subject that would be acceptable
to a majority, or even a respectable minority of the members of the
profession. While this state of things exists it will be difficult to
remedy the evil. How long will this condition remain with us?
Probably imtil some one develops the genius to catch the ear of
the profession and crystallize the apparent discord in operative pro-
cedure into one, two or more definite systems that will be recog-
nized as embodying in intelligent form the best thought of the pro-
fession. In lieu of this we may have a number of books contend-
ing for favor each of which has a succinct crystallization of opera-
tive procedures along definite lines of thought. This latter is
probably the most desirable, as furnishing more incentive to effort
and will therefore beget greater progress. If professors of opera-
tive dentistry would require that their pupils read this subject as
well as listen to their lectures the deficiency in books would soon
be remedied. New books would soon be demanded by practi-
tioners as well as by pupils.
In most other departments we are better supplied with books
though more are needed in all. The newer departments of crown
and bridge work have a better representation than the older operative
88 THE DENTAL REVIEW.
dentistry. These may be in a degree immature and will need much
revision both by addition and exclusion as time matures principles
and methods. Orthodontia is also becoming well represented.
But the simplification of the procedures in this department prom-
ises to render much that has been written valueless. Still the pu-
pil will find here a great diversity of plans from which to choose
for adoption in practice.
Materia Medica is represented in several books. In this field
the rapid introduction of new remedies necessarily renders the
books imperfect in a short time. This can hardly be regarded as
a drawback. Such new remedies belong properly to the Journals
until their merits are fairly well established. A few years may suf-
fice to rule them out and they would stand in the books as so much
waste space.
The surgical procedures in accidents to the mouth and face
and the surgical diseases of these regions are better represented in
books than any other department. Pvipils and practitioners have
abundant opportunity for reading and a mastery of what is known.
This subject is not confined to dental publications. Most of the
authors of surgical treatises have entered this field of work, for
here dental surgery and general surgery overlap each other.
Strictly dental pathology is not so well represented in our
books, which indicates either a dissatisfaction, diversity of opinion,
or a lack of interest, in this department of study. Dissatisfaction
with opinions in the presence of great interest in a subject
should express itself in a multiplication of books. But this is not
always the result as is clearly seen in operative dentistry in which
lack of interest cannot be claimed.
I need not speak of other departments. All are in some way rep-
resented,some poorly, some fairly well. Every dentist can find books
to read from which he can derive much information in regard to any
field of practice, and the time spent in reading them will be well
employed. There are many old books that should be read. There are
a good many old books that ought to be reproduced in their original
form ; not as books to be followed in practice now, but books that
should be studied because of the excellence of the thought which
they contain, and because they are mirrors of the past ages of our
profession. Among these are Hunter, Carrebelli, Fox, Robinson,
Fitch, Regnard, Kocker, Deserabode, and the early editions of
Harris and Tomes, with many others. The stud}' of these old
ORIGINAL COMMUNICATIONS. 89
authors gives one a broader view of dentistry and a better idea of
what the real advance of thought has been.
Some things cannot be obtained by reading dental literature.
Dentistry is in large degree an art and requires finger skill for
its practice. This cannot be acquired from books. One may read
all of our literature and not become a dentist. The handling of
instruments is acquired by practice, and the time required in learn-
ing is much shortened by personal instruction. All operative pro-
cedures should be taught first by personal instruction — by exam-
ples which are to be imitated by the pupil until he gains some pro-
ficiency in the use of instruments. This is necessary before he
can grasp the ideas of the lecture or of the printed page. Then
he ma)^ extend his knowledge by reading and adopt in practice the
plans given in books. Personal instruction is a necessity to the
beginner. The mature pupil should depend more upon books.
Personal instruction cannot be continued. If the pupil has not
learned to use books his education will be finished when he leaves
school, or he must yet learn to use books. If he has learned to
use books his education has only fairly begun.
THE JOURNAL LITERATURE.
The medical journal literature is exceedingly rich, and the den-
tal, though not so profuse, is very full and complete. The highest
object of a journal literature is to supplement books by a presen-
tation month by month of the most recent thought. Books present
more mature thought and generally in more concise form. In
journals there is necessarily much that is of little value. Much of
it is the presentation of impressions of something that is compara-
tively new to the writer, but which he thinks worthy of being
placed upon record that his profession may judge of its value. It
may be found important. If so others are likely to take it up, im-
prove the thought by weeding out here, adding there, and finally
the more valuable ideas will find their way into books. Therefore
the journal is in advance of books, in presentation of the thought of
the profession. In books a subject is taken up and discussed as a
whole, presented in its completeness so that the student may ob-
tain the beginning and the end. The journal article is devoted to
some thought, some particular mode of procedure in operating, or
some especial pathological condition. Therefore ,the articles are
comparatively short. They are suitable for quarter or half hour
90 THE DENTAL REVIEW.
readings. It requires, -however, more professional learning to read
the journals advantageously than to read books. Authors of jour-
nal articles take it for granted that the reader is acquainted with
the literature and modes of practice, and many explanations need-
ed by the novice are wanting. Again, so much of immature
thought finds place in the journals that the reader should have ac-
quired a fair degree of judgment as to the value of what he reads.
This cannot always be regarded as an objection to the journal;
never, unless the editor is neglectful as to the character of the arti-
cles he prints. Much of the thought presented in journals is sim-
ply placed on trial, and that which my judgment, or the individual
judgment of the editor, might condemn, may prove to be valuable.
Many of the better things in literature have been condemned at
first reading by learned critics and have afterward been recognized
by the world as models of thought and expression. We should
not, therefore, condemn journals because some of the articles are
of little value. Neither should we drop the reading of a journal
because a number or two fails to interest us. The next number
may contain a single article that will be worth a dozen years' sub-
scription besides compensation for much uninteresting reading.
The journal, standing as it does in the foreground of advancement,
becomes an element in the makeup of every man who keeps pace
with professional progress. Any one who fails to read the journals
will be behind, not only in his thought, but also in his practice.
Our profession is progressive; every year marks an advance in
thought, and in the details of practice.
This advance is recorded in the journal literature and is ab-
sorbed more or less perfectly by those who read, or by each indi-
vidual in proportion to his skill in reading. Those who fail to
read are dependent upon occasional interviews with their fellows
for any advance that accrues to them. Then is it not possible for
the individual to advance by the use of his own unaided mental
acumen ? Such efforts remind me of two bright farmer boys who,
when a rainy day came, shut themselves up in the barn and made
five dollars a piece trading jack-knives. I would be the last to
deny the utility of personal effort, but efforts extended along recog-
nized lines of utility have so long given the best results that I
have not much faith in those which the experience of the world has
shown to bring disaster.
ORIGINAL COMMUNICATIONS. 91
HOW TO READ.
How to read effectively is a serious problem. Men of my ac-
quaintance, whom I know to be good readers, pursue different
plans. Some seem to consume everything, digest it all, and in
some way cast out the refuse. But the best readers I have known
are not given to reading all that comes to their hands, whether in
form of books or journals. These may be divided into selective
readers and subject readers. The selective reader takes up his
journal and notes the names of the authors of the articles. Certain
ones whom he knows to be good writers are noted — "to be read ; "
his eye falls upon a strange name. Who is that ? He turns to the
article and looks over the pages. If he knows how to find out any-
thing about the man he goes about it. If not, he quietly sits down
to read the article and will in that way form an estimate of him.
He notes the form of the title and makes up his mind what ground
the article ought to cover. Then he reads slowly and carefully,
noting the forms of the sentences, their completeness or incom-
pleteness, the clearness of expression, etc. As he goes more deepl}^
into the reading he notes the arrangement of the presentation and
how the author develops the thought, whether haphazard or in a
consecutive and natural sequence of thought upon thought. He
may stop when half through, or if the article has pleased him,
when through the reading he is apt to sketch back over it, reread-
ing a passage here and there and arranging the thought in his own
mind in the order he finds easiest for himself. Now he has prob-
ably made up his mind whether or not he will read this author
afterward and will pass his articles or note them " to be read " ac-
cordingly. The authors noted " to be read " are gone over care-
fully and the journal is placed on the shelf with perhaps one-half
or one-third of the contents read by title only. This plan of read-
ing is the highest order of purely literary reading, but is possibly
not so well adapted to professional work as some others.
The subject reader pursues a different course. He too may
look for known authors or may scan closely the stjde of expression
of thought over a new name. But he is always studying some par-
ticular subject. Not always the same subject b}^ any means, but
one particular subject at a time and while studying this subject he
reads every author he can find who has written upon it. If his
journals of the current month have no articles upon his subject the
articles are read by title and certain ones marked — " to be read "
92 THE DENTAL REVIEW.
— perhaps the title is written in an index rerum and the journal
placed in its box until a more convenient time. This man is apt
to become a very persistent reader. If the opportunity offers he
visits the libraries in search of authors to whom reference has been
made. He borrows from his neighbors. He ransacks the old
journals seeking out half forgotten articles, and gathers together
everything available on that subject. He reads certain articles
many times. He makes himself master of all that has been said by
writers, compares them and draws his own conclusions. Then he
drops that subject for the time and takes up another which he fol-
lows in the same way.
In this way some men make themselves masters of the literature
of their profession and naturally of their profession also. Such
readers are now and then found to have weak spots. Some partic-
ular departments of professional work have never claimed their
earnest attention and therefore hatve been skipped in their selection
of subjects of study. But this class of men are more prone than
others to become masters in their particular fields. This plan of
reading when not too exclusively followed is probably the best form
of professional work. It should not, however, be followed to the
exclusion of miscellaneous reading for too long a period.
Still another group may be classed as spasmodic readers.
Their interest is aroused on some subject and they read everything
they can find. When the supply has been exhausted on that particu-
lar theme their interest is lost and reading flags and dies out alto-
gether. After a varying period of repose during which the jour-
nals are neglected, even reading of the articles by title, another
spasm is brought on by some remark or incident and another sub-
ject is read. Thus it goes on year after year.
Purely miscellaneous reading, that is, reading what comes to
hand without order or method has little to recommend it. Such
reading is apt to become listless and objectless. It is prone to
drift into careless reading. In this case the reader may as well go
fishing so far as the benefit of his reading is concerned.
To be most effective reading must be pursued for a purpose.
I had nearly said that it made little difference what the purpose
might be if it produced a strong impulse, but this is hardly true. I
have heard of some professional men who seemed to read only to
find out how little authors of books or journal articles knew about
their subjects. They seemed to read only for the purpose of
ORIGINAL COMMUNICATIONS. 93
averse criticism. I must say that this purpose, though it may be
very strong, is not favorable to the development of correct thought
and the most sincere practice. I have no fault to find with sharp
criticism now and then when persons hold different views. It
stimulates inquiry. But when I find a person who seems to read
only for this purpose I often wish he hadn't read. The gratifica-
tion of literary taste is a good motive in purely literary reading, but
it should form but one element in professional reading. In this
field the utility motive should enter largely into the work. Many
effective professional writers are but homely composers when
judged from the literary standpoint. On the other hand, some ex-
cellent writers in the literary sense are not forcible writers. They
are better fitted for fields of labor in which beauty of thought and
expression becomes the useful element instead of the enforcement
of the stern facts of pathology or operative procedures. He who
reads too purely from the literary impulse or judges his authors
too closely from that standard will not do the best professional
reading.
The desire to know, and the stimulation which effective reading
brings to this desire, coupled with conscientious practice, is per-
haps the most effective impulse to professional reading. If this is
spiced with a wise literary taste that will not be shocked by an au-
thor of homely but forcible phrase, all the better. Our profession-
al study is either utilitarian or scientific and the impulse to know
should overrule literary taste now and then and perhaps always
stand in the foreground. The desire to know is the first element
and the conscientious service of our patients is the second, and
this should grow in strength as we grow in knowledge until the
two become woven into a common sentiment as the woof and
warp in the fabric that binds us as a bond of love to professional
duty.
Post-Graduate Study.*
By R. B. Tuller, D. D. S., Chicago, III.
The subject I have chosen to bring before you this evening,
Post-Graduate Study, permits of a wide range of thought, but the
province of this paper is to present to you as briefly as I can some
essential features that appear to me to be worthy of your serious
consideration.
* Read before the Chicago Dental Society.
94 THE DENTAL REVIEW.
As it is said there is nothing new under the sun, I cannot hope
to advance many ideas that are new, but shall content myself with
the fact that in turning over some old ones, you will find the subject
one that has not been so often revamped as some others in dentistry.
"Education ends only with life." Hence the most extensive
period of our pursuit of knowledge comes after school days are
over and is therefore post-graduate study.
It would seem of importance then for us as dentists to thor-
oughly comprehend the situation, and in our aim to elevate the
profession collectively and individually, to look at the facts as we
find them.
We claim for dentistry the 7-atik of profession, but it is a fact to
be regretted that we are largely made up of men who never looked
inside of a college, and that the average graduate in dentistry does
not fulfill the conditions as to liberal education that one would
expect to find in a professional man, or even a thorough and com-
petent dentist in many cases.
As the same thing applies to graduates in other professions in
this country, we are not alone in that.
We may all know why this is so and the remedy for it, but'it is
not my purpose to enter into the why and the wherefore. I be-
lieve the recognized colleges of dentistry have kept apace with the
advancement of dentistry at large and will continue to do so in
future. Everything of this character is one of the educational
problems and has to grow and develop ; it cannot spring to perfec-
tion at a bound.
I simply desire to show by the existing state of things what
need there is to stimulate post-graduate study or home study to
greater activity.
If existing methods have failed to advance students sufficiently,
a way must be opened for further advancement by some other
method, which will be adapted to such conditions as they find after
leaving school, i. e., in practice.
Home study must be prosecuted during the leisure hours which
we may have. To one in fair practice and attending to the many
other duties of life, such leisure is not abundant. Whatever time we
may have for study or reading, it is essential to know how to em-
ploy to the best advantage. One hour a day systematically em-
ployed would add much to one's store of knowledge in a year.
One must per force add something in daily practice whether
ORIGINAL COMMUNICATIONS. 95
especially sought after or not. We must do one thing or the
other, advance or retrograde. We cannot stand still. The mind
that is not developing is deteriorating. Experience is a good teacher,
but life is too short to fill our measure in that way- To be success-
ful we must keep up with the procession. To be broadly intelli-
gent we must profit by the experience of those who have gone be-
fore, and who have woven the threads of knowledge which they
found by long dilligent search and weary groping, into valuable
literary fabric that others might be benefited thereby. But we do
not want to read at random. To be sure many men follow the bent
of their own inclinations in educating themselves and improving
their minds, ultimately reaching the higher rounds of the ladder.
But that does not argue that they might not have had much more
rapid progress and greater success under a properly directed and
systematic course. We are not all alike and have not all the same
capacit}' or power of comprehension and perception. Most of us
need guidance and advice when we undertake to navigate unknown
waters or follow unfamiliar paths. W^e are otherwise likely to
drift.
The Chicago Dental Society has upon its rolls the names of
many members who rank among the leaders in the dental profes-
sion and who have well earned that distinction.
I do not presume to come before such men and advise a course
by which they may be better able to uphold the dignity of the pro-
fession; but we know that taking the profession at large, as it
stands to-day, both as regards graduates and nongraduates there is
much to be desired in the way of advancement all along the line,
and I am imbued with the idea that a regular systematic course of
post-graduate study or reading can and should be established, ar-
ranged for and open to all kinds and conditions of men now in ac-
tual and legitimate practice of dentistry, and that it would do more
eventually to elevate the profession at large than all the laws or all
the influences that have so far been brought to bear, except per-
haps, that of good dental periodicals, and we should hope to have
their valuable assistance in this work.
Dentistry being largely a development of the last half a century,
and dental colleges a sequence in the progress, and there being a
necessity for restrictive laws not onl)' enacted but enforced — not
yet fully comprehended it seems : it is not surprising to find our
profession largely made up of practitioners without diplomas. I
96 THE DENTAL REVIEW.
think some may be surprised to know that out of about eighteen or
twenty thousand dentists now in practice in the United States,
less than one-third are graduates. The data for this statement
comes from rehable gentlemen in the profession who have taken
pains to get at the truth.
If what an eminent member of our profession, an M. D., D. D.
S., in correspondence with me, says is true, a diploma does not al-
ways indicate the better man or dentist. I will quote from his let-
ter: "The average student is after a diploma and nothing more.
When he has acquired it he at once proceeds diligently to forget
all that he learned, rather than to acquire any new knowledge.
He don't want scholarship, he merely wishes the name ol it."
I believe that is true of many. The hustle after the nimble
dollar absorbs all other ideas. To a greater or lesser extent it cuts
a figure in the affairs of all men.
But many men become indifferent to advancement because cir-
cumstances have cut them off from environments that are condu-
cive to the ever onward and upward. We in large cities where
it is easy to convene from time to time for mutual improvement
are more fortunate. In such intercourse there is that healthy com-
petition of active minds that stimulates all to greater exertion and
higher aims. The value of such personal contact cannot be over-
estimated.
Let me quote a little from Henry Drummond's "Natural Law:"
"The development of any organism in any direction is depend-
ent on its environments. A living cell cut off from air will die.
A seed germ apart from moisture and an appropriate temperature
will make the ground its grave for centuries. Human nature, like-
wise, is subject to similar conditions. It can only develop in
presence of its environments. No matter what its possibilities
may be, no matter what seed of thought and virtue, what germs of
genius or of art lie latent in its breast, until the appropriate envi-
ronment presents itself the correspondence is denied and develop-
ment discouraged, the most splendid possbilities of life remain un-
realized, and thought and virtue, genius and art are dead."
The " Chautauqua idea" which I believe originated the plan
of systematic home study is not new in connection with dentistry.
Dr. W. C. Barrett, of Buffalo, N. Y., urged a movement of this
kind as long ago as 1H84 and shortly after made a very urgent plea
for it before a dental convention at Springfield, Mass. In the
ORIGINAL COMMUiVICATIONS. 97
June number of the Independent Practitioner for 1886 he said: " Is
it not practicable to establish a grade of study to be pursued at
home, to mark out a systematic course to be studied under compe-
tent instructors, the tuition to be obtained b}' correspondence or
by the publication of lectures on definite themes somewhat after the
manner of the Chautauqua literary course, but modified to suit the
exigencies demanded."
There are difficulties in the way no doubt. There are difficul-
ties in the way of almost any undertaking. If the idea is good that
should not deter us. Under proper auspices, seems to me such a
course ought to become popular with every dentist in the profes-
sion. It should have the gooJ-will and cooperation of colleges and
college graduates, for in no way would it conflict with their work,
and in no sense could it be construed as a substitute for college
training.
There can be no injustice to graduates that I can see in opening
our course to nongraduates. Many nongraduates are in every way
worthy men and many of them practiced dentistry before a good
many of the colleges came into existence, and when we think of
their large number let us draw no line except to extend no benefits
to any not now in the profession.
Now, in establishing a post-graduate course of study, some new
degree, or something to signify reward of merit must be adopted.
It must not be a cheap distinction, but must represent real culture
and attainment which may be acquired by faithful study of the
course.
I have corresponded with quite a number of prominent men in
the profession and so far have not found one who does not speak
favorably of such a movement if it can be properly directed.
One writes me at considerable length and I will read a portion
of what he says. It perfectly accords with my own views and is so
much better expressed than I could do. He says:
" In the first place I should expect but a limited number to begin
with this course. We have too few real students to get many earnest
men. But 1 would have a convention of some kind, the most ex-
perienced educators in dentistry being in attendance, and after due
deliberation a schedule of real study extending over some years —
three at least — adopted, and text books recommended. I would
have a competent corps of teachers appointed, under whose advice
and instruction every student should study.
98 THE DENTAL REVIEW.
Of course this must be done by correspondence. * * *
Every year there should be a finishing course of lectures deliv-
ered upon definite subjects within the studies of the year, and a
careful examination held by the teachers, or better still, by a corn-
competent board, if such an one could be organized.
Let the examinations be rigid and exhaustive and incompetent
men be mercilessly plucked. Then there would be some credit in
passing the examinations, and the thing would not be a farce.
This annual meeting could take the place of a dental society
meeting. It might last a week or more. The very best men in the
several departments, the most experienced teachers could be en-
gaged. They could get some fees, for it is idle to believe that the
best men could be expected to give their time free. Fees could be
charged for passing and finishing.
If some plan like this could be rigidly enforced and the exami-
nations made something more than a mere farce, the annual meet-
ing would become one of the greatest events of the year. It would
be a gathering of the scholars of the profession, and very soon all
the scholars would be found there. The lectures and demonstra-
tions (not clinics) by the very best men outside or inside the pro-
fession would attract the attention of all and would insure, the re-
gard of the scientific world.
In time such an organization, if conservatively managed, would
occupy a position in dentistry analagous to that which the Royal
Society of England, and the Academy Francaise of France hold,
and membership would be an appreciated honor. But this could
only be accomplished by a very exclusive course. Anything which
should be done simply for the purpose of securing popularity
would be ruinous to the final end."
This seems to point out how a post-graduate degree might be
adopted and made one of high merit.
In my own way of thinking the course should embrace every-
thing from the fundamentals of dentistry up to anything that might
be demanded at the top to make men broadly intelligent outside of
dentistry, and should be divided into series or classes, with certifi-
cates granted at the completion of each series. Those who needed
to go through the entire course could do so, but graduates in den-
tistry and those further advanced might begin according to their
advancement.
I wish, gentlemen, this subject might have been presented to
ORIGINAL COMMUNICATIONS. 99
you by some one better fitted for it than I am, for I am one of those
who most thoroughly feel the need of post-graduate stud}' and
do not pretend to be a leader in such a movement. While it has
interested me greatly and I shall do what I can in my humble way.
to further the cause, I am seeking for some one who is well quali-
fied to step forward as its champion. With so much need of it and
so much to commend it I hope to see a post-graduate course estab-
lished. But a handful of somewhat obscure men cannot, I fear,
accomplish it. It must have the cooperation and indorsement of
the best men in the profession and the course of study must of
course be directed by the most competent men.
The Post-Graduate Dental Association of the United States was
organized with this movement as one of its aims and objects.
They are so unfortunate, as many of you know as to have your
humble servant as the present President. About the only quality
I pretend to possess concerning this matter is persistence in trying
to bring this movement to the front, and I am thus open to \'our
criticisms, and I shall feel that something has been gained if I can
get any suggestions or new ideas that will help along the cause.
Abscess of the Antrum, with Cases and Treatment.
By I. P. Wilson, D. D. S., Burlington, Iowa.
The subject of this paper has not, until within a few 3'ears, re-
ceived the careful attention of pathologists that its importance de-
serves, and, even now, some of our ablest writers on the subject
make out tneir diagnosis without ever taking into consideration
the most common cause of antrum disease, viz., diseased teeth.
The idea that diseases of the maxillary sinus have their origin
almost exclusively from abnormal conditions of the nasal fossae,
has for many years been exploded.
The New York Medical Journal of Nov. 7th, contains an elabor-
ate paper by F. H. Bosworth, M. D., of New York, entitled
^^ Various Forms of Disease of the Ethmoid Cells.''''
This paper was read before the Arnerican Laryngological Associ-
ation at its thirteenth annual Congress.
The writer reports a large number of cases of disease of the
ethmoid cells, eleven of which were complicated with disease of
the antrum. The paper is one of great interest, but there is room
100 THE DENTAL REVIEIV.
to doubt the correctness of the writer's diagnosis in several of the
cases reported.
If the author is in error as to the cause of the diseased condi-
tions reported, the fallacy of his reasoning is obvious.
The writer does not make a single allusion to diseased teeth as
being even a possible cause of antrum disease, but attributes all
to "mechanical obstruction."
After reporting a number of cases of disease of the ethmoid
cells complicated with antrum trouble, he endeavors to explain at
length the cause of these pathological conditions, and then con-
cludes by saying: "I take it, then, that the origin of both the
antrum and the ethmoid disease lies in the mechanical obstruction
which is caused by the presence of nasal polypi, and that these
growths are the cause, therefore, and not the result of the ethmoid
disease."
That disease of the sinus and the cells above referred to are usu-
ally the cause of mechanical obstruction is indeed very questionable.
Let us briefly examine this large air chamber, and consider
some of the perils to which it is exposed.
The apices of the roots of the first and second molars are sepa-
rated from the antrum by an exceedingly thin plate of bone, and
not unfrequently some of the roots of these teeth project into the
sinus with nothing but soft tissue covering the apices.
If the pulp of one or both of these teeth should become diseased
and die, and as a result an abscess should form at the end of one
or more of these roots, the only way of escape for the pus is into
the antrum and out through the nose. The normal mucous secre-
tions become contaminated with the pus, a large accumulation of
purulent matter soon forms, and in some instances the thicker por-
tions of it become stored away in the little " pockets " or recesses
of the antrum to breed disease of the mucous membrane of that
cavity and to the parts intimately associated with it. Not only do
the roots that penetrate the antrum very frequently cause this
trouble, but all roots that are separated from the antrum by only
thin plates of bone are liable to produce the same results.
When an abscess is formed at the root of a tooth an outlet is
gained at the weakest point. If the thin plate of bone between the
apex and the sinus is weaker than the alveolar process, the accu
mulation of pus will burst through into that cavity rather than
form a fistulous opening through the gum. The inflammatory con-
ORIGINAL COMMUNICATIONS. 101
dition will now subside to a great extent, but a dangerous nuisance
has been created, which assumes at once a chronic form, and un-
less the cause is removed, not only the antrum, but the ethmoid
and even the sphenoid cells and the frontal sinuses are sometimes
involved, not so much, perhaps, from continuity of the parts as from
actual contact of the virulent discharge being continually thrown
upon the delicate mucous membrane of those neighboring parts.
It should be remembered that while the body is in a recumbent
position almost if not all the air cells or cavities above named
may be visited by poisonous discharges from the antrum.
The pulp canals of an offensive tooth of this kind are filled
with putrescent matter that empty their foul contents and gases
unceasingly into the antrum. The septic matter then passes tar-
dily on to its only way of escape through the nose. Nature cannot
take the case in hand and cure such a diseased tooth. The antrum
may be opened and thoroughly irrigated and the condition thereby
greatly improved, yet a complete cure cannot be expected until the
diseased tooth is either extracted, or its canals opened, medically
treated and properly filled, and thereby remove the cause of the
malady.
A few cases in practice will illustrate more fully the points I
wish to make in this paper.
Case 1. — Mrs C, forty-five years of age, wife of a clergyman:
had suffered for eight or ten years with a heavy duU pain in her
right cheek — between her eyes and in the frontal sinuses. She
had been treated much of the time for nasal catarrh with only tem-
porary improvement. Her breath was insufferably offensive; she
did not relish food, and her health had become greatly impaired.
The physician who was at this time attending her requested me
to make a careful examination of her teeth. On doing so I found
the second upper molar on the right side badly decayed, with pulp
dead, and the cavity of decay clogged. There being no fistulous
opening upon the gum, I concluded that the hidden discharge was
taking place into the antrum.
On more careful inquiry I learned that just preceding the ca-
tarrhal difficulty some eight or ten years before, she had suffered
intensely from toothache, accompanied by atalgia, which subsided
in a few days, after which the tooth became sore, the jaw com-
menced swelling, a chill and fever followed and for several days
the lady was confined to her room.
102 THE DENTAL REVIEW.
At length her right nostril commenced dischargingcorrupt mat-
ter, after which the acute pain and the swelling of the face sub-
sided, and the chronic form followed as described above. I had
no hesitation in diagnosing the case as abscess of the antrum in-
volving to a considerable extent the entire nasal fossa?. I at once
extracted the offending tooth and found that the socket of the pal-
atine root opened directly into the antrum.
On injecting warm water into the sinus through this opening, a
a large quantity of purulent matter came gushing from the right
nostril. This was repeated several times until the water came
away clear. The socket was then plugged until the following day,
to keep it from closing, the patient being directed to lie on her left
side much of the time at night, so that gravitation would aid in
draining the fluids from the antrum. The day following the antrum
was carefully explored and cleansed with an antiseptic irrigation,
and two da\s later the same treatment was repeated.
The lady then returned to her home in a neighboring town,
where the same treatment was continued for a few weeks by her
family physician, when the disease entirely subsided.
In a few months she and her husband visited my ofifice for the
purpose of reporting a complete cure, and to express their grati-
tude for the treatment received. She informed me that the dis-
tressing feeling under the "bridge of the nose," and the discharge
from the posterior nares were loth to give way. And I may here
state, that in most of the cases I have treated, that the effect of
abscess of the antrum in neighboring parts, especially in cases of
long standing, yield to treatment more tardily than the abscess of
the sinus that caused it. This is doubtless because of the inacces-
sibility of the ethmoid region, making thorough irrigation and
medication difficult to accomplish.
In this connection let me again quote from Dr. Bosworth's
paper.
After relating a number of aggravated cases of ethmoid and
antrum complications, a few of which he reports as cured, while
the others had either not returned or were still under
treatment, he concluded as follows : "And although in these cases
the ethmoid affection was suspected, the diagnosis was only ren-
dered certain by the fact that the pus discharge persisted after the
antral disorder was brought under control."
A number of cases in my practice might be given here to illus-
ORIGINAL COMMUNICATIONS. 103
trate the fact that Dr. B.'s diagnosis was by no mQ.2.x\?,'' rendered
certain " because of the conditions he relates.
The case just reported and the one I will now relate will illus-
trate this point.
Case /I. — Mrs. Y., aged fifty-two, had suffered for many years
from nasal catarrh, with dull heavy pain in the cheek, mattering of
the eyes; and a distressing feeling in the ethmoid region.
She could not recall the time when this trouble commenced, but
the purulent discharge from her nostrils had been of long standing)
and year after year grew worse, with continually failing health.
She was keenly sensitive about her condition, knowing that her
breath was exceedingly offensive and must be annoying to her
family.
Believing from the history of the case that the origin of the
malady was from diseased teeth, the roots of a pulpless molar and
bicuspid were extracted, and the antrum perforated through the
alveolus of the extracted molar.
Warm water was then injected into the antrum, but, at first, only
a very slight discharge came from the nose. Enough escaped,
however, to indicate the purulent condition of the sinus.
At another sitting warm water was forced into the antrum until
a large cheesy looking plug passed into the nose, filling one nostril
so full that it required considerable effort to remove it. After re-
moving this obstruction a large quantit}' of offensive matter was
discharged from both nostrils. By making a bellows of her cheeks,
air was then forced through the perforation into the antrum and
out through the nose, producing a whistling sound.
The feeling of pressure so long experienced at that point was
now relieved, and irrigation of the antrum was easily performed.
The osteum between the sinus and the nasal fossa was greatly
enlarged from loss of tissue at that point, and the plug above re-
ferred to was doubtless lodged there.
The septum of the nose was perforated, and the following indi-
cations led me to believe that the iethmoid bone had lost consider-
able of its cavernous structure. As evidences of this her voice
had not the usual resonant sound, and the sense of smell was al-
most entirely gone, and, besides this, the air she inhaled and exhaled
through the nose seemed to pass freely through an open canal, in-
tead of a passage filled with convoluted walls, like the normal nasal
fossae.
104 THE DEXTAL REVIEW.
After the first treatment a piece of wrapping cotton, such as
grocerymen use, was doubled four times and twisted tightly to-
gether, making quite a heavy cord. One inch of this cord was
cut off and tied with waxed dental floss and then sterilized, after
which one end of it was dipped into a solution of carbolic acid and
then introduced into the antrum through the opening that had been
made, while the other end was left engaged in the socket of the
root that had been extracted. The dental floss that had been tied
around this short piece of cord was then fastened to a neighbor-
ing tooth. This, of course, was removed at every treatment, and a
fresh piece introduced in its place.
This appliance answered the desirable purpose of keeping the
antrum open, and at the same time leaving a suspicion of carbolic
acid in the cavity under treatment.
A cleansing antiseptic wash was used from two to four times a
week for nearlj' two months, when the abnormal discharge from
the antrum subsided, while the condition of the nasal passages
was greatly improved.
The usual methods of washing out the nasal fossae were resort-
ed to by the lady herself, and in a few months the entire difficulty
subsided, leaving only the results of lost tissue spoken of above.
I have treated several other cases similar in character to the
one just related, that might be reported here, but to do so would
be an unnecessary repetition.
It is sufficient to say that in each of those cases the ethmoid
and antrum disease was traced directly to diseased teeth, and in
each case the ethmoid difficulty was last to give way, though not
the seat of the disease.
The writer above referred to, in speaking of the swollen condi-
tion of the middle turbinated body in the cases he reports, says,
"That the diseased condition of the mucous membrane covering
the middle turbinated body in these cases is to be regarded as a
symptom of ethmoid disease rather than as constituting an inde-
pendent marked lesion."
It should be remembered that the middle turbinated body is a
part of, and belongs to, the ethmoid bone. So if that body is dis-
eased we may well suspect that other parts of the bone are in-
volved also.
That "an independent morbid lesion" is rarely found here I
believe to be true, but instead of looking into the hidden cells of
ORIGINAL COMMUNICATIONS. 105
the ethmoid for the lesion, I should rather expect antrum disease
from dental lesion to be the cause.
When an acrid flow from the antrum is for years thrown upon
the mucous membrane of the nose at that point, it is not strange,
that we should find in such cases a morbid condition of the mem-
brane covering this body, as well as a degenerate condition of both
the soft and hard tissues which surround the opening from the an-
trum into the nose.
Nasal polypus usually commences here, and so far as I have
been able to determine the osteum has in these cases become
greatly enlarged from destruction of the mucous membrane and the
fragile bones immediately surrounding the opening.
The carious, or it may be the necrosed condition of this frail
structure, is a sufficient cause of irritation to produce morbid
growths at that point which are liable to close up the only outlet
from the sinus, making it a closed cavity, with the most serious
consequences in store for the unfortunate sufferer.
Some years ago one of my patients said to me, " I used to be
able to whistle through my nose." On asking for an explanation
she said, " I had an upper molar tooth extracted and for weeks
after the operation I could extend my cheeks with air and produce
a whistling sound through my nose."
On further inquiry I learned that at the age of thirteen or four-
teen years she had a severe attack with toothache in a first upper
molar, after which her face became greatly swollen and a physician
was called. She was told that she had erysipelas (?) After a few
days' treatment she got better, but a purulent discharge from one
nostril followed. This, she was told, was the result of a gathering
in the head — the sequel of the disease.
She was soon well again except the frequent discharge from her
nose, which grew more offensive as the years passed by. At length
her health began to fail, and she was believed to be going into a
decline. The symptoms she gave me were similar to those I have
described in the cases above reported. The tooth had by this time
almost all decayed away, and she had repeatedly expressed a
desire to have it extracted, but her physician forbade the operation
because of her ill health, telling her she must wait until she be-
came stronger.
A few years later, however, she went to a dentist and had the
106 THE DEXTAL REVIEW.
roots extracted, and immediately afterward she was able to pro-
duce the whistling sound through her nose above referred to.
M\' readers have already diagnosed the case as abscess of the
antrum, and I need scarcely add that the swollen face was but the
forming of the abscess which opened into the antrum, and then
little by little the sluggish discharge passed on to the nasal outlet.
In less than a year after the tooth was extracted the nasal catarrh
entirely subsided without any treatment whatever. After the cause
was removed, nature performed the cure.
In such cases it is safe to say that the chances of a cure, espe-
cially in cases not too far advanced, are greater when the cause is
removed, and then left to nature without treatment, than the most
persistent care in cases where the lesion has not been discovered
and consequently not removed.
Of course frequent cleansing of diseased parts will greatly
modify the disease, but cannot entirely restore to health with the
aggravation still existing that produces the abnormal condition.
In conclusion then I would say that a correct diagnosis is of
first importance. We should seek well the cause of the pathologi-
cal condition to be treated, and then hasten to remove it, and more
than half of our work has been accomplished. Our success has
well nigh been secured. We have only to aid nature in her benign
work, and suffering humanity will often bestow laurels upon us,
that largely belong to her.
PROCEEDINGS OF SOCIETIES.
Dinner to the Executive Committee of the World's Colum-
bian Dental Congress* by the Five United Dental
Societies of Chicago. —The Speeches.
January 12, 1892, the Five United Dental Societies of this city
gave a dinner at Kinsley's to the Executive Committee of the
World's Columbian Dental Congress. There was a large attend-
ance. The members and guests began to arrive at fk.'iO P. M.,
first going through the usual preliminaries of handshaking, the ex-
changing of ideas, the making of new, and renewing old, acquaint-
* At the recent meeting of the Committee the word "Congress" was substi-
tuted for "Meeting," hence that term is used throughout these speeches. —Ed. ]
PROCEEDINGS OF SOCIETIES. 107
ances. Shortly thereafter they filed into the dining room and
wrestled with the very attractive and palatable articles that were
on the vienu. Each course was followed by a musical selection,
rendered by one of our city mandolin orchestras. The tables were
artistically, though not profusely, nor elaborately decorated. It
was a truly representative dental gathering, characterized by good
fellowship, unit}' and harmony. Around the festive board sat edi-
tors, authors and professors, some of the brightest intellectual stars
that adorn the dental profession. That the members of the Exec-
utive Committee have been, and will continue to be, tireless in their
efforts to make the forthcoming Columbian Dental Congress a grand
success both scientifically and socially, the speeches herewith given
in cxtenso amply testify.
Shortly after 9 o'clock, when the members and guests were
about to light their fragrant cigars, the Toastmaster, Dr. W. A.
Stevens, of Chicago, rapped for order, and delivered the following
brief Address of Welcome.
Gentlemen: I am delegated, as you will see by the programme,
to extend a welcome to our guests by the Five United Dental So-
cieties of the City of Chicago. It would be well if I knew
more, that I might give to each and every one that cordial
welcome which our city extends to the Exective Committee of the
World's Fair arrangements for the great dental congress in 1893.
We hope that America herself will extend to the whole world that
same cordial reception which we extend to the Executive Commit-
tee. Again, gentlemen, I extend to you a hearty welcome. (Ap-
plause.)
I have the pleasure of introducing as the first speaker of the
evening Dr. J. Taft, of Cincinnati, who will respond to the toast,
"The Success of the World's Columbian Dental Congress Largely
Depends Upon the Attitude of the Dental Press.
I have an arrow that will find its mark,
A mastiff that will bite without a \i2.xV.— Emerson.
Dr. Taft was received with applause. He said:
Gentlemen pf the Five United Dental Societies oj C/iicago. — I can
occupy your time but a few moments as I must leave very shortly.
I had hoped that the order on the programme might be observed,
and that I would slip out without being called upon, or would not
be here when called.
108 THE DEXTAL REVIEW.
Whenever any great enterprise is undertaken and carried for-
ward in the world, the means by which it is accomplished is always
a matter of interest, and the great enterprise that is being inaugu-
rated and that will be carried forward in this city is not an excep-
tion in this respect. The part that our profession will take in this
great exposition, the Congress it shall hold, will be accomplished
through means of various kinds. It ought to draw, and I think
will draw, out the interest and cooperation of the whole profession
— at least, those who are interested in it. And it will behoove us
if the work is accomplished as it ought to be, such as shall truly and
fully represent this young and growing profession, to endeavor to
have the effort and the interest of every member of the profession
in some way or other. From communications that I have had with
the profession during the last few months, there is great ground
for encouragement in the cooperation which will be afforded this
enterprise. It has been my privilege to have direct communica-
tion with about three hundred prominent members throughout all
the States and Territories of this Union, with two or three excep-
tions. Enthusiasm is everywhere manifested, and if we may judge
from the interest shown, from the promises made, and really from
the efforts that are being put forth by some, we may rightly antic-
ipate great results. I speak of this as encouraging. It shows us
that there will be cooperation in the profession throughout the
country.
Of the means and agencies that will help on this work in the
great forthcoming exposition, the work which will be accomplished,
perhaps there is no one instrumentality, no one agency that will
be more subservient and that will be productive of more and bet-
ter results than the press. The press has come to be in the world
of progress a mighty influence which no man can estimate. It
reaches everywhere, from the highest to the lowest. There is no
occupation of life scarcely in which the power of the press is not
cooperative, in which its influence is not called forth for support
and for promotion in carrying on great enterprises. Indeed, many
of the enterprises of the world are made or destroyed by the power
of the press.
Now, in the work which the dental profession is aiming to do
in connection with this great enterprise the press will be an active
aid. The general press will accomplish as much perhaps for this
branch of the work as for any other; but then, I suppose, in the as-
PROCEEDINGS OF SOCIETIES. 109
signment of this topic, "The Dental Press," the periodical litera-
ture of our profession was the matter or agency in the minds of
the committee when they selected me to respond to this toast. I
can only say, that I am sure the dental press will cooperate in this
respect to its utmost ability. (Applause). I think I can speak
for my brethren of the press, that there will be hearty cooperation
b}' the thirty or forty dental journals in this country, and perhaps
in other countries as well, for carrying on this work and making it
what we hope it will be, the greatest convocation of dentists that
the world has ever seen — one the like of which will not again be
seen in the day of any of those present to-night. (Loud applause).
There will not likely, in our day, arise an occasion again for an exhi-
bition of the profession such as we have now in contemplation. It
behooves us, therefore, to improve all the opportunities, to draw
together and utilize and make subservient all the forces in the pro-
fession for the accomplishment of this end in the highest degree.
The dental press will serve this purpose to its utmost. It has not
accomplished much as yet; the time had hardly arrived for a spe-
cial agitation of the subject. But the time has now arrived when
the organization is more complete than heretofore, when it is prop-
er to make an announcement to the profession and when it should
know all that is going on.
The executive committee, it appears, has been laboring for the
last 3'ear or more to bring the organization for this work into an
operating condition, a condition where it will, upon presentation to
the profession, command their attention, their interest and cooper-
ation, and I am happy to say on behalf of my confreres, that all of
us who have been working in arranging for this matter, that it is
brought to that state of organization now when it would seem to
be eminently proper and desirable that the present status of the
work should go to all of the men of our profession. I am sure that
what has been accomplished in this respect will meet with the
hearty approval and support of the entire profession.
The harmony that has prevailed in the executive committee at
all of its meetings, from the beginning to the present, has been re-
markable indeed. It would be impossible for any number of men
that could be brought together and upon any subject to harmonize
better than they have done in the making up of this organization.
It is high time that this should be made known throughout the
length and breadth of the land ; and every dentist who has an in-
110 THE DENTAL REVIEW.
terest in his profession, every one who seeks its promotion and who
would have it stand forth to the world in 1893 for what it is worth,
should have an interest in the work. So it becomes eminently
proper that the press should be used to its full power for disseminat-
ing knowledge in reference to this matter and stimulating an interest
in it for bringing about and securing the cooperation of all members
of the profession. Gentlemen, we ask your cooperation ; we ask
your support in all this work, and let us make it one of the grand-
est and greatest occasions that the world has ever witnessed for
the progress and upbuilding of dental science and art. (Loud and
prolonged applause.)
The Toastmaster: I have the honor to present to you as the
next speaker a gentleman from New York City, Dr. W. W. Walker,
Chairman of the Executive Committee. The toast is "The Devel-
opment of Ideas for the World's Columbian Dental Congress of
1893."
The general himself ought to be such an one who can see both
forward and back. — Plutarch.
Dr. Walker, on rising to speak, was received with applause,
and, when quiet was restored, spoke as follows:
Mr. Toastmaster and Gentlemeji of the Five United Dental Socie-
ties of Chicago: When one of your committee-men. Dr. Pruyn,
welcomed us at the hotel Monday morning he handed me a little
slip of paper, and said it was simply an invitation to respond to a
toast, and I told him at the time in a little haste, as I was detained
some hour and a half, that I would only be to happy to do so. Now,
that the time has arrived for me to take my part in the banquet, I
scarcely know what to say or where to commence. It has been
perhaps one of few opportunities thus far afforded the Chairman of
the Committee to start in on the programme of making speeches,
which we may have to make as regards the World's Columbian
Dental Congress You must remember that this World's Colum-
bian Dental Congress of ours is still in its infancy. As our illus-
trious friends, Professors Black and Sudduth, might say, " it is in
an embryonic state," but nevertheless it would be wrong for us as
a committee to say what we expect to do. It would be wrong for
us to prophecy what we expect to do; but we might give you an
idea of what we would like to accomplish. In the first place, the
most important factor that we have to contend with — and I say it
honestly and frankly— is harmony. Unless we can have harmony
PROCEEDINGS OF SOCIETIES. Ill
in our midst we cannot make a success of the Congress. (Applause).
In dental institutions and in dental societies, in whatever rank of
dentistry we are, we must try and harmonize the members, so that
they will work in unison for this great cause. If there has been
at any time in any of our dental associations dissension of any
kind, now is the time to eradicate it and put our shoulders to the
wheel and work nobly and honestly, not for any one individual, but
for the benefit and welfare of the dental profession and the World's
Columbian Dental Congress. (Applause.)
The Executive Committee have been working with diligence
and zeal in appointing several committees, and I am happy to in-
form you that we have nearly completed the appointments of the
different committees throughout the United States and Europe, or,
we might say, throughout the entire world. We have been careful
in appointing committees that would work well and work in har-
mony together. 1 know that those who have been appointed on
such committees will appreciate that when they receive the official
communication from the Secretary. If all this be accomplished, if
harmony exists throughout the United States, we will all meet here
on the I'Zth of August, 1893, and it will be our pleasure to repre-
sent not only to the world at large, but to our dental friends and
brethren throughout the world, that we are an independent profes-
sion. This meeting will be independent and purely dental, and
we will demonstrate from a practical and theoretical standpoint
that we stand preeminently alone, as a dental profession.
I want to say one word to the younger members of the dental
profession of this city. I want to ask them if they have ever
thought for a moment of the inheritance that has been left them by
the older members of our profession, those members who have
grown old and gray, and that have burned the midnight oil in their
endeavors to assist the younger members of the profession. Many
of our oldest members that have passed away, as for instance. Dr.
Atkinson, and I could mention others, have worked with diligence
and zeal to place dentistry where it belongs. It rests -with the
5'ounger members of the profession not only to keep the standard
aloft where it proudly stands, but to elevate it still higher, so that
when this dental congress has become a thing of the past, those
that have been connected with it can only say that the committees
appointed have done their work nobly, and go home with the stamp
112 THE DENTAL REVIEW.
of success upon their brow. It depends vastly upon the gentlemen
here to accomplish this act.
There is one thing I want to say, that I have been waiting for
an opportunity to say for many months, or, I might say, years, and
that is, I appreciate the friendship that has existed between my
Chicago friends and myself, and I hope nothing will ever occur to
mar it. I hope it will become stronger from year to year. I thank
you, Mr. Chairman and gentlemen for your attention. (Applause.)
The To.astmaster: We will now listen to our esteemed friend
from the east, Dr. L. D. Shepard, of Boston, the toast being " 'Tis
Money Makes the Mare Go."
"He that wants money, means and content, is without three
good friends." — Plutarch.
Dr. Shefard arose amid much applause. He said:
Air. Chairman and Gentlemen of the Five Dental Societies of Chi-
cago: I consider it an especial honor that I am one of the few
selected to speak this evening, and I think your committee has
shown great wisdom also in placing*my name among the early ones
of the speakers, for they must have known what is generally known
that, when such eloquent men are on the list as are on the list to-
night, I have one virtue which has been told us is the "soul of wit,"
and that is brevity. I cannot understand why I have been selected
to respond to this toast. It would certainly be most fortunate for
me — and I should esteem it a great privilege — if I could claim to
represent the class which has money, means and content. You
doubtless remember the story of the clergyman who borrowed a
ten dollar bill every Saturday night from a parishioner and returned
it every Monday morning, saying he could preach better when
he had money in his pocket. That is undoubtedly true. Our poet
who is on the programme is nameless in regard to that, as we know
that so distinguished a man as the late Wm. Shakespeare tells us,
that if one has not these three things, viz: money in the pocket,
meaning ready cash to meet any call upon him at the moment;
means, which here implies invested property from which he can
draw ready cash if he needs it, and content, he is wanting in three
good friends.
My familiarity with the younger members of the profession in
my own section of the country — and I trust it is the same here and
elsewhere over the country — is that the younger men differ largely
PROCEEDINGS OF SOCIETIES. 113
from the older practitioners who have passed away or are passing
away, in that they are thrifty, provident men, and good business
men. They generally have some money in their pocket. In my
own section they have generally bought the houses where their
offices are located, and consequently have means and are good citi-
zens because they are land owners; and thanks to the dental col-
leges, thanks to the dental societies, thanks to the spirit of enter-
prise and improvement which has prevailed during the last thirty
years. They are generally contented men, because they feel that
they are doing in the community a work that is valuable to it, and
they are doing it well. I suppose though, as a matter of fact, that
I am assigned to this subject because (through the mistaken idea
of my confreres or some other cause) I have been placed as Chair-
man of the Finance Sub-Committee of the Executive Committee.
Now, gentlemen, it is a pleasure for me to state to you that be-
fore a year has passed you will all hear from me, either personally
or through some representative connected with the committee. I
suppose I was placed in this position because my friends recognize
that I possess, as an ancient philosopher by the name of Plato has
perhaps exemplified more fully and beautifully, three cardinal prin-
ciples of faith or character — a combination of optimism, egotism
and fatalism. Gentlemen, I admit that if that was one of the rea-
sons why you selected me, I will plead guilty to the charge. The
optimist, in looking over the face of nature, in looking at all the
currents and countercurrents which are passing through the sur-
face of things, recognizes that everything is for the best. The
egotist, with sublime confidence in himself and with appreciation
of his capacities, knows that he is the best ; and the fatalist, with
a confidence in things to come as well as things present, knows that
everything will come about as it should whatever he does or what-
ever he says. With these combinations in a man he certainly is
apt to make a good beggar, and this is a compliment undoubtedly
to those qualities which my friends recognize as belonging to me.
I shall do all in my power to support and carry out the work you
have assigned me. The press will do all it can to urge the work
forward and support it, but unless the sinews of war are furnished,
we shall fall short in accomplishing the object we have in view.
Gentlemen, for twenty-nine years I have given one-twelfth of
my productive energies to dental progress. As a professor for
many years in a college, as one who has attended dental meetings
lU THE DEXTAL REVIEIV.
frequently and in other capacities, I have contributed my mite
toward the work of professional progress, and I have this to say, I
feel that every man who has done the same thing can testify to the
same truth, that the man who works for others, the man who works
without seeing a return come back to him directly is the man who
is a great gainer in the work of life. We may hoard money, but it
will pass away from us. No man can take from us the growth,
both intellectual and spiritual, which comes from labor in which no
return is seen and in which the motives which possess one must be
of a higher order than those of a pecuniary nature. (Applause.)
Dr. J. Y. Cr.^wford, of Nashville, Tenn., responded to the
toast, "The Congress of '93 as an Educator."
The man who seeks one thing in life, and but one,
May hope to achieve it before life be done ;
But he who seeks all things, wherever he goes,
Only reaps from the ho.pes which around him he sows
A harvest of barren regrets — Lytloii.
Dr. Crawford was heartily received. He said :
Mr. Chairtnan and Gentlemen of the Five United Dental Societies
of the City of Chicago : I must be excused for saying that I am pecu-
liarly embarassed on the present occasion in being called upon to
respond to the question of education so far as its influence may be
e.xerted by the great Congress in '9:3. Recognizing the fact as I do,
that I am in the presence of men who teach in the universities of
this great country, I can but be pardoned for being embarassed when
I think of the importance of the question to which I am to respond.
When I think of the particular influence it plays in the mainte-
nance of our free institutions in this country, there is awakened in
me an enthusiasm and a degree of moral courage that amounts to,
in my own individual realization, a work of supernatural character.
Education, from whatever standpoint you may view the question,
should be and is sacred, though given to the American character.
(Hear, hear.) Take the question and follow it out from the
present back to the first recorded instance connected with human-
ity— wherever you find education fostered by a people you find
that, comparatively speaking, they prosper. Wherever you find a
nation of people disregarding the influences of education, you find
them retrograding intellectuall}', morally and physically. (Ap-
plause.) The question of human longevity depends largely upon a
proper understanding of the great question of education. It is for
PROCEEDINGS OF SOCIETIES. 115
US to know in casting 'round and observing the events of human
life and human history, that within the last fifty years human life
has been greatly prolonged, and by the influence of education in
all departments, but more particularly, let me say from a dental
standpoint, in my humble judgment dental education has done as
much, and perhaps more, to increase the average length of human
life than any other one question pertaining to education. What
does it mean ? Education means to learn how to live in accordance
with nature's laws, so that from the crown of a man's head to the
sole of his feet there will be unity of action, not only physically,
but psychologically and morally; because, let it be known that one
of the men who believed and adhered to the original doctrine an-
nounced centuries ago (the man who drank hemlock as the result),
made the announcement that man was immortal, and that by virtue
of his immortality his nature is three-fold, not only ph}sically, but
psychologically and spiritually ; and be it known that the age in
which we live and the education that we support is an education
that recognizes in man the three elements to which I have referred,
and that his immortality is a conspicuous characteristic of his won-
derful maker.
If I had to die but for one single conviction in the world, I
would say let it be for my belief and confidence in the idea that
man is not only physical and mental, but that he is spiritual. If
he be spiritual, may it not be that to-night there is a spirit looking
down upon the things that are now occurring here; that from the
great beyond there is a character that we all loved while he lived ?
I refer to the distinguished, sainted Dr. Atkinson. May he not be
looking down upon what is occurring and wishing us God speed
in the grand work we are undertaking for the World's Columbian
Dental Congress, which we trust will be one of the greatest and
grandest convocations of dentists that has ever assembled upon
the face of the earth? (Applause). Dentistry, what does it
mean in its broad and comprehensive sense? Should the world
be educated upon this question? Wliat kind of men should fill its
ranks? They should be men by virtue of their education, their
mental attainments, understanding more of the laws of health and
living than any other class of men in the world. They have to
deal with the machine that prepares pabulum for tbe building up
of bone, skin and muscle — that has to go through the process of
triturating and grinding the food out of which the organism is to
116 THE DENTAL REVIEW.
be built. The idea is that the influence of education ought to be
so exerted by this grand, approaching congress, that those of us
who take part in its deliberations ought to be benefited as well as
the entire human family from one end of the earth to the other.
The public at large should feel the good results and benefit which
shall accrue from this great gathering. It ought to redound to an
aggregate increase of human life. Think about it ! Every depart-
ment of learning and of interest to mankind will be represented,
where? In the magnificent city of Chicago, resting upon the
western shores of your beautiful lake, with your buildings so high
as to command admiration. I counted some of the stories of your
high buildings to-day, and I think one was sixteen stories high in
a citv that is large enough to maintain a dental profession of over
600, and ought to have three times that many; a city that has five
dental societies for the advancement of education; a city that since
1836 has grown to such magnificent proportions that she to-day
has more than one million of people. In less than half of a cen-
tury over one million of people are engaged in developing the most
magnificent enterprises, in building the tallest houses and in equip-
ping and fixing for the reception of the world the most magnificent
entertainment that has doubtless ever been known in the world's
history. Why, of course, it will be a magnificent enterprise so far
as education is concerned. It is the duty of the dental profession
of America to go hand in hand and work in unison that this mag-
nificent movement shall put upon foot the means by which the
dental profession of the world can be entertained in a way that will
expand its entire organization mentally, physically and otherwise;
so that we will gain a sufficient amount of strength to go forth in
the further performance of the arduous duties that rest upon us;
so that within a few years we can be regarded by the public to a
much greater extent than we now are as the proper custodians of
the public health from a sanitary standpoint.
Proper sanitation is proper education. From a sanitary stand-
point the dental profession sustains a more important relation to
modern civilization than any other one profession known to the
world. It is a significant fact, that it is only within the last few
years that logical science has received any attention at the hands
of the scientific world from a practical standpoint. May it not be
that the disregard of the practical art of odontology has been a
more conspicuous fault than anything else? It has been said that
PROCEEDINGS OF SOCIETIES. 117
if America goes into decline and crumbles to the dust, the diseases
over which you and I of the dental profession have control, are
more responsible for it than any other deleterious influence. This
may be correct or may not be. But judging from a philosophi-
cal standpoint, I am bound to conclude that the gentleman who made
the statement was right. Then if there is such danger ahead
of us, in the name of all that is right, in the name of all that is sa-
cred to the human heart, let us elevate our profession from an ed-
ucational standpoint, and make the approaching Columbian Dental
Congress a potent influence for good. (Loud applause.)
Dr. H. J, McKellops, of St. Louis, responded to the toast,
''Unity of Action is Necessary to the Success of the World's Col-
umbian Dental Congress."
We must all hang together, or assuredly we shall all hang sep
arately. — Franklin.
He was received with applause, and said :
Mr. Toastmaster and Gentlemen of the Profession of Chicago: It is
not my forte to make speeches, but it is my forte to be with those of
my profession whom I love so much. (Applause.) As this toast calls
for unity, and in "unity there is strength," it is necessary for the
success of this great undertaking that we are now^ about to enter
into, for us to stand together each and every one. In this broad
country of ours which we travel over, as I do, where I visit my
professional brethren from one end of it to the other, there is hard-
ly a State in the Union into which I have not been with regard to
my profession — and I was going to say hardly a man in it that I do
not know. But with all that, when I look around, when I go
abroad, when I stand and see what is being done and the progress
that this glorious profession of ours has made, it fills my heart and
soul with joy. My friend, Dr. Taft, has said, this is to be the
grandest event that the world will ever see. I sa}-, no ! It will
simply be a rosebud in our profession. When I look around
and see the young faces that will bloom and see the roses which
we have brought up as buds, I say how beautifull}' those roses
will blossom some day. This is true of the younger members of
the profession. Go where you please, travel in any section of the
country, especially abroad, and you hear more or less of this glori-
ous profession of ours. We need to be proud of it. Every man
in the profession should not think of himself alone, but he should
open his doors and invite everybody in and extend the hand of
118 THE DEXTAL REVIEW.
welcome, and say "here, gentlemen, is the success of our profes-
sion." We stand together. We assist each other, therefore I open
my doors for you to come in and see what I do. When I lookback
years ago to the struggle which I went through to get into this
profession, having watched its progress since as it has bloomed
into manhood ; having seen the bright lights of the profession
shining around us and having thought ot the man}^ that have
passed and gone, I tell you my heart feels sad.
We have a great future before us. We have everything that is
bright. We have one of the grandest professions the world has
ever seen. I say to you gentlemen, let us stand shoulder to shoul-
der and don't give up. As my Texas friend says (meaning Dr.
Storey), " Mack, we young men must stand together." (Laughter
and applause.)
The Toastmaster. — We will next listen to the youngest mem-
ber of the dental profession in the City of Chicago, Dr. W. W.
Allport. (Laughter.) He will respond to the toast. "A little
neglect may bring mischief."
I repeat that in power is a trust; that we are accountable for its
exercise ; that from the people, and for the people all springs, and
all must exist. — Disraeli.
Dr. Allport was enthusiastically received. He spoke as fol-
lows :
Mr. Toastmaster. — I assure you sir, that I should not have left
my sick bed to come here this evening had it not been for my de-
sire to pay mv respects to our distinguished guests as well as to,
so far as the presence of one person could do so, say to the Execu-
tive Committee of the World's Columbian Dental Congress that
the dentisfs of Chicago are entirely united in their desire to make
the great meeting to be held in this city in 1893, the grandest con-
gregation of dentists ever held in the world. (Applause,)
The toast I am to respond to says, "A little neglect may bring
mischief." An important factor in bringing success out of an
undertaking is money, and to have the financial part of the under-
taking managed with ability, fidelity and sterling integrity.
The neglect to provide for which, is certain to result in a partial
or total failure.
It happened to fall to my lot previous to the meeting of
the International Medical Congress held in this country several
years ago, to have something to say as to who should be at the
PROCEEDINGS OF SOCIETIES. 119
head of the Finance Committee of the dental section on that
occasion. After looking the ground over very carefully, Dr. Taft,
the President of the section, assigned that position to Dr. Shepard,
the same gentleman that has been placed at the head of the Fi-
nance Committee of the World's Columbian Dental Congress.
With the knowledge I have, permit me to say that, in my judg-
ment, a better selection for the former or the present position
could not have been made. His former work was an unqualified
success. When we finished our work we had the largest fund in
hand of any of the sections, and when the Publication Committee
found they were short of money to complete the printing of the
transactions, our section, at the hands of Dr. Shepard, turned over
to this committee a check for $1,000, a thing that no other section
did, and the transactions soon appeared in good form.
Dr. Shepard has his own way of doing things, and he will not
do them in any other way. He carefully considers the matter and
makes up his mind as to about how much money he will require.
When he has done this and made up his mind as to those who
ought to contribute, and has sized them up, he goes straight to
them with cheek, if you please to call it by that name, enforced by
a knowledge of the facts, and tells them just what he wants. And
let me say it will be just as well for us to lay aside a little fund for
him, for when he calls or writes to us, he will expect money, and
the sooner it is paid the sooner will he be relieved from annoyance
and the sooner will our obligation to our profession be discharged.
But it is not always that a little neglect brings permanent mis-
chief. It is often the reverse. Had not the historic Mrs. O'Leary
neglected to milk her cow until after dark, and had she not then
neglected to put her lamp out of kicking distance of her bovine,
Chicago would not, the next morning, been in ashes, nor would
there upon the ruins of that night arisen our new Chicago, the most
wonderful, as well as one of the most magnificent cities upon the
face of the earth. It is in this grand city that the Dental Congress
of 1893 is to be held, and it devolves upon every one of us to not
only do what we can to promote harmony in our ranks, but to do
whatever may be right to make the meeting a grand success.
I want to remind you all, that this executive committee was
selected from the two leading dental associations in this country
and that its membership is composed of our very best and most
representative men. They are truly of the profession. In no
120 THE DEXTAL REVIEW.
event in the history of the world has there ever been confided to
any fifteen dentists such important interests as are now reposed in
this committee, and it gives me unspeakable pleasure to say that
the sacred trust confided to them seems to be fully appreciated.
That politics will have no place in their counsels and that every
duty that may fall to them to discharge will be performed with
such intelligence and fidelity that when the Congress is a matter of
history we may be able to look back upon it with pleasure and sat-
isfaction. (Loud applause.)
The Toastmaster then introduced Dr. Storey, of Texas.
"THE SUNNY SOUTH."
"Know ye the land where the cypress and myrtle
Are emblems of deeds that are done in their clime,
Where the virgins are soft as the roses they twine,
And all, save the spirit of man is divine ? "
The band played "Dixey" and Dr. J. C. Storey, of Dallas,
Texas, arose amid much applause, and responded to the above
toast. He said: Mr. Toasttnasier and Gentlemen of the Five United
Dental Societies of Chicago:
" Some feelings are to mortals given,
With less of earth in them than heaven."
Some good fellow once said that all along life's beaten pathway
there ever and anon arose some point more prominent than others,
a mile stone to which in after years he might look back with
grateful memories, and from which he might date events that re-
minded him of the joys he had tasted. This banquet, gentlemen, is
one of those high points in my life's journey to which I will always
refer with happy thoughts, as marking my first visit to Chicago.
I appear before you to-night, under circumstances peculiarly
embarrassing. The theme assigned me is one that has inspired
the brightest intellects that ever did honor to American oratory. It
was on a festive occasion of this kind in the city of New York, that
the late Henry W. Grady delivered an address which wrote his
name high on the temple of fame, and at once proclaimed him
among the great men of the nation. Mr. Grady spoke to the New
South, and here let me disclaim any desire to detract from his il-
lustrious name, nor would I lower one line, that marble shaft, which
commemorates his memory, but I speak to the Old South — the
same Old South it always was, and always will be.
PROCEEDIXGS OF SOCIETIES. 121
" Know ye the land where the cypress and myrtle
Are emblems of deeds that are done in their clime,
Where the virgins are soft as the roses they twine,
And all, save the spirit of man, is divine ? "
Yes, in that beautiful Sunny South all the spirits are divine save
those which come from Lincoln County, Tennessee, Bourbon
County, Kentucky, and Peoria, Illinois.
Geographically we stand unchanged as in the days when Colum-
bus landed on San Salvador, and we are to-day the same Sunny
South we always were — barring the robbery which took from our
people the accumulated wealth of centuries, and despoiled us of all
save honesty of purpose and integrity of character — we are the sons
of the same fathers who sent the Indians to their reservations,
felled our forests and made our country to bloom and blossom as
the rose. Ask the records and they will tell you that our success-
ful business men in all the vocations of life are of the Sunny South.
The same Old Sunny South whose genial sun and lovel}^ clime,
whose lowing herds and waving grass, whose flowering shrubs and
singing birds, whose brave men and beautiful women proclaim it
God's Country — Its people, God's people. Yes sir, ours is a grand
country — a magnanimous people — great in enterprise, and in genius
wonderful. 'Twas the south that gave to this country its Demo-
cratic Government, and there to-day you find it in all its purity.
In the arts and sciences the south has asserted and maintained her
preeminece. Of these, to mention all would consume too much
time— suffice it to saj' a Texan gave to the world that most wonder-
ful and useful food product — condensed milk — and to your city one
of her most philanthropic citizens, his son, Lee Borden. A Vir-
ginian, gave to Agriculture its most useful machinery. The
mower and reaper, and added much to the push and enterprise
of your own Chicago. A McDonald, of Kentucky, a Sims, of
Alabama, and a Battery, of Georgia, have contributed more to
gynecological surgery than all other scientists have done in all the
annals of time. 'Twas Georgia's Crawford Long who gave the
world anaesthesia which has robbed the surgeon's knife of its sting
and emphasized the discovery as man's greatest boon. But I must
turn me from her inventive genius and look in another direction —
glancing at her oratory, her statesmanship and her chivalry.
Where, let me ask, do you find such a combination of orator,
statesmanship and soldier as were embodied in the person of John
122 THE DEXTAL REVIEW.
C. Breckenridge; or who could equal W. L. Yancey as he held his
hearers spell bound with his silvery tongue ? One, and one only,
Judah P. Benjamin, of Louisiana, of whom it was said that even the
world did not possess his peer. These, and a host of others I
might mention, gave character to the nation's eloquence as they
made her halls of legislation echo with their matchless oratory.
And now let me ask, kind readers, who are the young men of
to-da}^ in the South who are adding splendor, aye, even over-
shadowing these great men who have gone before ? Cast your eye
if you will, into the political firmament; look at it all along the line
from one end of the horizon to the other; tell me, if you can, how
many of these brilliant stars who are ever and anon coming into
view, tell me how many are 7iot sons of these same old southern
fathers. The echo will answer, how many. As to southern chival-
ry, southern bravery, many of you before me to-night, having seen
the glitter of their bayonets and heard the whistle of their bullets,
can and will attest. And the south to-day has the finest citizen
soldiery on the American continent. Does not our own Woozen-
craft hold the highest prize for the best drilled battery of Artillery
— the Dallas Artillery — and the Houston Light Guards have they
not been ruled out of competitive drills in the line so often have
they been winners ? And permit me to say that should the Amer-
ican eagle feel a little Chile (chilly) just let him utter one scream
and fifty thousand Texans will bid him perch aloft on the Goddess
of Liberty which surmounts the Texas capitol, plume his ruffled
feathers and warm himself amid the sunshine of this genial sunny
south, while they stand ready to defend his honor and protect his
good name with their blood. And, Mr. Chairman, when that south-
land shall have fully recovered from General Sherman's march as has
Chicago from the kick of Mrs. O'Leary's cow, she proposes to give
color to the political aspect of this government and shed a luster
all over this entire land such as the world has never seen or even
the mind of man conceived.
In closing my remarks I cannot do better than add a stanza from
Alabama's sweetest singer, Judge Alexander B. Meeks, of Tusca-
loosa.
"Land of the south, imperial land;
Then here's a health to thee:
Long as thy niountain barriers stand
Mayst thou be blest and free.
PROCEEDINGS OF SOCIETIES. 123
May dark dissentions banner ne'er
Wave o'er thy fertile loam,
But should it come there's one will die
To save his native home."
Dr. a. O. Hunt, of Iowa City, Iowa, Secretary of the Commit-
tee, responded to the toast, "Write the Vision, and Make it Plain
upon Tablets, that he may run that Readeth it." — Bible.
Dr. Hunt, on rising to speak, was heartily received. He said:
Mr. Toastmaster and Gentletneti of the Pro/essiov of Chicago:
There is unquestionably some mistake. I think, without doubt,
that the Toastmaster, or those who assisted in arranging the senti-
ment of my toast have been in close conference in this matter. I
have been laboring, while in Chicago for the last few days, under
the effect of a case of mistaken identity which has been forced upon
me by the Chairman of your Executive Committee; so that his
views must undoubtedly have been carried to the Toastmaster and
those who are assisting him in this banquet. It seems that the senti-
ment is taken from the Bible. All of you know that the selection
is very appropriate for me, and I suppose the intention was to close
this banquet with a sort of praise meeting, and that is the reason
that this sentiment has been given to me. It is customary, I be-
lieve, for a man in a speech to do certain things; that the one who
is appointed to respond to a toast has the privilege of telling a
story or singing a song. It is not expected that I shall make a
speech on the present occasion, for the sentiment says "Write the
vision plainly." I will exercise the privilege of telling a story.
I feel fully as awkward in my mistaken identity as a celebrated
actor of olden times in England. He had been out after the per-
formance at the theater to an informal dinner. On his way to the
hotel the bishops and the clergy of that section of England were
holding a banquet or dinner, and he was invited to go in by some
one. He sent his card in, and was immediately invited to take a
seat at the table. Having just returned from his informal party,
with his white necktie on, etc., one of the bishops mistook him for
one of the clergyman, and called upon him to say grace, something
he had never done in his life. He was completely nonplussed as
to what to say or what to do. He had been trained in the Church
of England carefully in his youth and certain things came to his
mind, and rather than refuse to say grace, he said "O, Lord, open
124 THE DENTAL REVIEW.
thou our lips and our mouths shall show forth Thy praise."
(Laughter.)
Another case is related of a clergyman who lived in the country
and preached at the various school houses in the neighborhood.
One Sunday morning he got up, hitched up his horses, went into
the house and changed his clothing preparatory to going to service.
While doing so his wife had prepared some milk for the calf.
When he came out properly dressed for his divine work, he noticed
the pail of milk for the calf. He could not think of leaving the
animal all day without feed. He took the pail of milk, put the
calf's head into it, and in order to prevent the calf causing any ac-
cident, he got it by the ears and pressed its head carefully down
into the pail. The calf was drinking, but unconsciously the cler-
gyman pressed the calf's head down a little too far until its nostrils
were immersed below the milk. Raising its head, the calf threw
milk all over the clergyman, and he said, " If it were not for the
love I bear my master, I would break your infernal neck."
The toast says, "Write the vision plainly." The only man I
can call to mind who had the power to do that and have it pro-
phetic was the celebrated Robert Burns. Burns wrote a kind of
vision, which at the present day shows that he was not only a poet,
but also a prophet. I can ill afford to undertake to be a prophet.
I cannot write a vision, but this much I can assure you can be done
in the interest of the great forthcoming Congress. It will remain
with you and the rest of the profession to make the vision — and I
have no doubt but that it will be — of such a character that every
member of the profession will look upon it with pride. It is no ordi-
nary movement that we are undertaking. Probably never again
will we have the opportunity to do so large and so great a work as
now. The records of what we do then will remain many years after we
are gone. These records should be written plainly, and it requires
the cooperation of every member everywhere. When called upon,
he should at once respond willingly and cheerfully, and whatever
he does should be done carefully.
I am very glad of the sympathy expressed by the Toastmaster
for me, that I have to write to all interested in this great work.
There is a great deal of assistance to be obtained. I shall not have
to do all the work, as much of it will be done beforehand, and I
simply shall record the results and perhaps put the proceedings
in better shape for record. We cannot say how far reaching a
PROCEEDINGS OF SOCIETIES. 125
movement of this kind will be. My friend, Dr. McKellops, has
been for the last thirty years making a decided effort to collect the
literature of the dental profession. Much of this is difficult to
obtain ; much of it, in fact, is out of print or has been thrown awa) .
This will not likely occur as regards the reports and work of the
forthcoming Congress, because whatever we do, in its final wind up
the public libraries will contain an account of the 'proceedings and
will offer the results thereof and the records will never be lost. It
is important then, that we should write the vision plainly.
I have only this request to make to those who may be present,
that it will devolve upon me as the Secretary of the meeting for
some little time to send out certain notifications, and I urge all of
you here when you receive these notices to give a prompt and care-
ful response, because it will delay our work very materially if you
are dilatory in this matter. Remember, there remains much to be
done. The committee and others interested in the meeting have
to be informed what is to be done. It is the intention of the com-
mittee to send out a series of circulars embodying the work done
b}' the Executive Committee. I thank you, gentlemen, for your
attention.
At the conclusion of the toasts, several gentlemen were called
for to make short speeches. They responded in the following
order:
Dr. Foster, of Baltimore. Mr. Toastiiiasier and Members of
the Dental Profession of Chicago: — It is somewhat embarrassing for
me to make a speech after j^ou have heard so many eloquent gen-
tlemen. I hope I may be pardoned for saying just exactly what I
feel. An eminent writer once said that an "agitated heart" was
the vocal expression of ideas. We have had considerable agitation
this evening. Like a stone thrown into the lake, the waves
have gone forth until they have reached the shore, or until they
have reached a response in that heart.
I will say in regard to Baltimore and Chicago that I am half
and half to-night. Hospitality in Baltimore is, I think, great; hos-
pitality in Chicago is, if anything, greater. The lower part of me
is my own — that is Baltimore. The upper part of me — I think to-
night— is Chicago. (Laughter and applause). If there is any oth-
er half, that half is alligator. I was very much impressed with the
importance of the remarks of one of tlie gentlemen, who said some-
thing to the effect that "all things come to him who waits." The
126 THE DENTAL KEVIEIV.
gentleman who responded to this toast was called upon to do so
doubtless on account of being a descendant of John Wesley, the
great divine, and that is just exactly where it comes in. You all
know the bearing and the likeness he has to that celebrated divine,
the purity of character and other greater adornments.
Mr. Toastmaster, I thank you for the many courtesies that have
been shown to me, not only on this, but on former occasions. I
have never had such an opportunity of meeting the rank and file of
workers in the profession except the few I have met at dental con-
ventions. It gives me pleasure to see here so many representative
men of the profession — men with character and intelligence ex-
pressed in their countenances. We all look forward to the success
of the World's Columbian Dental Congress, which will convene in
this city in 1893. (Applause).
Dr. B.A.RTON, of Texas :
Gentlemen of the Committee and Members of the Profession of the
City of Chicago : I am somewhat in the position of Dr. Foster in
not having been assigned a toast on the regular programme. I
avail myself of the opportunity to thank you heartily not only for
myself, but in behalf of this committee for your kindness, considera-
tion and courtesy, and for the way in which you have so well enter-
tained us during the three or four hours since we have been in this
hall. It has given us great satisfaction in many ways. I believe
that in the interest of the forthcoming Dental Congress that there
might be this further thought, that we should endeavor to cultivate
a spirit of unity and harmony, if possible. We have seen this unity
manifested here to-night by the five dental societies of this city,
and "in union there is strength." From the sentiments I have
heard to-night harmony has been urged. It is still important that
we should keep it before us just as these five dental societies have
exhibited the true spirit in which we must work and through which
we must accomplish that which we desire. The good feeling in
this gathering will help us to cultivate and propagate the same
spirit in the forthcoming Congress. The advice is given to us by the
same divine authority' that has been quoted this evening, "Love
thy neighbor as thyself." An exemplification of this principle in
the forthcoming Congress will enable us to secure the harmony
which is desired in this great affair. If we can just have that prin-
ciple of brotherly love — love our neighbors as ourselves ; if we can
have forbearance and a kindly consideration one for the other as
PROCEEDINGS OF SOCIETIES. 127
professional brethren should have, the Congress will undoubtedly
prove a success. It has been said, that to him who works in a self-
sacrificing way, the highest and greatest blessing comes. If we can
cultivate a spirit of brotherly love and make harmony a necessity
in the case and cultivate it more and more upon the same ground
manifested and started here to-night, it will result in materially de-
veloping the great work which we are mapping out for 1893. So
far as these five societies are concerned, they have afforded us an
opportunity for the cultivation of this spirit of brotherly love
among the profession which we all admire.
I have heard that there are from 500 to 600 dentists in this city.
I have heard also that only about 150 are active members of the
city societies. That proportion exists in most of our States and
cities. There is something wrong just here. If we are in earnest
and exhibit the same spirit which we preach regarding the welfare
of the profession, professing a love for dentistry, an expression of
that love is needed. A sentiment which does not find expression
may not do much good. I believe, from my own observation in
dental societies, that if we can get the younger men of the profes-
sion into the local, state, national and international associations,
men who bear a good character and stand high in the profession,
it will do more for the development of dentistry than we can do in
any other way, and it will be an easy matter to make the great
meeting of 1893 a success. If we endeavor to increase the mem-
bership of these societies and make them so useful that the younger
members will wish to join and find them places of profit to them-
selves in many ways, it would do a good deal toward the develop-
ment of our profession. If we want harmon}' and success not only
for the great Dental Congress, but for the future, we must have
that spirit which has characterized many of the older men in the
profession — a spirit of self-sacrificing interest, a spirit of kindly
feeling toward our neighbors — in short, "Love thy neighbor as
thyself." (Applause.)
Dr. J. N. Crouse, of Chicago. Mr. Toastmaster and Gentlemen:
— If you think that you have seen all there is in Chicago, and all
the dentists and what they can do, you are mistaken.
Speaking of the World's Columbian Dental Congress, I have
known but little of the committee's work, owing to the fact that I
have been busily engaged otherwise. But the query has run
through my mind in this way : What in the d are those fel-
128 THE DENTAL REVIEW.
lows traveling around the country for, holding meetings, and not let-
us know what is going on ? Why do they not assign all this work
to the Chicago dentists ? We would be prepared for it ; we can ac-
commodate the crowd here, pay the bills, and everybody would be
happy. The dental profession of Chicago does not do anything in
a small way. This is only a little sample of what you will get be-
fore you are through, and to the committee I would say, if you run
short of anything, let us know what you want, and we are here
and are ready to do all in our power to assist 3'ou. (Laughter and
applause.) When we pull together we can compete with the
world, and that time always comes when it is necessary. Gentle-
men, I will detain you no longer.
Dr. Geo. H. Cushing, of Chicago. Mr. Toastmaster. — I sup-
pose I have been called upon for the reason that you all know I
cannot make a speech. What I shall say will be very short. I
cannot tell you how much pleased I have been at what I have
seen, heard and felt this evening. I can only reecho the sentiments
that have been spoken by those preceding me with regard to the
evidences of the unity and earnestness of the profession concerning
the coming Columbian Dental Congress. I have no question in
my mind of its success, whether depending on Dr. Crouse's pledges
or otherwise. I do not think there will be any necessity for
Chicago to make up any deficit. There will be an abundance of
money, and I know we shall all work in harmony in this city and
throughout the country. I thank you, gentlemen, for calling upon
me. (Applause.)
Dr. Ingersoll, of Iowa. Mr. Toastjnaster: — I hardly know
what to say. I feel more like singing than talking — " Hail Colum-
bia, Happy Land " in every town and hamlet in this broad country
until the echo of it has reached the very remotest corners of the
globe, and the people as one mighty caravan on their way coming
to Chicago, the center of America. (Applause).
Every educational interest in this country will be represented
at this great exposition, and it will mark the future of America's
educational institutions; and dentistry has as much right to be
represented as any other profession or country on the globe. (Ap-
plause).
Dr. Sudduth, of Minnesota : We have heard a good deal this
evening about the five united dental societies of the city of Chica-
go, and I must say that it is a very pleasing spectacle to see this
PROCEEDINGS OF SOCIETIES.. 129
unity manifested in our midst. But in reference to the matter of
union, you must not leave out other societies. I want to speak in
a Hne of thought not brought out by the preceding speakers, and
that is, we can appreciate the interest that has been manifested by
your five dental societies, but we want you to add the three dental
societies to your number which we have in the State of Minnesota.
(Applause). We want to pledge to this committee the hearty sup-
port of our State in any manner, shape or form that it can be ten-
dered. We are with you since you have assisted us in capturing
the Republican National Convention.
A compliment has been paid to your high buildings, one of
which, I believe (the Masonic Temple), is twenty stories high. We
have some high buildings in our town, but we have better founda-
tions for our buildings than you have here. Above all, I want to
say, we will render all the assistance that is possible to make the
forthcoming Columbian Dental Congress the greatest and grandest
convocation of dentists ever held in the history of the profession.
(Applause).
Dr. Crawford, of Nashville, at this juncture extended an invita-
tion to all those present to attend the next meeting of the Southern
Dental Association, at Lookout Mountain.
Dr. G. V. Black: I have been interested this evening in what
you have been doing and saying, and I have been wondering what
would be the more serious outcome of this Columbian Dental Con-
gress. We have been offering plans and suggestions in a sense,
and making arrangements for getting the members of the profes-
sion together. I suppose arrangements are also being made to in-
terest us when we do get together. Now, as this is a matter not
only to interest us, but is to attract the attention of the world, it
should be made known to the world that this congress will be of
benefit to the people and to our patients. There is where the great
work is to be done, and the work that is done must be done by in-
dividual effort. We, as an assemblage, can always make the ar-
rangements necessary in bringing a people together ; we can also
hear what individuals have to say, and it is what they may say that
will live in the future. I hope that the Congress will do both our
patients and ourselves good. If we rally around this Columbian
Dental Congress for this purpose, then the proceedings will live in
the future. If we rally as much as we please for any other purpose,
then it will fail.
130 THE DENTAL KEJ'IEIV.
Dr. Shepard: The Executive Committee have been and are
working simply as trustees to bring out from the few studious
minds in the dental profession throughout this and other countries
the very matter which Dr. Black refers to. They are nothing but
executive officers to call out the thoughts and researches to be pre-
sented here in 1893 as a monument of dental achievements up to
the present time. The results will be valuable and will live, or
otherwise, according as our wisdom shall have selected the proper
men and shall have called together the proper material by which
those thoughts, investigations and conclusions shall be formulated
for the benefit of our present time and future ages. (Applause).
Dr. Noble, of Washinton, D. C. : Afr. Toastmaster and Gentlc-
tncn of the Five United Dental Societies of Chicago: My thoughts,
while listening to the speeches that have been made around me,
have referred back to those men who labored first to establish den-
tal schools and societies. Many of the older men have passed
away. I remember their faces well. How pleased they would
be if they could look upon such an intelligent assemblage of
gentlemen as we have here to-night. I have seen the time when
such a representation of the dental profession could not be gath-
ered together even in this great city of Chicago; when they labored
under difficulties that we do not labor under to-day ; when they la-
bored to organize dental societies and colleges. I remember well the
labor of some of those men. I have the honor to have upon my di-
ploma names that, I think, you will recognize — Chapin A. Harris,
Edward Maynard, Thomas Bond, Phillip H. Austin, and the men
connected with that college. How pleased they would be if they
knew that we were going to have such a dental congress as we pro-
pose to hold here in 1S93. I think it would do their souls good.
I wish to say to the younger men, that they hardly realize the dif-
ficulties under which those men labored at that time and what an
inheritance they have left us.
Personally, I desire to thank the gentlemen of Chicago for the
cordial and pleasant entertainment that they have extended to us
and it has given me great pleasure to be here to-night. I have
met many of the members here individually from time to time at
our dental conventions, but this is the first time I have ever had
the opportunity to see so many of the Chicago men and make their
acquaintance, and I assure you all, gentlemen, that it has given me
unalloyed pleasure to be with you.
PROCEEDINGS OF SOCIETIES. 131
The objects of the Executive Co-mmittee and their labors have
been fully discussed. They have alluded privately to coming to
Washington to get an appropriation. If they are not more suc-
cessful with the present congress of getting an appropriation than
I have been in getting through a dental law for the District of
Columbia, then I shall feel sorry for them. I have labored for
eight years in that direction. I have not accomplished it yet. It
looks more favorable now than ever before, and I hope before the
expiration of the present congress that we will have a dental law
in the District of Columbia, which, I am sorry to say, we have not
to-day; because we are not a voting population; therefore we com-
mand no influence. An influence is being brought to bear upon
the matter at present from the outside, and I think it is getting
into shape. We shall have no difficulty with the Senators, and I
think not with the House of Representatives.
Gentlemen, again I thank you one and all for the pleasant time
I have had in Chicago. It makes us feel that we shall have a
great Congress in 1893. (Applause.)
Dr. Laurance, of Lincoln, 111. Mr. Toast master and Gentle-
7nen of the Profession of Chicago: — It is not a pleasure to be called
on for a speech at this late hour. As a member of the profession, I
congratulate the profession of Chicago upon their harmony and upon
the duties they have performed in this great work; and we should be
thankful for the presence of these distinguished gentlemen from
abroad who have come to us and outlined the labors that they pro-
pose to perform for the benefit of our World's Columbian Dental
Congress. That it will be a success, there is no question. I know
that the profession in Illinois will stand together, and that the
work to be done here, as Dr. Crouse has designated, will be a suc-
cess. Chicago never undertakes a thing unless she makes a suc-
cess of it. (Applause.)
As a representative of our examining board, whose work it is to
deal with irregular fellows that climb over the wall ; standing be-
fore you rather in the light of an officer of the law to protect the
community from criminal ignorance and stupidity, whose labor it
is to advance and elevate the profession, I take this opportunity
to say to my fellow practitioners in the State of Illinois, that as the
representative of my colleagues on this board, we shall extend a
welcome to our confreres from the sister States. Illinois leads in
almost everything except a dental law. We must work to uphold
132 THE DENTAL REVIEW.
our noble State, to try and have a dental law passed, and not be
the dumping ground for all of the quacks that you think of. (Great
applause.)
Dr. T. W. Brophy, of Chicago, extended (in behalf of the Pres-
ident of the American Dental Association, whose innate modesty
forbade him to do so) an invitation to all those present to meet
with the said Association at Niagara Falls, the first Tuesday in
August, 1892.
At the termination of the speech-making. Dr. A. E. Baldwin,
of Chicago, offered the following resolutions:
Whereas, The death of the son of Dr. J. A. Swasey, one of our active mem-
bers, has prevented him from being with us to-night,
Resol-'c-d, That we, the members of the Five United Dental Societies of Chi-
cago, sincerely condole with him and his family in the loss he has sustained; be it
further
Resolved, That this resolution of our sympathy and sorrow be forwarded to
him through Mr. Whitford, the stenographer of this meeting.
The resolution was seconded by Dr. H. J. McKellops, of St.
Louis, and unanimously carried.
Toastmaster Stevens requested every one to rise and participate
in singing Auld Lang Syne, after which the company quietly dis-
persed.
Chicago Dental Society.
Regular meeting, Januar}' 5, 1892, Dr. D. M. Cattell, President,
in the Chair.
Dr. R. B. TuUer read a paper entitled, " Post-Graduate Study."
Dr. J. W. Wassall, in opening the discussion, said : Mr.
President, I think we ought to be congratulated upon having lis-
tened to such a good paper and to one that touched upon points
always of such great interest. I am not at all inclined to be critical of
anything that has been said, although perhaps one might find fault
with the title. The principal part of the paper was devoted to the
question of instructing or elevating the great class of nongradu-
ates, therefore we could hardly call it "post-graduate study."
The first part of the paper, however, dealt with the question of
post-graduate study properly speaking, stating that the men that
were turned out from our dental colleges were usually incompe-
tent. That is of course a fact ; but the experience and study which
PROCEEDINGS OF SOCIETIES. 133
comes with the first year of practice finally make good dentists of
them ; they can do no better than to follow the injunction on the
front page of \.\i& Cosmos — "Compare, Reflect, Record." They
must "compare" different authorities with what they have learned •
at college. For instance, suppose he may have to treat an alve-
olar abscess the first thing in his practice ; it is then his business
to hunt up all the different authorities to find out the best methods
of treatment pursued by the best men wherever the best men
happen to be. He must " compare " all that with what he has
learned at college, which was only the method of one professor, per-
haps, and " reflect " upon it ; he will then arrive at conclusions
which will be of lasting benefit to himself, and if he '•' records " it,
of benefit to others.
If I were asked to name the two most useful ways of obtaining
post-graduate knowledge, I should sa}^ society meetings and their
published transactions as they appear in the monthl}' journals.
I do not think as much benefit is derived from attending a den-
tal society meeting, which convenes for a night, after a hard day's
work when the practitioner feels tired, as by attending a soci-
ety which meets for four days in a week, where he can go away
from business cares and associate with brother dentists. He then
has an opportunity to meet them socially and discuss cases. These
times to me have been the greatest teachers I have had, and I look
upon them as the best opportunities for post-graduate study, as
well as for the enlightenment of nongraduates.
The reading of transactions of other societies I consider the
best reading we can get in the waj' of dental literature. These
transactions represent the progress and methods of the best men
we have in the countr}' and are the things we can always get bene-
fit from. A man must ever bear in mind that he can only advance
by his own personal application and work.
The Chautauqua system seems, as the essayist has outlined it,
a very seductive one. I think the matter should be put to a test
by the Chautauqua organization already existing. I think if they
were approached in a proper way by Dr. Tuller himself, or perhaps
by a committee, that we could find out what they can do. It could
then be laid before dentists and a dental course arranged, and it is
possible that a good deal could be done if a general interest were
taken in it by dental societies and dental journals. I have not
thought enough of this phase of the question, however, to have
134 THE DENTAL REVIEW.
any opinion about it. I am in favor of anything that will make
men study more and go to dental society meetings. It will make
better dentists of them and they will become more enlightened and
more worthy to be called professional men.
Dr. J. G. Reid. One thought suggested itself to me in the pa-
per which was not elucidated by Dr. Wassail or the essayist, and
that is, if such a course were adopted it would undoubtedly stimu-
late a great many men to support a system of study such as has
been outlined, because it places them under an obligation. When
students leave college they lose to a certain degree their interest.
When they are attending college they are working for something.
They have something in view. If dentists should have an organiza-
tion of this kind or wish to take up a system of study covering the per-
iod suggested — one, two or three years — it places them in a position
where they would feel obliged to pursue their studies, because they
have something to gain. It is like a man being in debt; if he is an
honest man he wants to get out of debt. He works with that end
in view. If we engage in a course of study, we have something to
work for, and we put ourselves in a position where it is virtually
an obligation. It seems to me that the idea is a good one.
Dr. Louis Ottofy: I have had a number of interviews with
the essayist, on this subject, during the last two years; there has
been much talk and many papers have been read on the subject of
post-graduate study. It is time for some one to lead and act in
this matter. A number of plans have been suggested; some are
comparatively simple, yet not even the association of which the
essayist is president is ready to undertake to put any ot them into
operation.
The Chautauqua course was at its inception not what it is now.
It was evolved from a comparatively simple beginning. The first
dentists to commence with are those who are not graduates, those
who have never attended any dental college, either as beginners or
as practitioners. While the association of which Dr. Tuller is
president is really called a Post-Graduate Association, it is within
its scope to make of these men, graduates; that is, it could interest
them to the extent that they would eventually either become grad-
uates of a dental college after taking the regular course, or, at least,
would attend a practitioners' course. I suggested to him that it
would be a simple thing to begin with those whose applications he
now has; select and give them a certain book to commence a course
PROCEEDINGS OF SOCIETIES. 135
of reading. Let them go on with the reading of one book at the
present time, and then as the membership of the association in-
creases other books can be added, or text books can be written by
men who are competent to do such work. We will graduall}- learn
what the profession needs; and from this small beginning there
could be evolved a system of suitable reading courses that will
eventually embrace all dentists, whether graduates or not.
In my report before the American Dental Association last year,
I referred to the contemplated work of the Post-Graduate Dental
Association, and as a result I received several letters which I have
turned over to the President. These men wanted to know what
was being done. I have no doubt, if it is suggested to them, that
a certain number of pages of a selected dental work should be read
each week, and that they would be expected to pass an examina-
tion, the reading course, to a limited extent, would now be an es-
tablished fact. I would suggest that Dr. Tuller begin in this way,
then the system could be elaborated and improved until it becomes
perfect.
Dr. C. F. Hartt: We have with us to-night a man who has
not only talked on the subject of elevating the dental profession,
but one who in connection with a prominent medical college com-
menced this work in a small way long ago. I remember a good
man}' years ago he said to me, "I do not think you know as much
as you want to know." That was probably the case then and even
now. He was the means of giving me an entire year in Rush Med-
ical College, attending lectures, clinics, etc., which greatly benefited
me. He was the means of sending other gentlemen there — men
who are to-day ornaments to the profession. After that, he en-
larged his system. He started a post-graduate or practitioners'
course at' the Chicago College of Dental Surgery. I am not now
connected with that college, yet I want to say that Dr. Brophy de-
serves credit for starting and maintaining that course of study. It
is quite possible the term may be short; a month is not a great
while. It is a new thing, and doubtless a three months' course can
be established. If a man saves up his money, leaves his practice
for three months, and goes to the Chicago College of Dental Sur-
gery or any other college, it will do him more good than three or
even ten years' study at home.
Dr. J. W. Wassall: I think the point brought out by Dr.
Hartt ought to be made more prominent in the essayist's paper.
136 THE DENTAL REVIEW.
The post-graduate or practitioners' course we have in our dental
colleges is an excellent thing and is something I should have spoken
of in my previous remarks. I think that going to a dental society
for a week is simply a small post-graduate course. It answers the
same purpose, although the time is shorter. It is a highly credit-
able thing to the colleges to have established the post-graduate
course.
Dr. J. H. WooLLEV: — I am in full sympathy and accord with
the paper that was read to-night. I always think that we should
further any movement that will teach us the way out of ruts.
Possibly we may get into a rut in dentistry. Any movement that
is for the general diffusion of knowledge is very slow at first. Let
us take, for instance the movement that started university exten-
sion. It was away back in 18.50, I think, that one man started a
course of lectures and had 500 laboring men under his instruction.
He was interested in his fellow creatures. Coming down to a later
date another course of lectures was started. Hundreds attended
these lectures. University extension in England took that line of
thought, which resulted in 350,000 people attending the lectures
through England. Now, it seems to me, the best way to start a
movement like this would be in a small way. Get the dentists in
Chicago interested and a lecture course might be commenced in a
simple and modest way and its influence be felt ; lectures, if you
please, on scientific subjects seemingly outside of dentistry, yet
having a practical bearing on it. I think. we as dentists sometimes
are narrowed down to one special line of thought ; that if we go
out into other fields and embrace other opportunities in a literary
way, we would not only be benefited in that direction, but it would
enrich our whole dental lives. It would not only enrich what we
have to say to one another in our discussions here, but our papers
would show that there is much beyond and much to stimulate us
to get to the beyond. I think that if we have any ambition at all to
be anything, we can avail ourselves of whatever opportunities may
present themselves to us, and if we cannot get at the matter in a
larger way, why not take up some subject of a scientific nature con-
nected with dentistry whatever it may be. Let us take hold of it
in a small way, not only in this society but asking other societies
iYi Chicago to join us.
Dr. Edmund Noves : I remember that seventeen or eighteen
years ago in this city a dozen or fifteen men arranged two winters
PROCEEDINGS OF SOCIETIES. 137
for series of evening lectures upon chemistry, physiology, histology
and pathology, especially the pathology of inflammation, and some
of the men did a great deal of reading along with it. Others took
very little interest in the course and it was somewhat difficult to
get together a class large enough to support the undertaking ; but
as I look back upon it and think it over it seems to me to have
been one of the most fruitful things in good results that I can re-
member. A very considerable number of the men who were in
those classes afterward took a full course in a medical college and
graduated. I cannot say that the impulse to do so was derived
from those winter studies. It possibly may have lain back of that,
but it was promoted and perhaps brought to .a conclusion by them.
Every effort of every kind to promote interest in professional study
on the part of practitioners should meet with the heartiest encour-
agement, the most abundant help we can possibly give it, and such
study will always be fruitful of good to the men who undertake it
and to the profession.
The movement that is under consideration this evening seems
to me to be waiting for a man who has the experience, the judg-
ment and enthusiasm and can possibly devote the necessary time
to it. It wants a man, besides having first-class ability, who can
afford to give such time and effort and money as may be necessary
to establish a movement of this kind, such as some of the presi-
dents of our educational instutions have given to them ; in other
words, it is a life-work for some man. If such a man is found and
he is a young man and will spend his whole life at it, he can prob-
ably develop it into something valuable. I do not know enough
about the circumstances of the case to know whether the sugges-
tion made to put such work under the general charge of the Chau-
tauqua Association would be a practical one. It would seem to
me that great assistance could be had in that way in the arrange-
ment and management of the machinery of the course. It would
have to have competent dental men in the particular leadership of
that department. The very best men will pursue graduate study
without any such assistance. One man, whom I know well, said
to me that for fifteen or twenty years it was his invariable habit to
spend the hour from eight till nine every morning in either study
or experimental operations aside from any professional labors. I
am certain that man's life has been one of the most fruitful I know
anything about in any profession. (I think one hour in the morn-
188 THE DEXTAL REVIEW.
ing did not comprehend all the work he did in the way of study
during that time.) If a systematic course which is practicable to a
large number of men can be arranged, and a sufficient number can
be induced to begin it, the community of thought and the stimulus
of associated effort and interest will keep a great many men at
work long enough to accomplish something valuable, who would
soon tire of it if left entirely to themselves.
Dr. J. N. Crouse: — This is rather an unsatisfactory subject to
me ; not that I have not thought of it seriously many a time, but
because it is a subject that I have not yet mastered. I have not
been able to mature a plan that was satisfactory to my own mind.
After devising a plan I could see too many flaws in it. To-night I
am just in that position. I have no satisfactory plan to offer.
The dental profession so far as education is concerned, are
educated principally in three ways. First partially, in individ-
ual studv and in connection with a dental college. Second, in con-
nection with societies. Third, in associating one with another.
The last is one of the most prolific means of culture and of advance-
ment for the dental profession. It has been so with me at least.
The men in the profession with whom I have associated at one
time and another, have visited me; we have discussed subjects
quietly together, and it has been prolific of as much benefit to me
as an\' other one thing. Lately I have been so occupied with one
thing that it has almost been master of me at times, and I have not
had time to be even sociable ; but this is a feature of education
that ought to be more cultivated.
There are many practitioners in this city who have lately met
together, had dinner together — and that does not necessarily mean
drinking wine and making gluttons of themselves — and discussed
subjects in connection with dental practice. I believe if there
were more of that spirit cultivated, it would lead to more good
than the establishment of the dental colleges we have in this city.
It becomes a question when you establish rival institutions and
men work themselves into a spirit of animosity toward each other,
as has been experienced in this cit}', whether our dental colleges
have not done more harm than good to the profession of Chicago.
A good lawyer will not bring two dentists together in a court room
to testify on ths same subject at the same time. If one listens to
the other giving testimony, just as sure as one is up the other
knocks him down. I do not know why. I do not know that den-
PROCEEDLVGS OF SOCIETIES. 139
tists are more pugnacious or jealous than an}' other class of profes-
sional men, but it would seem that they are sometimes. I have
tried to study out why it is, and I have not come to an}' satisfac-
tory conclusion. Patent attorneys have told me that just as sure
as they have two dentists together giving testimon}' or discussing a
principle, one would be sure to oppose the views advanced by the
other every time. It is a serious matter ; it is a matter that puz-
zles me to find out, why men in the same profession, men whom we
might call the leaders of our profession, cannot get together and
discuss subjects without sawing each other to pieces, because
they are not connected with the same institutions. The dental
profession here will advance when the dentists of Chicago pull to-
gether to a man as the citizens of this city stand together. Is it so
now ?
I was informed a little while ago that the banquet we are to
have has been almost broken up by college factions. I said, let us
shut them all out, not have a college man in it, and we will have a
good time. (Laughter.) It would be a good thing to place them
in a position so that they would be ignored. I consider it a dis-
grace to the profession that such strife should arise from time to
time about comparatively nothing. I like controvers}', but I do not
like fights where one man stabs another in the back. I can go into
a controversy that is hot as well as anybody and finish it right
there. If I thought there was an}' possibility of the colleges stop-
ping this strife, I would like to get the whole crowd together, lock
them in a room and have them fight it out to a finish, and then
start a post-graduate course. (Laughter.) They could then get
together and establish on peaceable terms a post-graduate course
which would be an honor to this or any other city. There are hun-
dreds of men in the country who are desirous to attend post-grad-
uate courses and get benefits from them. All colleges should
have sincerity and brotherly love enough to be interested in this
work and organize such courses. They are the ones that should
do it.
Dr. C. F. Hartt: Dr. Woolley says something about bright
ideas. I think I have a bright idea, something that we can all act on,
and that is, before we talk of reaching quack dentists let us reach
the members of our own society. Where are the members of this
society to-night ? We are in session at this moment, and yet we
have not the attendance we ousjht to have considering our member-
140 THE DENTAL REVIEW.
ship. If every man here to-night will try and bring four dentists
of his acquaintance to the next meeting, I will do the same. Be-
fore we talk of reaching outsiders we want to reach our own mem-
bers. Why are they not here? In addition to this I might ask a
very pertinent question: how many of the members of this society
and other societies in this City and State, take two first class den-
tal journals, and read them carefully from cover to cover? This
will give them a course of reading for the year far superior to any-
thing found in the text books. I am sorry to say that I have heard
it stated in dental meetings that the journals of to-day are not worth
reading. I have given the authors of such statements careful
scrutiny, and I have come to the conclusion that these men as a
rule do not read the journals, and if they do their industry seldom
takes them farther than the finding of their own names and the
reading of their own articles; such statements are productive of
great harm to the profession at large, for the drones in the dental
beehive are only too willing to take up the refrain and make it an
excuse for their negligence in these matters.
Dr. Allport: While listening to the paper, it occurred to me
that if I could be put back twenty years in my life, I would not
only make better use of my time in study, but also be of more use
to others than I have been.
Th6 idea of a post-graduate course of study is a good one, but it
seems to me that in the paper as well as in the discussion the idea
has been confounded with other systems and courses of instruction
all good in their way, but distinct in their systems as well as in
their purposes.
A post-graduate course of instruction is one thing, a Chatauqua
course is another; a practitioner's course another, and a dental
college course still another and quite a different thing. A post-
graduate's course presupposes that those who attend it are gradu-
ates; that they have passed through the ordinary dental college in-
struction, and that they are so well informed that they can compre-
hend and be benefited by an advanced practicable, as well as
a scientific course of instruction. This course would be of little
benefit to the ordinary nongraduate practitioner for the simple fact
that his previous education and training would not enable him to
comprehend the scientific teaching in such an advanced course.
On the other hand, a course of instruction that would be adapted
to the needs of the ordinary nongraduate practitioner would be al-
PROCEEDINGS OF SOCIETIES. 141
most useless to the graduate. It would be threshing over old
straw, and nearly a waste of time. Those who might attend the
course would not intend to graduate, nor do they desire much sci-
entific instruction. They would simply want a helping hand in
practical work, chiefly in manipulations and new ways of doing
things. While the regular college course embraces the elementary
and advanced, both in science and practice, leading the untutored
both in hand and in mind, step by step until prepared to enter upon
practice on his own account.
A course of instruction that would cover all this has been sug-
gested here this evening, and would include the regular dental
college course, the Chautauqua Course, the post-graduate and a
practitioner's course as well, would demand an institution with
a corps of teachers and appointments far too large to contemplate,
or else the teaching would be confusing and of little practicable
benefit to those who might attend.
The course of instruction established in the Chicago College of
Dental Surgery a few years ago, and spoken of here as a post-grad-
uate course was not a post-graduate course at all. It was simply a
nongraduate practitioner's course, consisting chiefly of instruction
as how best to do things, all good and practicable in its way, but it
was in no sense a post-graduate course.
A Chautauqua system consists of a course of reading adapted
to the existing stage of mental development of each student, no
matter what this may be. To apply this idea, and make it most
useful to dentists who stand in the greatest need of its instruction,
a department for practical work would have to be included in the
course. This would be a usurpation of the functions of the exist-
ing dental colleges.
The spirit of the paper is most commendable, but it does seem
to me that in it, as well as in the discussions, too much ground has
been covered, and that the means to an end have been too indefi-
nitely stated. As a rule, it is not well to include too much where
a certain object is to be accomplished, and the means of accom-
plishing it should be made as simple and direct as possible.
As I understand it, the main thought in the paper is not the in-
struction of graduates, but the better education of a large class of
nongraduates, who, for various reasons have no intention of taking
the regular college course. The thought is worthy of careful con-
sideration and if anything is done about it, let the course be adapt-
142 THE DEXTAL REVIEW.
ed to the comprehension as well as the needs of such students. A
Chautauqua course of reading, or a post-graduate course would
meet the needs of certain classes of students, but as I have said be-
fore, they should be for different purposes and under different man-
agement.
The practicability of issuing a diploma, as has been suggested,
by such an institution as has been discussed here this evening, it
seems to me would be exceedingly questionable, for I really do not
see how it would be possible for one diploma to cover all the de-
grees of qualifications referred to, unless it was to usurp the func-
tion of the regular dental college diploma.
A certificate of attendance would be all that it would be proper
to issue.
Dr. Crouse : I have tried to have at every meeting of this so-
ciety some practical subject discussed not in the paper. I believe
it ought to be done. Men attend these meetings to learn some-
thing, to be entertained or to entertain others. There are many
times when the papers read here fail to bring out anything of a
practical nature. We should discuss things that interest us from
day to day. That is what the society ought to do.
Dr. a. W. Harl.an : I am interested in the discussion, and I
rather like the way Dr. Allport approached the question of making
divisions. I think there is room for a practioner's course in con-
nection with every dental college in the country. I think also that
there is room for a reading course. That is what I want to call it;
that those who cannot attend a practitioner's course, who will not
attend dental societies, should have some evidence that they have
pursued a three years' course of reading. My own definition of a
post-graduate course would be one where a man, who had already
graduated, could go and perfect himself in some special line in
which he was interested. For instance, if I desired to take a post-
graduate course in chemistry, I would go to an institution that was
open the whole year where I could get the instruction required at
any time. They would not confer a degree or anything like that ;
it would be a voluntary effort or action on my part and would result
in my gaining the required information if I stayed long enough and
studied hard enough for it. There is no reason why a dental col-
lege could not offer a strictl}' post-graduate course to the most ad-
vanced practitioner, because in the daily routine of practice our
most eminent practitioners have little time for study, and if there
PROCEEDINGS OF SOCIETIES. 143
were competent teachers they could have everything so systema-
tized that every one could get benefit if they absented themselves
from their offices or homes for a month or so.
The object of the post-graduate medical schools in this country
is to give instruction in various branches. The post-graduate
medical school on the South side in this city gives instruction in
operative surgery upon any region of the body — the eye, ear, genito-
urinary, etc.
If the pupil wants to study diseases of the nervous system, he
has a specialist there who devotes his whole time to that and noth-
ing else. He can get instruction daily, and most of the practition-
er's courses connected with medical and dental colleges are based
on the same plan practically that the regular student has presented
to him; that is, the instruction is more or less irregular. He at-
tends a lecture on surgery on Tuesday, say, and then attends one
on chemistry or some other branch on Friday, the particular
branch that he is interested in. He could not go there and spend
his whole time on one subject. The difficulty in the way is a finan-
cial one. If I were employed as a teacher in a post-graduate
school I should want a good salary for my whole time. It is the
only way we can give advanced instruction by having somebody"
there all the time.
I have visited the post-graduate institutions in Europe several
times. I have been through the laboratories at Oxford and other
colleges. Last August I went to Cambridge and spent some time
in the bacteriological laboratory. I could go there at eight o'clock
in the morning and stay as long as I wanted to in the presence of
one or more professors all the time. That is what is really meant
by post-graduate teaching.
It is not an impossible thing for this society to lay out a read-
ing course for dentists irrespective of their qualifications or diplo-
ma. I have no doubt a committee of three could be appointed to
select three works on three subjects, to lay out say fifteen pages
per week on each of the subjects, making forty-five pages to be
covered weekly.
Dr. Noyes spoke of the course of lectures which was estab-
lished in 1874, and of those who attended the lectures. The sub-
jects taught were chemistry, histology, pathology and physiology.
They were of great benefit to all. Some of the men who attended
144 THE DENTAL REVIEW.
these lectures were graduates and others were not. Some were
M. Ds., others D. D. Ss.
If this society has any desire to start a movement for a reading
course for dentists, I would be most happy to second any motion
of that kind. It is impossible for this society to establish a post-
graduate course of teaching. There is not enough coherence in it.
It has to have finance, laboratories, etc., and the society could not
undertake to sustain anything of that sort.
Dr. T. W. Brophv: — I am very much like my friend. Dr.
Crouse, on the subject of practical papers brought before the
Society. While I believe that papers of a practial nature are gen-
erally the most appreciated, I do think that the paper this evening
has brought out a more animated discussion than any I have heard
presented to the Society for some time. The discussion has been
entered into with an earnestness that we rarely see. I desire to
thank Dr. Tuller for the interest that he has manifested in what he
calls post-graduate study and for the paper he has read this evening.
It has put us to thinking. It has elicited a discussion that must
necessarily benefit the profession at large. It is the kind of dis-
cussion that the Society should have engaged in years ago. It has
pointed out the way by which' two-thirds of the members of our
profession may acquire the knowledge they desire.
The essayist has said that two-thirds of the dentists engaged in
practice in the United States have not had college opportunities
for acquiring dental knowledge or acquiring a dental education.
That is equivalent to saying that twelve thousand dentists in our
country are not graduates. If twelve thousand dentists can be im-
proved by a course of study that may be outlined, the benefits will
accrue to fort}- million people. What shall be done for these men ?
That is the question. I regard it as the most important question
before the dental profession to-day. What can these men do to
develop themselves, or rather to improve themselves, and thereby
benefit their patients? The doors of our dental colleges to-day
are practically closed against them. Three long years are required
and a large expenditure of money to pass the prescribed college
course of study to-day. Is it possible for these men to lay aside
their practice for three winter sessions and spend the necessary
funds to acquire that knowledge which the dental institutions of
the United States have required as necessary in order that they
PROCEEDINGS OF SOCIETIES. 145
shall receive a degree ? Every man who has spoken on the sub-
ject with reference to the financial phase has said that it is difficult
to leave one's practice for a brief period of time. How can they
leave then for eighteen months ? It is absolutely impossible,
gentlemen. They cannot do it. The profession must therefore
make a way by which these men can acquire the knowledge that
they desire and that they need for their own benefit and the benefit
of their patients. The younger men coming up may qualify them-
selves and may enter the profession with all of the accomplish-
ments that our institutions of learning can afford.
I do not agree with the gentleman who has said that the den-
tal colleges do not qualify men to practice dentistry. I will make
the assertion, and challenge its successful contradiction, that the
graduates of our reputable dental colleges are as well qualified to
enter upon the duties of their profession as the graduates of any
'Other professional educational institutions in our country.
I wish to make a statement. My position has been such that I
have from year to 5^ear received letters from dentists in various sec-
tions of our country asking me to send them assistants from those
who have graduated, and six weeks after commencement day I
have not been able to find young men to fill these vacancies. The
demand has always been greater than the supply. Those who are
in a position to know where they can get the best talent for assis-
tants in offices, seek the colleges for them. Point out to me a sin-
gle young man in this city, the graduate of a reputable college,
who is not making a respectable living. So much for the colleges.
I speak earnestly on this subject. The subject of colleges and the
work they are doing has not been treated fairly by certain members
of the profession.
The colleges are done an injustice in this matter. It is the
same old story that has been carried down from the days of Wild-
man. Our dental institutions have been underestimated ; the col-
leges, however, have been going on, rapidly advancing until they
are the only professional schools in the United States that have an
organized body, working to advance the interests of their students.
What can you say of law and medicine ? Have they such an or-
ganization ?
Dr. Crouse paid the Chicago College a high compliment when
he said the practitioner was started right ; but he was in error
when he said the course was hurried too much. Failure in the ar-
146 THE DENTAL REVIEW.
rangement of details at the college was discovered at the last
moment, which subjected the management to humiliation at a time
when better things were expected. When men fail it is not the
fault of an institution. The course went on and by unanimous
vote of the class at the close was pronounced a great success.
Some of the arguments that have been advanced this evening
are quite theoretical, although based upon honest convictions, no
doubt. The question is, What do these nongraduate two-thirds of
the profession desire? What do they most stand in need of?
A large correspondence and a practical experience of three practi-
tioner's courses convince me that the desire on the part of the
great majority of the professsion who seek what we call post-grad-
uate study or a practitioner's course, is to acquire a knowledge of
those things of a practical nature. I know Dr. Crouse is a prac-
tical man, and if he should take a practitioner's course I know it
would be for the purpose of acquiring practical knowledge. L
mention Dr. Crouse on account of my long association with him,
knowing that it will not cause any ill feeling. There are men who
desire a more extended knowledge of the fine manipulations neces-
sary in the construction of regulating appliances. Where can they
get it? Who can they go to? They cannot go to a practitioner,
because he is too busy attending to his own affairs ; and how much
information can they get from an ordinary wood cut and the de-
scriptions they read of it? Very little. They need someone to
teach them how to work. That is what a post-graduate course
does. The majority of the men who desire post-graduate study
are those who desire to learn special things.
When a post-graduate course was established here a full scien-
tific course was laid out. so ihat men who desired to study the re-
lationship of the eye and ear to the teeth could do so ; and those
who desired to acquire a knowledge of diseases of the nervous sys-
tem could do so. as well as the relations of the teeth to other parts.
More than thirty attended the first course. They took an interest
in the more practical subjects. Most of them wanted to know how
to make crowns and bridges. A course was laid out also in the
diseases incident to dentition, and one of the most competent
teachers in this city, a man having an experience of thirty years,
undertook to deliver a course of lectures on that subject. He did
not have an audience. The same was true of diseases of the skin
and other parts of the body that are so frequently associated with
PROCEEDINGS OF SOCIETIES. 147
dental lesions. They took very little interest in these subjects. I
do not blame the students at all. They wanted to know how to
swage gold plates, to make regulating appliances, to learn the
modern methods of filling teeth, the manipulation of gold and amal-
gam fillings — things which they had to do when thej^ got home. ■
They had not had the time to take up physioiog}', pathology and
surgical anatomy.
Gentlemen, if you have a reading course it must be started as
Drs. Allport and Harlan have said ; but it is not a post-graduate
course for the reasons stated. There was not a graduate in our
first practitioner's course and there were more than thirty students
in attendance. In the next course there was one graduate ; in the
third, six, and in the next course there will doubtless be a dozen
graduates.
Students who graduated from our college years ago are coming
back to "Brush up," so to speak, in certain departments in which
they feel themselves deficient. I think the majority of practition-
ers do not know exactly how the work is carried on in our schools.
If you can get men to say that they do not know how to do a cer-
tain thing, and are honest about it, then they are in a position to
learn something. If they admit that they do not know how to make
a gold crown, then we can show them how to do it. In our first
course we were experimenting somewhat. We began to instruct
students by demonstrations, and when they went home they could
not do the work. They had the theory, not the practice. Now,
these men are put to work and they are taught to do things right,
and when they go home they feel that their time has been well spent.
Some are returning to acquire further knowledge in the profession.
That is the proper way to elevate the profession from a practical
standpoint. There is not a man living who will see the rank and
file of the profession get down to scientific study. Let a scientific
course of lectures be delivered in this city, and I venture to say you
wouldn't have fifty out of 500 dentists present. I do not say this
to cast a reflection upon dentists ; they are busy men, and have
other things to attend to. They want something more practical.
If we can get graduates and nongraduates to familiarize themselves
with practical things, that will enable them to fill the teeth of their
patients better, to treat pulpless teeth better, to cure pericementitis
and alveolar abscesses, to make artificial dentures so that patients
can wear them comfortably, to instruct parents as to the care of
148 THE DEXTAL REVIEW.
children's teeth, and to make crowns and bridges and do it well, in
my opinion we have accomplished the greatest work it will be pos-
sible for us to do. We should encourage them to undertake dental
and medical courses, to read text-books and other literature that
ma)' be placed in their hands. If we succeed in doing this we will
have accomplished a great work.
Dr. E. M. S. Fernandez: I agree with Dr. Brophy's ideas in
the matter of a practical course of instruction, and I commend
post-graduate study, but by no means give a diploma. Our pro-
fession changes too much for that. Supposing we had had a post-
graduate school about twenty years ago and we looked for those
gentlemen to-day who had graduated, we would find them not up
to the standard of dentistry to-day as it is taught and practiced. If
dentistry would stand still, they would be all right, but it advances
too rapidly. A practitioner's course I approve of very much. I
would approve of a course of lectures of a certain kind, not old
style ideas, but condensed, intelligent lectures intended for men
that have been practicing their profession for some time and desire
to improve in each specialty. Let it be so that a man can attend
any course of lectures, on one specialty alone if he wants to, or some
other practical subject. Of course, if any of us want to take a
special lecture course we can go to a medical college and take an-
atomy, physiology, therapeutics, materia medica, or any other
branch, provided we can do that. Still in a special course de-
voted more to dentistry we would get a more condensed knowl-
edge.
In this connection I would like to say a few words in regard to
our dental colleges. I have heard so many slurs cast on dental
colleges that I know perfectly well the gentlemen do not really
mean what they say. So far as I am personally concerned, 1 can
say that the colleges I know of in this city are doing good work;
that the teachers are doing their duty, and they do it well. If the
students do not learn it is their own fault, and if they do not learn
in these institutions, they won't learn anywhere. The colleges
give their students good lectures and practical work.
Dr. J. W. Wassall: — I do not think any one has belittled the
dental colleges this evening. I am sure I have not. The efforts
they put forth are good and they have afforded the greatest benefit
to those who have had the chance to go to them. The only point
that has been made is, that the graduates from dental colleges are
PROCEEDINGS OF SOCIETIES. 149
not thoroughly prepared to do their work only because that is an
impossible thing in any professional school and hence no discredit.
Dr. Brophy challenged an}' man to prove that the graduates of
our dental colleges, or the institution with which he is connected,
are any more unfit to practice their profession than the graduates
of other colleges in other professions. That is true. A man may
be a graduate of a medical college, no matter how good the college
and how thoroughly he has done his work, still he is not yet ready
to cope successfully with disease. It is only after he has had ex-
perience in practice that he is able to do that. The same is true
of the legal profession. Only a day or two ago at a ministers'
meeting the Garrett Biblical Institute was criticized because the
products of that institution were not competent men to properly
preach the gospel. They were charged with not having the divine
unction. These men will make good preachers, the graduates of
medical schools will make good doctors, the graduates of law col-
leges will be good lawyers, and the graduates of dental colleges
will make good dentists, when they have had a little more experi-
ence in actual professional work.
Dr. Brophy: — May I add a statement to what I have already
said? About five years ago, at considerable expense and labor a
laboratory was fitted up in connection with our college for the pur-
suit of bacteriological study. The laboratory was elegant ; it was
thoroughly equipped. Some of the gentlemen here this evening
were very enthusiastic about it and my recollection is that they did
not convene a single night to pursue their work. If the}^ did, I
never heard of it.
Dr. J. G. Reid: — -What Dr. Brophy has said is true. There
were about ten young men who took money out of their pockets to
fit up a bacteriological laboratory that would be an honor to any-
body and an ornament to any practitioner's office. There was
nothing done to my knowledge. After the laboratory was nicely
fitted up the students lost their enthusiasm.
Dr. R. B. Tuller, in closing the discussion, said : In writing
my paper I elaborated the subject a good deal more than I have
produced this evening.
I thought it would not create as much interest as it has ; I
therefore condensed it, and in so doing omitted some portions I
should have allowed to remain in order to have been more explicit.
Drs. Wassail and Grouse *ay that while the title of m}- paper is
150 THE DENTAL REVIEW.
post-graduate study I have gone outside and devoted a large por-
tion of it to tlie consideration of nongraduates.
My reason for that is given in saying that we must consider the
situation as we find it, and we find we are largely made up of non-
graduates — more than two to one.
I thought as this large element was made up of recognized
dentists legitimately in practice, we must to a certain extent look
upon them as graduates. Not graduates of some dental school,
to be sure, but, having gotten their dental knowledge, their school
days are over and they are settled in practice, as many of them
have been for years.
If experience teaches much of the greatest value, such men
cannot be classed with beginners. Several years in the mill ought
to count for something.
Our work differs from that of other professions in the absolute
necessity of a great deal of mechanical ability. We have to edu-
cate our hands to that degree of manipulative skill whereby we may
do the most delicate and precise work under the most trying dis-
advantages.
A man who can not read or write may acquire a large degree
of manipulative skill in both operative and prothetic dentistry, but
he can not in this day and age be a competent dentist. On the
other hand, a man with the highest educational attainments may
read all that was ever printed on dentistry and yet not be any kind
of a dentist
It is not right, however, to ignore what a man has attained
since he has attained it, and we find him in the actual prosecution
of the work and perhaps satisfying the demands of his patrons.
A self-educated man may not be as good a dentist as he who
has gone through the regulation course; and again he may be bet-
ter than many who are college trained. Although self-educated,
self-made, he may in every way be worthy of our right hand of fel-
lowship. That does not argue that his way was the right way.
The die is cast that makes this condition of things in our pro-
fession and we cannot change it. These men are a part of the pro-
fession as much as we are, and were we disposed to debar them
from practice (which none of us are I am sure) we could not do it.
But we can do something toward bettering the condition in the
future, by extending to them every opportunity and offering every
stimulus we can to look up and come up to our standard. Then do
PROCEEDINGS OF SOCIETIES. 151
what we can to prevent any more from coming except through the
regular course of training. But the minority you know, cannot al-
ways have its own way. We think — we know we are right, but we
have to educate the minority to think so too.
Reference was made by some of the speakers to the great good
that came of dental meetings, saying they were the very best edu-
cators. My paper accords full importance to the benefit of such fre-
quent meetings, but I think a good many lose sight of the fact that
the greater number of dentists are scattered throughout the coun-
try in such a way that they cannot often assemble. Many are un-
able to get out even once a year, very likely. This applies to
graduates and nongraduates alike. If they were located in a large
city like this where a good many may easily come together the}-
would have the benefit of that contact.
We lose sight of the fact, too, that perhaps the nongraduates of
otir profession exert a good deal of influence when it comes to
matters of legislation which we sometimes desire. We have de-
sired for a number of years past to pass restrictive measures pre-
venting the dental profession from being augmented by that class
of men. Such measures cannot and do not aim to effect those
already in.
I had an experience in New York State a number of years ago
which illustrates the matter. I was not a graduate in dentistry
then. I knew that measures were to be brought before the legisla-
ture there and the representative from our district was one of my
patients. He came into my office one day and I extracted a tooth
for him without pain and " payin'," and when he got out of the chair
he said, " Doctor, if there is anything you want in Albany any time
let me hear from you." He took the side of the measure which I
advised.
These men distributed through the country exert a stronger in-
fluence in regard to legislative matters for dentistry than we can in
cities.
My idea then is to extend a course of reading among the non-
graduate dentists to bring them on a level, as nearlj' as possible
under the circumstances, with graduates. Open a possible way
for them, as I claim that under the present condition of things —
three or five j'^ears in college— it is practically impossible for 9!) in
100. Give them opportunities, and if they will not embrace them
we cannot help that. We will get some of them. If we can by
152 THE DEXTAL REVIEW.
such a course of reading bring them up to a standard of intelli-
gence where they would be capable of prosecuting a course of post-
graduate study, I would not hesitate to admit them and then open
the wav to the suggested post-graduate degree, if competent.
The idea again, and one I should have brought out in my paper
was to educate these men on certain lines of studies with the view
eventually of bringing them to our dental colleges for a short course
at least, such for instance as the Practitioner's Course in the Chi-
cago College of Dental Surgery, and which I think should be estab-
lished in all the colleges in the country. They would be better
able to comprehend the lectures and teachings, and such a course
being a recognition from them, we would gain their harmonious
action and connection with college work.
Education too, would bring them up to an appreciation of soci-
ties, society work and a good code of ethics; and in many other
ways bring them into line with our work, and into touch with us,
where now the}' are somewhat apart, forced into a position of an-
tagonism.
Dr. Allport thinks the scheme is altogether too broad. 1 would
defer much to the opinion of such a man and many others in this
society. I am not positive, nor tied to any of the opinions I have
expressed, but they come to me as a sort of conviction after care-
fully thinking and studying over the matter, and I shall endeavor
to carr\- my convictions to others until I am convinced I am wrong.
I want whatever is best for the profession at large and am open to
argument. If we want to elevate the profession let us begin at the
top and at the bottom and the middle and all along the line and
lift it all along together if we can. The brilliancy of our best men,
our leaders, will in no way be dimmed by such work. They
would still shine at the head of a higher grade of men. If some
way were provided by which our dental colleges could take the
practitioners and put them through such a course of lectures and
studies as they need to make them competent for the college
diploma I should be in favor of it. But as I have said the pres-
ent conditions practically shuts them out.
Not a college, nor any other organization can give a diploma
for something that a person has not done under their teachings and
guidance to merit and give proof that he merits it. A diploma
is nothing more or less than a certificate of having prosecuted and
passed certain studies and thereby understanding them.
PROCEEDINGS OF SOCIETIES. 153
The granting of a diploma at the end of such a course of home
study, as has been suggested, would be an incentive to men in
practice to study for it, the graduate having much the advantage
of course, as his diploma from the college would be a certificate of
having passed certain studies. I cannot see any inconsistency, as I
look at it now in the establishment of a degree, which it might be
possible for any man in the profession to attain or secure upon his
showing evidence of having followed certain required studies and
ability to pass a good examination on them. Once in practice such
study must be pursued at home during leisure hours, and I believe
it would help every man in the profession, from the highest to the
lowest, to have such a course of study inaugurated, and every one
of us should be interested in seeing it done. Leave out the non-
graduate if you will, and leave out the diploma feature if you will,
but I think a greater good would be accomplished if we open it up
to the whole profession and give a stimulus by having something
to work for.
I do not believe it is necessarily such an almost impossible
undertaking as Dr. Noyes and some others seem to think. It does
to be sure require a most competent man to manage and direct it,
but we have men and ways and means when we determine that such
and such things must be done. I mentioned the "Chautauqua Idea"
because that society has demonstrated that such a thing can be-
come a success. They have been in existence some fourteen years
and have a membership of about 200,000. They have the whole
country to draw from, while we have only the dental profession.
They conduct their course for 50c a year. I do not know why such
a scheme cannot |^e carried out in the dental profession under the
auspices of some dental society for $1.00 per year, an expense that
is nominal, except the books each subscriber would be required to
provide for himself, and the expense at the end for certificate or
diploma. It must be conducted in a way to avoid large expenses.
The work of teachers would no doubt have to be to a great extent
a labor of love, but such work would need to be so distributed as
to draw not too much on the time of any one without compensa-
tion. In fact, I do not think it would require more sacrifice on the
part of such as might be called upon than they are making to-
day in the interests of advancement of the profession.
Dr. Ottofy is correct I believe when he says, begin in a small
way and let the thing develop, and no doubt if properly fostered
154 THE DEXTAL REVIEW.
as we expect any infant to be, it will work out the way and the
means. We cannot expect to formulate plans, work out all the de-
tails, and put the whole machinery in operation at the start.
While we have the subject before this Society and there is
considerable interest awakened, I would like to move, Mr. Presi-
dent, that a committee of three be appointed of ways and means by
which a reading course can be established in this society — and I
should hope that it would be the means of encouraging other soci-
eties to adopt the same thing and cooperate with us — the commit-
mittee to make its report at the next meeting.
Motion seconded and carried.
Delta Sigma Delta Fraternity.
The semi-annual meeting of the Supreme Chapter of the Delta
Sigma Delta Fraternity was held in Chicago, Monday evening,
January 2.5. The Constitution and By-Laws were revised and
adopted. Drs. J. W. Slonaker, of Chicago, and C. B. Rohland, of
Alton, were initiated into membership.
The first annual banquet of the Supreme Chapter was given on
Tuesday evening, January 2Gth, at Kinsley's. About seventy
brothers of the fraternity participated, and from beginning to end
throughout the banquet, its speeches, etc., a general good fellowship
prevailed, and when the members separated it was with a hope of
early reunion. The annual banquets of the Delta Sigma Delta
Fraternity will be looked forward to with many pleasant anticipa-
tions.
The following were the toasts replied to : •
"Welcome," D. C. Bacon, S. G. M. "The Supreme Chapter,"
R. B. Tuller, S. W. M. "Our Honorary Members," G. V. Black.
"Alpha Chapter," W. L. Webster. "The Infant Class," P. J.
Kester. " Beta Chapter," Manning A. Birge. "The Dental Pro-
fession," E. D. Swain. "Gamma Chapter," Geo. B. Perry, P. G.
M. "Epsilon Chapter," T. W. Brophy. "Our Absent Friends,"
Geo. J. Dennis. " Zeta Chapter," R. H.Allen. "The Ladies,"
Edmund Noyes. A quartette, consisting of George Gould, B. D.
Barker, Frank E. Phillips and Chas. R. Currier, interspersed the
speeches with vocal music.
The Dental Review.
Devoted to the Advancement of Dental Science.
Published Monthly.
Editor: A. W. HARLAN, M. D., D. D. S.
ASSOCIATE EDITORS:
Louis Ottofy, D. D. S. C. N. Johnson, L. D. S., D. D. S.
The Endowment of Dental Colleges.
It had been our purpose to discuss this question last year but
the press of matter and other contributions caused the subject to
lie dormant until the present.
In all institutions where a dental department is attached to an
uuiversity, the presumption is that such schools are not dependent
on the fees of students for the support of the teachers and other
necessary expenses of the department. Is this presumption cor-
rect ? In Michigan, Minnesota, Iowa, Pennsylvania and Maryland
this is so, but not elsewhere as far as can be ascertained by inquiry
not addressed to the secretaries or deans of the dental faculty.
If we are in error we will cheerfully make correction in our next
issue.
This state of things brings up the question of the endowment
of dental schools so that the fees of students will not cut a figure in
their possible entrance or rejection. There are few examiners
not directly connected with every dental college or department, in
fact we do not know of one. This being true it may be seen
that favoritism, or fatal good nature, or avarice may tempt an ex-
aminer to be too lax and this laxity in one intently dishonest will fill
a low grade school so full of pupils that the effect of their ultimate
graduation will lower the professional tone for years. Once grad-
uate inferior men and control of them is lost ; graduate none but
those of a superior grade and the upward tendency is assured.
How soon will some of our rich and philanthropic dentists begin
156 THE DENTAL REVIEW.
the work of endowing a single dean in a dental college or a dental
department where the pay of the teacher is small and can only be
increased by admitting more students? More can be accommo-
dated. This is a subject that deserves careful consideration and
the best method of doing good for the profession and the people is
to render the teacher free from necessity of wondering where his
compensation is to come from. By paying teachers for their time
and paying liberally we get the best work — an endowed school or
chair will give the best work — other things being equal, if the
teachers are not bothered by the financial details or worrying about
their salaries.
Who will be first to start the movement, an individual or an
Alumni Association ?
The American Dental Association.
In looking over the transactions of the American Dental Asso-
ciation for 1891, you will find the text of proposed amendments to
the constitution. We cannot predict what the action of the asso-
ciation will be, but we hope that the wisdom of the body that con-
venes at Niagara Falls next August will fix the date of meeting in an
elastic manner, so that at one season of the year it will be possible to
meet anywhere in the south or west without making it obligatory
to always meet the first Tuesday in August, as is now provided.
The fixed date has much to do with making our National Associa-
ation a northern, western and eastern dental association. In order
to render it a compact representative body it is a necessity that
several sessions should be convened in various portions of the
south and southwest in the next few years.
It might be well to meet in May, 1803, in Nashville, as a starter
for the World's Columbian Dental Congress, which is fixed to be
held in Chicago, August 17, 1893.
There are too many progressive men in the south who would
be desirable as members of the American Dental Association for
the association longer to confine its meetings north of Mason and
Dixon's line. Let the change be made.
The Congress, 1893.
At the late meeting of the executive committee held in Chica-
go, at the suggestion of Mr. C. C. Bonney, President of ohe World's
Congress Auxiliary, the word "meeting" was dropped and the
EDITORIAL. 157
word "congress" adopted. Now the correct title is " The World's
Columbian Dental Congress," to meet in Chicago, Monday, August IV,
1893, and continue until August 2*7, 1893. Success to the Congress.
The Theory of Groups.
The Medical Record in a recent issue, referred to the peculiar
circumstances which result in the presentation of cases to the
physician in groups. It is true that zymotic diseases always do ap-
pear in groups and that probably many other diseases are epidemic
or prevalent for good reasons. But there seems to be no cause
why accidents for instance, should appear in groups, why the physi-
cian who is called to set a broken right leg in the morning should
by the unseen hand of fate be guided to the bed of the man who
broke his left arm in the evening of the same day. Nor is there any
apparent reason why the physician who has been waiting for the
god of gynecology to send him a " case "for a week, should without
warning, in one day be the "deliverer" of three additions to the com-
munity— all boys. But such is a fact, and the philosopher is looking
for a "theory of groups." Have not dentists noticed this same condi-
tion in the practice of their profession ? For a day or so probably
every troublesome tooth opened into will contain a dead pulp just
on the verge of resulting in an alveolar abscess. Mayhap he has not
seen an exposed pulp for a week, when all at once three or four
cases are under treatment. Mrs. Evingston just complained of the
loss of that "beautiful" filling, bemoaning its short life, when Miss
Souside conveys the painful intelligence that she cannot understand
how it happened so soon — the crown's off. If that old rubber plate
of Mr. Simpkins with its semiannual "tooth off" does not reach you
on the same day, its because you left the office earl}'.
Undoubtedly certain diseases, as pericementitis, exposure of the
pulp, alveolar diseases, gingivitis, etc., are directly influenced by
changes of temperature and the rise or fall of barometric pressure,
especially if sudden. The electrical conditions also have some in-
fluence. But why do several antrum cases come at one time into
the hands of the general practitioner ? Or why does he who uses
mostly vulcanite find at once two or three gold plates on hand ?
And why this week probably ten gold fillings to every one of amal-
gam, and next week the reverse ? Why do repair cases appear
about the same time, regulating cases, often of twin-like similarity,
why do they come together ? Yes, why ?
158 THE DEXTAL REVIEW.
Graduates of Dental Colleges.
We believe that the profession has almost outgrown the custom
still prevalent among dental journals, to annually publish a list
of graduates of the various dental colleges. The number of colle-
ges has rapidly increased during the last decade until we now have
thirty in active operation. The classes have increased in numbers
to such an extent that about 1,500 students will graduate this year.
The publication of these lists compels us to use space, which
if devoted toother reading matter would prove more valuable to the
majority of the readers. Information regarding any particular
graduate, or any special class can be readily obtained from the
dean or secretary of any college, inasmuch as all colleges publish
annually a catalogue containing the names of its students and
graduates. For handy reference, a much more compact and sui-
table method than publishing the lists in the dental journals, would
consist in the publication of an official, correct list annually on the
part of the National Association of Dental Faculties. During the
present year we -will publish the names, but in 'f>?, the practice will
be discontinued.
Exit Archives of Dentistry.
We regret to announce the sad niswsthat \hG. A i- chives of Dentis-
try is no more — at least not for '92, Our St. Louis friends have
laid down the pen — to be resumed, we trust, with increased vigor
some time in the future. The Archives has been one of the most
welcome visitors to our exchange table, and we hope the many
friends of progress in dentistry who have contributed to its pages
will continue to let their light shine in other journals.
Hungarian Dental Journal.
In January there appeared under the editorial management of
Dr. Joseph Iszlai, at Budapest, Hungary, the Odonioskop, the first
dental journal to be printed in the Hungarian language. We be-
speak for the editor — who is a well known writer — unlimited
success.
The languages in which dental journals are now published are:
English, French, German, Italian, Spanish, Russian and Hunga-
rian. Until a year ago there was also published a journal in the
Scandinavian language.
EDITORIAL. 159
Too Much Matter.
We are again compelled to add to the number of pages of the Den-
tal Review beyond the number originally decided upon, and we are
also compelled to ask the forbearance of those whose communica-
tions are now in our hands and which ought to be in print ere this.
DOMESTIC CORRESPONDENCE.
Letter From New York.
To Editor of the Dental Review:
The gavel has fallen and the 23rd Anniversary of the First
District Society of New York is a thing of the past, in fact, yet not
an event which memory will fail to sound with honor for many
years to come. So far as the carrying out of the programme, which
was so admirably arranged by the Executive committee, everything
has gone smoothly and profitably throughout the entire session and
by acclamation of all in attendance said to be one of the most suc-
cessful meetings ever held by the Society. Nothing occurred to
mar in the least degree, the harmony of the meeting, from begin-
ning to end. The meeting commenced with a liberal attendance
from many quarters of the country and all were made to feel at
home by an exceedingly felicitous address of welcome, by the
President, Dr. Norman W. Kingsley. We have listened to him
many times, but never heard him more to our satisfaction than on
this occasion. He generously acknowledged that it had been dis-
covered that the famed city of the Empire State, could no longer
hold the palm of being the leading city of the New World, but that
it could only be ranked in the future as second. The great city of
the future was to be Chicago — they had captured the World's Fair
and were entitled to the belt, they had won it fairly and so the wind
was out of our sails and it could now ably sustain the title of the
"Windy City." He paid a glowing tribute to the united energy
displayed and hoped and predicted that Chicago would fully vindi-
cate the fullest expectations of the whole world. He playfully
criticised their study of the almanacs in connection with dates of
Columbus' discovery of this continent, since they had set the date
for celebrating the momentous event in '93, when, according to all
reliable historians, it occurred in '92. Dr. Crawford was called up-
160 THE DEXTAL REVIEW.
on by the President to respond, in behalf of the visitors, which he
did, by introducing himself as hailing from the Rock City of the
Cumberland (Nashville, Tenn.) He proved himself a right smart
product from that country and captivated all by his marked oratory
which one could see was " pure and simple, native." His speech
made manifest that he was well informed on all the ruling topics of
modern thoughts and he also disclosed himself a faithful exponent
of the belief that the profession had a mission of importance on
this planet second to none other and that the signs of the times
fully indicated that they would be equal to the demand.
The first paper was by Prof. Peirce, of Philadelphia. Subject:
Some Thoughts on Transformism. As this paper was the begin-
ing of a series, it was at first given up largely to historical state-
ments. It showed intelligent and thoughtful research from the be-
ginning to the end. It seemed to be disposed to lead up to the
purpose of a compromise of Darwin's views with his own ; of the
latter many are somewhat familiar and may be given in the mere
statement that the tastes and necessities of the animal kingdom are
changed according to their changed environments.
The discussion was opened by Prof, Heitzman, and was lis-
tened to with enthusiasm by all. In a general thought he was much
in unison with the essayist, and, by his preeminent knowledge of
the morphology of the tissues, made a discriminating and intelli-
gent instructor on such a far-reaching subject. Prof. Heitzman,
to be full}', or partially, appreciated, needs to be heard in person.
He was up to high tide on this occasion. His familiarity of thought
in the dissection of the paper made him a profound adjunct to the
subject. Dr. J. Smith Dodge, well known in New York, followed.
The Doctor is an intellectual treat anywhere you may hear him.
He is by profession a dominie in the Universalist Church, and is
justly nominated the orator of that denomination. He was much in
concord with the essayist, although showing not a little growth in
that direction, as shown in former expressions, at an earlier
date, before the Odontological Society. The Doctor is highly
practical, and in this direction he applied this to the subject. He
emphasized one remark that will not be overlooked by some. He
declared that "Dentistry was not a science, but was preeminently
an art." I will add right here that in an article by Dr. Edison, of
New York, in the North American Review entitled, "The Past and
Future of Medicine," he says, "The formation of medica, is art."
Dr. Kingsley will enjoy both these statements.
DOMESTIC CORRESPONDENCE. 161.
I noticed an elevation of the superciliary muscle, as Dr. Dodge
uttered these remarks, so much in unison with his belief. Dr.
Dodge proceeded to show how this subject could be applied prac-
tically, simply by observing in their practices the progress which
followed a legitimate and intelligent effort to make dentistry a fac-
tor in the preservation of teeth. In other words, I would say that
the constant emphasizing of the importance of our services is mak-
ing such an impression on the minds of our patients that they give
more earnest heed, not only to their own necessities, but decidedly
more to those of their children, and in this way lessening the need
of repairing the wasted tissues of the teeth.
Dr. Stubblefield, of Nashville, Tenn., added to the discussion
a cultured dissertation, although showing not a little disposition to
€vade the scientific phase, and finally ended by italicizing the state-
ment that concerning the theory of man being a direct descendent
of the monkey, he was disposed to fall back upon his implicit belief
in his Heavenly Father and leave the whole question in his hand
for fuller definition.
Dr. Case, of Jackson, Michigan, opened the second session bv
an illustrated lecture on the "Borders between the Natural and
Artificial in Crown and Bridge Work." He proved himself a
^'master of the situation" and eliminated many important points
which practical men will be able to make profitable. Dr. Crawford
followed in discussion, and added not a little to the fund of infor-
mation, but largely from a conservative standpoint. He is a me-
chanic. Prof. Essig, of Philadelphia, delineated his familiarity
with the subject by an artistic handling of chalk.
Dr. Van Woert, of Brooklyn, followed. He is a young practi-
tioner of mechanical fertility. Dr. Bliven, of Worcester, showed
his sharp prolific ingenuity by voice and chalk. He is smart; he
not only knows it but it is conceded to him — this might shorten
the breath of a conservative. In all the crowns he has ever made
^nly one has ever broken. Amen. Yea, verily. Dr. Watkins, of
New Jersey, made the closing speech on crowns and border lines.
Watkins is a thoroughbred "Yank," full of sharp common sense.
He looked real nice this time, so blooming and cheek (so much)
so cherry red. Some will recall by my last letter that I spoke of
the experiment "he had caught onto" — the biozone treatment.
Well, he is in it. He was so brilliant. He'll get there. He al-
ways goes with one eye open to see into anything new and fresh.
162 THE DENTAL REVIEW.
Once on a time in an audience a misfortune overtook an individual
that produced beauty unadorned, and a precise old fellow in his
sincerity of good will, unfortunately called attention to the catas-
trophe, and to make protection doubly sure, calls out in thunder
tones that any one who looked that way would be struck blind. In
an instant one old curiosity shop took in the situation and sung
out, I'll go one eye on it. Dr. Watkins takes risks — not in this
line but he knows a good thing when he sees it, and somehow he
does see it. He pulls them right to the bull ring in Jersey so-
ciety. He is in it as a right smart chairman of the executive com-
mittee. He is on the antismoking advocacy and I think he will
not let up on that amendment to his report, which proposed mak-
ing cigars a substitute for cigarettes.
We think we may safely say that a resume of the discussion on
borders between crowns and bridges, indicates that rings or bands
are not so much considered essential as formerly. Although the
essayist did emphasize that he could burnish his band into deform-
ities of the root, we think he made himself clear. Mention was
made favorable to the use of all porcelain crowns. This will ac-
celerate the Pittsfield, Mass., dentists and all porcelain crown ad-
vocates early in the season.
The third session was a proud one for the essayist — Dr. Nor-
man W. Kingsley. Subject: Adenoid Growths, Mouth-breathing,
Thumb-sucking and Their Relations to Irregularities of the
Teeth. It was an occasion that covered the doctor with wide-
spread fame for all time, even if he may not chance to ever evi-
dence his brilliant skill again before his profession. Long life to
the doctor and many returns. The exhibition of beautiful life-
sized profile models, illustrating the doctor's subjects, were things
of beauty and a joy to all that saw them. It was one acclaim that
he had reached his zenith to date. It was worthy to be called a
crowning glory. The doctor is on record fgr claiming that dentis-
try is an art. Many may not, and do not hold to this idea, but you
will see that he is in accord with others, of more than ordinary
thoughts. All things are settled when settled right. This exhibi-
tion was one of a series he is preparing for publication, the
first already having appeared in the January number of the Cos-
mos. This effort wins the spurs. All those that took part gave
unqualified praise to the doctor. In a mass statement it may be
said that a general concurrence with the doctor's conclusions was
DOMESTIC CORRESPONDENCE. 163
made manifest. So far as this occasion notes it does not count in
favor of adenoid growths producing high vaulted arches, while it
may produce deformities of the jaws by the habit of thumb-suck-
ing ; yet not always a very forcible evidence of favor in this decision
was contributed by Prof. Guilford, of Philadelphia, in the form of a
model and the history of the case. It came out that it was possible
that open mouths — mouth-breathers — caused by a fixidity of the
molars and elongation, could come about by the mouth remaining
open, and thus allowing the molars to elongate, as does often occur,
in the loss of an occluding tooth.
This session was marked, from first to last with hearty enthusi-
asm. Dr. Kingsley, in calling upon Dr. Farrar to close the discus-
sion, paid him a very unique compliment as a worthy rival or com-
petitor, one that did honor to the art, in a superior way. Dr. Farrar
returned the same in a well prepared paper. These things are full
worthy of our admiration, for they do add luster to our profession.
To undertake an adequate description of Dr. Kingsley's exhibi-
tion would be a useless effort. Let it be understood that these
portraits in plaster, were works of art, but not correct as regards
the entire facial expression— the deformities were fac similes, but
the rest had been changed from the originals for disguise. The de-
formities were as before, and as afterward, besides this, models of
articulation, with mechanical devices which were used in each
case. This collection as seen, ought ultimately to occupy a niche
in a future place which, it is hoped, may, through a larger liberal-
ity in ambitious culture, be sure to come. The rare beginning of
museum deposits was purchased by the Odontological Society, by
the ardent wish of Dr. Barrett, of Buffalo. I refer to the remarkable
collection of dentition, probably unequaled in the world. These
movements are worthy of emulation in all departments. If not
in this generation of practitioners, still we predict it will come. We
do not doubt but that when Dr. Kingsley's full series of articles
are seen in publication, with the illustrations, it will stir the latent
talent in some one now unknown, and the future will add new lus-
ter because of those incentives. The fourth session was under the
chaperonage of Dr. Crouse, in the interest of his pet subject, the
Dental Protective Association — Its past, present and future. The
doctor carried the conviction to all, that things had come to such
a state of development that only a serious consideration of the vi-
tal interests of this body and the work in hand would be worthy of
164 THE DENTAL REVIEW.
the united effort of the largect number possible. For this, Dr.
Crouse earnestl\- plead.
There is a stronger conviction because of this conference, that
Dr. Crouse not only needs this aid and cooperation but surely he
has earned it and it will be only a base ingratitude if he does not
have it. We predict he will have it. The Doctor was plied with
much questioning and some of it seemed frivolous and doubting.
Our gratitude should be shown by our coijidencc being gained by
works which have been productive of good. Already the crown
patent has been defeated by the highest court and doubtless it is
true, as Dr. Crouse said, this organization has saved the profes-
sion a million of money. This is their first fruit which it is stated
is backed up by sensible evidence and that onl}' a fair test of the
bridge patent in court, and they will be able to antedate all pat-
ented bridge inventions. A spirit was earnestly evinced that out
of this meeting will come a decided effort to not onl)' increase the
membership, but give the moral support that Dr. Crouse so much
needs. He states that the circuit in which this question of bridge
litigation must be carried, to its final issue, must occur in New
York and Connecticut. We judge from general assent that this
conference will bear good fruit. We are sure that a healthy feel-
ing is growing that the mission of this protective body is a wise
one. Doctor, be of good cheer. The origin of pus, in the third ses-
sion, was ably presented by Dr. Stubblefield who did not much
favor the theory that its origin is by bacteria. The Doctor is a cul-
tivated addition to the ranks of our calling and is in every way an
attractive advocate. More and more this will be so as the stan-
dard is elevated. We are optimistic just here. Dr. Freeman
led in the discussion by a well prepared paper, mostly a classifica-
tion of the bacteria family and more leaning toward the initial step
by bacteria. Dr. Heitzman made decided emphasis on the point
that this question was not well enough understood to dogmatize.
Dr. Geo. Allen leans heavily to the bacterian theory and em-
phasized the fact that a majority of surgeons operated only in as-
sociation with antiseptics. He referred to the advance made in
abdominal operations, because of the general belief of the origin of
infection by bacteria. The experience of the unexcelled surgeon,
Taite, of London, does not emphasize this theory, and no surgeon
has advanced upon more extremely dangerous territory than he.
He did give the German surgeon an intelligent hint, when inter-
DOMESTIC CORRESFON'DENCE. 165
rogated as to what he attributed his eminent success. Mr. Taite,
casting a significant look at his questioner's fingers, said, one thing
I am fastidious about is this, I keep my finger nails clean. This
will apply to dentists also, for it is far from being properly re-
garded. Dr. Allen is one of those kind of persons who feels called
upon to express themselves very dogmatically. He does, doubt-
less, think he believes that bacteria originated all the disorders
that human flesh is heir to. We think we do him no injustice by
injecting his last remark in that discussion. Dr. Heitzman inci-
dentally referred to a demonstration produced by Dr. Bodecker
recently, and exhibited to him: a specimen of dentine that had
been so acted upon by a phosphate filling, that he was readily
able to distinguish the reticulum beyond all questioning, and
even under quite low powers. Dr. Allen took occasion to
challenge the proof of such a statement by remarking that if Dr.
Heitzman would put this specimen into the hands of experts — such
as he could name — he would prove that no such things existed.
All the notice Dr. Heitzman made of this was to pleasantly smile
and let it pass. This, it will be recalled by careful readers of the
journals, is the same old bone that Dr, A. has been gnawing ever
since Dr. H. announced his views upon this subject. Somebody will
know the truth of these things ultimately. Dr. Heitzman referred to
the theory that has been advanced — that bacteria did exist inter-
nally. He said there were instances where persons had received a
shock and it had developed inflammation in the femur and had focal-
ized in its destruction of tissue, in the patella. There was a little
mystery in such action, according to the sparseness of knowledge of
these things, and it was not strange that such action was fastened
upon diS prima facie evidence that it was originated by bacteria.
One portion of Dr. Heitzman's remarks are worthy of special
mention, viz: the eulogy he paid to the last published paper by the
late Dr. Atkinson read before a section of the American Medical
Association at the Newport, R. I., meeting, subject: The Origin
of Pus. The doctor had placed 100 copies in Dr. Heitzman's
hands for distribution. He had with him sixty copies which he
passed among the audience. We will add that in our judgment no
paper has ever emanated from the doctor's brain more fertile in profit
to any practitioner who is searching for knowledge. He went so far
in some remarks he made in connection with this subject we con-
sidered the little monograph immortal. We had read and re-read
166 THE DENTAL REVIEIV.
it, and each time with renewed interest and profit, and think the
Review would gratify many of its readers if they would republish
it. The subject, as stated in the programme, was "The Formation
of Pus Reviewed." The drift of the discussion tended toward the
bacterian theory. The sixth session was the last on the pro-
gramme. Prof. John Marshall, of Chicago, was announced as the
essayist ; his paper was in the hands of the executive committee.
The eminent gentleman was not on hand, and at the last moment
out of a clear atmosphere the lightning flashed along the wires be-
tween New York and Chicago, and the paper was consumed.
Nothing but the title of the paper left for discussion "A Plea for
Extraction and Replantation in Cases of Persistent Alveolar Ab-
scess." The shots came so thick and fast, and so effective from all
that spoke upon it, that the subject was left more holy than
right — eous. Dr. Kingsley closed the twenty-third anniversary with
some very appropriate remarks, in which all fully coincided. In
substance it was an expression of his hearty gratitude for the exceed-
ing good will that had pervaded the entire session. Everything
so far as the meetings were concerned, and those that had attended
them, had been in every way gratifying to him, and there was
no need of saying to those present that the proceedings would re-
flect honor upon the First District Society and add new luster to
its world-wide fame.
This was not overstating it, for it was the prevailing assent that
this meeting had never been excelled. Dr. Kingsley said that the
spirit of the session was the fullest recompense to him personally
and it would be joy to him for all time. The Dr. 's remarks were
listened to with a hush of every breath, and the fullest manifesta-
tions were given by long applause which carried conviction of con-
cord and hearty fellowship.
We have never heard a speech from Dr. Kingsley that was so
.marked with pathos and well selected sentences.
The clinics were largely attended and marked interest was shown
on every hand. These clinics bring out the practical enthusiasm.
I append the clinical programme. These things mark the progres-
sive energy that is a factor among us for growth and usefulness.
CLINICS. — TUESDAY, JANUARY 19TH, 9 A. M. TO 1 P. M.
1. Dr. Sydney F. Stowell, Pittsfield, Mass. New Removable
Crowns and Bridges.
DOMESTIC CORRESPONDENCE. 167
2. Dr. F. W. Rehfuss, Philadelphia, Pa. Massage in Den-
tistry.
3. Dr. W. E. Davenport, New York, N. Y. New Pluggers
and Filling with Gold.
4. Dr. Geo. V. I. Brown, Duluth, Minn. Gold and Porcelain
Inlays.
5. Dr. Rufus G. Stanbrough, New York, N. Y. New Crown
System.
6. Dr. F. T. Van Woert, Brooklyn, N. Y. New Lathe for
Grinding Porcelain Inlays for Irregular Cavities. Also, Method
and Instruments for Bridge and Crown Work with Removable
Porcelain Faces.
7. Dr. J. Y. Crawford, Nashville, Tenn. New Method of
Widening the Jaws.
8. Dr. S. C. G. Watkins, Montclair, N. J. Self-Adjusting
Head Rest. Filling with Glass Instruments.
9. Dr. T. P. Lennox, Toronto, Canada. Hot Nitrous Oxide
for Sensitive Dentine.
10. Dr. Z. T. Sailer, New York, N. Y. New Adjustable Nap-
kin Holder.
11. Dr. F. A, Roy, New York, N, Y. Filling with S. S. White's
New Mat Gold.
12. Dr. John L. Gish, Jackson, Mich. Electric Hot Air
Syringe. Electric Water Heater.
1.3. Dr. A. H. Gilson, Boston, Mass. New Method of Implan-
tation.
14. Dr. T. O. Oliver, New York, N. Y. Rotary Blower.
15. Dr. A. McAlpine, Bradford, Pa. Diamond Drills and
Method of Making.
16. Exhibit of Novelties, &c., by Dental Mfg. Co.'s.
17. Electric Motor, Hyer-Sheehan Co.
18. Electric Head Lamp, Ford Surgical Inst. Co.
19. Electric Batteries, Motor, &c., Bryan, Enholm & Co.
20. Electric Mallet, Wm. E. Gibbs.
21. Instrument Sterilizer, Flanders Mfg. Co.
22. Novelties, Chase Combination Plate Co.
In one of my former letters. Dr. J. W. Clowes' big deal in amal-
gam was noticed. It was the construction of "causeways" for the
purpose of providing masticating surfaces for spaces where the
natural organs had been removed. At the time of writing about
168 THE DENTAL REVIEW.
this new invention, for I think it will be admitted that it is one, I
had onh- seen the models, but I asked the Doctor that when he had
an opportunity, I would much like to see some practical work. He
has now afforded me a good chance. I am sure my readers will ad-
mit that I have seen a model piece of work. The patient, a gen-
tleman about fort}^ years of age, having twenty teeth with interven-
ing spaces, both upon the upper and lower jaws. As learned, it
was a case of extreme " Riggs Disease," many of the teeth loose.
These teeth have been put into a sanitary condition, by removing
all foreign matter, one tooth only has a dead pulp and this with
abscess. The remaining teeth have had all the pulps removed,
using the pulp chambers for retainers of the frame work for the
causeways. On this has been moulded amalgam into the spaces
of lost teeth, giving a semblance to these in form, so that when
completed it forms a complete fixed causeway from twelve year
molar to twelve year molar. Let it be understood that this amal-
gam is formed compactly against the gum tissue, leaving no space
for secretions. I took particular pains, by mouth glass, to examine
the appearance of the tissues and also to notice whether there was
any unusual odor. I found the tissues nearly normal in color, quite
as much as I would with a constitution such as exhibited. I found
no unusual odor.
On the whole, I am able to report a very remarkable piece of
work, which would I am sure, be admitted entirely original. It is
neatly done, as Dr. Clowes makes all his operations. It may be
noted that Dr. Clowes is not an amalgam slouch, nor does he fill
teeth with his thumb. Dr. Clowes has been in the swim of the
"400," for forty years in dental practice in New York City, and no
one of its operators is better known or more respected.
He has his views of a salvatory practice, and he has given them
freely, practically those on "Oral Gardening." Dr. Clowes' office
is on Fifth Avenue, and doubtless he will give any information to
any one who desires it and should they chance to be visiting New
York, they will be very cordially received, and my word for it, they
will see one of the finest fitted offices in the country, complete in
all that is useful and in fine form. This case I have described is
only one of many, from one space filled in, to varying numbers.
He has been operating on this plan nearly three years, I think. I
met a patient at this same visit, who had one of the doctor's
first attempts. The patient spoke in high praise of its value to
DOMESTIC CORRESPON'DENCE. 169
him. He had pieces on each side of the lower maxillary, including
the molars. The doctor showed me models of what he considers a
very novel case which has been in valuable use for some four
months and indicating good service indefinitely. This represents
the superior cuspid root, the lateral and central, considerably de-.
formed by caries, pulp dead, and a bare process or jaw from the
cuspid root ; back on this foundation he has constructed a cause-
way, having made a firm foundation on the fractions of teeth. His
next thought was how to make firm and practical the opposite end.
This is what he has accomplished: He laid bare the bone at the
point for the twelve year molar, etc, buried a dovetail mortise and
from this he has formed the opposite end of his causeway by build-
ing in an implanted amalgam molar, and the operation is a suc-
cess up to date. In the language of the late Dr. Geo. Q. Hawes,
of New York City, when Dr. Clowes, uncle of Dr. Barnum, intro-
duced rubber dam for the first time, before the New York Society
of Dentists. After Dr. Clowes had sat down. Dr. Hawes, noted for
his dry quaintness, arose and looked to right and left, in amaze-
ment, and exclaimed, "What next."
P. S. "Pardonnez-moi," but I must echo what has just come
to my notice, at the risk of giving the headache to the Western
Dental Journal. If somebody's head is off come to New York and
he will get a head put on him. If the Western Journal knew how
we did not say in our letters all that could be said — New York is
so large compared with Kansas City, so much happening every
moment and so much more that is going to happen, and that is
what I want to tell you in this P. S.
W. W. Walker is on the war path once more. He has in
charge a big mass gathering in March. Nothing ever like it. It
is in the interest of the American Dental Protective Association.
That body wants men, and men it is going to have. A large hall
is engaged with a band of music, etc., etc. It is intended to make
Dr. Crouse feel \.\\zX he has the whole earth at his back; in fact, it
is going to be a compliment to his honest zeal in a good cause.
New York, New Jersey, and all the New England States will be
there; and all the other grand things that are going to be flushed
on us would fill a page. W. W. W. is going to play his best card
for a big success. The ire is coming up and it will be like Jared
Perkins, of Albany, who at the American Dental Association's
meeting in Chicago in '65, arose in an excited manner and said:
170 THE DEXTAL REVIEW.
"At home in quiet life I weigh 148 pounds. Now (b — g — ), I am
mad, and when I am mad, I weigh a ton.^" With one voice they
say, sustain the D. P. A. "Amen."
P. S. Supply the word combined to plastic fillings, referred to
in my last letter, in connection with Dr. Line's paper.
Ex.
REVIEWS AND ABSTRACTS.
Tr.'^nsactions of the American Dental Association, Thirty-
first Annual Session, 1891. Published by the S. S. White Den-
tal Manufacturing Co , Philadelphia.
This handsome volume is larger than any of its predecessors
for a good many years, except the joint transactions with the South-
ern Dental Association, having 272 pages. The excellent editorial
work of the Secretary, Prof. Geo. H. Cushing, with such assistance
as the distance of Chicago from Philadelphia made necessary, and
the first-rate specimens of book making that have been sent out to
us so man)' years by the S. S. White Company, and by H. D. Justi,
last year, are so well known by everybody as to need no mention
here except for the purpose of acknowledgment.
The Association now shows some real waking up to the neces-
sity of finding some plan for conducting its affairs that offers good
prospects of increasing its numbers, its representative character
and the amount of its useful work. The President, in his annual
address, made a number of useful suggestions, and the committee
on Constitution and By Laws offered a good many amendments, on
different lines, which ought to be carefully studied by all the mem-
bers and by the committee till they agree, if possible; the chief
question being, if the present propositions are satisfactory, or
whether a constitution, &c., can be proposed at the next meeting
so much better than can be made out of these, as to justify a year
of waiting.
The main object in making changes appears to be to reduce as
much as possible the time of the Assembly, and the number of its
members that must attend to what is called " miscellaneous busi-
ness." It seems better to have a revolution once in a while if the
men intrusted with business do it too badly, than to tire and dis-
gust the whole Assembly in doing it, perhaps, no better.
Some plans have been set in motion, not dependent upon
REVIEWS AND ABSTRACTS. 171
amendments to the Constitution, which are very important. These
relate to making the .Society truly representive by inducing all
societies to send delegates and providing for reports from them of
the work their societies have done.
Dr. Ottofy's report shows at least 103 societies, but there were
represented in the Association by delegates, only twenty-two soci-
eties, from fifteen States and the District of Columbia, leaving
eighty-two societies and twenty-nine States unrepresented. It
would appear that here is a hopeful field for systematic efforts and
persuasion on the lines proposed by the report.
The volume contains twenty-three papers and reports which
have been pretty fully published in the journals and cannot be no-
ticed here in detail. Dr. E. S. Talbot has a very elaborate and
fully illustrated paper to show that mouth-breathing is not the cause
of contracted jaws and high vaults. Prof. John S. Marshall read
two papers, one on the use of pyoktannin for treatment of cancer-
ous growths, and the other on electricity as a therapeutic agent for
treatment of hyperaemia of the pulp. Prof. T. W. Brophy made
an interesting report of his operation for closure of cleft palate as
soon as possible after birth, which was followed b}^ considerable
discussion of the subject.
The principal objections related to the severit}' of the opera-
tion and danger of death from shock. Whatever ma}' be the rela-
tive danger from shock to a child a few days old as compared with
one a few months or years older, the deformity of a cleft palate is
so horrible that probably many parents would prefer to take con-
siderable risk in an attempt for its radical and immediate cure than
take the chances attending upon delay.
Several other papers have equal or greater interest than some
of these mentioned, especially the one by Profs. Carl Heitzman
and Frank Abbott on senile atrophy of the upper jaw. Those men-
tioned have been referred to especially to show what the near
neighbors of the Rf.view have been doing for the association.
One other paper (also by a Chicago member) relates to a sub-
ject of great interest to the profession, and likely to require some
time and much effort and good sense to bring about a solution that
will meet with general approval, "State Boards (the People's Offi-
cers) and the Profession," by Dr. C. R. E. Koch.
It was probably unfortunate that the author of the paper could
not be there to close the discussion upon it, for it appears to have
172 THE DENTAL REVIEW.
been, in some important particulars, misunderstood and conse-
quently misrepresented. In particular, the statement by Prof.
Abbott that the paper throws out a general slur that faculties of
colleges sell their diplomas for thirty dollars, does not appear to be
justified by anything in the paper. Dr. Crawford also appears to
regard the paper as a discouragement of legitimate institutions of
learning, both gentlemen quite ignoring the fact that there are some
colleges that are supposed to be giving their students a very inad-
equate education.
Prof. Barrett made a long speech, in the first part of which he
questions both the capacity and the opportunity of State boards of
examiners as compared with the faculties of colleges, to ascertain
the qualifications of candidates for practice, and in the latter part
contending for a determination of the reputability or otherwise of
colleges by a thorough examination of their methods and work by
State officers, and then concedes the most important point in Dr.
Koch's paper in a form slightly different but capable of accomplish-
ing many of the same results; by asking that the power of confer-
ring diplomas be taken away from the faculties of colleges and
given to a State board of regents, as has already been done in case
of the medical colleges of New York, whose duty it should be to
examine all candidates for graduation and confer the diplomas.
This plan would have some manifest advantage and convenience
over a reexamination by State officers, and the tone of the speech
tempts the suggestion (made very mildly) that most of the difficul-
ties in the way of obtaining the appointment of competent State
officers to conduct examinations will disappear if they are called a
" Board of Regents," and set to examine candidates for graduation,
instead of being called a "Board of Examiners" and set to examine
candidates for practice.
The paper and discussion emphasize the necessity that the
parties who are really desirous to accomplish the same ends,
namely, the State boards, the reputable colleges, and the better men
in the profession, should cordially admit the facts in the case and
discuss harmoniously the methods that give best promise of good
results without quite so much touchy sensitiveness as has been
manifested in some quarters. N.
Dental Questions and Answers, by Gustavus North, A. M., D. D.
S. Chicago, 1801.
This book contains an outline of the questions and answers of
REVIEWS AND ABSTRACTS. 173
about fifty lectures; Dental Pathology, Therapeutics, Embryology,
Hygiene and Care of Children's Teeth. It is designed for the use
of students.
Report of the Commissioner of Education for the year 1888-89.
Two volumes. William T. Harris, LL. D., Commissioner of Edu-
cation, Washington. Government Printing Office, 1891.
Zene Artzney, 1532. Translated into modern German from
the old German text, by Erich Richter, M. D., D. D. S., Berlin,
Germany, 1891. This is a reprint of the first dental work published
— anonymously — in the German language, at Mayence, in 1532.
Dr. Richter has translated this literary "curiosity" into the German
of the present. The title page, table of contents and preface are
reprinted in the laborious and almost unintelligible old German
text. It can have been no easy task to modernize the contents of
this interesting and carious book.
Pamphlets Received.
Seventh annual report of the Dental Examiners of the State of
Minnesota, to the Governor of Minnesota, December 15, 1891.
Dental Infirmary Patients; The Use and Abuse of Dental
Charity, by Richard Grady, M. D., D. D. S., of Baltimore, Md.
Reprinted from X^vo, Journal of the American Dental Association.
DENTAL COLLEGE COMMENCEMENTS.
UNIVERSITY OF CALIFORNIA.— COLLEGE OF DENTISTRY.
The commencement exercises of the College of Dentistry of the University
of California were held at Odd Fellows Hall, Wednesday evening, December 23,
1891. The term closed December 31. The number of matriculates during the
course was 98.
The address on behalf of the Faculty was delivered by Leander Van Orden,
Jr., M. D.
The degree of Doctor of Dental Surgery was conferred by Prof. Clark L.
Goddard, A, M., D. D. S., Chairman of the Faculty on the following named (24)
graduates :
Josephine Wright Armstrong,
Charles Franklin Bauer,
Charles Henry Bell,
John Millard Blodgett,
Cecil Corwin,
D. Carter Elliot,
Charles Avan Meek,
Albert D. E. Milds,
Robert Forrester Millar,
Robert Isaac Moore,
Howard Deloss Noble,
Forrest Hoy Orton,
174 THE DENTAL REVIEW.
Philip Foster Frear,
Charles Lawrence Griswold,
Charles George Hyde,
Edwin Chandler Hyde,
William Martin,
John Patrick McCarty.
Frank Harry Phillips,
Harry Griffin Richards,
Harold Lawrence Seager,
Harry Howard Shaw.
George Newins Van Orden,
Gustavus Adolphus Weyer.
PRACTICAL NOTES.
Mechanical Dentistry.
Symposium Four— By A. B. E. and F. (C. and D left out).
A. — I have noticed in examining mouths where plates were in
position, that a great many of them have no air chambers — full
plates as well as a great man}' partial plates, especially gold plates.
Is there any special reason for that ?
F. — The air chamber does not remain as an air chamber for
any length of time. It soon fills up with soft tissue, and conse-
quently if a certain plate be worn for some length of time you have
no air chamber.
A. — Is it really an aid to the retention of a partial plate at any
period ?
F. — Yes, where the teeth do not fit so tightly as to form sup-
port for the plate; in other words, where the plate finds its own
resting place. But these are exceptional cases.
A. —Is it not better to have a partial plate of rubber or gold
made so that it will fit snugly to the remaining natural teeth in-
stead of depending upon an air chamber and leaving a space be-
tween the plate and the teeth ?
E. — Yes, it is. But there is an element of danger in such plates
in always having the plate and the teeth in contact, especially if
the plate is worn at night during sleep.
A. — Is that danger greater than the danger of producing disease
by the impingment of the gum margin between the necks of the
teeth and the plate, and causing a recession not only of the gum,
but of the alveolar process, and possibly resulting in disease of the
peridental membrane ?
E. — My idea is that such a plate should come tightly around
the teeth. It cannot produce pressure for any length of time; the
plate will not any more than just touch such teeth, but if there is
any amount of pressure against them, the teeth move very quickly.
PRACTICAL iVOTES. 175
I think the best method is to have the plate just come to the necks
of the teeth with no gum between them, and kept absolutely clean.
F. — The drift of the question is toward partial upper plates. If
we refer to a partial lower plate, where only a limited alveolar bor-
der serves for a bearing surface, the conditions are different. The
recession of the gums is possibly due to pressure of the plate.
B. — Is there ever a partial plate made nowadays with an air
chamber ?
F. — Yes. We see them.
B. — Is it considered proper practice to use an air chamber in
the case of an upper plate ?
F. — I should say no.
A. — Has not the time of an air chamber for the retention of a
partial plate passed ?
F. — There is no necessity for it either in the partial or full
plate; in fact, I do not use it at all in the full plate.
B. — How often, in making partial and full plates, do you use
an air chamber ?
F. — I have not used an air chamber for four years.
B. — I was going to say probably in one plate out of fifty you
would use it.
E. — Do you depress the plate in the higher part of the mouth
sufficient to leave any space ?
F.— Yes.
E. — Does not that amount to an air chamber?
F. — It does if you leave sufficient space to compensate for the
settling of the plate against the soft tissues. You merely have fit-
ted the mouth.
A. — Is it your custom in making a full denture for the upper
jaw to let your plate extend back as far as the termination of the
hard palate, so that it will be retained firmly when the patient at-
tempts to masticate food, but will only remain in position in a lax
state at any other period ?
F. — I prefer to extend the plate beyond the palate bone, then
by scraping the cast I have it bear directly on the soft tissues.
A. — Do you follow that out along the alveolar ridge and clear
around the tuberosity, so to speak ?
F. — The scraping process ?
A.— Yes.
F. — No, sir.
176 THE DENTAL REVIEW.
A. — Why doesn't air get in between the lip and the rim of the
plate when the patient partially opens his mouth ?
F. — The opening of the mouth will tend to draw the soft tissues
tighter around the upper edge of the plate.
A. — That is true theoretically, but practically, is it not a fact
that unless it has been trimmed high up on the alveolar ridge mak-
ing a complete circle, that you do not have complete retention at
any time ?
F. — In one case in which I did that, I was uncertain at the
time whether it did any good or not. It was a difficult case from
all points of view. The mouth was exceedingly hard all over ;
there were no soft spots. It was drier than any mouth I ever
saw.
A. — Was the patient «in old person ?
F. — The woman was about thirty years of age.
A. — It is very unusual to find a dry mouth in a young person.
F. — I was unable to make any plate to stay in successfully.
The last plate (the third one I made) stayed in better than the
first. In that case I suggested scraping the cast at the limit of the
plate all around.
B. — As I understand it, it is a much better way to examine the
palate, where the plate is going to touch, and to trim only at the
hard portions, leaving the soft parts as they are. I do not see
much advantage from trimming all around evenly. If you trim
only at certain points, then you get a much better adaptation.
F. — It would be well to define the word " trim." I use it to
make the plate bear harder ; you (B.) use it to make it bear easier.
A. — I have seen several plates — full upper dentures — made by
a dentist in Chicago, and they seem to be retained in the mouth
better than any similar class of plates that I have ever seen, due, I
think, to the fact that they pass high up on the alveolar process
and uniformly around the tuberosity and across the posterior por-
tion of the palate, going a little beyond the termination of the hard
palate. All of these plates have a slight ridge resembling the
rounded portion of a split wire of say about the sixteenth of an inch
in diameter.
E. — On the plate side?
A. — On the side toward the mucous membrane, and those
plates stay uniformly well.
B. — That is done by cutting a groove in the model.
PRACTICAL NOTES. 177
A.— He began at the median line high up on the alveolar pro-
cess and passing around and going back to the starting point. None
of these plates ever had an air chamber, and an air chamber in my
opinion is not a necessity in any case.
B. — Probably, with rare exceptions.
E. — Does not that sort of a bead around the margin of the plate
really make an air chamber of the whole plate?
A. — ^Well, in one sense it does, but in another, it does not. It
pulls a certain small area of tissue into the plate where it really
does no good from the beginning. The question of the retention
of plates having been spoken of, when you have decided to make a
partial plate either above or below (excluding bridge work), what
guides you in the selection of materials — rubber, gold or any other
substance ?
E.— Where I am at liberty to use my own judgment, I should
always use gold.
F.— I, too.
A. — You think that is the best material ?
B., E. and F. (simultaneously). — Yes.
A. — Do you use backings or solder the teeth, or do you make
some of the partial plates with rubber attachments ?
F. — If the teeth are single teeth, I should solder them to the
plate. If the teeth were a series of three or four, I would attach
them with rubber.
E.— That is my method with some exceptions.
F. — One exception would be where the teeth are very short,
making it difficult to attach with rubber strongly.
E. — The point is to have the space filled to prevent lodgment
of saliva.
A. — In attaching rubber to a plate and a tooth, what is your
method of securely fastening the two materials to each other?
F. — I do it by means of loops either of wire or solder to the
plate.
A. — You never depend upon carvings or etching it? That is an
insecure union, is it not ?
B. — It is a help. If you do not solder a wire around where
the rubber joins the gold, etching the plate helps there, as the rub-
ber catches in the etched gold, and you prevent the secretion from
getting under the plate.
F. — In soldering on loops, see that the}' are soldered near the
178 THE DENTAL REVIEW.
edge of the plate, otherwise the plate springs from the rubber and
springs back again.
A. — Do you ever make a flange of gold so tliat the rubber is
vulcanized beneath the flange, furnishing a finished joint in these
partial plates ?
F. — I have done so.
A. — Do you think it is worth while to take that extra care?
F. — I do not. I do not like to do it. A plate coming from a
die that fits the mouth at the time needs the most careful manipu-
lation afterward, and even then we sometimes fail to prevent the
plate from being changed in shape.
A. — Could not that be done by swaging a small replica of the
plate and soldering that to it ?
F. — That could be done. In soldering a plate after it has once
been struck up, unless it is soldered in such a furnace as the con-
tinuous gum furnace, it is almost impossible to prevent one part
from being red hot, and the other being red or black. That means
of course, greater expansion and contraction in one part than an-
other. It means a change of shape, and one should manipulate the
plate as little as is necessary to do a good piece of work after it is
once struck.
B. — You were speaking awhile ago of using for partial plates
gold instead of rubber. Do you think that gold plates will wear on
the teeth more than rubber plates? As a matter of fact, does not
rubber injure the teeth around which it is put as much as gold
would ?
A. — Yes, it would.
F._Why ?
A. — Because it is a nonconductor.
F. — Of heat or what?
F. — Of cold or heat. You seldom see a mouth where a partial
rubber plate is put in with or without an air chamber, large or
small, but that the gums are reddened and there will be spots be-
neath the plate, no matter whether it is black, red, or pink rubber,
and no matter how well fitting it is.
E. — It is a good protection against heat or cold, and it favors
the growth of microorganisms. It serves as an incubator. Gold
plates are constantly changing; therefore the fungi cannot grow.
F. — I have seen a typical case of rubber sore mouth under a
gold plate.
PRACTICAL NOTES. 179
E. — Was it a clean plate?
F. — It was not a well-fitting plate. The patient came to me
saying she had lost a night's sleep, and the ill-fitting plate proved
to be the source of her trouble. Treatment consisted in removal
of the plate and keeping it out for ten days or two weeks, continu-
ous mouth washes, cleaning the teeth, and then 1 made a gold
plate, replacing it with another one. She has since borne it suc-
cessfully and comfortably.
A. — Is it not a fact that if you examine a large number of
mouths with partial plates, you find the following conditions :
Where gold plates have been used, the teeth themselves suffer more
from the clasps and the pressure of the metal against the teeth.
With the rubber plate it is the peridental membrane and the alveo-
lar process that suffer, and consequently is not a gold plate better
for the patient, because he only suffers loss of tooth substance, than
a rubber plate which causes loss of the socket and all that that im-
plies?
B. — I think the general impression prevails that a gold plate at-
tached by clasps is much more injurious, no matter how well the
clasp may be fitted, than a rubber plate.
F. — I disagree with you. If you had a mouth in which there
was a condition of the secretions which promoted softening of the
teeth, which induced a worn condition of the teeth or an abrading
surface, then they might be injured greatly b}' clasps, but in a
healthy mouth, in my practice I have seen but little ill effect from
a properly fitting clasp.
B. — There is a constant friction of the clasps in taking the plate
out, and the better the clasp fits the more you wear the teeth, of
course.
F. — If you wish to abrade teeth with clasp metal 5'ou have to
rub a great many hours before you succeed in affecting the surface.
A. — What is your practice in fitting a clasp ?
E.^I fit a clasp to the cutting edge of the grinding surface.
A. — That is a good plan.
E. — I prefer to have it just at the grinding surface and to have
a little lug extended to a sulcus on the grinding surface to prevent
it from moving up, so that the bearing is on the masticating sur-
face of the tooth.
A. — Is it not a fact that there is a strong tendency to cause de-
cay of the surface of a tooth by the fitting of a rubber clasp ?
ISO THE DEXTAL REVIEW.
E. — It is the best way to induce decay, because it is almost im-
possible to keep a rubber clasp clean. I have never seen one kept
clean.
B. — That is correct.
A. — To continue the subject further, as we have discussed par-
tial plates and their retention, what in your judgment is the best
permanent plate for an upper or lower edentulous jaw, leaving con-
tinuous gum out of the question?
B. — A gold plate with rubber attachments, for the reason that
you get the advantages just spoken of as to cleanliness, etc., and
the advantage that, in case of breakage or necessity to repair or al-
ter a plate, it can be done readily.
F.— I will amend that by using single teeth rather than gum sec-
tions.
A. — The universal custom would be to use single teeth instead
of gum sections.
E. — I agree with what has been said entirely.
A. — How about a lower denture?
F. — The same thing.
A. — Is there any advantage in using a metal plate for a lower
full denture ?
F.- For a heart}', robust person whose muscular system is well
developed, it is advisable ; but for an elderly person they usually
prove burdensome.
E. — They are burdensome, are they?
F. — Yes. Patients complain of the weight.
E. — How about cast aluminum ?
F.- There is little to be gained in using cast aluminum.
A. -Would there be difficulty in having the upper plate of gold
with rubber attachment and the lower plate of full aluminum with
no rubber attachment?
F.- The difficulty would be, that if the mouth was so shaped as
to expose the gum in opening it, you expose the metal surface.
A. - Would there be any incompatibility in the two metals in the
mouth?
F. No, sir, in my opinion.
A. -Have you ever made a cast metal plate for the alveolar ridge
and then attach the teeth to the plate with rubber ?
F.— I think that makes a good combination.
A. — Is not that a better combination than all metal ? Does not
that do away with the disadvantage of weight?
PRACTICAL NOTES. 181
F.— Yes.
A. — You would not favor the making of the whole upper and
the whole lower denture of gold and soldering each individual tooth
to the plate ?
F. — I did that once when a student. I would not do it again.
It is a waste of time and labor.
A. — It is impossible to keep that kind of plate clean.
E. — It is sometimes advisable to make a full upper plate with
single teeth, soldering them to the plate.
B. — Each tooth soldered separately?
E. — Yes, using single plate teeth.
F. — And having the plate extend over the alveolar border ?
B. — He (E.) means to make an entire plate with single teeth,
all soldered on. There would be no rubber about that. That
would be for a case where the gums are prominent.
F.— I want to say in regard to partial upper plates of gold, that
where the teeth are soldered on, if there are more than two teeth I
always vulcanize rubber in around them for the sake of cleanliness.
— Exit Reportei'.
" Conductivity of Heat by Filling Materials."
By Thos. L. Gilmer, M. D., D. D. S., Chicago.
In the December Review were presented the results of some ex-
periments to determine the thermic conductivity of filling materials
and the method employed to obtain them. At the request of the
editor I have made further tests which include tin and artificial
dentine.
Artificial dentine is one of the Fletcher preparations, and if I
am correctly informed, is an oxysulphate. It is nonirritant and
much esteemed by some as a material for capping exposed pulps,
and as a foundation under metal fillings in large cavities.
The table given in the December Review exhibiting the results
of my experiments is reproduced here with the results from similar
tests with tin and artificial dentine.
Gold 1000
Lawrence amalgam 852. 5
Copper amalgam V02. V
Tin 590
Oxyphosphate Zinc 584.2*7
183 THE DENTAL REVIEW.
Oxychloride of Zinc 525.25
Artificial Dentine 525
Gutta-percha 520
There was also given in the previous article a table of the rela-
tive conductivity of metals previous to their being transformed in-
to shape suitable for filling material. This table was the result of
tests made by Prof. F. Grace-Calvert and Mr. Richard Johnson in
1860.
As there is a wide difference between the results of their ex-
periments and those of others, I give below tables from three dif-
ferent sources :
CALVERT-JOHNSON.
Silver 1000.
Gold 981.
Copper rolled 845.
" cast 811.
Tin 422.
Platinum 380.
WIEDEMANN-FRANZ.
Silver 1000.
Copper 748.
Gold 548.
Tin 154.
Platinum 94.
JOHNSTON-TURNER.
Silver 1000.
Copper 736.
Gold 532.
Tin 145.
Platinum 84.
In my previous article I should have stated that the zinc pre-
parations were saturated with moisture so far as they could be in
a period of 25 to 30 seconds immediately preceding the tests.
Tests made with these materials thoroughly dry may give different
results: but by moistening them, their condition is rendered more
like that, when in the mouth.
MEMORANDA. 183
MEMORANDA.
Dr. H. A. Douglas, of Kansas City, Mo., is deceased.
Dr. R. A. Holliday is the new editor of the Southern Dental Journal.
Dr. W. O. Kulp, of Davenport, Iowa, was a recent visitor to Chicago.
Dr. G. y. I. Brown, of Duluth, paid a flying vist to Chicago recently.
Dr. G. L. Curtis, of Syracuse, N. Y., has removed to New York City.
Dr. L. C. Davenport has been reappointed as a member of the State Board of
Minnesota.
Dr. L. B. Smith, of Chicago, a promising young dentist, died recently of
typhoid fever.
Dr. Geo. H. McCausey, of Janesville, Wis., has been suffering from an at-
tack of neurasthenia.
Dr. F. O. Sale, formerly of Huron, S. D., has located at 520 63rd Street,
Englewood, Chicago.
Dr. J. Y. Crawford, of Nashville, says that crown and bridge work is being
done extensively in the South.
Dr. W. D. Miller, of Berlin, Germany, has been elected Professor of Histol-
ogy in the University of Pennsylvania.
The meeting of the Mississippi Valley Association of Dental Surgeons will be
held at Cincinnati, March 8 to 11, 1892.
According to statistics from Switzerland, there were 260 dentists practicing
their profession in that Republic in 1891.
The Utah Dental Association was recently organized. Dr. W. H. Bucher,
of Salt Lake City, is the Corresponding Secretary.
Drs. Thos. E. Weeks, of Minneapolis, L. G. Noel, of Nashville, and A. H.
Thompson, of Topeka, were recent visitors to Chicago.
Do not thrust even the smallest instrument into the contents of an unsteri-
lized root canal. If you do look out for an acute abscess.
The family of the late Dr. C. R. Coffin has issued a fine copperplate likeness
of the latter. We thankfully acknowledge the receipt of a copy.
The Hayden Dental Society, of Chicago, meets this evening at 63d and
Wright Sts. Dr. W. F. Michaelis reads a paper on "Carbolic Acid."
Dr. G. V. Black says that oil of cassia is one of the best parasiticides that he
is acquainted with. It is especially useful in barbers' itch and other cutaneous
affections.
The Union Medical Societies of Chicago, have united to give entertainment
to foreign medical men who may visit the World's Columbian E.\position in 1893.
Dr. Chas. Warrington Earle, is President, and Dr. A. Church, Secretary of the
organization.
184 THE DEA'TAL REVIEW.
Dr. E. K. Blair, of Waverly, 111., the genial whole-souled member of the leg-
islature, has met with the misfortune of having lost his office outfit, books, etc.,
by the ravages of fire.
Dr. L. C. Ingersoll, of Keokuk, Iowa, delivered a lecture on the "Origin and
Development of Written Language" at the Auditorium Recital Hall, in Chicago,
Wednesday evening, February 3, 1892.
Dr. Edward C. Kirk, the editor of the Dgtital Cosmos, was a welcome visitor
to the World's Fair city this month. He attended the annual dinner of the
Odontographic Society on February 8th.
Dr. J. C. Storey, of Dallas, Texas, attended the meetings of the Executive
]f Committee of the World's Columbian Dental Congress. Dr. Storey is booming
the Texas Dental Journal and the Congress also.
Dr. J. A. Kimball, of 58 W. 26th Street, New York City, is the publisher,
\y proprietor and editor of a new dental journal entitled The Dentist Himself. The
first number appeared last month. The subscription price is $1.00 per annum.
Dr. Ames asks what the effect of impregnation of the dentine with metallic
salts will be — detrimental or beneficial ? For instance, after filling a root with
copper amalgam or the adjustment of a How post. What answer ? Ours is that
it is detrimental.
For some reason unknown, many of the Chicago dentists are sufferers this
winter with the "Grippe" and other ailments too numerous to mention. At one
time eight well-known dentists were ill at their homes or they had to leave home in
order to recuperate.
We have recently seen some specimens of fillings made of a material in-
vented by Dr. W. B. Ames, of Chicago, known as o,\yphosphate of copper. The
material has qualities that will prove it a valuable adjunct to dentistry, especially
for setting crowns and bridges.
Dr. Gilmer says that the best plan of supporting a tooth about to be drilled
into, in a case of acute pericementitis, is to mold ordinary modelling compound
around it and the adjacent teeth, after adjusting the rubber dam. This will pre-
vent pressure against the inflamed apical tissues.
A recent law of the German Empire prohibits the sale of certain (poisonous)
drugs and preparations, except on presentation of a prescription from a pitysician,
dentist or veterinary surgeon — in the latter case for the use of animals only. It
seems that the Germans do give some recognition to dentists.
The Dental Congress which is to be held at the World's Fair in August of '93
will be highly edifying. For most persons, however, it will not have the vivid in-
terest attaching to the smaller congresses in dentists' offices, in which they them-
selves have occasionally been conspicuous figures. — Daily Paper.
The twelfth annual meeting of the Central Dental Association of Northern
New Jersey will be held in Newark, N. J., Monday evening February IS, to be
followed by the annual dinner. Drs. W. W. Walker, Louis Jack, N. W. Kingsley,
A. H. Brockway. R. Ottolengui, B. F. Luckey and C, W. F. Holbrook will
respond to the toasts of the evening.
MEMORANDA. 185
KANSAS STATE DENTAL ASSOCIATION.
The twenty-first annual meeting of the Kansas State Dental Association will
be held at Ft. Scott, April 26, 27. 28 and 29, 1892.
Members of the profession are cordially invited to meet with us.
C. E. EsTERLY, Secretary.
The Missouri Dental College is now the Dental Department of the Washing-'
ton University, St. Louis, Mo. A new building will be erected for the Medical
and Dental Departments, to be ready for occupancy by the opening of the ses-
sion of 1892-1893, and will be one of the best equipped buildings for the purpose
in the United States. Eames and Young are the architects, Mr. Will Eames of
the firm is a son of Prof. W. H. Eames.
ANOTHER DENTAL SOCIETY FOR CHICAGO.
The "Atkinson Dental Society" was organized in Chicago, February 8, 1892.
It is to be composed of young men. Monthly meetings are to be held; a dinner
to be followed by the reading of papers, etc. We wish success to this society
which completes a half dozen in the enterprising World's Fair City.
HAYDEN DENTAL SOCIETY OF CHICAGO.
At the fourth annual meeting of the Hayden Dental Society, held January 19,
1892, the folloAfing officers were elected for the ensuing year: President, J. O.
Brown; Vice President, M. B. Rimes; Secretary, Louis Ottofy; Treasurer H. Mc-
Neil. On the Board of Directors to rerve for three years, A. W. Freeman.
Louis Ottofv, Secretary.
COLORADO GOLD.
Few people know the real color of gold, as the metal is seldom seen except
heavily alloyed, which renders it redder in color than when in its pure state. The
gold found in the Ural mountains is the reddest of all in its natural state; Aus-
tralian gold is redder than that of California, while gold obtained from the
placers is redder than that obtained from quartz. What causes these different
colors is one of the mysteries of metallurgy. — Exchange.
ODONTOGRAPHIC SOCIETY OF CHICAGO.
Program of essays to be read before the Odontographic Society during 1892.
January. (Annual dinner.) Dr. G. V. Black. Subject — The Use of Books.
February. Dr. G. W. Haskins. Subject — Disease of the Peridental Mem-
brane.
March. Dr. J. G. Reid. Subject — Gold in Operative Dentistry.
April. Dr. Louis Ottofy. Subject — Statistics on the Removal of Natural
Teeth.
May. Dr. P. J. Kester. Subject — Copper Amalgam. Dr. D. M. Gallie.
Subject— Plastic Fillings.
June. Dr. L. L. Clifford. Subject— Care of Teeth During Eruptive Period.
September. Dr. E. A. Royce. Subject — Crowns. Dr. F. K. Ream. Sub-
ject— Bridge work.
October. Dr. E. MaWhinney. Subject — Disease of the Antrum, and Treat-
ment. Dr. U. G. Poyer. Subject — Care of Deciduous Teeth.
November. Dr. C. E. Meerhoff. Subject — Interproximal Spaces. Dr. R.
B. Tuller. Subject — Cervical Border.
186 THE DEXTAL REVIEW.
December. (Election of officers.) Dr. L. S. Tenney. Subject — Operative
Technics.
Officers: President, C. L.Clifford; Vice-President, Geo. J. Dennis ; Rec.
Sec'y., U. G. Poyer ; Cor. Sec'y., T. A. Broadbent ; Treas., E. Noyes. Board of
Directors: E. L. Clifford, U. G. Poyer, R. B. TuUer. C. E. Bentley, Geo. J.
Dennis. Board of Censors : D. C. Bacon, Louis Ottofy, D. M. Gallie.
CINNAMON A DESTROYER OF DISEASE GERMS.
After prolonged research and experiments in Pasteur's laboratory, M. Cham-
berland is reported to have come to the conclusion that no living germ of disease
can resist the antiseptic power of essence of cinnamon for more than a few hours.
It destroys microbes as effectively if not as rapidly as corrosive sublimate. Even
the scent of it is fatal, and M. Chamberland holds that a decoction of cinnamon
ought to be taken freely by persons living in places affected by typhoid or cholera.
There is nothing new in all this. In the oldest known medical prescriptions for
infectious diseases cinnamon was a prominent ingredient, and it was in great re-
quest during the plague of London. There is no reason for doubting that the
physicians of those early days were as familiar with its medical properties as with
its odor. — Exchange.
Chicago must not be outdone. We have a new fad. It is true that the col-
lege incorporation business is slack just at the present time and the young practi-
tioners in the poorer districts, whose own alma mater is his most bitter competitor
has another unpleasant feature of life's perplexities to contend with. It is re-
ported that a firm owning a large general store, made up of departments in which
almost anything from a pin to a derrick can be had, and which is about to occupy
a building on State street, covering a half block in area and is eight stories high,
has decided to open a medical and a dental department. This move will, of
course, compel other similar business houses to do likewise. To the weary shop-
per this will be a great accommodation. Just think of it, how nice, from the shoe
department, the crockery, hardware, tinware and soap departments to be able to
enter the dental department, restaurant or hair department, wiihout going out on
the street ! What next ?
OBITUARY.
Died at Chicago, January 21, 1892, Dr. D. W. Runkle.
Died at his home in Alpena, Mich., Jan. 2lst., Charles Cooper, senior student
in American College of Dental Surgery.
Died at her home, No. 24 Lincoln Ave., Chicago, February 10, 1892, Mrs.
Mary S. W. Noyes, wife of Dr. Edmund Noyes. The Dental Review extends
to Dr. Noyes the most heartful sympathy.
Died, in Chicago, Jan. 21, 1892, Harold Wescott Morse, of typhoid fever, at
the age of twenty-two.
He was a bright, promising member of the senior class '92, American Col-
lege of Dental Surgery, and his sudden death brings sorrow to many hearts.
We tender our deepest sympathy to his family and classmates in their sad
loss. The funeral was held Sunday, Jan. 24, at his home in Naperville, 111., and
largely attended by the students and many friends.
THE
DENTAL REVIEW
Vol. VI. CHICAGO, MARCH 15, 1892. No. 3.
ORIGINAL COMMUNICATIONS.
Surface Protection for Plastic Fillings.
By G. V. I. Brown, D.D. S., Duluth, Minn.
He who runs may read, and safely state as a premise that even
the most successful operators (wherever success has not clashed with
honesty, and admission of failure thus become impossible) fail by
the ordinary methods of filling teeth, to successfully stop in every
instance the progress of dental caries and the breaking down of tooth
structure.
The search for needed improvement takes us among the frag-
mentary principles of the theoretical targets of the earnest advo-
cates of the various methods of tooth filling left intact by reason of
true merit, after the sweeping fire of their opponents upon the floors
of dental conventions, in the pages of dental journals, and left un-
scathed by the sword of practical experience, whether among the
ranks of so-called new departure advocates who boldly proclaimed
their motto that "as teeth need saving, gold is the poorest material
for the purpose," or the "old guard" who would save nothing that
gold could not save, or the third element who hurled into the thick
of the fight the gold crown which having been brought forward
from the indisputable place to which it rightfully belongs of restor-
ing to roots of teeth the lost or broken down crowns; where it was
a boon and a blessing to that less rightful place among teeth with
large cavities and perhaps poor structure, but by no means in a
broken down condition, until by degrees the average practitioner
instead of feeling urged to struggle for that greater degree of ex-
cellence which would enable him to attain such perfection in the
188 THE DENTAL RE VIE IV.
manipulation of gold as would widen its range of usefulness in his
hands as a filling material, or the necessary instruction to his pa-
tients with regard to the care and watchfulness on their part which
should render the use of cement more beneficial, has snapped
off or ground down the natural crown surfaces, and covered with
caps of metal until the result has been such a snapping and grind-
ing, soldering and pounding of bands, and crowns throughout the
length and breadth of the land, that the very thought of it must
startle the careful observer even as the roll-call of dire results will
one day startle the profession.
That there is need of some material other than gold I think is
very generally admitted, for while it stands preeminently at the
head of the list as of greater general utility in the mouth than any
other filling, there is nevertheless a limit to its usefulness which falls
far short of the dentists daily requirements.
It is unsightly in the anterior teeth, it is incapable of preserv-
ing successfully a large class of teeth which are in too frail a condi-
tion for its proper insertion, and I believe that patients unstrung
as they frequently are by the depleting influence of modern civi-
lized life, and other causes which tend to deteriorate the healthful
condition of the nervous system, but which do not necessarily give
such outward evidence as to be considered serious at the time, are
often quite unfit to stand the strain of long sitting and painful op-
erations in the mouth, which do undoubtedly overtax the nervous
force under such circumstances, and indirectly hasten in many in-
stances more serious after trouble. After all life is too short for
needless suffering if by other methods it may be avoided, and at
least as good results obtained.
Cement alone will not bear the wearing effect of mastication,
and is too treacherous in its wasting away at the cervical border.
Amalgam is not generably admissable in all parts of the mouth
by reason of its objectionable color, and is subject to grave suspi-
cion on account of its tendency to shrink.
Gutta-percha so trustworthy as a preservative against destructive
influences upon the tooth structure, if unaided by other covering is
of very limited general practical usefulness because it wears out
too readily in exposed positions.
I do not wish to be understood as bringing forward these forms
of inlays, or surface protectors as substitutes in any way for either
gold fillings, gold crowns, or even good amalgam fillings in their
ORIGINAL COMMUNICA TIONS.
189
rightful places, but only as a suggestion for use in cases when these
materials would not fulfill their highest possibilities as under more
favorable conditions; a something which may be utilized not to
supplant the gold crown, but to occupy a place between, where the
best use of fillings end, and the present common necessity for
crowns begins, in other words to reduce to the minimum the neces-
sity for such treatment.
While I derive great benefit in my practice from the use of var-
ious forms of tooth crowns, especially as attachments for so called
bridge work it is my constant endeavor not to place a band of any
kind whatever around the neck of a tooth to offer as it must a pre-
mium for the advancement of irritating influences in that region, that
are so inimical to the healthful condition of the parts immediately
surrounding, unless I feel that such a proceeding is warranted by
reason of absolute requirement in order to give usefulness that will
prove of sufficient benefit to overcome what seems to be a deplora-
ble necessity. Thus I bring forward as a stepping stone to some-
thing better substitutes suitable at present to only a limited num-
ber of cases, but capable of illimitable enlargement as greater per-
fection is acquired, and well worthy of the earnest consideration
which only can bring the desired result, and having in view the
protection of gutta-percha and cement with hard smooth gold, and
porcelain, upon proximal surfaces, the preservation of the proximal
spaces so important to the cleanliness and the healthfulness of
teeth and gums, and with all having next the tooth substance, the
readily adaptable plastic material, the virtues of which
are too well known to need further reference.
The following examples are described from cases
in my practice that are still doing good service, many
of them having been inserted several years ago.
I frequently have in daily practice incisors from
which some portion of the cutting edge has been lost
by reason of an accidental blow, caries, erosion, or
abrasion, or perhaps it may be necessary to lengthen
one or more such teeth to make proper occlusions in
lengthening the bite of a whole mouth.
In such cases a porcelain tip made from a plate-
tooth, properly selected as to color, ground to fit the
edge of the natural tooth in such manner as to give
the proper outward appearance, a platinum pin fitted
FIG. I.
190
THE DENTAL REVIEW.
to extend up into the roots and attached to the porcelain tips,
the palatal surfaces filled in to proper contour with backing, and
solder or porcelain body baked upon them, the tooth cavities filled
with gutta-percha, and the tips heated and pressed home as illus-
FIG. 2.
a. Tooth and porcelain
corner In place.
f"lG?
h. Cavity exposed.
c. Pin and porcelain
Inner surface.
trated in figure number one, have given me good satisfaction.
This I feel to be a conservative operation much to be preferred
to cutting off the whole crown down to the roots and crowning by
any of the methods usually employed.
I have represented in figure No. 2 a. b. c. what has proven of
inestimable value to me in the restoration of proximal cavities in
the anterior teeth where the destructive process has extended to
the cutting edge, especially where the pulp has been devitalized
and the remaining tooth structure is so frail as to render the dura-
bility of a gold filling questionable. The result may be accom-
plished either by fitting a pin to extend up into the root and baking
FIG. 3.
a. Front view.
FIG. 3
b. Posterior aspect showing
gold backing.
ORIGINAL COMMUNICATIONS. 191
porcelain body in a matrix of platinum, burnished to fit the cavity
and allowing it to extend out to restore the contour, as shown in
fig. 2 c, or by grinding a portion of a plate to fit the required space,
backing with gold and soldering porcelain, gold and pin together,
as shown in fig. 3 a. b. The use of a pin gives sufficient security,
with gutta-percha lining the cavity into which the heated piece is
pressed. Many such corners are in good condition still in the
mouths of patients who have worn them for several years, and there
is no reason I can see why they should not continue to do good
service, barring accident, for a long time.
When we undertake to consider cavities upon the labial sur-
faces of incisor and cuspid teeth extending under the free margin
of the gums, I think, that however personal opinions might differ
as to the degree of success which each particular operator might
claim to have experienced in the durability of his gold fillings in
these positions, nearly all will readily acknowledge that gutta-
percha could be inserted with much less pain to the patient, and
f\ much less strain upon the operator, that there would
I I be much less danger of a recurrence of decay around
I I the border of the filling by its use than with gold, and
I I when we remove the objection of its rapid wearing
I I out with the rubbing of the toothbrush and other
I ^r^^^^ll causes, together with its tendency to assume a dis-
II J.? colored appearaace by covering with a hard, indestruc-
i fepHl tible, natural appearing porcelain surface, either by
/ ] grinding, or baking porcelain, as in figure 4 a., to fit,
f ll|(i.^ ^"^d having sufficiently deep undercuts in both por-
V ^y celain and cavity wall to make it secure with gutta-
riG.4. percha, it does seem to me that we have accom-
*'■ ^gutta-percha! pHshed something valuable, something at least worth
*■ ^cSnt. ''"'^ following up and improving.
Such small proximal fillings as shown in fig. 4 b, would of
course call for the sort of care only under such circumstances
as might in occasional instances for a time at least render the use
of gold unavoidable. For example I believe conservative opera-
tors favor the use of cement fillings under certain conditions with
the intention of keeping watch upon them either with the idea of
adding more material as the surface wears down, or replacing
with gold later on, when their condition has improved. It has al-
ways been my belief that this is the proper thing to do when the gen-
192 THE DENTAL REVIEW.
eral health of the patient would probably be better at a later period,
as after severe illness, when the vital forces have not had time to
return to a normally vigorous condition, with pregnant women, or
nursing mothers, or where some specific or other diseased con-
dition renders it necessary and certain that the patient will for a
considerable period be obliged to take powerful remedies of known
deleterious local effect upon the teeth when taken into the mouth,
even though care be exercised in its administration. Often the ex-
treme sensitiveness of the dentine may resist ordinary methods to
overcome it, and be so acute that sufficient excavation for the proper
insertion of a gold filling would be unendurable. Or in mouths of
young patients in whom the tooth structure may be softer than it will
be later in life, after the demand for general development and growth
has in a measure ceased. Plastic fillings do undoubtedly fill
a much needed requirement in such cases, and I am encouraged to
assert that they do even more; since having just heard Dr. Heitz-
man, of New York, assert, that he has now in his possession a
tooth which had been filled with cement on one side and amalgam
on the other, and which shows that during the six months or more
that these fillings had been doing service in the mouth with the
pulp alive, and other conditions quite normal, the history of this
case being authentic, that a noticeable change had taken place by
which there had been a hardening of the dentine around these fill-
ings, proving conclusively to any one who might examine them,
the truth of the theory upon which is founded the idea
of depending upon such fillings to build up and harden tooth
structure, and prepare it for the better protection of gold filling later
on. The drawback however, is that cement unprotected, though
it may sometimes do service for a considerable period, will
soon become hollowed out, leaving disgusting, unsightly looking
spaces which form a most annoying place for the lodgment of par-
ticles of food, whereas, by covering in the manner described, we
have every possible advantage of its use on the tooth substance,
protected upon the outer surface and a natural appearance, which,
while I have ever studiously kept it in the back ground as being
last in importance, compared with other considerations, is never-
theless one that will show itself to be quite important, especially
with patients among the fair sex.
Spare imperfect enamel, and spoil the filling is unquestionably
true in gold filling, and the conscientious operator must in every in-
ORIGINAL COMMUNICA TIONS
193
stance look first to the permanence of his work, and cut away freely
from the edge of the cavity every portion of frail or defective
enamel regardless of the vanity of his patient, and if the posterior
portion has been destroyed by decay leaving the anterior wall of
the tooth intact upon the surface visible to the outward observer
its protection and relation becomes at once an object worth trying
for.
I agree with the objection usually advanced that a perfect gold
filling looks better in a tooth than a porcelain one many times, be-
cause of the difficulty of matching the color, and also the line
of junction usually visible between the porcelain and enamel of the
tooth when the cement shows through, and this is one of the things
to study and overcome so far as possible, but to fairly consider the
matter one must remember that it is not usually the unsightliness
of any particular filling in the mouth that is so objectionable in ap-
pearance itself but it is the change in the expression of the mouth
given by the lights and shades noticeable in speaking and laughing,
and quite as often by small proximal fillings as large ones that have
much more to do with the general expression of the whole face
than one unfamiliar with thought in the direction would probably
readily admit.
Call it art, call it what what you please, but let us bear in mind
that our operations upon the anterior teeth govern largely for
good or ill the whole facial expression, and that we must look not
FIG.5:
a. Gold top In place.
b. Cavity exposed.
c. Gold top with button.
FIG, 3
Fastening in view.
alone within the limit of the circle of the orbicularis oris, but with
broader view study the effect upon the whole region of the face.
Foreigners whose ignornce upon matters pertaining to dentistry
we deplore, whose eyes have not become trained to the circle, and
194 THE DENTAL REVIEW.
semicircle of black and shining metal upon the white tooth surfaces,
speak with surprise and derision of the unsightly and vulgar dis-
play of gold in the mouths of Americans, whose wealth and stand-
ing entitles the belief that they represent the best effort of our
most skillful operators. I am not quite sure but that we may yet
find a measure of common sense and good judgment in the bliss of
their foreign ignorance.
Some three years ago I treated two molars from which gold
crowns (not my own) had to be removed b}' reason of the discharge
about the necks of the teeth, and it was found to be of course im-
possible to check the pyorrhcea so long as the gold bands extended
under the gums and afforded a lodging place for irritating influences.
Gold tips were put on as shown in fig. No. 5 a of swaged gold plate
filled with solder, and a button as in fig. 5 c soldered upon the bot-
tom of it, and the teeth restored to a state of usefulness which recent
examination gives every reason to expect will continue. There is
little possibilityof gutta-percha wearing out through to such a narrow
line of exposure as exists at the joining of the tooth and gold and
there is little or no possibilit}- of dislodging such a broad fiat close
filling surface.
Many such cases since have all proven very satisfactory.
Fig. 6. — Is the counterpart of a bicuspid tooth
which having lost part of the crown and both
proximal surfaces; these have been restored with
the top of a porcelain rubber tooth ground to fit
and porcelain body baked around a pin which ex-
tends up into the root canals, and baked in the
manner of the foregoing cases to fit the concavity
of the remaining portion of the natural tooth and
I y \.-i ^t the same time attach firmly the pin and ground
b\ ^ ' top.
\/ This is inserted with gutta-percha, and is more
riG. 5 satisfactory to me than the ordinary band crown.
a. Natural Crown. ,/• i , r ^ i i i- j .i
b. Too In piacp. If the pulp of such a tooth be alive, and the oppor-
Made either of gold , iiz-n- -n iit
or porcelain. tunity for gold fillmg still questionable 1 swage a
hollow tip of gold plate allow two flaps of gold to extend down to
cover the proximal surface, fill the cavity in the tooth with copper
amalgam, and press the top into place. Such a top has been doing
hard service in a mouth where I lengthened the bite, which made
the addition necessar}-, for two or three years, much better I think
ORIGINAL COMMUNICATIONS.
195
than either a gold or amalgam filling would have done alone.
Those three last methods are useful under almost every require-
ment of an abraded crown and for lengthening the bite with molars
and bicuspids.
For large cavities extending beyond the gum line in molars, and.
for bicuspids where proximal and masticating surfaces may both be
involved and the remaining tooth walls not to be depended on, No.
F1G.7.
Tooth with gold inlay
In place.
FIG. 7.
b. Tooth showing cavity.
FIG T.
c. J nlay with inner
surface and pin in
view.
30 gold plate is swaged to fit the outline of the cavity and also supply
the lost contour held in place by a platinum pin or pins that may
be allowed to extend up into the root canals if the pulp be dead as
in Fig. 1.
Or where this is not practicable, a porcelain piece may be baked
to fit the cavity just as was done in the other cases and allowed to
extend out to complete the proper outline of the tooth surface, deep
grooves may be cut on the sides of the inlay also deep undercuts
into the tooth walls which are coated with amalgam, and the por-
celain tapped into place with light blows from a mallet.
a. Porcelain filling.
FIG.9. riG.g
6. Inside of gold showing the fastening.
The excess of mercury is thus squeezed out of it, the danger of
shrinkage reduced to a minimum, the contour bolder and sharper
196 THE DENTAL REVIEW.
than amalgam alone, and the copper amalgam is left undisturbed
to protect and make full use of its antiseptic properties at the
margin of the cavity. (See fig. 8.)
Cavities on the labial and buccal surfaces may be quite simply
covered as shown in fig. 9, by fitting a little piece of gold plate
to the outline of the cavity and holding it in place in the gutta-
percha filling with little stays that have been soldered on its inner
surface for that purpose. I hardly think it necessary to explain
that such a gold covering as shown will protect it from wearing
out, nor do I think it necessary to add that it can be easily and
quickly made.
Y FIQ.IO
a. Porcelain crown. h. Corner of porcelain,
c, d, e, f. Porcelain fillings.
Fig. 10 is a drawing of the front of one of my patient's
mouths. These fillings were put in a little more than three years
ago. During that period it has been necessary to coat the edges
of the cavities with chlora-percha, and hot gutta-percha rubbed
well into them, as is my custom whenever the cement shows the
least sign of disintegration at the exposed edges. The treatment
made such a radical improvement in my patient's appearance when
the lips were parted in ordinary conversation that the result has
been highly satisfactory to us both, and as there seems to be no
reason from recent examination to apprehend that the improve-
ment will not continue to be permanent with occasionally* a few
minutes' care as described before.
To sum up the whole matter, my experience leads me to believe
that these operations are as yet unsuited to those operators whose
patients have no certain expectation at the time of an operation
that they will ever patronize him again, and is necessarily a failure
in the hands of oily gentlemen whose broadcast laudatory cir-
culars treat upon the value of the "ceramic art," known to but
few, etc., but is only safe and valuable in the hands of conservative
ORIGINAL COMM-UNICA TIONS.
197
practitioners whose patients have culture, intelligence and the de-
gree of training which makes them appreciate its advantage and
also makes the periodical visits to the dentist a matter of religious
duty.
Retention of Entire Artificial Dentures.*
By W. B. Ames, D. D. S., Chicago, III.
Without entering into a discussion of the principles on which
depend the utilization of the pressure of the atmosphere in the re-
tention of entire upper artificial dentures, the accompanying illus-
trations will aid in a description of a method of taking advantage
of this pressure for the purpose.
The necessary condition to be obtained in the adaptation of the
denture to the tissues is to have it embrace the alveolar ridge and
extend backward upon the palate to an extent that the entire pe-
riphery will impinge upon and slightly displace lax soft tissue.
This can only be definitely accomplished by securing an accurate
impression of the surfaces of these lax soft tissues which calls for an
impression of more of the surface of the mouth than it is ordinarily
considered necessary to obtain.
* This article consists practically of extracts from one written in 1885 and pub-
lished in the Independent Practitioner in July of that year.
198 THE DEiVTAL RE VIE IV.
It is important that the impression material should pass upward
between the alveolar ridge and the lip and cheeks to the greatest
extent possible without putting the lip and cheeks upon more than
a slight tension. It must be carried accurately to the extreme height
of the space at the outer side of the tuberosity when such a space
exists, and it should extend upon the tissue posterior to the tuber-
osity for a short distance and upon the soft palate for a sufficient
distance to allow of locating upon the model the line of attachment
of the soft palate to the posterior margin of the hard palate. Such
an impression is shown in Fig. 1.
The model obtained from this impression should not be trimmed
down closer than to the heavy line A, which model presents all
the surfaces to which it is desirable to adapt the denture, while if
it was trimmed down to the extent ordinarily practiced a great deal
of guesswork would be afterward called for. Such a model allows
of molding or swaging the plate so that its entire periphery will be
in nice contact with lax soft tissue and give the sam.e retention
from atmospheric pressure that is manifested when the attempt is
made to remove from the mouth such an impression as has been
described. It will be necessary, on removing such a denture, to
raise the lip or cheek free of the edge of the plate, admitting air
beneath, before the denture can be removed. I have seen the
capillaries of health}' tissue ruptured in an attempt to forcibly re-
move such a denture. The dotted line B, fig. 1, represents the
region in which the proper laxity of tissues is found, upon which
the posterior edge of the plate should rest. Some slight indenta-
tions are always present at the median line of the juncture of the
soft and hard palates. These indicate the location of the foramina
in the bone through which pass blood vessels and nerves. The
posterior edge of the plate should be located slightly posterior to
these indentations, so that being slightly upturned it will rest
against tissue of the proper laxity but not extend upon the soft
palate far enough to cause discomfort.
The posterior edge of the plate should be turned upward
slightly by forming it into a groove cut into the 7?iodel on a line
corresponding to the dotted line b, fig. 1. This groove should ex-
tend from a pomt posterior to the tuberosity of one side to the
same point on the other side, C. C, fig. 1. From these points for-
ward the contact of the cheeks and lip with the rim of the plate
will properly exclude air from beneath, if this rim is carried, as it
ORIGINAL COMMUNICA TIONS.
199
should be, to the extreme height taken by the impression material
at these points.
Fig. 2 represents a model with the groove A across the palate
on the line which should be occupied by the posterior edge of the
plate in such case. The lateral and anterior margins should be
at points indicated by dotted line B, which would give a snug con-
FlC.2
tact with the cheeks and lip. With such a plate, especially in cases
of extreme absorption, a great advantage is obtained by having a
bearing of the plate upon the horizontal surface of the malar pro-
cess of the superior maxilla at a point outside of the line of the
teeth, placing the fulcrum at such a point that the denture is
pressed more firmly against the mouth in mastication instead of
there being a tendency to displacement at the opposite side. If
the tissues forming the surface of the jaw are uniformly firm, no
trimming of the impression or model will be necessary, except as
has been described, but if the surface is firm in some regions and
soft and flabby in others, it will be necessary to pare the impres-
sion at the points corresponding to the hard parts or the model at
the points corresponding to the soft parts in order to obtain the
ideal condition in which there is an equal bearing upon the palate
and alveolar ridge.
In pressing to place a denture built on this plan the air is en-
tirely expelled from between the plate and mucous surface, if the
ideal has been carried out, and the lax soft tissues at the edges
200 THE DENTAL REVIEW.
form a joint that will prevent the air from reentering when there is
pressure applied upon the denture that naturallj^ tends to displace
it.
Under ordinary conditions the adhesion of contact is sufficient to
support the denture, but when powerful pressure is applied during
mastication in such a way that the leverage would tend to displace
the plate, there is a tendejicy toward the creation of a vacuum be-
neath the denture because the air cannot enter from without, and
there is a manifestation of atmospheric pressure exactly equal to the
force tending to displacement.
If a sufficient force is applied, there is a laceration of the tissues
a forcible cupping of blood before the denture will leave its posi-
tion. The denture is easily removed however by simply raising
the lip or cheek sufficiently to admit air between it and the surface
of the jaw.
To obtain the utmost satisfaction with a denture built on this
plan it is best that it should be dispensed with during sleep, and I
often advise the patient to occasionally drop the plate from its po-
sition during the day, as this allows the displaced soft tissues at the
margins of the plate to settle back to their normal contour. Con-
stant displacement of these tissues will in time defeat the purpose
it is intended that they shall serve.
A Brief Treatise on the Common Diseases of the Maxillarv
Sinus.*
By H. H. Schuhmann, D. D. S., Chicago, III.
(Professor of Oral Surgery at Hahnemann Med. Coll.)
To form a correct idea of the various pathological changes the
Antrum of Highmore is liable to, it is necessary to briefly recall to
our memory some of the most important anatomical features of the
region we intend to dv/ell upon in this paper.
A first glance at the superior maxillary bone makes it appear to
us as a clumsy solid piece of osseous formation ; instead of this
though, it is a most delicately constructed bone. It contains a
large pyramidal hollow, and is composed of a number of processes,
so arranged as to close in this large aparture from three sides,
leaving in the disarticulated skull the base of the pyramid, which
is the outer wall of the nasal cavity, open. Its boundaries and
*Read before the Chicago Dental Society.
ORIGINAL COMMUNICATIONS. 201
thickness of its walls vary greatly, and to form a correct idea of
these, it would be necessar}^ to study them on a large number of
specimens. The walls of the antrum are, as a rule, quite thin ;
more especially the orbital plate, also immediately above the ca-
nine fossa upon the buccal wall, and between the palatal roots of
the upper molars, of course this is the more so in young subjects.
A knowledge of this will explain how it is possible for engorge-
ment of the antrum to bulge out the eye-ball, or how easily at
times some of the walls give way to external violence.
In the articulated skull the large opening into the antrum from
the nose is almost completely closed by processes of the ethmoid
and palate bones, only two small openings being left. One of
these, the posterior one, is usually found closed by a fold of mucous
membrane, the other, when the parts are in a healthy state, is just
about large enough to admit a fine probe. Some operators have
used this opening for the introduction of a tube for injecting pur-
poses. But this procedure is far more satisfactory in theory than
in practice. Such performance is sometimes made absolutely im-
possible by the narrowness of the passages, and another reason
why I do not think this the best mode of access for treatment, is,
that if fluids are injected, they are usually supposed to flow off, and
for such a purpose, it seems that the most dependent part of the
floor of the cavity should be selected for the operation. In many
cases, the maxillary sinus is found to be divided into a number of
compartments by bony septi or ridges running across its floor. If
free drainage is to be obtained, these complications must of course
be removed. This must not be lost sight of, as it frequently makes
a cure absolutely impossible.
Quite frequently a number of small projections will be found
covering the floor of the antrum. When these thin covers are
opened, the apices of molar fangs are found projecting into the
cavity ; especially common is this with the palatine roots of the
second molars, thus associating the lining membrane of the sinus
with the covering membrane of the root, and thereby furnishing a
contiguity, if not a continuity of structure.
On the posterior walls, you will remember, are the posterior
dental canals, transmitting the posterior dental vessels and nerves
to the upper posterior teeth. This will show why in some antral
diseases the pain is felt often in a number, or possibly just in one
particular tooth, such pain being induced both by inflammation
202 THE DENTAL REVIEW.
and also by pressure upon these nerves by accumulated solid or
liquid matter.
Some diseases of the maxillary sinus may be of a very benign
sort, as long as they remain in the incipient stage, but if left un-
cared for for any length of time, they may become not only disa-
greeable, but malignant, and defy all skill and knowledge of the
practitioner, and the disease only ends when the unfortunate suf-
ferer does. (Cancer). Most antral troubles are benign if properly
cared for at the right time, and will usually succumb to proper care
very quickly, and without much discomfort to the patient. Here,
like in any part of the economy, the gravity of the trouble greatly
depends upon the general health and predisposition of the patient.
A slight irritation in one robust and strong may start up a slight
inflammation, while the same cause in one anaemic and weak or of a
scrofulous diathesis for instance might produce an indolent and
chronic ulcer. Some patients may carry an antral trouble around
weeks, months, or even years, without even noticing it, and in
others again the same trouble may extend with such rapidity, that,
even if timely, treated it will not succumb, but may even if only a
slight inflammation in the beginning, cause caries breaking down
of the surrounding structures, and may prove fatal.
As to the diagnosis, some antral troubles are easily diagnosed,
others are only recognized by using a great deal of judgment,
scrutiny and care.
Since the writing of this paper the electric transluminator has
come into use, and if the patient be a young subject where the
walls of the antrum are thin and partially cartilaginous, is a
fairly good and safe diagnosticator. Tapping though is the
best means of diagnosing, and the proper place for this (intro-
duction of a probe or trephine) varies with the case; it may be
above the second bicuspid tooth, about an inch above the gum-
margin, or in some cases through the canine fossa. In most
antral diseases, the danger apprehended arises through neglect on
the part of the patient and not from any necessary complicating
character of the trouble or predisposition. \x\ioxm\n^ 2. prognosis,
in these cases, the circumstances to be principally considered are
the general health of the patient, inflammatory tendencies, and any
spreading of the disease.
Usually antral affections, if running on for any length of time,
are loathsome and give sufferers great inconvenience. The dis-
ORIGINAL COMMUNICATIONS. 203
charge in some of these diseases is liable to become very foetid,
and by having access to the nose is likely to produce a continual
feeling of nausea and this by the way is one of the keynotes in diag-
nosing antrocele, especially in advanced stages. Patients suffering
from this trouble very often complain of no appetite in the morning,
a disordered stomach, and a feeling of nausea, which is quite easily
understood, those fluids having entered the nose and having during
sleep trickled down into the oesophagus, and having been swal-
lowed.
Most diseases of the antrum are due directly to dental disturb-
ances. There are many pathological conditions though, connected
with this sinus, which are just as likely to occur here, as in any sit-
uation on mucous membranes. It is wrong to think that all antral
troubles are due originally to dental disturbances ; not only do we
sometimes find these troubles just reversed in their succession, but
quite often affections of the antrum are secondary to nasal troubles.
The general sources of morbid conditions in the antrum may be di-
vided into two classes : First. By the roots of teeth reaching into
it, and secondly, by the lining membrane (being affected likewise
throughout mucous linings). Troubles derivea from the latter
cause, do not essentially vary from other mucous affections, modi-
fications being made only by the situation. A cause less often
thought of but none the less a very frequent one, is a root frag-
ment left in the alveolus (or in the antrum if it has penetrated its
floor), after attempts at extraction. Sometimes you know, roots of
teeth penetrate the antral floor and enlarge within, so that to extract
them without breaking or without taking along part of the floor,
becomes an impossibility, such debris will at times act as foreign
bodies, and produce the same deleterious results as foreign sub-
stances.
Let us at first consideradiseasedcondition which is often wrong-
ly termed abscess of the antrum, more correctly antrocele, it being
the commonest of those pathological conditions connected with a
liquid accumulation. We have here at first no suppuration, but sim-
ply an accumulation oi purulent fluid, Xhc^ excretion coming from the
lining membrane.
The lining membrane of the sinus is liable, as all mucous mem-
branes are (and especially this one, being a continuation of the
Schneiderian),to inflammation and alteration in its secretions, both
regarding amount and kind. The absorptive power of the lining
904 THE DENTAL REVIEW.
membrane in antral diseases, like that of vaginal mucous mem-
brane, in turn becomes greatly impaired, and we therefore have
two reasons for the accumulation of fluid, one being the increased
excretion, the other the decreased absorptive powers.
The symptoms var)-, usually commencing with a feeling of full-
ness, then a dull aching, throbbing, pulsating pain in the cheek,
sometimes accompanied by the usual signs of inflammation, heat
and a fullness of the soft parts externally. I believe that too much
stress has been laid upon the fact that a purulent discharge from
a corresponding nostril must be expected in these cases. This
opening may close at the very beginning of the trouble, in fact may
have been the cause of the deterioration of the enclosed fluid. If
the opening be not closed, the patient will notice a (fcetid) dis-
charge in the nostril, most in the evening, when he retires and lets
his face rest on the healthy side (as then the fluids, accumulated
during the day will run into the nose}, or, if he lie on the affected
side, the cavity will fill during his rest, and flow over into the nose
when he arises. As long as the excretion remains purulent and
watery, the disease is dropsy, antroceU or empyema; it might be called
abscess, when the fluids become thick and degenerate, but then
only. Should the disease be left to run its own course, the pres-
sure within the cavity increases by the increasing accumulation of
fluid, the pain assumes a more throbbing distential character and
may become very severe. Still later the same constitutional
symptoms arise as are. generally present in alveolar abscess, sup-
puration being ushered in by a chill and fever, followed with a
strong, high pulse. As the pressure within increases, the local
symptoms become more prominent, the features are liable to be-
come so distorted as to render the patient unrecognizable.
I had a case where the whole zygomatic fossa was expanded
and instead of a fossa beneath the zygomatic process there was a
fullness and prominence, the molars of the affected side felt elong-
ated, there was acute pericementitis, the concavity of the palate was
flattened, the nostril of that side was closed, the floor of the orbit
raised and the eyeball considerably displaced. This was a case
which had been standing for five months and the walls had become
very much atrophied. Antral abscess is liable to impair vision so
as to cause permanent amaurosis. Total blindness may result by
causing extreme anaemia of the optic nerve. Prof. Holmes says
that the inflammation accompanying abscess of the antrum is occa-
ORIGINAL COMMUNICATIONS. 205
sionally so severe as to implicate the periosteum not only to the de-
struction of some parts of the maxilla, but extending beyond these
structures so as to involve the optic and other nerves in their pas-
sage from the cranium to their destination in the orbit, producing
blindness and fixedness of the pupil on the affected side. These
cases are rare, but several of them are on record. The pressure
within the antrum may atrophy the walls of the cavity so that they
become quite thin and fluctuation or palpation may become a very
valuable symptom in diagnosing. The walls then convey a very
peculiar sensation to the touch, like the handling of fresh parch-
ment ; but to fully insure a correct diagnosis, a sure method of
testing the contents of the sinus is exploration. A minute trocar
and cannula, not above half the size of a wheaten straw, should be
used for this purpose. If the contents be fluid, frequently an ordi-
nary abscess needle will do, but if they be at all thick the matter
will not run down the narrow canal of such needles, therefore pre-
fer the trocar introduced either in the anterior wall or above the
bicuspids (within the mouth) or between the roots of the first
upper molar.
If not attended to the effects of antral abscess or antrocele may
be quite serious. Such an abscess may burst into the nose, or, as
it is often seen, through the cheek, leaving considerable deformity
by gluing the cheek to the bone and leaving a disfiguring scar.
(Such a scar may be removed by a plastic operation later on.)
I have seen one case in the Hotel Dieu in Paris, where the pus
found its way into the orbit, causing great displacement of the eye-
ball, and was finally evacuated through a fistulous opening at the
inner canthus. Not long ago I finished treating a case for a woman
who had been suffering for seven weeks with paralysis of the mus-
cles of expression on the left side; the eyeball was somewhat
displaced; she also had slight amaurosis of the left globe. Its
muscles were paralyzed and the lachrymal canal closed; the first
upper molar and second bicuspid tooth were both elongated and
loose. Neuralgic pains were felt in the ear and the zygomatic fossa.
The eyeball was very painful through the pressure on the orbital
plate from below. Diagnosis of this case was a rather difficult one,
the lady suffering at the same time from other constitutional dis-
turbances and the antronasal opening having dosed. This case shows
distinctively how necessary it is to use judgment and care, to form
a correct diagnosis; do not always expect to see a discharge.
206 THE DENTAL REVIEW.
The treatment of antrocele is not a very complicated one,
though it may become so, if the disease be left to run its own
course for any considerable length of time. I have known cases
where the simple extraction of the offending tooth or teeth was all
that was required for a permanent and immediate cure. There are
two points, which if carried out, I ought Ios^l^ properly carried out,
will in nearly every case effect an entire cure. These are '■'■free
drainage'" and '^cleanliness.'' No matter how extensive a treatment
you may prescribe, these ttuo main points tnust be followed with the
utmost scrutiny, or you will have no success. Now the question is,
how can both of these be obtained in the antrum of Highmore. The
operation is a slight one. General anaesthesia will not often be
necessary, unless an external opening should have to be made.
Let us first consider the methods of opening the cavity from with-
in the mouth (without perforating the cheek). Suppose the cause
to be a diseased tooth, the first, molar or second bicuspid should
be extracted (judgment to be used in deciding which one. If
these teeth are both sound and are not the cause of the trouble
then one of the other methods of access are to be followed). After
this the floor of the antrum is to be cut out with gouges or drills,
the latter instrument used in the dental engines, are probably the
ones more generally resorted to. The haemorrhage will be of a
capillary kind. Now there is one thing to be obtained here, and
that must be kept in mind, we want free drainage, so let us not
hesitate to make an opening large enough. In most cases the floor
should be excavated sufficiently large to admit the end of the little
finger. I cannot go into details of the operation, as the time
will not permit it. After opening and clearing away all debris and
the remains of the fluid enclosed within the sinus, all those bony
septi, previously alluded to, should be broken down, not leaving any
pockets for foreign matter to accumulate. Another mode of gain-
ing access to the antrum and a very effective one in persons of ad-
vanced age or prominent cheek bones is to remove the anterior wall
of the cavity, you can very readily make a good sized opening and
also save the teeth. Treatment of these cases ought usually to be
left to the oral surgeon and dentist as they have the proper instru-
ments and appliances for the proper treatment. I prefer this last
mentioned mode of treatment where there is any choice, for several
reasons.
The palate may be resorted to to make the opening into the an-
ORIGINAL COMMUNICATIONS 207
trum, but is only rarely advisable (in special cases.) Sometimes,
but rarely, usually only for the removal of solid growths, will
it be found necessary to open the antrum from the outside of
the face. When this must be done the incision should be made
through the soft tissues, corresponding to a line about three-quar-
ters of an inch above the gum margin, opposite the second molar
tooth, and the outer antral wall be removed. This procedure will
always leave a disfiguring scar, as the muscle fibers have to be cut
nearly transversely, and should not be used if at all avoidable.
After these steps in the operation, the cavity should be thoroughly
cleansed with a V2500 solution of bichloride of mercury. (This will
also remove any bad odors.) A piece of gum-elastic catheter,
placed on the nozzle of a syringe, will effectually aid in this inject-
ing and prevent the injected fluid from flowing over the surround-
ing soft tissues. Astringent disinfecting solutions should be used
daily. It is to be kept in mind that the very weakest of medicines
should be tried first, as very often a constant irritation is kept up
by either a too frequent use of drugs, or too much manipulation or
too strong medicines.
Remember that as long as free drainagt and cleanliness are ob-
tained, the two main points have been gained. There has been still
another method of tapping the antrum used b}' several without the
removal of any teeth (which 1 wish to mention), by drilling through
the mucous membrane and bone where the cheek and bone meet
right above the second bicuspid or first molar. But this mode
alone will be found inefficient in most cases, and will generally have
to be followed by one of those previously mentioned in order to ob-
tain a cure, as in order to get free drainage, the most dependent
part of the cavity must be opened. The length of time during
which this opening is to be maintained is to be governed of course,
by the progress of the individual case. If, to make the opening, a
bicuspid is extracted, the opening in the soft tissue may be en-
larged by the insertion of a piece of tent-wood for two or three
hours. Just a word in regard to a mode of treatment for antrocele
much in vogue at present, but which should, in my estimation, be
denounced most thoroughly. I am referring to the extraction of a
tooth and insertion of a silver tube clasped to the adjoining teeth. I
know that some of our recognized oral surgeons resort to this
measure still, and 1 shall expect to be thoroughly reprimanded for
this assertion in the discussion, and will therefore tell the reason
208 THE DENTAL REVIEW.
why I do not believe in the insertion of a tube, while I have a
chance. If a tube is placed in situ it can fill but one of three con-
ditions. It can be either too long, too short, or just right, and all
three Sixejust wrong. If the tube is too long it will do the same as
those bony spiculae above spoken of, it will allow a certain amount
of fluid to be retained below its opening; if it is too short, the ar-
tificial opening in the antral floor will close over it and if it just
reaches the antral floor, the mucous membrane will very soon over-
lay its opening and form a valve through which fluids can be in-
jected but not flow off. Absorbent cotton is very often used to
maintain the opening, but iodized lint will be found to be far pref-
erable. (I think it well in our meetings to bring forward these lit-
tle clinical hints.) Should the lint slip into the antrum it is an
easy matter to remove it by catching one end with a pair of tweez-
ers, while, if this should happen to cotton, you will find it embar-
rassing and tedious to remove it from the cavity.
In a healthy constitution a chronic inflammation in the antral
mucous lining may continue for months without any general dis-
turbances or without exceeding its present boundaries, and is often
unappreciated, the patient supposing that he has ozaena. To dif-
ferentiate ozaena from dropsy of the antrum, I think the best diag-
nosing point lies in the question, whether the discharge be of an
offensive odor or not to the patient himself. In the case of ozaena,
the odor is very perceptible to the examining physician, but in
dropsy of the antrum a close examination may be made, and very
frequently no odor will be recognized by the attendant at all, though
the patient may complain of a sickening smell. (In these latter
cases often after the antrum is opened, horribly smelling pus is
evacuated.)
Sometimes it is quite difficult to differentiate between a chronic
suppuration and a solid growth ; to do away with any doubts in
these cases, an explanatory punc.ture should be made; such a punc-
ture is not dangerous and may save the practitioner from making a
great blunder. As to foreign bodies such as bullets, or teeth
driven into the antrum by accident, it is unnecessary to say that
they cannot be promptly removed and the difficulty treated on or-
dinary principles.
Time will not permit of dwelling longer on liquid accumulations
in the antrum so let us consider a class of tumor forming the con-
necting link between liquid and solid accumulations. I am refer-
ORIGINAL COMMUNICATIONS. 209
ring to cysts and cystomata. A cyst, as 5^ou all know, is a tumor
formed by a sack, filled with fluid or a pulpy mass. The symptoms
are nearly all local, consisting in a general expansion of the tissue
over the antral region, accompanied by a corresponding disfigure-
ment of the features. The original sources may lie in dental irri-
tation, sometimes the cause may be a misplaced tooth. T^e size
some of these growths reach sometimes is quite remarkable. An-
tral cystoma have been known to reach the size of an ordinary
orange. The diagnosis is very much like that of the aforenamed
troubles. Fluctuation can sometimes be produced if the cyst is
sufficiently large and has caused absorption of the antral walls. If
pressure or percussion be applied in such a case, a parchment-like
crackling feeling will be noticed by the touch. But to clear away
any doubt in the diagnosis exploration with a small trephine will
be the surest and safest means. The treatment lies in first open-
ing the cyst and to remove its contents, then to inject it with stim-
ulating lotions. Should the patient be one not very prone to in-
flammation, the cavity may be packed with absorbent cotton, satu-
rated with tincture of iodine. Several weeks are generally required
for a complete cure of these cases, provided the patient has no par-
ticularly inflammatory tendencies. Let us now consider some of
the solid growths in the antrum. The limited time allowed for
these papers obliges me to cut the paper short and I cannot say
half of what I should like to on this subject.
Tumors of the upper jaw are of somewhat the same nature, as
those in the lower jaw, but their effects are more serious and they
cause greater deformity. As you know the most common variety
of tumors affecting the upper jaw, are sarcoma, carcinoma and os-
teoma. (Enchondroma, fibroma and cystoma are comparatively
rare.) There are two forms of morbid growths most apt to occur
in the antrum, one consisting of a hypertrophied gland or glands
undergoing cystical degeneration, and the other allied to tubular
epithelioma. The latter is a recurring and doubtless a malignant
neoplasm. The signs and symptoms of tumors of the antrum are
very much the same as those of the aforenamed troubles. There
is no increased discharge from the nose, and no, or at least very
little, escape of fluid after tapping. These tumors commencing in
the antrum grow into the nose, after expanding the walls of the
sinus in all directions, and give rise to singular distortions of the
features, obstruct the nasal passages and are often confounded
210 THE DENTAL REVIEW.
with nasal polypi. They may also occasion absorption of the walls
and protrude into the mouth and into the pharynx or the base of
the skull. To remove them, the anterior walls of the antrum will
first have to be excised; when possible, this should be done through
the mouth, without opening the face, by dissecting the soft parts
away from the jaws and cutting the latter away.
Osseous tumors of the jaw occur in two forms, growing either
from the surface of the maxilla, or from its cancellous portion. The
first may be regarded as an exostosis and have rarely anything to
do with the antrum unless their removal should require removal of
part of the parietes. A frequent seat for osseous enlargement is
seen in the tuberosity of the jaw and may extend to the alveoli,
including the floor of the antrum. I should like to cite a few
cases in connection with this, but time prevents me from going into
details. The origin of tumors of the jaws is generally of an inflam-
matory sort. Diseased teeth, illfitting plates and sometimes blows
upon the face are the most common causes. These tumors are
usually of slow growth, are not very irregular on their surface,
devoid of pain, and show no tendency to degenerate. They only
become serious when their bulk obstructs the nasal passages the
mouth or orbit, or interferes with the movement of the jaws.
As long as these tumors are small, but little or no inconven-
ience is caused by them, and no tendency to grow is present, no
surgical interference is necessary. When limited to a portion of
the jaw, or when occupying the antrum the removal can be effected
by chisels, gouges, bone forceps, pliers, small saws or chain saws.
Should the disease have acquired the form of diffused hypertrophy,
it will be necessary to extirpate the entire jaw. In all surgical
operations on the superior maxillary, the orbital plate should be
preserved, if at all possible.
Just a word about cancer originating in the antrum of High-
more. Cancer of the jaw in its beginning is never manifested by
any swelling and its growth in the antrum illustrates this fact more
particularly ; long before any swelling appears the disease will
have undermined the maxilla and spread in every direction. Its
first sign of life may be (especially in people of advanced age) a
severe toothache, for the relief of which a decayed stimip or tooth
is removed. (I intend to go over this very hastily, dwelling mostly
on the early diagnosis of this horrible disease.) From the result-
ing cavity pus will be discharged and the toothache remain unre-
ORIGINAL COMMUNICATIONS. 211
lieved. If a probe be passed up into the sinus of the antrum a
softened mass of dead bone will be clearly felt and ma}' lead the
examining surgeon to think he has a case of necrosis ; but if the
extracted root be carefully examined a soft growth may be seen
attached to it (microscopical examination should in all such sus-
pected cases be made at once and will quickly throw light on the
subject), after a time the same fungus mass will grow out of the
socket from which the tooth has been removed, or perhaps by
that time fistulous openings have already appeared on the hard
palate or in the nostrils from which fcetid pus is discharged and
also through them these fungous masses will be seen to crop out.
It appears that the various symptoms of cancer in the body of
the upper jaw conceal their true nature in the beginning and pro-
gress insidiously, except by the watchful eye, and are not recog-
nized until they have led to extensive destruction of the bone and
perhaps they have formed openings into the cavities of the mouth,
nose, orbit and possibly extended even within a few weeks beyond
operative relief. Operation even only a few weeks after the first man-
ifestation of the disease will show the bone entirely destroyed and
sinuses burrowing into all the neighboring muscles. Under these
circumstances it is evident that the most thorough removal of the
upper jaw will be totally inadequate to control the disease if it has
already advanced to such a state that it can be recognized by ex-
ternal characteristics. Our only safety lies in the very early re-
moval of the entire jaw before the disease has extended to any ap-
preciable extent. To disclose the existence of malignant diseases
which so cunningly conceal their presence, it is evidently necessary
to examine not only the mouth, but the nose, orbit, and indeed
even the throat. The electric transluminator may come in very
opportunely in such examinations.
Some antral diseases are due principally to constitutional pre-
disposing causes, such as scorbutus, mercurial stomatitis.
Scorbutic diathesis infers mostly to antral purulency and ulcer-
ation. The pathological changes in the maxillary sinus in scor-
butic affections are simular to those of the mouth in general. Treat-
ment of such cases have to be of a constitutional kind, locally
proper medications may be made with a fine trephine introduced
above the canine fossa.
Scurvy and mercurial diathesis both act very similarly by two
different methods ; they predispose through their constitutional re-
21-,' THE DENTAL KEITEIV.
lations and excite locally by inducing peridental inflammation. In
the treatment then we will have to combat the effects of these two
predisposing causes. First, the poison must be eliminated from
the system ; chloride of potash is a valuable medicine in this direc-
tion. Next, the pericementitis is to be cured.
These are the most common affections of the maxillary sinus.
There are more and of different treatment and diagnosis. Great
care should be taken in diagnosing these affections. Judgment is
always a necessary adjunct in the diagnosis of these cases. One
cannot depend entirely on what is to be seen, but must, by proper
questioning, find out the missing links to the chain of symptoms
constituting some particular disease.
Making a Name.
By Geo. W. Warren, D. D. S., Philadelphia, Pa.*
To relieve pain and add to the comfort and beauty of our fel-
lows, and it may be to prolong their lives, should be a sufficient
incentive to the cultivation of any art or profession. This, how-
ever, is not usually preeminent in the minds of the young men -and
women just starting on a professional career. It is for these — the
hundreds who have just left or are about to leave our colleges — •
that I am asked to write.
'•How shall I make a name in my chosen vocation?" is the
cry that goes up from the crowd of young men who are standing in
front of the lower rounds of the ladder ; they are told that there is
plenty of room at the top, but how to get there is the ever living
question.
First, as a member of a profession, what does the fact of our
holding a diploma from a reputable college signify ? In answer I
take the liberty to quote from the Rev. Edward Everett Hale, where
he says : " Every diploma given in a liberal profession contains
three pledges, which those who receive them bind themselves to
maintain in accepting — a pledge to learn for all, a pledge to prac-
tice for all, and a pledge to teach freely to all. The obligation to
learn and teach brings to the front the position of doctor or
teacher."
We must remember, then, the significance of our title, doctor
or teacher, one cannot have a grander title, if honorably won, and
♦Chief of the Clinical Stafif Penn. Col. Dental Surgery.
ORIGINAL COMMUNICATIONS. 213
it is he who wears his title best, who fulfills to the highest degree
the professional idea, does credit to himself, his profession and
his alma mater that rises the highest and makes the best name.
We must remember that college education is but the frame
work of the house ; and that it remains for us, by careful study,
close observation and increasing skill, to complete and adorn the
edifice. Again, we must remember that the possession of knowl-
edge and the power of applying it are two very different things —
our greatest orators and most fluent debaters in societies are by no
means always the best or most successful practitioners.
For one whose career is just beginning there is no better motto
than " perseverence and strict integrity in all things." From my
contact with students I am led to believe that it is the careless,
unprofessional habits formed by many that need the first and best
attention. It is presumed that you will not place yourself among
the quacks and charlatans by placing a showcase or gaudy sign
before your door, and make further efforts to deceive the public by
advertising prices and your methods of "painless dentistry."
We will take it that the young man has been fortunate enough
to secure a good office outfit and is anxious to start in the right
direction, upon an honorable career. Here it is that so many make
mistakes that are fatal, at least to their "good name." Many
labor under the mistaken idea that the first thing to do after enter-
ing a profession is to imagine they have a change of heart and
rush off to join some popular church. Do not use the church for a
commercial purpose ; never attend a place of worship for the pur-
pose of gaining or increasing your poj>ularity. I acknowledge that
I know successful dentists who, when starting in practice, hired
sittings, well to the front, in fashionable churches, and usually
managed to attract attention by coming in late. To say the least,
it is bad taste. Much better is a practice and much more are you
appreciated by patients that are drawn about you by your solid
merit, because you have a clear brain, an honest heart and a skill-
ful hand.
In all our work, from the simplest to the most difficult and in-
tricate operation, it is important that we should have before us our
ideal, we should have in our mind's eye the different points to be
accomplished, and each progressive stage. Our ideals should be
real and practical. Should you with increasing practice, grow
conscious of any superior aptitude or skill, or above your neighbor-
214 THE DENTAL REVIEW.
ing practioner in any essential quality, talent or experience, be not
boastful or intrusive; rect assured that your work will stand as a
living monument to your skill.
Avoid a multiplicit}' of callings; to use a familiar term, don't
have too many irons in the fire. It is true that after you have es-
tablished yourself, it is wise to have some diversion; but a man who
is part dentist, part politician, and part sportsman is not appre-
ciated by the public. Look around you and see how many such
men are successful in life.
Failure comes too, to those who lack earnestness and continued
endeavor, and to those who are constantly moving from one local-
ity to another or who are changing from one pursuit to another;
being "Jack of all trades" is usually to succeed in none.
To sum up then, let every step of your career be marked by
honest and honorable endeavor, by courtesy, truth and justice and
not only a good name will be gained but you will enhance your
profession in public esteem.
Address to the Odontographic Society of Chicago.
By E. L. Clifford, D.D.S., Chicago, III.
Fello7vs of the Odontographic Society of Chicago: — By the decision
of a majority of your members you have inflicted upon yourselves for
the current year the administration of your humble servant. To-
night we gather around the festal board, to retrospect the past,
and to lay plans for the future. All the associations of man pre-
sent of necessity an object to be attained, and these objects, in turn,
force upon us a due appreciation of societies.
On the night of December 12, 188*7, a few young practitioners,
energetic enterprising and ambitious, gathered together and or-
ganized " The Odontographic Society." This meeting therefore
plants the milepost that is to mark your fourth birthday. While
serving that purpose, however, it also suggests the funeral of former
years, and tends to remind us that while " Art is long and life is
short," it demands a concentration of all our efforts to accomplish
even a small amount of results. It is your good fortune and mine
to have for ours an age that has seen enormous advance in the sci-
ences on which the fabric of all branches of the healing art rests,
such as chemistry and other branches of physics, physiology, pa-
thology, and therapeutics. Each of these has taken giant strides,
ORIGINAL COMMUNICATIONS. 215
and while it is to be lamented that purely medical knowledge has
scarcely made proportionate progress, it can, in a measure, be at-
tributed to the fact that medicine deals with the aberrations of the
most complex organisms, is of all the sciences the most difficult, and
demands the greatest patience, the extremest perseverence and the
largest accumulation of data.
In the advancement of dental science, in former years, much
has been attained, and chiefly by individual effort. The value of
such work in the past we would not underrate, nor is it our desire
to lessen the amount of it in the future. But in all departments
of medicine there is much that defies interpretation from individual
experience, and many problems so far-reaching in an ever widening
field, with elements so manifold, that no single man, however
gifted and long lived, can hope to bring the whole within his range.
The need, therefore in dentistry, of that combination of individual
work which is adopted in many other branches of science and in
commerce, and to which increased facilities of intercommunication
have given so much impulse and so much strength, cannot be ques-
tioned. Indeed, we fully appreciate, that, resting on individual re-
search alone, dental knowledge can be advanced but slowly and
with difficulty. Future progress to any great extent must be the
work, not of units acting disconnectedly, but of the collective force
of many acting as one. For many to act as one organization is
needed, and there is little doubt but that the motives herein out-
lined, represent the impulses that stimulated the Alumni of the
Chicago College of Dental Surgery to father your construction.
Though only an infant, in a large and growing family, already your
voice has been heard, your influence has been felt. Your monthly
gatherings have been marked by no spirit of contest, the anxieties
and responsibilities of professional politics find no place in your
exercises, no offensive attitude is assumed, and no defensive pos-
ture is necessary; no pretention; no vain glorious parade. " A lit-
tle company of fellow workmen, you meet in the lengthening shadows
on the highway, to encourage, interest and instruct one another, to
speak words of sympathy, and then, each lifting his burden to
move on."
The past is gone ; the record, whatever it may be is yours, and
you cannot shift the responsibility of the burden. At your annual
meetings however, 'tis fitting to take counsel of the past, rectify its
errors and purify its practices, let the light stream in upon its frail-
216 THE DENTAL REVIEW.
ties and its faults, criticise yourselves that in future you may
stand even upon a higher plane. The future is unexplored, and no
man can say it belongs to him. But the present, // is ours, ours to
improve or destroy. Yes to us belongs the glorious nineteenth
century and the onward march of civilization is upward and
toward the light. In every department of industry a constant
change is going on, nourished and encouraged by the wholesome
desire to improve present conditions, not alone for the pecuniary
gain, but for the higher, nobler, and more enduring results of intelli-
gent advancement. Shall our selfishness, indolence or greed blind
us to the fact recognized by all other vocations, that no elevating
advancement can be made by solemnly following precedents
founded on reasons or necessities which have no place in the busi-
ness of to-day ? There never has been a period in the history of
our calling when the field for active, splendid progress has been
more inviting and encouraging than the one in which we live. Let
every member catch the inspiration and realize that to the extent
of his opportunities and capabilities he is a real factor in the
achievements of this restless age and charged with great and se-
rious responsibilities.
Be eager to perform your portion of the uncompleted task and
you will glory in the consciousness that life is worth the living.
Now then what are the demands of the present? Brevity at this
time is forced upon us, but I trust comprehensiveness and complete-
ness may not suffer from the fact. In order to embrace all with-
in one general assertion perhaps we can do no better than to claim
as an answer better and higher education. Such an education as
will justify us in the claim of standing within the ranks of a learned
and scientific profession. Such an education as will allow us, in
this intelligent age, to cast empiricism to the winds, remembering
always that a superficially educated man is a weak man, and a self-
confused empiric. The strong element in any vocation is the
thoroughly qualified man, who by self-sacrifice, persistent study,
and proper training, has mastered the fundamental principles of
his calling. At this time we would not detract from the value of
practical teaching, but we would enter a plea for the scientific, in
our course. And we embrace this opportunity for entering such a
plea because pure abstract science is ennobling and elevating in
its influence and is the basis of all knowledge and practice. Yes,
it is culture that lifts men and ennobles their souls.
ORIGINAL COMMUNICATIONS. 317
In this materialistic age it forces their thoughts high and
above the things that are earthly, above the mere monied value
of life and enables them to appreciate and long for the things
that are heavenly. We think that at this day no man will
doubt but that the persistent efforts of the bright lights that
have gone before, in the line of pure scientific investigation
and study have pushed upward our professional status, and
given us the advancement we have attained. For still further
advancement and higher standing the young men in our midst must
take up the work where the older ones have left it. To do this
there is no better way than attention to your Societies. Let it be
your maxim to always attend if possible, and when here to attend
strictly to the business of the meeting. Come with a purpose,
come to hear all that is said, and cultivate the habit of so prepar-
ing yourselves for the discussion of the subject appearing upon
your invitation that your contribution to our evening's meeting may
accomplish some good. Above all things, do not disappoint your
society if it is your turn to interest them; this is alwaj's discourag-
ing both to the officers and the members, and has the tendency of
looking disrespectful. If it is absolutely necessary for you to be
absent at such a time, it is indeed not asking too much of you to
notify the proper officer in due time that further entertainment may
be provided. Do not fear to "speak in meeting." Even though it
be a report of your failures, you do not stand alone, we all have
them, and can sympathize with you, and your report may save some
fellow mortal pain and suffering and some fellow practitioner
chagrin. Do not fear either of making mistakes. Erroneous re-
marks many, many times lead to valuable discussions, and one
error or failure may make a more lasting impression, and benefit us
more than many successes. Remember there is also a vast differ-
ence between discussions or criticisms and dissensions — the two
former should be fully encouraged, the latter never permitted.
It has been stated at one of our recent professional gatherings
that it was within the power of the dental specialty to add years
to man's allotted time. This statement has given rise to a new line
of thought, possibly to many of you, and the more we reflect upon
the subject the more logical it seems. The more light that science
and investigation throws upon the etiology of many of man's in-
firmities and misfortunes, the more value we are compelled to place
upon the condition of the oral cavity — as a factor in the cause.
218 THE DENTAL REVIEW.
And with Dr. Foster who wrote so forcibly, some years ago, we must
claim that the portion of the organism intrusted to our care plays
a part second to no other portion of the mysterious composition of
man. He says, " For w'hether its labors be in the line of the great
miracle of digestion, in the addition of beauty to the face, in the
varied and subtle expressions of the emotion, or in the glories of
speech ; in all these and many more, the oral cavity and its exter-
nal guardians, the lips, the dental armature within, the tongue,
with its vocal and dental adjuncts, are all rich in the vast and ac-
cumulated experience of the human race, and they still point to
an untold product in the harvest of man's progressive future.
Should we therefore aspire to the care of this portion of man's
Anatomy, remember it is within the walls of our society rooms, that
the possibilities of our calling become manifest.
To place ourselves in a position to add fact to the above senti-
ment, hard work and close application becomes a necessity. To
obtain and be possessed of the education required, reminds us of
the value of books and their proper use. The presentation of this
thought, we leave to our essayist for the evening.
Lingual Ulceration of an Epitheliomatous Appearance Due
TO AN Upper Full Artificial Denture.
By Arthur C. Hugenschmidt, M. D., D. D. S., Paris, France.
The dental specialist is often called upon to give his opinion in
regard to an ulceration of the tongue, especially as such lesions
very often are due to or arise from some defects in the dental ap-
paratus.
That the diagnosis arrived at should be a clear one, is easily
understandable, as on it depends a severe surgical operation,
namely: the removal of part or the whole of the tongue if the set-
tled diagnosis be epithelioma. Many a patient, I am convinced,
has had his tongue removed for lingual epithelioma, when if a den-
tal specialist had been called in he might have found the origin of
the trouble, and by removing it, cured the ulcerative process, and
saved to the patient a very valuable organ.
To such cases belong the following case, which came under our
care : In 1888, a lady about sixty years of age presented herself
for our consultation suffering from a very marked lingual ulceration
situated on the dorsal aspect of the tongue. This ulceration had
ORIGINAL COMMUNICATIONS. 219
been diagnosticated by an eminent European surgeon as lingual
epithelioma, who recommended the immediate amputation of the
left half of the tongue, which was to be performed two da3's later.
As soon as I examined the tongue, I was convinced from the
physical appearance of the lesion that I had to deal with an epi-
thelioma. Moreover the patient complained of very severe local
pains of a lancinating character, with difficulty of speech and mas-
tication. The lingual pains were increased by certain highly sea-
soned food, while, as regards the articulation of words, it was em-
barrassed, obscure and very much resembled the uncertainty, the
false steps, so to speak, of the tongue, which are observed in the first
stage of general paralysis.
The tongue was very voluminous, of a deep red or violet hue.
On examination of the lesion, I found at about the middle third of
that organ, on the left dorsal aspect, a transverse ulceration which
started from the left border, directing itself toward the median line
and perpendicular to it.
This ulceration was nearly an inch long and formed a hollow, a
cavity in the lingual tissue, of more than one-third of an inch deep.
The posterior border of the wovmd formed a projection which fall-
ing forward covered the cavity. Lifting up this projection one ex-
posed a vast crater-like ulceration, being one-half an inch broad, the
bottom of which was covered with large granulations, surrounded
by pus and bleeding very readily. The periphery of this ulcera-
tion was indurated. The submaxillary glands on the diseased
side were taken; everything in a word in the clinical aspect pointed
to epithelioma.
On examination of the dental arches, I found the following con-
ditions: The lower maxillary presented only the four incisors and
the right canine, all the other teeth had been replaced by a partial
lower set which fitted very nicely, and which in no way came in
contact with the ulceration.
At the upper maxillary all the teeth had been replaced by a full
suction plate, which seemed to keep well in place; no irregularity
existed on either of those artificial pieces, which were both well
finished.
Continuing to question our patient, I saw her suddenly in
answering, perform a rather awkward movement of deglutition. I
suddenly told her to keep quiet and not move, and on opening the
mouth slowly, I found ihe posterior palatal border of the upper full
220 THE DENTAL REVIEW.
set caught in the ulceration, between the posterior projection of the
ulceration and its anterior border; this apparatus seemed to be well
in place when the patient had her mouth open, but as soon as she
articulated, the movements of the palate, which attend such an act,
detached the prosthetic piece and by an instinctive movement by
which the dorsal aspect of the tongue raised itself, the plate was
replaced in its ordinary position.
This displacement of an upper piece rarely causes an ulceration
of the tongue, and in this case it was the unique cause of this ulcer-
ation which began six months previously by a little sensitive point
which had been cauterized for some time, with nitrate of silver,
and finally abandoned until the day when the lesion becoming very
extensive, the patient addressed herself to an eminent surgeon for
relief, who gave the advice mentioned above.
Needless to add, the cause of the trouble being found, that the
treatment was highly successful; all that was done was removal of
the artificial piece; rinsing the mouth with an antiseptic solution,
carbolic acid two per cent; the ulceration touched with tincture of
iodine and finally in two weeks the patient was cured and has re-
mained so up to date.
PROCEEDINGS OF SOCIETIES.
Chicago Dental Societv.
Regular meeting, February 2, 1892, Dr. D. M. Cattell, Presi-
dent, in the chair.
Dr. H. H. Schuhmann read a paper entitled " Diseases of the
Antrum."
Dr. T. W. Brophy, in opening the discussion said : I did not
suppose that I should be called upon to open the discussion on
this paper. I am very glad I had the opportunity of hearing it this
evening. Dr. Schuhmann deserves a great deal of credit for the
labor expended in the preparation of this elaborate paper. I do
not know that I can adversely criticise anything that he has said.
I feel like our lamented Atkinson, who, when he arose to discuss a
paper, would sometimes say, "I agree with everything the essayist
has said except what I mention." One special feature of the
paper that should be commended is the fact that the essayist has
PROCEEDINGS OF SOCIETIES. 221
kept constantly in mind and has urged the necessity of thorough
antiseptic cleanHness from the beginning to the end, wi'thout
which it would be almost impossible to cure disease of the antrum.
I have here some photographs of the antrum which I picked up in
coming down to this meeting this evening, and they will show
some of the anatomical peculiarities that were mentioned by the
essayist, especially the bone septum which we often find in the
antrum separating the cavity into various cavities. One of these
photographs will show very nicely just at the lateral third of the
antral cavity upon the right side a distinct separation. The author
of the paper has well said that it is sometimes difficult to make a
diagnosis and to treat these cases well without breaking down the
bone septum which separates the cavity into different parts. For
instance, an operator may diagnose, as he thinks, disease of the
antrum either by the presence of serous fluid or pus in the antral
cavity. He may open the cavity and find it apparently in a healthy
condition, and yet everything in the case indicates that he has an
abscess. Further exploration will develop this anatomical pecul-
iarity which is overlooked, the presence of the bone septum
separating the cavity into two or three parts. I have seen cases
where there were as many as eight distinct cavities formed, where
there were little cavities running out into the malar process, dis-
tinctly formed, and separated from each other, so that in case fluid
formed in one we might make several explorations before coming
in contact with it.
With regard to the question of drainage tubes and their use, I
do not agree with the essayist, because in my opinion the advan-
tage of a drainage tube is to secure continuous drainage. If a
large opening be made, which is the proper thing to do just as he
has described, making it as large as possible so as to introduce
even the end of the finger, such an opening will give good drainage
generally. The drainage tube must be just right, it must be neither
too long nor too short. How can we determine the proper length
of the tube? That is a simple thing to do. If an operator takes
a silver probe and bends its end so as to form a right angle, then
introduce it into the antrum, he may hook it on the floor of the
antrum, and by that means measure the distance between the floor
of the antrum and the masticating surfaces of the teeth, thus indi-
cating the length of the tube. He may then take platinum and
make a tube the right length. He should make a band in the
222 THE DENTAL KEI'IEIV.
manner we would proceed to make a band for a crown and fit it to
the tooth in close proximity to the opening or antral tube.
He can then take an impression with moulding compound of
the tube, and the band around the tooth, seeing that he holds the
tube where it ought to be. In taking that impression he removes
the tube and also the band from the tooth and makes a plaster cast
surrounding them. He takes the cast to the laboratory, he puts
platinum between the tube and band and solders the two together,
after which he adjusts the tube to the antrum, cementing the band
to the tooth. He can drain the cavity at the most dependent part,
which is at its floor. He has continuous drainage. That is the es-
sential feature of the treatment of antral disease. When the pa-
tient is taking his food he may plug the end with a little stopper,
and this may prevent the introduction of food into the antrum.
After meals he takes out the plug and gets continuous drainage. It
seems to me that this opening might be plugged with gauze, wax
or anything else. Wax is clean, and I would not hesitate to use it.
It will not absorb anything. I would use it in many cases about the
mouth where I wanted to secure a wide opening, and to aid nature
in filling in the cavity at its base with granulations, as, for instance,
in cases of necrosis or carious bone. After the removal of the dis-
eased bone the wax may be introduced after the cavity has been
antiseptically cleansed, and by shaving off a little of the wax, from
time to time the granulations will fill the cavity and the patient
will get well.
There is one point of interest that the Doctor in his paper
dwelt upon, and that is the use of irrigation. Irrigation is very
essential, and after it I think one of the most valuable means of
treating these cases is to make use of insufflations of powders, and
there is nothing that serves me better than powdered boracic acid.
That is my favorite remedy in these cases. An application that is
especially desirable in all chronic inflammations of the mucous
surface, attended with a low form of vitality and suppuration, is a
solution of nitrate of silver in about one part to five thousand,
enough to stimulate and bring about a healthy condition of the
parts. Here we have a surface that is secreting pus. We first
open the antrum and get rid of as much pus as we can by drain-
ing it, then we wash out the cavity with some warm carbolized
water or any other weak solution, but do not use peroxide of hy-
drogen in a case like that at first.
PROCEEDINGS OF SOCIETIES. 223
I saw a patient a day or two ago in whose case peroxide of hy-
drogen was injected in such a cavity as we are speaking about.
The patient called upon one of our practitioners, and he found
what he supposed was a chronic abscess where a tooth had been
extracted. He filled a rubber syringe with peroxide of hydrogen
and carried it up into the socket of a bicuspid tooth, and let the
fluid go. The patient told me that he thought he was going to lose
his head. I said, What do you mean ? "I really thought my head
would burst." The peroxide of hydrogen entered the antral cav-
it}' which was half filled with pus, and you know what the result
would be in such a case. The dentist did not observe the precau-
tion of thoroughly irrigating the cavity with carbolized water or
even warm water. He should have cleaned out the greater quan-
tity of the pus, and then he could have made use of the peroxide
of hydrogen and removed the little remnants on the mucous wall
which the carbolized water would not remove. He would then
have the cavity in shape to use boracic acid or whatever he wished.
I would put boracic acid crystals in there, let them lie so as to get
the prolonged action of the antiseptic. The crystals would dis-
solve slowly and would serve our purposes better than any fluid.
The doctor's paper was a most excellent one. He dwelt upon
the subject of tumors, cysts, and various affections of that sort with
reference to the antrum. I had occasion to-day (Feb. 2nd) to re-
move a dentigerous cyst of the lower jaw extending from the angle
of the jaw around to the point corresponding to the position of the
lateral incisor tooth. The bone was so thin that it could be broken
with my thumb and finger. The walls of the bone were exceedingly
thin. I cite this case briefly, simply to show what immense destruction
may occur in the presence of fluid which forms about malposed
teeth, forming the nuclei of dentigerous cysts. We have the
walls of the maxillary bones absorbed until they are as thin in
places as parchment paper. Fluctuation could be distinctly felt in
this case on the border of the jaw, due to the fluid accumulated
around a malposed second bicuspid tooth over which was still re-
maining the second deciduous molar. If I may be permitted to
digress from the subject a little, I will say that this case shows the
importance of removing deciduous teeth at the proper time. This
boy was seventeen years of age, and still the deciduous teeth were
present.
Dr. I. A. Freeman: I would like to ask Dr. Brophy how he
224 THE DENTAL REVIEW
would hold a drainage tube in position when the teeth are not
there ?
Dr. Brophv: Usually we have teeth in these cases. I would
make an opening large enough to secure drainage without a tube.
I had a case a little while ago in which there were no teeth; the
gentleman who was treating the case made a tube and put it in a
rubber plate, and that was a perpetual inconvenience to the patient,
the movement of the plate, which always occurs more or less, kept
up irritation of the surrounding tissues. I would do it in this way:
I take a large bur — I have some made for the purpose about four
or five times as large as the largest burs used for excavat-
ing the cavities in teeth, and make an opening as large
as my finger. By this means I secured continuous drainage and the
antrum was soon cured. This tube fixed to the plate was objec-
tionable because it caused more irritation than the patient could
endure. A patient may wear a plate without much trouble; the
secretions will find their way down and out. I do not think it is
advisable ever to put a tube in a plate where the teeth are all out,
as tubes thus attached are certain to produce a good deal of in-
flammation of the surrounding tissues.
Dr. Louis Ottofv: If the fluid you have injected comes out
from the opening through the nostrils, would that be a sufficient
indication that the antrum has been injected ?
Dr. Brophv: Generally it would. The opening between the
antrum and the nose is situated almost at the summit of the an-
trum near the orbital plate. If you succeed in carrying the fluid
up gently you can irrigate the antral cavity.
I want to say in this connection that I use a large syringe for this
purpose. The syringe I use in these cases holds about four ounces
of fluid. One of the important points in irrigation of the antrum
is to use a large quantity of fluid, keeping the stream constantly
running and thus washing out the cavity. If you keep the stream
flowing gently it irrigates the cavity thoroughly and rids it of the
fluids that may be there. I have a friend who endeavors to treat
antral disease in cases where the teeth are present by breaking
down the naso-antral wall. I think this practice is objectionable.
I have seen one or two cases where there were thick incrusta-
tions of the nasal mucus in the antrum and the incrustations
formed there will keep up the inflammation and rather aggravate
the condition. I would rather make the operation of Christopher
PROCEEDINGS OF SOCIETIES. 235
Heath, which is also objectionable, that is to make an opening
through the canine fossa. If we take a barrel, filled with fluid, put it
on its end, and then take the plug out of the bunghole it will drain the
barrel down as far as the bunghole, but will not drain it. This is what
occurs when we open the antrum at an}' other place than its base.
Ninety per cent of the cases of antral disease are due to abscesses
of the teeth, and if we succeed in removing the pus which finds its
way into the antrum from alveolar abscesses and keeping the cavity
antiseptically clean, we can speedily cure the antral disease. The pus
from alveolar abscesses making its way into the antrum establishes
inflammation of the mucous membrane of the antrum, conseqently
disease of the antrum is a secondary condition. First we have
abscess with all the preceding pathological changes, and then the
antrum becomes involved to an extent which may lead to extensive
caries or necrosis of the bones which form the antral wall. Should
the bones become diseased, treatment for the removal of the dead
tissue must be employed.
George L. Morganthau, M. D. (as guest): Permit me to say
a few words in regard to the paper that has just been read, from a
rhinologist's point of view. Firstly in regard to the etiology. Dis-
eases of the teeth very often affect the antrum, but I have also
found that troubles of the antrum cause diseases of the teeth. Dis-
eases of the antrum may be due to nasal catarrh ; they may follow
typhoid fever; the exanthematous diseases. You, gentlemen, as
dentists, know much better than I how, when suppuration of the
antrum takes place, it can affect the teeth.
Injections through the natural opening of the antrum are made
frequently in Berlin. The objections of my friend, Dr. Schuhmann
are theoretical. These injections can be practiced often when the
patient objects to a bloody operation. It is also good means in
aiding diagnosis, and I think it is very valuable. Unilateral puru-
lent discharge from the nose, however, which cannot be ascribed
to any other cause, is valued very highly by rhinologists as a diag-
nostic aid. Transillumination is used in Prof. Frankel's throat
clinic in Berlin. It should not be neglected in doubtful cases. A
rather powerful little lamp is necessary. I use one of 6 volts. That
can be employed in adults with just as good results as in 3'oung
persons. We sometimes make an exploratory opening, but prefer-
ably through the lower meatus of the nose. The instrument is
insinuated between the lower turbinated body and floor of the nose.
226 THE DENTAL REVIEW.
By aspiration some fluid is drawn. As soon as tjae diagnosis is
confirmed a trocar is inserted. This is Krause's dry treatment.
The antral cavity is washed out and then a great deal of air is
blown through. In Germany the antral cavity is flushed by the
use of;a Davidson's syringe, flushed continually for five to ten min-
utes, then air is blown through and powder insufflated. Boric acid
being hardly sufficiently strong enough, iodoform is used. If its
odor is objectionable, sulphonal or pyoktanin may be employed.
Judging from my experience, iodoform is the best. Kiister, for-
merly of Berlin, recommends an opening through the facial wall
of the antrum large enough to introduce the little finger. We are
thus- enabled to explore the whole field, remove any obstructions,
etc. I have seen cases in which the mucous membrane, seen
through this opening, appeared as a gelatinous mass, swollen
to many times its natural thickness. It may be necessary
to scrape the mucous membrane well with the sharp spoon.
Finally the whole cavity should be packed with iodoform
gauze.
Dr. T. W. Brophy: In regard to the method of treatment re-
ferred to by the last gentleman (Dr. Morganthau), I will say that I
have been a close observer of the treatment of a friend of mine who
has a great many cases of diseases of the nose and air passages,
and it seems to me that the mucus from the Schneiderian mem-
brane accumulates in the cavity, and the method is in my opinion
objectionable because of the incrustations formed therein. I do
not see how they can accomplish as perfect drainage by the means
outlined as by the method I have mentioned — opening at the base.
Let us consider for a moment the structure of the antrum. For
instance, we have at about the position of the first molar the most
dependent part. I am not an artist, consequently I cannot make
a drawing which would illustrate what I desire. The cavity is in
the form of a pyramid, with the base toward the nose and the apex
toward the malar process, and then dropping down so as to form
something of a V-shape with the sharp angle of the V downward. You
get that usually about the position of the first molar, and in cases
where the teeth are responsible for the trouble, and owing to the
fact that the first molars are the first to decay largely, in the greater
per cent of cases the molar is responsible for the antral disease, and
therefore it is the one which we would naturally select to remove
in order to secure the best drainage of the antral cavity. By re-
PROCEEDINGS OF SOCIETIES. 327
moving that tooth, increasing the size of the opening of the roots
we can introduce a large tube and secure good drainage. I regard
it as impossible to secure efficient drainage at the other points
named. I regard the opening through the alveolar processes far
more efficient than the nasal opening; besides it gives the opera-
tor easier access to the antrum in order to treat it. It seems the
use of warm air after irrigating the cavity would be advantageous
before making use of powders. The points made by the gentleman
in regard to diagnosis are well taken. It has been my custom
where I am in doubt to put the patient at night on the affected
side, then direct him if possible, to keep that position until morn-
ing, and suddenly turn to the healthy side. If the naso-antral
opening be not closed, the fluid will be evacuated into the nasal
passages, and it will pass into the pharynx when the fluid escapes
unless the patient leans his head forward. I can generally make
a diagnosis by getting the patient to follow directions without the
use of an exploring needle.
Dr. G. V. Black: I do not feel like sayiug much on this sub-
ject, though I should not have been here to-night were I not inter-
ested in it, and particularly am I interested in seeing our 3'oung
men bring out papers upon such subjects as this. I was much grat-
ified to hear a paper of this character and scope introduced by one
of the younger me.mbers of the profession. I am glad to see our
younger men coming forward in this work. I have no criticism to
offer on the paper. I have listened to it with interest all the way
through, from first to last. I have had considerable observation
and experience in diseases of the antrum. Antral troubles are of
three sorts — first; the most frequent are those derived from tooth
troubles; second, engorgements that come from irritations of the
mucous membrane from cold and various causes; third, tumors, or
diseases that happen to be located in this region, but not growing
on account of the anatomical forms here. I have seen all of these
varieties, and of course they will assume great variety of form.
The last case I examined, which was only a few days before leav-
ing home, proved to be epithelioma, not originating within the an-
trum however, but extending to the antrum. It was a rather sin-
gular case. It seems to have originated upon the cheek and had
penetrated the masseter muscle, causing ankylosis of the jaw, and
it was on this account that I was called to see the case. There was
sufficient contraction of the muscles to close the mouth perma-
228 THE DENTAL REVIEW.
nently. I found a large opening into the antrum about the position
of the wisdom tooth.
I will say a word in regard to the use of the drainage tube. I feel
that in what the essayist has said he is about right concerning the
use of drainage tubes, and yet I have a patient now with a tube in
the antrum. I put that tube in for the purpose of closing the open-
ing, not to keep it open. The granulations which occur about the
end of the tube that do not pass fully through will affect the
closure. I do not want continuous, but rather periodical drainage
in these cases. I want it closed all the time except when it is un-
der xny immediate observation. If it is to be open at all I want to
be there. I do not want saliva to enter the cavity at all, The
mucous membrane of the antrum is alwa)'S infected if we allow
saliva to pass in. It is infected through the nasal opening some-
times, but less extensively and injuriously, it appears, than by the
saliva. It is possible to keep the mucous membrane of the antrum
free from suppuration for any length of time, provided we do not
allow saliva to enter. Irritation by the saliva constitutes a very
radical objection to the opening from the mouth in the treatment
of the antrum, and if I could find another point otherwise as good,
I should prefer to use it and avoid opening from the mouth. An
opening from the nasal passage is better in some respects although
we as dentists might object to it. The mucus from the nostrils
might give some trouble. It is perfectly justifiable for those who
are skilled in the treatment of the nasal cavity to use this kind of
an opening. During the day there would not be perfect drainage.
I would not have continuous drainage, and it is easy to get drainage
when you handle cases with this kind of an opening. When I in-
troduce a tube I plug it, and open it only when I am handling the
case. As a matter of fact, I find little difficulty in the treatment of
antrum cases. I have had one or two cases, it is true, that did not
do well, that is, pus would recur though they might seem well for a
considerable time. But those cases have been rare.
I have a case on hand now where I removed a polypus from the
antrum which seemed to have grown from a little spicula of ne-
crosed bone left after the removal of a tooth. To remove the poly-
pus, it was necessary to make a large opening, so that I could in-
troduce my finger into the antrum, and there is trouble in getting
it to close. I do not like the idea of making a large opening, for
I have several times had difficulty in getting it to close. We
PROCEEDINGS OF SOCIETIES, 229
are sometimes obliged to make a plastic operation for its
closure.
I have, of late years, used different medication from that stated
this evening, and my experience in the use of it gives me still
greater confidence every year. In the case last mentioned, in which
I removed a mass of semisoft material, filling the antrum and
producing a great deal of pressure, there was never any pus after
the operation, aud never any foul smell. After the removal of the
growth or diseased part, I irrigated the antral cavity with a weak
emulsion of the oil of cassia in warm water. It is not necessary
really to have more than a solution to effect thorough disinfection.
I use a single tube with a large bulb as a syringe, often using three
or four bulbfuls in an irrigation. Then after draining, close the
opening from the mouth. If you have not a tube in place you can
use the wax plugs of which the essayist has spoken. This medica-
tion acts kindly upon mucous membranes, much more so than it
does upon the skin. It is not so liable to blister the mucous mem-
brane as it is to blister the skin. If the oil of cassia is used too
vigorously, it is an irritant, but not so much so as some of the arti-
cles mentioned, and it seems to me it is a much more effective an-
tiseptic than anything else we have used in such positions. It is
much more effective in such positions than bichloride of mercury.
Some of our German friends have condemned the oil of cassia
without giving it anything like a fair trial in actual work.
Dr. J. G. Reid: I do not readily understand how saliva can
enter the antrum on account of its situation, unless by capillary at-
traction.
Dr. Black: When you have a hole into the antrum from the
mouth the saliva will enter through it. A patient may take water
into his mouth and force it through the antrum and nostrils. Sa-
liva will be forced in during the motions of mouth and tongue.
Dr. Brophy : Mr. President, may I add a word to what I have
said on the subject of drainage tubes ? These fellows, called mi-
crobes, do not all swim, some of them fly. They are ever3'where
present. While I recognize the fact that saliva is one of the most
active ferments that we have, I also recognize the fact that if we
have continuous drainage, though the saliva should go into the an-
trum, which is doubtful, clinical history of these cases teaches us
that they will soon get well if properly drained and antiseptically
cleansed. The mouth is rarely if ever filled with saliva, the condition
230 THE DENTAL REVIEW.
is different from filling the mouth with water and using it as a pump
to carry water into the antrum. The patient does not fill his
mouth with saliva and then pump it into the antrum. If the saliva
enters the antrum and we have continuous drainage, it would not
do any harm. Ulcers of the mouth heal under the saliva ; they
heal under the tongue where saliva is always present. I am not
prepared to accept the statement that the antrum must be kept
free from saliva in order to get well. I am not prepared to say
that we are to exclude it in order to hasten the cure. I have taken
out the whole floor of the antrum on many occasions for the removal
of tumors and diseased bone, and the saliva has not poisoned the
freshly exposed surface nor in any way retarded the process of re-
pair. Only a week or two ago I opened both sides of the antrum
and there was very little inflammation. It healed up. The spaces
which are sometimes open are made by the removal of necrosed
bone, and they heal up without trouble in the presence of saliva.
If you get an opening large enough and get drainage the saliva
does no harm.
Dr. G. V. Black : I am aware that the mucous membrane
heals under the saliva. I have removed the floor of the antrum
and found no difficulty in the healing process, and yo^i will not
where there is a continual washing of the parts with the saliva;
but it is in those cases where the saliva is cooped up so that it will
lodge and decompose that you have trouble, unless you keep
the parts clean with a good antiseptic.
Dr. Brophy : The saliva is not cooped up in the antrum, be-
cause you have constant drainage.
Dk. BL.iVCK : You have a little drainage tube to drain the part,
but the hole is small and the antrum is large, you will have fer-
mentation taking place in the antrum. When you put saliva into
the cavity of a pulpless tooth what do you have ? He who treats
abscessed teeth without keeping saliva out knows he will get sup-
puration.
Dr. Brophy : When you use drainage you get a free flow of
saliva.
Dr. Black : You will find that it is where the saliva does not
flow freely that decomposition occurs, and there is where you get
the trouble. The partial septi and irregularities of the antrum
which prevent free flow, have been sufficiently described by the es-
sayist. I see these cases suppurating month after month — suppu-
PROCEEDINGS OF SOCIETIES. 231
rating every day. The saliva and other foreign substances do not
belong here and they cause inflammation in such places much more
certainly than ordinary mucus from the nostrils. We know that
saliva injected into rabbits is poisonous and generally kills them.
We know^ when we put human saliva in the tissues or in cavities
where it does not belong we get into trouble. At the Chicago Col-
lege of Dental Surgery the students cut their fingers and applied
courtplaster and had suppurating fingers. If they had put a little
cassia water on the plaster they would have avoided that, but they
licked the plaster. They poisoned themselves by their own saliva.
At one time a great many of these cases occurred in that school
and the suppurations ceased when they used an antiseptic to wet
their plasters.
Dr. J. G. Reid : I would like to ask Dr. Black a question in
in regard to saliva. For instance, you have a dog, he cuts himself
or is injured in some way. What does he do? He will lay down
and lick that sore from morning till night until it gets well.
Dr. Black : Yes, he keeps licking it all the time and by so
doing he prevents fermentation taking place. Suppuration is the
breaking down of inflammatory products by the process of fermen-
tation.
Dr. a. E. Baldwin : I did not intend to say anything to-night
as it is a subject I know very little about. In opening into the
antral cavity the difficulty is to formulate a rule to apply in all cases
as this cavity is not regular and the dependent portion is not
necessarily in the same place each time. If I were going to open
the oral cavity from below, I should open from the outside and not
from the alveolar ridge.
It seems to me that the same rule would apply in the treatment
of antral affections as in treating pulpless teeth and abscess teeth.
I believe oftentimes that the trouble of the antrum is continued by
overtreatment, by the use of remedies when they were not needed.
Oftentimes simple irrigation with warm water is enough.
I can see no object to be gained by treating the cavity with air.
In regard to the presence or absence of saliva as has been stated
we must not forget that the antral cavity is histologically and phy-
siologically somewhat different from the cavity of the mouth. The
location arid habit of the surroundings will make a great difference
in the greater or less irritation caused by the presence of foreign
substances. Saliva is foreign to the antral cavity, and there is no
232 THE DENTAL REVIEW.
doubt it will cause greater irritation even without any fermentation
there than it would in the mouth. If saliva gets into the antrum
and remains there until fermentation occurs it must necessarily act
as an irritant. I should not fear microbes getting up in there, be-
cause they are pretty lively things and will get everywhere. They
are present everywhere. The antrum is full of them before you
commence to treat it and full of them when you get through. Of
course they are not all alike and some cause more irritation than
others.
In regard to continuous drainage which has been referred to so
much to-night, I do not see how you can get continuous drainage
no matter what you do, The head is not carried in the same posi-
tion. A little change in the position of the head will interfere with
continuous drainage. For instance, if the floor of the antrum is
tapped in the most dependent portion, let the patient lie down and
you will see there is not continuous drainage. I do not see any
objection to closing the opening by packing it, providing we see the
patient often enough. I see a good deal to commend in that course.
I do not think it would be well to leave the opening closed too
long. We should see the patient frequently, have the accumula-
tion discharged and the cavity washed out. If 1 were going to
practice to open from the mouth I should keep it closed as much as
possible, and only at intervals cleanse and wash out the cavity. '
The principal thing I would advocate in these cases is to go slow,
and be sure that you understand the condition and do not over-
treat.
Dr. Brophy: We have to take into consideration the clinical
history of these cases. A patient comes to us with antral disease
which he needs to have attended to, and knows that the first thing
is to get the cavity drained. After we have secured drainage,
emptied the cavity of its fermenting contents, we irrigate it, and
apply our medicaments. My position on this subject is just this:
If you plug a cavity, as one or two of the gentlemen have advocated
to-night, so as to be sure that it is closed, you generally find that
when it is opened you have a cosiderable quantity of pus escaping
at that time, and that pus I contend, retained within the cavity is
a great detriment to the tissues. Pus retards the healing of the
tissues more than the saliva which might possibly get in the an-
trum, and I do not believe that saliva is likely to get in the antrum
except the patient makes a special effort to get it there. For that
PROCEEDINGS OF SOCIETIES. 233
reason, I have followed both methods of treatment, viz., keeping
it plugged, and keeping it open, and I have found in following up
the clinical history of the cases, that we get better results, a more
speedy cure, if we keep the cavity open so as to drain it continuously.
We cannot get constant drainage for the reasons that have been
stated. The patient is not upright more than two-thirds of his time;
the other time he is asleep. The antrum would certainly get well
sooner by having it open at the floor. Plugging of the cavity will
hold the secretions which are really irritating the tissues. I con-
sider it far better to keep it open, even if a little saliva did get into
it. Saliva upon the mucous membrane produces less irritation than
pent-up or retained or decomposing pus. The antrum should be
irrigated two or three times a day to get a speedy cure. If it is
plugged, you should remove the plug three or four times a day. If
you do not do this the patients go over Sundays and holidays and
cannot get to the operator to have it treated. It is better to remove
the pus than to have it in the antrum. As the last speaker (Dr.
Baldwin) has said, the microbes are present there all the time from
beginning to the end of treatment, and they will be there after-
ward. We have to keep in mind the fact that pus is forming and
accumulating and we must prevent it from remaining in contact
with the diseased tissues, in order to restore the parts to health.
Dr. H. H. Schuhmann: I have but very little to add, gentlemen,
to close this discussion. I wish to tender you my thanks for the
very kind reception of my paper.
In writing upon such a subject it would of course be impossible
for me to mention all I should like to about the treatment and
pathology of the various diseased conditions alluded to in the
essay. I am pleased that the discussion became so lively on the
question of the use and abuse of drainage tubes. It is apparent
that the gentlemen who have advocated the use of the silver tube
spoken of have overlooked just what I intended to impress upon
them in my paper. They expect a constant free drainage from
it — now that is just what they do not get, most emphatically not.
As I have said before if the tube is too long it will drain off no
more than the barrell which one of the debaters allud-
ed to, would be drained off by opening it in the middle of its
long axis If the tube is too short the opening in the soft
structures will close completely not allowing the fluids to be in-
jected by force much less to ?^o\s off without force. If the tube is
234 THE DEXTAL REVIEW.
just right then it \?,just wrong, the mucous membrane closing over
the top and forming a valve, fluids can be injected, but will flow off
either partially or not at all.
Prof. G. V. Black has given his reasons for abandoning the tube
I think Dr. Black's ability in his special line of stud)' is sufficiently
well known to us all so no further comment need be made on his
remarks.
The drugs to be used — I can only repeat what I have already
said — the less the better. If the antrum is over-aseptic, kept
aseptic by »?//</ antiseptics nature will in most cases do the rest.
My friend. Dr. Morganthau, made some very interesting re-
marks on "dry method treatment." I have used it occasionally
but don't like the way the powder sometimes becomes caked up
and acts as an irritant. When using the method I apply a powder
composed of aristol and iodoform equal parts. In the wet method
permanganate of potash and listerine, are my favorites. Dr. Black
has mentioned oil of cassia this evening. I have never used it
but will give it a trial in my next case.
That is all I have to say, gentlemen, on the subject. I thank
you for your very kind attention.
Southern Illinois Dental Society.
Report of the clinics of the sixth annual meeting:
clinic no. 1.
Dr. T. W. Prichett, White Hall, operator. Miss Stella Mur-
phy, East St. Louis, patient.
Case : Left superior lateral incisor, mesial proximal surface
badly decayed, requiring a contour filling. The doctor had a large
filling to make. The operation was necessarily a long and tedious
one, but, as in all else, the doctor proved himself equal to the oc-
casion. He went at it without the least reluctance and patiently
maintained an unflagging interest in the case to its completion.
He used Hood & Reynolds' cohesive pellets No. >^, starting the
filling with a few pellets which he made himself from cohesive foil.
Dr. Prichett's work was nicely and thoroughly executed and he
deserves credit for his patience, perseverance and thoroughness in
so long and tedious an operation.
PROCEEDINGS OF SOCIETIES. 235
CLINIC NO. 2.
Dr. G. W. Entsminger, Carbondale, III., operator; Miss Katie
Putnam, East St. Louis, patient.
Case : An aching first superior left molar, with a cavity on the
posterior proximal surface extending up and taking in a portion of
the coronal surface, pulp exposed. The doctor treated with cam-
pho-phenique, giving the pleasant result of relief in a few minutes.
Same operator; , East St. Louis, patient.
Case : Cavity on anterior proximal surface, extending up and
taking in part of the coronal surface of a right superior first molar.
The operator used Justi's Star semi-cohesive gold, most of the
time doing his own malleting. Although the cavity was not ex-
tremely difficult to fill, it required sufficient skill to justify the state-
ment that the people of his vicinity are blessed with the presence
of a skillful, careful and conscientious dentist.
CLINIC NO. 3.
Dr.W. N. Morrison, St. Louis, Mo., operator; Miss Anne More-
head, East St. Louis, patient.
Case : Making and fitting a hollow gold crown on a first supe-
rior left bicuspid.
The whole operation to be performed before the Society. The
doctor made a band from pure gold No. 30 gauge. Soldering with
-20 kt. solder. Swaged the crown with die punch upon a block of
lead. After fitting the band and obtaining the proper length, he
soldered the cusps to the band and filled in with gold and platinum,
then set the crown with Justi's cement.
Of course it goes without saying that the entire operation was
executed well in every respect, for all acquainted with Dr. Morrison
and his work, well know the thoroughness of his operations.
CLINIC NO. 4.
Dr. W. H. Damon, Mount Vernon, 111., operator; Miss Anna
Duddleston, patient.
Case: Left superior first bicuspid, crown fissure cavity. Cavity
running back to the posterior proximal surface. The doctor used
Williams' crystalloid gold No. 2. He did his own malleting
throughout the entire operation, and inserted the filling quickly
and neatly. He did the entire work very creditably and discharged
his patient with a first class filling in her tooth.
23(5 THE DEXTAL REVIEW.
CLINIC NO. 5.
Dr. A. D. Penney, Chester, 111., operator ; Miss Mary Kehoe,
East St. Louis, patient.
Case: Anterior proximal cavity extending up into the coronal
surface. Pulp exposed. The doctor treated antiseptically with
campho-phenique.
Then he anaesthetized the pulp with a six per cent, solution of
hydro-chlorate of cocaine.
This being accomplished, he drove a sterilized willow wooden
point into the canal with sufficient force to drive the pulp either in
or out as the case may be, and to seal up the canal effectually.
Crown cavity filled with Dawson's mineral cement.
Same operator ; James H. Marooney, East St. Louis, patient.
Case: Left inferior first molar, exposed pulp, treated in same
manner as above and filled with cement to be replaced later with
permanent filling.
Operation was performed under protest of the patient.
CLINIC NO. 6.
Dr. C. C. Corbet, Edwardsville, 111., operator ; Mrs. Hudson,
East St. Louis, patient.
Case: First superior right bicuspid, to adjust Logan crown with
gold joint between crown and root of tooth. Prepared tooth by
cutting off with fissure drill and opening up with Donaldson canal
cleaners, Gates-Glidden drills and canal reamers. Used as a medi-
cament H , Oo in full strength. After fitting the crown to the root,
he folded together 1.30 thicknesses of Globe No. 4 noncohesive foil.
Through this mat he drilled a hole sufficiently large for the post of
the crown.
Then he placed the mat of gold on the crown post and set on
the root with cement, using mallet and the force of biting to ad-
just the crown.
Then he burnished the gold down to the root. It was a nice
operation, and one that will most likely prove useful and durable.
CLINIC NO. 7.
Dr. G. A. McMillan, Alton, 111., operator; Miss Martha Schnell,
East St. Louis, patient.
Case: First inferior left molar, buccal cavity extending from the
free margin of the gum up to, and nearly across the coronal sur-
face. After a careful preparation, it was filled with copper amal-
gam.
PROCEEDINGS OF SOCIETIES.. 237
Same operator, same patient.
Case: Second inferior right molar cavity taking in nearly all of
the buccal surface of the tooth, and extending down under the free
margin of the gum, rendering the use of a clamp almost impossi-
ble.
After preparing the cavity, the doctor occupied less than five
minutes to pack the gold into place, using White's Globe non-
cohesive No. 4.
Taking into consideration the position of the cavit}' and the
short time required to fill it, we consider that a capital hit was made
in favor of the use of noncohesive foil, and that the doctor has
placed himself on record as one that has the unquestioned ability
to use it successfully.
His work was thorough and deserves commendation.
CLINIC NO. 8.
Dr. John G. Harper, St. Louis, Mo., operator ; Dr. H. R. Rut-
ledge, Hillsboro, 111., patient.
Case: Right superior cuspid cavity extending from the cervical
border of the distal surface up to, and embracing most of the coro-
nal surface.
Tooth devitalized and root previously filled. Root filling left
in place and tooth filled with Rowan's Decimal cohesive foil No.
4 folded to the thickness of No. 16 and No. 32.
The entire malleting was done with pneumatic pluggers, using
both the Palmer and the David mallet. He also used the Harper
rubber dam holder, a very unique and convenient appliance. In our
observations of the pneumatic plugger, we were impressed with
the strength of stroke as well as the ease with which it is handled
and the fact that in its use no assistant is required.
The doctor had a very difficult case, and the rapidity with which
he completed the operation speaks volumes of praise for the pneu-
matic plugger as well as the congenial doctor himself.
Now, gentlemen, in conclusion we desire to say that upon the
whole the clinics were a decided success. The operators per-
formed the duties assigned with an ease, gentleness and grace that
reflected from their brows a mark of unblemished courtesy; they
also showed that they had a sacred regard for honesty and thorough-
ness in their operations.
L. B. Torrp:nck, Supervisor of Clinics.
J. J. Jenklle, G. W. Entsmingek, Assistants.
The Dental Review.
Devoted to the Advancement of Dental Science.
Published Monthly.
Editor: A. W. HARLAN, M. D., D. D. S.
ASSOCIATE EDITORS:
Louis Ottofy. D. D. S. C. N. Johnson, L. D. S., D. D. S.
A Common Defect in the Insertion of Gold.
It would sometimes seem that nothing short of constant reiter-
ation would lead to the correction of certain defects in operations
which we see in every day practice.
For many years after the general introduction of amalgam, a
common defect in the manipulation of this material in proximate
cavities on molars and bicuspids was to allow an excess of the fill-
ing material to hang over the margin of the cavity at the cervical
border. Unless amalgam be trimmed to shape before crystalliza-
tion has taken place it is exceedingly difificult to dress it down to a
proper form. Amalgam when hard does not cut so easily as gold.
This has at last been generally recognized by the profession and in
these days — thanks to repeated caution against overhanging amal-
gam— we rarely see this defect coming from the hands of a reason-
ably careful operator.
But it took a great deal of talk to correct this practice, and now
we are called upon to keep up the war against a very prevalent de-
fect in the manipulation of gold.
This defect is briefly summed up in the failure to gain perfect
adaptation along the wall of the cavity which stands nearest to the
operator. This wall, especially if the cavity is in a molar or bicus-
pid, is usually in such a position that the operator cannot see it
without the aid of a mirror, and therefore defects are easily over-
looked. It may as well be recognized at once that it is in many
cases impossible to gain adaptation against these walls with the
ordinary pluggers used with mallet force. The principle is wrong.
EDITORIAL. 239
Walls which are in plain sight and against which the plugger
points may be placed with direct pressure admit of mallet force,
but these remote places can be reached only with properly curved
pluggers — preferably right angles — and the force used must be
hand pressure. The gold should be pulled against the walls, and
the force exerted in the direct line in which we wish the material
to be condensed. To attempt to fill all cavities with the mallet is
to invite failure.
This matter has been mentioned so often that there would be
little excuse for calling attention to it again were it not for the fact
that we see every day cases staring us in the face where failure has
occurred from lack of attention to this particular point.
C. N. J.
The Annual Outflow.
In this issue we begin the publication of lists of new graduates
from the various dental colleges of this country. We trust that
every one of them is prepared to take his place among his fellows
better equipped than any previous new graduates and that the in-
fluence of all will be to uplift the name of dentistry by contributing
in some way to its literature, in the field of invention or discovery.
Humanitarianism joined to honesty of purpose will make for the
fledgling a place wherever his services are needed. The profession
is not overcrowded, except in number, and we have a strong belief
in the survival of the fittest. The period of study is over foi- the
self-satisfied and indolent, but it has only begun for the one who is
ambitious for a place, a name, or the opportunity to become of ser-
vice to mankind. Success to every earnest, honest and right-
minded one of the whole number.
The Chicago Dental Society.
Within the last two years the Chicago Dental Society has im-
proved a great deal. The character of the papers read before it,
their number and the regularity with which essayists have filled
their places, are features highly commendable. In no small meas-
ure this has been due to the publication of the papers read, and of
the discussions in the Dental Review, thus giving the thoughts of
the members of the society a wide range of circulation and extend-
ing its usefulness beyond the confines of the city and her dentists.
240 THE DENTAL REVIEW.
It has also been the policy of the Society to introduce younger
members, and as a result thereof several of the best papers read
during the past year were by young men. The Society is rapidlj'
gaining in popularity, the interest shown in the meetings is con-
stantly increasing and the good work accomplished by the im-
provement of its members, both mentally and socially, is well de-
serving of the highest praise. For the coming year, a programme is
in course of preparation, which will still further commend the So-
ciety to the profession of Chicago. No dentist who pretends to be
in the vanguard can afford to be absent from such meetings. Den-
tists who are about to visit the cit}'' should bear in mind that the
meetings are held on the first Tuesday of each month (except Au-
gust and September), guests are always cordially welcome.
DOMESTIC CORRESPONDENCE.
Letter from New York.
To tlie Editor of tJie Dental Review :
Things have taken a leap this month. It is leap year. A paper
on the present code of ethics has proved a testy subject. In the
absence of the expected essayist, caused by illness. Dr. Ottolengui
filled the gap with the above named paper, and it did fill it full,
and some of it has been published in daily papers, together
with some of the discussions which followed it. Dr. Ottolengui
has written a good many papers, but none that will attract more
attention than this one. This session will prove a memorable one.
The readers of my former letters will recall that I spoke of a reso-
lution which pointed direct to the ineligibility of dentists holding
patents. This came up, for acceptance or rejection. It was ac-
cepted and became a part of the by-laws of the First District So-
ciety of New York. In the reports of the daily papers, of this
meeting, I find this statement: "This society leads all other so-
cieties in advanced matters." We ask, Avill it in this step just
taken ? An amendment was added that requires all present mem-
bers to sign this by-law; also a second amendment forbids not only
the case of exhibition at the door, but inside the ofifice as well.
To add to the color of the entire session, "black balls" fell thick,
and only one candidate for membership, out of a list of four, was
DOMESTIC CORRESPO!\iDENCE. 241
elected. That some idea may be formed of the spirit generated
during the present administration and culminating at this session,
I give this piece of news: After the meeting closed Dr. Norman
W. Kingsley wrote out his resignation and left it in the hands of
the secretary. This has been forced by self-respect. From the
moment Dr. Kingsley was made president a determined purpose
has been forcing his administration, in order to bring defeat.
Many stories were in circulation. One was this — "that fifteen mem-
bers would resign ; " and a second, which seemed like a thought to
go slow, that "they would remain and pay their dues and not at-
tend the meetings." Yet each meeting has revealed the fact that
no time would be lost in doing all that evil-minded men could do
to destroy the harmony of the society. We say " evil-minded
men," for it could not have been good-minded men that would have
gone to such extremes.
The first real showing of the animus, revealed itself at the an-
niversary meeting in January. We will give it as it was given to
us by Dr. Kingsley, and it has been verified to me by a prominent
member of the Odontological Society. "It was found that the
first allotment of time for holding the anniversary meeting was go-
ing to conflict with a meeting of the committee of the World's
Columbian Dental Congress committee, to be held in Chicago.
An effort was made to secure the rooms in the Academy of
Medicine upon dates that would not conflict with the regular
meeting of the Odontological Society, but it could not be
done. Then Dr. Kingsley called upon the chairman of the execu-
tive committee of this body and proposed a compromise, offering
to surrender the chair to the president of the O. S. the evening of
their meeting and hold a joint meeting," as most of the members
belong to the First District Society. This was absolutely rejected
and the result was a meeting of both societies in the same build-
ing and on the same evening, and almost an entire absence of the
O. S. members from all anniversary meetings. This was made the
occasion of much gossip, and no little mortification for those visit-
ing. Much regret was expressed by men of too much influence to
think that they will not resent it at a time which will surely come
when the good name of our profession will be protected from such
scandal, saddled upon it by an attack on a member who has con-
tributed more in his line than any other member.
Let us ask who are to be contributors in the coming World's
242 THE DEXTAL REVIEW.
Columbian Dental Congress? If not men of such ability as Dr. Kings-
iej', then we say fearlessly, it will be a disgrace to the manage-
ment. No practitioner in New York City, and I may say in any
portion of the world has better maintained the dignity of his pro-
fession, with contributions of acquired skill and the maintenance
of remunerative fees. Dr. Kingsley has won a professional fame
that no one can destroy by assailment, for personal motives. Only
two months since such a brilliant operator as Dr. E. Parmly Brown
was blackballed as a candidate for membership in the First Dis-
trict Society, purely on personal grounds. What are such doings
going to lead to ?
It looks too much like what is being so much condemned in
politics, " bossism."
It would have seemed that these intended obstacles thrown in
the way of the present management of this society, would have
sufficed ; but no, we are told that the committee was called upon
by the caterers that were to furnish a banquet and asked to pay
the money in advance, as the caterers had been advised that if
they did not do so they would get "left."
If these things be true, and they are, has not the good name of
the society had something to test its strength? "A good name is
better than riches." We predict that the party that has brought
dishonor to the First District Society, will live to reap a full har-
vest from such seed sowing.
It was freely said that this disturbance would manifest the
growth of an unfortunate animus, that would endanger the best re-
sults to be obtained at the Chicago meeting. I do not need to em-
phasize Dr. Kingsley's preeminence in our profession. It is true
that he has no peer in the line of his specialty. Whatever personal
grievance one may chance to have, no upright man would allow
himself to place a blotch upon one's true professional fame. But,
it has been done by some one, and by it a flagrant discourtesy has
been placed at the door of the First District Society and upon those
who were the guests of the anniversary meeting. This trouble has
come by its own members.
The use of books, by Black, in the February number of the
Review, is worthy of more than a passing notice. How do men
read ? All cannot read alike, but all men can cultivate reading.
It is true, as Dr. Black says, men who do not read some one or
DOMESTIC CORRESPONDENCE. 243
more of the journals will fall behind in ability. We think that is a
saying which ought to be italicized. We can name not a few men
who do not make themselves familiar with the contents of the jour-
nal or journals which they subscribe for. They of course help to
support them financially. That is good as far as it goes. Within
a year we had occasion to get the views of proviinent members of
our profession on a certain article. We interviewed eleven, and
found one that had " Just glanced it over." This, ten days after it
had come to hand. We not infrequently refer to something we
have met in the journals and I am asked, " Where did you see
that?" Here is an instance : Dr. Morgan Howe called the attention
of the Odontological Society at the last meeting to an article by
Dr. Stebbins in the October number of the International, " The
treatment of caries by the use of nitrate of silver." He remarked
that he did so that members might become familiar with the sub-
ject clinically as Dr. Stebbins had promised to present the subject
to them sometime during the year. He said further, that he had
become aware that so7ne members were not always cognizant of
how much they lost in not being familiar with the contents of the
journal. This tells the story. It is so all along the line, yet there
are close readers and they are obliged to read some things that
make professional men's blood tingle. What are we to think when
there are those who deliberately say they see the profession filling
up with so much indifferent material that they are glad that none
of their sons have joined the ranks. Yet they have accepted all the
emoluments offered, for themselves. This disposition to smirch
our professional escutcheon, which is going the rounds with un-
tempered mortals, is an unhealthy sign for whom? for the ones that
are in it. Felix quecum facient alena percide contuni.
Jersey was out in " full dress " at the annual dinner and meet-
ing this month. One hundred and five open mouths were well
filled with the unexcelled menu. We think New Jersey has a good
grip on dental prosperity. They all dress well and that goes far
for good looks. I don't know as they have gotten as far as Dr.
Shepard says they have in Boston — "owning their homes." But
they have got it fixed for interlopers. Any man that comes here
for practice — "shoot him on the spot." It is said to be a lucky hit.
If any is found meek and can't explain, he gets meeker.
W. W. Walker responded to a toast and elevated the New York
•244 THE DENTAL REVIEW.
State Society to a dizzy height. Jersey went them one better in
legislation. They have established one thing which is much
needed for the success of the World's Fair meeting, that is unity,
and " as go the Jersey boys so goes the politics of the American
Dental Association." We all know that after-dinner speeches are
far from reliable. It reminds us of the fable of the Cat and the
Rat. The rat had fallen into the vat of liquor and the cat being
conveniently by, was appealed to for help from his sure destruction,
but the' cat wisely replied, I would eat you. The rat quickly an-
swered, I will let you. Upon this the cat placed her dear friend
out of all danger and quietly awaited the ratification of the com-
pact : but in the meantime the rat had quickly sped to his hole out
of harm's way and complacently viewed the situation, whereupon
the cat disappointedly called the rat's attention to his promise.
Yes, yes, the rat replied, I did make that promise, but you must
know / 7vas in liquor then. Not a few of New York and Brooklyn
were present and went home early. Drs. Dwinnelle, Bogue, Kings-
ley, Francis, Carr, Grans, McLaren, Heart, McAvenny, Ottolengui
and Walker (with one W), Rippier and Campbell, of Brooklyn men.
We missed the genial Stockton. We hope he is not going to be
smoked out ; also Levy, perhaps he was " smoking down below,"
he was absent. The Jersey boys will rejoice over the prophetic
speeches that are reported in the February Review, which assure
harmony and success to the Columbian Dental Congress, which
" they originated." We thought New York was the only place
which could send out loving cups, but we think, judging from Dr.
Crouse's speech before the society in Chicago, that Chicago den-
tists could profit by going into the business and send a " loving cup "
wherever she hears rumors of discord. The Doctor travels so
much, he might be a good director in such a work of philanthropy-
By the way of a suggestion, doctor, have one in your vest when
you come East in March to the big mass meeting. Dr. Walker
said he expected 1,100 present, and to make them all members.
We told him we hoped we could report the fact. Just think of it
Doctor, your sorrows are all over. We suspect a surprise awaits
us all at this big deal. It is always the unexpected that happens.
It will be a dry subject to travel so far as "all over" Pennsylvania,
New Jersey, New York and New England, to join a protective as-
sociation. If only the projectors of this meeting will intimate a
theater party, or a Trip to Chinatown, or a 75 cent table d' hote
DOMESTIC CORRESPOh^DENCE. 245
dinner, at the great Columbian restaurant, how appropriate this
would be. It so chimes in with what all our hearts are beating
over, in anticipation. The five societies have started the ball. If
this 1,100 could all dine together once morel Fiinrior quo por
atior. The discussion before the Chicago societ}^ in the interest
of post graduate study cannot fail to enlist earnest attention, in
a general way, at least. It strikes us marvelously, that there are
so many non-graduates. We have taken a decided interest in this
class who are well known for their faithful pioneer work, particu-
larly during the last thirty years. These men have all been active
participants in society work and college teaching. They will not,
nor cannot, nor ought not to be called upon to pass muster, so to
speak, that they may be on a "level" with graduates.
This class which we refer to, some of them are fully equal, and
it is not saying too much, to say that some are far superior. Some
of the graduates would be surprised to know that names with which
they are familiar are "not on the list." Very man}' who ap-
pear as graduates never pursued any specific course of study.
Some are what are termed "honoraries." Many degrees are sim-
ply conferred on the basis of a certain number of years of prac-
tice. I could name many in New York, who would stand on a
level with any graduate, so far as being truly professional and of
good general intelligence, and have sustained first-class clientelles
for forty years. I will give the names of Drs. King, Lord and
Clowes. We could give hundreds of such names throughout the
countr5\ I have thought it would not be a bad idea to publish the
list and let those who are younger see who have been diligent in
the advancement of the true interest and elevation of our profes-
sion. For many reasons that would have no bearing upon present
conditions these practitioners have not secured a degree, but they
are on the level with all that pertains to progress. We would
emphasize close attention to all future incomers.
Dr. Porter, of Denver formerl}', now of Gotham, told how he
treated pulpless teeth, and why he used noncoagulants. Dr.
Harlan would have almost felt he was doing it himself. This was
at the Januar}' meeting. In the press of circumstances last month
we overlooked notice of the occasion and then we found we could
not be in two places at once, although in the same building. It
may not be generally known that the First District Societ}' has
246 THE DEXTAL REVIEW.
the capacity of doing just this thing, for most of the members of
the Odontological Society are members of the First District, in this
way the double meeting was accomplished. Dr. Crouse, we noticed,
played the part of Hyde and Jekyl that evening, in fact he was
seeking all the protection possible. He could not fully make up
his mind that he was getting what he sought. He told them that,
as he came in, he thought he was coming to a dental meeting, it
looked like one, and he saw bones and teeth all about him and
many familiar faces, but the character of the discussion after listen-
ing to it for some time, it suggested itself to him that he might be
in a kindergarten school. He did not find it necessary to go into
all this scientific gymnastics to fill pulpless teeth. He first got a
good free delivery into the tooth and pulp chamber and then put
in the carbolic acid and, with a rubber plunger that filled the aper-
ture, he just jumped on to it and coagulated the whole business and
trouble fore and aft, and so far as abscess had to do with his prac-
tice, he had found only three that he could not drop in twenty
years. The Dr. is all practice, whatever his hands find to do he
does it. He carries the courage of his convictions in his vest and
although he so much makes us think of the tale Mulberry Sellers,
he does not, like him, leave them behind by changing his vest, and
he thinks and fully believes that in this Dental Protective Associa-
tion, which is his pet, there is millions already. He says, it has saved
a million for the profession and if the bridge patent shares the same
fate ultimately there is certainly another million saved.
At the February meeting of the Odontological Society, Dr. Jack
came over and inspired the audience by reading a very practical
paper on the past and future uses of this D. P. A. and he did it
ably and well, and so accorded all. Although " la grippe " had
had a tussle with Editor Kirk, he did not fail to show that he had a
good grip on the practical workings of this body, for he viewed it
purely from a business standpoint. He thought one thing had got-
ten into the minds of many mistakably, that this body was in con-
flict with valid patents, while it only had to do with invalid ones.
Valid ones were entirely out of their jurisdiction. Among incidents
of office practice Dr. Ottolengui related an experience with chloroform
inhaled to the point of nonsensation and then the excavation was
accomplished painlessly. He inquired if any one could tell him
by verification or by confirmation, of a like experience ? We spoke
of our own experience in person, as taught us by the late Dr. Riggs
DOMESTIC CORRESPON^DENCE. 247
in lft74, and since in many hundred cases. This method of using
chloroform is what is known as analgesia, which is a loss of sen-
sation without the loss of consciousness. Dr Riggs' method was
to snuff it through the nose, intermittently until the patient be-
came conscious of its effect and then proceeded to operate, and the
patient knowing his own needs as the effect passed away, would
help himself, either with or without the aid of the operator, to an
additional supply. In this way it could be made invaluable
in any and all painful service. In all of our experience we
have not met with any unfavorable results, but in all cases
with the most happy ones. We published an article on this
subject, a few years since, in the Archives. If any one could
intelligently know the facts, as we know them, they would feel
that they had found a friend in the much misjudged article
chloroform.
Dr. Northrop sought to raise a signal of warning by instancing
the sad demise of young Mrs. Harper, at Yonkers, two years since.
We are acquainted enough with the facts to state, that we do not
believe that she would have lost her life in the hands of an intelli-
gent dentist. Intelligetii dentists do not need ph3'sicians to com-
plicate their services. Men want a good earnest heart and an ac-
tive intelligence, coupled with mechanical ability, to practice den-
tistry. We say it happily, and fearlessly that prolonged suffer-
ing is not a visitor in our ofifice any more. If any one doubts it,
call and watch us. Our practice is coming largely into the so-
called "cruel Riggs treatment." We are carrying out our promise to
the late Drs. Atkinson and Riggs to do all in our power to pro-
mote their theory and practises. This is the purpose of our post
graduate teachings to classes and students prepared for college
training.
P, S. — To be sure at the last moment that what we state, re-
garding Dr. Kingsley's movements, we can say with authority that
his resignation from both city societies is in the hands of the proper
officers and will doubtless be acted upon at the March meeting.
We append here the additional by-law and its amendments as
they were passed.*
The D. P. A. mass meeting is to come off March 28, and don't
you forget it. Ex.
*See memoranda.
248
THE DEXTAL REVIEW.
REVIEWS AND ABSTRACTS.
Catchinx's Compendium of Dentistry tor 1891. B. H. Catching,
D. D. S., editor and publisher, Atlanta, Ga., 1892. Price $2.00.
For sale by dental dealers and by the publisher.
The compendium of 1891 contains 241 well-printed pages on
good paper, preserved within a cloth cover.
It contains about 300 articles copied from the various dental
journals, of which the Dental Review has the honor of having
been called upon to furnish nearly forty. Every phase of practi-
cal dentistry is represented, and the subjects are arranged under
heads in such a manner that any desired topic may be found and
referred to without delay. The book is a useful one, especially to
the man who does not think that he has the time to read as he goes
along, for in this volume there is presented to him the cream of
the literature of Lhe past year. It also contains a list of the vari-
ous dental journals throughout the world and a synopsis of the
dental laws of the United States and Canada.
DENTAL COLLEGE COMMENCEMENTS.
KANSAS CITY DENTAL COLLEGE.
The tenth annual commencement exercises of the Kansas City Dental College
were held at the Grand Avenue M. E. Church, Kansas City, Mo., March 4, 1892.
The faculty address was delivered by Prof. Theo. Stanley, also an address by
Rev. J. E. Roberts. The degree of Doctor of Dental Surgery was conferred by
Dr. L. C. Wasson, President of the college association on the following named
(50) candidates ;
Charles Willam Day.
David Kerr Bryson.
Harry Baile Engel.
Harry Mitchell Doyle.
Charles Willetts Thompson.
Henry Wilfred Kelly.
Alanson Tuttle Havely.
William Amos McKee.
Frank M Blake.
Johann Christian Buttner.
Ernest Prindel Noble.
Jefferson Davis Barton.
Harry Hurt Turner.
Robert Edgar Barton.
Oliver Tennyson Griner.
Arthur Hoffman Bagby.
John Malcolm Campbell.
Frank Lincoln Williams.
James Daniel Neff.
Irwin Wilson Dills.
James William O'Bryon.
James Whitehill Butt.
John Howell Jenkins.
Ned Elmore White.
John George Alexander Kydd.
Arthur Monroe Tutt.
Martin Henry Hopfer.
George Leon Tetrick.
Samuel Joseph Renz
John Bratton Woodside.
Walter Emmitt Highnote.
Daniel Franklin Pendleton.
George Washington Amerman.
Ludwig Henning Bredouw.
P'red Louis Cobb.
Frank Lenoir Carter.
Mark Chester Lovell.
James Henry Goodwin.
Gustavus Montg(/mery Cross.
Amasa Molton Farnham.
Woodsf)n Thompson Smith.
Ole Anderson Smith.
Schuyler Colfax Grant.
Fred Pierce Cronkite.
George Daniel Mitchell.
Pitts Elmer Wilhite.
Clifford Howell Nelson.
Henry Eugene Lindas.
Arthur Lee Lindsey.
Eugene Aquilla Chase.
DENTAL COLLEGE COMMENCEMENTS.
349
INDIANA DENTAL COLLEGE.
The thirteenth annual commencement exercises of the Indiana Dental College
were held at English's Opera House, Indianapolis, Ind., March 1st., 1892.
The number of matriculates during the past session was eighty-eight.
Dr. John D. P. John, of De Pauw University, delivered an address.
The degree of Doctor of Dental Surgery was then conferred on the following
(56) candidates :
D. A. Elwell, Ohio.
G. C. Fleischman, Wis.
W. A. Gant, Ind.
E. H. Gage, Ind.
J. H. George, Ind.
H. C. Goodrich, Ind.
C. F. Gray, Ind.
B. F. Gray, Ind.
D. W. Gray, Ind.
W. M. Hall, Ind.
Elmer A. Smythe. Ind.
R. W. Sessions, Ind.
Blaine Sellers, Ind.
J. G. Schneider, Wis.
T. W. Scott, Ohio.
E. B. Tyler, Ind.
C. W. Throop, Mich.
F. E. Woods, Ind.
Q. H. Woodruff, Ind.
M. L. White, Ind.
J. E. Henderson, Ind.
F. Wright, Minn.
W. H. Harp, 111.
A. T. White, Ind.
D. S. Hontz, Ind.
F. Winchester, Mich.
W. Z. King, Ind.
C. C. Lester, Ind.
W. Anderson, Minn.
D. L. Lucus, Cal.
W. G. Burket, Ind.
B. B. Lockhart, Ind.
B. F. Batson, 111,
J. O. Miessen, Ind.
G. W. Burch, Neb.
P. N. Main, Minn.
C. E. Burket, Ind.
W. J. Morris, Ind.
Orlando Burns, Ind.
W. L. McNamara, Ohio.
J. H. Bloor, Ohio.
W. J. Bradbury, Wis.
G. G. Bilman, Ind.
H. M. Brown, 111.
W. T. Clarke, Texas.
Harry Corken, Ohio.
W. E. Diley, Ind.
H. E. Dewar, Mich.
Charles B. Fletcher, Ind.
A. A. Powell, Ind.
E. E. Pierce, Ind.
D. L. Prall, Ind.
P. A. Rood, Ind.
Claue V. Runyan, Ind.
M. A. Root, Mich.
W. B. Raidgeway, Ind.
MEHARRY SCHOOL OF DENTISTRY.
The sixth annual commencement exercises of the dental department of Meharry
Medical College were held in connection with that of the Medical and Pharma-
ceutical, February 18, at Nashville, Tenn. President J. Braden conferred the de-
gree of Doctor of Dental Surgery on J. B. Singleton, of South Carolina.
Geo. W. Miller, of the medical class, gave the address of welcome, and J. W.
Holmes delivered the valedictory. Robert Tyler, of Alabama, represented the
pharmaceutical classes.
The charge to the graduates was given by R. F. Boyd, M. D., D. D. S., Pro-
fessor of Physiology, Hygiene and Clinical Medicine. Rev. John Pierson, D. D.,
of Cincinnati, was present and gave an earnest and appropriate address to the
graduating class.
During the past session seven students have been enrolled in the dental depart-
ment.
PENNSYLVANIA COLLEGE OF DENTAL SURGERY.
The thirty-sixth annual commencement exercises of the Pennsylvania College
of Dental Surgery were held at the Academy of Music, Philadelphia, Penn., on
March 2, 1892.
250
THE DENTAL RE] 'IE IV.
The number of matriculates during the past session was two hundred and
seven.
The annual address was delivered by Prof. Albert P. Brubaker, M. D., D.
D. S.
The degree of Doctor of Dental Surgery was conferred by the President, I.
Minis Hays, M. D., upon the following (103) graduates :
C. E. Algeire, New York.
C. M. Ashton, Pennsylvania.
A. R. Atwood, New Jersey.
Edwin Banton, New York.
H. Baumgartner, Pennsylvania.
Caleb Bird, New York.
Edith L. Brown, Pennsylvania.
H. S. Brown, Pennsylvania.
Sylvester Byrne, Jr., Pennsylvania.
Thos. H. Carr, New York.
D. H. Covert, Canada.
C. C. Corbiera, California.
C. J. Chambers, Pennsylvania.
S. S. Crow, Missouri.
John Davenport, Pennsylvania.
A. R. Day. New York.
W. H. Deal, New York.
Geo. Doerbecker, Illinois.
Geo. R. Drew. Massachusetts.
H. J. Fleming, Pennsylvania.
Henry Fischer, Germany.
L. H. Frantz, Pennsylvania.
C. E. Foster, New Hampshire.
Emilio Galvis, Colombia, S. A.
Wm. Glading, Pennsylvania.
W. B. Gearhart, Pennsylvania.
W. C. Griffith, Pennsylvania.
Geo. F. A. Graf, New York.
C. H. Green. Delaware.
Mayo A. Greenlaw, California.
"W C. Gutelius, Pennsylvania.
F. E. Guteliuss, Pennsylvania.
A. J. Hamm. Massachusetts.
Josiah Hartzell, Ohio.
Mittie Tudor Haley, Virginia.
E. B. Heston, Pennsylvania.
Luther Hogarth, Canada.
Edwin Hollenback, Pennsylvania.
C. A. .Hottenstein, Pennsylvania.
Alice Jarvis, Michigan.
Mary Jaffe, Russia.
Samuel Johnson, New Jersey.
M. W. Jennings, Pennsylvania.
A. H. Keats, Minnesota.
Mary E. Keyser, Pennsylvania.
Geo. Kumpf, Canada.
H. H. Kuhn, Maryland.
W. H. Lancaster, Connecticut.
P. L. Longnecker, Pennsylvania.
M W. Maratta, Pennsylvania.
O. J. Marcy, Pennsylvania.
Jeannie Magnin, Germany.
W. C. McCarthy, New York.
G. S. McDowell, Pennsylvania.
Joe E. Mitmger, Pennsylvania.
G. A Miller, Pennsylvania.
E. L. Moore, Pennsylvania.
W. A. May, Canada.
D. H. Morgan, Ohio.
T. D. Morrison, Kentucky.
D. A. Myers, Pennsylvania.
Girardo Nunez, Colombia, S. A.
J. C. Nolen, Pennsylvania.
C. L. Pearson, New York.
R. B. Pealer, Pennsylvania.
J. R. Powell, New York.
Pauline Prime, New York.
Raul Ramos, Cuba.
Samuel Rankin, Pennsylvania.
W. A. Robb, Pennsylvania.
Jaoquin Restrepo, Colombia, S. A.
J. C. Reynolds, Pennsylvania.
E. C. Rice, Pennsylvania.
Oswaldo Ros, Cuba.
J. H. Ross, Missouri.
J. W. Ross, Pennsylvania.
W. J. Roe, Canada.
J. H. Russell, Pennsylvania.
W. A. Russell, Pennsylvania.
J. P. Sager, Pennsylvania.
Sophie Tuchner Satinover, Roumania.
F. W. Shephard, Wisconsin.
Ivar Siqveland, Minnesota.
E. M. Slonaker, Pennsylvania.
J. H. Slaughter, New Jersey.
M. W. Snow, Utah.
O. W. Snow, Utah.
Martha Sochatzey, Germany.
Thad. Stine, Pennsylvania.
M. A. Street, New Jersey.
C. S. Street, New Jersey.
E. A. Talmage, Pennsylvania.
F. W. Tate, New York.
L. G. Terry, New York.
John Toprahanian, Turkey.
J. W. Todd, Pennsylvania.
Archie V. Toy, Pennsylvania.
G. A. Vandersluis, Minnesota.
C. E. Wade, Pennsylvania.
E. F. Wayne, Pennsylvania.
J. H. Wardlaw, Canada.
G. M. Weirich, Pennsylvania.
E. C. Wiley, Pennsylvania
PRACTICAL NOTES.
251
SOUTHERN MEDICAL COLLEGE— DENTAL DEPARTMENT.
The fifth annual commencement exercises of the Dental Department of the
Southern Dental College were held at De Gives Opera House, Atlanta, Ga., on
February 29, 1893.
The number of matriculates during the past session was ninety-eight.
The valedictory address was delivered by Dr. W. S. Trent, of Alabama.
The degree of Doctor of Dental Surgery was conferred by Dr. J. S. Powell,
President of Southern Medical College, upon the following named (51) candidates:
Henry R. Jewett.
T. W. Henderson.
Robt. A. Patterson.
Wm. Christopher Morgan.
C F. Mermilliod, Jr.
W. A. Ellis.
J. J. Hendley.
Obed E. Griffin.
W. Luckie Cason.
Frank A. Henley.
W. H. Spinks.
Charles M. Bess.
J. C. Powell.
Jas. L. Dean.
Wm. A. Blasingame.
John C. Smith.
Willie G. Mason.
John R. Warren.
Geo. D. Stovall.
Geo. H. Davis.
Thos. D. Leonard.
Wm. F. Moore.
William L. Hightower.
Thos. D. Coty.
David M. Snelson.
R. P. Jackson.
Wm. E. Wheeler.
Z. Greene.
J. E. Cramer.
John R. Rountree,
W. Emmett Bugg.
Alfred A. Patterson.
Geo. R. Lovelace.
Charles C. Burbank.
A. C. Parry.
Stephen O. Poore.
Andrew M. Jamerson, M. D.
Frank H. Smith.
Thomas B. Robbins.
Joseph G. Heard.
H. W. Carpenter.
G K. Hawley.
Addiel M. Jackson.
E. N. Kibler.
Wm. A. Summerlin.
Wm. McLauren Bethea.
Claudius C. Parrish.
William Stewart Trent.
]. H. Gates.
Wm. Beckom Cone.
T. R. Jones.
PRACTICAL NOTES.
Replanting Elongated Teeth.
By T. W. Prichett, Whitehall, III.
Some time ago you solicited reports of cases of elongated teeth
— replanted.
A case was treated by Dr. Gustavus North and myself four years
ago next April which has proven highly satisfactory.
The case was a lower central incisor — elongated one-eighth
of an inch, and so loose the tongue would move it forward and
back through a distance of half an inch. The sockets of all the
incisors were shortened to half their normal height.
Treatment — extracted tooth. Drilled through crown to pulp
252 THE DEXTAL REVIEW.
chamber. Removed pulp, using freely of bichloride of mercury so-
lution in pulp chamber and root canal.
Filled root with chloropercha and gutta-percha cone — crown
with amalgam.
While preparing the socket, kept the tooth immersed in an eight
per cent solution of carbolic acid — 100° F. temperature.
Deepened socket until tooth was even with adjoining teeth,
sterilizing with peroxide of hydrogen and bichloride of mercury al-
ternately.
Inserted tooth — binding tooth in place with ordinary iron bind-
ing wire, looped around the adjacent tooth — cross tieing through
the interdental spaces.
This fixture was retained comfortably to the wearer until the
following November, when it was removed.
The tooth to-day is rigid in its position, and is, and has been,
as useful as any of its fellows. Subject is sixty-five years old.
Have just been reading "Practical Notes" in the February Review, and no-
ticed what "F." says as to case in soldering a gold plate after striking up. I
would like to ask this question. Given a gold plate and rubber attachment;
why not solder loops with fusible metal ? It will be so covered with rubber as to
prevent any deleterious influences, and will not the freedom from anxiety as to
warping more than compensate for any trouble caused by a possible necessity to re-
swage in after years? Yours, M.
MEMORANDA.
Dr. A. W. McCandless, of Davenport, la., was a recent visitor to Chicago.
Dr. A. G Bowman, formerly of Monroe, La., is now located in New Or-
leans, La.
Mr. J. H. Mummery is the new president of the Odontological Society of
Great Britain.
The "Atkinson Dental Society," of Chicago, completed its organization by
adopting a constitution and by-laws March 14th.
Dr. J. G. Reid read a paper on "Gold in Operative Dentistry" before the
Odontographic Society of Chicago, March 14th.
MEMORANDA. 253
Dr. Ferdinand King proposes to publish in an early edition of Tlie Doctor's
Weekly a complete list of medical, dental, pharmaceutical, veterinary and scientific
journals.
Dr. Guillermo Vargas Paredes, of Bogota, is Secretary of the section on oral
and dental surgery of the Pan-American Medical Congress to be held in the United
States of Columbia.
Aristol for stomatitis, "canker sore mouth," on the exposed pulp and in the
roots of teeth with multiple openings, /. e., after the drill has passed through the
side of a root, etc.
After a long intermission here we are again :
The North Side Dental College and Infirmary, Chicago ; capital stocky
$1,000 ; incorporators, A. H. Lane, T. M. Smith and H. C. Lane.
The Dental IVoi-ld \s a new dental journal, the first number having appeared
March IL It is a successor to the defunct Dental Mirror formerly published in
New York. Published monthly by F. W. Leonard, 85 Fifth Avenue, Chicago.
Subscription 50 cents per annum.
Des Moines, Ia., February 26, 1892.
The thirtieth annual meeting of the Iowa Dental Society, will be held at Ot-
tumwa, May 3d, 4th, 5th and 6th, 1892. All are cordially invited to attend.
G. W. Miller, Sec.
Dr. John G. Harper sends the following recipe for a Hand Lotion:
5 Bay Rum.
Glycerine.
Ex. Witch Hazel.
M. Aqua Rosa '? « f j.
S. Hand Lotion.
Thoroughly wash and dry the hands, then apply. The best time, just before
retiring for the night.
At the February meeting of the Chicago Dental Club, Dr. Bayard Holmes de-
livered an address on the " Evolution of Disease." The Rev. Dr. J. L. Withrow, of
Chicago, made a few remarks to the club from the standpoint of a layman. The
doctor said that dentistry was " the distinctively polite profession" — no civiliza-
tion— no dentists. He made a plea for personal and professional cleanliness
which was quite pointed. The Doctor does not believe in smoking or drinking
by dentists, but he advocated the use of perfumes ! — which makes us ' ' to remark "
that a clean man (or woman) needs them not.
Dr. Oscar Amoedo, of Paris {L Univers Medical, No. 8, 1891), gives the follow-
ing directions to avoid the toxic effects of cocaine:
1. The injections should be made with antiseptic precautions ; the solution
made with boiled or distilled water when about to be used. On filling the syringe
the point should be rolled with cotton in order to filter the solution which passes
into the syringe.
2. The injection should not be made when the patient has an empty stomach.
3. The patient should be in a horizontal position.
4. The patient's clothes should be loose.
.>54 THE DEXTAL REVIEW.
5. He should be under the influence of alcohol, given a half-hour in advance.
C. Persons who are sufifering from a disease of the lungs, heart, or kidneys, or
have any cachexia, should be carefully watched and in such cases the dose should
not exceed one cgm.
7. Women are more susceptible to the action of cocaine than men.
8. As antidotes one may administer inhalations of ammonia, acetic acid, or
nitrite of amyl : effusions of cold water to the back and chest. Any alcoholic may
be given, to which may be added five to ten drops of ether.
9. The nitrite of amyl may be administered in pearls, which are broken, when
desired for use.
10. The syringe-needle should be introduced with the quantity measured in
order to avoid injecting the solution into a vein and the pain of the puncture.
11. The hydrochlorate of cocaine, in doses of five mgms. to two cgms. pro-
duces local ansesthesia sufficient to perform painlessly minor surgical operations.—
Ar(h. of Gynecology .
DENTO-GVN.'F.COLOGV.
Examine under the tongue for two teats, about the size of No. 4 shot, each at-
tached to a slender cord in which a nerve runs, connecting with the genital center.
They are pale in the nonpregnant, but in the encimite they are purplish red. — Dr.
\V R Lowmann in Medical Summary. .
CHANGE OF NAME AND EDITOR.
The Ameriiati Journal of Dental Surgery has changed its name to " The
Amerimn Journal of Oral ami Dental Surgery." The quarterly has been en-
larged and Drs. O. P. Bennett and G. A. Stevenson are the editors. It is quite
attractive in appearance and bids fair to grow in interest.
NEBRASKA STATE DENTAL SOCIETY.
The next annual meeting of "The Nebraska State Dental Society" will be
held at Fremont, beginning May 17th. An interesting programme is being pre-
pared and every dentist in the State is earnestly requested to be present. Dentists
from neighboring States are invited. H. J. Cole, Cor. Sec'y.
ERRORS.
Several errors of proof were allowed to pass last month which the reader will
doubtless correct himself, the most serious being the "endowing of a single
dean." " Chair " was meant, page 150, top line. When our typewriter is out the
printer suffers, for he it is who cannot decipher our lucubrations in cold " ritin."
THE POST-GRADUATE DENTAL ASSOCIATION OF THE UNITED STATES.
The Post Graduate Dental Association of the United States will hold its an-
nual meeting April 'J9th and HOth, next, at the Leland Hotel; Chicago, III.
Dr. W. C. Barrett, of Buffalo, N. Y., Drs. T. W. Brophy, Louis Ottofy and
others, of Chicago, will present essays and addresses. An interesting programme
has been arranged and a good attendance is expected. All members of the pro-
fession are invited. Graduates of recognized dental colleges may become mem-
bers by paying membership fee ($1 ) and dues for one year in advance ($1).
R. B. TuLLER, President.
L S Tenney Secretary, ftfi State Street. Chicago.
MEMORANDA. 255
How much charity work is done by individual dentists ? Is it not a fact that
few, if any, are willing to spend an hour a week or even once a month in a free
dispensary ? In order to make itself felt as a philanthropic profession some work
must be done alongside our medical brethren to encourage them in their labors of
mercy. ,
CHICAGO DENTAL CLUB.
At the January meeting of the Chicago Dental Club the following ofificers
were elected for the ensuing year : President, A. E. Baldwin ; Vice-President,
B. S. Palmer ; Secretary, E. L. Clifford ; Treasurer, E. M. S. Fernandez ; Mem-
ber of Business Committee, I. B. Chrissman. Respectfully,
E. L. Clifford, Sec'y.
* DENTAL CARIES.
Decay of the teeth is causedby the action of microbes. The mouth forms a
warm bath, in which are realized the conditions of heat and moisture required for
the development of the germs which it invariably contains. The bacteria multiply
between the fibers and in the organic substance of the dentine, to which they gain
access by some opening in the enamel. From this point of view any roughness
orlittlecavity in which fragments of food collect should be treated. Now, though
it is possible to effect a relatively satisfactory disinfection of the mouth, this is
not sufficient in dealing with anatomical conformations existing from the begin-
ning in the teeth, both in structure and form. It will be necessary to have re-
course to the dentists to remove or fill these occasions for decay of the teeth.
— Daily Paper.
ENGLAND'S TITLED DOCTORS.
The rapidly succeeding deaths of Sir James Bennett, Sir Morell Mackenzie,
Sir George Paget and Sir Oscar Clayton reduce the number of the titled physicians
and surgeons in England to forty-nine.
Of these, one, Sir John Tomes, is a dentist, twelve are military surgeons, and
two belong to the navy. Seven others are public officials, mostly connected with
lunacy and botany, both at home and in the colonies.
Two, Sir John Kirk and Sir Rutherford Alcock, owe their honors to their diplo-
matic services. Another, Sir Charles Cameron, is a celebrated analyst and chemist.
One veterinary surgeon alone has been so distinguished. He lives at Windsor
and doctors the Queen's horses.
The importance of the profession has developed since Punch suggested the title
of "Lord Deliverus" for the Queen's accoucheur. — Exchange.
THE THERAPEUTIC VALUE OF EUROPHEN.
This is a chemical substance obtained by treating carbolic bodies by iodine.
It is a very fine yellow powder, insoluble in water and glycerine, but very soluble
in alcohol, ether, chloroform, collodion and oil, with an aromatic odor like that
of saffron. This powder is sticky to the touch, like rosin ; it adheres to the
mucous membranes, to the skin and raw surfaces, and is inoffensive.
Therapeutische (Monatshefle, 1B91,) have shown that this new substance is
very similar to iodoform, and that, like the latter, its principal action is to set free
56 THE DENTAL REVIEW.
a certain quantity of iodine; it also resembles it in preventing the growth of mi-
crobes that can live without air, and the reductive power of the staphylococcus
pyogenes aureus. It furthermore resembles iodoform in checking thesecretionsand
at the suppuration surface of wounds.
In a word, europhen has the same chemical and physiological property as
iodoform, but it is five times lighter and has also the very appreciable advantage
of having no odor.
HAVDEN DENTAL SOCIETY OF CHICAGO. — PROGRAMME FOR 1892.
March 21.— Essayist: A. W. Freeman; Subject: "The Manipulation of
Gold for Filling." Discussion opened by C. N. Johnson.
April 18. — Essayist: A. J. Oakey; Subject: "Reflex Nervous. Is Phenomena
due to Dental Lesions." Discussion opened by Edmund Noyes.
May 16.— Essayist: J. O. Brown; Subject: "Crown and Bridge Work."
Discussion opened by J. W. Wassail.
June 20 —Essayist: Louis Ottofy; Subject: " Pregraduate Study." Dis-
cussion opened by R. B. Tuller.
September 19. — Essayist: M. B. Rimes; Subject: " Prosthetic Dentistry."
Discussion opened by G. W. Haskins.
October 17 —Essayist: Hugh McNeil; Subject: "Operative Dentistry."
Discussion opened by J. G. Reid.
November 21 — Essayist: C. H. Sipple; Subject: "Pathology." Discussion
opened by L. L. Davis.
December 19. Annual Meeting. — Essayist: F. A. Hefner; Subject: "The
use of Amalgams." Discussion opened by H H. Wilson.
RULES FOR THE ADMINISTRATION OF COCAINE.
Dr. Magitot, in the Ri-pcrtoirc de Phannade for August 10, 1891, formulates
the following rules which should govern the employment of cocaine as an anaes-
thetic :
1. The dose of cocaine injected should be appropriate to the extent of the
surface desired to render insensitive. It should not exceed in any case 1 grain to
II4 grains. Each dose should be restricted in large surfaces.
2. Cocaine should never be employed in cases of heart disease, in chronic
affections of the respiratory apparatus, or in nervous subjects ; and this exclusion
applies also to other anaesthetics.
3. Cocaine should be injected into the interior and ncH under the derm of the
macous membrane of the skin. This is the intradermic method of Reclus,
which should be substituted for the hypodermic method. By this means the intro-
duction of a substance into the vein is avoided and the risk of accidents therefore
minimized.
4. The injections should always be practiced upon the subject in a recumbent
position, and he should only be raised when the operation is to be performed upon
the head and mouth, and then only after anaesthesia is complete.
6. The cocaine should be absolutely pure, since as pointed out by Laborde,
its mixture with other alkalies forms highly poisonous compounds.
0. Cocaine should be injected in divided doses, with a few minutes' intervals.
7 Suspension of administration, or, as the author terms the method, " frac-
MEMORANDA. 257
tional injection," renders it possible to guard against the production of sudden symp-
toms of poisoning. — Therapeutic Gazette.
AMENDMENTS TO BY-LAWS OF FIRST DISTRICT DENTAL SOCIETY, NEW YORK. —
PASSED FEBRUARY 9, 1892.
ARTICLE II. Section 3. Active members shall be dentists residing in the
First Judicial District of the State of New York, holding their membership in
accordance with the provisions of Section 13 of the Act incorporating this Society.
Also, any person registered as a dentist in the County Clerk's office of the County
of New York, and practicing in said county, shall be eligible for active membership
in this Society. — Addition — provided that he be of good character, that he does no-
conduct his practice by means of the exhibitioti of dental specimens, appliances or ap-
paratus in a window or in a showcase exposed to public inspection in or out of the
office, or by means of public advertisement, or by circulars describing modes of practice,
or patented or secret processes, or by the publication of his scale of professional
charges.
ARTICLE II. Section 3. Each applicant for admission to active member-
ship must have fulfilled the requirements of Section 13 of the Act incorporating
this society, and also all the requirements of the laws regulating the practice of den-
tistry in the State of New York, — Addition — and shall har'e subscribed to the condi-
tions laid down in Article 11, Section 2 of these by-lajvs, — and each applicant must
be endorsed by two members in good standing, and referred to the Executive Com-
mittee. Upon their approval he shall be eligible for election at a subsequent regu-
lar meeting, and three-fourths of all votes cast shall be necessary to elect. — Addition
— All members of the society shall agree to these provisions of the by-laws.
ILLINOIS STATE DENTAL SOCIETY.
The following is a partial programme for the Annual Meeting of the Illinois
State Dental Society to be held in the Senate Chamber, Capitol Building, Spring-
field, 111., beginning Tuesday, May 10, and continuing four days.
1st. Annual address by the President, Dr. W. H. Taggart, Freeport, 111.
2d. Report of committee on Dental Science and Literature, by Dr. Edmund
Noyes, Chairman, Chicago.
3d. Report of committee on Dental Art and Mechanism, by Dr. J. Frank
Marriner, Chairman, Chicago.
4th. Some Reforms Needed in the Practice of Dentistry, by Dr. James W.
Cormany, Mt. Carroll, III. Discussion opened by Dr. Wm. Conrad, St. Louis,
Mo.
5th. Second Period in the History of Dentistry (continued) with Biographi-
cal Notes, by Dr. John J. R. Patrick, Belleville, 111.
6th. Crown and Bridge Work, showing casts, models, appliances, etc., by
Dr. E. Parmly Brown, New York City. Discussion to be opened by Dr. J. J. R.
Patrick, Belleville, 111.
7th. Antiseptic Dentistry, by Dr. Garrett Newkirk, Chicago. Discussion to
be opened by Dr. T. L. Gilmer, Chicago, 111.
8th. Dental Legislation, by Dr. E. K. Blair, Waverly, 111. Discussion to be
opened by Dr. Chas. R. E. Koch, Chicago.
9th. The Enamel at the Gingival Line, by Dr. Y. E. Weeks. Minneapolis,
Minn. Discussion to be opened by Dr. G. V. Black, Jacksonville, 111.
258 THE DENTAL REVIEW.
lOth. Contour Fillings, What They Should Be, etc., by Dr. Geo. H. Gushing,
Chicago. Discussion to be opened by Dr. E. D. Swain, Chicago, 111.
11th Report of Supervisor of Clinics, by Dr. D. M. Gattell, Chairman, Chi-
cago, with discussions.
Dr. D. M. Gattell, of Chicago, 111., Supervisor of Clinics has made arrange-
ments for extensive clinics, to which two half days, Wednesday and Thursday
mornings will be devoted. The following is a partial list of clinics so far as pre-
pared :
1. Dr. J. N. Grouse — A method of retaining rubber dam in posterior teeth
without clamps and insertion of noncohesive and cohesive gold filling in compound
proximal cavity.
2. Dr. T. L. Gilmer — A gold inlay in compound proximal cavity.
3. Dr. E. J. Perry — A method of preparing and placing a molar gold crown.
4. Dr. J. W. Collins — Insertion of proximal gold filling.
5. Dr. J.W. Wassall— a method of attaching bridges.
6. Dr. W. O. Butler — A method of manipulation of alloy amalgam fillings.
7. Dr. C. N. Johnson — Insertion of contour cohesive gold filling in com-
pound proximal cavity, with reference to proper preservation of interdental space.
8. Dr. H. a. Costner — A method of preparing and filling root canals with
tin or gold.
9. Dr. W. B. Ames — Manipulation and insertion of phosphate of copper
fillings.
10. Dr. a. W. McCandless, Davenport, Iowa — A method of producing por-
celain-faced bicuspids.
11. Dr. T. W. Prichett — An idea about amalgam.
12. Dr. .
It is particularly requested that those having pathological specimens, peculiar
cases, models, new appliances and methods, will bring them to the meeting.
The utmost effort will be put forth to make both the Scientific and Practical
features of this programme instructive and interesting.
All practitioners of Illinois (including nonmembers) and of neighboring
States are cordially invited to attend. They are especially urged to be present at
the opening and remain through the entire session.
The usual reduction in Hotel and Railroad rates will be allowed.
J. J. Jennelle, Chairman Executive Committee.
ON the alleged bactericidal property of blood-serum.
Dr. A Gottstein, Berlin, after a thorough examination of the whole literature
on the subject, resumes the result he has reached in the statement that our
investigations of the bactericidal property of the humors of the living organism,
as well of its practical application, are nothing more than initiatory steps. The
author communicates an interesting personal contribution to the subject in
question. He has investigated the contents of blisters produced by cantharide
vesicatory and has found that they possessed strong bactericidal properties
These properties could not reside in cantharidine, the latter failing to show any
antiseptic action even in 0.2rj^ solution, — Thcrap. Monatsh.
The first difificulty which one experiences in studying the rotifers, says a
writer in \\^^ Archives de Biologie, is their constant motion. This difficulty is
OBITUARY. 25»
overcome, according to Masius, by the use of a mixture of methyl alcohol, water,
and cocaine in weak solution. After being anaesthetized by this fluid, the rotifers
may be fixed without contraction in the ordinary preservative fluids — Fleming's
fluid, for example. For the study of the head, an anaesthetized specimen is
placed on the slide, and the head cut off in a tranverse plan as near as possible
to the anterior end. The section thus obtained can be examined easily from any
side in water or weak alcohol.
SOMNAL.
From an article by W. Oilman Thompson, M. D., visiting physician to the
New York and Presbyterian Hospitals, published in the Ne7v England Medical
Monthly, we make the following extracts, which will doubtless be of interest in
estimating the merit of this drug.
After detailing the various experiments and observations which led up to his
conclusions, he states that the experiments show that —
1. — The ordinary dose of Somnal — thirty minims for man — may be given by
hypodermic injections to dogs, without other effect than drowsiness and slight
vertigo and muscular tremor.
2. — A dose of one fluid drachm and a half failed to effect a cat, except in
the same manner as the dogs.
3. — A fatal dose of half a fluid ounce stopped the respiration before the
heart, and caused congestion of all the abdominal viscera.
4. — The blood-pressure in the arteries of a dog is temporarily increased by
somnal, soon returning to the normal.
And his conclusions were as follows:
1. — The effects of somnal are much more striking and certain than those
of urethan, and far less depressing than those of chloral.
2. — There is no vertigo or depression after taking somnal, such as may fol-
low the use of sulfonal.
3. — The action of somnal is usually very prompt, and doses of half a drachm,
disguised in a little syrup of tolu, or whiskey, are always well borne, easily taken,
and entirely without deleterious effect.
4. — The drug, in doses of a drachm, is not powerful enough to decidedly
control delirium tremens, maniacal delirium or severe pain.
5. — In doses of thirty or forty minims, somnal is a safe and reliable hyp-
notic for ordinary insomnia.
So many of the new hypnotics have one or more objectionable features, and
their continuous use results in so many new drug "habits," that it is an evident
advantage to have another remedy of this class which can be used interchange-
ably with others if desired, and which seems to be singularly free from injurious
effects, and yet strong enough to act promptly and efficiently in ordinary insom-
nia, not due to intense pain or delirium. — Phar. N'otes.
OBITUARY.
Joseph A. Swasey, D. D. S.
The following resolutions were adopted at the meeting of the Chicago Dental
Society, March 1, 1892 :
ofio THE DE.VTAL RE]' IE IV.
Whereas. The Great Ruler of the Universe has in his infinite wisdom re-
moved from our midst Dr. Joseph A. Swasey.
Whereas, It is proper that this society should record its appreciation of his
many virtues ; therefore be it
Resolved, That in the death of Dr Swasey this society and the dental profes-
sion has lost one of its most worthy and promising members.
Resolved. That this society extend its heartfelt sympathy to the parents of the
deceased and that a copy of these resolutions be sent to the bereaved parents and
to the dififerent dental journals.
T. W. Brophv, 1
F. H. Gardiner, ;- Committee.
D. M. Gallie. )
Died, at De Funiak Springs, Fla., on March 1, 1892, suddenly of heart failure,
L. D. Mcintosh, M. D., D. D. S., of Chicago, aged fifty-seven years.
Born in Vermont, Dr. Mcintosh was educated both as a physician and den-
tist, and practiced both professions in his early days in Wisconsin and Minnesota.
His mind was inventive and he soon brought out valuable improvements, the first
being a uterine supporter, and later the battery which bears his name. Following
out this path he gave up practice and for years has devoted his energies to improve-
ments and inventions of a scientific and practical character, resulting in the crea-
tion of the extensive establishment of which his was the leading mind, the " Mcin-
tosh Battery and Optical Company," of Chicago.
His improvements, as well as his scientific work, have always taken high rank.
His battery is in general use throughout the country and has been adopted by the
U. S. G<jvernment. His milliamperemeter, when submitted to a test in competi-
tion with the best French instruments, bore off the palm. His lectures and illus-
trations before the American Microscopical Society and other leading scientific
bodies, have placed him high in the list of investigators. As a histologist and mi-
croscopist neither he nor his instruments had any superior and few equals.
At the time of hisdeath, Dr. Mcintosh was President of the American College of
Dental Surgery, one of the prominent schools of dentistry in Chicago. A man of very
frail physique, he struggled against odds, yet by indomitable perserverance and tire-
less industry, he accomplished a vast deal His plans were ever developing, and
his accommodating and obliging nature led him to assist in many directions, and of-
ten to burden himself with tasks and duties which he was quite unable to carry.
With his great abilities, he combined a modest and unassuming manner, which was
really remarkable, and a gentle and friendly spirit which rendered him beloved and
respected by all the large circle of his acquaintance, and greatly endeared him to
those who knew him most intimately. Stricken down suddenly, with scarcely a
note of warning, the manner of hisdeath, while undoubtedly painless to himself, was
shocking to his family and friends. He left Chicago Feb. 27th for a little trip of
relaxation, apparently in his usual health, and had but just arrived in Florida when
he wa.s called hence.
Dr Mcintosh was a soldier during the war of the rebellion, and a member of
the Grand Army of the Republic. He labored under physical disabilities contracted
during the service.
His loss will be felt, not alone by the surviving family, consisting of a wife and
two daughters (the elder Miss Rebecca Mcintosh, D. D. S ), and by the business
house with which ho was connected, but by a wide circle of friends and in many
circles everywhere A more sincere, faithful or a truer man never lived, and his
works will live after him.
"None knew him but to love him.
None named him but to praise." C. 5. S.
George Claudius Ash, the oldest son of Claudius Ash, of the well known dental
manufacturing firm of C Ash & Sons, died in London, January 17, 1892.
Dr, Noah Porter, a former President of Yale, and a noted writer and educator
is deceased.
THE
DENTAL REVIEW.
Vol. VI. CHICAGO, APRIL 15, 1892. No. 4.
ORIGINAL COMMUNICATIONS.
Mechanical Treatment of Congenital Fissure of the Palate.*
By Grant Molyneaux, D. D. S., Cincinnati, Ohio.
In presenting this paper on the mechanical treatment of cleft
palate, I have deemed it advisable to precede the description of
the appliance with a reference to some conditions that exist during
vocalization, with a normal and abnormal palate ; in order to better
understand the principle upon which the construction of an appli-
ance for the treatment of abnormal palate is based.
For perfect and pure enunciation it is necessary, other things
being equal, that the cavity of the nose be perfectly separated from
oral and pharyngeal cavities except for the sounding of the two
consonants M and N.
This separation under normal conditions is effected by the soft
palate acting in conjunction with the superior constrictor muscle of
the pharynx.
In congenital fissure of the palate, which is the only lesion
that can properly be called cleft palate, we have a permanent com-
munication between the oral, pharyngeal and nasal cavities, and
consequently impaired speech, the degree of which depends
largely upon the character and extent of the fissure.
The treatment consists of substitution in line of the fissure, of
various formed appliances, by which we can utilize such muscular
action as is available to close and open the posterior nares during
vocalization.
As there is a diversity of opinion as to the principle upon which
*Read before the Mississippi Valley Association of Dental Surgeons, 1892.
263
THE DENTAL REVIEW.
this closure is effected, it will be necessary to consider the anatomy
of these cavities, and muscular action, before we can determine
upon a definite basis of treatment.
In the normal palate we have a soft elastic curtain, projecting
from the hard palate, composed of, and actuated by, the levator
and tensor palati muscles, the palato-pharyngei, palato-glossi, and
azygos uvulae muscles.
When it is necessary to vocalize any letter except M or N, the
soft palate is extended posteriorly to meet the posterior wall of the
pharynx, which is, by the contraction of the superior constrictor
muscle of the pharynx, moved forward.
This extension of the soft palate posteriorly is caused entirely
by the action of the palato-pharyngei muscles, and as the soft
palate strikes the wall of the pharynx its lower edge is turned for-
ward, thereby presenting a convex nasal surface to the pharyngeal
wall.
This simultaneous action, of the palato-pharyngei acting on the
soft palate, and the contraction of the superior constrictor of the
pharynx, closes the posterior nares as in swallowing.
Now, when the expired air is thrown into vibration and a tone
produced, the tensor and levator palati muscles are called into use,
their function being to straighten and make tense the palate by
pulling against each other latterly; this tension being possible only
when the palate is intact, and drawn backward by the palato-phar-
yngei muscles.
This tense palate, which might be likened to a drum head, is
now capable of entering into a sympathetic vibration and adds
quality to the tone produced.
Beside the tension and straightening of the palate, the only
other function of these muscles, the levator and tensor palati, is to
dilate the eustachian tube, and in no wise can they by an elevation
close, or cause to be closed, the posterior nares.
By a closure of the posterior nares and tension of the palate,
the mouth is formed into a resonating chamber for all sounds save
M and N, and is capable of alterations in length, breadth and
depth, to afford a suitable resonance for each tone.
For illustration :
A as in ah, oo as, in boot — the larynx descends and the lips are
projected, lengthening the resonating cavity to the utmost, and is
estimated at about four inches; I as in it — the larynx is raised, the
ORIGINAL COMMUNICATIONS. 263
lips drawn tightly over the teeth, and the cavity is shortened to its
shortest diameter, about two and three-fourth inches.*
"The enunciation of the vowels is dependent upon an alteration
in the size of the resonating cavity, which gives a definite reso-
nance at all times for the same vowel sound."*
The position of the "lips," " tongue," and "larynx" determines
the size of the resonating cavity, and while these are constantly
changing position, the superior constrictor of the pharynx main-
tains nearly a uniform contraction ; the purpose of which is to as-
sist in closing the posterior nares.
Another point worthy of notice is that the vowel sounds can be
distinctly enunciated without a perfect closure of the posterior
nares, though for purity of sound it is better that it should be
closed.
When there is fissure of the palate we have-a condition widely
different from those just stated. The division in the median line
of the soft palate establishes a permanent communication between
the nose, the mouth, and pharynx, making articulate speech im-
possible, while the tone of the voice is flat and exceedingly disa-
greeable.
The tensor, and levator palati muscles have lost their functions,
and the palate can be made neither tense nor straight. On the con-
trary, by virtue of the palato-pharyngei, which are fully developed,
the palate is pulled downward and at the same time is drawn back-
ward, and the termini of the uvulae brought nearer each other so
as to touch at times.
The superior constrictor of the pharynx is also as fully devel-
oped as normally, and in every effort to swallow, or enunciate, it
exhibits the same uniform contraction as with the normal palate.
Dr. Wm. Siiersen, Sr., of Berlin, was the first to call attention
to the action of this muscle, in connection with treatment^ of
cleft palate, and based the construction of his appliance upon it.
When you consider how impossible it is to use any other muscle
to effect a mechanical closure of the naso-pharyngeal opening, it
will be seen that all appliances, no matter of what form or compo-
sition, if successful, depend upon the action of the superior con-
strictor of the pharynx.
Dr. Siiersen deserves the credit of bringing to notice the possi-
bilities in treatment of cleft palate, when the appliance was so con-
*Helmholtz.
064 THE DENTAL REVIEW.
structed as to obtain the full benefit of the natural action of this
superior constrictor muscle.
The clinical features of cleft palate are b}' no means uniform.
Clefts vary from a simple split in the soft palate, to various ex-
tents in the hard palate, and sometimes pass entirely through the
soft and hard palate, with complete loss of the intermaxillary bone,
and the four incisor teeth.
They are also of various widths, the narrowest being about one-
fourth of an inch between the approximating edges of the extrem-
ity of the soft palate, and the largest about one and one-fourth
inches wide.
The pharynx also varies in size, ranging from three-fourths of
an inch to an inch and three-fourths in width, and is frequently
larger on one side of the median line.
The distance between the opposing pillars of the fauces, or op-
posite the tonsils, varies in different individuals; as also does the
distance between the terminus of the soft palate, and the posterior
pharyngeal wall.
As regards their ability to speak intelligibly, we find that pa-
tients exhibit the greatest difference, this depending upon condi-
tions just observed and the intelligence and pride of the pa-
tient.
We have what we might call favorable and unfavorable classes.
The favorable class; patients fairly intelligentj narrow fissure
extending only through the soft, or partly through the hard pal-
ate, narrow between the tonsils, and narrow pharynx, and a long
soft palate.
The unfavorable ; the unintelligent, and who lack pride, with
extensive fissure, wide at the tonsillar region, wide pharynx, de-
formed lip, and a short soft palate.
Patients of the favorable class, by a well-trained tongue will ac-
quire many articulate sounds, though the voice will show the lack
of resonance.
In the unfavorable class, a and e, m and n, are the only ar-
ticulate sounds.
There is no uniformity in the speaking ability of different pa-
tients, but the average case will sound the vowels so they can be
understood, while the consonants will assume the vowel sound with
which they are associated.
For illustration :— B P C D G T V and Z will sound as E long;
ORIGINAL COMMUNICATIONS. 265
J K and H as A in hate; L F and S as E in net ; and R sounds
as ah.
But, if these letters are used before or after the long or short
sounds of the vowel, they will assume the character of the vowel
tone.
It can now be observed that during ordinary conversation the
quality of the voice depends upon the proper resonance to the vowel
tone, while articulation is the result of a constant opening and
closing of three valves.
These valves are the labial, formed by opening and closing the
lips, as in B and P ; the lingual, formed by the tongue against the
teeth, as in D and T ; and the naso pharyngeal, which closes for
all sounds save M and N.
In mechanical treatment of cleft palate, it is necessary to es-
tablish an artificial valve that can close the opening into the nose
at will.
This can only be accomplished speedily, definitely, and for all
classes of cases, by constructing an appliance that will fill the fis-
sure in the palate, at the same time projecting above and beyond
the soft palate, into the pharynx and of such dimensions that the
naturJil contraction of the superior constrictor of the pharynx will
meet the appliance and form a joint with it.
With this accomplished we turn our attention to the training
of the patient, which should be of a rational character, calculated
to develop melody and articulation at the same time, and as quickl)'
as possible.
The vowel sounds are the musical tones of the voice, and as
they require no trained use of the tongue or lips and can be uttered
distinctly with some air passing the nasal cavity, they become the
best sounds with which to begin training.
The practice of these tones should be associated with the proper
tone of some musical instrument, preferably the piano.
To this end I have adopted a course of training based upon the
theory of Dr. Helmholtz. He has found that the cavity of the
mouth gives a definite resonance for all sounds, and this independ-
ent of age or sex.
"The same resonance being found in man, as in women or chil-
dren."
After obtaining tlie scale of resonances, I have reduced them to
the compass of vocalization, and with the letters arranged to the
206
THE DENTAL REVIEW.
proper notes and variously transposed, turn the patient over to a
music teacher. 1 F. (f).
Ah. O.
TABLE.
00. A. E
«
P. B. G.
582 vib.
]l,fs_ *':2ri 346 vib. 320 vib -^
32a:
K.
D.
614A vib. 726 vib.
T.
776 vib.
F.
864 vib.
V.
i
3666 vib.
J and Ch.
232-< vib.
8 .
( Gutteral. ) ( Lingual. )
R. R.
Sh. same as J.
\6\ vib.
33 vib.
Zh.
L.
E.
:^
Cotu
(K. T FA R
:"2r Hf6 — ^~
EXERCISES.
R G B 00
=F1
Ah oo V All
-^-«— ^-^--^^ —
^ _^_^_«_
-I
L,.^_:^-:_[
EXERCISES.
V A R Ah oo V Ah oo Ah V oo Ah V oo V Ah
-MR. (Familiar.
^^3
B
i^
d=^
:=?=
T oo
oo B
R R
2
-•-—
Tlftr^— r-
A F
aFTooF AR GAFT 00
ORIGINAL COMMUNICATIONS. 267
The pupil of music now takes various exercises with the vocal
tones, having them arranged in every conceivable manner, but
always giving each vowel its definite tone.
The second exercise consists of the vowels, and the liquids L
M N and R, because these rank next to the vowels as regards the
difficulty of pronunciation.
Following these are the palatals K H G Y, always giving the
aspirate first, the subvocal last.
Next are the labials ; aspirates first P F Wh — B V W last.
The linguo-dentals form the last series and are the most diffi-
cult tones to acquire on account of the cumbersome and unwieldly
tongue. These are
Aspirates Subvocal
T D
Th th
ch J
S Z
sh zh
The reason for giving the aspirates first, is, that they are only
emissions of breath articulated and can be produced while the pa-
tient holds the superior constrictor muscle contracted on the appli-
ance.
This voluntary control of the superior constrictor muscle soon
becomes involuntary and the subvocal tone forms itself.
If the order is reversed it requires much longer to arrive at the
same result.
By pursuing a method similar to the above our patient improves
the quality of the voice and at the same time acquires a training of
the tongue and lips.
If, on the other hand, the patient begins with elocutionary
training, valuable time is lost, owing to his inability to use a cum-
bersome and overgrown tongue, as this organ must be dressed
down to a Working condition before any real progress can be made.
By the confusion of the tones of the piano with the voice, the
imperfect articulation is not so noticeable, and the patient's mind
is diverted from the real object, that of tr3'ing to utter some definite
sound; and a difficult task is made easier and progress more rapid
and encouraging.
26S THE DEXTAL REVIEW.
After a month or two of musical training, the teacher of elocu-
tion will be of great service.
The training now should follow the same line as that prescribed
in the musical course, vowel sounds followed by short words
formed of the vowel letters, and the consonants LMNRKGHY,
taking up the other letters as rapidly as the patient can acquire
them.
The most difficult sounds for a cleft palate to acquire are
those words ending in st, dst and sts.
I have obtained a verse with these sounds from Prof. Pinkley,
which is an excellent exercise, and is as follows:
"Amidst the mists and coldest frosts"
"With stoutest wrists and loudest boasts"
"He thrusts his fists against the posts"
:'And still insists he sees the ghosts "
This is a difficult task for many persons with a normal palate,
and when it can be spoken distinctly with cleft palate, everything
in the way of conversation is possible.
The condition of harelip, which is usually associated with cleft
palate, also plays an important part in the training of the patient.
If this is united late in life the lip is sometimes so shortened that
it is difficult to bring it in contact with the lower as in pronounc-
ing the labials; these letters then become more difficult than
the linguo-dentals.
This method of training, musical first, and elocutionary second,
to which I have but briefly referred, is one of the important fea-
tures of the treatment of cleft palate ; and when followed up care-
fully, is productive of the most immediate and satisfactory results,
provided the appliance is so constructed as to meet the require-
ments.
The principal requirements are, stopping up of the fissure in
the palate, and the pharyngeal cavity except the space left by the
contraction of the superior constrictor muscle of the pharynx.
Secondly, — that the appliance must extend sufficiently low in
the pharyngeal cavity, that the dorsum of the tongue can pass
firmly against it in swallowing, or as in sounding K.
This can only be accomplished by measuring accurately the
size and form of the oral, nasal, and pharyngeal cavities, and
their relation to each other; how to do this, I will explain later
on.
ORIGINAL COMMUNICA TlOlSfS.
269
Figure 1 represents what is known as the Kingsley Flexible
Rubber Velum, and Figure 1 A, the Suersen Obturator.
For convenience I have divided the appliance into three parts:
Fig. 1, C to B, pharyngeal portion; below C to A, the palatine por-
tion, and above C from C to A, the nasal portion. Dr. Kingsley
says: " Simplicity has gone one step further to remove the phar-
yngeal portion," disposing of the most essential characteristic.
That portion of the appliance anterior to the pharyngeal por-
tion, is only to stop up the fissure of the palate, separating the
mouth from the nose; while the pharyngeal part is for the purpose
of separating the posterior nose from the pharynx, and is ac-
complished by the contraction of the superior constrictor muscle
meeting the edge of this pharyngeal part, and not by the action of
the muscles of the palate.
It is a strange fact that while so much is claimed for this phar-
yngeal portion, none of our writers give us any idea of how to ob-
tain its proper size and shape.
We are told how by most intricate processes to get an impres-
sion of the floor of the nares, a part that is of no service with any
form of appliance.
Dr Suersen is the only person who mentions the necessity of
taking an impression of the pharyngeal cavity. His method was
to vulcanize an ordinary plate and upon a bar projecting from a
plate into the pharynx, build gutta-percha until he had filled the
cavity.
This operation required about two weeks, at various sittings, to
obtain the marking of the pharyngeal cavity.
When the cavity was so full that M and N could not be sounded
he trimmed the gutta-percha from the posterior until these letters
270
THE DEXTAL REVIEW.
were possible. This gutta-percha bulb was then duplicated with
vulcanite, making the plate an obturator in one solid piece, as
Fig. 1 A.
After deciding that the superior constrictor of the pharj'nx was
the only muscle that could be utilized in conjunction with an appli-
ance to close the posterior nares, I determined to note the action
of this muscle in speaking.
After a series of experiments on normal and abnormal palates,
I found that the contraction of this muscle was nearly uniform in
the pronunciation of the various letters.
The point now was to measure this contraction and its relation
to the fissure.
Ti^.
Just back and below the eustachian tube is an enlargement, or
bean shaped elevation, which is represented by the depression
marked J in Fig. 3.
Underneath this elevation is a fissure, sometimes quite deep?
which permits the air to enter the nasal cavity at the side of an ap-
pliance such as Fig. 1, and prevents its successful working.
Dr. Suersen has stated that it is always best, to insure uniform
results, to extend the appliance over this soft elevation.
The impression, which is to be an accurate guide to the con-
struction of an appliance, should represent these elevations at the
eustachian tube above with an imprint of the dorsum of the tongue
below, and the size of the pharyngeal cavity during the contraction
of the superior constrictor of the pharynx; and these in exact re-
ORIGINAL COMMUNICA TIONS.
.271
lation to the fissure in the palate and the palatine surfaces of the
teeth. Such an impression is represented in Fig. 3.
My first operations according to this method were made of flexi-
ble rubber, and appeared as Fig. 8.
ia. 8.
The wearing of such extensive appliances of flexible rubber,
seem to excite so many disagreeable symptoms such as redness,
soreness, and excessive mucous secretions, that I was compelled to
abandon its use, substituting hard rubber.
With the use of hard rubber these sj'mptoms disappear, and
from the fact that there is no soreness nor nausea, and that the
mucus can be removed by the usual method, and that enuncia-
Y\^.%
tion of all letters is an immediate possibility, I feel convinced of
the correctness of the theory.
DESCRIPTION OF APPLIANCE.
The appliance with which I have been most successful is a mod-
ification of the " Siiersen" which I liave tried to represent by the
attached illustrations.
THE DENTAL REVIEW.
These modifications do not in any way detract from the value
of the original "Siiersen," but have been added to simplify its con-
struction and at the same time get rid of many disagreeable fea-
tures that it possessed.
Fig. -1 represents the impression tray with wire in position for
taking the pharyngeal impression.
The bodv of the impression tray is of modeling compound and
follows the outline of the palate, extending into the fissure as far as
the terminus of soft palate, but touches no part of the mouth ex-
cept the cutting edges of the teeth.
This enables me to place the tray in the mouth as many times
as I desire while taking the pharyngeal impression with assurance
of always having it in the same position.
The pharyngeal impression was a difficult matter until I hit up-
on the wire.
This is bent to the general outline of the pharynx and is about
one-fourth inch from the posterior and lateral walls.
ilG 5
It exteini^ , i-h to touch the tongue in swallowing, and
is twisted and fastened in the modeling compound above and be-
hind the soft palate.
Fig. .'J represents the impression; one molar tooth is shown, the
others being fractured away in separating from the model.
Fig. 5 represents the divided model ; the teeth have been re-
ORIGINAL COMMUNICA TIONS.
273
moved. R, the posterior wall of the pharynx during contraction of
the superior constrictor.
T, eustachian tube.
TiG.e.
S, the bean-shaped elevation back and below the eustachian tube.
P, terminus of soft palate.
\ %
TT(q. 7.
M, hard palate.
Turn the dotted line N over to the other half of the model and it
will point to a turbinated bone.
U, the anterior extremity of fissure, three-fourths of an inch
274
THE DEXTAL REVIEW.
wide, between the approximating borders of the clef, intermaxillary
bone, and four incisor teeth.
Fig. 6, the same model closed.
X, molar tooth ; W, first bicuspid ; V, cuspid broken away.
Y\(a. 9.
Fig. 7, one form of retaining plate, with obturator detached.
By the spring (gold) 5 the obturator is allowed a compensatory
motion, but is quickly thrown into position when the muscles are
relaxed.
Tlaio
The lug (6) prevents the obturator from being displaced while
in the mouth.
The staple (4) receives a gold bar from palatine surface, which
holds the obturator on the proper plane.
ORIGINAL COMMUNICA TIONS.
275
Fig. 8, the appliance complete.
Fig. 9, this represents another form of attachment, used when
the fissure does not extend entirely through the hard palate.
Fig. 10, represents the retaining plate and the spiral spring,
which readjust the obturator when not in use.
Fig. 11, this shows the manner of making a mould in which
the obturator is vulcanized.
The last figure (not numbered) shows the appliance in position
on the model as in the mouth.
These obturators are not made hollow but in the form of a thin
shell with upper part removed.
o;g THE DEXTAL REVIEW.
The reason for this is that if the appliance has a horizontal
nasal surface, or convex, the mucus collects upon the appliance
and can only be removed by taking it from the mouth.
If left open and the edges turned slightly toward the median
line, the mucus is confined to the narrow space between the ap-
pliance and living tissue, and can be removed by the ordinary
methods.
By making the appliance detachable every part can be kept
clean easily and repairs if necessary, can be proceeded with as in
a simple case.
Recreation .a.nd the Conservation of Energy.*
Bv A. \V. Harlan. M. D.. D. D. S.. Chicago. III.
Gentlemen: In casting about for a subject which might be
appropriate for an after-dinner speech or address it occurred to me
that a nonpractical and nonscientific topic for once could be rel-
ished as a wind-up for this most enjoyable occasion. The subject
of recreation for professional men has received but sparse treatment
from those best fitted to handle it. All my life long I have been a
busy boy and man and it is only in recent years that I have felt the
necessity of taking recreation for the body and the mind. The strug-
gle for e.xistence, for riches, for fame, for the good of mankind, or for
the State is generally in the thought of most of us from the moment
we are cut loose from the ties of home or the parental roof. Unless
the youth seeking his fortune is carefully educated and trained be-
fore he enters the arena of life, he has little thought of the conser-
vation of energy in his early and sometimes bitter struggles for
recognition. For proof of this I refer you to the early decay of
physical and mental activity in the newer cities and countries and
to the great mortality among the ceaseless toilers, both men and
women breaking down under the labors that ambition for distinc-
tion entails. The constantly active brain or the overtaxed phy-
sique, no matter how perfect in the beginning, must become worn
out unless occasionally shut down for repairs or closed in order to
take stock. Most of you are on the threshold of professional life,
some, like myself, nearing the middle period of existence, but none
too old not to stop and ask of himself how best can I conserve
energy for future work and usefulness ?
Some one has said that it is not overwork that kills, but it is
♦Read before the Odonlographic Society, of Chicago.
ORIGINAL COMMUNICATIONS. 377
the indulgence of passions and appetites, the use of stimulants, and
the abuse of hours which should be devoted to recreation, sleep
and other forms of rest for the mind and body. Overuse of any
portion of the body, the arms, the legs, the eyes or stomach will as
surely result in bodily weakness as over use of the mental faculties
will result in defective memory, lack of logic in argument and fail-
ure of ability to reason or study well any subject undertaken for
the instruction or entertainment of others. Conserve your ener-
gies, do not overtax your strength; in other words recreate. Says
the immortal Cervantes: " Human nature or human frailt}^ cannot
subsist without some lawful recreation."
The bow thats always bent will quickly break,
But if unstrung will serve you at your need.
So let the mind some relaxation take,
To come back to its task with fresher heed.
— Phaedriis .
RECREATION.
Recreation is intended to the mind as whetting is to the scythe,
to sharpen the edge of it, which otherwise would grow dull and
blunt. He, therefore, that spends his whole time in recreation is
ever whetting, never mowing; his grass may grow and his steed
starve; as, contrarily, he that always toils and never recreates is
ever mowing, never whetting ; laboring much to little purpose.
As good no scythe as no edge. Then only doth the work go for-
ward when the scythe is so reasonably and moderately whetted that
it may cut, and so cut that it may have the help of sharpening. —
Bishop J. Hall.
The great men among the ancients understood how to reconcile
manual labor with affairs of state, and thought it no lessening of
their dignity to make the one the recreation of the other. — Locke.
He that will make a good use of any part of his life must allow
a large portion of it to recreation. — Locke.
R. Ascham. — Toxophilus. — For as man's wit fore-occupied in
earnest study, must be as well recreated with some honest pastime
as the body, fore-labored, must be refreshed with sleep and quiet-
ness, or else it cannot endure very long, as the noble poet saith:
''What thing wants quiet and merry rest, endures but a short
while."
Thomas Fuller. Recreation is a second creation, when weari-
ness hath almost annihilated one's spirits. It is the breathing of
the soul, which otherwise would be stifled with continued business.
278 THE DENTAL REVIEW.
Sam Slick: Employment gives appetite and digestion. Duty
makes pleasure doubly sweet by contrast. When the harness is off,
if the work ain't too hard, a critter likes to kick up his heels.
Ca-sar mistrusts Cassius because that lean conspirator "loves
no play, as thou dost Anthony, he hears no music, seldom he
laughs."
REASONS FOR RISIIULITV.
I've seen a Bishop dance a reel,
.\nd a sinner fast and pray
.\ Knave at top of fortune's wheel,
And a good man cast away.
Wine have I seen your grave ones quaff,
Might set our fleet afloat;
But I never heard a hearty laugh
From out a billains throat.
Izaak Walton says of the complete Angler that in writing it he
made a "recreation of a recreation."
Dr. Robert South. The pleasures of Amusement and Industry
compared. Nor is that man less deceived that thinks to maintain
a constant train of pleasure by a continual pursuit of sports and
recreations. The most voluptuous and loose person breathing, were
he but tied to follow his hawks and his hounds, his dice and his
courtships every day, would find it the greatest torment and calam-
ity that could befall him; he would fly to the mines and galley for
his recreation, and to the spade and the mattock for a diversion
from the misery of a continued unintermitted pleasure.
When to myself I act and smile.
With pleasing thoughts the time beguile.
By a brookside or wood so green
Unheard, unsought for, or unseen,
A thousand pleasures do me bless.
And crowds my soul with happiness.
— Burton's Abstract of Melancholy.
On the instruction of youth. By which means our very exercises
and recreations, running, wrestling, music, dancing, hunting, rid-
ing, and fencing will prove to be a good part of our study. I
would have his outward fashion and mien and the disposition of
his limbs formed at the same time with his mimd. — MoxTAiGNt;.
He that sinks his vessel by overloading it, though it be with
gold and silver and precious stones, will give his owner but an ill
account of his voyage. — -Locke.
ORIGINAL COMMUNICATIONS. 279
Industry is the natural sure way to wealth, this is so true that
it is impossible an industrious free people should want the necessar-
ies and comforts of life, or an idle enjoy them under any form of
government. — Bishop Berkeley.
Dr. Beattie on the law of nature. And from every mental
energy that is not attended with pain, and even from some of those
that are, as moderate terror and pity, a sound mind derives satis-
faction ; exercise being equally necessary to the body and the soul,
and to both equally productive of health and pleasure.
It must always be remembered that nothing can come into the
account of recreation that is not done with delight. — Locke.
Nor is that man less deceived that thinks to maintain a con-
stant pursuit of sports and recreations ; for all these things, as they
refresh a man when weary, so they weary him when refreshed.
— South.
Let not your recreations be lavish spenders of your time, but
choose such as are healthful, recreative, and apt to refresh you, but
at no hand dwell upon them. — Jeremy Taylor.
Against too much recreation the immortal bard of Avon says:
" If all the year were playing holidays, to sport would be as
tedious as to work."
The learned Francis Bacon, in "Studies," says recreations, of
study, "serve as delights" to the mind.
From these excerpts taken from the thoughts of the (witty,)
learned and the great, a lesson is to be learned whose application
must be made to the ones most interested. It is not possible to be-
come useful members of society, to grow in public esteem, to be phil-
anthropic or esteem yourselves if the whole of life is to be devoted
to the pursuit of pleasure, but it is a necessity for great deeds and
great works to be evolved from communing with nature. To be
ever dwelling in closed closets, hidden from the view of the world,
never did and never will paint the beauties of the landscape, de-
scribe the flowers and plants of the earth, scale the mountain
heights, explore new or savage countries, or construct bridges,
railroads or other evidences of the versatility of man. Therefore I
beg of 3^ou to make your life-work a pleasure, by indulgence in
proper and fit recreations, reading, music, study of books and
authors, engage in out-of-door sports, in experiments for the bene-
fit of mankind. Move through the world with the fewest thoughts
of envy, none of malice, all of things that are noble and soul inspir-
280 THE DEXTAL REVIEW.
ing, giving a helping hand to your less fortunate brothers and ever
keeping in mind this thought : That to do the most good to human-
ity, which includes yourselves, you must recreate and conserve
your energies in order that your personality shall makes its impress
on coming generations.
Failures of Dental Operations.*
By E. D. Swain, D. D. S., Chicago, III.
In looking for the definition of the word "fail" I find it given
"to be wanting " — "to fall short — to be deficient in any measure
or degree up to total absence — to cease to be furnished in the usual
or expected manner, or to be altogether cut off from supply."
Furthermore the paragraph seven says, to come short of an object
aimed at or desired ; to be disappointed of access or attainment.
Therefore you perceive that the scope allowed me is considera-
ble, and should this essay prove " deficient even into total absence ' '
in general interest and instruction, charge it up to the dictionary
and the broadness of the definition. Just how your committee
chanced to give the subject I was supposed to write upon, as "Fail-
ure in Dental Operations," I am at a loss to conceive, for I told them
my subject would be "Dental Failures," which you observe gives
me a still broader field, allowing me to criticise operations upon
the teeth or such other acts in our practice " as cease to be fur-
nished in the usual or expected manner" from my point of obser-
vation.
I shall endeavor to consider the following subjects :
What ought our patrons to expect from the operations of tooth
filling? Causes of some failures ! Use of burs in the engine in
the preparation of cavities and some thoughts regarding plugger
points used, and a word or two upon ethics.
The first question should perhaps have a little broader scope,
and in fact we may assume that it has, than mere operations upon
the teeth, and state first that they have the right to expect their den-
tist to deal with them in a strictly honest manner, and never so
conduct himself as to convey to the mind of the patient that he is
"making holes" for the purpose of filling and thereby increase the
size of his bill and volume of his business. I have too much faith
in the honesty of my profession to believe that this is often done ;
♦Read before the Chicago Dental Society.
ORIGINAL COMMUNICATIONS. 281
at the same time, people in whom I have as much faith as I have
in my professional brethren, frequently make this charge, and visi-
ble conditions sometimes lead one to infer that the patients are
correctly suspicious. They have the right to expect that the den-
tist shall use every means in his power by reading, associating with
his fellows and a free interchange of thought upon all questions
that he may first of all be able to correctly diagnose the diseased
conditions presented, or, if not able to do so, to have sufficient
honesty to so tell them ; furthermore, he should not possess that
jealous suspicion of his brother, whom he knows would be able to
help him were he called upon, and so deprive the patients of
needed knowledge as to their condition.
The characteristics of teeth vary greatly; the experienced dentist
recognizes at a glance those which once filled are no longer a source
of revenue to him; as he does those teeth in which even the most
skillfull}^ performed operations, are but temporary and which in
time will need refilling.
When he warrants operations or fails in any of the above re-
quisitions, he makes not only a failure of his professional integrity
but of his operations as well. I do not care to discuss the ques-
tion as to whether soft or cohesive gold should be used, hand or
mallet pressure, all gold and no amalgam, beyond the statement
that the dental practitioner who does not use all of them, as indi-
cated, makes a deplorable failure and the practitioner who sees no
good in a saved tooth, because its salvation was accomplished with
a material other than gold, to my mind fails to comprehend his
true mission in the profession he has chosen. I well remember cases
in the earlier years of my own practice, whose ghosts haunt me
now where failure of judgment, failure to use gutta-percha, oxy-
chloride of zinc, or amalgam, cost my patient their natural organs
and caused me the mortification of knowing that another failure
was charged against me. Contour fillings of gold are good, and
the theory that all teeth filled should be restored to their original
pristine beauty in form, etc., sounds good certainly, especially as it
is sometimes elaborately described to us by gentlemen competent
to talk upon such subjects. Still everyone of you have seen the
most outrageous failures from this source simply because the op-
erator was proud of the fact that he could make a beautiful filling in
a very frail tooth; deplorable failure in judgment as well as the
service rendered.
2S'2 THE DENTAL REVIEW.
Within a year I met a man and brotlier dentist who has been
in practice counting his college experience not more than five years,
who after some general conversation upon dental operations, said
I have seen some of your operations recently, made several years
ago, and could not help criticising them. I asked in what respect,
the repiv was "you cut away too freely." I asked if the operations
were saving the teeth? He replied, "Yes, I found only one which
required a slight repair at the cervical margin." He then volun-
teered the information that in those bicuspids and molars where
the dentine had been destroyed by disease, leaving the enamel
standing, he tried to preserve that rather than cut it away, thereby
exposing so much gold. M\- word for it, if this man continues in
practice he will have some failures which will annoy him and cause
his patients to speak after the manner of men, as forbidden in the
fifth commandment.
Prof. Black has recently, in a series of articles in the Cos?nos,
given us advice upon the preparation of enamel edges, which if
followed would save us many failures in this direction.
Another ^^roioing cause or failure, arises from the indiscriminate
use of the dental engine and burs in the preparations of cavities
for filling ; I have seen so many instances where the cavity was the
shape of a round bur, the enamel edges so thin that the most deli-
cate manipulation with the finest instruments could not prevent
their fracture, also in many localities it would be impossible to
pack the gold into the undercuts so made. I have always feared
the use of the bur in deep cavities, or in those where it was dan-
gerous to cut to any considerable depth, the hole being filled with
the fine cuttings of the dentine, making it next to impossible to
know what one is doing.
Recently two sisters applied to me for advice regarding their
incisor teeth, which were considerably discolored, the usual tests
convinced me that the pulps were dead. I removed some of the
fillings verifying my diagnosis in this direction and finding the cav-
ities formed as I have mentioned above, when burs were used. I
commenced a course of questioning, which proved to me that these
cavities were wholly prepared with burs, and that in each instance
an exposure of the pulp was the result, consequently abcesses, dis-
coloration and disfigurement.
A prominent dentist and careful operator in my office recently
remarked "that some operators seemed to feel that they knew
ORIGINAL COMMUNICATIONS. 283
just where to look for a pulp canal and seemed to think that when
necessary to open them for treatment, they could with a ver\' fine
drill and the engine, go through the crown and hit them every
time ;" his experience had been however, that they as often went
through the side of the root, through between the roots at the bi--
furcation, or at some other point, endangering the chances of sav-
ing the tooth. This is even a greater failure than those already
mentioned, arising from too free use of the dental engine. Another
dentist present, a teacher, suggested that students should not be
allowed the use of the engine during the first two years of their
pupilage. Another, a Professor in one of our Dental Schools,
not willing to go quite so far, was of the opinion that more atten-
tion should be given this subject in the education of dental stu-
dents. I do not condemn the use of the engine, or burs, instead I
find them very valuable aids, but if we would avoid such failures
as mentioned, we should use great care and discrimination when
we do use them.
Another source of many failures I believe arises from the use
of deeply serrated gold packing instruments. It can be readily
understood, that where comparatively large pellets are used, the
long sharp points pass entirely through, and not only fail to pack
the gold against the walls of the cavit}', but even pulverize them,
leaving under the gold a layer of chips of dentine, thereby pre-
venting the possibility of a moisture proof filling ; and furthermore
I have come to believe that much of the discoloration seen beneath
thin walls, especially in incisor teeth, is due to the failure to re-
m.ove all the dust produced by preparing the cavity.
Why do we speak of recurring decay about a filling of years stand-
ing as a failure, especially if that tooth has been filled with gold? Has
this material properties in its pure metallic state which will prevent
caries of the teeth ? It is not antiseptic, and only answers the pur-
pose best because it is soft and can be coaxed to remain in place
when once fixed, if properly done ; excluding moisture, particles
of food and decomposible secretions which are always present in
the mouth, the same conditions exist, the same tooth is composed
of the same materials, weakened in its powers to resist diseased
conditions now because of the disease infecting it years ago; to con-
vey the idea to our patient that a tooth once filled with gold, is in
the future safe from further disease, is one of our greatest failures
as professional men. Did you ever hear of a physician assuring
284 THE DEXTAL REVIEW.
his patient that when he had once mastered the present attack,
they would be exempt from similar ones in the future ? That a
• bone once healed would never break again ?
Is it not true that one has to grow old in practice, before he
has the courage to say to his patron, " little of the work I do for
you can be pronounced other than temporary, and in proportion as
your teeth are now liable to caries will these operations require to
be repeated ;" here we fail in courage.
It seems to me further that the profession, and especially those
of its number who are teachers in our Colleges, are failing in one
particular at least, to elevate our calling by impressing upon the
minds of the young men the fact that, as men of one calling, to
each and all is due a courteous, truthful and honest difference, or
what we have learned to call ethics. Ethics does not consist sim-
ply in subscribing to a code, that we will not do certain kinds of
advertising ; will not underbid our neighbor in prices ; or will not
trv to convey the idea that our work is better than his. Ethics
rather relates to the manners and habits or moral nature of man ;
it is the science of human dut\-. It is to "do unto others as you
would that others should do unto you." It is absence of professional
jealousy, and doing this, not in a manner that will convey the im-
pression that we simply mean " how much is there in this for me."
It is often a question in my mind, whether in the so-called elevation
of our profession we are not failing to encourage that love for our
fellows, and that courtesy toward each other, which was so marked
in days past, and is now among those who made up our profession
"before it was elevated.''^
Recent Conikiiiutions to the Diagnosis and Treatment of
Empyema of the Maxillary Sinus.
By G. L. MoRGENTHAU. M. D., Chicago; Late Assistant at the Throat and Chest
Department of the Policlinic, Vienna.
Empyema antri Highmori with its well-known classic symp-
toms is comparatively a rare occurrence, considering the frequency
with which this disease has been found postmortem. In 103 au-
topsies (Gradenigo), this disease was discovered nineteen times.
The great discrepancy is explained by the results now obtained by
the more accurate and simple methods of diagnosis. A recent
writer(Jeantyj maintains that, while typical cases are not very often
encountered, "latent " empyema often exists and persists.
ORIGINAL COMMUNICATIONS. 285
The influence of empyema upon the teeth need not be dwelt
upon. The first and second molar teeth usually project into the
floor of the cavity; and often they and other teeth penetrate into
the cavity itself. As the disease involves the deeper layers of the
naturally thin mucous membrane which acts as periosteum, caries
of the teeth can result. Thus, it is seen, diseased teeth may not be
the cause, but even the result of empyema. This explanation
must appear very plausible, a priori, when the etiology is consid-
ered. While authors disagree as to the relative importance of
nasal and dental troubles in the causation of empyema, there is no
doubt that both kinds of factors can and do exert a pernicious in-
fluence. Rhinologists meet with cases of empyema in which the
teeth, even according to the dental expert's opinion, are apparently
in excellent condition. These are brought about by nasal diseases.
Zuckerkandl has shown that the nasal and antral cavities are so
intimately connected that even a slight diseased condition of one is
followed often by injection of the mucous membrane of the other.
The huge number of nasal catarrhs, especially in our exacting cli-
mate, must lead us to expect many antral troubles. Hypertrophic
rhinitis can easily produce stenosis of the natural opening of the
maxillary sinus; nasal polypi, which so often originate from the
middle turbinated body, may occlude the same opening. The air
now completely enclosed within the cavity, is shut off from the at-
mosphere, and cannot be renewed. It is absorbed by the blood
vessels, causing passive hypera^mia and catarrhal hj'persecretion.
The mucous membrane, under normal conditions, does not secrete
more than can be removed either by evaporation or absorption by
the lymphatic system. Catarrhal secretion in a closed cavity, says
Bosworth, gives rise sooner or later to suppuration.
Whatever may be the origin of the disease, we expect a dis-
charge from the nasal cavity. In the majority of cases we do find
this most constant and reliable symptom.
The discharge may be from one or both of the nasal fossae ;
continued or intermittent, dependent on the position of the patient
or — more accurately — of the natural opening into the middle me-
atus of the nose ; accompanied, or not, by a fetid odor which may
be perceptible to the patient only ; causing an insipid or disagreea-
ble taste in the patients' mouth, depriving him of appetite ; escap-
ing through the anterior or posterior nares. Unilateral flow of pus
from the nose is of the greatest value, because its other causes
286 THE DENTAL REVIEW.
(syphilis, neoplasms, foreign bodies) could be diagnosticated by
an expert. When, however, inspection and treatment of the nose
(clearing the normal opening by the removing of polypi and hyper-
trophies, by pushing the turbinated body away from it with a probe,
etc.) are unsuccessful, then other means of diagnosis must be adopt-
ed. Hartmann's method of injecting fluid through the natural open-
ing still holds good as a diagnostic aid. It is certainly practicable in
a number of cases. I have seen him treat cases effectually in the
same way. The objections to this procedure will be discussed
later on ; but its value in aiding diagnosis should not be underrated,
for it is connected with but little discomfort to the patient. Still
more agreeable is transillumination. It is used in Berlin to con-
firm a diagnosis ; being free from all painful sensations to the pa-
tient, elegant, and of decided merit. Several conditions are essen-
tial if it should not disappoint. The room must be completely
darkened, and the lips firmly closed over the handle of the electric
lamp. The instrument itself must be small and yet powerful. I
use one which is fed hy a storage battery of six volts. The cheek
beneath the eye usually appears equally illuminated on both sides.
When one antrum is filled with pus the corresponding portion of
the cheek is darker than on the other side. The finer details
cannot, of course, be described in this paper, but will soon be ap-
preciated after a number of trials on normal and sick individuals.
When neither inspection of the nose nor transillumination lead
to a positive diagnosis while the subjective symptoms are present,
then we must have recourse to the third and most reliable diagnos-
tic aid. the exploratory puncture. It is then eminently welcome.
When we are dealing with cases in which the teeth are not affected,
the antro-nasal wall should be cocainized. A large syringe (on the
style of those commonly used for hypodermatic medication) with a
strong curved needle is thrust through the wall, as far back in the
lower nasal meatus as is possible. By aspiration fluid can be
drawn from the antral cavity. The appearance of only a few drops
of pus clears the diagnosis.
In most cases we will, by these various means, arrive at a con-
clusion which justifies us in performing one of the operations for
empyema of the antrum. If there are obstructions to the
escape of pus by the natural channel they must, of course, first be
attacked. The removal of polypi, etc., may alone suffice to relieve
•See the interesting article by Freudenthal, N. Y. Med. Rec. 1890.
ORIGINAL COMMUNICATIONS. 287
the patient of the distressing symptoms. As shown below, com-
munication between the nasal and antral cavities, is necessary for
efficient treatment. Injections through the natural opening can
then be attempted. They should be tried when the patient in-
sists on bloodless treatment. In the majorit}' of instances they
will not be able to cure the disease.
The operations now in favor with most rhino-laryngologists — as
far as my experience of several years in the clinics of Berlin, Frank-
fort-on-the-Main, and Vienna, permits me to judge — are made from
three different anatomical parts; the lower meatus of the nose, the
facial wall of the antrum, and the alveolar border of the superior
maxillary bone. Besides, perforating the antro-nasal wall from
the middle nasal meatus was suggested so long ago as the last cen-
tury, and recently advocated by Zuckerkandl. But the same
objections must be made against it as against Hartmann's less
painful method. The opening would be in the upper part of the
cavity instead of being at the most dependent portion. There
wo.uld be no counter opening, nor would it be possible to investi-
gate the cavity by eye or probe — essential points which will re-
ceive due consideration.
The two methods to which I would draw attention are urged
by Krause and by Kuester. They obviate the necessity of remov-
ing a healthy tooth and enable the use of the "dry" treatment. It
is maintained that repeated injections are a continued source of
irritation to the mucous membrane. On opening the cavity, it is
flushed with some warm solution of an antiseptic. Not a few
ounces are injected; but the medicated fluid is introduced through
the artificial perforation, and allowed to escape through the nat-
ural opening till the cavity is well cleansed, i. e., till the water runs
clear and pure from the nose. Then the remaining fluid is driven out
and the cavity dried by blowing air through the cavity. A David-
son syringe is very handy for producing a continuous stream, the
force of which can be regulated with nicety, and for supplying the
current of air. After the lining of the sinus is thus carefully pre-
pared, powder can be applied to it directly. Iodoform is the most
reliable. But if the patient objects to the odor, or fear of intoxi-
cation renders caution necessary, it can be replaced by iodole,
aristole, boric acid, pyoktanin, or sulphonal. It is gratifying to
see inveterate cases yield to this treatment. Only when pus again
appears in the middle meatus will it become necessarj' to repeat
the injection of fluids.
388 THE DE.XTAL REVIEW.
In Professor Krauses throat clinic in Berlin empyema is treated
in the following manner. The lower part of the nose is well co-
cainized (10 per cent) to lessen the pain, and to obtain as much
room as possible. A curved trocar of the size of a lead pencil is in-
troduced into the lower meatus untill it becomes necessary to crowd
the cartilaginous septum to one side. The point of the trocar
being thus carried to where the antral and nasal cavities are
separated by only a thin bony wall, it is thrust through it. The
stilet is withdrawn; and through the canula to which rubber tubing
is attached, the antiseptic solution and then the powder is thrown
into the antral cavity. The next day no or very little pus appears
in the middle meatus. The first washing-out will usually suffice.
The insufflations require the use of the canula. It is guarded by a
well-rounded, snugly fitting conductor, and introduced in precisely
the same manner as the first time, in order to find the artificial
opening. This is only too much inclined to close, as there is no
actual loss of tissue. The flap serves, however, as a protection
against the entrance of mucus, etc., from the nasal cavity.
Powder should be blown into the cavity generously every sec-
ond day or less, always according to the appearance of pus. It is
not at all necessary, namely, that the cavity be filled with pus to
cause it to ooze through the natural opening. I have seen the
mucous membrane of the sinus, both intra vitam and postmortem,
swelled to 10-15 times its normal thickness. Thus, if but a few
drops of pus are formed, they can with ease emerge from the hiatus
semilunaris ; the cedematous swelling bringing them near it, and
nearly obliterating the lumen of the cavity. Krause cured patients
permanently within two weeks. But there are undoubtedly cases
which are combated for years by various medicaments, with remis-
sions and exacerbations. The persistence of suppuration must be
ascribed to some obstruction or permanent irritation. It is well
known how frequently ridges and bridges extend from one wall of
the sinus to another, dividing the .cavity into compartments, which
in turn may not communicate with each other. While we are call-
ing upon every new antiseptic in the vain hope that it may stop
the process at last, we may be treating a lower division of the an-
trum which is not diseased, the guilty upper or outer chamber be-
ing out of our reach. The disease itself can, in the course of time,
lead to the formation of new bone. The spiculae can be the cause
of constant irritation, or the suppuration may be kept up by a
ORIGINAL COMMUNICATIONS. 289
supernumerary tooth. In a word, the diseased part is best examined
to its whole extent by the surgeon.
With this object in view, Kuester makes an opening in the
facial wall of the antrum large enough to admit the little finger.
He can thus explore, by palpation or by probing, all sides and-
nooks of the cavity, break down adhesions, ridges and septa ; re-
move irritating bodies or, possibly a sequestrum; and, lastly, if
ocular inspection and palpation prove it desirable, use the sharp
spoon more or less vigorously on the diseased mucous membrane.
Kuester states that microbes are not only in the fluid contents, but
also in the walls of the cavity. Suppuration persists as long as the
microbes exist in it. Furthermore, pus remaining in one of the
pockets becomes stagnant and irritant. For these reasons his oper-
ation is a radical one. After cocainizing the gum of the upper jaw
he makes a flap of both mucous membrane and periosteum, the
base above extending from the root of the first praemolar to that of
the first molar tooth on the affected side.
The periosteum is pushed away carefull}', and the flap clapped
and held back by an assistant. With hammer and chisel the bone
is removed to the desired extent. The little finger then explores
the whole cavity, on its important mission. The cavity is flushed,
the medicated solution traversing the cavit}^ and leaving it by the
natural opening; then it is packed with iodoform gauze. Suppura-
tion usually is reduced to a few drops within twent3--four hours.
After a few days a thin drainage tube, fastened by a thread to keep
it from disappearing within the cavity, prevents the flap from unit-
ing too soon. Kuester is also in favor of not repeating the flushing.
When only mucus is secreted, the mucous membranes may be stim-
ulated by a weak solution of nitrate of silver. He prefers to leave
a little fistula which he can close any time by touching the margin
with a cautery. A small plate will hold the tube in place, and
guard against the entrance of particles of food.
Finally, the old operation of extracting a tooth and penetrating
through the alveolus is now modified b}'- flushing the cavity but
once, and then employing powder instead of injections. The re-
sults are better than formerly.
That the process frequently cannot be stopped, however, must
again be explained by the supposition that irritation is kept up in
one of the ways described. It seems desirable in most cases to ex-
390 THE DENTAL REVIEW.
plore the cavity. Kuester's radical measures will, therefore, meet
with the approval of many. In obstinate cases which cannot be re-
lieved by milder means, Kuester's method must be adopted. It com-
plies with all the demands which the most exacting surgeon might
make:
(1) The artificial opening is at the most dependent part.
(2) The injected fluid enters and leaves by different openings,
traversing and cleaning the cavity before the powder is applied.
The medicated solution can be removed, and the lining membrane
dried.
(.3) We are enabled to submit the entire field of operation to a
searching examination; to detect and take away obstructions,
foreign bodies, etc.
(4) Direct action of both instruments and medicaments upon
the diseased membrane can be insured and watched.
Often Krause's treatment will be of avail. Dentists, above
all, will appreciate its applicability where a sound tooth is at stake.
240 Wabash Av.
\
PROCEEDINGS OF SOCIETIES.
Chicago Dental Society.
Regular meeting, March 1, 1892, Dr. D. M. Cattell, President,
in the chair.
Dr. E. D. Swain read a paper entitled, " Failures of Dental
Operations."
Dr. J. G. Reid, in opening the discussion, said : Mr. Presi-
dent, I did not expect to be called upon to open this discussion. I
certainly was well pleased with the paper, especially that part of
it that refers to ethics. It is difficult for one to discuss a subject
that is so near in harmony with his own ideas. There were some
things in the failures of dental operations that were not mentioned
in the paper, some that I hoped would be referred to, and I don't
know whether latitude is given to us to go outside of that or not.
I believe that the use of excavators and chisels are far more ser-
viceable to the dentist in the preparation of cavities than the
engine. I do not mean that as a general statement, but reasonably
so. I believe that the dental engine is used by many a great deal
more than it ought to be. I find myself drifting from it quite a
good deal, and I find that if the instruments are kept in good
PROCEEDINGS OF SOCIETIES. 291
shape, sharp and properly made, cavities are very easily, quickly,
and comfortably prepared.
Another thing. The burs that are used in the dental engine
are not of the best shape. I mean the burs are too large; they are
not fine enough. I believe we would overcome a great many of the ■
difficulties that we now experience in the preparation of cavities if
they were made smoother and not as large, and the blades were
more numerous on the bur.
There was one point I 'was interested in particularly, that is, of
opening into pulp canals with the engine. I think this might be
criticised a little, as in the hands of a very careless oper-
ator it may occur. An experienced man would make a very seri-
ous mistake to do it, and would be either blind to what he was
doing, or unthoughtful, careless, or thinking of something else
possibly. I have never been so unfortunate to my knowledge, as to
bore through a root canal with the dental engine, especially in
the locality mentioped in the paper, because I am careful about
using it. I can see how it might be done. I can understand how
a man might possibly go between the bifurcation of molars some-
times. I have done it myself in a few instances. We all have
such failures as that. They occur probably because of anatomical
abnormalities of the teeth.
With regard to the ethical part of the paper I will say that I
wish we had more ethics in the dental profession, that we could
discard the thoughts of jealousy. My attention has been called to
this many times. I know that persons are in the habit of criticis-
ing the dentists that have done work for them. Patients are going
from one dentist to another. That is a notorious fact in a large
city like this. A great many of them like to " shop," and they
sometimes have a tale of woe to tell about what their dentist did,
and there are persons who are eager to grasp such sentiments as
are presented to them. They make use of them to further their
own ends. I know this to be so. We should have no reason to
criticise the operations of another dentist. He may have done
what in his judgment at the time indicated was the best thing to do.
Dentists may have good reasons for performing operations that we
know nothing about, and these operations may seem to us impru-
dent. I have done this thing myself, and I have been criticised
for it. Patients have come back to me and said that so and so said
so and so. I had good reasons for performing those operations at
2<»2 THE DENTAL REVIEW,
the time. We err in judgment a great man\' times. We are not
all capable of being able to tell just what is the best thing to do at
all times. There are some persons who have a natural ability to
tell what is the right thing to do at a certain time, but they are few.
There are a great many physicians who are able to diagnose
disease very readily, while others cannot do it. They can tell ab-
solutely what is the trouble with the patient, while other practi-
tioners cannot and do not do it. I believe it is a gift. Therefore
we should do unto others as we should like to have others do unto
us. The sentiment of the paper is beautiful)}' expressed, and it
certainly is worthy of great consideration.
There is one point I desire to speak of that was not mentioned
in the paper, and that is the fitting of bands about the roots of
teeth. We have been taught that bands should pass just beneath
the margin of the gum. I will go farther than that and say that
where they have just barely passed under the margin of the gum,
the gum recedes very quickly above the band, and decay com-
mences at that point. I have seen it in a great many instances.
With the root well prepared I believe in having the band pass to,
or nearly to the process. If you just pass it under the margin of
the gum the food will generally crowd under sufificientl}' to be
caught by the edge of the band, I. do not care how accurately it
might be fitted.
Dk. I. A. Freeman: I was very much interested in the paper,
and there were many points brought out that were of interest to us
all, and yet there are some that have not been touched upon either
in the paper or the discussion. It seems to me that ver}' largely
our failures in dental operations are dependent upon a want of plan
or system, and I think we are very materially helped by adopting
a plan from the outset with regard to the usual work that we have
to perform. Of course the extraordinary work, that of restoring
and bringing into use for a limited time wasted teeth, is a very dif-
ferent thing. When we see operations that have lasted for twenty-
five years, and the walls about the fillings are still intact, we may call
them successful or typical operations. They are not failures and
cannot be recorded as such, although recurrence of decay upon
other parts may reach these fillings in time. From my own obser-
vation and study of this matter, I think that our failures are depen-
dent more upon a lack of system than upon the manipulation of
material, for we see it not only in our daily work but in clinics
PROCEEDINGS OF SOCIETIES. 393
where points are covered up by material so that we cannot tell ex-
actly whether there is sufficient material to protect them or whether
it is sufficiently condensed. I believe we should endeavor to begin
our operations covering such points as will be hidden later on, and
know positively that they are properly protected.
As regards our code of ethics suggested by the paper, it is one
of great satisfaction to me. I want to say that my acquaintance
with the gentlemen connected with dental societies for the last
twenty-five years has been this: that they have been very fruitful
in helpful ideas and purposes for our development. The}' harbor
no jealousies. Such was the condition of things in the past when
societies were not in vogue, and that was before dental education
had arrived at anything like the state it is in to-day. It is true
that men were very jealous of one another. While they were con-
scious of the fact that they did not possess ability or observation
to endure criticism, they hid themselves away in their own rooms
and laboratories and allowed no one to gain admittance.
It has not been so in the last few years, and I have been thank-
ful for the kindness that has been shown me in my professional life.
Where criticism could have doubtless been justly bestowed,
the assistance and suggestions of other practitioners have been
helpful to me. I have been subjected to very severe criticisms by
some of my competitors whom we never see in dental societies.
I have been censured by these men for my failures. I know a
great deal can be done in the way of discouraging young men by
these criticisms. I recall one instance where I was doing my level
best to save the pulp in a central incisor that had been injured by
a young lady while jumping a rope, it catching her in the mouth
and throwing her down, caused a good deal of disturbance. When
she came to me one pulp was dead, and the other, a central incisor,
was in a state of active inflammation. I endeavored to save that.
The pain was of such an excruciating character that I felt justified
after treating for two or three days in opening into the pulp cavity.
This occurred Saturday. During the following Sunday she visited
another dentist with her father, and the dentist declared that the
man who would open into a tooth of that character ought to
be horsewhipped, and I do not know but what he might have had
some idea of coming down to perform the deed. These cases
are not satisfactory, and as Dr. Reid has said, we do not know
what governs or prompts men to make operations that other
294 THE DEXTAL REVIEW.
dentists criticise. I have met with several experiences of this na-
ture, and I have found it convenient to look at the brighter side of
things and advise patients when they come to me and speak about
what the other dentist did, that the best was undoubtedly done
for them under the circumstances. For instance, a lady came to
consult me with reference to an extortionate bill that had been
rendered by a certain dentist. I refused to see the case at first,
but finally consented, but did not pass any judgment upon it.
The case was one that needed some little advice, and I simply said
to her that you and your dentist do not agree upon the price that
you consider right. I told her to go back to him and say that she
did not feel quite right about the charge and to see if there could
not be some settlement brought about. She declared to me that she
would rather he would sue her -first. However, she went and out
of a bill of $129 the dentist kindly agreed to settle, she giving him
$50 in all. It was quite a nice thing for her 'that the dentist was
willing to settle in that way. I will say that he was not a mem-
ber of any dental society.
Dr. G. S. S.algmon : When I came here this evening, I ex-
pected to have the pleasure of listening to a paper of at least an
hour's duration; I am disappointed, it being a very short one. I
do not know why it is a short one either. When a paper is read
before this society, at its close one member after another will get
up and compliment the essayist upon his excellent paper. This
has not been done this evening, and it may be a compliment to the
essayist, for these compliments are very seldom sincere.
The paper has dealt with failures in dental operations. What
has Dr. Swain touched upon? Simply filling teeth and why fill-
ings fail. The work of filling teeth is not all that dentists are
called upon to do. Would we be justified in calling them dental
operations ? It is certainly a dental operation to fill teeth, but it
is certainly not the only thing that a paper of this kind ought to
contain. There are a great many other operations which might be
named, but which were not touched upon in the paper. If a stu-
dent in a dental college had prepared such a paper as that he
would probably have done as well as Dr. Swain, although he would
not be able perhaps to do the work like the essayist does. Dr.
Swain's remark of a graduate who has had five years' practice,
talking to him as he did, does not enter into any consideration. I
PROCEEDINGS OF SOCIETIES. 295
have seen operations performed fifteen years ago that are not good,
and all of these had good margins, and that is where most opera-
tors fail in preparing the margins of their cavities they are about
to fill. There is very little said about the preparing of margins of
cavities, but how important is this in a good filling. It does not
make so much difference about the amalgam being thoroughly
hardened or the gold thoroughly condensed; if you have a poor mar-
gin in a cavity and leave it unprotected it is bound to give you
trouble. Your filling is apt to give away. It does not make a par-
ticle of difference whether you use excavators or burs, but you
should use the right instruments in the right place. Most dentists
use very large burs in large cavities to save time. These burs are
very coarse and are not fit for finishing margins. Finishing burs
should be used almost exclusively for this purpose, but most den-
tists imagine they are too expensive for the preparation and that
they should be used simply for finishing fillings. If you cannot
get small finishing burs have them made to order. That is where,
in my judgment, a great many failures occur, the margins of the
cavity not being properly prepared. Of course, if the material is
not put in in a proper manner, the filling will also come out, but it
does not make so much difference whether gold, amalgam or cement
is used as long as the cavity is prepared right and kept dry by ap-
plying the rubber dam. How many dentists there are that go to
work and prepare cavities in a slovenl}^ way and fill a tooth under
water and then expect such a filling to remain in a tooth. I can-
not see how they expect them to remain.
I expected the essayist to have touched upon crown and bridge
work, as it seems to me we are all trying to keep that part of the busi-
ness quiet. I do crown and bridge work m}'self and I do not pay
a license. I do not belong to the Dental Protective Association at
present. Maybe Dr. Swain does not do any crown and bridge
work, but for the purpose of drawing out a discussion I think he
ought to have touched upon it. Why do crowns fail? Because
the roots are not properly prepared, not properly treated. The
bands may fit all right, they may go under the gum far enough
after preparations have been properly made. The paper did not
touch upon rubber plates, gold plates, plates with clasps, suction
plates, etc. If the paper were to touch upon the failures of dental
operations, why were not these things mentioned so that we could
come properly prepared to discuss them ? I wish we could have
ooe THE DENTAL REVIEW.
the failures of our work discussed oftener than we do ; we are all
too apt to speak of our successes, but not of our failures.
Dr. a. W. Harlan : Mr. President if there is no one else burn-
ing to get on the floor, I would like to say a few words on this sub-
ject. I am very glad that Dr. Swain took up the subject of fail-
ures of dental operations so that we might have something to talk
about. I do not care to touch upon any of the points that the pa-
per touched upon, but I will begin with two or three headings I
have noted down.
About seventeen or eighteen years ago when I used to pump
medicines through the roots of teeth, and used a barbed broach and
wound cotton around the broach, sometimes I would leave cotton
in the root, and then I could not get it out. I failed to cure the
abscess, and I failed to fill the root. So one little failure brought
on two others. If I successfully, pumped medicine through the
root and it came out at the fistulous opening, and I did not leave
in any of the cotton, then I would take another broach with a little
cotton and moisten it with oxychloride of zinc, I would then pump
that up there, leave the cotton and I would not get the root filled,
so I would have another failure ; consequently I abandoned the
treatment of abscesses by using a barbed broach wrapped with cot-
ton, and adopted another method so that I would not leave any
cotton in there. I likewise abandoned the use of oxychloride of
zinc for filling the roots of teeth, because I could not get it to the
end of the root unless I forced it in there with such pressure that
the patient could not stand it. It was absolutely impossible to
reach the apex, because there were no smooth instruments that
would push it to place after I had got it there. If there was any
blood serum or anything that would have a tendency to become
decomposed, the oxychloride of zinc would fail. Again, if I tried
to fill the crowns of molars with cohesive gold and only used a nap-
kin to keep the cavity dry, generally some dentist or patient would
come in and distract my attention or something would happen by
which the patient would want to cough, or something like that, so
there would be moisture about the gold, hence I adopted a method
of not filling the crowns of teeth with cohesive gold unless I first
put on the rubber dam. I used to be foolish enough to take a little
child seven or eight years of age and fill its teeth with gutta-percha,
perhaps because the teeth were not well developed or because the
PROCEEDINGS OF SOCIETIES. 297
child was so irritable that I could not handle it. I would let them
go two or three years. Sometimes I would meet a child on the
street with all its teeth filled with gold. I worked on those teeth
during the critical period, and the parents doubtless discovered
that I was a bad dentist and they visited some other dentist, who
examined the child's teeth and immediately jumped to the conclu-
sion there was room for a gold mine, and the teeth were filled.
That brings up the question of ethics. I regard this as one of the
most unethical things in our practice. People have such small
ideas. They can't see that a dentist is trying to do the best possi-
ble thing for them. They break down the fabric he has been build-
ing up for them for years.
When I commenced to remove salivary calculus from teeth
the instruments were so large that you could not get more than two
or three of them in the mouth at once, and it was an utter impossi-
bility to remove salivary deposits with these instruments, and so
every dentist who used great big instruments, shovels and scoops
failed. But now, what have we? Within the last fifteen years we
have the most beautiful, delicate and highly tempered instruments,
splendidly shaped, and all that, and the practitioner must be either
negligent or does not realize his duty who does not clear off all the
salivary deposits from the teeth. He cannot do it in one sitting.
I used to bleach teeth 15 ye^rs ago. Many times I bleached
teeth without putting in a gold filling. In two or three da3^s I
found the tooth got black or dark. When I bleach a tooth now,
if there is an exposed end of a dentinal tubule on the side or cut-
ting edge, I cut it out and fill it with gold. I do not leave any-
thing but the gold and enamel to be exposed to the fluids of the
mouth. When you bleach teeth and protect the interior, the bleach-
ing will be successful.
I began to destroy the pulps of teeth a great many years ago.
I did as do a great many other people, I did not put on the rubber
dam. I did not keep the cavity dry. I dried it as well as I could,
then applied arsenic, covered it up with sandarac varnish and
let it stay two or three days. Then I removed the dressing.
I would perhaps punch a hole in the pulp chamber. I would tell
the patient to go home, and allow that tooth to be exposed to all
the tluids that pass through the mouth including, food, dirt etc.
When the patient came back I would fill that tooth, and it would
get dark. I did not see many of my own cases, but I saw other
298 THE DENTAL REVIEW.
people's. I do not do that now. When I want to destroy the pulp
of a tooth now, from the time I decide to destroy it until the root
is filled nothing gets in there except what I put in myself — not
even moisture. I used to be foolish enough to put amalagam on
the buccal surface of a tooth and gold in the crown and not con-
nect the fillings. I do not do that any more, for the reason that
the operation will prove a failure if you do not connect the fillings.
If you live in one region long enough you will observe or hear of
the failures that you have made.
In regulating teeth, I cannot say that this is a phase of prac-
tice I care very much about. It requires a great deal of judg-
ment to know just what to do in the extraction of teeth and to
look forward to the condition of the mouth of that person, ten or
fifteen years after the operation that you have advised, has been
performed. Do not remove lateral incisors. That is one of the
points. Do not remove cuspids, although I have seen quite a num-
ber of absent cuspids. That is one failure that dentistry ought to
be ashamed of, that is, to remove a cuspid tooth.
I used to file teeth and cut them away with discs. I began
that twenty years ago this last month just after I had read Arthur's
fascinating book on the prevention of decay of the teeth. Of all
the curses this profession has been subjected to, the publication
of that book has been one of the worst.
I presume there are more interalveolar partitions depressed so
that they have disappeared and let the teeth drop out in consequence
of the pressing in of food and beef-steak on account of the ill-ad-
vised operations following the issue of that book than anything
else. I do not file teeth any more. I do not Arthurize them. I
do not advise anybody else to do it. One of the failures of the
dental profession as far as I can see is that practitioners do not
charge for consultation. If your advice is worth anything it is
worth money. If it is not worth anything you had better quit. I
wish I could have had some young man talk to me when I was a
boy, and tell me what I ought to do. The trouble was dentists
were not the liberal-minded men then that they are now, and there
was no such vast fund of knowledge to draw from as we have at
present. We live in an age that is noted for its great strides.
This profession even in the short time I have been in it, has been
expanded and broadened and become so liberal that I am very glad
to-night to say that I see a great future for it ; and I hope that
PROCEEDINGS OF SOCIETIES. 299
every man who is conscious of the little defects in his own make-
up or in his knowledge will do all he can to recompense them, to
reconstruct himself and stand on a broader platform and get the
very highest professional ideas.
Dr. Garrett Newkirk : I am not quite willing to agree with
Dr. Salomon's estimate of the paper. In the first place Dr. Swain
is a near neighbor of mine, and if I can say anything that is agree-
able and flattering about the paper I want to do it. If we were to
consider all failures of dentistry we would talk here for a week and
then not be through. One paper cannot do any more than to give
us a start for discussion. Dr. Swain has done one thing for which
we are under obligations to him. He has given us a definition of
ethics which seems to me to be the best I ever heard. If I cor-
rectly understood him, it is " The science of human duty," the duty
of professional men toward each other and to their patients. It is
right in the line of the golden rule.
Now I wish to sa}^ a thing or two about my own personal rela-
tions with dentists. I was in medical practice for seven or eight
years, always believed in societies, helped to organize four or five
medical societies, and belong to two or three now. I associate
with medical men and I know that there is just as much jealousy,
meanness, narrowness and contemptibility, if I may use that word,
in the medical profession as there is among dentists. My experi-
ence has been rather in favor of the dentists, by whom I have usu-
ally been treated with courtesy and kindness.
My experience with reference to patients who come to me for
the first time is something like this : Of course some other dentist
has usually been doing work for them. I never ask them who the
dentist was, and as a rule they do not tell me. They come into
my office and engage my professional services. I take the mouth
as I find it and make no remarks. I have generally found that
they speak kindly and courteously of the former dentist, if at all.
That is the rule. If they undertake to criticise anything he has
done or attempt to get me to do it, I simply refrain from doing any
such thing. If I say anything to such patients it is something like
this : " I do not know what the circumstances or the conditions
may have been under which this or that operation was performed.
They may have been unfavorable. I presume tlie dentist did the
best he could under the circumstances." Whoever it is, I do not
300 THE DENTAL REVIEW.
indulge in anj- severe criticisms. I treat the practitioner as I
would like to have him or any one else treat me. I repeat that
patients do not often come to me complaining and finding fault
with other dentists.
I do not see why there should be any dispute about hand in-
struments and the dental engine. It seems to me we could not
get along without either. Each has its place. Certainly neat,
good chisels are essential, and if kept well sharpened, nothing can
take their place. I am very glad Dr. Nelson mentioned the spoon-
shaped excavator, and, by the way, I mean to get up a set before
long. It seems to me that the judicious and careful use of the
engine and bur has just as much its place as the excavator, steel
or chisel.
I wish to say that one cause of failure of operations has not
been mentioned to-night and that is finishing gold fillings with
coarse sandpaper discs or coarse emery strips. Those generally
used are not fit for the purpose. A rimmed sandpaper disc, coarse,
scratching, ugly thing, has no place between teeth. If you use a
coarse disc or a coarse emery strip, take a magnifying glass and
look at the revolting surface. It will take you half an hour or
more to remove the scratches or irregularities from the substance
of the gold or tooth itself \ }ou would better use only a burnisher than
the coarse strip. In my judgment we do not use enough of fine
finishing knives or cutting instruments, such as Dr. Black has put
upon the market. I mean those little, delicate, fine files that do
not scratch.
Dr. Crouse : What do you want a file for if you do not want
it to scratcli ?
Dr. Newkirk : These files do not scratch. They are not made
with creases running in different directions which make scratches.
They are really trimmers rather than files.
I am glad that Dr. Harlan spoke of the inefficiency of the dis-
cussion in regard to pulpless teeth. He struck the key-note of
the whole thing when he said he does not allow anthing to enter
the pulp chamber but that he puts in himself.
Dr. J. N. Crouse : I cannot wait any longer before saying
something in regard to this subject, because there is such a con-
glomeration in my head of contradictions and absurdities that 1 am
I
PROCEEDINGS OF SOCIETIES. 301
afraid I shall not be able to single out anything that will be of in-
terest.
The first gentleman, the essayist, closes his paper by decrying
the elevation of the dental profession. He closes the paper with
some remark of that kind which somewhat surprised me. He for-
gets that 25 years ago there were not so many dentists here, conse-
quently not so many to help get up a disturbance, and it is an old
saying that the more cats you get in a back yard the more noise they
will make, and if they are not killed the noise goes on. We are
living now in a city of over a million inhabitants with 500 or 600
dentists. Hence more unprofessional conduct because there are so
many to select from and not because the profession is more ele-
vated than it was 25 or 30 years ago.
The next gentleman advocated driving bands up higher to pre-
vent recession of the gums. I do not see how this will prevent re-
cession. As soon as you drive beyond where you have trimmed you
have gotten edges extending beyond the margins, and in most
cases harm will follow such practice.
The next gentleman wants spoon-shaped excavators. If there
is anything that is an abomination in sensitive teeth, it is a spoon-
shaped excavator. There is nothing that tortures a patient so
much and accomplishes so little in a given length of time. I gen-
erally prefer a hatchet-shaped excavator, I mean by this one that
is flattened on each surface so that each has five cutting edges. I
do not use as many of the common chisels as I used to, as these
excavators when sharp, take the place of chisels — they cut either
way by drawing or pushing and answer the purpose of other exca-
vators. Of course every man has a right to his preference in shape,
but I recommend this peculiar shape as preferable for most cases.
Dr. Harlan said he had treated alveolar abscesses with a
barbed broach and cotton to force the medicine through the fistula,
and had had a great many failures in years past. Taking a barbed
broach to force medicine through the root of a tooth was a foolish
thing to do even sixteen years ago. He did not tell us how he does
now. I have not changed my line or procedure in twenty years,
and have often described how I treat abscesses. After preparing
the cavity, getting it dry with the use of the dam — I take a piece
of soft India rubber — as near the shape of the cavity as possible —
perhaps a little larger — then fill the cavity with carbolic acid, and
with this rubber and a blunt instrument, force the medicine through
SOS THE DENTAL REVIEW.
the fistula. I have seldom failed in doing so effectually in this
\va)', and I still keep it up.
I am still foolish enough to put arsenic in a tooth and dismiss
the patient for two or three days.
One of the most common causes of failure is a lack of correct
diagnosis — that is a careful examination of what is to be done, also
good judgment as to the best way of doing it. Some cases should
be contoured and others should be separated, and it requires the
greatest amount of judgment to determine what is best in each
individual case.
If best to contour teeth when filling them, I should contour
them. If best to practice Arthur I should do so. There are a
class of cases where the hollowing out, and often the dressing out, of
cavities, from the approximal surface of the front teeth, is the
best thing to do, when this can be done without marring the ap-
pearance. In such cases I practice on the Arthur principle to the
best of advantage.
When I have patients that I know will take care of their teeth,
after they are filled, and they would be more comfortable for mas-
tication for being contoured, contouring in those cases would be the
best practice, although it requires much more labor to contour them
than to do it otherwise.
I should hate to dispense with excavators or burs. Instead of
boring away after the cavity is full of chips so that you cannot see
where you are going, my assistant stands by my side and uses a
warm air syringe, and I can see where the bur is going. I think I can
perform a delicate operation with a bur. Course burs are an
abomination. A long time ago I had some bur makers make me a
lot of burs with a third more wheels in them than the ordinary burs
have. I use this kind now and prefer them, because I think I can
prepare the cavity more rapidly and with more safety to the patient,
and with greater satisfaction to myself.
Just one thing more and that is in regard to patients accusing
the dentist of boring holes in their teeth — spoken of by the essay-
ist. I presume sometimes cavities are filled in teeth when it is
not necessary, and that holes are bored in teeth where there are no
cavities, but I think these cases are rare. The greatest mistake
however and one which is a greater injustice to the patient, is the
neglect to find the cavities that are there and should be filled.
Many times it is a very difficult task to make sure that you have
PROCEEDINGS OF SOCIETIES. 303
filled all the cavities there are to be filled. And a failure to do so
is the greatest injustice a dentist can impose, and this would be
my answer to the patient accusing the former dentist of drilling
holes in the teeth where there were no cavities.
Dr. a. E. Baldwin : Before the subject is passed I want to
acknowledge my indebtedness to the essayist for his excellent
paper. We could not expect him to state or touch upon all of the
failures of operations in dentistry because we cannot even speak
of our successes without referring incidentally to our failures. To
my mind the paper was full of texts for papers, and I do not see
how, considering its brevity, it can be improved upon. There was
only one point mentioned in it that I would hesitate to endorse,
and that is in regard to the implied idea spoken of by Dr. Grouse
a few minutes ago about the dentist making cavities. It does not
seem to me possible that one could do it. I think that we are more
inclined to make failures as dentists by not calling the attention of
patients early enough in the history of caries or decay of the teeth.
If one tooth is badly decayed and there is another one just begin-
ing to decay, some dentists are prone to fill the first and let the
other go. When instead if only one is filled let it be the one least
decayed. Many dentists simply fill the large cavities and let the
little ones go. Some years ago while in the waiting-room of a well-
known dentists office, a patient came in and went into the operat-
ing room and while he was at work I overheard a conversation that
took place. The lady called his attention to a certain place in the
mouth where decay was going on and wanted to have the cavity
filled. Before filling it, after preparing the cavity, with the pa-
tient's consent I was allowed to inspect the teeth, and while look-
ing in the mouth I discovered several small cavities. The dentist
filled the tooth, the patient paid the bill and passed out of the of-
fice, not a word being said about those small cavities. I said to
the dentist, "Didn't you see those small cavities?" " Oh, yes."
"Why in the world didn't you call her attention to them?"
"Well," he said, in a way that a great many dentists have
"when you have practiced dentistry as long as I have you won't
do it. You will just simply do what they want you to do, collect
your bill, and let them go." This is a mistake. It is a failure. I
think that dentist was remiss in his duty to that patient. I think
it is just as much our duty to call the attention of patients to any
3(>4 THE DEXTAL REVIEW.
lack of correctness in the mouth as it is to do that work for
which they come to us. We are largely the makers of our own
reputations. If we encourage patients to speak disparagingly of
others, we are injuring ourselves and our own reputations. I
do not think it is anything uncommon to have a patient speak
about some operation having been unsuccessfully done. I have
sometimes had my attention called to a tooth that was in a defec-
tive condition, and the patient would say "that Dr. so-and-so
fixed that only a short time ago and it ought not to be giving out
at this time." It is not wise to pay much attention to such a re-
mark. A good way to overcome that is to say, as has been sug-
gested by other speakers, "we will not discuss the past, but now
your tooth is in such a condition." I think the code of ethics which
has been spoken of is the greatest farce on earth. If every man
will do by his patients and his professional brethren as he would
like to have them do to him, he would then be ethical, and not
until then. There is a statement that has gone the rounds many
times which is true that "even damning can be done with faint
praise", and it is often done too.
There was one point brought out in the discussion that I can
hardly see its relationship and that is the comparative ethics of the
general medical practitioner and the dentist. Having had several
years' experience in each, I do not want to make any comparisons,
but I think where you find the most education you will find the
least disposition to jealousies. It is a positive injury for us to feel
that we must always praise each other. If there is ground for sin-
cere, honest criticism, it is a dental failure if we do not indulge in
it.
The putting of bands around the roots of. teeth has been dwelt
upon. It seems to me as though it is hard to suppose that a band
impinging between two natural surfaces would be better than one
where it impinges but little ; in other words, the least interference
with the tissue between the gum and the root of a tooth the bet-
ter.
The position taken by Dr. Harlan in not letting things into
pulpless teeth while treating them except what you put in your-
self, is commendable, and I will go farther than that and say, I
should be very careful what I put in. Dentists sometimes put in
too much. They overdo the thing.
Some one spoke of putting in fillings, which, if they remain for
PROCEEDINGS OF SOCIETIES. 305
twenty-five or thirty years, might be called successes. I do not
think it is necessarily so in one sense. Of course it would be con-
sidered a better operation than one that failed in ten years. I saw
a case when I was a beginner in dentistry, where a gentleman
showed me a prepared cavity in his mouth of twelve years standing
where no filling had been put in, yet the preservation of the tooth
was perfect. If a very poor operator had filled that tooth and it
had remained for many years it would have been considered a suc-
cess. I think we should be careful to use discretion and judgment
in the preparation of cavities, even more so than in putting in a
filling.
This point was referred to in the paper. If I understood Dr.
Swain correctly, he did not exactly criticise the use of the dental
engine, but that either it or hand instruments should be used with
care and thoroughness. With care and judgment we can use
either to advantage. I agree with the last speaker that there is
a great deal of good accomplished by the use of the dental engine;
that we sometimes do work with it that it would be almost impos-
sible to do with a hand instrument. I have no doubt that some
skillful dentists make failures because they do not use judgment in
preparing and shaping cavities. Unless we get a perfect enamel
edge with a supporting wall of dentine underneath, our work will
not be durable, it does not matter how skillful the operator may
be. I believe we would have many less failures, and it would be a
greater satisfaction to ourselves, if we would place ourselves as far
as possible in the position of a patient and look upon each opera-
tion as a very important one.
In regard to the implied criticism of crown and bridge work,
that a good many of us were probably practicing it, but did not
brag of it, I, for one, feel that a great deal could be written on fail-
ures in dental operations embracing nothing but crown and bridge
work. I do not wish to be understood as condemning all cases. I
think just the same care and judgment are necessary (and perhaps
to a greater extent) in properly deciding as to what cases are the
proper ones in which to resort to these remedies. An improperly
constructed or applied bridge is a great curse.
Dr. E. Noves : The saddest and most disgraceful failures re-
ferred to this evening are such as those mentioned by the last
speaker, when he told of the dentist who only made the operation
306 THE DENTAL REVIEW.
his patient asked him to do, entirely ignoring everything else that re-
quired attention. The dentist who conducts his business on such
a plan degrades himself to the level of an ordinary mechanic or
worse. A man is his brother's keeper by the force of moral obli-
gation, but in addition, he who studies and practices a profession
voluntarily undertakes to be so to those who intrust themselves to
his care, as far as the scope of his profession extends. It is still
more astonishing that a man should say, as this one did, "When
you have practiced dentistry as long as I have you will do the
same way." Gentlemen, length of service in practice does not tend
to produce that kind of sentiment or that kind of practice. If a
man does business on that plan it is because of his inherent incom-
petency and selfishness, and not because he has been a longer or
shorter time in practice.
The paper referred to the occasional assertion or supposition
on the part of some patients that holes have been bored in sound
teeth for the purpose of filling them, and intimated that probably
such a belief is sometimes well founded. Some criticism has been
made upon this, and I am going to tell you a tale in illustration of
it. A certain family had been for some years in the care of one
dentist, each of them visiting him about twice a year. One of them
had numerous very slight imperfections, or possibly only deep in-
dentations, in enamel of grinding surfaces, which had been care-
fully watched and observed to make little or no progress toward
decay, it being only occasionally that one of them needed filling.
It happened once that this individual came during the doctor's va-
cation and so went to see another dentist who proceeded at once to
fill a dozen or fifteen of these grinding surface pits or seams.
Comment is unnecessary.
Dr. Salo.mon: As the discussion is not strictly limited to fail-
ures, but seems to be more on the subject of incidents of office
practice, I would like to say a few words in regard to it. I recall a
circumstance which will show that the code of ethics is not always
the best practicable thing, or that men should have the same ideas
in regard to it. If a patient suffering from a severe toothache —
another dentist's patient, — should ask you to extract a tooth
for him, you would hardly feel like saying, ''I will not touch that
tooth, I will let you have your toothache." Some time ago a
patient of mine who has been under my care for ten years, had a
PROCEEDINGS OF SOCIETIES. 307
severe toothache. He went to several dentists to have it extracted
but they would not do it. Finally he happened to go to one who
extracted it for him. The tooth was a lateral incisor. In the even-
ing I happened to meet him, and I said, "What did you do with
that tooth ? " He said, "I had it extracted." I said, "let me see
it." I took the tooth, put it in a glass bottle, and told him to come
to m)' office in the morning. I had tried to stop the toothache for
him several times, but failed. I happened to be out of the city at
the time the tooth was extracted by another dentist. I took the
tooth and replanted it, and to-day, five months later, the tooth is as
good as any other in the mouth. I hope to be able to bring the
patient here some evening for you to examine the tooth.
Dr. Newkirk: In regard to the case spoken of by Dr. Baldwin
and mentioned by Dr. Noyes, who said such practice would bring
the profession down to the level of the artisan. I hold that the
labor of the artisan or mechanic is just as valuable and dignified as
anything else. It is bringing the profession a good ways below that,
it brings it below any valuable and dignified labor. For my part I
would not do an operation for a patient under such circumstances.
I give the person to understand that I am to put his mouth in good
condition immediatel}' or very soon, or I will not touch it. If he
will not let me do ever3'thing that is necessary, remove the tartar
from his teeth and leave his mouth in a healthful, cleanly condition,
I do not wish him for a patient.
Dr. Swain, in closing the discussion, said: I desire to say very
little except first to thank the gentleman for the very slight punish-
ment they have inflicted, and secondly to assure them that in m}^
belief the essay has been a success. I felt when I came here this
evening that my paper would prove a worse failure than any of
those mentioned in it, but on the contrary it has called out an hour
and three-quarters of good, profitable discussion, consequently I am
more than pleased. My foremost intention in writing the paper
was to say something that would elicit a good deal of discussion.
Two of the most prominent dentists in this city — or, for that
matter, in the United States — were recently discussing dental sub-
jects. One of them said, "there is no work on operative dentistry,
and you ought to write one." " No," he says, '• I do not care to do
it. Why we have not a good work on that subject I do not know."
One of them said it would take a long time to write such a book
308 THE DENTAL REVIEW.
and it would be a large one. If I had taken up the subject of fail-
ures and attempted to exhaust it, it would be coextensive with a
work on operative and prothetic dentistry. I should have taken the
wind of Dr. Salomon's speech and he would have gone home dis-
gruntled.
I thank Dr. Harlan for what he has said regarding the paper.
As to the matter of ethics, considerable has been said about
that. I was led to say what 1 did in that particular because with-
in the last \ear or two I have been led to feel more and more that
true ethics is lacking in the dental profession. I believe it is so.
Like every other advance that has been made in our profession it
can onlv be brought about by agitation and discussion.
I am afraid Dr. Grouse was not listening attentively when the
paper was being read regarding that portion pertaining to the
drilling of holes in teeth. I said a certain dentist of long contin-
ued practice made such a remark in my office, and that a certain
other gentleman who was much older than the dentist, sup-
plemented it with other remarks. I did not ask the young ladies
to give me their opinion as to what was done in the excavation of
the incisor teeth which I mentioned. I drew my own conclusions.
I did ask them a few questions, but the}' were not pointed.
In regard to the filling of small cavities referred to by Dr.
Baldwin, we all know how common it is for patients to aik us if a
cavity is large enough to be filled. Perhaps the same kind of con-
versation goes on in a doctor's office when a patient visits him.
I will close my remarks by saying that the Committee when
they make up their program for another year, you will know
where to go to find a man to write an essay upon the subject of
failures in dental operations. Dr. Salomon will fill the bill exactly.
He almost volunteered to do it, and I think the Committee should
go to him for such a paper.
The Dental Review.
Devoted to the Advancement of Dental Science.
Published Monthly.
Editor: A.W.HARLAN, M. D., D. D. S.
ASSOCIATE EDITORS:
Louis Ottofy, D. D. S. C. N. Johnson, L. D. S., D. D. S.
Clinics.
There is little doubt that a great deal of good has been accom-
plished in the profession through the medium of clinics. It is pro-
verbial that an idea can be grasped, or a method of practice taught,
better by demonstration than by written or spoken description.
There are many little tricks of manipulation which in the aggre-
gate prove a wonderful aid in practice, but which either seem too
trivial to write about or are of a nature not easily described. The
careful observer at a well conducted clinic can gain more practical
benefit in a given time than in any other way.
But we have a word to say on behalf of the two principal indi-
viduals connected with the average clinic, viz. : — the operator and
the patient. Too often do the members of a society — some of the
members at least — treat these individuals as if they were mere au-
tomatons erected there for the sole purpose of entertaining the
curious minded. We are willing to admit that for the time their
main office is to interest and instruct if possible, but the fact should
not quite be lost sight of that they are human. The position of
either is an unenviable one.
Speaking for the patient, it is bad enough to be operated upon
under any circumstances, but the miseries of the dental chair are
rendered infinitely greater by having a lot of spectators crowding
closely around the victim and often leaning against him, and exclud-
ing even the possibility of a breath of fresh air. The usual eleva-
ted temperature of the room adds to his discomfort. Worse than
all else is the rough usage his mouth sometimes gets from those
aiO THE DENTAL REVIEW.
who wish to examine the operation. A thoughtless on-looker, in
his anxiety to see what is being done, will often lean over and reach
past one or two others and pull down the corner of the patient's
mouth as if it were made of India rubber. A laudable desire to
gain all possible information is commendable, but this can be done
without abusing the patient, and with more decorum than is usu-
ally observed at clinics. Too many spectators crowding around
the chair at once is conducive neither to benefit to the members
nor to comfort to the patient.
As for the operator his position is often less enviable than that
even of the patient. At best he is working at a disadvantage. He
is removed from his usual environments and feels awkward. His
instruments are not in their customary places. That nice balance
of the nervous and muscular systems which calls out his most ex-
pert manipulation is lost. He cannot, as in his office, give the op-
eration that essence of concentration which renders him oblivious
to everything else. He should not be expected to do as good work
here as he ordinarily does, and yet the average spectator demands
of him more than usual excellence. The operator is doing well if
he succeeds in demonstrating some principle connected with the
work in hand, and his clinic cannot logically be called a failure be-
cause it lacks in some minor detail.
In view of all this it is especially gratifying fur him to hear
some one who is just walking away from his chair — usually an in-
dividual merely out of his teens telling a companion wherein the
operation could be improved. Or if the clinic is a filling which
has been properly finished and polished and the operator has left
the chair for good it adds to his reputation to have some critical
genius come along and probe around the filling and scratch it up
so that he who follows him will insert his mirror and ask "Who
put in that filling ?" The man with the glass usually elevates his
eyebrows when informed who the clinician is and then suggestive-
ly remarks : "I like the way that fellow polishes his fillings !"
These are some of the annoyances connected with clinical
work but so long as clinics seem the surest means of spreading
practical knowledge we suppose some one must submit to the an-
noyance— unless — unless — society members learn to exhibit more
charity toward clinicians and their patients. C. N. J.
EDITORIAL. 311
Delayed.
The pressure is so great on our columns that much matter of
interest has to lie over until next month.
The Illinois State Dental Society.
The next meeting will be held in Springfield the second Tues-
day in May. Dentists from neighboring States are invited to be
present.
Dental Advice Extraordinary.
It often seems marvelous hov^ wrong impressions become en-
grafted in the minds of people and how difficult it is to re-
move these notions or to estimate their deleterious effects. Prob-
ably the early origin of many medical superstitions and errors might
be traced to the time when medicine was shrouded in darkness and
when the healing art was the craft of the priest. The ignorant
were always expected to be awed in the presence of these "holy "
dispensers of the Grace of God, superstition and fear were instilled
into their narrow minds by these wily penetrators of human na-
ture.
Strange as it may seem in this enlightened age, it is neverthe-
less true that superstitions of ancient times still represent the be-
lief of many and stand as a living exemplification of the inferior
quality of the contents of their crania.
The frequently expressed connection between the "eye" teeth and
the eyes, had its origin with Celsus, who referred to the dangers of
extraction. The majority of the laity to-day, who know any-
thing about teeth at all, believe in that fossilized idea. Some ex-
cuse does exist for the fervent attachment to such an idea, for
Celsus was a great man, but why any sane professional man of the
present time should circulate the most unreasonable recommenda-
tions, such as we are about to mention, is beyond our comprehen-
sion. Dr. E. Feibes of Aix-la-Chapelle {Therapeut. Monatshefte
November, 1891,) recommends the use of chromic acid in the
treatment of syphilitic affections of the oral cavit3^ Among other
things he says: "In bad cases of stomatitis by means of a fine
probe armed with wool, I clear away the putrifying, stinking masses
from between the teeth and gums, then apply in a similar way wool
dipped in a concentrated solution of chromic acid, after previously
painting the parts with cocaine." So far as the future effects on
312 THE DEXTAL REVIEW.
the teeth of this individual is concerned, we should recommend that
he immerse his head for three minutes in a bucket filled with a
good quality of nitric acid.
Another squib that originated in the fertile brain of some den-
tist, and which was only recently again republished by a dental
journal, carries the wonderful thought that the addition of aromatic
sulphuric acid to the tooth powder or pumice or rubbed between
the teeth on floss silk, does clean them.
As a slight improvement on this crude method we would suggest
the use of a strong pure solution of sulphuric acid; not only would
this remove stains but an entire cavity could be wiped out of exis-
tence, the tooth could be cut down if necessary to the gum line and
it would be in condition for a crown. Certain stains upon the teeth
are situated on the surface of the enamel, other discolorations are
due to a deposit of pigment in defective interstices or pits of the
enamel. The former are readily removed by friction, the latter re-
quire the entrance of something into the pit, or the removal of the
enamel on each side of the pit thus carrying the objectionable col-
oring matter along with it. Such a process can not prove to be
other than injurious, not only because of the removal of enamel at
the time, but because of the necessity of subsequent cleaning.
The enamel's roughened surface collects deposits and necessitates
removal. It is safe to leave any stain or discoloration which can-
not be removed by the faithful application of those frictional sub-
stances, whose effect on tooth substance is well known. Let us
have less of these injurious recommendations originate with the
profession, and at the same time let us correct those that are al-
ready current.
DOMESTIC CORRESPONDENCE.
To the Editor of the Dental Review :
Dear Sir: —Will you kindly allow me space in your valuable
journal to correct an erroneous impression which may have been
made upon the minds of some of your readers, concerning my
views on " Dental Education," by a too liniited quotation from an
editorial in the November issue of the Southern Dental Journal.
Any right-minded person can readily understand how one's
entire meaning can be changed and misrepresented by clipping a
few sentences midway in an article, where the whole thing is inti-
DOMESTIC CORRESPONDENCE. 313
mately connected and bears upon the meaning intended to be ex-
pressed.
In Chicago there seems to exist a kind of professional " Carou-
sal Club" (imaginary or otherwise), in print styling their meetings
" Symposiums." At their meetings there is generally found a cer-
tam reporter who takes down discussions, imaginary or otherwise,
which take place between Messrs. A. B. C. D. E. and F., who seem
to comprise the discussing element of the " Club." At their carou-
sal No. 3, A. seems to have taken it upon himself to dissect one of
my editorials, which appeared as before stated, and selecting that
part, which being disconnected, seemed to him most ridiculous,
presented it for the criticism of Messrs. C. E. and F. (B. and D.
left out).
A. seems to have read the article carelessly; intentionally mis-
understood it for the sake of argument, probably, or perhaps it
might have been toward the close of the "Symposium," in which
case it would probably have to a certain extent mitigated the
offense; any way he seems to have entirel}' lost sight of the fact
that disconnecting the few sentences he quoted placed me in a false
light and rendered my meaning different from that which was in-
tended to be conveyed.
In defense of my views expressed in the article in question, I
simply ask for space to reproduce that portion of it as it appeared
in the Southern Dental Journal that it maybe correctly read, thereby
placing me in a correct light before the readers of the Dental Re-
view, many of whom probably do not read the Southern Dental
Journal.
After reviewing the progress of the profession for the last ten
years and expatiating on the rapidity of the changes which had
taken place in such a brief space of time, the article continued as
follows, the italics being the quotation which A. took issue with :
"Then again, some enthusiasts get an idea that there is no
limit to a student's capability of absorbing knowledge — that the
professional requirements in dentistry should extend into various
other branches of science— in fact, where to stop seems to be the
problem. In extending this limit we should always try to keep in
view the fact that it isonly a ver}' few minds, from the effects of various
consequences and environments, that are capable of acquiring and
appropriating knowledge beyond a limited area. It would indeed
make a beautiful profession from the standpoint of a literary enthu-
314 THE DEXTAL REVIEW.
siast, could we raise the standard so high and make the field so
broad as to shut out all medium sized brains — allowing only those
to enter who are capable, from the smiles of fortune, or otherwise,
of acquiring broad and liberal culture. This would be an ideal
profession, we must admit, and would bring honor, dignity and
recognition. This, however, is only the dream of an extremist and
is not practical. We want a high standard, but we want it placed
within the reach of all good, intelligent, practical men, that they
may go out and do good in the world by giving good and whole-
some advice and relieving suffering humanity. We cannot dis-
pense with the medium capacitated men, there are places for them
to fill. Then we need leaders and enthusiasts, too, but there will
always be a supply of these who will rise above the common level,
urged on by ambition, until they are listened to and recognized.
' The dental profession is fast becoming great atui we need men to work
in various capacities. We need leaders, teachers, writers, inventors,
investigators, and so on until the list could be extended illimitably. But
if 1 were asked who, of all the different classes named or unnamed, was
doing the most good from a philanthropic standpoint, the answer would
be the modest practitioner, who is seldom heard from, reads one or two
journals, attends his State society, and quietly pursues the even tenor of
his way, relieving suffering hutnanity by practicing his profession intel-
ligently and conscientiously.' In fixing the standard of the profession
let us not exclude the practical man."
Thanking you, Mr. Editor, for the space so kindl)' lent me to set
myself and the Southern Dental Journal right before your readers and
wishing you continued success with your most excellent publication,
I remain. Yours faithfully, H. Hkrbert Johnson.
Letter From New York.
To the Editor of the Dental Review:
New York is putting on its Spring airs, as one comes down town,
mornings — sackcloth, together with plenty of ashes. Our law de-
mands all this garbage removed before these hours, but what do New
York people care about their laws ? We have legislation enough for
the perfect regulation of all municipal affairs, more law is the call
and we are getting it. One side says, it is all the fault of Tammany,
and the other side charges it to the mugwumps. Judas Iscariot was a
square man compared with the present-day transgressor, for he had
DOMESTIC CORRESPONDENCE. 315
manliness enough to own up to what he did, had "no pards " and
saved all governmental expenditures, by taking himself off quickly.
It doesn't look that way in dental matters. It looks, at the present
writing, as though there was a disposition to try and make a scape-
goat, which is only a Jew trick. We predict it will not work well
for the projectors. We are gathering the ripple of gossip, which
is generating into a murmur, particularly since the Anniversary
Meeting of the First District Society, and the murmuring is going
the rounds to all points of the compass. Judging from many ex-
pressions that come to us, there is real cause for the repeating of
the inquiry which was sent out from the Odontological Society
some two years since, viz: "Are we a liberal profession?" We
hear expressions like this. Is it not about time that we settled this
question by electing men to the important offices of our calling,
who do represent the best professional expressions ? Cool, Anglo-
Saxon words do not indicate the animus of the future purpose,
nothing but italics are satisfactory. Who will fill the office of the
Columbian Dental Congress in '93 ? The answer is going out all
along the line. It is heard West and South, in a very pronounced
manner, to say nothing of this section of the country. "No man
shall occupy that office who has not some pronounced professional
standing, secured by the manifestation of decided skill in one or
more branches."
It is further said that we do not care to figure before foreign
professionals in anything like what may be construed into a com-
promise. We will stand represented as a ti'ue profession by a truly
professional man. We emphasize this as a worthy thought and not
any too easily put into active exercise. The man who shall pre-
side at Chicago in 1893, should be, and must be, one who will go
into history, standing for something in ability above the ordinary.
Such an one has been on the mind of many, and it was canvassed
and fully agreed by all that we had no one who could better fill the
position, for good looks, true gentlemanly qualities and scientific
ability. We do not believe that there would be a dissenting voice,
if we were at liberty to divulge the charmed name — enough for the
present.
There was no little speculation in connection with the monthly
meeting of the First District Society. The meeting passed quite
unexcitingly, although there was no little sparring over the question
of the constitutionality of the amendments attached to the new by-
316 THE DENTAL REVIEW.
law. We see a good deal ot tinkering in so much legislation, but
we are not in it, so do not worry about it. It got out that the
society would elect Dr. Gibson [who was brought before the society
for a supposed violation of the code of ethics; charge made by Dr.
Kingsley, some months ago which I noted in my letters] to fill out the
remainder of the term made vacant by Dr. Kingsley's resignation.
It was rumored the day previous to the meeting that the slate was
changed, and something was planned for the new adminstration
succeeding this that would freeze out all the undesirable material
which, it is claimed, the society has had enough of, yet we fail to
see how any board of officers could have worked more energetically
and sincerely for the good of the society. Dr. Kingsley's resigna-
tion was presented and accepted without any comments worthy of
notice. Dr. Jackson, the vice president, occupied the chair which
he will only do in the interim. Although by custom he would be
entitled to election as President, but (it is said) he is not the choice
of those who would rule. Dr. Jackson, certainly is not inferior in
real ability, he is one of our very promising practitioners.
The monthly clinic was fully up to the standard, 91 in atten-
dance. We are inclined to predict that Dr. Curtis will prove
timely in the introduction of his clinics in oral surgery. If he
proves his ability in the situation, it is an opportune field for him.
The Doctor has had all the modern education by such a cultured
surgeon as Prof. Garretson, 2.5 years ago he could not have had any
chance of success as doubtless awaits him now. The surgical
interest, value, and its understood necessity could not have been
so matured had it not been so assiduously taught by our devoted
friend and brother, Dr. Atkinson. To Dr. Atkinson's conversa-
tional methods the profession owe a debt of gratitude which will
become more and more apparent in the future.
Foundation work has been laid by him with great self-sacri-
fice, such as has never been excelled by any member of our
calling. All this, better prepares the way for a more appreciative
attention by those who have not had any educational advantages
in this connection. Dr. Curtis having announced that he should
give attention exclusively to cases of oral surgery, will attract more
unselfishly the notice of dentists. Dentists are peculiar in this re-
spect, (i. e.) they have sometimes been a little suspicious that in
sending a patient to another, giving his attention to surgery, that
the patient might not return to them, and that has sometimes proved
DOMESTIC CORRESPONDENCE. 317
true. Dr. Sisson, of New York, operated, using Canon's new gold,
a form of cylinder not in vogue. Dr. Parr, of New York, dem-
onstrated a new form of crown and bridgework. New methods,
and more a coming, and must be seen to be appreciated. Byron
E. Holm exhibited a primary battery in connection with a new
motor appliance, stopping, starting and reversing switch, etc.,
thereby changing the velocity without reducing the power.
Febuary 8, at Plainfield, closed the career of one who will
long linger in the memory of all who treasure character, sincere
purpose and skill of a quality far above the ordinary. Such a life of
professional activity has Dr. John Allen maintained for a period
of sixty years. For many years he has gone daily to and from
his country home to his New York office. He lingered but a few
days on a bed of sickness, which terminated in paralysis of the
throat. His second wife passed away some two years ago, and
since that time, he had notably failed in health and spirits, al-
though he kept a grip upon actual practice as long as he came to
the office. The Doctor's career has been full of incidents that
would be of practical interest to many, for he is familiarly known
in connection with the introduction and continued practice of
the notable porcelain teeth and base, fused upon a platinum base,
"white gold," as the doctor came to term it, popularly known as
" continuous gum work."
With this artistic work Dr. Allen's name will always be associ-
ated. The twenty-two beautiful souvenirs awarded him by all the
World's Expositions might well be the envy of any laudable ambi-
tion. We have known Dr. Allen personally for thirty years and
counted him as one of oui warmest friends. Dr. Frank Abbott
said truly at a banquet given the late Doctor that Dr. John Allen
was one from whom no breath of scandal ever came. Dr. Allen
was a consistent seeker after the values of a daily supernatural xeY\-
gion, a distinction we make from the common so-called " natural
religion," a religion of self; the former, a religion of unselfishness.
The dear old doctor has nobly earned the rest to which we have no
doubt he has gone His only son. Dr. Charles Allen, survives to
continue his father's practice, in which he has been faithfully
schooled for the past thirty-two years.
Dr. John Allen was nearly eighty-two years old. He was a
student of John A. Harris, brother of Chapin A. Harris, the founder
of the first dental college in the city of Baltimore, Md. His early
318 THE DEXTAL REVIEW.
practice was in the city of Cincinnati, Ohio, and during that time
he was prominent as a teacher of the Ohio Dental College. He
came to New York some forty years ago. Long may we cherish
the memory of ** honest Dr. John Allen."
F. R. Sturgis, M. D. presented a very able and exceedingly
interesting paper on "The distinctive character of Syphilitic teeth,"
illustrated by instructive cuts. He took the decided ground that
the deciduous teeth often manifested the same characteristics as
seen in the permanent teeth. Although this is not commonly the
accepted theory, Dr. Rhein sustained the essayists views. Dr.
Ottolengui took exceptions to the views advanced in the paper,
regarding the peculiar deformities of the teeth. He claimed that
all these were found in connection with cases of cleft palate. There
was a very long, but interesting paper on "Syphilitic Lesions in
the mouth." It was read by Dr. Ottolengui but was furnished by
Dr. Hugenschmidt, of Paris, France. He is an associate of Dr.
Thomas Evans, who, without doubt, enjoys the most popular
reputation of any dentist living, or dead, and whose history will be
most remarkable when written, interspersed with very interesting
incidents. Such popularity can never again be secured, for no
such circumstances will again occur.
We have not a few that are far in advance of him in scientific
attainments, but for his position occupied during the last forty years
no one would have sustained it better.
Dr. Marshall, of Chicago, edified the odontological at their
monthly meeting, upon the subject of " Shocks," or what may be
called " Surgical Collapse." The attendance was not a large one.
The paper was full of timely hints and worthy of all practitioners who
aim to make practice humanitarian. The paper was very favor-
ably received, so much so that most of the discussions took on,
principally, the form of compliment. As the use and disuse of chloro-
form was embodied in the paper, it was made a special object of dis-
cussion, for as it was announced that at the former meeting there
seemed to have been a suspicion that the society had too em-
phatically endorsed the use of chloroform in connection with minor
operations. However, it will continue to be the fact that there
will be those who think they are intelligently sanctioned in its use,
although some may think otherwise. We think it an utterly fool-
ish remark that we heard after the meeting: "No dentist should
be allowed io make any use of chloroform, whatsoever." There is
DOMESTIC CORRESPONDENCE. 319
no justifiable reason why an intelligent dentist should not make use
of any article that a regular medical man should see fit to make use
of, if in his judgment it will be of help to his patients. Is a den-
tist a doctor? — again pops into prominence.
Dr. Marshall made a good impression in New York. We en-
joyed a pleasant conversation with him the following day. A com-
plimentary dinner was given him at the Arena, an annex of the fa-
mous Hotel Imperial, corner of Broadway and Thirty-first Streets.
Moving time is at this season of the year. Dr. Bogue goes from
Twentieth Street to Forty-eighth Street ; having leased his present
office for ten years. He has been in Twentieth Street since 1862,
scoring a financial success we hear. It was once said that what he
made in his New York practice was required to meet the demands
of the Paris establishment. We recall readily the various specula-
tive remarks regarding the Quartette Association engineered by
him in Paris. It was doubted whether it could be made a success.
The arrangement was floated into existence by the payment of
$1,000 apiece, as a joint capital, by Drs. Bogue, Moffat (formerly
of Boston) Daboll, of Buffalo, and C. D. Cook, of Brooklyn, the
father-in-law of Charles S. Tomes, the son of the famous Sir John
Tomes, of London. The plan was that one of the party should be
in Paris six months, and in this way the foreign office would be
continually in operation. Drs. Bogue, Moffat and Daboll, proved
their staying ability. Dr. Cook, being a gentleman of very nervous
temperament, did not succeed in the French language. It was too
quick for him, and it doesn't do to (parler) with a French person,
and moreover, he may have been timid, ^^ Pastruient monies, nosci-
tein ridiciilas nius^
The Doctor is good in pantomime gestures, but the language
would run him off the track. Well, the quartette is now a thing
of the past, and Dr. Bogue is all there is to show for it. He puts
in his six months regularly alternating between New York and
Paris, and everything indicates prosperity.
Dr. Bogue is a painstaking operator and always full of little
practical suggestions. Dr. Atkinson used often to remark that Dr.
Bogue knew how a set of teeth should be cleansed. He also em-
phasized the importance of it to his patients, and we ditto it. It
is a great point in practice. Dr. Dunning, formerly of this city,
italicized the importance of it. The cleaner the teeth, the less of
caries, and the less need of germicides. Dr. Bogue has always
320 THE DEXTAL REVIEW.
indicated its value as a prominent factor in his professional work.
Patriuni viortis. The Paris mountain labored, and it has brought
forth a favored child christened Success.
We spoke of its being moving time. Bananas are again plenty
in the market, and we frequently see some very expeditious moves,
aided by the treacherous "peel" as we pace the streets. I never
saw any one gather themselves up so quickly that no one could see
them.
But we heard of a woman who got up in a meeting and gave
her experience in backsliding; she said, "I never backslid but once,
and then I slipped so quickly that God didn't see me." No one
that ever slips on a banana peel can slip back and have no one dis-
cover it. I recall my last slip on one. I fell down and off went my
new stovepipe into the gutter; when I got straightened up I could
hear a nice little feminine titter behind me. We don't fall so grace-
fully at sixty as we did at ten.
Dr. Bogue injects a hint, viz., the use of stearine to be applied
to phosphate fillings, after they are hardened, keep dry and apply
the stearine with a warm instrument; it will not only protect the
filling from dissolution, but enables one to put on a shine. Dr.
Bonwill suggested parafine sometime ago, claiming the same bene-
fits. Try these three things, and if found good, pass them along.
We think we recall his entrance to New York, coming from Chica-
go, formerly an associate with Dr. Allport. Dr. Bogue occupied
the office of Dr. Norman W. Kingsley while the doctor was in
Europe, for at that time he had interested the profession exceed-
ingly in his dealings with cleft palate, and from that date his pro-
fessional repute received an accelerated ascendency, which after-
ward was enhanced by the issuing of his able work on Oral De-
formities, which has given him a lasting reputation. The general
use of this work as a text-book also gives him the acknowledged
author in that department of art.
Dr. Bogue has occupied the office in Twentieth Street continu-
ously since entering it, and soon became the owner. He has proved
himself a successful financier, for he is reputed as being fully se-
cured in a fortune of $100,000. It is reported that he has rerented
for offices sufficient to give himself a free rental. Doubtless his
removal has been dictated by the overcrowded condition of his
street with business, which, of course, has enhanced the value of
his property.
DOMESTIC CORRESPONDENCE. 321
Is a dentist a business man ? This is the question that is going
the rounds just now. Look out for a corker in financial circles. A
few dentists have been making some money and are itching to
make more. Why not? Some are retiring with plethoric purses.
Dr. Charles Miller, formerly of New York, and treasurer for dental
societies for many years, has settled on a farm in Barnstable county,
Mass. Dr. La Roche, a practitioner in New York for many years,
has retired to New Jersey, and sent in his resignation as active
member of the First District Society, but reserved a desire to re-
main in some capacity. It was suggested that most likely he
wanted to be made an honorary member. He will be. How much
honor comes to a man that way? Have not some bodies cheapened
honorary membership of late years?
Dr. Grouse, can you ask more ? The mass meeting of March
29th, has undoubtedly given a certain sound — over 400 new mem-
bers have joined ; 300 of them cash the remainder notes, (so stated
by Dr. Walker.) By the janitor we learned that about 550 dentists
were present. Philadelphia turned out well — Pierce, Jack, Bon-
will, McQuillan, Faught and Rehfuss, New Jersey ditto, a
goodly number. It seems that Levy has got up from "below"
where he was supposed by some to be "smoking" for he was pres-
ent. Connecticut was headed by Gaylord, an ANo. 1 fellow, who
has put his hand down deep into his own pocket for protection,
and Dr. McManus, from Hartford, but no one east of there. Shep-
ard would have been here, but was confined, by sickness. The
query was, where was New England ? Well, she has never failed
in the hour of dut}^ and we don't think she will. Dr. Crouse can
well feel that a generous response in the interest of protection has
been made. The Doctor was more serious, we thought, than it is
usual for him to be. He tried to pose as an artist, an impressionist,
one of those fellows that rub a big lot of paint all over a canvass
and you have something that resembles a hay field with a whirl-
wind in it. This picture the Doctor tried to show by imagination ;
that in the "sweet by and by," this association was to enlarge its
charity and scoop in, not the whole earth but all that the dentists
might stand in need of, for independent manhood. He said
the profession was full of it, only it was latent. It needed develop-
ing. One thing he said that looked a little as though it was meant
for a pointer. He said there were no politics in the Protective
Association. Its aim was true professional ambition.
322 THE DENTAL REVIEW.
A very general approbation was evinced on all hands, over the
success of the meeting. Doctor, one thing you can be assured of,
the dentists believe in you.
You got right at them, this time. Every one felt it would
be mean, not to stand by you. We predict that fire was fully
kindled at this meeting. Now, don't get up nights any more but
put in all the sleep you can get. Forge out all you can during the
day hours and lay it before the boys and they will sustain you.
One thing Doctor, a good deal of query was made over your enig-
matic allusion to something, which you could not now tell. I
refer to the something that would be above par soon. Par noble
frater. (Is it?)
This is the onlv ripple we saw on the placid sea. We hope it
is not neglect that we have had three meetings this month since
the departure of so worthy a member of oar calling, as Dr. John
Allen, and not a word has been spoken of him. Dr. S. S. White
once said, it is a sad thought to nie that when we pass away from
this life, we are so soon forgotten. One year to-night our dearest
friend of the dental profession passed over into the immortal life
(Dr. Atkinson, April 2). We have had a numerous gathering of
co-workers pass into that existence during the last twelve months.
In such a time as we think not, the call may come to any of us.
Do we look forward to it in hope? We have often remarked
that we could wish that all could ariticipate so much as we do, for
the other life, yet we are happy and eager to remain and fill out
our career. So may we all of us be. We make these last remarks
thinking them appropriate, for we meet some who are nearing the
end of their career and are sad and hopeless.
Notices for the State meeting are out for May, with a fine array
of talent — Prof. Darby of Philadelphia, Talbot of Chicago, Boe-
decker of New York City, W'estlake of New Jersey, subjects not
yet announced. Dr. Boedecker is going to present an absurdity
proved to be scientific by the microscope. How scientific men will
howl when it comes. Dr. Boedecker is in the harness again ; good.
Ex.
REVIEWS AND ABSTRACTS. 333
REVIEWS AND ABSTRACTS.
Current from the Main.
By C. J. Boyd Wallis, L. D. S.
As electricity is now coming into more general use, some con-
venient method of adapting the dynamic current to our several pur-
poses is very desirable ; with this in view I have designed a switch-
board, with suitable resistances and shunts conveniently arranged,
which admirably answers the purposes for which it is intended. It
consists essentially of a series of carbon resistances arranged in
sets ; each carbon rod is placed in a glass tube and has a resistance
of about 25 ohms. ; the rods are capped with brass screw pieces,
by which they are coupled up for the various purposes indicated
on the face-plate, namely, a 32 c.p. lamp, a 2^ c.p. throat or mouth
lamp, a motor, mallet, cautery, and medical or induction coils.
The 32 c.p. lamp acts a double purpose, namely, as a resistance in
series with the throat lamp, and as a powerful illuminating medium
for special purposes. A feature in the board is a set of carbons,
each of about 14 ohms resistance, arranged as shunts to the resis-
tance carbons ; these are placed at the base of the board with a
switch to bring them into play. With this double arrangement of
resistance and shunts the current can be regulated to any required
force. The board consists of a mahogany frame having a polished
slate front, upon which are arranged the switches, sockets, safety
fuses and terminals. The glass tubes containing the carbons are
placed between thick sheets of asbestos board, and a clear ventila-
tion runs through the board. The motor answers admirably for
dental and surgical purposes, such as the working of circular saws,
trephines, drills, etc. It can be worked or regulated by increasing
or decreasing the pressure of the foot on a treadle, or indepen-
dently of the treadle by shifting the motor plug into the socket be-
low, and bringing the shunts into pla}', by means of which the
motor can be worked at any speed, from a gentle revolution of the
armature up to a speed of about 5,000 revolutions per minute. In
my own house I have had a special wire laid on to lead the current
to the board independently of the leads for the house illuminations;
this I think a good plan, for the extra cost is trifling (in my case
p{^2), and a good current is thus obtained, while the risk of inter-
3-'4
THE DEXTAL REVIEW.
rupting the illuminating current by short circuiting or otherwise is
avoided.
I have had a board on a smaller scale, but similar to the one here
described — in use with a powerful battery for years, and my new
board I have had in use some few months with perfect satisfaction.
The board here described was made for experimental as well as
practical purposes, and consequently is rather more complicated
than is necessary for dental uses, therefore Messrs. Miller & Woods,
electricians of Gray's Inn Road, to whom I am indebted for the
very satisfactory way they have carried out my suggestions, have
now modified the original designs, produced a board less compli-
cated, and consequently more suited to dental purposes. The ac-
companying illustration gives a very good idea of the general out-
lines of the nev/ board.
A milliampere meter can be introduced into the circuit by which
the current or " dose" of electricity to be administered or used,
can be estimated with sufficient accuracy. — The Dental Record.
Chart of Tvimcal Forms of Constitutional Irrkgulakities of
THE Teeth.— By Eugene S. Talbot, M. D. D. D. S., Chicago.
Published by the Wilmington Dental Manufacturing Co., Phil-
adelphia, ]8»1.
REV/EJVS AND ABSTRACTS. 335
This collection of plates is published by the author in support
of his well-known theory, according to which certain irregularities
of the teeth are due to constitutional causes. The work contains
the following tables:
I. Jaws in normal position.
II. Excessive development of superior maxilla; arrest of devel-
opment of inferior maxilla.
III. Excessive development of the superior maxilla and the
rami of the inferior maxilla; arrest of development of the body of
the inferior maxilla.
IV. Excessive development of the rami of the inferior max-
illa.
V. Arrest of development of the inferior maxilla.
VI. Arrest of development of the rami and excessive develop-
ment of the body of the inferior maxilla.
VII. Excessive development of the superior maxilla and
alveolar processes.
VIII. Arrest of development of the superior maxilla.
IX. V-shaped arch.
X. Partial V-shaped arch.
XI. Semi V-shaped arch.
XII. Saddle-shaped arch.
XIII. Partial saddle-shaped arch.
XIV. Semi saddle-shaped arch.
XV. Semi V and semi saddle-shaped arch on one side and
semi V-shaped arch on the other side.
XVI. Semi V and semi saddle-shaped arch on one side and
semi saddle-shaped on the other side.
Catching's Compendium.
The price of Catching's Compendium of Practical Dentistry
for 1891 is $2.50 instead of $2.00, as stated in last month's Dental
Review. Send orders to Dr. B. H. Catching, Atlanta, Ga., for both
volumes.
Pamphlets Received.
Noncohesive half cylinder and loop filling by Isaac B. Daven-
port, M. D., M. D. S. Articulation of the teeth by the same author.
Reprints from Dental Cosmos.
826
THE DENTAL REVIEW.
DENTAL COLLEGE COMMENCEMENTS.
STATE UNIVERSITY OF IOWA— DENTAL DEPARTMENT.
The Tenth Annual Commencement Exercises of the Dental Department of
the State University of Iowa, were held at the Armory. Iowa City, Iowa, on Thurs-
day. March 10. 1892. The annual address was delivered by John J. R. Patrick,
D. D. S. The degree of Doctor of Dental Surgery was conferred by the Presi-
dent, Charles A. Schaefifer, Ph.D.. upon the following named (57) graduates :
M. F. Anderson, Muscatine.
Fred. Anderegg, Mankato, Minn.
H. W. Anger. Brooklyn.
R. N. Baker. Iowa City.
J. W. Ball. Delaware.
F. A. Boysen, Dubuque,
Hugo Braun. Davenport,
H. W. Baldwin, Oconomowoc, Wis.
M. Brennan, Ashland, Wis.
J. C. Bralev, Harvey, 111.
C. P Burt,' Elwood, 111.
E. H Ball, Philips. Neb.
M. H. Breen. Le Mars.
J. F. Curry, Friendship, N. Y.
F. P. Chapman. Ciarinda, Iowa.
W. A. Dredge. Amboy. Minn.
C. F. Dwight. Marcus.
E. S Denbo, Corydon, Ind.
L A. Grigsby. Lena, 111.
J. C. Holson, Iowa City.
J. C. Hullinger. De Witt.
W. S. Hosford, Iowa City.
M. A. Humphrey, Minona, Iowa.
T. B Heckert, Red Oak, Iowa.
D. A. Haines, Decorah. 4
L. G Holmes, Burmingham.
H. M. Harlan. Seymour.
M. A. H. Jones. Iowa City.
C. H. Jacobs. Colesburg.
Harry Kelso. Ames.
E. W. Kerr, Newton.
C. B. Miller, Waterloo.
J. G. McCartney, Mitchell, S. Dak.
H. C. McCrea, Greenfield.
E. S. McWhorter, Canon City.
Miss O. A. Olte, Peabody, Kas.
Miss Julia Otte, Peabody, Kas.
Miss A. E. Owens, Parkersburg.
W. H. Pallett, Dorchester, Neb.
W. W. Perry, Elizabeth, 111.
B. A. Price, Afton.
H. R. Pasedach, Tipton.
G. F. Pratt, Red Oak.
E. A. Rogers, Vinton.
H. F. Randolph, Belle Plaine.
G. H. Reynolds, Binghampton, N.Y
H. C. Schoemaker, Muscatine.
Wm. Schlawig, Sioux City.
W. G. Skidmore, Moline, 111.
J. E. Stinehart, Iowa City.
T. S. Stanford, Cambridgeboro, Pa.
S. R. Swain, Iowa City.
O. H. Sossaman, Waterloo.
F. A. Strayer, Jefferson.
M. W. Warner, Parkersburg.
R. J. Wilson, Oelwein.
F. R. Wright, Morning Sun.
OHIO COLLEGE OF DENTAL SURGERY— DEPARTMENT OF DEN-
TISTRY—UNIVERSITY OF CINCINNATI.
The forty-sixth annual commencement of the Ohio College of Dental Surgery,
Department of Dentistry — University of Cincinnati, was held at the Odeon. Cin-
cinnati. Ohio. Wednestlay, March 9, 1892.
Conferring of degrees and address. James Leslie, D. D. S., of the Board of
Trustees.
Awarding of prizes, Prof. H. A. Smith, Dean of the Faculty.
Address, "The Demands of our Times upon Professional Men," Dr. W. O.
Thompson. President of Miami University.
Class oration. Garrett A. Billow, of New Carlisle. Ohio.
PRIZEMEN.
A gold medal to H. J. Custer of Ohio, for the best general examination in
senior class.
DENTAL COLLEGE COMMENCEMENTS.
327
A gold medal to H. T. Hawkins, of Ohio, for the best attainments in the op-
erative department.
A gold medal to G. C. Minturn, of Ohio, for the best attainments in the pros-
thetic department.
A silver medal to G. A. Billow, of Ohio, for the best examinations in chem-
istry and materia medica.
A silver medal to Jas. H. Robinson, of Canada, for the best examinations in
physiology and general pathology.
A silver medal to T. C. White, of Ohio, for the best examinations in anatomy
and oral surgery.
A silver medal to S. H. McCleery, of Pennsylvania, for the best examinations
in operative dentistry and special pathology,
A silver medal to W. B. Fahnestock, of Ohio, for the best examinations in
mechanical dentistry and metallurgy.
A silver medal to F. A. Lush, of Ohio, for the best general examinations in
junior class.
The number of matriculates during the session was 143.
The following named are the (89) graduates :
John Ray Adair, Kentucky.
Alexander Scott Ager, Ohio.
Anthony Lewis Amann, Ohio.
Charles D. Arthur, Pennsylvania.
Charles P. Balger, Ohio.
Isaac Pettit Bell, Canada.
Porter Adolphus Bereman, Ohio.
Charles Solomon Beyl, Ohio.
Garrett, Allen Billow, Ohio.
Will Gavitt Bradford, Ohio.
Louis Arnold Broring, Ohio.
Harry Lincoln Brown, Illinois.
Fred C. Burnham, Ohio.
Julian Caswell Cavagna, Ohio.
Henry M. Chaney, Ohio.
George Amos Chapman, Washington.
Charles Campbell Cherryholmes, Neb.
Josewh Boran Cochran, Kentucky.
Charlie Alvie Cole, Ohio.
John Lorenzo Conn, Kansas.
Neclessen S. Cox, Indiana.
Robert L. Criswell, West Virginia.
Harrison James Custer, Ohio.
Miss Hattie A. Dobell, Indiana.
Elvin Parker Eddy, Ohio.
William Baker Fahnestock, Ohio,
Phillip Robert Feigle, Kentucky.
Orlando Moses Flinn, Indiana.
Edward Bradley Greenlee Ohio.
Alex- Hall, Canada.
Ernest Rush Hall, Ohio.
Frank P. Hamilton, Ohio.
Clement Vernon Hargitt, Ohio.
Herman Haupt, Germany.
Homer Thomas Hawkins, Ohio.
Lonzo Carl Hill, Ohio.
Horace Anson Holmes, Michigan.
Curtin Joseph Howe, Pennsylvania.
Harold Lorenz Jensen, Louisana.
Archie Hubert Johnson, Missouri,
David Saylor Johnson, Pennsylvania.
Allen John Kimm, Indiana.
Augustus Fayette Knapp, New York.
Henry Charles LeBeau, Ohio.
Robbins Foster Lilly, Ohio.
George Love, Ohio.
Will Marquart, Ohio.
William Harrison McAdow. Ohio.
Samuel Hampton McCleery, Penn.
Louis Eugene Menuez, Ohio.
Charles Willett Mills, Ohio.
George Campbell Miniurn, Ohio.
Leon David Monks, Pennsylvania.
George Edward Moore, Canada.
H. Sterling Moore, Ohio.
Montie A. Morey, Michigan.
Edward Parker Nugent, Kansas.
David Cochran Patterson, Kentucky.
Edwin Auber Peebles, Ohio.
King Sansom Perry, Pennsylvania.
Robert Gale Pinney, Missouri.
Wilber Nathan Priddy, Kansas.
William Alonzo Pride, Ohio.
Henry William Radcliff, Wisconsin.
Frank Benjamin Rees, Ohio.
Oliver Taylor Robertson, Ohio.
James Holton Robinson, Canada.
Edwin Launder Ross, Ohio.
Daniel Ulrich Ruegsegger, Ohio.
Rudolph Schmid, Switzerland.
Albert Edward Sexton, Indiana.
Charles William Sodders, Ohio.
Talmon H. Speece, Ohio.
Henry Marion Smith, Minnesota.
THE DEXTAL REVIEW.
Charles Willard St. Clair. Ohio.
James Berry Stewart, Ohio.
William Harold Tenney, Ohio.
Clyde Everett Townley. Pennsylvania.
Joseph Armstred Turner, Ohio.
Rees L. H Turner, Missouri.
Francis Marion Van Buskirk, Ohio.
Horatio Frank Vandervort. Ohio.
Thomas Corwin White. Ohio.
John C. Wilde, Jr., Michigan.
William Elmore Wilkinson, Ohio.
Ellsworth Williams, Indiana.
Franz Ellias Willison, Michigan.
Mrs. Mellie C. Winslow, Indiana.
Sherman Tecumseh Yaple, Ohio.
CHICAGO COLLEGE OF DENTAL SURGERY.— DENTAL DEPART-
MENT OF THE LAKE FOREST UNIVERSITY.
The tenth annual commencement of the Chicago College of Dental Surgery
was held at the Columbia Theater, Chicago; Tuesday, March 22, 1892.
The class valedictory was delivered by Hans Bastian Wiborg, D. D. S. The
doctorate address by C. N. Johnson, L. D. S. D. D. S.and an address by W. C.
Roberts. D. D. LL D., President of the University The degree of Doctor of
Dental Surgery was conferred by Dr. T. W. Brophy, Dean of the College on the
following named (128) graduates:
Number of matriculates for the year 303.
Albert Bromley Allen.
Clarence Edson Allshouse,
George Henry Anderson.
Gustave Edward Anderson.
Huboard Gail Atwater,
Ernest Allin,
Manning Andrus Birge.
Thomas Jefferson Borland.
Jabez Bunting Burns.
John L Bingham.
Lemuel Fairfax Buck.
Calvin Fergeson Besore.
Albert Leslie Bents.
Samuel Hardesty Baker.
Mark Robert Brierly
Benjamin Dornblazer Barber.
John William Beetham.
F"rank Carlton Colby.
Charles Robert Currier.
Harlow Arthur Cross
Curtis Hammond Coe.
Frank L Condit
Bert C Campbell.
John Corwin.
Robert Clark Coy.
Herbert Armstrong Carson.
Orie George Collins.
Albert Paul Condon.
Amos Winship Dana.
Will Conger Dunn.
James House Davis.
Claude Howard Devereaux.
Frank P-imer Davis.
Hiram Darling
Lewis Mathias Doerr.
Henry Wallis Ewing.
Albert Eugene Eagles.
William Edgar Ervin.
Walter Howard Fox.
Lewis Eugene Ford.
Allen Joseph Freeman.
Frank Oren Finley.
Herman Peter Fischer.
Lawrence Sylvester Fezer.
George Emil Franke.
Edward M. S. Fernandez.
George Ramsey Guild.
John J. Geary.
Robert Good.
Jeremiah Gochenour.
Francis Marion Gray.
Alfred J. Homfeld.
Julian Frank Hixon.
Augustus Finley Henning.
A. Gallagher Hebberd.
Marion L. Higgins.
Robert Anderson Howell.
F'red Armstrong Ironside.
Albert Hamilton Johnston.
Albert George Johnson.
Austin Flint James
Frank King.
Ernest Venzel Kautsky.
William Frederick Leu.
Lewis Schuyler LaPierre.
Frank Leslie Lane.
William Arthur Lewis,
Hallvard Lie.
William Cutler Lumpkin.
Oscar Edward Meyer.
John Franklin McCrea.
William Ephraim Martin.
DENTAL COLLEGE COMMENCEMENTS.
329
Herman Minges.
John Simpson McQueen.
John Benedict Mason.
Henry Bruce Meade.
Walter John Morrow.
John Henry Muenster.
Samuel Alexander Nielson.
Bert Newsome.
James Toberman New.
John Egbert Lyman.
Charles H. Oakman.
Charles Fremont Palmer.
Albert James Prescott.
James Lyon Palmer.
William Abram Penn.
Franklyn Pfeiffer.
George Thomas Page.
John Dominic Purcell.
William Conover Parsons
Frank Everett Phillips.
George Samuel Root.
Dennis Herbert Rowells.
Fred Emerson Reynolds.
Charles Bennett Reynolds.
James Arnold Reynolds.
William Woods Robbins.
Joseph Herbert Robinson
Victor Hugo Rea.
Edgar Miner Richards.
Robert Hutchison Robertson. "
Omro Elmer Severance.
Bertram Grey Smith.
Ard Patterson Smith.
Fred John Staehle
George Mackay Sutherland.
Sylvester Elmer Stouffer.
John Franklin Stephan.
James Byron Stuck.
Jeffrey Springle.
Carl Oscar Wilhelm Schycker.
Sebastian Ricardo Salazar.
Paul Steinberg.
Arthur George Tibbitts.
Richard Elmer Thexton.
Edgar Felker Thomas.
Herbert Hawkesworth Tyler.
Edward Robert Victor.
Mathew Wilson.
Hans Bastian Wiborg.
James Abram Welch.
Clarence Walter Williams.
Charles Albert Wedge.
Fred H. Wallace.
Frank Pierce Welch.
William F. Whalen.
Louvain Alden Werden.
PHILADELPHIA DENTAL COLLEGE.
The twenty ninth annual commencement exercises of the Philadelphia Dental
College were held at the Academy of Music, Philadelphia, Pa., Thursday, Feb.
25th, 1892.
The address to the graduates was delivered by Prof. S, H. Guilford, D. D. S.,
Ph. D. The valedictory by J. R. Coleman, D. D. S.
The degree of Doctor of Dental Surgery was conferred upon the following
named (142) graduates.
Egerton S. Allen, N. S.
Courtland J. Allen, R. I.
J. Wilmot Angwio, Can.
H. D. Atkinson, Mo.
Vincent J. Baggott, R. I.
Adolf Balcke, Germany.
J. D. Ballard. New Jersey.
William A. Bartlett, Jr., Me.
Howard S. Bath, Canada.
Johannes A. Baumgardt, Germany.
Frank G. Bedell, N. Y.
Fred W Benz, N. Y.
Neil H. Bishop, Ohio.
John A. Blackett, Australia.
Sylvester J. Bourgeois, La.
D. L. Bower, Pa.
Arthur M. Bowman, N. Y.
Gertrude A. Bright, England.
Joseph Brooks, Canada.
Edwin D. Butterworth, N. Y,
Frank J. Bush, N. Y.
Hugh F. Calder, N. S.
Charles Cameron, Can.
E. E. Cawood, Ore.
Arthur J. Chilcott, Me.
John A Clark, Can.
J. Edwin Clark, Pa.
J. Robinson Coleman, Can.
Edward B. Cottrell, N. J.
Oscar B. Crawford, Pa.
Robert Crawford, Australia.
Wilbur B. Cresswell, Pa.
J. Maurice Crosby, Can.
William A. Crow, Can.
Wm. N. Daniels, Mass.
Jacques S. David, Roumania.
Wm. F. Dohrmann, Cal.
R. E. Duignan, N. Y.
380
THE DENTAL RE VIE IK
L F". Eaton, Conn.
Elma H. Edgar, N. Y.
David L. Edwards, N. Y.
Frank A. Elson, Ohio.
Edmund P. Ennis, Canada.
H. H. Erskine, Ohio.
Deering J. Fisher, R. I.
Christopher E. Fletcher, Mo.
Charles A. Frain, Can.
Carlos Formas Fuentes, Chili.
Edwin Russell Gamble, Pa.
Alexander J. Gillis. Mass.
Chas T. Gliden, Pa.
Wesley Good, Mo.
Sidney W. Gordon, Can.
Leslie H Grant, N. J.
Francis H. Greusel, A- B., Mich.
John Grieder, Jr., N. J.
Percy Loucks Haight, N. Y.
Herbert E Hall, B. C.
Charles Ransom Hambly, 111.
R. S. Hanna, Can.
Richard C. Hart, N. Y.
Harrie Tralee Harvey, Mich.
VV. G. Henry, Pa.
\V. E. P. Hewitt. Can.
F. B. Hewett. N Y.
R. Russell Hogue, Ga.
Thomas C. Hutchinson, Iowa.
John L Jamieson, Ohio.
Bertha M. Jarrett, Pa.
William Jones, N. Y.
Elton E. Jordan. Maine.
Lewis H Kalloch, R. 1.
H. P. Kenney, Can.
C. J. Kennerdell, Pa.
Chas .\. Kendall, Can.
Jas. A. Kent, Minn.
Frank W Ketner, Pa.
Howard Kingsbury, Pa.
E. L Lane, Ore.
Edgar D Larkin. Pa,
Albert W. Lavelli. Conn.
Arthur Lemieux. Can.
T. Segall Levien, Russia.
Samuel Loebenstein, Mo.
Charles N. Lord. N. Y.
Frank R Lord. N Y.
F. M. Lynch, Washington
James A. Lynch, Mass
Peter M. D McGill, N. J
A P. Mclnnis, Minn.
John J. McKinstry, Pa.
A. J. L. McKechnie, Can
James A. McLaren, Can
P. J. Macdonald, Mass.
Hugh S. Mackay, Can.
Carl C. Marggraff. Conn.
W. E. Marshall, Can.
Charles F. Meacham, Vt
L. D. Mitchell, Can.
Harry C. Moore, Del.
E. H. Munger, Conn.
Walter B. Ousley, Iowa.
E. C. Palmer, Neb.
W. T. Pearsoll, Pa.
Mme. Marie Pedemonte, Austria.
Oliver K. Pellman, Pa.
Edward J. Pierce, N. Y.
Glenn F. Pollard, N. Y.
W. Henry Povall, N. Y.
J. B. Pressey, N. J.
J. W. Purdy, Can.
R. L. Randall, N. Y.
Adolph G. Reinhardt, Pa.
C. H. Reynolds, Pa.
Henry W. Richards, Utah.
Duncan P. Robertson, Can.
Jonas S. Rosenthal, Pa.
Louis L. Ruppert, N. J.
David A. Scobie, N. Y.
G. W. Schock, Jr , Pa.
Maurice P. Searle, Ohio.
Frederick F. Beavers, Minn.
W. B. Sherman, Cal.
J. C. Shields, Jr., Ore.
Ella R Shinn, N. J.
Edward Shotthafer, N. Y.
E. R. Simmons, Germany.
John L. Spanogle, Pa.
J. Henry Stackhouse, Can.
Milo H Steel, Can.
Robert J. Stevens, Can.
Margaret E. Taylor, Pa.
Zane B Taylor, Pa.
D. A. Telfer, Wis.
A. Howard Thomas, Pa.
Georee K. Thomson, Can,
J. Melville Thompson, N. Y.
Frank L. Warren, N. Y.
Hugh A. Whytock, Utah.
L. N. Wiley. Conn,
Charles D. Winsor, R. I.
Wallace Wood, Jr., La.
UNIVERSITY OF MARYLAND.
The annual commencement of the Dental Department of the University of
Maryland was held at the Lyceum Theater, Baltimore, Md., Thursday, March 17,
1892.
DENTAL COLLEGE COMMENCEMENTS.
331
Reading of mandamus by the Dean, Prof. Ferdinand J. L. Gorgas, M. D.,
D. D. S.
Conferring of degrees and award of prizes, by Hon. S. TeackleWallis, LL. D..
Provost of the University.
Address to the graduates, by Rev. William T. Roberts, of Virginia.
Class oration, by H. Janney Nichols, Virginia.
The number of matriculates during the past session was 127. The following
is the list of (73) graduates :
W. Wolsley Alton, Canada.
Walter C. Anderson, Va
Fletcher G. Asbill, S. C.
Dabney G. Barnitz, Va.
Charles F. Baylis, N. Y.
John C. C. Beale, Md.
Alexander J. Beville, Texas.
Samuel E. Braendle, Canada.
Winfield S. Burd, Pa.
Andrew S. Burke, Pa.
W. Bolivar Byers, S. C.
E. Marcellus Copenhaver, Va.
W. Felton Deekens, Va.
J. Harry Deems, jr., Md.
William W. Dennis, Ga.
John H. Diddle, W. Va.
William E. Dobson, N. Y.
John Lyons Doremus, France.
Eben B. Edgers, Vt.
Robert W. Eicholtz, Pa.
Louis Ewig, Switzerland
C. Dixie Farriss, Ga.
Lawrence S. Fox, N. C.
Edwin J. Gill. N. C.
Eli Harmon Glasscock,
George H. Hargrove, S.
Oscar J. Harmon, N. H.
Lewis E. Hess, Md.
Frederick C. Humberg, Md.
Hugh Barbour Hutchison, Va.
Benjamin L. Jefferson, Ga.
Silas J. Johnson, Va.
B. Arthur Jordan, Cal.
James M. King, Canada.
C. Rogers LeFevre, Md.
J. Clinton Macomber, Pa.
Thomas Rollins Marshall, Va.
Mo.
C.
Anthony H. Mathieu, Md.
W. Glenn McGee, S. C.
George A. McGuire, Canada.
Robert J. McHarg, Canada.
J. Morton Mcllvain, Md.
C. Augustus Mitchell, N. Y.
Harry B. Mitchell, N. Y.
H. Janney Nichols, Va.
Clyde Sylvanus Payne, Cal.
George C. Probst, S. C.
George B. Quinlan, N. Y.
Turner A. Ramey, W. Va.
Joseph L. Rathie, Va.
E. Edington Reynolds, N. Y.
Jacob Riser, Iowa.
Edmund D. Shaw, N. Y.
James W. Simpson, Va.
Will R. Simpson, S. C.
Harry Blackburn Smith, Bermuda.
Charles B. Stouffer, Pa.
M. Emmert Stover, Pa.
Arthur O. Thomas, S. C.
William A. Thrush, 111.
Die P Tipton, Neb.
Arminius W. Totten, N. C
William H. Van Nostrand, N. Y.
Harry Van Tassel, S. D.
Joseph M Veza, Austria.
Frank Von Wachter, Md.
J. Willie Watson, W. Va.
Montgomery Lewis White, Texas.
Charles G. Wiley, Pa.
Henry A. Wilson, Md.
Edward Kirk Woods, N. H.
A. Watson Woodward, Va.
J. Harvey Wool, Va.
NEW YORK COLLEGE OF DENTISTRY.
The Twenty-Sixth Annual Commencement of the New York College of Den-
tistry was held at Chickering Hall, New York City, Thursday, March 10, 1892.
The number of matriculates was 273. Awarding of prizes was by Prof.
Faneuil D. Weisse, M. D. The valedictory address was delivered by Henry P.
King, D. D. S., of the graduating class. The address to the graduates by Wm.
H. McElroy, Esq.
The degree of Doctor of Dental Surgery was conferred by Wm. T. LaRoche,
D. D. S., Vice President of the Board of Trustees, on the following named (86)
gentlemen :
332
THE DENTAL REVIEW.
John Patrick Burke,
Miksa Lipot Braun.
Edward Santley Butler,
Walter Benney,
Frederick Brueckner,
Eugene Bonilla y Cuibas,
James Edward Byrne,
Henry Emile Bischof,
John Francis Buckley,
Carl Rudolph Otto Bickel,
Albert William Crosby,
John Phillip Cromwell,
Edward Archibald Crostic,
George Edward Christie,
Martm Lawrence Collins,
Nelson Millard Chitterling,
Louis Bristol Daboll,
Harry Clav Derby,
Richard Francis Doran,
Anthony Charles Durschang,
Joseph Fuld,
H. Clay Richardson Ferris,
Finn. Fosheim,
Edgar Ozias Goodell,
John Francis Goger,
VValter Harris Gardner,
William Henry Garratt,
Dexter Glennon Gordon,
Charles Frank Guntner,
Charles Casselman Gibson,
Joseph Gluck,
Joseph Harvitt,
John Henry Hughes,
Wm. Henry Moore Hamlet,
Peter James Heffern,
Otto George Hoffman,
Orion Perseus Howe,
Henry Dryer Hatch,
Byron Edward Joubert
George Washington Koles,
Eli Koles,
Harry Taylor Kelsay,
Isaac Kroch.
Henry Palmer King,
Henry Albert Kregeloh,
Ernest August Kolling,
Frank Belknap Long,
F'rank Leroy Lockvvood,
Alfred Tennyson Lockwood,
W. Hawthorne McCutcheon,
Miguil Ramon Mangual,
F"rank Lester Munsell,
Augustus MacCollom, Jr.,
Julius Adolph Mayer,
Alonzo Silas Mead,
Edward William McNeil,
Frederic Thomas Murlless, Jr.
Henry Alfred Neech,
F"rederick Smith Parsons,
Henry Amon Parmentier,
George Elbert Reynolds,
George Alphonse Roussel,
Samuel Schnaper,
Frank Schroeder,
Aug. Vancortlandt Stebbins,
Henry Josiah Stacpoole,
.Jacob Schnaier,
E. Warren Sylla,
Henry Gustav Schroeder,
Edward John Moritz Seebold,
Engelbert Stoetzer,
Mario Tolosa y Polidura,
Ezra Oakley Taylor,
Zebulon Scriven Taylor,
George Vande Verg,
Orwill Van Wickle,
George Putnam Willis,
Edwin Chapin Wallace,
Henry Lamont Wheeler,
Frank Jackson Woodworth,
Augustine Joseph Walsh,
Edgar Williams,
Willie Jackson Ward,
Leon Jabez Weeks,
Harry Fones Whitter,
Floyd Marcus Zelie.
MISSOURI DENTAL COLLEGE.
The twenty-sixth annual commencement exercises of the Missouri Dental
College, Dental Department of Washington University, were held in Memorial
Hall. St. Louis. Mo., on March 10. 1892.
Professor Wm. T. Porter delivered the address to the class.
Prizes were awarded as follows ; St. Louis Dental Society prize— Gold medal
for the best general examination to Orion W. Bedell, D. M. D., of Ohio.
J. W. Wick prize — Twenty-five dollars in gold for the second best examina-
tion to Everett M. Hurd, D. M. D. of Nebraska.
The S. S. White Dental Manufacturing Co. prize — A set of Varney pluggers
for excelling in operative dentistry, to Orion W. Bedell, D. M. D., of Ohio.
DENTAL COLLEGE COMMENCEMENTS.
333
John Rowan Dental depot prize — A Bonwill engine mallet No. 2 for second
best in operative dentistry, to Frederick W. Achelpohl, D. M. D., Missouri.
St. Louis Dental Manufacturing Co. prize— A laboratory lathe for the best set
of artificial teeth, to Joseph L. Bridgford, D. M. D., Missouri,
There were seventy-seven matriculates and thirty-three graduates.
A. H. Fuller, Sec'y.
Chancellor Chaplin, of the university, conferred the degree of doctor of
dental medicine upon the following named (33) graduates;
Frederick H. Achelpohl, Mo.
George W. Appelgate, Mo.
Orion W. Bedell, Ohio.
Joseph L. Bridgford, Mo,
Otis F. Burton, Mo.
Herman F. Cassell, Mo.
Isaac B. Coil, Mo.
Clarence C. Cowdery, Ohio.
William G. Co.\, Mo.
William G. Goodrich, Mo.
Lawrence E. Gordon, 111.
Christy G. Hampton Mo.
Richard I. Hart, Wis.
Thomas D. Head, Mo.
Everett M. Hurd, Neb.
Willard P. Inglish, Mo.
Sigmund Jacoby, Mo.
William Kalbfleisch, 111.
Alfred Lambert, 111.
Arthur N. Milster, Mo.
Otto Mallinckrodt, Mo.
Arthur T. Moser, Mo.
Christian Muetze, Mo.
Ormund H. Manhard, Mo.
Henry F. Naumann, Mo.
John L. Perry, 111.
Walter L. Pruett, Mo.
William F. Schwaner, Iowa.
Emil Schaer, Switzerland.
Otis Trotter, Mo.
William G. Teel, Va.
Harry G. G. Van AUer, Germany.
Frank F. Worthen, 111.
WESTERN DENTAL COLLEGE.
The Second Annual Commencement Exercises of the Western Dental College
were held in Music Hall, Kansas City, Mo., on Thursday evening, March 10, 1892.
The Faculty Address was delivered by Professor H. O. Hanawalt.
The number of matriculates for the session was seventy-nine.
The degree of Doctor of Dental Surgery was conferred upon the following (38)
graduates by the President of the College:
L. P. Austin, N. Y.
K. P. Ashley, Kan.
W. C. Allen, Mo.
E. C. Brownlee, Mo.
A. C. Barr, 111.
W. H. Condit, Kan.
T. H. Cunningham, Mo.
F. W. Drom, Neb.
R. E. Darby, Mo.
Fred. M. Franklin, Mo.
F. E. Gaines, Mo.
T. J. Henkens, Kan.
T. I. Hatfield, Kan,
D. J. Hayden, Kan.
William Harrison, Mo.
C. C. Jones, Kan.
L. G. Jones, Kan.
S. E. Johnson, Kan.
F. W. Johnson, Mo.
Otto Jacobs, Mo.
0. J. Kemper, Mo.
C. B. Leaver, Mo.
1. B. Nordyke, Mo.
P. J. Oriley, Mo.
S. T. Peter, Neb.
C. Robertson, Jr , Kan,
H. H. Sullivan, Mo.
W. W. Simpson, Kan.
A. L. Smith, Mo,
J. F. Spence, Mo.
J. H. Swan, Mo.
E. C. Taylor, Mo.
M. D. Vanhorn, 111,
O. C. West, Mo.
Frank S. Webster, Kan.
A. S. Wright, Mo
H. Yant, Kan.
Mrs. Alice Yant, Kan.
334
THE DENTAL REVIEW.
BALTIMORE COLLEGE OF DENTAL SURGERY.
The fifty-second annual commencement exercises of the Baltimore College of
Dental Surgery were held at the Lyceum Theatre, Baltimore, M.D., March ai,1893.
Matriculates during the past session, 181;
Conferring of class honors by Prof. M. W. Foster; Gold medal, Emile Gros-
beintz; silver medal, Clinton Kenney.
HONORABLE MENTION.
Robert Ivey Robertson.
James Walker Moore.
Patrick McCabe.
Clarence Hervey Terry.
Charlie Hurvey Winburn.
Nelson Henry Ehle.
Mortimer Lewis Fay.
Baskerville Bridgforth.
Alexander Francis.
Charles Covington McCloud.
Isaac Abner Frazer.
Charles Alberto Bland.
William Carpenter Callahan.
Fred Wickham Sweezy.
Walter Caldwell Carter.
John Emerson Storey.
Robert Steele Cole.
William Aydelotte Taylor.
Zadoc Prescott Shaw.
Emmett T. H. Leonard.
Archer C. Griffith.
Edgar Watts Marven.
Fred Allan Ford.
John Saylor Donaldson.
Peter Alexander McLean.
James Thomas Stuart.
Joseph Donaldson Whiteman.
John Neven Baker.
Awarding of prizes by Dr. Fred A. Levy, President Board of Visitors. Opera-
tive: First prize, James Thomas Stuart; Very Honorable Mention, Harry Wil-
son Knauff; Honorable Mention, Isaac Abner Frazer. Mechanical; First Prize,
Baskerville Bridgforth; Honorable Mention, James Thomas Stuart. Bridge
Work: First Prize, John Elisha Parker; Honorable Mention, Albert Galiton
Tillman, Essay on Orthodontia: First Prize, prank Harper Jackman; Honorable
Mention, Rudolph Louis Zelenka.
Annual Oration by Rev. F. M Ellis. Valedictory by Philip Ernest Sasscer,
Me. Prizes given. First Honor by Faculty; Second Honor, by James Hart;
Operative, by Snowden and Cowman- Mechanical, by S. S.White Dental M'fgCo. ;
Bridge Work, by S. S. White Dental M'fg Co.; Essay, by Dr. J. N. Farrar, N. Y.
The degree of Doctor of Dental Surgery was conferred by R. B. Winder, M.
D., D. D. S., Dean of the College, upon the following named (102) graduates:
Benjamin Dorney Altemus, Pa.
Charles Wesley Arird, Pa.
John Neven Baker, Pa.
Irwin Joseph Beach, Md.
William James Beatty, Pa.
James C. Buchanan, Pa.
William Carpenter Callahan, N. Y.
Walter Caldwell Carter, Mo.
Frederick Abraham Charles, Mass.
Charles Alvin Cochel, Md.
James Robert Donaldson, D. D. S.,Col.
Harry Donnan, Pa
Benjamin P'ranklin Dulaney, Tex.
Nelson Henry Ehle, Minn.
Mortimer Lewis Fay, N. Y.
John Newton Giddens, Ala.
Richard Lee Gill, Md.
Washington Irving Goodwin, Canada.
Harry White Graham. Pa.
Archer C. Griffith, Cal.
Julio Hidalgo, Venez'a.
W. S. Holbrook, N. J.
Frank Harper Jackman, Conn.
Alexander Jekelfalusy, Wis.
George Marshall Jones, Iowa.
Milo Dempsey Kottraba, Pa.
Robert Milton Krebs, Pa.
Joseph Edwin La Force, Ore.
Emmet T. H. Leonard, Miss,
lames Isaac Logan, Ala.
Simon Bernard Meyer, Md.
Patrick McCabe, Australia.
Charles Covington McCloud, La.
Geoige Bradley McFarland, E. Ind.
Wijliam Henry McGraw, Pa.
Louis Ambrose Reinhart, Md.
DEXTAL COLLEGE COMMENCEMENTS.
335
Isaac Lemuel Ritter, Pa.
Robert Ivey Robertson, Canada.
Ryland Otey Sadler, N. C.
Philip Ernest Sasscer, Md.
John Emerson Storey, Tex.
James Thomas Stuart, Ala.
Fred Wickham Sweezy, N. Y.
William Aydelotte Taylor, Md.
Fred Aubrey Taylor, Canada.
Thomas Frederick Warnes, N. Y.
William Henry Walters, Md.
Joseph Donaldson Whiteman, Pa.
Edgar Lucis Wilder, Vt.
Benjamin Hicks Williams. Ga.
David Morris Wilson, N. Y.
Charles Alberto Bland, N. C.
Charles Wallace Boucher, Md.
Harvey Vankirk Bradshaw, Pa. ♦
Baskerville Bridgforth. Va.
Burt Bernard Brumbaugh, Pa.
Robert Steele Cole. N. C.
Edwin Davis, Pa
Willey Clark Dawson, W. Va.
Jacob William Derlin, Md.
John Saylor Donaldson, D. D. S., Colo.
Howard Roswell Fonda, Vt.
Harley Brooks Ford, Canada.
Fred Allen Ford, N. Y.
Alexander Francis. Md.
Isaac Abner Frazer, Cal.
Emile Grosheintz, D D. S., Switz'd.
Clarkson Newberry Guyer, Col.
George Felder Hair, S. C.
Charles Edward Hamilton, Ga.
Willam Irvine Hatch, B. A., S. C.
Ernest Paul Keerans, N. C.
Clinton Kenney, Conn.
Frederick Henry Kestler, Cal.
Edward Thomas Ketcham, Cal.
Harry Wilson Knauff, Pa.
William Samuel Long, N. C.
William Latimer Lowe, Pa.
Henry Herbst Maloney. A. M., La.
Edgar Watts Marven, Canada.
James Walker Moore, Canada.
Peter Alexander McLean, N. J.
Ellis MacDougall, N. Y.
JohnElisha Parker, Tex.
Leo Arthur Pusey, Va.
Edgar Knox Rainey, Ga.
George Harvey Sayre, N. Y.
Albert Scott Shackleford, Tex.
Zadoc Prescott Shaw, Me.
John Hartwell Smith, Va.
William Henry Stokes, N. Y.
Clarence Hervey Terry, Tex.
William Poole Terry, La.
Albert Galiton Tillman, Miss.
Eduardo Vasquez, Guat'a.
Henry Augustin IVuxillo, La.
Charlie Hurvey Winburn, Ga.
James Isaiah Woolverton, N. J.
Frederic William Wright, Canada.
James Anderson Yates, Ky.
Robert Irving Youngs. N. Y.
Rudolph Louis Zelenka, La.
AMERICAN COLLEGE OF DENTAL SURGERY.
The Sixth Annual Commencement Exercises of the American College of Den"
tal Surgery were held at Hooley's Theater, Chicago, 111., on Wednesday, March 9>
1892, at 2 P. M.
The Valedictory address was delivered by H. E Myers, D. D. S.
The degree of Doctor of Dental Surgery was conferred upon the following
named (66) graduates.
W. C. Brown.
F. F. Brown.
A. J. Bacon.
W. T. Corwith.
C. M. Cody.
C. I. Chase.
George Collins.
C. L. Grossman.
A. E. Crum.
I. B Carolus.
L. M. Darling.
P. E. Douglass.
C. L. Davis.
H. W. Davenport.
E. A. Friis.
R. M. Grimes
A. L. Gilmer.
V. C. Garratt.
W. S. Graves.
W, S. Harter.
R. V. Hurdle.
E. C. Hoffman.
O. C. Hall.
Caroline L. Hartt.
J. Hetu.
C. S. Irwin.
Jennie Loretto Kelly.
H. P. Loomis.
C. L. H. Lennmalm.
W. H. Lillibridge.
J. A. Messenger.
H. E. Meyers.
Geo. W. Mills.
W. N. McKay.
386
THE DENTAL REVIEW.
M. G. E. Marshall.
C. S. Marshall.
\V. T. Morris
A S. Marshall.
W. A. Nelson.
J. M. Oakes.
I. J. Pierce
Edgar Palmer
Josephine D. Pfeifer.
W. E Pilcher.
S. T. Rice.
Fanny M Rowley.
F. C. Ross
Adelaide F. Rix.
W. T. Rogers.
W. E. Slurmberg.
B. R. Simons.
A. E. Si. John.
W. R. Smith.
A. O. Stutenroth.
H. F. Stempel.
C. F. Smith.
Lucy M. Scott
George Steele
Florence E. Thompson.
C. C. Trowbridge.
L. A. Tidball.
H. H. Von Lackum
S. A. Wilson.
I. C. Ward.
H. J. Wallin.
V. S. Wisner.
VANDERBELT UNIVERSITY— DEPARTMENT OF DENTISTRY. "
The thirteenth annual commencement exercises of the Department of Den-
tistry of Vanderbilt University were held at the Vendome Theater, Nashville,
Tenn., on Tuesday evening, March 8, 1892.
The class oration was delivered by C. J. Washington, D. D. S.; faculty ad-
dress by C. S. Stockton, D. D. S.
The number of matriculates for ^he session was one hundred and twenty-six.
The degree of Doctor of Dental Surgery was conferred upon the following
(70) graduates by L. C Garland, L. L. D., Chancellor of the University;
V. W. Alexander, N. Y,
C. R. Adams, Miss.
C. S. Allred, Ala
J. M Ashburn, Tenn.
G. M. Brown, Mich.
L Bland, La.
E. A. Brown. Tex
F. Bartell, 111.
J. A. Beavers, Ala,
J. R Beach, Tenn.
J. S Brown. Miss.
T. K. Barefield, Miss
J P Corley, Ala.
R. H. Carratte. Iowa
R. Z. Chapman, Ala.
J. J. Cook. Michigan
D P. Cook Kentucky.
S. C. Cawthon, Fla.
W J Dillard Tex
J. S. Dalton, Mo,
S. K Davidson. Ky.
E H. Dennisf)n, Conn
C C. Evans, 111
C. Eshleman. Iowa.
T A Fayette, Ala.
F. B Gaither, N. C.
C. B Graham, S C.
W. I. Hale, Ala
W. L Hansbro, Tenn
A. C Jones. Tenn.
R. A. Jones, Jr., Ala.
W. I. Johnson, Ala
E. L. Kendrick, Ala.
B. E. Kidd, Ala.
O. G. Mingledorff. S. C.
T. W. McKell, Miss.
M. B. McCrary, Tenn,
J. M. Murphree, Ala.
C. W. Mathison, Ala.
J. M. Millen, Tenn.
G. Minnick, 111.
A. I. Newcomer, 111.
J. B. Penny, Mo.
J. H. Palm. Germany.
W. H. Powell, La.
A. L. Pedigo, Tex.
M. D. Steele, La.
C. A. Sevier, Tenn.
R. Sanderson, Ala.
F. W. Simons, Tex.
W. K. Slater, Tenn.
C. C. Sims, Ark.
N. W. Sherman, Tenn.
M. O. Sailer. Ky.
H. E. Spencer, Miss.
W. S. Taylor, Ky.
R. E. Thornton, Ga.
F. O. H. Thiele, Germany.
C. J. Washington, Tenn.
V. B. Warrenfells, Va.
DENTAL COLLEGE COMMENCEMENTS.
337
J. D. Wise, Ala.
F. P. Ward, Ala.
W. L. Weathersby, Miss.
N. F. Weatherbv, Miss.
H.-W. Walker, Ga.
V. H. Ward, Miss,
V. A. Williams, Cal.
H. Wiggins. Tex.
A. Walker, Ga.
C. M. Walton, Tenn.
HOWARD UNIVERSITY— DENTAL DEPARTMENT.
The Sixth Annual Commencement Exercises of Howard University Dental
Department, were held at the Congregational Church, Washington, D. C. ,
Wednesday, April 13. 1892. The address to the graduates was delivered by Prof.
Daniel S. Lamb, A. M., M. D. Conferring of degrees and' address by J. E.
Rankin, D. D., LL. D., President of the University. The degree of Doctor of
Dental Surgery was conferred upon the following (8) graduates :
Andrew Gwathney, Virginia. Albert S. Johnson, New York.
John MacDonald, Canada.
COLUMBIA UNIVERSITY— DENTAL DEPARTMENT.
The Fifith Annual Commencement Exercises of the Dental Department of
Columbian University were held at Albaugh's Opera House, Washington, D. C,
Thursday, March 17, 1892.
The address to the dental graduates was delivered by John B. Rich, D. D. S.
The Valedictory by R. M. Geddings, M. D. Award of dental prize by Prof. J.
Hall Lewis, D. D. S., to William L. Clark of the District of Columbia.
The degree of Doctor of Dental Surgery was conferred upon the following named
(5) graduates :
John H. Burch, District of Columbia.
William L. Clark, District of Columbia.
Alva Sigel Roush, A. M., M. D., Ohio.
George H. Townsend, Virginij.
Carl Trede, M. D., Germanv.
TENNESSEE MEDICAL COLLEGE— DENTAL DEPARTMENT.
The Second Annual Commencement Exercises of the Dental Department of
the Tennessee Medical College were held at the Opera House, Knoxville, Tenn.
March 17, 1892. During the year there were forty-eight matriculates The charge
to the graduates was delivered by Prof. J. M. Masters, M. D. Address to the
class by E. T. Sanford, Esq. The degree of Doctor of Dental Surgery was con-
ferred by the Hon. Wm. Rule, Member of the Board of Trustees upon the following
(8) graduates :
John H. McCallie, Idaho. Thos. R. Donnelly, Tennessee.
John G. Foley, Kentucky. Geo. D Rouse, South Carolina.
David Rees, Tennessee. Sam. Bennett, Tennessee.
B. F. Scott, Tennessee. Evan B. Pennington, Tennessee.
338 THE DENTAL REVIEW.
MEMORANDA.
The price of the Doitijl World is $1.00 per annum.
Dr. D. Hayes Agnew, the renowned Surgeon of Philadelphia, is deceased.
Pyoktanin, yellow, applied to mucous patches is an excellent remedy. Use
it full strength.
Dr. G. L. Curtis has removed to New York city to devote his time to the
practice of oral surgery.
Dr. L. N. Seymour, lately of London, England, but formerly of Asbury Park
is now in San Francisco.
There has been established an Oral Institution of Mercy Hospital, at Fifteenth
and Fulton Streets, Keokuk, Iowa,
A court in Florida recently rendered a decision, according to which dentists
do not need any diploma to practice in that State.
The title of Dr. J. W. Cormany's paper to be read at Springfield will be
"Some Needed Reforms." instead of some reforms needed, as it was printed
last month.
Boro-Glycerine, one to twenty, is a good mouth wash, much better when ten
minims of crude carbolic acid is added to each ounce of the solution. It may be
used freely — diluted to suit.
The Viertfljahrsschrift fur Zahnheilkiinde has finished the first part of the
"Index to Dental Literature" collected by Dr. Steinfield and Carl Rellner. The
subject portion will begin at once.
Perfnanganate of potash is recommended for a sterilizer of the hands prior to
the performance of a surgical operation. A dilute solution of oxalic acid and
hyposulphite of soda will remove the stains of the potash solution.
In a very instructive article on the "Present Problems in Evolution and
Heredity," the Cartwright lectures for 1892, published \n i\\e Medical Record oi
March 5, 1892, the evolution of the cusps of human teeih is elucidated.
\a La Sc-niaiiiif Medical vie find the following : Traitement des douleurs et de
la fluxion d'origine dentaire, par M le docteur Hugenschmidt. Dr. Hugenschmidt
is one of our most valued foreign contributors and a leading dentist of Paris, the
associate of Dr. Tbos. W. Evans.
Mrs. Theresa Schrier, of Dubuque, Iowa, bought medicine to relieve her of
the toothache. After applying it to her gums, her jaws and throat swelled, and
after suffering great agony for several days she died last night. The opinion of
the doctors is that she was poisoned by the medicine. — Ex.
Dr. Molar — Now the tooth is out, Mrs. Maloney. If the cavity commences
to bleed, you must stand and hold your arms straight up over your head, like
this.
Mrs. Maloney— H.jwly Saints ! Av Oi shtand loike that, how will Oi ever get
me ir-r-noning done ? — Puck.
MEMORANDA. 339
Dr. Joseph Anthony is now a full professor of dentistry in the Royal Univer-
sity of Buda Pesth by act of the King of Hungary.
llie American yotirnal of Dental Science is constantly making improvements.
Not only has it added to its editorial staff Dr. Richard Grady, but it has even reduced
the time of publication. The January number which was not due until April 30,
has actually been delivered in our office March 26, 1892. At this rate of im-
provement the January, 1893, number, will be out four days ahead of time. Good
for you, Bro. Gorgas.
M. Paul Dubois, of Paris, France, for many years editor of LOdontologic,
has retired from the editorial tripod in consequence of a change in the management
of the affairs of the Ecole et Hopital Dentairede Paris. M. Dubois has been a most
faithful and tireless worker for the school and the journal as well as a potent force
in the elevation of the rank and file of dentists in France. We regret the neces-
sity for his retirement and hope to see him again in the harness in some other ca-
pacity suited to his attainments.
The management of a dental practice is very troublesome to many, but some
dentists are more troubled about how to get patients — trusting to luck for their
management a little later. We think that dentists spend too many hours at the
chair from day to day to accomplish the most good either for themselves or their
patients. Five hours per day for operating and one hour for consultation will
suffice for a comfortable income even at moderate fees, leaving some time for
study and experiment during daylight.
There will be a Joint Union Meeting of the New Jersey and Pennsylvania
State Dental Societies held at Cresson Springs, Penn., on July 20th, 31st and 22d.
We expect this to be one of the largest dental meetings ever held in this sec-
tion of the country.
All who wish to give clinics at this meeting, which will be one of unusual in-
terest, can communicate during April or May with T. K. Filbert, of Pottsville,
Penn., Chairman of Clinic Committee for Pennsylvania Society; S.C. G. Wat-
kins, of Montclair, N. J., Chairman of Clinic Committee for New Jersey Society.
To tlie Editor of the Dental Review:
The enclosed clipping was sent me by an elderly gentleman requesting my
advice on the subject of "the Death of the Tooth-nerves with Advancing Age,"
and as I am ignorant of this being the rule I take the liberty of sending it to you
for publication hoping that some light may be thrown upon this subject, and that
your readers, who like myself are at some distance from the large cities, may
know how "The Better Class of Dentists" " artfully saws the top of the tooth off
close to the gums and after scraping and cleansing the decaying part welds the
two pieces together as firm as before the operation was done."
Yours truly,
Crookston, Minn. W. A Robertson, D. D. S.
PAN AMERICAN MEDICAL CONGRESS.
This Congress will meet in the city of Washington September 5, 0, 7, 8, 1893.
Section nineteen will be devoted to Oral and Dental Surgery. The official lan-
guages will be Spanish, French, English and Portuguese.
340 THE DENTAL REVIEW.
The figures which will appear in the Michigan University calendar for 1801-
!»2 were given out recently. The total actual attendance is 2,()92, which is 34 more
than Harvard. The Literary department has 133 undergraduates, 4!» resident
graduates, 37 studying in absentia. 6 students in other departments, and 1 holder
of Elisha Jones' Classical Fellowship.
The total in the other departments are ; medical 370, law 658, pharmacy 81,
homoeopathic 7!i. dental 188, total enrollment 3,706, which leaves 2,6!)2 actual
students after deducting 14 who are twice enrolled.
The students come from every State and Territory in the Union, except
Georgia, New Mexico and Nevada. Fifteen foreign countries are represented,
Japan, Syria, Bulgaria and South Africa being included. Michigan leads with
1.322 students; Illinois second, with 322 ; Ohio third, 214 ; Indiana fourth, 118.
The Illinois students are entered as follows : Literary 21!>, medical 18, law 68,
pharmacy 9, homoeopathic 1, dental 7.
CAUSE OF SADNESS.
"Dora must have suffered some terrible disappointment. One never sees her
smile now. What is the matter ?"
"Two front teeth pulled." — Life.
CHICAGO TOOTH-SAVING DENTAL COLLEGE"!
At Auditorium Recital Hall in Chicago on Monday, March 28, 1892, diplomas
were conferred on the following named (7) persons : J. D. Burns, G. C. Gagnon, C.
A. Horsford, H. C. Miller, G. W. Ray, J. C. Scotland C. F. Smith.
ILLINOIS STATE DENTAL SOCIETY.
The twenty-eighth annual meeting of the Illinois State Dental Society will be
held at Springfield, 111., May 10-13, 1893. The State Board of Dental Examiners
meet at the same time and place. The profession generally is cordially invited.
Louis Ottofy, Secretary,
70 Dearborn St., Chicago.
DENTAL HOSPITAL OF LONDON.
During the year 1891 the enormous number of 13,392 plastics and tinfoil fill-
ings were inserted for the patients of that institution. Five thousand one hundred
and fifty-eight gold fillings were inserted during the same year and 29,317 teeth
were extracted. Irregularities of the teeth were treated in 902 cases. Compared
with 1874, where 1,292 gold fillings, and 2,264 of other materials inserted.
The school is growing in its value to the people of the metropolis of the
world.
CHICAGO COLLEGE OE DENTAL SURGERY.
At the eighth annual meeting of the Alumni Association of the above institu-
tion the following officers were elected :
President — C, E. Benlley ; First Vice President, A. H. Peck ; Second
Vice President, D M. Gallic ; Third Vice President, A. B. Allen ; Fourth Vice
President, W. T. Reeves ; Secretary and Treasurer, U. G. Poyer ; Executive
Committee. W. Girling, Chairman , R. R. Powell and A. Gunther. Members of
board of counselors for the College ; R. B. Tuller, one year, H. H. Wilson, two
years.
THE
DENTAL REVIEW.
Vol. VI. CHICAGO, MAY 15, 1892. No. 5.
ORIGINAL COMMUNICATIONS.
Oral Hygiene.
By J. W. Wassall, M. D., D. D. S., Chicago, III.
A PLEA FOR THE PREVENTION OF DENTAL DISEASES BY THE ESTABLISH-
MENT OF PROPER HABITS OF CLEANLINESS.
All statistics of civilized communities prove a gradual amel-
ioration and prolongation of human life.
Mr. George H. Knight in an article published in the February
number of the Cosmopolitan, makes the pertinent statement that for
the decade ending 1860, A. D., the annual death rate for New
York city was 33.66 per thousand. For the semi-decade ending
1865 it had fallen to 31.33 and in the semi-decade ending in 1890
to 25.54; the rate for 1890 being 24.58. This amounts to a saving
in the city mentioned of 3,000 lives annually. These results are
attributed to the advance of medical science and of State and
personal hygiene.
The same writer has it that the average life in Great Britain is
nine years longer than it was fifty years ago.
It was the knowledge of these or similar authentic statistics,
no doubt, which led Dr. J. Y. Crawford, at the recent banquet
given to the Executive Committee of the World's Columbia Den-
tal Congress — rather too warmly perhaps — to claim that modern
dental science had exerted greater potency than all other causes
in bringing about this felicitous result. No intelligent observer will
deny that the great awakening of civilized man, particularly
noticeable in the States, as to the importance of preserving the
350 THE DENTAL REVIEW.
natural teeth, has in the last half century, been a perceptible in-
fluence in bringing about the increased longevity alluded to. The
profession of dentistry then bears a more important relation to
human progress and comfort than is usually admitted even by the
profession itself. To realize the truth of this statement one has but
to picture to himself the unequal odds in the struggle for life, of
a community without the services of conservative dentistry, say for
four generations. In other words the proposition is tenable that
a man with defective teeth is to that extent unfitted to fulfill the
requirements of human life and activity.
Medical science, which in its broadest sense includes the prac-
tice of dentistry, has two purposes — restoration of the abnormal
to normal, and prevention of the abnormal. We have to do to-
night with the latter question, and the task to which I have set
myself is to endeavor to bring out, in some small measure, the
part to be played by prophylactic dentistry in the department of
preventive medicine.
The scientific and modern practice of dentistry implies that,
along with the restorative measures applied by dental surgery to
the correction of lesions of the teeth, must go the combative or
preventative measures supplied by the observance of rules of oral
hygiene.
Generally speaking, the whole range of pathological conditions
to which the teeth are subject, may be classified under two heads :
1. Diseases affecting the crowns of the teeth.
2. Disease affecting the roots and socket. Except traumatic
lesions, both these classes of disease are preventable by con-
scientiously following strict rules of hygiene. An attempt will be
made later on to formulate these rules.
It requires no argument to persuade you of the truth of the
hypothesis that "the disease known as dental caries will not occur
except where the causal microbes are permitted to grow undis-
turbed upon the teeth." The rational conclusion is then, that if
the teeth are not allowed to accumulate deposits upon either their
exposed or protected surfaces, they will be exempt from caries.
More broadly stated the proposition is :
Given the varying predispositions of different individuals to
caries, which is governed by the laws of heredity and environment,
the growth of microorganisms in the mouth is in proportion to the
ORIGINAL COMMUNICATIONS. 351
amount of disturbance they suffer, or, rest and opportunity they
•enjoy. That is a recognized fact, and almost axiomatic, I believe.
Is the practice of dentists as followed in the daily routine of
seeing patients consistent with these undisputed etiological facts?
We all know it is not.
Plainly, then, one great step in the direction of the establishing
•of correct habits of cleansing the teeth in the general public is to
be accomplished by reform of the dentist, making obligatory upon
him the performance of his duty. Similarly, as public sentiment
now requires a man to be a graduate of a reputable college before
•entering upon practice, so can it compel him to teach oral hygiene
and require his patients to observe its rules.
For the purpose of convenience, allow me to place people in
three classes with respect to the care they give their teeth : Let
us say that a certain number of people — the figures do not pretend
to be accurate — by assiduous, intelligent care and a natural ten-
■dency to cleanliness in the teeth themselves, have absolutely clean
teeth from year to year; the proportion is very small indeed, say one
per cent. A second class are just as anxious and spend as much
time or perhaps more, than class one, but their efforts are ineffective
because misdirected and on account of unsuitable cleansing imple-
ments and materials. This class constitutes say nine per cent.
All the others who give slovenly or no care, belong to class three,
forming the largest proportion, namely, ninety per cent.
If we are justified in assuming that caries and pyorrhoea alveo-
Jaris, the two diseases most destructive to the teeth, only occur in
the presence of foreign matter which is allowed to accumulate up-
on them, we next want to know how to prevent the accumula-
tions.
My own belief is, that it is possible in most cases for the indi-
vidual to keep the teeth absolutely free from all deposits and food
debris. I have been led to this belief by the study of several cases
which have been under my care and observation'for some time past.
The following would be the way of dealing with a person be-
longing to Class II. or III. who makes the periodical visit to have
the mouth put in order.
At the first appointment, examine the mouth as to the de-
gree of cleanliness usual to the person, and make a note of the
conditions in the record book for future reference. Catechize the
person to ascertain what are the present habits as to the number of
352 THE DEXTAL REVIEW.
brushings per diem, dentifrices, tloss, tooth pick, etc. Make notes
of each point. Then show to the person with mirrors every part of
the teeth which is unclean. The patient may apologeticall}^, or
even mdignantly say that it is impossible to be more thorough than
he is. It is not prudent to deny this at the time if you wish to
accompHsh your purpose, unless to explain that you may be able
to help him to be more successful. You must gain his good will
and inspire the desire by giving arguments for ordinary (ordinary
in its new sense) cleanliness and explaining its benefits.
It is now proper to scale and polish perfectly each tooth. The
mirrors should now be used again to show the patient the change.
Now is your time to teach a lesson of the most forcible kind. Say
to him; "it is quite possible for you, by your own efforts, to keep
every tooth in your mouth absolutely clean." Make this statement
positively and dogmatically. With the effrontery, if you please, of a
bichloride of gold doser promising his dupe a sure cure. The
moral effect of such an assurance and the placing of the responsi-
bility where it belongs will be very helpful.
The instructions in the daily care to be given the teeth should
now be distinctly and carefully impressed upon the patient's mind.
Printed direction for children might be useful but I have never
tried them.
Now, you may say all this and more — some people will require
the habit easily — others, never. It is your business to labor pa-
tiently to the right end.
At the next appointment, for a filling, perhaps make inquiries to
see that your instructions have been followed. If they have not in
every detail, reassert the necessity for it, refreshing the patient's mind
and, in some cases, demonstrate with a brush the practicability of
your statements. Be careful not to lay down more rules than can
be followed.
This system of following up the matter as long as the appoint-
ments last, seeing to it that the patient's efforts are sustained and
effective and that the Iiabit is formed, are the most important and
valuable services you can render in your capacity as a dentist.
The task is not a thankless one; your labor will invariably be
highly appreciated, and as these patients come back to you from
time to time, it will be one of the greatest satisfactions of your pro-
fessional experience to be able to say, after the most conscientious
ORIGIN'AL COMMUNICATIONS. 353
examination with the most searching of fine explorers, that you
find no decay— no pockets.
Now as to rules: Of first importance, of course, is the use of
the brush. Tztnce daily is sufficient — at night before retiring and
in the morning. It is of the utmost advantage to have three
brushes in use. This is imperatively required — three brushes. A
brush will not do effective work unless it has time to dry out. The
bristles will always, be too soft if it is used more than once in
twent3^-four hours. More good is obtained by this than one would
expect without trying. What is known to the dealers as "medium"
grade of stiffness is the best. To the well kept mouth with all its
parts and members in a healthy state, a good vigorous brushing with
a moderatel}' stiff brush is a pleasurable sensation. Three brushes
in use at the same time will also give longer service than if bought
consecutively.
The usual instructions as to vertical movements should be given.
Special directions are necessary to make the patient reach all the
accessible surfaces. Remember that few people do this. It be-
comes your duty to dispel the common delusion that the last mo-
lars and lingual surfaces cannot be brushed. Anyone can touch
all these surfaces who will use his brain, and for a time watch him-
self during the process. The old slovenly or thoughtless habit is
to be broken up and a new set of movements learned. Insist on
thoroughness, and keep on insisting.
Dentifrices: Some form of powder is the only proper dentifrice
and it should always be used whenever the brush is used.
A pound can or bottle from which the small bottle for present
use ma}' be replenished is indispensable in preventing a giving out
of the supply and a consequent deposit of calculus by a few days'
forgetfulness to go to the druggist. Aim to make the powder as
agreeable as possible, especially for the children.
Women and children can be induced to use floss silk or rubber
bands for interdental spaces at least once a day. Men should be
encouraged to use the toothpick.
Disinfectant and antiseptic washes are allowable and useful, but
should not take the place of powder applied by brush at the stated
intervals. As a rule I recommend it only in special cases. The best
results are obtained by the simplest means faithfully emplo}'ed. It
is more than probable that the individual whom we have
in hand will have anywhere from three to a dozen appointments
354 THE DENTAL REVIEW.
for the other needed operations. Opportunities are thus afforded,
to assist in putting him on the right track. You have given him a
good start — how shall he be watched ?
One or two months later, by previous arrangement, he must be
summoned to your office for inspection. Perhaps — yes usually —
a little scolding and lecturing will be necessary to put him right.
At suitable intervals he must be notified again and both of you
will be delighted at the fine appearance and freedom from disease
presented.
My own experience is that it is not a difficult matter to bring
about this happy condition and one success repays for a score of
failures.
RESUME.
A statement to the patient of the advantages and desirability of
absolute cleanliness of the teeth.
Namely, that it affords immunity from caries of crown and
loosening of tooth in socket.
Economy of time.
Economy of money.
Economy of pain: And preservation of natural teeth all through
life.
A statement of the means to be employed to maintain absolute
cleanliness of the teeth.
Establishment of habit.
Three brushes for daily use.
Thorough brushing of labial and lingual surfaces twice daily
with powder.
Silk, rubber bands or pick.
Regular visitation by appointments for inspection and in-
struction.
Introductory Lecture To Medical Students.
By Otto Arnold, D.D.S., Columbus, O.
Gentlemen: — We are about to begin again a short series of
lectures, in which I propose to consider a branch of the healing art
that is intimately related to general medicine, and yet is not ordi-
narily included in the practice of the general physician.
I know not how many of you propose to devote your energies
to special practice when the time for choosing your life work
comes, I feel safe however in predicting, that few if any of
ORIGINAL COMMUNICATIONS. SSS^
my hearers have as yet concluded to practice dentistry exclu-
sively.
I have, however, confidence enough in your judgment to be-
lieve, that you are willing to enlarge the horizon of your profes-
sional knowledge, and that you will take an earnest interest in
the subjects I am about to present to you.
The faculty and custodians of this institution, believe that
the profession of medicine is a complete system, embracing with-
in its extent in the broadest sense, all of the principles of prac-
tice that have for their aim the welfare of the human body — the
continuation of ease, the arrest of disease.
Thus it matters not how much you may divide the system into
branches or specialties, or how small you limit the territory of
the body to which the respective specialties confine their atten-
tion; each and all of them are subservient to the principles which
govern the whole and therefore cannot in any other light he
earnestly considered.
This is peculiarly the age of specialties. In every branch of
labor the tendency is toward divisions, and is only a natural ef-
fect of the demand for thoroughness and the result of progress.
The medical profession is abreast the times, and as a result
we have the numerous medical subdivisions or specialties, each
offering a limitless field for research and practice to its followers.
Dentistry claims an equal share of honor with the other branches
of medicine, and (has been) so recognized among the progressive
and enlightened men of science in all times.
A popular impression quite generally prevails, that dentistry is
a modern science. If we consider dentistry as an independent pro-
fession, we can trace its origin within the present century. Indeed,
the first dental college in the world began its first session only in
the year 1840 in the city of Baltimore. About the same time also
the first dental association was organized in the city of New York.
If we consider dentistry as a specialty of medicine, we can find
mention of it 500 years before the Christian era by Herodotus,
who, in narrating his travels through Egypt, "then one of the
greatest and most civilized nations of the world," noticed the divi-
sions of medicines in that kingdom into special branches, and the
existence of physicians, each of whom, says the historian, ''applies
himself to one disease only and not more. Some are for the eyes^
others for the head, others for the teeth and others for internal dis-
350 THE DENTAL KEl'IEir.
orders." Teeth containing gold fillings, teeth giving evidences of
other operations having been performed upon them, yea, even
"artificial teeth without plates," or bridgework, which is now so
graphically heralded in the public press as a new discovery, have
all been frequently found in the mouths of mummies.
Whether dentistry is a specialty of medicine or an independent
profession is even now a mooted question in the minds of many
equally learned men. About fifty years ago the progressive men
practicing dentistry (among whom were some of the brightest
lights in science and medicine), recognizing the narrow field of
usefulness and the limited scientific knowledge which was the stock
in trade of the average practitioner of dentistry at that time, began
to agitate a reform, and advocated the adoption of an organized
system for the teaching of dentistry- on a scientific basis, by adding
a chair on that branch to the curriculum in the medical schools.
Such a plan was not entertained with favor by the authorities of
the latter, however, and other means had to be sought to accom-
plish the aims of these reformers. Nothing daunted they con-
tinued their energies, which ultimately resulted in establishing the
first dental college, soon to be followed by others.
If at that time the medical colleges had granted the requests of
the dentists, even as an experiment, I doubt if we would ever have
known of a dental college. The founding, however, of a special
college conferring a special degree upon its graduates, was a deci-
sive declaration of independence, and thus, as it were, a new profes-
sion was born. This event marked the beginning of a new era, to
which is probably due the impression that dentistry is a modern
science.
To American dentists is due the honor of organizing the first
association of dentists, and founding the first institution for teach-
ing the art and science to its matriculates. In recent years, many
medical colleges and universities in this and foreign countries, have
added dental departments to their curricula, where both medical
and dental students maj- "drink deep from the Pierian spring."
About five years ago a section on dental and oral surgery was
established in the American Medical Association, which event
ought forever to settle the relationship of each to the other.
The further genesis and evolution of dentistry in detail, however,
is not of so much importance to you as the question, has dentistry
as practical to-day, anything in it that you as medical men would
1
ORIGINAL COMMUKICA TIONS. 357
profit b}' knowing ? I shall endeavor to confine m3self now to
answering this question.
There are some details in the practice of dentistry that 3'ou may
afford to ignore ; there are no principles involved, however, but that
knowing them would make you better phj'sicians. Our callings-
are built on the same broad platform, the foundation of which con-
tains the principles of anatom}', physiology and chemistry ; and
while the superstructure may divide and ramif}' in divers direc-
tions, the end sought is nevertheless the same.
Man is a complete being with many organs and members. Some
■of these are necessar}^ for his comfort and convenience, others are
for ornament and S3'mmetry ; while some are for the protection of
others, and some are absolutely essential for maintaining life.
Some of these organs or members may become more or less injured
or wholly lost, yet the man continues to live.
It is a familiar sight to see along the common thoroughfares
throughout the world, men and women with one or more limbs
missing, or figures so distorted as to be almost unrecognizable as
human beings. One can visit either of two of our State institu-
tions located in this cit}', and witness in the one a community
minus the sense of hearing, in the other a community with the or-
gans of sight either partially or wholly impaired. Indeed, one is
sometimes struck with wonder and amazement, when he realizes
how small a portion of the whole of man ma}' continue in vital ex-
istence.
In view of these facts that are constantly before us, do you in
any degree relax your efforts in the pursuit of knowledge, that will
qualify you to preserve the human body in its entiret}'? None of
you I daresay will make such admissions.
We must admit, however, that certain limbs and organs are more
important than others. Particularly is this true of such, which by
training and cultivation have become peculiarly fitted to perform
certain offices. Thus, the occupation of a violinist would be gone
should he lose an arm ; the painter's labors would cease with the
loss of sight.
The amount of responsibility resting with the surgeon, depends
much upon whether the repair of an injury or the loss of a part,
will or will not unfit the injured to continue in the pursuit of his
occupation. While the responsibilit}- assumed may in the one
-case be grave, in the other insignificant by contrast, the surgeon if
358 THE DE.VTAL REVIEW.
true to his calling, would in either case put forward his best
knowledge, skill and judgment to conserve every member of the
body.
What is true of the limbs, eyes and other parts of the body, is
in a great measure also true of the teeth and their environments.
These valuable organs were never intended, any more than others,
for reckless sacrifice. Nor, should they if in any sense diseased, be
permitted to remain so, since the science of dentistry is almost
limitless in facilities for restoring them to health and usefulness.
The zealous dental surgeon is as proud of his results in saving
teeth as is the general practitioner in his results upon other portions
of the body.
• Man at maturity is by nature endowed with thirty-two teeth.
This is not a mistake or a freak of nature. There is no more
chance about this process than in those which provide him with
two eyes, two legs or one nose. If . this is a fixed law of nature, and
granting there are no mistakes in the rule, it must be evident that
the teeth are designed to subserve certain and useful purposes, and
that they sustain important relations to the system in general.
Yet these organs are criminally neglected and ruthlessly sacri-
ficed, which sooner or later must bring its perils. One can find in
nearly every household some one who is either partially or entirely
toothless. What a commentary on civilization ! That in this age
and generation vast numbers of people are so little concerned
about an important part of their bodies, that they will submit to the
most intense pain flesh is heir to, endure untold torture and finally
resort to the means which promises the speediest relief — slaughter
of the innocents.
Within the shadows of our offices, thousands of teeth are neg-
lected and sacrificed annually. A host of mangled and distorted
mouthed victims meet you everywhere. Who is to blame for this
needless suffering or sacrifice? No doubt, the sufferers themselves
are entitled to the greatest share of censure, for their neglect and
indifference. But I venture the assertion, that this evil would to a
great extent diminish by education.
Many of these same individuals are often painstaking and fas-
tidious enough about the care of other portions of their bodies^
thus the contrast becomes all the more marked and censure more
deserved.
f
ORIGINAL COMMUNICATIONS. 359
Throughout the masses there prevails an astounding amount of
ignorance concerning the value and importance of these organs
and before any revolution takes place that can change the evil re-
sults from such practice, this class must be enlightened to appre-
ciate the influence for good the change would bring about.
The responsibility of enlightening the masses against the pre-
vailing ignorance in this matter, must to a large extent be taken by
the medical profession. You are the medium through which must
come the teaching, that no part of the human body can be neg-
lected without more or less serious consequences to the whole,,
stimulating them to adopt habits and means for the preservation
of the whole of man. It will be your privilege, and you must
make it your duty to disseminate knowledge that will benefit the
human race. You are in a position to make impressions where
others would fail. Your commands are law and will be obeyed.
When we consider the functions of the teeth, we find their chief
and relative value to the economy consists in the part they perform
in the act of mastication. Grinding and triturating the food, per-
mitting its thorough admixture with the saliva during the act. In
short, preparing the food that is taken into the mouth in the most
desirable and acceptable form for the stomach.
You all know, that perfect mastication is an essential auxiliary
to the digestive process. It is not difficult to comprehend that with
defects in the dental apparatus whereby this act is impaired, either
by decayed and sensitive teeth, or a limited number of them, or,
from the presence of vitiated secretions due to pathological con-
ditions within the mouth, it devolves upon the stomach to do ex-
cessive work, and such abuse lo.ng continued must sooner or later
bring forth the inevitable evil results. This is a prevalent con-
dition which physicians, indirectly at least, can prevent.
It is not our purpose to inveigle you into the practice of
dentistry, but, I believe every physician ought to know enough of
its principles to recognize the indications for extracting diseased
teeth or treating them as the case may be, and insist upon the
adoption of remedial means when needed.
There are many lesions reflex in their expression, whose source
is in or about diseased teeth. The physician should be able to
trace the connection of neuralgia and other nervous disturbances
that may have their origin in dental territory. The extension of
disease by continuity and contiguity of time is no less likely in the
3(;.. THE DENTAL REVIEW.
oral cavity than elsewliere. The maxillar}- sinus is a prolific field
or harboring pathological conditions. Teeth that to the inexpe-
rienced present no indications of abnormalit}-, often contain the
cause of obstinate and destructive lesions within this cavity.
These are some of the many, and are of the ordinary type of
complications having their origin from dental causes, in the treat-
ment of which a dental education would prove a valuable ac-
quisition. Physicians as a rule have in the past too much ignored
this part of the body. As far as it concerned a goodl}- number of
them, the mouth was never regarded as a possible factor, in which
might be found the solution of the problem to many otherwise ob-
scure lesions. I well remember this statement once made within
ni}- hearing by an eminent surgeon in a dental meeting, "that the
medical profession confined their energies altogether too much to
the other end of the alimentar}' canal."
Upon the other hand, dentists should know enough of general
medicine to be able to discriminate between strictly dental and
general lesions, which would enable them to give patients in their
care needing medical advice and treatment, such counsel and di-
rection that they may secure the proper service. We can best
subserve the interests of suffering humanity by mutual relations,
making our callings reciprocal in practice.
Dental caries, which is the beginning or primary cause of
most diseases of the dental t3pe, is one of the most universal
afflictions man is heir to. Few indeed entirely escape its attack,
and yet it is to a considerable extent preventable. To secure the
preventable state in the highest degree, surround the mouth and
teeth with proper hygienic conditions. This is within the reach
of all and consists in cleanliness. The thorough use of the tooth-
brush in combination with a suitable dentifrice, is as yet the best
known prophylactic. When caries already exist, they should be ar-
rested by suitable operations at the earliest possible moment,
which will restore the teeth to practically as good conditions as
before.
That the teeth when diseased are possible etiological factors in
systematic disorders should never be lost sight of. Septicaemia
from chronic abscesses about them may be more prevalent than
you imagine, and it would be commendable practice to search in
the mouth for causes that are not elsewhere apparent.
Mouths devoid of cleanliness offer an inviting abiding place
ORIGINAL COMMUXICATIONS. 361
and a fertile field for the propagation of microorganisms and
bacteria. Professor Miller, of Berlin, a distinguished dentist and
scientist, discovered seventeen varieties of microorganisms that
infest the mouth. He found, he says, in one human mouth, "one
is strongly tempted to add inhuman, at one time present, one bil-
lion one hundred and seventy million germs."
Gentlemen, the evil influences exerted by such conditions, and
they are numerous, upon the general health, need hardly be ex-
plained to you, nor could we estimate with even an approximate
degree of accuracy the number of germs which would daily be re-
ceived into the stomach of such a beastly individual.
It would be an easy task to prolong this subject, but I must
bring this desultory discussion to an end. I will state further in
closing, that the methods applicable for the treatment of dental
caries are scientific, effective and definite in result. They are to a
large extent mechanical, yet altogether in connection with living
tissue, requiring that the simplest operations be performed with
delicacy and precision, and in harmony with the law that con-
tinues the vital state, which is the very essence of surgery. When
these operations are supplemented with the proper treatment for
the correction of the oral secretions, the removal of foreign de-
posits, etc., etc., we are able to transform an offensive and disease-
breeding condition into a healthy and wholesome one.
As physicians, 3'ou will have abundant opportunities to direct
and advise, and in a large measure limit the extent of afflictions
from dental causes. If you are well prepared for recognizing ab-
normal conditions within the oral cavity you are to that extent
more thorough physicians.
Those of you who will practice in the sparsely settled or rural
districts, may have frequent demands made upon you to relieve
the sufferings from diseased teeth, therefore have special occa-
sions for acquiring knowledge in that direction. You whose lot
will be cast in more populous places and cities, will find it often an
advantage to consult with, and combine the skill of dentists with
your own in the management of peculiar cases.
This is being recognized as a healthful custom and is increas-
ing. It is a source of gratification to note the growing interest
manifested in dental practice by the best physicians, likewise the
broader education of dentists in general medicine.
In the few lectures I shall deliver to you, the subjects will be
3G2 THE DEXTAL REVIEW.
selected with special reference to what will be of the greatest ben-
efit to you, and treated as broadly as their nature seems to demand.
The cause and development of dental caries and its general
treatment. The dental pulps and pericementum, their functions
and diseases ; alveolar abscess, its causes and treatment ; the in-
dications for extracting teeth, when and how to extract them.
These are the subjects we may consider with more or less detail,
endeavoring to avoid wearisomeness.
Not attempting to make dentists of you, but helping to make
broader medical men, who shall realize the importance to the whole
of man of a cure for this part intrusted to the dentist's care. That
dentists and doctors are not natural born enemies, jealously ward-
ing each other off their particular premises ; but fellow soldiers
fighting side b}' side in a common warfare against their common
€nemy — death and disease.
Facial Neuralgia.
By a. W. Harlan, M. D., D. D. S., Chicago, III.
Definition: Pain, constant or remitting, usually from irritation
of one or more branches of the nerve, occasionally from structur-
al impairment of the nerve, functional or sensory. It may be re-
flex, but the most overwhelming symptom is always pain and
exacerbation, generally localized. There are many causes of
pain which I will not catalogue, as most of you are familiar with
them. The form of facial neuralgia to which I direct your special
notice is that connected with or dependent upon diseases of the
the teeth. We must eliminate from consideration, this evening,
these constrictions of branches of the fifth pair not connected with
the jaws themselves. Probably all are familiar with cases of pain
in the jaws from exposure of a pulp. When this is discovered the
manifest duty of the surgeon is to afford a protection direct, when
the pain will cease. It may be said here that nearly all pains in
the jaws or in the region of the temples originate from defective
teeth. I have found in a few instances that a tooth was split from
concussion of the jaw from falling from a ladder or other eminence,
and after fairly searching for the cause of pain suddenly was re-
warded by discovering its true source. Recently I found a cavity
in the cementum of a cuspid tooth at least one-eighth of an inch
from the edge of the gum margin. By retracting the gum and
applying an appropriate remedy the pain ceased. Without multi-
plying the unusual causes of pain connected with the teeth, such as
ORIGINAL COMMUNICATIONS. 363
impacted teeth, or the pressure of a plate or other mechanical de-
vice causing direct pain, or even considering concealed roots of
teeth in the jaws, or reflex neuralgia from displacement of the
uterus, foreign bodies in the antrum, or engorgement of the max-
illary sinus, necrosis, mercurial or other poisoning by drugs, forma-
tion of pulp stones, exostosis or other anomalous dental growths or
formations.
I desire to draw your attention to three causes of pain in the jaws
that have as yet received little attention, namely: the protrusion of
root fillings through the apices of roots, the incomplete steriliza-
tion of poisoned dentine and exposure of the pulp from pyorrhoea
alveolaris.
From some observations of the labors of others in the filling of
roots I have come to this conclusion: Any method of root filling
which will permit of the passage of metals, wood, or any corrosive
substance through the apex of the root (unless the metal be lead)
is liable to give rise to a not easily diagnosed neuralgia, more or
less constant, with intervals of freedom from pain, but the absolute
certainty of recurrence after any or all forms of constitutional ex-
hibition of remedies. This kind of root filling is practiced to a very
large extent, especially by a class of men who are desirous of mak-
ing a crown or bridge at a single sitting, or from haste to complete
the operation of filling a tooth in the shortest possible time. At
first the patient suffers little or no inconvenience, but after the lapse
of a few months or a year or two, pain is felt either in the region of
the tooth so filled or in a vacant space in the opposite jaw on the
same side of the mouth. You may ask why such foreign bodies
are not encysted ? I answer at once they are not isolated like a
piece of leaden bullet or a pellet of gold forced through the root, but
are projections from the apex of a tooth's root. They may be and
are frequently pointed, sharp, and may impinge on some portion
of the anterior, middle or posterior dental branches of the superior
maxillary branch of the fifth pair of nerves — or even on some
twig of the mental nerve or the inferior dental — more often how-
ever in the superior than in the inferior jaw. What is the remedy?
Taboo such practices for the future and remove the root filling of
this character for this generation as rapidly as possible.
In all cases where there is a persistent neuralgia without ap-
parent cause, other than a filled pulpless root I immediatel}'^ sus-
pect the presence of a protruding root filling of wood, gold,
364 THE DENTAL KEl'IEW.
silver, or some corrosive substance as oxychloride or oxyphosphate of
zinc. For the cure of such cases removal of the root filling or
extraction of the tooth is a necessity.
It may seem that the second of the previously unconsidered
cases of facial neuralgia "incomplete sterilization of dentine" had
little to rest upon, but I assure you that it is a potent cause of pain
more or less intermittent and for that reason often overlooked.
At some time or other the roots of all pulpless teeth, save the
few that are filled at once after pulp extraction are exposed to sep-
tic influences, through the saliva, water, food or the air. Even
in some cases to the defilement of unclean instruments. When
a tooth has been for a considerable period subjected to the retention
in its interior of a putrescing pulp or other decomposing animal or
vegetable matters, it stands to reason that the dentine will ab-
sorb the mephitic gases and other septic poisons which are
usually present. The dentine of the densest tooth will not
withstand for even a short period the invasion of microorganisms
per the soluble ferments excreted, when the pulp is alive, how
then is it to be rendered immune after the loss of that organ ?
I affirm that it is not possible.
If you will recall for a minute that the animal matter of den-
tine, in a normal state is nearly equal to one-third of the whole of
its substance and a portion of this being water, you will* readily
see that there is a considerable portion of the substance ready to
imbibe, or absorb; or become saturated, or infiltrated with septic,
gaseous and pigmented matters. Some or all of these forms of
impregnation will effect the dentine according to its density, now
suppose that the dentist more o^r less hurriedly washes the interior of
the root with warm water, then dries it indifferently, afterward
bathing or swabbing the canal with an antiseptic for five or ten
minutes, perhaps cuts out a small portion of the dentine with a
bur or reamer then fills at once. Does this practice save the tooth
from further destruction and render it innocuous as a source of
pain ? I say no, because it is not sterilized by such a procedure.
There is no disinfectant so potent that it will disinfect polluted
dentine in such short order. More time must be given with one
or more days for its penetration or diffusion to reach and destroy
the stored poisons in the dentine. What relation has this to the
subject of facial neuralgia. I will tell you as far as I know.
After the lapse of two or three years a tooth so treated and filled
ORIGINAL COMMUNICATIONS. 3(55
•
will begin to trouble its possessor by being the source of pain, at
first slight, but after a time more constant until it may become
localized by the formation of a small abscess on the side of
the root. How is this brought about? By the gradual impairment
of the cementum and pericementum through the influence of the
concealed poisons and gases in the unsterilized dentine. This will
occur even though the apex of the root be thoroughly well filled, as
I have frequently observed after the extraction of a tooth or the re-
moval of the root filling. All persons of sedentary occupations,
the anaemic, the feeble or those residing in malarial districts are
frequent subjects of facial neuralgia having as its cause such hastily
filled roots. What is the remedy? Take time for sterilization of the
roots of teeth previously exposed for any length of time to foreign
matters or prutrescing pulps. Immediate pulp extirpation admits
of immediate root filling under nearly all circumstances.
The third and last cause of facial neuralgia that I will dwell
upon is from exposure of the pulp per the peridental membrane
frojn advancing pyorrhoea alveolaris. The detachment of the
pericementum from the root of a tooth along its side may be un-
noticed by the dentist, for some time, indefed the patient will rarely
be able to locate the immediate source of the pain, as I have fre-
quently found by examination that the offending tooth was located
on the opposite jaw. When possible to eliminate all of the com-
mon causes of pain in the jaws, and finding the teeth vital. I pretty
generally conclude that the cause of trouble is confined to one of
two conditions : formation of pulp nodules or exposure of the
pulp at the apical end of the tooth. An examination for " pockets "
will make diagnosis certain, as the two conditions will not exist in
one and the same tooth at the same time. When the true
source of pain is discovered we have one of two things to do — ex-
tract the tooth or destroy the pulp. The latter is generally chosen
for the reason that it may be possible to render the tooth useful to
the possessor. If pulp nodules are being deposited in the sub-
stance of the pulp there are three remedies. If the patient can
endure the pain long enough the pulp will be obliterated, other-
wise the pulp must be destroyed or the tooth will need to be ex-
tracted in order to effect a cure. I have purposely left all reference
to the use of drugs for the alleviation of pain to be brought out in
the discussion, preferring that method to emphasize its importance
when indicated.
80G THE DEXTAL REVIEW.
Some Thoughts on the Manipulation of Gold for Filling.*
By Dr. A. W. Freeman, Chicago, III.
Gold is never found pure. Silver is alwa5's present with it. It
is also found alloyed with lead, antimony, bismuth, iridium, plati-
num and iron ; often with several of these metals.
When it has been refined at the mint it is found by test to be
from 'yy^2 thousandths to 908 thousandths pure gold. The gold
we use is thought to be 09-3 parts pure.
The silver is removed by nitric acid when the gold is left as a
dark powder. Boiling sulphuric acid applied to the amorphous
precipitate will so nearly remove traces of silver that the fineness
is raised to 99s or '.Mtit thousandths pure. Silver adds to the cohe-
siveness of gold but lessens its softness.
For many years gold was obtained from the dealers in dental
goods only in the shape of soft foil, and usually was four or six thick-
ness or about that number of grains to each leaf. These leaves were
made into pellets, or cubes, or ropes, or tapes, and thus used to
fill all cavities from beginning to finish of the filling. By this old
time method, work was well made, which has stood thirty, forty,
fifty or more years.
Fillings in general were made by hand pressure only, until 18G1,
when Dr. Atkinson introduced to the profession in general the use
of the mallet, though in our system of dentistry its discovery or
first use was accorded to Dr. E. Merritt, 1838. In 1855 Dr. Ar-
thur discovered the cohesive properties of gold by annealing or
heating some gold that did not work to suit him. A few years
later there was quite a general craze over cohesive gold, from
which there w.as a reaction until cohesive gold is now gener-
ally used to finish fillings or for building up corners and contour
work.
Pellets round or oval are very convenient for use in most cavi-
ties. We take a sheet of gold and tear off pieces with the foil car-
riers, which with the thumb and fingers of the left hand is quickly
made into a round ball. These should be made of varied sizes
and densities, according to cavities where they are to be used ; but
not of so great density that they will curl or roll in the cavity in-
stead of packing where we wish them. Extremely small pellets
should be made for very small cavities ; one, two or three may be
•Bead before the Uayden Dental Society March, 1892.
ORIGINAL COMMUNICATIONS. 367
used to nearl}^ or quite fill such cavity, though it is usually better
to finish with some small pieces of No. 4 cohesive or 30 of Ro-
man's rolled gold, which adheres firmlj' and packs better or more
readily than an}^ other I have used.
Some dentists use pellets made from cylinders. We have not
been able to make them quite so adaptable or packable, if we may
coin the word, as those made from the sheet.
If you wish them of uniform sizes you can cut your gold into
squares, by placing your gold on a leaf of paper from an empty
gold book, cutting through both at the same time. The gold will
not adhere to the shears, even though their cutting edges are not
absolutely perfect as is desirable. We prefer a nice pair of bar-
ber's shears to the longer and more expensive S. S. W. make.
Some good fillers use pellets alone for the entire work, soft gold
for the major portion, and cohesive for the very last or finishing
portion of the filling, discarding thick gold entirely. No. 4 foil is
the preferable number.
The rope is quite a common form in which to use gold, and is
adapted to a large class of fillings when made of sufficiently varied
sizes cut in proper lengths. A paper cutter is placed on the cen-
ter of a sheet or half sheet of gold, and it is folded back and forth
until it is of narrow width, when it is rolled with a napkin on a
chamois covered and padded board about five inches square ; or it
may be folded and then twisted to rope with the fingers, if the
hands are of the class called dry or usually free from perspiration.
Of course they should be clean.
These soft cylinder ropes are usually placed on end in crown
cavities, protruding about one-third out of the cavity, and pressed
to one or two or all sides of the cavity, and others are grasped and
forced between these cylinders until the cavity is quite full, then
the surplus end p6rtion should be compactly pressed and malleted
to a finish.
If the cavity is compound or crown and approximal, a layer
should be placed on either side lingual and buccal, and others in-
troduced between these, using a wedge-shaped flat plugger, until no
more can be crowded between these layers, when the surplus end
portion can be condensed as before mentioned.
If the cavity is not full when this is done cohesive gold can be
added. A judicious use of pluggers, of the mallet and firm burn-
368 THE DEXTAL REVIEW.
ishing will make a good filling of all soft gold when it is not sub-
jected to too much strain in mastication.
We should not only cultivate strength of hand pressure, but a
nicety of touch, which will assure us when our work is being thor-
oughly done.
Gold, except it be precipitated by sulphate of iron, is cohesive,
when one leaf is laid upon another. If subjected to exposure to
the atmosphere or kept in proximity to acid and gases, it loses its
cohesive properties, which can be restored by heat, as we all know.
Cohesive gold should be used immediately or in a short time after
it is annealed, as in a few hours it becomes noncohesive. Each
piece can be annealed as it is used if the quantity to be used is not
large. In continuing it can be kept ready for work and time saved
to heat it in a mica-bottomed tray resting over a small gas or alco-
hol flame. Theoretically there is an objection to the oxidation of
an iron-bottomed tray, but practically we do not think it of much
importance.
It is better that there should not be much surplus annealed, as
frequent annealing does not improve the working qualities of the
gold.
Cohesive gold should be folded in narrow strips about the width
of the cavity to be covered — 8,10 or 32 thickness — or it may be
used in a small loose rope. The amount of annealing required de-
pends upon the kind of gold used and its freshness. Williams' co-
hesive can be used in pellets.
Small depressions and borders can be evened up by small
crumpled pieces No. 4, or Rowan's No. 30.
You can start cohesive gold on soft gold by hand pressure bet-
ter than b}' mallet, usually.
If your gold does not stick you can heat a piece red-hot and
apply to the surface once or twice, and you can 'then proceed, un-
less the surface has been covered with moisture. If moistened it
can l)e dried by a small flash flame from a string of twine run out
of a slot in the side of a cork inserted in a bottle with a little alco-
hol in it.
It should be remembered that cohesive gold packs, but soft
foil spreads, hence the latter is best, especially next the walls of
cavities. If cohesive gold is used it must be used in small pieces^
and packed with extreme care lest we injure the walls or leave a
leaky filling.
ORIGINAL COMMUNICATIONS. 369
The platinum gold foil makes the best wearing surface for
abraded teeth, and some operators like the looks of it better than
the all gold fillings, while some others think that it mars the looks
of the teeth, giving them the appearance of poor work.
There are some cases where I want to use Watt's crystal
gold, now in use for thifty-five years. It makes a very solid and
durable filling. As made at present it is very reliable, being free
from acids which marked some of its early make.
Instruments with medium serrations are best to pack this kind
of gold.
This gold takes a firm hold of all unevenness of the cavity and
does not require great force; small pieces, with uncrushed crystals
and careful packing from first to last is essential. The mass can-
not be changed by final malleting as with soft gold.
If you do your work well with certain makes of gold, it is better
not to change because some Dental Goods man has something
new — but "prove all things and hold fast that which is good."
A dentist of all persons needs a clear head, a steady hand and
to be at peace with himself and his patient, or his work will be
labored and faulty.
A new form of crystal gold by the S. S. White Dental Mfg.
Co. seems well adapted to start fillings as it is very soft and seems
to spread in the cavity. It has not had sufficient test of time to
judge of its reliableness or as a full filling.
Crystalloid gold is also a ver}^ good starter.
Hand pressure and suitable pluggers will carry gold into some
portions of cavities where malleting will not reach — usually sur-
faces or walls next to us and where we cannot see directl3^
We consider it necessary to use magnifying mirrors much, as
concentrating more light and giving a better idea of our progress-
ive thoroughness.
Dryness is essential and a positive necessit}'' to our work as a
rule — but some fillings made with a slight degree of moisture be-
fore the days of rubber dam have been found to preserve
teeth.
Abbey, we believe, makes or did make the only soft foil not made
cohesive by heating, so said. We have seen work done with it over
thirt}' years ago, still reliable.
Rowan's soft gold makes a very reliable filling when the gold is
not too old.
370 THE DEXTAL REVIEW.
Ney's gold is very even cr uniform and with practice works
nicely.
Packs' cylinders are a necessity with us — soft and very co-
hesive. Nos. ^2. 34 ^"^^ ^•
Dr. Black informs us that a bottle of carbonate of ammonia
kept in a drawer with our soft gold will ke'ep off the effect of de-
leterious surrounding gases, and if gold has deteriorated it will be
restored to its former working properties.
Sulphur and phosphorus should be kept as far from gold as pos-
sible, as they rapidly lower its working standard.
Dr. Black also says cohesive gold will become noncohesive
when subjected to the influence of the carbonate of ammonia.
Our work often varies with our own moods, now good, now
better, but no one makes a perfect filling said our lamented At-
kinson— yet our constant effort and aim should be for that noble
end.
Pulpitis.
Bv I. A. Freeman, D. D. S., Chicago, III.
Pulpitis, or inflammation of the pulp, is a disease the dentist
is frequently called upon to treat. In many instances it is quite
difficult of correct diagnosis, owing to the fact "that the dental
pulp has not the sense of location or touch," being encased in
the inflexible bone covering. Much reflex pain may be had and
nothing to indicate what tooth may be the one involved or seat
of the disturbance, hence the operator will sometimes be put to
his wits end to find or locate the trouble. Sometimes it will be
necessary to wait for developments, for if it be that the pulp of
any tooth be in a stage of inflammation, it will as a rule pass on
to suppuration. This will in most cases be the result. Then as
there are the different stages of decomposition there will be corre-
sponding disturbance in the surrounding membranes, the peri-
dental membrane becoming involved will very soon indicate the
offending pulp.
Sometimes the operator first consulted, acting upon the ex-
pectant plan, will find the patient later in the game has consulted
some other practitioner, who, with the advanced stage or con-
dition, will be more fortunate in being able to locate the trouble,
for the manifestation of the now inflamed peridental membrane in-
dicates exactly and unerringly the afflicted pulp. Now, he scores
ORIGINAL COMMUXICATIONS. 371
a big card for himself, while No. 1 is left to wonder what has been
the result of his treatment and suggestions. Meantime the patient
has no doubt who is learned and skillful, having been relieved of
his pain in a moment by the operator last consulted. He having
opened the pulp chamber, giving escape to the pent-up gases, the
product of decomposition ; of course, the patient has almost im-
mendate relief, this may occur when there has not been but
little pathological change in the tissue of which the pulp is made
up or composed.
The books lay down symptoms b}' which we may be able to de-
termine when we have a case of inflammation of the pulp as against
that of hyperaemia, and undertake to tell us where inflammation
begins with the aid of hyperaemia to beoeme a settled condition,
but we will leave that for the discussion of the more scientific and
pass on to some or the causes of inflammation of the pulp.
I find the term pulpitis is a word that is one of convenience
used outside of medical dictionaries, a word known only to the
dental profession. The causes of pulp irritation are quite nu-
merous ; among them are dental caries from the most super-
ficial to the deep-seated where there has resulted full exposure
to foreign substances, fluids, etc. Where these maj^ by the pro-
cess of endosmosis. have entered the pulp chamber, or the forces
of mastication may have proved too powerful for the weakened
covering, and so from yielding walls the pulp has received in-
jur}', which becomes, by the constriction of space, an irritant, re-
sulting in inflammation prolonged, intense pain being the result'
unless the pressure upon the pulp be immediately relieved by
excavation and opening up fully the pulp chamber or lessening
its volume by evacuation of the gorged vessels by incision of the
tissue, and both should as a rule give desired relief from pain.
Traumatic affection of surrounding parts may result in inflam-
mation of the pulp, especialh" in young patients. Operations upon
the teeth in preparation of cavities, excavating the diseased tissue
resulting in partial or complete exposure; attempts to protect the
pulp by introducing some form of filling material, causing by its
irritating properties either galvanic, escharotic, dessicating, or
conducting power and also carelessness in introduction, too great
force being exerted in placing the materials in position.
Predisposition to inflammator}' action has much to do with the
phenomena of pulpitis.
872 THE DENTAL KEIIEIV.
I here refer to rheumatic tendencies, or a predisposition also
to the condition noticed in young girls about the age of puberty,
who take on inflammatory diseases readily. Practitioners generally
have noticed that greater disturbance is seen in thermal changes at
this time, and there is probably greater tendency to acidity of the
serections which may and does promote galvanic action, if gold,
tin or amalgam are in the proximal surface or in close proximity to
each other. Inflammation may be general or local, active, dis-
playing considerable energy by producing severe pain, or ma}' be
what may be termed a low state or condition of inflammation, the
disturbance being nonexpressionless, -so to speak, a condition
which may exist for some time with so light inconvenience to
the patient as to be quite forgotten at times, passing on to the
stage of suppuration or may become of the nature of dry gan-
grene.
Pulpitis may and does occur when teeth are being moved by
regulating appliances, not always when force has been applied with
which the teeth have been moved rapidly, but when the move-
ment has been slowly and carefully performed, resulting in what
has been termed dry gangrene or mumification of the pulp. Not
always so, but this condition is seen where from the color of the
tooth we know the pulp has died, and when opening into the pulp
canal nothing is found save the dry, or nearly so, remains of the
defunct pulp. This tooth has never given the slightest inconven-'
ience it may be. Dry gangrene is seen frequently where there has
not been any effort to regulate or change the position, and when
able to get a history we hear that a blow was received at some time
previous, it may be years since, and no inconvenience during the
subsequent time save a slight uneasiness at times. The too ener-
getic application of force, in gaining space for fillings, results in
pulpitis to a greater or less degree. Pulp nodules are a source of
irritation.
The treatment for the different phases of pulpitis are somewhat
variable.
In the case of superficial caries the proper procedure is to re-
move the diseased tissue and apply a remedy containing a disin-
fecting and anaesthetic property; at the same time; ten per cent
carbolic acid, oil of cloves, oil of cajuput, oil of cassia, contain
these properties sufficiently for these conditions. Then fill the
cavity, thus excluding foreign irritating substances or fluids. In
ORIGINAL COMMUNICATIONS. 378
more advanced stages of dental caries a non-conductive material
should be placed upon the floor of the cavity, it having previously
been treated as suggested for superficial cavities.
Treatment for pulpitis, which is the result of deep-seated caries,
the pulp not fully exposed, or if it be very slightly so, would be to
clear cavity of the debris, wash with quite warm water. Pond's
extract of hasmmamalis should also be warm. A mild solution of
boracic acid thrown gently into the cavit}^ with syringe, the object
being to clear the cavit}' of all extraneous matter, using those
agents that will be of a palliative nature. Peroxide of hydrogen
will be found helpful here. All decalcified dentine should be care-
fully cut awaj', meantime the cavity should be protected from
fluids of the oral cavity by the rubber dam being adjusted. When
all this has been satisfactorily performed, the cavit}^ dried, then
bathe the cavity with carbolic acid about twenty per cent solution.
Again dry, flow over the floor of the cavity a thick solution of
gutta-percha and chloroform, allow time for pretty perfect evapora-
tion of the chloroform, then varnish the entire cavity with copal
ether varnish, or 3'ou ma)' use sandarac varnish. This is to pre-
vent the drinking up of the moisture of the tooth or pulp b}' the
material that follows which ma}' be oxychloride or oxyphosphate of
zinc, which should be of a consistenc}' to be drawn over the floor
of the cavity rather than forced 'down upon the exposed pulp or
yielding floor or wall of cavity, thus saving the crowding of the
pulp. The better plan is to use a small portion at first, giving
time for hardening, and add more as it is needed to make a strong
floor and be of depth or thickness to aid in breaking up thermal
changes or shock. This course is to be pursued where there are
no complications to be met with, as, for instance, where there is so
great exposure as to determine the necessity of expiration of the
pulp, which would be usually performed by first giving treatment
to reduce inflammation, and then 10 devitalize by the application of
arsenious acid which should always be held in position by using
first a drop of chloro-percha over arsenic, which should be allowed
to harden, apply carefull}- oxyphosphate of zinc for filling cavity,
thus giving an inflexible covering so that pain may not result wdien
mastication is going on. Of course, later the pulp should be re-
moved, not forgetting the application of glyceride of tannin to
bring about the most desirable condition, the removing of the pulp
entire. Should death of the j>ulp from inflammation have resulted,
374 THE DEXTAL REVIEW.
the usual treatment for putrescent pulp is of course indicated. In-
all conditions of pulpitis a hot mustard foot bath is helpful, also
counter-irritation mayaid in aborting strangulated pulp by determin-
ing the blood to other parts. Saline cathartics have been recom-
mended, and no doubt may have good effect upon plethoric
patients.
Aluminum.*
Bv Geo. W. Haskins, M. D., D. D. S., Chicago, III.
I desire this evening to call your attention to a few facts rela-
tive to that most interesting of metals, aluminum; interesting
because of the great possibilities which its cheap production fore-
shadows; interesting because it is a new metal which is not a labo-
ratory curiosity, but one which in time we will see on every side
entering into the composition of many useful and ornamental
objects, making them cheaper and better than w'ill any other metal
or alloy with which we are now acquainted.
As a metal aluminum is never found free in nature, but always
in combination with some other element. It is difficult to go any-
where and not find it ; the beds of seas, lakes and rivers are made
of it in the shape of clay; the hills are made of it in the form of
granite, slate, feldspar and mica. Such ornamental stones as the
garnet, ruby, sapphire, turquoise .and topaz are largely composed of
the salts of aluminum. Our buildings are made of the clay and
the stones, and we touch it and walk upon it constantly, and yet,,
through difficulties in converting it to the metallic state from any
of its salts, it still remains too expensive to be used for many things
which its attributes fit it for.
Late in the eighteenth century attention was first called to a
substance called alumina, which was obtained by calcining alum.
About that time the opinion was offered that our earths and stones
were made of something which had a metallic base, and it was gen-
erally concluded that the alumina was the oxide of some metal,
which, though it had never been seen, it was decided to call alumi-
num, or aluminium. Experimentation proceeded for the manufac-
ture of the metal for many years afterward, but it was not until
1854 that the metal in anything like purity was produced. This
St. Claire Deville did while seeking to make a higher oxide than
was known then. His method was to produce the proto-chloride of
♦Read before the Odontographic Society.
ORIGINAL COMMUNICATIONS. 375
aluminum, and from this he hoped to be able to make the proto-
oxide. In his experiments he used metallic potassium, and at the
conclusion of his experiments he found many small metallic shot
which possessed remarkable properties. Recognizing the impor-
tance of his discovery, his experiments in the future were turned in
the direction of making aluminum and making it so cheap that it
might be of use. It was not long before it was discovered that
sodium was a better reagent than potassium and it was used in
the place of the latter.
Up to within comparatively few years, sodium has been used
exclusively for the production of aluminum, when it was produced
for commercial purposes, and the attention of every one was
directed toward the production of cheap sodium, as cheap sodium
meant cheap aluminum, with what success may be determined by
the prices of the metal, the great difference of price between 1856
and 1886 being largely due to the cost of production of the sodium.
In 1856 aluminum was sold at the rate of $90 per lb.; in 1886, $12
per lb., then a further great reduction to $2 in 1889, and to-day the
price is about 90 cents per lb. for pure aluminum. The change
between $12 per lb. and 90 cents per lb. is not due to the cheaper
sodium, but to a method of reducing the metal by electrolysis. It
has been estimated that of the entire cost of the metal when re-
duced by the sodium process, the production of the sodium costs
57 per cent, the production of the double chloride of aluminum and
sodium costs 33 per cent, while the production of the aluminum
costs but 10 per cent.
It has always been extremely difficult to produce pure aluminum
for commercial purposes, the difficulty lying in the fact that it is
practically impossible to purify the metal when it is once reduced.
Its purity varies between that which Grabeau produced, which was
about 99.8 fine, to Devilles', which was about 88.3 per cent
aluminum.
The solution of the question is, in starting with a pure native
salt of aluminum and preventing its contamination during the
process of reduction, as, at a heat greater than is required to melt
it, aluminum alloys very greedily with iron, copper or silicon, and
a very small percentage of either of these will so change its
character as to make it valueless.
In the process of converting aluminum from its chemical com-
binations with the other elements to a metallic state, it is usual to
376 THE DENTAL REVIEW.
use one of four forms, viz. : the hydrate of aluminum or beauxite,
the oxide of aluminum or corundum, the double fluoride of al-
uminum and sodium or cryolite and the sulphate of aluminum.
Beauxite is a combination of the hydrate of aluminum and the ox-
ide of iron principally, in addition to which there is a much smaller
percentage of one or all of the oxides of silicon, sodium, potassium
and hydrogen. It is not by any means a pure mineral, and as this is
the source from which Deville derived his aluminum, it is not sur-
prising that he did not produce a pure article.
Beauxite is found principally in France, Austria and Ireland ;
the first discovered beds were found near the town of Beaux,
France.
The oxide of aluminum or corundrum is familiar to us all in
the laboratory as the corumdum stone, in jewelry as the garnet, the
latter being the purer form. Corundum is quite a pure mineral
and is the principal source of aluminum in the United States being
the base used in the Cowles and in the Hall process ; until the last
twenty years its principal source was India, where it was taken
from the beds of rivers ; since then it has been discovered in large
quantities in the mountains of Georgia, North Carolina and
Pennsylvania, where it is mined irom its original beds before the
elements have pulverized and washed it into the rivers.
Cryolite, or the double fluoride of aluminum and sodium has
its almost exclusive source in Greenland, small quantities have
been found in Pikes Pe^k, California; it may be found quite pure,
but often is not, and in those processes which use it in the pro-
duction of aluminum it is artificially prepared; as found in nature
it is used by the soap-makers for its sodium and by glass-makers
to make a glass which bears a close approximation to porcelain in
appearance.
Aluminum sulphate, or native alum, is found in quite large de-
posits in New Mexico, and quite pure . . . and this salt it was
which was used by Grabau, whom it will be remembered was
credited with producing the purest aluminum.
There are a great man\- ways of reducing these salts, of which
we have spoken, to metallic aluminum, some of which have been
put to practical use, and some of which have gone no farther than
laboratory experiments; but, the various practical methods may
all be classified under two heads, and these are :
First, reduction by sodium, and
ORIGIXAL COMMUXICATIONS. 377
Second, by the electric current; in the first classification sodium
is the agent used in all of the different methods which come under
that head and no matter what salt of aluminum is used, the sodium
is used to deprive it of its acidulous radical, thus freeing the
aluminum ; in the* second classification the electric current is used
for two purposes, first to generate heat and second by the process
of electrolysis to decompose the aluminum salt. This may be done
when the salt is rendered fluid by dissolving it in water or by dis-
solving it in a melted bath of other minerals, or it may be done
with the melted salt alone. I will describe two processes of recover-
ing aluminum from its salts, one by sodium and one by electroly-
sis. The first produced the purest aluminum and the second is
producing a very large proportion of the aluminum used in the
United States, and they are each typical of the two methods.
One of the difficulties in the production of pure aluminum is
the greediness with which, while melted, it alloys itself with other
elements. The two principal foreign substances which are found
in aluminum which the makers have tried to make pure, are sili-
con and iron, and these come from the vessels in which it was
melted; another insurmountable difficulty at this writing is the im-
possibility of purifying the metal after it becomes contaminated;
of course it may be purified, but at such an expense as to make it
a commercial impossibility. Now to prevent these troubles, one
must have a pure salt to start with and then must exercise all care
that the metal does not become alloyed in process of melting.
The first of these requisites Grabau succeeds in meeting by using
the sulphate of aluminum and reducing it to the fluoride of alumi-
num. His object in using the sulphate, is that it can be procured
cheaply, in large quantities and very pure. How he accomplishes
the second will be understood after an explanation of his process
and reduction.
As the process of reducing the sulphate of aluminum to the
fluoride is rather complicated, it will be sufficient to say it is done
by causing it to react with the purest obtainable cryolite (the
double fluoride of aluminum and sodium), the bases change places
forming the fluoride of aluminum and the sulphate of sodium.
Cryolite is very apt to be impure, but fortunately for the suc-
cess of his process, in the next step in the operation there is
formed a pure cryolite, and in quantity greater than is needed to
carry on the first.
37?
THE DEXTAL REVIEW.
Grabau had constructed a furnace of rather peculiar pattern of
which I have made a drawing : A A represents a brick furnace with
grate at M, enclosed in this so that the flames may pass around
them are two iron pots— H and E. H is used to melt the sodium
in and has at its lower portion a cock, I ; E is u^ed to heat the flu-
oride of aluminum in and is closed below by a sliding bottom, F,
upon the removal of which the contents can be discharged into the
pot below. J is an iron pot with double sides and bottom, the
A
/'y
W^
1
H
E
\||
■^
1
F
A
M
space between the outer and inner sides is constantly filled with
running water, entering at K, the pot is swung on trunions and is
supported by the pillars N, the action of the sodium upon the
fluoride of aluminum would be to free the aluminum as metallic
aluminum and become converted itself to the fluoride of sodium.
It is desirable, however, to have formed the double fluoride of
aluminum and sodium, consequently such proportions of each are
taken, that after the sodium is first converted into the fluoride
there shall still be present sufficient aluminum fluoride to recon-
vert the sodium fluoride first formed into the fluoride of sodium
and aluminum or cryolite ; the pot E, is filled with the fluoride of
aluminum and heated to a low red heat, the sodium is then put in
ORIGINAL COMMUNICATIONS. 379
the pot H. where it immediately melts, the cock I, is then turned,
causing it to be discharged into the pot J, the slide F, is then
drawn, precipitating the contents of E, upon the melted sodium ;
at the heat used the fluoride of aluminum remains granular and drops
upon the sodium below, very much like sawdust on water ; reac-
tion commences at once between the two substances and in less
than a minute is completed ; such rapid chemical change neces-
saril}' raised the temperature quite high, melting the cryolite which
is formed; a portion of this becomes chilled against the side of the
pot and is unaffected by either the melted cryolite or the melted
aluminum, thus thoroughly protecting the aluminum from contact
with the sides of the iron pot, which would contaminate it while it
is melted, thus removing the second difftcult}' which all makers had
encountered in the production of a pure aluminum, no silicon in
the form of sand crucible being used. In all processes of reduc-
tion with sodium there has always been a great waste of sodium,
in the neighborhood of twenty-five per cent, while in the Grabau
process as high as ninety per cent of the sodium is utilized. This
is due to the fact that the sodium is protected from contact with the
air by the fluoride of aluminum.
From its light specific gravity other makers have found diffi-
culty in causing the globules of aluminum to run together as soon
as formed and found it necessary to add a flux of some kind; this
Grabau does not do, as the melted cryolite is quite thin and acts
as a flux.
As soon as reaction ceases in the pot J, it is shaken to facilitate
the union of the aluminum and then inverted, its contents emptied
into an ingot mould constructed after the manner of the pot J, the
object being to keep it quite cool, that the hot aluminum may not
contaminate itself with iron.
Mr. Hall, of Pittsburgh, Penn., is the inventor of a process of
producing aluminum by the action of the electric current, which has
proven very successful in producing an aluminum quite pure (from 95
to 98 per cent) and at such a price as to make it a practical process.
The salt which he uses from which to produce the aluminum is
the oxide or alumina which he procures by calcining pure alumi-
num hydrate; this is dissolved in a bath composed of the fluorides
of sodium, calcium and aluminum which he obtains by melting
together cryolite (the flouride of sodium and aluminum), fluorspar,
(the fluoride of calcium), and fluoride of aluminum.
380 THE DEXTAL REVIEW.
The melting pots are cast iron and are lined with carbon, similar
to that used for electric light carbons; the bath is melted in these
and the aluminum oxide is added and is immediately dissolved as
is sugar in water ; in the center of the vessel are suspended sev-
eral carbon cylinders, to them is attached one of the wires which
forms the positive electrode, while the carbon lining of the melt-
ing vessel serves for the attachment of the negative wire.
The electricity seems to confine its decomposing energy almost
entirely to the oxide of aluminum, for there is very little waste of
the elements composing the bath; the metal is produced at about
the rate of one pound an hour, and is allowed to collect in the bot-
tom of the pot, from which it is ladeled out at stated intervals.
Mr. Hall at first used external heat to render the bath fluid, but
now, at the commencement of the melting the electrodes are sepa-
rated as far as possible, thus increasing the resistance to the cur-
rent; this furnishes heat enough to melt the bath, and when that is
accomplished the electrodes are allowed to come nearer together.
The temperature of the bath is kept about high enough to melt
brass, and the process is continued uninterruptedly for two or
more weeks. Since putting up their last works they have been
able to furnish alluminum for fifty cents a pound.
It will not be necessary to dwell long upon the physical charac-
teristics of aluminum; a few statements will be sufficient ; its color
we are all familiar with; as to harness, pure aluminum, or aluminum
99 per cent fine is quite soft, a trifle harder than pure tin, easily
cut with a knife which will turn up clean shavings that will not
break, but a slight addition of alloy, five per cent will change all
this; it will be much harder; the knife will have a grating sensa-
tion while cutting, the shavings will break and crumble ; this test
with a knife blade is a good offhand test to determine the purity of
any aluminum in question.
Aluminum is quite as malleable as gold and may be beaten into
as thin sheets; it may be drawn into very fine wire but with con-
siderable trouble, as the annealing must be performed frequently
and is quite difficult from the readiness with which the metal melts.
Another peculiarity is the greater amount of power required to
either draw it into wire or roll it into sheets than is required to do
the same work with other metals. The melting point of aluminum
is placed above 700 or somewhat higher than zinc, its specific
gravity at 2.5, or it is 2i4 times heavier than an equal bulk of water.
ORIGINAL COMMUNICATIONS. 381
As a conductor of heat and electricity it is good but not remark-
able. It has one curious propert}^ however, which makes it valu-
able from the cook's standpoint; when heated it loses its heat very
slowly.
Aluminum resists the action of oxygen and sulphur and their,
compounds perfectly, under which to other metals would be trying
circumstances. Nitric, sulphuric and muriatic acids all act slowly
upon aluminum. Of the three, muriatic is the most active, but
even this is slow when the metal is pure, but quite
the contrary when the metal is impure. Of the organic acids
acetic in connection with chloride of sodium is the most energetic,
but even this has not much effect. It has, however, a decided
effect upon tin, and when we consider that the acetate of tin is poi-
sonous, and that the acetate of aluminum, or the subacetate which
forms on cooking, is not poisonous, the lesson is plain — make culi-
nary vessels of aluminum and not of tinned iron.
Of all chemical substances, the hydrates of sodium and potas-
sium act the most energetically upon alumnium, dissolving it
greedily.
The melting, casting, rolling, drawing and soldering of alumi-
num is different from all other metals in common use, and must be
understood in order to make these operations successful.
It is best melted in the sand crucible. This crucible should
have been filled with a mixture of lamp-black and molasses allowed
to dry slowly, after which a hole is excavated in the center, or the
crucible may be merely smeared on the inside with this paste. It
is possible, by using great care, to melt it in the naked sand cruci-
ble, but the danger is that with much heat the aluminum will take
up silicon from the crucible. As to the manner of heating, it should
have a slow fire and patience, as it is very slow to melt. Use no
flux, as the metal will not oxidize. In melting the scraps be sure
they are free from foreign metals, and if they do not unite well
when melted they may be pressed together with a smooth, clean
iron bar. It is advised by some that the pieces to be melted be
dipped in benzine before melting, others add benzine to it when
they are melted.
When melted, aluminum is viscid or thick, and does not run
freely. For this reason and from its light specific gravity it is
somewhat difficult to cast. To avoid these difficulties, if cast in a
382 THE DEXTAL REVIEW.
sand mould, the sand should be left as loose as is consistent with
making the mold, to permit egress of air, and the gate should be
large and long, furnishing sufficient head or weight of metal to
force the melted metal beneath into the finest portions of the mold.
Dr. C. C. Carroll's method of furnishing artificial pressure b}'
means of air answers admirably.
In hardening and annealing, aluminum is peculiar. It is best
softened bj- heating to low red then suddenl}' cooling, and by heat-
ing to redness and cooling very slowly and gradually it becomes
decidedly hard and springy. In rolling, hammering or drawing it
very quickly becomes hard and elastic, and requires frequent an-
nealings with sudden coolings. These operations all require a
much greater expenditure of force to accomplish the same results
than thev do in other metals. The power needed to roll cold
aluminum has been compared to that required to roll hot steel.
When first brought to general notice one of the greatest draw-
backs to its use, was the great difficulty experienced in soldering
it, this has to some extent been overcome, but it is still difficult and
somewhat unsatisfactor\ . Two solders are recommended for den-
tal work, the formulas are for the platinum aluminum solder, gold
30, platinum 1, silver 20, aluminum 100; and for the gold alumi-
num solder, gold 50, silver 10, copper 10, aluminum 20.
Mourey experimented a great deal with aluminum solder and I
quote direct from him, directions for soldering, "The separate
pieces of metal to be soldered together are first well cleaned then
made somewhat rough with a file at the place of juncture, and the
appropriate solder put on in pieces about the size of millet grains;
the objects are laid on some hot charcoal, and melting of the solder
effected by a blast lamp, or a Rochemont turpentine lamp; during
the melting of the solder it is rubbed with a little soldering iron of
pure aluminum; the soldering iron of pure aluminum is essentially
a necessity for the success of the operation since an iron of any
other metal will alloy with the metals composing the solder while
the melted solder does not stick to the iron made of aluminum.
Fluxes for soldering are recommended by some, some of which
are balsam copaiba, benzine, paraffin, stearin and vaselin. As
in other respects aluminum is peculiar, so it is in regards polishing.
Like silver it takes the best finish by burnishing but the fluids which
are so effective in burnishing silver would ruin aluminum; a mix-
ORIGINAL COMMUNICATIONS. 383
ture of equal parts of olive oil and rum is recommended for the
burnishing, after which it is buffed.
Some of the alloys of aluminum promise to be of great interest
but the useful one seems to fall into one of two sets, these are
those combinations in which aluminum forms 15 per cent or less
or 85 per cent or more of the compound, those in between these are
for the most part useless.
Alloys of silver and aluminum containing about 10 per cent of
silver make very useful articles of table ware as they are not at all
easily tarnished and present fully as pleasing an appearance as does
the silver alloyed with copper. Dr. Carroll's metal for cast alum-
inum plates, according to the description in his patent papers, con-
sist of copper 1, silver 5 to 9 and aluminum 90 to 94, the addition of
the small amount of copper it is claimed does awa}' almost entirely
with the shrinkage.
Compounds of copper and aluminum are more generalh' known
than any others and of them all that which contains 90 per cent of
copper and 10 per cent of aluminum is the most useful; when the
percentage of aluminum increases, the alloy becomes ver}' brittle;
this is true up to the point where the aluminum forms 90 per cent
of the mass, when the alloy again regains its malleability, but not
to as great an extent as in the first named. The different alloys of
aluminum and copper are called aluminum bronzes and are desig-
nated as 5 per cent or 10 per cent bronzes according to the amount
of aluminum present.
The effect of small percentages of aluminum on iron and steel
is ver}' marked. One or two per cent of aluminum in cast steel low-
ers its melting point and makes sound castings, it increases its ten-
sile strength; tools cast from this compound come from the mould
ver}' sharp, require less finishing, take a higher polish and are at
once ready for hardening and tempering. The melting and casting
of wrought iron is very unsatisfactory, first from the excessive high
heat required to render the metal fluid, and second, the castings are
not at all strong; during the process of melting a point is reached
when the metal is in a pasty condition, it is melted, but so thick it
is impossible to pour it; to render it fluid enough for this purpose it
must be raised to a much higher temperature, if at the pasty stage,
a small amount of aluminum is added the iron at once becomes
thin and rests quietly in the pot, it maybe now made into castings
384 THE DEXTAL REVIEW.
sound and as sharp as cast iron having all the properties of
wrought iron except the fiber, castings of this alloy are called Mitis
castings.
The action of small percentages of aluminum in cast iron is
most marked in poor white iron which is usually hard and brittle;
the desirable changes which it produces are that it makes the
harder irons softer, renders them more fluid when melted and
makes more solid castings.
As to the uses of aluminum and its alloys, with the exception of
aluminum bronzes, they have not as yet in many ways taken the
place of the older metals and alloys, and probably will not until
some method has been devised by which aluminum can be pro-
duced at quite, or nearly the same price as iron. Its main claims
upon our attention are its great strength and light specific grav-
ity, together with its resistence to many of the corroding forces
which affect other metals. The first article made of alunimum
was made in 18.5(), and was a baby' rattle made for France's baby
Prince Imperial. It can and has been used for culinary utensils
but not to any great extent, because it is most too expensive; on
the contrary it is not used on the table to take the place of silver-
ware because it is not expensive enough ; its claims for exellence
in the kitchen rest upon the resistance which it offers to the action
of sulphuretted-hydrogen, oxygen and the Organic acids.
In surgery aluminum is of very decided advantage from its in-
nocuousness, light weight, and strength ; surgical instruments^
suture wire, surgical appliances used in orthopedic surgery may all
be made from it with great benefit to both physician and patient.
It has been used perhaps as much as in anything in the manu-
facture of astronomical, surveying and optical instruments, for
which purpose no other metal answers so well.
For scales and weights aluminum and the aluminum silver
alloys are extensively used.
Those who are interested in aerial navigation pin their faith to
aluminum and are waiting patiently for a process which will make
it cheaper.
With its use for dental plates we are all familiar.
The soldiers equipments in other lands are now largely made
from aluminum; his canteen, cartridge shells, buckles, sword scab-
bard and handles are all made from this metal, very decidedly
lightening the load he must carry.
ORIGINAL COMMUNICATIONS. 385
Priority in the Use of the Screw, in Regulating Teeth.
Bv Edward H. Angle, D. D. S., Minneapolis, Minn.
As the screw does, and most probably alwaj's will, occupy
such a prominent place in the regulation of teeth, it must always
be of much interest to the student of Orthodontia, to know its
history, and by whom first used in regulating the teeth. On this
subject much inquiry and research has been made.
The late Dr. James W. White, in answer to the question as
to who first used the screw in the regulation of teeth, says: on
page 404 Cosmos, Vol. 20., (18Y8.)
"The first, so far as we know, to suggest the employment of
screws in regulating apparatus, was Chas. Gaine, M. R. C. S. of
Bath, England, who claims to have originated the idea in 1849.
He published, some twenty-two years ago, a pamphlet entitled,
''On certain irregularities of the teeth, with cases illustrated of a
novel method of successful treatment."
In this little work the following paragraph occurs: — "I now
have recourse to the following method — a gold plate extends back
to, and embraces firmly, the first molars. To this support a thick,
flat piece of gold is attached and carried around the front part of
the dental circle, so as to cover all the anterior surface of the
incisors leaving only the cutting edges free. This accomplished,
I cut away the plate from the posterior surface of the irregular
teeth, and opposite to these vacant parts, drill holes in front
through the thick gold, into which each screw is inserted for each
tooth to be operated upon. The action of the pressure on the
fault}^ teeth, is direct, painless, and most easily controllable, and
for its efficiency I can freely vouch. A fortnight suffices to bring
the teeth into a true form."
Dr. Farrar, in his late work, claims to have made special efforts
to gain information which would settle the point of priority, and
after devoting six pages on the subject, says:
The credit should be awarded to Dr. Gaine, Bath, Eng., and to
Dr. W. H. Dwinnelle, N. Y. City. Dr. Gaine having been the
first to use the screw simple in 1849. Dr. Dwinnelle for making
use of it in the same year in the form of a jack-screw."
But from recent researches, I find the screw was used long be-
fore this date both in France and Germany. For my library con-
tains a book written by J. M. A. Schange, and published in Paris
386 THE DEXTAL REVIEW.
in 1S4-2 entitled -'Precis sur Le Redressement Des Dents, ou Ex-
pose des moyens rationnels de prevenir et de corriger Les Devia-
tions des Dents, suivi dequelques reflexions sur les obturateurs du
palais." In which several regulating appliances are described and
illustrated, clearly showing the use of the screw in the regulation
of teeth. Three of which appliances are here reproduced.
The author says: — "Very often as the central incisors stand out
obliquely, the lateral incisors stand inward. It results that all at-
tempts to make the centrals come into line would be vain, without
moving the laterals at the same time. I have often used an appli-
ance to serve the double purpose; this appliance resembles a band
which Fauchard made use of and since used by the greater num-
ber of dentists to detract teeth that are inlocked. But I have
anchored it to the sides of the molars and have appropriated it to
two uses.
It is composed, as we see in Fig. 1, of two hooks that are in-
tended to embrace the molars. On the external face of each of
ORIGINAL COMMUNICA TIONS.
387
these hooks is soldered a gold band which follows the contour of
the external face of the teeth, to the limit of the part that corres-
ponds with the central incisors. This band is pierced by two holes
which receive two little vis (screws) and opposite the lateral incis-
ors are also holes indented to give passage to the ligatures of silk
which are tightened around these teeth. As we tighten the screws
they press on the central incisors, but as these teeth move in with
difficulty, the band springs out increasing the tension on the later-
al incisors, and the cuspids also, should they be attached. This
appliance has been drawn in such a way as to make its action
clearly understood, but applied on the person the band is a great
deal more approached to the laterals, and screws of pressure are
so small that they do not interfere in any way with the complete
movement of the mouth. I have recently applied it on the mouth
of a young person belonging in the family of M. Rignoux, im-
primeurde la Faculte de Medicine, who had been recommended
to me by M. le docteur Pinel-Grandchamp.
388 THE DEXTAL REVIEW.
Several very distinguished dentists to whom this lady had
been sent, did not wish to attempt the cure of this vice it being
so pronounced that they judged it to be impossible. I undertook
what my confreres supposed impossible, and applied the ap-
pliance as above described.
Perceiving that there would not be sufficient space to bring all
the teeth into line I extracted the first petit molars, after which I
drew back the canines with ligatures attached to other holes in
the band, causing space sufficient to admit the central and lateral
incisors which were drawn completely into line at the end of the
second month.
I owe to M. Sampson, manufacturer of surgical instruments,
the small ingenious machine shown in Fig. (2) to draw in the two
centrals, at the same time drawing out the two canines and later-
als. This seductive little machine consists of a tree of a screw
secured in a plate of gold, threaded in its center and operated by
a watch-key. This appliance when pressing the plate in front of
the teeth, draws at the same time another plate in a similar way,
at the posterior, bearing on the lateral incisors and canines.
In Fig. (3), also from the same work, the clamp band is plainly
indicated, and it is worthy of note that it is of the identical pat-
tern as that claimed by Dr. Farrar and illustrated nearly 200
times in Vol. I of his new works, and described by him on page
235 as follows :
"The above instrument made by me, which will hereafter for
brevity be spoken of as the clamp band, consists of a thin ribbon
of platinum or 18 K gold about one-sixteenth to one-eighth of an
inch in width, having a nut soldered to each end, one smooth bore,
the other threaded, both of which are connected by a screw hav-
ing a square nib or globular head with a hole through it — this de-
pending upon the fancy of the manufacturer, or the requirements
of the case. The screws are turned by a watch-key or a lever."
ORIGINAL COAIMUXICATIONS. 389
Again, in the excellent librar}- of Dr. W. P. Dickinson of this
city, I find a copy of Robinson "On the Teeth," published in
London in 1846, in which the screw is shown in regulating, and
described by the author as follows : (See cut Fig. 4.)
vxyctxx
"I determined to have an instrument made that would be free
from the objections to which those hitherto used by Fox, Bell and
others are liable. It consisted of a piece of hippopotamus (den-
tine) carefully fitted to a model of the anterior part of the palate
and internal surface of the upper teeth, the edges being rounded
•off so as to make it comfortable as possible for the tongue. It ex-
tended in the form of a bar behind the four incisors, beyond which
it was flattened so as to form at each extremitj^ a sort of cap,
which on the left side was carried over the crown of the bicuspids
and first molors and on the right after passing over the bicuspids,
accommodated itself to the space left by the removal of the first
molar tooth, which had been extracted at a former period. This
arrangement fully answered the purpose of preventing the under-
jaw from closing in its former position, and the power of exerting
the pressure required to force the irregular teeth into their proper
positions was given by two pieces of strong gold wire screwed into
the bone immediately behind the teeth. These wires were turned
and flattened so as to present a button-like surface to the posterior
aspect of the same teeth. The instrument was firmly retained in
its place by means of two broad clasps inserted into the bone and
and fastened around the second bicuspids.
And in the supplement to the German edition of the above
work, the screw is again clearly shown in the very original but
somewhat clumsy manner, as seen in Fig. 5.
And, again in the second edition of Delabarre, we find the
screw forming a part of the regulating device. In which one end
of a lever is bent at right angles, and is screwed into a cap which
is slipped over the tooth to be rotated, the other end of the lever
being tied to an anchor tooth, as shown in Fig. G.
Thus it will be seen that the screw employed by this author was
890 THE DEXTAL REVIEW.
for the attachment of an appliance, and not the direct power in
moving the tooth — as shown in the appliance above.
The date of using this appliance is not given by the author,
other than the date of publication, 1819. Neither is the date given
by J. M. A. Schange, in which he employed the screw, but as his
book was published in 1843 it is reasonable to suppose that one
or two years must have elapsed between using and publishing — or
1840 or 1841.
• Possibly further research may show still earlier dates, but until
then the honor must be given to C. F. Delabarre for first making
use of the screw in a regulating appliance. And to J. F. A.
Schange for first employing the screw directly in the movement of
a tooth.
PROCEEDINGS OF SOCIETIES.
Chicago Dental Society.
Annual meeting April 5, 1892.
president's address.
By D. M. Cattell, D. D. S.
Gentlemen of the Chicago Dental Society:
My address to you this evening will be brief. But few things of
marked importance have happened to this society since I w^s
chosen to preside over you at our last annual meeting.
We began the year with a membership of ninety. We have
had three members resign, and two have left us by death's door;
fifteen have applied and become members. So at present the mem-
bership's roll shows a body of good and true men numbering 100.
We have had nine papers read, and the subjects they pertain to
discussed, eight of which were presented by members of the so-
ciety, and one by Dr. Holmes, of Joliet, a guest of the Society for
the evening.
The year has not been prolific of any great scientific elabora-
tions among us. But certainly the average of the papers, and also
the discussions, have been above that of previous years. Let me
repeat — the year gone by has shown an increase of good essays —
both in number and quality, a few being presented by our younger
members.
PROCEEDINGS OF SOCIETIES. 391
Why is it our young members are not heard from more, either
with papers or in discussions ?
The business of the society has been done in an orderly man-
ner and with dispatch, and I certainly thank you for that as well as
for the courtesy shown your presiding officer.
The importatit action of the year by this Society, was the turn-
ing over or presenting to the Newberry Library Association our
own library^one that had staid by the Society through thick and
thin, prosperity and reverse, pleasure and pain, health and disease,
happiness and sorrow, through its life so far. But the action was
that of the Society — after due deliberation.
The Library — our library — was given away. There were but
few of us at the time, that raised our voices against the resolution.
We were outnumbered, the resolution became a fact. So to-day
we are without a library. The Newberry Association has a Dental
Library of value to itself as an historical fact — as a library of refer-
ence for us it is, practicall}^, a nonentity. Pardon me, gentlemen,
for so particularly alluding to this bit of history, but my remarks at
the time the said resolution was under discussion were rather de-
rided by some who thought they saw great benefits in the near
future for such disposal of said library. Indeed, I felt rather sat
down 2ipon for presuming to disparage the gift. But now, gentle-
men, my day has come and I have had my say. Let it be recorded
as one of the feio mistakes that this society of ours has made dur-
ing its existence of over twenty-five years. In other ways it has
made for itself a record, a name. Do not some of you remember a
resolution presented to this societ}' b3^ Dr. A. W. Harlan a few
years ago, when we met in the lecture-room of the Chicago College
of Dental Surgery, at No. 6 Washington street, looking toward a
World's Denial Congress? Said resolution was adopted and ordered
placed in the records of the society. Indeed, gentlemen, if I mistake
not, the first note ever sounded on that great issue was blown by this
same society, and if the records were searched I feel sure they would
bear me out in the thought that to this society belongs the honor of
the suggestion for which such great preparations are being made
and from which such great things are expected. It was months
after that resolution was presented before other societies caught up
the refrain and commenced to "resolve."
Another important fact has occurred. This Society, as leader.
892 THE DENTAL REVIEW.
has, with other local societies, given a Union banquet in honor of
the Worlds Columbian Dental Congress' Executive Committee.
The banquet was a success, due to the individual interest taken
in the great meeting to be held in 1893.
As this banquet was given the evening of the 12th of January,
near the time for our own usual annual dinner, it seemed unnecessary
that we should give another so soon following.
The great success of the ''Union'' banquet was in the fact that
five local societies could and did work in harmony — showing that in
the necessities of the near future, much may be expected and much
can be done in harmony and with profit.
If I am rightly informed there is already a project in embryo to
soon form a Union Society for the purpose of listening to and taking
part in a high grade course of lectures pertaining to and benefit-
ing us in our calling. Possibly a " University Extension " course.
Let us hope the germ will develop and become a full grown
fact.
How better can we entertain ourselves in post graduate study?
Now, gentlemen, I have presided over you the past year in
a mild sort of way and you have been courteous enough to allow
matters to slide along easily — which fact, I assure you, is appre-
ciated. We have before us the coming year much work to be
done — many meetings, may be, to be presided over of a special
nature. Let us select for the coming year, a president that will
do us credit — a goodly presiding officer. Remembering, that the
World's Columbian Dental Congress will have been born e'er long
in our midst — we must recognize our offspring — although greater
than its parent — we must bend every effort to make its short life
a success and its death a glory.
The Dental Review.
Devoted to the Advancement of Dental Science.
Published Monthly.
Editor: A. W. HARLAN, M. D., D. D. S.
ASSOCIATE EDITORS:
Louis Ottofy, D. D. S. C. N. Johnson, L. D. S., D. D. S.
Young Men in Society.
At a recent meeting of the Chicago Dental Society, the ques-
tion was raised as to why we do not see young men taking a more
active part in society work. It was stated that the younger mem-
bers of this society are seldom heard in the discussion, and that the
society by reason of this had drifted to a point where it should
properly be called an old man's society. This was considered a
cause for regret, as the success of any organization depends much
upon the influx of new blood.
We are scarcely in accord with the views of the retiring Presi-
dent who gave as his idea that the fact of having a short-hand re-
porter always present at the meetings to report discussions
deterred young men from venturing on the floor.
We have always felt that since the Dental Review began to
publish verbatim reports of the discussions of this society that the
work was of a better order than formerly. It should prove a stim-
ulus to any man, old or young, to know that his remarks are to
receive the benefit of publication, and no man however inexperi-
enced in speaking, or however halting in his sentence, need fear
the reporter in this instance, on account of an invariable rule
which provides that the reporter's manuscript shall be submitted
to the speaker for revision before publication. We do not know of
many young men who dislike to see their names in print, and we
certainly think that the reason why our young men keep in the
background at the meetings must be sought for on other
grounds.
894 THE DEXTAL REVIEW.
One thing must be borne in mind when we consider society
work in Chicago, and this probably influences some of our young
men in their attitude to the Chicago Dental Societ)-. In this city
the young men have a society of their own — a society organized
by them and expressly for them. The idea was to make it a
sort of training school for young men where they could meet and
discuss matters among themselves without running the gauntlet
of criticism from older and more experienced men. At this so-
ciety they are all on a level and they consequently feel little diffi-
dence in advancing their views on any subject.
And let us say right here that we think the principal reason
why we do not hear oftener from them in the older societies is on
account of a natural lack of confidence which makes them hesitate
to pit their judgment and opinions against those of men who have
been longer in practice. Our views of the matter is therefore com-
plimentary to the young men, for a certain degree of diffidence in
a young man is commendable. At the same time we must warn
them that this kind of diffidence may be fostered too long, and
that in trying to be too modest they may sometimes avoid being
useful.
We would urge the young men then to come forward and as-
sume their proper share of society work, and we also bespeak for
them from among the older members a considerate hearing.
\'ery often a young man whose maiden effort receives criticism
is deterred from future attempts. Young men are essentiall)' sen-
sitive of criticism, and do not realize in their earlier experience of
society work that when an older member takes issue with them it
is for the purpose of bringing out the truth rather than to belittle
the speaker.
We have a word of encouragement for the young men. We
invite them cordially to take part in our discussions. We assure
them that this is important for they are the men who one day will
form the working force of our societies. They cannot have too
much preparation. C. N. J.
Cotton as a Root Filling.
One of the strangest phenomena of this progressive era is the
persistence of some men in continuing to fill root canals with
cotton. If any one still adheres to the belief that anything with
which cotton may be saturated is going to " hang on, bull-dog
EDITORIAL. 395
fashion," for an indefinite length of time, that belief will be soon
dispelled if he will only stand by and enjoy the odor, when one of
these antiquated fillings is unearthed. If any, contrary to the
teachings of the day, still persist in using cotton, let them use the
most oil}' and if possible dirty cotton, on the principle that the
more of this it contains the less of anything else it can take up.'
The poorer the cotton, the better its absorbent quality, hence the
more dangerous is it as a root filling. A tooth, the root of which
is filled with cotton, is never thereafter in a physiological condition;
the inflamrriation surrounding it causes the patient to shield the
tooth in question, and in so doing the entire side of the mouth, re-
sulting in injury to other teeth; the soreness is often supposed to
be due to a ''cold," or it is sometimes thought to be a condition
always present in bad teeth. Probably in no branch of dentistry
is the adage that whatever is worth doing at all is worth doing well
so true as in the treatment of diseased conditions in or about the
roots of teeth and their subsequent proper filling. We have found
cotton in teeth, where the cavities were filled with gold quite re-
cently. It is a disgrace to the profession that these occurrences
are stUl so frequent.
Consistency, Thou Art Etc., Etc.
The dental profession is at the present time endeavoring in
various ways to elevate its standard, to demand recognition as a de-
pendent or independent profession worthy to command the highest
respect of the people. In doing this it demands of members of
the profession, that the}' shall live and act as professional gentle-
men, and observe the principles that govern professional men. No
other profession — not even excepting the medical — has so high a
regard for what is known, as the "Ethics of the Profession." In
its college work, literature, societies and among its individual mem-
bers (taking into full consideration all short comings), the dental
profession of to-day is the most ethical yet liberal and tolerant.
Under these circumstances it is painful, very painful, to see a
prominent dental society, show so small a regard for the profession,
as to accept and give prominent place on its programme, to the
claims and work of one, who stands expelled from the Society of
his own State, and who saved himself a similar disgrace by resign-
ing— on request to do so — from the American Dental Association.
396 THE DEXTAL REVIEW.
If we desire to maintain our present position, and improve there-
on, it is not well to trifle with these things. What is consistent in
one State should not be inconsistent in another.
World's Columbian Dental Congress.
A general interest is being taken by dentists everywhere in the
dental congress to be held in Cliicago in 1893. It is hoped that
all dental societies in the world will take early notice of the date
for the opening of the congress, August iVth, 1893. Visitors from
Europe who sail from Bremen or Hamburg, in Germany, on Sat-
urday, the 5th of August, will have ample time to reach Chicago.
Those sailing from Great Britain and Ireland can sail the same
day, reaching New York on Sunday or Monday; and our Belgian,
Dutch and French confreres may leave on the same date from
Antwerp or Havre or Boulogne, reaching New York on Monday
or Tuesday at latest, and Chicago Wednesday night.
It is hoped that the various dental societies in Europe will fix
the date of their meetings either earlier than August 1st or later
than September 5th, to enable as large a number of their members
to visit Chicago as can possibly be spared the perils of an ocean
voyage. Visitors from other countries will necessarily leave home
from one to two weeks earlier in order to receive the first impres-
sion of the opening of the World's Columbian Dental Congress.
We hope our friends will begin to arrange their itineraries at
once in order not to miss this notable event.
Caution.
In using the oil of sassafras in teeth where the pulp has been
dead for some time be careful to seal the cavity pretty well or the
patient will suffer from nausea if allowed to swallow more than a
drop or two of the oil.
Chicago Dental Society.
At the May meeting of the Chicago Dental Society there were
62 members and 29 visitors present. 1 here was nothing special
on the programme to bring out such a large number, but the officers
had issued a circular of general interest (which will be found else-
where in this issue) that caused such a large outpouring. One
lady was admitted as a regular member and Mr. J. H. Mummery
DOMESTIC COJiRESPOA^DENCE. 397
M. R. C. S., L. D. S., Eng., was elected to Honorar}' member-
ship.
There are now two honorary members Dr. G. V. Black and
Mr. Mummery. For a society more than a quarter of a century
old, this is a good showing. The views of this Journal on the
question of conferring honorary membership in Societies and hon-
orary degrees from colleges are to the effect that the recipients
should have by their previous labors advanced the cause of edu-
cation or science in such a noticeable manner as to have fixed the
eyes of the world upon them and then the Societ}' or College has
good grounds for conferring the special mark of their good will
and esteem; merited honors are always gracefully worn by true
scientists, teachers and authors and we felicitate the above named
gentlemen on their accTession to membership in the Chicago Dental
Society.
A new era of good feeling and interest is abroad and it argues
well for the coming congress that not only the Chicago Dental So-
ciety but the Chicago Dental Club, and the other societies, are
having meetings filled with enthusiasm and large attendance. Let
he work go on until every dentist of respectable lineage is a mem-
ber of some dental societ^'.
DOMESTIC CORRESPONDENCE.
Post-Graduate Study.
By Wm. c. C. Ball, Jacksonville, Fla.
To the Editor of the Dental Revie^v :
Sir — I have seen some good articles in the Review about the
Post-Graduate Course. The course as given by the Chicago Cole
lege of Dental Surgery is a thorough one. If all the colleges would
take it up and have the class actually perform its work there is no
doubt that nongraduates could be almost as good practitioners as are
the graduates. There is a question I desire to ask those not in favor
of granting a Post-Graduate diploma. Where there are two
dentists in a small town, and one of them has been in practice
about ten years, the other just out of college, which of them would
th^y like to have extract a tooth for them or administer nitrous
oxide gas to them ? I should wish the man with experience. If
the colleges desire to unify the profession let them give a diploma
to a dentist who has been in practice five, eight or ten years. If
898 THE DENTAL REVIEW.
he is willing to leave his practice and attend college for one, two-
or three months, taking a Post-Graduate course, let them, bring a
certificate with them from a notary that they have been in practice
the stated number of years ; compel them also to pass a prelimi-
nary examination. If the examination was vested in the Deans of
the colleges, such men as Brophy, Abbott or Taft, in twenty or
thirty minutes' conversation they could readily determine whether
the candidate is suitably educated to enter the course. In the
class of 1891were graduates and three nongraduates ; by their work
one could not distinguish one from the other, hence I claim that
one man was just as good as another, and I believe the entire
class would corroborate my statement.
Letter From New York.
To the Editor of the Dental Rcvieiu:
Dear Sir — April, as formerly, has been a fickle month, and is fully
in keeping with my observations among men and things. Things
are not running smooth, the trickling brooks have lost their happy
gurgling sound, so joyful in the first spring days, and have put on
a turgid, muddy appearance. Men are not what they seem. No
man who has done a mean thing can disguise his countenance.
The quicker he goes and cleans up, just so much sooner, his coun-
tenance will put on a manly glow. Crying "Rats" doesn't fix it,
but that is what the politician says, so the paper tells us.
Dr. Barrett has put it, as it is and will be. In the April number
of the ^i/i'ertiser he says that the late disturbance in the First Dis-
trict Society, has produced a more bitter crop of dissensions and
recriminations, than any meeting within the period of our remem-
brance, and has left behind it a train of evil influences, of which
none of us will see the end. That is the way we have viewed it,
and it is a most unfortunate occurrence at this particular period of
our history. Who did it ? will be the interrogation of hundreds of
men. Bad news travels fast, and we do not have any anxiety, but
that the whole affair will be properly located. "What we sow,
that shall we reap."
The slate of the annual meeting of the first district society was
carried out as predicted, aside from giving the names of officers
that would be elected. Dr. Carr was elected President, Dr. Hart
Vice-President; Dr. Gibson Treasurer; and Dr. Nash Secretary for
the past seven years, was reelected. He is of a kind that gives
DOMESTIC CORRESPO\rDENCE. 399
satisfaction to all. Always a nice little p;entleman and assiduously
attends to his official duties. The only report that was of any
marked interest was the report of the Executive Committee, and
this was worthy of special notice for it was a perfect refutation of
untruthful charges brought against the Committee. Hearsay is a
dangerous thing to meddle with unless you are quite sure wdiat
you hear is right. We quietly think that one of the virtues of our
letters is that they tell what is true.
A motion was made at the annual meeting by Dr. Morgan
Howe looking to the discontinuance of clinics, which have been so
many years an extremely popular feature of the First District So-
ciety. It was advocated that such a step decided upon would be
"a black eye" for the Society, considering that it had already got
one, it did seem rather wise not to disable both, certainly until
time had elapsed for the recovery of the first. A compromise was
finall}' accepted, by voting a vacation until October next. It may
be a little premature to say that this is onl}' a step for the removal
of the Society's clinics to a more convenient place, and while we
have the thought in hand we will add the proceedings of the So-
ciety also; you know, or some do, that ihere is a Society 'Journal
to be looked after, and it is perfectly natural that this self interest
should have attention. But in spite of all this there will be those
that have an ambition to see iheir articles published in the Jour-
nal that has the biggest circulation. This fact has already come
to light in the Odontological Society and been discussed. At the
hour for the monthly clinic we found that it was off officially by
the absenteeism of the chairman of the Clinic Committee and the
resignation of another member. Yet b}- force of habit quite 50 den-
tists convened, and an interesting clinic was held although en-
tirely informal. A case of much interest was presented by Dr.
Peters, of Jersey City, for counsel. We pronounced it retarded
development of a superior lateral, caused by deformed supernum-
erary. The enlargement appeared like a bony cyst. There proved
by probing to be quite a copious discharge. We tented it freely
and advised a renewal from day to day, for the purpose of devel-
oping a large and free opening for ready inspection. In this way
the case would be made instructive to the dentist having it in
charge, and if he needed further'counsel or assistance he could pre-
sent it at a future period.
A case needing regulation was presented of what may be
400 THE DEXTAL REVIEW.
termed overhung teeth, and what to do is the question so often
asked. The lower centrals biting against the mucous membrane
and quite a space behind the centrals. The dealings with such
cases are just now having attention by Dr. Kingsley in the Cos-
mos, and we suggested to the practitioner presenting the case, to
study these articles.
Ane.xtremecase of abrasion so-called and erosion, involving the
grinding and cutting surfaces of all the teeth; advised crowns, cap-
ping and also Dr. Knapp's idea of placing over the entire surfaces a
rubber plate, which he claims will check the difficulty. We re-
commend attention to the conditions of the gum margins, a la
Riggs. This is our method of dealing with such cases sur-
gically and then apply such mechanical dealing as the case indi-
cates. A case of Porcelain bridgework in the mouth of Dr. Ather-
ton, of Battle Creek, Mich. Two superior bicuspids put in the
day previous by Dr. Parmly Brown. This work speaks for itself,
and judging from the interest Western dentists are manifesting,
they seem disposed to know for themselves. When the doctor gets
home to Michigan his patients are going to have an object lesson
based on his own tuition. I see Dr. Brown is invited to the Illi-
nois meeting. He won't let an}' grass grow under his feet, and
while he is there all one has to do is to keep eyes open and he can
catch on, if he has the grit.
A case of bridge work called the Bar method was shown at this
monthly clinic, put in by a Dr. Calder, of Salt Lake City, in 1874.
One of the teeth that the bar was attached to had loosened and
come out. Dr. Brown took it out in the presence of a New York
dentist. Bridge work has been about a good many years. It has
come to stay in the hands of men of good judgment. A dentist told
us at the late mass meeting in New York that he wrote to a New York
dentist nine years ago to know about the merits of this work ?
The reply was that no one of any reputation would have anything
to do with it. Some changes since. But this practitioner living in
a distant part of the State, thought there must be something in it,
and took another tack for information, which resulted in his be-
coming an expert, and he put money in his purse, and he told us
further that he had paid over Jl,GOO for royalty. He joined the
D. P. A. at the late mass meeting and will sin no more. Ye that
read this, go and do likewise.
No little comment has been made regarding the results claimed
DOMESTIC CORRESPON'DENCE. 401
at the late mass meeting. Four hundred new members were claimed,
we have been told by a dentist who said, by actual count by him-
self, there were but 864 in the hall. It might be that members
were made by proxy.
A dentist very prominent, remarked when it was announced
that 400 new members had been added, "Oh ! that's only a show-
man's statement."
Odontological Society meeting found but a small number to
listen to a very painstaking paper on '- Copper amalgam " by Dr.
Osman, of Newark, N. J. No one has presented so excellent a
review of the subject. The matter of research was commendable
in a degree far above the ordinary. Dr. Osman's effort was intel-
lectual. Taking a subject so much tabooed at the present time, to
be able to say so much in its behalf up to date and predict what
may come of it ultimately, and based on so much sound reasoning,
was a success that copper amalgam much needs, for it has gotten a
back step of late that must send it to the rear unless such
efforts afford it a better standing, as Dr. Osman seemed to have
the purpose to do by his paper. The summing up of this directed
the thought to the belief that he had established for himself that it
did possess merit and he had come to this conclusion by a perse-
vering experimentation and close observation. He did not evince
any purpose to drop the article without exhaustive investigation.
We are glad to emphasize Dr. Osman's spirit to be a useful investiga-
tor, rather than an easy going one. There was so much desultory talk
we cannot don it with a title of discussion, a number owned up
that they have dabbled with it and have gotten all kinds of un-
favorable results and yet they could give no lucid reasoning for them.
Dr. John B. Rich, of Washington, formerly of New York City,
took occasion to say that he did not feel proud of his confreres
for acknowledging that they were willing to make use of an article
that had played so many tricks upon them. It seemed to him as crim-
inal. The idea that we American dentists should be following so
much the lead of English dentists, when we have taught them all
they did know (don't yer know). Dr. Boedecker said he received
a good idea from Dr. Herbst, of Germany, relative to copper
amalgam. It was combining in the mixing with mercury a
sheet of pure silver, about a quarter of a grain to about eight grains
of the C. A. This did prevent the turning black and also the
waste. Dr. Bogue had found that by several reheatings after
102 THE DENTAL REVIEIV.
pressing out all the mercury, facilitated the harding quality, and
this prevented the waste, also so much complained of. Dr. Bogue
did not use this material except in buccal cavities. He used other
amalgams in proximal cavities, but no amalgams in grinding sur-
faces. Somewhere we have met with a similar remark and we
gathered from it at the time, the impression that he uses gold always
on grinding surfaces because of its better appearance. If this is
true, I think the C. A. on buccal surfaces would mar the aesthetic
effect.
We gather the impression that Dr. Bogue had emphasized the
use of C. A. in New York during the past few years. Dr. S. G.
Perry seemed to think so also. Dr. Davenport, an associate of
Dr. Bogue's intimated that Dr. Bogue did not now think so favorably
of the material. An effort had been made by the O. S. to get a full
expression of the views of its members, on the subject of C. A.,
judging from the voluminous roll that appeared at the meeting,
said to be testimony. Some of us will get the headache by the
time we get through reading it. It was voted to publish this testi-
mony in the proceedings without boring the Society with the bur-
den of it. We sighed a relief.
Copper amalgam is evidently going to get an ardent attention
if the voice that was raised against it at the meeting was an indica-
tion, and if there is no more intelligent opposition arraigned against
it than appeared at the meeting by the discussion, save Dr. Bogue's
remarks and the essayists, the readers of \.\vt. Journal will be but
little wiser regarding the demerits of this material.
It was announced by the Executive Committee, that Dr. Steb-
bins, of Shelburn Falls, Mass., would read a paper at the next
meeting upon the use of nitrate of silver in arresting caries and also
its use in connection with pyorrhoea alveolaris, and will show some
cases that have been treated by this agent. I have noticed his pa-
per published in the International Journal, in one of my late letters.
A banquet was given by the Odontological Society to the honor
of the Barrett Osteological collection, there being some seventy-
five present, including several dentists from other cities.
An enthusiastic effort is being made in New York for the com-
pletion of the tomb to be erected in memory of Gen. Grant, and to
have it completed by '03. The dentists, together with other pro-
fessions and the trades, have formed their committee for the collec-
tion of funds in aid of this memorial. A singular coincidence
DOMESTIC CORRESPON'DENCE. 403
occurred at the forming of the committee. The meeting was
called to order by Dr. Parr, who was formerly an officer in the Con-
federate Navy. He said he contributed to the erection of a mon-
ument to Gen. Lee, and he was ready and willing to do the same
for Gen. Grant.
How often extremes meet. A good many dentists have pur-
chased the Small obtunder for obtunding sensitive dentine. It is
now, as exhibited at the clinic, ver}' much minimized in its propor-
tions since its first presentation by Dr. Niles, of Boston. This
subject of treating sensitive dentine is taking up a good deal of at-
tention from different points of compass. This small appa-
ratus is nothing more or less than an alcohol blow pipe, which many
of the older practitioners are perfectly familiar with. This instru-
ment differs from others that are devised to do the same service.
Associated with various medicaments these have a valve direct
in the cavity for letting on the current of vapor when it is heated
to its proper temperature. It is in this sense a disadvantage, we
think, not to have such a valve on account of the difficulty of read-
ily approaching the carious portion of the teeth. The vapor is at
high heat, and thrown upon the mucous membrane it would not be
very comfortable.
It came to us that at a late demonstration before a class of
students the patient was cooked too much and rebelled. It was
said that it was carelessness. The question will arise, what does
this degree of heat do to the dentine ? It is claimed that it so acts
on the fibril that it contracts, and leaves a space between the
fibril and the decayed portion, cutting off the mechanical action
which produces sensation. This is the claim made in Boston,
What do western dentists think of it ? It looks a little as though
Boston and Harvard were rushing this small instrument. Prof.
Fillebrown is out with large endorsement of it, and the agent has a
good sized package of other endorsements. One thing was brought
out at the late meeting of the O. S. that will strike bright men as
strange, in these days, certainly, after so much reiteration of intel-
ligent dealings with cases such as was referred to. It was stated
as a decided prejudice to copper amalgam that it produced pulpi-
tis. Three cases in which it occurred, the party went on to state
and that " in such cases you know that we alwa}"s take out the fill-
ing as quick as we can." Do the readers of the Review accept
such practice? What is a practitioner taking out a proper filling
404 THE DENTAL REVIEW.
for when pulpitis occurs? This, I admit, would not be common
practice, yet we hear it still from not a few quarters. It is strange
how many poor listeners there are after so much teaching. "Hav-
ing ears but do not hear." I suspect that some worthy one maybe
saying, I wish that this correspondent had told how to take care of
a case of pulpitis and not take out the filling. Well, just as
we would if it had no filling, and that does not answer the
query. We will be definite. Open directly to the pulp chamber
at such point as the case indicates. But some one says, the tooth
is so very tender and painful ; support the tooth by tension with a
ligature or by the thumb and finger. Gentle dealing and a full un-
derstanding of what is needed. When the pulp is reached and it
bleeds, as it is quite sure to do, the pain will ultimately subside ;
yet to alleviate the pain sooner apply a pad of Japanese paper
saturated with tincture of aconite, and the case comes under con-
trol. It may require renewal. Many cases can be so restored to
usefulness, but I think a majority destroy the pulp after controlling
the pain. After we secure relief from pain, if w'e think of trying to
save the pulp, we dress the pulp with tincture of aconite, combined
with oil of cloves, and stop the opening gently and loosely. To
protect the tooth against mechanical disturbance we apply a gutta-
percha cap to an adjoining tooth which lifts the teeth apart. This
we allow the patient to wear until the case is free from tenderness.
This gutta-percha cap is preeminently valuable in cases of perice-
mentitis. We have used it in hundreds of cases during the last
thirty years, and are indebted to Dr. Wm. B. Hurd, of Williams-
burgh, Brooklyn, Eastern District, for the suggestion. We always
like to give credit for such helps ; we do not think it is done any
too often.
Quite a little breeze is getting under way.
In my last letter I mentioned that there was a query going
around in reference to the statement made by Dr. Crouse regarding
a ^something) that would ultimately wipe out the present Lowe
claims, etc., etc. The Doctor did not make himself clear to all. It
was queried whether the books that Dr. Parr had placed in his
possession had anything to do with this statement. If it had any-
thing to do with it it was said they were of no value anyway etc.,
etc, and many other remarks that I will not now give. Dr. Parr
does not feel that he has been dealt fairly with. He had known
more or less of the rumors concerning him and he claimed that it
DOMESTIC CORRESPONDENCE. 405
was due him that he make a statement explaining his true position.
He expected he would be allowed to do this at the late mass meet-
ing, but was ruled out. We will by inference intimate a glimmer
of what is in his mind and more ma}^ come later. He would like
to know wliy letters that were in the hands of a prominent dentist
in New York (a correspondent of his), were placed in the hands
of Mr. Atwood, the Crown Co.'s agent, and confronted him in court,
when he was fighting a case against the Crown Co. (and he paying
his own expenses), why this was given into the hands of the enemy
by a supposed friend of the profession. Dr. Parr called and asked
this person if he had the letters sent to him. He said yes, and went
to his desk to produce them and found them gone. (He did not tell
him that they had confronted him in court.) This person says in
a surprised manner. "Who do you suppose could have stolen those
letters?" "Well," he said, "Mr. Atwood, the agent, was here in
my office one night and we had a little lark together, and I don't
understand it." Dr. Parr says he has not been able to get an expla-
nation so far.
It is a query why a friend of dentists was blocking another
friend of dentists, m a litigation that was to be helpful to dentists
in trying to settle a perplexed question in which all dentists are
mutually interested; to put aid in a known enemy's hands is some-
thing that ought to be explained, in the interests of ethics, and
Dr. Parr says that if it is not explained, he will consider it only
justice to himself that he explain it. Yes, justice, though the heav-
ens fall.
A misprint was made in the use of Dr. Parr's name in connec-
tion with a new invention of crown and bridgework. The true
inventor has "come off" and we cannot track it. Doubtless there
will be a new invention within a month and we will not miss it.
It makes a quick step to keep up with dental ingenuity which is
being generated continually by mother necessity.
The last sentence of my April letter gave notice that Dr.
Boedecker was to again enter the arena of dental discussion.
This is after an absence of several 5'ears. We do not propose to
turn on the light and show up how this absence came about, although
we could make some spic\' reading if we should tell what we do
know of the initial discord, and who it was that engineered it, and
the First District Society lost the intelligent services of one of our
ablest microscopical investigators. Dr. Boedecker has shown
406 THE DEXTAL KEVIEll .
himself the peer of his instructor, Prof. Heitzman, to an extent
that no other pupil has. We are pleased to give the readers of
the May number of the Review the first of his latest, and it will
be fresh, for it will hardly be cool from its utterance at the State
meeting the second of May, at Albany. This paper will be
received with as much credulousness as any paper that has ever
come before a dental body. Why ? Because it is arsensic on dental
pulps, and they don't die. But some one will say, Hold your
nose. No, gentlemen, only hold your know and listen attentively,
and you may be instructed. The doctor does not put this paper
before the minds or seekers after the truth, as a finality. It opens
the question of the raison d'etre he finds things that do appear
under the power of the defining lens. Dr. Herbst, his German
friend — whom all men of intelligence admired for his sincere and
honest intelligence during his visit to this country — has been plac-
ing cobalt, or arsenic and cocaine on pulps, and covering them for
two days and then removing the coronal portion of the pulp by a
revolving bur, leaving the stumps or portions in the canals, and
over these he burnishes a capping of No. 4 tin, which hermetically
seals them. He emphasizes the burnishing the tin coverings, for
this process forces the tin into all the anatomical interstices. This
method he has dealt with for over eight years, with a degree of
success that surprises all to whom the facts are known. The
readers of the Review recall that I presented this subject some
months ago, as it was brought out before the Brooklyn Society by
Dr. Schultze, an associate with Dr. Herbst, for two years.
Dr. Boedecker throws down the gauntlet, for this friend's
theory and practice, and applies to it an intelligent investigation,
and this is what he is to present at the Albany meeting. He will
illustrate the paper, showing what the microscope has defined.
Together with that marvelous discriminator, his tutor. Prof. Heitz-
man, they unite so that the results are exceedingly interesting. It
not only confirms the professor's recticulum theory, but it also
shows that some of the branches of the pulp in the canals, are
actually living and in others secondary formations of osseous
structure were formed even to the apices, which asks the question,
What could be put there that would make a safer root filling?
Do we know all yet ? What will those (wise) men say who ask.
What does the study of the microscope have to do with dentistry?
We suggest--wait until the evidences are all in. We know of
DOMESTIC CORRESFO.YDENCE. 407
some men that have left societies, because they have tired of so
much science. What would such men do with this question :
What produces the secondar}^ formation, shown by the microscope,
in the pulp canals? It is hinted that possibly the sulphide of tin
may have a chemical effect. We add that possibly it is the mechan-
ical effect of a foreign substance, producing irritation, which stim-
ulates a physiological action. The action of the tin is shown by
the drawling, quite a distance into the dentinal fibril, by changing
the color. But the good work will go on while we have so many
willing workers. While you are reading these remarks of ours,
you will find the old views turning somersaults in your mental
gymnasium. We say, go slow ; oceans of things are going to
happen, even after we are off for the unknown fields, of still greater
marvels. Let us keep our grip on all that betokens helpfulness to
each other, for we all, sooner or later, come to friendly need of our
elder brother, and happy will he be that has kept lock step with the
highest and best things.
Three men especially in New York City, had unusual cause
for real fraternal assistance, from first to last for true brotherly
helpfulness, and they were Profs. Heitzman, Boedecker and Ab-
bott, but none of them were in attendance on the last obsequies of
our grand and dear Dr. Atkinson, which fact has been much com-
mented upon. So far as Boedecker and Heitzman are concerned,
I am able to solve the mystery. Dr. Boedecker tells me (l i d uly
I have the fullest confidence in him) that he felt so tenderly, that
'he could not trust his feelings to go to the funeral. He sought the
company of Heitzman, but they could neither of them meet the
sorrow. Noble compliment, I say, to a noble self-sacrificing
brother. This will be a gracious explanation.
Judging from the able list of essayists for the State meeting at
Albany, we predict an interesting session. The list of discussors
are noted as distinguished, a term to which much latitude is given
in these days, making it mean much, or little. Too much the same
is the conferring honorarj- memberships. This is the sign of the
age and mean men go to Congress. Ex.
New York, May, 1892.
408 THE DEXTAL REVIEW.
REVIEWS AND ABSTRACTS.
Salivary anp Sanguinary Calculus. By W. H. P. Jones, D. D.
S., Nashville, Tenn. Read before the Dental Section of Nash-
ville Academy of Medicine.
Sanguinary, I take it, means "of or from the blood." The-
blood is a nutritious fluid circulating through the tissues of all or-
ganized beings. This liquid, which is essential to life, in the plant
is known as "sap;" in the animals, as "blood."
The elaborated juice constituting the former is probably simply
nutritive. Blood, or '-liquid flesh," as it has been called, is a
nutriment and something more. It is the means by which used-up
materials are gathered up and probably passed to other fluids to be
removed from the system.
The characteristics of living organisms are ceaseless change
and ceaseless waste. The blood becoming impaired or weakened
it cannot dispose of waste materials properly and may therefore
play an important part in these calcareous deposits. But I cannot
see that it is more conspicuous in this than in the biliary, urinary or
salivary calculus, allowing for the variations in characteristics ac-
cording to the organ in which the deposit is found. For it is a
reasonable conclusion to suppose that the blood — as general scav-
enger of the system — gathers up the material and passes it on tO'
the various organs by means of the fluid passing through and pecu-
liar to that particular organ. And therefore I beg leave in this
manner to dispose of the sanguinary and pass on to the considera-
tion of salivary calculus.
Calculus means, literally, "a small limestone." Calculi are
concretions which may form in every part of the animal body, but
are most frequently found in the organs that act as reservoirs and
in the excretory canals. They are met with in the tonsils, joints,
biliary ducts, salivary, spermatic and urinary passages, and upon
the teeth.
The causes which give rise to them are obscure or not well un-
derstood. Those that occur in reservoirs or ducts are supposed to
be owing to the deposition of the substance which composes them
from the fluid as it passes along the duct ; and those which occur
in the substance of an organ are regarded as the product of some
chronic irritation. Their general effect is to irritate, as extraneous
REVIEWS AXD ABSTRACTS. 409
bodies, the parts with which they are in contact and to produce re-
tention of the fluid whereof they have been formed.
The symptoms differ according to the sensibility of the organ
and the importance of the particular secretion whose discharge
they impede. Their solution is generally believed to be impracti-
cable. Spontaneous expulsion or removal by mechanicai meains is the
onl)' way of getting rid of them.
We will confine ourselves to the consideration of the kind found
in the oral cavity, salivary calculus.
Salivary calculus, or tartar of the teeth, is composed of earthy
salts and animal matter. According to one authority it is com-
posed of phosphate of lime, fibrin and animal fat. Another says
that it is composed of phosphate of lime, magnesia, ptyalin and ani-
mal matter.
* * * *
The relative proportions of its constituents vary according as it
is hard or soft, or the temperament of the individual is favorableor
unfavorable to health, and therefore rlo two chemists give the same
result.
We find the black, hard, dry tartar, which affects the teeth of
those persons of good constitutions, not in very large quantities.
It is hardly soluble in muriatic acid, while the dry, yellow tartar,
found upon the teeth of bilious persons, dissolves more readily in
it. The soft, white tartar, found on the teeth of persons of a mu-
cous temperament, is scarcely at all soluble in the acids, but is
readily dissolved in alkalies.
The black tartar is the hardest, the white the softest, and the
■density varies as it approaches the one or the other of these colors.
There is one kind of black tartar found upon the teeth of those
whose imiate constitutions were good, but by disease or through in-
temperance and debauchery have impaired their physical powers.
It is deposited in hn ge quantities on the teeth opposite the mouths
of the salivary ducts. It is hard and so firmly attached to the
teeth that it is with the greatest difficulty it can be removed
from them. It is very black, with rough uneven surface, and is cov-
ered with a glairy, viscid, and almost insufferably offensive mucus.
This kind of salivary calculus is very hurtful, not only to the gums,
alveolar process, and teeth, but to the general health also. The
gums inflame, swell, suppurate, and recede from the necks of the
teeth. The alveoli waste, the teeth loosen and frequently drop
410 THE DENTAL REVIEW.
out. The secretions of the mouth are vitiated by it, and are unfit
to be taken into the stomach, and so long as it remains on the teeth
no treatment can fully restore the system to a healthy condition.
There is another kind of black tartar, but this variety rarely ac-
cumulates in large quantities, and is much less harmful to the teeth
and gums. It is very hard, adheres very firmly to the teeth, and
indicates a good constitution.
The dark-brown tartar is not so hard as either of those just de-
scribed. It collects in large quantities-on the lower front teeth, and
sometimes on the first and second superior molars, and is frequently
found on all the teeth, though not in such great abundance. It
does not adhere so strongly to the teeth as either of the black varie-
ties, and can therefore be more easily removed. The odor from this
variety is less offensive than the first, but more fetid than the sec-
ond. Those subject to this kind of tartar are of mixed tempera-
ments ; the sanguineous, however, usually predominating. Their
physical organizations, though not of the strongest, may, neverthe-
less, be considered very good. They are more susceptible to morbid
impressions than those of the more perfect constitution.
The yellow or yellowish brown variety is softer in consistence than
the dark, and is generally found upon the teeth of persons of a bil-
ious temperament. It is sometimes found on every tooth in the
mouth. It contains less of the earthy salts than any of the forego-
ing descriptions, and owing to the vitiated mucus adhering to it^
has an exceedingly offensive odor. It is so soft that it can very eas-
ily be removed.
White tartar is not often found in large quantities, generally
upon the outer surfaces of the first and second superior molars, and
the inner surface of the lower incisors, and frequently on all the
teeth. It is almost devoid of calcareous ingredients. Fibrin, ani-
mal fat, and mucus constitute more than one-half its substance. It
is quite soft, exerts but little mechanical irritation on the gums, but
its acrid qualities keep up a constant morbid action in them. It
vitiates the fluids of the mouth, corrodes the enamel, and causes
rapid decay of the teeth. This kind of tartar affects persons of
mucous habits, or those who have suffered with some disease of the
mucous membranes.
Green tartar, or green stain, though commonly classed as /rtr;Vrt;-,
is not properly a calcareous concretion. It affects the teeth of chil-
dren and young persons ; not often the adult. It is usually confined
1
REVIEWS AXD ABSTRACTS. \\\
to the labial surface of the upper incisors and cuspidati, and bicus-
pids. It is exceedingly acrid, and corrodes the enamel and irritates
he gums. This discoloration — it is hardly more — indicates an irri-
table condition of the mucous membrane, and viscidity of the fluids
of the mouth.
The general effects of the deposition of tartar upon the teeth are
irritation, inflammation, turgescence and suppuration of the gums,
inflammation of the alveolar dental periosteum, the destruction of
the sockets, and loss of the teeth. Tumors, spongy excrescences of
the gums, haemorrhages, an altered condition of the fluids of the
mouth, are among the local affects arising from a long-continued
presence of large collections of tartar upon the teeth. The consti-
tutional effects are hardly less pernicious, and are not well under-
stood. Indigestion, and general derangement of the assimilative
functions are among the most common.
I desire to call your attention to a calcareous deposit found on
the teeth of some persons, remote from the gum margin, attached
to the root at a point seemingly inaccessible to the saliva. It pos-
sesses the same characteristics as the dark brown tartar. It is
found in varying quantities, and may attack any tooth, but rarely
have I found it on more than two or three teeth in the same mouth
and at the same time. It is an irritant to the extent of producing
abscess and loss of tooth.
Whence comes this deposit ? Hardly from the saliva, as it seems
to be beyond its reach. Can it be from the gum, itself apparently
healthy? It is only of late years that I have observed this deposit.
And on making inquiry I have learned that such persons were of a
decided rheumatic or gouty tendency. We know that pericemen-
titis is often directly traceable to a rheumatic condition of the sys-
tem. May not this fact lead to the belief that a want of proper distri-
bution of the acids exert a greater influence over diseases of the
mouth than is generally thought? And may we not look to the
adoption of systemic along with local treatment for better results in
diseases of the mouth ? This affection is not to be mistaken for
Riggs's disease. I hope for a full discussion on this subject, for I
think that there is more in it than would appear on the surface.
Another point in this connection. It is the peculiar and destructive
effects of tartar upon the teeth of some moutlis, teeth that have been
filled, notably on the neck of a tooth, along the gingival border.
You fi"^^ ^^^^ g'^i™ turgid and spongy, discharging constantly a poi-
412 THE DEKTAL REVIEW.
sonous fluid — serum, perhaps — fearfully destructive to enamel and
dentine alike.
How shall we alter these conditions and bring about a health}'
action in the parts, and stop the destruction going on around the
fillings under this moist, gummy, disgiisti?ig deposit? And this brings
us to the treatment of tartar.
The thorough removal of every particle of tartar is tlie first step,
and of the first importance. One, two, three, y?z'^ sittings, if neces-
sar}', until you do get it, every particle. For this purpose, variously
constructed chisels, hoes, hatchets, scalers, scrapers, turned at ever}'
conceivable angle — in fact, anything of any shape in the way of an
instrument best adapted to getting it off is what you want. Oper-
ators will differ in their selection of instruments for this purpose.
So it is almost useless to recommend any particular set or make of
instruments.
Having removed the tartar, ordinarily you will need very little
medicaments beyond a simple astringent and stimulative tonic, such
as nutgalls and cinchona, soda, sage, and honey, tincture of white
oak bark and honey, alum and cinchona, among the old, with a
world of new solutions and mouth washes. In some cases you may
find the inflammatory action so great as to call for general consti-
tutional treatment in addition to the local, in which you will be gov-
erned by the indications, and select your remedies to suit the pe-
culiarities of each particular case. Manifestly it would make this
paper too long to attempt a detailed description of the treatment
of the varied cases. In m\' opinion there is a great deal in this
subject. I mean in the causes that lead to this deposit. And I
regret my inability to present this paper to you in better shape. —
Dental Headlight.
Two Cases of Removal of the Gasserian Ganglion Through the
Floor of the Skull for Trifacial Neuralgia. By Edmund
Andrews, M. D., Surgeon to Mercy Hospital, Chicago. Read
before the Chicago Medical Society, February 1, 1892.
Eight months ago I read before this Society, a report of cadaver
■studies on the possibility of removing the Gasserian ganglion
through the floor of the skull, and demonstrated six different meth-
ods of operating. I also showed the probability that in the worst
•cases of trifacial neuralgia the true seat of the disease would thus
be taken away. While making these studies, Prof. Rose of Lon-
REVIEWS AND ABSTRACTS. 413
don had, unknown to me, been considering the same problem,
and found opportunity to test it on two patients. Since then I
have done the operation twice on living patients, and I have a
recent letter from Prof. Rose, informing me that he has lately done
it twice in addition to his former cases.
Case I. This patient was a woman about sixty years of age'
Her neuralgia came on five years ago, beginning mildly, and
graduall}' inceasing in severity. The inferior maxillary nerve was
the one affected, and the least touch on the cheek, and every effort
at swallowing, caused horrible paroxysms of pain. Owing to the
distress caused by swallowing she had long ago given up taking
solid food, and grown so weak that for the last five months she had
been confined to bed.
I etherized the patient and proceeded as follows, making the
external incisions after the plan of Rose, but operating on the
deeper parts by a method of my own.
A horizontal incision was made along the zygomatic arch, and
crossed b}- two vertical incisions, one at each end. The arch was
sawed off at each extremity and turned down upon the cheek, carry-
ing with it the masseter muscle which arises from it. This uncov-
ered the temporal muscle and its insertion into the coronoid process
of the lower jaw. I then sawed off the coronoid process and turned
it upward, carrying with it the temporal muscle. Beneath lay some
loose fat, containing the superior maxillary artery and the dental
and gustatory branches of the affected nerve.
Tying the artery, I found the two branches of the nerve, cut
them off and seized the stumps with strong forceps, and used them
as a guide to the foramen ovale, through which their common
trunk emerges from the cranium. I then cleared away the tissues
from the level area of the cranial floor which lies just external to
the foramen ovale, and applied a trephine with a long shaft to the
area mentioned, setting its edge about two millimeters from the
foramen. The button of bone being removed the dura mater was
brought to view. The septum between the edge of the trephine
hole and the foramen was then removed with bone forceps. The
nerve was drawn outward and the inner half of the wall of the for-
amen nipped away. Taking the nerve as a guide I then opened the
capsule of the ganglion and scooped it out with a small sharp surgi-
cal spoon. The temporal flap was then laid down and the coronoid
process fastened to the jaw with silver wire. Next the masseter
414 THE DENTAL REVIEW.
flap was brouglit upward and the zygomatic arch wired to its place
in a similar manner, and finally the incisions in the skin were
closed by silk sutures, a small point being reserved for drainage.
The wound healed mainly by first intention. The neuralgia
ceased at once. The entire area of the distribution of the nerves
derived from the ganglion was deprived of sensibilty. A peculiar-
ity was that the third and fourth nerves, which control the recti
muscles, were paralyzed, so that the patient could not move the
globe nor lift the upper lid, showing that these nerves were injured
by the instruments while enucleating the ganglion, owing to their
close proximity to it. However, the nerves were not destroyed,
for at the end of four weeks the patient had completely recovered
the lost motions, but not the sensibility of the organ.
The pain of swallowing having been abolished, the patient be-
gan to eat heartil} , recovered strength and resumed personal care
of her household. Three months have now elapsed with no return
of the pain, and it is to be hoped the cure will be permanent.
Case 2. This patient was a woman, sixty-five years of age, and
in much the same condition as the other. A year previously I had
trephined the ramus of the jaw and resected the dental nerve on
the proximal side of the ramus of the jaw. The pain stopped for
three months and then relapsed. I therefore decided to remove
the ganglion and operated by the same method as in Case No. I.
The dental branch of the nerve having been removed at my pre-
vious operation, I was deprived of the use of its trunk as a guide
to the foramen ovale. However, I found easily the free edge of
the external pterygoid plate, and tracing it upward to its junction
with the floor of the cranium, 1 found the foramen, and passed a
probe into it. The rest of the operation was the same as in Case
No. 1. The pain was at once relieved and there was no paralysis
of the muscles of the eye.
Four weeks have elapsed, and there is thus far no return of the
pain.
There has not been time since my operations, or those of Prof.
Rose, to settle the question of permanency. However, I think it
in the highest degree probable that in almost all cases the pro-
gressive neuritis causing the pain ceases when it reaches the gang-
loin, and rarely extends onward to the brain, just as it usually does
in the ganglia of the intercostal nerves in herpes zoster; and if this
be ultimately found to be true, then this operation will permanently
cure the great majority of cases. — Chicago Medical Recorder.
REVIEWS AND ABSTRACTS. 415
PAMPHLETS RECEIVED.
Tenth Annual Report of the Illinois State Board of Dental
Examiners. December 15, 1891, Springfield, 1892.
We regret that the publication of a register of the dentists of
the State has been abandoned. While under the present State
law it is impossible to publish a correct list the annual publication
of the Register often proved of service.
Valedictory ADDRESS delivered by J. J. R.Patrick, D. D. S. at
the annual commencement of the dental department State Univer-
sity of Iowa, Thursday evening March 10, 1892.
Tenth Annual Report of the Illinois State Board of Dental
Examiners. C. S. Smith Secretary 1891. We extract the
following from the last report:
Schedule of Minimum Requirements.
1. conditions for matriculation.
1. Certificate of good moral character.
2. Evidence of a good English education, to be shown by a
diploma from a recognized literary or scientific institution, high or
normal school, or first grade teacher's certificate, or, in the ab-
sence of these, an examination in the branches of a good English
education.
II. FULL COURSES OF DIDACTIC LECTURES AND INSTRUCTION.
These must each be of not less than five months' duration and
be held in separate years, with practical instruction intervening be-
tween the courses. The following subjects must be embraced in
the curriculum, viz: Anatomy, histology, surgery, physiology, path-
ology and hygiene, materia medica, chemistry, therapeutics, oper-
ative or clinical dentistry, prosthetic dentistry and deformities, and
metallurgy. There must also be proper clinical instruction in the
operating rooms and practical work in the chemical and prosthetic
laboratories and dissecting rooms.
III. ATTENDANCE ON EXAMINATIONS, QUIZZES AND CLINICS.
Attendance upon the entire courses as named above will be re-
416 THE DEXTAL REVIEW.
quired, deductions of not exceeding 20 percent to be allowed for
sickness and unavoidable absence. Quizzes must be held at least
once each week in each branch.
IV. CONDITIONS OF GRADUATION; TIME OF PROFESSIONAL STUDIES.
Candidates for graduation must have attended two full regular
courses of lectures as above stated, and must pass satisfactory ex-
aminations in the above named branches. They must also furnish
credible evidence of having spent not less than three calendar years
in the study of dental surgery, or medicine, surgery and dental
surgery, in which last case not less than two full calendar years
must have been spent in the study of dental surgery proper, and all
these studies must have been under the direction of a competent
preceptor.
After June, 1892, this Board will recognize as reputable only
such colleges as require, as a condition of graduation, attendance
upon three full courses of lectures, with conditions as prescribed
above.
V. FACILITIES AND EQUIPMENT. '
The college must have suitable and proper facilities and equip-
ment as regards lectures, chemical laboratory, dissecting rooms,
operating rooms and prosthetic laboratory, all the practical instruc-
tion to be under the constant direction of qualified superintendents
or demonstrators.
VI. ADVANCED STANDING; REQUIREMENTS AND CONDITIONS.
Applicants for advanced standing must be required to furnish a
certificate from the dean or other ofificer of some college recognized
as reputable, showing that such student has matriculated and at-
tended the lectures and clinics of one or more courses as required
in Rule III. and if such certificate does not show that the stu-
dent has passed all the branches embraced in the course or courses
attended, he must be submitted to and must pass an examination
in the same, before being admitted to the advanced standing.
But this rule shall not be so construed as to prevent an exam-
ination in all such branches before admission, at the option of the
faculty.
VII. APPLICATIONS FOR RECOGNITION.
The Secretary is not authorized to issue the license of the Board
REVIEWS AND ABSTRACTS. 417
upon diplomas of colleges not previously recognized. Any such
colleges in order to obtain recognition must, either through their
officers or graduates, make application to the Board, accompany-
ing it with authenticated copies of the announcements, schedules
of lectures, quiz and examination questions, or so much of them as
the Board may require to form an intelligent judgment; and there
should also be furnished a statement of the equipment and facili-
ties of the institution, and its legal status in other States, particu-
larly its home State, if not located in Illinois.
VIII. RIGHTS RESERVED.
In recognizing dental colleges the Board reserves the right to
withdraw such recognition at any time, upon proof that any col-
lege has not fully complied with this schedule of requirements;
and the Secretary is instructed to suspend such recognition,
pending an investigation, when any charges or facts shall come
under his cognizance affecting the standing of such college.
IX. ADDITIONAL REQUIREMENTS.
In addition to the minimum requirements of the Board, col-
leges will be held to a strict compliance with all of their own pub-
lished requirements, and to the observance of all rules which
they profess to observe; and any material deviation therefrom,
coming to the knowledge of the Board or its Secretary, will be
held to be sufficient grounds for suspension of recognition as
above stated.
Complaints.
Every person practicing dentistry in this State whose name is.
not upon the books of the Board, is practicing dentistry contrary
to law, and will be liable to prosecution. Upon complaint being
made to the Secretary; a warning notice will be sent such delin-
quent, provided the full and correct name and address of the party
be given. No attention will be paid to anonymous complaints, but
all communications are treated as confidential.
In the absence of a revenue for the support of the law and the
prosecution of offenders, the Board cannot be expected to under-
take prosecutions throughout the State, and the furnishing of wit-
nesses and other evidence, must be left to the party commencing
the action. The prosecuting attorney of the county should have
418
THE DEXTAL REVIEW.
his attention called to any case where the warning of the Secretary
has been disregarded.
Board Meetings.
The regular meetings of the Board will be held on the Monday
before the second Tuesday in Maj', and on the second Tuesda)^ in
November in each year. The May meeting will be held at such
time and place as the Illinois State Dental Society may meet, of
which due notice will be found in the dental journals. The No-
vember meetings will be held at the State House, in Springfield.
The next meeting will be held at Springfield, May 9, 1892.
C. Stoddard Smith, Secretary,
103 State St., Chicago.
I
DENTAL COLLEGE COMMENCEMENTS.
WESTERN DENTAL COLLEGE.
The commencement exercises of the Western Dental College were held March
10, 1892, at Music Hall, Ninth and Broadway, Kansas City, Mo. Faculty address
by Prof. H. O. Hanawatt. Number of matriculates, 79.
The following named (3!t) persons received the degree of Doctor of Dental
Surgery ;
H. H. Sullivan, Mo.
E. C. Laylor, Mo.
E. C. Brownlee, Mo.
O. C. West, Mo.
F. W. Drom, Neb.
L. P. Austin, N. Y.
Frank S. Webster, Kan
T. I. Hatfield, Kan.
C. Robertson, Jr., Kan.
O. J. Kenper, Mo.
C. C. Jones, Kan.
R. E. Darby, Mo.
L. G. Jones, Kan.
P. J. O'Reily, Gala,
C. B. Leavil, Mo.
D. J. Hayden, Kan.
Fred. M Franklin. Mo,
W. W. Simpson, Kan.
W. H. Condit, Kan.
H. Yant, Kan.
Mrs. Alice Yant, Kan.
A. L. Smith, Mo.
S. E. Johnston, Kan.
F. W. Johnson, Mo.
Otto Jacobs, Mo.
K. P. Ashley, Kan.
M. D. Van Horn, 111.
J. F. Spence, Mo.
A. C. Barr, 111.
F. E. Gaines, Mo.
T. H. Cunningham, Mo.
J. H. Swan, Mo.
Wm. Harrison, Mo.
S. T. Peter, Neb.
A. S. Wright, Mo.
W C. Allin, Mo.
I. Bascon Nordyke, Mo.
T. E. Jackson, Mo.
T. J. Ht-nkens, Kan.
NORTHWESTERN UNIVERSITY DENTAL DEPARTMENT.
The second annual commencement exercises of the Northwestern University,
Dental Department, were held in Central Music Hall, Chicago, on Tuesday, April
6, 1892. The faculty address was delivered by Prof J. H. Hollister, A. M,,
PRACTICAL NOTES.
419
M. D. and the degrees were conferred by Henry Wade Rogers, L L.D. Presi-
dent of the University. The number of matriculates in the Dental School for
the session just ended was 56 and the number of graduates 18.
GRADUATES.
Charles Martin Baldwin,
James Lewis Blish,
William Leonard Barnes,
Joseph Free Baird,
Edwin Morgan Chapman,
Lewis Samuel Celley,
Adam William Feltmann,
John Lloyd Foster,
William Alfred Grove,
Alvah Bradmon Graham,
William Fielding Garnett,
George Byron Hiller,
William Edward Merritt,
Augustus Gorman Miller,
Samuel Thomas Mitchell,
Clifford Murry Roberts,
George Everett Warren,
Doctor Merritt Wilcox.
ROYAL COLLEGE OF DENTAL SURGEONS OF ONTARIO.— SESSION
OF 1891-92.
Number of students in attendance 64 — 22 Seniors and 42 Juniors. The title
of L. D. S. (Licentiate of Dental Surgery) was conferred upon the following :
S. A. Aykroyd, Kingston, Ont.
R. Agnew, Clinton, Ont.
S. Anderson, Mitchell, Ont.
E. A. Billings. Leamington, Ont.
J. A. Black, Kingston, Ont.
W. A. Burns, St. Thomas, Ont.
J. A. Edwards, D. D. S. Uxbridge. Ont
J. H. Fell, Burlington, Ont.
Hermon Hart, Lindsay, Ont.
H. F. Kinsman, Exeter, Ont.
F. A. Lackner, D. D. S. Berlin, Ont.
H. G. Lake, Toronto, Ont.
M. A. Morrison, Petersboro, Ont.
G. J. Musgrove, Wingham, Ont.
F. D. Price, Napanee, Ont.
F. B. Ross, Hamilton, Ont.
D. C. Smith, Uxbridge, Ont.
T. C. Trigger, St. Thomas, Ont.
G. A. Walters, Forest, Ont.
W. R. Wilkinson, D. D. S. Elmira, Ont.
S. C. Wilson, D. D. S. Hanover, 111.
PRACTICAL NOTES.
The Management of Pulpless Teeth.
Symposium Five — By A. B. C. E. and F. (D Left Out).
A. — The Western Dental Journal ior January has revived a paper
written by Dr. J. E. Cravens, of Indianapolis, on the management
of pulpless teeth, which was presented to the International Medical
Congress at Washington. At that time the paper was fiercely as-
sailed by several gentlemen, who objected to the purely mechanical
method of the management of pulpless teeth. The author of the
paper claims in a prefatory note to the editor that the paper never
had a fair hearing, in consequence of incorrect reporting ; there-
fore he claims that he has been subjected to much erroneous and
unfair criticism, hence he requests space for the republication of
the article.
420
THE DEXTAL REVIEW.
The management of pulpless teeth is a very broad subject to be
spoken of in a single essay or an article to be read before a dental
society, because there are so many phases in managing pulpless
teeth that they cannot all be carefully considered, therefore we will
take that portion of Dr. Craven's paper relating to the purely
mechanical method, which is, after the thorough mechanical re-
moval of the pulp and the adjacent infected dentine, his claim is,
there being no peridental inflammation, that the root sliould be
filled immediately ; that there is no necessity for medicating the
root canals because they are not diseased. I take issue with him
in this, and say that the dentine cannot remain in contact with sep-
tic matters, or mephitic gases any length of time without being
saturated, and it is not certain but that the poisons produced by
microorganisms infiltrating the dentine of a tooth ultimately affect
the cementum, so that the purely mechanical method is a method
that must be classed among the lost arts. It is not up to date.
E. — It seems to me, that the advocacy of mere mechanical
cleansing is untenable. In the first place, as has been said, if the
pulp has been dead for any length of time there is more or less in-
filtration into the substance of the dentine and sometimes undoubt-
edly of the cementum itself. The whole mass is infiltrated more
or less.
A. — Is it not a fact that all teeth containing dead pulps, where
there has been decomposition, the dentine of such teeth must nec-
essarily be permeated by the gases of decomposition ?
E. — Certainly.
A. — To say nothing of any accidental matters, such as bacteria
or micrococci getting in there from an opening through the crown.
E. — That is necessarily so and unavoidable. Moreover, as to
mechanically cleansing by a removal of the infected portion
adjacent to the cavity, which Dr. Cravens advocates, that can only
be done in the main pulp chamber and to a short distance in the
root canals, because it would be impossible to use a bur- and
cleanse out any considerable part of the infected dentine at the
apex of the roots. That portion could not be mechanically
cleansed. ^
A. — In other words, the diameter of the interior of many roots
of teeth is such that they cannot be reamed out.
E. — That is just what I mean exactly, it is an absolutely im-
practicable thing. We must depend upon medical disinfection.
PRACTICAL NOTES. 421
F. — I very well remember this article of Dr. Craven's and was
present at the time he read it at the International Medical Con-
gress, and I was astounded at the position he took.
A. — The author says: " In cleaning out pulp canals simple
manipulation will accomplish all, and medicines will be of no as-
sistance. The fluid contents of pulp canals may be easily removed
by absorption."
C. — I suppose he means by absorbing it with cotton or some-
thing like that.
A. — I hardly know what he means. " The gaseous contents of
a pulp canal may readily be removed by displacement." Of course,
the gaseous contents of a pulp canal escape the very instant you
open the pulp chamber. What about stored gases and septic pto-
maines that have infiltrated and permeated the dentine of the root
or crown? Can you displace them? Not unless you destroy them
by the use of chemical substances.
F. — In the discussion of the paper before the International
Medical Congress, one gentleman spoke of it as a " medieval
romance," which seems to be a very proper title. We would be
retrograding rather than advancing if we should adopt the sugges-
tions offered in that paper. They are the methods that our fathers
pursued years and years ago when dentistry was in its infancy,
when we knew nothing about medication or the advantages to be
derived from the use of drugs in the treatment of diseased condi-
tions about the mouth and teeth. We have seen too much practi-
cal benefit from the use of H2 Oo, followed by some of the essential
oils to ever lead us to abandon this practice and go back to that
advocated by Dr. Cravens.
A. — Did you ever open into a pulpless tooth and treat it me-
chanically and fill the root at the same sitting without the introduc-
tion of drugs ?
F. — Never.
A. — Would you consider it safe practice to do it ?
F. — Very unsafe.
A. — Do you know of anybody that does it ?
F.— Yes.
A. — But you have to extract the tooth ?
F. — Yes, almost invariably.
A. — I have tried to be cosmopolitan in practice ; I have tried
nearly everybody's method, including the one of boring into the tooth
42 2 THE DEN'TAL REVIEW.
and filling the root without the introduction of drugs. That kind
of practice has been a failure in my hands. I have tried the method
of immediate root filling and used drugs, and that has been a failure
unless the end of the root of the tooth had been encysted, and if
the end of the root has been encysted it does not make any difference
whether you use any drugs or not, because it is perfectly safe to fill the
root. The way you discover that the end of the root of a tooth is en-
cysted is when you put the rubber dam over the tooth and bore into it,
there is absence of moisture and absence of odor, the tooth having
no history of previous tenderness. It is not discolored, it seems
to be of the same color as the adjacent teeth. That is the only
physical part of the encystment that you can find. I have dried
teeth when there was absence of odor and moisture but discolora-
tion, and every time you will find the roots are not encysted, you
have got to have a normal color, dryness, absence of odor, because
absence of odor is not proof alone of encystment of the root.
F. — Can you rely upon the signs you have given as pathogno-
monic of an encysted root ?
A. — I have never seen one yet that did not present these condi-
tions.
E. — Does not that rule apply to single-rooted teeth? Because
in teeth with two or more roots it would be very seldom that
you would have an encystment of all the roots at the same
time.
A. — That is true, but I have never seen many multiple-rooted
teeth where I felt sure that the roots were encysted; but you must
remember that we have manj' single-rooted teeth in the mouth, and
the probabilities are that the pulps die in single-rooted teeth oftener
after pulp capping than elsewhere, because the tendency on the
part of practitioners, as a rule, is to save the pulps of anterior teeth
on account of the color, and frequently tliej^ do not take chances to
save them in the posterior teeth, and there is a greater number rela-
tively. A great many pulps of teeth die under cappings, no matter
of what kind they may be, and probably just that kind of inflam-
mation that takes place following or concomitant with the death of
the pulp is sufficient in many cases to produce the encystment of
the apex of the root, and that is what saves the color.
B. — You draw the line at immediate root filling, do you?
A. — Yes, even though the pulp chamber were dry and there is
absence of odor.
PRACTICAL NOTES. 433
E. — How about double-rooted bicuspids ?
A. — If the color is normal and there is no odor and no moisture,
then I would risk it. There are few such cases.
E. — I would like to bring out this point in connection with
■mechanical interference with roots, that my experience has de-
monstrated that it is absolutely unsafe — in fact, almost certain to
produce trouble to attempt mechanical cleansing of a root without
previous thorough medical disinfection.
A. — That is correct.
E. — If I should accidentally, — as I do occasionally but not often,
pass a broach into the root of a tooth I carry perhaps something
with it.
A. — You carry a pus microbe with it.
E. — In cases in which the pulp has been dead, decomposition
takes place, and I am afraid that the slightest pressure, as mani-
fested by the patient, will cause trouble.
B. — It does not require much pressure to carry septic matter
■through the apical foramen.
A. — It does not need to go through the apical foramen, if it is
infectious it finds its way beyond the apex.
F. — It finds its way beyond the apex afterward.
E. — It is a safe and necessary rule in opening into such teeth
always to refrain from attempting to cleanse the root canals until
•thorough medical disinfection has been given from three days to a
week, or perhaps longer.
B. — In speaking about immediate root filling, you do not refer
to cases where the pulp has been destroyed by the operator ?
A.— No.
F, — Would you feel justified in immediate root filling after
*' knocking out" the pulp?
A. — Well, yes. I think that if the pulp of a tooth is forcibly
removed and you can absolutely arrest the haemorrhage, there is no
objection to filling the root at once.
F. — Would you not feel safer to wait ?
A. — I would feel safer in my. own mind, but at the same time I
■do not see any theoretical objection to filling the root at once.
F. — Supposing anything had gained entrance from the time you
entered the pulp chamber, would you feel safe then? Would you
feel sure that there was not a serous exudation from the apex
down to the crown ?
424 THE DEXTAL KEl'lElV.
A. — I have a fear that something of that kind will occur. The-
oretically there is no serous exudate ; practically there always is.
F. — The practical part is the one we want to have in mind.
A. — If you coagulate a serous exudate you are bound to have
abscess sooner or later, because there is no coagulated material
that will stand for ages even though it is hermetically sealed.
C. — Would it not be removed if it is pushed through the apical
foramen by the filling ?
A. — The coagulation is inside the apex of the root, not beyond it.
C. — But in filling you naturally get that through.
F. — There might becoagulationin thedentinal tubuli themselves.
We are not sure but that there might be matter in there which,
would coagulate by the application of escharotics.
A. — If the tooth were like a gas pipe the force used in filling
the root might push the matter beyond the apex, but the force
used in such cases is not such as would push it through.
E. — In any event, even in the case cited of removal of the pulp
by forcible removal, or the "knocking out" method, we are liable
to have a blood clot at the ends of the broken vessels. You are
almost sure to have that.
A. — Still, that would be removed by nature's method, that is, if
it were beyond the apex of the root.
E. — The trouble is the canal is so uneven and the exact location
of the apex not definitely known, it is absolutely impossible to
draw hair lines in such treatment. You do not know whether you
are just to, slightly beyond, or just short of the apex. Inasmuch
as it is a safer practice to wait and disinfect in all cases, why is im-
mediate root filling ever advisable ?
F. — I see no advantage in it.
B. — Except where the patient is going away, that would influ-
ence the operator to resort to it, otherwise he would not do
it.
F. — That you would call an emergency.
A. — We will exclude emergencies. Is there any necessity for
immediate root filling where the pulp has long been dead ?
F. — .\re there any possible advantages ?
C. — It saves an expense of time if it can be done just as
well.
B. — The chances are too great to be taken.
C. — It seems strange to me that the writer of that paper, who is-
PRACTICAL .VOTES. 425
•SO prominent a man and so well read, would be the author of any-
thing of that kind without having some foundation for it. It has
occurred to me sometimes that we know life will resist the en-
■croachment of septic matter or diseased conditions to a certain
limit, and it remains active until it is overcome by the diseased
condition. Would not that possibly be the condition around the
Toot of a tooth? For instance, the pericementum, leaving the root
in a health}' condition, probably extends its vital energy to some
extent into the tooth ; if the root is cleansed mechanically as Dr.
Cravens states, and there has not been too extensive an infiltration
into the dentine and too much decomposition, and that root is
sealed up, is it not possible that the life in the pericementum may
overcome the encroachment of that septic matter, and that septic
matter must become inert on account of exclusion of air and
moisture ?
E. — It seems to me that the fault of the theory is, that the
pericementum has nothing to do practically with the dentinal
tubuli.
C. — The pericementum is very vascular and active. There is
quite a circulation in the pericementum,
E. — The fault of Dr. Cravens' theory consists partly in this,
that the absolute mechanical cleansing which he speaks of is in
many cases an impossibility. It cannot be done. There is nothing
left to do but to cleanse it medically.
B. — There is another objection to the theory, and that is the
clinical experience of the majority of the better operators and that
the method does not ordinarily result in success.
E. — It is a dangerous method to put into the hands of young
men.
C. — How do you account for his success at all? That is the
point I am trying to get at. A man of his reputation must be suc-
cessful or he would not claim it.
F. Perhaps the patients drift into the hands of other practi-
tioners after he has filled the roots.
C. — Is it not possible for the pericementum to overcome the
encroachment of septic matter ?
A. — It has the power to resist, but septic matters in dentine
gradually enfeeble it and the object in filling pulpless teeth is not
to have them enfeebled, but to have them vigorous so that they
can be used. The object is to retain them in a state of health for
126 THE DENTAL REVIEW.
the longest possible time and not let the chance slip away by care-
lessness or inefficient management of them. You fill a pulpless
tooth for a person 25 years of age, if at 40 the patient has lost the
tooth, do you call that a success ?
C. — No, I do not think I would.
A. — You would call it successful if the patient retained the
tooth till he was sixty ?
C— Yes.
B. — Success is measured also by the comfort the man has with
the tooth. Very often teeth remain in the mouth when they are
not comfortable to the patient, and still he submits.
C. — He does not know how much more comfortable he would
be were it out.
E. — As regards the success which Dr. Cravens may have had,
we can say this of all methods of procedure that have been used
in the past, no matter how imperfect and unscientific they have been^
that they have, in the minds of those who practiced them, some
degree of success. The question is, is it a scientific method ac-
cording to the present light which we possess?
B. — And is it a method which will stand the test of time?
A. — Is there not a probability of a greater number of teeth be-
ing saved by the antiseptic method over the purely mechanical
method?
F. — There is no question or doubt about it,
— Exit Reporier.
MEMORANDA.
Dr. W. H. Taggart has removed to Chicago.
Dr. L. Ottofy has removed to 1220 Masonic Temple.
Dr. Wm. Taft, of Cincinnati, visited Chicago recently.
Dr. Geo. H. Wilson, of Cleveland, visited Chicago in April.
Dr. Thomas Gaddes, lately of Denver, Colo., has returned to England.
The address of the editor of the Dental Review is 1000 Masonic Temple.
Dr. A. W. McCandless, formerly of Davenport, Iowa, has located in Chicago.
Dr. C. R. Taylor, of Streator, 111., was a recent visitor at the World's Fair
City.
Drs. J. H. Martindale and E. H. Angle, of Minneapolis, were recent visitors
to the World's Fair city.
MEMORANDA. 427
Dr. E. E. Hughes, of Des Moines, and R. L. Cochran, of Burlington, la.
were recent visitors to Chicago.
The annual meeting of the Maryland State Dental Association is to be held
May 9, 10 and 11, at Baltimore, Md.
Dr. E. H. Angle, J. H. Martindale and W. C. Barrett attended the meeting
of the Postgraduate Dental Association in Chicago, April 29,
As usual the St. Louis delegation was out in full force at the Illinois meeting.
The clinics of the Wednesday morning session were not only interesting but largely
attended.
Dr. C. F. Hunt, a promising young dentist of Chicago, died recently in the
village of Austin. Dr. Hunt graduated in 1891 from the Chicago College of Den-
tal Surgery.
In the coming winter a course of dental lectures will be delivered in a new
college organized in Buffalo, to be known as the Dental Department of the
University of Buffalo.
For quick drying of cavities after the rubber dam is in place, fill the cavity
with chalk and blow it out with a chip-blower. It may be used to dry a wet liga-
ture which it may be inconvenient to remove.
Liquid Vaseline may be used to saturate cotton as a temporary covering for
medicaments in the root of a tooth when it will not bear the pressure of varnish or
gutta-percha. It will endure for two or more days without becoming foul.
Dr. F. C. Marshall, the well-known mechanical dentist, died of paralysis,
April 29, at his home in Chicago. He was formerly located in Aurora, 111., but
latterly had resided in Chicago. Dr. Marshall had been in ill health for the past
two years.
The "Atkinsonians," a dental society of Chicago, contemplates fighting the
advertising dental colleges "tooth and toe-nail." They will also expel from mem-
bership those who retain connection with or accept remuneration for services
from an advertising college.
Dr. H. J. McKellops, of St. Louis, will buy any old books, pamphlets or
journals if the owner will give the title and date of publication and language in
which the works are published, with the price asked. It is his desire to collect
the most complete dental library in the world.
The Supreme Chapter of the Delta Sigma Delta Fraternity held a special
meeting in Chicago, April 30, 1892. The modified constitution, by-laws and one
of the most advanced code of ethics were finally passed on and adopted. It was
decided to hold the annual meeting at Lake Geneva, Wis., July 5, (i and 7,
The twelfth annual meeting of the Texas Dental Association will be held in
Fort Worth, Tex., beginning Tuesday, May 24, 1892, at 10 o'clock a. m., and
continuing four days. The Executive Committee earnestly request you to attend
this meeting. The Association will hold its session in the Y. M. C. A. hall, with
a room for clinics close at hand. The hotel rates will be from $1.50 to $2.50 per
day. All railroads into Fort Worth will give a rate of four cents per mile for the
round trip. Tickets on sale May 23d, good to return until May 28th.
488 THE DEN'TAL HEV/EIV.
Do vou moisten sandpaper discs with liquid vaseline ?
Boroglycerin diluted with water, is an efifective and pleasant mouth wash.
The Nebraska State Dental Society will convene at Fremont, Tuesday, May
17. for four days.
There are 310 names in the list of members of the Dental Protective Associa-
tion in the State of Illinois.
Dr. S. C. Hatch, of Sioux City, Iowa, the retiring President of the Iowa State
Dental Society visited Chicago in Mav.
Dr. L. K. Fullerton, of Waterloo, was elected President of the Iowa Dental
Society at the late meeting in Ottumwa.
The capital stock of the American College of Dental Surgery has been in-
creased from ten to twenty-five thousand dollars.
Dr. A. G. Gray, of Emporia, Kan., wants to know why oxychloride or oxy-
phosphate of zinc sets. Will some chemist answer this question ?
The Southern Dental Association will meet at Lookout Mountain, Tenn.,
overlooking Chattanooga, the last Tuesday in July. Dr. Gordon White is Presi-
dent, and H. C. Herring, Secretary.
A prominent dentist recently made a mistake in syringes and injected some
pungent solution containing carbolic acid instead of water into the patient's mouth,
the cigars will be furnished on application to the p. d.
The burning question of the hour now, seems to be whether Dr. W. Mitchell
or the Deans of the British Dental Schools will get the best of it in their controver-
sy on education. We simply sit and look on at present.
Dr. C. S. Case, of Jackson, Mich., Professor of Prosthetic Dentistry and
Orthodontia in the Chicago College of Dental Surgery will soon take up his resi-
dence in Chicago, and devote his whole time to the correction of irregularities of
the teeth.
The Michigan State Dental Association will meet at Saginaw June 2, 3, 4,
1892. The profession are most cordially invited to attend.
J. Ward House, Secy,
Grand Rapids.
Dentist Fichte, in Aachen, was sentenced two weeks ago to nine months im-
prisonment and the payment of $125 damages to Frau Helena Schmidt, of Aachen,
because he pulled out all her teeth and charged SlOO for a set of false ones. Frau
Schmidt wished to have but one tooth pulled and told him so, but while he had
her under the influence of laughing gas he took out all of them. Five months ago
Fichte's first assistant drew all the teeth of a Jesuit priest under similar circum-
stances, and was sent to prison for three months. — Exchaw^e.
Dr. Taft of the dental department of the "University of Michigan, was given
a reception April 15, by the Isaac Knapp Dental Coterie of Fort Wayne, Ind., at
the residence of its President, Dr. Shryock. Dr. Taft's address on the occasion
was what might be expected from one so distinguished. Of the seventeen dentists
MEMORANDA. 429
in the city only nine are members of the above society. These meet fortnightly
for improvement and to keep pace with all approved modern methods in both
American and European dentistry. The invitations to last night's entertainment
were extended to every registered dentist in the city. A number from adjoining
towns were present, and many regrets from others received. — Fort Wayne
Sentinel.
To the Executive Coniniittee of the World's Columbian Dental Congress:
Gentlemen: — The Sodthern Dental Association has instructed me, their Sec-
retary to cordially invite the E.xecutive Committee of the World's Columbian
Dental Congress to meet with them at Lookout Mountain, Tenn., on the 26th of
July next. It is to be hoped that as many of your number will attend as possible.
Fraternally yours, H. C. Herring, Secretary.
Editor Dental Review; — Enclosed please find a celluloid mustard spoon
(attached to the Heinz mustard bottles) which has for the past two years been
used on a great many occasions for holding the tongue and cheek from teeth
necessary to be operated on or examined. It has proven itself so useful that many
others may also find operations made much easier (for themselves) by being the
possessor of one. If the shank could be made stiffer or metal substituted for
the entire spoon it would be much more serviceable. If this has been introduced
heretofore I am unaware of it. It is so useful I could not forego the pleasure of
sending and wishing others the same joy from having it. Yours,
E. K. Wedelstaedt.
One of the courts of Germany has rendered the following novel decision ac-
cording to which American dentists will find it impracticable to be known as doc-
tors, and even many who are entitled to that distinction by the universities of
Germany, must abandon the use of the title. According to this decision there is
no such title as "doctor" but there are: "doctors of medicine", "doctors of the-
ology", "doctor of philosophy" and "doctors of jurisprudence." If therefore any
one uses the title "doctor", with no further explanation, the public takes it, for
granted that the individual in question has received the degree from some faculty
teaching the specially which he practices. A dentist who holds the title "doc-
tor of philosophy," and advertises himself as a "doctor" thereby implies that he
is a "doctor of medicine" and hence utters a falsehood. Over thirty dentists of
Berlin, have been fined for "bearing a false title."
" Fill your own teeth with Muddoline" would be better than the title selected
for a substance which is offered to the unsuspecting public. We publish the cir-
cular accompanying the stuff. As a novelty it takes not only the confectionery,
but the fixtures, building and all.
stops pain and decay, lasts a life-time. — HOW TO FILL YOUR OWN TEETH.
This material offered to the public as an additional aid in preserving the
natural teeth, possesses the desirable qualities of easy mixing and retention of
plasticity long enough for proper introduction into the cavity. Any one without
experience can fill their own teeth and those of their friends without any difficulty
and do good permanent work. Becomes as hard as the tooth itself and is non-
conducting, nonirritating to the nerve, giving no pain whatever to sensitive teeth,
acts better on a tooth than either gold or silver, and will last a life-time. The
430 "^I^E DEXTAL REVIEW
best time to fill a tooth is before it begins to ache. As soon as yoa find a decayed
spot clean it out and fill with ; your tooth will be as good as ever it was. If
it has been aching it will in nearly all cases stop and be all right as soon as it is
filled with , as this will exclude the air, moisture and food, and relieve the
pain at once. You can fill your own teeth easily, quickly and without pain.
is easier to use than any other filling. It is not necessary to remove all
the decay, as after becomes hard, the decay will form a protection to the
nerve. Dentists make filling teeth a painful and tedious operation ; a great many
people prefer to have their teeth extracted rather than endure such torture.
Thousands of teeth are extracted every day that might have been filled with
and saved to do service for many years. Parents will find very
valuable for filling children's teeth. Mothers often neglect the tempo-
rary teeth, probably thinking that, as they are "only baby teeth,"
which must eventually be shed. But it is a most set^ious mistake to
allow these teeth to decay or to be extracted, as they control to a great extent the
regularity beauty and perfection of the permanent teeth. You can fill your own
teeth with as well as the average dentist can, it will save you a great deal
pain, time and money, and best of all will save your own teeth. The importance
of good teeth cannot be over-estimated, for actual service in conducting health to
the whole body their value is beyond price. If you wish to maintain health and
live to a ripe old age, keep your teeth in proper condition so as to thoroughly
masticate your food. has proved very valuable to a great many people
who fill their friends teeth as well as their own, charging only a moderate price
for filling, but making censiderable money at odd times. Why suffer the agonies
of toothache and torture in a dentist's chair when you can fill your teeth without
pain with . Any person who buys a package of or a set of instru-
ments and does not find it all we claim it to be, can return within thirty days that
portion of not used with the instruments and get their money back by re-
turn mail. You cannot loose anything in trying . All we ask is to give it a
fair trial.
We take the following from Dr. H. B. Wiborg's valedictory address:
So far as history discloses, Hippocrates, who lived about 400 B. C, is the
earliest writer who treats of medicine. In his writings mention is made of the
teeth, both with regard to their healthy and diseased conditions. He prescribed
various remedies for their improvement, particularly as to abscesses, diseased
condition of the gums and osseous tissue. He recommended the fastening of
loose teeth, otherwise healthy, to the adjoining ones by means of silk or gold
ligatures, and advised the removal of loose, decayed teeth, while the foul odors
of the mouth he essayed to mitigate and correct with aromatic lotions and
powders.
That mechanical dentistry, at least, was practiced in some degree among
the ancient Greeks is abundantly testified to in ancient lore. The tenth of the
celebrated Greek laws of the Twelve Tables, provided that any gold used to fasten
teeth, might be burned or buried with the body, and this undoubtedly re-
ferred to what we to-day term bridge work. We also know that it was customary
with these people to fill frail teeth containing large cavities with lead, in order to
facilitate extraction.
I
MEMORANDA. 43 1
The Greek historian, Herodotus, contemporary with Hippocrates, recites that
the Egyptians practiced the art of dentistry. In his second book narrating his
travels through Egypt, he states that the art and practice of medicine was divided
among the Egyptian priesthood, each physician applying himself to one class of
diseases only; some to the head; others to the eyes, and others to the teeth, etc.
It has been recently announced in medical and dental journals that in one of the
royal mummies taken from the catacombs of Egypt, a set of artificial teeth was
found in which the plate was of wood carved to fit the roof of the mouth, while
the teeth were of brass. Belzoni and other archaeologists have found artificial
teeth of sycamore wood, which had been fastened to the adjoining natural teeth
by ligatures or bands of gold or silver. Although reports have, from time to time,
appeared announcing the discovery of teeth in the mouths of mummies which have
been filled with gold, they do not appear to be well authenticated, and we must,
therefore in the light of our present knowledge of the practice of dentistry among
the ancient Egyptians, receive such stories cum grano salis although it is not un-
likely that the Egyptians, who were so proficient in industrial and mechanical
arts, had some knowledge of the principles of the practice of dentistry, though nec-
essarily crude and superficial.
Aristotle, the Greek philosopher who lived about 350 B.C., gives considerable
consideration to the teeth in his book of problems and treatise on physiognomy, as
well as in other works, and relates that one Erasistratus deposited in the temple
of the Delphian Apollo a leaden instrument for extracting teeth. Although appar-
ently of a trivial character, history credits one Celsus, who lived about 100 B. C,
with having been the first to suggest the use of an iron file to remove such points
of decayed teeth as hurt the tongue.
As we approach the Christian era we find that the custom of aspribing human
ills to divine origin was not confined alone to the ancient heathen, for in the days
of the primitive Christian Church, when reason was dominated by fanaticism,
the invocation of Saints Appolonia and Lucy was considered a specific against
toothache. This form of treatment would scarcely be considered conservative
dentistry at the present time, 'and must have proved exceedingly discouraging to its
votaries. From the beginning of the Christian era to the commencement of the
seventeenth century darkness was upon the face of the world of dentistry, with
only an occasional ray of light penetrating its misty veil, to be immediately
swallowed up in the dense surrounding gloom of superstition and religious intoler-
ance.
Directing our steps to the far east we learn that one Actius, an Arabian,
(A. D. 300) was the first to discover the foramina in the roots through which the
nerves and vessels enter into the pulp chamber; while Albacasis, an Arabian phy-
sician who lived about 1100 A. D., suggested means for replacing lost teeth by
substituting other natural ones or those made of bone or ivory. Pursuing our
steps still farther east to that ancient Eldorado of wealth and luxury — the Indies,
we are informed that in the year A. D. 1176, (573 of the Hegira), a Hindu Rajah,
of Benares, who was called Kutah-ud-dinabiek, a Turkish general under Mo-
hammed of Ghor, conquerer of India, was slain, and his body only identified
by means of the false or artificial teeth he wore, held in place by gold wedges and
Avires.
433 THE DEXTAL REVIEVr.
As summer approaches and it is necessary to have the person as well as the
wardrobe put in order for the summer campaign, there is not unnaturally a run on
the dentists. Now it must be known that there are some of the Boston dentists
who are fairly to be described by no other epithet save "topping." It is true
there is asocial line which they are not allowed to cross, but they take their re-
venge— some of them — by the lordly manner in which they conduct their profess-
ional business, not to mention the prices which they ask for their work. Within
a few days the following correspondence is said to have passed between a man, a
member of an old Boston family, and one of these top-loftical dentists. The den-
tist to whom the man was in the habit of going having been removed by death
the latter made inquiries for a reliable man, and was recommended to try Dr.
Goldtooth. The following note was accordingly written .
Mr. Q. Z. Oldfamily wishes to know whether it will be possible for Dr. Gold-
tooth to give him an appointment for Thursday or Friday next, as he wishes to
have his teeth examined before sailing for Europe.
In due time the following answer was received, on the swellest of station-
ery:
Dr. Goldtooth is not in the habit of receiving clients without a proper in-
troduction, and begs that if Mr. Q. Z. Oldfamily wishes to become such he will
take the trouble to be properly recommended. If, however, if Mr. Oldfamily
is the son of the late X. Y. Z. Oldfamily, Esq., that would in itself constitute a
sufficient introduction, and Dr. Goldtooth will be happy to receive him at one
o'clock Friday.
Whether Mr. Oldfamily became a "client" of the bumptious Dr. Goldtooth
I do not know, but this is the way in which we do it now.
There is one of the dentists here who affects great splendor in the appoint-
ments of his office, who has the clasps with which the bib-like rubber dam is fas-
tened made of gold in the form of lions' heads with eyes of genuine rubies.
The dam itself is of a rubber specially manufactured for him; the tools are sur-
rounded by a coil of hot water which is suppo.sed to keep them at the temperature
of the mouth; the appointments are noted down on specially imported Japanese
paper, and the whole process of dentistry is in this office conducted as if it were
a social "function" of high importance. — Boston Correspojidence in Chicago Trib-
um.
The American Dental Society of Europe will hold its eighteenth meeting at
Basel August 1st, 2d and 3d.
Officers for 18i»2 : President, Dr. Lyman C. Bryan, Basel; Vice-President,
Dr J. H. Spaulding, Paris; Treasurer, Dr. C. H. Adams, Frankfurt, A. M.; Sec-
retary, Dr. Chas, W. Jenkins, Zurich. Executive Committee : Drs. Bryan, De
Trey and Prick, Membership Committee : Drs. Spaulding, Davenport and
Wetzel.
In order to prepare a programme for the meeting, the Executive Committee
desire definite and early answers to the following questions, viz.:
Do you intend to be present ?
Will you engage to read a paper? If so, please give full title, that it may be
announced in the programme.
Will you engage to demonstrate or to operate clinically ? If so, state what, if
MEMORANDA. 433
any, special arrangements you desire to be made. An ingenious amphitheater
for accommodating a large number of spectators of clinics in the immediate
vicinity of the patient will be loaned to the Society by the Swiss Dental Associa-
tion, which holds its annual meeting in Basel May 14th to 16th. Clinics will be
a special feature of the next meeting, several having been already arranged for.
The University will place desirable rooms at the disposal of the Society.
The Committee are convinced that it would greatly promote the interest and
profit of the occasion, if members who intend to be present would arrange in ad-
vance 'to take some definite part in the discussion of the topics announced in the pro-
gramme. It has often occurred that some members were unable to present their
views to the best advantage for the lack of incentive to preparation. Naturally
no one cares to prepare his remarks beforehand if they are to be made at the end
of a rambling discussion, or may be excluded altogether for lack of time. It
also sometimes happens that certain subjects which have been discussed very
fully already are allowed to take up a disproportionate amount of time. Both
these evils are at least partially obviated when one or two members engage to
open the discussion and are followed by speakers whose remarks are wholly ex-
temporaneous. System and conciseness are thus combined with reasonable free-
dom of discussion.
Writers of papers would therefore contribute greatly to the worthy consider-
ation of their subjects if they would engage, either personally or through the
Committee, some fellow member — better two — to lead in the discussion. It is be-
lieved that by this means time will be economized and the labor of maintaining
the interest at a high level more equally distributed.
The Reception Committee, consisting of several dentists of Basel, will pro-
vide recreation for members and visiting dentists, to fill hours not occupied by
the sessions of the society. The Verkehrs-Vereiti, o^c& on the Schifflande, near
the Old Rhine Bridge, will also lend its assistance to make the stay in Basel
pleasant, and will furnish gratis full information as to the best routes to and from
the city, &c.
A card, with coupons attached, will be provided at a fixed price, to include
various items of expense exclusive of room and breakfast at the hotels, thus
enabling visitors to lunch and dine together, go on excursions, attend the ban-
quet, concert, &c., at the minimum of expense.
August being the height of the season of travel, roovis must be ordered in ad-
vance. Questions as to local arrangements may be addressed to the Secretary or
direct to the President at Basel.
Zurich, April, 1893. Chas. W. Jenkins, Secretary.
INCORPORATED.
Union Dental Company, at Chicago ; capital stock, $100; incorporators,
Robert Steele, George Steele and James Hutt.
THE MISSOURI STATE DENTAL ASSOCIATION.
The twenty-eighth annual meeting of this association will be held at Clinton,
Mo., commencing Tuesday, July 5th, and continuing four days. Members of the
profession cordially invited to be present.
William Conrad, Corresponding Sec'y.,
St. Louis, Mo.
484 THE DENTAL REVIEW.
CAMPHORIC ACID IN ACUTE CORYZA.
A cotton wool tampon charged with a 2 per cent solution of camphoric acid,
and introduced into the nostril, gives rapid and permanent relief in acute coryza.
— St. Louis Cliniijue.
BASE BALL IN CHICAGO.
The Justi Insolubles and S. S. White Bicuspids played their first game at
the grounds corner 61st and State streets Saturday May 7th. The result was a
victory for the Insolubles with a score of 11 to 7.
INDIANA STATE DENTAL ASSOCIATION.
The Thirty-fourth Annual Meeting of the Indiana State Dental Association
will occur June 28, 2!t, 30, at Lake Maxinkukee, Ind. The State Board of Dental
Examiners will meet at the same time and place. All dentists and physicians
cordially invited to attend. G. E. Hunt, Secretary.
NOTICE.
Section V. Materia Medica and Therapeutics. Any member of the Section,
or any proposed member for 1802, is invited to send to the Secretary the title of a
paper to be presented at the next annual meeting at Niagara Falls, August 2,
1892. If not possible to be present, the paper will be read in the Section, and if
found suitable will receive due attention. A. W. Harlan, Chairman,
1000 Masonic Temple, Chicago.
G. E. Hunt, Secretary, Indianapolis.
NOTICE.
American Dental Association, Niagara Falls, August 2, 1892.
Section VI. Physiology and Etiology. H. A. Smith, Chairman, 128 Garfield
Place, Cincinnati, O.; L. E. Custer, Secretary, 28 East Third Street, Dayton,
Ohio. You are earnestly requested to prepare a paper for this section, to be pre-
sented at the next meeting in August. Anything new pertaining to the work of
this section, which may have been presented at your Local or State Society the
past year, will also be highly acceptable. Please give this your early attention,
in order that the report may be properly arranged.
COMING TO AMERICA TO STUDY.
We know that every year many Americans go abroad to study, but we scarcely
appreciate the strength of the current setting this way. An examination of recent
university catalogues shows that practically every civilized nation in the world is
represented by students now in America. In a single great institution, the Uni-
versity of Pennsylvania, there are students from twenty-eight foreign countries.
The Massachusetts Institute of Technology alone shows students of eighteen
nationalities; seventeen are represented in the University of California, fifteen in
both Harvard and Yale, fourteen at Cornell and Michigan, ten at Princeton, nine
at Lehigh, and two each in Brown and Wesleyan. Even remote countries like
Japen send many students here, Yale having this year seven Japanese students,
the University of Pennsylvania six, Cornell five. Harvard four, and many other
colleges one or two. Our excellent professional courses are the attraction to most
of these foreigners, the University of Pennsylvania medical and dental schools
showing to-day seventy-five foreigh students, chiefly Europeans. — Augusta Chron-
icle:
MEMORANDA. 435
THE PURIFICATION OF RESINIFIED ESSENTIAL OILS.
Old ethereal oils differ from fresh ones mainly in two points — first, that the
terpenes contained in the former are partly polymerized and resinified in the
course of time in consequence of exposure to light, air and moisture ; and, second,
that the esters and aldehydes existing therein have undergone a partial saponifica-
tion or oxidation whereby they have become acid.
Dr. H. Werner gives the following method (in Pharm. Zeit., No. 5, 1892) for
their purification. The editor of the paper points out that this is not equivalent
to a complete restoration, since this implies the reconstruction of the oil so as to
contain the same percentage of every constituent, which is impossible. Neverthe-
less the "purified" oils will be useful for many purposes.
The first step is to neutralize the oils with a trace of soda. Next they are
distilled with steam. A good arrangement is the following : The oil is placed
into a short-necked, round-bottomed flask, connected with a Liebig's condenser.
From an ordinary tin can, filled with water and heated by a flame, steam is gen-
erated and conducted by a bent glass tube to the bottom of the flask containing
the essential oil. The oil will gradually become heated by the passing steam and
will be carried over with the vapor. The distillate consists of oil and water, the
latter of which may be utilized by itself, if there is any use for it. The oil thus
obtained ought to be once more rectified, if a perfectly satisfactory product is de-
sired. For this purpose it should first be entirely deprived of water by being dried
over a caustic alkali, such as caustic potassa. This is best done by introducing
the oil into a bottle, adding some sticks of the alkali, then heating to 50 to 60^
C, and allowing the flask to stand overnight. The oil is then distilled from a
flask, with a delivery tube fused to it, over a naked fire. The vapors need not be
cooled. To prevent bumping a little talcum is added to the oil.
When only small quantities are to be purified it is sufficient to treat the oil
with an alkali and then to distil. The flask will then retain all the sticky resin.
When larger quantities are to be treated the presence of the resin would be very
objectionable and greatly interfere with the distillation.
Add 5 parts of calcined magnesia to every 1000 parts of peroxide of hydrogen
when you bleach a tooth.
A NEW AND PRACTICAL USE FOR ALUMINUM.
This metal with its unlimited uses seems to be peculiarly adapted for surgical
appliances, instruments and artificial limbs; its low specific gravity together with
its great comparative strength are qualities that are desirable to be combined in an
artificial leg or arm, and we predict a very large demand for the new aluminum
limbs just about to be put upon the market by this enterprising house.
There are amputations of the lower limbs that surgeons deem desirable to
make in order to remove a part or the whole of a diseased or injured foot, with-
out sacrificing more of the member than the parts involved. We refer to amputa-
tions technically termed tibio-tarsal, tarso-metatarsal and medio-tarsal. These
amputations have always been in disfavor with artificial limb makers, who have al-
most to a unit decribed their license, and in too many instances have persuaded
the surgeons to sacrifice much of a healthy leg merely to obtain a stump that
would better accommodate the artificial limbs that they were able to produce.
The new artificial leg constructed of aluminum combined with the rubber
486 THE DEXTAL REVIEW.
foot is adaptable to the above enumerated amputations. The socket of aluminum
encases the stump and on account of the strength of the metal, the socket does
not increase the diameters of the ankle to an objectionable degree in order to ob-
tain the requisite strength; the metal is cast into the proper shape to give ease and
comfort to the wearer, the aluminum socket is terminated by a rubber foot, which
not only produces simulation of the natural foot, but provides a soft, springy me-
dium to walk upon, and a resistant, phalangeal ball to raise upon while walking,
running or ascending stairs.
It is obvious that by this invention the amputation can be conditional upon
the injury, and the artificial limb conditional upon the amputation. In this alone
the invention of the aluminum and rubber leg will prove not only a boon to the
man who has suffered the amputation, but the solution of a problem that has many
times perplexed Ihe operating surgeon, as it eliminates all the objections hereto-
fore pressed against amputations in the region of the tarsus. The surgeon may
thus rejoice in being able to observe the c/i/ and consistent law of amputating with
the least sacrifice.
Aluminum also plays an important part in the construction of strong and
durable artificial arms. The socket of an arm being made of that metal is light
and strong, and will enable the wearer to subject the artificial arm to severe uses
without danger of destruction. It will not crack from overstrain like wood; it
will not become soft and limpsey or foul from perspiration like leather; it is
lighter than any other metal and is amply strong for every purpose.
These inventions will unqestionably mark a new era in the industry and add
much to the prestige of the house that has already achieved distinction in its hu-
mane work.
MEETING OF THE .AMERICAN DEN-T.^L ASSOCIATION, AUGUST 2, 1892, AT
NIAGARA FALLS.
The following circular has been promulgated:
Chicago, April 16, 1892.
Dear Doctor; — The meeting of the American Dental Association- will take
place at Niagara Falls, the first Tuesday in August. We are trying to get a con-
densed report of the important work that has been done in the different societies of
the United States of a scientific nature, during the year; also a description of any
new practical methods or appliances. Will you cooperate with us in this effort,
and see to it that at least a synopsis of the papers that have been read in your
society during the year, and a brief report of anything new in practice or appli-
ance which you or any member of your society may have, is forwarded to me?
I will see that all such communications are forwarded to the proper sections of
the American Dental Association, to be incorporated in a condensed report.
Although the American Dental Association is made up of representatives from
local societies, thus far there has not been the bond of union that there should be
between the State and local societies and the American Association. The work
and progress made by local societies has not been reported or given to the
main body, hence much of the growth that should come from such cooperation
has been lost to the entire profession.
When the plan proposed is intelligently carried out, we are sure to have meet-
ings of so much profit that no society can afford to fail of representation, even
MEMORANDA. 437
though they defray the expense of sending delegates, and the increased value of
these meetings to the whole profession cannot now be estimated. Each society is
entitled to one delegate for every five members.
Do not rest satisfied with sending one delegate, but let each society give us a
full delegation of representative men. This is doubly needed this year, as much
of the arranging for the World's Fair Meeting will be planned during the year,
and every section should be thoroughly represented.
If you expect to attend, let us know, and information regarding Hotel and
Railroad Rates, etc., will be sent you. In buying your Railroad Ticket be sure
to take a receipt showing that you have paid full fare in going to the meeting.
By attending to the above requests, promptly, you will greatly aid in increas-
ing the interest in the ne.Kt meeting and in raising the standard of work done by
the American Dental Association. You will also bring prominently before the pro-
fession the work you are doing
Hoping to hear from you, I remain.
Yours very truly,
J. N. Crouse, Chr. Ex. Com.,
2231 Prairie Avenue.
CHICAGO DENTAL SOCIETY.
Chicago, April 26, 1892.
7^1? the Members of the Cliicago Dental Society :
Gentlemen, — It seems fitting at this time, when all departments of industry
and thought are being quickened by the approaching World's Fair, that the den-
tal profession should begin to show that it feels the same stimulus. All signs
indicate that the World's Columbian Dental Congress will bring together in Chi-
cago the largest body of Dentists ever assembled. It is time, therefore, to begin
to realize the responsibility resting upon us, so that when visitors from all parts
of the United States and foreign countries come to our city we shall be prepared
to acquit ourselves creditably. There can be no doubt that, when the time does
come, Chicago will do her best — which means that the congress will be an un-
qualified success. It will be mainly through the different organizations that this
happy result will be attained; therefore, it is highly important that each society
should be working up to its greatest capacity.
The officers of the Chicago Dental Society, in order to give it an efficiency
■corresponding with its age and representative character, urge upon members the
necessity for new interest and special effort in its behalf.
Members are asked to attend the meetings with the utmost regularity circum-
stances will permit ;
To take pains to have friends who come to town plan their visits so as to attend
the meetings ;
To be prepared to take part in discussion of topics announced ;
To voluntarily contribute something outside of the announced program ;
To contribute something of scientific or practical interest, voluntarily at any
meeting. This will be announced in the printed program if the President or Sec-
retary be informed beforehand ;
To obtain new members.
The officers will endeavor to make the program for each meeting an attractive
438 THE DEXTAL REVIEW.
one, and ask the earnest cooperation of each member to this end. It is especially
requested that cases in practice, casts, apjiliances. methods, medicaments, new
and old books, instruments and specimens be presented. Ample opportunity for
their description will be allowed and an electric mouth lamp will be provided when
patients are brought to the meetings.
Believing that by benefiting others you will benefit yourselves, and that the
society will be given a new impetus by the personal interest and participation of
every member in all its proceedings, we remain. Sincerely Yours,
J. W. Wassall, President.
L. L. Davis, Secretary.
THE METHOD OF DISINFECTION USED BY THE SANITARY AUTHORITIES OF PARIS.
Attached to the sanitary department of Paris there are a number of disinfect-
ing stations, in which clothing, bedding, furniture, and any other article of house-
hold implement is disinfected, either by order of the authorities or at the demand
of private individuals or corporations. Connected with these stations are also
wagons carrying all necessary implements to perform the operation of disinfection
in private houses.
In the disinfecting stations the main process consists in exposing the sub-
stances first to the action of superheated- steam, and afterward spraying them
with a solution of corrosive sublimate, 1, in 1,000, to which are added tartaric
acid in the proportion of 7.") gr. to the quart, and a few drops of an alcoholic so-
lution of tincture of carmine or indigo. The steam apparatus used is that of
Geneste & Herscher, which is now employed by the Government and a large
number of cities and public administrations, both French and foreign. After fif-
teen minutes of steam heating and fifteen minutes of drying, the disinfection is
complete.
As for the vaporizers (for spraying), which are constructed by the same house,
they are designed to project the antiseptic liquid in a very fine spray over all ob-
jects that cannot be placed in a stove, such as leather, furs, etc., and also to dis-
infect rooms and their contents. With the solution mentioned above this mode
of disinfection is done rapidly, without any injury even to objects of high price,
provided the operation be performed with some care. The perfect efficiency of
this process has been many times demonstrated. It is destined to replace disin-
fection through sulphurous acid gas, which is a difficult, always incomplete and
illusory process in the conditions of current practice, and so lengthy as to render
the use of it much more injurious than useful as regards the generalization of
disinfection.
The municipal disinfecting stations of Paris are open to the public gratutiously,
either when one carries the contaminated objects thither directly, or requests the
employees to come to the house for the objects, and, what is indispensable, to
disinfect the house at the same time. The service is performed by special men
whose experience has been tested, and it is supervised with much care by Menaut,
the director of municipal affairs.
When the wagon starts the disinfectors must be sure that it contains the fol-
lowing material: (1) the vaporizer pump and several bottles containing the disin-
fecting liquid, which are confided to their care and responsibility and must never
be entrusted to any one else, no matter who it may be; (2) a bottle containing a
MEMOKAXDA. 439i
quart of solution of permanganate of potash in the proportion of 12 gr. to 1,000;
(3^ a canvass bag containing the working costume — say, for each man, a canvass
cap, a pair of canvass trousers, a canvass blouse fitted to the neck and wrists,
and shoes; (4) several wrappers closed in any way except by leather cords, and
which must be of different forms for mattresses, bolsters, pillows, coverlets, etc.,
and must be marked with numbers or letters in red, of large size; (5) rags, de- ■
signed for wiping purposes; (0) two large sponges, a scrub brush, and a brush
with a handle; (7) a tool bag; and (8) a jointed ladder, provided with rubber at
the extremities oi the uprights.
As soon as they reach the house the disinfectors carry their material to the
room to be disinfected, and put on their working clothes before entering it. They
first, with a brush, scour the linen spotted with blood, with the aid of the perman-
ganate solution, after which they put into wrappers all the objects that are to
be carried to the stove, such as mattresses, bedclothes, linen, curtains, clothing,
etc. Then, after pouring the contents of one of the bottles into the vaporizing
pump, and after filling the latter with water, they project a spray of disinfect-
ing liquid against the walls, floors, woodwork, carpets, furniture (especially the
beds) night tables, and all the other objects left in the room.
No portion of the rooms to be disinfected, nor any of the objects that they
contain, must be neglected.
The mirrors and their frames, the pictures and art objects, have to be rubbed
with rags that have been dipped in the disinfecting solution. The carpets and the
hangings left in the house on account of their bulk have to be removed and treated
on both sides with a spray of the disinfecting fluid. The floor or the walls that
they cover have likewise to be disinfected. The vessels and utensils that have
been used by the patient, as well as the water closets and toilet tables, have to be
washed with the disinfecting solution. After these operations are finished the
disinfectors must take off their working clothes and put them in a bag provided for
them and take them to the disinfecting stove along with the bags containing the
objects that are likewise to be placed in the stove. As soon as the objects to be
disinfected reach the establishment they are unloaded and the whole must, as soon
as possible, be disinfected. After disinfection the objects are carried back as soon
as possible to the house of their owner by the wagon especially designed for the
purpose.
Such is the programme followed in great part by the disinfecting service of
the municipal station. All the details of this programme have their importance,
and it is because they can be carefully executed by such service that the latter is
the only one that is now capable of inspiring confidence in the citizens of Paris. —
La Nature and Scient. Ant. Suppl .
AMERICAN DENTAL SOCIETY OF EUROPE.
The American Dental Society of Europe will hold its eighteenth meeting at
Basel, Switzerland, August 1, 2 and !!. Members of the profession are cordially
invited to attend. Clinics will be a special feature of this meeting. The Univer-
sity will place desirable rooms at the disposal of the Society, and an ingenious
amphitheater for accommodating in the immediate vicinity of the patient a larger
number of spectators than are able to witness operations under the ordinary cir-
cumstances, will be loaned by the Swiss Dental Association. Programmes may
be had on application to the president. Dr. Bryan, of Basel, or to
Chas W. Jenkins, Secretary.
440 THE DE.VTAL KEl'/Eir.
NATIONAL ASSOCIATION OF DENTAL EXAMINERS.
The annual meeting of the National Association of Dental Examiners will be
held at Niagara Falls, Monday, August 1, 1892, at 10 A. M. All State Boards
are invited to send representatives.
Fred A. Levy, Secretary.
OBITUARY.
Died at Tipton, Iowa, April 2, 1893., of oedema of glottis, Herman Pase-
dach, D. D. S., in the twenty-fitth year of his age. Dr. Pasedach was born in
Berlin, Germany, in 1860. Came to this country when fourteen years of age.
Being scientifically inclined he entered upon the study of dentistry, and spent sev-
eral years in the office of Dr. S. A. Garber, of Tipton, with whom he entered into
partnership April 1, lS!t2. He was a graduate of the State University of Iowa
Dental Department, class 1892, one of the brightest of his class and a favorite of
one and all.
REUBEN JOHN KIRK.
Whereas, It has pleased an all-wise Providence to remove from our midst our
well-beloved brother, Reuben John Kirk ; and,
WHERE.ts, In his untimely demise our fraternity has lost a true and faithful
brother, an honest and upright man ; his family a loving and dutiful son and
brother. Therefore be it
Resohed, That the Supreme Chapter Delta Sigma Delta Fraternity, in execu-
tive session assembled, does hereby sincerely mourn the loss of him who has been
called from us in the prime of his young life ; and be it further
Kesohfd, That we extend to the family of our deceased brother our sincerest
sympathies in this their sad afHiction, and commend them to the great Comforter,
who is Omnipresent and ever willing to aid ; and be it further
Resolved, That a copy of these resolutions be sent to the family of our deceased
brother and a copy handed to the dental journals for publication.
•C. E. Meerhoff, ) ^
„ , y.^ - Committee.
Geo. J. Dennis. S
RESOLUTIONS PASSED BY THE ALUMNI ASSOCIATION OF THE CHICAGO COLLEGE
OF DENTAL SURGERY.
Your committee begs leave to report that since the formation of this associa-
tion, the following members have passed away, viz. ; Drs. J. Grant Emery, Wil-
liam Witt, G. E. Brownlee, E. J. Kautsky. A. G. Moffett, the dates of whose de-
mise we have been unable to ascertain. Also Drs. E, B. Ward, who died April
25, 1891. in Virginia, Joseph A. Swasey, January 12, 1892, at his home in Chicago,
and D. W. Runkle, at the Presbyterian hospital, Chicago, January 21, 1892.
Your committee submits the following resolutions, viz.:
Whereas, It has pleased an allwise Providence to remove from our midst
Drs. Wm. Witt, G. E. Brownlee, E. J. Kautsky, A. G. Moffett, E. B. Ward,
Joseph A. Swasey and D. W. Runkle. and
Whereas, In their demise this Association is deprived of seven worthy and
respected members, and the dental profession has lost some of its brightest and
most promising lights:
Now. Therefore, be it resolved. That the Alumni Association of the Chicago
College of Dental Surgery hereby most sincerely deplore the loss of these young
members who have been called from us in the morning of their existence.
Kesol-.ed, That we extend our sincere sympathy to their bereaved and sor-
rowing relations and that we commend them to the Great Creator of Heaven and
Earth for comfort and support; and be it further
Resohfd, That these resolutions be spread upon the records and a copy of
the same be sent to the dental journals for publication.
T. A. Broadbent, I ^
C.H.WRIGHT, ;- Committee.
THE
DENTAL REVIEW.
Vol. VI. CHICAGO, JUNE 15, 1893. No. G.
ORIGINAL COMMUNICATIONS.
The Interproximate Spaces.
By G. V. Black, M. D., D. D. S., Jacksonville, III.
In an article read before the Odontographic Society of Chicago,
and published in the Dental Review of July, 1890, and also in a
series of articles on the management of enamel margins, published
in the Dental Cosmos last year, I have called attention strongly to
the matter of care in the preservation of the form of the interproxi-
mate spaces. I have also, in some degree, called attention to the
evils which follow in case of failure to observe this care in the treat-
ment of proximate cavities. My feeling is that much more needs
to be said of this matter before the profession, as a body, will real-
ize its full importance. This is a result of the long habit of dis-
regard for the form of these spaces, and of doing violence to the
gum septum. In bringing this matter before you now, though I
have something more to say, my principal desire is to provoke a
discussion of it. Many men read articles of the kind I have writ-
ten and pass them by without giving the subject sufficient study.
Their attention has been but momentarily occupied by the
thought presented, whereas if they should engage in a discussion
of it in this society they might be led to think more deeply of the
subject, and make trial of the plans of practice proposed. Most of
us learn of these subjects, and improve our methods of practice
slowly, and adopt this or that thought only after it has repeatedly
found temporary lodgment in our minds. When I stop to review
442 THE DEXTAL REVIEW.
ni}- own progress I find that this has been the case with myself,
and my observation points out that the same is true of most
men.
In this paper it is not proposed to endeavor to discuss all of the
causes of failure of proximate fillings, but to confine it to three
points relating particularly to the interproximate spaces. These
are: imperfect forms of proximate contact; bad forms of, and in-
^sufficient width of, the interproximate space, and needless in-
juries to the gum septum.
There are other prolific causes of failure of proximate fillings,
such as imperfect excavation, bad forms of the enamel edges, bad
arrangement of the lines of enamel margins, injury to the enamel
edges while packing gold, imperfect adaptation of the filling ma-
terial to the enamel edges, insufficient or faulty anchorage. While
all of these are regarded as prolific causes of failure, any one of
•which might well serve as the basis of a paper, I shall not now dis-
cuss them.
The propositions to w-hich I shall now direct your attention and
endeavor to maintain are these :
1st. A healthy gum septum of good form, or filling the inter-
proximate space, is necessary to the cleanliness of the space.
2d. An interproximate space not filled by the gum septum, and
of such form as to retain food debris, serves as a pocket for the
accumulation and decomposition of such debris, with the forma-
tion of acid products, which cause the beginning or recurrence of
-decay of the teeth.
3d. An unhealthy gum septum and an unclean space, are a
■constant menace to the health of the peridental membranes, and a
frequent starting point of disease of a serious character.
4th. Proximate fillings must be so formed, and finished, as to
produce a proximate contact that will not hold food debris in its
grasp, nor leak the same into the interproximate space during mas-
lication, and thus injure or destroy the gum septum. Thus will be
maintained, with the greatest certainty, the health of the teeth, the
-gum septum, and the peridental membranes.
.5th. The full width and proper form of the interproximate
space must be maintained so that the gum septum shall have
sufficient room to maintain its health and perform its functions.
Bad forms of the interproximate space should be improved when
treating proximate surfaces.
I
ORIGINAL COMMUNICATIONS. 443
6th. When the interproximate space has been lost, or its width
diminished, by previous loss of the contact points of the teeth from
caries, which has allowed the teeth to drop together, the space
must be regained by judicious wedging, and the fillings so formed
and finished that the width of the space shall be maintained.
7th. The gum septum must not be seriously injured by the
use of wedges in separating the teeth, by temporary fillings crowded
against the gums while treating pulp cases, nor by the improper
use of instruments in finishing fillings.
The first proposition, that a health}^ gimi septum of good form,
or filling the interproximate space, is necessary to the cleanliness of
the space, would seem to need no argument to make it apparent
to everyone; for if the space and gum septum are not of such form
as to be self-cleaning, or the space is not perfectly filled by the gum
septum, it simply becomes a catch-basin for debris. This is true
except in abnormally broad spaces without contact of the teeth.
This condition can rarely be produced artificiall3\ The artificial
production of permanent separations to obtain self-cleaning spaces
was extensively tried in the first half of the present century, and
its failure is so generally admitted that it may be dismissed with this
reference. The space, artificially produced by filling, closes by the
teeth falling together, producing a shrinkage of the arch to that ex-
tent; and generally the form of the space produced is found to hold
lodgments of food debris when the teeth have fallen together.
Therefore the experience of the profession has shown that space
produced by the file to give room for operating is bad practice.
In case there is no intention to produce a permanent open space,
but only to give room for finishing the filling, a proximate contact
cannot certainly be made that will not hold food debris in its grasp,
or leak into the interproximate space to such a degree as to de-
stroy the gum septum, or seriously injure its arched form by break-
ing down its central portion causing food to lodge and undergo
decomposition with acid products. This becomes a cause of recur-
rence of decay. I ma}- state here that in what I shall term the
arched form of the gum septum tlie tissue is fullest in that portion
central from buccal to lingual between the teeth, so that food de-
bris that may have been forced past the contact point and thus lies
loosely in the space is constantly dragged out by the sliding of food
to the buccal or lingual sides of the teeth and gums in the act of
mastication, thus continuously cleaning the space. This is a form
444 THE DEXTAL RE VIE IV.
of the gum septum that is cleanly though it may not fill the inter-
proximate space.
THE FORM OF PROXIMATE CONTACT.
Now what do we mean by reproducing the correct form of
the interproximate space? Is it the exact reproduction of the
original form of the tooth? No, not always. Many natural teeth
are well formed, and not a few are of bad form. When the forms
were originally excellent we will do well to reproduce them. We
will do well to reproduce good forms, or at least improve the
forms, in those cases in which the forms were originally bad.
What are good interproximate spaces? Who among us have
studied the forms of the teeth, the forms of the interproximate
spaces, the forms of the proximate contact, and the gum septum
closely enough to answer this question. I can give my views
and sta-rt the discussion of the subject, feeling certain that the
close study of it will serve to correct many grave errors in prac-
tice. It is certain that there are good forms and bad forms of
these spaces, and so long as we are unable to clearly define good
forms we will certainly be unable to produce good forms in our
treatment of proximate surfaces.
/ There is one principle that obtains in the make-up of every
good interproximate space, and that is a form of proximate con-
tact that will not hold food debris in its grasp. This does not
depend entirely upon the rigidity of the contact, or the firmness
with which the teeth resist separation, but upon form. We cannot
expect the accuracy and rigidity of the contact to absolutely ex-
clude food debris. What form, then most certainly gives the re-
quired result.
All know that the teeth have motion in their sockets, much
restricted certainly, but still a certain amount of motion, by which
the contact points are rubbed one upon another. Suppose, for
illustration, we take two marbles with perfectly polished surfaces
and press them together, giving them ever so little sliding mo-
tion upon each other, and at the same time press some fibers or
particles between the contact points and try to make them stay
in the grasp of the contact. It will be found impossible, such
things slip out one way or another. Now this is the principle
of the contact between the teeth? It is the contact of rounded
surfaces in which the actual contact is a small point rounded
ORIGINAL COMMUNICATIONS. 445
quickly away in every direction, so that ddbris of any kind forced
in is quickly removed by natural processes. In the study of the
best formed arches we find the contact between the teeth based
on this principle from the incisors to the molars, and as dentures
are presented to us in our offices, if we study them carefully, we
will find that they correspond sharply to this principle ; the con-
tact is effective in maintaining clean spaces, while as they diverge
toward broad flattened contacts they are correspondingly faulty.
In this respect we find a constant gradation in comparative
anatomy, from the sharply rounded contacts that prevail in the
carnivora that eat tough stringy food, to the broad, flattened con-
tacts in those animals that subsist largely on grain or brittle food,
of which the horse will serve as a type. In the omnivora we find
a middle form between these extremes. In man this middle ground
is generally mantained, but we will find gradations that in a degree
typify them both. In some we find very strong square tooth
crowns that proximate with comparatively broad, flattened surfaces,
while the majority of even broad crowned teeth form contact with
rather small round points. In the long bell crowned teeth the contact
points are much rounded and small in area though the teeth ma}^
be large.
The contact between the marbles which I have given as typifying
the contact between the teeth is substantially correct, but the con-
tact points of the teeth are not perfect spheres as in marbles. They
are generally more rounded in one direction than in another. And
in many instances the mesial surface of a tooth is nearl}' flat at the
contact point while the distal surface of the neighboring tooth is
sharply rounded. Between the incisors, the contact points are
rounded most in the labio-lingual direction. Between the bicuspids
the rounding is often about equal, but between broad crowned
teeth the rounding is greatest in the occludo-gingival direction. In
the lower molars, the contact of the first and second is generally
rounded in all directions, while between the second and third it is
somewhat broader from buccal to lingual. In the upper molars
the contact becomes broadest from buccal to lingual, but it is
sharply rounded from occluding to gingival, with a broad space to
the gingival; however, in many dentures the contact between the
upper molars is quite sharpl}- rounded from buccal to lingual as
well.
A mode of measuring the area of the contacts of the teeth is
446 THE DENTAL REVIEW.
very desirable, and the plan that I have used, though only ap-
proximating an actual measurement is of much value. Take a
thread of some given size, say size A of sewing silk and pass it
into the interpioximate space. Then bring the free ends together
and draw them tight enough to bring the thread close around the
contact point, but not so tight as to strain the teeth apart. The
space between the threads where they leave the space will show the
area of the contact, plus what the thread by reason of its size lacks
of reaching the actual contact. In this it will be seen that the size
of the thread cuts an important figure, for on account of the round-
ing of the surfaces a large thread cannot be brought so near the
actual contact as a small one. After the thread has been brought
fairly tight, and has been observed, draw it gently through the con-
tact and observe carefully how nearly the two parts approach each
other, and especially whether the thread comes through the con-
tact with a snap, as it should if the contact is well rounded, or
drags through with more or less grating. This latter is character-
istic of a flattened contact, whether made by a file or by the wear
of the contact points against each other in mastication. It the
thread is drawn parallel with the length of the teeth the bucco-
lingual breadth of the contact will be shown; and if it be drawn at
right angles to the length of the teeth the occludo-gingival
breadth will be shown. This plan of measurement is valuable in
the examination of the contacts that we make in our treatment of
proximate surfaces.
The form of the space to the gingival of the contact seems to
be important. The best formed spaces broaden quickly from the
point of contact so that any particles of food that are forced past it
in mastication are not held, but are at once loose and freely mova-
ble so that the next morsel of food that is crushed between the
teeth, as it glides aside over the lingual and buccal sides of the
teeth and gums, will catch and carry them out of the space. To
this end the arch form of the gum septum from buccal to lingual
is important.
When we study closely the beginning of caries in the proximate
surfaces of the teeth of young people, we find that it almost always
has its point of first penetration of the enamel slightly rootwise from
the contact point. This occurs in individuals in whom there is
rather a strong predisposition to caries early in life when the fes-
toons of the gum septa are so prominent as to prevent the cleaning
ORIGINAL COMMUNICATIONS. 44'Zr
of the spaces, or to cause them to hold d6bris. In individuals in-
whom the predisposition to caries is less strong, or in whom the proxi-
mate contacts of the teeth, and the gum septa are of better forms^
such decays ma^' not occur. When we find the festoons of the
gingivae large continuously for a considerable time in young people
(when not swollen from calcareous deposits) we may expect a number
of proximate decays. This is, I think, because these enlarged fes-
toons interfered with the natural process of cleaning the interproxi-
mate spaces during mastication. Therefore an overfull gum sep-
tum is worse than one that is underfull, but presents a good arched
form. This condition of overfullness is frequent in young persons..
A gum septum that is lowest centrally between the teeth, forming a:
pocket in which debris is retained, is bad, whether the condition is
caused by overfullness of the festoons or from the breaking down o£
the central portion.
Many persons of middle age, or past, whose teeth have pre-
sented good proximate contact, and who have escaped with little,,
or no proximate decay in early life, are found to have one or more,
proximate decays beginning near the gingival line. In these cases-
we generally find that the contact points have been flattened and
their area much increased by wear of the one against the other,
and that in the particular space, or spaces, where decay occurs,
these flattened points of contact have held food debris in their
grasp, and this has been forced more and more against the gurrt
septum until the central portion of it is broken down, forming a
pocket in which decomposition with acid production has occurred-
Caries is the consequence. It is notable that in these cases the
decay is much further toward the gingival line than that which,
occurs in younger persons when the contact points are less flat or
in whom the gingival festoons are overfull.
What shall we do with these cases when they are presented to>
us before caries has occurred. Patients not unfrequently consult
us early, when the wedging of food into the space is causing dis-
comfort from pressure on the gum septum, and upon close examina-
tion we find a much flattened contact, and the gum septum being:
broken down. Shall we treat these cases at once by wedging suf-
ficiently and then forming sufficient cavity to restore a rounded'
contact by filling, and thus relieve the patient of discomfort at
once ? or shall we wait until a considerable part of the tooth has-
been destroyed by caries ? Suppose decay is found to have begun..
448 THE DEXTAL REVIEW.
shall we fill the cavity- and finish with a separating file, and leave
the flat contact to renew the mischief ? Certainly we should wedge
sufficiently to restore the rounded form of contact and finish
toward the cervix with a file with a rounded face, widening the
space to the gingivae of the contact as we find it in the best forms.
In many of these cases we may exaggerate the rounding from
buccal to lingual to advantage. Then food that happens to be
forced past the contact will be freely movable and the space will
be kept clean in the natural way.
These cases of flattened contact by wear with their results
furnish a picture of much that is being done in the treatment of
proximate cavities. A decay has occurred. The cavity is, we may
say, well excavated, skillfully formed, and carefully filled. The
contour of the occluding surface is restored, but the proximate
surface is shaped with the separating file, leaving a broad flat sur-
face instead of the rounded contact point. And especially no con-
cavity is formed to the gingival of the contact point, so that in this
direction also the grasp of the contact holds food that is
forced in, instead of leaving it loose and movable as it has
passed into the space. The next that is forced in sends the first
on to the central portion of the gum septum and holds it firmly.
The gum breaks down, or is absorbed, so that the cervical margin
of the filling is uncovered, decomposition and acid production oc-
curs in apposition with the enamel margins, and decay recurs.
In this it will be seen that the operator has produced the con-
dition, as to form, that seriously endangers the permanence of the
filling. The safer plan is to get the necessary space to reproduce
the contour of the proximate surface and finish to a rounded point
that will preserve the gum septum and a clean interproximate
space.
THE SPACE.
I will now speak of the interproximate space apart from the form
of the proximate contact. I have already referred to the fact that
in normal conditions this space is filled with the gum septum to
the contact point, and that the integrity of this tissue is important
to the continued health of the teeth and their membranes.
It is of the utmost importance that the full width of the inter-
proximate space be preserved in order that the gum septum shall
have sufficient room for the maintenance of its tissue in the full
measure of health and function. It is a matter of observation that
ORIGINAL COMMUNICATIONS. 449
wide interproximate spaces rootwise from the proximate contact
maintain the health and cleanliness of the teeth better than narrow
ones, or that bell crowned teeth are, other things being equal,
cleaner and healthier than teeth with thick necks and narrow inter-.
proximate spaces. While we cannot make bell crowned teeth of
thick necked ones, we can maintain the full width of the spaces
provided by nature; and this should always be done by gaining suf-
ficient room to complete our filling to represent the full original
mesio-distal diameter of the teeth. In no case in which there has
been original contact can this be done without artificial separation
of the teeth for finishing the fillings. Separation by the use of the
file is no longer to be thought of. It does not give the room we
want, and is bad practice. The dentist of to-day has no use for
the separating file as such.
But we are called upon to do more than maintain the space.
The contact points are frequently destroyed by caries, and the
space has become much narrowed by the teeth dropping together
before patients appl}^ for treatment, and occasionally this has pro-
ceeded so far that the necks of the teeth touch each other, annihi-
lating the space altogether. In these cases it is not a question of
obtaining room for operating, but a question of regaining the lost
interproximate space. We hiay operate, or make a filling in much
less room than is required to reform the interproximate space that
is so necessary to the renewal of the gum septum and the con-
tinued health of the surfaces operated upon.
To some this may seem like rehearsing an old story. I have
written of it plainly and pointedly before (See Dental Review,
July, 1890, page 452), yet I was surprised to see in a recent number
of the Dental Cosmos, over the name of one who is giving instruction
in operative dentistry, a case in which the central incisors had
dropped together from the loss of their proximate contact and were
wedged apart for the recovery of the space (regulated) and then
filled to the normal form, cited as something new. (See Dental Cos-
mos, April, 1892, page 278.) I should not have presented this paper
were it not a fact that I am continually meeting cases in which this
whole subject has been neglected, such as this: A lady, a stranger,
coming from a distant city, presents herself complaining of pain
in the region of the lower first and second molars. I find two large
proximate fillings with insufficient interproximate space, and a
separating file contact ; the fillings, I am informed, have been in
450 THE DENTAL REVIEW.
position eighteen montlis. The gum septa are ahiiost entirely
destroyed centrally between the teeth and packed with decompos-
ing debris. The whole region between the teeth is exquisitely
sensitive. Now this patient tells me she has repeatedly com-
plained to her dentist of this pain, and that he was unable to find
cause for it. Only one thing is to be done; wedge until the space
is regained, and then remove the fillings and make others of
proper form to preserve the space and protect the gum septum.
But many, yes the greater number of these cases, go on without
much, if any, complaint of pain until the gum septum is destroyed
and caries has recurred at the gingival margin.
Will the gum septum regain its former size and fill the space if
it be given sufficient room and proper protection afforded ?
This is a pertinent question, and often an important one. It
may be stated as a general rule, that in patients under middle age
the gum septum will be completely reformed, provided the border
of the alveolar process is still of full height. Especial care as to
cleanliness should be observed for a time — a month or two — after
the operation. Indeed I am in the habit of seeing such cases sev-
eral times within a few weeks that I may insure the renewal of
the gum tissue, and sometimes resort to stimulating lotions in
addition to rigid cleanliness.
In some cases we cannot expect a complete renewal of the tis-
sue, that is, the interproximate space will not be filled to the con-
tact point. In these the form of contact is all the more important,
and especially it should be sharply rounded, and narrow, from
buccal to lingual. Then the tendency will be for the short gum
septum to assume the arch form, being highest just under the con-
tact point. In this case the gliding of the food to the buccal and
lingual during mastication will drag out all particles that may be
forced in past the contact point, and keep the space clean. A close
examination of mouths in which the septa have become short, and
in which the spaces remain clean, will show plainly that this is the
principle upon which cleanliness is maintained. A little study
will enable us to copy them in our operations.
Those cases in which the septum of the alveolar process has also
been broken down, often remain bad spaces after all I have been
able to do for them. It is in these that a departure from the
normal types of contact may be tried. Some will do better if the
contact is removed considerably toward the gingival, and the grind-
ORIGINAL COMMUNICATIONS. 451
ing surface cut away, either to buccal or lingual — generally the latter
— so that the act of mastication will induce a strong gliding motion
of food in such direction as to clean the space, or the whole bucco-
lingual width of the grinding surface may be sloped away to a posi-
tion reasonably near the contact point. In doing this the filling i?
rounded boldly out from near the neck of the tooth to form the con-
tact point and the concave portion finished with suitably formed
instruments. This plan may also be used in teeth that are so badly
broken down that it is not thought well to build on the full form
of the crown from fear that the strength will not be sufficient to bear
the strain of mastication.
INJURIES TO THE GUM SEPTUM.
I will now refer more particularly to injuries of the gum septum
during operations upon proximate surfaces. This tissue suffers as
little perhaps from temporary abuse as any other, but it is liable to
serious injury from long continued maltreatment. One of the most
constant abuses occurs in cases in which the treatment of root
canals, or exposed pulps, requires some kind of temporary fillings.
In these, it seems to be common practice to fill both the cavity in
the tooth and the interproximate space with cotton saturated with
some kind of gum or with gutta-percha forced into position without
reference to compression of the gum tissue. Indeed severe com-
pression is often recommended as a means of getting the gum tis-
sue out of the way while making the filling. In this way the gum
septum is often destroyed, or a deep pocket formed centrally be-
tween the teeth. After the treatment is finished and the cavity
filled, even when the proximate space and contact are left in good
form, this gum septum often fails to recover; or is only partially
restored to its former fullness and strength. If the proximate con-
tact is faulty it is irretrievably lost, for the vacant interproximate
space or the pocket which has been formed centrally between the
teeth, fills with debris which undergoes decomposition with the
formation of acid in contact with the unprotected margins of the
newly placed filling. This insures a recurrence of decay even
though a perfect filling has been made.
The destruction of the gum septum may have been regarded as
legitimate in times past, especially after we had cohesive gold and
before we had rubber dam. The mode of practice has, in a man-
ner, been inherited by us of the present da)'. But close observa-
452 THE DENTAL REVIEW.
tion of cases has shown its evil results, while improved methods
demonstrated that this mutilation is unnecessary. It is easy to
take a thin blade, such as one of Harlan's scalers, or a somewhat
broader blade of the same pattern, and place one edge of it against
the neck of the tooth operated upon and lean the other against the
proximating tooth, and while holding this rigidly in place insert a
gutta-percha filling firmly and at the same time protect the gum
septum and give it sufficient space. This requires almost no time.
It is convenient to have two or three widths of these blades for the
purpose. Cotton and sandarac is an abomination and should have
no place in a well regulated office.
In wedging teeth, injury to the gum septum is far too common.
In times past many of us have driven wooden wedges between the
teeth, crushing out the entire gum septum at a blow. I hope that
mode of separating teeth is not practiced by any of us now, for it
was essentially bad. I only allude to it to show how our profes-
sion has grown up in disregard of the contents of the interproxi-
mate space.
Although we may no longer drive such wedges, we are often
guilty of destroying this tissue in wedging with rubber, cotton, etc.,
by injudiciously placing the wedge so that the gum is compressed,
or by allowing it to slip from the proximate contact, where it should
always be held, into the wider part of the space against the septum
of the alveolar process, where, besides causing the patient extreme
pain, it will do a lasting injury to the gum tissue. Possibly but
few of us are entirely free from this, as an accident of practice, but
to do this frequently, or to fail to observe great care to avoid it,
and to use all means to mitigate the injury in case of accident, is
bad practice.
Injury to the gum septum in finishing proximate fillings often
becomes a serious matter. Think of pushing and pulling a sepa-
rating file back and forth to file down a proximate filling with the
saw on its edge, tearing the soft tissue at every stroke, often until
the last of the gum septum is lacerated beyond recovery, if not en-
tirely removed from the space. Then the fillings are finished with
flat proximating surfaces that will catch and hold food between
them and prevent the recovery of any gum tissue that may be left
in the space.
The separating file should not be used to trim proximate fillings.
When it becomes necessary to cut to make room between a newly
ORIGINAL COMMUNICATIONS. 453
made proximate filling and the neighboring tooth for passing finish-
ing instruments a thin separating file might be used, but a fine saw
held in rigid frame is better. This should be used carefully to
make the one cut and then immediately laid aside. Every instru-
ment used afterward should present a smooth polished edge to
the gum tissue. The instrument with which I do the bulk of the
trimming is the thread saw. This is turned with its smooth pol-
ished back to the gum tissue and cuts toward the occluding sur-
face of the tooth. It is insinuated under the overhanging por-
tions of the filling, and the trimming is expeditiously done with the
minimum of injury to the gum. The trimming about the buccal,
labial, or lingual angles, that this instrument will not reach, is done
by the smooth edged draw files and with disks, and the contact
point is rounded to the desired form. This work cannot be done
with the same expedition and effectiveness with the separating file.
Its shape is unsuited to the work.
Many dentists are using the revolving disk for finishing proxi-
mate surfaces. So far as the form of the proximate contact is con-
cerned this is as bad as the separating file. The tendency of the
disk is to cut away the prominence of the contact point, and this
occurs almost inevitably when the endeavor is made to finish the
proximate surface with it. Yet the disk is a very useful instrument
for rounding the buccal or lingual angles of proximate fillings. I
make much use of it for this purpose, but do not use it between
the teeth, except occasionally a rim disk when I have plenty of
room to pass the rim safely beyond the contact point.
Now it may be said that the dental profession have used flat
separating files for forming the proximate surfaces of fillings from
time immemorial, and certainly their fillings have not all failed.
Certainly not. Many good fillings have been made in spite of the
unsuitableness of the flat files, and there has been a continuous
advance in the treatment of proximate surfaces up to the present
time. So please do not consider me pessimistic in this matter.
But many teeth of bad form and faulty texture have never
decayed. Many contact points flattened by wear have never
leaked food into the proximate space. Also, many fillings of bad
form have done excellent service. Yet it is the teeth of bad form
and faulty texture that decay most. It is the badly worn contacts
that oftenest do damage by leakage. It is the fillings of bad form
that are most liable to failure.
454 THE DEXTAL REVIEW.
Continually the question is being asked, "why do so many prox-
imate fillings fail?" In this paper I have tried to point out, not the
sum, but some of the whys with the hope that a close study of it
may reduce the number of failures.
Some Needed Reforms in the Practice of Dentistry.
By James W. Cormanv, M. D., Mt. Carroll, III.
The first reform to which I would call your attention is that
students graduating from some of our dental colleges be not taught
that the college from which they graduate is the only one teaching
the latest improved methods in the practice of dentistry, and the
graduates should not be sent forth with the idea that they " know
it all." They will find a few dentists perhaps practicing in the
country who have stood tlie heat and burden of the day for lo, these
twenty years, and who know a little something. The student is not
entirely to blame for this for he is taught it, and the egotistical
ones carry it awa}' in a great degree. I have had not a few experi-
ences with these, and this has led me to suggest the first reform.
There may be some dentists with long necks and cross-eyed
one way that might be successful in filling approximal cavities in
the anterior teeth from the lingual side, thus preventing much gold
showing from the front. Some claim that by the use of the mir:
ror they can accomplish good results, but I am led to advocate a
reform in this method, first'by securing plenty of room by the use
of wedges and time, and thus filling from the front. Better work
may be done in this way with less inconvenience. In the practice
of filling proximal cavities in bicuspids and molars with amalgam,
without proper separation, there should be lasting reform. It is
so easy to run a file between the teeth, cutting away more tooth
substance than is necessary, to use no rubber dam, to clean out the
cavity hurriedly, insert the amalgam, run a thin bladed instrument
between the teeth, take out the surplus amalgam with a thread,
wipe off tlie excess on the grinding surface with a piece of wet
spunk, and dismiss the patient.
May I ask in what condition these cases are likely to be found?
Usually with flat surfaces nearly in contact, with sufficient
amalgam between the teeth to fill several cavities, with space
enough to allow the packing of food causing irritation to the mu-
ORIGINAL COMMUNICATIONS. 455
cous surfaces and great annoyance to the patient. The patient
tries in vain to get out the pieces of amalgam with a wooden tooth-
pick, and failing, applies to the dentist, who then uses a thicker file
to dislodge the excess of amalgam. This of course leaves a larger
space between the teeth, but the patient is consoled by the promise
that when the third molars erupt they will press the other teeth for-
ward so as to close the spaces.
This picture is not overdrawn one iota, and it all might have
been avoided by gaining proper separation before operating.
Amalgam is all right if it only receives the attention it deserves.
Were these same approximal fillings to have been of gold, separation
would have been demanded regardless of time, because with gold,
the operator must see what he is doing. I ask for the reform that
the same consideration in this particular be given to amalgam as
to gold.
Consider a large cavity on the anterior proximal surface, ex-
tending well on to the grinding surface of a superior first molar,
second bicuspid absent, and the antagonizing lower tooth artic-
ulating amidships. This tooth would have demanded heretofore
a large contour filling with screw anchorage requiring time and
patience for its insertion. When finished it might appear a mon-
ument to the skill of the operator, but the first closure of the
mouth with some hard substance between it and the opposing
-tooth would dislodge it. The reform I would suggest for this is a
gold crown completely surrounding the tooth, thereby making
the operation permanent.
Supposing a case with a cavity on the distal surface of a lower
second molar, with pulp exposed, the third molar in place, and the
first molar absent. It is far better in this instance to extract the
second molar, and bridge from the third molar to the second
bicuspid, than to attempt a filling. The patient may object to
this, but right here a reform is needed to impress patients that
they must not place their ignorance against your experience. You
all know the annoyances of a cavity in this particular place.
In most cases the crown of the second molar faces toward
the front and the third molar tips forward more and more
every day. I feel very anxious about this particular reform for
I have passed through all the tortures incident to such a cavity,
and after suffering for years, thanks to our worthy President, I
had the second molars removed and bridges made, one on either
456 THE DEXTAL REVIEW.
side. No tongue can describe tlie comfort I now enjoy, and this
brings me to the consideration of crowns and bridges.
One day when I returned from the noonday meal I found sit-
ting in my office a friend from a neighboring State. The first
thing that attracted my attention was the appearance of his upper
central incisors. I locked at him in horror, for the two central
incisors were capped with gold. They appeared as if the cutting
edges of the teeth had been ground down about the sixteenth of
an inch, an impression taken and caps struck up to fit the teeth.
The caps did not reach the gum by a line nor did they fit the teeth
snugly. They stood away at least a line, and the border next to
the gum was left with a square angle between which and the gum
there lodged the remains of several meals. Think of it, gentlemen,
the man had a short upper lip and thin mustache. Every time
he laughs he shows the upper teeth as far as the second molar,
and these two crowns of gold glaring in the sunlight. The work
was done by a graduate of a college which claims that what its
graduates don't know is not worth knowing.
Next, a gentleman called to inquire about a friend. He had
a bridge of four upper incisors, anchored to the cuspids with caps
of the same kind referred to. There was the same space between
tooth and cap, and cap and gum, allowing the lodgment of food,
and in this case something worse, for the man chewed tobacco.
Fortunately the incisors were porcelain faced.
I might mention other cases similar to these that h'ave come
under my observation but these two will be sufficient to call your
attention to a needed reform in this direction. Briefly stated, a
crown on any of the six anterior teeth should be porcelain faced,
the gold band should not only go to, but under, the gum fully one-
sixteenth of an inch all round the neck of the tooth to be crowned.
The band should be free from irregularities, and should fit closely,
and be burnished so smoothly that no irritation will ever occur to
the soft parts.
If this is done, food or other deleterious matter cannot lodge
around it.
It is not always necessary to remove the pulp of a tooth to be
crowned. I have set a number without doing this, and have four in
my own mouth, the abutments for bridges. The pain is more se-
vere in preparing the tooth for the crown, but I believe a better
feeling is given the patient after the crown is on a few days. Cold
ORIGINAL COMMUNICATIONS. 457
water held in the mouth will lessen the pain and hasten the setting
of the cement.
There is not enough machinery used by the majority of dentists.
I feel sorry for those who are still pounding away with the auto-
matic mallet. The instrument is good enough in its place, but why
torture the patient with its thump, thump, thump, when the elec-
tric or Bonwill machine will do the work in one-third the time ?
The patient may be dismissed sooner and it is better for every
one concerned. I called on a dental friend of mine last fall in a
neighboring State and almost his first salutation was that he was
very busy — worked from daylight till dark. I asked him of what
his practice mostly consists, and he said operating. (Of course no
dentist nowadays would admit that he labored in the laboratory.)
Upon inquiry as to what he had to assist him in his extensive
practice, he answered two automatic mallets.
After twenty years spent in the practice of dentistr}', I have
reached this conclusion, that there is nothing too good for the
dentist in his profession, socially or spirituall}'. He is entitled to
the best of everything, the best appliances suited to his skill, and
his machinery should be run with power outside, and with brains
inside, himself. If there is water power in his city he should use
water motors ; if no water use electricity ; if no water nor elec-
tricity hire some one to mallet and run his engine for him. What
is fifty or one hundred dollars properly invested in the best dental
appliances compared with the convenience of having machinery
that will go by simpl}^ pointing the finger at it. The dentist has
enough worry and vexation of spirit without being deprived of the
many improvements that money will buy. I am almost willing to
guarantee that within six months after one hundred dollars has
been paid out for this labor-saving machinery enough extra work
will have been secured to more than pay for this expenditure.
Again, and lastl)', the dentist who has so far succeeded in edu-
cating the community of which he has been a member up to the
necessity of caring for and preserving the natural teeth, is deserv-
ing of a crown — not a porcelain crown, nor a porcelain faced
crown, but a crown of gold surmounted with points, and each point
set with a diamond of rarest beauty.
458 THE DE.VTAL REVIEW.
Contour Fillings — What They Should Be.
By Geo. H. Gushing, M. D., D. D. S., Chicago.
In the September, 1891, number of the Dental Review, is a very
able article on the subject of contour fillings, by Dr. C.N. Johnson,
with which you probably are all familiar. In that the subject is dis-
cussed in a more general way than has been attempted in this
paper, and you are urged to read it again very carefully.
It was thought that though nothing new was to be presented in
this brief article, yet that some of the most important points made
by Dr. Johnson could be more forcibly impressed on your minds
by the models here exhibited and the discussion which it is hoped
will follow.
The word contour means ''the outline or general periphery of a
figure," and the term "contour filling," was in the first instance in-
tended to imply the complete restoration of a tooth which had lost
a part of its substance by decay, to its original and natural out-
ward shape.
• When the use of cohesive gold was claiming the attention of
the leading operators of the profession, and the possibilities of the
material were developed under their skillful hands, the ambition of
some of the most prominent of them, led to their advocating this
complete restoration of the lost parts of the teeth, even to the ex-
tent of reproducing the cusps and all irregularities of the grinding
surfaces of molars and bicuspids.
In their enthusiasm and devotion to the aesthetic, they for the time
being, lost sight of the character of the material with which they
had to deal, the purpose which fillings were intended to serve and
in fact most of the principles which underlie the operative treat-
ment of the teeth by filling.
In consequence of such advocacy, this practice became very
general and was continued by a large number of the profession for
a long time, but experience soon taught the majority the lack of
wisdom of these methods and they then modified their practice and
teachings accordingly, though a few still cling to the idea of com-
plete restoration of original contour. Thus the term "contour fill-
ing " has come to have no real significance, as a descriptive term,
as it is applied indiscriminately to all operations where any part of
the original shape is restored, and this indefiniteness has led to
the waste of much valuable time in discussions at society meetings.
ORIGINAL COMMUNICATIONS. 459
wherein the disputants frequently are only disputants, because
each attaches a different meaning in his own mind to the word
contour, while practically they stand very near together in their
methods. It is hoped that this paper may tend to lessen this evil,
but its main purpose is, if possible, to establish upon sound princi- ■
pies some general rules as to the shapes which should be given to
fillings that in any degree restore original contour.
It is not intended in this paper to discuss all the steps of the
operation of making contour fillings, and aside from the main pur-
pose as just intimated, reference will only be made to the method
of anchorage in the classes of cases which will be spoken of.
The preservation of the teeth and securing the greatest degree
of usefulness of these organs for the longest possible period, being
the object in operative treatment, it only remains to consider what
influence contour may have for or against the accomplishment of
this end.
It may be laid down as the absolute rule that the contour of all
fillings which will be subjected to great strain should be such as to
most fully protect them from any force of impact that would tend
to dislodge them or to drive them away from the walls of the cavity.
This rule, of course, only applies after the restoration of such
natural contour as may be essential for hygienic or aesthetic reasons,
and may be more profitably followed in the case of proximal and
crown surfaces in molars and bicuspids.
In these cases, where the decay extends below the point of
natural contact of the proximal sides, it is essential to reproduce
the natural contour, to such an extent that the fillings may, when
finished, touch again at the same point. This is necessary in
order to preserve the interproximal space toward the necks of the
teeth and also to prevent food from crowding between the teeth
and upon the gums, where it sometimes causes serious disturbance.
Beyond this point a restoration of natural contour is rarely if
ever to be tolerated.
From the point at which restoration of the natural .contour on
the proximal sides ceases to be essential up to the termination of
the filling in the crown, the surface should gradually slope, or, to
reverse the statement, the surface of the filling should slope down-
ward from its most remote edge, either mesially or distally, as the
the case may be, to the point at which it is desirable to commence
the restoration of the original contour on the proximal surfaces.
460 THE DEXTAL REVIEW.
The anchorage of such fillings should be made as strong as
possible without weakening the tooth. There should be if possible
a strong square base at the cervical portion of the tooth, a firm
seat — that shall be at a right angle with a perpendicular line drawn
on the proximal surface, and the walls should be made as nearly
parallel as possible.
Unless the walls are extremely thick and the dentine ver\^ firm
it is better not to make any undercuts or grooves, but to rel}'
entirehupon the proper seat and thorough anchorage in the crown.
If they are thin or the dentine of poor quality grooves and under-
cuts must not be made. If the square seat cannot be obtained,
as large retaining pits should be drilled as can be done without en-
dangering the pulp. Of course this is only a general rule and sub-
ject to such modifications as the peculiarity of individual cases may
render necessary.
Where such shapes as have been described are given to fillings
of this character the force of impact tends to slide over the surface
and not to drive the filling awa}' from its seat.
If on the contrary the filling is built up so that its grinding sur-
face presents' a horizontal plane even, the force of mastication will
tend constantly to drive it outward from the center of the tooth.
If the restoration of the original contour is carried still further and
the marginal ridge is raised in the normal form, the strain upon
the filling will be much greater and its value correspondingly im-
paired.
Now in many cases, where the cusps of the natural teeth wliich
antagonize the gold filling are very long, it is necessary to grind
them off, as well as to shape the surfaces of the fillings as above^
described. Without thus grinding off the cusps, it would in some
instances be impossible to get sufficient thickness of gold to insure
any stabilit}' of the filling.
It will undoubtedly be thought and urged by some, that such
extreme precautions are not necessary, if cohesive gold is solidly
built up as it can be from secure anchorage made at all possible
points.
Such a defense of the practice of restorijig the natural contour
in situations that have been considered, can only come from a want
of knowledge of the materials we have to deal with and the prin-
ciples upon which our operations are based.
If two fillings could be placed in precisely corresponding situ-
ORIGINAL COMMUNICATIONS. 4(31
ations, by the same hand, one contoured as laid down in the above
rule and the other contoured approximately to the original shape
of the tooth and we could be assured there would be no recurrence
of decay, — of the first it might be predicted with assurance that it
would last indefinitely, — while of the second it could positively be
asserted that it would fail sooner or later. The latter might under
favorable conditions last for some years but it would eventually be
certain to give way simply through the agency of mechanical
force.
A grave error that many operators fall into, is the belief that
gold can be so thoroughly impacted into strong tooth structure as
never to be disturbed or displaced except after a recurrence of
decay.
Such a belief ignores the fact that the ability to resist mechani-
cal force has a limit, and when the force exceeds that point some-
thing must give way.
The great malleability of gold renders it impossible for it to
sustain through a series of years the constant impacts imparted in
the act of mastication, without eventually being drawn away irom
its bearings upon the edges of the cavit}', and even were it less
malleable and did it not yield to the force of impact at all, the
structure of the tooth would eventually give vv^ay to the incessant
pounding to which the filling would be subjected.
The cases thus far considered are the most important and the
ones most likely to fail from improper contouring, but there are
others where the observance of this same principle will prove of
great value, though it can be carried out to only a limited degree.
In the building down of incisors where a considerable portion
of the labial wall has been lost, it is desirable to slightly slope the
cutting edge of the filling from its most distant mesial or distal
proximal corner up to the point of contact with the tooth. This
would unq^uestionably lengthen the term of usefulness of such
fillings as compared with those that were absolutely restored to
their original contour. In all such restorations — sharp corners
should always be slightly rounded.
With regard to the anchorage of such fillings — the same rule
holds good as given before.
There is one other situation in which the restoration of natural
contour would be undesirable, and that is in proximal fillings in the
463 THE DEXTAL REVIEW.
superior incisors, where the palatal angle of the filling should be
cut away so as to leave a self-cleansing surface.
Enough has been said though imperfectly, to call attention to
the great danger attending the improper contouring of fillings and
probably to provoke such discussion as will prove profitable to us
all.
President's Address.
Bv W. H. Taggart, D. D. S., Freeport, III.
One of the most natural things to do when one has friends who
have made a decided success of life, is to congratulate them and
wish them years of future prosperity.
As vour presiding officer for this year, I feel as though, while
other Presidents have had sufficient reasons for praising your good
qualities, and feeling proud of the standing you have made in the
dental world, none more than myself have a right to congratulate
you, for you are a year older, and in better working order than
ever before, and the fact that you are twenty-eight years old, and
have never taken a backward step, shows a sturdy manhood that
makes you by right the most looked up to State Dental Society in
the world.
Another thing, you are the father of four flourishing district socie-
ties whose names are already receiving favorable mention from the
outside world, and their meetings are being compared in interest
to yours, which should spur you on to always be the head of the
house, and not allow the youngsters to outstrip you.
Pn account of having to make so many suggestions for the
smooth working of the society, my address will necessarily be dis-
connected, and will lack the quality so essential in an essay, of
sticking to the subject.
I feel so much the importance of attending dental societies, and
meeting men who are leaders in their profession, that I cannot urge
on you too strongly the help it will be to you to identify yourselves
with your local societies.
Do not think you cannot afford it, for if you make it a busi-
ness to be known as a progressive dentist, your patients will be
perfectly willing to pay all your expenses and feel it an honor
to do so.
The ones who write our papers, and furnish food for thought.
ORIGINAL COMMUNICATIONS. 463
are not, as a rule, men to the manor born, but have good ideas,
and it takes them weeks and months to bring out their thoughts in
presentable form ; and it is very embarrassing to the author of a
paper on bacteriology to have those who discuss the paper so
soon run ashore on thoughts pertinent to the subject as to have
the discussion take the direction as to the advisability of using
plain teeth or gum sections in an artificial denture; and out of
compliment to the essayist I would suggest, that you stick to the
subject under discussion.
There seems to be rather a general feeling that the Committee
on Dental Science and Literature, which now consists of three
members, should be reduced so as to hold one person responsible
for the work done in that direction, and while not casting reflec-
tions on the efforts of previous committees, it seems quite reason-
able to suppose that if the responsibility for a comprehensive re-
port was centered in one person the society would profit by the
change.
We have now been working two years under the system of hav-
ing all business attended to by an executive council, and as nearly
as any one system can give satisfaction to all members, I think
this has done so, but as the aim of the workers has been to please
all and at the same time conserve the best interests of the society,
it seems as though for the good of the society the constitution
which now places the power of nominating a President and Vice
President in the hands of the executive council should be so changed
as to place these honorary offices entirely at the disposal of the
society.
The Illinois State Dental Society has always been noted for the
liberal spirit shown toward men who advocated new and novel
methods or appliances, and I hope the time will never come when
we will try to discourage the granting of patents to members of the
profession, as was done at the last meeting of the First District
Dental Society of New York, at which meeting they incorporated
in the by-laws their disapproval of professional patents.
It seems as though they were trying to place inventive genius
on a lower plane than literary ability, because you never hear of
their trying to handicap an author by incorporating in the by-laws
objections to his copyrighting his book, which he certainly does for
the same purpose that the inventor obtains his patent, and that is
the hope of monetar}' reward.
464 THE DEXTAL REVIEW.
Patent laws do not exist for inventors alone, but for the public,
and the organic law, the constitution of the United States, says they
are made to promote the progress of science and the useful arts.
Men create values by invention, and it seems almost com-
munism to ask men to invent and not receive reward or to ask them
to divide profits, and I hope the Illinois State Dental Society, with
her well established broad views in extending open arms to men of
literary ability, will include in her embrace the no less useful and
deserving inventive genius.
In conclusion, let me draw your attention to the importance of
lending every effort to make the World's Columbian Dental Con-
gress a success, for as the time draws near for that meeting we are
on the threshold of being recognized as an independent profession
and as the whole is no stronger than the weakest part, do not let
the weak point come from the Illinois joint, but let each dentist of
our State feel that on his pushing powers depends the success of
the meeting for he who doubts his own powers shrinks from put-
ting them to the test, while he who is convinced that he can suc-
ceed has already made the most important step in that direction.
Dental Legisl.ation.
Bv E. K. Blair, D. D. S./Waverly, III.
The dental profession seems to be awakening in a slight degree
to the importance of dental legislation — particularly so in Illinois.
This, coupled with the fact that I have had some experience in "try
ing to secure such legislation, is the only excuse that I offer for ac-
cepting an invitation from your committee to write a paper upon a
topic so well worn and so uninteresting to many. In consid-
ering the subject matter of such a paper, I find it impossible to
expel from my own mind the thought that any attempt on my part
here and now to formulate a law would be justly regarded as pre-
sumptions. Feeling so, you will not be surprised when I say to
you that I shall only consider the subject by reference to our past
experience in trying to secure such legislation and by further over-
looking the field in which your labors are to be extended, if another
effort is to be made. This society, through its committees, has ap-
pealed to the XXXVIth and XXXVIIth General Assemblies. It
has been my privilege to know fully the character of the work per-
formed by these committees — the hopes they have entertained, the
ORIGINAL COMMUNICATIONS. 465
difficulties met, the results attained, and so far as it was in my
power, the causes that led to these results. These observations
and this experience has full}^ convinced me that no desirable legis-
lation will be secured, save through the agency of this society, and
that only by means of a committee regularly appointed — heartily
and enthusiastically supported.
In saying this I do not mean to speak disparagingly of mem-
bers of the profession not members of this body. Our State is so
large — the population so great — its chief legislative body so un-
wieldy and the growing conviction that it is unwise to extend the
power of existing boards, so firmly fixed that to secure recognition
of our right to more advanced legislation is no small task. Under-
takings of greater magnitude have claimed the attention of more
potential organizations than this, without desired success.
There is now no collective force within the State, with either
equal or approximate strength to this society. Surel}' none en-
deavoring to accomplish this work, so that I feel warranted in
making the assertion, that it is through you and your committee
that success is to be attained. You may not be capable at present
of doing all you may wish to do — all the profession, as a whole may
desire. If not, who individually or collectively will be found equal
to the task? How is the work to be done? Of first importance it
seems best to dispel two illusions. First we must teach the law-
maker, that as a society we are not extra-judicial of the remainder
of the profession, and secondly we must by dint of constant inter-
course with those outside our organization, teach them that their
cause is our cause — that in all matters pertaining to the welfare of
the profession and the rights of the people we are one and the same.
I regret very much being compelled to recognize the fact that
so many well meaning dentists have failed to unite with the parent
society in this State. Is there not slight reason to hope that this
very agitation of the subject in hand may be the means of bringing
into closer relationship members and nonmembers of this society
and the further hope that the ultimate result may be that those
heretofore not enjo^'ing the unmistakable benefits of such member-
ship may cast their lot here and become co-workers, not only in an
effort to secure better laws under which to practice, but in all the
varied branches of our profession.
Your committee must be composed of your strongest, most
self-sacrificing workers. The exigencies of political life will be at
406 THE DENTAL KEVIE]V.
once manifest to them when the}' observe how few members of the
XXX\'Ith and XXWIIth assembhes will occupy seats in the
XXX\'IIIth. They will in this respect find almost a new field for
their labors. This, however, will not be true, when they turn to
consult 1,400 practitioners throughout the State.
Those with whom I have conversed in the past may remem-
ber that I have never entertained the belief that it is either
proper or feasible to expect the passage of a new law unobserved
by the mass of the profession. In fact, no one thoroughly' familiar
with the needs of the profession or the task of securing the passage
of such a measure desires or approves such a course. Far better
that we fail more than once, if the agitation and discussion by den-
tists all over the State will only awaken the slumbering toiler in
his narrow office to the realization of his rights as a citizen and
dentist. It may be that he who learns to seek out the representa-
tive from his own district, and urge upon him his disapproval of a
pending bill because, forsooth, he himself does not comprehend
its provisions, may some day in the near future take on a new
growth and go so far as to familiarize himself with the provisions
of the proposed measure, learning that it is not only harmless, but
helpful, and give to it his intelligent, earnest support. The great-
est hindrances to passage of bills in the past has been interference
in the work by dentists who have frankly admitted that they did
not know the character of the law sought by your committee and
feared molestation themselves.
Only those who have combated such opposition realize its
power.
First, gain the respect as a citizen and dentist of the assembly-
man of your district and then urge upon him your desire to have
him quietly refuse to support a measure touching the welfare of your
profession, or, that which is still worse, to openly oppose it and the
"new comer" who is pressing the passage of the bill will indeed
find it difficult to overcome the desire of said assemblyman to serve
well, as he terms it, "his neighbor-dentist and constituent." Such
opposition, if we succeed, must be met, and the best method is by
elimination. Adequate preparation and proper organization will
bring to your support the aid of all desirable; and arm you with
evidence sufficient to cope with any obstructionist that may be
found interfering with an effort to place the profession in this State
on a par with other States in point of proper legal enactments.
ORIGINAL COMMUNICATIONS. 467
From another source has come opposition. It is from that class
who desire to ply their vocation, be it bartering teeth-filling mater-
ials or diplomas — unwatched, ungoverned and unmolested. Like
the poor I fear they will be with you always — but unlike the poor
they neither merit your sympathy or forbearance. If the passage
of a new law does not make it possible for our State board to mete
out justice to this class by a judicial procedure, plain, simple, and
yet effective, then the people and this profession had best call a
halt and our efforts to benefit mankind and elevate our profession
be declared unavailing.
It is gratifying to me to here record that when differences of
opinion as to form of law or method by which it should be executed
have been entertained by contending forces in this society, these
questions have been settled by discussion within our own ranks
and in no way that would jeopardize the passage of any bill. How
gratifying this is. Discussion tempered with reason in its proper
sphere is harmful to no one. We can only hope to attain the best
results in matters pertaining to the public or our profession where
the fullest and freest expression is encouraged. All should be
heard, due weight given to every suggestion, and from the com-
bined thought of Illinois dentists we can form a law that will take
rank for justice and equity with any in existence.
If what I write be true, it remains for me to urge the necessity
of establishing some fixed method of reaching dentists individually
throughout the State, to the end that a very large per cent of our
profession unite in pushing forward the work. If we act collec-
tively our strength will manifest itself. Those who are unheard
remain unnoticed. Those who speak the most intelligently and
persistently are quickest served. I would not advise any of you
individually to engage so freely in politics as to neglect your pro-
fessional duties, but I do yield to the temptation here to urge upon
all present the necessity of giving proper heed to governmental
affairs. Our profession will only become more powerful when we
as members of the great contending political organizations make
our wants known and our strength as political factors felt.
This does not suggest that which is improper. It is an appeal
to you to occup}' that position, politically, which }-ou upon com-
parison with all other classes are fully entitled to. I have no sj-m-
pathy for him who fails to do his whole duty as a citizen because
he fears the loss of a patient. What we most need is: first, a com-
468 THE DEXTAL REVIEW.
petent dentist, and second, a good citizen who acts from a belief
that he is right politicall}-, and so believing spurns to permit either
vantage ground, professional or political, to interfere with the other.
How to reach members of the profession, secure their advice and
aid, or prevent a blind opposition, will be the most arduous task
confronting your committee. No less than two or three hundred
have already shown unmistakable signs of heart}' cooperation
in the work. They will be found ready to assist in any wa}' within
their power, and there can be no doubt but that our past experi-
ence has better fitted us for a renewed effort. This is not the work
of a da}'.
In fact it may upon consultation seem wise to petition the
XXXIXth rather than the XXXVIIIth General Assembly. Act
when we may, let us comprehend fully the position occupied by
all with reference to this matter. If we meet opposition success-
fully, we must meet it intelligently. Give this committee one year,
or even six months in which to act^arm them with the services of
a competent clerk, and when the final struggle is at hand, they will
be so equipped that the enemy will be vanquished. Let each den-
tist be sought out, his aid invoked, or his objections met. With
untiring energy this committee must put itself in possession of
every fact bearing upon the work. In this connection our State
Board may be helpful. A well arranged "Exhibit" show^ing the
existing laws in all the States, as well as the proposed law for this
State, for easy reference, placed in the hands of every dentist, will
aid in bringing to our support many. This may also be used with
force when we appeal individually to the legislators.
Most of the work of this committee should be done before the
legislature convenes. Our bill should be introduced early and
pressed forward. It occurs to me that having had our bills favor-
ably considered by the Judiciary Committee twice in the House
and twice in the Senate, and never having suffered a negative vote
but once, and that upon a light house, that we are armed with
very strong evidence so far as the opinions of past legislatures are
concerned of the justness of our cause. With what weapon we
vanquish the enemy does not now seem so important to me as it
once did.
The end to be attained is the same. For one I am willing to
trust to the product of the brain of any committee appointed by
this society. Looking over this entire field — possessing a full
ORIGINAL COMMUNICATIONS. 469
knowledge of the work of past committees and inspired with a de-
sire to do the greatest good to the greatest number no one need
fear the result, and all may safel}' lend a helping hand.
No desired end can be attained with the major portion of the
profession divided as to the kind of legislation wanted. To unite
those at present desiring new laws and those who are moribund
upon this matter will be helpful to all of us professionally and
otherwise.
That which we most need is a method by which earl}' and vig-
orous legal steps may be taken to bring offenders of the law into
courts of justice. Our State Board is a necessity. It should be
clothed with power to appear as plaintiff without bonds for cost,
and a sworn statement of the Secretary filed with the proper author-
ities ought to be sufficient to open any case. No class of men are
more amenable to the law should any desire to prosecute for
offenses real or imagined, than we. An intelligent profession wel-
comes all statutory' enactments that protect the people and invites
the closest scrutiny of the service we render mankind, and while it
does so, it appeals to the law making power to cease putting a
premium upon ignorance and charlatanry by continuing in force
the present law, ineffective because you cannot execute it — unwise
because it does not meet the wants of a progressive people and
profession.
Improvements in Porcelain Bridge and Crown-Work.
Bv E. Pakmly Brown, D. D. S., New York, N. Y.
It is not a question of whether a permanentl}- attached denture
to restore lost teeth is the proper thing or not. That has passed.
The question now is, what kind of bridge and what kind of crown
is the best for the case at hand ?
The fact that a large majorit}- of dentists are not inserting
bridge dentures, is no proof that a large majority would not be
practicing the art if it were known to them.
The broad-minded practitioner diagnoses his cases and selects
from a large assortment of methods the best treatment of each
case ; the man of one idea always has gold for filling, or if never
gold, always amalgam, or always gutta-percha, or alwa}S the zinc
oxide cements.
470 THE DENTAL REl'IEW.
The same may be said of bridge and crown work.
The bridge worker who always cuts off his pier teeth is circum-
scribed in his knowledge and usefulness in the art ; ten cases pass
him by unattended to where he operates on one ; lacking, as he does,
the hardihood to attempt the destruction of good teeth for piers, or
failing to get the consent of the patient to attempt such a rash pro-
ceeding. The reasons are obvious to bridge workers ; a few cases
of denuding fairly good teeth of their enamel, with pulps alive, to
make ready for their capping; or amputating such teeth for piers
for bridges, satisfy the operator, and he shrinks from any more of
that kind of work, which brings more curses than compliments
from the patients.
The practice of inserting from one to four or five teeth into gold
or amalgam filling attachments will broaden the field of usefulness
of the operator.
To sa\' that you have seen failures of fillings holding bridges in
place for any great length of time, as an argument against the
system, has the same weight as the assertion that you have seen
fillings fail, as argument against the wisdom of filling teeth.
I recently extracted a very loose left upper central, from the
mouth of a clergyman in New York in the presence of another
dentist, on account of root absorption, which the living central had
attached to it and the living cuspid, anchored* into gold fillings, a
lateral incisor bridge, a porcelain gum plate tooth with soldered
gold backing and crossbar; this bridge had been in its place with-
out repair for eighteen years, having been inserted in 1874 in Salt
Lake City by Dr. Calder, which bridge tooth and natural tooth I
offer for your inspection.
With modern solid gold and improved gold alloy fillings, and
most cases more favorable for good attachment than this presented,
who can longer have doubts of the great possibilities of the future
in this line?
The fact that your essayist has inserted over a thousand bridges
mostly by filling attachment, many of them having been in about
eight years, and most of them being under his inspection, accounts
for his faith in the practice.
The beginner who with doubts and misgivings fails in his at-
tempts, does not prove that one cannot succeed who has become
expert by years of study and practice.
Ten years experimenting with porcelain for crowns and bridges
ORIGINAL COMMUNICATIONS. 471
has made your essayist a firmer believer than ever in porcelain
for most cases; very often using gold crowns for single teeth or
roots, or piers for bridges where not in sight; and once in a great
while a gold bridge where indicated.
The improved porcelain bridge, should rest firmly on the ridge,
the surface in contact with which is constructed with a platino-iri-
dium swaged plate, the cross bar and tooth or teeth being first
soldered to the plate with pure gold as in continuous gum work; a
moderate amount of tooth body first applied, and baked, then full
contour obtained at the second baking, gum enamel to finish if
necessar}^ at lower heat, at which baking any small crevices could
be filled in with English body, which fuses at about same heat as
American gum.
Soft platina caps for ends of roots, either for single crowns or
bridge piers (as designed by your essayist), where caps are indi-
cated, made by fitting band, soldered with pure gold, and cut
into slits as far as the end of the root, then this aggregation of
points is burnished or pressed, one at a time, on to the end of the
root, taking its exact form, no matter how irregular; the pin is
then pressed to its place, waxed, invested, and soldered with pure
gold, unless a porcelain crown is being used with pins, then
soldering is not imperative, baking without soldering being
sufficient.
The porcelain denture when completed is as cleanly as the
natural teeth. It is nearer to nature in form and appearance than
any work your essayist knows of, and he is satisfied that in the
near future, when the facilities for doing the work are to be had,
and the dentists become conversant with the art, that it will be
a delight to patient and operator as well as a profit to both in
every way.
The difficulty of the work will tend to increase fees; for that
which is easy to do most anybody can do, without much study or
effort, and therefore will be done cheaply.
If the essayist could not have porcelain bridges he would be
putting in good bridges made on swaged platino-iridium plates,
fitting close to gum on ridge, teeth backed with platina, caps made
of platina bars of platino-iridium square wire, all soldered with
pure gold, cap crowns made also of platina and pure gold flowed
upon them for appearance.
The contour of this structure to be restored as much as practi-
472 THE DEXTAL REVIEW.
cable to natural form. This would have some of the points of per-
fection of the porcelain work, lacking mainly in artistic appear-
ance, lacking some in natural contour, some in strength, some
in cleanliness, and much in econoni}' of metal and labor. Six
points of advantage claimed by the porcelain work over the
metal work described, which has the advantage of the ordinary
gold bridge that does not rest firmly on the gum, in several
respects, principally in the additional support obtained by so
resting.
These gold bridges I would insert as I do now the porcelain
bridges, mainly with filling attachments, some cemented to root
piers, and some to cap crowns.
The question of solid gold fillings to anchor bars, extending
from bridges into cavities in pier teeth, is solved by using the Bon-
will electric mallet with current from the Edison circuit if possible,
if not a strong battery, or the next best force to thoroughly con-
dense the gold.
The tooth to be braced at first by heavy retaining instrument
held in left hand until the filling is anchored, then the tooth should
be braced by an appliance devised by your essayist, which he has
used for several years, made of a bar of tin pointed and curved
properly to hold against the tooth malleted on, held either by left
hand of operator or by an assistant, which bar is suspended by
cord and counterbalance from above, or can be held in hand only.
This metal bar takes nearly all the force used in condensing,
and holds the tooth rigid to make the force applied more effective.
The necessit}- of solid gold fillings to anchor bridges, brings the
operator up to a higher standard of well-anchored and solid gold
fillings for all his work.
I have for your inspection in addition to the eighteen year old
bridge, two temporary porcelain bridges of four front teeth each
worn three years, and replaced by permanent bridges with gum to
restore absorption; these bridges were cut out from their filling at-
tachments, having served their time and purpose well, having been
inserted immediately after the loss of the teeth by accidents.
There is also one model with tooth on natural root, of porcelain
crown and platina-cap baked on crown as described for crowns
and bridge attachments.
The platino-iridium plate struck up ready to make bridge,
(in the box of specimens), illustrates its great stiffness if you try
PROCEEDINGS OF SOCIETIES. 473
to bend it with your fingers, showing the addition of strength it
gives to the porcelain.
The four front teeth with gum illustrate the improved porce-
lain bridge as anchored in pulpless teeth with fillings.
The central incisor bridge shows anchorage at one end of bar
in living tooth, other in pulpless tooth. The old style of bicuspid
bridge shows bar extending into second bicuspid only, several like
cases having been doing well for seven years.
PROCEEDINGS OF SOCIETIES.
Illinois State Dental Society.
Discussion of Dr. Black's paper, on "The Interproximate
Spaces " {see page 441).
Dr. C. N. Johnson, in opening the discussion of this paper,
said: Mr. President and gentlemen, I regret exceedingly the cir-
cumstances which rendered it necessary to defer the discussion on
Dr. Black's paper from one session to another. Those circum-
stances however could not be avoided. I am especially interested
in having a good rousing discussion of this subject, as it is certainly
one that deserves it even if we had not the incentive of a good
paper upon it. The paper itself deserves our highest commenda-
tion, and if I can only succeed in getting the Society into the same
mood they were in last night at the end of the reading of the
paper, I am sure we will have a good discussion.
In one place the essayist made mention of the fact that it
seemed to be necessary to repeat any teaching or theory a number of
times in order to secure its adoption by the profession. That is
true for two principal reasons. One is that the majority of the
profession do not study carefully enough the papers read before so-
cieties and published in the dental journals. Another is, that a great
many of us in the profession have that unfortunate element of con-
servatism which argues against the adoption of new ideas. This
leads us into following grooves or ruts; in other words, we are
routinists. Some of us appear to be confirmed routinists.
Now' in regard to the form of the interproximate space.
The essayist said it was not always advisable to follow the original
form. I desire to emphasize that fact. We have too long been
474 THE DE.VTAL REVIEW.
contouring teeth to the original form irrespective of whether that
form was the best or not. I was taught that as a student. The
original form is not always the best. Even where the teeth them-
selves are of good form, their unfortunate arrangement in the arch
often results in three or four very badly formed interproximate
spaces. The point I wish to make is this, that in every case we
should operate with a view to producing a good form irrespective
of what the original form was.
In regard to the contact point it seems to me the essayist has
brought that out more clearly than we have ever seen it in any
paper on the subject. As he says, the best contact point, other
things being equal is the small one. A broad contact point will
hold fragments of food tightly between the teeth. If we make
proper contact and bevel our fillings well away from it, it will pro-
tect the interproximate space and food will not wedge between.
Another point the essayist called particular attention to is the
liability to proximate decay in young patients where the festoon of
the gum was prominent. He mentioned particularly the natural
form of gum septum which is in the shape of an arch between the
teeth. I was pleased to hear him emphasize the necessity of re-
taining that arched condition of the gum-septum. This condition
is interfered with the moment we have large festoons. It inverts
the arch to have an enlarged festoon. In cases of proximate de-
cay where it is necessary to place gutta-percha between teeth as a
temporary stopping, sealing in medicine, I have been in the habit
for the past two or three years of carrying my gutta-percha over the
festoon, keeping it down so as to preserve this arched form. If the
gutta-percha were merely crowded between the teeth so as to ex-
pose the cavity along its cervical outline, it would leave an inverted
arch to the septum, and in these cases the food remains and is
packed into the inverted arch so that the space is not kept clean.
Where the festoon is pressed well down, it preserves the arched
form, and the food, instead of lodging in the depression, slides off
on either side and the space is kept clean in that way.
Reference was made in the paper to the articles in the Dental Cos-
w£;j, mentioned in the report of the Committee on Dental Science and
Literature, and I have been requested to say something about them.
I shall not say very much, however, but I want to say one thing that
bears strictly on this subject. In one of these articles the author ad-
vocates a broad contact point, if I understand his teaching. We
PROCEEDINGS OF SOCIETIES. 475
have had here an ilhistration, both in the arguments used in the
paper and by the specimens Dr. Black has passed around, of the
evil effects of making a broad contact point. But it would not be
fair to the writer for me to attempt to discuss in detail all of his
teachings in a short discussion of this kind. He has taught some
good things. I can hardly say he has taught them, but I will say
he has said some good things. I believe that many of the best
points in these articles have been published unthout being copy-
righted long before the articles in question were ever written.
Injury to the gum septum. Ever since Dr. Black's first article
I have been watching the condition of the gum filling the inter-
proximate space, and have avoided as much as possible the lacera-
tion of the gum tissues in finishing or putting in a filling. It is my
experience that gum tissue, when it is lacerated by a saw, file or
disc, does not heal nicely and does not revert to its original health-
fulness so readily as it does when it is pressed back to avoid lacera-
tion. I would rather go to the extreme of inserting gutta-percha
previous to operating and pressing the gum well back from the
margin of the cavity, than to leave the gum in situ and run the risk
of lacerating it in filling. The reason is this : I have found ordi-
narily that where I keep the gum back out of the way and avoid
lacerating it, it will creep up into place again and remain healthy,
if the contact is perfect and the space is properly formed.
In regard to the material used for these temporary stoppings; in-
stead of using base plate gutta-percha as is almost universally
used, I employ softer gutta-percha, such as Gilbert's temporary stop-
ping. It can be molded with less heat and pressure, and works
more kindly in my hands.
I want to add a word sustaining Dr. Black in his condemnation
of cotton and sandarac as an agent for sealing cavities temporarily.
If one is accustomed to the use of gutta-percha he can seal cavities
in my opinion just as rapidly with it as v/ith cotton and sandarac,
and the cavity will be more perfectly sealed and the dressing less
offensive on removal.
Now as to the methods of trimming fillings. We may all agree
I hope as to the form that it is proper to give the interproximate
space, but probably few will agree as to the best means to be em-
ployed in trimming fillings to preserve this space. Dr. Black has
mentioned the saw and file, and he condemns discs for fear of de-
stroying the contact point. In my hands I cannot accomplish
476 THE DENTAL A'EV/EIV.
nearly so much witli the saw and file as I can with discs or strips.
I can employ the latter to better advantage and give a more de-
sirable contour to a filling. This question of instrumentation is
Jargely a matter of individual preference. I have no quarrel with
the instrument that any operator uses so long as he accomplishes
the result. The instrument with which he succeeds is the one for
him to use. I can conceive however that there are instruments
which cannot be made serviceable in these cases. For instance,
the stiff separating file. I do not know how an operator can round
these fillings with a separating file. A disc is a useful thing, and
if used intelligently can be made to round a filling in the proper
place without cutting down the prominence forming the contact
point. In the first place, you must have a fine, thin disc, and then
that disc must be smeared with some lubricant. I use vaseline and
a great deal of it, and by it the disc is rendered so pliable that it
may be pressed to place with an instrument so as to cut exactly
where you wish and at no other point. We should be cautious
and watch the contact point and not trim it away. I have tried the
other way, but to me the disc and strip are the most effective means
for trimming proximate fillings in the majority of cases.
I want to say one word of caution, in closing, and that is this,
that there are two principal things to be considered in the insertion
of proximate fillings. One is the anchorage of the filling in such
a way that the walls will not be broken down or the fillings forced
out. If we pay particular attention to this one thing of preserv-
ing the interproximate space and lose sight of the other fact, we
are going to have a crop of failures. If we build these fillings out
with a table-like occluding surface we are going to invite failure on
account of the leverage of the opposing tooth, so that we must bear
in mind, not only the preservation of the interproximate space, but
the proper beveling of the occluding surface of our fillings when
the leverage is so great that in all probability the filling might be
broken away.
I hope this paper will elicit a good and free discussion.
Dr. G. J. Dennis : The paper of Dr. Black has interested me
greatly. I had read several papers written by Dr. Black and Dr.
Johnson, which came in just at the time I was working on a case
of my own. It took me some time to complete it, and these papers
were in line with the idea I had in my own mind. I subsequently
wrote a paper upon the subject and described the case, and the
PROCEEDINGS OF SOCIETIES. 477
paper was published in the November, 1801, number (p. 838) of
The Dental Review. I made some points in connection with the
gum and its relation to the teeth and to the space. Dr. Black has
described it thoroughly in his paper, but at the same time it seems
to me that a few diagrams on the blackboard would bring it ouf
still more thoroughly.
(Here Dr. Dennis illustrated his remarks on the blackboard.)
In regard to laceration, the same thing is true of the gingival
arch as of any part of the body. If you lacerate it you have a
cicatrix formed, there is more or less shrinkage, and we have, of
course, an imperfect reproduction tissue. It will not return to its
original normal condition, though it will bear a certain amount of
laceration, if the space is properly preserved. A great deal of lacera-
tion, however, causes an extensive cicatrix and the destruction of
the gingival arch. •
In completing contour fillings I have invariably brought the two
surfaces together before finishing, then used thin, fine cutting strips,
finishing the cervical border first, and bringing them gradually down
to the surface, and I have never been able to use a disc of any kind
between the teeth in making a perfectly contoured surface.
Dr. J. N. Grouse : Like all the members of the society, I also
was pleased with the paper of Dr. Black, as well as with the dis-
cussion, but thus far the most difficult part of the problem has not
been touched upon ; I refer to the cases where some one has ex-
tracted one or both first permanent lower molars in early life, and
the teeth are tilted forward, so that we have a wedge forcing itself
between the upper teeth and displacing them, resulting in their
separation. Shall we contour to the extent of a full form? These
are the cases that I wish some one to tell me how to manage. If
there is any rule, I wish to learn it. In my practice the most diffi-
cult thing I have to do is to know what is to be done with each
particular case, and if there is any rule that can be laid down by
which I can be governed, I would like to be familiar with it.
Even with the aid of my assistants in the examinations we make,
we find it one of the most difficult problems in dentistry to decide
how to take care of the proximal surfaces. The warning would be,
first, to be careful what teeth we extract in early life, endeavor to
keep the arch perfect in the cases of children as they come to us,
and keep each tooth in proper position as it comes into the arch,
the upper teeth upon the lower.
478 THE DEXTAL REVIEW.
There is not nearly the necessity for the Arthur disc that there
formerly was. I have very little or no use for it except in contour-
ing teeth so that I can get between them with a sandpaper disc, I
know of nothing that in my hands has been so useful, or with which
I can accomplish the purpose so well, as with the sand paper disc.
I do not wish any varnish on it. See that the discs are pliable,
then with cosmoline they become flexible, but they do not cut any
better by using a greater amount of force. My assistant, with a
little instrument held against it, turns the disc to the exact point
where I wish it to cut. It might be well to utter a word of caution
here with reference to the matter of holding the disc tightly against
the tooth and running the engine rapidly, thus heating the tooth.
Many of the pulps of teeth are injured by holding the disc to a
tooth until it is hot. The disc does not cut any better. Another
point is with reference to the matter of getting space. In my
hands, I would not know how to practice dentistry without some
of the forms of separators. We have the Perry and the Parr sepa-
rators, and I know of no instrument that saves me so much annoy-
ance as one of these separators.
Reference was made in the paper of that class of cases where
the teeth have been filed apart and driven together by coming in
contact with the lower teeth, it was advocated that they should be
wedged apart and contoured to the original shape. Dr. Black did
not say at what age this was done. If he can take these cases and
wedge the teeth to their original position, and contour them to
their original shape, he is more fortunate than I have been, if he
has succeeded in making a good chewing apparatus for the patient.
Some patients will be exceedingly annoyed. I have several cases
where I had to remove part of the contour and allow the teeth to
return, partially at least, to the point where I tried to commence
to remedy the form. There must be two things remembered, one
to keep the point of contact, the other is to put in the filling so that
the walls will not be destroyed by the force of mastication on the
gold of which it has been built. Another thing is to keep the chew-
ing apparatus in a condition so that the patient can masticate food
properly and with comfort. The greatest use of teeth is to masti-
cate food, and if we do not keep this in mind in our operations we
lose sight of an important factor. Sometimes in contouring teeth,
where we have contact and have done the best we could, it is not
comfortable to the patient. I have tried the practice of filling these
PROCEEDINGS OF SOCIETIES. 479
with oxychloride of zinc and tried one shape and another to get a
shape that is comfortable to the patient.
I would like to mention one point that was not dwelt upon in
the paper, and that is in regard to the care of the teeth after they
are contoured. The patient should be instructed to take care of
these proximal surfaces, and unless he does so and follows our in-
structions it is hardly necessary for us to spend our time in filling
and fixing them. I care not what the condition of the proximal
surfaces may be, if patients do not do their part, failure follows.
The first education of a child after leaving the kindergarten should
be, how to take care of the teeth. When children come to me
with their teeth in a bad condition, I talk to them and try to im-
press upon their minds the importance of cleaning and caring for
their teeth, if I cannot do otherwise, I make them brush their teeth,
and when a boy comes to me for treatment I resort to that kind of
stratagem, and often say, " you go home and brush your teeth or I
will not do any work for you." By doing this these patients be-
come a little more interested.
Dr. C. a. Kitchen : I am reminded of a story regarding the
effect on patients in trying to make them care for their teeth, and
especially with children. I had a little boy whose mother was
quite anxious for me to make an impression upon him in this
regard. I attended to his teeth and told him I wanted to see him
in a few months. He came back and I saw by all appearances
that he had neglected to keep them clean. I told him that he
ought to clean his teeth at least once a day, and he said, "What !
every day ? Why, I thought once a week was bad enough /" I
mention this to show that it is not always an easy matter to change
children from negligent habits, and to convince them of the impor-
tance of regular and daily attention.
Dr. Morrison, St. Louis: With regard to the care of the inter-
proximate space, I just wish to refer to the latter part of Dr.
Grouse's remarks. We go through the same thing year after year
making these fillings on the proximal surfaces, and the patients
come back again with the fillings loose, and the last state is worse
than the first in a good many cases. Now, it is our duty, as Dr.
Grouse has said, first to educate these people and keep on doing it
day after day, and if patients will do their duty in this matter it
will not be necessary for us to make such heroic operations in
these trying positions. I seldom use a piece of dam for any of my
480 THE DEXTAL REVIEW.
patrons but that I take the piece that comes from their mouths
and tell them to cut it into strips or bands to be used for cleansing
the interproximate spaces carried high enough to cleanse the
mesial and distal surfaces of the teeth. I instruct them to carry
the rubber after it has been on that mission to the nostril and see
if there is any odor perceptible, and that so long as there is, their
teeth are in danger.
With regard to the use of the brush. How many of the den-
tists in this room take these little ones that comes to us, and teach
them to use a toothbrush. There are a few of us who do. It has
been my habit for thirty 3'ears to educate each individual as
though it were the first time to them in regard to the care of their
teeth.
As to the forms of brushes, we do not want them too large. We
should use a brush with the bristles being carried downward upon
the upper teeth and forcing through both from without and within.
I think we as missionaries should devote more attention to this
matter as the best service we can do. In filling, the best we can
do is to bring the teeth to as nearly the original form as possible,
keeping the space of contact well toward the coronal end of the
teeth and as far from the gum as possible.
Dr. p. J. Kester : The discussion has now touched upon a
very essential point, that is, the care of the interproximate space,
and Dr. Morrison has briefly dwelt upon one of the most frequent
causes of destruction of the gum in the interdental space. I refer
to the use of the toothpick. I am surprised that gentlemen of this
profession will insist upon using an instrument which is bound to
destroy that which Dr. Black has so beautifully demonstrated to
us and which he told us was one of the necessary things to save.
I refer to the use of the toothpick, especially to that abomination
of all others — the wooden toothpick. Gentlemen come from a din-
ing room, they step up to the desk and provide themselves with
wooden toothpicks which injure the gum. I believe a large
majority of failures at that point are due to the injudicious use of
the toothpick, rather than a lack of care. The teeth will be pre-
served much longer in the interproximate space if no toothpick is
used. Dr. Morrison has told us how the interproximate space
may be cleansed and kept clean by pieces of rubber dam. I believe
that with a piece of rubber dam or, what is more convenient to
the patient, the ordinary little rubber bands which are put up in
PROCEEDINGS OF SOCIETIES. 481
packages and can be carried in the pocket, this space can be kept
clean without injuring the gum. This is an important matter.
Dr. J. W. CoRMANY : I presume there are a great many people
who do not know how to make a toothpick out of an ordinary quill,
such as we get in any of the stores. Cut one end down and scrape
with the knife to a slender, smooth pick that will pass between the
teeth anywhere.
Dr. C. R. Taylor : I desire to call attention to this one point,
that a dentist can tell a hotel boarder who uses a wooden tooth-
pick as soon as he looks in his mouth. Instead of having a fes-
tooned gum, he has one that is flat like the toothpick.
How to make strips for finishing fillings ? Those on the market
are not formed so as to prevent laceration of the gum tissue when
finishing proximal fillings. If you will cut strips like this (illustrat-
ing), narrower at one end than the other, then draw from the
direction of the narrow end, you will be drawing it against the gum
all the time, while by drawing from the larger end it is drawn from
the gum.
Dr. Black said that teeth of the worst form are most liable to
deca3^ Now I think that statement ought to be modified by add-
ing "everything else being equal." The cuboidal teeth with
flat proximal surfaces are the best organized teeth we see and
those with which we have the most difficulty in preserving the in-
terproximate spaces. But as a rule they are the best constructed
and are least subject to decay, excepting what their shape helps to
produce.
Dr. Black : Teeth of cuboidal form are the worst we have.
Dr. Taylor : Nature in the formation of teeth has never antici-
pated decaj'. If she has done so, she has made many mistakes.
An ideal tooth, so far as the interproximate space is concerned, is
one which has a bell-shaped crown. Usually, however, that form
does not go with material of the best quality. Very poorly organ-
ized teeth of square or cuboidal form, with surfaces coming in con-
tact from the grinding surfaces to the cervical border, would be
most liable to decay of any kind we could have.
Dr. G. D. Sitherwood: I think the point brought out with ref-
erence to educating patients in the matter of cleanliness and the
care of their teeth is very important. I have had considerable
success in this regard myself. But I would like to know how any
dentist can expect to have much influence in educating his patients
482 THE DEXTAL REVIEW.
in the care of their teeth who uses tobacco in any form himself.
I say this in all sincerity. If we are educators, if we expect peo-
ple who come to our offices to take care of their teeth properly and
give them proper teaching, we must set the example. I say this
with no reflection on any gentleman present, but to my mind to-
bacco belongs to a semibarbaric age, not to the latter part of the
nineteenth century. It belongs to the Indians.
Dr. T. W. Brophv: I have been very much interested this
afternoon in listening to the discussion on Dr. Black's paper, and
and I desire to begin where the discussion has ended, that is, with
reference to the undercuts at the base of proximal cavities for the
retention of fillings. I do not regard it necessar}' to make under-
cuts or retaining pits at these points. The first duty of the den-
tist in the preparation of a cavity at this point is to make it square
so that he can place his gold in and make it fast without retaining
pits, for undercuts and retaining pits in a large percentage of cases
endanger the vitality of the tooth pulp, hence they should not be
resorted to. The place to retain a filling is at the point where the
greatest strain comes, that is upon its masticating surface. If we
retain it there, we need have no fear of it being displaced.
One word with reference to the strips that have been men-
tioned. I like very much the suggestion made by Dr. Taylor to
have them taper and draw from the broad end toward the pointed
end. My experience with strips was not satisfactory until I suc-
ceeded in getting those manufactured by Dr. Howard. They are
made upon fine silk, exceedingly thin, and cut with a degree of
satisfaction that I have not found in others. They are not only
thin and nicely made, but are very strong. They may be used un-
til they are worn out without breaking them. The average strip
we get is so thick that it is almost impossible to place it between
teeth, and besides it is so exceedingly brittle.
With sandpaper and crocus discs I have had much satisfac-
tion in finishing proximal fillings ; also in the preparation
of cavities, polishing the margins with them, especially where
the walls are thin and need to be cut down; and in forming
them we can make use of the sandpaper, then polishing with a
crocus disc, finally preparing the cavity for the reception of the
gold. After filling the cavity and contouring it properly, there is
no way that I can so satisfactorily finish the gold as with a disc, in
order not to destroy the results of the labor performed in produc-
PROCEEDINGS OF SOCIETIES. 483
ing the contour, it is necessary to use a lubricant. That is a point
I have attempted to force upon my friends for a long time, the
necessity of using a lubricant in finishing a filling; whether we use
a finishing bur, a stone, a disc, a strip, or whatnot; there is no
lubricant better than vaseline or cosmoline, this can be kept at
hand, taking a little from the bottle, placing it upon the slab, and
using what we need. The slab should be washed, that we have
something that is absolutely clean, and instead of putting a bur in
the jar, remove the quantity required from the jar, keeping the jar's
contents clean, that the virus of some disease may not be carried
to other patients, and thereby set up infection.
The disc should be of a small size and there will not be danger
of destroying the contour. Take the disc, carrying it half way
round the tooth from the buccal surface, then carry it round on the
lingual side and it leaves the surface beautifully contoured. If we
take a large sandpaper disc and carry it straight through, and use
force, it will destroy the contour. I do not know why such a disc
should be employed. These little, fine discs, made of cuttle fish
and crocus, are especially desirable in giving it a final finish. When
the disc is put on the tooth lubricated it will make as fine a finish
as any one would desire. Stones and burs ought all to be
lubricated before they are used. What an unwise procedure it
would be if a worker in iron were to take a drill and revolve it rap-
idly on a piece of metal without first lubricating it. It would be-
come red-hot. The heat generated by the use of our finishing ap-
pliances leads to the destruction of pulps far more frequently than
we anticipate, for that reason burs should be lubricated and this
generation of heat avoided by the use of a lubricant, using good
judgment not to revolve the bur so rapidly, or keep it in contact
with the metal so as to generate that heat. It is the most disagree-
able sensation in the whole experience of filling teeth, to have a
dry bur cut gold while revolving rapidly. It is an experience that
patients dread more than all other experiences.
The rubber dam can be kept in place until the filling is finished,
when it can be taken off, then the operator should examine the
masticating surface and determine whether it is necessary to re-
move moreofthe gold to secure perfect occlusion. The proximal
surface should be finished before the rubber dam is removed. If
that is done, the operator will not endanger the gum tissue in finish-
ing the filling.
484 THE DEXTAL REVIEIW
Cutting away portions of frail teeth is a necessity oftentimes,
but by contouring tliem as they should be we will restore the teeth
to that condition which has been mentioned by Dr. Crouse, secur-
ing for the patient a good masticating apparatus. The function of
the dentist is not only to stop the decay from progressing, but to
supply the patient with something that will enable him to masti-
cate his food well. That must be always kept in mind. If I have
succeeded in impressing upon those members of the profession who
have neglected the matter of lubricating their finishing appliances,
the value of so doing, I think that they will find it of great advan-
tage to themselves, and their patients will appreciate it.
Dr. H. a. Costner : I think sometimes that the gingival mar-
gin is destroyed by want of a toothpick rather than by the use of
it. We find people with natural separations of the teeth, where
the teeth have been lost or extracted, and it is in those cases
where the inverted arch is found. Where you find these people
coming into your oflftce you generally find the cause of these inverted
arches always there. There is a state in which decomposition is
taking place. That is one point, we should be particular in in-
structing patients as to the use of a toothpick, to use it judiciously
and correctly. I would like to ask Dr. Black what he says to his
patients, when they say, "Doctor, I want you to fix those teeth so
that I can pick between them."
Dr. Black : I generally tell such patients that I will fix their
teeth so that they won't need to pick between them. Besides the
subject I introduced was not the picking of teeth. The members
who have taken part in the discussion have drifted away from the
important points of the paper.
Dr. J. N. Crouse: I want to speak of an important point
that I neglected to mention in my previous remarks, the greatest
number of failures occur, because we are not sure that we have
found all of the points of destruction on the proximal surfaces.
For instance, we make an examination, find a simple proximal cav-
ity, and we may go so far as to fill it, when we come to finish it
and have space enough to finish it, we find a white streak running
along the gingival margin — the most vulnerable point of the oper-
ation. Here is the point where skill comes in, and if we notice this
defect it should be attended to with the greatest amount of dili-
gence.
In speaking of files, a file has been recently introduced into the
PROCEEDINGS OF SOCIETIES. 485
profession by Merriam, of Salem, Mass., which curves and has a
thick upper edge. It is not as delicately made as it ought to be.
It works well, and if you have a considerable amount of gold to cut
away it does it better than anything I know of.
Dr. W. a. Stevens made some remarks on Dr. Black's paper
and illustrated them on the blackboard.
Continuing he said: I cannot see from a mechanical point of
view why the fillings in the interproximate space should be oval, if
I understood the remarks of Dr. Black and others correctly. Why
are they not just as well perfectly straight, with square, broad con-
tact ?
Dr. Black, in closing the discussion, said: Mr. President, I
will only say a few words. I must confess a little disappointment
at the turn that the discussion has taken. I had hoped that the
subject of the paper would be discussed more fully. It is true
that I mentioned the use of discs only to condemn them, and I still
think with good reason. Now, it is a fact that instrumentation is
largely personal, and I do not wish in anywise to endeavor to
eliminate that personal equation. We cannot do it. I have seen
Dr. Johnson use discs, and know he uses them well. I have '^een
other gentlemen use discs and I know they use them well. But I
have seen a great many use discs to the detriment of their patients.
I think I am perfectly safe in stating that nine tenths of the per-
sons who use discs between the teeth are doing injury. It is not
an instrument that can be successfully used in this position by the
general operator. A few individuals may succeed in doing it, and
do it well, and not inflict injury, but the majority of dentists will
not succeed in doing it without doing injury. They will cut away
the contact point and injure the forms of their fillings ; therefore I
think I am right in condemning the use of the disc between the
teeth. • There are other modes of operating upon these surfaces, of
trimming fillings, that are not liable to these objections, and by
which the fillings can be finished just as quickly, and a little
quicker, namely, by the use of the saws and files I have shown. I
have used this particular plan of manipulation for a long time and
have attained facility in its use. No man can use them with facil-
ity at first.
There are several points that have been well discussed. I was
particularly pleased with what Dr. Dennis said in regard to the
gum not filling the space. There are a great many cases in which
486 THE DENTAL REVIEW.
the gum does not fill the spaces. The original form of the gum,
however, is a complete filling of the space ; it comes clear up to
the contact point and the margin of the gum tissue is so sharp that
you can hardly see it without the aid of a microscope. Of course,
we have a great many cases where the teeth have been removed
and contact destroyed between those that remain, the teeth leaning
over here and there. I did not discuss that phase of the subject
in my paper ; there were a great many other things that I did not
touch upon. I did not tr)- to cover the whole field of dentistry.
In regard to the point of wedging in those patients who have
gone on for years (persons 50 years old) with the teeth all filed
apart, I have detailed plans of dealing with them in a previous
paper, and it can be done. It cannot be done in a week, but it can
be done by taking sufficient time, and they can be made comforta-
ble and serviceable.
Broad contacts. I have studied the matter of broad contacts a
good deal. I have made them myself, and I have never seen a
broad contact yet that served the purpose as well.
You cannot build in a filling so close to a neighboring tooth
that food will not be sometimes crowded in. A broad contact
holds it there, and the only thing to be done is to be continually
cleaning it out with a toothpick, and generally this is not success-
ful for many years. This is all I intend to say about toothpicks.
What I talked about in my paper was the natural processes of
cleaning, not the toothpick process. That is another subject.
Many of the specimens shown were neglected interproximate
spaces. How neglected ? Neglected by the patient ? Yes, neg-
lected to apply to the dentist, and neglected by the dentist. They
are flattened proximate contacts where we get these decays at the
cervical margin, whether the decays are at the cervical margin of
fillings, or whether they are decays de novo, and a large proportion
of them are at the cervical margins of fillings that the dentist has
left with flattened contacts. Take this home and study it in con-
nection with this paper; as your patients come to you study it
carefully, and in the future tell me if you do not find that it is correct.
Xq-.v, gentlemen, in concluding this discussion, I must say that
I could not reasonably expect that this paper would be fully un-
derstood at a single reading. It would require time for even as
intelligent a body of men as this to fully understand it. There are
reasons lying back of it which make it necessary that much time
PROCEEDINGS OF SOCIETIES. 487
be given to a study of the forms of the teeth before this sub-
ject can be fully appreciated. The habit of the profession in
regard to the treatment of the interproximate spaces, and the
proximate forms formed in their operations have been such that it
will require much time for a full appreciation of well-rounded con-
tacts in maintaining cleanliness.
Indeed, it involves a long and careful study of tooth forms, and
the objects to be subserved by the particular adaptation of forms
to uses, to come to an understanding of this subject. This study
has not been followed by the dental profession in the past. Speak-
ing of this being an old chestnut, gentlemen it is not an old chest-
nut. The first approach to a discussion of this subject was the
paper of Dr. Perry in which he advocated the knuckling of teeth,
but in this it was still the contouring of a tooth rather than the
contouring of the space. The contouring of the space is only
beginning to be studied, and the particular forms of contour of the
distal and mesial surfaces of the teeth is only beginning to be
studied with reference to maintaining cleanliness. I say take these
matters home with you, study this paper; but above all, study the
forms of the teeth themselves. How many of you have a dozen
good tooth forms in your offices as objects of study, and which
you can look at occasionally. I would like all those who have
such to raise their hand. (Only a dozen lifted their hands). If you
will understand tooth forms you must have these teeth and you
must study them. I do not care how old you are you will not
learn them by operating on teeth in the mouth. I asked a gentle-
man, who is as intelligent a man as we have in the profession,
not long ago, to tell me the difference between a lower first, and
lower second molar, that is, the radical difference between these
teeth. He could not do it. I am in earnest in this matter of the
study of tooth forms with reference particularly to the conserva-
tion of their functions and the conservation of their health.
Discussion of Dr. Cormany's paper on "Some Needed Reforms
in the Practice of Dentistry" {see page 454).
Dr. William Conrad : In opening this discussion I will say
that the gentleman's paper was very practical, although not what I
had expected from the subject, "Some Needed Reforms in the
Practice of Dentistry." In connection with the first "reform"
mentioned he says there are dental colleges whose faculties make it
488 THE DEXTAL REVIEW.
a point to impress upon their students, that their college is
the only one teaching *'the latest improved methods in the practice
of dentistry." Now, if the gentleman has made the charge in
good faith and there are such colleges, I for one would like to know
them. Yet it is but natural that this should be so when the Mr.
Professor claims his work is purely a labor of love. Neither can
we blame the graduates of such institutions for going forth im-
pressed with the idea that they have had a very superior class of
instructors, much above the ordinary practitioner of dentistry.
The second "reform." — In reference to filling proximal cavities
of anterior teeth from the lingual surface. Judging from the gen-
tleman's remarks, I would suppose he considers it an impossibility.
It is largely a matter of experience. I have had the pleasure of
seeing many teeth filled in this manner, and well filled. Of course
we all recognize that plenty of room is desirable, especially in
order to save the appearance of the anterior surface of the tooth,
therefore I would always separate the teeth — freely — by wedging.
Third " reform."— Referring to the filling of proximal cavities
in bicuspids and molars with amalgam. I do not know of any one
who has received instructions in the "latest improved methods in
the practice of dentistry" who would fill teeth as he says he has
seen them. There are none on our side of the river I am sure. If
he is certain this is the practice in Illinois, I am sorry for you, and
I can only attribute it to an overproduction in dental college tal-
ent, due to active dental college competition.
The fourth "reform." — The substituting of gold crowns for large
contour fillings. I certainly cannot agree with the gentleman. I
think any tooth that can be filled with a fair likelihood of its re-
maining useful is in a much better condition than a crowned tooth.
With me any crown is a last resort.
The fifth "reform." — Extracting roots or teeth in order to
bridge the space In this connection the essayist thanked the
president for the comfort he had experienced in the last few years,
from an operation in his own mouth. This is just the class of
cases where I would condemn the practice of cutting off or ex-
tracting teeth. In this case, as I understand it, the second molar
badly decayed, the first molar gone. The second molar was ex-
tracted and space bridged from the third molar to the bicuspid. It
was not necessary to extract the molar. A wisdom tooth can in no
case take the place of a good second molar root for anchorage.
PROCEEDINGS OF SOCIETIES. 489
If the roots of the second molar were in a much worse condition
than he describes, I would use it as part of the anchorage for the
bridge. I would not extract under any circumstances. I do not
believe it is good practice, in fact, I consider it very bad practice.
I hope it is not universal in this State.
With reference to crown and bridge work, referred to by the
essayist, I will say that these four things should be considered in
all cases — cleanliness, appearance, durability and usefulness. I
look upon bridge work, so far as I have been able to observe it, as
much more cleanly, better in appearance, much more durable and
useful than any other class of work we have as a substitute for the
natural teeth. So far as caps, half caps, full gold crowns, open
face and porcelain face crowns are concerned, I think they all have
their place. The gentleman speaks of caps as if they were some-
thing to be avoided. He advocates in all cases a band under the
gum. I do not think it is always necessary to extend the band so
far. All the forms he has mentioned have their place and it re-
quires judgment on our part to know where to use them. If we
use a cap in the place of a full gold crown by mistake, it is a very
bad one. If we use a gold crown when it should be a porcelain
faced crown, it shows bad judgment. We should understand where
to draw the line and where to use these different forms. I will say
this, the most durable crown is the all gold crown ; the most beau-
tiful, the porcelain faced. In my practice I never have any use for
an all porcelain crown. I do not believe they are safe, and they
are only used by dentists on account of the ease with which they
can be adjusted and the cheapness to the patient.
" Reform" No. seven. — The essayist thinks it is better in most
cases to leave the pulps alive in teeth where the}' are crowned for
bridge work. In preparing a live tooth for a crown to support a
bridge, there is in most cases considerable grinding to be done,
and we should take into consideration the pain it causes the pa-
tient, but if it is a proper practice, the pain caused the patient
should not enter into the question. If the pulp in a tooth is a
necessity, it should remain there and I would not take it out, but
it has been my experience that in dressing a tooth sufficiently to
make a cap or a crown fit properly, the pulp is always irritated.
Irritation of the pulp produces calcification, and calcification of a
pulp means the commencement of death. This occurs where teeth
have been crowned, more especially where crowned to support
490 THE DENTAL REVIEW.
bridges, owing to strain brought upon them. You will often wish
you had devitalized the tooth at once and properly filled the roots.
I have paid the price, gentlemen, and I speak from experience.
Under the head of " Reform" number eight he refers to a
dentist who said he was busy, working from daylight until dark,
mostly operating, and had as assistants in this great practice two
automatic mallets. Now, gentlemen, we have a great many den-
tists who seem to delight in parading before the community, and
especially to their patients, the fact that they are "worked to
death," working from daylight until dark, with no time for their
lunch — the demand upon their time so great it becomes utterly im-
possible for them to take the proper care of themselves. I do not
think any good dentist ever works from daylight to dark as a rule ;
certainly he could not remain good very long. After a certain
time in the day, when the dentist becomes tired, any patient who
applies to him for his best service never gets it, and any dentist
who does not give all his patients his best service robs them.
The tenth " Reform " refers to dentists who have practiced
twenty years, not being able to get the good things of life — I be-
lieve most dentists are satisfied. They live well and have a few
dollars to spend among the boys.
Eleventh " Reform. " He offers to guarantee to any dentist who
will invest SlOO in machinery perfect satisfaction. I know men
who have spent several $100, who never had a particle of
satisfaction. With me the greatest satisfaction is electricity as a
motor power. The Edison Electric Motor and outfit has the
power, and any gentleman who can get the alternating current will
never have any trouble with it ; the motor will pay for itself in an
average practice every month. I have been running one about
nine months at an average expense of one dollar per month.
In conclusion I wish to say that any dentist who has so far suc-
ceeded in educating his patients as to the care of the natural teeth
and impressed upon their minds that the loss of a tooth is one that
can never be repaired, has done a good work. I do not think any
dentist has succeeded in educating a community to care for the
natural teeth as they should. I doubt if dentists as a class know
how to take care of their own teech properly. There are at present
too many testimonials given of secret preparations.
The President : In defense of my own method, I desire to
PROCEEDINGS OF SOCIETIES. 491
State that Dr. Cormany has drawn on his vivid imagination. The
molar was not extracted at my suggestion. I found it missing.
Dr. W. a. Stevens: I have one particular objection to Dr.
Cormany' s paper, and that is the advocacy of bridge work. I think
bridge work is a good deal of a fad which of itself is going to die out
like a great many other fads that have been introduced into the
dental profession during the past twenty years. Of the large num-
ber of bridges I have seen, nearly ninety per cent are failures. I
wish I had brought a specimen here of bridge work to show which
cost a man $400, and he suffered the tortures of purgatory in wear-
ing it for four years. Dentists crown a great many teeth that are
in no condition to be crowned. They are in the condition of the
patient who sent for an old physician in the town of York. The
physician after examining him carefully said, " Why did you send
for me when you have one foot in the grave and the other has no
business out?" That is the condition of the great majority of teeth
to which crown and bridge work is attached.
A lady patient was brought to my office who said she had been
recommended to have certain roots crowned and bridge work at-
tached. Judging from the condition of her mouth I should sa}^ she
had been salivated. There was not a tooth or root that was solid.
I did not believe her teeth or the roots could be restored to any-
thing like a normal condition again. My advice was to take every
one out and put in teeth on plates.
Now as to cleanliness. I never saw a bridge that was cleanly
yet. I believe there are cases that can be properly crowned, but to
crown every root that comes along is absurd. I believe a plate
can be kept cleaner than any bridge work. From my own obser-
vation I prefer a plate to a bridge ; as a general rule a bridge is a
constant source of irritation. I realize the fact that the majority of
the profession do not agree with me.
Dr. McKellops: I was very much interested in the paper just
read, and it is, in my estimation, a paper that the author should
feel proud of. I am actually astonished in this enlightened age
and with the brains we have in this society to hear gentlemen make
such remarks among those who pride themselves on being profes-
sional experts in " crown " and " bridge " work.
I travel over this country a great deal, and I have seen as beau-
tiful work as any one would wish to see; work done by members of
the profession, and of which they should be very proud. I would
492 THE DEXTAL REVIEW.
like to ask if the surgeon is always successful when he is called to
the bedside to save a patient's life ? Can it be expected that every
bridge put in a patient's mouth should be a success, or that every
man who tries to put it in should be an artist ? We are all bound
to make failures. Where is the man that makes a piece of artifi-
cial work that does not fail some time ? We have failures all through
life. No man has perfect success in it, yet I have seen beautiful
work in the mouths of patients, and as clean as possible.
I may not be successful in doing this work because it is beyond
my time. I must have some one who has a steadier hand than
mine to do this kind of work. As far as cleanliness is concerned
it is just as neat and cleanly as can be.
I saw a piece of movable bridge work in Dr. Dwinelle's mouth
made by Dr. Richmond of New York, as fine a specimen of artistic
and practical bridge work as I ever saw. And I also saw a piece
of work done by my friend, Dr. Knapp, of New Orleans, which
was a credit to him and to the profession. Therefore such work is
not a failure.
It is a credit to any man to read such a paper as Dr. Cor-
many has read, and we ought to applaud him and appreciate the
views he has advanced. In the case of Dr. Cormany, Dr. Taggart
has certainly given him much comfort, and he deserves great credit
for it. We are here not to cry down our profession but to elevate
it. (Applause.) I do not pretend to be a little god. (Laughter.)
I do not pretend to know everything. I came here to learn and I
have picked up many little items to-day relating to invention by
members of the profession. I like to encourage this work. I like
to be here and see what is going on, take an idea home and utilize
it for the benefit of my patients. The gentleman gets up and
says that these patients with bridges do not keep their mouths clean.
I can show him plenty of patients that keep their mouths and bridges
perfectly clean. It is the dentist's duty to teach his patients how to
take care of the mouth just as soon as they fall into his hands. He
should also impress this upon the minds of the mothers who bring
their children to him. Mothers do not instruct their children as
they should, to take care of their teeth, and especially their daugh-
ters who get married and in after years bring up families.
A gentleman came into my office not long ago with a child and
said, " I want you to take out a tooth for the child. I have been
walking the floor all night and have not been able to sleep." I
PROCEEDINGS OF SOCIETIES. 493
said to him, "I cannot take that tooth out." He said, "If you do
not, I will get somebody else to do it." I told him it was his
privilege to do so. I then said, " Whose child is this?" "It's
mine." "Who gave you this child?" " God," he answered. "What
did he give it to you for?" " To raise and take care of." "Have
you done your duty to it ? " He replied, " For God's sake, Mack,
do not say anything more. I have six children, and they will all be
down here to-morrow." (Applause.)
That is what we want to do, we want to educate our patients
in the matter of cleanliness, but, first of all, be cleanly ourselves. I
am willing for any person to come into my office and examine
everything I have. I have instruments by dozens. I am not like the
man writing for the Denial Cosmos, Yjh.o in filling teeth operates with a
broken instrument and a Bonwill mallet, which he has used for a
year, just the one instrument, thinks no more are necessary. He
recommends young operators to have as few instruments as possi-
ble to do their work.
The idea of an artist doing a beautiful piece of work with a
broken or faulty brush, or a sculptor carving out a statue with one
little chisel. The young operator wants to be encouraged to use
every useful instrument in his practice. I want to see a man at
work in his office, then I will tell you very quickly what I think
of him. Some will turn their back on you and not give you a
chance to get inside.
These are the little things that I am proud of in my profession.
I come here to see them, to learn, that I may show others. I take
these ideas and improvements to other dental societies where I go,
and they are of benefit to us all. As for crown and bridge work, I
will say that it has been a God-send to the human race. Mind you,
I do not believe that every man is successful in it. W^e all differ
in regard to putting them on, and this depends upon a man's judg-
ment and taste. I have seen teeth crowned for years and doing
first-class work, giving perfect comfort and health, and what more
can you have?
Dr. C. R. Taylor : There are a number of points in Dr. Cor-
many's paper that should be thoroughly discussed. It is held by
the best enlightened dentists of this State and all over the United
States, that it is disreputable to do certain things, and a man who
does them in his practice is subject to discipline by the societies
of which he may be a member. I think that is all well enough,
494 THE DEXTAL REVIEW.
but we ouglit to have a reform that will go farther and discipline
men who are connected with institutions that will advertise and do
disreputable things. A dentist connected with a dental college,
who will do things for patronage and business for the college,
should be subjected to the same kind of discipline that a member
of this or an}- other society would be if he did the same things in
connection with his private practice. This is one of the greatest
reforms we need at the present time. As a man who has no inter-
est in any dental college, I take the privilege of entering my pro-
test against the practice mentioned.
Now in reference to gold crowns on front teeth. I would like
to ask for information. How is a man going to avoid placing a
half crown or cap in which gold is conspicuous, where the cutting
edges of the teeth occlude; where there is large loss of tooth struc-
ture from erosion of the cutting edges of the front teeth with proxi-
mal cavities, and cavities at the cervical borders of the same ?
What can we better do than to put gold crowns on in these cases ?
Dr. E. NovES : I desire to say a few words, not so much in
relation to the question of reform as in answer to one or two
queries and suggestions, particularly the one by Dr. Taylor, and
the suggestion in the paper that a good many teeth should have
crowns put upon them instead of being filled. It seems to me
that at the present time the danger and the need of reform lie in
exactly the opposite direction. Teeth are crowned which ought
to be filled. The general statement has already been made that
the crowning of a tooth should be the last resort for the preserva-
tion and usefulness of its root when no other means are available.
Of course, a broad statement like that is subject to exceptions,
just as a broad statement on the other side might admit of in-
stances in which it is correct; but it should be an axiom with the
dentist to take into consideration the crowning of a root only after
he has fully determined that a filling cannot be made useful and
serviceable, for the reason that however well crowns may be put
on, there is probably a limit to their service and durability. We
all recognize the fact that the danger to teeth which have been
crowned is that of irritation of the peridental membrane; therefore
as a general principle you may say that a crowned tooth has a
limit of life and usefulness. Of course, the limit varies exceed-
ingly in different cases, and still more so by the skillfulness with
which the work is done. But it cannot be said, considering in the
PROCEEDINGS OF SOCIETIES. 495
average work, or even the better work done by the profession, that
a crowned tooth is in as good condition and as likely to remain
permanently firm and free from peridental irritation as a well
filled tooth under the same circumstances. That being the case,
the longer you delay the time of putting on the crown, the longer
the loss of the tooth is likely to be delayed.
In regard to the lower and upper incisors spoken of, it is merely
a question of judgment in my mind between two plans of proce-
dure. The cavity would determine the propriety of m.aking a crown
I should think. I do not say that it would absolutely, but it would
be an important factor in the question. A person cannot stand up
and say that such cases should always be filled instead of being
crowned; but I will say that the first thing to consider is, whether
carefully made fillings are admissible, useful, and durable for the
case. If they are, you do not need to consider any further. If they
are not admissible, then you have to consider whether you can put
on crowns or caps that will be so. Such cases in many instances
are a question of putting into use a metal surface in the place of
further wearing out the natural teeth, and you put on a filling of
platinized gold, or a metal cap with a view to having the patient
wear the metal surface instead of the dentine surface, and you ex-
pect when he wears out the gold it will have to be replaced. Now
the accuracy, the neatness, cleanliness, and appearance are all in
favor of fillings as against crowns or caps, and so they should have
first consideration as to their availability.
Dr. Sitherwood: The first thing I wish to call attention to
are the specimens of Dr. E. Parmly Brown, which have been
passed around. There are so many methods of practice that every
dentist has his own way of doing things. I wish to call attention
to the two different methods that have been advocated. I under-
stand from the crown and bridge work we have seen presented,
that Dr. Brown advocates that method of putting on bridge work
that will most nearly approximate or imitate nature; that there are
no gold bands or anything of that kind to be seen. I confess that
I have grave doubts whether I could make such a bridge that would
stand the wear in the mouth, but he certainly does bridge work of
that kind that wears. If it stands the wear and does the work, the
appearance is much better. In some of his articles, speaking
of gold bands, he refers to a needed reform " of driving a gold band
on the root of a tooth the sixteenth of an inch," which-, I under-
496 THE DENTAL REVIEW.
Stood the essayist to say, was his practice. Just think of it ! Some
of you saw Dr. Crouse put on the rubber dam without a ligature.
Never put a clamp on the tooth if you can get along without it.
Why ? Because below the gum margin there is a sensitive mem-
brane which is so easily irritated, and you can do irreparable injury.
Dr. Conrad spoke of never putting on a crown part gold and
part porcelain. I would put on a crown that is all porcelain, so
that none of the gold will show if it is possible. There are cases
where I admit you cannot put them on, especially if you put on a
piece of bridge work that will wear. If a piece of bridge work is
successful as a mechanical piece of work, it must also, from an ar-
tistic standpoint, imitate nature.
The other thing I wish to speak about is the use of the automatic
mallet. I say use it or anything you can use best. I use Dr. Abbott's
on account of its reverse action. I could not get along very well with-
out it. I use hand pressure in the old-fashioned way. I use every-
thing or anything that I find of advantage in my work. Dr. Cor-
many should not say, " Never use the automatic mallet."
Dr. Cormanv: I do not think I used the word never. I said
the automatic mallet was good in its place.
Dr. a. W. Harlan : Nearly all reforms spoken of in the paper
would be considered trivial if the essayist were not in earnest. Re-
form is a word, used in this connection, which has the meaning of
correcting an abuse in practice, in education, ethics and other
questions of the greatest importance to our future welfare. The
essayist has failed to touch upon the duty of every dentist to prop-
erly instruct his clients in the care of their teeth not only by
demonstration, but by example. Dentists need to reform by pur-
suing a plan which will ensure the cleanliness of their own mouths
and teeth, A needed reform is to exclude cotton or any other
porous substance from the roots of teeth. Another reform that is
loudly called for is the abandonment of the filing of teeth to gain
space for filling. This abuse of an innocent instrument has grown
to such large proportions that it calls, if not for the total exclusion
of separating files, for their very limited use on the surfaces not
having contact with other teeth.
A needed reform in the practice of dentistry is the more accurate
fitting of bands to roots and the limitation of the adjustment of a
crown as a last resort for the salvation of the tooth's root. Reform
is called for in the more general practice of packing cohesive gold
PRGCEEDINGS OF SOCIETIES. 497
slowly after it is thoroughly annealed. This will make many fill-
ings more durable and they will for a longer time be presentable
to the eye and tongue. Reform is needed in the administration of
anaesthetics. A second person should always be present.
The general practice of endorsing preparations of medicine for
the induction of local anaesthesia should be abandoned absolutely,
and the giving of certificates for new devices, amalgams, cements?
etc., should be limited to private circulation only. It is an injus-
tice to an ignorant and innocent purchaser to recommend any article
for use unless it has been tested thoroughly and the character of
the manufacturer is above reproach. I might speak of other re-
forms needed in the practice of dentistry, but I will close with the
suggestion that dentists lessen their hours of labor daily, in order
to devote more time to study and recreation.
Dr. Conrad : Dr. Sitherwood misunderstood me. I said
never use an all porcelain crown. Certainly a gold and porcelain
crown should be put on so as not to show the gold, and in most
cases this can be done.
I am sorry for the class of people Dr. Stevens seems to have
coming to him, for whom ninety per cent of all cases of bridge work
are failures. I presume he means those upon whom he operates
himself, as well as those he sees from other dentists. It does seem
to me to be a stretch of the imagination when he refers to such a
large percentage of failures.
Dr. Stevens : I wish to say in reply to Dr. Conrad that first-
class dentists did the work and the patients came to me afterward.
Dr. Conrad : The doctor says the work cost the patient $400.
Any dentist who gets $400 for a single piece of bridge work must
be a first-class dentist. I think any case of bridge work that has
saved a person four years of plates at $100 a year is cheap.
In the case where the doctor removed the $400 bridge he also
removed the teeth or roots. Now, if the doctor will follow the
practice of treating the roots and leaving them in position, he will
find it of great advantage in many ways. By retaining even a few
roots in the mouth, although the patient may not care to have a
bridge, there is maintained a greater permanence of the process,
which permits greater length of muscle; the length of muscle causes
that flexibility or e.xpression of the face which we find is lacking in
many cases where the teeth are all taken out, and the roots in the
mouth, well treated, give a more securely fitting plate.
498 THE DENTAL REVIEW.
Dr. Noyes, in speaking of irritation of the peridental membrane
caused by the presence of a crown, gives me to understand that he
fears the loss of such crowned roots, as a result of said inflamma-
tion. In the treatment of such cases, the roots should be perfectly
fitted — plenty of time taken to properly fit the band — crown articu-
lated accurately and cemented in position. There will follow no
irritation caused by the presence of the band, which will in any
way effect the future comfort or usefulness of the root as a support
for the crown.
Dr. J. W. CoRM.\NV : The reason I placed water as a motor
power ahead of electricity, is because we have no electric current
in our city and I have no means of getting it into my ofifice. If we
had the electric current I might change my mind on the subject.
In regard to the removal of the second molars referred to in
the paper, I will say that it has been done long ago; that I am now
thankful to the dentist who removed them, and for the bridges that
are in my mouth at the present time. They are doing good ser-
vice ; so far as the lives of the pulps are concerned under the
crowns, I am convinced from their natural sensibility that they are
still living. I have worn the bridges six years and the}^ have not
given me a particle of trouble. I desire to thank the gentlemen for
their kindness in discussing my paper and speaking so favorably
of it.
Discussion on the President's Address {see page 462).
Dr. George H. Gushing: I do not know that there is anything
to discuss in the president's address ; but I want to commend it for
its brevity, which is an admirable quality in a paper of that char-
acter, while to many of the suggestions that have been offered we
should all give heed. That with regard to the matter of discus-
sions which commence with bacteriology and end with the manipu-
tion of artificial teeth, is very timely. A great deal of time is lost
in desultory discussions, which we are so apt to hear.
I will say a word with regard to the question of patents. I
think what he says is very just and proper. The chief objection
to professional men holding patents is, I believe, simply an objec-
tion to the method in which such patents are generally placed
before the public. I do not think the holding of a patent by pro-
fessional men would generally be deemed objectionable, provided
the patent article or articles were placed before the profession, so
PROCEEDINGS OF SOCIETIES. 499
that they might be purchased. It is the method of selling office
rights and subjecting the profession to the espionage which it en-
tails that is so objectionable to the profession at large.
Dr. T. W. Brophy: The subject of patents is one of those
things that will regulate itself. I see no reason why a man who
has the ingenuity to invent anything should (if he treats his profes- •
sional brethren properly) not do so, and set forth his right or claim
to an invention, and then if he pleases give it to the profession. If
he does not do that, it goes into the hands of the manufacturer and
he reaps the reward. I see no reason why a man, who devotes
himself as a professional man to a particular thing and invents it,
should not receive some reward for the outcome of his professional
endeavors. If any gentleman here should invent an appliance of
value to the profession, why should he not receive some remunera-
tion for it ?
Some gentlemen down East are wild on the subject of patents
and are carrying it to extremes, as the President has said. If their
plans are adopted and generally acceded to throughout the coun-
try, it will dwarf talent in this direction; it will remove all incentive
to invention; it will be a retrograde movement rather than a progres-
sive one.
The instruments, appliances, and improvements that have been
made in dentistry within the last fifteen or twenty j^ears have been
largely due to the genius of its members. The manufacturer never
invents anything. He takes the instrument or appliance that is
brought by the skilled practitioner, puts it in shape and makes it.
That is the way we have gotten all of the valuable appliances we
use to-day. Electricity, the dental engine, excavators, pluggers.
all in the hands of manufacturers, have come through dentists. He
conceives that if they be formed in a different way they would be
better, consequently the manufacturer takes them and pushes
them, and the dentist gets little or perhaps nothing for his efforts.
Dr. J. H. Woolley: I think the remarks of Dr. Brophy are
very timely, and it would seem to me that the subject of patents
should receive some special consideration, or that we might get
the concensus of opinion of dentists upon the subject. I have had
a little experience in this direction myself. I had worked for four-
teen years on an instrument. I had you might say, crystallized a
thouglit and brought it into shape as far as the manufacturer of the
instrument was concerned. I then applied to the patent office for
500 THE DEXTAL REVIEW.
a patent on this instrument. About tliat time there was a good
deal of discussion pro and con in regard to whether a dentist should
patent instruments, and it seemed to me that the weight of opinion
was against it. So I waited a while. Then I received word through
my lawj'er from the patent office, stating that there was a similar in-
strument back of mine waiting for a patent, that if word was not
received the latter instrument would be patented. I concluded
therefore to let the matter drop, although I had a desire to have
given it to the world at a fair consideration, not in the way of a
trust. I learned afterward that this instrument similar to mine
was in the hands of S. S. White & Co., but patented through an-
other party. Dr. Evans, of New York. As Dr. Brophy says, where
one has toiled for years, whose aim and purpose was to benefit the
profession, and feels that he would like to give something to the
world, it is perfectly fair, that he should be given credit for his brain
work and service.
Dr. C. R. Taylor: I think the dental profession as a whole re-
alize that they owe something to the men who make great inven-
tions. The profession assented to the obligations they owe to the
man who invented the rubber dam. When he died, we all in a
meager way gave donations to his widow.
As Dr. Gushing has intimated, the profession is more or less to
blame for the difficulty arising in reference to patents. A manu-
facturer said to me not long ago that the dentist accused the man-
ufacturer of everything in regard to patents, but he said the den-
tist who invented "wanted the earth" with a fence around it.
The profession has been bled both by the manufacturer and mem-
bers of our profession, and the profession has said that "the whole
thing is wrong." I think every man here will concede that our great
inventions must come from the man who first feels the necessity
of an invention. The manufacturer, as such, cannot know the
needs of the dentist. He is not a practical operator, therefore he
cannot appreciate his necessities, until the dentist has first told
him what needs to be done. Then as a workman, he makes it and
sells it to us. If the dentist who makes the invention would give
the right of manufacture to more than one man, so there should be
no monopoly but a reasonable remuneration to liim for his inven-
tion, that would be proper and we would then, it seems to me,
have mastered the difficulty. As a rule the man who is an inventor
PROCEEDINGS OF SOCIETIES. 501
and gets a hold on the profession, becomes as grasping as the
manufacturer himself.
Dr. H. J. McKellops: I congratulate the President on his in-
teresting address, and I desire to refer to that portion of it which
alludes to the Columbian Dental Congress that we are to have in
Chicago in 1893. We want every dentist in the State of Illinois
and throughout this Western country to put his shoulder to the
wheel, for it is going to be the meeting of our profession. It is
going to be a meeting that every man in the profession should be
proud of, and each should do his utmost in coming forward with
his contributions, no matter how small the amount.
With reference to patents I heartily approve of well rewarding
a man who has the genius to invent instruments and machinery
for the benefit of the profession. I believe he should be protected
by the profession. Edison says in the Items of hiterest, "I have,
taken out two hundred patents, but I never had one moment's pro-
tection. I have never made one cent. All I have made is out of
manufacturing. The companies with which I am connected have
spent millions in trying to defend the patents. I have spent about
six hundred thousand dollars myself and I believe I would have
been six hundred thousand dollars better off had I never taken out
a patent."
I want to encourage every man in the profession who has the
ingenuity to invent any new appliances to bring them forward in
the proper way for the benefit of the profession
Discussion on Dr. Cushing's paper entitled " Contour Fillings —
what they should be " {see page 4j8).
Dr. E. D. Swain: Mr. President I shall be brief, because the
subject matter of the paper as well as the remarks I intended to
make were anticipated this afternoon in the discussion upon Inter-
dental Spaces. Many of you present remember very well that
upon the advent of cohesive gold, which made those fillings
possible, and later that of the rubber dam which made them easier,
the great interest which all operators took in contour fillings. The
entire profession almost went wild upon the subject; first because
they made fillings that showed up well and the theories and reasons
advanced for putting them in were excellent, or at least sounded
so. But soon like most all such cases, were submitted to the judg-
ment of the profession, and the result has been that less contour
502 THE DEXTAL REVIEW.
work is done to-day than formerly for the reasons which Dr. Gush-
ing has given you. They are almost certain failures, and with the
failure of the filling a further breaking down of the tooth and its
consequent loss. To make contour fillings it requires, so far as the
packing of gold is concerned, no great amount of skill. If the
material is kept dry, and the proper instruments are used, any man
who can pack small particles of gold after it has been annealed
can build it almost to any desired shape and extent. The skill re-
quired is in the preparation of the cavity and as you have been told
the anchorages. Dr. Gushing has explained to you what should be
done in the preparation of a cavity for the setting of the filling.
He has cautioned you against lack of anchorage in the grinding
surface."
We will suppose that this is a molar tooth cut longitudinally
through. He has cautioned you against anchorage at this point
(illustrating) upon the grinding surface. This may be done
either by cutting out the fissures in the remaining portion of the
tooth, or by cutting a square groove in the dentine across
the grinding surface, or by setting retaining screws. He has men-
tioned this point to you, and I wish to emphasize the point that if
the cusps in the antagonizing teeth are left they should be sacrificed
and be cut away, not cutting away too much of the filling at this
point, weakening it there (illustrating). We must remember that in
doing this kind of work we are using a metal which is little harder
than lead and the constant impact of the other teeth in the mastica-
tion of food has a tendency to tear off whatever prominences we
have built along the grooves cut in the sides of the teeth or even
in the grinding surfaces. At the present day we are not so fond of
building up gold in the mouth to make beautiful contour vvork.
You had a demonstration yesterday of what may be done with in-
lays ; in certain classes of teeth I consider this method far superior
to that of malleting in the necessary amount of gold to restore the
teeth to usefulness. There is an advantage in inlays over gold
packed with instruments, its strength, hardness, and smoothness
thereby overcoming one of the objections which Dr. Gushing men-
tioned, the possibility of the antagonizing tooth embedding itself,
as it were, making an indent into the filling and thereby getting the
whole bite which constantly tends to pull the filling away from the
tooth.
There was considerable discussion upon the finishing of fillings
PROCEEDINGS OF SOCIETIES. 503
this afternoon, but there was one point which I did not hear men-
tioned and wish to speak of, which apphes especially to contour
fillings. In the interdental space on the mesial and distal surfaces
of a tooth, of the incisors, cuspids and bicuspids especially, and
often of the molars, there is often a depression at the gingival mar-
gin or interdental space, the ridges being on either side of course
higher, rounded and smooth in accordance with this depression.
Supposing the cavity either for a contour filling or any other ex-
tends into that depression, I contend it would be impossible to
make an absolutely perfect finish at the margin of that filling with
the surface of the tooth with discs, however small they were. For
this kind of cases Dr. Black has given us a set of instruments in the
way of knives and small files which you have seen and which
answer a very excellent purpose. But, in the first place, in making
these fillings they should only be made where we have plenty of
room. If we have sufficient space in which to introduce the work,
we have sufficient to finish it. If they are contour fillings we should
have room enough to finish the contact point without difficulty.
Dr. E. Noyes: In the restoration of incisor teeth aesthetic
considerations of course take precedence of all others, because it
would be better to make an operation that would last only a few
years that would be handsome, than to make a positive disfigure-
ment that would last three times as long. The restoration of the
corner on a front tooth with gold or with platinized gold, or any
of the combinations of materials which are practicable, is a disfig-
urement at the best. The material catches the eye more quickly
and prominently than the natural tooth material. There is some-
thing about it of such quality to the eye that if the contour of a
tooth is absolutely and accurately restored to its entire extent, the
eye will seize upon that, and it will appear to have been over-
restored and the impression to the eye will be that there is an
exaggeration of contour. This is very fortunate for us. It gives
an opportunity for slight sloping to the cutting edge so that the
force of occlusion will come upon the remaining part of the tooth
and upon the other teeth, and not quite reach the filling; it permits
a slight narrowing of the tooth on its proximal side; remember,
these modifications must be slight, and they must be done with
good taste and good judgment, so that the shape is not dis-
figured and changed in its character, but only modified in
its extent. A tooth may be slightly narrowed from the con-
504 THE DEXTAL REVIEW
tact point to the corner. The corner itself may be rounded
the least bit more than natural, and when finished and the eyes of
spectators look at it, it will appear to be as big as it ought to be.
I say it is fortunate for us that aesthetic considerations and consid-
erations of safety correspond and run parallel.
At the risk of being misunderstood, I will venture to say that I
believe that sometimes, in certain cases of molars and bicuspids, to
have the undercut upon the labial and lingual wall is good practice,
rather than to do so much cutting in the grinding surface, and
have so great a weakening of the grinding surface, angles and cor-
ners. Remember, I am not putting this forward as a general prac-
tice, but there are certain forms of teeth and certain sizes of cavi-
ties in them in which it seems to me that it is better practice. It
must be remembered that the greatest strain upon the molars and
bicuspids comes upon the top of them, and they are built with
their greatest strength around this periphery. Of course, if the
grinding surface angle has to be invaded at all it weakens the trjoth
materially, and in many forms of teeth it weakens it so much that
it won't do to carry it any further by any lingual or labial under-
cuts. It is practicable to depenS wholly on labial and lingual
undercuts for the retention of proximal fillings in certain cases
which reach slightly into the grinding surface corner instead of cut-
ting a deep groove through the whole grinding surface.
It is not always necessary to slope fillings so much from the
grinding surface to the proximal as was described in the paper,
and is represented in this model. As soon as you get beyond
the point where there is a perpendicular floor, then the filling
should begin to slope awa}', but the grinding surface is better if
you bite against a square surface than if you bite against one
which slants. It is more efficient for the trituration of food.
Sometimes you can get sufficient strength and still have greater
efficiency than was described in the paper or represented in the
model. These things are to be determined on two lines: (1) We
must have general principles and guiding lines of practice and
rules, and (2) we must notice in each individual case how well the
rule fits and modifj' it as may be necessary under the circum-
stances.
Dr. G. V. Black : Mr. President, I desire to say only a few words
upon this subject. Dr. Noyes spoke of sloping fillings. I do not
like to slope fillings so much as he indicated, unless there is a grave
PROCEEDINGS OF SOCIETIES. 505
necessity that it be done, because they make gliding motions of food
that is detrimental to mastication. The seat upon which the filling
rests at the cervical wall is one of the most important points in the
anchorage of fillings. This seat should be a square surface suffi-
cient to support all the crushing strain that may be brought upon
the occluding surface of the filling. Then, if the other points of
anchorage are sufficient to prevent the filling being toppled over,
it will be secure.
Discussion on Dr. Blair's paper, entitled "Dental Legislation"
{see page 464).
Dr. C. R. E. Koch : Mr. President, I take it that the position
of dental boards, of the people, the profession and the colleges, in
their relation one to another are yet so poorly understood by the
average practitioner that perhaps a great deal of charity may prop-
erly be exercised toward the harsh criticism, that has from time to
time been given to the practitioners who, unfortunately for them-
selves, have been put in charge of the execution of the dental laws
in the several States.
The essayist has spoken of dental legislation in a circumscribed
sense. He outlines the possible means of changing the dental law
of this State. He has also presented some things that are desir-
able. Now, I do not propose to go into the question of what sort
of a law we ought to have. Tf I can have your indulgence for a
short time I will point out some reasons for a change of the present
law, and I want to emphasize the fact that there is no necessity
whatever of greater power being given to the Dental Board of the
State of Illinois by any law; in fact, I think the power it possesses
now is too great and ought to be circumscribed. That brings me
to a consideration of the dental colleges to our profession, a very
ticklish subject. I do not like to touch it, but we cannot consider
the question without doing it. I am speaking to a number of gen-
tlemen who have given a great deal of thought to the scientific
growth and advancement of our profession, but who in the nature
of things very rarely give a thought to this matter, because it does
not seem to concern them. They are verj' well-to-do, and their
limited time prevents a thorough and impartial study of the ques-
tions involved.
The present law has devolved upon the State Board of Illinois
to settle the reputability of colleges. It is a power that has given
506 THE DENTAL REVIEW.
infinite trouble to the board, and while this board (I, myself, am
still a member of it, though my resignation has long been tendered^
and perhaps modesty should forbid me to say it) has always been
composed of earnest, intelligent, conscientious and upright men^
who fully realize that as members of the board they are not the
servants of the dental profession, not the servants of the dental
colleges, but the servants of the people first and foremost ; yet no
board that has ever existed in this State has escaped either indi-
vidually or collectively the accusation or the suspicion of being a
special friend and advocate of this or that college. That has been
one of the main difficulties, under our law, to determine whether a
certain college is reputable or not. If the board should in any
case be compelled in the discharge of its duty to say a college is
not reputable, then all the graduates of such a college become dis-
qualified from receiving a license to practice in the State of Illi-
nois, without first submitting themselves to a personal examination-
by the board. It is a power much greater than if the board were
compelled simply to examine each individual upon his own merits^
and let merit determine his right to practice among the people of
this State. I have said the members of this society. I will go
farther and say the mass of the profession do not give any thought
to this matter whatever except at times when an effort may be
made to get a change in legislation. Immediately some one springs
up and imagines that there is something in a bill proposed that is
to encroach upon his vested rights. I want to say parenthetically
that during the history of legislation throughout this country, there
has never been but one instance in which legislation affected in
any manner whatever a man or woman, then practicing in their re-
spective States, but the rights that had been gained by general
consent previous to the dates of any enactments have always been
protected. There has never been in this State any attempt to
legislate so as to encroach upon any one's rights already obtained.
All legislation has been made with a view of providing for the fu-
ture, of securing for the people of the State better service. The
fact that legislation has been made in this manner is an evidence
that the people never desired to have the legislative assembly re-
flect discreditably upon the dentists that were in practice
previous to these enactments. In this day of progress, however,
the people desire that those who commence to practice den-
tistry hereafter should enter with better preparation than their
PROCEEDINGS OF SOCIETIES. 507
early predecessors. I think the interests of the profession, the
people and the dental colleges all run in the same groove, although
the practical experience of our board has been that they have worked
in opposite directions and mainly through misapprehension. The
thinking men who have given the matter consideration have been,
in such a hopeless minority, that a few designing men who believe
they have personal ends to gain, have generall}' succeeded in de-
feating their efforts so far as this State is concerned, at least.
One of the faults with our present law is that there has been no
well-defined method of legal proceeding in the prosecution of of-
fenders, and in the second place there has been no revenue with
which to carry on the prosecutions. It is singular that so many
intelligent men should have such a fear of legislation, should have
such a fear that in case the people's interests are more closely pro-
tected there is going to be personal hardship. Laws are not made
for the law-abiding, they are made for the lawless.
Those are the persons we ought to be after.
The Illinois board has, in the peculiar situation in which it finds
itself, probably attracted more attention than any board of its kind
in the country. There have been more questions raised, there has
been more work done, than in any other State. I believe that
Illinois stimulated the formation of the first national organization,
namely. The National Board of Dental Examiners. Peihaps you
will think I am getting away from dental legislation; I will get
back to it again. The object of that association was not only to
use its influence in the direction that dental colleges should edu-
cate, but to compel dental colleges all over the land to educate on
something near uniform lines. We see at present as a result, al-
most uniform requirements and a nearly uniform system. This
was the inevitable result of the meetings of conferences between
the several boards representing the several States, created by the
dental legislation of the different States, and that should show you
that dental legislation is a desirable thing. While Illinois has used
her influence in this direction, there have at times been occur-
rences outside of Illinois that have somewhat worried your board.
Some time ago the Illinois board was prosecuting a case in the
Supreme Court in which the board was sustained, but in which
also there was a slight rebuke given the board for going outside of
Illinois for information and instruction, as was intimated by some
of the evidence. Your present board has carefully avoided any such
508 THE DEXTAL REVIEW.
Strictures on the part of the Supreme Court of this State. It has
recently been stated in a certain Dental Journal that unless the
Illinois board did thus or so, there would be an explosion. The
Illinois State Board is responsible to Illinois and her laws and peo-
ple only, and the members of said board will discharge their duties
faithfullytohercitizensas their consciences, under their oath of office,
dictate, without fear of threats or intimidations from within or with-
out the State. Has this dental board, created some twelve years
ago in a crude form, done anything to elevate the dental profession
of the State ? Well, if graduates of colleges are better informed
and better dentists than those who have been compelled to pickup
their professional education, and I cheerfully concede they are, we
must confess that dental legislation has accomplished a great deal
in this State. I have not the exact figures, but I believe that when
the law went into effect (1881) in this State, the proportion of
graduates to nongraduates of dental colleges was twelve per cent;
to-day it is over fifty per cent.
Not over ten per cent of those admitted to practice since the
law went into effect are nongraduates; this notwithstanding the
fact that the law permits any one to come before the board for
examination.
Probably forty per cent of the applicants for examinations have
been refused licenses in the past three years, because they were
found unworthy.
The board has been accused of many things by professional
educators, and yet I am not afraid of successful contradiction,
when I say that the board, hampered as it has been, has always
been in the advance in thought and action leading to better educa-
tion. The statutory law says that any person can come before this
board and be examined. The Supreme Court of this State decided
that the board could make any reasonable rules which would com-
ply with the law. The board decided to examine no one for license
who had not had three years previous instruction, requiring of them
the same amount of time now required by the colleges. This it did
before the colleges established such a requirement.
The board has recently been accused of the habit of licensing jun-
ior students. I would say to you that if the Illinois board has ever
done so, it did it lawfully. The law permits any one to come before
the board and if he passes the examination the board is compelled
to issue a license to practice. But the matter of examination of
PROCEEDINGS OF SOCIETIES. 50!)
junior students has long since been abandoned unless they can
show three years of study and instruction. It was abandoned at
the time the rule was adopted requiring a certain length of tuition
before an examination would be given. The board has also been
accused at times of licensing the plucked seniors of colleges. I pre-.
sume that it ma}' have done so. The colleges have never informed
the board of their plucked students so that it might probe their
specially weak points, which the board would have done had they
been informed by such colleges. In this State the colleges are sub-
ject to the supervision of the board, but the law does not say that
the board or its actions must meet the approval of the colleges.
The criticism has been made that the board's examination is
merely theoretical. That in the main has been correct, because it
was the best thing it could do under the circumstances. If we
should have legislation that will provide for ample means, the ex-
aminations would never be carried on in that wa}' alone.
Now, the essayist has outlined to you how to obtain better leg-
islation. If I have succeeded in presenting some of the defects of
our present law ; if I have succeeded in showing the benefits that
shall be derived by better legislation in the public's interest, by
the dental profession, and that includes the colleges of course, then
I want to urge you to be impressed with some of the excellent
features of this paper. If the law imperfect as it is has done some
good, a better law will confer more benefit and it will be more de-
sirable. I trust you will go to work and encourage your neighbors,
and if there is any matter of doubt in any new legislation that may
be proposed, something you do not understand, do not oppose the
new law, as I know a great many have done both in this Society and
out of it, simply because you do not understand its provisions, or
have not read it. Enquire about it, obtain full light on anything
you do not understand or that seems improper to you, and then if
you approve of the general scope of the measure support it with
all your might, and get all your friends to do it. (Applause).
Further discussion was participated in by Drs. Grouse and
Ottofy, and the discussion closed by Dr. Blair.
Discussion of Dr. E. Parmly Brown's paper, entitled "Crown
and Bridge Work " {see page 46^).
Dr. J. J. R. Patrick: I very much regret that Dr. E. Parmly
Brown is not here in person to defend his thesis, but he is a gentle-
510 • THE DEXTAL REVIEW.
man who has all the courage requisite in support of his convictions,
and we might have a very lively entertainment this afternoon if he
were here. The doctor has asked me to open the discussion on his
paper. He has also sent a number of specimens of his work,
which, while I will not say they are the perfection of crown and
bridge work, are worthy of your examination.
The compliment paid the society by some gentleman from Chi-
cago, while speaking of crown and bridge work in regard to pass-
ing around specimens and expressing a doubt of having them re-
turned again, places me in a rather delicate position. Dr. Brown
attaches a great deal of importance to the work that he has sent
from New York, and expects every particle of it to be returned. I
have great respect for the knowledge of human nature that the
gentlemen from Chicago have always exhibited in my presence at
least. However, I will assume the responsibility of passing around
these specimens and expecting every one of them to be returned.
(Laughter.)
I do not know what to say about the paper. In the first place,
it is a difficult subject to talk about. It is difficult to even illus-
trate it on the blackboard. I think the Avork that Dr. Brown has
sent here will speak loud enough for itself and appeal to the in-
telligence of any ordinary dentist. I do not think there is a
member of this society present, but who is fully capable of ap-
preciating this work without any comments on my part. I am
willing to answer any questions that may be asked to the best
of my ability, but I am afraid to criticise this work. I hardly
know how to criticise the paper of Dr. Brown, read by Dr. Cush-
ing, but I will make a few remarks in regard to the failures of
this class of work. We all hear of the successes, but it maybe
quite a treat to know something about the failures. I think if
we were to candidly confess one to the other our failures (we do
not like to do it in public), we would all be mutually benefited.
I have here in addition to Dr. Brown's, some forty-eight speci-
mens of crown and bridge work, not sent here as objects of per-
fection, but simply failures that have been taken from the mouths
of patients at different times and preserved. The)' are not
mine, they were sent to me by Dr. McMillan, of Kansas City. I
have taken out a great many myself. I have had an oppor-
tunity of seeing the work of men from almost every portion
of the United States. I have seen miserable work done by
PROCEEDINGS OF SOCIETIES. 511
most excellent dentists in every other department of practice. A
man cannot be perfect in everything. If he were, he could not
make any progress. He never could learn. That is a self-evident
fact. It has always astonished me in lecturing before students and
in walking through the laboratories of some colleges to see how
quick the young men learn to work in the mechanical department
of dentistry. After some reflection on the subject I have come to
the conclusion that every man who feels himself capable of becom-
ing a dentist and practicing it as a profession is naturally endowed
in that way, that is, he, like the surgeon, has a natural passion for
mechanics, and that is the only way in which they can perform the
work they do. If we take into consideration the small amount of
time that our young men who have never used a blow-pipe, who
have never used solder, never constructed a piece of metal work in
their lives, devote to the mechanical department of dentistry dur-
ing their college career, it is wonderful that they make pieces of
work as good as the poorest in these specimens; and yet that nat-
ural feeling and desire to work v/ith tools in a mechanical way un-
fortunately makes them very conceited. After they leave college
they pursue their own course, and if they happen to fall among a
class of dentists who are capable of doing that kind of work and
adopting anything that is new and good, they are as a rule the
most self-sufficient insufficient men I have ever met. (Applause.)
If the dentist is successful in other departments and can fill teeth
well and perform all other operations in the best possible manner,
he cannot separate that from the art of working in gold that class
of work called crown and bridge work, the most difficult and
probably the poorest work to-day on the average that is turned out
by the dentist; at the same time, without a doubt, the finest and
greatest triumph in the science of dentistr}^ is the construction and
reconstruction of the teeth of the human mouth by artificial means
without plates. (Applause.) It is the triumph of the nineteenth
century in dentistry, and you cannot "be surprised to find so many
failures when there are so many at it. I have a case on hand to-
day in which the dentists did not allow themselves sufficient time
to put in a good piece of work. Three pieces were put in a lady's
mouth, two on one side and one on the other. It was done in a
week. The operators did not allow themselves sufticient compen-
sation to have paid a jeweler to have done the same kind of work,
who could have done it in two days if he had the opportunity.
512 THE DEXTAL REVIEW.
They had failed to fill the root of a tooth in which the pulp was
dead. The crown was prepared and put on after a fashion. I do
not think they charged more than §65.00 for the "job." It is
abominable. It would not be cheap even at 25 cents; it was
horrible workmanship.
Now, there are certain principles governing the fitting of
metal to objects that cannot be ignored and must be learned be-
fore any man can intelligently adapt a piece of metal to a form.
Dr. McKellops : I would like to ask Dr. Patrick whether
he approves of the class of bridge work that has been passed
around.
Dr. Patrick : I most assuredly do not. Here is an elaborate
piece of crown and bridge work — a failure. In criticising the char-
acter of work in any person's mouth performed by any dentist, we
frequently meet with the declaration by the operator, however
poorly the work may be done, that " I am successful." There are
a great many factors connected with this thing called success in
the profession. The patient has not as much to do with it as the
operation itself. You cannot determine how readily one patient
will tolerate certain kind of work that would be impracticable in
the case of another. There is a difference between individuals. I
have a central incisor which remained in the mouth, with a gold
wire extending beyond the apex of the root one-quarter of an inch,
and that patient has worn it for twelve years and never had any
trouble with it during that length of time. The person is per-
fectly satisfied with the gentleman who performed the operation.
An old lady entered my office a few months ago with a set of teeth
made on a rubber base, which were protruding. She was about
eighty years of age, and had worn them for twenty years. She said
if she could get a dentist to make her as good a set of teeth as
those she had in her mouth she would be happy. I examined the
teeth of the old lady, and I must say I never saw a more miserably
constructed piece of rubber work in my life. There was a complete
sulcus where the set of teeth had embedded itself in the soft tis-
sues and had completely exposed parts of the molar process. The
soft tissues were nodular, hard, and were like two loops embracing
the edge of the plate completely around her mouth. She retained
the two parts of the broken plate in her mouth. I told her it would
be impossible for me to construct a set of teeth like those. She left
satisfied, and thanked me. The cry of success for this character
PROCEEDINGS OF SOCIETIES. 513
of work is no evidence that the work is well done. You put on a
crown, I do not care how poorly it is constructed, as long as it does
not interfere with the closure of the jaws, stuck on with cement,
there is nothing to pull it off, pressure is all in the direction of re-
taining it there. In mastication, the molar teeth or the bicuspids
are never strained, pressure is direct from the crown, it is vertical,
naturally food is pressed in between it, then there is slight lateral
motion and the crown is held to the adjoining teeth and there is
no chance for it to come off. Any man may be successful in stick-
ing it on, if it was done in such a manner that it embraces the
periphery of the root above the gum with oxyphosphate. Although
the crown may be attached with oxyphosphate, moisture could
hardly reach the oxyphosphate, if the work is done with care, the
parts concerned are thoroughly studied, and the dentist understands
the use of metal. He should understand it enough to know not to
buy a large amount of spurious solder and spurious gold, and be
able to know the character of the material he is using, what it is
composed of, etc. Another failure in regard to making bridge work
is that there is an immense amount of unnecessary soldering.
Whether poor or useful, there is little difference. I have seen the
work done and find such work in all of the specimens I show you.
I do not know that I can say anything more in regard to this
work, you are capable of judging of it as well as I, and also of
the work Dr. Brown has been kind enough to send here.
[to be continued.]
The Dental Review.
Devoted to the Advancement of Dental Science.
Published Monthly.
Editor: A.W.HARLAN, M. D., D. D. S.
ASSOCIATE EDITORS:
Louis Ottofy, D. D. S. C. N. Johnson, L. D. S., D. D. S.
• Illinois State Dental Society.
The twenty-eighth annual meeting of the Illinois State Dental
Society, held at Springfield last month, was one of the most
successful in the history of the society. In point of attendance
it was up to, and probably somewhat above the average. In the
number of those who became members of the society, there
was an unprecedented excess (excepting the meeting in 18'72,
at Chicago) a larger number having affiliated with the society than
in any other year. We believe it was a mistake to select Rock
Island for the meeting of 1893, the general sentiment would prob-
ably have been in favor of Chicago, and it is still a matter of pos-
sibility that the next meeting may be a "special " one held in the
World's Fair city on the eve of the opening ceremonies.
The Revikw has never considered it good polic}' to use the pro-
ceedings of societies for "padding," when the publication has been
accorded to it exclusively, and therefore we give prominent place
in this issue to six papers and the discussions following them, the
remaining ones to appear in the Jul)' number. We believe it to be a
matter of justice to the author of a paper that it should be circu-
lated and read as soon as practicable.
The majority of the papers read at this meeting were practical
and interesting — in everyway worthy of careful perusal. Regarding
the management of the society's business, we would suggest that
in future the programme be so arranged that the last day be devoted
to clinics and the exhibition of practical appliances, new inven-
EDITORIAL. 515
tions, etc. This might result in securing a better attendance on the
last two days of the meeting.
The Annual Meetings.
April, May and June are the favored months for State meetings
of dental societies. This year the gatherings have been largely
attended, particularly in the west. There are general evidences of
progress, so far as we can learn from published reports and from per-
sonal observation.
The topics for discussion are mainly on principles and science
rather than on details and methods of performing operations. The
wonderful work of the microscopist is beginning to be appreciated
by the everyday dentist, and now it is not difficult to hold an audi-
ence for an hour or longer when photo-micrographs are projected
on the screen. These are things we note with pleasure, as it shows
the gradual awakening of the thought chambers of our busy prac-
titioners. Comjnittees having in charge the getting up of pro-
grammes should have in mind the necessity for enlisting the new-
comers to our ranks for essayists — once force the diffident to pre-
pare a paper and we generally secure a steady writer. All of the
meetings have shown the most friendly attitude toward the dental
congress, which must be gratifying to the general executive com-
mittee. This great convention is likely to attract to Chicago hun-
dreds if not thousands of dentists, and every effort will be made to
give a warm and cordial welcome to visitors both professionally
and socially.
What Next?
In a quarter of a century the dental engine, rubber dam, elec-
tric and mechanical pluggers and other labor-saving appliances
have been invented and made to subserve useful purposes in the
dental office. It is not easy to catalogue the discoveries in pure
science during that period, but to refer to the discovery of the
causes of caries and the evolution of the germ theory of disease,
will awaken a great many reflections in the minds of our readers.
Dwelling upon the above for a moment, think of the possibilities
for the next twenty-five years. An infallible cure for loosening of
the teeth, with a probability of a perfect prophylaxis ! The dis-
covery of a cement which will take the place of gold or other met-
516 THE DENTAL REVIEW.
als. A perfect pulp protector, the banishing of arsenic from the
dental medicine case. An uniform method of filling roots and a
simple and easy treatment for abscess that the merest tyro will be
able to follow.
A perfect method for whitening a discolored tooth and the evo-
lution of a porcelain plate that will fit well and not break. These
among other things will be hailed with delight by our hard-work-
ing confreres of the coming generation. Along with such blessings
perhaps we may find such an enlightened clientele that there will
be few or no remonstrances against the payment of just accounts or
haggling over fees. What next ?
Looks Like Success.
In two very pronounced cases of loosening of teeth during the
past few months, we have tried the following in their therapeutical
treatment : After removing all deposits and fastening the loosest
teeth when necessary, we have injected into the pockets aquaozone
first, and then followed with a solution of iodide of zinc, ten grains
to the ounce of water, daily, for thirty or forty days, then twice per
week for six months. In both cases, they seem to be cured after
four months cessation of treatment. Carbonate of magnesia was
used as a dentifrice during the time of treatment. When the gums
were flabby and relapsed, we added two minims of a saturated solu-
tion of tannin in glycerine to every sixty minims of the zinc iodide
solution as it was used. Try it in a favorable case.
Pamphlets Received.
Second Annual Report of the Board of Dental Examiners of
North Dakota, 1891.
DOMESTIC CORRESPONDENCE.
Letter From New York.
To the Edit Of- oj the Dental Review:
Dear Sir — Dr. Bogue has introduced glass beads mounted on a
mandril for use in burnishing by attachment to the engine. He
spoke of them at the April meeting of the Odontological Society
in connection with the discussion on revolving burnishers of
DOMESTIC CORRESPON'DENCE. 517
Steel and agate, round and corrugated. This reminds us of an
allusion we made to Herbst's method in a late interview with
Dr. Boedecker. We said, you know, doctor, that the Herbst
method has not proved practicable. Says he, I scarcely put in a
gold filling that I do not use it. We emphasize the importance of
it, for we make frequent use of the revolving burnisher in connec-
tion with our fillings. A dentist who has not found the value of
its use, has a missing point in his office. Tr}' it.
We took much pleasure in reviewing the discussions in the Chi-
cago Dental Society, published in the April number of the Dental
Review. It gives private satisfaction, for we have spoken strongl)^,
on neglecting to put the mouth in order, as it is the cotnmon cus-
tom of dentists not to do, and as we have often said, they are a
class of men that manage to be put on prominent committees. We
know some that say boldly that they have worked long enough
for glory, that when they have a patient come in that has easy
going operations required, they attend to those, and let the more
difficult ones go. Putting the mouth in order and charging a
respectable fee for it, was what Dr. Atkinson "died game," on the
altar of self-sacrifice for, as no dentist has ever done.
We have heard much about contour fillings during the past
year. There is a vital point in connection with these operations
that has not been made manifest. We have been not a little sur-
prised because of this. To Dr. Atkinson is due the credit of dwell-
ing upon the importance of bringing the lateral support up to a
tight knuckle, as he always termed it. We have seen him exag-
gerate the form of a tooth often to secure this service. We have
observed that some of those who have had a good deal to say on
this subject (contouring), pay no attention to the knuckling. The
matter of "food pressure," so termed by Prof. Miller, cannot be
too much talked about. It is a source of untold discomfort in
many mouths that are predisposed to weak gum borders. We see
in some mouths that this food pressure does not create tenderness
and loose sockets, but so large a proportion do, we will find it
necessary to dwell upon it often. We put it on record here, that
to Dr. Atkinson is due the credit of putting into practice b}' his
teaching the important art of "knuckling" in connection with con-
tour operations. This is one of the important facts, in connection
with many others, which we shall not let the opportunity slip to
give as they come in line. We suggest that the Atkinsonian So-
518 THE DENTAL REVIEW.
ciety make note of these things, for our quiver is full of them,
which have been gathered from nearly thirty years of very intimate
acquaintance with him; we do not hesitate to saj^ more so, than
any one now living, and we think as much so as any that have
lived (save one), and this outside of his own family. We refer to
Dr. S. S. White. There was no man that held so strong a tie on
Dr. Atkinson, and as we have often witnessed, in no man's presence
did we ever note so much his change of demeanor, and how much
it was reciprocated by Dr. White. This remark will convey an
idea. We heard him say this : " I will follow 3'ou any where."
Friendships are not a common commodity, associations very
common. We are watching some that have been formed of late.
We were talking with a person since our last letter, who has
had much contact with dentists during the last twenty-five years,
and it would be a surprise to some, if we should reveal what he
told us about men and things. We will only give a hint of what is
going on. Later we may sound an alarm. Put this in ethics^ "The
best men, those who are furnishing the qualities that make a pro-
fession noble and useful, are drifting in the current of fitful waters,
and they do not see it; we are charitable enough to admit it now,
further on it may not be permissible to shut one's eyes to what is
sooner or later to be fully approved."
It is only being whispered. Oh ! we marvel that so many good
men do not follow the courage of their convictions and stem the
current that is going against the interests of a "liberal profession."
Don't forget "Old Dog Tra3\" It will come sure.
There is a large number of young professional dentists that
are not going to follow in this uncertain drift, and they will put
themselves in a thought and purpose ere long that will prove the
material they are made of. "We speak that which we do know."
Could we tell the contents of five letters that have been seen
within a month, these would show which way this thought is
leading.
The First District Dental Society only met and adjourned this
month because of the State meeting at Albany. This meeting re-
minds us of some remarks made last year by Prof. Barrett in refer-
ence to the discontinuance of giving the degree of M. D. S. Does
the worthy Professor and editor have the courage of his convic-
tions or is he talking with his mouth? We have heard of the say-
ing that " Talk is cheap." Men who have earned their reputation
DOMESTIC CORRESPON'DENCE. 510
should Strike telling blows against such an error until it is ham-
mered out of sight.
A new obtunder has appeared this month, to be used hypo-
dermically ; also a new hand-piece with a slip back movement that
fastens the bur. Dr. Grouse's circular has started the tickers from
Maine to Georgia. Ten thousand members at $10 each will give a
fund that can be a powerful lever in the hands of wise men. "Such
an organized movement can't be bought out," March on, Dr.
Grouse, the dentists believe in your ability to succeed. So far as
we know we have not heard a dissenting voice.
We omitted a valuable point in our last letter in connection
with Dr. Boedecker's paper on the Herbst's treatment of dental
pulps. He says he found at the point of division of the coronal
portion, and the root portion, a number of micrococci, these in the
specimens sent him by Dr. Herbst. The cause of it he assigns to
be want of disinfection in those he has experimented with. After
disinfection he has not found the micrococci.
A report came to us lately by a patient that the tooth implanted
by Dr. Younger at a clinic six years ago in the mouth of the colored
porter at White's Dental Depot, had failed. We took the first op-
portunity to learn the facts. It was a right superior central incisor.
We found it all right, but the mate had quite a good sized gold
filling which resulted in the death of the pulp. About three months
before Dr. Atkinson died, the porter called at his office with his
thick lip twice as thick. I saw the doctor open a well-developed
abscess and evacuated it freely, dressed it and told him to call
again. Whether he did or not, I do not know. I found a sluggish
abscess. It is my opinion that if the tooth is not properly attended
to by treating the pulp canal, it will endanger the territory of the
implanted tooth. However, I saw no change apparent in connec-
tion with it, the report of failure was based upon the condition of
its mate. How often this happens with bad associations.
The Brooklyn Dental Society has made a new departure in
making a compromise with the Second District Society, which in-
cludes Brooklyn. They are, during the coming year, to divide the
times of holding their meetings. This movement has been in the
mill for many years, but the scheme has always been defeated
when brought before the society. We learn that the plan is to be
tried for one year. Dr. O. E. Hill has been elected President.
Dr. Hill's good, jolly nature goes without saying. Now, Doctor,
820 THE DENTAL REVIEW.
Stir up things and put some of the old time vim that was known in
days gone. You'll be gone by and by. You know the time was
when the society stood right up front. We recall the many visitors
that graced the earlier meetings; many of them will come no more.
Dr. Atkinson honored the society with his last public utterance.
His attachment for this body had an enduring thought, for which
none have made more manifest. Brooklyn dentists cannot afford
to let go of a society that brought most of them into prominent
notice. In a city of 800,000 inhabitants that cannot support a local
society there is a manifest lack of professional pride. We repeat
again at the risk of seeming thought to be over-remindful, that the
society that does not take interest enough to report energetically
their doings will not elevate themselves much in the thought of
their fellows. No society has been able to get along without ad-
vertising. Where would the Jersey Society have been if they had not
advertised, and that vigorously ? If they are not what they seem,
they think they are. " Whatsoever a man thinketh, so is he."
I will give a fac simile of their circular. "To members only."
It is for the purpose of booming the May meeting.
To THE Members Only.
Do you know that the Central Dental Association is the widest
known, the most progressive, most talked of, and affirmed
by some to be the best local dental organization in the country
to-day.
Now we cannot lay back on- our oars and live on prestige
gained ; the world moves too fast, and we must still be on the alert
for everything new and good. It is the duty and should be the
pleasure of every member to help the society in every way possible.
You see by the programme for the " May Meeting," we have a
good paper and a young man of to-day to read it. This meeting is
the last of the season until September. Now let us have a crowd
at the dinner and meeting. '^^^You (each one individually) in-
vite some prominent man to be your guest for that evening, no
matter how learned he is, how scientific his attainments, or
whether he comes from the clergy, the law, medicine or dentistry.
You need not be ashamed of the paper, the essayist, or the im-
pression he will produce on your guest, because the man, his pres-
ence, his reading, his essay, will not be disappointing ; and then.
DOMESTIC CORRESPOh^DENCE. 531
with all that you can cherish the selfish feeling that your guest is
secretly pleased that liis dentist is a member of a body of pro-
gressive professional gentlemen ; and at the same time (excuse the
word) you are booming your association and helping to keep it at
the top notch of popularity with our brother dentists from other
States, who come to our meetings and always seem to enjoy it, and.
help spread our fame abroad. And now, last of all, you gladden the-
hearts of your obedient servants, the Dinner Committee, wha
promise something new for September.
Chas. a. Meeker,
Chas. F. W. Holbrook:.
It may look a bit galorious, but it means a full meeting and a
first-class time, and a first-class dinner for $1,00, laid two hours
before the hour of meeting. Luckey, Meeker, Watkins and Stock-
ton are the quartette that do the energizing. Wait till you see
Watkins' headrest. It is so comfortable ; it will put the patients
asleep so gently ; it is the latest and best. The children will all
cry for them. Dr. Levy, report says, goes west, his eliminators
are in need of repair. Dr. Faught, of Philadelphia, tells New
Jersey about failures in dental operations, a big subject, and will
continue to be for some time yet. We note here that question of
a work on " Operative Dentistry " has been proposed, yet how
would a work of this kind, compare with those we have, written
from the modern view of things? Such a work properly prepared
would do much to answer the vexed question, why do our opera-
tions so often prove faulty?
To our mind, it is easily answered ; we do not mean b\^ this, that
we think that we can escape failures altogether. That we have no
work to meet this subject is not very strange, and it will continue
so until we have those that discuss such questions from a broader
view than the mass of dentists do. Rarely do they go farther than
materials and faulty manipulation. This proves that mechanics
are the main consideration. Surroundings have far more to do
with failures. By this we mean when we see reputable practition-
ers (according to custom) putting in large gold fillings in a supe-
rior cuspid tooth and at each pressure of the instrument pus oozes
out from under the gum. Something is wanting. It tells us that
knowledge is not all crowded into some heads. We give this as a
forcible illustration, though quite radical, yet verily true.
We note a fact in the May number of the Dental Review, giv-
522 THE DEXTAL REVIEW.
ing Dr. Harlan the credit of suggesting the holding of the Colum-
bian Congress. (He is the original Jacobs.) This will strike Jer-
sey silly, for they verily think they did it. One thing they have
done, they claim to be proud of putting up the bars, so no outsiders
can practice in their State, unless they give them leave, but one
thing they did not do, although they tried to. They started out to
follow the foolish steps of New York, to create a degree. Dr.^ James
W. White did them a very quiet and salutar}- service in an edito-
rial, advising them not to do it, and they did not. A wise decision.
How long will the profession honor such degrees, is a question
which is being asked. As New York seems to claim to be the Boss
State in politics, why not make this State degree national ?
Couldn't it be decided by '93 and elect a President of the Congress
on that basis?
It seems that Buffalo is not without its afflictions. The estab-
lishment of a dental department in connection with the University
has created a feud. Human weakness is the cause assigned. Why
should not Buffalo have a dental school, can't they have it ? We
think so.
There is a rumor that New York has an itch for another school,
on a far more liberal plan than any school yet. Knowledge vs.
Time. We repeat that it is the unexpected that happens; there is not
a little unused ability in New York hoping for a chance to teach
dentistry in a way that it has never been taught. By this we mean
on advanced lines. Ambition is not easily put into a box and the
cover screwed down ; it is a too lively commodity to be buried
alive. There is to be a book published very soon and to be in the
market for the next winter students. "Methods of Filling Teeth,"
by R. Ottolengui.
The Second District Dental Society is twenty-five years old this
coming October. It is thought that the agreement regarding the
time of meeting of these societies will facilitate the growth of a
large interest in dental matters. This is a commendable purpose,
if genuine; certainly it is much needed that such a city as Brook-
lyn should keep abreast of progress. It has been noticeable for
many years that Brooklyn dentists have not manifested anything
more than a lukewarm interest for our national meetings; why?
many have often queried. We understand that the State meeting at
Albany had a good attendance, minus the absence of some on the
list of the distinguished.
DENTAL COLLEGE COMMENCEMENTS. 523
A notice just received tells us that the twenty-third session of
the State Association of California convenes in July next. These
quarter century societies suggest to us that out of these years
we have been gathering large experiences that ought be found re-
corded in the proceedings of the coming World's Congress in- '93.
We have tried to find out how much success has been gained
in aid of the Grant Monument Fund. No one seems to be familiar
with the matter.
We were told on good authority that many young practitioners
are giving free expression of matters in general. It will be wise
for those who are in control, to cater liberally to the younger por-
tion. They will, sooner or later, assert themselves. It is not a
very wise man who does not see that the signs of the times are in
the direction of independence, in thought and action. Men are not
going to be dictated to by the few. In the next century, the world
is going to governed on the basis of a broader intelligence. Ex.
New York, June, 1892.
DENTAL COLLEGE COMMENCEMENTS.
GERMAN-AMERICAN DENTAL COLLEGE.
The annual commencement exercises were held at the College Building, Chi-
cago, March 26, 1892. The number of matriculates during the session was ten.
The degree of Doctor of Dental Surgery was conferred upon the following (1) candi-
date : Herman Schuitker, Chicago, 111.
HOMCEOPATHIC HOSPITAL COLLEGE.— DENTAL DEPARTMENT.
The first annual commencement e.xercises of the Dental Department of the
Homoeopathic Hospital College, of Cleveland, Ohio, were held in connection with
that of the other departments in the College Building, on March 22, 1892.
The number of matriculates for the^ession was fifteen.
The degree of Doctor of Dental Surgery was conferred on the following (6)
graduates :
P. W. Murton.
C. L. Kelsey.
C. S. Geer, M. D.
J. M. Clyne, M. D.
G. E. Bishop.
W. E. Root.
UNIVERSITY OF PENNSYLVANIA.— DENTAL DEPARTMENT.
At the annual commencement of the Department of Dentistry, University of
Pennsylvania, held Friday, May (>, 1892, in the American Academy of Music,
Philadelphia, the degree of Doctor of Dental Surgery was conferred by William
524
THE DEXTAL REVIEW.
Pepper, M. D., LL. D., Provost, upon the following (92) gentlemen ; after which
an address was delivered by John Guiteras, M. D., Professor of General Pathol-
ogy and Morbid Anatomy. The number of matriculates during the past session
was l!t6. Graduates :
Carlos A. de Amanda, Brazil.
Josiah Ayers, P. Ed. Island.
Harry K. Baer, Pa.
Walter G. Beitzel, Kans.
Joseph L. Benninghofif, Pa.
Johannes Berger, Germany.
Fred M. Bodine, Pa.
Francis H Bond, Pa.
Edward W. Bonwill, Pa.
John J. Bowen, R. I.
Andrew Law Brown, Conn.
Wilhelm E. Christensen, Denmark.
Frank T. Clark, Pa.
Edward B. Coen, 111.
Frederick L. Condict, X. J.
Frank P. Cook, Pa.
William M. Cooper, Pa.
Charles W. Crankshaw, Pa.
Joseph T. Danforth, Pa.
Victor H. Diefenderfer, Pa.
Jeremiah H. Dreher, N. C.
J. Smallwood Eldredge, N. J.
John B. Ernsmere, N. P.
Richard J. Flexer, Pa.
J. Beaver Gearhart, Pa.
Lewis H. Gilbert, N. Y.
Henry Ernest Goddard, England.
A. Herbert Grubb. Pa.
William Gunn, New Zealand.
Harry B. Hamilton, N. Y.
Arch Coombs Hart, Cal.
Edward B. Hause, Pa.
Melvin G. Haynes, N. Y.
Robert H. Hine, Conn.
Walter T. Holmes, Conn.
Paul Hotz, Switzerland.
A. Scott Ives, Canada.
Edward B. Joachim, Pa.
George H. Johnson, Jr., Bahamas.
Oakley Johnson, Wash.
H. Frank Johnston, Canada.
James H. Kittams, N. Y.
Johannes Kniewel, Germany.
Bernhard Landsberg, Germany.
Elbert W. Lapp, Pa.
Burtis E. Lawton, Neb.
W. J. ter Kuile Lemker, Holland.
Charles J. Leonhardi, Cal.
William J. Lesuer, N. Y.
Louis G. Ligonde, Hayti.
Jose Lucio. Lopez, Central America,
Clarence D. Lukens, Iowa.
Patrick F. Lynch, Pa.
Edouard Matthey, Switzerland.
W. Clay Middaugh, Pa.
Vethake E. Mitchell, Ohio.
Frank D. Murto, Pa.
George H. Nellis, N. Y.
Charles Newgarden, Pa.
Edward E. Parshall, Pa.
Harry D. Phipps, Texas.
Albert B. Protsman, Ind.
John W. Richards, Pa.
Shessie Worth Ridgvvay, Pa.
Alfred T. Ross, Pa.
James Francis Rymer, England.
T. Darwin Saunders, N. Y.
P. Frank Scboff, Pa.
J. Clark Segar, Conn.
Robert J. Seymour, Canada.
E. Harvey Skillman, N. Y.
A. Fowler Smith, N. Y.
W. Harry Sowash, Pa.
James R. Stathers, W. Va.
Charles A. Stewart, Pa.
Harry R. Swing, Pa.
Frank C. Wardell, Pa
Edward P. Whitlock, Pa.
S. Edwin Whitmer Pa.
Albert Lincoln Willis, Wash.
George J. Wimmer, Pa.
Percival Windmiiller, Germany.
Carl Witthaus, Germany.
Eugen C. Wuensche, Germany.
Philip W. Adams, Mass.
A. Lee Foster, Pa.
William B. Horter, Pa.
George A. Lawton, Conn.
Thomas A. McCarthy, N. H.
Robert Macdonald, Australia.
John M. O'Bourke, Cuba.
George R. Ulrich, Pa.
NORTHWESTERN COLLEGE OF DENTAL SURGERY.
At the annual commencement exercises of this institution, the degree of Doc-
tor of Dental Surgery was conferred upon the following named ('3) gentlemen :
Geo. W. Westcott. I Conrad J. Meyer.
Joseph A. Marshall. |
MEMORANDA. 525
MEMORANDA.
A cotton pellet roller is very handy if you use it according to directions.
Missouri Dentists will have a good meeting at Clinton, July 5, 6, 7, 8, 1892.
Dr. F. A. Levy, of Orange, New Jersey, paid a flying visit to Chicago in May..
Dr. W. Herbst has been giving some clinics in the Dental School of Paris
■with great success.
Dr. Geo. H. McCausey has been appointed a member of the Board of Dental
Examiners in Wisconsin.
Vaseline rubbed over rubber dam, makes it slip easily over the teeth and
prevents burs and disks from catching it.
Angle's Impression Trays are invaluable to one who has much regulating to
do; they are also good for taking impressions for partial sets.
Lintine, manufactured by Johnson & Johnson. Have your druggist order
a pound for you and use it for napkins, to wipe instruments, etc.
The Dental Hospital, of London, is now lighted by electricity — a great boon
for the students in the short winter days of foggy old London.
The dental department of the Homoeopathic Medical College of Cleveland,
O., conferred the honorary degree of D. D. S., upon Dr. S.J. Hill, of Fargo, N. D.
NEW DENTAL COLLEGE.
The Dental Department of the Western Reserve University of Cleveland,
Ohio. W. H. Whitslar, M. D., D. D. S., Secretary. And still they come.
Dr. A. C. Hugenschmidt has located at 23 Boulevard Malesherbes. Dr. H.
was for several years associated with Dr. Thos. W. Evans, and is one of the most
promising young men of intellect in the French capital.
MINNESOT.\ STATE DENTAL ASSOCLATION.
The Minnesota State Dental Association will hold its annual meeting July
13th, 14th, and 15th, at Minneapolis:
251 Nicollet Ave., Minneapolis. L. D. Leonard, Secretary.
A dental auction.
A dentist of Ansonia, Conn., a few days since advertised that he would sell
at public auction a set of false teeth, "now in the mouth of a patient." The den-
tist made the teeth seven years ago, and claims they were never paid for.
WISCONSIN state DENTAL SOCIETY.
The 22d annual session of the aboved named society will convene in Milwau-
kee, Tuesday, July 19th continuing three days. A cordial invitation is extended to
dentists to be present. . Claud A. Southwell, Secretery.
Milwaukee, Wis.
M. Th. David, Doctor of Medicine, and a well-known dentist of Paris, died
suddenly at Paris, France, of pneumonia. Dr. David was a favorite pupil of Dr.
E. Magitot, and at the time of his decease a Deputy of France, Chevalier of the
Legion of Honor and a well-known bibliophile. France can illy afford to lose men
of the character and ability of Dr. David.
536 THE DENTAL REVIEW.
The 9th annual session of the National Association of Dental Faculties will
beheld on Monday, August 1, 1893, at Niagara Falls. Roll call at 10 o'clock a. m.
Applications for membership should be sent to Dr. J. Taft, Chairman Execu-
tive Committee sixty days before the meeting. J. D. Patterson, Secretary.
A dental society has been organized in Rome, Italy, with M. Francesco Ser-
letti, President ; RiboUa and Chamberlain, Vice Presidents ; Betti, Secretary ;
Van Marter, Sr., G. Serletti and Angelo, Executive Committee. This is encour-
aging for the dentists of Italy, and is the beginning, we trust, of an organized
dental profession in that cc^intry.
ARKANSAS DENTISTS.
The Arkansas State Dental Association elected the following officers June 8:
President, L. Augspeth, Little Rock; Vice President, H. P. Dooley, Forest City;
Secretary and Treasurer, W. H. Buckley, Little Rock; Corresponding Secretary,
L. K. Lond. Pine Bluff; Executive Committee, W. H. Buckley, M. C. Marshall
and T. Y. Cooper.
Four per cent of the qualified dental practitioners in Great Britain hold for-
eign diplomas. Twenty-four per cent of the total number in the United Kingdom
are registered with qualifications, /. e. diplomas. Of course some of the seventy-
five per cent not holding diplomas as shown by the register may hold registrable
qualifications as the law only dates back to 1878. This is a gratifying showing.
We hope to chronicle the fact by 1900 that fifty per cent hold the L. D. S. or
some other evidence of qualification — D. D. S. for example !
OMAHA, NEBRASKA.
At last they have an organized profession in Omaha. On Wednesday evening,
May 25th, a few practitioners met and formed the Odontological Society of Omaha
and elected the following officers: President, G. W. Wertz ; Vice President, F.
M. Schriver ; Secretary, Geo. S. Nason ; Treasurer, A. P. Johnston. Committee
on by-laws and executive, F. N. Connor, J. C. Whinnery and M. Despacher. The
first regular meeting was held Wednesday evening, June l.st, at the office of Dr.
J. C. Whinnery, when a constitution was adopted. Success to the new society.
ILLINOIS STATE DENTAL SOCIETY.
The twenty-eighth annual meeting of the Illinois State Dental Society was held
at Springfield, May 10-13, 1892. The following named officers were elected
for the ensuing year; President, E. K. Blair, Waverly; Vice President, C. N.
Johnson, Chicago; Socretary, Louis Ottofy, Chicago; Treasurer, W. A. Stevens,
Chicago; Librarian, F. H. Mcintosh, Bloomington. The next meeting will be
held at Rock Island, second Tuesday in May, 1893.
Louis Ottofy, Sec'y, Masonic Temple, Chicago.
The American College of Dental Surgery, of Chicago, 111., has recently
passed into the hands of a syndicate of business and professional gentlemen. The
new management propose to make the American College a first-class institution.
Several changes have occurred in the faculty of the American College of Den-
tal Surgery, Dr. J. S. Marshall has been elected Dean, and Drs. R. F. Ludwig,
B. J. Cigrand and E. L. Clifford are new additions to the faculty. Dr. L. C.
Ingersoll will remain with the college. Miss V. A. Latham, D. D. S., is Professor
of Histology and Bacteriology, and Theo. Menges is the Secretary.
MEMORANDA. 537
Imposition. — A man giving the name of Fred J. Prior, and claiming to repre-
sent the " Biographical Department of the Columbian Exposition and World's
Fair Illustrated," is going about the city of Chicago and inducing dentists to have
their biographies inserted y)v^ of cost, provided the sucker will pay $25 for an en-
graving, which must be made for the publication by Ihcir house only. The agent
in misrepresenting facts has secured a number to advertise who otherwise would
not do so. Drs. Harlan and Ottofy have given him no authority, and it is doubt-
ful that Drs. Allport, Bropby and many of the others whose names he has, have
authorized the use of their biographies in such a bare-faced advertising scheme.
Dr. A. H. Bennett, Bruxelles, Belgium, relates the following incident of one
of our Americans, doing Europe, who came into his office in need of the services
of a dentist:
"Doctor," he said, " I have a tooth here I want filled, and I want it done
with Amalgum; and I have another I want ////Av/. But before you commence I
want to know how much the job will cost." Dr. Bennett replied, "Well, sir, if
you have a tooth filled it will cost at least $4. 00, and if there is one to be extracted
that will be $2.00." The man threw up his hands and exclaimed, " Je-ru-sa-lem!
I won't pay any such prices as that. Why, up in Michigan, where 1 live, a fellow
comes around every month and only charges 10 cents for extracting, and 50 cents
for lillings; and for $3.00 I can get a full set of teeth."
world's COLUMBIAN DENTAL C0NGRE.SS.
There will be a meeting of all sub-committees of the "World's Columbian
Dental Congress" at Niagara Falls immediately after the meeting of the American
Dental Association.
The date of the latter meeting is on August 2d, and usually continues for four
days, so that the time for the meeting of the sub-committees will be on the 5th or
6th. It is important that there should be a large meeting in order that all may
work understandingly for the best interest of the Congress. Please notify the
Secretary whether you will be present.
By order of the Executive Committee. Signed,
W. W. Walker, Chairman,
A. O. Hunt, Secretary,
Iowa City, Iowa.
DENTISTS to ORGANIZE IN OREGON.
The leading dentists of Portland gathered at the Portland to pay a fitting
tribute to their distinguished friend and guest. Dr. W. W. Allport, of Chicago,
who is visiting his son. Dr. Allport is recognized as one of the leading men in the
profession, and his name is familiar to every practitioner. Those present were;
Drs. W. VV. Allport and son, H. W. Allport, J. R. Cardwell, J. Welsh, S. J.
Barber, C. R. Templeton, L. E. Hibbard, W. B. Knapp, and E. G. Clark.
After Dinner the party was escorted to one of the private parlors, where the
President of the Board of Dental Examiners, Dr. J. R. Cardwell, acted as Chair-
man of Ceremonies and delivered an address of welcome to Dr. Allport.
The latter responded in a very happy manner, expressing pleasure in being
honored, and being able to meet a few of the dentists of Portland. He spoke of
the vast possibilities of the Northwest, and urged the State Dental Board to re-
628 'THE DEXTAL REVIEW.
member the responsibility resting upon them to use all the means within their
power to lay well the foundations for the future of the profession, and suggested
that there ought to be a State Dental Society as a means to this end.
On motion of Dr. Knapp, temporary organization was effected by electing Dr.
J. R. Cardwell, Chairman, and Dr. L. E. Hibbard, Secretary.
Drs. Cardwell, Welch and Knapp were designated to issue a call to dentists
in all parts of the State to meet and organize. — Exchange.
ADVERTISING "PROFESSORS."
At the regular monthly meeting of the Atkinsonian's (a dental society of Chi-
cago), it was unanimously decided that the custom of advertising in vogue among
X\\& Dental Colleges oi C\\\Z7\.%o\s pernicious 2iXidi injurious to the best interests of
the dental profession; it was also decided to attempt to eradicate this evil. The
present move of this society is to be followed from time to time by such action as
the circumstances may warrant.
The following resolutions were unanimously adopted, and the Secretary was
instructed to send copies of the same to the various dental colleges, societies and
journals now located in Chicago.
Whereas. We are of the opinion that the practice of advertising on the part of
dental colleges is one of the most injurious and menacing customs of the day, and
Whereas, This practice has a deleterious effect on the students of the various
dental colleges, be it
Resolved, That the Atkinsonian's most urgently recommend that this practice
be discontinued by those responsible for it; be it further
Resolved, That this society shall not abandon its warfare against this most
reprehensible practice until it is completely eradicated.
H. H. Wilson, T. A. Broadbent,
President. Secretary.
Chicago, May 3, 1.S1J2.
[These resolutions were adopted at late meetings of the Chicago Dental Club
and the Hayden Dental Society of Chicago.]
TWENTY-SECOND ANNUAL MEETING OF THE KENTUCKY .STATE DENTAL ASSO-
CIATION.
Programme for the twenty-second annual meeting of the Kentucky State Dental
Association, to be held at Louisville, Kentucky, Tuesday, Wednesday, Thursday,
June 21, 22 and 23, 1892, at the Louisville College of Dentistry, Chestnut Street,
between Floyd and Preston.
Address by the President, Dr. H. B. Tileston, Louisville, Ky.
PAPERS.
Tuesday June 21, 1892. at 2:30 P. M. "The care of children's teeth." Dr.
S. T. Butler, Litchfield, Ky. Discussion opened by Dr. J. B. Alexander,
Louisville, Ky.
" Effects of acquirements upon hereditary." Dr. A. O. Rawls, Lexington,
Ky. Discussion opened by Dr. J. S. Cassidy, Covington, Ky.
"Dental caries," Dr. M. W. Steen, Augusta, Ky. Discussion by Dr. Wm.
Van Antwerp, Mt. Sterling, Ky.
"Antiseptics, " Dr. J. S. Cassidy, Covington, Ky. Discussion opened by Dr.
J. C Blair, Louisville, Ky.
"Defects of Palate," Dr. G. Molyneaux, Cincinnati, O. Discussion opened
by Dr. H. B. Tileston, Louisville, Ky.
MEMORANDA. 529
"Gold Crowns and Bridge Work," Dr. C. G. Edwards, Louisville, Ky. Dis-
cussion opened by Dr. B. Oscar Doyle, Louisville, Ky.
"Educating The Public," Dr. Henry Pirtle, Louisville, Ky. Discussion
opened by Dr. B. Oscar Doyle, Louisville, Ky.
"Subject to be announced," Dr. J. F. Rees, Owenton, Ky.
CLINICS.
All clinics will be given in the Infirmary of the Dental College at such hours
as may be announced.
SUBJECTS.
Antagonizing Wax Models, Dr. W. E. Baxter, Frankfort, Ky.
Filling With Sponge Gold, Dr. J. W. Clark, Louisville, Ky.
Filling with Non-cohesive Gold, Dr. E. M. Kettig, Louisville, Ky.
All Porcelain Bicuspid Crown, Dr. F. Peabody, Louisville, Ky.
Adjustment of Rubber Dam, Dr. B. Oscar Doyle, Louisville, Ky.
Root Filling, Dr. J. C. Blair, Louisville, Ky.
The State Board of Examiners will meet daily during the session to examine
and register applicants.
HOTEL.
The Williard Hotel has been selected as headquarters and a special rate of
$2 a day arranged for. This hotel offers excellent accommodations, and being
located on the lines of street cars, running to the college building, etc., it is be-
lieved that visitors will find it a most convenient place to stop.
Members of the dental profession at large are cordially invited to meet with
us, and assist in making this meeting of great profit.
Members or visitors having anything new in appliances, or methods, will have
proper time allotted to them, by applying to the Executive Committee. For any
further or special information, write to Dr. J. H. Baldwin, Secretary, 609 West
Chestnut St., Louisville, Ky.
AMERICAN DENTAL ASSOCIATION.
The Thirty-Second Annual Session of the American Dental Association will
be held at Niagara Falls. N. Y., commencing at 10 o'clock, A. M., Tuesday, Au-
gust 2, 1892. Geo. H. Cushing, 96 State Street, Chicago, Recording Secretary.
COCAINE — its AN.ESTHETIC PROPERTIES.
From a series of experiments with cocaine. Dr. A. Bignon, of Lima, has ad-
duced a number of interesting facts relative to the anaesthetic action of this alka-
loid {Bull. Gen. de Ther.) He found that cocaine loses its anaesthetic properties
when in acid solution. They are not destroyed properly speakmg ; they merely
become latent. In fact, to restore them, it is only necessary to neutralize the
acidity of the solution. The intensity of the anaesthetic action of the cocaine solu-
tion, it is claimed, attains its maximum when, after complete neutralization of the
acidity, the alkaloid is suspended in a slightly alkaline liquid — forming a prepara-
tion which, owing to its milky aspect, has been designated niil/c of cocaine.
Most of the salts of cocaine, particularly' the crystallized hydrochlorates ex-
tracted from acid liquids, retain a certain quantity of the acid. For this reason it
is rnaintained their solutions do not possess the same anaesthetic power as those of
the alkaloid itself, a part of that power remaining latent in the former case.
Milk of cocaine is regarded by Dr. B. as the most powerful form of cocaine.
It may be obtained by precipitating the hydrochlorate or any other salt of the al-
kaloid with a slight excess of sodium carbonate : sodium bicarbonate is not con-
sidered quite so efficacious.
It is furthermore claimed that there are crystalline hydrochlorates of cocaine
530 THE DENTAL KEVIEW.
which are so acid that the same anaesthetic phenomena can easily be obtained with
five centigrammes (?+ grains) of the neutralized salts employed in the form of co-
caine milk, as with ten centigrammes (1^^ grains) of the same salt in ordinary
aqueous solution. Finally, the author believes that it is largely to the difference
in the degree of acidity of the solutions, as employed by different authors on this
subject, that the divergence of opinion in regard to doses necessary for cocainic
anaesthesia ought to be attributed.
MOUTH ANTISEPSIS.
In order to put into proper light the importance of mouth antisepsis — and of
proper care in operations about the mouth. Dr. Hugo Dellevie (Deiif. Med. Zeit.)
gives a review of the kinds of microorganisms found in the oral cavity, which
already exceed the astonishing number of over one hundred. He describes a
streptococcus unknown before this, which he had found, bred, and carefully ob-
served. This streptococcus is of the most virulent type, and possesses against
most antiseptics a power of resistance greater than that of most of the other mi-
croorganisms.
Pneumonia cocci have been found in large numbers in the saliva of healthy
persons ; they are always present in the saliva of patients suffering from pneumo-
nia— during convalescence, and in many instances after the patient has recovered.
It must be accepted that the presence of this microorganism is harmless only as
long as the lungs are in a sound and healthful condition; but as soon as those or-
gans lose their power of resisting disease, the coccus commences its deadly work.
It often extends to the lymphatics, and is frequently found in large numbers in the
abscesses which it provokes in the vicinity of the teeth and mastoid process. This
same germ has been found by some investigators in the saliva of patients suffer-
ing from cerebro-spinal meningitis ; by others, in endocartitis and parotitis.
The streptococcus tetragenus of healthy saliva is often found in phthisical
cavities and in mastoid abscesses. The ubiquitous staphylococcus pyogenes
aureus and the streptococcus appear in every buccal cavity, and to these the saliva
owes its power of producing a pus discharge. It is a matter of course, that with-
out anything being done on the part of the patient, suppurative processes can be
produced in the oral cavity by these microbes. Even septicaemia, pyaemia, or
metastatic abscesses can be attributed to this cause. The saliva of one infected
by syphilis, can convey the disease by kissing, by wounds from a bite, or by suck-
ing wounds (as in the ritual of circumcision). By such measures tuberculosis has
often been conveyed from one to another. The register of such diseases as diph-
theria, actinomycosis, apthai and influenza which have been communicated by
the fluids of the mouth, is complete. Care and cleanliness of the oral cavity
should therefore be observed for prophylactic and therapeutic reasons. The
author recommends solutions of corrosive sublimate (1;1500), beta-naphthol
(1:100), thymol (1;100), salicylic acid (liJJoO), saccharin (l:2r)()), or benzoic acid
(1:100). Particular mention is made of the necessity of dentists being careful
about disinfecting their instruments.
OBITUARY.
HARRY G. DUNAVEN.
Died, Sunday May 29, 1892, at Pontiac, 111., Dr. Harry G. Dunaven, aged
24 years. He was a nephew of Dr. Marvin E. Smith, of Chicago, a graduate of
Ann Arbor, Class I88lt. He practiced his profession in Chicago for one year after
graduating, and two years ago accepted a position in the office of Dr. H. H.
Townsend. at Pontiac, III., which position he ably filled up to the time of his death.
He was a good operator, a successful mechanical dentist, and especially skilled in
crovn and bridge work. Being of a kind and generous nature, gentle and syrripa-
thetic with his patients, he became a great favorite among a large circle of young
people, who mourn his untimely death. Dr. Townsend has lost a congenial com-
panion, a valuable assistant, and the profession a worthy member, who, although
comparatively unknown to the majority, gave promise of becoming a prominent
and honored member of the profession he loved.
THE
DENTAL RtVIEW.
Vol. VI. CHICAGO, JULY 15, 1892. No.
ORIGINAL COMMUNICATIONS.
Orthodontia — A Practical Case.
By C. S. Case, M. D, D. D. S., Chicago, III,
The case in orthodontia I desire to present at this meeting is
one which I think will be found of unusual interest. 1st. Because
of the difficulties which seem to be presented iu the way of, even a
beginning, toward restoration. 2d. On account of the simplicity
of the method which was adopted, and its success in correcting a
most unhappy deformity. And 3d, Because I shall be able to
show you, in plaster models, the entire change in teeth, jaws and
facial expression, together with the apparatus that was actually
worn — with slight variation — from the beginning to the comple-
tion of the operation. .
The case is one of a young lady 13^ years of age when it was
commenced, and 16 when finished.
By examining the models it will be seen that the difficulty was
not so much because of the marked protrusion of the upper teeth
and jaw, with consequent deformity of the face (see Figs, 1, 2
and 3), but mainly on account of the close occlusion of the jaws,
which permitted the lower front teeth to strike into the gums in
the rear of the upper (see Fig. 4), and so extensively as to keep
the mucous membrane inflamed and its surface often abraded,
while the alveolar ridge and teeth were being forced further for-
ward, making it impossible to reduce the deformity until the jaws
were opened by permanently lengthening the posterior occluding
teeth.
532
THE DENTAL REVIEIV.
Facial deformity in these cases is always more or less marked,
and its unpleasantness, not more largely due to the exposure of
protruding teeth than to an irregular fullness and peculiar hanging,
or immobile expression of the upper lip ; partly produced by a
conscious effort of the muscles to keep the teeth covered. {This is
not shown in Figs. 2 and j nearly so strongly marked as in the model, or
face itself, before correcting.)
After trying — without avail — a complicated affair for lengthen-
ing the bite, I finally inserted a simple black rubber plate that
ORIGINAL COMMUNICA TIONS.
533
covered the roof of the mouth and possessed a thickened. portion in
front to receive the thrust of the six lower anterior teeth. This
was worn during the entire operation, with occasional alterations
according to the demands of change. The posterior teeth were
thus prevented from forcible occlusion until nature had produced
in them a sufficient growth and fixed them permanently in their
extended positions.
Fig. 5 * is made from a model of the upper jaw at the beginning
of the operation, with the plate in position. Note interproximal
spaces.
*All of the cuts lu/iich illustrate this report were made from photographs of the
plaster models and apparatus exhibited at the meeting of the Illinois State Dental So-
ciety, 7vith no variation in position or shape. — [Editor.]
534
THE DENTAL REVIEW.
The only apparatus that was used to overcome the prognathous
position of the teeth and jaw was a simple band extending from
the molars around the front teeth: the ends of the band were sol-
dered to German silver wire bars (No. 19 E. s. g.), which were
threaded and passed through long tubes, or pipes, attached to the
buccal surfaces of the banded first molars. The first bicuspids
were banded and carried short pipes in which the bars loosely
rested, to aid in giving greater stability to the anchorage by pre-
venting the molars from tipping forward.
The centrals were also banded and possessed lugs for holding
the traction band in position.
Fig. 6 represents a model made from an impression taken dur-
ing an intermediate stage of the operation with the traction appa-
ratus in position. The interproximal spaces are closed and also
the space nearly closed where a bicuspid had been removed. The
left second bicuspid was also removed about this time. The plate
that was worn is laid upon the model.
The nuts were never turned so as to give a painful tension to
the traction band, and the apparatus was worn from the beginning
to the end of the operation with comparative comfort and so little
mental and physical derangement that school duties were never
interrupted on this account.
ORIGINAL COMMUNICA TIONS.
535
This I consider one of the most important factors in correcting
every case of malposed teeth, compared to which time is a matter
of Httle consequence. If there is anything distasteful to me
it is to hear the much vaunted expressions relative to ease and
shortness of time in which certain skillful operations were or can
be performed ; and especially a case in orthodontia, the treatment of
536
THE DENTAL REVIEW.
which should always be kept subservient to the physiological de-
mands of nature, regardless of time.
Figs. 7, 1^, 0 and 10 show position of teeth and facial expres-
sion at the close of operation. A staying band had been worn with
the teeth in this position for about six months.
ORIGINAL COMMUNICATIONS. 537
Antiseptic Dentistry.
By Garrett Newkirk, M. D., Chicago, III.
The subject assigned me by the Executive Committee, for a
paper to be read at this meeting, is one of great interest and im-
portance. It is also a question of such magnitude that it cannot
be treated exhaustively in a single article of reasonable length.
It shall be my purpose to give briefly some of the reasons why
we should, and how we may, apply the principles of antisepsis to
everyday office practice.
What do we mean by the term antiseptic ?
It is — anti, against — against the septic.
We must learn then, first, what we mean by the term septic in
general, and as applied to dentistry in particular.
In the older dictionaries the term stood for whatever promoted
putrefaction. The antiseptic, therefore, was that which should
prevent or retard putrefaction. For example, to give the most
familiar illustration — moderate heat was septic; extreme heat or
cold antiseptic.
The attempt to make fine distinctions between antisepsis and
disinfection has caused confusion in the minds of many. In prac-
tice, the two are so closely associated they scarcely bear separation,
as I think will appear from considerations following :
As I understand it, to use the plainest possible English, sepsis
is poisoning, by anything which is of the nature of an organic fer-
ment, or the product of such ferment.
Poisoning by any inorganic substance, such as nitric acid or
arsenic, or an active principle of vegetable origin, like strychnine
or aconite or opium, does not come within the meaning of the
term. They are poisons, but not septic; their action is chemical
or irritative. They call for antidotes, but are not opposed by anti-
septics. Their action is limited by terms of quantity. They may
act upon certain nerve centers very actively, but if not sufficient
to produce paralysis or death, their force is spent; their effects
pass. They are not living forces; they possess within themselves
no multiplying power. They do not increase. True septic agents,
on the other hand, do have this power of indefinite, and often very
rapid, reproduction and multiplication. They are themselves alive
within the living. They are not limited by laws of chemistry, or
by rules of quantity, but by laws of life — by conditions favorable or
538 THE DENTAL REVIEW.
unfavorable to reproduction. A septic agent is simply that which
contains the germ, the seed, the spore, the reproductive cell of
a low form of life, that with conditions favorable to itself is inimical
and destructive to the substance belonging to another and higher
form of life.
The act of introduction is injection. Infections matter is septic
matter. Disinfection is the act of destroying infectious or septic
matter.
Antisepsis is to prevent — is against sepsis. It includes neces-
sarily disinfection. The latter is the minor term.
Infection is done variously, by whatever means the septic ma-
terial is brought into living contact with the body which it poisons.
The small pox patient has probably been infected through the
agency of the air, but he may have been inoculated through the
skin. The scarlet fever and the measles patients have been in-
fected usually by the road of the lungs, the typhoid fever victim
by his alimentary canal.
The milkmaids, whose immunity from small pox first caught
the observation of Jenner, had been infected with vaccina through
abrasions on their hands.
By virtue of this wonderful discovery, the people of the civilized
world to-day are infected with the same matter introduced at the
point of the surgeon's lance.
It is simply voluntary and intelligent infection with one less
dangerous virus (an attenuated virus it may be of the same sort) to
prevent another infection of deadly fatality.
But mark you, what the surgeon does designedly with the
matter of vaccina, he may do unintentionally with the germs of sep-
ticaemia or the virus of syphilis.
The one condition of infection is this, that the septic poison,
the seed, shall be in some manner brought to the fluids of the body
— blood, lymph, serum, protoplasm — soil in which it may grow and
reproduce its kind.
I was somewhat surprised a \'ear ago to hear a venerable and
highly respected member of the dental profession antagonize the
modern ideas of disinfection, in this wise — as I remember, he said:
" We drink at fountains from cups which have passed from mouth
to mouth, and have not been disinfected. We go to hotels and use
forks which have been in the mouths of we know not whom ; we sit
in seats in railroad cars that may be covered with germs; we ride in
ORIGINAL COMMUNICATIONS.
539
crowded street cars laden with the breaths of many occupants, —
we do all this with comparative immunity. Why then should we
be so extremely careful beyond ordinary washing of our dental in-
struments ?"
I say I was surprised because such an argument shows plainly
that his thinking had never been thorough enough to go to the core
of the subject.
The alligator in the Florida swamps is covered with scales for
his protection. So is man. The cuticle is no more apart of living
tissue than the scales of the alligator. Ordinary agents of attack
are repelled and fall harmless from either. A germ to infect must
penetrate within this coat of mail. The same is true largely of the
mucous membrane. The man is not poisoned because poisons are
within his mouth. They are not necessarily within his body because
they are in his stomach or intestine.
Many deadly agents are destroyed by digestion, or passed on
without digestion or absorption. To every normally protected
surface they are inocuous. If there is no breach in the wall, the
enemy besieges in vain. But woe to the surface abraded, the spot
unprotected by nature's usual armor. A perfectly whole man might
be bathed in the infectious matter of vaccina; there might be a
spoonful in his mouth, which could even be swallowed without in-
fection, and yet an amount so small that it could not be seen, of
the same matter introduced on the point of a needle within a living
cell would inoculate as certainly as that two and two make
four.
The surgeon may open a great abscess; he may perform a lapa-
rotomy, where his hands are bathed in septic matter, and no harm
follow to him; but if there be anywhere a broken surface, even a
pin scratch, he is in imminent danger. Woe to him, if with point
of infected knife or needle he touches his own blood. His life may
pay the forfeit, or disease may scourge him from the crown of his
head to the sole of his foot.
The ordinary condition of the cup or glass at the well or foun-
tain, is that of smoothness. It is not likely to catch and hold on
its edge infectious or other matter. It is frequently washed, and
its coolness is unfavorable to the growth of organisms. But if
there v^ere upon the edge of the cup a ragged point of tin; if that
point should by any possibility become infected with septic germs
from the mouth of a drinker it might inoculate by scratching the
640 THE DEXTAL REVIEW.
lip of another. It is within the range of possibility that such things
have taken place.
Forks and spoons are of smooth metal. They are not liable to
infection, and they often pass through the best possible condition
for disinfection, namely, boiling water. Furthermore, all food well
cooked, and all drinks of boiled water, have been disinfected by
heat.
As to the argument from the experience of those who ride in
crowded street cars and breathe atmospheric "hash," it is proba-
bly true that many are infected thereby, so far as infection may be
communicated through respiration.
If the integrity of the epithelial covering of the mucous air
passage be not perfect, the individual takes his risk of infection by
any poison to which he is susceptible, and that is so transmissible.
Nevertheless his risk is infinitely smaller than that of the surgeon
who pricks his own skin, or that of his patient, whom he inoculates
with the infected instrument.
Let us further illustrate. Here is a person in whose mouth
there is a chronic alveolar abscess, or an alveolar ulceration with
pyorrhoea. Pus is daily discharged and mingled with the fluids of
the mouth. More or less for months or years it is mixed with food
and drink and swallowed. It may be at times of the most virulent
character, yet the individual is not consciously harmed thereby. At
the point of disease nature has made a wall, a limit between the
living and the dead. The living may pass to the dead, but the
dead may not come into the living. The daily swallowed infec-
tious matter is digested and destroyed. There may not be abso-
lute immunity, though the danger is comparatively slight. But
mark you, let a point of steel but touch this infectious matter and
then be carried but one inch in the same mouth, or to another mouth,
with puncture, and there may follow a train of dire results. There
may be extensive ulceration, local or general blood poisoning;
there may be boils, carbuncles, or pulmonar}', hepatic, or abdomi-
nal abscess, and not impossibly death. '■'■Behold, tv hat great matter
a little fire kindleth!" There was not more comparative potency in
Mother O'Leary's lamp and the straw in Mother O'Leary'fj barn,
which burned Chicago, than there is in the microscopic germ of
septicaemia or syphilis in touch with their fuels.
A young man of eighteen years, brother of one of my patients,
applied to a surgeon for a slight operation on his foot and had the
ORIGINAL COMMUNICATIONS. 541
misfortune to be inoculated with an infected bistoury. Abscesses
followed in the lungs and elsewhere, and after suffering for months,
and undergoing several surgical operations, with no end of anxiety
on the part of his family, he died.
And all this loss and grief was suffered and borne because a
certain man was ignorant or lazy or careless, and failed to disinfect
one little instrument. If he now appreciates the truth, one would
think his peace of mind would be gone forever. An experience
like this would cloud the sky of a lifetime. Where could be the
possible compensation or consoling thought to the surgeon who
had inoculated a patient with the virus of syphilis ? As I under-
stand, it was claimed by the first surgeon in this case that " Ery- \
sipelas had set in.''^ We used to hear that expression frequently.
Have you noted that it has quite fallen out of the language in | §
these days of antiseptic surgery ? It was often merely a term of
convenience, to cover unexplainable happenings which we know )
now were of septic poisoning.
That which holds true of the general surgeon is applicable to
the dentist. He uses a greater number of itistrutnents liable to be
injected, in close proximity to territory favorable for infection than any
other tnan on earth. Every instrument which enters a carious
tooth is likely to be infected by 09e or more of the agents or prod-
ucts of decay. A smooth excavator may not be, or if it is, may be
readily cleansed, but a bur with its many grooves is certain to be,
and is not easily cleansed. One of the most, if not the most dan-
gerous instrument for infection is the bur when allowed to slip
from the cavity and make a punctured wound of the soft parts.
Let me here remind you that of all wounds the puncture is j
most to be dreaded.
Ordinarily nature protects herself from inoculation by an in- ^
stantaneous flow of blood, which washes away all foreign matter, i
or, mayhap imprisons it within a clot, but the punctured wound
defeats her efforts.
The hypodermic syringe is a device to secure absorption by
means of a puncture through which nothing may return.
The penetration of the rusty nail into the foot of the boy — the
wound by the septic tine of a stable fork, as sources of tetanus, are
examples familiar to common experience.
The chance of making a punctured wound with an infected
bur, adds another reason for the use of rubber dam in preparing
/>'
642 THE DENTAL REVIEW,
cavities. How often does the dam ward off the bur from contact
with soft tissues, or, failing to do this completely, removes the
principal part of foreign matter adherent thereto — just as cloth or
leather wipes the tooth of the rabid dog or the fang of the rattle-
snake, so greatl)^ diminishing the chances of inoculation.
Forcep blades are especially liable to become septic, and re-
main so, first, because they are used so often upon teeth diseased
and in mouths diseased; and, secondly, because of the roughened
surfaces of their jaws. They are especially dangerous because they
will be applied to other teeth in other mouths, and crowded down
beneath the gums. They would doubtless infect oftener were it
not that the parts wounded by them are highly vascular and
usually bleed very freely. Nevertheless, given a forcep touched
with the germs of pyorrhea, septicaemia or syphilis — possibly other
poisons of which we are as yet ignorant, how easily might any of
these be transmitted from one patient to another.
Of such transmission there are many recorded instances, and
little doubt that the unrecorded, if known, would far outnumber
those.
In relation to possible infection, rubber dam clamps may be
classed with forceps. Whatever is about the necks of teeth, ad-
heres to the clamp, and becoming dry is hard to remove. It may
be doubted whether one in fifty of the clamps used by us are kept
always surgically clean. As another possible agent we may not
overlook the rubber dam itself, the edges of which, forced beneath
the gums, are sure to carry away some of the adherent secretions
of the part, and rubber is particularly hard to disinfect. The pass-
age of rubber dam from mouth to mouth is one economy certainly
that is scarcely "penny wise," while it may be many pounds
foolish.
However, as a means of preventing infection by all other means,
there is nothing to compare with it or take the place of a piece of
clean rubber dam.
We must remember too, that intelligent people are thinking of
these things, and will continue to think more and more. They
observe our methods often more closely than we suppose.
I have purposely omitted so far any mention of the broach and
the aseptic management of pulpless teeth, or of teeth the pulps of
which are being devitalized, because these special subjects have
been of late pretty thoroughly treated and brought to the attention
ORIGINAL COMMUNICATION'S. 543
of every intelligent reader of dental literature. I have sought
rather to keep in view the surgical principles involved within the
whole range of practice, and lead up to certain questions which I
wish to ask, and would like every one to ask himself.
Are we practicing dentistry antiseptically ?
If not, why not ?
There are many, no doubt, who are well informed as to the dan-
ger of sepsis, and who realize in theory the necessity of antisepsis,
but from lack of a proper system, do not carry out their ideas prac-
tically. In order to do this there are required certain special
arrangements and conveniences, together with scrupulously careful
attention to details. There must be also careful instruction of
assistants, and keen oversight that orders are obeyed.
The dentist here may get valuable hints from the general sur-
geon. How does he go about operating with a view to prevent in-
fection of his patient ? First, the surfaces near the part to be
operated on are thoroughly cleansed with water and soap, followed
by alcohol, and possibly the bichloride solution. The hands of the
operator and his assistants are likewise cleansed. Their coats are
laid aside, and other clothing covered with clean gowns. The in-
struments have been made aseptic and are laid upon clean napkins.
The water to be used has been boiled, and sponges are sterilized.
The operation throughout has in view the avoidance of any possi-
ble introduction of foreign matter, and the final dressing of the
parts is strictly antiseptic.
Should the dentist be any less careful as to surgical cleanliness
as to himself and his instruments; and should he not also cleanse
the mouths, and especially the teeth before he proceeds to further
operations ?
As before said the dentist must have special arrangements and
conveniences.
If water pressure be available, the fountain cuspidor. If not,
then one nickel-plated, to be cleansed after each patient's use, kept
partl}^ filled with water, and daily scalded.
Hot water always ready for use upon instruments, and for
cleansing the hands of the operator. The hands cannot be so
thoroughly cleansed with cold water as with warm.
An abundant supply of towels and napkins. There should
always be a clean napkin on the bracket upon which are laid the
instruments, and this should be changed often. It is my habit to
544 THE DENTAL REVIEW.
buy plain towels, one of which will make two napkins cut to fit the
bracket. I take pains to mention this, because I have often ob-
served dentists using merel}' the cloth cover of the bracket which
had become stained and saturated till it was a sight to behold if not
to admire. One could scarcely imagine anything better calculated
to promote surgical r///cleanliness.
An indispensable convenience to me for purposes of cleanliness
consists in the use of three or four inch squares of bleached mus-
lin, such as one may bus- for five or six cents per yard. My assist-
ant keeps a sufficient number of these prepared, and I should
scarcely know how to keep house without them.
Am I removing tartar, or treating a case of pyorrhcea, one of
these squares is always in my left hand, serving to hold the lip,
and when the instrument needs wiping it is used for that purpose,
and consigned to the waste basket and the fire. I use them for
the wiping of burs and excavators, for stripping the soiled cotton
from broaches when cleansing pulp canals, for absorbing blood,
etc., for laying hold of loose pieces of amalgam or tartar in the
mouth, for receiving the tooth just extracted, for wiping the mouth
mirror or the hand glass, for use with a little alcohol or chloroform
to cleanse the points of the pliers when gummed with sandarac, for
removing dirt from the engine hand piece, etc., etc.
Infinitely better, it seems to me, to use this inexpensive muslin,
which may be at once consigned to destruction, than to depend on
the heavier, less convenient napkin that accumulates filth upon
filth to be carefully saved for the washtub. It is the rule now,
both in surgery and medicine, to dispose of all filth and products
of disease rather by fire than the laundry.
A great convenience, one that was suggested to me some
years ago by Dr. Harlan, consists in a number of small cups or
jars for holding burs. One is able by this means to keep them as-
sorted and only use those which are clean. As a rule, when a bur
has been used once or twice its glory has departed, and it should go
at once into the waste or a convenient box kept for those which
may be worth resharpening. On the bracket too should be a re-
ceptacle for burs which have just been used and one may wish to
use again after they have been cleansed and disinfected.
All burs when received, either new or resharpened, should be
given a coat of some disinfectant oil, for insurance against both
rust and infection, and the rule applies equally to excavators,
ORIGINAL COMMUNICATIONS. 545
scalers, forceps, clamps, etc., which after cleaning are put in place
to await use.
A simple and convenient device for the use of heat to clean in-
struments, is the following: — Take a small tin or copper tea-
kettle, having a straight spout. Have the tinner attach to the lid
of the kettle two or three tubes an inch in diameter and long
enough to reach nearly to the bottom. These closed at the
bottom and opening outward, may be used for dry heat or oil,
while all the long instruments may be dipped in boiling water
through the spout.
Any sort of small burner will keep the water at the boiling
point with but little trouble or expense.
Antiseptic dentistry or antiseptic anything, means cleanliness.
But how can we expect surgical cleanliness if we fail to appre-
ciate the ordinary cleanliness reached by the simplest means. By
hot water and soap, the dentist himself, his coat, his hands, and all
the belongings of the chair, and bracket, may be clean. Then,
with a little care surgical cleanliness is added, and antisepsis is
complete. I leave the subject at this point hoping I have devel-
oped sufficient interest to cause a free discussion.
Report of the Supervisor of Clinics. — Illinois State Dental
Society.
By D. M. Cattell, D. D. S., Chicago, III.
Wednesday, May 11th.
Clinic, Dr. J. N. Grouse, Chicago. Patient, Dr. C. N. Trom-
pen, Roseland. — Lower left second molar. Mesio-compound cavity.
Dam held in place by use of punk and thick sandarac varnish^
Filling one-half or two-thirds of cavity with Globe foil No. 3, non-
cohesive — locked in with Globe foil No. 10, extra cohesive — the
case requiring about one-eighth oz. of gold.
Clinic, Dr. W. B. Ames, Chicago. Patient, W. W. Tobey, Dan-
ville.— Second inferior bicuspid. Disto-compound cavity. Filling,
oxyphosphate of copper cement; black oxide of copper with phos-
phoric acid.
Clinic, Dr. J.W.Collins, Lincoln. Patient, E. J. Rose, Spring-
field. First superior right molar. Mesio-compound cavity. Fill-
ing, combination Pack's cylinders No. 4, semi-cohesive, and
Williams' No. 60 foil, using the Harris dental pneumatic mallet.
546 THE DENTAL REVIEW.
Clinic, Dr. T. L. Gilmer, Chicago. Patient, Dr. C. E. Austin,
Chicago. First inferior right molar. Disto-compound cavity.
Operation, gold inlay. Ames' method of operation with Gilmer's
improvement of bending up the edges of gold so solder will more
easily flow up forming the contour. The operator showed the differ-
ent steps in the operation with the final inlay cemented into the
cavity.
Thursday, May 12th.
Clinic, Dr. C. N. Johnson, Chicago. Patient, Dr. W. F. Green,
Pullman. — A superior right second bicuspid. A disto-compound
cavity. Cervical wall very sensitive, covered with a layer of gold
and tin on account thereof. The remainder of the cavity filled with
cohesive gold. A matrix was used. The filling was finished with a
marble-like contact with a mesial face of posterior proximating
tooth at such a point as to leave the V-shaped interdental space
free for nature to fill with gum tissue.
Clinic, Dr. H. A. Costner, Chicago. Patient, Magnussen's
"Dummy head." Superior right cuspid root. "A method of prepar-
ing and filling root canals with tin or gold points." The Doctor
prefers this to other methods, claiming no disintegration of filling
material, no irritation, hence no after effects.
Clinic, Dr. G. A. McMillen, Alton. Patient, dining-room waiter
(colored), Leland Hotel. Lower right second molar. Large crown
cavity. Filled with cylinders of tin — hand pressure — in the good
old way. The operator fills suitable cavities with noncohesive gold
in the same way.
Clinic. Dr. T. W. Prichett, Whitehall. "Insertion of an amal-
gam filling in an ideal place." No patient could be found.
Dr. J. W. Fisher, Bloomington, exhibited two bridges, one con-
sisting of five teeth, the other of two. The former included superior
incisors and left cuspid, being attached to three natural roots by
cement; the other, including two superior incisors, being attached
to one natural root, with lug at other end to be inserted into gold
lined mortise in lateral incisor.
Dr. J. Campbell, Bloomington, exhibited models repriesenting
irregularities and method of rectifying.
Dr. J. A. Dunn, Chicago, exhibited hand matrix for plastic fill-
ings. Superiority over fixed matrices allows a better adaptation of
filling material to cervical margin. Also a buccal cheek-holder.
Dr. A. E. Matteson, Chicago, exhibited models representing
ORIGINAL COMMUNICATIONS. 547
irregularities, as discussed Tuesday under the head of Orthodontia.
Also torch made of a glass drop tube filled with cotton and satu-
rated with alcohol.
Dr. E. J. Perry, Chicago, demonstrated a method of articulat-
ing crowns with models, etc.
Dr. Garrett Newkirk, Chicago, exhibited a set of scalers for
removing calculus from the roots of teeth in cases of pyorrhoea.
Dr. D. O. M. LeCron, Rockford, demonstrated a method of at-
taching porcelain facings, bending the pins and using cement
instead of soldering.
Dr. A. W. McCandless, Chicago, demonstrated a method of
producing porcelain faced bicuspids on extracted roots with gutta-
percha, drawings, etc. No patient found on which to demonstrate
the method practically.
Dr. J. G. Harper, St. Louis, Mo., exhibited an electric fan,
alternating current motor. Simplicity of construction and com-
paratively noiseless, are the points of superiority claimed. It can
be attached, after removing the lamp, to any electric lighting cur-
rent.
Report of the Committee on Dental Art and Invention.*
Read by J. Frank Mariner, D. D. S., Chicago, III.
We desire to call your attention to a new cement for setting
crowns and bridge work. It is said to be superior to any hereto-
fore used. The color will perhaps limit its use somewhat as a fill-
ing material, but where it can be used it has worn well.
In using, follow directions, particularly the one to rub vigor-
ously until a smooth plasticity is obtained. It can be worked de-
liberately, yet hardens quickly under the influence of the heat of
the mouth. Fillings that have been in the mouth one }ear show
little, if any, sign of wear or disintegration. It is the oxyphosphate
of copper cement, prepared by W. B. Ames, D. D. S., 34 Wash-
ington Street, Chicago.
We call attention to another filling material which is new, to
some entirely unknown, viz., aluminum amalgam, made and sold
by the Carroll Aluminum Manufacturing Company, of Meadville,
Pa. After some experience in its use, your Committee recommend
it, and believe it worthy of trial. Although it may prove to be a
* Illinois State Dental Society.
54S THE DEXTAL REVIEW.
snare and a delusion, so far we are pleased with it. It sets
quickly, is without shrinkage, makes a strong, fine grained filling,
has a beautiful white luster that has not yet tarnished or changed
color in wear, and is less conspicuous than any other filling
material
Another new filling material is aluminum foil, made by the
same concern. The following is what the manufacturers say of it :
"It is nonoxidizable and remains unchanged by the fluids of the
mouth. It is easily and speedily packed, adapting itself perfectly
to the tooth walls, making a compact, firm filling that takes tem-
per in manipulation, and finishes with a hard, finely polished sur-
face, is less conspicuous than gold, combining more desirable
qualities as a tooth saving material than any other metallic filling."
The committee can speak of this material with but limited knowl-
edge, having seen it in use in but a single case. This case was in
the mouth of a boy about fourteen years of age, whose teeth were
of a poor quality, and badly decayed, defying usual means to pre-
serve them. It has been in this mouth one year (other materials
failed in much less time), without any perceptible change. Direct-
ions for use : Roll into ropes with foil crimpers, anneal at a low
heat on a mica sheet, and fill as with soft gold.
After considerable correspondence with inventors and manu-
facturers of materials and appliances in which the dental profession
is interested, we have received the following in circular form.
Many of these articles have been brought into notice somewhat
through the advertising medium of our journals, yet to many they
are unknown, and to all are new, having been brought out or im-
proved since April, IHOI :
Ethyl Chloride, as an obtundent and local anaesthetic.
Cavity Stoppers, class A, B, C, D, E and F.
Porcelain Inlays, and Porcelain Inlay Rods.
The Kells' Electric System, adapting the electric current to
dentists' uses : 1st. An electric motor, with magnetic clutch de-
vice for stop motion. 2d. A pedal switch for the control and di-
rection of the current. 3d. A variable resistance to vary the cur-
rent. No. 1. Kells' system for engine, mallet and mouth lamp.
No. 2. Double resistance, for engine, mallet and mouth lamp,
adapted to any single pulley engine head. No. 3. Double resist-
ance for engine mallet and mouth lamp, adapted to the new cord
engine. No. 4. Single resistance, for engine only, adapted to any
ORIGINAL COMMUNICATIONS. ■ 540
single pulle}' engine head. No. 5. Single resistance, for engine
only, adapted to the Weber-Perry engine. Electric Mouth Illu-
minator and Electric Laboratory Lathe, and Kells' Adjustable
Bracket Arm for Engines, and Electric Incandescent Lamps from
^ to 50 C. P. These were completed and placed upon the market
June. 2, 1891.
The Ideal Dental Base Plate. Plastic as wax, rigid as metal,
fits like a glove, does not "crawl" from the cast, nor soften under
the heat of the mouth. Held in boiling water for a few moments it
softens, and can be moulded easily to fit the most minute inequali-
ties of the cast. It hardens in a few minutes, and then is inferior
in stiffness only to a metal plate of same thickness, retaining its
shape unchangeably. When soft it is easily cut, when hard trims
to any form with a file, even to a feather edge. June, 1891.
"Flexo" files, saws and strips, separating and plug-finishing
files, saws for saw frames, files for saw frames, and finishing strips.
They cut rapidly and smoothly, without dragging. Used wet,
clean themselves. July, 1891.
Side-wheel Engine, improved August, 1891.
Improved Root Dryer. The improvement consists in a better
means for fixing the probe in the bulb, probe passing through the
bulb from the rear, and steel handle screwed in behind, locking it
firmly. August, 1891.
A new set of Root Trimmers. This set is an enlargement and
an improvement of the two trimmers formerly advertised under
Dr. Evans' name. August, 1891.
Weston's Insoluble Cement, improved. The improvement con-
sists in the best results being obtained when the filling is at once
submerged in water as hot as the patient can bear, and kept there
three or four minutes. August, 1891.
Bibulous Paper. A new, neat, and ingenious method of putting
it up ready for use. August, 1891.
Spring-tempered Porte polisher, improved August, 1891.
Right and left elevators, devised by Dr. J. F. Canine, very effi-
cient. October, 1891.
Rowe Disk Carrier. Special points of advantage are shown in
its simplicity, ease and rapidity of adjustment. January, 1892.
Roberts' Cotton Pellet Roller. Any sized pellet can be made
almost instantly. Being attached to the bracket table, the appli-
ance is always at hand when wanted.
550 THE DEXTAL REVIEW.
Improved Soldering Appliances, devised by Geo. W. Melotte, M.
D. S., Ithaca, N. Y. A very complete outfit in this line, and has
been greatly improved during the last few months.
The Brewer Universal Forceps, for rubber dam clamps, im-
proved. The improvement consists in one appliance having the
functions of two or three different forceps.
Improved Rubber Dam Clamps. The improvement consists
in providing with holes all the forms which will admit of the
change, adapting them to the Brewer Universal Forceps.
Root Clamps for Crown Work. Suggested by E. L. Hunter,
D. D. S. Strictly speaking, these are not rubber dam clamps, but
more properly adjusters of the dam to roots upon which crowns
are to be fitted. When the dam is adjusted and ligature tied, the
clamp is removed, leaving dam in position.
Crystal Mat Gold. A great deal of care and thoroughness
has been exercised in the production of this new preparation. It
has been tried by many experienced operators, and used at clinics
in a large number of cases. The criticisms it has received have
been almost uniformly favorable.
The Bosworth Universal Mallet. This mallet belongs to the
automatic class. Its inventor claims that it is so constructed that
with it, any tooth cavity, however difficult of access, may be filled.
The blow is struck at an angle, with the plane of the handle. The
lever spring, with which it is equipped, produces a sharp, quick
blow, without vibration, the value of wkich is especially seen if
filling weak and delicate teeth. '
Dr. How's Heater for scientifically heating gutta-percha.
Judging from the many overheated, and thereby ruined, gutta-
percha fillings that are to be seen in nearly every mouth, we think
this appliance should be found in every dental office in the
land.
Dr. How's Pellet Pliers, Improved. The improvement consists
in their being especially applicable to the new crystal or mat gold
recently introduced.
Improved Dento-Electric Cautery. The principal Improve-
ment consists in the introduction of a more efficient and convenient
means of closing the circuit, also an increased length of handle
modified to a more convenient form.
A new Blow Pipe polished and nickel-plated throughout. The
gas inlet is placed in line with the air jet for convenience of attach-
ORIGINAL COMMUNICATIONS. 551
ment with gas opening at back of workbench. The flame can be
directed at any angle. The top lever when pushed backward, will
turn the light out, and when drawn forward, will leave a small pilot
light. Total height, V^ inches. Air can be supplied by the mouth,
or by a foot blower.
A gold pointed probe, wood handle, hexagon ferrule, to elevate
point and prevent rolling on the table, 18k. gold point, not affected
by iodine, acids, etc.
Rubber mounted Arkansas Stones, very neat and tasty ; also a
new waxing burner, which is unique.
We wish to call your attention to an appliance, though not new
to some, to many others may be entirely so. It is the Bonwill
Articulator. The object of the committee in bringing this appli-
ance to your notice is the fact, that it has never been appreciated as
it deserves. It is exceedingly simple, easily adjusted with extra
loops or bows, any number of cases can be articulated with same
appliance. Speaks for itself more eloquently than we can
praise it.
Also an appliance presented by Dr. John G. Harper, of St.
Louis, for " keeping cool " during extreme hot weather, viz.: The
Meston Alternating Current Motor Fan." The new model of
1892 is very complete. It can be used wherever the alternating
current is used, can be placed in any part of the room, and moved
at pleasure. Connects directly to socket of your incandescent
lights. It is not a toy, btrt perfectly built, strong, durable, and a
handsomely finished machine, and costs from one to two cents per
hour to run it, furnishing a great deal of comfort to the operator.
Commanding a cool and refreshing breeze, when most needed.
Any information relating to its mechanism, capacity, price, etc.,
can be obtained from Dr. Harper, or "The Meston Electric
Manufacturing Co., St. Louis, Mo."
A very useful appliance is a new flask press, which on account
of its simplicity is superior to the more complicated forms. It will
speak for itself.
The most conspicuously original paper of the year pertaining to
dental prosthesis is that of Dr. Grant Molyneaux, of Cincinnati, in
which he describes the construction of the modification of the
Suersen appliance for the mechanical treatment of cleft palate.
By personal observation we are convinced that this is the most
practical method of treating this lesion, and consider the modifi-
55-2 THE DENTAL REVIEW.
cations made by Dr. Molyneaux to be a valuable improvement on the
original method. The above paper appeared in full in the April
1892 number of the Dental Review.
J. F. Mariner, Oiainnan,
W. B. Ames,
E. H. Allen, Committee.
Report of Committee on Dental Science and Literature.
Read by Edmund Noyes, D. D. S., Chicago, III.
The volume of periodical literature has been increasing in late
years. Most of the journals are larger, and several of them fre-
quently issue single numbers greatly enlarged from their usual
standard for the purpose of promptly publishing the transactions
of some society. It is to be noticed particularly also that it is no
longer possible to get everything of value that is published by
taking one good journal, for there is less copying than formerly
of original articles from one journal to another," and the custom
is growing of dividing up the reporting of society proceedings
so that different journals report different societies. The American
Dental Association, the National Association of Dental Faculties,
and the National Association of Dental Examiners, furnish proper
exceptions to this rule, and all the larger journals publish reports
of their proceedings. The contents of the different journals is not
now duplicated to a sufficient amount to enable any intelligent
practitioner to get along without taking several of the best ones.
In relation to operative dentistry the series of articles by our
Dr. G. V. Black, in the Detital Cosmos, on "The Management of the
Enamel Margins," deserves special mention. The clear, orderly and
scientific presentation, in full detail, of such a subject as this is a
great benefit to the profession and likely to modify for the better in
greater or less degree the practice of almost all who read the arti-
cles. It is to be remembered that we have nothing worthy to be
called a text-book on operative dentistry, and occasional chapters
like these, which are suitable material for such a work, are very
welcome. The series of articles by Dr. Ottolengui, of New York,
on " Methods of Filling Teeth," are a more extended series than
have lately appeared in any of the journals upon the subject. They
are worth careful reading.
* Illinois State Dental Society.
ORIGINAL COMMUNICATIONS. 553
The paper by Dr. E. A. Stebbins before the American Dental
Association upon the use of nitrate of silver for the arrest of caries
in certain cases deserves attention and such trial of the practice as
may determine the scope and usefulness of its application. It prom-
ises to be of great value for children's teeth. Dr. Talbot has made
several additions to his already considerable contributions to the
subject of deformities of the mouth and jaws, and Dr. Angle one on
the forcible eruption of teeth, Dr. Whitefield one on " Pathological
conditions produced by galvanic action between dissimilar metals
used in the treatment of caries of the teeth." But one needs to
make only a very cursory examination of the contents of the jour-
nals to find how futile any attempt would be to enumerate the arti-
cles of special value, unless a large part of their contents were
listed, and to discriminate what is new or original, or what marks
distinct advance over previous knowledge or practice, is still more
difficult and requires a fuller acquaintance with the past as well as
the current literature than most of us possess. It is not possible
either, in a short report, to give such a summary of what has been
said and done in the profession as may in the last degree supply
the place of a regular and reasonably thorough reading of the jour-
nals. Such an attempt requires a volume at least as large as Catch-
ing's Compendium, which might, perhaps, be considered as having
removed the necessity for any such committee as the present one,
and which is warmly commended to all practitioners, whether they
take all the journals from which it is compiled or not, but with
the warning that some of the most important articles in the jour-
nals do not appear to admit of the kind of boiling down that would
prepare them for that work. The articles on enamel margins, and on
filling teeth, before mentioned. Miller's articles on elephants' tusks,
on diffusion of antiseptics, and on the mouth as a focus of infec-
tion, those by Heitzmann and Abbott and very many others are ex-
amples.
The subject of dental education considered in its relations to
the colleges, the State Boards of Examiners, the Association of
Faculties, the profession, and the public, is one of the problems
under active discussion by the profession, and far from being set-
tled. This is not the place for any consideration of the subject
except to say that it is time to lay aside much of the apparent
jealousy and antagonism which have characterized some of the
discussions, and to give careful and good tempered expression to
554 THE DENTAL REVIEW.
the great diversity of views that are prevalent, seeking with pa-
tience and good nature to bring about such agreement among all
good men as may establish a policy calculated to secure the best
results at present attainable. The most important thing just at
present in this relation is the arrival of the time for the require-
ment of three full courses of lectures in the dental colleges before
graduation. This most important step in advance will be watched
with great interest by everybody in the profession. It is yet to be
seen how much open or concealed opposition to it may be devel-
oped, or how much evasion of it may be practiced. It is most
earnestly to be hoped that all of the colleges having the least pre-
tensions to reputabilit}', and the entire number of respectable prac-
titioners will cordially and fully uphold and enforce this position.
The portion of the report on histology and on electrical appa-
ratus, etc.. has been written by Dr. T. L. Gilmer, as follows:
Three articles of histological interest relating to the teeth and
approximate tissue have come to the notice of this committee dur-
ing the year. One by John Humphries, L. D. S., F. R. S., England,
relating to the development of the teeth. Another b}^ A. Hopewell
Smith, M. R. C. S., L. R. C. P., L. D. S., England, on the Patho-
histological Conditions of the Dental Pulp. The other is an exten-
sive writing by Mr. Mummery, of London, England, on the Soft
and Hard Tissues of the Teeth. The latter appeared in \}c\^ Jotir-
nal of the British Detital Association, and later in pamphlet form.
Any one of these articles is worthy the attention of the student in
dentistry.
In dentistry and medicine there has been a growing demand for
some means of adopting the Edison or incandescent system of
electricity to the various needs of these professions. The current
has been available and easily controlled for certain purposes, but
seriously deficient for others, viz., for actual cautery, and for elec-
trolytic use. The voltage of the incandescent system is high, 110,
while the ampereage is very low. For cautery and other work just
the reverse condition is demanded, /. c, low voltage and high
ampereage, small force but great quantity.
Much time and expense have been devoted to this subject, and
we have a number of times been informed that successful results
had been reached, but after a fair trial they have not proven satis-
factory.
During the last 3'ear Dr. J. L. Gish, of Jackson, Mich., has
ORIGINAL COMMUNICATIONS. 555
seemingly succeeded in this direction. The writer has seen the
improved Gish apparatus, and is convinced that it will do the
work claimed for it. He has three different appliances, one
especially adapted to the uses of the dentist, another for heavy
cautery work, and a third for electrolytic work. The appliance
adapted to the uses of the dentist may be employed for the con-
trolling of the current for motor, hot blast, and mouth lamp; and
for actual cautery purposes if the wire is No. 25, or smaller. For
heavier cautery work the cautery apparatus must be employed.
The cost of the apparatus for dentists' use is $45.00, and is procur-
able from Messrs. Chas. Truax, Greene & Co., Chicago.
The report on books has been prepared by Dr. A. W. Harlan as
follows:
From the date of the last meeting of this society to the present
time more than two hundred pamphlets and books have been pub-
lished in different languages on dental topics. This does not
include new editions of works alread}^ in print. In order to present
to the society that which would be valuable for members to read
it would have been necessary for the committee to employ at least
three translators and one stenographer for four months and twenty
days of eight hours each. As this was an impossibility on account
of lack of funds the committee has not attempted to even outline
what should be read by the busy dentist. Matter that is useful
for one mind is not suitable for another, and to attempt to lay down
for you a recommendation as to the reading or study of books or
magazine articles would be considered a presumption on our part.
The committee has no hesitancy in calling attention to an article
by Dr. G. V. Black on "The Use of Books," published in the
February number of the Dental Review. Dr. Talbot's charts of
the typical forms of irregularities is a book which may prove of
great value to the student interested in the subject of orthodontia.
Catching' s Compendium is for the busy practitioner just what its
name implies, a resum^ of the best articles published in the dental
journals. During the year no new work has appeared on any of
the following subjects: Operative Dentistry, Dental Chemistr}^
Dental Pathology, Mechanical Dentistry, Crown or Bridgework, or
in fact on an}^ subject in which the practical dentist would be
interested. The committee are of the opinion, that the
merit of an annual report on any subject consists largely of the
force or originality of the individual making the report; in fact, if
556 THE DENTAL REVIEW.
a good report is to be made on science or literature some one
should be appointed to do the work and present it over his own
signature. In this manner he would receive credit for the work.
Three new dental periodicals have been established in the world
during the year, but none of them equal those previously in exist-
ence. One has already died. One journal, the Archives of Den-
tistry, has suspended publication. What is most needed at the
present time is a good quarterly journal of about 600 pages annu-
ally, which could be sold at $5 per annum, filled with nothing but
original matter, and edited by a competent literary dentist, and
published by a house selling dental goods or a syndicate of den-
tists able to pay for contributions at $5 per page. In addition to
this some one should start a weekly dental journal of sixteen or
twenty-four pages in a central location, so that dentists could be
kept an courant with dental news as it transpires and not get matter
so old that they will not read it when it comes once per month. If
two journals of this nature could be established we think they
would pay from the start. The weekly could be sold for $3 per
year, and if ten thousand dentists would subscribe there would be
such an awakening of literary activity as has not been seen for
some time past.
The Exsection ov Nerves.
By T. W. Brophy, M. D, D D. S., Chicago, III.
The neuroma or nerve tumor is usually connected with the
nerve sheath. It may be of the nerve itself, but not frequently so.
The substance of the tumor is fibrous; it is generally rounded or
oval and varies in size from the most minute enlargement to a large
orange. It is usually benign in its character and it gives incon-
venience only by the pressure it exerts on the neighboring parts.
It is sometimes free from pain ; in other cases it is exceedingly
sensitive to the touch. The results of their presence are depen-
dent upon their location and the relation they bear to the nerve
tissue with which they are connected. If located at the foraminae
through which the nerves make their exit, the pain, in consequence
of pressure upon the bony walls, is frequently very severe. Medic-
inal agents may afford temporary relief, but exsection of the
affected nerve is the only reliable treatment.
ORIGINAL COMMUNICATIONS. 557
Neuralgias may be dependent upon an anaemic or impoverished
condition of the system. True neuroses are not amenable to sur-
gical treatment. The terminal branches of the trigeminal nerves,
the diseases of which come within the domain of oral surgery, in
consequence of their situation and exposure to external violence,
frequently become the seat of diseases which call for surgical treat-
ment.
1 1 is not my purpose to enter into detail on diseases of the fifth
pair of nerves, it will be sufficient to say that nerve lesions occur-
ring in subjects of gout, rheumatism, malaria, lead poisoning, S3'ph-
ilis, etc., call for treatment of a nature to meet the requirements of
each case.
Neuromata are classified as constitutional and traumatic. Nerve
tumors constitutional in their origin usually affect the whole of a
particular group of nerves, and these tumors, as in muscular or
other tissues, may be malignant or benign.
Traumatisms which lead to the formation of nerve tumors sit-
uated upon the supraorbital, infraorbital and inferior dental and
gustatory nerves are, especially with the three former, of very fre-
quent occurence. The method of procedure in exposing the first
division as well as the second and third should be such as to cause
no visible scar. The first branch should be reached by making an
incision beneath the supraorbital ridge and just beneath and close
to the eyebrow. When the integument has been divided it should
be reflected upward so as to enable the operator to expose the
nerve through the upper fibers if the orbicular or palpebrarum
muscle. This exposure may be easily accomplished and the nerve
seized by a tenaculum or forcep and a section excised from it.
The operation for exsection of the infraorbital nerve simultane-
ously proposed by the late Professors Parkes, of Chicago, and
Hodgen, of St. Louis, commends itself as highly meritorious.
It consists in making an incision beneath the lower eyelid, and
thus entering the orbit and lifting the eye so as to reach the nerve
as it dips down from the floor of the orbit to pass through the
canal and makes its exit at the infraorbital foramen. When the
nerve is exposed it may be lifted and divided, after which the tis-
sues at the incision beneath the eye may be depressed so as to ex-
pose the infraorbital foramen, and the nerve may be seized by the
forcep drawn from the canal and the section thus removed.
Abnormalities of the third division are more frequently met
558 THE DENTAL REVIEW.
with than they are in the first and second divisions, owing princi-
pally to greater exposure of the terminal branches as they make
their exit from the mental foramen. Neuromata occurring along
the course of this branch very frequently call for surgical treat-
ment.
I have no doubt that diseases of the teeth are responsible for
the presence of nerve tumors, especially so in relation with the in-
ferior dental nerve. My experience has convinced me that neuro-
mata in edentulous jaws are not infrequently due to irritation of
the nerve at its exit from the mental foramen caused by a lower
denture. More especially is this true in the aged.
The anatomical changes which occur in the lower jaw from
youth to old age are well known. It is sufficient for our purposes
to remind you that the aged edentulous jaw has no alveolar proc-
esses and no gum tissue and becomes nearl}' flat upon its superior
surface ; it is covered only by the periosteum and mucous mem-
brane, and the mental foramen, instead of occupying the place it
formerly did, midway between the superior and inferior borders of
the bone, is now on its superior surface. In such cases, the finger
passed over the upper border of the jaw will distinctly feel the in-
ferior dental nerve as it passes from the mental foramen. A lower
denture adjusted in such a case will surely exert undue pressure
upon the nerve and cause great discomfort to the patient. So
painful indeed is it in many cases that the plate is abandoned.
The irritation of the nerve thus established often leads to the
formation of neuromata. If the denture were constructed saddle-
shaped it would not press upon the nerve and no injury would en-
sue. Exsection of the inferior dental nerve should invariably be
made within the mouth.
I have never found it necessary to make an external incision
in performing this operation, and I see no reason why external in-
cisions should be made.
Any mouth which will admit of access to the second molar
tooth for the insertion of a filling will allow abundant room for the
performance of the operation in question.
In performing neurectomy upon the inferior dental nerve the
operator should remove all that portion of the nerve situated in the
inferior dental canal.
This may be accomplished in two ways: 1st, by separating the
nerve from its branches at the mental foramen and then by the use
PROCEEDINGS OF SOCIETIES. 559
of a tenaculum take up the nerve as it enters the inferior dental
foramen (at this point it is only submucous) and draw it from its
canal after which it may be excised. 2d, The operation which I
prefer is to expose the mental foramen and by the use of a flame
shaped bur cut away the buccal wall of the canal thus ex-
posing the nerve nearly as far back as the ramus of the jaw; the
nerve may then be drawn forward far enough to enable the operator
to excise it and remove all that portion which lies within the canal.
To prevent its reproduction I have after removing ?t made
use of a bur and thoroughly removed the inner walls of the canal,
which procedure has happily terminated in the formation of an
exudate which in turn ossifies and permanently closes the inferior
dental canal and thereby renders the reproduction of the nerve im-
possible.
PROCEEDINGS OF SOCIETIES.
Illinois State Dental Society.
(Continued from page .313.)
Discussion of Dr. Case's paper on "Orthodontia" {see page ^ji).
Dr. J. J. R. Patrick: Mr. President — When I came here I did
not expect to be called upon to open the discussion on " Ortho-
dontia " or I should have brought with me a couple of models sim-
ilar to the ones exhibited by Dr. Case. The appliances for regu-
lating the teeth are more numerous than the teeth themselves.
Some years ago, after studying the different appliances that had
been in use during the last two hundred years, I conceived the idea
of constructing an appliance that would be universal in its applica-
tion, without the use of plates or the phosphates to retain it in
place. An appliance that could be removed, cleansed, and put back
in a few minutes. There is a cut and description of the appliance
in Dr. Guilford's work on " Orthodontia." There is nothing new
in the appliance, with the exception that it is a combination of all
that has been used before; and the use of plates and cements are
dispensed with. But since we are on the subject, I will make a
few remarks as to the origin or cause of this class of deformit}' —
that is protrusion or anteversion of the teeth of the superior
maxillary.
560 • THE DEXTAL REVIEW.
Anteversion of the teeth of the superior maxillary never occurs
with the deciduous set but is confined to the region occupied by
the succedaneous teeth. In the majority of such cases the fault
exists in the inferior maxillary; the horizontal ramus being too
short, and the angle of the ascending ramus too acute; the lateral
excursion is limited, but the movement from the posterior to the
anterior is often almost equal to the rodent?.. The condyles of the
jaw in such persons can be slipped forward in the glenoid fossa,
which becomes elongated to the anterior, changing the form and
reducing the articular eminence by co-relation. This anterior ex-
cursion of the jaw is accomplished with rapidity and without in-
convenience. Whenever the lower jaw presents this conformation
the upper has all the appearance of anteversion, which is, however,
more apparent than real. A case in point to which I desire to call
your attention (exhibiting the models), will illustrate this char-
acter of deformity : Both jaws are laterally constricted, so that
the occlusion of the molar teeth is fair and could not be much im-
proved, the lower anterior six teeth close inside the upper at least
one-half inch when the molars antagonize. I removed the first
superior bicuspids right and left, and then waited two months to
allow time for the formation of new bone in the root cells of the
process from which the teeth were extracted. I then attached my
appliance to the first molars, the bow spring embracing the ante-
rior teeth, and by the aid of the buckle screws drew the bow spring
to the posterior, drawing the anterior teeth with it, gradually from
day to day. The operation produced no pain, the first molars to
which the appliance was attached remained firm, from the fact that
a very small amount of force was used at one time, but the force
was persistent and renewed from day to day without causing in-
convenience. In the course of four months the anterior teeth were
moved back evenly and compactly until the two cuspid teeth rested
against the second bicuspids, closing the space, produced by the ex-
traction of the first bicuspids. In this condition the appliance was
allowed to remain for two months, it was then removed and re-
mained off for one month, at the expiration of that time the ante-
rior teeth had moved forward about two lines. The appliance was
again adjusted and the teeth screwed back and retained in place
for three months and then removed. One month later I examined
the mouth and finding the teeth had not moved forward the patient
was dismissed.
PROCEEDINGS OF SOCIETIES. 5GI
Dr. Brophy: I would like to ask Dr. Patrick if the arch
corresponds with the teeth below ?
Dr. Patrick: My experience is, that in all deformities such as
I have attempted to describe, the lower jaw is more in fault than
the upper, the deformity in the upper is brought about by co-rela-
tion by the movements of the lower upon the stationary upper,
and as a consequence the arches do not correspond nor can they
be made to do so. It is an easy matter to move teeth back to a
natural or more seemly position, but where the malposition has
been produced by the action of a deformed lower jaw, it becomes
exceedingly difficult to retain them in their new position.
Dr. L. L. Davis: Don't you find trouble in attaching to the
first molar by its tendency to move forward ?
Dr. Patrick: The first molar is the first tooth of the perma-
nent set to develop, it is the largest and strongest of the permanent
series and is in actual use longer than any other tooth, it is there-
fore the most desirable tooth for anchorage. The cause of the
trouble experienced by operators in displacing the first molar, is in
the operator and not in the molar; operators are as a rule impa-
tient of results; they expect to correct a deformit}' in a few weeks
that it has taken years to produce.
Dr. H. J. McKellops: These cases are interesting to every
one of us, and I am glad to see so much attention paid to them. I
do not suppose there is a dentist within the sound of my voice who
does not have from time to time some of this kind of work to do.
I have taken a great deal of interest in this work, and the more we
can simplify the appliances, the better it will be for us.
When I was attending the Southern Dental Association in
New Orleans, Dr. B. S. Byrnes, of Memphis, not only brought all
of his impressions down there, but the patient, to show what had
been the result of his work. Since that time I have had three
cases of pushing back of the upper teeth, and in one case they were
separated so that a lateral incisor could have been placed between
the front teeth. The little girl was fifteen years of age. In one of
the cases the lip was drawn close under the nose so that it was im-
possible to close the lips. Byrnes appliance is very simple for the
correction of these irregularities, and that is what we want to get
at, to do things so that every man can do them. I am sorry I did
not bring some of the bands with me. After you get the model
study your case, fit the band to the molar and the cuspid. The
563 THE DENTAL KEVIEvV.
first motion is to move the cuspid, which is more stubborn than
any other tooth to move and takes more pressure to start it.
Placing a little rubber between it and the lateral (the first bicuspid
being out) causes it to 3'ield more readily. Place a gold band
around the first molar and the cuspid — with a pair of pliers
prepared for that purpose — crimp the gold a little every day. This
brings the cuspid back to the second bicuspid. When this is
accomplished I then attach a band around the anterior teeth and
crimp that also every day until I bring them back into position.
A Member: What gauge of gold do you use ?
Dr. McKellops: About No. 30. Gentlemen, I assure you that
this method is worth trying. If you had seen the models and the
patients to whom I have applied this method, you would think
very much more about it. I had Dr. Byrnes come to St. Louis to
show this thing.
In bringing the two front teeth together, I take a fine gold band,
put it around them, and start them in the same manner. As soon
as I get these together I put my band around, commence my crimp-
ing on each side so that the child never feels any pressure or in-
convenience.
Still, with ever so little discomfort, they will take it out, throw
it out, or drop it on the street, and worry the soul out of a man in
trying to keep it in the mouth. This takes time, as Dr. Patrick
has said. It takes at least a year or fifteen months before you can
get the mouth in a perfect condition. It requires patience and
time to accomplish it, and you should value your services accord-
ingly.
Dr. a. E. Matteson: Is not that method more applicable to
young than older patients ?
Dr. McKellops: I think it as applicable to both.
Dr. H. a. Costner: Would not rubber bands do as well?
Dr. McKellops: No.
Dr. Costner: Why?
Dr. McKellops: Because there is too much pressure all the
time. Rubber bands would cause irritation, and with the crimping
process there is very little pressure. You can have a screw put on
the side, and with it you can tighten the band a little every day. I
you apply rubber bands you will have constant irritation.
Dr. J. H. WooLEV: What objection is there to cementing on
the band so that it will remain ?
PROCEEDINGS OF SOCIETIES. 563
Dr. McKellops: I want to teach patients cleanliness, to get
rid of the dirt and microbes that are in the mouth and to keep the
plates and everything else in the mouth clean.
Dr. E. D. Swain: Mr. President, any method of accomplish-
ing the difficult operations that are presented to us is of course of
interest to us all. About ten months ago a young patient was
brought to my office presenting nearly the same conditions as ex-
plained by Dr. Case, of the lateral incisors striking the gum margin
at the necks of the superior central incisors; in fact, the lower in-
cisors left quite a mark in the soft tissues. The patient was four-
teen years old. I recognized the fact that nothing could be done
until the lower incisors were removed in some manner, from pro-
ducing pressure on the superior incisors. I simpl}^ took advantage of
the well-known fact that at that age if pressure is removed from
molars and bicuspids they will elongate of their own accord. I
capped the molars and much to my gratification the bicuspids in
about four months were in antagonism, they had elongated suffi-
ciently to take up the distance which the teeth were thrown by the
caps above the molars. I removed the caps. When I saw my case
some two weeks ago the molars and bicuspids were in antagonism,
and the points of the lower incisors were at least the twelfth of an
inch from the palate, and one-fourth of an inch from this point (illus-
trating) to the rear. I am now ready to put on my appliance to
bring the superior incisors back to their place. There is space
enough in this case between the upper incisors, that is, the anterior
teeth, to allow of their being brought back in the proper position
without extraction.
Dr. a. E. Matteson : I have two cases of irregularity which
I had under my care early this spring. One of them was a young
lady, eighteen years of age. The central incisors were occluded
just inside of the lower as represented in A, Figs. 1 and 2. The
appliance used is simple, as you will see, and rather after that of
Dr. Angle's system. After using and turning the screw, the teeth
were brought forward, they had been worn so short it was neces-
sary to elongate them. All that I did was to use the same appli-
ance by bending the wire toward the cutting edge, the spring of
it drew the teeth down. A, Fig. 3, shows the case a month after
the appliance had been taken off. The appliance was worn six
weeks.
The other case (B, Figs. 1, 2, 3,) was that of a boy aged thirteen
564
THE DENTAL REVIEW.
years, with the left central and lateral incisors occluding within the
lower teeth — the bicuspids standing within the arch — nearly their
width — and the left second bicuspids twisted fully 45° and the
whole arch contracted.
The management was as follows:
PROCEEDINGS OF SOCIETIES.
565
566 THE DENTAL REVIEW.
The first right molar and first right bicuspid were banded. On
the lingual side of the bicuspid was soldered a short tube. One
end of screw-cut German silver wire (No. 20 gauge) was soldered
to the band on the molar — the other end passing through the tube
on the bicuspid band.
On this wire screw between the bands, was placed first a nut
then a T tube and in front of the T tube and of the band of bicuspid
another nut.
The left central was banded with "gold platina " plate with a
lug on the lingual surface.
The left second bicuspid was banded and a short tube on the
buccal, and a long T tube on the lingual surfaces, was soldered
transversely.
Schomacher gold-plated piano wire (No. 10 gauge) was formed,
the ends passing into the openings of the T tubes and in contact
with the central incisor above the lugs.
This piano wire was supplemented with another (No. 14) and
united by winding with fine wire and soft solder. The free end of
this wire (No. 14) forced out the lateral.
The second bicuspid was rotated by changing the angle of the
piano wire where it entered the tube of the left bicuspid.
By turning the nut which is back of the loose T tube forward
the pressure was brought against the central and lateral. This
also permitted the adjustment of the expansion of the arch either
in the region of the molar or biscupid. The nut in front of the
screw was used to draw the first biscupid back.
The tube on the buccal surface of the left biscupid band was to
lock, when in position with a pin.
The long tube on the inside of this band was to support it with
the contingency of cutting a thread on this end of the piano wire,
and with a nut, form a jackscrew to assist in forcing the incisors,
although the necessity for this did not arise. This piano wire which
I have mentioned is superior to any which I have used. It might
be improved by a heavier plating. It can be obtained larger than
I have mentioned but I have found No. 16 sufficient to expand the
arch of any case so far since commencing its use.
In regard to making these nuts for irregularity cases, having
found that cutting them out of solid nickel and German silver plate,
to be drilled, tapped and squared, a very tedious process, I have
simplified the method greatly by first draiving tubes of platinized
PROCEEDINGS OF SOCIETIES. 5G7
silver (one part platinum and two parts silver), soldering the joint
with 20 k gold, then drawing through a " square hole " draw plate,
inserting piano wire in the tube, thus making a square tube with a
round hole, then sawing off enough for a nut.
In regard to the use of plates or bands not cemented on the
teeth, I must differ with my friends, Drs. McKellops and Patrick.
I have 710 use for appliances 7vhick a7'e not fixed ; patients ta'/// take
them out and the next morning they cannot get them back. I
know of few more perplexing positions than to have a "kid" come
into my office with plate in his hand and my time for the day
engaged.
Discussion of Dr. Weeks' paper, entitled " The Enamel at the
Gingival Line." (Paper to be published in the August number).
Dr. G. V. Black : Mr. President and gentlemen, there is not
much for me to say upon this subject in the way of discussion.
You have had an illustrated lecture on dental anatomy in its rela-
tion to the placing of gold crowns, or collars, upon the stumps of
teeth. It is, so far as I know, the first clear elucidation of this
subject that has been given before this, or any other society, in
which the actual anatomy as it exists has been displayed so that it
could be readily seen and understood. Of course, this subject has
been explained through dissections of the teeth before, but not
thrown upon the screen in this way so that a whole audience can
see it at once, and our thanks are due to Dr. Weeks for his enter-
taining lecture. It is another object lesson in the further study of
dental anatomy, a subject, I am sorry to say, that has been most
wonderfully neglected in the practice of dentistry. When I look
back over the history of the practice of dentistry, I sometimes feel
amazed that this subject has been so long and so much neglected;
for we find every point in the anatomy of a tooth, even in the ex-
ternal form, markings of the external surface, and the relations of
its different tissues becomes important to us in our operations.
Some of our operations touch upon every point of the anatomy of
the tooth, and it is necessary that the anatomy, external and inter-
nal, be well understood so that when we look at a tooth we know
all about it.
Dr. C. S. Case: I am glad to have an opportunity to see the
pictures exhibited before us, giving a perfect outline of the ana-
tomical shape of the enamel, its gradual thickening, and its relation
568 THE DEXTAL REVIEW.
to the gingival border, viewed with the idea of using it as a guide
in the construction of artificial crowns. It convinces me that the
profession is gradually, if not rapidly, progressing to an apprecia-
tion of that which must come in the operation of crown work, viz.:
that the border line where the band joins the root will in time be
taken just the same care of in regard to finish and perfection at
the joint as it is to-day at the cervical border of gold fillings; and
until that time comes, until men are willing, are skillful enough, if
you please, to use the proper amount of time and skill for the per-
fection of that joint, just so long will we have the same exhibition
before dental societies relative to differences of opinion in regard
to crown and bridge work as we have had this afternoon. The dif-
ference between operations of crown and bridge work by different
men is just the same as the difference that exists between men.
The skillful man who is capable of doing work properly will be
successful. The man who expects to put on something that will
do as an apology for the purpose of making money will fail, and
that will always exist among dentists.
Relative to the border line of the enamel, I was pleased to hear
Ur. Weeks emphasize strongly some of the points that I endeav-
ored to make in a paper read before the First District Dental
Society, of New York City, last winter. If any of you read that
paper — it was printed in the Dental Cosmos — you are aware that I
was severely criticized with regard to some things that I said.
I believe it quite desirable, in the first place, to use a mate-
rial for bands that is thin enough and soft enough so that one may
be able to burnish it to perfectly fit the root of a tooth; and that
the border of the band be smooth and finished after the work is
done. It should also take its proper relative position to the gum-
line; extending under the free margin only so far as to prevent food
from lodging along the border of the band. That is not always
possible if we follow the original position of the natural border of
the enamel of a tooth, as shown by the pictures, because in many
instances where we crown teeth the gums are absorbed far beyond
the position of the border of the enamel; and I consider it impor-
tant that the border of the gold should follow- a relative distance
under the free margin of the gum rather than follow always the
line of the enamel. Still, if the gum has not receded and is in its
normal condition, there could be no better place to put the
PROCEEDINGS OF SOCIETIES. 569
border of a band than exactl}' where the border of the enamel
came.
In regard to the removal of enamel and the instruments used
for that purpose, j'ou are all aware, as has been suggested here,
that it is quite difficult to remove enamel in large portions that js
not first disintegrated; whereas, if its integrity is first broken by a
proper instrument, it will readily chip away. I find that the instru-
ment for this purpose should be intensely hard, as hard as steel can
be tempered. That is the important feature in regard to an instru-
ment for removing enamel in the same way that it is important to
have a diamond for cutting glass. The diamond does not cut into
the glass, it passes over it; and simply because it is so much harder
than glass it cracks the surface and sends a crevice far beneath
into the brittle substance. If the sharp point of an intensely hard
instrument is drawn over the surface of enamel in the same way it
will crack and disintegrate it; then the side or blade of the instru-
ment can be turned on the enamel and there will be no difficulty in
removing it. Some instruments made with this idea will soon
be manufactured.
Dr. J. G. Dickson: That it should be necessary to discuss a
question like this is a source of never-ending surprise and wonder
to me. Those of you who received your first lesson in dentistry
twenty or twenty-five years ago, will remember that there was a
fundamental principle that underlay the whole question and in-
volved this: In proportion as teeth need treating, conservative
treatment should be applied. If a tooth requires to be filled, the
joint must be so perfect as to hermetically seal the cavity. What
would you think of a man going into a canning establishment and
arguing for the hermetical sealing of fruit? Here we are
discussing the proposition of hermetically sealing up a tooth that
is impaired, b}^ whatever process of nature, it matters not. It
appears as if the profession did not know that these things were
agitated in years gone by. Of course, where you seal up the
stump of a tooth you do it so as to render it impervious to the
products of heat, moisture, and atmosphere, you produce as
natural a condition as possible. Will you do it with cement?
You cannot do it with cement. You must do it with metal, some-
thing that is indestructible under the conditions which produced
the caries or impaired its better condition. And so I say it is a
source of wonder to me and astonishment that a liberal profession,
570 THE DENTAL REVIEW.
and one claiming foundation in exact science, should go back and
touch up the question of perfect joints in the crowning process.
Dr. Noyes: I fear Dr. Dickson his been laboring under a
slight misapprehension. We have not been discussing the sub-
ject of which he speaks exactly. Nobody ever questioned that
crown bands should fit well, but we all recognize the fact that it is
not always a perfectly easy thing to do, and these discussions relate
to the necessity of doing it, and to the conditions, relations and
methods of accomplishing it perfectly.
Dr. Case: I am glad Dr. Noyes has awakened me to that par-
ticular point. I meant to express myself a little more fully. When
I was on the floor before, I neglected to say a word in regard to the
border of the band. I endeavor to have it thin at the edge, then
gradually thicken if possible in the same way that the enamel
thickens. I do not always succeed in bringing out a thickening of
the metal in the same way that Dr. Weeks suggests in following
the line of the enamel surface, but I always endeavor to follow the
contour of natural forms in making crowns, believing we can have
no better guide if we wish to arrive at the most perfect results.
Dr. William Conrad: I would like to ask Dr. Black if the
restoring of the contour of a band in a porcelain face crown is a
theoretical or clinical necessity.
Dr. Black: I think it is both a theoretical and clinical neces-
sity.
Dr. Conrad: I see I understand the gentleman correctly, but
fearing that I might not have done so, I asked the question.
In quite a number of years experience in constructing the va-
rious kinds of band crowns, I have not met with the necessity of
increasing the thickness of bands for porcelain face crowns, nor
going to the extreme our friend Dr. Weeks represents upon the
screen. It is my experience if the edge of the band comes in con-
tact with the root nearest to the process, and this portion of the
band being smooth and thin it matters not whether the band is
contoured to the original outline of the enamel or not. If you will
watch your cases for a sufficient length of time I believe you will
see I am correct. The slight difference in thickness given to the
band in an effort to contour it will have no effect upon the perfect-
ness of the work when compared with the cases where no effort
has been made in that direction, provided the band fits the root
equally in both cases and the edge that comes next to the process
PROCEEDINGS OF SOCIETIES. 571
is smooth and thin. In my practice I never use for bands gold
thicker than No. 30. I desire to say a word in connection with
that portion of the subject spoken of by Dr. Weeks and represented
upon the screen, where he insists upon following the festoon of
the gum where you place a band upon the root in the most extreme
cases. If you place a band upon a root that is straight across,
without regard to the festoon, and leave it there for a while, nature
will protect itself at that point, and 1 believe in such cases you will
have a much more secure fit. I do not think you will have as good
a case if you try to follow the festoon of the gums, and if 3'ou try
it in an extreme case you will have a defect rather than a benefit
as the result.
In reference to the removal of the enamel, if you cut that por-
tion of the enamel in a perpendicular rather than in a horizontal
direction you will find it can be removed more easily.
Dr. Weeks: What advantage is there in using a straight band
in festooning and inviting absorption of the process which we must
have at that point ? I would like also to ask Dr. Conrad if he has
such a physical condition in his patients as will insure a perfect
action of the absorbents and the restoration of tissue?
Dr. Conrad: Clinically I have had to use a much straighter
band than I would use if I tried to follow out the original festoon
as marked. We are dealing with cases where the original festoon
will lose its outline in time. I find that if you do not try to fol-
low the festoon too closely you will have a more secure tooth and
better results will follow. The reason I use a straighter band is
because I get a better and tighter fit, and that is what we want in
crown work.
In regard to the other question asked by Dr. Weeks, I have no
special physical conditions in my patients, other than that which
is present in all mouths, when roots need crowning. The conserva-
tism of nature is such, she will help us out of many difficulties,
provided we give her a chance. Take time and the absorbents will
act properly, and the restoration of tissue will not be hindered to
the disadvantage of the work on hand. Nature takes care of these
things kindly, unless there is a complete absorption.
Discussion of Dr. Newkirk's paper on "Antiseptic Dentistry,"
{see page sjj). %
Dr. J.G. Reii) : This subject has been elucidated in such a man-
ner that no member of the society can be mistaken as to what is meant
572 THE DENTAL REVIEW.
hy antiseptic dentistry. The author of the paper has told us how to
practice it, but he mentioned nothing about practicing antiseptic
dentistry- from a medical standpoint. That is the fault of many pa-
pers that have been read, they merely allude to it, but do not explain
to our satisfaction how they. would and ought to do it. One thing
regarding the mechanical treatment of antiseptic dentistry is, that
the "teapot" is not exactly strong enough to do what it ought to.
As I understand it, boiling water does not destroy germs. It may
destroy some germs, but it does not destroy the spores of germs.
If we could arrange some kind of- a receptacle by which we
could get heated steam, we could not get anything better as an an-
tiseptic agent, because it is an absolute disinfectant, but I hardly
think that boiling water of itself is an absolute disinfectant. It has
been stated that if dentists take an instrument and dip it into some
antiseptic agent, it will destroy germs. It will not do it. We may
take the strongest agent we have, for instance bichloride of mer-
cury, dip an instrument into it, then wipe it, and we would have to
do this at once, because the solution would affect the instrument,
but at the same time this would not destroy septic matter. I speak
of this as an illustration. It requires some little'time for the action
of these agents. If we expect to destroy diseased germs by medic-
inal agents, we have to keep our instruments in those agents
continually. That is not always a convenient thing to do, but
it is the proper thing to do. Water will answer the same
purpose exactly. We may take a broach from a pulp canal, use
it for a while, lay it down on the operating table, let it remain five
minutes and it becomes dry ; dip it into some water, wipe it off,
and then put it away. A good many call that cleanliness. We
might as well have laid the instrument aside as used originally as
to have done that. What I wish to impress upon you is this, that
we should go beyond what the essayist has recommended.
Dr. G. V. Black: I do not care to enter into the discussion
of this paper at any great length. I must say that I commend it
as being correct, and I desire simply to reinforce the paper by the
recital of a few cases that have come imder my personal observa-
tion of infection which threatened life. While the essayist was
reading the paper I hurriedly noted from memory some cases in
which life was threatened from infection. I am not engaged in the
general practice of surgery, although I am somewhat close to it. If
I were, I might recite many more cases perhaps. Some of these
PROCEEDINGS OF SOCIETIES. 573
cases are properly surgical cases. The first case that occurred to
me was that of a boy who rubbed his heel with his boot. The
parents noticed the next morning that the boy was in trouble and
sent for a physician who lived some ten miles distant. The physi-
cian after examining the boy came to my office and related the case
to me. It seemed so serious that no time was lost. Instruments
were taken for amputation, but too late. The boy died some hours
after of gangrene of the most virulent type.
Dr. Brophy: How long did the trouble exist?
Dr. Black: He died the same night. This is, of course, a
remarkable instance occurring in the countrj' as it did.
Another case was that of a child that had a slight burn on the
wrist and was crawling about on the floor. The sore had been
partially wrapped but became uncovered and the child got erysip-
elas. The child was sick six weeks, the er5^sipelas passed over the
whole body, except a portion of the head, even down to the ends
of the toes.
Another case of infection. A child had fallen, striking the chin
against the doorstep, crushing the teeth together with great force.
Alveolar abscess occurred which was not recognized by the physi-
cian. Extensive necrosis of the jaw followed in this case. I had
to remove much bone, and the crj'pts of all permanent teeth from
the lateral incisor back on the one side, and a numbei of them, not
so many, on the other. The first bicuspid on the other side may
be retained, but everything back of that was removed. Metastatic
abscesses opened on the sides of the face and neck with not a
prospect of recovery. This may be set down as a case of infection.
A young lady, from whom was removed a considerable osteoma
of the lower jaw, went home three weeks after the operation.
The wound had not quite healed. Two weeks later she returned
with septicaemia, with a temperature of 102°. Metastatic abscesses
occurred in the angles of the neck as in the last case. Two or three
abscesses occurred in the floor of the mouth. The swelling of the
throat and neck in this case was so serious as to threaten suffocation.
I could collect many cases of infection by dental instruments.
Another case is that of a minister who went to a barber shop to
get shaved, and had a beautiful face on him afterward. He was
six weeks out of the pulpit before he found out what was the mat-
ter. There was considerable irritation of the skin, in other words,
it was a very serious case of barber's itch.
574 THE DENTAL REVIEW'.
These cases have occurred recently, and I simply relate them
to enforce what has been brought out in the paper.
Dr. T. L. Gilmer: I was much pleased with the paper, and I
think it is a good one to be placed into the hands of our assistants,
so that they may know more of the dangers to which patients are
liable. It would, perhaps, stimulate them to a greater care of our
instruments. I do not depend wholly upon my assistant for the
care of instruments, but it is a <\\xiy which should largely be put
into their hands.
Dr. Newkirk did not speak of special medication. I presume he
preferred to treat the subject in a general way, allowing the dis-
cussion to bring out other points.
I wish to show you a receptacle which I have used for a number
of months for the purpose of keeping broaches in an aseptic con-
dition. I am associated in an office with a physician, and some
months ago he purchased some wooden bottles for dispensing tab-
lets, and I conceived the idea that if I were to thoroughly saturate
these wooden bottles with the oil of cassia, and after thoroughly
cleansing my broaches, place the broaches in them, I might be
able to keep them in a better condition than if they were kept in
my operating case or in a glass vial. You will find broaches in each
of these bottles, and if they are taken out you will discover they
give off a strong odor of oil of cassia. Perhaps they are not
thoroughly aseptic, but they much more nearly approach it than
they would be if not subjected to this diffusive medicament.
Dr. C. a. Kitchen: In connection with the remarks of Dr.
Black, I will speak of a case that occurred in Rockford in which
Dr. Taggart lost his life by having a slight scratch in performing
an operation. Dr. Fitch nearh- lost his life by a similar occur-
rence.
Dr. T. W. Brophv: In the city of Chicago a few years ago a bril-
liant young physician lost his life in the same manner as Dr. Tag-
gart, of Rockford. The gentleman was Dr. Hibbard, son of one of
our most prominent citizens. All efforts to save him were una-
vailing.
There is one practical lesson that may be learned from this pa-
per with reference to the use of broaches. The essayist did not
speak of it in particular, and that is, a great many operators are of
the opinion that if they make use of a broach which is thoroughly
disinfected and is truly aseptic, it is sufficient. Let us take, for
PROCEEDIXGS OF SOCIETIES. 575
instance, the upper molar tooth the pulp of which has died and
the contents are of such a character as to infect the broach. We
introduce a broach, that has been thoroughly sterilized, into one of
those canals and then possibly carry it into another canal in which
the pulp is not thoroughly devitalized. We meet with many such
cases. The palatal root is devitalized, one of the buccal roots is
devitalized, but the other buccal root is not. By this procedure we
may infect the part so as to lead to trouble. I have seen
cases of infection that have been a great source of trouble.
It teaches us a lesson, namely, that the operator should use at least
three broaches, one for each canal, in operating on teeth which
have three roots, each broach sterilized, and by so doing we ma}'
proceed with the least danger of carrying infection from one canal
to another. The same reason exists why each instrument should
be sterilized when using them in the treatment of teeth having
two or more canals as there should be in carrying them from one
patient to another. That is a fact often lost sight of in the man-
agement of pulpless teeth, or in the use of broaches, in their treat-
ment.
I am very glad that I heard the paper this afternoon because it
is full of good things. It has gone into the matter in a general
wa}^ I do not think the paper is incomplete, as has been
stated, because the essayist was frank in the statement that he did
not desire to enter into the details of antiseptic surgery pertaining
to the teeth and associate parts, because that would be brought
out in the discussion. It is a paper that may be taken to our
homes and read and studied, and a great man}' things contained in
it can be put into practical use from day to day.
Dr. J. G. H.\RPER : The bottles mentioned may be too expen-
sive to keep burs and other instruments in. Very little of the oil
of cassia would disinfect or kill most any germ if shut up in a room
with it.
Dr. a. W. Harlan : The paper is in the right direction and is
well timed, and if I can say anything to emphasize it I will do so.
The question of treating cases antiseptically and of treating every-
thing that you handle antiseptically is growing in importance. Very
soon I presume that every dentist in the United States — in fact in
the civilized world — will try not only to use disinfected instru-
ments, but will try to make every operation as nearly aseptic as
possible. The question of the disinfection of instruments is really of
576 THE DENTAL REVIEW.
more importance to the practicing dentist than some of the minor
questions, as the care of napkins, rubber dam, cuspidor, etc. Of
course an unclean cuspidor lis a nauseous thing to look at and
smell of, but the patient does not take its contents, and does
not handle it, so that he does not become infected in that way.
It is in the use of unclean forceps, clamps, knives, burs and broaches
that the greatest danger lies. The ordinary barbed broaches are
so cheap that when I use one I throw it away, that is the cheapest
way to disinfect that kind of broach. The smaller broaches are
easily disinfected either by heat or hot water to begin with, and
then soaking them in some solution. What solution ? I prefer a
solution that is not odorous, one that can be made with water in
preference to an oil for that purpose. For all the usual purposes
of sterilizing instruments a ten per cent solution of boro-glycerine
in water will disinfect your forceps, broaches and cutting instru-
ments, and will leave them without a bad smell. That is one solu-
tion that may be used. A saturated solution of the silico-fluoride
of sodium, which is a cheap drug, can be used to disinfect instru-
ments after they have been cleaned, and there is no odor or taste
to it. I use both of them. I make these solutions instanter on
the desk from time to time. Of course, there are a great many
different agents that may be used for disinfecting instruments, but
I prefer to limit them to those that are soluble in water.
I know of a good many cases of infection of patients from the
use of unclean instruments, and especially the kind of infection that
Dr. Brophy has spoken of where there is a portion of the pulp left in
a tooth and other portions have been removed from the other roots.
This will explain to you why we have an alveolar abscess following
the introduction of a clean instrument. I have under my care at
the present time one of the worst cases of blood poisoning I ever
saw, but I am happy to state that the patient is out of danger. This
was due to the slow formation of an abscess from one of the buccal
roots of a molar tooth that had been filled for more than ten years.
The palatal root had been filled and the other buccal root was filled,
and one was not, and I presume the remains of the pulp were left
in there and there was the gradual formation of an abscess and it
did not open externally because it was of such a low grade, and
finally the patient had all the symptoms of septicaemia. Her hus-
band spoke to me and assured me that his wife had some trouble
with her teeth, and I told him to have her come down to my office.
PROCEEDINGS OF SOCIETIES.^ 577
She came down and I realized the danger she was in, and with the
prompt cutting in and opening of the abscess, which was very large,
although there were no external evidences of it, and the dressing of
the interior antiseptically and putting her into the hands of a med-
ical man who treated her constitutionally, in four or five days she
was in a very much better condition. But her wrists and all the
joints of both hands and jaws, knees and ankles and toe joints and
pretty nearly every portion of the locomotor apparatus were so
affected that she could hardly move, in addition to the other symp-
toms of blood poisoning. Of course, strictly speaking, that only be-
longs to antiseptic dentistry in a degree, but if the remains of the pulp
had been removed from that root and the root had been filled, she
would not have had these symptoms and the consequences.
Dr. E. D. Swain: I have little to say on this subject beyond
relating some of my own experience to demonstrate that we are
ourselves sometimes in danger as well as our patients; also as to
how small a quantity of the matter is necessary to make severe
trouble.
In preparing for treatment an upper molar similar to that
spoken of by Dr. Brophy, and later by Dr. Harlan, with one of the
Donaldson broaches, a very fine broach, after using it I laid it
down upon my table with the point extending over the edge, and
in reaching for another instrument, without paying particular atten-
tion as to where my hand was going, I barely pricked the joint in my
little finger, not sufficient to make it bleed. In a very few hours
this joint was badly swollen. The pain was extending up my arm.
I spent a sleepless night, and in about thirty-six hours from the time
the injury occurred I went to a surgeon who made extensive cuts
in the arm and put me under rigorous treatment. This simply
shows that we are liable to infection ourselves.
Dr. Ira. B. Crissman : I want to thank Dr. Newkirk for the
excellent paper he has read and for the many suggestions it con-
tains. I may be a crank on this subject, a very good subject to be
in earnest upon ; it is one of the greatest importance to us as
dentists to remember. The question is, do we practice what we
preach in regard to the disinfection of our instruments and the an-
tiseptic preparations used? Some of us do, others do not. How
are septic matters carried ? B}^ unclean instruments, careless op-
erators, neglectful assistants. How many dentists in this room
clean that little instrument attached to the dental engine, the bur
578 , THE DENTAL REI/LIV.
brush ? One bur is used, laid aside, and then another is taken, but
are they kept clean ? No. The bur is filled with dried decay, how
easy to store infectious' matter. The first patient on whom the
dentist operates may have syphilis, and if the instruments he uses
are unclean, and not sterilized and disinfected, infection is liable to
follow in operating on other patients. Some dentists neglect to
clean their instruments because they are in a hurry, but that is no
excuse for a man not properl}' taking care of his instruments.
Necessit}' forces us oftentimes to be in a hurry. Being in a hurry
is no excuse for a man not properly cleansing each instrument.
We go from one patient to another, and because we have several
patients to attend to in succession, we do not follow out the rule
we should in the matter of cleanliness. Here is an example:
A lady came to my office who had previously called on another
dentist in Chicago. He invited her into his operating room imme-
diately after dismissing a patient. In looking on his dental tray
she saw excavators, broaches, etc., with decayed matter on them.
This disgusted her, and she walked out of the office and did not
return. She said she would not submit herself to those influences
which she knew were wrong ; that she would not allow any dentist
to use an excavator on her teeth that had been previously used
upon another patient without being sterilized.
Another case. Before I started for this meeting, a gentleman
came into my office and wanted a left superior first molar extracted.
I took my forceps and extracted it. After the tooth had been ex
tracted, the gentleman leaned forward to rinse his mouth out, and
my boy noticed his neck and called my attention to the condition
it was in. There were two syphilitic patches on his neck as big as
a half dollar. Supposing I had not carefully cleaned and disin-
fected that instrument, I might have carried syphilis from that pa-
tient to the next one operated upon.
In regard to keeping ourselves clean. The idea of a man op-
erating with his finger-nails dirty, not washing his hands before at-
tending to each patient, using soiled towels. Is that cleanly?
Ask yourselves that question ?
Then again, some dentists will use one side of a napkin, turn
it over; and then use the other side; in some instances the napkin
being covered with blood and stains, soiled and filthy napkins on
the head-rest.
A word in regard to the mouth mirror, that little instrument
PROCEEDIXGS OF SOCIETIES. 570
that lies on the bracket, so often used, never out of use. It is
very rarely given a bath, seldom wiped, and as a consequence the
patients have to suffer.
Another point I desire to speak of, and that is the tooth brush
that is used in the dental engine to clean teeth. How many men
will use this little tooth brush covered with salivary calculus, blood
and rust, pass it from one patient to another, because they are
too infernally stingy (if I may be permitted to use such an expres-
sion) to use a new one ? Any man who will use the rubber dam a
second time, punctured with holes, washed or not washed — well, I
don't know what ought to be done to him; decide that for your-
selves. Another case of a small, mean, stingy man.
I thank Dr. Taggart to this day for the instruction I received
while under his care as a student. He swore at me many times
for neglecting these matters of so great importance, for which I
give him credit. (Laughter.) If any man would come into m}^
office and say, "Dr. Crissman, you are not cleanly enough about
j'^our work," or this or that duty was not as it should be performed,
I would thank him for it.
Dr. Garrett Newkirk, in closing the discussion, said: I hardly
think I could add much to what has been said. Dr. Reid, as I un-
derstood him, asserted that boiling water would not disinfect instru-
ments. I think that the experiments of Dr. Miller, recently pub-
lished show that the introduction of instruments into boiling water
for five or six minutes will almost invariably disinfect them. I
wish to call attention again to that kettle which I mentioned. I
had the tinner make two tubes reaching down into the bottom, one
of which I use for dry heat and the other for sweet oil impregnated
with a little of the oil of cassia or other disinfectant. My assistant
puts the instruments into the boiling water,then in the dry chamber,
then in the oil, after which they are wiped and laid awa\'.
I was very glad to hear the report of cases by Dr. Black and
others which emphasized the importance of this subject, also that
by Dr. Swain showing how a very minute puncture with a fine
broach, which did not even draw blood, had produced such a se-
rious effect upon himself. I was glad to hear him call the attention
of the practitioner to the danger to which he is exposed.
Dr. Harlan criticised me a little because I paid so much atten-
tion to matters of minor importance, such as clean cuspidors, nap-
kins, etc. I assume that the cultivation of cleanly habits is a very
580 THE DENTAL REVIEW.
important thing in relation to this subject. If he is careless with
reference to these matters, he will quite surely be careless with re-
ference to disinfection. One is cleanliness, and the other is simply
surgical cleanliness, and we cannot cultivate too much the habit of
cleanliness in every respect. The little bottles shown by Dr.
Gilmer will answer a most excellent purpose for keeping our burs
and broaches. I cannot imagine how broaches could be otherwise
than aseptic if cleaned beforehand and kept in such a box.
I was glad that the attention of the society was called to
this fact, that although a broach be perfectly aseptic, if it be passed
through a root of a tooth it immediately becomes septic and will
infect the tissues beyond if it is permitted to touch them, or it
may do so without touching them, providing matter is forced
beyond the apex of the root, and it may be well to emphasize
the fact right here which has been so often brought forth that
we cannot be too careful about introducing any instrument into
the root of a tooth until we have first thoroughly treated it for a
number of days so that its contents are disinfected.
Discussion of the Report on Dental Science and Literature {see
page 552).
Dr. J. G. Dickson: I desire to discuss this paper briefly,
relative to the time required to graduate in dentistry. I would
like to know if there is a college President or professor here who
would like to take a student indiscriminately and agree to graduate
him in any specified time. Can you make a dentist out of any-
thing ? That is the question. If you can't do it, there is no use
talking about specifying the time. If you can make a dentist out
of any man in a given time there must be a mechanical process
about it. When you are dealing with mind there is such an in-
finite variety of it, that it is impossible to prescribe a limit of time
in a dental school. There are persons who will grasp the situation
in a moment ; there are others who will require a great deal of tell-
ing and they will ask many questions which have no direct bear-
ing on the question in point at all. That grows out of a lack of
proper habit of thought and this touches the condition of mind
of which I speak, and it also has to do with the time in which
a man may attend a dental school and pursue a course of study;
therefore I say it is absurd to attempt to prescribe time for study
and for graduation. In all reasonableness it seems to me a ques-
PROCEEDINGS OF SOCIETIES. 581
tion of competency solely. I know of competent men who never
saw the inside of a dental school, and I know of men who have at-
tended college four and five terms and have not graduated. Again,
I know men who have graduated but are certainly incompetent to
say the least, so that it seems to me an unreasonable thing to limit
the time, and it would be more equitable to require competency
and not time as qualification in this matter.
I Dr. C. N. Johnson: I wish to say a few words in regard to the
report of the committee. In answer to Dr. Dickson it may be
stated that no reputable college will guarantee to graduate a stu-
dent in a specified time. It is not a matter of time but of qualifi-
cation. Most of the colleges prescribe that no man shall be
graduated in less than three years. This is as it should be. It is
not possible for the brightest men to be competent to practice their
profession in less than three years, and it will be longer after a
while when the profession is more educated. I do not think
Dr. Dickson quite understands the situation. There are men who
come before our colleges for graduation at the end of three years,
and who fail. If they are not competent they will fail every time
they come up for final examination, if the colleges do their duty.
I heartily commend the recommendation in the report with re-
gard to dental journals. There is a place in the profession for both
a weekly and quarterly dental journal, and if the matter were prop-
erly brought before the profession I think it would be endorsed. I
am glad the matter has been mentioned.
I will now say a word or two in regard to the articles referred
to in Dr. Noyes' report, the articles that have been appearing in the
Dental Cosmos on "Methods of filling teeth." Dr. McKellops re-
ferred to them incidentally this afternoon. I want to say, in passing,
that I regret that the gentleman who wrote those articles is not my
personal friend. I am sorry he is a stranger to me. If he were a
friend of mine I should feel like expressing very freely my opinion
of much of the teaching in those articles. Dr. McKellops has
criticised one point. I think the number of points that might be
criticised are limited only in a slight degree by the length of the
articles. But for me to attack the theories advanced by the
author under existing circumstances might seem like taking an
undue advantage by firing at a false prophet at long range. If
the gentleman were here I should like to take issue with him
on many points.
582 THE DENTAL REVIEW.
Dr. Garrett Newkirk: Considering the disadvantages under
which tlie committee have labored, they have presented us with an
excellent report, and one that scarcely needs an apology. Dr. Noyes
has passed through serious trials during the year, and under the
circumstances his work has been done remarkably well. It is
worthy of commendation and publication, and comes as nearly fill-
ing the requirements of the committee as any we have ever had.
Discussion of the Report on Dental Art and Invention {see
page 547\
Dr. G. D. Sitherwood: I rise, not to criticise the report, but to
say that I was very much interested in it, and that I shall try some
of the things that have been suggested when I go home, to see
whether they are good or bad. We are benefited and instructed
by having our attention called to new things that have come up
during the year.
Just one other point I wish to speak of, and that is with refer-
ence to aluminum amalgam and aluminum foil. I have had no
experience with either, but I have had a long experience with
aluminum in plate work, and when properly manipulated it is a
success. There is no doubt in my mind about that. I intend to
try aluminum amalgam when I get home and see what success I
can make of it. An amalgam that will not shrink, stay bright in
the mouth, a plastic filling of that kind is worthy of attention.
Dr. Geo. H. Gushing: I desire to say a word in behalf of the
report. It is a good one. It is not expected that the committee
will know everything that has transpired during the year. We all
realize the great difficulty of getting information from the profes-
sion or the manufacturer of what they have as new,
Dr. H. J. McKellops: I approve very much of the report. It
is one that we all ought to feel proud of, and one from which any
man can learn after listening to it. There are a great many things
that are new, and they are advantageous to every one if they only
look at them carefully.
Dr. T. W. Brophv: I desire to call the attention of the society
to a new absorbent. It is called Lintine, manufactured by Johnson
& Johnson, of New York. I have a little piece of it here for you to
see. It is especially desirable as an absorbent for the removal of
moisture from cavities and as a material with which to keep dry
the gums or any part of the mucous surfaces within the mouth
PROCEEDINGS OF SOCIETIES. 583
while applying medicines. It is desirable also in excluding moist-
ure for the treatment of pyorrhoea alveolaris and such conditions
of the gums as require the exclusion of the saliva during the appli-
cation of a medicinal agent. It is exceedingly cheap and far more
efficient in its use than raw cotton or any other form of absorbent
material. It comes in bales like cotton cloth, rolled up. Three or
four yards will last for a long time.
Dr. J. G. Reid: It seems to me that as the committee has men-
tioned aluminum foil and aluminum amalgam, that here is the
place to demonstrate the results of what those materials will do.
This is one of the things that ought to have been provided for
under the circumstances. There might have been a clinic arranged
for the purpose of demonstrating it, and it could then be watched
closely from time to time. I have used aluminum amalgam, hav-
ing put in about a half dozen fillings with it, and shall watch them
from time to time. It looks very nicely and works well. I put
them in about three months ago. I have had no experience with
aluminum foil, and regret that we have to send direct to Meadville
for it, it not being procurable in the dental depots. I hoped that
we could get some of it here in order to have a clinic.
Dr. W. a. Stevens: I would like to hear from some meijibers
to whom the committee refer as to how long they have used alumi-
num amalgam and aluminum foil, what test they have given them
to deserve their high commendation.
Dr. E. D. Swain: I will say that I encountered no greater dif-
ficulties in using the aluminum alloy than any other amalgams. I
am, unfortunately, one of those operators in the dental profession
that cannot get along without amalgam. We have some men in
this society who claim that it is unnecessary in almost all cases,
and that teeth that cannot be saved with gold should be let go. I
do not agree with them. My experience has been in very large
cavities, in one or two instances where the tooth crown was cut
away to perhaps one-half its length, of putting on a matrix and
making a crown of aluminum amalgam. I saw the first fillings I
put in some eight months ago, and to me they are more satisfac-
tory in every way than any amalgam fillings I have ever made.
With the eight months test there is no perceptible shrinkage either
to the naked eye or under a magnifying glass. They are strong,
and the color is even preferable to gold in my opinion, because it
is less observable. I have had no experience with aluminum foil.
584 THE DENTAL REVIEW.
I have seen some fillings of it that were inserted by Dr. Gushing
which promise well.
A Member: Did the amalgam discolor the tooth ?
Dr. E. D. Swain: Not in the least. Dr. Carroll put up the
aluminum amalgam, and it is understood that pure aluminum will
not mix readily with mercury; therefore I say the aluminum alloy.
My impression is that it is zinc alloy. When that occurred to me
I was fearful we might have the experience which we have met
with in other amalgams containing zinc, a wasting of the filling.
But, on the contrary, the aluminum amalgam seems to grow
harder in time.
If I may be allowed to digress a little, I wish to second the
sentiment expressed by Dr. Reid in regard to clinics. I may be a
little cranky on the subject of clinics, but I think the time has
come when we can in a large measure do away with clinics as we
have conducted them. It is not necessary for men to spend two
half days in seeing another man do a simple operation in inserting
and packing a simple gold filling. I think it is a waste of time.
Our clinics should be conducted with the idea alone of presenting
new operations, new appliances, etc., and not going over and over
again. year after year with the same old clinic of cutting a hole in
the crown of a tooth and filling it up. We can all do that at home.
It is the new things we want to see.
Dr. Geo. H. Gushing : In speaking of aluminum amalgam
Dr. Swain has said all that I can say. My experience has been
similar to his. We commenced its use at the same time. I think
it is a little over eight months since we began to use it, and it cer-
tainly seems to give promise of being an excellent material, perhaps
in some respects taking higher rank than any other that has been
offered to the profession. It takes time to demonstrate the value
of such things. So far as my experience goes it is precisely like
that of Dr. Swain, it promises well, it keeps its color to a degree
exceeding that of any other alloy I have ever used in the mouth,
and it finishes up very beautifully.
With regard to aluminum foil, I can only speak from a limited
experience with it. I have under my care four boys in Ghicago,
brothers, ranging from eight to fourteen years of age, whose teeth
are of that character that we dread to see come into the office.
They melt away before your eyes, and you are at a loss to know
what to do with them. The cavities were very extensive in some
PROCEEDINGS OF SOCIETIES. 585
cases; in others they were commencing. These boys come to my
office regularly every two months, and there is always something to
be done, no matter how thoroughly I treat them at each sitting. I
filled some of the teeth of one of the boys with gold, some with the
ordinary amalgam preparations that we have, and then it occurred
to me to make use of the aluminum foil experimentally. I think I
filled four cavities in the mouth of this boy with aluminum foil.
Two of them were very large cavities and very difficult to fill. The
boy was one of those patients of whom you can have almost no
control. I could not adjust the rubber dam, and could not keep
his mouth in a very satisfactory condition; but I filled a compound
cavity in a lower second molar, a very large crown and large buccal
cavity extending below the margin of the gum. I filled it with this
material very unsatisfactorily to myself as would naturally be the
case under those circumstances. I saw the filling two or three
weeks ago, and it was protecting the tooth admirably so far as
could be judged, and was wearing nicely, very much better
than I anticipated when I made it. I think it is almost impossible
for it to stand any great length of time, owing to the fact that I
could not keep it dry and manipulate it to the best advantage. All
the other fillings of this material look well and are apparently pro-
tecting his teeth better than anything else in his mouth, either the
gold or ordinary amalgam that I had used. I have since placed in
his mouth, and in some of the other boys mouths, some of the
aluminum amalgam which I cannot say very much about because
it has not been in long enough for me to tell how it is going to
work.
Dr. W. a. Stevens: Do you use it with coarse instruments?
Dr. Geo. H. Gushing: It is used the same as noncohesive
gold in cylinders or pellets would be used. It works very much
like tin. It is considerably harder than tin when it is finally con-
densed. If annealed, it works kindly if manipulaled in the old-
fashioned way that noncohesive gold was manipulated.
Dr. T. W. Brophy : I would like to ask Dr. Gushing a ques-
tipn. Is the aluminum foil prepared in the form of cylinders, and
do you think it would be the best form in which to use it?
Dr. Gushing : That seems to me to be a matter of personal
preference. Some men can handle cylinders better than any other
form of gold either cohesive or noncohesive; others prefer to roll
it up in pellets, and still others use it in the form of strips. Per-
586 THE DEXTAL REVIEW.
sonally I prepare it in square pellets, as I use noncohesive gold.
I do not think it makes any material difference which way it is
used, yet I think if it were rolled into cylinders, as Dr. Brophy
says, we could get in that way a preparation which would be more
uniform. The cylinders could be rolled in gradations of hardness
from the softer to the more dense. In that way we would be able
to manipulate it to better advantage than by ourselves rolling it in
pellets. Those who are experienced in the handling of noncohe-
sive gold and making their own pellets, make them satisfactorily for
their own use, but for general use and the commencement of its
use, I think the suggestion of having it in the form of cylinders a
good one.
Dr. W. B. Ames : Dr. Gushing very kindly showed me the
work he had done in a young man's mouth and certainly the fillings
in this case were very commendable. I secured some of the alu-
minum foil a short time ago and I was not impressed with the ma-
terial itself, from the fact that I was afraid that it would be hard to
work, knowing it should be worked as soft foil I never attempted
to use it. The fillings spoken of by Dr. Gushing had a splendid
appearance. I would like to ask if it does not work harshly?
Dr. Gushing : No. It works somewhat more stiffly than tin,
yet you could not say it was really a harsh working material. It
requires a little more care in manipulating it, but after you have
filled one or two teeth in the mouth you see how it is manipulated,
and you adjust your manipulations accordingly. I do not think it
can be in any sense considered a harsh working material. If an-
nealed, it works more kindly.
Dr. J. J. R. Patrick : I understood one of the gentlemen to
say that it was pure aluminum. If so, I wish to make a statement
the reverse of that and say that if it was pure aluminum it could not
be worked.
Dr. Gushing : Whether it is or not is immaterial if it preserves
the teeth.
Dr. T. W. Brophv : It seems to me it would be of interest to
the members present to know why aluminum cannot be worked. .
Dr. Patrick : Simply because it has no adhesive qualities and
it is too stiff to be worked alone. You can try it at any time.
Furthermore, if it was pure aluminum it would not stay in the
mouth any length of time. Any small amount of alkali present in
the mouth at any time would destroy the aluminum. It would dis-
PROCEEDINGS OF SOCIETIES. 587
solve it. Aluminum is not attacked by acids of any kind; it will
resist all acids, but it will not and cannot resist the alkalies. It is
soluble.
Now as to aluminum plates. When they were first given to the
profession it was said that they were made up of pure aluminum.
I asked the gentleman who had the aluminum plates particularly
whether it was pure aluminum or not, and he said it was. I said
will you give me some of it ? He said yes he would give me some
of it, and I took it home, put it in acid, and it dissolved the tin out
of it. I put the balance of the residuum in alkali and that was dis-
solved— separated easy enough. It is not a difficult matter to test
it, and I hold it to be the duty of every man in the profession to
know what he is using. I do not propose for any man to come and
tell me that a certain thing is so-and-so, when I know it is not. If
it works well, all right, I have no objection to that, but I say let him
state exactly what it is, not attempt to hoodwink me. You cannot
mix but a small portion of aluminum with tin or any other metal
and make an amalgam of it. There is an antipathy between mer-
cury and aluminum. You could not use pure aluminum filings
and put mercury with it and rub it a minute in your hands, because
the reaction is so great that you would have to drop it. It would
raise a blister. You find there is a disposition to separate right
away. There is a small proportion of aluminum with the ordinary
amalgam alloys, enough to say that it is about as much aluminum
as we had years ago in the gold amalgams, just enough gold to
satisfy the conscience of the manufacturer.
Dr. Sitherwood: Have you ever used any pure aluminum for
base plates ?
Dr. Patrick: Yes, I used it I think when it first came out, be-
fore the war, about thirty years ago. I made a plate of perforated
gold and soldered it. You cannot solder aluminum alloy to alumi-
num itself. I made plates and had the satisfaction of knowing that
they were full of holes in a month.
Dr. C. R. Taylor: I would like to ask Dr. Patrick why there
is such an antipathy between mercury and aluminum that they will
not readily unite, and yet he says if you rub some of both metals
in your hand they become intensely hot. How can heat be gene-
rated under those circumstances?
Dr. Patrick: I cannot satisfactorily explain why mercury
should have an antipathy to aluminum.
588 THE DENTAL REVIEW.
Dr. Taylor: If there is such antipathy how can you get such
a heat ?
Dr. Patrick: If you take aluminum, file it up, and put mer-
cury in contact with the aluminum, it turns black, and heat is gen-
erated in so doing.
Dr. Taylor: There must be some chemical union or you
could not have heat.
Dr. Patrick: The heat is generated by the reduction of the
aluminum to its oxide. The amalgam takes the place of the alloy
that produces the filling material. The filling material may not
only be tin, but there may be something else in it. There may be
copper with aluminum added, and if the alloy parts with some of
its aluminum in the mixture with the mercury it separates, and
there may be some of it retained. I know it has to be a very small
portion, because you cannot add much aluminum to any alloy and
mix it with mercury without a settlement. The alloy may retain
a portion of the aluminum, but I know in the mixture with mercury
it generates heat, and in proportion to the amount of aluminum the
heat increases.
Dr. G. D. Sitherwood : Mr. President, I wish to say a few
more words. I am interested in this subject because I believe in
the working of aluminum. I have successfully worked it for ten
years, and when men speak of its dissolving in the mouth, they may
as well say to me that a gold plate dissolves. If it is pure alumi-
num it will last as any other plate — even a gold plate. I am just
as sure of that as I am of anything in dentistry. I have put in a
great many plates that have been worn ten years, and they are as
good to-day as when they were first put in the mouth. Aluminum
is the softest and most ductile of metals. You can roll it into rib-
bons, and tie it in knots, if it is properly annealed. It is a most
beautiful metal. I was glad to hear the subject brought up and to
know in what proportion tin, zinc or any other metals are alloyed
with it. I want to get at the facts. I am disgusted with copper
amalgam and many other filling materials that I have used, and
when I cannot use gold I want something that will remain bright,
will not disintegrate, and that is artistic in appearance.
Dr. a. E. Matteson : The gentleman says he uses pure
aluminum, it lasts well in the mouth and holds its color as well as
gold, and then he says there may be tin in it. How does he know
it is pure?
PROCEEDINGS OF SOCIETIES. 589
Dr. Sitherwood : Because I have tested it. If there is tin, an
acid will take it out. Only a strong alkali will attack aluminum.
Dr. Matteson : Sulphuric acid will not attack aluminum. If
you want something that is artistic, what is better than gold ?
Dr. Sitherwood : I am not discussing gold, I am speaking of
aluminum.
Dr. Matteson: What are you going to make your joints with ?
You cannot solder aluminum.
Dr. Sitherwood : It is soldered by all the workers in alumi-
num.
Dr. Matteson : If it can be soldered then it is not pure
aluminum.
Dr. Patrick : I wish to correct an impression that has been
made. I have no antipathy to aluminum. It is the mercury that
has an antipathy to it. I think it would be practicable for dental
purposes, but I have never found an alloy that I could use. As to
soldering I defy any man in this audience to solder pure aluminum.
If you can find aluminum that can be soldered, I can prove that it
is not pure. It is a beautiful metal and might be a splendid ma-
terial for filling teeth, if it were not for the fact that an alkali is its
solvent. If you have some of the aluminum foil here, without en-
tering into further discussion we can test the matter in half an
hour. I will take the aluminum foil and show you what I said to
be a fact.
Dr. H. a. Costner: I desire to state that in a scientific re-
port read before some New York society, on the subject of alumi-
num, the author states positively that there was a good solder for
aluminum. I do not remember it just now.
Dr. Matteson: I saw the same article I think that Dr. Costner
speaks of. I experimented with the ingredients, and gold was one
of them. There were two forms given in the article I saw, and
with all the skill I was capable of I could not succeed in unit-
ing them with pure aluminum, and as I have said before, with
pure aluminum you cannot make a solder. I know of manufac-
turers who, if they could get a solder for aluminum to make a
perfect joint, would be willing to put up thousands of dollars.
The President: You can solder it with any of the solders by
using chloride of silver as a flux.
Dr. C. R. Taylor: How much pure aluminum do we get as
dentists? Can we use it as such? If I remember correctly the
r>90 THE DEXTAL REVIEW.
Carroll Compan}- advertised their amalgam as pure, but that the
amalgam they use for casting purposes is not pure. It has both
copper and silver in it— slight traces of it — to make it workable
and useful for dental purposes as such. It is not pure alumi-
num, and there is where the trouble arises in reference to this
discussion. The question is in reference to pure aluminum not
an alloy.
Dr. Costner : This is a grand line of thought to pursue and
I would like to see every one who is interested in this subject
express himself. It is worthy of investigation and pursuit. We
should try it and I believe it can be used. We should discuss
why it can and why it camiot be used. It is perfectly proper for
a man to say that it cannot be done, but because that man can-
not do it is no excuse why any one else cannot. (Applause.)
Dr. Gushing: I desire to reply to one remark made by Dr.
Taylor with regard to the claim of the Carroll Manufacturing Co.
They do not claim that it is pure aluminum.
Dr. Taylor: I thought they did it in the circular sent out by
them. I may be mistaken about it.
Dr. H. a. Gunther: I have used filings from aluminum fill-
ings with the oxyphosphate of zinc, and it seems to produce a
staple filling. I do not know whether any one else has used it.
Dr. W. a. Stevens: There are two things in the paper which
occurred to me, and I want to speak of them. They were recom-
mended very highly. The first is what you call a cotton gin. If
any of you can conceive of its practical use you can do better than
I can. The other is for heating gutta-percha, or anything of that
kind, so that you will not get it too hot. I think that I have some-
thing that was made twenty years ago that excels it, a soapstone
griddle, four by four inches, and seven-eighths of an inch thick, and
it retains the heat. I regard it as useful to every dentist. A great
many things have been introduced in the profession that we have
tried, and most of us young men of thirty years' practice have used
them and stored them away, and labeled them useless.
Dr. J. W. Cormanv: I want to call Dr. Stevens to task for
what he has said. If he has a soapstone griddle which has done
such excellent service for the last twenty years, where has this grid-
dle been all these years. I have met him for ten or fifteen }'ears at
these meetings and he has never said a word about a griddle until
to-day.
The Dental Review.
Devoted to the Advancement of Dental Science.
Published Monthly.
Editor: A. W. HARLAN, M. D., D. D. S.
ASSOCIATE EDITORS:
Louis Ottofy, D. D. S. C. N. Johnson, L. D. S., D. D. S.
The Southern Dental Association.
The annual meeting of the Southern will be held at Lookout
Mountain, Tuesday, July 26. It is expected by the programme
committee that a large number of dentists will get together and re-
solve to come in a body to Chicago next year to attefid the World's
Columbian Dental Congress. We think that the Southern and
American Associations should adjourn to Chicago and hold business
meetings about Tuesday, August 15th, or Wednesday 16, 1893, and
adjourn over to 1894. In this way the efforts of the combined
membership can be concentrated on the Congress, which will be
opened August 17, 1893. Take this into consideration, gentlemen.
Adjourned.
All the local societies have adjourned to the period "when the
leaves begin to turn." We trust that the vacations will be enjoyed
by our overworked brethren in every clime, and that renewed vigor
will be injected into our city societies in the fall. Great possibili-
ties of fame await the workers this coming year who will be able
by their wit, good sense, tact, scientific work, or in some other way
help us entertain the vast throng of dentists who will flock to our
city for the treat in store for them. Awake from your lethargy and
do your best to show the world what you are made of as a host,
essayist or dinner giver.
592 THE DENTAL REVIEW.
The World's Columbian Dental Congress.
There never has been a meeting in the historj' of the profession
that promised so well as does the coming congress. The time
never before seemed so ripe for an event of the magnitude and im-
portance of this meeting. Never before did an equal body of men
work more effectively or harmoniously than has the Executive
Committee from the time of its appointment till now. It has
started out along the proper lines and the unanimity and harmony
prevailing throughout all of its deliberations augurs well for
future success.
But the work of the past— laborious as it has been — is as noth-
ing to that which must follow. Something is needed in the way of
revision, for, carefulh' as the work has been done, there are yet
names missing that should be present on some of the committees.
All of these matters will undoubtedly be attended to in due time
and we look for a truly representative showing throughout the
whole organization of the Congress.
But the preliminary work should not all be left to the Executive
Committee. The men comprising that body have already sacri-
ficed a great ideal in time and labor. They have worked
incessantly to systematize the organization and to arouse the en-
thusiasm of the profession. It now remains for every man calling
himself a respectable dentist to constitute himself a committee of
one to help work up interest in the meeting. In laboring for the
success of the Congress he will not only benefit the profession but
he will make himself a broader and a better man. No work of this
kind can fail to redound to the credit of the man who takes part in
it, and no man need consider himself too humble to come forward
and offer to do his share. There is work enough for every one of
us. We cannot all prepare essays suitable for a meeting of this
kind; we cannot all take part in discussions involving such deep
scientific research as will probably enter into the deliberations of
the Congress; but we can each of us do something toward making
the meeting a success.
Every man should perform the labor for which his capabilities
best prepare him, and he should do it willingly. More than that
he should begin to do something at once. The months will soon
slip by and the date of the meeting will be upon us almost
before we realize it. Let it not find any of us unprepared.
No opportunity should be missed to urge the importance of the
DOMESTIC CORRESPONDENCE. 593
meeting. The gospel should be freely spread that this is to be the
most successful dental meeting of the century. It will be to the
dental world what the Fair will be to the world at large — the
greatest thing of its kind ever known.
C. N. J.
DOMESTIC CORRESPONDENCE.
Letter from New York.
To the Editor of The Dental Review:
Dear Sir: — Again the month of roses is with us, full of per-
fume, suggestive of much that is elevating — certainly a new start
in life.
Nobility is not all English — you know — yet we have made the
acquaintance in our day, of dentists that in our estimation had
noble natures and noble purposes. The name and fame of such
need no bolstering by laudation. What the majority says is far
from a true value of a noble pilgrimage through the common vicis-
situdes of each one's career; circumstances are frequently occur-
ring among us that recall the lamentable loss that has come to us
during the last thirteen months. Many have said how much we
have needed the heroic counsels of Dr. Atkinson duiing the late
disturbances. "Could such discord have been consummated ?"
The First District Society has passed the first two months of
its new administration. The May and June meetings were scarcelj'^
more than formal gatherings that met and adjourned. The essaj^-
ist failed to put in an appearance until an adjournment had been
ordered. "Facts and some Fancies," the subject for the evening
was laid over until October. It's no telling whether they will be
facts or even fancies at that date. Progress deals so rapidly with
everything, that we have to move quick in these hurr3'Ing times.
Dr. Walker, under the head of "Incidents of Office Practice,"
stated that he attended the day previous a meeting of the Second
District Society at Newburgh, on the Hudson. There was an ex-
cellent meeting; he said there were sixty in attendance — he
counted them, and had it sworn to by a notary public. He did not
show us the papers. The doctor is troubled, like many mortals,
with unbelief. Suppressio veri suggestio falsi. He also announced
that the second and first district would hold a union meeting
594 THE DENTAL REVIEW.
during the winter, to end with a bancjuet. The query was made,
who would pay these second fellows' grub bill. It was all satis-
factory when told that they would pay their own bills.
The Robber of the Rhine, is one of the attractions of New York
just now in the opening of the new rebuilt Fifth Avenue theater.
The Robber is the star, and hails from London, and is a pro-
nounced success, has a rich baritone voice, is fine looking and a
gentleman of ver}' refined and affable manners. He is English,
you know, born of American parents, and strange as it may seem,
he has practiced dentistry five years. Haj'den Cofifin is the son
of the late Dr. Cofifin, of London, and the Cofifin brothers now in
practice there are his brothers. They are much esteemed by
many of our American dentists for their professional attainments
and generous hospitality. Chips of the old block. We had a very
pleasant chit chat with Mr. Hayden Cofifin, a few evenings since,
together with his bright wife, at the Fifth Avenue theater. We
went behind the scenes to their private room. From Mr. Cofifin I
learned that his father was about the first, if not the first American
dentist that went from America to England, and settled to practice.
This was about thirty-eight years since. First locating in Man-
chester, and securing a large and lucrative clientele, being natur-
ally ambitious, as all skillful practitioners are prone to be, he
moved to London and took a first-class house in a location to cor-
respond, and readily secured patients among the best people, prac-
ticing in this house twenty-one years before his decease. Dr. Cof-
fin was widely known as a practitioner of liberal and progressive
views, and carried these into his hospitality, which many can hap-
pily testify. Many know the value of his invention, "the expansion
plate." It is readily granted by those who are personally ac-
quainted with the two sons that follow their father, that they are
worthy successors. Our acquaintance with the father, which was
made at Dr. Atkinson's, is recalled with pleasant memories.
Young Hayden Coffin has practiced in the mechanical department
of his father's practice, having a liking for mechanical pursuits.
Having a rare and rich voice for music, he has been lured into opera
singing, for which with his recognized talent, liberally accorded by
the New York press, he will find a much larger compensation.
But, all dentists cannot sing well enough to command generous
fees. Sometime, some day, we may all sing; yet, as Dr. James
White said in one of his editorials, to be an angel we need to try
DOMESTIC CORRESPONDENCE. 595
to be a good boy first. We are all on a pilgrimage, and will be
obliged to do a good deal of traveling before it is ended, if a man is
much in earnest. It involves ^-^z^a// also; by it we get experience,
and out of this hope. What is a man without it ? Much of this
life is poorly untraveled, and there is a great beyond un-
traveled. Good health has much to do with our travel here,
and how we get on. The question is often raised, is our
calling a healthy one ? Dr. Eames, a Boston practitioner, has
just sent us a list of printed questions, relative to this subject. We
have not been able to see why dentistry should be more unhealthy
than many callings. Getting married is far from being healthy un-
less the parties know, or are willing to live so that it may not prove
a failure. The mainspring of married life is love and respect, and
we say that it is much, the necessity that it be so with us. One
that does not have these two characteristics to inspire him cannot
get on with much satisfaction, nor is there going to be much success
from a professional point of view. More lose their health by lack
of interest than by an excess. There seems to be a very unintelli-
gent idea in the minds of some that the inhaling of noxious breath-
ing is a source of infection to one's health. We do not entertain
such views as rational. I do not believe that our daily practice is
of itself unhealthy, with a reasonable hygiene, reasonable hours,
proper exercise, of a nature best suited to one's tastes. Some like
to go on fast; horseback, boating, fishing, gaming, all legitimate
and helpful. Some of depraved tastes, habits, or form such, that
do not conform to the laws of abiding health. We have ob-
served many that have no system of labor, or of recreation. Too
many accept the necessity of recreation by compulsion.
Men who confine themselves to twelve and fourteen hours in
the office are sure to come to a premature old age, as a general
rule. We think our calling has this one important advantage, an
opportunity for cultivating sociability, and we think as a class, we
are preeminently social, both in the office and out of it, far more
than the physician can be, particularly in connection with practice,
and there is in this a second advantage over the physician. We
have a large portion of the twenty-four hours of time that is ours
for diversion. This is worthy of notice.
While I do not think we are at disadvantage, so far as an un-
healthy occupation is concerned, yet there is profit in the consid-
eration of a subject that has so many complicated sides to it.
590 THE DEXTAL REVIEW.
Whatever may be deduced from the discussion, each individual
must apply that to himself which is best suited for his use; what's
one's food may be another's poison.
The European travel is setting with full steamer lists; so far we
have learned of only one dentist booked. Dr. A. L. Northrop and
wife sail July 6. We reckon he has earned the rest and gratifica-
tion the trip will afford. The doctor will find some things as tall
and good-looking as he, say the Cologne Cathedral. Dr. Atkinson
said, in this beautiful structure he for the first time while away,
forgot himself. Try it, doctor 3'ou may do the same; it is a good
thing to do occasionally. JV/ia/ is man? Its too hot to try even to
tell our thought. We are among the ninety and nine, and one
thing is sure; chemically considered man is largely water, and some
gas. The real man is behind the scenes, and when we get there,
what we now call man, will look pretty small to us, with our illu-
minated vision. Now it is much in our "I," then it will be as we
are seen.
We think it profitable to call the attention of readers seeking
intelligent reading, above the ordinary, to an article by Prof.
Peirce, of the Pennsylvania College of Dental Surgery. Subject,
"Pyorrhoea Alveolaris due largely to Systemic Predispositions."
We do not accept all of it as borne out by the facts as we have
viewed them during the last sixteen years, but we regard this
article as a very valuable contribution to our literature. The part
that directs our attention to what the professor terms "Calcic Peri-
cementitis." Some day we will handle this subject with a larger
grasp of possibility, because of such intelligent thought. Already
this article has given a decided outing for those who advocate that
this disorder is of local origin, and that successful treatment is
possible, in the hands of those of mechanical ability only, such a
paper directs thought to a larger mental application to things com-
mitted to our hands. A dentist will be a doctor some day. Papers
of this class don't leave room for politics, and men that are able to
take an intelligent grasp of them have no taste for politics. Give
us more of such articles, and we will sooner be a "liberal profes-
sion." Yes, verily. We have this day received the official an-
nouncement of the Buffalo University Dental Department. It
talks well. This school, it is said, is to be conducted in accord
with the legal aspect of the State Society. Why have we two
schools conducted in accordance with the legal aspects of this so-
DOMESTIC CORRESPOh-DENCE. .-)97
ciet}'? In what manner is this second school to differ from the
first, is a query that is raised, and we think wisely. What will the
degree be in the second school? The first one has caused denun-
ciation enough, from leading men of the profession, not to make a
second venture. The Odontologicals tried to keep cool at their
meeting this month. They failed as did the first district. A ba-
ker's dozen gathered rather reluctantly at a late hour and went
through the formal opening, and voted to publish the two papers
by title without reading or discussion. It was said, rather queerly
we thought, that there was no one present that could discuss the
first paper, which was by Drs. Heitzmann and Roy, on the "Minute
Anatomy of the CBmentum." We thought such a remark was an
assumption. Dr. Heitzmann was present, and we surmise he was
not only a little surprised but a good deal disappointed that there
should be such apathy and disinterestedness; not much encourage-
ment to those that take the trouble to prepare such papers. To
be sure it was somewhat warm. The second paper was by Dr.
Hugenschmidt, of Paris, "Alveolor Abscess without death of the
Pulp." This was disposed of ditto. The question was raised
whether any one believed that such a thing could occur. Accord-
ing to whose observation, we would ask? To be sure they are not
common, but they do occur?
Dr. Hugenschmidt has in one of his late papers advanced the
theory that there was to be found pus in a living pulp from causes
remote, and he has carried his theory into this subject. Certainly
not an uninteresting subject, we think; quite worthy of intelligent
men's attention. The doctor shows himself an active thinker and
a diligent one also. Well, both papers got to press without the
courtesy of a discussion. Referring in a late letter to Dr. Stebbins'
use of nitrate of silver for caries, which was presented to the May
meeting of the Odontological Society, we heard this remark at the
June meeting. It was thought to be nothing new. We think the
doctor is entitled to the credit of introducing a systematic method
of its use at least. It is true that many do know of its effects. It
is to diligent, investigating men that we do and will continue to owe
much for bringing these floating ideas to our attention in a system
of arranged practice, and then let each, as they feel disposed, test
their value.
We heard it echoed that it is useless to hold dental meetings in
May and June; we should say it was, if no more interest is to be
598 THE DENTAL REVIEW.
manifested than has appeared by both societies this year. (Perhaps
the day has gone by for so many meetings.) Better liave a few
good ones in attendance, than many hike-warmlj' noticed. A mo-
tion was carried at the last First District Society meeting to send
out all future notices of the monthly meeting under a two cent
stamp, for many never notice an envelope with a one cent stamp on it.
We were told that many tell the postiTian not to drop any circulars
in their boxes, for they never read circulars. Are not these fellows
high-steppers? We believe that such is the custom of the 400, and
fellows that suck their cane heads. Let those that send out circu-
lars hereafter, bear these things in mind, and save their cents, and
the pennies will take care of themselves.
Dr. Heitzmann gave fresh evidences to the May meeting of the
Odontological Society confirmatory of his recticulum theory, and
they were so plain that they who ran could read. With all this,
ain't it queer that Dr. Geo. Allan don't see it ? Well, Dr. Heitz-
mann, the world will go on and learn if some won't, see? "You
can lead a horse to water, but you cant make him drink." That is
so in America. If Harrison is elected it may be different. If
Cleveland, yours truly.
Another disc holder, new, by Dr. Steinburg of New York City.
In the discs is a metal eyelet, oval shape; corresponding to this is
a metal cap which is formed upon a stem that moves within a wire
coiled spring around the head of the bit; placing the disc on the
ball of your thumb, and you press the bit against it until the cap is
through the metal eyelet, and with a half turn of the bit the oval
cap is placed across the orifice, and your disc is fastened. The
Doctor will step to the front until some fertile mind eclipses him.
All eyes are focalized on the joint meeting of the Pennsylvania and
New Jersey Societies at Cresson Springs, Pa., July 22d. This
place has a charm for all that have had the good fortune to visit it.
High altitude, fine hotel, reduced rates, and no change in the bill
of fare. " Joint meetings " have been the fad among the dentists
for several years. They originated in the Chinese laundry, mean-
ing in our terminology. Chin-ease. We again quote the saying of
our late endeared friend, Atkinson, "men that holler so loud over
violated ethics need watching." We should say so. If flying re-
ports are half true. We will only hint in this letter. If we find it
honest, we will break the egg in our next, and woe to the men in
high office if it does prove true. It becomes no small matter when
DOMESTIC CORRESPONDENCE. 599
such men try in a stealthy manner to hbel their fellows and prevent
the bread and butter coming to their mouths, and thus make it
necessary to raise funds to keep them in daily comfort. It would
seem that men of level heads would see the wisdom of a halt, for
they may not realize that the high altitude which they have gained
by blind maneuvering, places them on dizzy heights. We probed
one nonprofessional move of men in high position to its core, and
if we see symptoms of blood poisoning we can do it again, and we
will. The pen sometimes becomes mightier than the sword. It
is said that light comes from the East; if it does, it will reach the
West ere long, and we predict that the West is ultimately going to
give us a higher standard of ethics than New York, the much
boasted Empire State, has been doing of late. From the cloudy
look we turn to a brighter view, and show that true merit ultimate-
ly brings its reward. Geo. Weld, D. D. S., M. D., who has
practiced in New York City for^the last twenty-two years, has at last
earned his reward for his studious investigations both in the inter-
est of dentistry and also reflected honor upon his earned degree
M. D. The Doctor's papers have secured more than ordinary at-
tention both professionally and by the public press. As an out-
come of these he has invented a formula called " The Syrup of
Iron Chloride," and has not only eliminated all the hurtful proper-
ties which acted upon the teeth, so long associated with the old
formulae of iron tonics, but has added an advantage which has
secured a decided recognition from the medical profession by a
liberal endorsement. Physicians find that this new remedy is
capable of being received into the stomach of the most fastidious
without the disagreeable nauseous effects that so commonly arose
from the old remedy. It is the testimony of many physicians of
high repute in New York City that no iron tonic has ever shown
such capabilities for increasing the haemoglobin as this syrup
chloride. So quick was this new remedy seen to be of decided
value over the old, at once a marked value was recognized by such
sagacious business pharmaceutists as Parke, Davis & Co., of
Detroit, and they have secured to Dr. Weld a choice financial in-
terest and are putting $50,000 into its first year introduction. Dr.
Weld goes to Europe during this season to look after the further
interest of his favored medicine. No one will be more glad than
the Doctor's many appreciative friends, only those who stand idle,
do the grunting and say, " I have done all I am going to do for
GOO THE DENTAL REVIEW.
the profession. It isn't appreciated." To young practitioners we
say, do something that is valuable and the intelligent public will
want it. In some future writings we propose to say further of this
remedy, for we have been putting it to use and it has done great
things for some of our patients afflicted with " Pyorrhoea Alveo-
laris," and "Calcic Pericementitis," and " Riggs' Disease." We
have sworn always by our dear favorite remedy day and night,
sulphate of cinchonidae, so often emphasized by Dr. Atkinson, but
this new remedy has made things so wel — d and done — we must go
one better for it. Try it. Send to Parke, Davis & Co. for sample-
Let us say that there are some things that this medicine will not
do. It will not restore lost reputation to a broken down politician,
nor will it let off steam dentists from smoking down below, who
tear human teeth ruthlessly out of the jaws and put in their place
" Biled Rubber " and " Store teeth " at $4.00 a set.
This, is a good move, we think. The odontological society passed
a resolution asking the cooperation of chemists in producing a
formulae which will become of use to us in any manner, and they
also advise the publication of the formulae of all our compounds,
believing that in this way we can be of valuable assistance to each
other. Bring out the secret archives if we expect to become a
" liberal profession." We have just received a "yellow covered "
circular announcing a new local anaesthetic called a " Dental Sur-
prise," " perfectly safe." It comes from Holly, Mich. Those put
out in the way that is, are of a kind. It all belongs to the " Biled
Rubber" man. It means indiscriminate extraction of teeth, to be
replaced b}' artificial ones. Good men with intelligence, cannot
italicize enough against such things.
We congratulate the readers of the Dental Review on the rare
quality of its contents, although it did not come to our hands until
the 24th instant, yet we have carefully perused the papers and find
much to commend and no one subject more than that of Dr.
Black. We felt all through the reading of it, that we were on
high ground, and that it would take no little mental activity to
intelligently get it digested. It pleases us that we were so much
in line of the thought of what the doctor is trying to impress the
importance of on the minds of our profession viz. the integrity of
the gum septa, or as we have used the term in our last letter,
"gum borders." We can assure Dr. Black he is sowing good
seed, and it will bear good fruit "after many days." How few of
REVIEWS AND ABSTRACTS. 601
the many are leading busy, studious and observing lives, as the
authors of such papers exhibit, and how often they will be pricked
in their sensitiveness by seeing their ideas made use of, and no
credit, (and copyrighted.) Well, as the dear old Dr. Atkinson so
often said, " Let the truth be preached, however it may be." Dr.
Black proves himself a busy man. A member of our society once
said, "he did not see how Drs. Atkinson and Mills found so much time
to write papers for dental societies." There is time for everything
that oneloves to do. We make the writing of these monthly letters
a pastime. It is a part of our recreation, and in many ways we are
assured that they are interesting to many that read them, and we
hope helpful and useful. For we reason thus, if one's service does
not serve some good purpose it is time and labor wasted. We have
met Dr. Cochran here who has come by the Isthmus from San
Francisco, coming this route essentially for regaining his strength,
having got overworked. He has been connected with the dental
department of the university of California. Dr. Roy, a wide-
awake and progressive dentist is sojourning at New Orleans for
recuperation. He has been connected with the New York Dental
College. He is one of the kind that is not content if not pushing
ahead in same studious pursuit. His studies, which will be pub-
lished soon in the Intertiational Dental Journal^ will tell the stuff
he is made of. Under the instruction of Prof. Heitzmann he has
been investigating the minute anatomy of the cementum. The
more we can know of these matters the stronger we are scientifi-
cally. We doubt if there is an opening of more fertile opportuni-
ties for scientific study for an ambitious young practitioner than
in the laboratory of Prof. Heitzmann. A knowledge of the tissues
with which we are daily dealing, is the key that unlocks the door
of a successful practice. Such a practice is to become the demand
from an intelligent clientele in the near future. Young men should
have an ambition to magnify the importance of their calling.
New York, July, 1892. Ex.
* REVIEWS AND ABSTRACTS.
Die Orthopedische Behandlung der Sattelnase, mittelst von der
Zahnheilkunde gebotenen Hiilfsmitteln. Von Matti Ayrapaa,
M. D., University of Helsingfors, Finnland. Kuopio, Finnland,
1892.
This interesting treatise on the orthopedic treatment of cases
where the destruction of the bridge of the nose creates an unsightly
•
602 THE DEXTAL REVIEW.
deformity, is illustrated with 82 cuts showing the results attained
in the treatment of twent}- practical cases. Instances in which the
loss of the nose or the nasal septum, including a part of the roof of the
mouth, has resulted from syphilis, lupus, scrofula, abscesses, ex-
ternal injuries, congenital deformity, etc., are fully described.
The author has corrected many of these deformities by means of
supports attached to the roof of the plate, extending through per-
forations in the roof of the mouth to the sunken nose, and by thus
raising the tissues converting an insignificant nose and an almost
repulsive face into an intelligent appearing countenance. A con-
cise history of this branch of rhinology — which the author considers
a part of dentistry — is also a part of the work.
The Dental Law for Washington, D. C.
Pl'blic — No. 74. — An act for the regulation of the practice of
dentistry in the District of Columbia, and for the protection of the
people from empiricism in relation thereto.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress asseifibled, That it shall be un-
lawful for any person to practice dentistry in the District of Colum-
bia, unless such person shall register with the health officer in com-
pliance with the requirements hereinafter provided.
Sec. 2. That a board to carry out the purposes of this act is
hereby created, to be knovv'n as the Board of Dental Examiners, to
consist of five reputable dentists resident of and for three years
last before appointment actively engaged in the practice of dentis-
try in the District of Columbia, to be appointed by the commis-
sioners of said District for terms of five years and until their suc-
cessors are appointed : Provided, That the first five a'ppointments
shall be made for terms of one, two, three, four and five years,
respectively. A majority of said board shall constitute a quorum.
Vacancies occurring in said board shall be filled by appointment
of eligible persons for unexpired terms.
Sec. 3. That it shall be the duty of the Board of Dental Ex-
aminers, first, to organize by electing one of their number Presi-
dent and one Secretary, to provide necessary books and blank
forms, and publicly announce the requirements of this act and
the time, place, and means of complying with its provisions within
thirty days from its passage; second, to promptly certify to the
health officer for registration all who are engaged in the prac-
tice of dentistry in said District at the time of passage of this
REVIEWS AND ABSTRACTS. 603
act who apply therefor; third, to test the fitness and pass upon
the quahfication of persons desiring to commence the practice
of dentistry in said District after the passage of this act and cer-
tify to the health officer for registration such as prove, under ex-
amination in theory and practice of dentistry, qualified in the
judgment of the board to practice dentistry in said District;
fourth, to report immediately information of any violation of this
act, and, annually, the transactions of the board to the commis-
sioners of the District of Columbia : Provided, That all gradu-
ates of dental colleges which require a three years' course of
study shall be entitled to certificates upon payment of the certi-
fication fee and without examination as to their qualifications.
Sec. 4. That it shall be the duty of every person practicing
dentistry in said District at the time of the passage of this act
to make application to said board, in form prescribed by said
board, for certification, and present the certificates thus obtained
for registration to the health officer within sixty days from the
passage of this act. Every such person so registering may con-
tinue to practice without incurring the penalties of this act.
Sec. 5. That persons desiring to commence the practice of
dentistry in said District after the passage of this act shall first
obtain a certificate of qualification from the Board of Dental Exam-
iners, granted under authority conferred upon said board by section
three of this act, and present the same to the health officer for
registration.
Sec. 6. That it shall be the duty of the health officer to regis-
ter all persons presenting certificates from said board in a book
kept for this purpose, and indorse upon each certificate the fact
and date of such registration.
Sec 7. That certificates issued and indorsed under the pro-
visions of this act shall be evidence of the right of the person to
whom granted to practice under this act.
Sec. 8. That any one who shall practice or attempt to practice
dentistry in said District without having complied with the pro-
visions of this act shall be deemed guilty of a misdemeanor, and,
upon conviction thereof, shall be fined not less than fifty nor more
than two hundred dollars, and in default of payment of such fine
shall be imprisoned not less than thirty nor more than ninety days,
said fines, when collected, to be paid into the Treasury of the
United States, to the credit of the District of Columbia: Provided,
604 THE DENTAL REVIEW.
That nothing in this act shall be construed to interfere with phj'si-
cians in the discharge of their professional duties, nor with stu-
dents pursuing a regular uninterrupted dental college course or in
bona fide pupilage with a registered dentist.
Sec. 9. That to provide a fund to carry out and enforce the
provisions of this act the Board of Dental Examiners may charge
such fees, not exceeding one dollar for each certificate and ten dol-
lars for each examination, as will from time to time, in the opinion
of said board, approved by said commissioners, be necessary.
From such fund all expenses shall be paid b}' the board: Provided,
That such expense shall in no case exceed the balance of receipts.
Approved, June 6, 1892.
A Treatise on Dental Jurisprudence for Dentists and Law-
yers, embracing the following subjects : Dental Jurisprudence;
Dental Expert Testimony ; Cocaine Poisoning ; Fracture of
Maxilla during Extraction of Teeth; Injuries and Deaths due to
Anaesthesia; The Jurisprudence of Dental Patents, etc., etc.
By William F. Rehfuss, D. D. S., author of "Dental Massage,"
member of Odontological Society of Pennsylvania, of the New
Jersey Dental Society; Dental Protection Association of U. S.,
etc. Published by The Wilmington Dental Manufacturing Co.,
No. 1413 Filbert Street, Philadelphia. 1892. Cloth, ^2.50.
Sheep, $3.50.
Marvelous as has been the growth of the profession of dentistry
in the past decade, and accustomed as the reading practitioner has
been to the appearance of new publications of a high order of
scholastic and practical worth, the present volume from the pen
Dr. Rehfuss marks a noticeable step in dental progress. It will
be a surprise to many steady-going ones to realize that the profes-
sion has arrived at such a dignified position in human life and
affairs to furnish material and bring forth such a good book on
forensic dentistry. If it serves no other purpose it will have justi-
fied its production in the increased self-respect engendered by a
reading. The author had the rare fortune of an opportunity. A
work on Dental Jurisprudence is unique. Whether time is ripe
for its appearance is a question the publisher will soon be able
to determine. There is no doubt that every practitioner of any
considerable experience will recall occasions when some of the
REVIEWS AND ABSTRACTS. 605
information or advice contained in this work would have been of
great service if not of decided financial assistance.
There are ^'o^^ pages. It is a very lucid presentation of the
problems which any dentist is likely to be confronted with. The
author has taken great pains to go over the whole history of legis-
lation appertaining to dentists, both in their individual and collec-
tive capacity. The compilation and aggregation of cases fur-
nished cannot fail to make a most convenient and useful authority
for both legal adviser and client in all dental cases. The first 204
pages are devoted to this task. The cases cited are quoted from
court records and published accounts in the literature of the pro-
fession, and are gathered with consummate care and good judgment
for all possible and probable needs. While it is not a book in-
tended to be read, being rather a book of reference, it nevertheless
is very readable, and the man who "keeps up" will not be content
till every paragraph is his, while he who wants accurate knowl-
edge of past events of a legal nature will find it indispensable. To
give an idea of the field covered, allow me to quote from table of
contents:
Dental Expert Witnesses.
Qualifications Required of Experts.
The Distinction between an Expert and a Common Witness.
Identification by Means of of the Teeth.
The Legal Right of Dentists to Administer Remedies Systemic-
ally.
Malpractice. What Constitutes Malpractice.
The Dentist as Defendant in Criminal and Civil Prosecutions.
The Degree of Skill Required.
"Ordinary Skill."
.Damages.
Infection or Disease from Unclean Instruments.
Rape Under Anaesthesia.
The Legal Rules Governing the Fees Recoverable.
The Book Accounts of Dentists.
Authority and Legality of State Boards.
Patent Rights.
It will be seen that even this partial list of subjects deals with
questions of vital interest. Every one should be cognizant of both
his own and his patients rights. This book furnishes in ready form
information which goes farther to settle such problems both by the
606 THE DENTAL REVIEW.
decisions of eminent jurists in high courts and the opinions the
author himself offers than can be elsewhere found. The book. is
faultlessly done by the printer and every way worthy a place in
the dentist's and lawyer's library.
Pamphlets Received.
Our State Dental Laws. A historical and comparative anal-
ysis, by C. B. Rohland, D. D. S. Reprint from Dental Cosmos.
Biological Teaching in the Colleges of the United
States, by John P. Campbell, Ph. D. Government Printing Office,
Washington, D. C.
The Fourth International Prison Congress, St. Petersburg,
Russia, by C. D. Randall, official delegate from the United States,
Washington; Government Printing Office, 1891.
History of Higher Education in Michigan, by Andrew C. Mc-
Laughlin, assistant professor of history in the University of
Michigan. Ibid.
The History of Higher Education, Ohio, by Geo. W. Knight,
Ph. D., Professor of History, Ohio State University, and John
R. Commons, A. M., Associate Professor of Political Economy,
Oberlin College. Ibid.
History of Higher Education in Massachusetts, by George
Gary Bush, Ph. D. Ibid.
Analytical Index to Barnard's American Journal of Education.
Ibid, 1892.
The Scientist International Directory, compiled by Samuel E.
Cassino, 1H92, Boston. The Casino Art Co., Exchange building.
Price $2.00.
DENTAL COLLEGE COMMENCEMENTS.
CINCINNATI COLLEGE OF MEDICINE AND SURGERY— DENTAL
DEPARTMENT.
The annual commencement exercises of the Dental Department of the Cin-
cinnati College of Medicine and Surgery, were held at the Young Men's Christian
Association Hall, Cincinnati, Ohio, March 16, 1892.
The number of matriculates for the session was thirty-four.
MEMORANDA.
607
The degree of Doctor of Dental Surgery was conferred by the President of
the Board of Trustees, Prof. Geo. W. Harper, A. M., on the following (10) can-
didates:
Ernest Bragdon, M. D.
James F. Clayton.
B. Frank Corwin.
G. W. Hoffman.
James F. McCamant.
Clifford E. Silett.
William E. Sloan.
John C. Wallace, M. D.
S. H. Wardle.
Fred G. Williams.
NATIONAL UNIVERSITY— DENTAL DEPARTMENT.
At the annual commencement exercises of the Dental Department of the Na-
tional University held at the Academy of Music, Washington, D. C, May 17,
1893, the degree of Doctor of Dental Surgery was conferred by Hon. Arthur Mac-
Arthur, Chancellor of the University, on the following (4) candidates;
William E. Bradley, California. I Edwin K. Gerow, New York.
Sheldon G. Davis, Ohio. David E. Wiber, District of Columbia.
UNIVERSITY OF MICHIGAN— COLLEGE OF DENTAL SURGERY.
The degree of Doctor of Dental Surgery was conferred on the following (39)
persons:
Burt Abell,
Samuel Howard Arthur.
Harry Howard Avery.
Harry Park Ball.
Walter Joel Bell.
Charles Lee Blunt.
Herbert Warren Bovee
Charles Edward Burchfield.
Charles Sylvester Chadwick.
Timothy Spencer Childs.
Thomas Coleman, D. D. S., Royal Col-
lege of Dental Surgeons.
Eli Mahlon Conard.
Oscar Willmott Daly, D. D. S., Royal
College of Dental Surgeons.
Archibald Warren Diack.
George Dil worth.
Elmer C. Goldthorp.
Allison William Haidle.
Charles William Hall.
Henry James Harvey.
Thomas Ebenezer Howson.
Osgood Frank Ingalls.
Vida Anette Latham.
Ben Hubbard Lee.
Frank P. Martin.
James Andrew Milliken, D. D. S
versity of Pennsylvania.
Henry Milling.
John Albert Moore.
William James Mummery.
William Edward Prather
University of Maryland.
Frank S. Prettyman.
Ellen Dennison Searle.
Edward Douglass Slawson
Joseph Allen Snyder.
Edward Bartlett Spalding.
Carrie Marsden Stewart.
George Ernest Tribby.
Anthony Van Kammen.
Austin Smith Watrous.
May Weston.
MEMORANDA.
Uni-
D. D. S.
Have you used Europhen ?
Are you going to Niagara Falls ?
Dr. B. H. Teague, of Aiken, S. C, visited Chicago recently.
Dr. C. L. Goddard, of San Francisco, visited the Hawaiian Islands last month.
608 THE DEXTAL REVIEW.
Dr. W. J. Younger, of San Francisco, was a recent visitor to Chicago.
Drs. R. N. Laurance and C. A. Kitchen spent a few days in Chicago in June.
We learn that the Dental Department of the University of Denver, has been
abandoned.
Dr. A. E. Baldwin is the new Chairman of the Section on Dental and Oral
Surgery of the A. M. A.
The twenty-second annual meeting of the Wisconsin State Dental Society,
will be held at Milwaukee, July 1!) to 22, inclusive.
Dr. A. P. Southwick is the Secretary of the dental department of the University
of Buffalo. His address is No. 11, Niagara street, Buffalo, N. Y.
The Missouri State Dental Association held its twenty-eighth annual meeting
at Artesian Park Hotel, Clinton, Mo., and was largely attended.
Mr. H. Baldwin, M. R. C. S., L. D. S., has an interesting article on " Non-
cohesive gold and tin fillings," in the Dental Record for June.
Dr. Garrett Newkirk has been appointed on the State Board of Dental Exam-
iners for Illinois in place of C. R. E. Koch, who declined reappointment.
The Missouri Dental College will be located in the new college building on
Lucas Place, St. Louis, at the beginning of the fall term, September 27, 1893.
It is now the Cosmos and the Journal of the B. D. A. who are paying each
other delicate and sarcastic compliments. Wonder when our turn will come ?
The following gentlemen compose the Board of Examiners of the District of
Columbia ; John B. Rich, H. B. Noble, J. R. Walton, L. C. F. Hugo, and W.
Donnally.
James Miller and Tullius Fay, of Paris, were fined for injecting cocaine into a
patient's jaw, recently, without being licensed so to do. Both are Englishmen not
possessing registrable qualifications in France.
Mr. Harry Rose, L D. S., is the new dean of the National Dental Hospital
of London, England. Very soon the hospital will be located in its new building,
now in course of construction.
CAMPHOID.
Camphor, twenty parts; alcohol, twenty parts; pyroxylin, one part. A good
protective.
AMERICAN DENTAL ASSOCIATION.
The above association will convene at Niagara Falls, New York, Tuesday,
August, 2d, and continue in session four days. Be sure to attend.
Drs. H. B Noble, Wm. Donnally. L. C. F. Hugo, J. H. Lewis, and S. L.
Hills have been largely instrumental in getting a law passed to regulate the prac-
tice of dentisty in the District of Columbia, the full text of which we publish in
this number.
Felix Weiss, L. D. S., is deceased. Mr. Weiss was respectively Librarian,
Secretary, and President of the Odontological Society of Great Britain, and a very
MEMORANDA. 609
voluminous author and earnest advocate of dental education and legislation in
England. He will be universally mourned.
By decrees of the 19th of February and 22d of March, the two dental schools
of Paris have been decided to be establishments of "public utility," and will be so
recognized and published in the official gazette of the laws of France. Approved
by Carnot, President.
In cocaine poisoning the patient should be placed in a horizontal position.
Bathe the face in cold water, let the patient inhale nitrite of amyl, give coffee or
caffeine or inject ether subcutaneously, massage, flagellations, and artificial res-
piration should be resorted to if necessary.
A large number of dentists throughout the country are becoming interested in
the reading classes established by the Post Graduate Dental Association. This
character of home reading will undoubtedly prove very beneficial to those who
join the classes and pursue the study recommended.
The annual session of the Wisconsin State Board of Dental Examiners, will
be held at the new Pabst Hotel, Milwaukee, July 19th, 20th and 21st.
Edgar Palmer, Secietary,
LaCrosse, Wis.
Recently ye editor entered a building in Chicago, where nearly all the offices
are filled by dentists and approaching the magnate who runs the elevator " asked
if he were the new elevator ;nan " " yes," said he, " but I think I'll quit, would
you like the job " ! And then the editor walked out.
At the regular monthly meeting of the Chicago Dental Society held Tuesday
evening, July 12, Dr. E. A. Royce read a paper entitled "Filling with Crystal
Gold on the Surface of Amalgam." "»
CROTON CHLORAL.
Croton chloral in five to ten grain doses, in pill form, administered three times
a day will often relieve facial neuralgia when other remedies will fail. The dose
should be diminished after two or three days to five grains or less as occasion de-
mands.
The annual meeting of the Delta Sigma Delta Fraternity was held at Forest
Glen Park, Lake Geneva, Wis., July 5 and 6. The revised constitution, by-laws
and code of ethics was adopted. The following officers were elected for the
ensuing year: D. C. Bacon, S. G. M.; R. B. Tuller, S. W. M.; Louis Ottofy, S.
T.; and T. A. Broadbent, S. S.
INDIANA DENTAL ASSOCIATION.
At the thirty-fourth annual session of the Indiana State Dental Association
the following officers were elected : President, Robert W. Van Valzah, Terre
Haute; Vice-President, W. M. Hindman, Vincennes; Secretary, G. E. Hunt,
Indianapolis; Treasurer, R. T. Oliver, Indianapolis. G. E. Hunt, Secretary.
HONORED.
The honorary degree of Master of Arts was conferred on R. R. Andrews, D.
D. S., of Cambridge, Mass., by Dartmouth College, at the annual commencement
610 THE DENTAL REVIEW.
held June 30th, 1892. This is a well-merited recognition of much painstaking
labor by Dr. Andrews in the field of science.
It may not be known to many that it requires considerable care not to violate
some code, law or rule of associations of which we may be members. A resolu-
tion which was adopted in 1888 at Louisville by the American Dental Association
is as follows:
'■Resolved, That it is unprofessional to use on cards or signs anything except
name, title and address, "
The next meeting of the Northern Ohio Dental Association will be held in
Akron, Ohio, the first Tuesday in May, 1893. The newly elected officers are: W.
H. Whitslar, Cleveland, President; S. B. Dewey, Cleveland, Vice President; H.
Barnes, Cleveland, Corresponding Secretary; L. P. Bethel, Kent, Recording Sec-
retary; Chas Buffett, Cleveland, Treasurer. H. Barnes;
Corresponding Secretary.
NATIONAL ASSOCIATION OF DENTAL FACULTIES.
The Ninth Annual Meeting of the National Association of Dental Faculties
will be held at Niagara Falls commencing on Monday, August 1, 1892, at 10 o'clock
A. M. Each delegate must be a member of the faculty of the school he repre-
sents, and be provided with the proper credentials.
W. H. Fames, Pres. J. D. Patterson, Sec'y.
The London Polytechnic has already booked more than 800 for the World's
Fair tour which it has undertaken to manage for English artisans, and the number
is being increased daily. These excursionists will visit the Exposition and inci-
dentally see the sights of New York, Philadelphia, Washington, Chicago and Niag-
ara Falls, on a total expense, including transportation both ways, of about $125.
They will be comfortably lodged, while in Chicago, in D. L. Moody's bible insti-
tute, and in barracks on a block of ground belonging to Marshall Field, the use of
which accommodations has been donated by the gentlemen named.
TAKE notice.
The following amendment to be introduced directly after the period at the
end of the word "year" in the twenty-seventh line in the Senate copy of H. R.
bill No. 7690 of this session of Congress, which passed the House of Representa-
tives June 4, 1892 :
"Provided, that nothing in this act shall be construed as authority to collect
statistics from professional men, such as lawyers, physicians and dentists, of the
products made for their individual clients or patients."
A PROTEST.
A committee representing Maryland, Pennsylvania, New Jersey, New York,
Connecticut, and District of Columbia, had a hearing last Monday, June 20th,
before the Census Committee of the U. S. Senate (Hon. E. Hale, Chairman), pro-
testing against the classing of dentists as manufacturers, and asking for an amend-
ment 'see enclosed). The Superintendent of the Census was present, and agreed
in writing to carry out the amendment in spirit and letter. We regard it as a
great victory for our profession. Sincerely yours,
H. B. Noble.
MEMORANDA. 611
The North Dakota State Dental Society meets at Grand Forks, August 17-18.
It is anticipated that the meeting will prove to be one of great interest and bene-
fit. Among those who have consented to be present will be Dr. T. E. Weeks, of
Minneapolis, who will deliver a lecture; Dr. S. J. Hill, of Fargo, will read a
paper on the "Early History of Society and Legislation in the Ftate ;" Dr. A.
T. Bigelow, of Bismarck, will read a paper on "Pioneer Dentistry in North
Dakota," Dr. Louis Ottofy, of Chicago, will read a paper on "Post Graduate
Study,"
Dr. Nason, the secretary of the new dental society at Omaha, Neb., was a re-
cent visitor to Chicago.
Dr. N. D. Edmonds, the genial and popular young demonstrator in charge of
the Infirmary of the Chicago College of Dental Surgery, hath turned Benedict,
taking unto himself a charming bride. A host of students wish him an eternal
honeymoon.
AMERICAN DENTAL ASSOCIATION.
The executive committee is completing arrangements regarding railroad and
hotel reduction for the meeting to be held at Niagara Falls, j^ugust2-5. The pro-
gramme when completed will be sent to members and to the profession generally.
Any one desiring to attend must provide himself at the starting point (and at each
point where another railroad line carries them), with a certificate showing that
one regular full fare has been paid. As the various accessory meetings, such as
the National Association of Dental Faculties, the National Association of Board
of Dental Examiners, various committees of the World's Columbian Dental Cc«i-
gress, the Dental Protective Association, and the Post-Graduate Dental Association,
will begin July 29, the executive committee has arranged that tickets will be good
from July 26 to August 8 inclusive.
The chairmen of the sections are requested to call meetings of their re-
spective sections before the general meeting on August 2, and be prepared to pre-
sent their reports promptly, when the sections are called.
DEATH FROM A SINGULAR MALADY. JAMES MULLEN DIES AT LOUISVILLE FROM A
DISEASE OF THE BLOOD.
Louisville, June 26. — From a hole not larger than a pin point, James Mullen
of 1012 Seventeenth Street, bled to death yesterday morning. He had been ill for
several months, and his malady baffled the physicians who attended him. Dr.
Wood, who was with him when he died, ascribed his death to the fact that bis
blood had lost all its coagulative power and had taken in its appearance the quality
of milk. The corpuscles of the blood had become perfectly white. From a small
scratch or cut the blood flowed with such rapidity that on several occasions it was
scarcely able to be stopped before causing death. Yesterday morning one of the
smallest of the blood vessels under the tongue became broken. The point where
the blood came from was so small that no danger was apprehended at all. All
efforts, however, to stop the flow were futile. Every remedy was resorted to, but
to no avail, and in little less than an hour Mr. Mullen bled to death.
612 THE DENTAL REVIEW.
Dentists and the Census Bill. — A bill was introduced in congress last
week that, if passed, will have a direct bearing upon the completion of the bulle-
tin of Baltimore manufacturing statistics.
As the census law at present exists, there is a doubt as to whether the penal-
ties for refusing to answer questions asked by the enumerators, apply to all
branches of statistics included within the scope of inquiry of the census ofiBce, or
solely to the population statistics. It is feared that prosecutions can be made only
in those cases where citizens have refused to answer the questions put to them by
the population enumerators, and that the agricultural, manufacturing and other
divisions have no authority to enforce answers to such questions as may be asked
by their enumerators. The bill referred to provides penalties for refusal to
answer any questions included in the schedules of the census office, and will be
used in the nature of thumbscrews and spiked boots to enforce replies.
The dentists of Baltimore, who, by their refusal to answer certain questions
asked by the manufacturing division enumerators, have caused the delay in the
work of preparing the bulletin of Baltimore's statistics of manufactures, will be
the first victims of the inquisitorial machine, if the bill is passed. The Balti-
more bulletin of manufactures cannot now be brought out, before midsummer.
Had these dentists answered the questions put them by the enumerators, the bulle-
tin would have been issued last '\^XiM2.xy .^-Balliinore American, April, 1892.
WISCONSIN STATE DENTAL SOCIETY, MILWAUKEE, JULY 1!) TO 23, INCLUSIVE. SUB-
JECTS AND ESSAYISTS.
"Dental Medicines, their Specific Action and when Indicated." Dr. Edgar
Palmer, La Crosse.
"A Glance at Familiar Characters." Dr. George H McCausey, Janesville.
"The Use of the Public Press." Dr. J. W. Gale, Chippewa Falls.
"Reflex Action." Dr. O. Thompson, Neenah.
"Electricity as Applied to Dentistry. Illustrated with all the Electrical Ap-
pliances used in Dentistry." Dr. F. H. Berry, Milwaukee.
"A Talk about Toothache." Dr. C. C. Chittenden, Madison.
"Dental Advertising. ' Dr. Jas. P. Flaherty, West Bend.
"Dental Ethics." Dr. W. H. Carson, Milwaukee.
"Educating the People." Dr. H. A. Palmer, Edgerton.
"Pfeculiarities of the Mouth under Plates." Dr. R. E. Maerkelein, Mil-
waukee.
"Typical Cases of Irregularities, and Treatment of Fractures of the Maxillary
Bones," (Illustrated.) Dr. E. H. Angle, Minneapolis. Minn.
"Inlays of Various Kinds, Illustrated by Charcoal Sketches, and Cases out of
the Mouth." Dr. G. V. I. Brown, Duluth, Minn.
State of Illinois, I
State Board of Health. ^
office of the Secretary, Springfield, June, 1892.
Smallpox in New York City, Pittsburgh, Pa., at several places in Ohio and
West Virginia, in Iowa and Michigan, as well as recent cases in Chicago, clearly
indicate that this loathsome disease again threatens Illinois after ten years of al-
most complete freedom from its ravages.
MEMORANDA. 613
The last smallpox epidemic resulted in panic and quarantine ; interrupted
travel, traffic and business; closed schools, churches and courts; caused 8,856
cases and 2,978 deaths, and involved a money loss of nearly $7,500,000 — without
counting the value of human life destroyed or the permanent disability of many
of the survivors.
It is a demonstrated fact that the epidemic continued to increase in extent
and virulence until a system of wholesale Vaccination and Revaccinalion was put
into effect by the State Board of Health. It is an equally well-demonstrated fac^
that within twenty days after this wholesale vaccination was well under way
there was a sudden and marked decline in the epidemic, which decline contin-
ued until the disease died out for want of unvaccinated individuals on which to prey.
Illinois cannot afford another smallpox epidemic — still less can Chicago,
with the World's Fair on its hands.
There is only one sure method of prevention.
Vaccination properly performed and duly repeated with reliable vaccine,
under aseptic conditions, is incontestibly proven to be a safe -and positive pro-
tection against smallpox.
The Illinois State Board of Health desires to secure this protection for
the commonwealth now — while there is yet time, before the smallpox contagion
shall have been still further introduced from neighboring communities, or
through hordes of unvaccinated immigrants, or by the multitudes attracted by the
Columbian Exposition.
To this end the board enjoins upon municipal authorities and upon local
boards of health the urgent necessity of steps to secure the vaccination or revacci-
nation of all over whom they have authority.
Ordinances should be passed enforcing this measure upon all school children,
public, private and parochial, as well as upon teachers, janitors and others; upon
all public employes and officials, and, generally, upon all citizens who may be
reached in this manner. Employers of labor, skilled or unskilled, should exact
this protection as a condition of further employment. Superintendents of public
institutions should cause every inmate, employe and official to be at once vacci-
nated or revaccinated.
The board will use its resources to secure the end in view.
It will furnish carefully selected, reliable vaccine at wholesale cost, accom-
panying each package with plain, practical instructions for the operation. To
communities unable to purchase vaccine, if any such there be, it will be furnished
gratuitously on proper representation of the facts and an agreement to report re-
sults on the blanks furnished by the board.
Finally, the board appeals to the public press, as the most effective agency in
informing the public as to the necessity and the sufficiency of vaccinal protection
against smallpox.
Editors who receive this circular-letter are earnestly requested to publish its
substance, or otherwise to urge their readers to act upon its suggestions.
F. W. Reilly, M. D., Secretary. VV. A. Haskell, /';v.f/V<?///.
POST GRADUATE DENTAL ASSOCIATION.
The following circular letter has been issued;
The Post Graduate Dental Association of the United States is an organization
solely engaged in the work of educating dentists. By different courses of reading
614 THE DEXTAL REVIEW.
it aims to reach every class of dental practitioners. These courses of reading are
divided into pregraduate and post graduate courses, the one designed for the non-
graduate, the other for the graduate. The classes organized and to be organized
are as follows.
Class A. Two years' course; composed of practicing dentists and students or
those who desire strictly practical instruction, who have never attended a regular
course of lectures, or a practitioners' course at a dental college, but who eventu-
ally expect to attend a dental college, and of those practitioners not mentioned in
the succeeding courses. At the close of the term the successful candidate receives
a certificate of proficiency.
Class B. Three years' course. Composed of practitioners whose aim is not
future attendance at a dental college, on account of age, permanence of location,
lack of means or any other cause, but who are desirous of improving themselves
and of giving the best service to their patients. This is a combined scientific and
practical course. On its successful completion the candidate will receive a cer-
tificate of excellence.
Class C. Four years' course. Composed of practitioners who are graduates
of dental or medical colleges in regular or special courses, or who have attended
a practitioners' course. This is a combined course comprising dental science and
practice and the study of collateral sciences. On completion, and the successful
passing of a thorough examination, the successful candidate becomes a member
of the Post Graduate Dental Association and receives the degree of Fellow of
Dental Science.
Class D. Five years' course. Composed of regular graduates of dental and
medical colleges of not less than five years' standing and of nongraduates, who
(1) have been in active continuous practice not less than ten years: and (2) have
completed either course A, B or C; (3) can pass a satisfactory preliminary exami-
nation and furnish satisfactory evidence of original thought and research in the
domain of dental science. At the end of the five years' course they become
members of the Post Graduate Dental Association and must pass a rigid examina-
tion, practical, oral and written, before a Board of Examiners, upon whose unani-
mous recommendation the degree of Doctor of Oristry, will be conferred on the
successful candidates.
This in brief, is the outline of the work of the Post Graduate-Dental Associa-
tion. Any one entitled to follow the course of reading of any of the advanced
classes may also at the same time be reading in any or all other classes. Class A
is now instituted and all desiring to enter it should at once communicate with the
manager of the association.
The complete expense of the two years' course is $9.00. The two books
alone and the German silver would cost, if bought by the individual, $0.00. The
amount (except membership fee) may be paid at such times as you may desire.
For instance, you can send for Black's Dental Anatomy and your membership fee
now, making $4.25. Within six months send for Evans' work and practical out-
fit furnished you by the association at a cost of $2.75; at the end of one year send
your membership fee of $2.00 for the second year, making a total of $9.00 in two
years. If circles are organized, the cost will be reduced, in a circle of two mem-
bers to $6 72 each, three members $5.85 each, etc.
Any information in regard to dental reading, whether you are a member of
any class or not, will be cheerfully furnished on application.
Respectfully yours.
Post Graduate Dental Association,
Masonic Temple, Chicago.
THE
DENTAL REVIEW
Vol. VI. CHICAGO, AUGUST 15, 1893. No. 8.
ORIGINAL COMMUNICATIONS.
The Application and Influence of Force in Orthodontia.
By C. S. Case, M. D., D. D. S., Chicago, III.
The operation of correcting irregularities of the teeth by me-
chanical force is gradually being placed upon a scientific basis,where
even the most difficult cases may no longer be considered doubtful
problems, or their perfect restoration more than should be naturally
expected from the hands of a dentist who gives this department of
his profession its legitimate share of his attention.
This I believe to be largely due to the somewhat modern
adoption of the banding of teeth as a means of support to regulat-
ing appliances ; which enables one to construct an apparatus that
can in most instances be permanently attached to the teeth from
the beginning to the end of the operation ; that will possess proper
machinery for delivering the force in amount and quality directed
and controlled throughout all the processes of change in exact
accord with physiological requirements ; and finally to possess
means for holding the teeth until they are permanent in their
new and regular positions.
It is unfortunate, however, that our literature in this depart-
ment is far from complete, judging from the most modern publi-
cations ; and will continue to be so as long as text-books upon
orthodontia ignore as a prime factor to the beginning of every
work, the principles of philosophy of force in all its relations to
this subject. For if anything is true, the whole subject from a
mechanical standpoint of correcting malposed teeth, resolves itself
616 THE DEXTAL REVIEW.
into a question of ways and means for the utilization of force — its
application, transmission, distribution and management along lines
of contact and resistance.
Nearly all the literature upon this branch of the subject deals
with specifics rather than principles, and consists largely in a vast
number of histories of cases in practice, with the particular method
of treatment so emphasized by the author that a novice would
imagine there was no other way than the one described — whereas
there may have been a number of even better ways. Show me a
case of irregularity of teeth, and I will study out a half dozen ways
for correcting it, many of which as they occur to me will seem to
be the only true way, until by continuing the study I am suddenly
surprised by another and far more practical way which arises in
thought.
We are all more or less influenced in our professional lives by
others who perhaps have made a special study of some particular
branch, and whose teachings we are glad to accept as a guide in
our daily practice ; yet in every department there will arise indi-
vidual peculiarities which demand individual thought and variation
of treatment; and what is of peculiar importance in this department:
— there are rarely two cases of malposed teeth so alike that each
does not demand some peculiar and very important variation in
the correcting apparatus. Even where the teeth in some case
presented for treatment, seem to be situated in exactly the same
position shown in the illustration of a similar case in text-book or
periodical, there may be other and equally important conditions —
not shown or mentioned by the author — which make the two cases
decidedly different, and the method he has successfully used quite
impractical for us.
To those therefore who hope to be eminently successful in this
department I wish to emphasize the importance of thorough
training in the foundation principles. Know well the possibilities
presented by nature; the principle of force and its proper appli-
cation and management; then if you will adopt some system in
the main whereby the appliances may be constructed under your
immediate supervision — permitting a freedom of ingenuity not pos-
sible in an attempt to use some particular set already in the market
— a far more perfect treatment of malposed teeth will be given,
suited to the needs of particular cases in hand.
In the short time alotted to a paper I shall attempt to give only
ORIGINAL COMMUNICATIONS. 617
a few thoughts relative to the principles of force in the correction
of irregularities of the teeth, dwelling more particularly upon the
influence which different ways of attaching the appliance have in
the production of certain movements — on the one hand to obtain
all the advantage which the force employed affords in producing
the greatest amount of- movement, and on the other, of so distribut-
ing or managing the anchorage force that little or no movement of
other teeth is produced.
In correcting the positions of malposed teeth, it should never
be forgotten that the important and indispensable part of the
operation is to so regulate the force that the normal functions and
healthful conditions of the teeth and surrounding tissues are pre-
served, and that nature will permit their movement, physiologically,
only so rapid as she is able to take care of the broken down tissue
of retrogressive metamorphosis, caused by pressure of the tooth
upon the walls of the alveolar socket. The rapidity of the move-
ment will be influenced largel}^ by the age of the patient, and differ
as other things differ with people.
The point which interests us under the caption of this paper
relative to the application of force may be stated as follows: as
soon as the applied force overreaches the possibilities of natural
(and I may say phj'siological) change — the surplus is liable to
spend itself in producing some undesired and unlooked for condi-
tion. In other words, nature can work only so rapidly, and any
attempt to force her beyond her natural powers will result — if not in
disaster — certainly in a misdirection, and transferal of the force to
other parts which should not, and would not, otherwise be disturbed.
For instance, it is not always possible to move the apices of the
roots of teeth in the same direction that we are able to move the
crowns and it is usually quite important to avoid moving them in
an opposite one.
On account of the relatively hard surface layer of alveolar proc-
ess there is always a tendency for it to act as a fulcrum over which
the tooth is tipped; but fortunately the apical region of bone in
which the roots are imbedded usually presents sufficient resistance
for it to remain as the true and immovable fulcrum of the lever so
long as the force is not increased beyond the powers of absorbtion
in other portions of the socket. The moment this does occur, how-
ever, the peripheral surface of the alveolus becomes the fulcrum
while the load is delivered at the end of the root in the opposite
618
THE DEXTAL REVIEW.
direction, and in exact proportion to the surplus force. If we ad-
mit that the apical portion of the socket — blending as it often does
with the cortical layers of true bone — presents greater resistahce
to changing the position of that portion of the root, there can be
but one conclusion, viz: So long as the pressure is kept within
physiological bounds, it makes little difference in regard to the
length of the arm of the lever, or, in other words, whether the force
is applied near the occluding surface of the teeth or at the cervix,
providing always that it is not restricted in its action by the method
of attaching the appliances.
As an illustration, notice the action of the force of an oar in
propelling a boat in still water. If only sufficient pressure is used
against the oar to permit the water to pass from in front of the
slow-moving blade, there will not be sufficient pressure at the ful-
crum, or oar-lock, to overcome the inertia of the boat; but imme-
diately upon the force being increased above the possibilities of the
water to get out of the way, the fulcrum of the lever is transferred
to the water and the load of surplus force is delivered at the oar-
lock with a movement of the boat. Let me give another and
FIG. 1
ORIGINAL COMMUNICATIONS. 619
perhaps, more forcible example. Drop the point of a crow-bar
into the ground at the side of a large cake of ice fixed immov-
ably in place. (See Fig. 1.) Now, if we heat the bar and press
it against the cake with only sufficient force to permit the ice to
melt in front of it, little or no change of position will take place at
the front of the bar, but the moment we increase the pressure above
the melting possibilities of the ice, the fulcrum of the lever is trans-
ferred to the cake and the load of surplus force is delivered at the
point of the bar, with a tendency in proportion to the pressure
of forcing it laterally in an opposite direction in the ground. This
illustration is only one of many conditions which may and often
are produced by excessive or misapplied force in operations for
correcting irregularities of the teeth.
It must never be forgotten that the exact load or measure of
kinetic force used in the movement of a tooth must always be ex-
pended in another direction upon a rest or anchorage.
It has been the common custom for a great many years of dis-
tributing this second force upon a broad surface, by means of a
plate where it was received partly upon the jaw and partly upon
a number of teeth producing no material change in their position.
With modern methods for correcting the position of malposed teeth
there is not often a need for an anchorage plate, and there are
many reasons for avoiding its use — which it is not necessary for
me to mention here. Suffice it to say that the single reason alone
of the instability of such anchorage, making it impossible to utilize
and properly direct the positive and intermittent force of a screw,
would be sufficient for me to employ other means for this purpose,
which are now amply supplied by attaching the appliances to
bands permanently cemented upon the teeth.
Perhaps the most scientific and important possibility in the
utilization and management of force is where two or more mal-
posed teeth are so situated that the force which would otherwise
be expended upon a static anchorage for the movement of one, is
neutralized and rendered inert, by an equal force for correcting the
position of another or others. A single form of this is shown
when a wedge, spring, or jack is used to separate two teeth
approximal to each other or on opposite sides of the mouth, each
requiring the same magnitude of force. But if a proper amount
of study were given to every case, and sufficient ingenuity em-
ployed in the construction of the apparatus, a vast variety of
620 THE DENTAL REVIEW.
changes would be found possible, and often with little or no force
expended upon teeth other than those required to be moved.
Under this head I wish to mention an implement which I call a
"jack and traction screw." It was introduced at the First District
Dental Society of New York City in, 1890, and published in the
April number of the Cosmos of that 3'ear, but I have since made an
important addition to it which greatly enlarges its usefulness.
See Fig. 2. With this implement the anchorage force used in the
FIG. 2.
movement of one tooth is rendered inert by an equal force ex-
pended upon another tooth in an opposite direction. Originally it
was intended to move two teeth which were approximal or situated
near each other, the one standing within the arch and the other
without, both requiring the same magnitude of force to correct
their positions. By means of the improvement if one tooth takes
its position now before the other the force can be immediately
transferred from it to a static anchorage on the opposite side of the
jaw, or to some other tooth requiring the same direction of move-
ment, after which the apparatus can be made to continue its work
until the other tooth has been forced to the desired place.
The improvement or addition consists in resting the end of the
screw bar, loosely in a short tube soldered to a static anchorage
bar, or to a bar or contrivance extending from some tooth which
requires to be moved or rotated, and which is brought into the
field of work to utilize the force of inequality, which would other-
wise need to be transferred to — and, therefore, lost in — a static an-
ORIGINAL COMMUNICA TIONS.
621
chorage. Then, by adding two extra nuts to the screw bar, the
force can be perfectly directed and controlled. For instance, in
Fig. 2, if the bicuspid comes to place before the cuspid has been
forced out from its inlocked position, the nuts 2 and 3 are tightened
on either side of the anchorage bar fixing it immovablj^ to the an-
chorage teeth, while by operating nut 1 the cuspid is continued to
be forced to place. If on the other hand the cuspid goes to its
place first, nut 2 should be loosened and nut 3 made to do the work
of pulling in the bicuspid, while nut 1 is kept sufficiently tight to
FIG. 3.
FRi. 4.
hold the cuspid in place. Fig. 3 represents the teeth after correc-
tion. Fig. 4 shows the original position of the cuspid inlocked by
the lower bicuspid.
622 THE DEXTAL REVIEW.
Another very important application of the jack and traction
screw — where it can be used — is in torsion, and especially when the
tooth to be operated needs also to be pushed out or drawn back
into the arch.
A thin band soldered to the end of the bar is passed around
the tooth and buttoned to the cemented band, while the base of the
jack rests against a lug or series of lugs on the opposite side. As
the nut is turned, a traction force is extended upon one side of the
tooth and an equal jack force upon the other, rotating the tooth
upon its long axis which is the only true way of torsion. Other
motion if required is produced by operating the nuts at the end of
the bar. See Fig. 5.
FIG. 6.
In regard to methods of attaching the appliances to teeth to
produce required movements or static anchorage, I desire to have
it understood that I claim no originality. My purpose only is to
emphasize some of the important rules laid down by others.
In order to bring these ideas practically before this convention
I have constructed a large model of the alveolar arch in soft clay,
into which I have inserted large wooden teeth with bands and ap-
pliances attached, with the view of showing the influence in motion
and direction which different ways of attaching the appliances will
tend to produce upon natural teeth with a similar application of
force.
ORIGINAL COMMUNICATIONS.
G23
It will not be necessary for me to enter into a detailed descrip-
tion, in my paper, of different methods already published, although
I am sorry to say that no author has yet given a perfect analysis
of the distribution, management and utilization of force which
different ways of constructing regulating appliances exert. I shall
attempt to show the practical features, however, by black-board il-
lustrations and by operating the model, describing the various
methods as I proceed.
The Enamel at the Gingival Line, with Lantern Exhibit.
Bv T. E. Weeks, D. D. S., Minneapolis, Minn.
INTRODUCTION.
The purpose of this paper is to show the form of enamel and
how it encapsules and protects the dentine, placing especial empha-
sis upon that portion beneath the free margin of the gum, applying
the knowledge gained from this study to the construction of bands
or collars which form the basis of gold or gold and porcelain crowns,.
plate l
Superior Incisors and Cuspids.
PLATE II.
Inferior Incisors and Cuspids.
as in my opinion that portion of artificial crowns which is covered by
the free margin of the gum should imitate as nearly as possible the
natural protector of the tooth at this point.
I have endeavored to so select and present the illustrations
that the points will be clear with but little comment.
C24
THE DENTAL REVIEW,
All the teeth present in a labial or buccal view, the form of
truncated cones, the bases presented to the line of occlusion ; the
cutting edges or grinding surfaces (morsal surfaces of Kirk). The
molars and bicuspids viewed mesially or distally present the same
PLATE III.
First Bicuspids, Superior and Inferior.
PLATE IV.
Second Bicuspids, Superior and Inferior.
general form, while the incisors and cuspids, in this view, present
the form of cones, their bases presented rootward, uniting with the
conical roots at or about the free margin of the gum. See plates
I. to VI. inclusive.
PLATE v.
First Molars, Superior and Inferior.
PLATE VL
Second Molars, Superior and Inferior.
ORIGINAL COMMUNICA TIONS.
G25
The crowns of all the teeth, or that portion above the gingival
line, are covered with and protected by that substance which we
know as enamel, commencing with a thin edge at the gingival line,
PLATE VII.
Section of Superior First Bicuspid. Buccal View (3 In. objective).
PLATE VIII.
Section of Superior First Bicuspid. Mesial View (3 In. objective).
626
THE DENTAL KEVIEIV.
gradually becoming thicker as it approaches the morsal surface.
See plates VII. and VIII.
It also gives to the teeth the form above mentioned. The thick-
ness of the enamel is in a direct ratio to the amount of work which
the tooth from its location is expected to perform, being thinnest in
lower incisors and thickest in molars.
The dentine when denuded of the enamel presents, in a labial
or buccal view, either the form of a parallelogram or a truncated
cone with its base presented to the gingival line. In a mesial or
distal view the incisors or cuspids present the form of cones, and
the bicuspids and molars those of truncated cones with their bases
at the gingival line.
In the labial or buccal view we find exceptions to this rule in
the incisors and bicuspids. See plates I. to VI., also plate IX.
PLATE IX.
Lateral Incisor. Labial View. Denuded of Enamel on Mesial Surface (3 In. objective).
The enamel at the gingival line terminates in a thin edge, meet-
ing the cementum at this point, and usually we find the cementum
slightly overlapping the enamel. In examining a large number of
specimens we are struck with the sudden thickening of the enamel,
especially in those sections presenting a labial view. See plate VII.
ORIGINAL COMMUNICATIONS. 627
As the rods of which the enamel is composed have their gen-
-eral direction at right angles with the surface of the dentine, espe-
cially upon plane surfaces, and as the tendency of the enamel rods
is to separate in thin chips from the mass, under well-directed
force with properly-shaped instruments, when a break has once
been made, we find but little difficulty in denuding the dentine of
enamel when the tooth has been cut or broken off near the gums.
Our illustrations teach us that when this is thoroughly accom-
plished we have a properly shaped root for the perfect adaptation
of collars or bands, with the exceptions noted. They also teach
us where to look for these exceptions.*
PLATE X.
Plate X. shows the form a crown would assume were we to give
it the exact form or contour which the tooth presented before being
•denuded of its enamel. This was traced from a negative of a sec-
tional view of a superior bicuspid, and follows the lines exactly.
To one who has studied the interproximate spaces the impor-
tance of following this contour (in perfect specimens) is patent. We
should at least finish the edge of the collar, which is presented root-
ward in a rounded bevel, allow the outside, and after adapting to the
root, give it an inward inclination by rubbing it on the outside
with a burnisher. In regard to finish of this edge, observation
teaches us that a smooth edge having a proper bevel, even though
*In selecting the sections for illustration I purposely chose those which pre-
sented, before cutting, the most pronounced bell crowns.
628 THE DENTAL REVIEW.
it does not fit the root s/it/g/v throughout its whole circumference,
will cause much less irritation to surrounding tissue than one which
may fit closely, in which proper attention has not been given to
bevel and sniooihiicss of edge.
Having considered the subject from the point afforded by sec-
tional views, we come to another consideration no less important,
and which if overlooked will result in failure, even after having
paid close attention to the points already noted, /. e., the curvature
of the gingival line.
On the labial or buccal and lingual surfaces we find this line
presenting a curvature whose convexity is rootward, and which is
paralleled and indicated by the free margin of the gums; while on
the mesial and distal surfaces the convexity of the curvature is
toward the morsal surfaces, and is not so closely paralleled and in-
dicated, as the festoon of the gum is more sharply convex, and the
distance from gingival line to free margin greater than upon the
other surfaces. This shows that, while the collar may extend far-
ther under the gum upon the mesial and distal surfaces than upon
the others, it should follow closely the outline of the gums, thus
avoiding pressure at any point.
ToB.ACCo, ITS Use and Effects.
By L. L. Davis, D. D. S.. Chicago, III.
When this subject first suggested itself as a topic of some inter-
est to the profession, I expected to dilate on its useful and bene-
ficial properties as a preserver of the teeth, but the greater the
amount of literature conned to support me in that idea the more
strongly did I become impressed with the fallacy of such a position.
Tobacco is described in Farquarson's Therapeutics, as a well-
known member of the Solanacea;, and its most important constit-
uent, nicotin (Ci(,HiiN2), an alkaloid somewhat resembling
conia, but which, among other properties, is more readily soluble
in water.
Phillips describes it as possessing two active ingredients — nic-
otin, the alkaloid, which is present in the leaf, and an empyreu-
matic oil, which is generated only in combustion.
Nicotin was at one time considered as the sole agent in pro-
ducing poisonous effects. More recent researches have rendered it
ORIGINAL COMMUNICATIONS. 029
at least probable that tobacco smoke owes very little of its potency to
nicotin, and very much to the combustion products, which consist
of resinous and fatty acids, Hydroc3^anic acid and sulphurretted
hydrogen, pyridine and ammonia; of these, pyridine seems to be
the most powerful.
Pyridine and the other combustion products of tobacco seem
only to differ from nicotin in their action, so far as that they are
milder and less rapid in their toxic action.
It has been stated by recent experimenters that nicotin is not
at all present in tobacco smoke; and it is certain that the empyreu-
matic products are powerfully narcotic.
It is not my purpose to enter into a discussion of the physio-
logical and therapeutical action of the alkaloid, except to state that
it is a powerful base, and completely neutralizes acids, but to note
some of the effects of tobacco smoking, chewing, etc.
I have looked in vain through our various text-books for a
thorough treatment of this subject, and it is with a little disap-
pointment I note the brief mention made of a substance so gener-
ally used. Perhaps the various writers of text-books were addicted
to the habit, and did not wish to pry too closely into, or explain to
its fullest degree the results of the use of tobacco.
All users of the weed have at some period of their life experi-
enced the physiological effects of tobacco. Nausea, giddiness,
vomiting, cold sweatings and an exceedingly feeble pulse are the
ordinary results of first attempts to smoke.
The smoke habit once formed, chewing may be added, or, if
neither of these suit, snuff-taking may be resorted to.
Much has been said of late regarding the antiseptic properties
of tobacco smoke, and the experiments of Miller and Black prove
without doubt its potency as a germ destroyer, the smoke from
the first, third or last quarter of a "Colorado Clara" cigar being
found amply sufficient to sterilize 10 c. c. of a beef-extract-sugar
solution previously richly infected with caries fungi.
Dr. Black, from whom I quote the last statement, also adds, "In
consideration of the strong antiseptic power of tobacco smoke we
might be inclined to infer that tobacco smokers should never suffer
from caries of the teeth; it is evident, however, that there are very
many points in the dental arch to which smoke never penetrates."
To this, more arguments can be added why we should not ex-
pect to see the teeth of tobacco smokers free from caries.
€30 THE DENTAL REVIEW.
The continual flow of saliva and its expectoration as soon as
laden with the combustion products, would prevent antiseptic
action. The retention of food particles within the cavity or at the
point where the caries fungi are working, practically guards them
against disturbing influences, and our observation shows that
neither tobacco smoking or chewing prevents caries.
It may retard or render more slowly the ravages of decay, but
sooner or later the services of the dentist are needed.
Its well-known sedative action has been and is the great argu-
ment in its favor by those accustomed to it. Griesinger says, "it
aids the easy flow of ideas and equalizes the temper;" thus, in per-
sons suffering from mental derangements a desire for tobacco
should be encouraged for even such habits, unimportant in them-
selves, may assist the mind to resume its former thoughts, and fol-
low in its former courses.
In tobacco smoking, the coatiq^ of the teeth with combustion
products may prevent caries.
Tobacco smoke has been recommended in catarrhs of the
eustachian tube and tympanum, by forcing the smoke into the
interior of the ear. It has also been found beneficial in respiratory
diseases, as asthma, whooping cough, etc.
Trosseau speaks of the use of tobacco in toothache, washes of
the decoction, friction of the gums with the extract of the plant,
being very helpful, more so than the pipe or quid.
Bcerhaave directed the application of fresh tobacco leaves to
the forehead and temples for neuralgia.
The same remedy, or better the decoction or extract, is useful
in calming the pains of gout or rheumatism when superficial.
Tobacco, in small doses, used with perseverance, has a stimu-
lating action on the brain, cerebellum and spinal medulla, in cases
of paralysis. It has also been successfully used in incontinence
of the urine due to paralysis of the sphincter of the bladder, as in
paralysis of the lower limbs.
In certain headaches, especially those which seem connected
with a state of extreme dryness of the pituitary membrane, the use
of snuff has been recommended, while in many other persons the
habit of continually taking snuff keeps the mucous membrane in a
state of hyperaemia, and causes headache.
Those who suffer from chronic affection of the nostrils, and
continue to use powdered tobacco, expose themselves to many
ORIGINAL COMMUNICATIONS. 631
accidents, cases of cancerous ulceration of the skin, usually in the
eyelid or on the side of the nose, have been noted — due to no other
cause.
On the other hand, tobacco may be of use in increasing the
nasal secretions, softening them and aiding respiration through the.
nose.
The lacrymation which is caused by hardening of the mucous
of the lower part of the nasal canal may also be treated with ad-
vantage by snuff; this explains the saying, that tobacco clears the
sight.
In chronic ophthalmias it is useful as a revulsive.
The evil is close to the good, for the people whom the powder
of tobacco irritates too much, diseases of the nasal fossae may
supervene, which, communicating with the lachrymal ways at last
produce tumors or fistulae.
In tobacco chewing, the only probable good effects, come from'
the continued use of the teeth in mastication, tending to a stronger
alveolus, and perhaps by the frequent bathing of the teeth with a
solution of nicotine, a certain proportion may be absorbed by
the tooth structure inhibiting the action of caries.
One of the most often noted results of tobacco chewing, is
mechanical abrasion, and the same habit is also productive of
erosion, especially at the necks of the teeth.
Those of you who have marked the character of teeth pre-
sented to us for restoration by tobacco chewers, will bear me
out in this testimony. A yellowish-brown stained and softened
condition of tooth substance, oftentimes running completely
around the teeth, the pulps sometimes devitalized, and a condition
of affairs that call for our best skill and judgment to repair the
waste.
Recession of the gums invariably results from this habit, and
is very marked in persons long addicted to tobacco chewing, as
is also derangement of the alimentary canal, dyspepsia, etc.
Of the more chronic forms of mischief which are said to be
produced by tobacco smoking, are granular inflammation of the
fauces and pharynx, gingivitis, amaurosis, from atrophy of the
retina ; color blindness is not uncommon in smokers ; chronic dys-
pepsia is at least aggravated by the waste of saliva which should
have gone to assist digestion, and is undoubtedly a frequent result
of prolonged excesses in tobacco.
632 THE DENTAL REVIEW.
The occurrence of angina pectoris as the result of the pros-
trating influence of great and prolonged excess upon the heart has
been noted.
General nervous depression is frequently produced, showing
itself in restlessness, insomnia and a tremulous condition of the
limbs, not. unlike the phenomena of chronic alcoholism. Gingivi-
tis is, to my mind, one of the serious results of excessive smoking.
We frequently note in cases of pyorrhoea alveolaris, the inflamed
condition of the whole mucous membrane of the mouth, and I do
not believe I draw too greatly on my imagination in stating that
pyorrhoea may result from the excessive use of tobacco.
The teeth affected in such cases are those that come in contact
with the cigar, or the palatal surface of molars which receive the
full blast of the heat generated in smoking.
It is certain that in the treatment of pyorrhoea alveolaris, in
tobacco users, we cannot carry it to a successful issue unless the
patient abstains from, or, at least, moderates the smoking.
Another theory may here be advanced. By long continued
irritation of the mucous membrane, is there not a possibility that
the secretions are altered, and the saliva itself become a factor
in producing pathological changes?
There are several well-known cases of epithelioma on record as
the result of the tobacco habit; of late years there have been a num-
ber of cases recorded of insanity and death from cigarette smoking.
Heredity is a factor I have not found advanced in connection
with this subject, but if the parent has produced in himself, by the
tobacco habit, nervousness, derangement of the alimentary canal,
spinal diseases, heart failure, together with the minor disorders, the
fundamental truth that type transmits type must hold good in this
case, and may not the results in the progeny be such as renders the
child liable and readily susceptible to influences that otherwise
might not affect the general system ?
Care of the Deciduous Teeth.*
By Dr. H. J. Cole, Nokfolk, Neb.
This class of patients require more tact and skill for successful
management, and is probably more of a strain on the operator
than any other class. But they must be served, and if this paper
*Read before the Nebraska State Dental Society.
ORIGINAL COMMUNICATIONS. 633
will draw out in discussion the methods adopted by our best and
most successful operators, as how best to serve them, the object of
the writer is accomplished, I shall make no pretense at anything
new or startling, but simply outline my method of dealing with the
little ones from the time they are usually brought to us — seldom
before the fifth or sixth year — and in so doing hope to be as practi-
cal as possible. Could we reach the ears of all parents and impress
upon them the great necessity of the constant care and attention
the teeth of their offspring demand, and the suffering that may be
prevented by early and frequent visits to the dentist, then our
work with them would be comparatively easy as well as very
pleasant.
Our attitude toward this by no means small percentage of our
clientele is one that should receive considerable attention. There
is too much inclination with busy practitioners to pay but little at-
tention to the children when they tremblingly enter our offices.
But if approached rightly and confidence once gained, there is no
part of our practice that is more satisfactory, and for which more
blessings will be bestowed, and in the long run more remunerative.
Confidence of the child once gained insures the confidence and
patronage of the family.
If that cannot be done at the first visit, better a great deal dis-
miss the little one for the time being, and make an appointment
for another da}'. We must study children closely, being ever kind,
yet firm, using no deception.
The trouble we have with so many children is due in a great
measure to their parents or those with whom they are closely asso-
ciated so often relating in the presence of the child their experience
while in the dental chair, until the very presence of the dentist on
the street causes a thrill of horror to creep over the little frame.
The next thing we see the same personage entering our office
with the young hopeful crouching beneath the folds of her skirts,
and all the while assuring the child that it "won't hurt."
The first thing then is to allay the child's fears if possible. If
the work necessary to be done should cause pain, say so kindl)^,
and if the parent is inclined to give more trouble than the child,
you should not hesitate to invite her to occupy the waiting room.
After the first visit, if another is necessary, I invariably encour-
age the child to come alone the next time, and usually succeed.
If not entirely alone, accompanied by a schoolmate or playfellow.
634 THE DEXTAL REVIEW.
Nothing adds so much to a Httle fellow's courage and importance
as to be able to show his playfellow what he can endure.
Occasionally the disposition is such that it may be necessary to
use force to compel submission to some slight operation — such as
the removal of a very loose tooth to give room for the permanent
one that is being forced out of position.
And in this connection I would say, cultivate skill with the fingers
and remove as many such as possible without the aid of instruments,
and when once understood you will be surprised at the number
that can be displaced in such a way.
For such operations, if the child's fears cannot be allayed, I
think it is better as a rule to use a napkin saturated with chloroform
held to the nose for a few moments.
Whatever is done we should aim to make a friend of the child
before he leaves the office. Next the eruption of these teeth should
be superintended by a competent dentist. With all due respect
to the knowledge and skill of our family physicians, in infantile
troubles of doubtful diagnosis the dentist should be consulted as to
whether or not the trouble may not arise from dental irritation.
We should endeavor to impress upon the parents the great ne-
cessity of looking after these teeth and not allow them to decay down
to the gum margins without an effort being made to preserve them.
The natural way is for these organs, by the absorption of the roots,
if not actually to fall out of the way of the permanent ones, to become
so loose that they are easily displaced. If for any reason such ab-
sorption does not take place, under no circumstances should the
first one be allowed to remain in place till the second is making its
appearance through the gums, causing irregular permanent ones.
Neither should the first ones be removed too soon for obvious
reasons. Whilst a great deal of the alarming prevalence of decay
is owing to lack of function, yet instruction should early be given in
the use of the toothbrush, and those in charge of children should
be impressed with the importance of frequent and thorough clean-
ing of the teeth as well as the whole body.
After their eruption, they should be examined from two to four
times a year and such attention given as the case may require.
When the time comes for their removal, the skillful dentist is the
proper person to perform such operations.
We come now to the treatment of caries in such teeth and take
it for granted that all are agreed that such should be filled.
ORIGINAL COMMUNICATIONS. 635
For cavities of decay where the pulps are not exposed in pre-
paration for filling use sharp spoon and battle-ax excavators re-
moving the decayed tooth substance as carefully and thoroughly as
possible. I would seldom if ever use the engine in such cases, as
the cavity can be prepared with much less dread, and almost as
quickly with the proper excavators. For such cavities on the grind-
ing surfaces usually use amalgam, and in approximal cavities where
a sufficient undercut is easily obtained I would also use amalgam, but
where I cannot get sufficient undercut without causing pain, quick
setting cement, and frequently gutta-percha is the best thing to be
used. Often in approximal cavities where both teeth are involved
good results are obtained by using gutta-percha, pressing it into the
cavity, uniting both teeth by the filling.
When the pulp is exposed and badly inflamed, causing parox-
ysms of pain to the little sufferer is the trying time both for opera-
tor and patient. In such cases always the first thing is to relieve
the pain, and by washing the cavity with warm water, drying and
applying a little oil of cloves the desired result will usually be ob-
tained. Have also had good results with campho-phenique. In
nearly all such cases would keep the cavity sealed with occasional
changes in the dressing till the pulp dies, then remove and fill the
canals with chloro-percha and the cavity of decay either with
gutta-percha or amalgam.
Where there is a putrescent pulp causing an abscess to form,
accompanied by profuse swelling of the surrounding tissues, as in
the former case, the first thing is to relieve the pain, though the
method of relief be quite different.
Usually the desired result may be obtained by removing the
debris from the cavity opening into the pulp chamber and letting
the pus escape. Then by applying a dressing of oil of eucalyp-
tus or campho-phenique, seal up the cavity temporarily and dismiss
the patient for a few days.
As a rule at the next visit the roots and crown can be filled.
Then proceed as before described.
If the pus cannot be gotten rid of in the way indicated it may
sometimes be advisable to open through the gum; but I would pre-
fer, if the child be 7 years old, for either the first or second
molar, extraction rather than the latter method. For it is a clini-
cal fact if either temporary molar abscesses and is removed
as early as the seventh year, before the eighth the bicuspid is
636 THE DENTAL REVIEW.
making its appearance. In all operations on the temporary teeth
the operator should be very careful not to allow an instrument to
slip, an}' medicine to touch the tongue, or anything that will shake
the confidence of the child. It is very seldom that the rubber dam
can be used, so we are obliged to resort to other means for keeping
the tooth dry. Very small soft napkins or rolls of absorbent cotton
carefull)' applied are quite efificacious.
But don't do anything that will make the child imagine that he
is going to be choked to death. Better fill the tooth even if a little
moisture does get in, than to unnecessarily frighten the patient.
Crown and Bridge Work.*
By Geo. S. Nason, D. D. S., Omaha, Nebraska.
I fully appreciate the fact that writing on any subject is out of
my line, but circumstances over which I had no control forced me
into it, so my dear brethren at the close kindly take into consider-
ation the fact that this is my first offense, deal with me gently and
I will promise in the future to avoid all such dilemmas.
The first step, as you all know, in crowning a root is to get it in
proper shape by the use of antiseptic medicines and filling the
canal. I have had marked success in filling root canals with
Caulk's cement and iodoform, half and half mixed into a thin paste,
inserted by the use of a thoroughly saturated cotton string, owing
to the odor attached have given it up and returned to gutta-percha
points in connection with chloro-percha which answers the pur-
pose admirably. Take an accurate impression of the root and
adjoining teeth, as a rule modeling composition is all right, but
once in a while I have to resort to plaster. It is a wise scheme in
all cases to take a measure with binding wire as it prevents possible
mistakes.
If there are articulating teeth take a wax bite, mount on the artic-
ulator and carve up to suit the case, trim and fill in or out as the
case may be so that there are no undercuts and get a good mould.
I find zinc as a rule is the best material for a die, as it is not easily
misshapen in swaging. It is nearly always necessary to smooth it
a little with a file. Make a model of heavy tin and cut and solder
the band. I use gold coin rolled out in No. 31 standard gauge and
solder with 20 k, solder.
•Read before the Nebra.ska State Dental Society.
ORIGINAL COMMUNICATIONS. 637
For bridge work, in cases where sound teeth are capped, shape
up with corundum wheels and take impression in plaster of Paris
and pumice or sand, equal parts of each, dry out thoroughly and
pour zinc.
Where roots are capped the same process as in crowns
applies, fit the crowns, take the wax bite without disturbing their
positions and then get an impression, drawing the crowns off in it,
varnish and oil. After it has thoroughly hardened, mix plaster and
pumice or sand half and half and pour, being sure the crowns are
filled separately. Place the bite in position, mount on articulator,
grind facings and caps in position, invest and solder.
For the crowns, use coin gold hardened with platina, melt the
gold and add platina in small thin strips, as long as it is taken up
rapidly, drop in muriatic acid and roll out to No. 31 standard gauge,
soldering with coin. For final soldering use No. 20 k. solder,
polish and set on the root.
President's Address.
By Dr. A. W. Nason, Omaha, Nebraska.
To THE Nebraska State Dental Society: I am not much of
a speaker but perhaps a short review of the past history of the
society may be of interest to you.
On August 25, 1868, was organized at Council Bluffs, Iowa,
what was known as the Missouri Valley Dental Society. A few of
us here present were made members at that time. In 1876 the
meeting was held at Drs. Charles & Paul's office, Omaha. Dr. Rose-
man acting as President, in the President's absence; Dr. F. M.
Shriver being Secretary and Treasurer. In this year your humble
servant became a member.
At that meeting we thought it advisable for Nebraska to start
a society of its own and be considered of more importance in the
American Dental Association.
The first annual meeting of the Nebraska State Dental Society
was held at the office of Dr. King, in Lincoln, 1877. The Presi-
dent, Dr. Charles, being absent. Vice President S. H. King occu-
pied the chair, six members answered to roll call.
The second meeting was held in 1878 at the office of Dr. Rose-
man, Fremont. Dr. Roseman held the combined ofifice of Secre-
«38 THE DENTAL REVIEW.
tary and Treasurer: Dr. King, President, in the chair. Only four of
the faithful being present.
We have kept on with moderate success for fifteen years, meet-
ing annually, and have from fifty to seventy-five members at the
present time. We have lost several of our number; some by death,
some by change of residence, and last but not least, some by their
own carelessness in neglecting to keep up their dues. It is to be
hoped we may not lose any more the following year by the same
causes.
Some dentists say when we ask them to join us, I would, but
so and so belong. The most foolish excuse in the world, and
others say, I don't think I will go they have such a poor programme.
The thing to do is for such persons to be at the meetings and make
his objections. He might be able to start a good discussion, just
the thing that is needed. If any one has an idea it is an easy mat-
ter to arrange the programme, let him ask Dr. Cole, or try it him-
self. Each and every dentist in the society should lend a hand to
make every meeting a success financially as well as intellectually.
If we are well fixed, to use a common phrase, we can call on the best
of talent in our profession and make each meeting more and more
entertaining and instructive.
My ideas you will find expressed as to the advancement of State
societies in a circular which I trust you have all received from
J. N. Grouse, Chairman Ex. Com. of the American Dental Associ-
ation.
I hope to see you all, or as many as possible, at the World's
Fair meeting. I have served as your President twice. I thank
you kindly for the honor and if I have been of help or a detriment
to you it is for you to decide.
PROCEEDINGS OF SOCIETIES.
Southern Dental Association and Tennessee Dental
Association.
The Tennessee Dental Association was called to order at 9
o'clock A. M., July 26, 1892, by Vice President S. B. Cook. F. A.
Shotwell, of Rogersville, was named as temporary Secretary.
In view of the meeting of the Southern Dental Association, the
State Association decided to adjourn, after attending to routine
PROCEEDINGS OF SOCIETIES. 639
work, and resolve itself into a Committee of the Whole to entertain
the sister association.
A committee consisting of Drs. J. Y. Crawford, R. R. Freeman,
R. B. Lees, W. T. Arrington, and S. B. Cook, was appointed to ar-
range a banquet at the Inn. The meeting then adjourned until
afternoon, as the Southern Dental Association was called to order.
In the afternoon, the State Association reconvened, and the fol-
lowing ofificers were elected.
President, S. B. Cook, of Chattanooga; First Vice President,
W. W. Jones, of Murfreesboro; Second Vice President, W. J. Mor-
rison, of Nashville.
The Executive Committee was named as follows: S. B. Cook,
J. U. Lee, and S. A. Pope. All of these officers serve one year.
" In view of the delightful climate and unsurpassed hospitality
of the people " the association unanimously agreed to hold its next
meeting in Chattanooga.
A membership Committee, consisting of Drs. W. W. Jones and
R. B. Lees, was appointed to serve one year.
All papers prepared for the State Association were ordered
turned over to the Southern Association for consideration, and the
State Association adjourned to entertain the Southern delegates.
For the twenty-third time the annual session of the Southern
Dental Association was called to order at 10 o'clock of the same
day. President Gordon White presided.
After prayer by Dr. Jonathan Taft, Dr. L. P. Dotterer was
elected Secretary /rf tern.
On behalf of the association, Dr. J. Y. Crawford presented a
fine silver-mounted gavel to the President, who accepted it in a
graceful speech.
H. T. Olmsted, on behalf of the Chamber of Commerce, wel-
comed the members to Chattanooga, and he was followed by Pres-
ident D. R. Stubblefield, of Nashville, who welcomed the Southern
Association in behalf of the Tennessee Association.
To these addresses Dr. Geo. J. Friedrichs, of New Orleans, made
a fitting response.
President Gordon White then read his address, which was as
follows :
Gentle7nen of the Southern Dental Association :
I purpose to bring before you at this meeting several subjects
of interest to our profession. The one I deem of greatest impor-
640 THE DENTAL REVIEW.
tance has been talked of, in an undertone, by many of us for a long
time. We should have no secrets in our professional family — the
subject is professional dignity, or rather lack of professional dig-
nity, for the subject is too broad for me to touch on any but abuses
known to all.
"Every profession has its scum," says a noted Frenchman.
Alas, that those whom in the South we term good men should
place themselves on a level with that scum by their methods of
advertising. True, it is often only a newspaper interview that
catches the eye as we glance through the paper, but it is an adver-
tisement none the less. In the secular press of one section we find
a column given the dentist who has performed, what he considers,
a very remarkable operation; in that of another section a column
and a half is required to properly describe the beauty and perfect-
ness of a certain piece of extensive crown and bridgework ; while
in still another we read not only of the wonderful inventions of our
brother but also of the architecture and furnishings of his office.
In one locality we find a college graduate asserting his skill in
every known branch of the profession and guaranteeing his work;
in another, the familiar poem, " Mary Had a Little Lamb,"
adapted to the requirements of a dental advertisement. Such
advertisements are usually accompanied by broad headlines and
not infrequently by a picture of the remarkable individual.
Gentlemen, need I tell you that members of our association
engage in this reprehensible practice? Is it professional? Is it
dignified ? Does the profession approve it ? Does it win public
respect ? A prominent man who for twenty years has advertised,
said to me in a recent conversation, that he did not remember a
single desirable patient who came to him through his advertise-
ments.
Why is it that we are so frequently confronted by such adver-
tisements ? Are not the schools primarily responsible for this?
One reputable (?) college advertises in the newspapers and holds
out as an inducement to the uninformed would-be student the fact
that the dental graduate is now recognized by the medical profes-
sion as occupying the same level as the medical graduate, and
further that their graduates at once step into a lucrative practice,
making in ready money so many dollars a day. Another adver-
tises for infirmary patients and holds not even church pews too
sacred for the desecration of its handbills. Do such advertise-
PROCEEDINGS OF SOCIETIES. 641
ments on the part of the schools give the students a correct idea of
the dignity of our profession ?
The student while at college should live in an atmosphere of
ethics. Does he? It is generally understood that there is one lec-
ture on ethics, delivered usually by the dean at the close of the
term, but perhaps not more than one-half of the students hear it.
A worthy professor calls attention to the fact that a student, as
a mirror, reflects the idiosyncrasies of his preceptor. What shall
we sa}' when a graduate from a college, presumably reputable, with
the certificate of the State Examining Board, locates in a town or
city and at once calls attention through the medium of flaming
handbills to his " New Dental Parlors " and extraordinary low
fees ? Does he not as a mirror, reflect the college from which he
comes? Are we not agreed that by both precept and example the
colleges should sustain and increase our dignity? Are such prac-
tices (of both dentists and schools) consistent with our code of
ethics? If they are, should not the code be revised? If they are
not, should we not feel it our duty to report such violations?
Hitherto we have been too timid to report. It is not a personal
matter, gentlemen, but we owe it to our profession to aid in every
way possible in the suppression of that which will drag us into the
mire. The highest court of England quite recently held that a
man who joins an honorable and registered society must strictly
observe the rules of that society under penalty of forfeiture of his
membership and sustained the action of the General Council of
Medical Education and Registration in removing the name of a
prominent dentist from their membership because of his having
advertised his business contrary to the rules of that body. The
decisions of that court are a precedent for the courts of other
countries. Is not the action of that council a worthy precedent
for our association ?
Should not the undignified practice of many reputable men of
placing on their envelopes their business cards be condemned ?
Do they not labor under the mistaken idea that it advertises them
or their business ? We are professional men, not tradesmen,,
furthermore, I find upon investigation that in the rarest instances
does a letter pass through more than four or five hands in reaching
its destination and only when it fails to reach its destination is the
business card referred to by the busy postman. To be sure there
is nothing wrong or unprofessional in having our name and address
642 THE DEXTAL REVIEW.
on our envelope for the safe return of our mail, but is it not shock-
ing to receive a letter from one of our professional brothers, the
envelope of which is adorned with a cut of his wonderful invention ?
Strange as it may seem, I have received such from members of
this association. In a few instances I have received them with a
cut of the writer on both letter head and envelope, but they, I be-
lieve, were not from any of our members.
To my mind the propriety of having price lists is questionable.
There is certainly no reason why a patient may not know the cost
of each operation, but the list, varying as it does from ^5 to $50,
practically amounts to no list. To be sure we have our rates, but
you each know that in like operations the fees are rarely the same.
It seems to me that it would be difficult to explain the difference
satisfactorily to the patient. After all, is the list necessary ? We
are not in the mercantile business and do not need the advertise-
ment. Do not our patients place themselves in our hands because
they have confidence in our integrity and skill? During a practice
of thirteen years I have only once been asked for a list, and during
my investigation extending through a number of years I remember
only one man who claimed to adhere to his list. He very frankly
said that he did. If we have a list should we not adhere to it. If
we do not, are we not practicing fraud and deception ? Does it not
look unprofessional ? The " Cheap John " displays his list on his
sign, the dentist of the " upper ten " on his appointment card. Is
there any difference save in the fees?
In most, if not in all of our States, laws have been enacted re-
stricting in some particulars the practice of dentistry and boards
of dental examiners have been appointed. These laws were en-
acted for what was conceived to be the protection of the public
and our profession as well. They may not, and do not, fully ac-
complish the desired result, but they are a step toward a higher
standard of requirements for the dentist, and the boards in enforc-
ing them should have the moral support of all dentists. The
boards need the support, for, while it is almost beyond belief that
any one would oppose that which even tends toward our elevation
the board of Tennessee has met with opposition.
Our fathers in 18G9 organized our association for advancement in
the science and dignity of our profession. Then the spirit of pro-
fessional interest was stronger than the animal of self-interest, and
those loyal, high-minded men did not even dream that one of our
PROCEEDINGS OF SOCIETIES. 643
membership would ever be so debased as to be valued for personal
aggrandizement. It has been said that the professions are made
strong by what they include rather than exclude. Let us then in-
clude so much love for our grand profession, such high, pure aims
in its practice, so much enthusiasm for its advancement, that there
shall be no room for any unprofessional act or thought. Let us
work to an ideal, and let that ideal be as high as finite conception
can reach.
Much has already been said in regard to a home for the South-
ern Dental Association and a permanent committee on a "Dental
Chautauqua " has been appointed. The idea, as I understand it^
is to erect at some desirable summer resort a building in every way
adapted to the needs of the association, and where year after year
the meetings may be held. There is much that is desirable in this
plan, but is it practicable? It means the outlay of a large sum of
money without any return, a dead weight for the association to
carry. Furthermore, men will not go to the same place year after
year.
If the association will have a home, let it by all means be locat-
ed in some central city -and so constructed that a part can be
rented, yielding sufficient revenue to pay all expenses. So located
"The Home" will be an object of interest to all dentists passing
through that city. Besides, there will always be a number of resi-
dent dentists to keep up the interest. My preference is not a
southern but a national home and, as has been suggested, a na-
tional museum, located in Washington or some central city, where
from all parts of the country we can send our treasures. Why not
unite with the other societies and build a home that will be a credit
to our profession and establish a museum that will fittingly pre-
serve our history for this and future ages — in other words, a mon-
ument to the dental profession of America.
In 1890, at the meeting of our association in Atlanta, it was sug-
gested that we be represented at the World's Fair in 1893. The
American Association took up the suggestion and a committee of
fifteen has been appointed by the two societies, which committee
will meet during our present session. The work of organization is
far advanced and the World's Columbian Dental Congress will be
held Aug. 17 to 27, 1893, in Chicago, III. Let us not forget that it
was our suggestion and that as such it behooves us to give the com-
mittee all the support they expect from us. Certainly they have a
644 THE DENTAL REVIEW.
right to expect our presence, and so far as possible we should attend
this congress.
At our last meeting there was a resolution to the effect that the
constitution be so changed as to provide for the election of officers
at a much earlier hour, so that the newly-elected President might
have the opportunity to make his appointments. This idea is ex-
cellent. I would suggest that a section on orthodontia be cre-
ated. Properly, it does not come under the head of any existing
section, but is separate and distinct.
It would be well, also, to thoroughly revise the constitution.
There are some defects not necessary to allude to here, which a
committee would readily detect, and of which all the ex-presidents
are aware. The principal one is its vagueness in setting forth the
duties of the officers and committees. I do not make this last
suggestion to bring about a discussion of the constitution, for we
wish to embody nothing new, but simply to make plain that which
we already have.
I have called attention to these things, gentlemen, because of
my deep interest in the continued advancement of our profession
and the preservation of its dignit}'.
In the name of those who have shed luster upon that profes-
sion, let us be faithful to our sacred trust, transmitting to those who
will succeed us an honorable record of duty faithfully performed.
Drs. Chisholm, Marshall and Lawrence were appointed a com-
mittee to consider the address.
A report of the Executive Committee as to what that committee
is doing with regard to the Columbian Dental Congress, was then
presented. All members were invited to attend the meeting of the
American Dental Association at Niagara Falls next week and the
Association adjourned until 3 o'clock.
The resolution offered last year, to make the election of officers
the special order of the afternoon of the first day's session, was
defeated and the election made the special order of this afternoon.
The following new members were then elected, who were per-
mitted to assume the floor upon payment of dues: Drs. Thomas
B. Hinman, Atlanta; W. J. Morrison, Nashville; N. A. Williams,
Valdosta, Ga.; E. N Wells, Savannah; C. H. McDowell, Griffin;
F. A. Pope, Franklyn; F. C. West, Natchez, Miss.; S. W. Foster,
Decatur, Ala.; E. F. Grant, Columbia; W. E. Watkins, Bay St.
Louis, Miss.; U. D. Billmeyer, Chattanooga; R. D. Griffith, Hynes,
PROCEEDINGS OF SOCIETIES. 645
Texas; W. F. Arrington, Jr., Memphis; J. N. Jones, Jacksonville,
Fla.
The courtesies of the floor were extended our visiting dental
surgeons, and especially to the members of the Tennessee Asso-
ciation.
The committee to discuss the address of President White re-
ported an indorsement of the address, except as to the advisability
of inviting all dental organizations into the movement to build a
permanent Chautauqua, and the paper was opened for discussion.
A large number of finished addresses were made on the subject,
and then Dr. B. Holly Smith presented the report of the Commit-
tee on Dental Education. The paper was an excellent production
and elicited much discussion, during which the Association ad-
journed to meet at 8:30, when discussion was resumed.
American Dental Association.
The thirty-second annual meeting of the American Dental As-
sociation was called to order by the President, Dr. W. W. Walker,
of New York, at the Casino Opera House, Niagara Falls, N. Y.,
Tuesday morning, August 2d, at 11:15 o'clock.
The roll call revealed about eighty members present.
Various officers' and committee reports were read and adopted.
Dr. W. W. Walker read the annual address, wherein he re-
ierred to the forthcoming World's Columbian Dental Congress,
and recommended that in view of the advanced standing and im-
provement in the colleges of the United States, the practice now
existing of compelling a graduate to undergo an examination in
each State in which he desires to practice, be abandoned. He
further referred to the advisability of increasing the section work
of the American Dental Association, by bringing the local societies
into closer relationship with this the representative body of dentists.
The consideration of the address was referred to a committee.
Adjourned.
Tuesday Evening Session.
Sec. Vn., on Anatomy, Pathology and Surger}^, made its annual
report through the chairman. Dr. T. W. Brophy, of Chicago.
A statement was made of the important articles which appeared
in the dental periodicals during the year. The first paper pre-
646 THE DENTAL REVIEW.
sented by the Section was by Dr. J. E. Cravens, of Indianapolis,
Ind., on "Pyorrhoea Alveolaris." The essayist related a practical
case of pyorrhoea alveolaris cured by the use of diluted sulphuric
acid, followed by nitrate of silver.
The subject was discussed by Drs. Barrett, Rhein and Mor-
gan (W. H.) Pyorrhoea alveolaris was- declared to be a constitu-
tional inherited malady, which eventually leads to loss of the teeth.
Many cases are said to be absolutely incurable, except by the re-
moval of the teeth. The discussion was continued by Dr. Harlan,
who recommended the use of diluted sulphuric acid in preference
to aromatic sulphuric acid. He believed the disease to be more
of a local character than is generall}' admitted. Dr. Cravens
closed the discussion.
Dr. M. H. Cryer, of Philadelphia, then described a "New Opera-
tion for the Resection of the Inferior Dental Nerve. " The operation
consists in cutting out the bone below the sigmoid notch until the
opening of the inferior dental nerve is reached, the nerve is then
drawn out as far as possible from the inferior dental canal and
severed, it is then cut as far up as is possible toward
the base of the brain. The subject was discussed by Dr. A. E.
Hoadley, of Chicago. Dr. Morrison, of St. Louis, advocated the
older method of making no external incisions, but operating en-
tirely from within the mouth, by using the dental engine and drill,
cutting out any portion of the nerve desired. Dr. Fillebrown cited
a case in which the removal of almost the entire nerve resulted in
no permanent relief. He also advocated operating from within the
mouth, as did the next speaker, Dr. Brophy; the discussion was
closed by the essayist.
Dr. A. H. Thompson, of Topeka, read a paper entitled " The
Grinding Teeth of the Herbivorous Mammalia."
Adjourned.
WEDNESDAY MORNING SESSION.
Dr. W. C. Barrett, of Buffalo, N. Y., read a paper on "Com-
parative Dental Anatomy." The subject was discussed by Drs.
Geo. E. Hunt, James Truman, A. H. Thompson, C. N. Peirce, and
the discussion was closed by Dr. Barrett.
Dr. W. B. Ames, of Chicago, read the report of Sec. I. on Pros-
thetic Dentistry, Chemistry and Metallurgy. The report was dis-
cussed by Drs. F. W. Low, of Buffalo, and George Evans, of New
1
PROCEEDINGS OF SOCIETIES. 647
York; the latter then presented a new method of making crowns,
which was discussed by Drs. A. H. Thompson of Topeka, J. D.
Patterson of Kansas City, H. J. McKellops of St. Louis, S. H.
Guilford, of Philadelphia, and the subject was passed.
Sec. II., on Dental Education, Literature and Nomenclature
then presented the annual report through its chairman. Dr. Louis
Ottofy. The report referred to the increase of dental colleges from
thirty-three to thirty-eight, stated the number of dental graduates
for 1892, to be 1483. It referred to the attempt made during the
year to bring into closer relationship the various local societies
with the American Dental Association. Mention was made of the
establishment of reading courses on the Chautauqua plan, by the
Post Graduate Dental Association of the United States. A criti-
cism of the latest books on dental subjects published during the
year, was also presented.
The subject was passed.
The sections were then organized.
WEDNESDAY EVENING SESSION.
Dr. L. D. Shepard, of Boston, read the report of the committee
appointed to consider the President's address — and in accordance
with the recommendations made by the President and endorsed by
the committee, the association adopted resolutions embodying the
following topics :
1. An appropriation of $500 from the funds of the association
to the treasury of the World's Columbian Dental Congress.
2. A standing committee of three on "State and local organ-
ization," to be appointed to serve for one, two and three years,
respectively, and thereafter each new member to serve for three
years. The object of this committee is to bring into closer rela-
tionship the local societies with the American Dental Association.
3. The meeting of 1893, is to be one of business, revising of the
Constitution, By-Laws, etc., and is to be held immediately preced-
ing the meeting of the World's Columbian Dental Congress at
Chicago.
The resignation of Dr. Frank M. Odell, of New York, was
read and accepted.
Sec. III., on Operative Dentistry then offered its report through
Dr. A. W. McCandless, of Chicago. In the report there was pre-
sented a list of the most important articles pertaining to the work
648 THE DENTAL REVIEW.
of this section, which appeared in the periodical literature during
the year. The important materials introduced were also described.
The section reported several papers; the first read was by Dr. W.
N. Morrison, of St. Louis, on " Transplantation," reporting the
present favorable conditions of several cases transplanted so long
ago as 1875.
Dr. Geo. E. Hunt, of Indianapolis, read a paper from the pen of
Dr. J. E. Cravens, of Indianapolis,entitled, "Matrices." These sub-
jects were discussed by Drs. Head, Morrison, Swasey, McKellops^
Taft, Darby, Morgan, Ottofy, Allport, Watkins, and others.
Adjourned.
THURSDAY MORNING SESSION.
On call. Sec. IV., failing to respond, was passed and Sec. V.^
on Materia Medica and Therapeutics made its annual report
through the Secretary of the Section, Dr. Geo. E. Hunt, of Indi-
anapolis. Among the remedies and their effects described were
pental, aristol and bichloride of mercury. According to the re-
port the germicidal powers of the latter drug have been greatly
overestimated.
Dr. A. W. Harlan, of Chicago, then read a paper on "Euro-
phen and Trichlor Acetic Acid." The subject was discussed by
Drs. Frank Abbott, John S. Marshall, F. Peabody, Geo. E. Hunt^
F.W. Low, Thos. Fillebrown, C. N. Peirce, J. D.Patterson, J.Taft,
James Truman, James McManus, J. Hall Moore, W. C. Barrett, J.
Y. Crawford and closed by Dr. Harlan.
In course of the discussion, the various speakers referred to
the use of iodoform, europhen, the germicidal powers of the bi-
chloride of mercury, the nitrate of silver for the relief of sensitive-
ness around the necks of the teeth, and for the arrest of decay of
children's teeth.
The subject was passed.
Sec. IV., on Histology and Microscopy, then made its annual
report through its chairman, Dr. Frank Abbott, of New York.
Dr. C. W. Stainton, of Buffalo, N. Y., read a paper entitled
" Crownless Teeth." He presented a case of defective calcifica-
tion of the teeth of three children of one father ; in all these cases
the teeth are stunted, deformed and almost crownless, as a result
of defective calcification, the teeth were worn off almost to the
gum line. The subject was discussed by Dr. Frank Abbott, who
PROCEEDINGS OF SOCIETIES. 649
also cited a similar case; Drs. C. N. Peirce, W. H. Morgan,
A. O. Hunt, C. C. Carroll, W. C. Barrett, W. N. Morrison,
John J. R. Patrick, Joseph Head, S. H. Guilford and closed by Dr.
Stainton.
According to the report of the Committee on Credentials, 25
societies and seven colleges were represented by delegates.
Adjourned.
THURSDAY EVENIJJG SESSION.
Sec. VI., on Physiology and Etiology made its report through
the chairman. Dr. H. A. Smith. Dr. J. D. Patterson then read a
paper entitled, " Diseases of the Tissues of the Oral Cavity caused
by Medicaments," which was discussed by Drs. Fillebrown, Mor-
gan, Hunt (G. E.), Smith (H. A.), Barrett and others.
Dr. John J. R. Patrick of Belleville, 111., then read his annual
report on the " Condition of Prehistoric Crania " as far as the work
at the present time can be reported upon. The report was dis-
cussed by Drs. C. N. Peirce, H. A. Smith and Louis Ottofy.
The subject was passed.
The Committee on State and Local Organizations presented a
partial report. They intend to send out the following ten ques-
tions pertaining to dentistry, to all local dental societies, and to
secure condensed reports of the meetings of local societies:
No. 1. Should Examining Boards have power to grant certifi-
cates of qualification to undergraduates ?
No. 2. Should immediate root fillings be practiced while pur-
ulent conditions exist at the apex ?
No. 3. What are the best materials to enter into the composi-
tion of temporary fillings to be retained for a minimum of three
years ?
No. 4. What are the best methods for obtunding sensibility of
the dentine by either local or general means, should arsenic ever
be used ?
No. 5. What are the best forms of partial lower dentures and
the methods for constructing the same ?
No. 6. Corrective dentistry. Its present status. What are the
simplest and most universally applicable forms of apparatus and
most efficient retaining fixtures ?
No. 7. To what extent and under what conditions is the collar
crown a cause of pericemental inflammation?
650 THE DENTAL REVIEW.
No. 8. In cases of congested pulp should the arsenical applica-
tion be made without preliminary treatment?
No. 9. What are the advantages and disadvantages of the use
of the matrix. 1. With gold. 2. With plastics ?
No. 10. The etiology of pus formation ?
FRIDAY MORNING SESSION.
Dr. John B. Rich, of Washington, D. C, then made the report
of the committee appointed in regard to the attempt of the census
bureau to classify dentists as manufacturers. The report of the
committee gave a history of the subject and related the manner in
which the objectionable feature was overcome.
Dr. L. D. Shepard then offered some resolutions in regard to
the same matter, the principal object of which was that the Super-
intendent of the Census should be requested to return all reports
that he has received from dentists, and that dentists should de-
mand the return of the statements which they have made.*
Dr. J. Taft then read the report of the Committee on Necrology
reporting on the death of Dr. John Allen.
The next meeting of the association will be held at Chicago the
second Tuesday in August, 1892.
The election of officers resulted as follows:
President, J. D. Patterson, Kansas City, Mo.; First Vice Presi-
dent, J. Y. Crawford, Nashville, Tenn.; Second Vice President, S.
C. G. Watkins, Montclair, N. J.; Corresponding Secretary, F. A.
Levy, Orange, N. J.; Recording Secretary, Geo. H. Cushing, Chi-
cago, 111.; Treasurer, A. H. Fuller, St. Louis, Mo.
Executive Committee for three years, Drs. W. W. Walker, of
New York, S. G. Perry, of New York, and D. N. McQuillen, of
Philadelphia.
The newly elected officers were then installed. Drs. Patterson
[*A11 dentists who have made any statements to the census
enumerators in 1890 should at once write to the Superintendent of
Census and demand the return of what statements they have made.
The Superintendent of Census has signed an agreement with repre-
sentatives of the dental profession, according to the terms of which
no reports as to the business of dentists will be gathered hereafter
by the bureau, thus partially acknowledging the injustice or want
of necessity to collect statistics from professional men. Write at
once for the statements you have made. — Ed.]
PROCEEDINGS OF SOCIETIES. 651
and Crawford accepting the offices to which they were elected, in
brief well chosen words.
The President appointed Drs. A. W. Harlan and E. T. Darby
as members of the publication committee.
The Association then adjourned to meet in Chicago, on the
second Tuesday in August, 1893.
Chicago Dental Society.
Meeting of May .3d, 1892. — University Extension.
Address by Mr. Charles N. Zeublin.
Mr. President, Ladies and Gentlemen: — I am very glad indeed
to present this subject, even in a brief way, to you, chiefly because
this is a scientific body. I have come so thoroughly to believe in
University Extension as to think that it is no longer a merely popu-
lar movement and hence superficial, but that it can be thoroughly
scientific and that it is adapted to the study of scientific subjects by
scientific people. I think the history of the University Extension
movement is of sufficient significance for me to call your attention
to a few salient points of it,^ because it is thoroughly in harmony with
the development idea of the age. The evolution of teaching natur-
ally results, if not in University Extension, in a similar means of
instruction.
You are familiar with the fact that about the middle of this
century the first step was taken toward giving greater advantages
to the people from the universities. This was done by the univer-
sities of England, or rather, by certain progressive members of
them deciding that it was no longer right to restrict the university
advantages to the members of the Church of England. Having
once broken down that barrier, the next to be destroyed was a
geographical one, and leading educators thought that university
advantages ought to be taken from the small university center and
given to people in their homes, because the great majority of the
people, whatever their thirst for study, could not go to the univer-
sity. A great many means were discussed and projected and some
were applied, but this University Extension system originated if
in one place — most of these great movements originate in several
places at once — if in one place at all, it was at Cambridge in the
mind of Prof. Stuart, who was invited by a group of ladies to talk
65'2 THE DENTAL REVIEW.
to them on pedagogics. He said that he could not lecture on the
theory of teaching, he could not give one lecture, least of all half a
dozen or a dozen, but he would be very glad to illustrate to them
the methods of teaching by giving them a course of twelve lec-
tures on history. In order to bring more clearly before their minds
the idea which he had, he presented a printed analysis of his lec-
tures which the students had before them in the class. This he
termed the Syllabus, and that is now the technical term by which
the outline is called, which is always put in the hands of Univer-
sity Extension students. University Extension is not complete
without it.
From this beginning has resulted now a movement which in
England reaches at least five hundred localities, and in this coun-
try is constantly growing. The central idea of the system
is thorough systematic instruction on the part of a specialist
in his particular branch, a man associated with the university. In
England the affiliation with the university is not so close as here,
because the demands have become so great that it has necessitated
a staff of lecturers not intimately connected with a university. In
America up to the present time, and I trust it will always continue
so, the men are actual university professors or instructors and have
come from university life and enthusiasm, fresh from their study
rooms and their classes, and bring their results to the people in the
systematic way in which alone such ideas can be impressed upon
those who are not giving up their time to study.
A great feature of University Extension is the fact that one
does not have to give himself up wholly to it except for a brief
time, but in that brief time it does demand concentrated attention.
The lecturer speaks to the people for an hour or an hour and a
quarter, and the results of that are dependent largely on his
hearer's attention. If they fail to remember every word of the
lecture, at least with the help of this syllabus which they have in
their hands, at some future time they may recall what he has said.
After this lecture they have a quiz of an hour, in which an oppor-
tunity is given for the lecturer to become acquainted with this new
class of students, and to have them come into personal contact
with him and to gain more of what he has to give, to learn by ques-
tioning him, perhaps, much of what he has in reserve. If any of
those who are in the class desire afterward to pursue the study
they have the opportunity of sending to him weekly or fortnightly
PROCEEDINGS OF SOCIETIES. 653
papers upon questions which he suggests, and at the end of the
course they may take an examination. Now there is in this every
advantage of university work and the additional advantage which
I think we are coming more and more to see, that we can carry it
along with our other affairs of life. We have the means and the
stimulus of life held before us all the time in our business, in our
professions, even in retired life, and this may be coupled with the
scholarly acquaintance that is formed by these studies, making that
ideal life which the students in the universities do not realize,
which our professional and our business men do not realize,
because both of these classes are in the habit of divorcing
these important things, the true intellectual and the true social
development.
I think it is a matter of interest to you that this last year, of
the lectures given by the University of Oxford, which amounted
in all to nearly five hundred courses at various places throughout
England and Wales, 219 were purely scientific. Now we know
from the history of the University Extension movement that it is
usual to start centers with courses on literary or historical sub-
jects. They appeal to the largest class of people, and it is with
some centers a matter of time to worl* up interest in a scientific
theme. But the fact is coming to be seen that there is this de-
mand for the sciences and when they attempt to satisfy this de-
mand they get on the whole better work out of the students than
they do in the literary, historical and economic fields. These lec-
tures by the University of Oxford as well as those given by the
universities of this country embrace the whole field of the scien-
tist, and although they cannot be expected to give such thor-
ough laboratory or microscopical work as is done in the colleges,
at the same time advantages are given to earnest students who
can remain with the classes and do just as exact work for this
brief time as is done by the scholar in his laboratory or in his
study. It is coming to be recognized that the sciences can be
taught to those who have but little time, and that is the important
feature for us Americans, for us Chicagoans to consider. It is
true that we are rushed, that we are in great haste in our life, that
we do not take time to rest. Yet if we are going to continue to
labor in a state which demands competition we must yield to
the competition, and this competition drives us on so that the only
way we can get an opportunity for intellectual development is by
654 THE DENTAL REVIEW.
saving an hour now and then. That saving can be affected by
making an engagement with the lecturer, writing down one's
engagement and keeping it weekly or fortnightly, and using one's
spare moments for preparation. I do not hesitate to recommend
even to men in professional life, even to dentists, and I recognize
the standing that American dentists have among scientists and the
world, I do not hesitate to recommend to such a body of men the
kind of studies that are pursued now by workingmen, by wealthy
people, by every one, because this movement can be adapted to
those who can pursue the study, and it can be made just as scien-
tific as the equipment of the listeners demand. The subjects that
are treated are such as you and such as other men in like profes-
sions demand, they are subjects which on the whole, without hav-
ing time to personally investigate, that is, thoroughly investigate,
these men must necessarily have a superficial knowledge of or
neglect their profession. Here is the advantage of bringing to
you a specialist with his patiently acquired results, an authority on
his subject and who has done the work which the pressure of other
work prevents your doing. I believe thoroughly that if bodies like
this, scientific societies, organizations of professional men, would
interest themselves in thi» movement, interest themselves by doing
thorough work in an extension course, it would not only be of in-
estimable advantage to them, but it would raise the standard of
University Extension and that is just as important with us as rais-
ing the standard of our colleges. We are in danger of making all
such movements too popular; let us make them scientific by giv-
ing to them the support of scientific men.
Discussion on a Paper entitled "Tobacco and its Effects,"
Read by Dr. L. L. Davis before the Chicago
Dental Society.
Dr. E. D. Swain: I desire to congratulate the essayist on
giving us so good a paper upon this subject. I went to the books for
ideas with which to open the discussion, but I found them very
meager indeed; there was ver}' little said about it, and most of that
was that years ago it was considered to possess great medicinal
virtues, but of late years the use of tobacco as a medicine had been
largely discarded. I believe its curative virtue, if it has a good
PROCEEDINGS OF SOCIETIES. 655
property, is that it is a sedative. The long continued use of
tobacco is unquestionably, however, a nervous irritant and any
person who has used it for many years, either as a chewer or
smoker, will, I think, concur in the statement that it becomes an
irritant rather than a sedative. I question very much the state-
ment that the excessive use of tobacco will help one mentally or
physically. We have all observed in those people who have used
tobacco for a number of years the conditions explained by the
essayist, namely, the receding of the gums and the softening of the
tooth about its neck.' I can speak on this subject somewhat from
experience; I used tobacco myself from childhood up to a little
more than a year ago. I have chewed and I have smoked, and I
am satisfied that my teeth were injured from the use of tobacco,
not only in chewing from the grit which* it contained causing
mechanical abrasion, but in that peculiar condition which it pro-
duces of congesting the mucous surfaces which results in a disorder
of the subcutaneous glands causing them to give off a diseased
secretion which destroys the tooth. I don't know that I have ever
observed any bad effects of nicotin or the product of combustion
of smoking, on the enamel of the teeth other than to stain it;
tobacco colors the teeth yellow, but the other conditions I have
not noted during my experience as a practitioner of dentistry. The
worst results from the use of tobacco come from the smoking of
cigarettes. The combustion of the paper, especially the cheaper
qualities of paper, I consider very deleterious. Just what the pro-
ducts are I cannot say, but the condition of the mucous membrane
of the mouths in those people who are confirmed cigarette smokers
gives us all the evidence that is necessary that it is very in-
jurious.
Dr. T. L. Gilmer: My experience leads me to the belief that
tobacco tends to prevent decay of the teeth. I recall a number of
instances where patients have left off for a time the use of tobacco^
and in these cases almost invariably has there been a marked
increase in the tendency to decay. So frequently have I observed
this that I cannot but conclude that tobacco must have a preser-
vative effect. If this condition were only found in the mouth of
former chewers we might question whether the increase in decay
did arise from the lack of friction offered by the chewing process
rather than by virtue contained in tobacco, but I have seen similar
results following the discontinuance of smoking but not so marked.
656 THE DENTAL REVIEW.
Dr. a. W. Harlan: I do not rise for the purpose of defend-
ing the use of tobacco, but the thing I would like to know is which
are 3'ou going to do, chew gum or chew tobacco ? What is there
about tobacco that will cause deterioration of the teeth? To-
bacco is a vegetable, cabbage is a vegetable. Cabbage is an
article of diet, but it is capable of being so treated that there will
be so much lactic acid as to injure the teeth. Tobacco is never
treated in that way, so that you do not get the ill effects of it in
chewing or smoking. Opium is a vegetable, a so-called medicinal
plant, it has a great many derivatives, many of which are used in
medicine as sedatives, etc. Tobacco per se does not injure the
teeth any more than corn husks or bean shells ; not half as much
as beans, for the simple reason that it does not contain the con-
stituents that microorganisms can live upon. It is the
misuse and abuse of tobacco that makes it one of the objects to
which civilization is directing its eyes. The experiments which
have been made with reference to smoking tobacco are successful
as to its properties in that respect ; but does tobacco smoke affect
the teeth? If it does, it does it beneficially, that is, it will de-
stroy the microorganisms on which the proliferation of dental
caries depends ; but tobacco used in chewing is used in a bad way.
One of the reasons why people suffer from stomatitis and things
of that sort is because they do not use anything that will act as a
laxative, and tobacco to a great many people is a laxative, and in
so far as it is a laxative it is beneficial to health. Nine-tenths of
the bad smells which you encounter are not due to the supposed
gases at all, but to the inaction of the alimentary canal. If
you do not bathe, or if you do not drink enough water the contents
of the alimentary canal are not discharged and consequently people
suffer from bad breath. They perspire from the whole glandular
system; and are disagreeable to every one who comes in contact
with them. Those people I recommend to take a smoke. You
know what tobacco is, but the other odors come from unknown
and unseen sources that you do not know anything about.
With reference to the effects of tobacco on the teeth; there is a
circle all around the necks of the teeth above the termination of
the enamel that is due to filth, that is due to the continual bathing
of the mouth with the fluids, the juices that are extracted from
tobacco by chewers. I have known any number of men who have
chewed tobacco moderately and who are sixty-five and seventy
PROCEEDINGS OF SOCIETIES. 657
years of age and their teeth are all sound, and I have known others
whose teeth have decayed rapidly, but they would have decayed
anyway.
With reference to the wearing down and mechanical abrasion,
I had in my office to-day a gentleman who has eight teeth in his.
upper jaw and nine in his lower and he never chewed tobacco in
his life, and all of these teeth have worn down until they are nearly
to the gum. So that it is not an uncommon thing for the teeth
to be worn down by persons who are not tobacco chewers. I don't
defend the habit : I never smoked until I was twenty-five years of
age and I didn't do it then from choice, but I do now and tobacco
is a great satisfaction to me every summer, and it is to any man
who may be walking in the woods, traveling in a boat, or be in a
solitary condition. I apprehend that it is more used by people who
are in the habit of thinking by themselves and who want to be un-
disturbed, and they use it for its sedative properties, probably, in
the same way as some other people use articles of food. There is
no doubt but what there are many people who eat too much
pie every day, and pie is very much worse than tobacco if you eat
three pieces a day, and if you eat ice cream every time you get a
chance it is a very bad thing for the coats of your stomach. If you
go to discussing tobacco on its merits I will put it against any
vegetable or animal tissue that is used for the purpose of nutrition,
because it prevents waste. A man can take a chew of tobacco, or
smoke a pipe or a cigar and he can endure more, he can walk
farther and go longer without water to drink than the man who
simply eats the same quantity by weight of oats or wheat or corn
or rice or animal tissue. So I say it prevents tissue waste, and that
is the reason why the whole civilized world has taken up its use.
I do not discuss the question of the use of tobacco simply on ac-
count of its preservative or its nonpreservative qualities on the
teeth, because it is inert, it does not affect the teeth at all. There
is nothing in tobacco deleterious to the teeth and microorganisms
will not pry into tobacco juice. I simply state that as a proposition
which any scientific man here can disprove if he has the necessary
proof. Tobacco juice will not ferment when it is mixed with saliva
and if you don't have a fermentable substance you don't have any-
thing that putresces, and so you have to leave that out of the ques-
tion. There is no doubt that tobacco will stain the teeth after the
enamel has been worn off ; there is no doubt that it will, on account
658 THE DENTAL REVIEW.
of this agency around the necks of the teeth, tend to promote art
aggregation of foreign particles and large deposits of salivary
calculus, a form of which is the lipidodes localis, and that
is one of the most annoying organisms that live in the mouth. One
of the greatest scientific men in dental surgery advances the theory
that caries are caused by lepidodes localis. It is claimed innocent
microorganisms never produced caries in the world, but on account
of their location on the teeth and growing on what they are fed,
that is the decomposition of the saliva in consequence of the com-
ing in contact with it of ammoniacal products and the liberation of
the elements by which they grow ; and if dirt and grease, and things
like that collect around it perhaps there might be a cavity. I
don't advise any person to begin the use of tobacco, to chew or
smoke it, I simply say from the standpoint of science that tobacco
as tobacco is not injurious to the teeth at all.
Dr. Garrett Newkirk: Having used the weed at one time
myself, I think I can look at the tobacco question fairly. I believe
that some of the accusations presented against it to-night are true,
that on the whole it usually does exert an injurious influence,
especially upon the nervous system; that it very frequently has a
bad effect on the action of the heart, and that physicians fre-
quently meet with cases where they would be very glad if they
could prohibit its use. Frequently they try to have their patients
use it more moderately if they cannot get them to give it up
altogether. Before the discovery of America civilized man did not
know anything about tobacco. We might suppose, from the elo-
quent plea which we have heard from Dr. Harlan, that tobacco is
probably the greatest civilizer which this world possesses. See
how man has advanced during the last century since the introduc-
tion of tobacco into Europe ! The only fault in that theory is that
the poor Indian, who has used it a great deal longer, does not
seem to have advanced at all. It has had one effect upon him and
another upon us. There are a great many habits in the world that
are hard to account for on any reasonable grounds. I think most
people form certain habits because others do, just because it is the
fashion. There isn't anybody who can give a sensible reason why
the ladies should be trailing their skirts along our streets at the
present time. There is no reason why they should and there is
every reason why they shouldn't. I saw one of the most promi-
nent reformers in my office yesterday. "Well," I said, "fashion
PROCEEDrMGS OF SOCIETIES. 659
has you by the skirts." She said she had to fall in with the
fashion, she couldn't be singular; so I suppose that is why a great
many people chew tobacco and drink, and why they do a great
many things, just because other people do. There is no philo-
sophical reason for it.
I have not in my experience seen the same things which Dr.
Davis advanced with regard to pyorrhoea. 1 do not remember that
I have ever seen a case where I had reason to suppose the disease
was produced by the use of tobacco. I have seen some of the
worst cases in the mouths of those who have not used it, and I
should not consider it essential in the treatment of a case to insist
upon the patient leaving off. However, in chewing, masses of the
weed are sometimes forced into the interspaces of the teeth, crowd-
ing the gums at the gingival margins. This acts as a mechanical
local irritant and I believe has more ill effect than anything in the
chemical action of the tobacco.
Dr. Louis Ottofv: I expected that the essayist might be able
to state the reason why tobacco affects the teeth favorably. I did
not think there are any who claim that there is not some peculiar
effect from tobacco upon the teeth. I do not think there are any
dentists who claim that that effect is not beneficial; at least I have
never heard any one say that tobacco smoke is injurious to the
teeth. We attempt to explain the cause as though it was exerted
on the exterior of the tooth, but it has been for some years my
opinion that tobacco smoke affects the teeth favorably through the
internal circulating medium, the nicotin in the circulation in all
probability exerts its influence ■within the tooth. I have always
noticed that a dead tooth in a tobacco consumer's mouth is much
softer and more chalky than a dead tooth in the mouth of any one
else. No man can smoke and not inhale some of the smoke; in
this way he gets the nicotin into the circulation very rapidly ; it
goes at once into the blood, being transmitted in the lungs, is cir-
culated and brought into the tissues and the teeth, and it is there
that I believe it exerts its influence. I believe that in chewing the
beneficial effects are counteracted by the unfavorable effects on the
soft tissues of the mouth; however even this habit is a benefit to
the teeth by means of the nicotin being introduced into the teeth;
it is injurious to the teeth, because chewing tobacco does con-
tain impurities, especially molasses, sugar or grit, which will affect
the gums and teeth. A habit, the tobacco chewer forms, is to
660 THE DENTAL REVIEW.
place the tobacco on one or the other side of the mouth and on the
outside of the teeth and let it rest there, which eventually results
in the destruction of the gum tissue, thus overbalancing the ben-
efit he derives from the tobacco. I would like to see the essayist
continue to investigate, and determine if possible, where the bene-
ficial effect of tobacco smoke in the mouth comes from, whether it
is the effect of the tobacco upon the enamel or whether it is the
effect of the tobacco in the circulation through the pulp upon the
dentine.
It seems to me that whatever beneficial effect the use of
tobacco has in preventing caries of the teeth is probably due to its
antiseptic properties. Smoking or chewing is one of the com-
monest ways in which some antiseptic influence is exerted within
the mouth with sufficient regularity and duration to accomplish
any appreciable result, and it does not seem necessary to go any
further than that to account for the ordinary beneficial results from
the use of tobacco in respect to the preservation of the teeth.
Dr. C. F. Hartt: I don't think we are looking at this subject
in the right light; if tobacco preserves the teeth it does it in a very
unsatisfactory manner, and we as dentists owe it to ourselves and
to our brothers, to discourage the use of tobacco, because it not
only destroys the beautiful appearance of the teeth, but causes a
man to become careless, taking less pride in them. In addition,
the man who sells the tobacco gets the money that the dentist
ought to have.
In a word, let the tobacco fiend worship at the altar of his fam-
ily dentist, and arm himself with a good tooth-brush, and he will
then have very little excuse for continuing in a habit which is not
only expensive, but very annoying to the majority of refined and
cleanly people.
Dr. Truman W. Brophy: A number of years ago when the
question of the preservation of the teeth by the influence of tobacco
was under consideration, I had a discussion with a friend of mine
who told me he had been making some experiments with a view to
ascertaining whether tobacco really does preserve teeth or not; he
believed that tobacco was an antiseptic and would preserve the teeth,
he believed that smokers' teeth were better than the teeth of those
who did not smoke, and that the teeth of chewers were better than
those of people who did not chew, and he was surprised at the re-
sult of his experiments. He told me that he placed some extracted
PROCEEDINGS OF SOCIETIES. 661
teeth in a solution of tobacco and in the course of six or eight
weeks they began to disintegrate, the action of the tobacco upon
them was similar to that brought about by the influence of acids.
The gentleman who made these experiments was Prof. Haines of
Rush Medical College. I wish Dr. Davis, if he intends to pursue
this matter further, would see Dr. Haines and learn his conclusions
and get the benefit of his experiments upon the teeth with tobacco.
I mention his name because he is recognized everywhere as an ex-
pert upon the subject of chemistry and the results of his experi-
ments would have a great deal of weight in settling the question.
I would say that the tobacco he used was bought at the stores
where tobacco is sold to men who chew and smoke; I don't know
that there is any such thing as pure tobacco. The experiments
Sir Humphrey Davy conducted for over four years with a view to
procuring pure water, did not succeed. There is nothing abso-
lutely pure, all substances are more or less adulterated.
Dr. L. L. Davis, in closing the discussion, said: As stated in
the beginning of my paper, when I first took up this subject, I
hoped to find good argument in favor of tobacco, so I read, or
looked over some twenty or thirty different authors, and laid just
two aside who spoke favorably of the use of tobacco, and I have
quoted from those two on this subject. Nothing would please me
better, from the standpoint of a smoker, than to have some good
authority for a favorable judgment in this matter and I would have
liked to have heard more in its favor by those who discussed the
subject this evening, but only one person has spoken to any ex-
tent in its favor, and I for one should have been pleased if he had
talked longer, as I wish to obtain all the favorable argument I can
on this subject.
There is no particular point I can touch upon; there have been
a few things said which I might criticise or emphasize, but I think
on the whole the matter has had a thorough exposition.
The Dental Review.
Devoted to the Advancement of Dental Science.
Published Monthly.
Editor: A. W. HARLAN, M. D., D. D. S.
ASSOCIATE EDITORS:
Louis Ottofy. D. D. S. C. N. Johnson, L. D. S., D. D. S.
The March of Progress.
One who does not visit the various societies engaged in diffu-
sion of knowledge can scarcely comprehend the rapid strides made
in the various departments of dental practice. The journals give
very good reports of the meetings and congresses, but they fail to
do more than report discussions and publish papers read at the
meetings. The modest dentist who is of an inventive turn of mind,
goes about talking to his fellows, and quietly pulls out from his
pocket, or elsewhere, a new labor saver, or an instrument which
will make it easier for dentists' daily work.
These quiet and unassuming gentlemen never patent their
inventions ; they give them freely to their brethren as a slight
recompense for the gratuitous labors of the vast throng who have
contributed so freely of their time and talent to make this the most
progressive and enlightened profession of rapid growth the
nineteenth century has seen. But for the self-sacrificing work, of
the many who have done their utmost to keep alive societies, jour-
nals, schools of dentistry and a permanent literature, we would
not to-day hold the position we occupy before the laity.
It should be our endeavor to encourage freely to our whole num-
ber and sustain all high-minded, generous givers of new inventions
and discoveries. A- word of commendation and praise will often
make of a wavering man one of the most substantial and respected
citizens, and it is our duty to encourage and fight for those of our
rank and file who are our benefactors.
EDITORIAL. 663
Let the work of discovery and true progress go on, while we
assimilate and reciprocate, if not in those channels, in others that
are equally as important, if they do not involve the intense mental
energy of our best workers.
The Dental Congress.
The executive committee of the World's Columbian Dental
Congress met at Lookout Mountain, Tennessee, Monday, July 25,
1892. All the members of the committee except two were pres-
ent. Several of the standing committees were filled and quite a
number of additions were made to those not already filled. An
honorary bureau was created for the following countries : Great
Britain, France, Germany, Belgium, Holland, Denmark, Scandi-
navia, Italy, Austro-Hungary, Russia, Spain, Portugal, Greece,
Asia, Africa, Switzerland, Canada, Mexico, Central America, South
America (two), Australia and the British Colonies, and a bureau
for American dentists practicing in foreign countries. Member-
ship was defined for Americans in accordance with the paragraph
on page 33 of the revised circular issued some months since and
quite generally republished: "The membership shall consist of
legally qualified and reputable dentists, as defined in the code of
ethics of the American and Southern Dental Associations, residing
in the United States." This rule will apply to all American den-
tists practicing in foreign countries. The foreign membership
will be passed upon by the honorary committees consisting of
three persons selected for this purpose by the executive com-
mittee. Two women dentists will be invited to read papers.
The selection of the honorary officers will take place between
the publication of this note and the 24th of October next.
The general committee will meet at that time in Cinninnati, Ohio,
and select all the officers of the congress not yet appointed. The
utmost harmony prevailed and the work of the various subcom-
mittees was reported to be highly satisfactory. The duties of all
the committees, so far provided for, were clearly outlined, so that
nothing remains to be done but for the committees to get to work
and do their whole duty in the endeavor to make this the most
noteworthy congress that will assemble in Chicago in 1893. The
detail work, the work of the finance committee and all the neces-
sary preliminaries were provided for at the last meeting. The
Southern Dental Association adjourned to meet in Chicago, as well
664 THE DEXTAL REVIEW.
as the American Dental association, so that all eyes will be directed
towards Chicago in 1893, and all footsteps will be turned in that
direction by the dentists of the world at the beginning of August
next year. Chicago will be well prepared to receive every one
who comes with the label of approval from some one of the various
committees having the power to issue cards of eligibility or invi-
tation.
Specialties.
One of the noticeable features of recent days in even the den-
tal profession, is the tendency to divide and subdivide the work of
the dentist. The first attempt generally is to separate that which
is objectionable to the general practitioner on account of the an-
noying interference with general operating, thus it was that the
prosthetic part of the dentist's duties were delegated to an assist-
ant or some one who devoted his whole time to that branch. The
practice of surgery was found to. be absolutely impracticable to the
general practitioner, the giving of anaesthetics, etc., much inter-
fering with other patients. Finally, extracting and regulating is
relegated to the specialist. In many respects this is a great ad-
vantage to all concerned. The dentist is enabled to rid himself of
much that is annoying and which saps his energies without much ac-
complishment, the patient gets the beneht of superior skill, saves
time and is served more promptly. The specialist is happy be-
cause he can give his sole attention to something he loves and he
generally makes money. In view of all these considerations, wel-
come be the thorough, upright, honest specialist.
DOMESTIC CORRESPONDENCE
Letter from New York.
To the Editor of The Dental Review :
Dear Sir. — New York goes earlier and stays later as the years
go by, and when the people go the dentist goes also, nothing to do
if he stays. Truly we are creatures of circumstances. Who will
say that brother Parkhurst didn't stir up a hornet's nest? Lo and
behold! the New York Herald of the Vth of July, announces in big
headlines, thirty thousand Christians have arrived in New York
during the last twenty-four hours (to endeavor to straighten out
DOMESTIC CORRESPONDENCE. 665
things.) One thing is sure, if we do not have less theory and more
practice we'll all go, where ? — to degeneracy — according to Dr.
Talbot. He says, "We are beginning on the jaw." This may be
so, but we shall want a good deal more jaw before we get the
great problems settled that come into the explanations, how and
where civilization is going to send us. The human race starts out
as suckers, and are we going to conclude by Dr. Talbot's reason-
ing that we will ultimatel}' be suckers again. Once a man, twice a
child. Will the coming man be edentulous. We saw an editorial
lately in the Herald, "Will the coming woman be a man?" Dr.
Talbot, we feel like jumping upon you for your weak theorizing
over " Riggs' Disease." Dan Bryant once said he wondered
about the egg that struck him in the face when thrown at a party,
and whether the hen was well that laid the egg ? We don't fear of
our egg being addled, for it is our egg, we have set on it out of
respect to old Dr. Riggs, and we do not propose to leave it un-
guarded until we secure a nice brood of chickens.
Here is a bright question which we wish Dr. Talbot would
answer. How about the extraction of the deciduous teeth as it
stands in vogue to-day ? Does it apply in practice the same as you
advocate for the permanent teeth ? You know the ideas in vogue
by would-be prominent men regarding the removal of the first
teeth. We have some new thoughts in line with the Doctor's views
on nonextraction in connection with orthodontia. Further on we
will give them. Dr. Bogue says that they have never been dis-
cussed by the profession (although he has thought of them).
While we seem to criticise Dr. Talbot, we say pleasantly we think
it a commendable article and worthy of earnest reading by earnest
men. Such articles as these coming along monthy, ought to make
all thinking men scratch up their ideas, for all things are not settled
yet.
How little we do know. Yet how some rub their ponderous
bread baskets, swell up so big and look so wise. In view of all
that is so vastly interesting to be known, it is grand to be living.
Only little by little does our true living reveal itself day by day,
regenerating a life that helps to discern the knowable. Inspira-
tion from above gives understanding. To every one this is mani-
fested if they will take notice.
However, we may differ with regard to these far-reaching ques-
tions, viewed from a larger point of value, they will in the end re-
666 THE DENTAL REVIEW.
ward us all richly if we will be patient, even though we may some-
times suspect things are a little premature. No one should be
unwilling to cross swords in friendly discussion whenever oppor-
tunity offers.
The case as a leader, in the July Dental Review is a case that has
been generally thought to be a hard one ; but my ! how simple it is
shown to be there ! And we are happy to add, that Dr. Case has
the glory.
We could run and read such articles.
Editor Harlan's remarks in his report on books before the Illi-
nois State Dental Society pleases us fully, because we think much
as he does and have advocated the same thoughts in our letters,
publicly and privately. We do fully believe that a quarterly with
paid articles would honor us as a profession, and bring the ducats
to the publishers.
Secondly, is our pet plan — a weekly. Let us tell a bit of pri-
vacy, only two other men know about. A plan for a weekly has
been talked (over a claret punch — a light one.) The prospectus
was drawn up, etc., that is all now. (Brother Hungerford hold !)
We hope sincerely that Chicago will get the five million. By the
wav, we see to-day while writing, it is going to be better, they get
two and a half million as a gift. Thanks ! Now, we don't hope
that they will get the credit of starting this new weekly. Chicago
got the World's Fair and the Columbian Dental Congress. While
New York don't care a knickerbocker, yet it will never get over
the loss unless she is humored in her kinder-weekly condition.
This enterprise would stimulate her through her pride, and by the
formation of Cruoin — or red blood, and brotherly love, would again
continue. Wait ! Give her a chance to redeem herself.
Bring forth the new. Dr. Osborne, of New York City, has
shown us a new device for correcting the malposition of natural
crowns of teeth, taking the ground for argument that all apices of
roots of teeth are in their normal condition. His plan is, where
he finds a depression of the cuspids, to spread these to their proper
position and then by simple methods place the jumbled incisors
easily into position. His device for direct continued pressure is
by banding the teeth to be carried out, soldering a stop upon the
bands for securing the opposing ends of his bar which has upon it
a screw, over this is a spiral spring, and over all is a metal tube.
The pressure of the spring is regulated by the screw. It is
DOMESTIC CORRESPONDENCE. 667
virtually a spiral spring jackscrew. We saw many models of cor-
rected cases of much jumbled inferior cuspids and incisors. Ac-
cording to reliable testimony these operations can be made with
absolute comfort to the patient and accomplished in an expeditious
manner. [We saw his papers of acceptance by the patent office.]
The doctor proposes only to make this patent secure to him the
credit of invention and to furnish the apparatus, an inexpensive
one, to the profession, securing whatever profit there might be,
which he says he don't want large, for his financial reward. He
thinks the apparatus will scarcely exceed the cost of %'3. He ar-
gues that this seems to be a truly professional method of introduc-
tion. He wishes only to do what is right, and he secures it in the
patent right. As this idea of right is an open question with a large
following in favor of the doctor's views, we cannot consider by an}'^
means that the doors are closed, although some organizations seem
to think they are settling the question by voting the truth. Truth
isn't secured that way. It was once, but this age don't accept it.
He says he has met ardent attention to his invention by some of
the society directors, but he (suspects) that they are not in accord
with his securing a patent, as it is not in line with the thought of
medical gentlemen. (The italicising is ours.) We told the Doctor
we thought there would be no difficulty in securing the attention of
his invention by the profession. This is what we referred to in
connection with Orthodontia as being something new and we think
in consonance with Dr. Talbot's views, namely : Dr. Osborne is
tenacious for saving all the teeth. He claims that to remove a
tooth that is out of place is the way to establish a permanent irreg-
ularity. His views also, regarding the apices of roots, claiming
that these are in their normal position whatever direction the
natural crowns may tend.
Dr. Osborne will be an interesting man to hear from. He is
half lawyer, dentist, and an unusually skillful mechanic, cuts his
finest burs with the greatest facility, producing as fine instruments
as we ever saw. These are the practical men, and the more the
profession can have the better, but a young man of thirty and out-
side of dental organizations. He is one of hundreds of just such
who are outside, and Dr. Kirk, in his able editorial, says, they all
ought to be in associations. Does he know why they are not ?
We hint there is a strong reason, and it would be a nice thing for
some one to study and find out. More later.
668 THE DENTAL REVIEW.
Rumor says that there are tivo movements for a dental com-
bine that are in conflict. Does Dr. Crouse know anything about
this? This will please the regulars in trade. Some one has been
writing letters, which often proves a very dangerous thing, they
are so often misunderstood. Look out for a microbe of a new
specie, a kind of spirillius micrococcus, anaerobic, lives without
air and is mighty, living in the dark. Its ways are various. Turn
on the light.
It is said that this microbe is of a McKinley breed, under pro-
tection.
The discussions of the Chicago Dental Club in the July Dental
Cosmos are profitable reading, quite above the average. Note Dr.
Marshall's emergency provision on the operating table. It was a
bright and humane hit. Brass screws and cigar boxes can be
turned to good account. Saving these bodies of ours means some-
thing. They are for worthier purposes than use for sour mash vats
and smoking chimneys.
What is man? Some say, "nothing but a dentist." Some
day, sometime our filmy eyes will be opened. Men who are pre-
pared for emergencies can only meet them. Men who are
courting newspaper glory will never, never fill the bill in such
emergencies. Only those who watch and wait.
How some dentists get attention from the public by advertising
squarely and others (under cover), the latter claim it is unprofes-
sional to do so.
In the first class we will not include what is termed the "gutter
dentist," "biled rubber man," "steam dentist," "parlor dentist"
and etc. This method of putting oneself before the public has
been one that has racked the heads of many an ambitious practi-
tioner and not necessarily thoughtful of anything that is really an
infraction of the moral law. There is no disguising the real fact
that the true animus against advertising has come from the cheap
John style, which has been quackish. By this we mean, offering
to practice certain methods, which bore on the face of them, base
evidence of fraud and were calculated to deceive the public. It is
a fact now, and was more so when P. T. Barrium announced that
the public did seek " Humbugism." We all know that our field
of operation admits of as much opportunity as any for such
practices — by the unprincipled. The first decided public venture
in advertising in dentistry that comes within our memory was
DOMESTIC CORRESPONDENCE. 669
in the noted Gleason's Pictorial, which during the period of 1840
to '50, was very popular as a family paper. It was one of the
most popular ventures, as the old New Englander said, "as a
picter paper." In this journal was illustrated very largely and
lavishly and yet interestingly, carrying with it a good deal of intel-
ligence, the practice of dentistry — as it was understood in those
days, principally mechanical. The proprietor of this advertise-
ment was Dr. Hitchcock of Boston, a fine, aristocratic gentleman,
genial, cultivated and a man of merit. These articles would interest
many to-day as a matter of reference. Emphatically joined to
the illustrative was the practical thought he had in mind, the
securing of a large practice, which he did gain and with it financial
success. In his advertisement, as plain as printer's ink could make
it, he did bid for the public, offering terms favorable to the clergy
and to any of limited means. The doctor strongly guarded his
surroundings with everything that pleased the cultured and
the curious eye of the public in his finely furnished apartments.
The best evidence of success was his apparent success. This was
before the dictation of arbitrary associations. Dr. Hitchcock was
the father of Prof. Thos. Hitchcock in the initial school of dentistry
in Harvard. We readily recall the senior Hitchcock's genial
bearing, line-looking face and as handsome a set of teeth as we see
in any mouth. Yet he was caught by the destructive malady,
" Riggs' Disease."
With a little detour we will intertwine with this letter a little
history. In the August of 1864, the American Dental Association
met in Boston. Standing on the State House steps during the
session were a few dentists, and among them were the late Drs.
Riggs and Hitchcock, a few others whom I do not recall. Dr.
Riggs, by way of conversation, described certain conditions of
disorder, which he had been long observing associated with the
teeth. He turns to Dr. Hitchcock and sa3's: "What do you do
with such cases?" He replies, "I am not able to do anything with
them, I do not try." "Further," he says, " I am loosing my
own teeth, one by one, from the same disordered condition
which you have described, and greatly to my consternation."
Dr. Riggs, after taking a casual view of the doctor's teeth,
which readily exhibited their condition, says, "Here's an excellent
chance to practice what I preach, not so much in public as yet."
This led to an invitation to visit Dr. Hitchcock's office at once and
670 THE DENTAL REVIEW.
a little nucleus of dentists followed on, saying in side talk, now
for something new. Dr. Hitchcock tells Dr. Riggs to look over
his case, anything he wished was at his command. The doctor
says quaintly, with one of his inimical laughs, "I don't expect
to find anything; I have a novel instrument of my own, although
not with me. Show me your laboratory with a forge and I will
produce a pair of instruments with which I treat this disorder.
Within an hour the instruments were produced and the operation
commenced. This was the first public clinic of what is now
known popularly as the "Riggs' Treatment." While it was the
cause of much interest to those who witnessed it, there was little
response to those who repeated what they had seen. Well, this
was an advertisement of another class. The next that was heard
from this subject was at a meeting of the Connecticut Valley
Dental Association. Notice what follows. A set of instruments
were exhibited by a Boston dentist as (original,) which were fac
similes of those Dr. Riggs had manufactured and used at Dr.
Hitchcock's office, (he leaving those instruments there.) This will
be seen as another class of advertising. This event was the means
of arousing an interest in the real virtues of the subject. It be-
came the occasion of advertising Dr. Riggs and his treatment in a
way that could have hardly been predicted. From that time Dr.
Riggs' fame has increased, and I do not say anything marvelous
when I say that his name will be remembered as long as any man
that has yet been identified with the profession of dentistry.
In 1880 Dr. CM. Richmond, coming from California, exhibited
in New York City his novel crown invention; which was put into the
dental depots in its manufactured parts, allowing each dentist —
who had ability — to purchase and to apply to cases in demand. It
consisted in a porcelain face, a screw and nut with gold backing,
giving contour to the shape of the tooth, this being fastened
to the root held in place by the nut cemented in the root.
Dr. Richmond was en route for Europe but was met with so much
encouragement to stop in New York and apply this crown person-
ally to those who would wish the operation for their patients, the
doctor manifesting such unusal ability in applying them expedi-
tiously. This crown was found to be, further on, so expensive
necessarily, was $50, that the Doctor's fertile ingenuity sought an
improvement, in order that it might become more within the means
of the larger demand. The result was the crown now known as
DOMESTIC CORRESPONDENCE. 671
the "Richmond crown," and later by a combination of this crown
and "the all gold crown," "bridge work" was introduced on a
decidedly different plan from the Low method, which was first
exhibited in New York, at a meeting of the Odontological Society,
by Dr. Low himself, and did not gather much enthusiasm from
those who saw it. This was previous to the Richmond method.
The Improved crown it was found could be given to the public at a
reduced price, namely $15, and the All Gold Crown, $10. The
sagacity of a business eye fell on this invention and the inventor
was captured, a most natural occurrence as human nature goes.
Into the New York Herald and Times went a big " Ad," costing the
sum of one thousand dollars for a single insertion. This was
placed over the entire side of the paper, headed with big letters,
^'Artificial Teeth Without Plates,'' followed by large illustrated cuts,
showing very intelligently, at a glance, what it all meant. It was
a bold and expensive experiment, but " nothing ventured, nothing
gained." Suffice it to say, it was a great success from the first.
We know it from the best authority, that the two days following
these "ads." there was over five thousand dollars' worth of this
special work booked for appointments. The office being centrally
located, in a first-class neighborhood, and under first-class
appointments, never anything like it in this country. From
this the work commenced and increased to the demand of twenty-
two operators inside the first year, callers numbering as high as
one hundred daily, of all classes but largely of the bettered condi-
tion. Over a thousand dollars a day has been taken, and the check-
book showed the receipt of a little over ninety-six thousand dollars
the first year. The appointments at the door were in the highest
order of livery, and the enterprise was an envy to the envious.
Cabinet meetings by outsiders were frequently held in various
caf^s to consider what could be done to stay the rush and possibly
the entire captivation of the dental practice in New York. We
state this as a fact that ambitious men considered the propriety of
starting other establishments. The excitement over this establish-
ment was phenomenal. It was a tidal wave in dentistry. Fully
one hour it was under consideration at one of the meetings of the
Odontological Society what could be done, it was vigorously
argued that the society should vote it out of existence and make
their action public. Dr. Atkinson, although not a member, advised
against any notice of the enterprise. He argued that it would not
672 THE DENTAL REVIEW.
help them out, but would call attention greatly to their trouble, ad-
vertising the establishment and therefore defeating their purpose.
After all this expense of energy, Dr. Kingsley, always level-
headed, suggested the propriety of dropping the whole subject,
"for," says he, "it does not seem to have occurred to my friend
who I so much dislike to differ with, that this whole matter is out
of order, for the parties which it is the desire to deal with, are not
members of this society." We recall a queer look that passed over
some of the faces, light had dawned, and the subject was quietly
dropped with a call for " Incidents of Office Practice," always of
an interesting character.
This mammoth bonanza, by liberal advertising, came to grief
before the end of its second year, for reasons which we could name,
but deponent saith not. During the second year Dr. Richmond
withdrew his association which cost him many tribulations and liti-
gations of a vexatious nature, becoming "more sinned against than
sinning," and leading to misunderstanding by the profession. It
is doubtless no overstatement to say that his experience in the
"crown and bridge work department" has been larger than any
other practitioner, which entitles him to the favorable recognition
secured by his recognized merit in the illustrated papers com-
mencing in the July number of the International Dental Jour-
nal, to be continued throughout the coming year. These par
pers will illustrate only work that has proved its efficiency
by practical test. Leading from fixed bridges (the distress of so
many early in practice with this work) and greater distress often-
times of patients, it has brought an evolution of movable bridges.
The specimen of this later work, which was seen last year by so
many dentists at the Union meeting of New Jersey and Pennsylva-
nia dentists at Asbury Park, and also at the American Dental As-
sociation meeting at Saratoga, which received the most favorable
comment, and was repeated by our illustrious Mac at the late Illi-
nois State Dental Society meeting and reported in the June num-
ber of the Dental Review. To show what has come out of all this
booming of crown and bridge work, during its first advent. Dr.
Patrick echoed also at the Illinois meeting the thought of all open-
eyed practitioners "that it is the greatest advance of the Nineteenth
Century and has come to stayy Truly it has been a child of many
sorrows, because of its precocious childhood and luxurious sur-
roundings. Out of Jill this and litigations that have come and are
DOMESTIC CORRESPONDENCE. 673
doubtless yet to come will strengthen its value and make it a joy
to many for ages. Think of the violent opposition at the
beginning, and note the change now. "They all do it." — A good
many cannot do it well. — It takes ability of high order to make it
successful and useful. Is it not so in all that is useful? In all
these various kinds of advertising from both points of view, it has
done its work. We could continue this line of thought and show
how advertising enters into all our dealings with each other. There
is one way of putting advertising to a fruitful use, namely: by deal-
ing in a spirit of fraternity toward each other. This includes a
sincere respect of each other's opinions. Earnest and able writers
cannot so palpably disagree as they seem to, that is, if they can
consider long enough to understand each other. We would recall
many bitter criminations and recriminations of able men among
us, but they have later come to respect what each says and this
makes it more profitable for those who listen. Better far better,
"jump our bites" than to go so far and intimate falsity of state-
ment. Authors that have proved their ability, as both these have
to which we allude, cannot wisely charge the other thus. Let us
think that this comes rather from a little cerebral friction than of
the heart.
We have met Dr. Younger in town, and never so much younger
as he appears now, full of good physical and mental enthusiasm.
" Implantation" not in all his thoughts, but some of them. It is
a scientific operation to the contrary notwithstanding, and one
versatile writer has put himself on record as saying, "it is ?iot a
scientific operation." Here's the Doctor's proof, he has the slides
showing beyond contradiction to men capable of knowing a thing
when they see it, and have the grace to say so. These slides
show pericemental attachment. Where the pericemental mem-
brane has //^/ been removed previous to the operation. It is known
by reading men that, according to some German authority, the claim
has been put in that by removing this membrane, absorption
which sometimes occurs is prevented. Dr. Younger is prepared
to prove directly the opposite. Revivication is still a fixed fact
in the Doctor's noddle. The Doctor tells of a new method of
dealing with indurated cicatrical tissue induced by alveolar ab-
scess. After dividing the tissue from its basal attachment he
uses a tent of cotton and wax forced into the wound attached to
the adjoining teeth, or tooth, by ligation, keeping it in place
674 THE DENTAL REVIEW.
until healing is secured. Previous to this, let me say, he dresses
the wound with an ammonia sulphite, I think, to secure at the
start an eschar covering of the wound. This he does in his
socket formation for implantation. The Doctor is in New York
to see his wife and three children go out for a European sojourn,
and he is to meet them some months later. He proposes to be at
the Italian Medical International Congress, meeting at Rome in
1893, and returning for the Chicago meeting. We might as well
ask the question here, for many are asking it, is this congress to
be a delegate body only of associated bodies, or is it a congress of
dentists as dentists ? It has been published ad nauseum that all
reputable dentists are to take part. Many are whispering, what
constitutes a reputable dentist? It is said that a list is being
made up in our section that drops out not a few that have been
foremost in all that has been progressive, and yet they are not
now considered reputable, according to whom ? rumor asks.
According to those who are in command, rumor answers. Now
we will say, without any danger of dispute, that Christopher
Columbus never discovered a country for any such purpose as
this. If this congress is not to be one in which all factions are to
be buried, the sooner the whole affair is buried, and those who are
in it, the better. We, personally, don't want to indulge in any
such thought, and are not going to until we are compelled to do so.
Let us have all the ablest men to the front, that have earned a pro-
fessional reputation by putting their shoulders to the wheel of the
slow car which has been so accelerated during the last thirty years.
The American Dental Association, of which Dr. Allport was first
Chairman, and Dr. Atkinson first President, was the beginning of
this progressive movement, including, as the French say, the true
spirit of frceternite. Coincident with this Dr. Atkinson, in a
marked providential way, was led to New York City to commence
his marvelous career that has been first and foremost in the in-
citement of this notable progress of ours. No one thing has been
so potent for energizing the work of the A. D. A., as the energy
that was infused into this body by that novel and fraternal associa-
tion, the Brooklyn Dental Association (not Society), composed
mostly of New York City dentists (a few, a very few, from Brook-
lyn), and ultimately many of the prominent active workers in the
country became identified with this fruitful body. This nucleus
of notably warm-hearted practitioners was a boomer to this
DOMESTIC CORRESPONDENCE. 675
national body. At its second session, held in the city of brotherly
love, a significant coincident also, we could never forget the enthu-
siasm which followed the reception of the first delegates of the B.
D. A. at this meeting, marshaled as they were by the great heroic,
self-sacrificing Atkinson. Many, many are gone on before us, but,
the work remains. With this movement commenced a new era in
dental education, a new school and an advanced practice. Find-
ing dentistry a business, as Dr. Atkinson often said, but leaving it
.at the end of his career a hope of its being a scientific practice,
and a true history will not be secured at this great gathering of all
nations if this fact is not brought out, emphasized and worthy
recognition accorded to those who were its pioneers.
We congratulate Dr. Truman in the spiciness which is in-
creasing from month to month in his editorials touching so em-
phatically and in many respects wisely, the thoughtful questions
that are engaging thoughtful men. His views regarding honorary
degrees may not be fully accepted, but in a general sense they
are very largely truthful. It would be an unfortunate occurrence to
many men if the method of procuring honorary degrees, that has
been so much in vogue, were photographed. Dr. Barrett steps
to the front in an animated reply more muscular than really in-
tellectual. It is too warm weather to indulge in any attempt of
the analysis of this question of degrees and non-degrees. While
we have warmly advocated a just recognition to a large number
of diligent workers in the earlier times, and who reflect much
credit upon our profession to-day, giving them recognition from
the schools with a degree, yet perhaps on second consideration in
view of the discussion in the shape which it has taken, we are dis-
posed to let the subject, the part we have advocated, take care of
itself. All honor be accredited to such men as Dr. Andrews, of
Cambridge, Massachusetts, and others who have lately had de-
grees worthily bestowed upon them. Certainly no man has more
honorably won the degree of Master of Arts than Dr. Andrews.
We publish here, for the benefit of Kansas City, who reported
lately that '^ the. Eastern Dental News was moving politically to-
wards the Columbian Dental Congress." Dr. Andrews' name has
been mentioned preeminently as a worthy possessor of the pres-
idential chair at this great body of dentists, which is to be repre-
sented from all parts of a civilized world. His preeminence con-
sists in his preeminence of ability, earned in such a modest, gentle-
676 THE DENTAL REVIEW.
manly way. He is a man who would impress any of the belles-
lettres of dentistry of the old world in the most favorable manner.
This nomination may be considered out of order, but as the walk-
ing committee are not in session, it is ventured, for it has been
seconded all along the line. Dr. C. D. Cook and wife, Dr. Ben-
son of New York, Dr. Woodward, President of the Odontolog-
ical Society, have crossed the Atlantic. Dr. Cook, it will be re-
membered, is the venerable father-in-law of Charles Tomes of
London, noted for his literary ability among dentists. Au revoiry
as we go outing also.
Dr. Steinbourough, the inventor of the " Dies " mentioned in our
last letter, should read Stonbourough.
Drs. Carr and Bodecker are summering at Carrville, Long Is-
land.
All aboard for Cresson Springs, Pennsylvania, says the con-
ductor to a large party going to the Union meeting of Jersey and
Pennsylvania dentists. This gathering will doubtless augment
the attendance of A. D. A. The query is, who the Jersey boys
will make President this year? It was a good thought that both
American and Southern bodies adjourn to meet at Chicago and
do their legitimate business and adjourn. "The biggest show on
earth," truly, we hope. Ex.
New York, July 1892.
REVIEWS AND ABSTRACTS.
TWO NEW DENTAL JOURNALS.
The Dental Journal, published by the Dental Society of the
University of Michigan, editors, A. W. Diack, Miss C. M. Stewart
and C. A. Hanley. This journal is published by the students of
the University. The July number is a very creditable effort.
There is a sketch of the dental department by Dr. J. Taft, the
dean of the College, an article on Evolution, by H. F. Hussey,
one on exposed pulps by Henry Milling, and several minor articles.
The editorial department is filled with interesting matter, and it
seems probable from the start that the Journal will prove of great
value to all concerned. We wish it great success in its chosen field.
Revue Internationale L' Odontologie; editor, Paul Dubois;
associates, M. M. G. Blacman, R. Chaurin, Ch. Godon, R. Heide,
REVIEWS AND ABSTRACTS. 677
E. Papot, A. Presel, A. Rounet and Maurice Roy. Editorial office,
2 Rue d'Amsterdam, Paris, France. Price 10 francs in France and
Algiers, and 12 francs per annum in the Postal Union. M. Dubois,
so long the editor of L' Odontologie, as we predicted, could not
remain inactive, consequently we have before us this handsome 06-
page monthly dental journal. M. Dubois has associated with him
as collaborators some of the best known teachers in the dental
school of Paris, and from his great capacit}' for labor, his disinter-
estedness in the course of dental reform and progress in France,
we predict a brilliant success for the new journal. Since the
foundation of the dental school and the establishment of the first
journal, U Odontologie, a new impetus was given to the science and
practice of dentistry, very largely due to the herculean efforts of
Dubois, Lecoudrey, Godon, Rounet, Blacman, Copot and their con-
freres. It is with pleasure that we note their new venture, as it is
our sincere wish that they will succeed not onl}' with this literary
venture, but in their efforts to strengthen the morale of the profes-
sion in France by stamping out every species of quackery and
charlatanism and gain that recognition from the State that the
dental profession is entitled to in one of the most enlightened
countries of Europe.
The first issue is devoted to the visit of Herbst at Paris, the
new dental law, and much other matter of varied interest. The
journal is well printed and carefully edited, and we felicitate the
editors and publishers on its clean-cut and handsome appearance.
DENTAL COLLEGE COMMENCEMENT.
NATIONAL UNIVERSITY— DENTAL DEPARTMENTS.
The commencement exercises of the dental department of the National Uni-
versity was held at the Academy of Music, Washington, D. C, Tuesday evening,
May 17, 1893.
The conferring of degrees vi^as by Hon. Arthur MacArthur, Chancellor of the
University.
An address to graduating classes was delivered by Prof. J. B. Hodgkin, D.
D. S.
The Valedictory address was by Wm. S. Thomas, M. D.
The degree of Doctor of Dental Surgery was conferred upon the following
named (4) graduates :
William E. Bradley, Cal. | Sheldon G. Davis, Ohio.
Edwin K. Gerow, N. Y. 1 David E. Wiber, D. C.
GTS
THE DENTAL REVIElir
BOSTON DENTAL COLLEGE.
The twenty-fifth annual commencement exercises of the Boston Dental Col-
lege, were held at Berkeley Temple, Boston, Wednesday evening, June 15, 1892.
An address was delivered by B. S. Ladd, Esq.
Awarding of prizes, by the Dean, J. A. Follett, M. D.
Conferring of degrees, by the President of the college, I. J. Wetherbee,
D. D. S.
Valedictory by Ellsworth N. Brown, D. D. S.
The degree of Doctor of Dental Surgery was conferred upon the following
named (38) members of the graduating class :
John Charles Fremont Bridge.
Karl Schurtz Brock.
Ellsworth Newton Brown.
Richard Bullock Callaway.
Thomas Patrick Cahill.
Stephen Harry Chase.
Pearl Raymond Copeland.
Thomas Francis Cuff.
William Vaughan Davies.
Albert Jones Derby.
William Henry Duddy.
Walter Lovett Dunton.
Arthur Ellis Esterbrooke.
James Andrew Ewing.
John Wood Forbes.
Guy Norman Gammon.
Daniel Griffin.
William Irving Hervey.
Mozes Jessurun.
George Nelson Johnson.
Philip Patrick Kelley.
Albert Henry Ketcham.
John Stephen King.
Irving Miles Luce.
John Fletcher Maloney.
William Rodney Marsh.
Frank Rittle Mayers.
Norry Miett.
Louis Dearborn Millett.
William Samuel Pearman.
Charles Nahum Piper.
Edwin Alexander Quinn.
Frederick Alexander Robinson.
Julius Stahl.
William Pray Swasey.
George Lawrence True.
John Edward Walsh.
Clarance Parker Whittle.
MEMORANDA.
Dr. Louis Augspath is the oldest practitioner in Arkansas
A good location for a dentist is at Grantsburg, Wisconsin. So we learn.
Dr. Gordon White made an excellent presiding officer at the Southern meeting.
Dr. J. C. Story has retired from the editorship of the Texas Dental Journal.
Dr. Frank Harlan, of Atlanta, Ga., is an expert handler of the electric
mallet.
Dr. Evans fuses a porcelain glass front on a gold crown without the use of
solder.
Dr. S. R. Salazar, of Lima, Peru, was one of the visitors at the A. D. A.
meeting.
The A. D. A. sections were all creditably prompt to make their reports when
called.
On the first day at the Lookout meeting there were about 200 present, in-
cluding the ladies.
The business of the American Dental Association was expedited under the
efficient presidency of the genial Walker.
MEMORANDA. 679
Many of the dentists in attendance at the A. D. A. were taken ill; a large
number were indisposed a greater part of the time.
Dr. George J. Friedrichs delivered a polished address at Lookout, in response
to the welcome of the Tennessee Dental Association.
Excepting the city of Buffalo, New York, there were more dentists at Niagara
Falls, New York, from Illinois than from the State of New York.
The next meeting of the World's Columbian Dental Congress Executive Com-
mittee, will be held in Cincinnati, O., Tuesday, October 24, 1893.
Dr. Dunn, of Chicago, forces teeth apart by using dry cotton forced between
the teeth, then tying a ligature around the cotton perpendicularly.
The twenty-third annual session of the Virginia State Dental Association
will be held at Rockbridge Alum Springs, Virginia, beginning August 30, 1892.
Members of the American Dental Association should at once notify Dr. A- H.
Fuller, Treasurer, 2602 Locust St., St. Louis, Mo., of any change of address, that
they may appear correctly in the transactions.
Dr. J. Y. Crawford, of Nashville, on behalf of the Tennessee dentists, pre-
sented to Dr. Gordon White, President of the Southern Dental Association, a
beautiful silver-mounted gavel made from historic wood.
The Southern Dental Association adopted resolutions protesting against the
attempt of the census bureau to classify dentists as manufacturers. There are
more than four hundred members of the association in good standing at the pres-
ent time.
First District Dental Society of Illinois.
The First District Dental Society of the State of Illinois will meet at Peoria,
the second Tuesday in September, 1892.
W. O. Butler, Secretary.
Dr. Geo. H. Watson, of Berlin, Germany, was a visitor at the Niagara Falls
Meeting.
Dr. W. W. Walker, Chairman of the Executive Committee of the World's
Columbian Dental Congress, sailed for Europe August 10th, to be gone two
months. Dr. Walker will look after the interests of the Congress while in Europe.
Dr. George Evans makes a base plate gutta-percha cup, using two or three
thicknesses, bending it over flat, making a base for it to stand on, so it will not
tip while using. When he desires to use a gutta-percha solution for any purpose
he drops a little chloroform in the bottom of the cup, and the solution is made
instanter. By adding the thickness of a new sheet when the old one is used up,
he has a perpetual bottle without using a cork.
Chicago was well represented at Niagara : Geo. H. Cushing, W. W. AUport,
John S. Marshall, A. W. Harlan, J. W. Wassail, J. A. Swasey, T. W. Brophy,
Frank H. Gardiner, Louis Ottofy, J. A. Dunn, W. H. Taggart, T. Menges, W. B.
Ames, E. D. Swain, A. W. McCandless, W. H. Prittie, Garrett Newkirk, C. S.
Case, B. J. Cigrand, B. J. Roberts, and J. D. Banes. From outside of the city
but from within the State of Illinois, were J. J. R. Patrick, Belleville; G. D.
Sitherwood, Bloomington ; F. S. Eiles, Blue Island ; T. W. Pritchett, White-
hall.
680 THE DENTAL REVIEW.
SOUTHERN DENTAL ASSOCIATION.
At the last meeting of the Southern Dental Association the following officers
were elected for the ensuing year : President, B. Holly Smith, Baltimore, Md.;
First Vice President, R. K. Luckie, Holly Springs, Miss. ; Second Vice President,
S. B. Cook, Chattanooga, Tenn.; Third Vice President, L. P. Dotterer, Charles-
ton, S. C; Corresponding Secretary, D. R. Stubblefield, Nashville, Tenn.; Re-
cording Secretary, S. W. Foster, Decatur, Ala.; Treasurer, H. E. Beach, Clarks-
ville, Tenn.; Executive Committee, Gordon White, Nashville, Tenn., and W. R.
Clifton, Waco, Texas.
Thirty-five of the forty-nine States and Territories in the Union have accepted
the building sites assigned them on the Exposition grounds, and have submitted to
the construction bureau for approval the plans of the buildings they propose to
erect. Nearly all the others, it is known, are about ready to take like action.
Every State and Territory, with perhaps three exceptions, will erect a building.
Quite a number of these buildings will be reproductions of historic structures such
as Independence Hall, Washington's Mt. Vernon home, old Fort Marion, etc.
They will occupy the northern portion of the Exposition grounds and will be sur-
rounded by walks, lawns, shrubbery and flowers. They will be used as headquar-
ters for State boards and visitors and as receptacles for exhibits showing State re-
sources, etc.
ABNORMAL MENSTRUATION — TOOTHACHE.
I have a patient now having a menstrual period who has not menstruated for
the past thirty years. She has raised a family, and is now nearly seventy-six
years of age. She has enjoyed fair health usually through life. Is of a very in-
dustrious, temperate and moral disposition. Now, as the forceps, ergot, post-
partum haemorrhage and bloodless labor have all been thoroughly discussed, I
propose that we gather up a reliable history of menstruation during old age for a
change. I start with seventy-five years and seven months. Now menstruating
this 27th of April, 1892. I should like to hear from the general profession of their
knowledge of all similar cases through the Brief.
Immediately relief will be obtained by painting the tooth and gum with a ten
per cent solution of cocaine, made by dissolving the cocaine in pure alcohol. —
/. Humphrey, M. Z>., in The Medical Brief.
Fairbury, Neb.
NORTH DAKOTA STATE DENTAL SOCIETY.
The annual meeting of the North Dakota State Dental Society will be held in
Grand Forks, August 17th and 18th, 1892.
Among the papers to be presented will be "Pioneer Dentistry in North
Dakota," by Dr. A. T. Bigelow, of St. Paul, who was the first dentist to locate
within the bounds of our State.
"Post Graduate Study," by Dr. Louis Ottofy, of Chicago, well known to all
the old practitioners of North Dakota.
Dr. T. E. Weeks, of Minneapolis, will also be present and contribute much
of interest to all who desire to keep abreast of the times in professional advance-
ment. Let every dentist make an effort to be present and contribute something
to the general interest of the meeting.
There will be a special session of the Board of Examiners for the benefit of
any who may desire an examination for license to practice.
Fraternally yours, S. J. Hill, Secretary.
THE
DENTAL REVIEW.
Vol. VI. CHICAGO. SEPTEMBER 15, 1892. No. 9.
ORIGINAL COMMUNICATIONS.
The First Permanent Molar.
By Dr. J. H. Woolley, Chicago, III,
One of the great difficulties that a professional man has to avoid
is that of hobbies and narrowness of view. Opinions should be
formed slowl}', and then only upon careful research, close study
and patient plodding, with a constant comparison of notes.
The subject of this evening, tiie First Permanent Molar, is one
upon which there are wide differences of opinion. I cannot expect
to treat it with that thoroughness which it deserves in the time
placed at my disposal. This subject has so great a range, connect-
ing itself with so many departments of dental science, that if I can
cover two or three points in the discussion it is the most I can
hope to do. To successfully treat this subject requires a good deal
of experience and research, extending through years of observation,
and with the comparative little study I have given it, I fear that
my opinion will not be worth much.
The jaws and teeth of our little patients are like clay in the
hands of the potter, to be shaped from a good or bad design. Our
best results are gained by experience extending through years of
painstaking toil. Many times have we blundered, not only at
the expense of the patient but of ourselves.
I am inclined to compare the first permanet molar to a waif or
outcast in the street, that is neglected through ignorance of its true
value. The condition of the teeth, either healthy or unhealthy, is
owing to hereditary and parental influences, together with the kind
of care the child receives before and after their eruption. At the
682 THE DENTAL REVIEW.
time the first permanent molar is calcifying, there are physical
causes at work to disturb its harmonious growth and development,
springing from diseases of childhood. We are also to consider that
we are living in an age of ceaseless activity. All are pushing to the
front and forcing themselves to the highest tension, and children
brought into this world under such conditions inherit a highly ner-
vous organization. When we consider that the most rapid growth
of the brain takes place before the age of seven (according to many
physiologists), we find it growing at the expense of the other organs.
Not only the bones of the body, but the teeth suffer from this
rapid development of the nervous structure. When we consider
;aU these facts, together with the brain-forcing the child receives,
iit is not strange that we see diseases of childhood occurring to retard
jits proper physical development, and that of the teeth naturally in-
'cluded. Neglect, caused by ignorance on the part of parents, who
"think these teeth belong to the first set, plays a prominent part in
'this early destruction. These teeth appear at a time when many,
•of the temporary set are decayed and the mouth is in a condition to
lielp along any predisposition to decay. If parents were well in-
formed as to the time of eruption of the first permanent molar and
would place their children in the care of a competent dentist, a large
majority of these teeth could be saved. Having thus considered
the causes at work to prevent a perfect development of the first
permanent molar, let us now pass to other phases of the subject.
Mr. Tomes in his record of 3,000 extractions states that one-
third of them were the first permanent molars. This does not
seem to me a fair test, as a great many, perhaps a majority, of
extractions occurred among the poorer classes in hospital practice.
I have tried to briefly show what causes were at work to pre-
vent a healthy growth and development of these teeth. Consider.
ing the circumstances under which they have erupted, there
are many who believe them to be short-lived, but they also believe
they should be preserved until the time when the twelfth year
molar first makes its appearance. There are many who believe
that these teeth being lost at so early an age, are consequently
more liable to decay. They claim that the time of life when these
teeth are erupted, and the condition of the mouth, etc., are the
reasons why these teeth are lost at an early age. It is said that
■space is gained by the removal of these teeth which prevents the
remaining ones from decaying, and that in case of irregularities,
ORIGINAL COMMUNICATIONS. 683
and a crowded condition of the teeth, their removal will give room
for the proper replacement of the remaining teeth. The answers
to these objections given by Dr. Arthur are the same that are
found in the experience of many dentists and my own as well. I
will try to show some of the reasons why so man)^ of the first per-
manent molars are lost.
About the time the central incisors are shed four new teeth
appear. They are the first permanent molars. As I have said
before, they appear at a time when many of the first teeth are still
in the jaw; and through carelessness, or inattention on the part of
the parents, they are overlooked, or if noticed, they are supposed
to belong to the temporary teeth; consequently it is only when the
child is suffering from the toothache, that it is brought to the den-
tist. The teeth may be slightly decayed, and the dentist fills
them. Now the child at this age is difficult to manage, if den-
tal operations are to be performed. Many dentists prefer not to
have children under their care at all, and when they are obliged to
take charge of such cases, they hurr}' through their operations.
What is the result? They are usually imperfect and sometimes a
complete failure. Besides, the parents' sympathies are enlisted in be-
half of their children, and the dentist is encouraged to believe that
if the operation does not prove a success he will not be blamed.
These considerations are unworthy of the man professionally and
morally. He has shirked his responsibility of educating the parents
in regard to the care of their children's teeth, and believes it is of
little consequence whether they are saved or not, after the twelfth
year molar is erupted, as the latter takes its place.
By the extraction of the first permanent molar it is claimed that
more room is given for the bicuspid and cuspid teeth to move back,
and that the spaces thus made render the teeth less liable to decay.
It is urged that the twelfth year molar will take the place once oc-
cupied by the first permanent molar. Rarely have I seen that the
bicuspids have separated enough to prevent their decay. I have
found, as others have, that, when the first permanent molar has
been extracted, it made very little difference in regard to the decay
of these teeth. In regard to the extraction of these to correct a
crowded condition of the arch, and particularly of the front teeth, I
will say, according to the laws that govern the movements of the
teeth, I have found that they always move forward and rarely back-
ward. Dr. Arthur is quoted as saying, " where the front teeth are
684 THE DENTAL REVIEW.
crowded, he has never known them to change their position, as a
result of the extraction of the first permanent molar, without me-
chanical assistance." He cites a case where "four first permanent
molars were extracted, and the second molars came forward in time,
until they touched the second bicuspids both above and below."
The absence of the extracted teeth, he says, "would not have been
observed, except by dentists, yet all of these teeth were attacked
by decay on the surfaces in contact." Now in regard to the re-
moval of the first permanent molar to correct irregularities, there
may be exceptional cases where necessity demands it ; there may
be cases when these teeth by carelessness, as before shown upon
the part of the parent or dentjst, have reached that stage of decay
requiring theirremoval. But that these should be removed to cor-
rect irregularities, I believe to be a mistake.
Is it true that irregularities of the teeth are necessaril}' caused
by lack of room in the jaw for them to assume their natural posi-
tion ? It is the opinion of many authorities that there are
other causes at work to prod-jce irregularities. Dr. Kingsley
says: "The conclusion then is this: La>'ing aside all cases
that may be due to an inherited tendency to follow or exag-
gerate some given type, together with those which are man-
ifestly due to forces operating only after eruption, the primary
cause, so far as the individual is concerned, of any general disturb-
ance in the development of the permanent teeth, showing itself
particularly in their malposition, is directly traceable to a lesion or
innervation of the trigeminal nerve ; it is an interference, more
or less prolonged, with one of the prominent functions of that nerve,
and operating at its origin. While there may be no way to prove
this by any examination, microscopical or otherwise, while the nerve
center is under this influence, it is nevertheless sufficiently proved
by secondary phenomena which could only have originated from
such a source. The function of the trigeminus, thus stimu-
lated or interrupted, is that which supports, regulates and governs
the nutrition of the tissues to which its terminal branches are dis-
tributed." He further says: " During the formative and eruptive
periods of the permanent teeth, they are under the influence of an
independent and peculiar vital (nervous) force; this innervation
pushes on their development, regardless of the more tardy growth
of the osseous system; being implanted in a crowded position in
undeveloped maxilla, they never have an opportunity to recover
ORIGINAL COMMUNICATIONS. 085
from it, and emerge in the same disordered arrangement in which
the crowns were formed. In these positions, when fully erupted
and surrounded by their alveolar walls, they become fixed, regard-
less of any subsequent growth of the jawj for it is one of nature's
laws that when the climax of development has been reached and
the type is complete, function ceases."
Mr. Tomes also says that the teeth when they are erupted do
not come down and take a place in bone already prepared for
them, on the contrary, that which is there to start with, is absorbed
and the bone in which they are ultimately implanted is built up
around them, no matter what position they assume subsequent to
their eruption. He also says, the size of the dental arch is not ab-
solutely fixed by the size of the jaw; this has been confirmed by
others, and in my own experience as well. In a great majority of
models of mouths that I have obtained in cases of irregularities,
by measurement I have found room enough in the jaw to bring all
the teeth into proper position without extracting the first perma-
nent molar. Dr. Lord does not now believe in the extraction of
these teeth, and confirms the opinion held by Dr. Arthur, and also
considers them the most important teeth in the jaw, in preserving
its natural size and shape, and preserving the teeth in their
natural strength and position. He further says that "by their
extraction how often do we see so much lopping of the remain-
ing molars and bicuspids, as to occasion great loss of grind-
ing surface. By this shortening, under force is brought upon
the front teeth, with very unfortunate consequences." He believes
we should begin the care of these teeth in time and prevent caries
upon their surfaces, for the decay can be stopped as readily in
these as in any other teeth. If they come to us badly decayed he
believes in breaking down the corners or sides of the crown, and
not in building them up, leaving as much as can be saved with
certainty.
Again, I believe that extraction of any of these teeth causes
a depression of the face and a loss of individual expression.
In the regulation of teeth we have to consider what relation they
bear to facial expression, and also the effect the shape of the arch
has upon the human voice. When the former is narrow, cramped
and pinched, the latter takes on a nasal tone. If the arch is wid-
ened the voice becomes rounder and fuller. In a private letter
from Dr. G. V. Black he gives some very forcible reasons for the
686 THE DENTAL REVIEW.
retention of the first permanent molars. He says, " The one point
that I have espacially urged is the office of the first permanent
molar in holding the jaws in position during the process of the
shedding of the temporary teeth." He adds, " This point so often
overlooked, I deem very important. These teeth take their position
before the beginning of the shedding, and while the antagonization
is otherwise broken up they hold the jaws in position and prevent
any twisting of them by the powerful masseter and temporal mus-
cles; a thing that is very liable to occur if this support is lost by the
removal of any one of them before the twelfth year molars have
come into position." This forcible argument given by Dr. Black
for the retention of the first permanent molars should be heeded
as good advice to us all. He believes it very important for these
teeth to be preserved, at least until the twelfth year molars have
come into position. I have heard him say, " If these teeth, the sixth
year molars, could be kept until the child has arrived at his teens,
their chances were good for a permanent retention." He further
says, " My study of the comparative liability of the teeth to decay
at the different periods of life, shows that the first molars
are attacked in the first two or three years after eruption, much
oftener than any other tooth. But in after years they are attacked
less often than the second. If both the teeth are in a fair condi-
tion at the age of fifteen, the chances for the first are better than
those of the second. Decay occurs on the surface of the second
molar much oftener than in the same locality in the first, and is
much more difficult to treat."
I do not mean to be understood as saying that th^ causes
I have mentioned, are the only ones that bring about the malposi-
tion of the teeth. For we know in some of our own cases, that the
roots of the temporary teeth, when left in too long, sometimes di-
vert the direction of the incoming tooth from its natural position.
It is claimed the first permanent molar is a frail tooth, consequently
will not last but a few years. From the experience that I have
had in the treatment of these teeth for many years, I have found
that if they are watched with the same zealous care as others,
they in all probability can be saved. The coffer-dam should al-
ways be used in making a thorough examination of these teeth.
By this means, the surface of the crowns can be more critically ex-
amined. Sometimes you have to exert some pressure in exploring
out decay, the fissure not being well defined. Very often a slight
ORIGINAL COMMUNICATIONS. 68??
decalcification is discovered, which can be stopped by a small
filling, but which if neglected will spread and soon involve the
whole crown, and eventually the pulp, finally resulting in the loss
of the tooth. In regard to the mesial surfaces of these teeth, i§
the adjacent temporary molars are in close contact, they should be
separated by cutting away their distal surfaces with a safe-sided
file ; and if the mesial surface of the first permanent molar is
superficially decayed, proceed to remove this decay and polish the
surface. Whether these teeth are extracted singly or all four at
once, whatever time it is decided to extract them, it is rarely the
case that any of the evils existing are remedied. The tipping or
lopping of the crowns'of the remaining molars has almost always
occurred, occasioned by the loss of the bones and tissues, as the
result of the extraction of the first permanent molars.
Before concluding, a word should be said on the treatment of these
teeth. I found them more difficult to successfully treat in the first few
years of my practice, than subsequently. The reason of my early
failure was because I had comparatively limited knowledge of the
nature of these teeth, for I treated and filled them the same as
others. I have since found greater care is necessary in their
treatment, and as far as filling large cavities is concerned, my
mode for the last few years has been different from that followed
in my earlier experience. In large cavities, where the inner sur-
face is sensitive, without nerve exposure but with a thin covering
of dentine over the latter, I fill with the cements, allowing this
filling to remain in the tooth anywhere from one to six months. I
am careful first to flow over the floor of the cavity this cement in
a soft state. After it hardens I then fill the remainder of the
tooth with the same material mixed harder. When this cement
begins to wear, if the patient has had no trouble with the tooth,
I remove the cement, leaving only enough to cover the floor and
walls of the cavity, and allowing none to remain against the margin
of the cavity. I then fill with tin and gold foil combined, or what-
ever material is best adapted for the case. I believe these teeth
to be more susceptible to thermal changes when metallic fillings
are used, than any other teeth. I have found it so at least, and as
before said have lined the larger cavities with the oxyphosphates.
I believe the pulps of these teeth are more susceptible and more
tender, in the first few years after their eruption than in any of the
other teeth. When these teeth (particularly in the first two, pes-
•688 THE DENTAL REVIEW.
sibly three years after their eruption) are studied histologically, and
their nature and resources are well understood, the universal ver-
dict will be, that when taken in time and properly watched, it will
be the fault of the dentist and not the teeth, if in most cases they
cannot be saved.
Hypnotism as Applied to Dkxtistry.*
By Thomas Fillebrown, M. D., D. M. D., Boston!
Hypnotism is the modern name for a physical condition which
has been observed for many centuries.
It was known to the earliest races of Asia and among the Per-
sian Magi, and to this day the Yogis and Fakirs of India throw
themselves into a state of hypnotic ecstasy and reverie by fixation
of the gaze.
It has been known by the names of Trance, Fascination, Mag-
netism, Mesmerism, Electrical Ps3'chology, Animal Magnetism,
Electro Biolog}', Braidism and Hypnotism, and the science in its
remedial action is now called "Suggestive Therapeutics."
Down to near the end of the eighteenth century this condition
was imperfectly recognized, yet about A. D. 1(300, Von Helmont
wrote a work on the Magnetic Cure of Wounds, and Kircher, in
164G, described catalepsy produced in animals.
Mesmer, born in 1734, and graduated an M. D. in Vienna
in 1766, a man of great abilit}' and much learning, discov-
ered methods of producing this hypnotic condition at will in a
very large majority of cases. His theory was that a fluid passes
from the operator to the patient, and vice versa, and through this
medium the influence was transmitted and the effect produced.
He called this a magnetic fluid, and for fifty years the theory of
animal magnetism prevailed, and is still held by very many. Mes-
mer's popularity was so great that the public called the condition
thus produced, mesmerism.
In 1778 Mesmer came to Paris and announced his discovery.
He made many cures. Thousands flocked to him for treatment.
He hypnotized as many as 8,000 in a single year. Mesmer's
methods of conducting his clinic were open to criticism. Pro-
fessional opinion did not sustain him, and shortly he left Paris
in disgust. Later he returned. The government took notice of
♦Read before the Massachusetts Dental Society, July. 1892.
ORIGINAL COMMUNICATIONS. 689
him and appointed a commission to examine his claims and prac-
tice, and offered him a life pension. He did not accept, but chose
to return to Prussia, and there continued to practice his art until
he died.
From 1780 to 1841 mesmerism ceased to claim public notice as
a remedial agent, though individuals practiced it.
In 1812 the Prussian government sent Wolfart to Frauenfeld,
■where Mesmer had settled, to examine and report. Wolfart not
•only declared in favor of Mesmer, but adopted his practice in his
hospital treatment.
In 181*7 a law was passed in Prussia confining the use of mag-
netism to medical men.
In 1820 Du Potet began a series of observations at the Hotel
Dieu, and in 1825 the French Academy of Medicine appointed a
•commission to examine the claims of animal magnetism. There-
port concludes thus: " Considered as the agent of physiological
phenomena or as a therapeutic expedient, magnetism must take its
place in the scheme of medical science, and consequently it should
be practiced by physicians only."
John Elliotson used it in his practice in London in 1837. Dr.
James Esdaile, in 184.5, had in Australia made a record of 100
•cases of anaesthesia for surgical operations, when the English gov-
ernment placed him in charge of a hospital, and in 1851 he had
completed a record of 261 cases of complete insensibility to pain
in severe surgical operations, by the use of hypnotism.
In 1841, James Braid, of London, examined into the subject
and experimented with it. He became satisfied that no magnetic
or other fluid was concerned in the matter, but it was simply a con-
dition of the patient, induced by outward circumstances, suggest-
ing to him this state. To rid the science of all personality, he
proposed the term hypnotism, from h3'pnos, sleep, and since that
time it has been called by that name. There was for awhile a dis-
position to call it Braidism, but it did not obtain. In 1843, Dr.
Braid published a work on hypnotism and continued to practice
the art. Also in this year. Dr. Joly, of London, amputated an
arm painlessly by means of hypnotic suggestions, and the great
Liston made use of it successfully, and Velpeau and Broca re-
ported that they had employed hypnotism satisfactorily in twenty-
four operations.
M. Liebault, of Nancy, near Paris, had a copy of Braid's book
690 THE DEXTAL REVIEW.
fall into his hands. He studied it, believed in it, and in I860
opened a clinic and practiced the art among the poor of his village-
He soon found that audible suggestion increased his success, and
he soon demonstrated that suggestion was the key to all remedial
effects of hypnotisms, and if enforced by the voice through the
auditory nerve, it was made much more effective than without-
This came to be his constant practice, and is to-day the theory
upon which all hypnotists act. Braid did not fully recognize sug-
gestion as the cause of the cures, and hence did not seem to find
the ke}^ to so complete and uniform success as has been since ob-
tained.
While Braid may be considered the father of modern hypnotism,.
Liebault is the one who took the child, watched its growth, educa-
ted it, perfected it, and put it before the profession full grown to
the stature of a man and entitled to the name and rank of a science-
For twenty years Liebault continued to practice hypnotism,,
quietly going his own way, looked upon by the profession as a
crank and passed by with a slight.
But Liebault's continued success compelled attention, and in'
1881 M. Dumont and Prof. Bernheim, of the hospital at Nancy, at-
tended his clinic, studied his methods and witnessed his success-
Prof. Bernheim became convinced that there was something of
value in it, and forthwith applied it in his hospital practice, and
with the results described in his great work on suggestive therapeu-
tics, first published in 1886 and rewritten in 1889.
Bernheim himself had in 1889 hypnotized over ten thousand
times, and to-day it is practiced by some of. our best men in all
parts of the globe. It has passed the stage of experiment and is no
longer under the ban of charlatanism, but is considered as one of
the most useful remedial agents at our command, and no physician
can be considered truly progressive who refuses to inquire into the
subject and admit the possibilities of its usefulness; and he who-
does not use it is missing the means of curing maladies that noth-
ing else will heal.
WHAT IS HYPNOTISM?
Hypnotism is a misnomer, but it has become so firmly fixed that
it is useless to attempt any change or substitution. Generally pa-
tients do not sleep in the sense of being unconscious, as in ordinary
sleep. They are fully conscious, their faculties are keenly active.
ORIGINAL COMMUNICATIONS. 691
and their perceptions more acute than when in their usual state;
still the condition of the nervous system is radically different.
We have said hypnotism is a misnomer, yet no one has suggest-
ed a better name. We call it sleep to induce it, and we call it
sleep to continue it, and we call on the patient to awake when we
wish to terminate it; hence it must be considered sleep, though in
most cases not inappropriately conscious sleep. " The great es-
sential feature of hypnotism is not sleep, but a heightened recep-
tivity of suggestions with or without sleep; in other words, any
suggestions offered to a person during hypnosis has an exaggerated
effect in his mind." But up to a certain point, that of lethargy, the
deeper the sleep the greater the effect of the suggestion.
The mind seems to become nonresistant, and old thoughts are
held in abeyance, and new thoughts are suggested and received to
hold control, so that sometimes, during a single hypnosis, a condi-
tion directly opposite to that which previously existed may gain
permanent control. Courage may succeed fear, rest replace fa-
tigue, and sweet natural sleep come to the patient instead of in-
somnia.
HOW INDUCED ?
It is impossible in one short paper to describe many methods of
inducing hypnotism, and I must be content with a description of
the one method which has proved so successful with the Nancy
School, described substantially as follows by Bernheim:
"When the patient becomes quiet and assured, I' hold my two
fingers of my right hand before the patient's eyes and ask him to
look at them, endeavoring at the same time to concentrate his at-
tention upon the idea of sleep. I say, 'You think of nothing but
sleep, your eyelids begm to feel heav}', your eyes are tired, they be-
gin to wink and they are getting moist, you cannot see distinctly,
they are closed, you are asleep.' Repeating the word ' sleep ' in
commanding tones will often turn the balance, and the eyes close
and the patient sleeps. Sometimes I close the eyes immediately
without use of fixation of the eyes, when by suggestion sleep fol-
lows.
" The patients usually find the object looked at grows indistinct.
The eyelids blink and quiver, the eyes may water, the breathing
frequently becomes quickened and may even be panting, though
often it shows only the quiet, deep breathing of normal sleep, the
the pulse is often accelerated, then the eyelids gradually close and
692 THE DENTAL REVIEW.
the patient is asleep. Sometimes the eyes shut suddenl}', some-
times remain open and have to be closed forcibly."
DEHVPNOTIZATION.
For most patients the simple suggestion " Wake up " is quite
sufficient to terminate the condition. Occasionally it may need to
be repeated perhaps a little more emphatically. If the arousing
is sluggish, fanning or blowing on the face is useful, with the com-
mand " Wake up " repeated. A slight shock, as a slap on the arm,
will quicken the termination of the condition. No hypnotist of
good technical knowledge has ever had any difficulty in arousing
the patient from the hypnosis at will.
There are many ways of estimating the amount of hypnotism.
Bernheim divided it into nine distinct stages, Liebault into six,
while the most simple division is conscious and unconscious sleep.
I have adopted the classification of Dr. Tuckey, of London.
1. Light sleep. 2. Profound sleep. 3. Somnambulism. 4.
Lethargy.
The most of my patients have not gone beyond the second
stage, a few reached the third, and one a ver3'deep somnambulistic
state.
Among my dental cases there have none gone beyond the
third stage. I earnestly recommend the careful study of Bern-
heim's great work. If any one desires to understand the science
and the art, there will be found a complete and exhaustive treat-
ment of the subject.
WHO CAN HYPNOTIZE ?
Undoubtedly every one has the power in some degree. It
seems to be one of the faculties of the human mind. Some have
not enough of the faculty to amount to anything practically, while
others have great ability in that way, while between those two ex-
tremes are all degrees of skill, according to nature and education.
I consider it like the mechanical talent in man. Such are born
mechanics, while others can never attain to any useful degree of
skill.
It is as reasonable to expect success with hypnotism as for
any good operator to succeed with any of the important opera-
tions in dentistry, and success with hypnotism will be at least as
general as is success in the general practice of a dentist. There is
nothing occult or strange about it, and nothing for any one to fear.
ORIGINAL COMMUNICATIONS. 693
WHO CAN BE HYPNOTIZED.
The same answer as before serves. Some hypnotize very
readily and deeply ; the other extreme are not effectual enough to
be noticeable, while between these extremes are all grades of effect.
Bernheim and other good authorities say that an ordinary good
operator will hypnotize seventy per cent of all his patients ; an
operator who is especially experienced, careful and persistent,
will attain eighty per cent, while exceptional natural ability and
cultivation may obtain good results in as many as ninety per cent,
but the last is exceptional. Dr. Kingsbur}^ of Dublin, considers six
successes out of ten trials to be good results. My own cases have
been exceedingly favorable. I have failed in not more than one
case in fifteen, but mine have been selected cases, and I do
not consider m}^ experience extended enough to fix any definite
per cent.
IS HYPNOTISM DANGEROUS ?
The condition itself is not in the least dangerous. The patient
is put into a quiet sleep, being light or deep as the susceptibility
of the subject may determine. The patient is comfortable and
resting, and if left alone will usually in fifteen or twenty minutes
wake spontaneously as from a natural sleep. The hypnosis wears
out. The patient may feel drowsy for some time longer, but soon
returns to the former condition of wakefulness, but the quiet
calming influence of the hypnosis is sure to remain.
Mr. Liebault says, "The accidents in hypnotism are due
wholly to the ignorance of giddy tricks of the operator."
Moll says, " It is insufficient technical knowledge that is
dangerous, not hypnotism. Hypnotism properly used is as harm-
less as electricity properly used."
CAN HARM BE DONE WITH HYPNOTISM?
I believe there can be. Anything that is powerful for good is
also powerful for evil. Suggestion will cure headache ; it will also
cause headache. It will relieve contraction of the muscles, so it
will cause it. Suggestion will stimulate good thoughts, and so it
will give rise to bad thoughts.
But hypnotism can never do one tithe of the evil that alcohol
and opium have done and are doing. They do their evil when
used for good purposes by innocent and well-intentioned persons,
694 THE DENTAL REVIEW.
and they usually have done their work before the victim is aware
of it. Hypnotism can do no harm unless the operator is unpar-
donably ignorant or basely vile. Whatever ill or unpleasantness
has seemed to attach to hypnotism has been when in the hands of
amateurs or ignorant persons, who have at the time lost control of
themselves and become frightened, and have frightened their sub-
jects and lost control of them. No competent operator need have
any fear for himself or his patient.
Patients so far as they are asleep are in an anaesthetized con-
dition, and all the physical sensibilities are lessened, and facts
show that the will becomes strengthened instead of weakened, and
the patient is the better able to command himself.
Any thought averse to a patient's conviction is almost sure to
rouse them, and it is very difficult to make even a somnambulistic
subject do acts which violate his convictions even in a slight de-
gree, and while a subject when hypnotized has been made to seize
a paper cutter for a dagger and stab a door panel for a man, no
violence has ever been recorded as a result of a post-hypnosic
suggestion. In the few cases where personal submission seemed
to have been the result of hypnotic influence, it to my mind is very
evident there was not a state of complete unwillingness. Used by
honest operators for therapeutic purposes, the influence of hypno-
tism is only for good.
The subjects previously mentioned, for whom the surgical op-
erations were so successfully performed under hypnotic anaesthesia,
were all subject to deep hypnosis, somnambulistic degree, and
while exceptional cases of successful Dental Ancesthesia have been
recorded, no uniform success has been attained or believed possible.
For a quarter of a century I have been hoping that the princi-
ples as now developed in hypnotism might be applied so as to
bring relief to patients during dental operations, and it is with
pleasure that I am able to-day to report a pronounced success in
that direction.
A success I believe will continue, and the methods will be so
formulated that the art will be within the reach of every intelligent
operator on the human teeth.
During the past year, and especially during the past six
months, I have been carefully studying the later works on hypno-
tism. I found that all the writers upon the subject, as far as I
could learn, stated that pain would always wake a patient from the
ORIGINAL COMMUNICATIONS. 605
laypnotic sleep, unless such patient was in a somnambulistic con-
dition. I felt it might be quite possible to derive distinct benefit
in the lighter stages if they could be kept continuous. I soon
believed \t possible, and after a diligent study of Bernheim, I com-
menced to hypnotize, and my first effort proved a success, the pa-
tient reaching the second stage.
Early in March I felt equal to a trial for anaesthetizing dentine
for excavating, and then made the discovery that continuous sug-
gestion makes it possible to keep a patient hypnotized, and the
dentine wholly or partially anaesthetized for a full preparation of
a cavity during the light sleep of the first and second degree. I
am not aware that this has ever been made successful before.
I maintain the hypnosis and the anaesthesia by a constant rep-
etition of " Sleep, sleep, you are resting, 3'ou are not suffering,
you are not dreading it, j^ou do not care for it, sleep, sleep," and so
on continuously so long as the condition is desired. It is prac-
tically a continual rehypnotizing to offset the continual waking
caused by the cut of the instrument.
Sometimes the hypnosis will wear out in spite of continual sug-
gestion, especially if the operator's attention is too wholly absorbed
in the operation and his suggestions become weak. In such a case
I stop and hj^pnotize again. I have hypnotized as many as six
times at one sitting.
If the sitting is long and the hypnosis deep, the patient is likely
to get tired, and I have found it better to wake them up at intervals
for rest or suggest a ready change of position, but the waking is
much better. By making this conservative use of hypnotism, the
patient in every instance will feel rested and stronger at the close
of the sitting than before, and will improve in courage and quiet as
the sittings succeed each other, and in many cases the need of hyp-
nosis will cease to exist and the patient submit to the operation in
the wakeful state without shrinking.
I had a case lately that illustrated it. A girl fourteen years old
had dreaded dental operations so much that for two years she had
not been able to have her teeth even cleansed. Hypnotism made
cleansing, preparing and filling perfectly easy, and at the fourth
sitting she had become so indifferent that she was quite willing to
have a large cavity in a molar prepared and filled while fully awake.
Others have experienced the same benefit.
These results have, it seems to me, proved that in my hands
696 THE DEXTAL REVIEW.
hypnotism as a sedative and as an obtundent is a marked success,
and, I believe, equal and greater successes may be achieved by
many other operators when they make intelligent effort to accom-
plish this desired end.
I give the following summary and analj'sis of twenty-one con-
secutive strictly dental cases, that you may judge from the record
of the success of the anaesthesia. One patient failed to h3pnotize.
In everyone of these cases it was proved that the dentine was very
sensitive.
Hypnosis was applied thirty-eight times to twenty patients. Full
anaesthesia of the dentine attained twenty-one times for eight pa-
tient, or for forty per cent of the patients.
Anx'Sthesia not quite complete, but practically successful,
twelve times for seven patients, or for thirty-five per cent of the
patients.
Anaesthesia complete with addition of alcohol vapor with
Small's obtunder, six times for five patients, or for twenty-five per
cent of the patients.
For use in surgery I record the following :
Applied successfully for removal of necrosed bone, once.
Applied successfully for extracting teeth, five times.
Applied successfully for operations on alveolar abscess, once.
Applied for removal of dread of taking gas to two patients —
successful, one; unsuccessful, one.
It is impossible to indicate in any table all the benefit that ac-
crues to the patient from the hypnotism.
In every case there was almost complete and in most cases en-
tire relaxation of nervous and muscular tension, so that the patient
rested during the operation instead of being exhausted. Almost
every patient left my operating chair, sa3'ing they felt better than
when they sat down. I always suggest that the patient is rest-
ing, will wake up refreshed, will be undisturbed, and this result
uniformly follows. If by any chance a different result obtains, I at
once hypnotize again and correct the error. This has occurred in
a few instances, but thus far I have not failed to relieve the dis-
comfort.
Another distinct gain has been described by several patients in-
dependently, viz.: When any pain is felt, it is sensed only at the
point of contact of the instrument, and not over the whole system
as is commonly the case. If a tooth is extracted, there is no dread
ORIGINAL COMMUNICATIONS. 697
felt before the operation nor shock produced by it, only a little
twinge felt the instant the tooth is being pulled.
A worthy Scotchman expressed himself to the point, after hav-
ing a tooth extracted under hypnotism, " I rather think it helped
m'e, it kind of reconciled me doivn to it."
The operation for necrosis mentioned was for a patient whose
nervous S3'stem was much broken down. Any excitement from
sorrow, fear or joy would invariably cause her several hours of
nervous excitement and distress, entirely disabling her at the time.
The hypnosis prevented any unfavorable results from the opera-
tion.
CASES.
I give the following cases in the order in which they followed,
that you may see my progress in the art of hypnotism as well as of
the anaesthetic effect.
Case 1. March 14th. My first attempt to hypnotize for dental
purposes was for Miss L. age twenty-two, to remove pulp
after arsenic application. She hypnotized in about one minute to
the first degree; very light sleep. I suggested anaesthesia of tooth
and pulp. It lessened the pain very much; could not overcome all
the sensitiveness of the pulp, nor have I been able to do so since
in any case.
April 12th. Hypnotized and suggested for relief of toothache
and restfulness, as she was very weary. Waked her in five min-
utes and found her toothache gone and herself feeling entirely
rested and refreshed.
Case 2. March 16th. Mrs. L. , aged thirty-six. Hyp-
notized first degree, very light sleep. Suggested for anaesthesia of
sensitive dentine. Pain during previous operations almost un-
bearable. Relieved sensibility very much. Made the cutting of
two cavities on buccal surface of inferior bicuspids with both exca-
vator and bur very easily borne. Suggestion did not last long,
and hypnosis and suggestion had to be repeated several times.
Case 3. March 22. Miss C, age fifty. Necrosis from ab-
scess on R. Sup. Lat. Incis. Upper teeth all extracted five months
before. The patient had nervous collapse seven years before and
has since suffered repeated attacks. Any excitement of joy, sorrow
or fear, or a pleasant hour with callers, would bring on a nervous
spasm which would last one or two hours. Ether had an unpleas-
ant effect upon her, and she preferred the operation without an
698 THE DENTAL RE FIE IV.
anaesthetic on account of nervousness. Hypnotized first degree,
bordering on second ; applied cocaine to gum ; incised and
removed sections of gum ; trephined the alveolar wall and re-
moved spiculae of dead bone. The operation lasted from seven to
ten minutes. Patient laid quietl}^ scarcely flinching ; dread a*ll
gone; upon awaking pronounced herself comfortable during the
operation and suffering no shock, depression or weakness.
I did not think to suggest against subsequent pain, and some
pain persisted in region of wound, also her temple and ear of same
side. Hypnotized the second time and relieved the pain in wound
and face. Waited twenty minutes, thinking the rest of the pain would
subside ; pain in ear persisted. Hypnotized the third time and
suggestion relieved pain entirely, and the patient left my office
feeling in very much better condition than before the operation.
March 28th. Had been getting along well, wound healing,
nervous condition good, some neuralgia of head, face, arm and
hand. I hypnotized and suggestion relieved the pain entirely.
March 29th, A. M. No return of pain in the arm or hand, a
little pain in the head last evening and to-day. Hypnosis and
suggestion relieved it again completely. At 4:30 P. M. called
again. Had been very bus}' during the day out in the wind, and
tic of right temple had returned and involved the eyes. Hypno-
tized twice and completely relieved the trouble. The patient left
town the next day, but subsequently I saw her and found relief
from pain proved permanent, also the general good effects of the
hypnotism continued.
Case 4. March 29th. Mrs. P , age forty-five. R. Sup.
1st Molar abscessed. Crisis passed, tooth very sore, dead pulp re-
maining. Tooth needed drilling for removal of pulp. Patient
dreaded the operation very much ; did not sleep the night before
on account of it ; had a bad headache and neuralgic pains over
entire system. Hypnotized to second degree, dread entirely re-
moved, scarcely any hurt during the operation ; was very comfort-
able and did not mind it at all ; systemic pains cured. Filled
temporarily and hypnotized again, and suggested recovery without
further trouble.
April 2d. Found tooth in good condition ; filled permanently;
hypnotized and suggested for continued health of tooth and system.
The tooth has since remained well.
Case 5. March 31th. Prof. O , age thirty-five. R. Inf.
ORIGINAL COMMUNICATIONS. 699
1st Molar to be extracted, very badl}^ abscessed. Hypnotized to
first degree. Suggested that pain of extraction would be lessened
and dread removed and shock prevented. The result fulfilled the
prophecy.
April 14th. Had a R. Sup. Bicuspid root; had wished it out
for ten years ; could not get up his courage. Hypnotized to note
effect on his mind ; soon opened his mouth without dread ; ex-
tracted tooth; felt no pain, only a little wrenching sensation, only
local. He called it perfectly successful.
April Vth. Excavated and filled R. Inf. Lat. and Cusp., very
tender indeed. Hypnotized; relieved sensitiveness very much,
and with alcohol vapor added made the anaesthesia complete.
Patient said the pain was only local; did not disturb the system;
found great relief.
Case6. March 26th. Dr. P. Dentist, age thirty-four. Filled R.
Sup. Cusp, lab, cavity; exquisitely tender. He was unable to bear
his finger nail on it. Hypnotized, second degree, light; anaesthesia
almost complete; nervous and muscular relaxation entire; used
excavator and burs with engine all around the cavity; and in
twenty minutes from the time he sat in my chair the cavity was
prepared. He found it a complete success.
April 1st. Filled R. Sup. Cusp. mes. cavity, not tender; did
not h3^pnotize at first. When tooth was nearly filled said he felt
broken up; was very much disturbed. Hyptonized him; he be-
came immediately quiet and entirely relieved of his discomfort.
Case 7. March 18th. Master G. age ten. Very sensi-
tive and uncomfortable. Hypnotized, first degree, very light.
Quieted him a good deal and made it possible to do a little, but
my success was indifferent, largely due, I think, to lack of interest
on the patient's part, whose mother had little faith or interest in
it. I hypnotized him for three sittings with about the same
success.
Case 8. March 30th. Mrs. W. age forty-three. Filled R.
Inf. first molar very sensitive. Patient always very much dis-
turbed by prospect and performance of dental operations. H}^^-
notized readily to first degree, but full influence maintained but a
little time; a drows)^ feeling persisted; all dread of operation gone;
I used bur and chisel without resistance or suffering on her part.
She thought it a complete success.
April 8th. Hypnotized with same success as before. Could
700 THE DEXTAL REVIEW.
not completely anaesthetize the dentine; added alcoholic vapor
and completed the insensibility.
Case 9. April 1st. Mrs. C , age twenty-nine. Condition^
hypnotism and success same as in last case.
Case 10. Miss H , age forty. Teeth always very sensitive.
For twenty years had been troubled with insomnia; very nervous^
excitable and apprehensive. Teeth in bad condition, owing to
neglect on account of fear of pain.
April 5th. Hypnotized, third degree, somnambulistic, anaes-
thesia of dentine complete. Operated April 9th, 12th, 21st, and
May 7th and 16th. Hypnotized each sitting.
May 28th. I gave a short hypnosis at the beginning of the sit-
ting, and one at the end, operating in the meantime on a post hyp-
notic anaesthesia which was complete. This method gave relief
and comfort; some of the former hypnoses had proved wearisome.
The incidental benefits derived from the treatment were very
marked. Up to the date of her first sitting she had uniformly
taken some hypnotic to afford sleep. The night after her first hyp-
nosis in the afternoon, she slept all night and far into the morning,
and every night since, except three or four that she had some face
ache. Her general condition is much improved; apprehensive-
ness much less, and nervousness much reduced, and has much bet
ter command of herself.
Case 11. April 11th, 18th, May 16th. Mr. M , age thirty-
two. Teeth very sensitive. Hypnotized third degree; anaesthesia
complete. Operated from an hour to an hour and a half at each
sitting. At the close of the longer sittings he complained of feeling
tired sitting so still; thought an hour long enough.
Case 12. Miss B , age fourteen. A refined, healthy, vig-
orous girl, but so afraid of dentistry she had not been able to have
teeth even cleansed for two years. Teeth extremely sensitive.
Upon my promise that I would not touch her teeth, talked hypno-
tism to her, interested her, and made an appointment to try it and
operate.
May 28th. I hynotized her, first degree, suggestion removed
all fear, and I cleansed her teeth without trouble and prepared and
filled with cement two cavities in front teeth.
June 11th. Hypnotized again; prepared and filled with cement
four cavities in front teeth. While excavating one of the cavities
she flinched some. I feared discouraging her and waked her and
ORIGINAL COMMUNICATIONS. 701
asked if I should go ahead if it did hurt a little ; said, " I don't
care; go ahead ! " Hypnotized again and finished according to in-
structions.
June 17th. Hypnotized twice; excavated three cavities and
filled with gold; used bur with engine without discomfort.
June 18th. Hypnotized and prepared one tooth, waked the pa-
tient and filled; then prepared and filled another molar while awake.
The transformation of the patient was wonderful.
Case 13. Miss L . age forty-two. Called on me in December?
1891, for new upper plate. Had been wearing artificial teeth on rub-
ber for three years. Mouth had been constantly red with serious
itching and burning. I made her a good fitting plate on rubber.
Her mouth was no better. A few weeks later I made a gold plate,
which she has worn since. It gave no relief from the burning and
the redness persisted.
June 2-3, 1892, she called, seeking relief. I proposed hypnotism
as an experiment. She was agreeable to it. Hypnotized her to
nearly second degree. Suggested cessation of burning and change
of color and return to health. Slept perhaps ten minutes. On
waking the mouth had changed color perceptibly, burning gone.
June 24th. Had experienced discomfort only aboutone hour the
evening of the 23d, and again this morning about the same length
of time. Hypnotized again and suggested for health and comfort.
June 25th. Had experiened a little discomfort once for a short
time since yesterday. Mouth still better. Hypnotized for com-
plete recovery. I did not see the patient again until the 29th, four
days intervening. Has had hardly any burning of the mouth since
last visit until to-day, rather more. Mouth seems much improved
in color and texture. Hypnotized for relief and cure.
June 30th. Mouth much better; no discomfort since yesterday.
Hypnotized also on July 1st, 6th, Tth, 8th, 14th and 21st. July 22d
mouth felt entirely well since June 30th ; is now normal in color
save two small patches, which are a little red, but not at all tender
or uncomfortable. The patient has worn her plate all of the time.
These cases fairly represent the fextremes and average of the
results in my practice of the application of hypnotism to dentistry.
I believe it is a power of great value to my patients and may be to
the patients of other operators who may practice it. I invite the
attention and thoughtful consideration of every one present to the
subject.
702 THE DENTAL REVIEW.
A Glan'ce at Familiar Characters.*
By Dr. G. H. McCausey, Janesville, Wis.
"From all blindness of heart; from pride, vain-glory, and hypocrisy; from
envy, hatred, and malice, and all uncharitableness, Good Lord, deliver us."
A proper treatment of the subject chosen as a basis of this pa-
per, involves a knowledge of human nature; and character becomes
familiar to us only, when studied from that standpoint. It is a fact
that human nature is very much the same thing the world over,
yet it appears with modifications under different circumstances,
and when studied in connection with dentists and the practice of
the profession, it presents many peculiar phases, so far as a recog-
nition of the ethics of the profession is concerned, as well as its
practice.
The patient of average understanding, is not inapt to speak of
the office of the dentist as a shop; and, at the same time, classing
the dentist with the tradesman, or, at best, with the artisan.
The question at once arises with the intelligent dentist, why
does that opinion exist ? It is a fact long conceded by the dentist
of fair intelligence, that the practice of dentistry if successful, in-
volves the possession of a broad knowledge of many subjects, and
each so closely related to the other from its practical significance,
that the period has long passed when the practice of dentistry can
be considered otherwise than that of a learned profession. That
fact being conceded, the question at once arises, why the status of
the profession should be wrongly estimated ?
The average American citizen is generally disposed to call a
thing by its correct name, yet, as it appears, he is at times puzzled
to determine what the correct name is. He is, however, not dis-
posed to accept the word of every man as gospel truth regarding
any one thing, but, like the physician who diagnoses health or dis-
ease by the presence of certain well-defined symptoms, he will
judge of the existence of truth in the same way, and if certain
symptoms appear, or are entirely absent, he will judge accordingly,
irrespective of protests to the contrary. The standard of the pro-
fession as a whole will always be found to bear a close relation to
the standing of the members, and it is not sufficient that the rep-
resentative members endeavor to create the impression that den-
*Read before the Wisconsin State Dental Society, July, 1892.
ORIGINAL COMMUNICATIONS. 703
tistry deserves to be classed with the learned professions, for it is
as true as that we exist, the general public will estimate the dental
profession in accordance with the ethical spirit of its rank and file.
If the dentist shows by his every act that he is willing to class
himself as a tradesman, the public will admit the justice of his
claim, and give him the benefit of no doubt whatever.
These facts have led the writer to glance hurriedly at certain
characters which are familiar to us all, and who are important fac-
tors in the creation of public sentiment, regarding the status of the
dental profession.
There is one character with whom we occasionally meet, and
by far too seldom, who has possibly never perused the code of eth-
ics, yet has definite ideas regarding that which constitutes an act
which is dishonorable. He has concluded to commence practice
in the same town with ourselves. He calls and notifies us of the
fact, at the same time expressing a hope that our relations as com-
petitors may prove mutually agreeable. He shows no suspicion
whatever regarding us, but evidently assumes that we recognize
for him all the rights which we claim for ourselves.
He commences practice, and after a few days a patient calls
and asks our opinion regarding the merits of the new dentist, as
exemplied in an operation lately performed by him.
As a matter of principle we decline to criticise the effort of a
competitor, and on account of possible lack of time prefer to expend
no time in the examination of operations which we are not person-
ally interested in. But we are interested in learning of his ability
as an operator, and therefore gladly examine the result of his ef-
forts, and we are pleased to astonish the patient by asserting that
the operation is a credit to the operator, and that such an operation
would be a credit to any person capable of performing it. The pa-
tient expresses astonishment that one dentist should express satis-
faction at the result of another's efforts, and at the same time
expresses yet greater astonishment when informing us that it was
at the doctor's request that she came. But why should she be sur-
prised that one dentist should speak well of the operations of an-
other? The question is not a difficult one to answer. She has
heard dentists condemn in immeasured terms the operations of
other dentists; men of reputation and standing, and has, at the
same time, heard it insinuated that the fee charged for the same
was a most extortionate one.
704 THE DENTAL REVIEW.
She has time after time seen the same act committed by one
tradesman in the disparagement of the goods of another, and she
reasons that the methods being the same, the six of one is equiva-
to the half dozen of the other. But our treatment of the case has
not in the least injured us. On the contrary we have treated the
doctor as we could hope that he would treat us, were the conditions
the same, and we have caused the patient to have a higher respect
for at least two members of the profession, and that on account of
their own acts. But a further acquaintance with our new friend
develops the fact that he is an acquisition heartily hoped for but
never expected. We find in his every act and word an entire ab-
sence of trickery of every name and nature, and although looking
carefully after his own interests, is to his friends an open book, and
while not thinking of the matter of ethics, he is yet the embodiment
of ethics, for his every act is clean.
But we turn from the consideration of this case to that of a
very, very much more common one. He was evidently conceived
in depravity, born in suspicion, and reared in envy. Surmise, as a
trait in his character, is more strongly developed than is his ability
as a practitioner. In fact, when he learns that a patient has visited
another dentist, he assumes that his competitor is undermining
him by a sudden lowering of price, and forgetting that water sooner
or later attains to its own level, he sails in for blood and fills a
column of the daily Balloon with a list of prices.
A certain element in the community, hailing with delight that
which they are pleased to term relief from the "extortions" of
others, soon cause him to become aware of the fact that they are
not " agin " him, and all goes swimmingly, until on taking account
of stock he finds that the aggregate of bills payable greatly ex-
ceeds in amount the sum of those receivable. The result is that
he works harder than ever, and yet becomes immersed deeper in
debt, and charges it all to his competitor who has felt compelled
to ignore him, and who yet prospers. Verily, every dog has
his day.
He is, however, a grade above another whom all can recog-
nize, and he is the individual who creates misfortune in every
town which he chances to infest. He is the one who boasts that
his extremely low prices serve to prevent a better and more ca-
pable man from becoming his honest competitor. Such a combina-
tion of hog and dog-in-the-manger is deserving of the pity of all
ORIGINAL COMMUNICATIONS. 705
decent men, while its effect on a community can easily be im-
agined.
The next lower grade in the scale is the dentist who, while
secretly hating each and ever}^ competitor, is yet willing to unite
with the majority in the effort to encompass the ruin of the only
reputable one among them all. In such a case he proves, beyond
the shadow of a doubt, his ability as an expert in the use of in-
nuendo, while according for his victim liberal praise of the left-
handed variety.
If the prospects are fair for escaping detection, he is not averse
to conspiracy in the direction of placing his victim in a false posi-
tion before a communit}'', and in the effort to do so generally proves
himself to be a "slick " one. He occupies a niche in altitude yet
several degrees above another yet to be described.
In order to do him justice, the historian should be a confirmed
dyspeptic and hypochondriac, with jaundice thrown in.
That prince of character delineators, Charles Dickens, must have
thought of him at least twice, for he is a hybrid, partaking of all
the characteristics of both Pecksniff and Uriah Heep.
He is not a man of ver}' great professional ability; in fact, it is
not with him a matter of very great necessity. He is, however,
"genial," and with him geniality is one of his drawing cards.
He is generally invested with a stereotyped smile which is in
the highest degree seraphic, and were it possible for that smile to be
made steel pointed, it is upon that point that he would impale his
victim. The distance from the roots of the hair of his forehead, to
the extreme point of his chin, is generally less than the width of
his face at the level of his eyes, and his inferior maxilla gener-
ally projects outwardly beyond the intermaxillary bones of the
superior maxilla, while the labial surface of the incisor teeth
are generally worn flat from impingement of the lower ones, in pro-
ducing the seraphic smile. That smile is a "corker," and is most
effective when produced on the street, and employed by its pro-
prietor in buttonholing a prospective patient, with a view of se-
curing a "job." Another of his drawing cards is his disposition
to be accommodating, and the general opinion of the community
is that he is so. In fact, through that disposition he becomes a
sort of dental general jobber, and seldom expresses an opinion of
his own in respect to a prospective operation until he has learned
what his patient has guessed regarding the matter, and as his
700 THE DEXTAL REVIEW.
motto is " we study to please," his own opinion and that of his
patient are very apt to coincide. At the present time bridges
are directly in his line, and he is building them as often as de-
manded, and the plethora of his patient's bank account will
warrant.
It invests him with a quasi authority for inserting his digits into
his neighbor's pocket for the purpose of withdrawing recompense
for bridges constructed without the slightest regard to practicabil-
ity or future usefulness. For the purpose of flattering a matron of
mature age, he will, after a mild protest, furnish her with a plate
with teeth suitable for a blonde of sixteen. And all of this time he
is very "pious." In fact, one of his great specialties is that of im-
pressing that fact upon the public ; whether he is greatly devoted
to the principles of Christianity or not is an open question, but he
is very "pious." As a matter of fact, he will without much ques-
tioning admit it himself, and many little acts of his warrant the
supposition that he is willing that it should be kept before the
public and not forgotten.
He is an expert in working the pious dodge for practice, and
should a competitor prove short-sighted enough to refer a patient
to him, it does not require a long time for him to conclude that he
has made a great mistake in the supposition that he had referred
the patient to a gentleman, for the patient is scarcely comfortably
seated in the chair before he commences the act commonly termed
in ordinary parlance, ripping up the back of his benefactor. His
competitor is apt to be a dissipated individual, and while expressing
great sorrow for his wife and family, he himself purchases whisky
by the gallon for his own use, and haggles with the dealer regard-
ing both price and quality. His knowledge of anatomy being lim-
ited, he is continually compelled to be feeling for his competitor's
fifth rib, in order that he may not forget its location. Our man is
vastly more brilliant than the average man, and more than usually
sly. He is as deep as a well, yet the well always has a lighted
candle at the bottom, but he is not capable of detecting it. He at
times submits to his competitor for consideration some deep-laid
scheme which is generally of that transparent texture that he sud-
denly finds himself "sat down upon" by his intended victim, with
the result that he is deeply "grieved," "cut to the heart," with a
few other trimmings of pious rot.
He is an adept at working what is known as the church
ORIGINAL COMMUNICATIONS. 707
"racket," and he aspires to positions of prominence in church
work.
During the cold weather he is never absent from the church
parlors on those occasions when the solitary oyster is given a
formal introduction to the barrel of water, and having been sub-
mitted for a proper length of time to the action of caloric, is
utilized in working the $5-a-week clerk and his girl for the coin
of the realm. At such times he generally receives the cash, and
beams on every one who pays for the pleasure of having partaken
of the alleged soup, and it is then that his geniality shines re-
splendent. He is apt to aspire to the position of deacon, yet he
will accept the position of professor of elementary theology in the
Sunday school.
In other words he will consent to hold down the chair of the
Superintendent. That he has never been a student of theology in
any respect has no significance; he makes an admirable figure-
head, and he secures the full benefit of the advertisement by being
seldom absent. He is seldom present at the 10:30 service^
and his continued absence is the occasion for much solicitude on
the part of the saints, but after the six days' application he con-
fesses that he needs an unabridged rest on Sunday morning. Yet
people who are more disposed to attend to the affairs of others,
than to look after their own, are unkind enough to say that he is at
his office and engaged in filling teeth, and up to the time for Sun-
day school to be in session. Of course they lie about him, and in
that respect he is peculiarly unfortunate, yet the saints are and
always have been the subjects of persecution. His field days are
when he attends the revival and experience meetings of "our"
church, or those of any other for that matter. They are both
good mediums for advertisement, and he makes the most of it, but
is at times liable to create an impression which is generally held
to be incorrect. As an instance, the Creator is supposed to be
omnipresent, yet our subject when addressing the throne of Grace,
utilized power of lung, limited only by lack of endurance of the
vocal chords, and thereby creating the impressiofi that the Creator
is either a long distance away or that the telephone is out of order.
At any rate, he sees well to it that each individual present
hears him ; and credulous old ladies have been heard to say, '-what
a good man is our Dr. Blowhard." In the experience meeting he
finds a red letter chance for posing as one superlatively " umble."
708 THE DENTAL REVIEW.
Whenever he can succeed in securing the pious ear of the public,
he takes occasion to say that although a church member of many
years' standing, he now knows that he has never before "enjoyed" re-
ligion. After speaking in that strain for a time he winds up with
an aggregation of self-criminations, but it is a noticeable fact that
while thus exploiting himself as a "tough," he neglects to be
specific. Whether such neglect is born of fear of arrest, or fear
of the difficulty attendant upon the securing of bail, is as yet an
open question. However, he is both pious and " umble," and he
don't care who knows it. He, like the canine, is granted his
twenty-four hours in fee simple. Another character infests our
dental societies, and he is a sort of fair-weather individual. He is
at times afflicted with a sort of professional neurasthenia, and
spinal osteo-malacia. When his affairs progress swimmingly, and
nothing occurs to mar his serenity, he is a fair member of his so-
ciety, but when a vile quack invades his little kingdom, and un-
furls his advertising union jack, our friend begins to wilt. He
soon commences to look upon our code of ethics as a fair-weather
document, pure and simple, and wonders how he is to exist in the
future, unless he lowers himself to the extreme level of the quack,
and it needs but little consideration of the subject, before he con-
cludes that his only hope lies in self-abasement. His integument
has by this time become thicker than usual, yet lie has a sug-
gestion of shame and self-respect left, and he therefore saves the
society, much shame and mortification, by withdrawing.
He is even then somewhat at sea in determining how to commence
his advertising operations, for touch the subject as he may, he
always finds it sticky. He knows full well that the intelligent por-
tion of the community is thoroughly posted regarding the word
cheap, when applied to dentistry. But he is "in for it," and must
do something. He has shown a certain grade of consistency in
his withdrawal from the society, and a still higher grade in burn-
ing the bridge behind him. After a period of mental hardship he
discards the word cheap, and substitutes the term " moderate,"
and which bears about the same relation to the word cheap that
the word hades does to the sheol of the new revision.
The next issue of the weekly Trombone coxi\.z\n% a choice literary
production headed "Moderate Prices." He has started out to
overshadow his opponent and, figuratively speaking, he seeks gore.
A perusal shows an expertness hardly credible in one so little
PROCEEDINGS OF SOCIETIES. 709
experienced in the art of advertising. We find that he has ad vr -
tised transversely, longitudinally, circularly and octagonally, and
in fact he has missed no device, and it is the chemically pure
quill of advertisement. He has resorted to the devices employed
in selling codfish and molasses, but does the community have a
higher respect for his profession than he does himself ? His
quack nightmare soon eliminates himself from the community,
having found his level, and our nervous friend is again in posses-
sion of the field, but has thrown to the winds his professional
status, lowered himself to the level of a quack, and surrendered his
membership in his society perhaps never again to regain it.
Requiescat in pace thou lost one, and when meeting thy former
professional brethren, remember that they have measured the
diameter of thy caliber.
PROCEEDINGS OF SOCIETIES.
National Association of Dental Faculties.
The ninth annual meeting of the National Association of Den-
tal Faculties was held at the Cataract House, Niagara Falls, com-
mencing Monday, August 1, 1892.
Twenty-six colleges were represented, as follows :
Baliimore College of Denial Su? gery — R. B. Winder.
Boston Denial College — J. A. FoUett.
Chicago College of Denial Surgery — Truman W. Brophy.
Harvard University, Dental Department — Thomas Fillebrown.
Kansas City Dental College — J. D. Patterson.
Missouri Dental College, Dental Department of Washington Uni-
versity— W. H. Fames.
New York College of Dentistry — Frank Abbott.
Ohio College of Dental Surgery — H.'A. Smith.
Pennsylvania College of Dental Surgery — ^C. N. Peirce.
Philadelphia Denial College — ;J. E. Garretson.
University of loiva, Dental Department — A. O. Hunt.
University of Michigan, Dental Department — J. Taft.
University of Pennsylvania, Dental Depart incnt--]dLxnQS Truman.
^ Vanderbilt University, Denial Department — W. H. Morgan.
Northwestern College of Denial Surgery — B. J. Roberts.
710 THE DENTAL REVIEW..
Louisville College of Dentistry — Francis Peabody.
Indiana Dental College — J. E. Cravens.
Xorihwcsterti University Dental School — E. D. Swain.
Dental Departfnent of Southern Medical College — William Cren-
shaw.
Dental Department of University of Tennessee — J. P. Gray.
School of Dentistry of Meharry Medical Department of Central
Tennessee College — G. W. Hubbard.
University of Maryland, Dental Department — John C. Uhler.
Columbian University, Dental Department — H. C. Thompson.
Royal College of Dental Surgeons of Ontario — J. Branston Will-
mott.
American College of Dental Surgery — John S. Marshall.
University of Denver, Dental Department — George J. Hartung.
The ad interim committee reported that it had investigated a
charge preferred against the University of Maryland, Dental De-
partment, by the College of Dentistry of the University of Cali-
fornia, of graduating a person in less time than the rules demanded ;
that it found that no rule of the association had been violated, and
had so reported to the parties in interest ; that it had dismissed an
effort for the reinstatement of the American College of Dental
Surgery, Chicago, as not within the jurisdiction of the committee,
with the advice to reorganize the college before attempting to in-
fluence the association to change its action, which reorganization
has since been accomplished.
The committee also stated that its value in settling such mat-
ters had been made so clearly apparent that it recommended that
it should be made a standing committee, to be elected by the as-
sociation, instead of being appointed by the President.
The report was received and placed on file, and the recom-
mendation with regard to the status of the committee was adopted.
The following resolutions, laid over from last year, were adopted :
Resolved, That in case of charges against any college no final action- shall be
taken until all parties concerned shall have at least thirty days' notice.
Resolved, That at all future meetings of the National Association of Dental
Faculties the delegates shall consist of members of faculties, and demonstrators
will not be received.
The following resolutions, also over from last year, were laid on
the table :
PROCEEDINGS OF SOCIETIES. 711
Resolved, That after June, 1893, the yearly course of study shall be not less
than seven months, two months of which may be attendance upon clinical in-
struction in the infirmary of the school, now known as intermediate or infirmary
courses.
Resolved, That after the session of 1802-93, four years in the study of den-
tistry be required before graduation.
The following resolutions lie over under the rules :
Offered by Dr. Winder :
Resolved, That hereafter graduates of pharmacy be placed on the same foot-
ing as graduates of medicine, and be entitled to enter the second year or junior
class, subject to the examination requirements of each college.
Offered by the executive committee :
Any college failing to have a representative present for two successive ses-
sions without satisfactory explanation shall be dropped from the roll of member-
ship of this association.
The chair, having been asked for a ruling upon the admission
of graduates of pharmacy to the junior class, decided that under
the rules they could only be admitted to the first-year or freshman
class.
The executive committee offered a report recommending the
restoration of the American College of Dental Surgery to full
membership, which, after an explanation by Dr. Marshall of the
reorganization of the college, was unanimously adopted.
The executive committee reported on the application of the
Western Dental College, of Kansas City, recommending that it lie
over for another year. The report was adopted.
The report of the executive committee recommending the re-
jection of the application of the Tenessee Medical College, Dental
Department, of Knoxville, Tenn., for irregularities in conferring the
degree of D. D. S. and in the reception of students, was adopted.
The application of Howard University, Dental Department,
Washington, D. C, was laid over for another year.
The following applications for membership, also reported by
the executive committee, lie over under the rules:
United States Dental College, Chicago.
Homoeopathic Hospital College, Dental Department, Cleveland.
Detroit College of Medicine, Department of Dental Surgery.
The report of the executive committee recommending that the
Baltimore College of Dental Surgery be censured by the association
for conferring the degree of Doctor of Dental Surgery upon Charles
712 THE DENTAL REVIEW.
F. Forsham, M. A., LL. D., of Bradford, England, in absetitia, and
honorarily, in violation of the rules of the Association, was adopted.
Dr. Truman offered an amendment to the rule regarding the
conferring of the degree of Doctor of Dental Surgery honorarily,
absolutely prohibiting the exercise of that privilege to the members
of the Association, but the amendment was lost, after discussion,
it being the general sense that the present rule is a sufficient safe-
guard against the unworthy bestowal of the honor.
Dr. Cravens offered the following amendment to the constitu-
tion, which goes over under the rules:
Amend Article VII. so that it shall read as follows:
Art. VII. Any reputable dental college, located in any State of the United
States, may be represented in this body upon submitting to the Executive Com-
mittee satisfactory credentials, signing the constitution, conforming to the rules
and regulations of this body, and paying such assessments as may be made.
The Association adopted a protest against the classification of
dentists as manufacturers, as provided in House Bill No. 7,696,
known as the Willcox Bill, and against the collection of statistics
from dentists under its provisions, on the grounds that dentists are
not manufacturers in any sense, not being engaged in the manufac-
ture, fabrication, or sale of any product having a merchandisable
value; that all the laws heretofore passed in the various States and
Territories and the District of Columbia distinctly recognize den-
tists as professional men; and that the attempt to collect statistics
would be an injustice not only to them but to their patients, and
that such statistics if collected would be valueless to the govern-
ment because showing the products of a class of men not engaged
in manufactures.
The following, offered by Dr. Winder, was also adopted:
Resolved, That the National Association of Dental Faculties recommends that
their alumni write and demand of the Census Bureau of the United States the re-
turn of all statistical reports, as, under the recent agreement between the dental
profession and said bureau, lawyers, physicians and dentists are exempted from
making statistical reports for the census of 18i»0; and that a copy of this resolution
be forwarded to the chief of the Census Bureau.
A communication from the Post-Graduate Dental Association
of the United States, suggesting the establishment by the colleges
of short courses of training and teaching especially designed and
arranged for practitioners, was received and referred to the Execu-
tive Committee.
PROCEEDINGS OF SOCIETIES. 713
The manuscript of a Compend of Materia Medica and Pharmacy
for Dental Stuents, by Dr. E. L. Clifford, of Chicago, was referred
to the committee on text-books, with power to act.
Dr. Marshall offered the following resolution, which was adopt-
ed :
Resolved, That the secretary be instructed to notify the National Association
of Dental Examiners that the National Association of Dental Faculties considers
it out of its province to legislate upon the relative values of the L. D. S. and D. D.
S. degrees.
The following were elected officers for the ensuing year: J. D.
Patterson, Kansas City, President; H. A. Smith, Cincinnati, Vice
President; J. E. Cravens, Indianapolis, Secretary; H. A. Smith,
Cincinnati, Treasurer; F. Abbott, of New York, J. Taft, of Cincin-
nati, and A. O. Hunt, of Iowa City, Executive Committee ; James
Truman, of Philadelphia, Frank Abbott, of New York, and Thomas
Fillebrown, of Boston, ad interim Committee.
The President appointed as the Committee on Schools, Drs. J. A.
Follett, Boston; S. H. Guilford, Philadelphia; E. D. Swain, Chi-
cago; C. N. Peirce, Philadelphia; T. W. Brophy, Chicago.
Adjourned to meet at the call of the Executive Committee.
National Association of Dental Examiners.
The eleventh annual meeting of the National Association of
Dental Examiners was held at Niagara Falls, commencing Monday,
August 1, 1892.
The sessions were presided over by the Vice President, Dr. Ma-
gill, the elected President, Dr. L. D. Shepard, of Boston, explain-
ing his resignation from the State Board of Massachusetts, which
necessarily carried with it his resignation of the presidency of the
association. The resignation was accepted with regret, and Dr.
Shepard was unanimously accorded the privileges of the floor.
The following State boards were represented at the sessions :
Colorado. — George J. Hartung.
Georgia. — D. D. Atkinson.
Iowa.—]. T. Abbott, J. B. Monfort.
Indiana. — S. T. Kirk.
Maryland. — T. S. Waters.
Minnesota. — L. W. Lyon.
714 THE DEXTAL REVIEW.
Massachusetts. — E. V. IMcLeod.
New Jersey. — Fred A. Levy.
Ohio. — Grant Molyneaux, Grant Mitchell.
Pennsylvania. — W. E. Magill, Louis jack, J. A. Libbey.
Tennessee. — J. Y. Crawford.
Wisconsin. — Edgar Palmer.
Kansas. — A. H. Thompson.
The following boards were admitted to membership :
Virginia. — J. Hall Moore.
North Carolina. — V. E. Turner.
Oklahoma. — D. A. Peoples.
South Dakota. — C. W. Stutenroth.
District of Columbia. — Williams Donnally.
At the instance of the committee on colleges, the following
communication was. sent to the National Association of Dental
Faculties :
Niagara Falls, Aug. 1, 18!)2.
To the National Association of Dental Faculties:
Gentlemen — Whereas, a very considerable abuse has arisen by the improper
use by students of the various certificates of the schools, such as the "standing"
and " passing " certificates, to support students and graduates under age in their
attempt to illegally engage in practice; we therefore ask your association to request
the various colleges to have their " standing" and "passing" certificates of such
uniformity of terms in each case that they can be used for no other purpose, and
that they be printed in few words and small type, and be signed only by the dean.
Respectfully,
National Association of Dental Examiners,
Fred A. Levy, Secretary.
A committee of conference was appointed, consisting of Drs.
Truman, Marshall and Swain, on the part of the Faculties Asso-
ciation, and Donnally, Palmer and Monfort, on the part of the Exam-
iners'Association, which after consultation agreed upon a favorable
report.
Dr. Lyon offered the resignation of the Minnesota board, which
was laid upon the table, as it had evidently been offered as the
result of a misunderstanding, and the board was requested to with-
draw it.
The following resolution, offered by Dr. Crawford, was adopted :
Resolved, That when a member of any State board becomes a teacher of a
dental school, his resignation from his board should follow.
PROCEEDINGS OF SOCIETIES. 715
A resolution protesting against the classification of dentists as
manufacturers and the collection of census statistics from them
under the provisions of House Bill No. 7,696, commonly known as
the Willcox bill, was adopted. The resolution was similar in
terms to those adopted by other dental societies.
The committe on colleges reported that they had received re-
ports showing that the actual number of students in attendance at
the last sessions in the schools recognized by the Examiners As-
sociation was 2,881 ; of graduates, 1,35V. In the schools not recog-
nized by the association the students were 236 ; graduates, 96.
The report also considered desirable advances to be made in
educational methods, and offered the following memorial, which
the Secretary was directed to transmit to the National Association
of Dental Faculties :
The National Association of Dental Examiners AA^ould respectfully memorial-
ize the National Association of Dental Faculties to authorize two advances in the
system of dental education.
These are : First, that your association require the universal enforcement of
a higher grade of preliminary education of candidates for matriculation. This
proposition lies at the foundation of dental education, in which is involved the
quality of the graduates of the future, upon which depend the advancement, the
standing, and the dignity of the dental profession.
The second proposition is that complete preparation be made in each school
for laboratory technique in the study of histology, pathology, and in each of the
departments of dental surgery and dental prosthesis, and that this method of
teaching be made a requirement of the schools.
The committee also reported the following amended list of
colleges which they recommend as reputable :
American College of Dental Surgery, Chicago, 111.
Baltimore College of Dental Surgery, Baltimore, Md.
Boston Dental College, Boston, Mass.
Chicago College of Dental Surgery, Chicago, 111.
College of Dentistry, Department of Medicine, University of Minnesota^
Minneapolis, Minn.
Dental Department, Columbian University, Washington, D. C.
Dental Department, National University, Washington, D. C.
Northwestern University Dental School. Former]}- Dental Department of North-
western University [University Dental College].
Dental Department of Southern Medical College, Atlanta, Ga.
Dental Department of University of Tennessee, Nashville, Tenn.
Harvard University, Dental Department, Cambridge, Mass.
Indiana Dental College, Indianapolis, Ind.
Kansas City Dental College, Kansas City, Mo.
Louisville College of Dentistry, Louisville, Ky.
716 THE DENTAL REVIEW.
Missouri Dental College, St. Louis, Mo.
New York College of Dentistry, New York City.
Korthwestern College of Dental Surgery, Chicago, 111.
Ohio College of Dental Surgery, Cincinnati, Ohio.
Pennsylvania College of Dental Surgery, Philadelphia, Pa.
Philadelphia Dental College, Philadelphia, Pa.
School of Dentistry of Meharry Medical Department of Central Tennessee
College, Nashville, Tenn.
University of California, Dental Department, San Francisco, Cal.
University of Iowa, Dental Department, Iowa City, la.
University of Maryland, Dental Department, Baltimore, Md.
University of Michigan, Dental Department, Ann Arbor, Mich.
University of Pennsylvania, Dental Department, Philadelphia, Pa.
Vanderbilt University, Dental Department, Nashville, Tenn.
Western Dental College, Kansas City, Mo.
Minnesota Hospital College, Dental Department, Minneapolis, Minn.
(defunct.)
St. Paul Medical College, Dental Department, St. Paul, Minn, (defunct.)
The report was adopted.
Tne following officers were elected for the ensuing year: W.
E. Magill, Erie, Pa., President; J. Y. Crawford, Nashville, Tenn.,
Vice President; Fred A. Levy, Orange, N. J., Secretary and
Treasurer.
Adjourned.
Chicago Dp:ntal Society.
Discussion on June 7, 1H02, of the essays read at the meeting
"May 3, 1892, entitled "Facial Neuralgia" and "Pulpitis and Pulp
Capping."
Dr. Thos. L. Gilmer: Mr. President, Ladies and Gentlemen:
The paper has pretty thoroughly gone over the subject of pulpitis
or inflammation of the pulp as well as pulp capping, and I do not
know that I can add much to it. Perhaps my treatment may be
somewhat different from that of the essayist. It is often very diffi-
cult to differentiate between hyperaemic and inflamed pulps, and I
think many so-called inflamed pulps are simply hyperaemic, and it
is these latter that we are the most successful in treating. If pulps
are much inflamed, I do not believe, owing to their histological
make-up, that they are often saved. The pulp is devoid of lym-
phatics, which of course makes it more difficult to treat, the veins
alone being depended upon to carry off the products of inflamma-
tion. These veins have very thin walls, simply a covering of a
PROCEEDINGS OF SOCIETIES. 717
single layer of cells, lying end to end and side to side, so thin and
so frail that in hyperaemic conditions they are very liable to break
down, the blood being poured out between the cells in the body of
the pulp. It is possible perhaps that we may have extravasation
and then have the pulp restored to health, the blood that has been
poured out may be taken up and carried off, but in my opinion
after it has gone to that extent, a restoration to health is doubtful.
The vaso-motor nerves which control the caliber of the blood-
vessels of the pulp, seem to be more easily paralyzed than do the
vaso-motor fibers in other parts of the body. It is certain at least
that they become easily paral3^sed when in a hyperaemic condition,
and drop their grasp on the vessels, allowing the blood to be
forced in, and then not having sufficient power to send it on, it re-
mains there and we have a congested state. Some years ago I
made a number of investigations to see the conditions of hyper-
aemic and inflamed pulps. When I found a tooth that was giving
a good deal of pain, and which it was necessary to extract, I would
immediately drop the tooth into Miller's fluid, and by that means
capture the conditions. I would get a natural injection, the ves-
sels of the pulp would be filled with blood cells and harden in situ.
After they had remained in the fluid some time I cracked the teeth
and removed their pulps, putting them in gum arable, then making
sections of them, and upon microscopical examination many pulps
which I had supposed to be inflamed proved to be only hyperaemic,
and I said a moment ago I believe in a majority of cases of ex-
posed aching pulps, in the treatment of which we are successful,
the condition is hyperaemic and not inflamed.
Causes were mentioned which produce pulpitis, but there is one
cause not mentioned which I think is worth while to take into con-
sideration, and that is the use of burs and sandpaper discs on fill-
ings. A hyperaemic condition is only a short step to an in-
flammation and is a very dangerous condition for the pulp ; it is
easily excited by the too rapid or too long continued use of sand-
paper discs and finishing burs. Therefore, as a rule, I lubricate
my sandpaper and burs in polishing fillings and do not hold them
on too long. I also lubricate my strips and do not pull them
through in polishing to their, full length, but work them backward
and forward slowly. It takes longer but it is certainly not nearly
so dangerous to use them in this way.
In case of a pulp exposed to the cral fluids it is certain, if it
718 THE DEXTAL REV/EH^
remains long under such unnatural conditions, that it will become
inflamed.
In treating a tooth recently filled having a hyperaemic pulp,
it is desirable to protect it from thermal changes thereby giving
it rest; this may be done by covering it with gutta-percha, or some
other nonconducting material. The oxyphosphates have been
used for this purpose, but as they are not good nonconductors I
would not recommend them. Counter-irritation is one of the best
methods of treatment for hyperaemic or inflamed pulps. It matters
not so very much how we get it, whether it be by mustard or capsi-
cum plasters, or by dipping a piece of metal in hot water and plac-
ing it on the gum, or whether it be by the application of chloro-
form, capsicum and aconite. M}^ treatment of inflamed exposed
pulps is to remove the debris and render the cavity aseptic and
protect it from outside influences. It is better, if possible, and it
usually is possible, to apply the rubber dam. Should not like to
use peroxide of hydrogen; would not use it unless there had been
a formation of pus in the pulp, in which case should not expect to
saVe it. My objections to peroxide of hydrogen are that it is an
irritant and an acid. Should I use it, would dilute and neutralize
it. Other material will answer as well, for instance the water of
oil of cassia. Do not think I should cover the pulp with oxyphos-
phate as was directed by the essayist, but use some of the gutta-
percha preparations. Should use on an inflamed pulp just that
which many of you will condemn. I continue m its use simply
because I have emplo3'ed it for twenty years with better results
than with any other material I have tried.
I commenced capping pulps about 1872. Have a pulp in my
mouth which was capped in 18'72 by a fellow-student at colleget
and another capped later, both were capped in a similar manner.
I commenced the use of oxychloride of zinc for capping pulps a
good many years ago and have been more successful with it than
any other material. In capping I first coagulate the surface of the
pulp by applying carbolic acid 95 per cent, this forms an eschar and
puts the pulp to sleep for a time. I leave a sufficient quantity of
carbolic acid in the cavity to be easily seen. I mix oxychloride of
zinc so that it will flow nicely, previous to that having prepared a
little piece of paper about the size of the cavity, on which I place
the oxychloride of zinc, carry it into the cavity and tap gently to
convey it to place and allow it to harden. Of course some pulps
PROCEEDINGS OF SOCIETIES. 719
die under this treatment, not necessarily because of the treatment,
but in some cases at least owing to the impossibility of determin-
ing what pathological conditions are present. We must be very
careful in the selection of patients for whom we cap pulps. We
must not cap pulps for anaemic persons, or those who are malari-
ous, but for ordinary robust persons where the pulp has not sup-
purated, I have no hesitation in capping them.
I have here a toothbrush I wish to show you. It bears the
name of Dr. Mintzer. It is of French manufacture. Two years
ago I found a brush of excellent quality and shape but too large,
and the bristles were too thickly set. I cut out every other row of
bristles and considerably decreased its size and sent it as a sample
to the manufacturer, and this is the result returned to me.
Dr. p. J. Kester: Dr. Harlan has given a few unique or un-
usual causes of neuralgia. The protrusion of root fillings being one,
we may have the same results from fillings that do not protude, in
fact did not completely fill the roots, or when the material was of
such a kind as to absorb gases which produce irritation enough to
give a neuralgic response. I had a case a few days ago where
there was a persistent neuralgia the cause of which was obscure,
but we finally found a tooth that was just slightly tender under
pressure, the filling was removed and the root found filled with
cotton. Any other material which does not hermetically seal the
root may produce the same disturbance.
The subject of neuralgia from peripheral irritation seems to
me to be the subject; in fact, that is about the only kind of
neuralgia that we have to deal with, where the periphery of the
nerve is irritated. Dr. Harlan has given a few unique or remote
causes or strange causes, causes that have not been spoken of. He
speaks of the protrusion of a filling. We have all of us had more
or less experience in the irritation which is just enough to produce
a neuralgic response and not enough to produce abscess. I have
found the same result from fillings that did not protrude. I
remember a case which I had to deal with quite recently, where
we had to hunt for the pain, and we finally located it in a tooth
that had been filled. The tooth was not sore, possibly just
slightly tender, but not sore in the strict sense of the word. I
removed the filling and I removed the filling in the root which I
found to be cotton. I said to the lady that she evidently had her
tooth filled in the east where they taught the filling of roots with
720 THE DEXTAL REVIEW.
cotton. She said no, she had the tooth filled in Tacoma, but that
the gentleman was a graduate of an eastern college. There was
just enough irritation produced by the absorption of the gas in this
cotton to produce the neuralgia, and I have had several cases of
this kind where the roots have been imperfectly filled where the
irritation was not sufficient to produce any extensive inflammation,
and I think that might be classed properly as one of the obscure
cases of neuralgia.
Another peculiar condition of things producing neuralgia is the
condition of the gums brought about by the recession, or where
there is a recession of the gum, which may be brought about by
the improper use of what to me is something of a bugbear, that is,
the wooden toothpick, which is used about the roots of the teeth
producing a slight irritation which will produce neuralgia from
that source. I do not see anything in the paper that I may dis-
cuss ; the doctor has covered the ground on those three peculiar
causes and he has said nothing about the treatment of these cases.
The treatment of all cases of neuralgia has to be suggested by the
causes which have produced them.
Dk. C. N. Johnson: I do not like to see these subjects go by
default; I have not very much to say, but I will start the discus-
sion with the hope that others will follow. I simply want to refer
to one phase of the subject treated by Dr. Harlan. He spoke of
some of the peculiar causes of facial neuralgia, and I want to men-
tion one cause, which seems to me the most prevalent. In my
practice, at least, I have found it the most frequent cause of facial
neuralgia when connected with the teeth, and that is a suppurating
pulp. This is sometimes a quite difficult affection to diagnose ac-
curately, and it has caused me much annoyance from the fact that
the patient can seldom signify exactly where the pain originates.
I remember one case in particular, in which pain was referred to
a lower second bicuspid, decayed but with a living pulp. The pulp
was not exposed, but from the fact that the patient persistently
pointed to the second bicuspid as the seat of the trouble, I was in-
duced to expose the pulp and destroy it, but the same symptoms
continued after the removal of the pulp; all pain being referred to
that single bicuspid. After removing the pulp carefully and clean-
ing the canal, I knew that that could not be the cause of the pain
as explained by the patient. There was a second molar on the
same jaw that had been filled with a cement filling some time
PROCEEDINGS OF SOCIETIES. 791
before, and on pressing very hot gutta-percha onto that tooth, the
patient complained of the same degree of pain that he had ex-
perienced while troubled with neuralgia, " but," he said, "it is in
this tooth," pointing to the second bicuspid. I removed the ce-
ment filling, exposed the pulp and found it suppurating. After
this pulp was destroyed there was no more neuralgia. Those cases
have been more annoying to me than any other kind on account of
the difficulty of diagnosing, and whenever I find neuralgia referred
to any particular tooth, if I cannot locate it in that tooth myself, I
examine the teeth in that region, or in any other region of the
mouth, and especially any large filling, and if I can get that pain
reproduced by hot gutta-percha pressed upon the tooth I gener-
ally drill into the filling and investigate. In the majority of cases
of that kind I find that the neuralgia has been caused by a sup-
purating pulp.
We may have a suppurating pulp that is not a dead pulp. In
fact we often find a suppurating pulp in an extremely sensitive con-
dition.
Dr. H. a. Costner: I did not have the pleasure of listening
to the paper, but I wish to narrate a case in point. A lady had
been suffering for two or three weeks with neuralgia which she
located in the right inferior maxillary in the region of the molars.
She had not had a tooth on that side of the mouth back of the
bicuspid for thirty or forty years. She went into the hands of a
physician, as a great many people do for such ailments, and he'
treated her for three or four weeks; she suffered great agony, with
but little relief, until I, being a friend of the family, heard of her
trouble. I had previously filled and destroyed the nerves in two
molars on the left side; this was on the right side. The physician
had induced her to believe that the trouble came from the molars-
on the left side, in which the nerves had been destroyed, and she
was on the point of having them extracted. But I found at once,
upon examining her mouth that all her trouble came from a nerve
in a superior canine tooth on the right side that had died under the
filling that had been there for years, and it was in a state of
decomposition, and upon removing the filling and boring into the
tooth she received instant relief. In speaking of neuralgia of the
teeth I find that it will not do to pay very much attention to what
patients say in regard to locating the pain, as it is impossible for
them to do so. It seems that there is such a close relation between
732 THE DENTAL REVIE^V.
tlie superior and lateral branches of the dental nerve that they can-
not locate whether it is above or below, and so a man must know
his business in order to locate a neuralgic tooth.
Dr. D. M. Cattell: I should like to remind the gentleman
who asked the question about suppurating pulps, that there is
quite a difference between suppuration and putrefaction. A pulp
putrescing is certainly very dead, but a pulp may suppurate, or
suppuration may commence upon some part of the surface, or one
of the horns may be suppurative, and the rest of the pulp may be
very much alive. That is a point that I feel a little touchy upon
— the terms that we use. I think if we carefully studied these
technical terms we would not be led into error so often. With a
great many of us it has only been a few years since we knew the
difference between suppuration and putrefaction. Where putre-
faction of the pulp has taken place, the resulting gases forming
within the chamber and heat coming in contact with the tooth dis-
tending the body of the gas, would certainly produce pressure
upon the living tissue just beyond the foramen and give intense
pain. In regard to neuralgia I remember an incident that hap-
pened several years ago where I filled the canals of a lower first
molar. A year or two afterward the patient returned with intense
pain in that particular tooth; I felt chagrined. She had been
under a physician's cajre for several days who dosed her heavily
with quinine. The onl}' way the pain could be kept anywhere
^vithin comfort was by giving very large doses of quinine. I re-
moved the filling, removed the contents of the canals, found every-
thing clean and sweet, no pain that I could produce by percussion
or probing until I got clear through the apex of the roots, and that
only as one would from pricking healthy tissue. I was sure that
tooth was not the seat of the trouble. Then I made a careful
examination between the teeth to see if I could not find exposure,
wedging successively; getting between the lower teeth on that side,
I failed to find anything the matter. Then I commenced on the
same side above, and finally found a small mesial opening and an
exposure of the pulp of the wisdom tooth. The moment the pulp
was touched it located the seat of the pain, and it was the first
time it had been located by either the patient or myself since the
ne\iralgia had commenced some two weeks previous. Upon open-
ing it up and treating the pain ceased. That was my first practi-
cal knowledge of the fact that the feeling of pain to the patient
PROCEEDINGS OP SOCIETIES. 733
Ttiight be ver}' distant from the point of lesion at which the pain
really existed.
I heard very little of the paper on pulpitis and pulp capping,
etc., but as the subject is before us, I would like to call your atten-
tion to an article in the last Ohio Dental Joiirtiah from the pen of
one of our eminent men in the east, in regard to pulp capping.
The subject is the pulp nodule, he claiming that it is not wise to
cap a pulp, that one of two conditions must surely arise, the pulp
either immediatel}^ dies under the cap, or else pulp nodules are
formed and that this is especially true in the teeth of the young, if
the pulp has ever bled. It was quite a surprise to me that anyone
to-day could advance such a doctrine, as I certainly think that
pulp capping is a very good thing to do.
Dk. Do?j M. Gallie : I have a case that I would like to relate
in regard to facial neuralgia. A gentleman who is in the same
office building with me came to me last week suffering severe pain
in his face. He located the pain in the second right bicuspid;
said he had been troubled with this at intervals for about six years.
All the molars on that side had been extracted, and at intervals of
a few months pain always returned. He came and asked me to ex-
tract the tooth the other da}^ I treated it and told him I would
like him to wait awhile and see if I could not remedy it. After
coming two or three times he told me that he had received a blow
on his right superior central incisor when a boy, and once in awhile
pus would ooze out from under the gums. After telling me this I
opened into the central incisor and found that the pulp was putre-
fied and there was a good deal of pus present. He was in again
to-day and said that although the tooth felt a little sore he was not
suffering the severe pain he had been for the last six years. I con-
cluded that the central incisor was the cause of all the trouble and
am heating it, hoping to effect a permanent cure. This patient has
had the upper molars on the right side, and the bicuspids on the
left extracted for this same trouble. He has never had any teeth
iilled.
Dr. Truman W. Brophy: I was not present when the paper
on neuralgia was read, but while listening to the remarks of those
who have spoken since I came, I am reminded of two or three
cases of odontalgia, in which nearly all the pain was neuralgic in
its character, and this often leads to errors in diagnosis. One case
was that of a lady of about thirty-five years of age, who had been
784 THE DEXTAL REVIEW.
suffering very severely during a period of three weeks. A gentle-
man was treating her who was a very conscientious young dentist;
he had made examinations repeatedly and failed to discover an ex-
posed pulp or any apparent cause of the trouble within the mouth,
and then with the assistance of a medical man, he administered
morphia with a view to correcting the trouble, and alleviating the
pain. Of course this stopped the pain, but it was only temporary.
By and by he concluded that there must be pulp nodules in some
of the teeth, and after opening the second superior bicuspid on the
left side and treating it, the pain did not lessen, and he finally ex-
tracted the tooth. He kept on treating the patient but the pain
did not disappear. Apparently it was not located in the upper jaw
but below. Then he came to the conclusion that it would be well
to open the second and third lower molars on the same side, con-
cluding that pulp nodules were forming, but before that was done
the patient was directed to me by him, and upon careful examina-
tion of the distal surface of the first bicuspid, which was in contact
with the one he extracted, I found a cavity in the tooth beneath
the gums and an exposed pulp. Of course applications for exclud-
ing the air and alleviating the pain in the exposed pulp cured that
case of neuralgia.
Another case of facial neuralgia which I remember was just
the reverse of this. The pain seemed to be located in the upper
jaw and the patient was treated quite a long time. Certain teeth
that had pretty good sized cavities were filled, after first putting in
some gutta-percha, or some substitute, but the neuralgia did not
disappear. The patient was a young man. I found a cavity in
the lingual surface of the second molar, a place where cavities do
not frequently form, and this cavity had extended in so as to ex-
pose the pulp. The application of suitable agents to alleviate the
pain cured that case of neuralgia, and this shows us that we should
be exceedingly careful in making a diagnosis; there is no surface of
the tooth that is absolutely exempt from the ravages of decay and
it becomes our duty to examine all those surfaces. How frequent-
ly it occurs that we do not make careful examinations of the lin-
gual surface of the lower molar and bicuspid teeth, simply for the
reason that cavities do not occur frecjuently in those locations.
The different causes of neuralgia is a subject that might be dis-
cussed at great length. The different causes of neuralgia of the
dental branches of the fifth pair of nerves are so numerous I
PROCEEDINGS OF SOCIETIES. 725
^will not attempt to go into a discussion of the subject further than
■, to call attention to one form in the absence of all the teefh, that is
.a neuralgia which comes from an hypertrophy of the inferior den-
tal nerve in aged people as it makes its exit through the dental
foramen. It is a most common origin of neuralgia and, as in other
cases, the neuralgia is not often located at its real seat but may be
located some distance from the point of irritation. The remedy is
simple; it is to make a saddle-shaped plate so that pressure will
not be exerted upon the nerve as it passes out of the foramen to be
distributed to the teeth and gums and parts adjacent.
Dr. Rollin B. Tuller: I shall not undertake to discuss the
paper but I wish to relate an incident that occurred in my practice
about fifteen years ago, when I was in a country town, and which
may be of interest in connection with this subject. A farmer drove
up to my ofifice, about three miles, and said he had a tooth that
was aching, in fact that the whole side of his face was in the most
distressing pain. He described the pain as neuralgia shooting up
through the side of his head, and located its origin in the first lower
molar on the left side. I examined his mouth and found as perfect
a set of teeth as I have ever seen. They v;ere fully developed in shape
and texture and what I would call almost a typical set. I made as
thorough an examination as I possibly could of the tooth indicated
and all the other teeth, but could find no defect whatever, nor any-
thing likely to cause such pain and I declined to extract the tooth
as he demanded. I passed a lance around it and applied some-
thing to the gums that afforded a little relief for the moment, and
induced him to go home and see if it would not pass away. He
started home and drove out of town for some distance, and came
back on the run and said if I didn't take the tooth out he would go
across the hall to my competitor. Finally I extracted it and to
satisfy him and myself I split it open. I found a calcified pulp,
the whole chamber and the roots were filled with a calcific depos-
it that was detached entirely from the tooth substance. There
seemed to be serum all around it but there was no indication of
blood nor any of the original conditions of a pulp in the pulp
chamber nor down the roots. In the extreme parts of the roots the
calcific formation was so thin that it readily crumbled to pieces
on the slightest touch. The portion in the pulp chamber was
quite dense and hard and conformed exactly to the shape of the
-chamber. I had occasion a few months afterward to extract the
726 THE DEA'TAL REVIEW.
corresponding tooth, tlie first lower molar on the right side under
similar circumstances, and I found exactly the same conditions.
It is difficult to diagnose such cases, and when extraction and
splitting or opening discloses these calcified pecularities, it is diffi-
cult to explain why they should suddenly cause such intense pain
when months and perhaps years have been consumed in gradually
taking on such conditions. INIy experience has taught me that
when a live tooth (if you can locate it) is " acting up " in queer
and unaccountable ways, not responding as teeth generally do to
certain reliable treatment, to look for pulp nodules or calcific de-
posit of some sort in the pulp chamber, and I often find it. It is a
great satisfaction to roll out a boulder about the size of a millet
seed and exclaim, " Ah I I thought so. Here is the cause of all
your trouble ! " It is so satisfying too, to your patient to know
that you have at last found the cause of the trouble after an effort
necessarily long and tedious, whether you can make them fully
comprehend just why that caused all the pain.
Dr. C. F. Hartt : I think Dr. Harlan's paper is a very timely
one. I want to say right here that confession is good for the soul.
I have filled the roots of teeth with almost everything I could get
hold of. I have filled them with copper, I have filled them with
wood, I have used lead, tin, gold, almost everything. It got to be
a question with me, what can I fill root canals with? Now I think
when I am filling a root, how can I get this out again, and I have
come to the conclusion that a dentist who fills the root of a tooth
with wood or any substance that cannot be gotten out reasonably
easy, is doing an injustice to his patient. I would not allow a man
to fill the root of a tooth in my mouth with a metal or wooden
point; I should want it to be gutta-percha or something that could
be readily taken out. I have found teeth that I have filled come
back troubling the patient, and I think, when did I fill that tooth ?
I get my book and look it up and find that the roots were filled ; I
think to myself, was I well at the time I filled that tooth, was I at
my best, I wonder if that root is filled properly. Upon examination
I find the roots filled up with wooden or copper points, and I can-
not get them out. Dr. Harlan has recommended for a number of
years that the roots of teeth should be filled with something that
can be removed easily. I believe it is a very bad thing, indeed, to
fill the canals with anything that you have to drill out.
Dr. A.W. Harlan: The particular points that I brought forward
PRGCEEDIXGS OF SOCIETIES. 727
in my paper were, unusual cases of facial neuralgia from the pro-
trusion of fillings through the roots of teeth, cases of neuralgia
resulting from incomplete sterilization of the dentine of polluted
teeth, and cases of neuralgia resulting from exposure of the pulps
of the teeth at the apex. Those three phases have not been
touched upon either by the gentleman who opened the discussion
at the last meeting, or by the speakers of this evening. I need not
assure this highly intelligent audience that the three causes I have
mentioned will probably cover the vast majority of cases the}' have
to handle where it is impossible for them to diagnose because of
the pain, and that those three phases of pain of facial neuralgia
are worthy of serious investigation. You cannot do a greater ser-
vice to a patient under any circumstances than by almost intuitively
locating the source of his pain and relieving it.
The case mentioned by Dr. Gallic, where pain was felt in the
second bicuspid, coming from a dead pulp in a central incisor, sim-
ply goes to show the possibility of the reflex nerves of the anterior
dental branch of the superior maxillar}' branch of the fifth pair of
nerves being pressed upon by the accumulation of pus in that
region, which was undoubtedly the case, and the pain was felt and
located by the patient in the second bicuspid because those nerves
have not a tactile sense.
I do not feel ashamed to relate a case in my early practice where
unfortunately I caused the loss of two teeth by not realizing the
necessity for thorough examination before extracting the teeth.
The patient, a man about 40 years old, applied to me for the relief
of pain in the first superior molar on the right side. I examined
that tooth carefully arid found there was no cavity, and that the
pulp was not dead. I examined the second molar and it was in the
same condition. Thinking that there was something beyond my
ken 1 applied the usual aconite preparation in use at the lime and sent
him away. He came back in a few hours and said the pain was in
that tooth and he must have it out, so I extracted it. He came
back the next day and said the pain was in the same locality, but I
could not discover anything; the next day he came back and I ex-
tracted the second molar, and then I looked his teeth over again
but did not discover anything. He came back again and I looked
them over again and discovered a cavity on the buccal surface of
the third inferior molar on the right side immediately below the
gum, that exposed the pulp. I extracted that and it relieved him,
728 THE DEKTAi. REVIEW
but he lost two sound teeth. So I would emphasize the necessity
for a thorough examination of every case before you extract a tooth.
But I want to call your particular attention to the suffering that
is caused by the protrusion of root fillings. I know there are some
gentlemen present who defend the filling of the roots of teeth with
metal points. I simply want to utter a word of caution; it is a
dangerous procedure to force wood or metal or any other irritating
substance through the roots of the teeth, on account of the danger
of future trouble and possible loss of the teeth in consequence.
If you have to remove a metal point it is always a matter of great
difficulty; if you attempt to remove a piece of wood or whalebone
you will find that it is no boy's task, and it is much better to use
something like paraffine or shellac dissolved in alcohol, or gutta-
percha dissolved in chloroform, or something of that sort, that can
be acted upon by agents that you can introduce into the tooth.
If it then becomes a necessity to remove it, it is possible for you to
relieve the patient and place the tooth in a condition of comfort.
The methods of sterilizing poisoned dentine I will not dwell upon,
because you must be aware of the necessity for its thorough per-
formance in order to maintain a degree of health of the cementum
and pericementum. Anyone who is familiar with the microscope,
must know that all teeth are not of the same denseness of struc-
ture and that wherever there is an area of space and mephitic gas
in contact with that, it must be eventually filled, and if the gases
are not driven off — and you know that gases are frequently not
driven off except by intense heat, they greatly impair the cemen-
tum, and impairing the cementum further deteriorates the receding
quality of the pericementum, and that becomes a useless tooth and
the patient always avoids it. You will find that on the side of the
mouth where there is a lame tooth, a tooth with an incomplete fill-
ing, the patient invariably chews on the other side, that tooth
becomes coated and the jaws drawn; that side of the mouth is
unused and is not only a source of pain but also of physical dis-
comfort. Exposure of the pulp by the side of the tooth or at the
apex of the root, you are familiar with, and in all cases of that kind
the promptest measures must be instituted; either the tooth must
be extracted or the pulp destroyed; if you wish to save the tooth
you will have to destroy the pulp and fill the root before the patient
secures relief.
[Ca+3HoO
PROCEEDINGS OF SOCIETIES. 729
ASAPROL
Is the name given by Stackler and Dulief, of Paris, to the beta-
naphtol-alpha-monosulphonate of calcium, which has the following
formula :
OHC.oH.SO;,
OHC„H,SO,
It occurs {PJiarm. Zcit.) in small scales, easily soluble in water,
but less freely soluble in alcohol, and is decomposed at 100° C. It
is prepared by heating one part of beta-naphtol with two parts of
sulphuric acid to 100° C. for two hours, and converting the acid
thus obtained into the calcium salt. Physiological experiments
have demonstrated its nontoxicity, while it arrests the development
of and destroys microorganisms. Since 5 to 15 per cent solutions
are required for this purpose, however, its utility as an antiseptic
is questionable. — A;n. Druggist.
MEMORANDA.
Dr. C. L. Goddard is once more enrolled as a member of the Dental Society of
California.
Assurances have been received from Russia that representatives of the pro-
fession will be with us at the congress in 1893.
CHANGE OF TIME OF MEETING.
The British Dental Association will hold its next meeting in April instead of
August, in order to permit members to attend the Dental Congress.
We are assured that the breach has been healed between the State Dental As-
sociation of California and the dental school of the university. This is very grati-
fying to all concerned, and the hope may now be entertained that the American
Dental Association can hold a meeting in the Far West at no distant day — say
1895. Chicago looks to California, Nevada, Oregon, Washington, Wyoming, Ari-
zona, Utah and other Western points for a large delegation in 1893. It is none
too soon to begin to organize parties for August 15 of next year.
The Dental Review.
Devoted to the Advancement of Dental Science.
Published Monthly.
Editor : A. W. HARLAN, M. D., D. D. S.
ASSOCIATE EDITORS:
Louis Ottofy. D. D. S. C. N. Johnson, L. D. S., D. D. S.
Winter Evenings.
Very soon the long evenings will be here and the studious den-
tist will have at his disposal more leisure hours than should be
spent wholly in frivolous pastime. Some of our most distinguished
scientists have laid the foundation of their influence and popularity
by wisely disposing of an hour or two in the evening time. Others
prefer the early hours of the morning — this, however, is nearly al-
ways a matter of habit, more than of preference. No matter what
may be the selfish wishes of the greater number of us, at least a
portion of our time should be spent in reading, systematically, on
some subject that we are desirous of mastering.
The late Henry Ward Beecher said that he read all of Gibbon's
Rome in ten minute snatches before breakfast. We know from
experience that Bloxam's Chemistry was read entirely in fifteen
minute sessions during one winter, after dinner. In the same way
Fray's Histology and Green's Pathology was gone over as well as
Wagner's greater work.
It would be a good plan for one interested to read Miller's
Work on the Micro-organisms of the Mouth, Black's Anatomy of
the Human Teeth, Wood's Therapeutics or Smith's Operative
Surgery, or some general work in its entirety.
If one is disposed to do so a miniature chemical or mechanical
laboratory may be fitted up in one's private residence as well as a
microscopical work room. Every one is not fitted, nor has he the
inclination to do microscopical work, but there are other depart-
ments lying fallow for want of attention, and we appeal to the un-
EDITORIAL. 731
employed to go to work, in some direction from a stern sense of
duty to those of our ranks who are doing so much for them — and
reciprocate in some slight way the many benefits that they have
received already from these unselfish labors. It may be that at
first the work will be irksome, but soon you will become interested,
then enthusiastic, and later you will be competent to instruct and
delight your auditors, whose encouragement will spur you on to
perhaps a great discovery for the benefit of mankind.
Do not neglect your opportunities but seize them now.
Does It Pay?
In unison with the predominating question of the age, "Does
it pay?" we are inclined to raise the query as to whether or not it
is profitable for a dentist to follow, month in and out, the routine
of office work without permitting himself, at reasonable intervals,
the relaxation and recuperation which a judiciously spent vacation
affords? Can a man advisedly ignore nature to the extent of dig-
ging after the dollars to the exclusion of everything else? Is it jus-
tice to himself or his family that he should jeopardize his health
and his temper by a blind policy of continuous application ? Does
it pay ?
Dentistry is a trying occupation. It entails upon the individual
who follows it faithfully an undue nervous strain, which, if too long
continued, results in some kind of collapse. It is confining to the
body, and narrowing to the brain. Can a man afford to wrap him-
self about with habits which partake largely of the monotony of
machinery, and do nothing to break that monotony?
How rapidly will a man grow, or how long will he live under
such circumstances ? And how much enjoyment does he get out
of life while he does live? The height and depth of human ac-
complishments should not be measured solely by the medium of
money.
Happiness is the greatest good, and the greatest happiness is
attained only through the greatest growth. Can a man grow who
limits himself to a horizon bounded by two and thirty teeth ? In
order to develop, a man must have communication with the world.
He must see something, and know by experience a few of the things
that happen outside the four walls of his office.
We are prompted to these remarks by the personal knowledge
732 THE DENTAL REVIEW.
of men who have been in practice for years, some of them more
than a baker's dozen, and who never take a holiday. The question
arises : Can these men, honest and worthy as undoubtedly they are,
do their patients as good service in the long run as they could if
they took advantage of an occasional breathing spell to renew their
vigor? Dissolved to its final solution this matter of continued
application proves an injustice to all concerned. The patient suf-
fers as well as the practitioner, and the practitioner's famil)^ often
suffer most of all. A man cannot be all that he should be to his
home and friends, if he makes himself a slave to his office.
When dentists claim that they cannot afford to take a vacation
they simply prove their own short-sightedness. We are firmly
convinced that even in the matter of money a man loses nothing.
Look at the men who have accumulated the most money in dentis-
try, and almost invariably they are men who have taken frequent
vacations, men who have traveled extensively, and who have
broadened their ideas by intercourse with the world. A man be-
comes a better financier, as well as a better individual, by extended
experience, and the most observant man in the world cannot gain
a very extended experience in a dental ofifice alone.
Let us appeal to some of our perpetual pluggers of teeth and
ask them to reflect and see if, after all, it pays. C. N. J.
Corrections.
The leading article by Dr. C. S. Case published in the August
number of the Dental Review should have been credited to the
Iowa State Dental Society, where Dr. Case read the paper at the
May meeting.
Unfortunately in the notice given the Revue Internationale D^
Odontologie SLXiwrnb^x of the names of the gentlemen connected with
that journal, were not corrected in the second proof sheets, and as
a result some of our worthy confreres will never forgive us if they
thought that we were personally responsible for these errors.
REVIEWS AND ABSTRACTS.
Western Branch, British Dental Association.
The annual meeting of the western branch of the British Den-
tal Association, which is held this year in Penzance for the first
REVIEWS AND ABSTRACTS. 733
time since its formation, opened on Friday morning. The council
met at 10 in the Lecture hall, and the general meeting of members
followed in the Alverne Hall. The chair was taken by the retiring
President, Mr. E. L. Dudley, L. D. S. (Bath), and the members
present were Messrs. J. H. Gartrell, Penzance (the President
elect); Messrs. E. Brand, Exeter; E. Brown, Barnstaple; F. H.
Colwill, Ilfracombe, E. R. Gay, Merthyr; T, A. Goard, Exeter , E.
Goodman, and A. Kendrick, Taunton ; W. A. Hunt, Yeovil; H. B.
Mason, Exeter (Honorable Secretary);}. C. Oliver, Cardiff ; W.
B. Pearsall, Dublin ; H. C. Riches, Penarth ; J. G. Robertson, Chel-
tenham ; J. J. H. Sanders, Barnstaple; G. Thomson, Torquay; G.
W. White, Newport ; W. Woodruff, London ; A. B. Phillips, Fal-
mouth ; and the following visitors — Messrs. G. Robinson, W.
Badgery, J. Perrow, H. Gartrell and W. J. Trembath.
APOLOGIES FOR NONATTENDANCE.
The Honorable Secretary (Mr. H. B. Mason) said that letters
apologizing for nonattendance had been received from Messrs.
E. Apperly, W. H. Mayne, T. P. Ritchie, W. Helyar, R. Brown,
H. H. Tuckett, Turner, White, Dr. Stack (Dublin), and Mr. Len-
nox (Cambridge).
NEW MEMBER.
Mr. A. R. Phillips, of Falmouth, was elected a member of the
branch of the association.
NEW MEMBERS OF THE COUNCIL.
Messrs. E. Apperly and F. H. Colwill were elected members of
the Council to fill the vacancies caused by death, and Mr. W. Hel-
yar was reelected.
REPORT OF THE COUNCIL.
The honorable Secretary read the report of the council, which
after an illusion to last year's successful annual meeting at Bath,
•stated that at the April meeting of the council at Dartmouth a
resolution was unanimously adopted in favor of the branches
electing instead of nominating, as at present, members to the rep-
resentative board. The council regretted that the board had de-
cided not to proceed further in the matter at present. They con-
sidered the change very desirable, and felt sure that it could not be
long delayed. The council had to lament the loss of two promi-
nent members of the branch, Mr. Cooke Parson, of Clifton, and
Mr. Pearman, of Torquay. The financial statement of the branch
734 THE DENTAL REVIEW.
was satisfactory, there being a balance in hand of ^12. 4s. The
council had that day elected Mr. T. A. Goard, of Exeter, as hon-
orable secretary of the branch in the place of Mr. H. B. Mason,
who ceased to fill the position at the close of the present meeting.
The council proposed that next year's meeting be held at Chelten-
ham, and nominated Mr. J. Lewis Robertson, of that town, as pres-
ident-elect. The members now numbered 80 against 85. The re-
port, together with that of the Treasurer, which had been audited
by Messrs. Colwell and White, was adopted.
THE RETIRING PRESIDENT.
The retiring President delivered a brief valedictory address, in
the course of which he thanked the members for having done their
utmost to make the Bath meeting a success, and assured them that
he should always be glad to do anything that lay in his power to
advance the interests of the branch. On the motion of Mr. Hunt,
seconded by Mr. Goodman, a vote of thanks to Mr. Dudley was
carried by acclamation. The chair was then taken by Mr. J. H.
Gartrell, the President elect.
THE president's ADDRESS.
The President then delivered his address. He thanked the
members very warmly for placing him in that honorable position,
for to have the good opinion of the best men in his profession was
something which he did not lightly esteem. When Mr. Gartrell
joined the Association at its commencement it never entered his
mind for a moment that he would ever attain to the position of
President, and still less should he have thought that he would pre-
side at a meeting of dentists in that far away corner of the country,
and although he assumed the position with great diffidence and a
sense of his unworthiness to fill it, yet he ought to feel proud that
that was the first dental meeting, and that he was the first Presi-
dent of a meeting of dentists held in Cornwall.
He had lately given some consideration to the claims the coun-
ty had to the benefits conferred by modern dentistry on the human
race. The raw materials they used in the profession were to a
great extent produced by Cornishmen. He might mention the
metals in this connection, and particularly tin, which was of great
use both in the mechanical and surgical departments. One of their
demonstrations that day was a combination of tin and gold for fill-
ing teeth. Gold, the principal metal used both for dental plates
HE VIEWS AND ABSTRACTS. 735
and for filling, although not found in the county in sufficient quan-
tities to pay for mining, was chiefly mined by Cornishmen. The
only gold mine in Great Britain had for its manager a native of
that neighborhood.
Another natural production found in Cornwall in much greater
perfection than any other part of her Majesty's dominion, and
which was of very great importance in dentistry, was china clay.
The feldspar and kaolin prepared from it were the two principal in-
gredients used in making porcelain teeth, of which from 25,000,000
to 30,000,000 were sold every year for use all over the civilized
world. The general public were not entirely disabused of the no-
tion that ivory and human teeth were used as substitutes.
During the thirty-four years Mr. Gartrellhad been engaged in
dentistry in America and England, he had never used an ivory or
human tooth. It was to a Cornishman and a native of Penzance
that they owed the discovery of the anaesthetic properties of nitrous
oxide gas. Sir Humphry Davy, whose monument they might have
seen, made this discovery about 1800, and suggested that it might
be valuable in surgical operations. This suggestion, however, was
not acted upon until about forty-four years afterward, and they
must remember with pride that it was a dental surgeon. Dr. Wells,
of Connecticut, who put the anaesthetic properties of the gas to
practical use by extracting teeth under its influence. Dr. Wells,
however, had an imperfect apparatus and did not succeed in bring-
ing nitrous oxide into general use.
Another American dentist. Dr. Morton, discovered sulphuric
ether and this overshadowed nitrous oxide for some years, chiefly
because it required but little apparatus. Dr. Morton also used
chloric ether, and from chloric ether Mr. Waldie, of Liverpool^
separated chloroform. To dentists must therefore be given the
credit of reducing to practice the great and merciful discovery of
anaesthetics. Ether and chloroform threw nitrous oxide into the
shade till 1863, when Dr. Colton, another dentist, began giving
popular lectures on the gas in New York.
At that time Mr. Gartrell was practicing in the city and attend-
ed the lectures. He was one of those who went on the platform to
inhale the gas for the amusement of the audience and to gratify
his own curiosity. In this year, sixty-three years after its discov-
ery by Sir Humphry Davy, nitrous oxide was effectually introduced
as an anaesthetic. Dr. Colton associated himself with three other
786 THE DE.VTAL REVIEW.
dentists of New York, and the four devoted their time to the prep-
aration of mouths for sets of artificial teeth.
In a short time nitrous oxide became generally used in the
United States for dental operations, but was not introdued into
England till 18C8, when Dr. Evans, also an American dentist, ex-
hibited it as anaesthethic at the London Dental Hospital. Since
then it has been used in millions of cases, and for short operations
such as occur in dental practice it is the best and safest anaesthetic
known.
It is probably more dangerous to life to extract a tooth when a
cardiac trouble exists without nitrous oxide than with it. There
had only been, he believed, two or three fatal cases in this country,
and in these the gas might not have been at fault.
Looking back over the subjects that had interested the dental
world since their last meeting, it would be noted that some ques-
tions had advanced while others had receded in the interest they
had created among the profession; for instance, a short time ago
implantation attracted a great deal of attention, but scarcely
anything had been heard of it for the last year or two. Perhaps
this, like nitrous oxide, would take sixty-three years to come into
general practice.
The President was among those who took an interest in it. He
might add that he became a martyr to it. In 1887 he was in
Washington, U. S. A., attending the International Medical Qongress,
and became acquainted with Dr. Younger, who was one of the
first to reduce implantation to practice. He suggested to Mr.
Gartrell that he should have two upper lateral incisors implanted
in the place of those which had been extracted two or three
years before. After inspecting a case of successful implantation Mr.
Gartrell consented, and two teeth were found for his case, which,
he was told, had been extracted in a case of irregularity from the
mouth of a beautiful American lady, The teeth looked to his eye
more like those from an Egyptian mummy, but after they had been
sterilized Mr. Gartrell sat in the the operating chair before an
audience of two or three hundred Americans and a few European
dentists, among them Drs. Cunningham and Walker, who were
there to see that the Britisher had fair play. Dr. Younger oper-
ated rapidly. In six minutes he had the gum slit like across, the
hole drilled in the alveolus and one of the teeth in position. The
other took about eight minutes to fix. The whole operation was
REVIEWS AiVD ABSTRACTS. 737
performed without any anaesthetic, and Mr. Gartrell confessed it
took all his resolution to bear the pain. To hold the implanted
teeth steady they were tied to the adjoining natural teeth with silk
thread, and this made the operation unsuccessful. In spite of all
Mr. Gartrell' s care, the ligatures got loose, and although retied,
he gave up the attempt to keep the teeth in his mouth longer than
ten days. If a thin, soft platina plate had been used to hold the
teeth in position the operation might have been successful. It was
not at all impossible that in a shorter time than it took to introduce
nitrous oxide, dentists would be able to implant beautiful sets of
teeth in their patients' jaws without pain, which would answer all
the functions of mastication, enunciation, etc., so perfectly as the
natural set. The past year had been one of considerable activity
in the mechanical branch of the profession. Crowns and bridges
appeared to attract as much attention as ever, the great object
being to avoid the intolerable objection of wearing plates. There
was no doubt this method of supplying substitutes had come to
stay.
One reason for the success of crowns and bridges was the
greatly improved method now used in the treatment of roots and
teeth with dead pulps. The general public were still quite ignor-
ant of the improved methods now in use in conservative dentistry,
and often thought that they must have teeth and roots sacrificed
that could be treated and preserved for a life time.
In speaking of the efforts made by Mr. Rose, of London, and
Mr. Turner, of Glasgow, to improve the continuous gum process,
Mr. Gartrell said that base had been his ideal of plate work ever
since he first saw it. He did not approve of the methods advocated
during the last few years, and known as continuous gum facings
on vulcanite plates ; in the method he used soft platina was dis-
carded entirely, the plate being made of hard platina.
With respect to the present position of the dental profession,
he thought it might be considered satisfactory when they reflected
it was only fourteen years since they obtained the Act of Parliament
which gave them a legal status and established a dental register.
The British Dental Association was then founded, and at present
numbered, he believed, about 1,000 members. Unfortunately there
had to be admitted to the register many hundreds of men who had
no bona fide qualifications. Many hundreds of chemists' and
dentists' assistants, for instance, got on the register merely on the
':38 THE DENTAL REVIEW.
ground they had pulled teeth previous to 1878, while any boy who
happened to be employed about dental laboratory in that year had
been able to do likewise up to last year. They of course presented
themselves before the public as fully qualified dentists, and in
most cases a good deal better qualified than regular practitioners.
It was of course, unfair to the public and an injury to the profes-
sion that such should be classed with the young men who had
passed through the curriculum of the colleges and properly quali-
fied themselves for the discharge of their duties ; however, their
number would gradually decrease. The medical profession, at
the beginning of the century, had to pass through the same ex^
perience, and they must be content to follow on the same lines-
There were men among the British dentists to whom the profes-
sion was greatly indebted for their efforts to elevate it. The Pres-
ident was not able to boast of having very materially assisted
them. In the first place he was educated in Canada, and practiced
for eight years there and in New York before he located in his native
town; and here he was so far away from the great centers of dental
authority that he had only been an humble soldier in the ranks of
the British Dental Association. In conclusion, he welcomed the
members to Penzance, with the hope that their visit would repay
them for the long distance some of them had traveled, in the op-
portunity it would give them of viewing the beautiful coast scenery
and the other objects of interest which abounded in the neighbor-
hood.
At the conclusion of the President's address a vote of thanks
was accorded to him on the motion of Mr. Balkwill.
The Essentials of Histology, Descriptive and Practical,.
For the Use of Students. By E. A. Schafer, F. R. S., Jodrell
Professor of Physiology in University College, London ; Editor of
the Histological Portion of Quain's "Anatomy." Third edition
revised and enlarged. Philadelphia : Lea Bros. & Co., 1892, pp.
298. Price, cloth, $3.
To the average student Histology is the most uninteresting.
study in the curriculum. Anatomy is dreaded, but physiology and
histology are nightmares.
That this is so is due not to a scarcity of text-books, but a lack
of suitable ones.
REVIEWS AND ABSTRACTS. 739
Some one has said, " It is an easy thing to write a book, but it
is very difficult to write one that will be read." This is especially
true as regards students' text-books.
From the date of its first appearance Schafer has been a favor-
ite not only with instructors but with students. Its universal
recognition is shown by its being on the list of books recommended
by most of the English speaking colleges.
In the present volume the same character is preserved as in
former editions, but the size of the pages has been cut down,
making the book more convenient to handle. The paper and press-
work are also superior to that of previous editions.
The work has been thoroughly revised, obscure passages re-
written, and much new matter incorporated.
In the choice of illustrations the author has been singularly
fortunate. The old schematic diagrams have been largely dis-
carded and their places supplied by illustrations that resemble the
object for which they are intended. Many new illustrations have
been added, most of which have never before appeared in a work
of this kind.
The matter relating to the microscope and the preparation of
microscopical objects has been entirely rewritten, and, although
brief, covers the entire subject.
In its present form Schafer is the most complete hand-book of
histology at our command, giving, as it does, an outline of the
structure of all the tissues of the human body, and presenting it
in a way that makes it intelligible to a student of average ability.
For an exhaustive study of a particular subject the larger works
would be necessary, but for the student commencing the study or
for a practitioner desirous of reviewing histology there is nothing
superior. H. N. L.
Post Graduate Dental Association.
Syllabus of Dental Anatomy.*
Requisites for the course:
1st. Black's Anatomy of the Human Teeth.
2d. A sufficient number of human teeth for study. These
should consist of at least twelve teeth of each denomination, — i. e.
twelve upper central incisors; twelve upper lateral incisors; twelve
♦Prepared by Dr. G. V. Black.
740 THE DENTAL REVIEW.
upper cuspids, and so on with all of the teeth of the human mouth.
A greater number would be better. These should be as free as
possible from caries, and a considerable number of them should be
teeth removed from young persons so that the surface markings
shall not have been obliterated by wear.
One or more skulls with as perfect teeth as possible.
3d. Instruments for making dissections. A thin saw in a
strong frame. A good vice; such as is used by dentists. Several
good files, flat and quarter round. A dentist's grinding lathe. A
number of wood blocks one-half inch square by one inch long on
which to fasten teeth with sealing wax for convenience in printing
silhouettes. Ink pads, ink and rubber. Two memorandum books
for silhouettes, one to be retained by student and one to be sent
to the Post Graduate Dental Association.
(See Black's Dental Anatomy, paragraphs 158, 166, 171 and
179.)
Section 1.*
Dental Nomenclature.
Names of the teeth. Names of the parts of the teeth common
to all. Names of the surfaces of the crowns of the teeth and the
modes of expressing their relation to each other. The angles of the
teeth — how named; also the edges and cusps. The surface mark-
ings of the crowns of the teeth; grooves, sulci, fissures, or faults.
The ridges, tubercles, supplemental grooves, interproximate spaces,
bell crowned teeth, thick necked teeth, etc.
Every subject must have a set of names and phrases peculiar
to it, called its terminology, or system of nomenclature, and which
must be learned by students of that subject before they can com-
municate with each other, or read effectively.
Section 2.
The Upper Central Incisor.
Note. Study the table of measurements carefully in connection
with each tooth as it is presented in the sections.
In studying the illustrations remember that they are pictures of
individual teeth and will not always correspond with the text which
describes average forms. Their principal uses to the student
*The subject treated in one section is to be studied in one month. Every
student is at liberty to cover the ground in less time or more time.
REVIEWS AND ABSTRACTS. 741
should be as aids in locating surfaces, and surface markings, on the
natural teeth in his collection, which are the real objects of study.
Form of the crown. How the cutting edge is formed. Names
and forms of its surfaces. Difference in the forms of the mesial
and distal surfaces. The angles. The gingival line. The gingival
line not the line of the free margin of the gum. (See par. 211 and
212.) Curvature of the gingival line. Developmental lines or
grooves. The crowns of the teeth divided into lobes, each lobe
beginning its development separately and the developmental lines
or grooves mark their junction. Form of the roots of the upper
incisors.
The Upper Lateral Incisor.
Differences in the sizes and form between the several parts and
surfaces of this tooth and the central incisor. Note carefully the
curves of its several surfaces and angles, and especially the differ-
ence between its mesial and distal surfaces. Gingival fissure.
Section 3.
THE LOWER INCISORS.
General outlines more slender than the upper incisors. Devel-
opmental lines or grooves the same but much less marked, and
generally not visible. Lines of the cutting edges of the central and
lateral different. The distinctive form of the distal surface of the
lower lateral. Roots of the lower incisors slender and much
flattened. Form of the body of the root. Form of the apex of
the root.
Section 4.
The Upper Cuspids.
Observe carefully the form of the crown and root. The mesio-
distal width of the crown as compared with the neck of the
tooth. The cusp, angles, convexity of labial surface; the lingual
surface narrower than the labial and caused by the form of the
flattening of the mesial and distal surfaces. The gingival ridge
longer than that of the incisors. Curvature of the gingival line.
Size and length of root ; form of body of root ; form of apex
of root.
Section 5.
The lower Cuspids.
Slightly smaller than the uppers, and more slender. Form of
mesial surface as compared with the distal. Effect of the pro-
742 THE DEXTAL REV/EIK
trusion of the distal angle on the general form of the tooth, crown
and root. I'he peculiar manner in which the form of the cusp
is changed by wear. Form of the labial surface ; form of the
lingual surface. Absence of prominent ridges or grooves. Form
of root. Form of apex of root. Peculiar curve of the tooth the
crown and root taken together.
Section 6.
The Upper Bicuspids.
The form and relative size of the lobes of the bicuspids. How
changed from the forms of the incisors and cuspids. The outlines
of the occluding surface of the upper first bicuspid. The forms of
its ridges ; of its grooves ; its sulcus ; its liability to pits and fis-
sures. The buccal surface ; its cusp, angles and grooves. The
smooth rounded lingual surface with its cusp. Make a careful
analysis ot the forms of the mesial and distal surfaces with refer-
ence to the formation of contour fillings and the perfect finish of
margins. The forms of the root ; generally two roots, but not
always.
Upper second bicuspid. Resembles the first but is smaller. The
cusps, ridges, sulcus and grooves are less prominent; the pits
closer together and the buccal triangular ridge narrower. There
are often a number of small supplemental grooves in the occluding
surface. The tooth has not so much of the bell crowned appear-
ance. The buccal surface narrower from mesial to distal. The
proximate surfaces more rounded. The lingual cusp nearer the
mesial than the distal. The root a little longer than that of the
first in proportion to the crown. Generally but one root, crooked
roots are frequent.
Section 7.
The Lower Bicuspids.
The lower first, the smallest of the bicuspids. The lingual cusp
nearly wanting and the buccal very large. Trace the grooves of
the occluding surface carefully and make out the form of the lobes.
Ridges of the buccal cusp. The marginal ridges prominent,
giving the tooth a strongly belled crown. The lingual lobe varia-
ble as to size but generally very small. The buccal cusp is to the
distal of the perpendicular line. The proximate surface well
rounded.
The lower second bicuspid is a little longer than the lower first
REVIEWS AND ABSTRACTS. 743
and the lingual cusp better developed. It presents three typical
forms of the occluding surface in which the grooves are differently
disposed. The root is larger and longer than that of the first.
Section 8.
The Upper First Moi.ar.
Note carefully the language of paragraphs 66 and 67 before
beginning the study of the first molar, then study the illustrations,
carefully comparing them with the natural teeth point by point,
until all of the surface markings are located. Then follow out all
parts of the text. Distinguish carefully between four cusped and
five cusped teeth, and the modifications between these, in which
there is only a line indicating the position of the fifth cusp. Fol-
low carefully the outlines of the lobes and trace the grooves divid-
ing them. Note also in your collection of teeth the differences of
form produced by the greater or smaller development of certain
lobes. The forms of the proximate surfaces of these teeth are of
special importance.
This tooth will be found the most complex of the human teeth,
and therefore difficult, but the text is very full and complete.
Section 9.
The Upper Second and Third Molars.
Note particularly the differences in form produced by the diminu-
tion of the disto-lingual lobe as compared with the upper first mo-
lar, and the otherwise less perfect contour of the teeth. The entire
absence of the fifth lobe in the second and third molars. The
forms of the teeth in the almost complete absence of the disto-
lingual lobe. The forms of the three cusped teeth in the complete
absence of the disto-lingual lobe. If the differences in the forms
given to the several surfaces of the teeth by these changes in the
forms of the lobes be carefully noted in following out the text they
will be readily fixed in the mind. The forms of the necks and roots
of these teeth should receive careful attention.
Section 10.
Lower First Molar.
A five cusped tooth. Lobes and developmental lines are ar-
ranged on a different plan from those of the upper molars. Study
the illustrations, first comparing them carefully with the teeth in
your collection until the lobes and grooves are well made out.
744 THE DEXTAL REVIEW.
Then follow out the text, comparing it paragraph by paragraph
with the points as illustrated by the teeth themselves. In this way
the forms of the lobes individually and the forms of the surfaces of
the tooth as a whole will be easily made out and the several grooves
fixed in the mind. Observe the grooves and parts of grooves that
are most liable to fissure. Note particularly the differences of form
produced by the more or less full development of individual lobes
among the teeth in your collection, especially the distal lobe and
the variations in the form of the distal surface thus produced.
Two roots with the bifurcation closer to the crown than in any
other tooth. The forms of the roots of this tooth are particularly
important in their removal after breakage of the crown.
Section 11.
Lower Second and Third Molars.
The lower second molar is like the lower first with the distal lobe
left out and the disto-buccal lobe joined with the disto-lingual and
with the changes in form which this implies. It is the simplest
tooth form in the human mouth. The developmental grooves form
a simple cross dividing the four nearly equal lobes. Note particu-
larly among the teeth in your collection the variations from the
typical form produced by the unequal development of the lobes of
some of the teeth. This tooth is particularly favorable for the
study of triangular ridges, and the occasional observation of trans-
verse ridges and supplemental fossae. Note carefully the forms of
the mesial and distal surfaces, etc.
The lower third inolar is very variable in size. It has two typi-
cal forms, and is often very irregular in form. Note particularly
the form, and the variations of the form, of the neck and root of
this tooth with relation to the fitting of bands for crowns, or the
support of bridges.
Section 12.
The Deciduous Teeth with the exception of the first deciduous
molars. In studying the deciduous teeth compare them critically
point by point with the corresponding permanent teeth and note
particularly the differences pointed out in the text. Make in this
way a comparative review of the permanent teeth, studying the
differences in form found in the deciduous teeth. It should be
particularly remembered that the text is only a guide to the study
of the teeth themselves.
REVIEWS AND ABSTRACTS. 745
Section 13.
The Deciduous First Molars.
These are different from all other human teeth in their lobal
construction. The deciduous upper first molar has only three cusps
divided by three developmental grooves. The buccal marginal
ridge is a high cutting edge broken by a groove into two cusps.
There is but one cusp to the lingual. The lingual surface smoothly
rounded, and much inclined toward the occluding surface. The
buccal surface is also much inclined toward the occluding surface,
is flattened over much of its surface, but has a remarkable ridge
running nearly horizontally near the gingival line. The neck of
the tooth has the characteristic constriction of the deciduous teeth
in a marked degree.
The deciduous lojuer first molar has four lobes but differently
disposed from any of the other four lobed teeth. It has one large
and one small fossa in the occluding surface. The four develop-
mental grooves radiate from the larger fossa, divide the four lobes,
and break the marginal ridges into four cusps. The buccal surface
has a prominent bucco-gingival ridge similar to that of the upper
first. The roots of these teeth are spread widely apart to accom-
modate the bicuspids which are developed between them.
Section 14.
The Pulp Chambers.
The plans laid down in the text for the dissection of the teeth
and the study of the pulp chambers are to be substantially fol-
lowed, and the prints should be made in duplicate, one copy to be
retained by the student and one copy returned to the Post
Graduate Dental Association, Masonic Temple, Chicago, as an
evidence that this part of the work has been properly done.
Students will find that wood blocks one-half inch square and one
inch long on which to fasten dissected teeth with sealing wax for
printing will be better than to rely on the sealing wax alone as
recommended in the text.
As large a number of teeth as possible should be dissected (not
less than three of each denomination) in order that the variations
in size and form of the pulp chambers may be well observed.
• Note that the pulp chambers require for their description the
technical use of certain words and phrases, as coronal portion,
root canal, apical portion, apical foramen, horns of the pulp.
746 THE DEXTAL JREVIEIK
etc., and that these terms are applied and used in a special sense
necessary to this subject.
Pulp Chambers of the Upper Incisors and Cuspids.
The pulp chambers of these teeth have no distinct division into
coronal and canal portion, the one merging imperceptibly into the
other. Three short horns on the extreme coronal portion in young
incisor teeth. Only one usuall}' in cuspid teeth. They gradually
become narrower from the broadest part in the crown to the api-
cal foramen.
In dissecting teeth alwa3's study carefully plans for obtaining
access to the pulp chamber for the removal of the pulp and filling
the root canal, and note the size and form of the apical foramen.
Section 15.
Pulp Chambers of the Lower Incisors and Cuspids.
Three short horns extending from the extreme coronal portion
of the pulp in young incisor teeth. Only one in the cuspids, and
this is apt to be long and slender. In the incisors the canal por-
tion is much flattened, the long diameter being from labial to lin-
gual, or it is divided into two very small canals which in most cases
reunite in a common apical foramen. In the lower cuspid there is
great variation in the size of the pulp chamber and root canal in
different teeth, and occasionally a division of the canal portion.
Note carefully the flattening of canals in teeth with flattened roots.
Section 16.
Pulp Chambers of the Bicuspids.
All of the dissections recommended in the text should be made
of specimens of each of the four bicuspids and the prints should be
made in duplicate.
Note that in the upper first bicuspid there is generally a dis-
tinct bulbous coronal portion of the pulp with horns extending to-
ward the point of each cusp, and that these are often slender and
sharp in young teeth. Note carefully how the root canals leave
the pulp chamber with reference to entering them with a broach
through a cavity in the crown of the tooth. Study carefully the
variations in the form of the pulp chamber in the several bicuspids
and the peculiarities of each ; and note that in the lower bicuspids,
and occasionally in the upper second, the bulbous coronal portion
is usually funnel shaped toward the root canal.
REVIEWS AND ABSTRACTS. 747
Section lY.
Pulp Chambers of the Upper Molars.
Make all the dissections recommended in the text for each of
the three upper molars and print them in duplicate.
In all of the upper molars, except rarely in those with a single
root, the coronal portion of the pulp chamber is very distinct from
the root canals. The horns of the pulp point to the apex of each
of the cusps on the crown. Give particular attention to the molar
triangle, and to the position, size, form and direction of the several
canals as they leave the pulp chamber with reference to entering
them with a broach through cavities in the crown, and follow them
carefully to the apical foramen.
Section 18.
Pulp Chambers of the Lower Molars.
Make all of the dissections recommended in the text of speci-
mens of each of the lower molars and print them in duplicate so as
to return one copy to the Post Graduate Dental Association, Ma-
sonic Temple, Chicago, and retain the others.
The coronal portion of the chamber is very distinct from the
canals. Horns extending crownwise toward the apex of each cusp
on the crown. Note carefully the position, form, size, and direction
of each of the canals, and especially if there is a funnel shape that
will direct a broach into it. Study the position best for the handle
of the broach when directing its point into each canal supposing
the tooth in its normal position in the mouth. Give especial atten-
tion to the forms and operative difficulties presented by the two
canals in the anterior roots of lower molars.
Section 19.
Pulp Chambers of the Deciduous Teeth.
A general review of the pulp chambers of the permanent teeth
and a comparison with them of the pulp chambers of the deciduous
teeth. The deciduous teeth are so difficult to obtain in suitable
condition for this work that it is not expected that every one can
return a full list of prints, but the greatest number possible should
be dissected.
748 THE DEXTAL REVIEW.
Section 20
Arrangement of the Teeth.
(Paragraphs 18V to 192 inclusive.)
The ellyptical form of the arch. The arch of the lower teeth a
little smaller than the upper. The particular manner in which the
cusps and sulci of the upper and lower teeth fit into each other in
occlusion. Arrangement to prevent the crushing of the soft parts
between the teeth. The line of the occlusion from before back-
ward, or the plane of the occlusion. The relative mesio-distal pos-
ition of the teeth in the upper and lower jaws when in occlusion.
The inclinations of the teeth.
In the study of this section as many skulls with good sets of
teeth as possible should be used, but especially all of the points in
the text should be verified by an extended study of good natural
arches in the living subject. Casts of these are excellent for study.
Also, read carefully an article by Dr. I. B. Davenport published in
the Dental Cosmos for July, 1887, the part pages 413 to 433 inclusive.
Section 21.
Interproximate Spaces and Proximate Contact.
(Paragraphs 193, 194, 195.)
In the study of this section, in addition to the text, return to
the tables of measurements and examine carefully the mesio-distal
measurements of the crowns and necks of the teeth, noting their
differences. Make a careful review of the forms of the proximate
surfaces of the teeth with reference to the form of the immediate
proximate contact. Make out from the study of the proximate sur-
faces of the teeth in your collection the form of the contact points
and observe carefully the size and forms of the facets produced by
the wear of the contact points against each other. On this point
study Dr. Black's article in the Dental Review for June, 1892.
Also, read Dr. Davenport's article in the Dental Cosmos for July,
1887, part from page 433 to 439 inclusive.
Section 22.
The Alveolar Processes and Alveoli.
The roots of the teeth lodged in alveoli. Alveolar processes.
The alveolar borders. Thickness of the alveolar walls on the labial
buccal and lingual of the roots of the upper teeth. Buccal alveo-
lar ridge. Anterior palatine foramen. Borders of the alveolar
REVIEWS AN'D ABSTRACTS. 749
process about the teeth of the lower jaw. Effect of the external
oblique ridge. Thickness of the alveolar walls on the lingual sides
of the lower teeth. The milo-hyoid ridge. The thin lingual wall
over the root of the third lower molar and its advantage in the re-
moval of the root of this tooth. Septi of the alveoli. Structure of
the alveolar processes.
Section 23.
The Peridental Membrane.
The peridental membrane invests the roots of the teeth and
lines the alveoli, forming the attachment of the teeth to their
sockets. Continuous with the gums and periosteum over the alve-
olar borders. It is one membrane only. Blood vessels, nerves
and lymphatics. Its white fibers. Conditions in childhood; in old
age. Its blood supply. Its nerve supply.
Section 24.
The Gums.
Character of the tissue of the gums. Firmness of the gums
near the teeth. The characters presented in different parts of the
mouth. Connections with the lips. Fr^enum labium. Fraenum
linguae, etc. The gingivae, or free margin of the gums around the
teeth. The gum septum, etc.
In connection with this section, study Dr. Black's article on the
interproximate spaces in the June number of the Dental Review,
1892, and make extended studies of the forms presented by the
gums in the living subject.
Syllabus of Crown and Bridge Work.*
Medicinal preparations, instruments, tools and materials requi-
site for the study and practice of crown and bridge work.
Medicinal Preparations.
Oil cloves or cassia.
Oil eucalyptus.
Creosote. (Refined.)
Carbolic acid.
Aristol.
10 per cent solution of cocaine.
♦Prepared by Dr. Geo. Evans.
760 THE DENTAL REVIEW.
Surplus of the solution during its application should be instantly
absorbed with absorbent cotton or bibulous paper and patient in-
structed not to swallow saliva. Mixture of one part chloroform, 3
parts of aconite to apply locally to the gum margins to relieve pain.
Chloroform.
Peroxide of hydrogen.
Aromatic sulphuric acid.
Instruments.
Corundum points, disks and wheels.
A set of Brown's are suitable.
Separating files, two or three with small curved points, similar
to what is used to trim the cervical part of a filling.
Pulp canal probes.
Pulp canal broaches.
Pulp canal filling instruments:
Three Gates-Glidden drills, small, medium, and large, for
direct use.
Three each of the same for right angle attachment.
Hot air syringe.
Root canal dryer.
Clamp instrument to hold sponge to moisten corundum wheels
and protect the tongue and cheek when grinding in the mouth.
Excising forceps.
Excavators, hatchets, hoes, and spoon shaped, rights and lefts.
Syringe.
Dunn's abscess syringe.
Mouth mirror, small and large.
An Abbott foot shaped condenser.
Spear shaped drills.
Spatula.
Burnishers. Burs, round and fissure.
Tools.
Large Tweezers.
Small Tweezers.
Ordinary Straight Pliers.
Narrow-pointed Pliers for bending gold collars.
Riveting Hammer.
Punch Forceps.
Plate Files, flat and half round.
REVIEWS AND ABSTRACTS. 751
Hand-Vise.
Small Anvil.
Set of Crown Dies or Plates to stamp occluding surfaces.
Two Wire Clamps, one straight pointed, the other ring-shaped
at the points, for use in soldering.
Bunsen Burner.
A Lee or Mellote's Gas Blow-pipe.
Mouth Blow-pipe.
Shears.
Charcoal to solder on.
Alcohol Lamp (jeweler's size.)
Knife.
Small Ladle.
Impression Cups. (Full and partial sizes).
Materials.
German silver plate and wire.
Some porcelain plate teeth — cross pins.
Old fashioned pivot teeth.
Waxed floss silk.
Absorbent cotton.
Square glass bottle on which to mix cement.
Gutta-percha.
Gutta-percha points for filling root canals.
Wax cement (one part wax, two parts rosin).
Sulphate of potassium.
Carmine for coloring plaster impressions.
Sheet copper No. 35 U. S. gauge.
Copper wire No. 28 gauge.
Fusible metal and mouldine, pulverized soap stone.
Olive oil.
Vaseline.
Sandarac varnish.
Calcined marble dust.
Common sand.
Impression compound, wax.
Pure gold plate, No. 30 gauge.
Gold and platina crown metal. No. 32 gauge.
Thin platina plate.
Thin platina foil.
758 THE DEXTAL REVIEW.
Platinum wire, No. 16 gauge.
Silver wire for posts, 15 gauge.
20 carat gold solder.
18 carat gold solder.
14 carat gold solder.
Parr's flux.
Fluxed gold solder filings.
Corundum tape, corundum disks and carrier.
Pulverized pumice and whiting.
Moos(2 hide points and mandrils to carry same.
For a thorough and systematic study of Crown and Bridge
Work over a period of twenty-four months, the subject is divided
in sections as follows :
Section 1.
Preliminary study of forms of teeth and position of root canals.
Reaming of root canals, and filling of them with gutta-percha.
For the purpose insert natural teeth in position in plaster
models of the mouth and mount the models on a Bonwill articula-
tor. Fasten the articulator so it will not open more than the
mouth would, and work on it in a line or position similar to that in
which the mouth would be. Open up the pulp cavities from all
possible positions, and ream out the canals of teeth thus mounted.
Likewise perform shaping of natural crowns and roots for inser-
tion of artificial crowns. In actual practice knowledge and skill in
these operations are of vital importance, as on them depend the
practical value of all others.
Section 2.
Shaping of natural crowns and roots for crown work.
Insert posts and otherwise prepare and restore roots and natural
crowns for artificial crowns. Draw outline of cervix of any tooth
and bend narrow strips of metal to represent collars, to the shapes
of different cervices from memory, then compare them to the rec-
ognized forms.
Section 3.
Study and practice the insertion of porcelain crowns. A few
old style pivot teeth will answer the purpose. Crowns similar to
the Logan or Brown can be made by first cementing a post of wire
in the porcelain crown with oxyphosphate cement. By first cement-
ing a post in a root a crown can be used in a manner similar to the
REVIEWS AND ABSTRACTS. 753
Bonwill, Perry or How crowns. Attach the crowns with gutta-
percha amalgam or oxyphosphate cement.
Make dies of forms of teeth and models of the mouth as des-
cribed in " Evans' Crown and Bridge Work," using copper tubes
and impression cups.
Section 4.
Practice the construction of gold crowns with porcelain fronts
without a collar.
Section 5.
Make, shape and fit collars for all the different teeth.
Section 6.
Make all metal crowns for bicuspids and molars.
Section 7,
Make collar crowns with porcelain front for incisors and
cuspids.
Section 8.
Make collar crowns with porcelain front for bicuspids in the
different methods described in "Evans' Crown and Bridge Work."
Section 9.
Make shell crowns or anchorages for bridge work. Make all-
metal crowns for long and short or abraided incisors and cuspids.
Section 10.
Study and consider the principles involved in the construction
of bridge work ; the abutments used. Make an extension bridge
consisting of a central collar, crown and a lateral bridge tooth or
dummy with spur resting on cuspid.
Section 11.
Make a bridge consisting of a shell crown for second bicuspid,
with pin in sulcus of occluding surface and dummy or bridge tooth
for first bicuspid.
Section 12.
Make a gold crown for molar, shell crown for cuspid, and
bridge between them consisting of two dummy bicuspids.
754 THE DENTAL KEITEW.
Section 13.
Make bridge between lower first bicuspid and second molar;;
place all metal crowns on the abutments.
Section 14.
The same as last described with a cap and pin attachment on
top or occluding portion of bicuspid. The bicuspid is supposed to^
lean in a posterior direction toward the molar.
Section 15.
Make a bridge of four lower incisors between two shell crowns
on cuspids.
Section 16.
Make a bridge in which an artificial inferior right central and left
lateral are sustained by shell crowns on right lateral and left cus-
pid, with a connecting bar spanning the intervening tooth present.
Section 17.
Make a bridge as follows : Cap with metal first right bicuspid,
make collar crown for right central and left cuspid, and bridge with
dummies the vacant spaces between the crowns.
Section 18.
Make an extension bridge of one or two teeth.
The construction of bridge work described for the preceding
months should be conducted the same as in practical cases. Re-
move the crowns in position from the models as though the models
were the mouth. Varnish the models and smear with a little vase-
line to permit easy removal of plaster. Unless this work is pro-
ceeded with in this manner, many obstacles met with in the con-
struction of bridge work will not be encountered and an amount of
experience of great practical value to the student be missed. The
bridge when finished must fit the model correctly; if not, the
bridge must be altered to do so, and not the model made to fit the
bridge. Inaccuracies and mistakes the student is thus obliged to
correct.
In cementing with oxyphosphate cement compare the differ-
ence between mixing the cement on a glass slab at 70° F., and on
a flat sided bottle filled with ice water at from 35° to 40° F.
REVIEWS AND ABSTRACTS. 755
Section 19.
Make detachable bridge to fit between molar and bicuspid that
tip toward each other, according to method described as the
"Parr," in "Evans' Crown and Bridgework."
Section 20.
Removable Bridge Work.
Make removable partial cap for metallic crown on molar (see
Evans' Crown and Bridge Work, 3d edition), clasp and cap at-
tachment for cuspid and bicuspid.
Section 21.
Make removable crown with porcelain front for a cuspid with a
tube and spring post in root.
Section 22,
Make removable bridge between lower second molar and first
bicuspid.
Section 23.
Make removable plate bridge between second molar and cus-
pid.
Practice making flat connecting bars for use between attach-
ments or sections of a removable bridge.
Section 24.
Make bar bridge, one end to an anchor in occluding surface of
first molar and other end in cuspid, the anchorage material to be
gold foil or its equivalent.
Make a gold tip to restore the broken end of an abraded cen-
tral incisor also a lower central or lateral.
German silver plate and wire and ordinary silver solder are suit-
able and economical metals for use by students in the study of the
construction of crown and bridge work.
Platinum foil will need to be used to a limited extent to form
the caps to collars and backings to porcelain fronts.
Owing to the superior flowing qualities of gold solder when
melted, in comparison with silver, twelve or fourteen carat gold sol-
der should be used in small fine solderings.
•m
THE DENTAL REVIEW.
DENTAL COLLEGE COMMENCEMENT.
LOUISVILLE COLLEGE OF DENTISTRY.
The commencement exercises of the Louisville College of Dentistry, dental
department of the Central University of Kentucky, were held at Macauley's
theater, June 21, 1892. The degree of Doctor of Dental Surgery was conferred
on the following named (33) candidates :
Harry B. Bartlett, Kentucky.
Charles H. Barton, Massachusetts.
Z. Bell, Mississippi.
C. Forest Bogges, Kentucky.
Louis C. Chatham, New York.
Israel Cook, California.
Andrew Crossley, Texas.
Marion Hargis Dailey, Kentucky.
W. P. Hill, Tennessee.
Jas. T. Hull, Missouri.
Alfred T. Hyde, California.
John W. Juett, Kentucky.
Joseph J. Kennedy, Missouri.
William B Kidd, Kentucky.
E. G. McMackin, Illinois.
T. Ellwood Morgan, Missouri.
Charles E. Nary, Kansas.
Emmet Peyton, Illinois.
Eduard Pfander, Switzerland.
George W. Pringle, New York.
William J. Reynolds, Alabama.
E. C. Robinson, Ohio.
Thomas O. Sherman, Illinois.
J. Fred Sigler. Kentucky.
J. Avery Spaulding, New York.
S. L. Strickland California.
Albert L. Stringer, Illinois.
Warren Xerxes Taylor, Wisconsin.
Alansan S. Thomas, New York.
V. W. S. Trippett, Indiana.
Clement Victor Vignes, Louisiana.
Robert Houston Walker, Kentucky.
E. T. Zewicki, Missouri.
MEMORANDA.
Dr. L. ]. Mitchell, of London, Eng., has been visiting in Chicago recently.
Dr. B. J. Bonnell, of London, is in New York for a short visit to old friends.
Nineteen students passed their first examination at the " ^cole dentaire de
Paris" last month.
Drs. P. V. Guerry and S. E. Gilbert, of Philadelphia, spent a few days in
Chicago last month.
If your town is big enough to hold three or four dentists why do you not in-
crease their usefulness by establishing a reading circle, and study?
The summer vacationists have all returned and the treadmill is again buzz-
ing around as usual. Most of them will have something for the Congress next
year.
M. G. Blocman has been named an officer of the Academy in France.
This is the second time within a year that one of our confreres has been so
honored.
Dr J. A. Kimball, a dentist of New York, committed suicide August 16,
-while suffering from melancholia. He had recently issued a dental journal called
The Dentist Himself.
Dr. L. C. Bryan, of Basel, Switzerland, President of the American Dental
Society of Europe, paid us a visit with his wife in August. Dr. Bryan is now in
the far west and will return to Basel about November 1.
MEMORANDA. 757
NEW DENTAL COLLEGES.
One new in Cleveland, Ohio; one in Detroit, Mich.; one in Columbus, Ohio;
one in Buffalo, N. Y. , and one in Bridgeport, Ala. Next !
The dental department of the University of Denver, which has been errone-
ously reported as having been discontinued, has recently been reorganized, the
faculty having been added to, and the prospects for the future are said to be
flattering.
Geo. Northcroft, D. D. S., Michigan, class of '90, is now a student in the
dental hospital of London. He took the Saunders prize this year for being the
best all round man in his studies in the dental school as above. His preceptor in
England was W. Mitchell, D. D. S., (Mich.) 1878.
From the report of the Department of Health of the city of Chicago for 1891,
we see that eighty-one deaths out of a total of 27,754 were due to dentition. The
same authority places the number of dental supply houses in Chicago at eleven,
employing forty males and twenty females, and the number of dental establish-
ments last year was 470, giving employment to 62.") males and seventy-five females.
Tne Rev. Sam Small last November got into a broil and had one of his teeth
knocked out. He sued his assailant and assessed his damage at $5,000. As Sam
has thirty-two teeth he thus estimates their value at $160,000. The jury thought
that pretty high and took off one cipher and gave him $500, thus making the ag-
gregate for Sam's teeth $16,000. This is liberal, as a full upper and lower set can
be had in any market for $20.
Dr. Lauder Brunton, in the course of a recent lecture on " Mastication," at
St. Bartholomew's Hospital, made use of the following remarks : "I think it was
a magnificent stroke of genius on the part of the President of the Royal College
of Physicians, Sir Andrew Clark, when he informed Mr. Gladstone that he had
one mouth and thirty-two teeth, and that for every mouthful of food he took every
tooth should have a chance, so that he should take thirty-two bites to every
mouthful. And," continued Dr. Brunton, "if the patient has lost some of his
teeth he should allow two bites for every missing tooth, and even that will not
always do if many teeth have gone." — Exchange.
At the Eighteenth Annual Meeting of the American Dental Society of Europe,
held in Basel, August 1-3, the following officers were elected for the ensusing
term: President, Dr. L. C. Bryan, Basel; Vice President, Dr. J. H. Spaulding,
Paris; Treasurer, Dr. Chas. J. Monk, Wiesbaden; Secretary, Dr. Chas. W. Jen-
kins, Ziirich; Executive Committee, Dr. Bryan, of Basel, Dr. H. Dane Hurlburt,
of Geneva; Dr. J. F. Patterson, Montreux; Membership and Ethics Committee,
Drs. Spaulding, Weitzel, and Davenport, of Paris.
The next meeting will be held at Geneva, in 1894; the meeting next year be-
ing omitted, as many of the members expect to attend the congress at Chicago.
Zurich. Chas. W. Jenkins, Sec'y.
CALIFORNIA STATE DENTAL ASSOCIATION.
The Twenty-second Annual Meeting of the California State Dental Associa-
tion was held in San Francisco, July 19th, 20th, 21st and 22d. On account of the
758 THE DEXTAL REVIEW.
" Columbian" congress in 1893, the next annual meeting will be advanced to the
second Tuesday in June.
The Board of Trustees is composed of the following officers; President, W.
Z. King, First Vice President, L. A. Teague; Second Vice President, I. W. Hays;
Third Vice President, J. P. Parker; Corresponding Secretary, Chas. E. Post, 30"2
Stockton Street, San Francisco, and Recording Secretary, L. Van Orden, 14
Grant Avenue.
CORRIGENDA.
Summer vacations are seldom well borne by ye proof-reader. It is then that
he turns himself loose as it were and makes// of piety, and other things too nu-
merous too mention. On page 67(i it says he did his level best : Z' Odontologie
should read D' OJoiilo/ot^ie, Blocman for Blacmon, Chauvin, Prevel, Ronnet.
Lecoudrey should be Lecaudey. Copot is Papot, and last but not least, on page
658, the intelligent reader readily would read leptothrix buccalis for lipidodes lo-
colis. We sometimes grow weary at repetitions of stale jokes, but never will our
digestion be good until a satisfactory terra cotta monument is placed over the
mortal remains of some member of the proof-reading brotherhood. Peace to
their ashes.
FLEXIBLE RUBBER PLATES.
To THE Editor of the Dental Review :
Herewith I give you the result of a little experiment in thin, flexible rubber
plates. — Wax up the case in the usual manner. After trying in the mouth to see
that it is correct, fasten the outer rim solidly to the cast with wax, then cut out
the wax from palatal portion and burnish tea lead in its place ; letting it come up
well around the teeth. Flask as usual and after washing out the wax and remov-
ing the lead apply dry heat to the case to dry the surfaces, then paint with liquid
silex; the heat of the case will soon dry the silex. Make a good large gate at heel
for surplus rubber and pack the same as for thick plate, using black rubber for
palatal portion. Care must be exercised in cutting away surplus, not to split the
thin rubber. The polishing can be done with brush and cotton wheels. No
scraping or sandpapering necessary. This makes a much pleasanter plate to
wear in the mouth and gives better satisfaction to the wearer.
Yours truly,
Butte, Montana. W. G. Stowell, D. D. S.
standing resolution passed JUNE 13, 1892, BY the odontographic .society of
CHICAGO.
Whereas : We have among our members those who are connected with den-
tal colleees, which are continually violating the code of ethics of the American
Dental Association, and,
Whereas : This practice has a deleterious effect upon the students of said
colleges by teaching adherence to a code of ethics, while practicing the opposite,
therefore, be it
Resolved: That members of the Odontographic Society who are in any way
connected with dental colleges who shall violate the code of ethics of the society
shall be held equally responsible, as they would be if said violations occurred in
their private practice. Be it further
MEMORANDA. 759
Resolved: That any matter other than the name, address; office hours and
telephone number, that shall be authorized by a member of the society to be
placed in a public print of any kind shall be considered as a violation of our code
of ethics and subject said member to the penalty provided for such violation.
NORTH DAKOTA STATE DENTAL SOCIETY.
The North Dakota State Dental Society held its Tenth Annual Meeting in
Grand Forks, August 17th and 18th. There was a good attendance and an addi-
tion of six new members.
Dr. T. E. Weeks, of Minneapolis, was present and gave an interesting clinic
on contour gold fillings, restoring interproximal space, and also a lecture on forms
and structure of teeth illustrated by stereopticon views.
Dr. A. T. Bigelow, of St. Paul, who was the first dentist to locate in North
Dakota, read a paper entitled: " Pioneer Dentistry in North Dakota," which was
listened to with interest because of its historical data and the amusing situations
in which the Doctor sometimes found himself.
Dr. Louis Ottofy also contributed to the historical part of the proceedings, as
well as giving a paper on " Post Graduate Study," which met with much favor
among those present.
The meetmg gave promise for better things and a greater interest in the Soci-
ety for the future.
Dr. H. L. Starling, of Fargo, is President, and Dr. R. B. Foster, of Grand
Forks, Secretary for the ensuing year.
MOUTH BREATHING CHlL-DREN.
The dangers to children accustomed to breathing through the mouth instead
of the nose have been quite seriously treated of late, in papers on the subject by
physicians in Germany, France, England, etc., the principal disturbance accom-
panying the habit being described as inability to fix the attention on any more or
less serious subject, and with this impairment of the attention goes feebleness of
memory and tendency to headache, while in some cases the organs of sight and
hearing are successively affected, conjunctivitis and hardness of hearing being the
results. In Germany, some time since. Dr. Max Bresgen placed before the Min-
ister of Public Instruction a request that a regular medical supervision should
take place in schools, especially with regard to the state of the upper respiratory
organs of the school children. In France also Dr. Raulin has published the same
views, laying great stress on the necessity of regular medical inspection not only
of the schools, but also of the school children, especially with respect to the
state of their nasal respiration. Dr. Guye, of London, also declares that so long
as medical school inspectors are wanting, teachers should be impressed with the
importance of giving attention to the question of mouth-breathing, especially in
children intellectually backward.
MISSOURI STATE DENTAL ASSOCIATION.
The Twenty-seventh Annual Meeting of the Missouri State Dental Associa-
tion was held at Clinton, Mo., July 5th to 8th inclusive. There were twenty-six
new members admitted and eleven papers read.
The following is the list of officers and committees elected for the ensuing
year : President, J D. Patterson, Kansas City; First Vice President, VV. E.
700 THE DENTAL KEt^IElK
Tucker, Springfield; Second Vice President, DeCoursey Lindsley, St. Louis; Cor-
responding Secretary, Wm. Conrad, St. Louis; Recording Secretary, H. A. Ru-
bey, Clinton; Treasurer, Jas. A. Price, Weston. Executive Committee: C. B.
Hewitt, Kansas City; A. J. McDonald, Kansas City; J. E. Crozier, Lees Summit.
Board of Censors: E. E. Shattuck, Kansas City; H. A. Cress, Warrensburg; E.
B. Crane, California. Committee on Ethics: Frank Slater. Rich Hill; J. B.
Newby, St, Louis; C. L. Hungerford, Kansas City. Law: Jas. A. Price, Wes-
ton. Committee on Publication: J. E. Crozier, Lees Summit; T. J. Prey, Moberly;
C. L. Hickman, St. Louis. Committee on New Appliances; C. L. Hungerford,
Kansas City. Supervisor of Clinics: C. H, Darby, St. Joe.
The next meeting will be held at Excelsior Springs, Mo., on the first Tuesday
after July 4, lS9:i. William Conrad,
St. Louis, Mo, Corresponding Secretary.
JAPANESE DENTISTRY,
In Japan the dentist extracts every tooth, be it upper or lower, incisor or mo-
lar, without the use of an instrument, his fingers having been trained to take the
part of the forceps. And, although it may seem incredible, it is nevertheless a
fact that the Japanese dentist is more proficient in his art than his European
brethren, and here is the way that he arrives at his proficiency :
In a board of soft wood holes are drilled, and in the holes pegs are inserted
loosely.
The board is laid on the floor, and the apprentice tries to pull out every peg
perpendicularly without in the least disturbing the position of the board, using
the thumb and forefinger of his right hand. Able to do this, the pegs are inserted
tighter, the thumb and forefinger gaining strength and dexterity in manipulation
as he keeps on practicing.
Having perfected himself at the pine board, an oak board is substituted, the
oak pegs being driven in tightly. There he practices for weeks and months, till,
finally, the oak pegs succumb to the skill and power of his fingers.
The third and last term comprises the extracting of maple pegs, very tightly
fastened into a maple block. Passing the required examination at this block, he
is graduated and sent forth to try and pull "human pegs."
There we see him take a position similar to one we would assume, hold the
jaw and keep the mouth open with his left hand, while with the two fingers of his
right he passes into the mouth and extracts, if necessary, five to seven teeth in a
minute.
ESSENTIAL-OIL VAPORS AS BACTERICIDES.
The bactericide action of the essential oils has been well established by a
number of experimentalists. Recently, however, M. Omeltschenko has made
experiments which not only confirm the views held previously, but establish also
the quantity of vapors necessary per litre of air. He arrived at this fact by using
specially contrived culture-flasks, and passing through them air impregnated with
the vapors to be studied. Among the results obtained he gives the following :
The bacillus of typhus is killed by air saturated with oil of cinnamon or oil of
of valerian, in 4.") minutes; 0.0005 gramme of the- first oil per litre of air was
necessary, while 0.0O8'J gramme was necessary of the second. The bacillus of
tuberculosis is killed by the vapors of cinnamon in 23 hours, the air contain-
MEMORANDA. 761
ing 0.018 per litre. It is killed by oil of lavender in 12 hours, 0.0078 gramme
per litre being the amount necessary. The oil of eucalyptus destroys this
germ also in 12 hours, but the degree of saturation must be 0.0252 gramme
per litre. Among his conclusions we find that the vapors of oil contain a con-
siderable degree of activity as disinfectants when the air saturated with them
is constantly renewed. When the degree of saturation diminishes, the vapors
destroy the germs at the beginning, but after that they only prevent their
growth. Regarding their germicidal properties, he classifies the oils according
to their strength, as follows ; The oil of cinnamon, the oil of fennel, oil of
lavender, oil of cloves, oil of thyme, oil of mint, oil of anise, oil of eucalyptus,
oil of turpentine, oil of lemon, oil of rose. The two last named, lemon and
rose, are very slight disinfectants. — Bacter. World.
POST GRADUATE STUDY.
It is wonderful what a store of valuable knowledge one can gain in a year by
employing, say, one hour a day in systematic and selected reading. Picking up
what comes handy and reading at random may be pastime and no doubt with a
retentive mind one may gain some knowledge. So one may climb a mountain
without guide or direction and come out on top ; but no doubt with a guide know-
ing the best routes and how to cover them without wandering, one may gain the
top much more safely and surely and in better condition " to view the landscape
o'er " appreciatively. There is the same difference in progress in system and
lack of system in reading as in anything else. A dentist or any busy man reading
and searching for that which will benefit him most wants the chaff separated from
the wheat as much as possible. If you read for a purpose you must read to the
point. The importance of this thing is being recognized all over the land and
the needs of the people, the busy man of affairs, etc., in getting knowledge and
education which for some cause was neglected in earlier life, is being appreciated
by many large educational institutions throughout the country, and the wants of
such people supplied by what is known as university extension, a system of
educating people and conveying desired knowledge to them at their homes. The
Post Graduate Dental Association assumes to take up such work among dentists
and extend a course of readings which as rapidly as can be will be arranged to
suit all classes of practitioners from highest to lowest. Opening a way also for
those who begin at the lowest to reach the highest classes. The effort of the as-
sociation in this direction is certainly a commendable one and should become
popular and successful. To be successful it should have the support of the pro-
fession at large, and it is certainly deserving for undertaking a work so entirely a
labor of love and aiming only to elevate and advance the dentist in practice.
PRELIMINARY ADDRESS OF THE COMMITTEE ON A DENTAL CONGRESS.
It is the aim of the World's Columbian Exposition to gather together the evi-
dences of the material progress and achievement of the civilization of the world,
and so arrange them that every department of human endeavor may be studied
and examined through all its various grades of development.
It is also their desire to represent the intellectual and scientific development
and achievement of the entire civilized world by a series of great Congresses, to
be held during the progress of the Exposition.
In pursuance of this object the World's Congress Auxiliary was organized by
762 THE DEXTAL REVIEW.
the World's Columbian Exposition, and it has received the recognition and sup-
port of the government of the United States.
It is the plan of the World's Congress Auxiliary to bring into communication,
through these Congresses, the best thinkers and workers in every department of
knowledge, including Religion, Science, Philosophy, Literature, Art, Agriculture,
Trade and Labor, etc., and by the presentation and interchange of ideas, methods,
theories and practical experiences to promote the advancement of all that is
noblest and best of our present civilization.
Committees have therefore been appointed to organize a series of Congresses,
representing nearly every field of thought, and of speculative and practical
endeavor.
In the field of professional achievement, Medicine and Surgery, in their
various special applications, will form a very large and interesting feature of the
■work of the World's Congress Auxiliary.
Dentistry is an important department of Medical Science, and an outgrowth
of our modern civilization. Its present perfection is in cofisiderable degree due
to the thought and labor of American minds.
The history of modern dentistry is covered by a period of less than two
generations, and yet it has advanced from the rude operations practiced by the
blacksmiths and barbers, to one of the most scientific and exact of the specialties
of the healing art.
Scientific Dentistry had its birth in the United States of America. This
country has the proud distinction of having organized the first school for the
teaching of dental science, and the establishment of the first periodical journal
devoted to the interests of dentistry, while very many of the most useful ap-
pliances and scientific methods have originated on this side of the Atlantic.
It is therefore eminently fitting that Dentistry be represented at the World's
Columbian Exposition by a display of the progress which has been made in the
development of its materials, instruments, appliances, processes and methods of a
practical nature, and in scientific research, literature and professional education.
With this end in view the dentists of the United States took steps in August,
1890, to organize such a World's Congress, by the appointment of a General
Executive Committee, to whom the whole matter of organizing and conducting
the Congress was referred.
The work therefore of the Committee on Dental Congresses appointed by the
World's Congress Auxiliary will be chiefly in cooperation with that General Ex-
ecutive Committee, in publishing to the world from time to time the progress of
the work of organization in promoting the interests of the Congress in every
way within their power, and keeping it in harmony with the general plans
of the World's Congress Auxiliary.
Every effort will be made to secure the best talent in the presentation of
■scientific subjects, and in practical demonstrations.
The World's Columbian Exposition, through its Directory, will provide
ample accommodations for all the various World's Congresses to be held in Chi-
cago in 1893. The Memorial Art Palace now in process of erection upon the
shore of Lake Michigan, and located near the center of the city, will be de-
voted to this purpose. This building will contain two large audience rooms, with
a seating capacity of about three thousand each, which will be used for the gen-
jeal Congresses of the various departments, besides numerous smaller rooms,
MEMORANDA.
r63
suitable for the Chapters and Sections of the Congresses, thus affording for the
Dental Congress ample accommodations for clinical demonstrations of a suitable
nature.
During the sessions of the Dental Congress several popular evening meetings
will be held, to which the general public will be invited. At these meetings, which
are intended to be educational, illustrated lectures will be delivered by some of the
most eminent men of the profession upon topics which are deemed to be of vital
importance to the public. These meetings will be especially under the control
and management of the World's Congress Auxiliary. When the suggestions of the
Advisory Counselors of the Dental Congress shall have been received as to the
most interesting and vital questions to be presented, a programme will be arranged
for publication.
A cordial invitation is extended to the dentists of the world to take part in the
scientific work of the congress by the presentation of papers and discussions or
demonstrations of new or improved methods and appliances.
America, and Chicago in particular, will have a hearty welcome for all who
may come.
An earnest effort was made to bring the meeting of this congress in close
connection with others of the Department of Medicine, but that effort having
proved unavailing, arrangements have been effected under which the meeting of
the dental profession will be held on or near August 17, and is expected to con-
tinue during the week or ten days following. Definite dates and details will be
given in the programme.
Communications in reference to the special work of the congress should be
addressed to Dr. A. O. Hunt, Secretary of the Executive Committee World's
Columbian Dental Congress, Iowa City, Iowa, U. S. A.
Communications in reference to the general work of the World's Congress
Auxiliary and suggestions from the Advisory Counselors may be addressed to the
•chairman of the committee.
Dr. John S. Marshall,
Chairman,
34 Washington St., Chicago,
Dr. a. W. Harlan,
Vice-Chairman,
Dr. G. V. Black,
Dr. N. Nelson,
Dr. E. S. Talbot,
Dr. C. N. Johnson,
Dr. a. E. Baldwin,
Dr. George A.Christmann,
Dr. George H. Gushing,
Dr. a. W. Freeman,
Dr. Hattie E. Lawrence,
Chairman,
Dr. Marie T. Bacon,
Vice-Chairman,
Committee of the
World's Congress
Auxiliary on a
Dental Compress.
Dr. Emma Benham,
Dr. Louise Peterson,
Dr. Rebecca H. McIntosh,
"World's Congress Headquarters, Chicago, June, 1892
The Woman's Com-
mi 1 1 e e of the
World's Congress
Auxiliary on a
Dental Congress.
764
THE DENTAL REVIEW.
PARTIAL LIST OF THE ADVISORY COUNCIL OF THE WORLD S CONGRESS AUXILIARY
ON A DENTAL CONGRESS.
Dr. W D. Miller, Berlin, Germany.
Dr. F. Busch, Berlin, Germany.
Dr. Thos. W. Evans, Paris, France.
Dr. E. Magitot, Paris, France.
Dr. G. W. Sparrock, Lima, Peru.
Mr. \V. B. Macleod, Edinburgh.
Dr. A. W. W. Baker. Dublin.
Dr. Ernst Sjoberg, Stockholm, Sweden.
Mr. Chas. S. Tomes, London, England.
Mr. W. H. Coffin, London, England.
Dr.W. Geo. Beers, Montreal, Canada.
Dr. H. C. Edwards, Madrid, Spain.
Dr. E. Lecaudey, Paris, France.
Dr. M. Plattschick, Pavia, Italy.
Dr. Joseph Arkovy, Buda Pesth, Hun-
gary.
Dr. C Kedard, Gene%'a, Switzerland.
Dr. J. G. Van Marter. Rome, Italy.
Dr. W. H. Morgan, Nashville, Tenn.
Dr. W. H. Dwinelle, New York City.
Dr. R. B. Winder, Baltimore, Md,
Dr. Elisha G. Tucker, Boston, Mass.
Dr.W.W. H.Thackston, Farmville, Va.
Dr. J. B. Rich, Washington, D. C.
Dr. W. H. Fames, St. Louis, Mo.
Dr. J. B Patrick, Charleston, S. C.
Dr. C. N. Peirce, Philadelphia, Pa.
Dr. F. J. S. Gorgas, Baltimore, Md.
Dr. G. V. Black, Jacksonville, 111.
Dr. R. Finley Hunt, Washington, D. C.
Dr. E. Bacon, Portland, Me.
Dr. Benjamin Lord, New York City.
Dr. A. L. Northrop, New York City.
Dr. W. W. Allport, Chicago, 111.
Dr. Geo. H. Cushing, Chicago, 111.
Dr. W. W. Walker, New York City.
Dr. L. D. Carpenter, Atlanta, Ga.
Dr. J. Y. Crawford, Nashville, Tenn.
Dr. W. J. Barton, Paris, Texas.
Dr. J. Taft, Cincinnati, Ohio.
Dr. C. S. Stockton, Newark, N. J.
Dr. L. D. Shepard, Boston, Mass.
Dr. H. J. McKellops, St. Louis, Mo.
Dr. A. O. Hunt, Iowa City, Iowa.
Dr. H. B. Noble, Washington, D. C.
Dr. Geo. W. McElhaney, Columbus, Ga.
Dr. J. C Storey, Dallas, Tex.
Dr. M. W. Foster, Baltimore, Md.
Dr. A. W. Harlan, Chicago, 111.
Dr. J. S. Marshall, Chicago, 111.
PARTIAL LIST OF THE WOMAN'S ADVISORY COUNCIL ON A DENTAL CONGRESS.
Dr. Lucy Hobbs Taylor, Lawrence, Dr
Kas.
Dr. Olga Neymann, New York City Dr
Dr. Jessie M. Ritchey, Des Moines, la.
Dr. Jennie Hilton, Freeport, 111. Dr.
Dr. Clara W. McNaughton, Washing- Dr.
ton, D. C.
Dr. Kate C. Moody, Mendota, 111. Dr.
Dr. Martha J. Robinson, Cleveland,
Ohio. Dr.
Dr. Annie F. Reynolds, Boston, Mass. Dr.
Dr. Marie Hoist, Aarhuus, Denmark. Dr.
Henrietta Tiburtius-Hirschfeld, Ber-
lin, Germany.
Helene Wongl v Swiderska, St.
Petersburg, Russia.
Bella Meller, Vienna, Austria.
Helene Freudenheim, Konigsberg
Germany.
Marie M. Schneegans, Elberfeld,
Germany.
Emma Lacey, London, England.
Clotilde Lenta, Rome, Italy.
Mary T.Benfield, Honolulu, Hawaii.
THE
DENTAL REVIEW.
Vol. VI. CHICAGO, OCTOBER 15, 1893. No. 10
ORIGINAL COMMUNICATIONS.
Combining Amalgam and Gold.
By E. A. RoYCE, D. D. S., Chicago, 111.
Our subject this evening, the combination of gold and amal-
gam, requires consideration of the qualities of each of the metals
separately. For all ordinary cavities in teeth of good or even
medium structure, gold has proven itself to be the best and most
perfect filling material.
When a cavity has been properly prepared in a tooth of good
structure, and the gold is well condensed, we expect the form of
the filling will not change, and as long as the walls remain firm
the gold will retain its position and preserve the tooth, if a good
joint is made between the gold and enamel. It is the tooth that
disintegrates, if the joint becomes imperfect.
The color of gold is somewhat objectionable in the mouth, but
is far superior to amalgam, as it usually retains its bright yellow,
and even if it does grow dark it does not stain the tooth. But one
of the best qualities of gold is its cohesiveness, which enables us
to add one piece to another in such a manner as to restore the
tooth which has broken down to its original shape, and the place
where this is most useful is in the proximate cavities of bicuspids
and molars.
Those of us who attended the Illinois State Society and heard
Doctor Black's paper on " Interproximate Spaces" will remember
what great importance he attached to these spaces. This is a sub-
ject which is of great importance and has been very much neglected
by the profession. A tooth may be plugged or stopped when the
proximal face is left flat, but not filled in the proper sense of the
706 THE DEXTAL REVIEW.
word, many operations coming from the hands of those who stand
high in the profession, show that there is almost a total disregard
of this and the shape of the teeth in some cases would remind one
of saw teeth. Teeth with V shaped spaces between them are al-
most useless for purposes of mastication. The food wedging
up against the gum is a source of great irritation, not only to the
gum but to the peridental membrane and periosteum as well, caus-
ing absorption of process and gum, and frequently loss of teeth.
Gold is the only material now at our command with which we can
make a positive contour filling, as it is also the only material with
which these spaces can be perfectly preserved. But gold acts
simply as a stopping, as it has no medicinal effect upon the tooth,
and if the stopping is not perfect, or the tooth is of poor structure,
the gold acts as an assistant to the destroyer of tooth substance.
Some time ago Dr. Whitefield demonstrated before this society
that there is an electric current between different metals when used
as fillings.
Dr. Bridgman is quoted as saying that ''any plug in a proximal
cavity, as in the external basal area of the molars, will have the
cervical edge continually wet, while the upper part may be com-
paratively dry. And therefore it will assume the polarized con-
dition."
Now it is true that an electric current generated in this way
may not be very strong, and would not in itself disintegrate a tooth.
Neither can bacteria batter down the walls of a tooth ; but Dr.
Miller has demonstrated beyond a reasonable doubt that acids which
are formed by chemical action caused by bacteria will deprive a
tooth of its lime salts. So it has also been very clearly proven
that electrolysis breaks up some of the chemical compounds of the
fluids of the mouth, the elements finding their way, each to its
respective pole of the battery, where uniting with their affinities
they form new chemical compounds, some of which are acids of
sufficient strength to act upon tooth substance. Defective ma-
nipulation and defective tooth structure allowing moist dentine to
act as the corroded or inferior metal of the battery accelerates the
disintegration. While dry tooth substance that is thoroughly im-
pregnated with lime salts is a poor conductor of electricity and
will resist the action of the acids, thus tending to limit the galvanic
action. As the only saving quality of gold is keeping moisture and
other extraneous matter out of the cavity, and it has many
ORIGINAL COMMUNICATIONS. 767
agencies working against it, causing repeated failures of fillings
from the hands of the best operators, and so many more from the
hands of others, is it any wonder that we look to some other mate-
rial for the preservation of teeth of poor grade ?
Amalgam is used very largely for fillings and is saving many
teeth, but at what an expense of efficiency and beauty.
It is a very difficult operation to fill teeth with amalgam. I
know this is not the accepted idea, and in many cavities it is a
mere matter of drill a hole and putty it up, but take the proximal
cavities of bicuspids and molars and fill them so as to restore the
contour, fill them so as to preserve the interdental space and mor-
sal surfaces, build up cusps that are gone, leave no flat surfaces,
but round out good points of contact, restore the tooth and keep it
restored until the filling is hard, and you will prove that you pos-
sess more skill than is shown in one amalgam filling in one hundred
that is inserted in the mouth.
The spheroidal tendency of amalgam destroys the usefulness of
some of the most carefully inserted fillings, great crevices are found
between tooth wall and the metal that in many cases cause failure,
and in others are saved only by the deposit of insoluble salts
around the amalgam. The oxidation of the amalgam preserves the
tooth by excluding moisture, its antiseptic properties and also as a
nonconductor of thermal changes and electricity.
In this brief statement we find that gold lacks some qualities
which are necessary to preserve a certain class of teeth, and also
that amalgam lacks many qualities necessary for the most perfect
restoration of these organs. Gold has its place and should be used
where it is indicated, biit one of the most popular errors that has
ever crept into our profession is that of using gold in all places and
under all circumstances. The result of the errors of judgment in
the selection of filling material stares us in the face continually.
Gold should never be used because it is gold. The color of gold
combined with the popular idea, will never save a tooth. Select
your material to suit the case in hand.
Using amalgam regardless of indications or surrounding condi-
tions is as great a mistake as the other. To scoop out a little of
the decay and throw in a little amalgam is very eas}', but it does
not give the patient the best that can be done. It is to displace
amalgam where gold is contra-indicated, that I use so largely both
gold and tin and gold and amalgam in combination.
768 THE DEXTAL REVIEW.
Amalgam was first used in combination with gold to repair gold
fillings where decay had recurred at cervix. This was soon fol-
lowed by the use of gold upon amalgam that had previously hard-
ened, and from this it was but a step to the use of gold upon the
surface of freshly inserted amalgam.
The operation of filling with gold and amalgam has been so
frequently described that it is not necessary for me to give more
than a brief outline. The cavity may be prepared as for gold, ex-
cept at the neck of the tooth where it should be shaped for an
amalgam filling with very slight if any grooves, and no pits. This
portion need not be cut as deep, or as square, to get a good seat
for the filling as for gold, tin, or gold and tin. Where the cavity
extends well under the gum this is many times a great advantage.
The amalgam should extend from one-fourth to one-half of the
distance from cervix. Any good amalgam may be used. It should
be used dry and care taken to thoroughly pack it to its place. A
matrix seems a necessity, but should extend only far enough to hold
the amalgam and cover the union between gold and amalgam.
Any of the so-called plastic golds will work with the amalgam,
but Watt's Crystal has proven in my hands the most satisfactory.
The mercury seems to affect its working qualities very little and
there is little waste.
This gold when placed upon the fresh amalgam absorbs mercury
so readily that I have found that I could not depend upon the color
to tell if it was thoroughly condensed, and as this is one of the most
important points care should be taken that every piece is placed
so it is in positive contact with the amalgam. Enough of the plas-
tic gold should be used so the color of mercury is not seen and
then the filling may be finished with any gold, giving the contour
desired.
Here we have an amalgam guard to a gold filling. The first
advantage gained by this is, as you can readily see, in cutting the
cavity to which I have referred, ease of adaptation in cavities diffi-
cult of access, less liability to fracture margins at cervix or in very
frail teeth, preservative qualities of the oxidation, in short all the
saving qualities of amalgam combined with the positive contour,
edge strength, beauty, stability, etc., of gold.
The gold and amalgam filling is a solid filling, not one filling
built upon another, held by pits and grooves, but the union is per-
ORIGINAL COMMUNICATIONS. 769
feet, so that retention in any part of the cavity assists to retain the
whole structure.
The tendency of the amalgam to assume the globular form is
reduced to a minimum by gold absorbing the mercury. The ab-
sorption leaves the amalgam slightly brittle, and in finishing it is
better not to burnish this part of the filling.
Electrical shocks from the meeting of different metals in the
mouth are readily stopped by inserting in each filling a small piece
of the metal of which the opposite is composed. This with exper-
iments which have been made proves that while there is galvanic
action between the two metals at a short distance apart, it is im-
perceptible if the two metals are in perfect contact.
The color of part of the filling surely is not very desirable; but
I much prefer that the filling should be dark over part of its sur-
face than that it should be dark over all of its surface, as amalgam
would be, and you will agree that the black at the cervix is far
better than a recurrence of decay at that part.
If the gold should discolor, polish the gold but do not remove
the oxidation from the amalgam, and you will have no further
trouble.
My use of this filling is almost entirely on the proximate sur-
faces. I seldom see the necessity of it upon the morsal surface, as
there is little advantage in this place over other combinations.
Thoughts on Dental Education.*
By J. D. HoDGEN, D. D. S., San Francisco, Cal.
The subject of dental education is every day commanding more
and more attention, not only from the profession, but from the
laity as well, and never before has the body corporate of the
profession been so impressed with the vast importance of better
facilities for teaching and more thorough practical training of
students.
Since the time of the establishment of a separate and indepen-
dent school for teaching the science and practice of dental surgery,
our dental colleges have been constantly enlarging the curriculum
of instruction. Nor have the better few of them spared any effort
in their earnest endeavor to afford the fullest possible opportunity
for the impartation and acquisition of knowledge. This not only
* Read before the California State Dental Association July 20, 1892.
770 THE DENTAL REV FEW.
in their own school, but they have compelled others less willing
to adopt a prescribed standard of duration of course and methods
of instruction.
That this was an arduous and self-imposed task, no one can
deny, for ever since the accomplishment of the Delavan fraud, in
Wisconsin, and the conferring of degrees "honoris causa" by the
"grand old school," there has existed an element of impecuniosity
in the ranks of the so-called dental educational institutions as diffi-
cult to combat, and as formidable a foe to honesty and integrity as
it has been a commercial success. And, even since the inaugu-
ration of the National Association of College Faculties, colleges
of less repute have been content to follow, and at that a great way
off, those whose progressive spirit have spurred them on to their
present standard. They are content, I say, to comply with the laws
of that association, to just that extent which admits them to mem-
bership.
These are some of the barriers that have been and are being
surmounted. These are the millstones that progression has been
compelled to drag from about its neck.
However, be that as it may, the time of pupilage has been ex-
tended to three distinct years ; and the terms have been lengthened
to five months each. Though quite all of the best colleges demand
the attendance of seven or nine full months, the College of
Dentistry, University of California, has practically made its course
three full years. It has made nine months of practical and didactic
instruction obligatory in each year and the remaining three months,
a "practical course" in the infirmary and laboratories with its full
corps of demonstrators and instructors. This differing from the
"regular course" only in the absence of didactic instructions; nor
has the new resolution of the National Association of College
Faculties worked any hardship or radical change in its curriculum;
for eight years it has been a "three years" school, and to it belongs
the credit of first adopting the nine months term.
Many colleges have been compelled to accommodate themselves
to stringent circumstances, and to make the most of limited re-
sources, they have struggled along in debt and out of it, spurning
the proffered aid of making their's a commercial enterprise.
To such colleges do we as a profession owe our sincerest re-
spect and fullest support ; to such men as comprise their faculties
do we owe our everlasting debt of gratitude ; to such men as these
ORIGINAL COMMUNICATIONS. 771
are we indebted for the high standard of excellence our profession
has attained and which we enjoy ; and to such men is due the credit
of eliminating the element of mercantile or commercial spirit. They
have chosen quality rather than quantity.
The great problem of education is to secure in due proportion,,
instruction of the mental faculties and the development of practical
manual training; the chief faculty alike in the common education
of children and the special education of later life. The object of
instruction should be to impart facts so as to educate the mind in
scientific thought, that it may be able to found a correct judg-
ment; to determine that which is true and that which is false; and
to place the proper value upon such. This accomplishment is
of far greater value than the memorizing of facts.
The instructor should not only be a scholar in the science he is
teaching, but he should also be skilled in the methods of teaching,
being thoroughly capable of imparting that learning which he may
possess patiently and scientifically. Truths are only effectively
taught by those who have been tempered for their work by that
enthusiasm that comes from a growing insight into some chosen
mental field. Men thus equipped should compose all of our
institutions of education; men of experience and devotion.
The California State Dental Law is entitled, ''An Act to Insure
the Better Education of Practitioners of Dental Surgery, and to
regulate the practice of Dentistry in the State of California."
But having secured such an act the question naturally arises
how are we to practically " ensure the better education of practi-
tioners of Dental Surgery," and how, are we to "regulate the prac-
tice of dentistry in the State." How are we as a profession to be
enabled to bring about that condition of affairs which we all so heart-
ily unite in agreeing to be correct and preeminently essential?
The college is our educational center, the birthplace of our
future brothers, and our own foster mother. How now, are we to so
regulate this huge family that it may practically be under the con-
trol of the profession at large, governed and directed by those
best fitted as dental educators, legislators, counsellors and leaders?
The State Board of Dental Examiners is the legal protector of
the profession and laity alike, but how are we as a profession and
the laity as our patients to secure this protection unless the repre-
sentatives of the profession, as a whole, unite with the repre-
sentative of the people--the Governor — in selecting those who are
772 THE DENTAL REVIEW.
the best, the most able, the most enthusiastic, and the most
devoted to fill its chairs, and to point out to us our rights and
secure them for us ?
The question is answered by the natural power vested in the
State Dental Association by virtue of its existence which is au-
thoritatively the profession. It is then the duty, as it is the privi-
lege of every legitimate practitioner of dentistry in the State of
California to become not only a member, but an active, energetic,
and enthusiastic member. For what purpose, you ask : First, for
the education of yourself and your brothers in return. Second, for
organization and proper, ethical, legislative, and educational con-
trol of each other. In other words, to so thoroughly organize the
profession in the State that it may be governed by those best fitted
to govern it.
But you still cr}' — how shall this be accomplished ? Let me
explain : Let the State be apportioned geographically into seven
districts, to be known as first, second, third, etc., districts; in
each district organize a District Society who shall elect their
members from the licensed ethical practitioners of that district,
provide that every member of each of the seven district societies
by virtue of that fact be a member of the State Dental Association,
also provide that each of the several Presidents of the several
district societies constitute the Board of Trustees of the State
Dental Association.
The State Dental Law reads : Sec. 2. " A Board of Examin-
ers, to consist of seven practicing dentists, is hereby created,
whose duty it shall be to carry out the purposes and enforce the
provisions of this act. The members to be appointed by the Gov-
ernor from the dental profession from the State at large."
This section permits a further provision without tiresome and
tedious legislation, in that it permits the appointment of the mem-
bers of the board "at large." Then be it provided that each dis-
trict society shall select two of its members, one of which shall
be elected by the profession assembled at its annual meeting as
the State Dental Association, as a candidate for the representative
of his district on the State Board of Dental Examiners, subject to
the approval of the Governor of the State.
Through such management the College and Board would work
perforce hand in hand, shoulder to shouder, ignoring selfish inter-
ests and giving place to a nobler and greater work, thereby solv-
ORIGINAL COMMUNICATIONS. 773
ing the greatest problem of the day — the proper, scientific and
manual education and training of dental students.
By this management the State would be thoroughly and impar-
tially represented on the Board of dental examiners, as the letter
of the law directs — "at large." It would insure the best man in
the right place. Our annual meetings would be attended by
hundreds instead of handfuls. It would be the grand reunion of
the several families of a great family at which each would vie
with the other in presenting the greatest and most complete num-
ber of their district, in presenting the most practical and scientific
papers, or most logical discussion, and social enthusiasm. The
quack, where ever might be his lair, would be shown as such, not
only to his victims, but to all. The nonlicentiate would be
forced to license, and the better practice of dental surgery would
be insured and regulated.
Copper Amalgam.*
By P. J, Kester, D. D. S., Chicago, 111.
This very interesting material has long been used in England
and the Continent in large quantities, but all efforts to introduce it
into this country failed, as the amalgam was black and unclean and
unsatisfactory and the process a secret, until Dr. Weagant, of Can-
ada, published a method for making it, but like its prototype from
over the water, it contained many impurities which made it utterly
unfit for general use.
Then the inventive minds of our own dentists developed the
idea of depositing copper on a surface of mercury, by which proc-
ess the resulting amalgam was at least clean. This product was
then hailed as the long sought for mat^ial which was going to save
everything that could be saved by a plastic filling. How well it
has fulfilled its promise you all know ; like the newest street song
it became the fad, and it seemed that everybody was using copper
amalgam.
Gentlemen who had condemned amalgams of all kinds saw in
it — or thought they saw in it, the material that was going "to fill
a long felt want." It was used indiscriminately, it was plastered
into every cavity where gold was not indicated, and the dentist
congratulated himself that at last he had discovered a filling that
was going to preserve teeth for all time to come.
*Read before the Odontographic Society of Chicago.
774 THE DENTAL REVIEW.
It was said that the only thing against it was its dark color,
and the dentist when he looked into the mouth of his patient and
saw what seemed to be a good prospect for a coal mine, chuckled
with delight, and assured his victim that his teeth were all right
now. Were the}' ?
The writer was sharply criticised, for discouraging the indis-
criminate use of this material, at a convention more than three
years ago, by a gentleman who at that time was a strong advocate
of copper amalgam, who now, I have reason to believe, has come
to himself and is using it very sparingly.
That copper amalgam has some peculiarities which make it
especially desirable in certain cases, any one who has used it for
any considerable time will admit. It is indicated in such cavities
of such teeth as are bathed in the saliva and mucus, and these are
mostl}' found on the buccal surfaces of the second and third molars.
And it will be found useful in cavities which dip down below
the margin of the gum in proximate surfaces, and then only when
a small portion is used to fill the cavity to the gum border,
finishing the filling with some other good amalgam or other
material ; gold even being placed on it with very satisfactory
results by some good operators.
As moisture does not seriously affect it and it adapts itself to
the inequalities of the walls, and as it undoubtedly possesses anti-
septic qualities, it will be found useful in the filling of children's
teeth ftemporar}'). These three classes of teeth comprise about
the limit of its usefulness, and we believe should be confined to
them,
Copper amalgam is not indicated, where the filling comes to a
masticating surface. It will not do for bicuspids or molars at any
place except as indicated above. It is not good practice to patch
old copper amalgam fillings with the same material, as it will be
found invariably that the old filling will maintain its color and
position, while the patch will remain bright and will soon waste
away. It is a matter of history that a very large per cent of all
copper amalgam fillings in all positions in the mouth will waste out.
The best (?) reason that I have heard for the indiscriminate use
of copper amalgam was given by a dentist who replied to the
question as to why he used it when he knew that it would fail in a
large proportion of cases. He said: "I want them to come out,
for then I can replace them with gold fillings." If this gentleman
ORIGINAL COMMUNICATIONS. 775
will develop his talent he ought to be able to enrich himself dur-
ing the world's fair year.
After a somewhat extended experience with amalgams the
writer has come to some conclusions which may or ma}^ not be of
value to the dentist. It has long been claimed^and with much
apparent reason — that copper amalgam fillings were less liable to
change in form than any other of the amalgams, and this we be-
lieve is simply following a general chemical principle that the more
simple the composition of a substance the less likely it is to change,
and that the ideal amalgam must be composed of the fewest possi-
ble component parts. And that the addition of gold, platinum,
zinc, etc., is of no benefit to the alloy, except as it appeals to the
pride of the operator.
It is very probable that the solubility (in mercury) of the metals
used has somewhat to do with the resulting amalgam. We have
found experimentally that copper amalgam contained about 66
per cent of mercury, while another alloy of silver, tin, and a trace
of copper was readily dissolved in 50 per cent, and could be ma-
nipulated with 40 or 45 per cent. May it not be possible that the
large amount of mercury necessary to form an amalgam with copper
will account for the wasting of the copper amalgam plug.
The manner of mixing an amalgam has much to do with the
results, and the same observation will apply to cements, plaster of
Paris, and other substances which crystallize by the addition of
liquids. The alloy or powder should be mixed with the liquid and
not the liquid with the powder; "^. ^.," if you were going to mix
plaster you would not fill your bowl half full of plaster and then
add the water, for if you did there would be an immediate crystal-
lization which would render the results unsatisfactor}'. Cements
do not work so well when the liquid is worked into the powder,
and I believe that a better amalgam can be made if the alloy be
mixed with the mercury, and added gradually until you get a
proper consistenc}'.
I am aware that I have wandered from the subject somewhat,
but I refer to these matters as some things that have been devel-
oped by the experience I have had with copper and other amalgams.
In conclusion let me say that I would not condemn copper
amalgam entirely, but my advice would be to study well the cases
before using it, and it will be found that the places indicated will
be the most favorable to the success of this material.
776 THE DENTAL REVIEW.
Thoughts on the Density of Dentine.*
By E. a. Gillette, D. D. S., Norfolk, Neb.
The percentage of organic (animal substance) over the in-
organic (bone substance) in the bone structure, is at its highest
point in infancy. The inorganic, however, as though asserting that
its material was the only thing that could give strength to the
bones, commences to displace the organic, and filling up the places
with its own substance, changes the skeleton from a soft, pliable
condition, in which it may be easily bent without breaking, to that
firmer state which permits the weight of the child to be supported
on its feet. As the bone structure changes from the soft cartilag-
inous state of infancy and childhood to its firmer and more perfect
condition as found in the grown person, possessing its full quota
of inorganic material, so with the teeth in childhood, the dentine
(the bone structure of the tooth) is in a soft condition, and needs
to have a part of the animal substance taken away and its place
filled up by the true bone material, that the dentine may be
brought up to the perfect condition, where decay cannot molest
or destroy. At this period of the child's life, when there is
such a demand for the bone-making material to build up and
strengthen the bones, and give density to the dentine, if there is
found plenty of material at hand with which to build, it is well.
But from the number of small statured men and women, the weak
bones, the poor, miserable teeth we see every day, we are com-
pelled to say that in too many instances there is a lack of bone
material in the present generation. And there can be but one of
two causes for this great evil. Either it is a lack of bone-making
material in the system, or a failure on the part of nature to take up
the material and deposit it where it belongs. To the last propo-
sition we say no; nature does not fail in that way, so the only
cause must be a lack of bone-making material. And if this is the
cause, why should it exist? Either there is short-sightedness on
the part of nature again in not being able to recognize a good
thing and supply the system with the very thing so many people
are needing, or there is a lack of bone-making material in the food
we eat, which is the only thing nature has to construct with. To
the first allegation we enter a denial for the defendant, nature, and
plead not guilty. Nature does not do business in that manner.
*Read before the Nebraska State Dental Association.
ORIGINAL COMMUNICATIONS. nTl
Then there Is nothing left for us to do but to say it must be a fail-
ure on our part to eat the proper food. Let us put the blame
where it belongs. In the outside of the kernel of wheat (the hull
or shell) is the only part in which is found the bone-making prop-
erties of that grain, and in our present manner of doing things, we
throw away the outside in the shape of bran and middlings, and
with it is thrown away the very part our osseous system needs. I
speak of wheat in particular, for it is our best bone-making (mate-
rial) food. Potatoes and vegetables in general do not contain bone
material like this much abused grain.
There is bone food in corn, but the trouble is in the way most
people use it. Feeding it to the horses and pigs does not put the
bone material in the human system, except in extreme cases of the
latter kind. And in drinking corn, the bone food has been lost in
process of construction. (For their benefit) hypophosphites and
other conglomerations have been put upon the market, that the
dear people might go on throwing away their bone-making foods,
and grow their bones in a sumptuous manner with these villainous
compounds taken from a spoon. And with flourish of trumpets it
is heralded to the world; the spring of perennial life is found; come
and buy with money, and freely take your bone pabulum from our
bottle, (beware of imitations; see that our trade-mark is on the
bottle.)
The inorganic matter of bone substance must be taken from its
inactive, inert condition, and changed by vegetable life to a con-
dition where we can have it enter into our systems by assimilation.
For it is not possible for the animal life to take hold of matter in
its unorganized state; therefore our bone food must be prepared
for us outside of the chemist's bottle, and we look to the vegetable
kingdom, or to the animal, for the sustenance of life. The soft
bones of chicken, veal or mutton, properl}^ prepared, make the best
kind of bone food, and will supply all of the demands of the system
for that material, making teeth which are invulnerable to the at-
tacks of decay.
Especially should mothers who have just passed through the
period of gestation use plenty of bone food, to make up for the
extra demands which have been made on her system. And moth-
ers who nurse their children would do well to eat freel}- of soft
bones through all of that time, that they may supply to the little
lives intrusted to their care a proper amount of bone-making ma-
778 THE DENTAL REVIEIV.
terial, and at the same time save their own teeth from destruction.
For, if there is not a proper supply of bone material in their food,
it will be taken from their own system; and how often have we
seen a mother lose a good set of teeth because she did not eat the
proper food for bone growth and meet the extra demand put upon
her. And how often in people of middle life, and older, have we
seen a hitherto good set of teeth lost because the person did not
eat the food that would keep in repair his osseous system, and the
bone material would be apparently taken from the teeth to make
up the deficiency of some other part.
There must be more bone food used by the American people.
It will make stronger men and women; it will prevent people from
being dwarfed in size if given to children, and save them dental
bills besides. Let us put upon our banners the motto, "More
bone growing food."
Pyorrhcea Alveolaris, or Riggs' Disease of the Gums.*
By M. W. Swartz, D. D. S., Peoria, III.
When requested to contribute a paper upon this subject, I took
it for granted that I was to confine myself strictly to the disease of
the gums and peridental membrane coming under this head as the
term is now applied, as at least there are a number of later writers
upon the subject who make a decided distinction between this term
as now employed and other terms used to designate other diseased
or abnormal conditions of the gums and peridental membrane of a
kindred nature. Earlier writers upon the subject made little or no
distinction between this diseased condition in the general accept-
ance of the term as then employed and kindred diseases, but in
treating the subject I employed a number of terms, and one of
which was accepted as designating this condition, the following
terms being those most generally used : " Spongy gums ; phage-
denic pericemeiititis ; scurvy of the gums ; inflammation of the
gums ; odontolithus ; suppurative inflammation ; gingivitis ; alve-
olar pyorrhcea, etc. ," the greater number of which are now employed
to designate separate and distinct diseased conditions of the gums
and peridental membrane. Therefore, I shall confine myself strictly
to the treatment of the subject of pyorrhcea alveolaris, — a flow of
pus from the alveolus.
* Read before the First District Dental Society of Illinois.
ORIGINAL COMMUNICATIONS. 779
The term " Riggs' Disease " seems to have been applied to this
affection on account of Dr. J. M. Riggs, of Hartford, Conn., repeat-
edly treating of special phases of the subject at society meetings,
which has had the effect of calling general attention to, and of
awakening interest in it.
Dr. G. V. Black, in speaking of the term pyorrhoea alveolaris,
says : " The term pyorrhoea alveolaris expresses one fact common
to all these forms after they have made considerable progress, in-
cluding alveolar abscess as well — a flow of pus from the alveolus.
It must be seen by all that when we come to a classification of
these affections, this term loses all distinctiveness and cannot be of
use. Possibly this name might be retained as expressive of the
whole group of diseases in which there is a flow of pus from the al-
veolus, but this could not be of much value ; especially is it objec-
tionable after the use to which it has been put in the past. There-
fore, I think it best to drop it altogether." But as neither Dr.
Black or any one else has found a term more suggestive than the
term to which he objects, or if found he does not employ it, I shall
employ it as I know of no other term that is preferable.
Pyorrhoea alveolaris, or Rigg's Disease, is first indicated by an
uneasy sensation ; then inflammation of the margins of the gums ;
looseness of the gums about the teeth, which form pockets ; necro-
sis of edges of alveolar processes ; a tendency to haemorrhage, in-
flammation extending deeper into the gums ; small sulci filled with
pus ; looseness of the teeth and change of position of the same ;
disagreeable taste ; peculiar fetor of the breath ; dark livid color
of gums, with thick margins, and often extremely sensitive to the
touch ; in some cases the gums are denuded of their epithelium,
with a polished appearance, in others with a pimpled surface ; the
teeth, at length, held in their cavities by a tough ligamentous at-
tachment, due to the change occurring in the peridental membrane.
A simple form of this disease may manifest itself at the gum mar-
gin, indicating its presence by a congested appearance, beneath
which may be found a granule of calcified material. While in
many cases there is a general congestion of the affected gum, and
a proneness to haemorrhage ; in other cases the gum may pre-
sent an anaemic appearance — pale and bloodless. This disease
may also be associated with syphilis, mercurial salivation and
scurvy. The deposit of salivary calculus and calcified substance is
supposed by some to be secondary to this disease, as a deep red and
y
780 THE DENTAL REVIEW.
denuded gum about the necks of the teeth ma}' be present without
any deposit. Yet in the vast majority of cases, this diseased con-
dition is traceable either directly or indirectly to calcic formations
about tlie neck and roots of the teeth.
True, it may be said that all the above named diseased or ab-
normal conditions of the gum and peridental membrane begin with
an inflammation of the gingivae. And also, it maj' be said that the
term pyorrhoea alveolaris, is the term employed designating the ul-
timate termination of all the above forms of disease — even to that
^ of alveolar abscess — if not checked before they have advanced to
that stage.
All of the above diseased or abnormal conditions are of vast im-
portance to us in our daily practice, for very few of us there are,
who do not daily treat patients who have some one of these affec-
tions in a greater or less advanced stage. But particularly that of
pyorrhoea alveolaris. Yet we have learned that this term is em-
ployed simply to designate the condition sure to be reached by the
milder forms of disease of the gums and peridental membrane if
allowed to progress. And for this reason, comparatively speaking,
it is just as important that we give close attention to these milder
forms of disease, in that they can more easily be brought into sub-
jection than if allowed to drift on and terminate as above stated.
As I above stated, this disease is of vast importance to us, pri-
marily, in its ravages upon the gums and peridental membrane,
causing complete destruction of both ; secondaril)', the loosening
of the teeth and the ultimate loss of these important organs. It is
not enough for us, as dentists, in so important a subject to be sim-
ply able to define a term employed to designate a certain condition.
And undoubtedly there is not a practitioner present who cannot di-
agnose a case coming under this head. To the contrary, notwith-
standing, I fear far too little attention is given this subject in our
daily practice. And further, that unless a case in an advanced
stage comes under our observation, we little suspect the presence
of such a condition, and as a natural consequence we do not exam-
ine the mouths of many of our patients to ascertain whether or not
such a condition exists ; or if we examine for this purpose at all,
the examination is too frequently conducted hurriedly and more or
less carelessly.
To illustrate the carelessness given this subject by some, I will
say that during the six months spent in a preceptor's office, not one
ORIGINAL COMMUNICATION'S. 781
case of pyorrhoea alveolaris received any attention whatever, save
in the superficial cleaning of the teeth, and that to be done in a
manner which would not cause haemorrhage of the gums. I was in-
experienced, but nevertheless I was not oblivious to these cases
when the}^ came under my observation. But to venture a sugges-
tion relative to this condition being present in any given case, or to
the treatment of the same, was to commit a wrong that would not
be easily forgiven or readily forgotten. Therefore, I determined
to hold my peace and not incur the ill-will of the gentleman under
whose instruction I was for the time. However, at one time when
no one save he and myself were present, I referred to the subject,
at the same time asking him if he considered the thorough super-
ficial cleaning of the teeth all that was necessary to restore the gum
to its normal condition. The answer came, "Just clean the teeth
well, but do not make the gums bleed, and they will come out all
right." Well, I did as directed, but had serious doubts while per-
forming this operation upon certain patients, although I did not
know what condition existed, or just of how much importance it
was, but felt sure that something w^as not as it should be. You
may ask, did the gums heal after the teeth were thus treated ? I
answer, by no mea7js. Yet how many of us follow almost in detail
this line of treatment. And if we do, with what success do we
meet ? We may remove the deposits from about the necks of the
teeth. But if pockets have formed, the diseased condition ad-
vances, probably not as rapidly, but assiduously, and if any-
thing to make more certain its destructiveness, in that after we
have cleaned the teeth superficially, we dismiss the patient, and
then for the time the patient is lost to us. We do that patient a
gross injustice to say the least. Most certainly it was necessary
to remove the deposit from the necks of the teeth, for this was^
at the inception of the disease, the cause of the inflammation of
the gums and peridental membrane, and the recession of these tis-
sues from the necks of the teeth. But so far as the superficial
cleaning of the teeth goes as a means of treatment, to say nothing
of the arresting of the disease, amounts to practically nothing.
As I above stated, by all means remove the deposits from the
necks of the teeth. But what condition do we find beneath the
gum margin ? It is stated in a few words : At the free margin of
the gum the saliva deposits a product of that secretion known as
salivary calculus. And where the formation of pockets has begun
782 THE DENTAL REVIEW.
as a result of this deposit, we have along its line on the root of the
tooth a deposit distinctly different from the above, a product
deposited and derived from the serum of the blood, known as
\/ serumal calculus. This last deposit is the one which keeps up
the diseased condition known as pyorrhoea alveolaris — a flow of
pus from the alveolus. True, no tissue can retain its healthful
condition if in contact with salivary calculus. And in any case it
is not the deposit of calculus that is to be so much feared, as the
continuance of that deposit, of whichever character, in contact
with the tissue ; for this it is that brings about the evil results.
One may say that he has seen the presence of this disease when
no deposit was to be found upon the root of the tooth. But I
think b}' close and careful examination we will find more or less de-
posit present, if we have failed before to discover the fact. We can-
not be too thorough in the examination of all cases, and particularly
in those where at first there seems to be no deposit present. How
many teeth have become almost useless, or entirely so, if indeed
not lost altogether, through carelessness or improper treatment.
This is a subject of far more importance than is generally under-
stood, and which demands and should receive the greatest care
and attention.
A dentist once told me that he scarcely ever treated the
inflamed and swollen gums of his patients, and especially was he
averse to doing so when they were very bad, as he considered it
far better to not meddle with them while in this condition. He
also stated that one could not receive proper compensation for the
time and trouble enlisted in the treatment of such cases, so what
is the use to trouble one's self about it. I do not think I am pre-
suming at all when I state, in the first place he did not understand
or know what the trouble was, or what diseased condition existed ;
secondly, not knowing or understanding what the trouble was, of
course he would not know how to treat the condition ; thirdly, not
knowing how to proceed with the proper treatment of the condi-
tion, he certainly could not expect to be rewarded for something
he was unable to accomplish. If he really thought that one could
not receive proper compensation for the time and trouble enlisted
in the proper treatment of such cases, I think could he have
effected a cure of a marked case of this kind, he would certainly
have occasion to change his opinion upon the subject. For in
practice I have found that patients, are as a rule, willing to pay
ORIGINAL COMMUNICATIONS. 783
one quite well for the proper treatment of this disease. Impress
upon them the necessity of having this condition corrected. If the
patient be slow to comprehend the necessity of treatment, you can
readily call to mind one or more cases in which the patient has,
through carelessness or sheer neglect, lost one or more of the
teeth. If the subject is brought before them in a way that they
can be made to understand its importance, few indeed will hesi-
tate to have the necessary treatment carried out.
Once more I would impress the necessity of a thorough
and rigid examination of the mouths of all those who visit us pro-
fessionally. Not only the lower incisors, cuspids, bicuspids, and
the superior molars, where this disease most commonly manifests
itself, but examine each and every tooth in the mouth. I have seen
the absence of the disease in all the teeth save the superior incis-
ors ; or when it existed only in the second or third inferior molars;
or again, only the superior cuspids being affected. In short there
is no rule governing the seat of this disease. And you can onl}' be
sure of its absence when you have examined each individual tooth
and have in each case found the gums and peridental membrane
free from any such affection.
As to the treatment of cases coming under this head, a great
deal has been said. I shall at the proper time give you simply the
treatment followed in my daily practice. I shall quote no author-
ity upon the subject for I trust we all have been enough interested
in the subject to have looked into it. Much more, however, is to
be learned from clinical observation. If any of us have failed to
properly look into the subject, then I consider it most important
that we do. Not merely as a means of knowing how to treat the
disease, but that we may also know and understand the vast bearing
it has upon the all-around success in practice. We ma}^ be suc-
cessful in everything else we do, and in every other operation we
perform. But if we fail in this particular, it is far more serious
than at first may appear. And before we are incited to take active
steps to arrest any disease, we must, first, know of its presence ;
second, understand its aggressiveness ; third, realize its destruc-
tiveness. The point I wish to make is simply this: In proportion
to the degree of demand and necessity of action in a certain direc-
tion, the manifest interest in that direction will be ; and to full}'
comprehend and appreciate the necessity of action in a certain
784 THE DENTAL REVIEW.
direction, we must understand upon what grounds the demand is
made, and upon what basis our subsequent action depends.
There is one other subject to which I wish to call especial at-
tention before I enter upon the treatment of this disease. It is in
reference to the employment of proper mouth washes during, and
for a time subsequent, to the treatment of the patient in the chair.
I consider it very important, and to the employment of such washes
I attribute much of the success with which I have met. And I
have also found that far greater progress is made when proper
washes are used. And I fear that in the matter of mouth washes^
we, as a rule, overlook their value and underestimate the results
that can be attained by their proper use. For what, I would ask,
have we a dental Materia Medica and Therapeutics if we do not
employ it ? For a great portion of these works treat of washes
for the mouth, and the good to be derived from their employment.
Indeed I have few patients for whom I do not prescribe.
THE TREATMENT.
First of all in any given case, thoroughly and completely re-
move all deposits from the tooth and its root. Be sure of this, for
upon the thoroughness of this operation very largely — I may say
entirely — depends the success with which we are destined to meet.
Have no fears as regards the haemorrhage of the gum during this
operation or any part of the treatment of these cases. Of course
do not cause pain to the patientby unnecessarily lacerating the gums.
But in practice I have found that free haemorrhage in advanced
cases seems to prove a benefit rather than a detriment. Also that
when the gums become more or less lacerated during the removal
of the deposit from the roots, the condition seems rather to promote a
healthy condition than otherwise. However, considerable care
should be exercised during this operation, for upon the extent to
which the gums will be restored to their natural height and position
about the root of the tooth, depends the condition of the remaining
portion of the peridental membrane. And in fact it is quite as nec-
essary to preserve the peridental membrane for this purpose, as
it is to preserve the periosteum while operating upon diseased
bone.
In the removal of the deposit from the root, it requires consid-
erable skill, which can only be attained by practice. A steady
hand and considerable confidence in one's self will aid in acquiring
the necessary skill.
ORIGINAL COMMUNICATIONS. 785
As regards instruments for this operation, I think the set
made by the direction of Dr. Geo. H. dishing are best when the
pushing force is to be used. However I use others as well, and
sometimes when the teeth are very irregular, I discard them and
employ still others. In short, I use the instrument best adapted to
the case in hand, even though it be a spoon excavator. For I do
not think one can judiciously confine himself strictly to the use of
any one set of instruments in this operation.
For an injection into the pockets after the removal of the
deposit, I am partial to the use of peroxide of hydrogen. But to
derive the greatest amount of good from its use it must be fresh.
When it cannot be thus obtained, I use a solution of carbolic acid,
from two and one-half to ten per cent, or any of the other good
antiseptics or disinfectants. For the purpose of injecting I employ
a Dunn's syringe where the pockets are not very deep. When
the pockets are deep, I employ the ordinary metallic syringe
which is used almost daily by all of us. By the employment of
this last mentioned instrument, greater force can be obtained than
from the Dunn syringe, and for this reason I usually prefer the
larger one, as one can apply force enough to thoroughl}' wash out
all foreign matter from the pockets.
After thoroughly injecting the pockets, absorb with absorbent
cotton all moisture about the tooth to be further operated upon.
And then by the use of a piece of soft pine wood cut in form of a
tooth-pick, force into the pocket, its full distance, finely pulverized
fresh cupric sulphate. For this purpose I employ nothing else.
This operation will likely cause considerable pain, but never mind
that. Heroic treatment is demanded. And if this operation is
thoroughly performed at first treatment, in many cases nothing
further need be done than the injection of the antiseptic and dis-
infectant. I am not in favor of too frequent treatment of these
cases. And unless the case in hand is far advanced, I advocate
the lapse of five or six da3's between treatment. Of course in the
meantime I have the patient use some good antiseptic and disin-
fectant wash, alternately with a wash that tends to toughen and
harden the gums. And in many of the milder forms of this disease
after the removal of the deposit, I confine myself strictly to the
employment of washes, and the results attained in almost every
instance are very gratifying indeed.
The washes I employ are principally the following:
786 THE DENTAL REVIEW.
Class One.
• Antiseptic And Disinfectant.
Acidi Carbolici (Cryst).
Glycerini.
Aqua Rosae, aa 3ii.
M. S. Six to eight drops to a wine glass of water morning and evening, or
more frequently if necessary.
Or
Acidi Salicylici Partes, i.
Sodi Phosphatis, " iii.
Aqua Destillati, " xxx.
M. S. Use as a mouth-wash, morning and evening, or more frequently if
necessary.
Or
Acidi Carbolici, gtt. xx.
Glycerini, liv.
Aqua, fx.
M. S. Use as a gargle or mouth-wash, three or four times a day.
Those of the second class — to toughen and harden the gums, I employ prin-
cipally the following:
Acidi Tannici, gr.x.
Tincturae Pyrethri, 3iij.
Aqua Rosae, §vi.
M. S. Use as a gargle or mouth-wash.
Or
Acidi Tannici, Iss.
Spiriti Vini Rectificati, 3ss.
Aqua Camphorae, f|v.
M.S. Use as a mouth-wash.
Sometimes when I find a case does not yield as quickly as the
indications would seem to point, 1 use on a pellet of cotton and
apply to the pocket aromatic sulphuric acid. One case in partic-
ular which I treated several months since would not yield under
ordinary treatment, and the aromatic sulphuric acid did the work
after a few applications. > / " .
1 ' \' \ ^
President's Address.*
By Dr; E. C. French, Eau Claire, Wis.
I should feel myself the most unworthy of the unworthy did I
not express to you my keen sense of appreciation of the great
honor you have conferred upon me, in selecting me to preside
over your deliberations during this twenty-second annual meeting
of our society.
* Read before the Wisconsin State Dental Society.
ORIGINAL COMMUNICATIONS. 787
Through the efficiency of your officers elect and committees
appointed, we are able to present for your consideration, a pro-
gramme which compares favorably with any previous programme
in the history of this society.
It now remains with you, brethren, that the details of this pro-,
gramme be so carried out as to elicit the fullest discussion upon
the several papers to be read and clinics given.
The precedent established at our last annual meeting of
appointing all committees and essayists immediately at its close,
has been productive of much good, and I would urge upon you the
importance of so amending your by-laws that it shall be obligatory
upon the part of the President, to so appoint all appointive com-
mittees and essayists, and that it shall be the duty of the Secretary
to notify all appointees within sixty days after their appointment
thereof ; this gives your presiding officers ample time in which to
appoint others in place of any who may refuse to serve.
We have within the borders of the State of Wisconsin, between
four and five hundred regularly licensed practitioners, and this
society having attained its majority, finds itself with the exceeding
small membership of seventy; this is sufficient cause for us to
reflect, and if possible, to ascertain the hindrances, which stand in
the way of increasing our numbers and extending our influence for
good. If the impression has gone forth that this society is one of
mutual admiration and self-aggrandizement for a select few, the
sooner this impression is dispelled, and this society placed in its
true light, a beacon light held out to all who are seeking the portals
of truth and advancement in the science of dentistry, the sooner
we shall realize the objects for which this society was organized.
If Section 7 of the By-Laws requiring the Board of Ex-
aminers to prepare a list of sixty questions, seventy-five per
cent of which shall be correctly answered by the applicant
for admission to the society is a barrier in the way; then that
section should be so amended, or a new section added, which
shall designate the special branches in which the applicant shall
be examined, and that any regularly licensed dentist under our
State law, who may desire to become a member'of this ' society,
may at any time make application to the Secretary, and on the pay-
ment of two dollars and fifty cents, shall be entitled to receive
from the Secretary the names of the several branches pertaining to
dentistry in which the applicant shall be examined. And on the appli-
788 THE DEXTAL REVIEW.
cant presenting himself before the Board of Examiners at the an-
nual session, he shall be entitled to an examination in one-half of the
branches prescribed by the society. Having passed a satisfactor}^
examination, said applicant shall, on the payment of two dollars
and fifty cents, be entitled to all the benefits, excepting the right
to vote at said annual meeting at which he takes his examination;
and at the succeeding annual meeting, said applicant on passing a
satisfactory examination before the Board of Examiners on the
remaining branches may, on the recommendation of a majority of
the Board, by paying the regular annual dues, and signing the con-
stitution become a member in regular standing.
A section in our by-laws covering the principal points of sugges-
tion will, we think, do away with what many outside of the society
look upon as a very objectionable feature, of having to come be-
fore the board wholly ignorant of the line of questioning on which
they may be examined; further it will stimulate a course of reading
that will serve a like benefit to the individual dentist, the public,
and to the profession in general.
Believing that this society exists for something more than an
organization, calculated to benefit its individual members, I would
suggest for your consideration the importance and feasibility of
organizing what may be known as the Wisconsin State Dental So-
ciety Scientists Course of Dental Reading; let this course of read-
ing be for a period of two or more years and its privileges ex-
tended to all dentists within the border of the State, who shall
conform to its rules and regulations. On the successful comple-
tion of the course the societ}' shall issue a certificate of excellence,
which certificate shall answer in lieu of an examination for admis-
sion to the State Society.
The time has come for this society to close its page of preface
and begin writing the pages of history that shall mark a new era
in its life and usefulness.
Let us "In honor preferring one another," build a superstructure
that shall be worthy of the foundation our fathers laid, a number
of whom are with us to-day to give aid and counsel.
OUR STATE DENTAL LAW.
After a period of seven years of criticism on the part of many
dentists of our State, the law still remains upon our statute book,
the benefit of which is apparent to every fair-minded dentist, while
ORIGINAL COMMUNICATIONS. 789
the law ma}' be defective in part, and the powers given the Board
of Examiners somewhat limited, nevertheless it has had a very sal-
utary effect in thinning the ranks of empirics and quacks who have
heretofore flourished in our midst. The accusation that this law
is a mere subterfuge and passed in the interests of dental col-
leges, is unjust and unworthy the dentist, who has at heart the best
interests of his profession.
Many dental colleges chartered and run purely as business en-
terprises, have been somewhat benefited, nevertheless the tendency
has been to elevate the standard and bring into line these ques-
tionable dental colleges. The law governing the practice of
dentistry in our sister State, Minnesota, has the appearance of
being somewhat arbitrary and unjust, but upon mature thought we
are convinced that it strikes at the root of a gigantic evil which can
only be obliterated b}' the passage of similar laws throughout the
several States of the union.
DENTAL EDUCATION.
In these days of multiplicity of dental colleges, the rapid
" grinding out " of full-fledged dentists, is subject matter proper
to come before this society for discussion.
The practice of nearly, if not all, of our dental colleges of ad-
mitting students to their halls who have had no previous prepara-
tion and in the short space of two or three j'ears turn out full-
fledged dentists simply because they have passed through the col-
lege curriculum is an evil which should be corrected by organized
effort on the part of all dental societies, insisting that all dental
students entering college should have had at least two years previ-
ous preparation under a competent preceptor. This gives the stu-
dent and his advisers ample time to ascertain his taste and abilit}'
for the practice of dentistry.
OUR LIBRARY.
Very little if anything is being done toward the building up of
a permanent library. We desire to call your attention to the im-
portance of this branch of our work that you make such annual
appropriations as shall enable you to add yearly to this library the
latest text-books and scientific publications on dentistr}'; also to fix
a central location, elect a librarian, adopt by-laws to govern the
loaning of books and periodicals to the members of this society.
The policy of this society should not be arbitrary on the one
790 THE DENTAL REVIEW.
hand or lowering of the standard on the other, but one of honest
endeavor, embracing all the means at our command to encourage
the spirit of earnest effort on the part of every dentist in the State
to enter our ranks and help make this society the ideal one.
That we may attain this end let us so manifest the spirit of
earnestness, push and regard for one another that all visiting dentists
shall go away from this annual gathering impressed with a deter-
mination to become a member of the Wisconsin State Dental
Society.
A Talk About Toothache.*
By Chas. C. Chittenden, D. D. S,, Madison, Wis.
It is not my expectation or hope to present a single thing here
to-day that is not thoroughly grounded and rooted in the inner con-
sciousness of every well-informed dentist in the land. But men are
so prone to forget that they do know, and so sometimes act as if they
did not, that plain truths cannot too often be iterated and reiterated.
Toothache to the Ia3"man is conglomerately simple to under-
stand (particularly if he has been there), and the remedy equally
simple, "pull it out."
To us who are supposed to hold ourselves in readiness to cope
with and control it, it assumes so many myriad phases and forms,
that a lifetime devoted to the fathoming of its causes and overcoming
or removing them, is all too short. To describe it is unnecessary —
Webster's Dictionary does that. Our daily listening to descriptions
of it by the victims, is as full of " infinite variety " as Mark Antony
claimed that Cleopatra was. I propose to note the various causes
of toothache, from sensitive dentine through to alveolar abscess,
touching at the principal stages on the route, and making simple
suggestions for immediate relief as we go.
Toothache results from many different causes, for example :
From living pulp in irritation from sensitive dentine to full ex-
posure.
From congested pulp.
From dead and putrescent pulp.
From involvement of surrounding tissue by continuity and con-
tiguity when poisonous gases in confinement force their way out of
the roots.
♦Read before the Wisconsin State Dental Society, 1892.
ORIGINAL COMMUNICATIONS. 791
The first thing to do is to find out its cause and origin, and to
locate and diagnose ; next to reach it, and then to control it by re-
lieving nature of the disturbing influence.
The cause of facial neuralgia — tic douloureux toothache — what-
ever form of pain may be present, is frequently so hidden as to nearly-
baffle the closest inquir}^ The safe rule is never to hit a head un-
til you are pretty sure you see it. The patient may locate the pain
in a superior lateral incisor, and if you diligentl}^ search, you are as
likely as not to locate the cause in the lower third molar. Reflex
manifestation is as misleading as a mirage, or a search for the
"Earthly Paradise " unless you are fully up to its tricks.
Having located the trouble, it must be reached and fully dis-
covered, to know its true character. It may prove a mere surface
of inflamed dentine, with no real pulp involvement, in which case
simply cleansing, stimulating with eugenol or creosote, and then
perfectly covering with a cement, will command the situation until
you are read}'^ to make a permanent filling — always first having
commanded the pain. It may transpire that a cavity reaches very
nearly to the pulp chamber — so near that a turn of an excavator
would expose the pulp. Then comes in play your best judgment
as to what to do. The age, health, etc., of patient, general condi-
tions of mouth and teeth are all to be considered. It is always best
to make haste slowly though and do nothing you cannot undo. The
first thing to accomplish is relief from pain. In this case, as in
that of full exposure with haemorrhage from pulp, a careful re-
moval of debris, cleansing and drying of the cavity and application
of a pledget of cotton dipped in eugenol and then touched in iodo-
form crystals and acetate of morphia powder, the whole placed in
actual contact and sealed with bibulous paper saturated with san-
darac varnish or chloro-percha without pressure, will bring your
patient back next day happy and relieved, ready for whatever you
may deem best to do further. Quick thermal changes are excellent
helps in finding out "what's the matter." If colder temperature
produces quick pain, the pulp is surely in full life, and the above
mentioned conditions and course of treatment are indicated.
If, on the other hand, cold produces relief, and heat a welling-
up or paroxysmal pain, you will diagnose at once a congested pulp,
that is, one where the application of heat induces an increased
flow of arterial blood into the pulp tissue which the capillaries are
unable to handle and return promptly. This pressure of engorge-
792 THE DENTAL REVIEW.
ment produces paroxysmal pain, which will be relieved by quick
wounding and bleeding of pulp, followed by the same dressing
mentioned above. A stage further on, you will find — especially
in teeth of more than one root — a portion of the pulp converted
into pus, which, on uncovering and venting, will often enable you
to see the heart pulsation welling through the opening of chamber,
thus showing that a pcnrtion of the pulp further up the canals
is still living. Depletion, cleansing and the same dressing before
mentioned means relief to yowx patient. (Let me here remark that
"wherever I have used or may use the term cleansing, I mean the
free use of H., O^ with the Dunn syringe, as the simplest and
most convenient vehicle I have yet found for liberating the oxygen
where it is most needed to get in its work of purification.)
The next stage is where the tooth is sore and elongated, and
pulp not very sensitive. On opening you will find a putrescent pulp,
the gases generated from which have forced their way through the
apical foramen, poisoning and inflaming the peridental membrane.
To relieve, you have but to cleanse (that is, boil out with H, Oj
and dress canals lightly with phenol sodique, iodoform and mor-
phia.) A little later, this case would present with swelling and
soreness of the surrounding tissue, tending toward alveolar
abscess. The same treatment with the additional use of stimu-
lants and counterirritants to reestablish circulation on the mus-
tard plaster principle, will give relief. In these cases the lancet is
always a factor of resource to be held in great consideration, for
it is often helpful in every stage of inflammation from its begin-
ning to pus generation. If you use the knife, be sure to cut to
the spot and to the very bone too. Oftentimes the cutting and
venting of extravasated blood will abort an alveolar abscess.
When you find fluctuation and pus indications, get there with
the bistoury, deep, sure, and quick. Applications of cloths wrung
out of hoi water to the surrounding tissues after using the knife, is
often very helpful.
Gentlemen, this subject is so very prolific and diffusive that any
attempt to properly handle it in a paper is like trying to cover a
ten acre lot by walking over it. I now leave the field for you to
occupy.
ORIGINAL COMMUNICATIONS. 793
Plastics.*
By D. M. Gallie, D. D. S., Chicago, III.
In presenting this paper to you to-night, I do not expect that I
will be able to advance any new ideas or methods in the use and
manipulation of plastics, nor do I expect that you will glean any
new information from the reading of it, but I trust that the discus-
sion which may follow will accomplish that which I have failed to
make clear or bring before you.
The too free use of plastic material I consider has done a great
deal to injure the profession of dentistry, for by its aid quacks and
charlatans have been able to hoodwink and rob the public by
plastering and puttying everything in the shape of a cavity, and
finishing all by the name silver or bone fillings. The first of the
plastics that I will dwell on will be amalgams, as I consider them
the most satisfactory and deserving first consideration, and before
finishing this paper will dwell briefly on the cements and gutta-
percha. Copper amalgam I will pass by, for you have just
listened to a paper on that material.
About the year 1820 a Frenchman presented to the then small
class known as dentists an amalgam which was at that time called
a mineral cement. It was used, abused and condemned by many
operators at that time ; in fact it gave poor satisfaction and it was
only when Townsend and Flagg investigated the material, that any
kind of perfection was attained, and the amalgam to-day is the
result of their investigations and experiments.
Though amalgam cannot by any means be considered an ideal
filling, it comes nearer filling the bill than any of the other plas-
tics; it has its defects, but it possesses the good property of dura-
bility. True the unsightly margins and bulging surfaces after a
few months wear cause a great many to cry it down and condemn
it, but by proper amalgamation* and manipulation which I will
speak of later, a great improvement can be made in this direction.
The discoloration of the tooth by this material is imfortunate and
unsightl}', but in order to preserve, amalgam must discolor, and the
opinion is that it discolors and darkens in proportion as it preserves.
This discoloration, which is caused by the deposit of metallic salts,
which become insoluble, possesses therapeutic properties which
*Read before the Odontographic Society of Chicago.
794 THE DENTAL REVIEW.
preserve the tooth; and quite frequently we will find apparent
leakage around a margin and no signs of new decay.
But I will say in regard to discoloration, that much improve-
ment can be made by using the same precaution as is necessary
to avoid bulging surfaces, and that is proper amalgamation of the
filings and mercury.
A great many operators washed the amalgam after mixing,
believing that by doing so less discoloration will follow, but this
practice has fallen into disuse on account of the moisture that re-
mained in the material, which many claimed caused more discol-
oration.
I will now speak of the spheroidal tendency which you all
know is the most prominent defect of amalgam fillings. That
the material becomes hard by cr3'stallization of the mass
and evaporation of mercury is known ; hence it is neces-
sary that the greatest care should be taken to have the
proper proportions of amalgam and mercury. To do this
a great many advocate the weighing of each, but such practice
requires a great deal of time, more, I have no doubt, than many
members of this Society can spare, and I think just as good results
will follow the use of mortar and pestle. Pour the desired amount
of filings into mortar and add a small quantity of mercury, mix
well or rub well ; if too dry add mercur}^ until the mass is of pro-
per plasticity. It is well to avoid the use of too much mercury,
for when you squeeze this surplus out there is danger of losing a
certain amount of the alloy, and if this is done your alloy will not
be of proper proportions, and this also affects the crystallization and
setting of the filling. Some operators claim that it is better to
have the alloy that is used in the last one-fourth of a cavity a
little drier than that used in the first three-fourths, for often we
find when a large cavity is about three-fourths full there is visible
on the surface quite an amount of surplus mercury; if the material
for the last one-fourth is dryer we will have the surplus taken up.
This I consider a good idea and, if followed carefully I think we
would see fewer crevices around margins and bulging surfaces.
A great many of the failures with plastics can be attributed to
the carelessness in preparing the cavities. Now I consider that
in preparing a cavity for amalgam, the same care and thoroughness
should be given as when the cavities are prepared for gold. First of
all, I believe in using the rubber dam wherever it is possible, for
ORIGINAL COMMUXICATIONS. 795
although amalgam is not affected by moisture to the same extent
as gold, we all know that moisture is detrimental and entirely an-
tagonistic to a good operation no matter what material we use.
In the preparation of grinding surface cavities we experience
no trouble, but with some buccal and proximal cavities we do'.
All frail walls should be trimmed away, although not to the same
extent as for gold, all decayed and softened dentine removed
unless by doing so we endanger the pulp. In such a case it is
advisable to allow sufficient substance to remain to cover the pulp.
This should be carefully medicated with some of the medicinal
agents used for disinfecting tooth structure ; namely, the essential
oils and then use a capping of cement or other nonconductor.
A cavity for this material should if possible be somewhat ball-
shaped, but comparatively few cavities can be prepared in this
manner. Still we can aim to have the wall form the segment of a
circle b}^ preparing a cavity, in this manner we will have it nearer
the spheroidal shape required. All angles and straight walls should
be rounded. By doing this we are less liable to have leakage. The
enamel margins should be cut parallel; if beveled we will have
weak filling margins for the edge strength of amalgam is poor.
We have from good authority the statement that amalgam fill-
ings shorten through their long diameter and lengthen through their
short. Therefore, in preparing a cavity we should strive to have
the walls that embrace the short diameter as strong and well pre-
pared as possible. If such practice is followed we will have fewer
fillings fall out after a few months' wear. In the finishing of grind-
ing surface cavities we should make the surface concave, in proxi-
mal cavities convex. This is necessary of course to save the inter-
proximate space, but also necessary to insure a good filling.
Amalgam, when used as a filling, should if possible be kept out
of sight. To do this we must limit its use to the molars and lower
bicuspids. But quite frequently we are warranted in using it in
upper bicuspids, when an amalgam can be well inserted, and be
serviceable where a gold filling would fail, and we all remember the
saying that a good amalgam is better than a poor gold filling.
The instruments best adapted for this filling are the smooth
round headed, and flat or slightly convex burnisher. B)'^ their use
the operator is more sure of thoroughly packing, and is more sure
of getting better adaptation against the walls of the cavity. The
careless habit of so many operators in finishing amalgams is very
796 THE DEXTAL REVIEW.
conspicuous, a great many onl)^ using the burnislier at the time of
insertion. All fillings should be finished around the gingival mar-
gins while the plastic is soft, and should be burnished down so that
there is perfect articulation. Then a few days should elapse before
they are ground and polished.
The cements, oxyphosphate and oxychloride, I use very little
as permanent fillings. The fact of their solubility in the oral fluids
make them filling materials that should be used with the greatest dis-
cretion. Of the two, oxyphosphate is the most durable. In a few
cases we hear of its lasting a surprisingl}' long time. I found a few
days ago in a large grinding surface cavit}' in a molar of a patient
an oxyphosphate filling that had been in four years, and it
showed very little signs of wear, only slightly cupped out on the
surface. This was in a tooth of a child, and for such cases I con-
sider it a good material, both for the filling of temporary teeth un-
til the permanent ones show signs of erupting, and in the perma-
nent teeth of children under fourteen j'ears of age. Often the
cements are of excellent use for the filling of frail anterior teeth
of adults, whose teeth are too frail to fill with gold, and whose purse
is too light for a crown. That its color is the most desirable of
all filling materials we all know, and for this reason our brothers
across in France are called upon to fill most anterior teeth of the
ladies there with cement instead of gold, but there unlike America
the material cuts no figure with the fee, as the charges are for the
operation, not the material.
The cements are decidedly useful for what we will call inside
work, such as strengthening tooth structure and frail walls, filling
in large cavities that are to be finished with gold or amalgam and
capping pulps, but when used alone its best place is in the teeth
of children. It is absolutely necessary to have perfect dryness
when filling with cement so that the rubber dam should be ad-
justed if possible, or an absorbent used to insure perfect dryness.
Before inserting either oxyphosphate or chloride into a cavity
when the pulp is nearly exposed, the covering should be varnished
with something like copal, then a solution of chloroform to pre-
vent the escharotic properties injuring the pulp. This precaution
should especially be taken when using oxychloride.
In order to have any success with cement great care must be
given to mixing. No doubt we have all had experience with a soft,
sticky mixture, or a dry, crumbling mass. To avoid this we must
ORIGINAL COMMUNICATIONS. 797
become accustomed to using right proportions of fluid and powder.
Mix carefully with a slightly rounded spatula — an agate spatula is
well recommended for this purpose — and when we have a substance
that can be rolled between our fingers like putty it should be
inserted into the cavity and manipulated rapidly as it sets very
quickl)^
The best method I have found for inserting cement is direct
pressure, not the rubbing motion which we sometimes apply to
amalgam. The filling should be kept dry for ten or fifteen min-
utes until thoroughly hard, then finished with strips or fine discs,
and before removing dam, it is well to varnish lightly with
sandarac.
Of gutta-percha I will say little, as its uses are quite limited.
It is exceedingly useful as a temporary filling, and can be used to
advantage in the teeth of children. It is nonconducting and non-
irritating, two properties which especially recommend it. As
gutta-percha has to be heated before using, and as the heat causes
expansion, we have after cooling a leaky filling, and it is easily
destroyed by force of mastication. I think the cause of so
many failures with gutta-percha is that it is improperly heated.
Instead of evenly heating the material, a great many operators pass
it through the flame of a spirit lamp and burn it, thus destroying it.
There are a number of devices used for evenly heating this fill-
ing material, and if some of these are employed we will have better
success. Some advocate the use of oiled instruments for inserting
this filling, as it prevents the drawing away of the filling from the
walls.
A nice finish can be obtained by burnishing surfaces and around
margins lightly with chloroform. Of Hill's stopping and some
other plastics I will say nothing, as they are worked quite similar
to the ones I have spoken of.
Dental Medicines. — Their Specific Action and When Indi-
cated.*
By Edgar Palmer, D. D. S., LaCrosse, Wis.
The advanced, conservative position which the practice of Den-
tal Surgery has assumed, brings dental therapy into an exalted
place in the discursive elaboration of those fundamental truths
*Read before the Wisconsin State Dental Society, July 20, 1893.
798 THE DENTAL REVIEW.
which \z.\ the foundation of success in this specialty of general
medicine. I fear too nianj" of us feel our way along in darkness, or
put too much confidence in others' theories and notions to fit us
for the scientific use of those agents we call medicines in our daily
practice. I shall follow this line of thought in my short paper
which I have the honor to present to you at this time.
No real cure of any disease can be effected, or any scientific ap-
plication of remedies be made without a thorough knowledge of all
the pathological conditions of the parts involved, or, in other
words, the dentist who best understands the alphabet of molecular
change induced by disease, will be the one who treats most suc-
cessfully the impairment of functional activity, for he makes this
knowledge the foundation for nominating changes to be produced,
assisting nature by prescribing chemical substances in harmony
with her laws, thus accelerating instead of retarding therapeutic
service.
I find it impossible, in glancing at my subject, to go over but a
small portion of the field which it embraces, and will confine my
remarks to topical remedies, arranged in two groups, the first of
which will be
OBTUNDERS AND LOCAL ANAESTHETICS.
How to operate upon sensitive tooth structure without inflicting
severe pain is certainly a subject which ought never to be consid-
ered out of place in our deliberations ; for every one ought to real-
ize that aside from sympathy for our patient there is method, rep-
utation, and the success of our operation depending upon our abil-
ity to perform our duties without causing pain sufficient to delay or
defeat our purpose.
The cases of sensitive dentine we have to contend with are very
unlike, and are modified by so many conditions that it is difficult to
postulate any method of treatment which shall prove effective as a
specific.
Two methods, however, are always indicated in such practice.
First,
BY OBTAINING AND RETAINING THE CONFIDENCE OF OUR PATIENTS,
as the presence or absence of pain depends largely upon the men-
tal act. A frank, simple statement of existing difficulties, and a
kind word, timely spoken, will often do more than drugs toward re-
ORIGINAL COMMUNICA TIONS. 799
lieving us of what seemed to promise a painful, tedious operation.
Second,
BY THE EMPLOYMENT OF DRY HEAT.
Hot air lessens sensation by dehydration and contraction, and no
matter whether there is suffering manifested by the patient or not,
dehydration, as well as perfect sterilization of the cavit}' of decay
is indicated.
The number of cases requiring the use of obtunders, other than
this, I find very small in comparison. Obstinate cases, many of
them due to systemic conditions, must be met with heroic treat-
ment. For this purpose, it is my rule to select such agents as will
cause the least suffering ; but any drug powerful enough to cook
albumen, or coagulate the protoplasmic contents of the tubuli, can-
not be expected to be very gentle in its action. Some cases of
erosion or chemical abrasion seem to defy our whole outfit of drugs
and the best hypnotic skill we can command. For such cases a
temporary filling of oxychloride of zinc sometimes bridges over the
chasm and lets us escape.
Passing from this group to
ANTISEPTICS AND DISINFECTANTS,
we are confronted v/ith numerous questions which must be settled
by the physiologist or histologist before any of us can scientifically
enter upon a line of treatment, or formulate a remedy. i\ patient
comes to us with a tooth having a dead pulp, and we cleanse the
chamber and apply an antiseptic. How do we know that tooth is
in a septic condition ? We don't. If we find a tooth tender to
the touch, giving off a putrefactive odor or weeping tears of pus
from a local abscess, we are safe in saying these advanced stages
indicate a septic condition; but we all know these extreme cases do
not form the bulk of those demanding our skill. You will sa}" that
the process of the destruction of tissue predisposes the presence
of putrefactive organisms. The first stage of the putrefactive
process is simpl}' a stage of fermentation, and comes without
odor. This stage of fermentation may or may not be produced by
the action of microorganisms, and it would be simply absurd to
medicate, using the same drug in this stage of fermentation as
indicated for septic and putrefactive conditions. So that in the
treatment of devitalized or pulpless teeth, we should be exhibitiiig
culpable ignorance if we did not recognize these different stages of
800 THE DENTAL REVIEW.
putrefaction in forming our diagnosis of the pathological conditions
in our endeavor to apply a correct line of treatment.
Our materia medica is full to overflowing with remedies for
every stage of this putrefactive process, and I will not epitomize
the well-known list. Supposed discoveries in the science of
pathology, and improvements in the art of applying remedies illu-
minate the pages of journals wherever some of our prolific writers
upon these subjects find space for their new-born fantasy, and I
shall not attempt to cast any shadow of disappointment upon their
factitious light by applying the crucial test of my own experience.
So many agents are good, and so many efficacious in your hands if
not in mine, that I hope your discussion of this subject will reveal
the best.
The fact has long since been recognized in general surgery, that
"life is the great antiseptic," that it is not the wound that requires
treatment, but its secretions. In our practice it is not the tooth
with a dead pulp which requires treatment; but the different stages
of pyogenic inflammation existing in the surrounding tissues from
septic contagion with the putrefactive contents of the pulp cham-
ber. We assist nature to restore health or forestall such derange-
ments by cleansing the tooth of its foulness and making the parts
surgically clean, or, as ordinarily termed, aseptic. This accom-
plished, there is usually little else required but protection and rest
— that kind of rest which is twin brother to cleanliness and godli-
ness in the restoration of healthy function.
One point I wish to emphasize parenthetically, namely, in the
treatment of pulpless teeth in any stage of the fermentative pro-
cess, exclude the saliva.
The pathologist sterilizes his culture tube, plugs it with cot-
ton wool to keep his culture free from the contact of atmospheric
putrefactive germs. In like manner ought the dentist who has
driven out the germs from the surfaces under treatment and is
trying to sterilize the soil, take precaution to shut out the putre-
factive germs contained in saliva, which is capable of supplying
microorganisms much faster than any death dealing agent can
destroy them.
In conclusion, I hope I have made it plain that I have no hobby
to ride, but simply plead for a higher, more scientific, as well as
practical application of well-known truths illustrating the lesson
which meets us at every turn — that the teeth and their pathologi-
PROCEEDINGS OF SOCIETIES. 801
cal states sustain such intimate relations to all portions of the body
that a demand is made upon us for a wider knowledge and more
careful training in general pathology as well as materia medica,
and emphasizing the fact that vmless we recognize this interde-
pendence of the teeth to the pathological conditions of other or-
gans and tissues, and are made to understand these fine affinities
which should exist between the medicines we use and the tissues to
be dealt with, we are prescribing carelessly if not empirically, and
need some gentle reminder to make us realize that we are not doing
ourselves justice or our patients the greatest service.
PROCEEDINGS OF SOCIETIES.
Chicago Dental Society.
Regular meeting July 12, 1892, Dr. J. W. Wassail, President,
in the chair.
Dr. E. A. Royce read a paper entitled "Filling with Crystal
Gold on the Surface of Amalgam."
The President called upon Dr. A. W. Freeman to open the dis-
cussion. Dr. Freeman said: I might say for once in this Society
you have taken me by surprise. I had no intimation that I should
be called upon to open the discussion on this subject, as I have
had very little experience with this method of making fillings. I
therefore hardly know what to say. I feel that I cannot advise
you as a good adviser. I should first like to see the specimens
and then judge in regard to the work. I would say, that I am
always willing to try anything and ever\'thing that I think will save
a tooth. I have always made it a practice of buying things at con-
siderable expense oftentimes and sometimes have found them of very
little good. If we can judge a thing by its looks, I should think
the specimen we have here might be very good. I have put in
perhaps ten or twenty of these fillings, and they have extended
over a period of four or five years. I have never used all crystal
gold. I have used Steurer's gold, but did not have first rate suc-
cess with it, and I have not had perfect success with crystal gold
as I should judge our friend has by his specimens. I have taken
cases where I could hardly make a gold filling and have veneered
the surfaces of them, and they remained quite well. I have
oftentimes mingled with that a little phosphate, and I am looking
802 THE DENTAL REVIEW.
for results from those fillings. I cannot say that I have had
enough experience to recommend the use of phosphate and amal- .
gam highly, but I have had enough experience to recommend it
as a fairly good thing. I believe that it is better than all phos-
phate from my limited experience with it. I am here to gain
knowledge, and not to impart much on this subject.
Dr. J. G. Reid : Mr. President, I do not think I have very
much to say on this subject. I have patched a few gold fillings
with amalgam, or at least tried to, but have never had very much
success with them. If I had taken the fillings out and filled the
cavities anew, I perhaps would have been better off.
I attempted once to put in a gold and amalgam filling, and I got
it about half way in, then it all sqeezed out and I quit. I went back
to gold and tin, and finally filled it satisfactorily. I do not see that
there is any particular advantage gained using an amalgam filling
over tin and gold. I believe a tin. and gold filling combined will
produce equally as good a result. I am not saying this from expe-
rience, because I am not experienced in the use of amalgam as Dr.
Royce uses it. The amalgam filling I attempted to cover with
foil, I expect was a miserable failure, but it would not have been
a success anyway. It looks well. I think the crystal gold com-
bined with amalgam will look better than the foil, and I use crys-
talloid gold entirely, and have for years, and have not used any-
thing else. 1 do not know whether crystalloid gold works with it
nicely or not. It seems to me crystalloid gold would not work as
well as Watt's crystal gold.
The specimen that has been passed around is very good indeed.
All fillings look well out of the mouth. The only way to see them
is in the mouth after they have been in two or three years. I should
say it will expedite some fillings very materially, but not any more
so than with tin and gold in combination. I have great confidence
in this combination and always have had. They fail sometimes
just as any other filling, but that is not the question before the so-
ciety. It is the question of amalgam and gold. I cannot speak on
this subject from a practical standpoint. I have never put in one
of these fillings in my life, and have never seen one put in as rec-
ommended by Dr. Royce, that is, the filling being started on soft
amalgam.
Dr. C. p. Pruyn : Unfortunately I did not hear all of the pa-
per. I think I heard enough of it to get an idea of what the essay-
PROCEEDINGS OF SOCIETIES. 803
ist intended to say. I have heard him talk on a previous occasion
on this subject. I have tried in one or two instances to carry out
the ideas that he has advanced, but I have not succeeded for some
reason. I do not know just why I have been unsuccessful, but I
have failed to make the gold work. I have failed to get the gold
to thoroughly unite with the amalgam, and it became a mixed up
mass and did not work well in my inexperienced hands. The other
method, the mechanical union of gold and amalgam, is one that
has interested me considerably, but I think perhaps that is foreign
to the subject of the paper. If it is not, I might talk a little on it,
I am a thorough believer in gold and amalgam. I have practiced
this method in many cases ever since I commenced to practice,
putting amalgam in at one sitting, and at a subsequent occasion
putting on gold. Where this is done there is rapid oxidation of
the amalgam, so that it becomes black like copper amalgam, and
the gold remains bright and clear, and if proper pains are taken the
amalgam filling is quite as good as with gold. In the worst cases,
where you use such a combination, you preserve the teeth better
than with either one of the metals alone. This is my belief founded
on fifteen or eighteen years' experience. Doubtless many of you
have seen cases that have been in my hands in former years; they
have drifted into your hands. You may have seen these opera-
tions. If you have not, I would like to show them to you. Take
the class of teeth spoken about so persistentl}- a few years since by
Drs. Chase and Palmer, below the average in quality, they could
not stand well with metal alone. If you take this combination you
will have better results with it, I think, than with any other one
method that can be used. The curse that was heaped upon amal-
gam ought not to have been upon amalgam per se, but upon the
slovenly way in which it has been used. It is a good filling mate-
rial for saving teeth. There is none better if it is used as it should
be. If any of 3^ou have never filled a glass tube with amalgam, do
it, with paper wrapped around it, then take the paper off and see
the imperfections in the filling unless ordinary care has been used.
The practitioner will see air spaces where he thought the amalgam
was in complete apposition. It takes no longer to fill a tooth with
amalgam now than it did fifteen years ago. I have found that it
needs time, it cannot be done as we were instructed to do it years
ago. It cannot be done slovenly ; we must use just as much care
and thoroughness as with any other material, and I don't know
804 THE DEXTAL REVIEW.
but more. Then, we have with it a peculiar electrical condition
of things that will destroy the microbes that produce decay. Amal-
gam does its best work at the cervical margin ; gold does its poor-
est work at the cervical margin. Amalgam does its poorest work
upon crown surfaces or angles ; gold does its best work there.
Take a large cavity in the distal surface of a second molar, fill it
with amalgam, but with no attenuated edges. The cavity must be
prepared differently for gold. We must have good., sharp, square
cut walls, otherwise the attenuated walls would be chipped down
and break off. We must have a beveled surface, there you use
gold to advantage, using these two metals only. Where you use
one at its strongest point and where it does its best work, you do
your patient better service than if you attempt to use gold alto-
gether. When I do work of this kind, I do not propose to put in
such fillings for $1.50 or $3.00. If necessary, I charge $10.00; I
charge the patient for time. If you are doing your patients a ser-
vice with amalgam that you could not do for them with gold, charge
them for it just as though you were using gold.
Dr. J, H. WooLLEY : In using a combination of amalgam and
gold, do you fill with gold before the amalgam sets ?
Dr. Prl'vn : I do not. I have never advocated that system.
It does not seem to me that it is as practical, when done on me-
chanical and philosophical principles, as the other ; still the essayist
has shown from his experience that it is satisfactory in his hands.
Dr. a. E. Matteson : I cannot say that I have had a great deal
of experience with amalgam and gold as a filling material. I am
firmly convinced that amalgam is a good thing, and that gold is a
good thing. I have seen some very poor results from the use of
amalgam and gold in combination from the best operators in the
countr)'. I have used amalgam and gold in combination fre-
quently in repairing cervical margins, and I have had very good
results following the use of them in that waj'. The great trouble
with the use of amalgam is, in my experience, due to a lack of
proper manipulation. I doubt if twenty five per cent of practi-
tioners who are using amalgam use it as it ought to be used.
They do not follow the directions. They have not the combina-
tion that was originally made, because they make amalgam and
press out parts of the alloy with the mercury in excess. It is all
wrong. If the combination is correct it should be there and the
mercury should be in proportion as it forms the mass. If there is
PROCEEDINGS OF SOCIETIES. 805
too much mercury, add more alloy, and vice versa. I believe that
a great majority of the failures are from a lack of manipulation.
I have occasionally filled cavities (proximal) with the first half
of amalgam, and gold for the remainder, for a number of years,
allowing the amalgam to remain two or three days, then polishing
and finishing it, then building over it with gold. I believe that
there is chemical union after it has been allowed to set.
Dr. a. W. Harlan : I listened very attentively and carefully
to Dr. Royce's paper, and his ideas on the subject are very ex-
plicit. He says in a certain class of cases he mixes amalgam dry
and uses a matrix, packs the amalgam between the cavity wall and
matrix nearly up to the edge of it and adds crystal gold until there
is perfect union, then he fills the tooth with gold. That is very
plain, and I believe I will try it. I have filled a great man}^ teeth
by introducing amalgam first, then cutting out the next da}' or at
some other period, a sufficient quantity and welding on with gold.
I think it is justifiable practice, but not always. I tell the patient
what I do it for. I have had very good results from operations of
this kind, but to say that it should become a general practice would
be far from what I mean. It is adapted for a certain class of cases
where it is impossible to make a good firm joint between the gold
and tooth structure on account of the difficulty of reaching it with
gold, so that it can be thoroughly packed, and the class of teeth
where there is still greater difficulty in making a perfect edge out
of the quality of the material. This other method, it seems to me,
is preferable to the one I have practiced. I shall try it. Anything
that will help to save a tooth is worthy of trial, and this seems to
offer a new line for experiment. You do not need to make many
of these fillings before you find out what the result will be, and if
it is satisfactory it will become an accepted mode of practice.
Dr. R. B. Tuller : My first experience in trying the method
of filling outlined by Dr. Royce was a little peculiar. I heard him
describe his method on a previous occasion, and the first opportu-
nity I had I tried it. I put in my amalgam at the cervical margin,
filled up about one-third, and commenced packing in Watt's crys-
tal gold, and as I was packing that in I was knocking out the
amalgam until I finally found the cavity was filled entirely with
gold. That experience taught me that the matrix was an essen-
tial feature, and since that I have tried it in several cases where it
has given me a great deal of satisfaction; but whether it will stand
806 THE DEXTAL REVIEW.
the test of time we will have to wait and see. It has been so satis-
factory to me in a certain class of cases, as described by Dr. Royce,
that I shall try it I think whenever such cases present; but I am an
advocate of gold wherever I can use it and make a filling that will
do what we aim to do — preserve the teeth. There are some cervi-
cal borders where the best and most skillful gold workers in the
profession could not, in my estimation, make as good a gold filling
as could be done with amalgam.
Dr. Geo. J. Dennis : I have had no experience in this line,
but I have had the opportunity of seeing several of Dr. Royce' s
fillings that have been in four or five years, and all of them seem
to preserve the teeth, with the exception that the walls of the teeth
were frail, the}' were split off, leaving the gold and amalgam ex-
posed from the crowns of the teeth to the cervical border. When
I looked at the tooth, it seemed to me the wall had broken down,
or the tooth had split off because of the expansion of the metal.
Whether that was true or not I cannot positively say. There ap-
peared to be a chemical union between the two metals, the gold
and amalgam. The amalgam was pitted on its surface. The
proximal surface was also pitted to a certain extent on the surface
next to the tooth wall. The only objection I have to the use of
amalgam is, that there is an unequal degree of expansion or shrink-
age in the case of the gold; that is, if very much mercury is used
in the amalgam it takes up considerable gold. In the case in which
the wall was split off the cervical border was perfectly preserved.
Dr. J. N. Crouse : I have not had much experience with a
combination of amalgam and gold, except as I have observed them
in the mouths of patients, or where a gold filling had been put in
and somebody put amalgam in and patched it up. I had a mouth
of that kind to-day with eight or ten amalgam fillings combined, in
different teeth. From the hands the cases were in, I know why
amalgam was in the teeth. In one or two instances I have gouged
out some portions of amalgam fillings and added gold rather than
take out all the amalgam. It is a kind of operation that I should
regret to see highly recommended to beginners or practitioners in
middle life or old age. It tends, I think, to slovenliness. You can
put an amalgam filling in a tooth where it is not half prepared and
have it look well, and the chances are that if you operate with
amalgam you will not properly prepare the cavity, whereas you
would if you used gold. It has a tendency also, in my opinion, to
PROCEEDINGS OF SOCIETIES. 807
take away the enthusiasm of the operator, that influence that every
good operator must have and that fills him with encouragement,
when he has done a good piece of work. When a dentist has per-
formed a good operation he looks upon it with pleasure. One of
the fascinations of operative dentistry is the beauty and perfection
the operator sees after he has made a great effort. It is not only
true of dentistry, but it is true of everything in which a man suc-
ceeds.
What can be the advantages of amalgam and gold combined?
It has been said that it has an additional influence in that it de-
stroys microbes. That is a very indefinite proposition. If there
is anything in a combination of mercury and tin, platinum and cop-
per fillings, of amalgam and gold, I should think it would be used
exclusively for the destruction of microbes. Personally I have very
little faith in such a theory or that kind of recommendation. The
onl)'^ good ground for the use of this combination is where the cav-
ity passes so high up that it is impossible to get the dam above the
cervical margin without inflicting a great amount of torture to the
patient. You can pack amalgam quicker, and the very small
amount of moisture that comes in contact with it and the cervical
margin will not interfere with the operation. I can see how that
can be done with credit and success. Generally speaking, if the
practitioners of dentistry would practice the old and first method
that had merit in it, which is packing soft cylinders of noncohesive
gold, they would have an operation that is more perfect as to the
safety of a tooth, consume very little more time, and would have
that influence that shows when you are through that you have ac-
complished the object that you started out to accomplish. Show
me any college that teaches its pupils how to pack soft cylinders of
noncohesive gold, and I would like to have a photograph of it. If
there is one in this country that does it, I do not know where it is.
It requires good judgment and self-collection to do it. You cannot
pack noncohesive cylinders and talk; you have got to have your
mind on the work. If there is any better way of filling teeth than
that I want to see it.
If I understood the essayist correctly, one of his reasons why
amalgam is better, was, that the packing of gold took away the ex-
cess of mercury, etc. I want to say that teeth can be saved in
the way described by the author of the paper, but where are the
advantages ? Is it better than gold? I challenge that proposition
808 THE DEXTAL REVIEW.
to any kind of test that may fee brought out. If you are going to
use amalgam in connection with gold, I would recommend its use
in large cervical cavities where decay has taken place beyond, and
in order to fill such teeth with gold properly you have got a good
deal to do. It would be justifiable to pack gold with amalgam in
such places. I have performed this operation, I have gouged out
gold away up under the margin of the gum, and have patched it
with amalgam or gutta-percha. I do not know which is the better
of the two, but I should say gutta-percha.
Dr. C. F. Hartt : I believe most of the gentlemen who
have spoken to-night are away off. I have given up entirely the
filling of large cavities with metal of any kind. A tooth of good
structure should be filled with gold, and teeth below the average
should be filled with cement. If we want something to hold the
outside walls of the cavity together, fill the teeth with cement,
then cut out say the sixteenth or. eighteenth of an inch all around
up to the enamel margin, and have a smooth, clean cut margin
wherever the enamel and cement come together. Fill that full
with gold. You cannot get up there with cylinders, a spongy mass
like that. You make a little retaining point or groove, you can fill
it with cement, and you will be astonished how little gold is neces-
sary to spread over the surface to protect the cement. It is a mis-
take to fill teeth with metal of any kind. Cement is the thing, then
pack over it anything you want to that is durable.
Dr. E. a. Rovce: One of the first objections that I expected to
hear has not been spoken of, that is the liability to mistake the
color given by the amalgam at the gum margin, for decay. This
may be obviated by allowing the amalgam to extend farther down
upon the lingual aspect of the tooth so it is plainly visible.
In regard to noncohesive gold, I think that since I have been
in Chicago, I have given more clinics to demonstrate its use, than
any other man in the cit}'. I have at the present time under
observation a number of cases where the compound proximate
cavities of molars and bicuspids are built up entirely of noncohe-
sive gold, the contour is such as to give fairly good points of con-
tact, and the fillings are doing good service. I use the combination
of tin and gold for a large class of cases, and am perfectly satisfied
with it in its place.
Gold and amalgam should not take the place of gold. The best
operators in the countr}- are losing gold fillings every day, not
PROCEEDINGS OF SOCIETIES. 809
entirely because of faulty manipulation, but in a great degree
because of galvanic action. In the combination the amalgam will
oxidize rapidly, stop the current, stop any minute openings, and in
that way assist in saving the tooth. I do not attempt to save
time by its use but save the tooth that is below grade.
Crystal gold acts so nicely with mercury because it is manu-
factured by making a gold amalgam, and the mercury is then
removed by acids, leaving the gold to be prepared for market.
Address of Mr. H. C. Quinbv, L.D.S.I., Retiring President of
THE British Dental Association.
Inaugural Address by Mr. H. C. Quinbv, L. D.S.I.
Mr. Quinby thanked the Association for the position in which
they had placed him, and he did so, he said, all the more because he
believed that while conferring the highest honor in their gift upon
him they intended to reflect honor upon the type of American
dentistry which was so well represented on this side of the Atlantic
when he came to England earl3Mn the first decade of the second half
of the century which was now drawing to a close. While there were
some features in the present aspect of what was called American den-
tistry which American dentists were not proud of, he was sure there
would be a general feeling of pride in the fact that on the first occa-
sion on which the members of that Association had seen fit to elect an
alien to occup}' the Presidential chair the choice had fallen on an
American. Proceeding to point to some of the causes of the change
that had taken place in the estimation in which American practice
was held now compared with what it was forty years ago, he said he
wished to speak of some of the phases of what he must call unpro-
fessional conduct which had brought discredit upon American
dentists at home and abroad — discredit which was deeply felt by all
earnest, conscientious members of the profession in America.
Before doing so, however, he desired to remind the meeting of the
immense strides which English dentists had made in scientific
conservative practice in the four decades to which he had alluded.
There was no profession without its camp followers, a parasitic class
which never by any chance reflected credit upon the professional
prestige and dignity. That class would always be found hanging
upon the rear of the main army, ready to pick up such crumbs of
810 THE DEXTAL KEVIEW.
emolument as it might be able to seize, and would not have any
scruples about carrying off the whole loaf if circumstances should
permit. Living in a state of warfare against their own kind, as well
as against the community, they naturally acquire a certain sharpness
of intellect which, with a limited knowledge of technique, made it
possible for them to impose upon the credulous and ignorant.
Another class not much more creditable, having obtained what
appeared to be a legal right to a place in the ranks, but lacking the
true professional feeling, drifted away into practices which no man
of standing would countenance. Some of that class had no capacit}'
to govern themselves, and fell into the hands of those unscrupulous
practitioners who were always on the watch for opportunities
to make ust of brains which had been able to gain a qualification but
were not regulated by that moral rectitude which was so necessary
to keep abilit}' in straight paths. Such men soon lost their self-
respect (which might, under wholesome direction, serve in the place
of honorable principle) and rapidlj' degenerated into mere hacks
in the team of quackery and charlatanism. There was also too
much reason to think that a traffic in illegitimate diplomas had
been recently revived, if indeed it had ever ceased to exist within
the last thirty years, and those, which were purely a matter of
purchase, without the too troublesome formality of examination,
and which would be useless to a respectable practitioner, were made
to pass as current coin for advertising purposes, where genuineness
was not considered essential. It was also much to be regretted that
the decision arrived at b}' the assembled faculties of the American
dental colleges to the effect that no diplomas should be granted
/// absentia or without full compliance with the specified curriculum
had not been so religiously adhered to as it might have been. It
was reported that even an honorary degree granted by the oldest
dental college in America (though why an honorary degree nobody
could understand) had been used in the most unscrupulous manner
for advertising purposes both in the public papers and by circular.
The restrictions on registration should be such as to prevent the
great mass of those men from practicing on their own account in
this country, but an evasion of that part of the Dentists Act by
means of a system called "covering" had been for some time rather
extensively carried on by certain men who were not eligible for
membership of that association. Under that S3'stem, which
was manifestly contrary to the spirit of the act, he was given
PROCEEDINGS OF SOCIETIES. 811
to understand that numbers of 3 oung Americans possessing
qualifications, or what appeared to be such, and which had been
advertised as American quahfications, even giving the names of
the persons supposed to be so qualified, were employed in
dental practice, although none of them were registered, that
want being covered by the sole registration of their employer or
manager. Certainly none but those who were totally destitute of
all the instinctive aspirations which elevated and ennobled the
professional life could engage in a system of practice which involved
advertising in the public newspapers.
It was a well recognized principle in the liberal professions that
advertising barred from membership of all professional societies
and associations those who made use of such public announcement
of themselves and the advantages they claimed to be able to give
their patients or clients; in short, it simply meant professional
ostracism, and it was quite time that the public should know that,
and be able to judge whether men who had forfeited, or never
obtained, professional recognition were to be trusted to perform
professional duties. They could not, however, ignore the fact that
at present the constant reiteration of a phrase or a statement did
make an impression on a very credulous portion of the public, and
it appeared to be just now the policy of those advertising institu-
tions to keep a certain phrase constantly before the public eye, and
to convey the idea that it was essentially an American class of
work, whence arose the necessity that the employes should be
Americans to give some appearance of consistency to the decep-
tion. He alluded to the stock phrase "crown, bar, and bridge
work" as being the latest form of imposition upon that portion of
the public which took its ideas of dentistry from advertisements.
It was evidently intended to suggest a new development of dental
science, by which any broken down and hopeless antiquities
in the mouth might be restored to permanent usefulness and
beauty. (Laughter.) They knew what utter nonsense that was;
that in reality the phrase meant little that was new in dental prac-
tice. Another subject which had sorely exercised the minds of
their American colleagues of late had been the ethical effect upon
professional character and standing of the taking out of patents on
ideas and methods which were purely professional in their applica-
tion. He thought they might admit that the Americans were an
inventive people, and that the great facilities given by the United
812 THE DENTAL REVIEW.
States Government for the procuring of patent rights had done
much to develop and stimulate that talent. It was the purpose of
the statesman who framed the patent laws that the}- should have
the effect of encouraging a talent which the American colonists
inherited from their British ancestors, but which had thriven well
from the necessity which made men who were placed in new
surroundings where additional labor was unattainable, think out
and contrive ways and means to increase the capabilities of their
own hands. In the case of surgical appliances there did not
appear to have been to any noticeable extent, if at all, any reserva-
tion of rights by the inventor; the ideas, the methods, and the
means for working them out had been freely and fully explained
and illustrated in the professional journals, and the instrument
makers had loyally exercised their best skill to perfect the instru-
ments suggested by the surgeon, who in due time received and was
satisfied with the approval and thanks of his colleagues. He was
sorry to say, however, that that had not been the case in too many
instances with the instruments and preparations for the use of
their branch of surgery in America. In confirmation of that state-
ment, he pointed to the buying of royalties upon the use of vulcan-
ite for dental purposes in America, and to the selling, by men
claiming a professional standing, of patents taken out by them to
the large manufacturing companies who made and prepared instru-
ments and materials for dental surgery. Those were, he believed,
some of the reasons why the word American, used as a prefix to
dentistry, constituted almost a term of reproach, for on this side of
the Atlantic it had become, he was sorry to say, synonymous with
the veriest chicanery and humbug; but America had not ceased,
and he hoped would never cease, to produce dentists that were
honorable men, and who would cordially agree with the sentiments
of a late letter in the Times by a distinguished member of that
association, who said, " Dentistry, like medicine and surgery, is
catholic, and is practiced by honest men for the public good, and
therefore all its methods are made public to all members of the
profession." A professional man, by the act of adopting a profes-
sion and qualifying himself to practice it waived the right, morally,
to keep to himself for his own profit, any knowledge which would
benefit his professional colleagues and help them to be more use-
ful to their patients. He meant that if the idea of some new
operation, or of some improved means of performing an operation.
PROCEEDINGS OF SOCIETIES. 813
occurred to a man, it was only a matter of duty to make it known
to his colleagues as soon as possible after verifying its value.
They had what they considered to be more than their fair share of
charlatanism in this country, but the}' could not be too thankful
that they did not find it in their associations and scientific socie-
ties. Their numbers, actuated by the true spirit of professional
life, were read}' to give freely their contributions to professional
knowledge, while fully conscious that, however much they might
give, it was but an atom in comparison with the much they had
received. So long as respect, esteem^ — they might say brother-
hood— could be maintained in their association and societies they
might take it for granted that they should have no claims made by
their own members for patents; but they must take care that as
few such claims as possible were established by those who chose to
stand aloof from their association and those others whose unprofes-
sional practices rendered them ineligible for any association, in the
broad sense of the word. Commenting upon the address of his
predecessor in London last year, an exposition of the etiology of
tooth deterioration, in which he entirel} concurred, he said they
went too far back in many things, and made the fathers account-
able for their children's sins. But if they would correct the
faulty structure of the children's teeth, if they would supply them
with the proper materials in a form to be properly assimilated
for the building up and nourishing of their teeth, they must go
far back as the mothers, or rather they must teach the mothers
of the coming generations how it must be done. The feeding
must begin before the child was born; and it must continue with
watchfulness and discriminating judgment through infancy, child-
hood and adolescence. That that should be intelligently and
effectively done it was necessary that every dentist should be a
teacher, and endeavor as far as possible, to disseminate informa-
tion on all possible occasions. They were doubtless all aware
(certainly those who had had much experience were) that attempt-
ing to teach men and women to do or to leave undone such things
as might give trouble or interfere to some extent with their com-
forts or their pleasures would be a thankless task in most cases,
but when they sowed good seed broadcast some of it would fall
on good ground. There were many mothers who were so sincerely
anxious for their children's good that they would listen to teach-
ing about present care for the future good of their teeth, and
814 PROCEEDINGS OF SOCIETIES.
would try to act upon the instruction which was given them, if
they believed in the teacher, even when it did not in all respects
conform with what was taught by their grandmothers. It was to
those who wished to learn that they must look with some degree of
hopefulness for a beginning of improvement in the structure and
preservation of children's teeth, always remembering that in pre-
serving these they were taking care of the adult teeth. Their work
was to advise, to prevent, to repair, to restore. Immediate results
were not what they should chiefly look for. The future effect of
what they did in the mouth should be the idea ever foremost in
their minds. (Applause.)
The thanks of the association were accorded to the President
for his address.
The seventh annual meeting of the Southern Illinois Dental Society will be
held at Mt. Vernon, Tuesday. Wednesday. Thursday, Oct. IS, 19, 20, 1892. The
following clinics have been arranged for :
T. W. Pritchett, White Hall— "Pulp Canal Filling."
G. A. McMillan, Alton — "Making and Adjusting a Bridge before the Society."
B. B. Tatman, Mt. Vernon — "Bicuspid Crown, Porcelain Face."
A. R. Rainey, Centralia— "Extracting Teeth Without Pain by Local Appli-
cation."
I. G. Dickson, McLeansboro — "Extracting Pulp Without Pain, and Imme-
diate Filling."
J.J. Jennelle, Cairo— "Soft Gold Filling."
W. N. Morrison, St. Louis- "Open Face Crowns."
C. B. Rholand. Alton — "Making and Demonstrating the Crown."
N. H. Jackson. Greenville — "Compound Gold Filling."
R. H. Canine. East St Louis — "Plastic Filling, Administering Nitrous Oxid
Gas."
T. L. Phillips, Nashville, will illustrate his mode of Articulating Full Upper
and Lower Set of Teeth.
SUBJECTS FOR DISCUSSION'.
L. Betts, DuQuoin — "Local Anaesthesia." Discussion opened by H. E,
Van Allen, Carlyle.
L. B. Torrence, Chester — "Inflammation." Discussion opened by W. N.
Morrison. St. Louis.
G. A. McMillan. Alton — "Odds and Ends of Daily Practice." Discussion
opened by Simon Willart. Mound City.
J. E. Entsminger. Murphysboro — "Dental Medicine." Discussion opened
by L. T. Phillips, Nashville.
L. E. Gordon, Chester — "Treatment of Deciduous Teeth." Discussion opened
by A. R. Rainey, Centralia.
J. G. Harper. St. Louis — "Electricity in Dentistry." Discussion opened by
H. M. Prickett, Springfield.
The Dental Review.
Devoted to the Advancement of Dental Science.
Published Monthly.
Editor: A. W. HARLAN, M. D., D. D. S.
ASSOCIATE EDITORS:
Louis Ottofy. D. D. S. C. N. Johnson, L. D. S., D. D. S.
Dental Students.
The freshmen in our colleges at the present time will need a
little preliminary instruction from what they have had in the past.
It seems to us that the establishment of recitations on different
subjects that are taught, will more thoroughly ground them in the
elementary branches than to place the whole of the teaching on
the system of didactic instruction so generally pursued in re-
cent years. If a class is compelled to recite once per week in
chemistry, physiology, anatomy, materia medica, dental anatomy
and mechanical dentistry— say five or ten pagf s per lesson— with a
competent quiz master, the members will soon be stimulated to
bend their energies to the mastery of a subject. When such stu-
dents are afterward lectured to by the teacher they will have a bet-
ter understanding of the subject than to enter the class room with-
out previous preparation. The practical work in chemical and
histological laboratories will be better comprehended and better
work will be done. The subjects named are not arbitrary; in fact,
too many subjects may have been named, but the idea of a fixed
recitation will entail on the student the necessity for a definite
amount of reading. Too few of our students are thoroughly well
equipped in first principles, and if such methods of instruction are
undertaken we believe that the classes will show a more marked
appreciation of such subjects at a later period.
This need not interfere with practical work in the mechan-
816 THE DLXTAL REVIEW.
ical laboratory or the technic room. In addition to storing up use-
ful knowledge the student will have less leisure time to be frittered
awa)' in the aimless pursuit of matters not beneficial to his future
welfare. We hope to see the experiment tried systematically.
A Correction That Does Not Correct.
The learned editor of The Dental Practitioner and Advertiser
in his October issue corrects the prescription of the erudite Miller,
published in the July number. What must be his "feelinks" when
he discovers that arseniosi is spelled "cosi," which makes us to re-
mark that the sympathy of a brother in distress goes out to him in
his hour of trial. But there is a bright outlook ahead — the
thought that the proof reader will once more have to wrestle with
his manuscript should sustain him; he will get at him again — say
in January or even in December's dark days. That's the way we
punish 'em. No holiday gifts will efface the hours of anguish
spent in trying to decipher his hieroglyphics — nor ours for that
matter.
REVIEWS AND ABSTRACTS,
EXTR.^CTS FROM AN ADDRESS BeFORE THE MASSACHUSETTS StATE
Dental Society.
Bv L. £). Shepard, D. M. D., Boston, Mass.
Mr. President and Members of the Massachusetts Dental Society:
Over a score of years ago I had the honor to deliver the annual
address before this society. I chose as my subject Professional
Fidelity, which I treated in its three relationships of fidelity to pa-
tients, to the profession and to one's self.
On the present occasion my invitation to address you is coupled
with the assignment by your executive committee of a subject,
namely, "What changes are necessary to make the Massachusetts
Dental Society more efficient as a State Society and more thor-
oughly representative of the whole profession of the State."
I must assume that the honor of this second choice and the cir-
cumscribing of my efforts to a stated subject presupposes that from
my long experience in dental society work I may be sufficiently fa-
REVIEWS AND ABSTRACTS. 817
miliar with the past history and present conditions of the society
and the profession as to be able, in a measure, to assist in pointing
out the way by which the fact, which we must conclude is a fact
from the giving to me of the subject, shall cease to be a fact. ■ In
additional proof that the society is not as efficient and representa-
tive as it should be to hold the position of the Chartered State So-
ciet}', I need only to remind you that it has to-day enrolled on its list
of membership onl}' about eleven per cent of the legal practitioners
of the State, and also more instructive and discouraging, that a
larger body, about fourteen per cent of the profession, have been
members but are not now, having withdrawn or been dropped. It
will be my aim with as little superfluous language and as plainly
as possible to try to answer why this is so and to suggest some of
the remedies.
The first and principle cause of the failure of the society to
have been in the past or to be at present what its name implies, a
State Societ)^ will be readily apparent from a study of the history
of the last three decades.
Thirty years ago there was no dental society in New England.
I think one or more had been organized before that date, but prac-
tically the statement is correct. In fact, throughout the country
the societies were few in number. It was just at the dawn of the
grand society rising which has brought so much light and life into
our bod}^ The societies and colleges mutually reacting jointly
merit the credit for the marvelous progress since that date. The
dentist of that day was generally a poorly educated man. Here
and there a graduate in medicine or in dentistry might be seen,
but the great mass were graduates only from the laboratory and
office of a practical, frequently ignorant, dentist. I need not en-
large upon this point. It can be verified by many still amongus
who remember the darkness cf that hour just before the dawn, and
by referring to the many addresses and reminiscences which may
be found in the magazines.
It is rather singular that almost simultaneously three large and
pretentious societies, still flourishing, were organized in Massachu-
setts. The Merrimac Valley, now called the New England, was
started in Lowell in May, 1S63. The Connecticut Valley, in Spring-
field, in November of the same 3'ear, and the Massachusetts Dental
Society in Boston a few months later, March 4, 1804. These three
societies were started almost exclusively by three different sets of
818 THE DEXTAL REVIEW.
men, and naturally at the beginning, and for some years, covered
the three sections of the State, the northeastern, the western and
Boston and vicinity. The removals of men from place to place,
especially the promotion of the more ambitious and successful
from the country towns to the cities and the activity of the leaders
in educational matters has caused, in more recent years, many to
become members and active workers in two or even all of these
societies. Another factor which for a time restricted our society
was the holding of monthly meetings in the evening in Boston,
while the two other societies held semiannual meetings of one or
more days' continuance.
It is a pleasant fact that these three societies have always dwelled
together in peace and harmony, frequently holding joint meetings,
with no friction or jealousies and only that rivalry which is to be
commended, of which should do the better work for self-improve-
ment and the advancement of the whole profession.
As one of the founders of the Connecticut Valley and a member
almost from the start of the Massachusetts and the Merrimac Val-
ley, the histories of these three societies are a part of my own. I
have the honor to have been President of all three, and have been
absent from but a few of the meetings of either. The language of
Ruth to Naomi would express my love and loyalty to each. It
would be difficult, nay, impossible, for the most expert judicial
adjudicator to differentiate between them as to their actual work
for the grovvth of their members, their stimulating influence on
education, especially in inciting the young to commence properly
with a college training and the older practitioner to repair the mis-
fortunes of a false start by leaving business and taking the college
course, or in any other respect in which progress was striven for.
There is, however, one distinction which from the nature of
the territory covered belongs to the Connecticut Valley and the
Merrimac Valley, in which the Massachussets can have little or no
part. These two societies — the one with chief membership from
Western Massachusetts, Vermont and Connecticut, and the other
from Eastern Massachusetts, New Hampshire, Maine, and Rhode
Island — have so stimulated the activities in our sister States
that each State has a State society, all of which are to-day active
and vigorous and doing splendid work. In my opinion each can
justly claim the devotion and loyal support of every dentist within
their confines as his first duty. Every argument which I may
REVIEWS AND ABSTRACTS. 819
advance in this address applies equally to each of our five sisters.
As among women maturity is counted blessed, so should the Mer-
rimac Valley and Connecticut Valley rejoice that their travail has
brought forth such vigorous progeny; and as in the family, when
the two parents have waxed old after years of hard work, and the
children have set up establishments of their own, is it disIo}'al or
unfilial to ask whether the grand achievements of the past are not
sufficient honor and renown, and whether it is not befitting for the
parents to retire from active competition in the same lines and on
the same ground where their children are endeavoring to carr}^ on
the good work in which they had grown gray ?
I yield to no man in my appreciation of what these two socie-
ties have accomplished for New England. Were the conditions
the same to-day as of yore, no question could arise as to their
future usefulness. But the fact is, the conditions have changed.
A wandering society in New England to-day in active competition
with State organizations is an element of weakness and not of
strength, is a drawback to every State society — is an impediment
in the path of progress, is the lagging superfluous on the stage
after its best work is done. A local society where the community
is large enough to support one, is useful as a tributary to the State
society. But with the new conditions and new duties which ob-
tain now, a peripatetic inter-State society is an anomaly, is a sur-
vival of the unfittest, is a relic of a happily past age of adoles-
cence, ignorance and missionary necessity.
The educational victory is practically won. The ignorant and
unskilled dentist is fast becoming obsolete through the thinning
of the ranks by the relentless hand, and with some exceptions,
none but the learned and skilled can have a legal chance to take
his place.
Language fails me to express my J03' and pride at the contrast
between the past and present. It will be but a few years till we
shall have all the honor and recognition as a liberal profession
which the optimist hopes for.
All honor to the noble men who at a loss of time and money
have labored, in the societies and in the colleges, to so
advance professional education that public sentiment has
called for the enactment of laws to protect society from the depre-
dations of the ignorant and unskilled. While the laws in
the various States differ in minor points, they are all in unison on
820 THE DENTAL REVIEW.
the main point, which is that a man must give evidence of compe-
tency. The enactment of a law, however, is but the initial step.
Its chief value lies in its thorough enforcement. To secure this
either public sentiment must be peculiarly interested and vigilant
or there must be some organization to attend to it. A State So-
ciety is the natural guardian of the law. It can act through a
specially appointed committee with the minimum offense to those
who are violators and at the expense of the whole body and free
from the opprobrium of personality.
In the laws of nearly every State, while directions are made
and officers appointed for the licensing of men and penalties pre-
scribed for violators, there is no provision for prosecution or the
appointment of agents to attend to the enforcement of the law.
The obligation upon every citizen, whether dentist or layman, is
the same. The Board of Registration in Massachusetts is an ex-
amining and licensing body and no more obligation rests upon it to
secure the enforcement of the law than upon each dentist here
present and every citizen of the commonwealth. While the members
of the board have prosecuted violators and secured convictions
with fines, they have done so as individuals and not as officials and
also at their own expense in time and money. There has been a
great disinclination on the part of the profession to openly inaugu-
rate or even assist in the arrest and prosecution of offenders, And
even when knowing to violations and writing letters to the board, the
great majority of informers and complainers have cowardly con-
cealed their identity behind an unsigned letter.
Our law is a splendid one notwithstanding a few defects, and
these defects can all be remedied by a few decisions from the
courts. It has done so far a magnificent work. The members of
the Board of Registration the past five years, have contributed for
professional progress, in downright loss of money from time spent
in their ill-requited labors, many times more than any other five
dentists in the State. They have endeavored to do their full duty
with patience, industry and an appreciation of the solemnity of
their official oaths. They have succeeded in so administering the
law, by a liberal construction of it at first, that no man could say
that the new law deprived him of a right which was his before the
law was passed, and afterward by a fair and impartial examination
of all applicants, that the law has grown steadily in public estima-
tion as a wise and just protection for the State. No one outside
REVIEWS AND ABSTRACTS. 821
the board could realize what a horde of incompetence would have
spread over the State except for this barrier, and few, I think, fully
appreciate what it is for a profession like ours to have its members
augmented b}^ one-fifth in five years, all of whom are educated and
skilled. Gentlemen, you are unreasonable and over-exacting when
3'ou expect, or even ask, these generous and patriotic laborers to do
your work.
Taken all in all, notwithstanding the little annoyances, the
arduous labor and large pecuniary loss, I look back upon my
five years' service in the board with great satisfaction. At
the beginning the members were comparative strangers, enter-
ing without experience upon a trying and difficult work,
but the single-mindedness, freedom from pett\^ jealousy, con-
stant courtes}^, earnest devotion to duty and spirit of con-
fidence and cooperation of each member made the board a happy,
loving family of devoted friends. I cannot let this occasion pass,
while considering the subject, without paying this tribute to my
late associates. They will do their duty. We should do ours,
and foremost among our duties is the strengthening of the State
Society, so that it will be the embodiment of the general sentiment
of the whole profession of the State, the right hand of our law,
the advisor of the executive, the guardian of all our interests.
I shall devote but a few words to a consideration of the other
causes which have restricted our membership and caused so many
to conclude that a continued connection with the Society was not
worth what it cost. Chief among these causes is the propinquity
of the members. A very large majority of the members and active
workers from the organization have been residents and competitors
in one city. If you will look over the list of members in the pro-
gramme before you, you will find of the 124 active and junior mem-
bers sixty-four are Boston practitioners and fifteen live in adjoining
places, leaving forty-five for the balance of the State. Neighbors
quarrel naturall}', while association with outsiders begets charit}^
courtesy and breadth. For the past thirty years some of us have
been seen and heard too often. The same gladiators have contended
for victor}' on the same sands, and the audience is tired and wants
new actors and new plays. There has been less of this the past
few years than formerly, though the opprobrium of the bear-garden
days still clings to the Society's name. This will entireh' cease
when our membership is five or eight hundred.
822 THE DEXTAL REV/EIV.
The ambition and striving for office was a marked feature of the
early years, caucuses even having been held, but 1 think it is true
that this evil has been steadily declining.
I cannot find that an}' criticism should be made of the scientific
attractions which have been offered from year to year. The Exec-
utive Committees have worked faithfully, and considering the leth-
argy of members, have generally prepared good programmes. The
papers have been many and worthy, the discussions have been in-
teresting and well sustained, the exhibits have been good — some
exceptionally so — and the clinics pretty fair. On the whole the
meetings will compare satisfactorily with those of other Societies.
The stimulus of a larger attendance will undoubtedly be all that is
needed to cause improvement in these respects.
Let us now consider if there are any remedies and hopes for the
future.
I would recommend :
First. That the doors be opened wide to every legal practi-
tioner who is "worthy and well qualified," wherever his education
was obtained and whether supplemented by a degree or not, who
carries on his practice in accordance with the requirements of pro-
fessional courtesy otherwise called ethics. In other words, the
only question should be character and respectability. Some of our
most valued and respected members, even ex-Presidents, have never
had a degree. If they had not joined the society before the amend-
ment excluding nongraduates was adopted, we should not have
had their esteemed cooperation. Some who were long members,
but by our iron-clad rule about pa)'ment of dues lost their member-
ship, cannot rejoin the society as many in a similar fix have done,
some several times, because of the same disqualification. When
the amendment was adopted provision was made for nongraduates
by the establishment of junior membership. This was well enough
for that time, but has proved less successful than was expected and
should now be abrogated and our nine junior members be made ac-
tive members.
There are two main reasons for this alteration which both came
under the changed conditions of which I have spoken. One is, as
I have said before, that the educational victory is won. The great
object of the early years of society work was to encourage men to
pursue the collegiate course. It may not have been so prominent-
ly mentioned as to merit this distinction, but the leaders and most
REVIEWS AiYD ABSTRACTS. 82S
devoted workers have alwa3's been those interested in the colleges,
— the well-educated and far-sighted men who hoped to live to see
the day tvhen the term dentist should mean as much in an educa-
tional distinction as the term physician does. Many men like Keep
and Hitchcock among us and Harris, McQuillen, Buckingham,
Taylor and scores of others, college professors and society workers,
have passed on without the fruition of their hopes, but can any one
who knew them doubt that the college and collegiate education
held the first place among the motives which made them active in
the Societies ? Since in Massachusetts no one can commence
practice unless he has pursued the regular course or an equivalent,
this object in the Society has ceased to exist. The change then
would affect only those who remain with us from the old dispensa-
tion. They are in a minority to-day in the State and the propor-
tion is fast diminishing, and all can claim an experience of five
years or more. A great many of the answers to my circulars which
I have received have expressed the hope that this change would be
made.
I cannot see that it would be a backward step nor one fraught
with any dangers. The class which from any reason would be
objectionable as associates is not likely to wish to join us, and a
good part of those who would be eligible are as skillful, well-in-
formed professionally, and as desirable as members as many of
those who graduated from college years ago, and some of the re-
cent graduates of some colleges.
The other changed condition results from the enactment of our
law April 1, 1887. Before that day any one could commence
practice with little or no previous training. In fact many did with
practically no professional training and, if possible, less general
education. While the law and the liberal construction of it by the
Board gave these ignorant ahd incompetent men the same right
to continue practice as the educated and competent, it is a fact
that the former have been dropping out of sight as is shown by the
return of letters which could not find them. Before the law the
distinction between graduates and nongraduates was an easy one
and had an object. But since the law has legalized all and as
each man though humble has an influence in his community at
least, he may be the dentist to the rej^resentative or senator from
his section, he should have a chance, though not a graduate, if his
824 THE DENTAL REVIEW.
methods are respectable, to meet every other legitimate practi-
tioner on equal termc as fellow members of the State societj'.
I would recommend : •
2d. That we should exert an influence in so far as we can with
courtesy and propriety relieve our field of the competition of
societies which divide our territory and divert the talent which the
society needs. It is perfectl}' legitimateand courteous for us to
present arguments to those of our members who are also members
of one or both of these societies.
My own position is fair and above board. I have in mind all
the time in writing this address to send a copy of it, if printed, to
each of my fellow members of the Connecticut Valley and New
England Societies. In fact my first move in this line and the
cause doubtless of my being invited to address you to-day was the
resolution which I prepared and introduced to the New England
Dental Society at its last annual meeting. It was passed and the
committee provided for appointed. It has also been passed by the
Connecticut Valley Society and the associate committee ap-
pointed.
The resolution was as follows:
Whereas, A question has arisen since all the New England States have den-
tal societies and dental laws, whether it would be for the best interests of the pro-
fession that efforts should be made to strengthen the several State societies, there-
fore,
Resolved, That a committee of five, of which the incoming President and Sec-
retary shall be members, be appointed by the New England Dental Society to
take the matter into consideration, and to report at this meeting or at the next
meeting.
Resolved, That this resolution be forwarded to the Connecticut Valley Dental
Society, with the request that a similar committee be appointed by that society,
and that the two committees be a joint committee to consider the matter.
The joint committee will meet in due time, consider the matter,
and each committee will report to its respective society. I do not
wish to forestall the work of this joint committee, nor should we,
as a society, take any action in the premises. We are interested
parties and can discuss the matter fully to get all the light possible?
but any action looking to a solution of the matter should be by
these societies and not by us.
This is not a matter of feeling or prejudice. It is a question
for calm and deliberate consideration. It is particularly my expe-
rience the past five years in the State Board of Registration which
REVIEWS AND ABSTRACTS. 825
has convinced me that our greatest need to-day in Massachusetts
is a strong and large State Societ}'. I reason that the same is true
in all States which have laws or wish to have laws. It would be
eas3% if desired, to have union meetings of several or all of the six
New England State Societies, if New England needs any union of
sentiment or action. Similar union meetings have been held. Un-
der the present conditions of the profession, if a man has leisure or
inclination for but one society, that society should be his State So-
ciety.
It seems to me :
3d. That if we are to have a society of six or eight hundred,
as I certainly expect to see within a few years, it would be too
large to be successful, unless subdivided somewhat after the style
of the Massachusetts Medical Society. I will not take time to go
into this topic at length, for it would be the proper work of a com-
petent committee. I would simply say that by the subdivision we
would secure what is now lacking and which is very much needed,
a greater prominence of the social element. This criticism of
the society has appeared in many of the replies which I have re-
ceived. A stranger comes to our meeting for the first time ; no
one knows him or seems to care to know him, and he does not
come agam. But in the smaller district societies, whose meetings
should be held in the afternoon at least three times per year, and
be preeminently social, he would soon become acquainted, have his
heart warmed toward his fellows, while his stomach was also pro-
vided for.
Each district should elect counselors to the number of five so
arranged that one should go out each )'ear, and after the term of
service should be five years each. The counselors of all the dis-
tricts should meet annually, elect all the officers of the society, ap-
point all committees and attend to all matters of a business nature.
This is the plan under which the Massachusetts Medical Society
has worked so successfully.
Our annual meeting then, with the best of the papers which
have been prepared for the district meetings and rewritten after
discussion, would be wholly given to science and sociality, and be
so attractive as to secure a large attendance.
In this case there should be one executive officer, called a Sec-
retary, if you please, who need not be a dentist or even of the male
sex, who should have a sufficient salary to devote a good deal of
826 THE DEXTAL REVIEW.
time to the work, be able to attend most of the district meetings
and know all that is being done in every district. The election of
such an officer should be for a term of years or during good be-
havior. He should collect all dues and be in short the one busi-
ness person or executive officer. The revenues of so large a soci-
ety would be sufficient for this, as well as for the expense of a com-
mittee on the enforcement of the law, or this same executive officer
could attend to that also.
The Students' Quiz Series; Materia Medica and Thera-
peutics. By L. F. Warner, M. D. The Series Edited by B.
B. Gallaudet, M. D. Lea Brothers & Co., Philadelphia:
Cloth, $1.
This latest addition to the armamentarium of the Student is a
compact, neatl}' printed volume of 220 pages of convenient size
and good type. It is brought down to date, which is a creditable
thing for the author — and of much value to the student and practi-
tioner. The arrangement of subjects is good and the full index
with the dosage tables, poisons and their antidotes, incompatibles
and general classification are to be commended. Works of this
character for reading courses, or for quick reference are ijivaluable
to the student.
567 Useful Hints for the Busy Dentist. By Wm. H. Steele,
D. D. S. Published by the Wilmington Dental Mfg. Co., Phil-
adelphia ; 1892. Cloth, $2.50.
This is a miscellaneous collection of ideas from the journals
and society transactions published within the last three years, after
the style of Dr. Catching's Compendium. Some irrelevant things
have crept in, such as cures for dandruff and warts, or "How to
remove ring from finger," which would be more in place in a patent
medicine almanac. The general contents, however, are useful and
instructive. It is difficult to open to any page without finding
something of practical utility, and, indeed, many points and proc-
esses are explained which perhaps have heretofore eluded the
reader. A very good " index," or rather list of topics appears
at the end, but the value of the book is seriously impaired by
its unsystematic arrangement. For instance, the two methods of
taking a bite correctly are separated by almost 100 pages. A
grouping of topics and a careful classification of matter, with a
PRACTICAL NOTES. 827
table of contents at the beginning and a complete index at the end,
would improve the book materially. The proof reading is full of
sins of omission and commission from beginning to end. The au-
thor's own contributions, wherever he has been obliged to supple-
ment the work of the scissors, consist of sound and excellent
methods.
There will be no one, we venture, who opens the book but he
will be tempted to turn over page after page. The first four articles
alone are worth the price of the book.
PRACTICAL NOTES.
Effect of Electricity on Filled Teeth.
By Geo. E. Zinn, D. D. S., Chicago III.
I have lately discovered, what seems to be a fact, and which, if
not new to all Dentists, is certainly new to some. In my practice,
1 have often had patients who complained that a filled tooth was
very sensitive and that whenever they touched it with a pin
they experienced a sharp stinging pain. I have also had patients
tell me to be careful ; they always felt a sharp pain going through
them when I touched a certain tooth.
On reading an article from the Electrical Review on "An
Electrical Dentist," there came to my mind immediately such
cases in practice, and also the fact of how we used to run or slide
across the carpet, generated electricity, which collected in our
bodies and which by placing our finger near a metallic object,
would pass off with a spark.
The following explanation forced itself upon me : Some
patients are of such a bodily temperament, as to act like Leyden
jars or storage batteries, and hold the electricity themselves.
This electricity may be generated by the friction of hands on
dry substance, such as cloth in case of a seamstress. It is not
evenly distributed through the body, and whenever a metal instru-
ment comes in contact with the tooth, there results an electric
current for the equalizing of the electricity, this accounts for the
pain experienced from one touching his own tooth. Another con-
dition may exist which gives rise to the same phenomenon.
Some dentists are living storage batteries, they have their
offices carpeted and the friction of their feet generates electricity,
82S THE DEXTAL REVIEW.
they approach the patient to examine his teeth, touch a filled one
with an instrument and the patient experiences a sharp pain.
This is caused by the passing of electricity from his body through
the instrument to the tooth and the body of the patient by
means of the connection made with the tooth. It is a well-known
fact that bodies have different capacities for electricity, that •vthen
two bodies unequally charged in proportion to their capacities
come in contact, a current passes from the one to the other, equal-
izing the electricity of the two bodies, and it is so with regard to
the patient and dentist. This explanation seems to me clear. I
have heard it attributed to the " Electrical Condition " but not
explained, consequently I have told my patients it was due to cer-
tain "Electrical Conditions," but never had a rational understand-
ing of it. They, of course, would go home half believing it was
so, or fully believing that it was the fault of the filling or of my
work.
If this casts a true and new light on the point I gladly give it.
MEMORANDA.
Have you used tri-chloracetic acid ?
Dr. C. N. Peirce paid a flying visit to Chicago in September.
Dr. W. C. Barrett, of Buffalo, New York, visited Chicago early in October.
There were ninety-seven present at the October meeting of the Chicago Den-
tal Society.
Dr. W. W. Walker has returned from Europe. Ditto, Dr. A. L. Northrop,
of New York.
Dr. John H. Martindale, of Minneapolis, has gone to Germany to study the
diseases of the nose and throat.
According to Dr. C. Prioux, pyoktanin and gentian violet stop all developing
microorganisms in ' ,00 in water.
The British journals for September came with the Students' Supplement, tak-
ing in most cases the whole of the reading matter.
Pineapple juice has been recommended as a solvent for diphtheritic mem-
branes. Why could it not be used as a solvent for the dead dental pulp ?
FOR BURNS.
Europhen, olive oil, vaseline and lanolin for burns: 1 part, ^ parts, 16 parts,
8 parts. Mix, use externally.
DEATH FROM PENTAL.
Eight or ten drops only were used on a face inhaler, the tooth was removed
and the patient died. — British Med. Journal.
MEMORANDA. 829
CHRONIC RHINITIS.
Menthol, citric acid, lithium carbonate and powdered benzoin, 1 drachm each.
Use five or six pinches daily as a snuff for each nostril.
The Dental Review will publish the complete report of the American Den-
tal Society of Europe, in the November number. By vote of the society we have '
the exclusive right to all papers and discussions of that society.
Dr. M. H. Fletcher, of Cincinnati, is Chairman of the Dental Section of the
Pan-American Medical Congress, to be held in Washington, September 5-8, 1893.
Dr. John S. Marshall is Secretary, There are fifteen honorary Presidents or
Chairmen.
The Southern Dental Joiirnal for September comes to hand with a complete
report of the meeting of the Southern Dental Association, held at Lookout Moun-
tain, July 2.j to 28. This is a new evidence of enterprise which does much credit
to the editors and publishers.
A mixture of potassium and sodium has been recommended for saponifying
the contents of a root canal by Dr. Emil Schrier, of Vienna, Exposure to the air
destroys the surface of the mixture, which also acts on a steel instrument, making
it friable. Weiss & Schnorg, of Vienna, are sending out samples.
The Northern Illinois Dental Society will meet in two days' session, Wednes-
day and Thursday, Oct. 26th and 27th, 1802, at Rockford, Ills. A good pro-
gramme and an interesting session is in store for those who attend.
James W. Cormany, Secretary.
The Dental College of the Province of Quebec will begin a course on Mon-
day, October 17th. Among the list of provisional lecturers are W. G. Beers, L.
J. B. Leblanc, S. J. Andres, S. Glohensky, R. H. Berwick, F. H. Stevenson and
J. H. Bourdon. Dr. Beers, the genial editor of the Dominion Dental Journal is
Dean of the new school.
Dr. L. P. Haskell, of the Haskell Post Graduate School of Prosthetic
Dentistry, recently paid a visit to the early scenes of the days of his childhood and
youth. While there the Doctor had the unalloyed pleasure of seeing two plates
made by him, one of continuous gum and one of metal base, which had been
•worn continuously for nearly forty years.
The Executive Committee of the Dental Congress have voted to hold their
next meeting in Chicago, instead of Cincinnati. The charms of dedication day
were too many for them so they will once more be in our midst October 22d.
It is expected that the whole committee will be present as the officers of the Con-
gress are to be elected. Will lightning strike you ?
SOUTHERN ILLINOIS DENTAL SOCIETY.
The seventh annual meeting of the Southern Illinois Dental Society will be
held at Mt. Vernon, Tuesday, Wednesday, and Thursday, Oct. 18, 19, and 20,
1892. All dentists are cordially invited to attend. W. E. Holland,
Secretary.
The Post-Graduate School of Anaesthesia, Chicago; capital stock, $25,000;
incorporators, S. J. Hayes, Hugh Mclndoe and Louis J. Pierson.
Now, if somebody would only incorporate a Post-Graduate School for " the
830 THE DENTAL REVIEW.
prevention of dark joints," one for the " introduction of gutta-percha fillings " and
the " application of the rubber dam," there will remain nothing for dentists to do
except to attend post-graduate schools.
MINNESOTA STATE DENTAL ASSOCIATION.
The following resolution was passed at the last annual meeting :
"Resolved, That the thanks of the association are hereby given to Dr. J. H.
Martindale for the dignified, conscientious and efficient interest he has always
taken in matters pertaining to the welfare of Dentistry and the Dental Profession.
May success attend him in his new field of labor." L. D. Leonard,
Secretary.
AMERICAN ACADEMY OF DENTAL SCIENCE.
The Twenty-fifth Annual Meeting of the American Academy of Dental Sci-
ence will be held in Boston, Wednesday, Nov. 16. 1892. Dr. A W. Harlan, of
Chicago, will deliver the annual address.
As this will be the twenty-fifth anniversary of the Academy, a full attendance
of the members (active, associate, and honorary) is particularly requested.
E. N. Harris, Corresponding Secretary,
248 Boylston Street, Boston, Mass.
In filling teeth with gold there comes a time when the filling is fixed — it can-
not rock — then it is a matter of great moment to build to the walls instead of in
the center. Too many dentists keep the filling high in the center, depending on
ramming gold down on either side to fill the gap that exists. This is a mistake.
The gold should always — when cohesive — be packed step by step a little higher at
the junction of the cavity wall than to err in "balling" it up.
When you are filling a large proximal cavity in a bicuspid or molar, watch
yourself and see how you do it. Then do it right and you will succeed.
dental colleges in CHICAGO.
The American College of Dental Surgery commenced its session September
20 ; The Northwestern University Dental School opened September 27 ; The
Northwestern College of Dental Surgery, September 29 ; The Chicago Tooth
Saving Dental College, and The German-American Dental College, October 1st;
United States Dental College October 3d, and the Chicago College of Dental
Surgery on October 5th. The Haskell Post-Graduate School of Prosthetic Den-
tistry is open throughout the year, except during the month of September.
OFFICERS OF THE VIRGINIA STATE DENTAL ASSOCIATION, 1892-93.
President, E. P. Beadles, Danville ; First Vice President, J. O. Hodgkin,
Warrenton ; Second Vice President, H. W. Campbell, Suffolk ; Third Vice Presi-
dent, Geo. K. Heist, Winchester ; Corresponding Secretary, J. Hall Moore, Rich-
mond ; Recording Secretary, Geo. F. Keesee, Richmond ; Treasurer, Jas. F.
Thompson, Fredericksburg; Executive Committee, Chairman, W. E. Norris.Cbar-
lottesville ; J. A. Colvin, Charlottesville ; W. H. Gingrich, Norfolk.
The Twenty-fourth Annual Session will be held at Charlottesville, August 8,
1893.
Editor of the Dental Review:
The case quoted in the Dental Review, in August, from Dr. Humphrey
MEMORANDA. ' 831
{Medical Brief), as of menstruation at the age of seventy-five years, is probably
not one of menstruation at all.
He seems to have based his conclusion on a single flow, then taking place.
To make his opinion credible a number of repetitions at regular times, and pos-
sessing all the characteristics of menstruation, with exclusion of all abnormal
conditions, such as cancer, polypi, etc., would have to be assured, and there
would probably even then be a cloud of doubt somewhere in the horizon of prob-
ability.
Garrett Newkirk.
first district dental society of the state of illinois.
The First District Dental Society of Illinois held its second annual meeting
in Peoria September 13 and 14, 1892. The officers were all present. Dr.
O. M. Daymude, of Roseville, was elected President; Dr. H. H. Silliman, of
Chenoa, Vice President ; Dr. W. O. Butler, of La Harpe, Secretary ; Dr. E. C.
Stone, of Galesburg, Treasurer.
Peoria was selected as the next place of meeting.
This year the work of the Executive Committee was placed in the hands of
one man — Dr. W. A. Johnston, of Peoria, and the society pays him $25 for his
services — arranging and preparing an interesting programme for the next meeting.
W. O. BuTLER, Secretary.
CIRCULAR NO. 2.
Chicago, Sept. 26, 1892.
To THE Members of the Chicago Dental Society :
Gentlemen: — It is estimated that Chicago and Cook County contain 700 prac-
ticing dentists. Of this number but 175 are members of dental societies. For
the purpose of inducing a larger proportion to become members of the different
organizations, the following preamble and resolutions were adopted at the June
meeting of this society :
Whereas, In common with those of other professions, dentists are depen-
dent upon association for whatsoever of progress and growth they may attain, and
Whereas, There is a large number, constantly^increasing, in the city of Chi-
cago and adjacent territory who should be, but are not connected with dental
societies, and
Whereas, An International Dental Congress will be held here next year, in
connection with the greatest exposition known in the history of mankind and
Whereas, This Congress will need all the material assistance and moral
support that may be given by the profession in the United States, and especially
by the dentists of Chicago and vicinity. Therefore, be it
Resolved, That the reasons always sufficient, are now multiplied and of
unusual force for every progressive dentist to ally himself with at least one dental
society.
/Resolved, That the members of this and other societies, collectively and indi-
vidually, should see to it that each and every reputable dentist in Chicago and all
near cities and towns has an earnest invitation to attend our meetings and have his
name presented for membership.
832 THE DENTAL REVIEW.
Resolved, That we invite the cooperation of other societies in this work, and
suggest the formation of an associate committee composed of one member from
each society who shall consider and report upon the best means to further the
interests of the profession in our own city and State, and promote the success of
the approaching International Congress.
Copies of the above were sent to the Secretaries of all the dental societies and
clubs in Cook County, and it is earnestly hoped they will act promptly. Dr. Gar-
rett Newkirk has consented to represent this society.
The object of dental societies is two-fold, viz.: Social intercourse one with
the other, and the cultivation of scientific and practical knowledge. There is no
doubt but that the individual, the profession and the public, each derive benefit
from such organizations. It has been repeatedly stated by our most eminent and
respected men that constant attendance on dental societies has been the strongest
factor in their growth and success. It is conceded generally, that the community
of interests and friendships, which grows out of frequent commingling of members
of one vocation, are the most potent influence in raising the general standard of
excellence. Is it not a rare occurrence for a member of a society to lapse into
unprofessional conduct ? Why, then, should not many more men, or all, share
such advantages ?
TOPICS FOR DISCUSSION BEFORE THE DENTAL CONGRESS — SUGGESTED BY THE
ESSAY COMMITTEE — GENERAL TOPICS.
Dental Anatomy and Histology.
Physiology and Etiology.
Dental Medicine and Pharmacology. v
Chemistry and Metallurgy.
Dental and Oral Surgery.
Dental Therapeutics.
Operative Dentistry.
Mechanical Dentistry and Prosthesis, including Crown and Bridge Work.
Bacteriology.
Pathology.
Prophylaxis.
Orthodontia.
Ethics.
Dental Education, including Post-Graduate Work.
Instruments and Appliances.
Statistics.
Nomenclature and Terminology.
Denial Legislation: Its Local, National, and International Relations.
Dental Professional Organization for Protective and Educational Ends.
Miscellaneous.
SPECIAL TOPICS.
What is the best means of arresting decay in the deciduous teeth ?
What is the best prophylactic treatment for the teeth of pregnant women ?
The importance of considering and providing for the comfort of the patient
during dental operations.
MEMORANDA. 833
The selection of such instruments and appliances as will perform the
necessary work with least pain and irritation to the nervous system.
The best means for conserving the health of dentists.
The present status of crown and bridge work. What is its future ?
What are the best means of repairing fractured porcelain facings in crown
and bridge work ?
What are the best means of securing comfort and rest to the patient during
dental operations ?
Corrective dentistry : Its present status. What are the best regulating appli-
ances and the best forms of retainers ?
The importance of extracting some teeth from the crowded arches of young
patients. What teeth shall be extracted, under what circumstances, and when
shall they be removed ?
Nitrate of silver as a means of arresting decay in the deciduous teeth.
The effects of hereditary diseases of the brain and nervous system upon the
formation and arrangement of the teeth : To what extent are these abnormalities
evidenced by the teeth of patients in hospitals for the treatment of such diseases
and in asylums for imbeciles and hospitals for the insane ?
Rheumatism and gout : the part they play in the abrasion and erosion of the
teeth.
What are the effects of syphilis upon the teeth ? Have we marks and tracings
of this disease in the teeth of children born of syphilitic parents ? Do such chil-
dren live to complete the second denture ?
Are white and yellow spots upon the enamel of the permanent teeth caused
by alveolar abscess the result of death of the pulp in the deciduous teeth, or are
they sequelae of zymotic fevers ?
Rapid and extensive absorption of the alveolar processes produced by the con-
tinued wearing of vulcanized rubber dentures . To what extent is this evi-
denced by comparisons between cases wearing vegetable and metal plates ?
On the use of stimulants and anodynes to prepare patients for dental opera-
tions.
On the sterilization of dental instruments : The best means or appliances for
this end.
On obtunding agents ; Local anaesthetics and general anaesthetics.
On the best methods of constructing lower partial dentures.
Disease of the antrum of Highmore, and treatment.
The treatment of pulpless teeth : What is the best filling material for the
roots and pulp cavities ?
On the lighting of dental offices : What is the best color for the walls and ceil-
ings of the dental operating room ?
On electrical appliances for the dental office and laboratory.
The formation of pus.
What is the function of the leucocyte ?
Microscopic research in the domain of dental caries.
On the etiology of dental caries from the standpoint of the chemist.
On the construction and destruction of soft and hard tissues : The differentia-
tion between life and death.
What are the best antiseptic and germicidal remedies in the dental pharma-
copceia ? and how to use them.
834 THE DENTAL REVIEW.
Dentition in Infants.
A communication from the pen of H. C. Wood, upholding gum lancing, and
taking issue with the views of Forchheimer on the subject, as detailed in his re-
cent book on Diseases of the Mouth, has been copied very generally by the med-
ical press of the country. This extensive republication may fairly be taken as
expressive of a general approval of the position taken by Prof. Wood.
Upon the questions of difficult dentition and gum lancing, the medical world
has been for some years divided; the smaller party taking the modern view that
dentition is a normal process and rarely if ever produces dangerous symptoms; the
larger party holding that dentition is responsible for most of the ills that infants
suffer from, and that gum lancing is its sovereign remedy. This latter view is
one of our most ancient possessions, having come down to us from Hippocrates.
For centuries it remained unquestioned, and has consequently become firmly in-
trenched in both the professional and the lay mind.
John Hunter ascribed the following conditions to dentition: "Diarrhoea,
costiveness, loss of appetite, eruptions on the skin, especially on the face and
scalp, cough, shortness of breath, with a kind of convulsed respiration, and sim-
ilar to that observed in whooping cough, spasms of particular parts, either by
intervals or continued, and increased and sometimes decreased secretion of urine,
a discharge of matter from the penis, with difficulty in micturition, resembling
symptoms of gonorrhoea in its violent form. The lymphatic glands are apt to
swell at this time; if the child has a strong tendency to scrofula, this irritation
will promote the disease. There may be many other symptoms with which we
are not at all acquainted, the patients not being able to express their feelings.,"
Most, if not all of these symptoms, are attributed to teething to-day.
Perhaps the earliest opposition to these views was by Rosen von Rosenstein,
in the middle of the last century ; but his opposition was only partial. But
Wichmann, in 1800, expressed the true status of dentition when he said ; " It is to
be hoped that, in the future, dentition will be called up only when it would be
impossible to comfort the relatives with the impotence to designate the true
nature of the disease, or to quickly calm the laity."
Billard, who was a careful student of pathological anatomy, particularly
with reference to infancy, found nothing to impress him with the importance of
dentition.
As we look over the list of symptoms given by Hunter we find that many of
them can be explained much more rationally by the results of modern positive
observation. Diarrhoea has been shown to be intimately connected with fermen-
tative processes ; Lhe respiratory symptoms are those commonly met in rickets
and in cases of pharyngeal adenoids ; the convulsions are probably due to rick-
ets ; and the enlarged glands are tuberculous.
During the past summer this subject has occupied somewhat the attention of
the Academy of Medicine of Paris. At the meeting of July 12, Magitot said, "We
wish that the so-called diseases of dentition, might be definitely erased from our
medical nosology."
This brought a reply from M. Pamard, on August 9, who took the following
ground :
1. All difi&cult dentition is accompanied by a disturbance of the health of the
infant.
MEJMOKANDA. • 835
2. In cold climates, and in cold seasons, all difficult dentition is accompa-
nied by reflex phenomena on the part of the respiratory organs. In warm climates
and in warm seasons, all difficult dentition is accompanied by reflex phenomena on
the part of the digestive organs.
3. The diseases allied to dentition in the infant, pursue a course, and pre-'
sent characteristics, which are clearly defined and well established.
These propositions were supported only by the old argument of coincidence,
but the essayist was upheld by MM. Le Roy da Mericourt, Herard, Charpentier,
Peter and Constantin Paul. He was opposed by MM. OUivier and Hardy.
In the study of this question, it is necessary to separate dentition and gum
lancing. The first is a possible pathological condition, while the second is a
therapeutic procedure.
We think it can be said without fear of contradiction, that there is not a
single positive observation which has ever been recorded to prove that dentition
produces general or reflex symptoms. It is undeniable that at the period in life
when dentition is in progress, the infant is subject to certain disorders which
occur much more commonly than at any other period of life.
If it could be shown that dentition was the only peculiarity of the infant,
then its causative influence v/ould be clear. But dentition is not the only pecu-
liarity of the infant, and coexisting phenomena can only be classed as coincident,
The most profound characteristic of infancy is that it is the period of most rapid
growth and development of all organs ; and careful observation of infants
reveals numerous and great deviations from the normal growth and devolop-
ment in many instances. It will probably not be denied that such deviations are
found most commonly in infants who have been artificially fed. In infants im-
properly fed, and this term is too extensive to attempt to define here, reflex mani-
festations are very readily produced, and it is not improbable that even a nor.
mally developing tooth may, in such an infant, be the exciting cause of trouble.
We have seen infants, who would invariably have a bronchial attack immediately
before the proruption of a tooth, but they have invariably been infants who
were suffering from demonstrable deviations from normal nutrition. We have
further found that after improving the nutrition of these infants, the further pro-
gress of dentition was unaccompanied by symptoms.
In such cases while it would be just as well perhaps to recognize the possi-
ble influence of dentition, its subordinate importance should be kept clearly in
view. The great danger of teething is in the diagnosis, for when this is once
made, the important underlying conditions are apt to be neglected, and permit-
ted to progress to the death of the child.
Dentition is a convenient scapegoat, and Ollivier has well said in the discus-
sion just referred to: " During the nearly ten years that I have been connected
with the Hospital for Sick Children, it has often happened that children brought
to me for diseases of this type (teething) have been found to be suffering with an
altogether different affection. It is very easy to invoke this diagnosis, but by
passing in review the different organs and apparatuses, the diagnosis can
easily be rectified."
But if dentition cannot be shown to be the great etiological factor of infan-
tile disorders, it does not follow that gum lancing should be abandoned. It is
diflScult to overlook the numerous instances in which careful observers have
836 T^tlE DENTAL REVIEW.
thought they have obtained good results from its use, but it would be well also to
bear in mind the many cases in which it has failed. As a therapeutic procedure
it may have some value, but the indications for its use must be sought
elsewhere than in a supposititious condition of teething. We should like to offer
the following conclusions :
1. Before the diagnosis of " teething " is made, there should first be care-
fully excluded, organic disease of all organs, infection, intoxication, and perver-
sion of nutrition.
2. Gum lancing as a therapeutic measure should stand on its own merits,
and be studied apart from any supposititious and undemonstrable process of
teething. — Journal Amer. Med. Ass'n.
We understand that Prof. J. S. Cassidy, of the Ohio Dental College, will
soon publish a book of some three hundred pages on Chemistry and Materia Med
ica. It will be such a book as may be used in dental colleges, and will be the pre"
scribed text-book for his classes.
The Twenty-sixth Annual Meeting of the Ohio State Dental Society will be
held in Columbus, December 6th, 7th, 8th and 9th, 1892. Ample accommodations
and opportunity will be given for the exhibition of appliances, etc. Correspon-
dence is solicited from those having anything good and useful to offer for the ad-
vancement of Dental Science.
A cordial invitation is extended to all,
Otto Arnold, Secretary,
Columbus, Ohio.
OBITUARY.
S. A. GARBER, D. D. S.
Samuel A. Garber was born March IT, 1843, in Highland County, Ohio. In
1856 he removed with his parents to Iowa and settled at Marion. Two years later
the family removed to Fairfield, Iowa. When the war broke out young Garber
was scarcely old enough for war, but his patriotism was of that type that never
shrinks, and he enlisted Aug. 9, 1862, to serve three years, becoming a member of
the Nineteenth Iowa Infantry. He returned to Fairfield much broken in
health, and completed his education. In 1867 he began the study of dentistry un-
der Dr. J. Reynolds, of Orangeville, 111., and began practice there. He was mar-
ried to Anna C. Bloom Nov. 12, 1868. In 1873 he came to Tipton and soon se-
cured a fine practice. In 1880 he went to the Western College of Dental Surgeons
at St. Louis, Mo., for special instruction and graduated from that institution. His
advancement in his profession after this was very rapid and his great abilty was
everywhere acknowledged in dental circles. He was honored with the presidency
of the Iowa State Dental Society, and since 1886 has been Secretary of the State
Board of Dental Examiners.
Early last spring he determined to move to a larger town for a two-fold rea-
son. He desired a larger field for the finer grades of dental work, and a residence
in a city where his children could enjoy the advantages of a college. With these
OBITUARY. 887
ends in view he determined to locate in Cedar Rapids. He was to have gone there
April 1st, but the sudden death of Dr. Pasedach delayed him somewhat. When
he finally reached his Cedar Rapids office, business came at once, and his best
hopes were being realized when sickness entered the family. The death of his
son Edgar was a terrible blow, and when Roy became ill he himself was prostra-
ted. Roy's death added to his already full cup, and it is perhaps very near the
truth to say that Dr. Garber died of a broken heart.
As a professional man, Dr. Garber had no superiors and few equals in lowa-
As a man he was generous, noble, and devoted to his family and his friends.
There was a deep vein of earnestness in his character.
His death seems to us untimely ; but who of us can say that the dreamless
sleep in which he now rests is not after all a blessing to him, to whom life must
have been bitter with grief had he lived. The serious illness of the wife and
daughter prevented their attendance at his funeral, which was held last Satur-
day at 1:30 P. M., at the Lutheran church. The Masons of Cedar Rapids, and
many of his Tipton brethren were present, and the exercises were under their
direction. The G. A. R. Post of Cedar Rapids furnished a guard of honor. His
brother, Dr. T. W. Garber, and his wife, his brother-in.law, D. Pollock and son,
and a number of prominent members of the dental profession from various parts
of the State, besides a number of Tipton friends were present at his funeral. In
a beautiful spot in Oak Hill Cemetery he rests beside the bodies of his two sons
wohm he loved, and whose death he so mourned.
REPORT ON NECROLOGY.
The following testimonials and resolutions were presented, read and adopted
at the recent meeting of the American Dental Association :
IN MEMORIAM — DR. JOHN ALLEN.
In the dispensation of an all-wise and overruling Providence, Dr. John Allen
of New York, on the eighth day of March, 1892, at the age of eighty-two, passed
from this to a higher and better life ; having attained a fullness and ripeness of
age beyond that of the common lot of men.
Dr. Allen stood as a representative man in the profession of his choice.
In the line to which he gave special attention he was the chief, and was so
recognized not only in this, but in the countries of the world wherever prosthetic
dentistry is known and practiced. He, it was, who brought to its present high
state of perfection that variety of substitutes known as continuous gum dentures.
Though his chief attention and labor were devoted to this special work
he was interested, and took part in the various lines of thought and effort,
that were employed for the development, growth and establishment of dental
science and art. He was ever ready to defend, and sought to elevate the profes-
sion to a higher plane of usefulness.
Dr. Allen was one of the organizers of the Ohio College of Dental Surgery, a
professor and an efficient teacher in that institution.
In the subject of dental education he always manifested a warm interest. A
writer of more than ordinary ability, he has added many valuable contributions to
the literature of the profession.
838 THE DEXTAL REVIEW'.
He was an active member of this association from almost the time of its organ-
ization, and did much to promote its welfare. He was also a member of, and an
active worker in, a number of other dental societies.
Dr. Allen was a man of purest character and highest integrity ; one not only
respected but loved by all who knew him ; in manner affable ; in bearing digni-
fied ; in spirit gentle and sympathetic.
The loss of such a one is always an occasion of sadness and sorrow, but we
have the consolation of the knowledge that his career was rounded, full and com-
plete, and his death closed a life filled with good works for his fellowmen.
In view of the above,
Resolved, That we will ever cherish the memory of our departed brother, and
seek to establish and perpetuate the high principles that were so fully illustrated
in his noble life.
Resolved, That the traits so preeminently characterizing the life of him we
now commemorate are worthy, not only of our high regard, but most earnest
emulation.
Resolved, That this testimonial be placed on a memorial page of the transac-
tions of this body and a copy, properly engrossed, be sent to the family of the
deceased ; also that a copy be sent to the dental journals of this and other coun-
tries for publication.
IN MEMORY OF C. A. KINGSBURY, M. D. , D. D. S.
Within the last year Dr. Chas. A. Kingsbury was called from this to a higher
life, in the seventy-second year of his age.
Dr. Kingsbury many years ago became identified with this association and re-
tained his membership to the time of his death, and though he was not always
present at its meetings, so highly was he esteemed by the membership of the body
that it was a pleasure to all to have his name upon the roll of members.
Dr. Kingsbury entered the practice of the profession in 18:J9, in Philadelphia,
and continued actively engaged in its pursuit during hislife. He studied dentistry
in Trenton, N. J. He was intimately acquainted with the leading men of the pro-
fession almost the whole of his professional career, and imbibed, in a largs
measure, the interest and enthusiasm of those men for dental science and art; in-
deed, that association, in a degree, shaped his professional life. He was familiar
with all things that entered into the development and progress of dentistry for
about fifty years. He was a man of liberal learning and broad culture; one whose
sociability was a predominant characteristic. In his early life he was a teacher,
and after many years' practice of his profession he was for a time a successful
teacher in one of the dental colleges in the city of his home. He was highly
esteemed by all who knew him; he was a man of sterling characteristics, genial,
kind and sympathetic in his association with his fellows. In his death, not only
this association, but the entire profession loses another of the pioneers who was
ever devoted to its interests, ever contributing of his resources to its up-building.
Resolved, That we will ever cherish the memory of our departed brother as
one whom we delight to honor, and to emulate in his leading characteristics.
Resolved, That this statement and resolution be placed upon the memorial
page of the proceedings of this body. That a copy, in proper form, be transmit-
ted by the secretary to the family of the deceased, and that it be sent to the
journals for publication.
THE
DENTAL REVIEW
Vol. VI. CHICAGO. NOVEMBER 15. 1892. No. 11
ORIGINAL COMMUNICATIONS.
American Dental Society of Europe.
The Eighteenth Annual Meeting of the American Dental Soci-
ety of Europe was held at Basel, August 1st, 2d, and 3d, 1892, in
the halls of the " Vesalianum," generously placed at the Society's
disposal by the University. It was called to order at eight o'clock
A. M., Monday, August 1st, by the President, Dr. Lyman C. Bryan,
of Basel. Thirteen new members were admitted to membership,
an evidence of the interest which the younger American dentists
practicing in Europe have in cooperating to maintain the reputa-
tion of the profession abroad. There were also in attendance over
fifteen guests, American, English, German and Swiss ; some of
whom greatly contributed to the success of the meeting.
The President delivered the annual address.
Address of President.
« Dr. L. C. Bryan, Basel, Switzerland;
Gentlemen and Brethren: — The custom of delivering an address
before this society is more honored in the breach than the keeping,
and I had hoped, and many of you, if you have thought of it, have
also hoped that I might let the matter be passed quietl)'^ over and
get directly to the business of digesting the food for thought, pre-
sented to us by the rather large programme, some of which I
regret to say is not forthcoming, and is only on the programme.
But the Secretary and other members who arrived early, have
not looked at it in my light, and saj' I must revive what seems to
me an obsolete custom as far as I can find b}' reference to
the notes of former meetings. Our Constitution, which unlike the
840 THE DENTAL REVIEW.
laws of the Medes and Persians, meets with changes and revisions
which are so numerous and frequent tliat former Secretaries have
not been able to keep a record of its evolution — always keeps the
one clause unchanged — "The President shall also deliver an ad-
dress before the societ}."
As I have so far conscientiously endeavored to do my duties as
laid down, at the eleventh hour I must essay this one also.
After nineteen years of wandering up and down the continent
of Europe, sowing seeds of thought and good endeavors among all
these political divisions, it comes again to its cradle on the Rhine,
where with six members it commenced its career of usefulness. Of
those six members we have five still on our rolls, and all six are
distinguished and useful members of the honorable profession of
dentistry, and bid fair to continue the good work for years to come.
Around this nucleus of earnest workers you have gathered the best
of your fellows in all parts of Europe until to-day with our forty
odd active, and a goodly number of honorary members, we are a
power in the land and hope to bring to our midst all those of our
profession who have its elevation and usefulness at heart.
The founders of this society built well and laid out their plans
on broad and generous principles as the growth and success of the
society shows, and though some have gone, more have come, and
we are a brotherhood who look forward with pleasure to the
annual gatherings, and these informal meetings which bring old
friends and colaborers together in thoughtful intercourse and relax-
ing recreation.
Senator Hale, of Maine, once said that he considered the
Americans practicing dentistry in Europe, were the best represen-
tatives of America he had met abroad, and although 4ve endeavor
to adapt ourselves to the customs about us, it is the exception
when we do not remain true Americans and proud of the great •
country which will soon lay before the world the results of its
growth, industry and development at the great Chicago Exposi-
tion.
Here will also be the greatest gathering of dentists that the
world has ever seen, and it is a question which must receive your
consideration at this meeting whether we shall forego the pleasure
of our annual meeting next year to meet with the great throng
which gathers there next August, or whether we cannot have our
session at such time and place as to keep up the interest in our
ORIGINAL COMMUNICATIONS. 841
own 'work, and go in a body under special arrangements to the
World's Columbian Dental Congress.
As Americans we will, at that meeting in Chicago, be proud to
show the world our achievements in the last few years in every
branch of our beloved profession; in its art and its science; in the
universal elevation of the standard of graduation by which we
place ourselves on an equal footing with the other learned profes-
sions of the day, and our colleges on a plane equal, if not superior,
to those in any land.
We can point with pride to the fact that we have throttled those
shameful and mercenary institutions which sold diplomas to the
highest and lowest bidders and dragged the name of American den-
tistry in the mire ; that we have succeeded by general cooperation
in thwarting the designs of speculators who sought to corner the
market of dental inventions and trade on this wonderfully futile
field, levying a tax on dentists, more odious than those of the rub-
ber patents or the Stamp Act of our forefathers. We now leave
open and free the legitimate channels by which inventive geniuses
among dentists can secure the rewards for their inventions which
they so justly deserve.
I need not refer to the position which American dentistry occu-
pies in Europe, it is enough that the young dentist of Europe does
not consider his education complete until he has sought our shores
and sat at the feet of our great teachers ; that he is the most proud
of his American degree and that his countrymen appreciate and re-
ward him for his enterprise and success in securing it.
To the young dentists who have joined us to-day and in whose
hands we have placed our Constitution and Code of Ethics let me
ask them to ponder well the thoughts there presented and to which
they have subscribed. To set their mark high and live up to it.
They need no better example than the achievements of the older
members of this society.
Few if any have allowed the exigencies of their extensive prac-
tices to relax their efforts to maintain a high standard of work, and
though conservative and true to their early teachings, thejMiave not
been slow to adopt that which the more venturesome of the rising
generation have proved to be of value.
The perfection attained at the present day in crown work has
made the long and tedious operations which were necessary a dec-
ade ago — almost a thing of the past, and where the courage of the
842 THE DENTAL REVIEW.
operator and the endurance of the patient permit of these all day
sittings — the new forms of crystal gold which will be demonstrated
to you at this meeting and which have come into such great favor
of late promise to become a great boon to humanity, under which
heading — owing to the fact that there are no patients present — I
may also include the dentist.
At the last meeting a new departure was made in the selection
of the place of meeting, it being the first time that the society has
met at the place in which the President resided. This is a desira-
ble innovation in that it allows that official to actually arrange mat-
ters beforehand, and the meetings should never be held when we
have not a competent member to make the necessary preliminary
provisions for your comfort and entertainment.
After these general expressions of approval of your good quali-
ties as a whole, I hope I may be allowed to apply a counterirritant
in the form of a bit of criticism.
The Secretary and your committee have been seriously delayed
in the arrangement of your programme by the late replies received
from members who have been asked to reply to three simple ques-
tions.
Not one-fourth of the members replied, and when the pro-
gramme should have been issued, there were only three promises
of papers. This necessitated the writing of personal letters to each
member of the society and the arrangement of clinics to occupy
half the time, and the invitation to guests to assist us in making a
presentable programme. This is a great contrast to the early meet-
ings of the society, when legend says, " every member read a pa-
per." In this matter our older members are sadly changed.
These latter I can freely criticise for they are conspicuous by
their absence.
It is with deep regret that we notice this absence of so many of
the strong men of the society. Miller, Field, Elliott, Crane, Kings-
ley, Davenport, Jenkins, Spaulding, Sachs, and others, we have
always considered indispensable to our meetings, and it is with a
sad heart that I think of a banquet without a Patton.
To you all who as members, candidates or guests have made
the pilgrimage to our. old city of Basel to meet with us, as Chair-
man of the Executive Committee, I give you hearty welcome and
greeting.
ORIGINAL COMMUNICATIONS. 843
On conclusion of the address, the Society repaired to the hall
set apart for clinics, and examined a ver}'^ interesting exhibit of
porcelain inlays prepared by Dr. William Dall, of Glasgow. The
doctor, with whom skill and enthusiasm go hand in hand, showed
his method of grinding the prepared rods, or, in case of necessity,
a piece of a porcelain tooth — Ash's make preferred, being harder —
setting in cement and then covering the cement with gold. The
large number of specimens shown displayed fine workmanship, pa-
tience, and an earnest purpose to unite all the requirements of an
ideal filling. The Society thankfully appreciated the service of
Dr. Dall, who came some distance and as a guest, to make this ex-
hibit.
Dr. Alfred Gysi, of Zurich, another guest, then showed some
lantern projections of micro-photographs of tooth sections.
Gentlemen. — At the request of Dr. Bryan, I take the liberty to
give you a lantern show of some microscopical preparations. 1 do
not intend to give you an extensive or detailed lecture, but simply
desire to show you some preparations of teeth which illustrate old
and well-known facts in a more natural way than is possible by old-
fashioned wood carvings as shown in books on dentistry. I only
intend to show you a few of the preparations, so that it will not be
difficult for you to remember them after they have been taken from
the screen. I wish especiall}^ to call your attention to some prep-
arations by Dr. Koch and applied b}' Dr. Weil. By this process,
pictures are obtained which illustrate the nerve fibers more clearl}'
and minutely than they have ever been shown in a text-book.
The members were unanimous in praise of the astonishing
distinctness of these projections, which were made possible by
extraordinary skill and patience in preparing the sections and the
evident superiority of the process. The doctor's demonstration
was warmly applauded.
MONDAY AFTERNOON SESSION.
The first paper was read by Dr. Chas. W. Jenkins, of Zurich,
entitled, "A Vision of Dead Teeth."
Dr. Bryan, the President, then read a paper entitled, •* The
Surgical Treatment of Irregularities."
The discussion of this paper was deferred until the next day,
after the clinic in illustration of it. The operation performed was
the bringing forward of the left central incisor which was stand-
844 THE DEXTAL REVIEW.
ing within the arch. The patient was a boy thirteen years of age.
The alveohis was thicker and denser than is usual at that age;
the cuspid was not yet erupted. Dr. Brs'an first injected cocaine,
mouth and instruments having been already disinfected — as con-
cerns the former certainly a wise precaution — and proceeded to
wedge away the alveolar bone on the labial side, pushing the in-
strument steadily, under guard, until the indications showed that
there was no longer any unloosened tissue between the gum mar-
gin and the apex. He also broke up the retaining septa of bone
between this tooth and its neighbors, the little patient meanwhile
showing no sign of pain. Following the other specifications men-
tioned in the paper, the doctor brought out the tooth to place,
to the gratified interest of the entire assembly. To judge by the
heavenly expression of the patient — when the hat was passed
around, and its unusually bright contents bestowed upon him —
the operation was as successful from his point of view as it cer-
tainly was in the opinion of the spectators. He appeared next
morning with slight superficial inflammation.
At this clinic, and at some of the others, the facility of witnessing
the operation was greatly increased by the use of a semicircular
frame, so constructed for both standing and sitting spectators,
that a large number could be accommodated. It was kindly
loaned to the society by the Swiss Dental Association.
Dr. a. V. Elliott, of Florence, read a paper entitled, " Pa-
tients and Patience."
The Society then adjourned for the day, the evening being
spent at the Summer Casino, where good cheer, good music, and
jolly comradeship prepared the members for a punctual appear-
ance at the
TUESDAY MORNING SESSION.
This forenoon was given up exclusively to clinics. Dr. Adolph
Wetzel, of Paris, filled a right superior bicuspid, mesial surface
and crown, placing tin and gold at the cervical wall, filling a
portion of the cavity with cylinders and finishing with cohesive
gold. He uses a leather-faced hand mallet. The doctor conceives
that there is no better protection against- decay at the neck of
the tooth than tin and gold, or Abbey's soft gold, properly con-
densed and finished. Those who followed his manipulations know
what that means.
ORIGINAL COMMUNICATIONS. 845
Dr. Louis J. Mitchell, of London, set a Bonwill crown. He
prefers to grind directly to tlie root, enlarging the opening in the
crown with a diamond drill and countersinking upon the grind-
ing surface. The pivot having been set in phosphate cement, the
doctor placed quick setting amalgam in the countersink and
cement in the cervical opening and pressed the tooth into place,
the amalgam under the finger pushing the superfluous cement into
the joint. The tooth was held in position until the cement had
sufficiently hardened, making a very close fit and admirable opera-
tion.
Dr. de Trev, of Basel, filled a left inferior second molar with
a kind of sponge gold, of his own manufacture, which he has
used successful!}^ for years. It can be used in larger pieces than
Watt's and similar makes, and the filling finishes well and is
extremely hard. The doctor used broad faced pluggers, and after
fixing the gold masses — we can use no other word — with hand
pressure the hand mallet. His manipulations were followed with
great interest.
Dr. Terry, of Milan, filled a right superior central incisor,
having very thin labial wall, by putting Abbey's soft foil at the cer-
vical margin, wedging it with Watt's No. 1 crystal foil, annealed,
with which he also filled all the undercuts, and against the thin
enamel, using a great deal of hand pressure until there was a tol-
erably thick mat of gold protecting the fragile parts. He then
malleted the rest of the filling, using No. 40 and 60 cohesive, and
finished in the usual way. He uses the automatic mallet. The
gold was brought over the thin edge and point so as to clamp the
frail wall securely. Other similar fillings in the same mouth that
had stood the test of years testified to the success of this method
of work.
Dr. de Trey afterward demonstrated on the cadaver the inser-
tion of an artificial section of upper jaw, left side, in accordance
with a method devised by Dr. Martin, of Lyons. The piece is
made of vulcanite, by measurement, to cover a somewhat larger
area than the surgeon intends to resect, to provide for any possible
necessary extension of the operation. The appliance used by Dr.
de Trey was constructed in three sections joined by pins and
hinges for ease of introduction. Channels for the injection of an-
tiseptic washes are made b}' the insertion of thin zinc tubes in the
vulcanite, which are dissolved out with sulphuric acid. When the
846 THE DENTAL REVIEW.
piece has been trimmed and fitted to place, the flap is sutured over
it, and when tlie wound has healed, a permanent piece made from
an impression of the part is put in its place. Dr. de Trey has not
yet attempted this operation on the living subject ; the inventor,
who calls it "Immediate Prosthesis," is reported to have per-
formed it with success, and has published a work describing it.
After dinner at the Three Kings, the reading of papers was re-
sumed at the
TUESDAY AFTERNOON SESSION.
The Secretary read a paper prepared by Prof. Schiess, of the
Basel Universit}', entitled "Hints on Vision." A vote of thanks
was unanimously carried for his kind interest in the work of the
profession.
Dr. H. L. Schaffner, of Florence, presented some original
methods of bridge work, reading partly from notes, and illustrat-
ing his remarks . on the blackboard. His suggestions, though
eagerly attended to by those present, cannot be reported intelli-
gently without illustrations to explain them.
Dr. J. L. Mitchell, of London, then read a paper on "The
Cleansing of Teeth."
The session then closed and the assembly took a special train
to Bottmingen Castle, where supper, "stumps" and a stag dance
endtd the second day.
Wednesday's session.
A paper b}' Dr. W. Mitchell, of London, entitled "Some Hints
on Practice," was then read.
After a short discussion of this paper, as time was lacking, the
guests withdrew and the members proceeded to the unfinished
business of the session, the only portion of which to be here
recorded is the election of officers, which resulted as follows:
President, Dr. L. C. Bryan, of Basel.
Vice President, Dr. J. H. Spaulding, of Paris.
Treasurer, Dr. Chas. J. Monk, of Wiesbaden.
Secretary, Dr. Chas. W. Jenkins, of Zurich.
Executive Committee, President Bryan, Dr. Patterson, of Mon-
treux, and Dr. Hurlburt, of Geneva.
Membership and Ethics Committee, Vice President Spaulding,
Drs. Davenport and Wetzel, of Paris.
In consideration of the fact that a large number of the mem-
ORIGINAL COMMUNICATIONS. 847
bers are intending; to go to the Chicago Fair, it was voted to ap-
point the next meeting, to be held at Geneva, for the first Monday
in August, 1894.
Of the banquet at the VetHner Halle, and of the delightful
drive to the Hermitage, the latter through the hospitable courtesy
of the local dentists of Basel, all who shared brought away the
most happy memories.
Charles W. Jenkins, Secretary.
A Vision of Dead Teeth.
Charles W. Jenkins D. D. S. Zurich, Switzerland.
It struck twelve. Midnight. I was passing a graveyard, and
not fearing ghosts I went in. Those pale gentry are said to show
themselves at this weird hour. But I waited in vain; in vain I
watched; in vain I quoted Hamlet; — not a rattle of bones, not a
rustle of dead leaves, not a gleam of shroud, not a whisper of night-
wind to stir imagination — or conscience. The long rows of white
marble slabs stood out in relief against the rotten grass, like artifi-
cial teeth on wax. There was nothing else to hear, see or smell.
After ten minutes of this unfruitful silence, in order to break
the monoton}', I laughed. There was scorn in that laugh — contempt
for a graveyard that could not furnish one decent apparition for
the entertainment of a tired dentist. No response coming, I
turned to go, flinging my disdainful ejaculation right and left, as
old Cadmus, the first dentist, flung broadcast the proceeds of his
first operation. Like our illustrious predecessor, I too was
astounded at the result. Dragon's teeth — carefully implanted,
with antiseptic precautions, may produce armed men; I should
not like to dispute so ancient and truculent an authority, but that
a few impatient words, sown more in disappointment than in anger,
should yield a crop of — excuse me if I forbear to characterize that
mob. It seemed to me that a thousand buried generations had,
each man of them, sent up a delegation of thirty-two dead teeth,
armed with biting accusations of our profession. How they
swarmed, covering the broad earth, filling the vast heaven, clos-
ing out all other sights! Happy should I have been had the mere
sight of them been all- -I should not have had to write this paper!
Gentlemen, they were real ghosts. They could not be put out
of mind by being put out of sight. They had been summoned by
848 THE DEXTAL REVIEW.
a jeer, but they could not be laughed away. It was tlieir turn to
laugh now, those thinnest of ^^^ shadows, those dreamiest of all
phantoms, those most ridiculous of all the doll-children of super-
stition, the ghosts of dead teeth, grinned, chuckled, and reveled
in hideous gymnastics, to find me in their power. As I found no
relief in closing my eyes, so it did no good to stop my ears. You
have listened at the telephone when conditions were unfavorable;
have strained attention and exhausted patience to unravel some
important message; but if you were never cornered in a gravej'ard
at midnight by voices that would be heard, voices that made a re-
ceiver of every pore of your skin, that seemed to endow every separ-
ate object in the universe wtih powers of distinct reproach, you
have never known aggravation. Better far hear too little than too
muchi
Of the multitude of accusations to which I was obliged to lis-
ten, I have written down a sufficient number to enable you to judge
of the rest, and to understand what is the public opinion in the
ghost countr)', as regards dentists. To bring the report within
reasonable limits I have put into the mouths of a few what in real-
ity, was said by many, said many times with every conceivable
variety of emphasis, illustrations and profanity. I give the exact
language, so far as I can remember it, except the oaths. As the
whole multitude evidently mistook me for a chosen representative
of the profession authorized to stir them up, they belabored me
accordingly. I trust my vicarious sufferings may be counted in
commutation whenever the brethren sit in judgment on my share
of our misdeeds.
The foremost in impudence and calumny were the bicuspids.
'• You tried to rotate me," said one, " you know I have flat sides.
OutrageousI"
"You split me with a screw," cried another.
"You dug me out piece-meal with the bur engine," squealed
a cuspid, " and all to make room for my worthless bicuspid neigh-
bor. You shouldn't extract us at all — we are the foundation cor-
ner stones of the whole denture."
" The devil you are!" called out the right superior wisdom,
" who knows more about corners than I?"
"Corners in rot," sneered the bicuspid, "'twould be a good
thing if your whole family had been buried with Moses and nobody
ORIGINAL COMMUNICATIONS. 849
known of your sepulchre unto this day. For pure cussed self-con-
ceit and wilfulness, you and the cuspids are peers."
The uproar that followed this speech was the avalanche after
the gust of wind. I was hoping that the fighters would eat each
other up and leave the field to me, but the cuspids soon got the
floor again — that is, the ground, the air, the sky, everything.
" Talk of extraction," said Number One — " the wretch poisoned
me with arsenic, tore out my vitals, sawed me off close to the gum,
chipped away what enamel was left, drove a gold collar tightly
over my neck and a stake into my stomach."
"Oh, how sweet of him!" exclaimed my Lady Lateral, "a gold
collar! I should like a new necklace myself."
" I should like a piece of that steak," growled Herr Central,
" my belly has had nothing but stinking cotton in it for full ten
years — thanks to dentistry."
"Wait till you hear the worst," replied the Cuspid. " This son
of mischief then fastened a long row of crockery teeth to the post,
four between my mate and myself, and three more behind, a regu-
lar chain-gang, and left me to carry the disreputable lot for the
rest of my natural death-in life."
"How insulting!" " What ingenious cruelty!" "Too much
to have asked of four live teeth!" were the cries that now filled
the air. The molars were particularly sympathetic, but the bicus-
pids were inclined to be sarcastic. "Served you right! you are
the foundation corner-stones of the whole denture," the}^ shouted
in chorus. I picked up my ears again at the prospect of a feud,
which circumstances being unfortunately very noticeable, as was
also the unguarded smile of triumph in my hitherto mild and melan-
choly eye, the assembly became immediately solid and silent.
" Let the Bicuspids speak," majestically said the first molar,
who seemed to act as moderator.
" Campared to us," said the new speaker, "the cuspids have
little to complain of; dentistry was invented for our destruction."
" In-d-e-e-d!" sighed my Lady Lateral, "you have not such
delicate constitutions as we. Ah me! will those rude rough men
ever learn to treat us gently? Think of packing a whole book of
hard gold into my lame side with a trip-hammer! My nerves have
been entirely shattered by scientific dentistry."
" Madam, I must beg to disagree. We bicuspids are the true
Martyrs of Dental Science. Not an item in the whole range of
850 THE DEXTAL REVIEW.
human ingenuit}' that has not been expressly devised for our undo-
ing. We are marked for outrage from our birth. We are often
sacrificed to those self-conceited cuspids. If allowed to remain, it
is only to be subjected to insult and abuse. We are regulated to
death, or ground off to improve the occlusion, filled fiat and left to
decay again, pared down as thin as a German professor, so thin
that we are sure to break off, or cut into halves to get anchorage for
a big swell-head; or filled with amalgam on a pretense that we
'won't bear gold — ' "
"Just fancy!" interrupted my lady, "he can't bear gold! "
The bicuspid went on with increasing dignity; "or plastered
over with oxyphospate, or worse still, treated to an endless variety
of nasty drugs. I should like to know if there is a single vile sub-
stance in the ^\^^ole pharmacopceia that I have not had stuffed into
me."
" You can't hold as much antiseptic filth as we can," cried the
molars.
"We have just as hard a time trying to get rid of it ; I had a
chronic abscess fifteen years, and that fellow there said it was in
the order of nature," rejoined the bicuspid. " It was in the order
of his ignorance," said a central.
" If these bunglers would onl}' be content to give nature a
chance instead of sitting up nights to circumvent her ! Half the
time all that we need is a rest. But the}' stir us up every day
with some new compound, each more irritating than the last. I
should really like to know how many medicaments have been tried
and discarded the last ten years."
Odors of creasote, oil of cloves, iodoform, permanganate of
potash, carvacrol, terchloride of phenol, thymol, salicylic acid,
eucalyptus oil, aristol, and of other more or less familiar agents
now filled the air making the graveyard seem more homelike, at
least more human, than before. It was an ingenious way of
increasing my torments while pretending to lessen them. After
an impressive silence, to ensure the full effect of this demon — stra-
tion, the speaker proceeded.
" The cussedest of your deviltries, sir, is your way of covering
up neglect and malpractice. You call it capping, because you
thereby cap the climax of your sins. You exhaust ingenuity and
skill in the vain attempt to conceal murder. You smother us so
adroitly that we can't give the least sign, not even summon
ORIGINAL CO.hnrUNICATIONS. 851
mourners to tlie funeral. If bj^ chance one of us, after dying by
millimeters under your hands, does call out a little sympathy and
and there is some natural excitement in the neighborhood, you
make that an excuse for pulling us all to pieces again, administer-
ing more poisons, making new fillings(at one hundred francs
apiece) and using big latin words to hide your ignorance. Just as
the all-round doctors do. That's what you call science, but we
call it the crime of crimes: ODONTOCIDE "— ! ! !
The whole immense throng screamed out this word in unison.
Up to this moment I had borne the assaults of these misguided
spirits with a fair amount of equanimity, I had felt a natural pity
for their sufferings, and had professionally discounted their exag-
gerations. But even a dentist can lose patience I So long as they
confined themselves to charges of ordinary caliber and used words
to be found in the dictionary, I could put up with it ; but when
they presumed to call killing a crime, and to invent a new term
for it, my gorge rose. I felt that it was quite time to assert the
dignity of the profession. At any rate I would show that I wasn't
cowed. So when this culmination of insult was reached, I mount-
ed the highest gravestone in my neighborhood and spoke thus.
" When a dentist claps the climax of his many skillful opera-
tions by successfully putting a head on a bicuspid who has lost
his, he may take the fellow's life, if he choose, and can only be
fairly criticised if he do it with unnecessary torture — or lie about it
afterward. I am not prepared to say exactly what amount of
agony he is justified in inflicting ; — that depends on the case ; — 1
should judge some of you had been let off too easy ; — but if he
candidly says, 'die, bicuspid ! I'm glad to bury you alive !' no
ghost of you may stand up to rebuke him. Only when he boasts
that these gently murdered and cunningly buried pulps do live
and deposit secondary dentine, does he deserve to — spend the
midnight hour in a graveyard."
There were plain signs of approval at this speech, for the pre-
molars carr}' their cantankerous reputation with them into the
subtwilight. Seeing that I had struck the popular vein — the vein
of personal abuse — I took courage and ended with a story that
also had its point.
" A young but guileless D. D. S. was once surprised and de-
lighted by receiving a professional call from a person who was
reported, by letter of introduction, to have a 'very wide influence.'
8.12 THE DENTAL REVIEW.
He wished to have a tooth drawn. It proved to be the right su-
perior wisdom tooth. The case was a difficult one of its kind, but the
young dentist attacked it with skill and patience and soon suc-
ceeded in dislodging a decayed crown having three roots. These
he believed to be all, but as the patient was confident of there being
one more, he made another e.xamination and discovering a remain-
ing root, removed that also. 'There must be still another,' insisted
the visitor, whereupon renewed search revealed a fifth.
This the practitioner declared to be the very last vestige of wisdom
in the mouth; but could not refuse the civil though apparently use-
less request to look again. He was astonished and mortified, to
find two more, and now began to ask himself what sort of an
anomalous case he had encountered. Who is this person of wide
influence ? he queried. He seems to be a gentleman, in spite of his
air of contempt for the knowledge of his professional adviser.
Meanwhile he worked on, extracting one root after another till he
encountered one that defied his utmost skill. After repeated at-
tempts and failures, he acknowledged his inability and advised his
heroic and mistrustful patient to be content. At this the hitherto
courteous bearing of the eccentric personage changed to vulgar
abuse. 'You're a fraud, sir! What, charge five francs for breaking
off a rotten tooth like that! Do you call that scientific dentistry?
I suppose you imagine that you have just performed a very extra-
ordinary operation?' 'I was under that impression, certainly,'
said the doctor, a trifle vexed — only a trifle. ' The best any of us
can do must sometimes fall short of perfection ; I have not charged
you anything 3et; if you do not think I have earned a fee, I shall
be content with having served you to the best of my ability. But
I admire your courage.'
Thi': tactful stroke put the stranger into good humor. He put
his hand in his pocket, saj'ing as he did so, 'I am at the head of a
department of a very large establishment — the largest that exists,
I believe.' The young man's face brightened. But it's the lower
department, you know, and the salary is very small — (the face
grew dull again — ) perhaps I might create a sentiment in your
favor — use my influence — to repay )'ou — I really feel delicate in
making the suggestion — .' 'Don't mention payment,' said the D.
D. S., overjoyed at last. 'I shall do my best for any patients you
may be kind enough to send.' 'Allow me to leave my card,' said
ORIGINAL COMMUNICATIONS. 853
the retiring superintendent of the lower department. The doctor
took the card and read, 'His Satanic Majestj'. Hades.'
Messrs. Inhabitants of the Lower Department, that D. D. S.,
no longer young and guileless, stands before you. As His Majesty
has failed, I perceive, in using his very wide influence, to create a
sentiment in my favor, I am here to collect the bill."
That graveyard w^as emptied of ghosts in a twinkling, and your
accidental representative sought his well-earned couch.
DISCUSSION.
Dr. de Trev : It is to the detriment of our clientele that we
are experimenting all the time. I have had about twenty-five
years of experience, and the longer I practice the less medicaments
I use. There is an old saying that there is nothing new under the
sun, and coming back to our old antiseptic, I have been using
charcoal with a great deal of success. It is one of the best anti-
septics in any closed place. The idea was suggested to me b)^
watching the rebuilding of an old house, the bottom of which was
taken off. They put in charcoal to prevent decomposition.
In simple cases I use alcohol, cold or hot air to dry out, and
afterward put in charcoal and creosote. Since using this method
I have had less trouble than with any other antiseptic system. I
have not been using charcoal much, but when I have had patients
who have not had the time to have their teeth properly treated,
in many cases I could only put in my application of charcoal and
creosote ; when these patients have returned to me with this prep-
aration in their teeth, only covered with Hill's stopping, they
have told me that they have never had any trouble. With creo-
sote alone there will certainly be trouble, but not when combined
with charcoal.
Dr. Bryan : How do you combine them ?
Dr. DE Trev : I just take very fine charcoal; it can be mixed,
and is then a kind of paste.
Dr. Bryan : Do you use it in spite of the fact that it pene-
trates the dentine ?
Dr. DE Trev : It discolors the dentine but it does not go
through.
Dr. Roussy (guest): I should like to say a few words to corrobo-
rate what Dr. de Trey has just said. I learned dentistry in the
year 1875, with Bing, and he came to exactly the same conclusion
854 THE DENTAL REVIEIV.
using charcoal and creosote in just the same way. I, myself,
never use anything else. Bing puts nothing but cotton in the
root ; he does not fill the root entirely, he says it does not matter
but I insist on closing the foramen and find that it is a very good
thing. There is great danger even with hot air, to treat a tooth
without first putting in something which will not disintegrate at
the end of the root.
Dr. a. V. Elliott, of Florence : It is a well-known fact that
charcoal absorbs putrescent gases, and when applied in that way
the only question is if it absorbs the gas, but is itself not absorbed.
What then? It is apt to get into the cracks of the enamel.
Dr. J. E. Wetzel : The powder must be very fine. It is a
great absorbent of gases. I think the best thing is to close up the
apex of a tooth with something more solid, when once the crown
is broken off. I have had two or three cases where a tooth has
been filled with charcoal which gave trouble. When I cleaned
out the pulp chamber it was quite filled up with charcoal, and in
the root canal there was a little bit of charcoal or something,
which took me days to get out. I think it is the best thing to fill a
root directly with something more solid than charcoal.
Dr. de Trey : I do not mean charcoal as a filling, but as a tem-
porary antiseptic treatment. I should take elastic wood, and
char the little pieces shaped to fill the root ; dissolve with some
eucalyptus. Hill's stopping to make a paste. Do you know that
eucalyptus dissolves Hill's stopping nicely ? You dip it in and
push it right up in its place. I think eucalyptus is more antisep-
tic than chloroform, and is therefore more useful. The solution
does not dry so quickly, and slips better into the roots.
Dr. L. J. Mitchell : The same thing was done in America
when tooth crowns were used with the old wood pivots ; they were
first charred then dipped in creosote before insertion.
Dr. C. T. Terry, of Milan : Energy and perseverance are the
best antiseptics, but unless you have the proper instruments, it can
not always be done. It is sure to give trouble if a piece of pulp is
left; not one case in forty fails if a tooth is properly treated me-
chanically. We are likely to be in too great a hurry ; if we would
take our time before we get to the end of the root we should have
less ghosts to haunt us.
Dr. de Trey : If I spoke of it as an antiseptic, it is not to say
that I use it much. In ordinary cases I never use anything but
ORIGINAL COMMUNICA TIONS. 855
alcohol, and I believe that you can go through all operations in the
roots directly ; if you have not an alveolar abscess, every tooth
can be treated without any trouble. If I speak of using this anti-
septic it is only in very bad cases.
Dr. L. J. Mitchell: I think that one of the greatest factors in
treating a tooth is to get thoroughly into the roots ; you cannot
feed a man in the back yard, through the key hole of the front
door. If you can secure direct access, you can get better
success than any other way. I use a solution of bichloride in
ether in drying them out, it is better than alcohol.
Dr. Bryan : Iodoform is almost universally used here, and
with good success. I have opened many teeth filled with it and
have found no trouble in any of them. It has been mostly suc-
cessful treatment, and I always fill the roots that way myself.
Dr. Merriam (guest): I always use iodoform and creosote and
push it down with an air pump. I have used it for the last 5 years,
previously I used the charcoal, and several times found the tooth
became discolored on the margin of the gum. Since using the
iodoform and creosote, I have found no discoloration whatever. I
make my paste very liquid and blow it down with an air pump as
much as possible. I alwa3's fill these teeth at the same sitting.
Dr. Monk of Wiesbaden: With regard to iodoform, I should
like to say a few words. I use it in two ways, mixed with a medica-
ment which is simply a means of deodorizing. I have used it in
that way for the last four years, and have been satisfied with my
success. The German doctors began to say that iodoform had no
antiseptic value, and among them was Dr. Miller. I told him of
my success and his opinion is that by taking oil of cinnamon alone
without the iodoform, the same results would be obtained.
Dr. Merrl^m: A small piece of zinc should be used when there
is a smell. I think that creosote mixed with iodoform will answer
the purpose, same as they use it in the L5'on's hospital, and they
derive great benefit from its use.
Dr. Monk: I always use Evans' root dryer; it is a very satis-
factory instrument; in treating through a cavity it is always well to
open up with a right angle.
Dr. Terry: Use the best disinfectants, according to Dr. Miller
or an}^ one else. Speaking of dead teeth I have seen teeth which
have been sensitive to heat and cold afterward, although thorough-
ly disinfected.
850) THE DE.VTAL REVIEW.
Dr. Brvan: One member says it is luck !
Dr. Schaffnf.r of Florence : We should distinguish between
the temporary and the permanent antiseptic. We may get very
good results for a certain length of time. It may be perfectly filled
and exposed again to the original cause of decay. Iodoform may
be beneficial in that its effects are lasting, while many other anti-
septics decompose.
Dr. de Trey: I have found by experience that the eucalyptus
stood longer in the cavities than any other antiseptic except iodo-
form. I have left cavities for 5'ears, as far as I remember four or
five, just when eucalyptus was first introduced, and from the exper-
iments with it among my own servants I found that you could smell
the eucalyptus after four or five years. The same with my clientele.
With creosote, of course, you find nothing of this smell. My opin-
ion is that eucalyptus is the best and most lasting antiseptic which
can be used. If you take it between your fingers it is sticky like glue,
and after well drying the dentine, it penetrates into the tubes, and
stays in that state probably a very long time. Other antiseptics
disappear after a time by evaporation, but this does not.
Dr. Monk : If a tooth is well cleaned out, iodoform cannot
decompose.
Dr. Bryan : Has Dr. Jenkins any remedies for allaying his
ghosts?
Dr. C. W. Jknkins : I was not intending to incriminate all den-
tists, but only to signify in an indirect way that it seems to me
that the work of medication is overdone. I am of the opinion of
Dr. Terry that the first thing must be cleansing of the roots. The
ideal which no one absolutely and always realizes is to get out of
the tooth every possible vestige of septic matter before anything
goes into it. It seems to me that any disinfectant, if carefully put
in, will make an antiseptic condition. Let us make as solid work
as we can, and I think then we have the condition that will be
likely to result in a permanent cure. One disinfectant may do it
a little faster, but if we can get the clean condition, I don't think it
matters so much whether we use one or the other. Having, we
suppose, made it aseptic, then let us fill it as quickly as possible
without letting in foreign matter, and let us fill it with something
that will let nothing else in there. I can never say, for my own
part, that I have got out every particle.
Dr. a. V. Elliott: Has any one had any experience with copper
ORIGINAL COMMUNICA TIQNS. 857
as a disinfectant? I have used it a good deal, and I think Dr.
Schaffner has also used it.
Dr. Bryan: There are as many kinds of root fillings as there
are dentists, and about twice as many remedies for treating the
roots as there are root fillings.
Dr. Terry: I find that the filling of roots is the most difficult of
operations, and requires more perseverance, more time and more
conscientiousness than anything else. I never met with success
until I knew how to put cotton on instruments. It is a thing which
requires skill, provided you want to save your patient a swollen
face. Young operators as a rule put on too much cotton, and force
the instrument up to the end of the root, which of course causes
disturbance. I found out how to make a broach and have any size
you wish. I would like to see any one put a disinfectant further
than I can put one with these instruments. They do not break,
and the ver}' fact of knowing that you can rely upon them, enables
you to do your work thoroughl}^
Dr. Wetzel: Hew does Dr. Terry temper these broaches ? If
you have a very fine broach, the steel commences to burn.
Dr. Terry: I put the nerve broaches in a glass tube to anneal
them.
Dr. de Trey: One very important point in regard to broaches
is when we sometimes break a long broach in a cavity. A consci-
entious man has often felt a cold shiver down his back when this
occurs. I have tried to allay the inflammation in such cases by a
mixture of eucalyptus. I have a little bottle always by me (not
only for these cases which fortunately do not happen every da})
and I take a little of this mixture and let it go down, then drop
that solution of eucalyptus, very liquid, so that it can go all round
the steel which is apt to rust in the contact, and since I have done
that I have never seen a case which has resulted badly. I do not
see the use of staying two or three hours trying to bring out these
pieces when one can do as I have described. Ash's are the best
and toughest broaches I have ever found.
Dr. Bryan : My experience has been that one of the best root
fillings is a molar drill ! The only exception has been that it has
been expensive for filling roots.
858 THE DEXTAL REVIEW.
Surgical Treatment of Irregularities.
By L. C. Bryan, D. D. S., Basel, Switzerland.
There is one class of irregularities which is exceedingly annoy-
ing and "time robbing," as the Germans say ; and after a consid-
erable waste of energy on my part, and a trial of endurance on the
part of the patient, I have for four years tried surgical treatment
on them of what might be called a heroic nature. Irregularlj'^
erupted incisors and cuspids erupting palatally — inside the arch —
are the special class to which I refer ; but the treatment described
for them will appl}' in modifications to a variety of irregularities.
The notorious resistance of the long rooted partially erupted
cuspids to almost all of the usual appliances for their regulation,
and the persistent effort necessary to move them, with not infre-
quent cases in which this resistance requires a force which not
only puts serious strain on other teeth used as fulcrums or abut-
ments, but produces displacement of them of a serious and annoy-
ing nature, are my excuse for presenting the following treatment
given a cuspid which has erupted irregularly inside the arch, say
for a young lady of twenty.
The temporary cuspid has, perhaps, remained firmly in place
and the young lady has never consented to its removal. The den-
tist not being assured that a successor will immediately present it-
self to fill the void, which would be a decided disfigurement if the
eruption of the permanent cuspid were long dela3'ed, the operation
is deferred and in time the point of the permanent cuspid appears
inside the arch. These cases usually develop very slowly. The
partiall}' erupted point is the most trying subject to grapple with,
and the most difficult to deal with, when secured, of any dental
member. I had three cases in one year, and speak from the full-
ness of the heart.
The treatment which I have finally adopted is to inject cocaine
and either partially cut away the thick intervening alveolus with
drills and long fissure burs, or, when the alveolus is thin, bodily
wedge the outer alveolar wall away with a half round, wedge-
shaped chisel, by inserting the point of the instrument between the
tooth crown and the bone, and forcing it up along the root until
enough space is secured for the tooth to be brought out into place
outside the lower tooth. This latter I formerly accomplished by
pressing the above wedge-shaped instrument or the inner beak of
ORIGINAL COMMUNICA TIONS.
859
a suitably formed forceps up along the palatal surface of the tooth
until the crown was forced outward sufficiently to be firmly grasped.
It was then brought gradually out into place, and secured with a
small plate, or ligatures. My present method of operating on these
cases is much simplified by the forceps and fulcrum which are here-
with presented.
FIG. I.
This pair you will see has lobster claw formed jaws or more re-
sembles the Tapir's jaws with round drooping proboscis and the
short receding lower jaw.
This curved long round serrated jaw rests on a fulcrum fitted to
the arch of the maxillary to be operated on, and the short beak
pushes against the palatal aspect of the tooth to be brought out in-
to line. I consider it absolutely necessary to lift the outer alveolar
plate before attempting regulation on account of the great danger
of accident to the pulp if the alveolar margin including the solid
septa between the teeth are not broken up. The outer alveolar
plate must be so broken up nearly as far as the apex, that the apex
will not be moved in its position, otherwise the nerve will be cut
off by any considerable lateral movement of the point of the root.
In bringing teeth into the arch by any system of regulating, or
in moving them in any direction, in which heavy alveolus is to be
encountered, great assistance is afforded to nature in her efforts to
860 THE DEXTAL REVIEW.
absorb the alveolar bone through which the root must pass, if a
part of the bone is drilled away, and the inflammation which accom-
panies absorption by almost all the usual methods of moving teeth,
is greatly lessened.
^ari^g^^^g^^^
FIG. II.
The greatest point of resistance in the alveolar wall is the heavy
margin, or ridge, and the septum which clasps the neck of the tooth;
and if this is broken up, either by wedging outward, or drilling it
away, the deeper bone, which is very cellular and soft, offers little
resistance to the tooth root being moved. The strength of this al-
veolar ridge of bone is so much greater than that of the internal
bod}' of the bone that when teeth are pushed with great force, ap-
plied against the point, this ridge acts as an unyielding fulcrum,
while the point of the root moves an equal distance in an opposite
direction to the point, generall}' cutting the pulp connections off on
the bone through which it is moved. Shocks, such as blows on
the incisors, often cut off the nerve and pulp connections in this
way, while the heavy marginal ridge keeps the center, or neck, of
the tooth apparently in its normal condition, the point having
moved suddenly through the soft cellular bone, and destroj'ed the
connection of the pulp at the apical foramen.
In moving teeth, by traction with ordinary forceps, great care
must be exercised, and the forcep beaks must be lined with sheet
lead, that the enamel be not injured, or the tooth slip. A strip of
sheet lead the breadth of the tooth is bent over the crown from
one side to the other, and burnished down approximately to the
surface. When a tooth crown is sufficiently prominent to take an
impression, a model of it can be placed in the beaks of a suitable
forceps, leaving space around it, and inverting the points of the
forceps, melted lead can be poured around the model of the tooth
so as to fill out the jaws of the forceps. The resulting lead cap-
sule, slipped over the tooth in the mouth, can be grasped with per-
ORIGINAL COMMUXICATIONS: 861
feet security by the forceps, and they cannot slip or injure the
tooth, although the tooth crown may be decayed and frail. The
strip of sheet lead or tin, will generally answer the purpose, and is
much simpler. In extracting teeth which are to be replanted, or
implanted, the crown should alwaj's be protected with sheet lead
or sheet tin.
By the injection of cocaine, or the application to the gum of
calorific fluid, the pain of drilling, or breaking away the bone, can
better be borne b}' highly sensitive or nervous patients than the
continued pain of regulating pressure, and consequent systemic
disturbance from infllammation and broken rest. When general
anaesthesia can be resorted to, the work can be done more thoroughly
and carefull)'. But a small thin model of the points of the antag-
onizing teeth should first be made to use as a bite for the articula-
tion when the jaws are in a rigid state under the anaesthetic.
Injections of cocaine must be deep and high up to prevent pain
in all cases, it being difficult for the cocaine to affect the nerve tis-
sue in such deep-seated operations, for older patients though, the
preparatory operation of opening the gum, and lifting alveolus
margin, can be done painlessly with cocaine. Gas may be admin-
istered if the case is simple, and the operator cool and familiar
with it; otherwise, a more lengthy and profound narcosis should be
induced, the patient's head being held firmly by an assistant during
the operation.
Calorific fluid applied to the gum locally on a pellet of cotton
for two or three minutes has a powerful effect, and can be relied
on in minor operations on gum and alveolar tissue. I often use it in
extracting with good results.
The first impression of those who have not seen the easy and
generally painless manner in which the operation may be per-
formed is that it must be a very cruel operation, while those who
have seen the operation and the patient will assure you that, with
cocaine injected after taking an alcoholic stimulant or strong cof-
fee a half hour before the injection, to prevent systemic disturb-
ances from the cocaine — it is the most humanitarian method of
operating for irregularities.
The after-effects are generally very satisfactory, no pain being
experienced except soreness, and occasionally some swelling, last-
ing for some hours. The open socket at the palatal side offers
perfect drainage should any inflammation supervene, but patients
862 THE DENTAL REVIEW.
complain of no inconvenience and are much pleased to get through
with it so easily — each one of whom I have inquired have said that
they would willingly undertake it again if necessary.
Young persons are particularly suitable subjects. I have ope-
rated in two cases for seven-year-old girls who for filling operations
were particularly nervous and sensitive, who did not, with a
cocaine injection, make the least sign of the slightest pain in bring-
ing in each case a right superior central incisor — the roots of
which were not fully developed — from the inside to the outside of
the arch. Both of these cases never gave a moment's pain during
or after the operation, and the teeth after one j'ear and four
months, and one year and nine months respectively are in perfect
condition, only having been tied to the adjoining central with silk
to steady them, for several days.
In two cases of ladies of twenty-five and thirty-five years respec-
tively, some pain was felt after injections of cocaine when forcing
the tooth out with forceps, but described it as a dull pain not
severe, and more easih^ borne than excavating a sensitive tooth.
I have two failures — or partial failures — to report, one operated
before the Swiss Dental Association, in Berne, for an eighteen-
year-old dental student, in which case I operated under some
excitement with the regulating forceps, bringing out a lateral
incisor witliout first lifting the alveolus, which was heavy and thick.
The pulp was ruptured and root filled later, and the tooth is after
a year not so firm as its neighbors.
The second case of failure was of a girl twenty 3'ears of age, and
was brought to me by a dentist. The dentist gave bromide of ethyl,
but could not produce profound narcosis so that the patient
wrenched the head violently and the tooth, a cuspid, was forced out
of the socket by the elevator which I was using to start the tooth
in its socket.
The models of this case are presented here and all will recog-
nize that it was an extraordinarily difficult case at the best, and
could have been better regulated by the usual methods, and should
never have been undertaken. It was, however, the only case I
could secure for this meeting, and as both cuspids were alike
irregularly erupted palatally I wished to try one, and if successful,
regulate the other before the society.
Under no conditions would I attempt the other now. Since
1888, I have had fifteen cases, all of which have been successful
ORIGINAL COMMUNICATIONS. 863
except the two mentioned. None of these patients, who hve
in town — most are away now-^would agree to appear before the
society, but I have been able to show one of my first cases, the lady
of twenty-five, to two of the guests present, and others of my col-
leagues have seen other successful cases.
DISCUSSION.
Dr. Bryan : You have seen the clinic this morning and heard
the paper read yesterday. Are there any remarks to be made on
the subject ? I am sorry to say that Mr. Dall, of England, who
saw the patients in my office operated on by this method, is ab-
sent. I expected to have his evidence that the pulps after two or
three years were still alive in these teeth. The patients operated
on were ladies of middle age. Perhaps he may come in later, but
it will be in order now to discuss the last paper read yesterda}'.
Dr. de Trey : I would ask Dr. Bryan what he thinks of the
state of the nerve at the apex of the root of a tooth in such a mov-
able condition ? Is the nerve broken, or is it only drawn out of
place ?
Dr. Bryan : My paper explains that fully to the effect that the
apex of the tooth should not be moved in the least. All precautions
should be taken to that effect. The lifting of the alveolus as you
saw in the operation insures the apex remaining in its normal con-
dition, and there can be no movement \vhatever at that point.
Those cases which I operated years ago now show perfectly
healthy pulps answering to all the tests which we can apply to
determine the condition of pulps, and they have convinced me
that operations can be performed anywhere from the age that the
central incisors erupt, to the age of forty or so. It is difficult at
the age of forty to inject cocaine so that it will affect the tissue
surrounding the teeth, sufficiently to make it a perfectly painless
operation. The patients do not complain. As you all know, we
do not attempt to regulate teeth by the usual methods, after the
age of twenty or twenty-five. Persons in the usual occupations of
life cannot afford the time nor the loss of rest, nor the nervous
strain necessary to regulate those teeth, as they have to be
brought through bone that is fully developed. Regulating after
the age of twenty-five would be better performed under an anaes-
thetic, if profound anaesthesia can be perfectly accomplished, so
that the patient does not move. As I told you yesterday, I had
864 THE DENTAL RE VIE IV.
operated for cases where, under an anaesthetic, the patient moved,
and I had an accident. We had to remove the nerve by the apex,
and replace the tooth in its socket ; the next day vi^e secured it
with a small plate. That should not occur, and was a very
unusual case ; as it was the only one that offered itself for the
meeting, I ran risks rather than fail to fulfill my promise to demon-
strate. The greatest successes have been attained with very
youthful patients.
Dr. E. J. Wetzel: I do not think that it is so easy to injure a
healthy pulp. Some years ago a lady came with a child and her
nurse ; I wondered why she was bringing a child of two years; she
explained that the mother of the child was ill in bed, and the little
boy had met with an accident loosening a tooth. In fact he
nearly pushed out the tooth completely ; the tooth was fairly drop-
ping in my hand. They did not want the mother to know any-
thing about it, as she was afraid the second tooth might not come.
The nurse had the child on her lap, and I advised her to press the
tooth up into the socket again. When I saw the boy five years
later, it was grown exactly in place as it was before The nerve
must have been nearly drawn out of the pulp canal. It was a
temporary cuspid tooth, and the child was then about seven years
of age.
Dr. Bryan : Patients occasionally suggest to us after we have
worked with screws — " Dr. don't you think you could take that
tooth witTi a forceps and bring it out into place immediately ?"
Somebody was saying that a patient suggested the same thing to
him. We often get these hints from patients, which, if followed
out might be useful in our practice, although they seem, and are,
as a usual thing, foolish remarks without any scientific basis.
Occasionally we see a case where the whole jaw will be forcibly
depressed and that will remain. Certain teeth if struck on the
point will move at the apex sufficiently to destroy the nerve with-
out moving the tooth at the cervical wall, or at the gum margins,
or at the alveolar margins, and the very point which I wish to
insist on is that of breaking up the alveolar margin, whereas the
tooth is easily moved higher in the jaw. I think you can move a
tooth, and especially is this the case, where the root of the tooth
is not fully developed, as seen so plainly yesterday in Dr. Gysi's
preparations. In an incisor tooth I think we can use a good deal
of force, and do a good deal in those teeth with immediate treat-
ORIGINAL COMMUNICATIONS. 865
ment without endangering the pulp. We must exercise great
care in lifting the alveolus in making the way perfectly clear.
Dr. Rathbun : Is the apparent, not real severit}', any deterrent
in the minds of well to do patients?
Dr. Brvan : Well I never ask the patient ; they come and
want a tooth regulated, and I say, "certainly, we will do that to-
morrow," just as I would with filling a tooth.
Dr. Rathbun : Yes but when a patient is brought by the mother,
you must surely consult her. I grant it is a painless operation, yet
in the eyes of an on-looker, it is a serious question whether an
operation apparently so forcible can be endured by the patient.
W^ould not a slow way be more agreeable to the feelings of the
parent?
Dr. Bryan : They submit to my judgment in the matter if I
tell them that it can be performed at one operation, they take it
for granted that it can best be done at the one sitting.
Dr. : Can Dr. Bryan get these teeth into position in so
short a time, without periostitis?
Dr. Brvan : I should never attempt to draw back a tooth in an
arch that never protruded. I should inject cocaine on the palatal
surface of the teeth, and with a drill cut away part of the alveolar
at the back and regulate by the usual methods. You open a canal
for the exit of inflammation; you provide a canal in the alveolus
incase you have forced septic matter in around the tooth. This
patient may have by to-morrow morning a swollen face, but there
will be no pain, because there will be no confined periostium there.
The pain comes from the fact that the bone tissue is unyielding.
A Member : One can hardly avoid producing periostitis in
regulating in so short a time. I don't see how it is possible to do
it.
Dr. Bryan : It is always an inflammatory process that removes
bone to provide for the moving of a tooth through solid tissue; and
what I claim is that you break up the tissue there and provide a
drainage for the periosteum.
Dr. Rathbun : I would like to ask if a mild amount of per-
iostitis is not necessary to regulation, that is to say that until Ave
can get enough we cannot get regulation.
Dr. Brvan : The only regulations that are accomplished with-
out periostitis more or less acute, are those which are accomplished
by nature. The lip and tongue regulate teeth in the best possible
866 THE DEXTAL REVIEW.
manner. You will always find that irregular teeth occupy the
spaces just as perfectly as nature can arrange it, and that is the
onl}' regulation that I know of that is accomplished without pain.
Dr. Rathbun : Do you rotate teeth by this process ?
Dr. Bryan : Never without lifting the alveolus. If a tooth is
moved further than the case operated on this morning, you can
then rotate it if you hold it in such a position that you do not
move the apex of the root. If any of you have had any experience
in rotating teeth, I shall be glad to hear from you. I have found
nothing in works on dental surgery relating to this subject. My ex-
perience with these older patients is that the teeth become perfectly
solid and are comfortable, only that we cannot get as perfect anaes-
thesia as we can for a child. These two little girls that I operated for,
sat without the least indication of pain, and although I was quite
excited under the operation, and the mothers sat by trembling, the
little patients kept perfectly smooth faces. Although it seems to
be a cruel operation, it is the most humane way of treating these
cases.
The operation is so entirely new that the details must be worked
out after a time. It is evident that the thing is practicable, and
time will prove that the details can be so modified as to make it
accessible to every dentist who extracts teeth.-
Dr. Guye, (guest): I was very much interested in the operation.
Do you find the teeth elongate after the operation? I have noticed
in rotating teeth where the apex has not been moved, that they did
elongate.
Dr. Bryan : Yes, because if you take a cylindrical root in a
cylindrical socket, it must of necessity elongate. I believe this has
been practiced in England.
Dr. Guye: Have you noticed much receding of the gum after
these operations?
Dr. Bryan : I have never noticed any receding of the gum.
If the tooth is elongated, and if it is erupted well inside the arch,
and is brought out and is longer, of course part of the root will be
exposed.
Dr. Guye : You performed this operation under very unfavora-
ble conditions. I think it would be wise to rinse the mouth with
Miller's wash, which he claims disinfects the mouth perfectly.
Does not Dr. Bryan think it should be disinfected ?
Dr. Bryan : Yes, this is a very, very important matter, not
ORIGINAL COMMUNICATIONS. 867
only for the success of the operation, but to avoid inflammation. I
had the patient come to my office before coming here, and during
the operation I had all the instruments dipped in carbolic acid,
and I hope to have no inflammation. It is a most important point
to have all the instruments dipped in some antiseptic before they
are driven into the live tissue where septic matter would produce
inflammation.
Dr. Schaffner : Do you think it would be possible or even
easier to perform that operation by means of the old key? You
would have a great force.
Dr. Bryan : You must have a fulcrum which allows space for
bringing a tooth into its normal position.
I am very sorry the gentlemen are not here who have seen the
cases in my private practice, because I have operated on two or
three cases for one dentist here, and he is very enthusiastic on the
subject.
Dr. Terry : Could not some screw be made to keep the tooth
in its place and that it could not leave its bed at all?
Dr. Bryan : You saw by the operation this morning that every
thing is in a very crude condition and that there is plenty of room
for suggestions on the subject.
Patients and Patience.
By a. V, Elliott D. D. S., Florence, Italy.
The message, my brethren, which it is my purpose to deliver to
you to-day, is entitled Patients and Patience — patients' patience — a
happy if seemingly a somewhat paradoxical combination. As
commonly understood a patient is the client of a medical man or a
dentist. The word itself comes from the latin word patiens — the
active participle of the word patior — to suffer — to endure suffer-
ing. And patience, one of the virtues most required by the dentist
is of the same root, meaning waiting or long suffering. We have
thus from the same origin but spelled differently, two very impor-
tant requisites for a successful career on the part of a practitioner.
He must have the one before he can have any use for the other.
According to the old theology, the world is composed of two
kinds of people, saints and sinners. But in the experience of the
impressionable dentist, the formula is changed to good and bad
patients instead, which amounts virtually to the same thing, a good
8G8 THE DEXTAL REVIEW.
patient being in his estimation a fit subject for the Kingdom of
Heaven and the otlier fellow otherwise.
We all know bj- experience, sometimes by painful and weari-
some experience, how great the difference is.
There is nothing like the dental chair as a reagent, so to speak,
to test the qualities of an individual, and how of ten are we surprised
at the result. To a student of human nature and of national
traits, such experiences are interesting, if sometimes annoying.
One of the first things I noticed when I entered the profession
was the small number of persons having the ideal superiority of the
moral over their physical natures. After all, as the Irish poet
might have justly said, there is much human nature in human
nature, and it only needs some exciting cause (outside of the usual
routine of life) to develop it and one of those exciting causes I
have found to be the impelling force that drives a man to the dentist,
where, according to the nature of the case, the nationality of the
person, his previous experience, his education and his moral and
physical balance he will behave himself in the chair.
To arrange and classif}^ patients except in a general way is im-
possible. The varieties are as infinite as the characteristics of the
human famil}' are infinite. It is therefore not the ordinary every
day kind of patient that I wish to present to your notice, but those
which are more exceptional and which affect us in our efforts to
minister to their comfort the most. Since most of the members of
this society are men of great experience their opportunities of ob-
servation have also been great and their experiences I have no
doubt will enable them to appreciate and confirm to a greater or
less degree the truth of what I am about to give in regard to the
unnecessary trials and annoyances we as dentists are too often sub-
jected to.
To begin with let me call your attention to a class of patients,
who, all will admit, are but too common. I refer to the late comer
— the one who always comes late. Besides the divisions of the
human family before referred to we might add those who are,
barring accidents, always punctual, and those who are, barring ac-
cidents, never so. With a dentist in full practice, time is not only
money, but the loss of it in this way makes ofttime's confusion and
embarrassment. It so often happens that the next patient after
the late comer is a superpunctual person — one who values your
ORIGINAL COMMUNICATIONS. 869
time and his own too. What are you to do with these inconsider-
ate people.
The excuse given — they always have good excuses — does not
give you the time lost without encroaching on that of the next, and
does not enable you to do an hour's work in half that time. How
often is our patience tried by such badly disciplined people who
prove by their conduct how badly they have been brought up.
Slovenly domestic discipline is a moral crime against society. The
spoiled child usuall}' develops into the selfish or inconsiderate man
or woman and society suffers in consequence.
In dealing with such people who, by the wa}' I am sorr}' to
say, are usually of the fair sex, when the question of time is an
important one, the dentist must be guided by circumstances and
console himself for his patience b}' making his charge somewhat
commensurate with the loss of time. But in regard to this
class of delinquents who make appointments and neither keep
them or notify to the contrary, the only way in such cases is to
charge them for the lost time, which has the double advantage of
remunerating oneself and teaching them a lesson on self-interest.
Another class of persons which try our patience — somewhat re-
lated to the foregoing — is the self-willed and perverse. Such
people do not like to have to submit to the necessary pain and in-
convenience and project a spirit of antagonism toward the opera-
tor as if the work he might be doing was for his own pleasure and
gratification. There are varieties of this class, including the ner-
vous, and fussy self-willed, who make a great ado of their sufferings
and hinder the dentist to the utmost. He is anxious to do his work
well, but between what the nature of the case will admit and
what the patient will submit to there is little margin left, and one
reason why the conscientious dentist worries at such times is
because he knows that if the work fails, this kind of a patient will
not have the justice and charity to assume any responsibility for
having contributed to it, but on the contrary, have a great deal to
say about how much she suffered, etc. Patience is necessary
here, and much of it; sometimes dentists, like medical men,
get blame where they least deserve it and praise too sometimes
where they least deserve it.
Belonging to the same family here referred to are those who to
produce an impression and call attention to themselves have an exag-
erated way of emphasizing. Not that such people suffer anymore
870 THE DENTAL REVIEW.
than others, it is their way. They are selfish and self-asserting.
Then there is the patient who has a little knowledge and a great
deal of conceit — who, in fact, knows everything — who totally ig-
nores your three terms at college and maybe twelve years of
practice, and the fact that even a dentist must depend on the ad-
vice of a brother practitioner to a greater or less extent when his
own mouth needs attention. Such a one is positive thdt such and
such is the case.
He requires that you shall do the work as suggested by him.
He takes up your valuable time arguing the matter, and then when
you tell him you will do as he directs, let him boss the job, pro-
vided he takes the responsibility — he is unwilling to do that but
resorts again to arguing through which, if by nothing else you
learn how ignorant he really is. Those people are great nuisances;
the only thing to do with them is to put on the cloture, the rubber
dam, as soon as possible and give them leave to print as they do in
Congress, any further remarks they may have to make and do the
work as you think best.
Then there is the offensive aristocrat — not offensive necessarily
because he is an aristocrat, but an objectionable variety of that
social order. The real aristocrat is in my experience the most
unassuming, unpretending, and the most friendly, sometimes even
chummy of clients, but there are exceptions. Those who behave in
a condescending way, whose manner would imply that they hardly
knew the distinction between a professional man and a servant
who, at least, although compelled by the force of circumstances, to
consult the dentist and allow him to put his fingers in their unclean
mouths, will resent it afterward by the cold cut, should chance
bring them face to face outside the office.
Such vulgarit}', I am happy to say, is rare, and when it does
occur it hurts the possessor more than it does the recipient, as it
proves the rule how utterly unworthy such people are to be con-
sidered superior.
Then there is the paradox, the impatient patient, the one we
will say, who having a plate for the first time expects it to be as
comfortable within the first few days as her grandmother's is after
thirty years' experience She comes day after day and insists
upon your doing something. In vain you argue to prove that it is
not the fault of the plate, but of her not being accustomed to it,
and that to undertake to improve it would risk spoiling it alto-
ORIGINAL COMMUNICATIONS. 871
gether. M}' brother's recipe for such people was to tire em out.
Sooner or later she and her plate will have more affinity for each
other, and she will cease her visits,
I once had a case soon after commencing practice when I was
very inexperienced and had the idea — the exalted idea — that the
patient must be made satisfied no matter what the sacrifice on the
part of the dentist. I altered over her plate for her five times and
worked nights. It was a perfect fit from the first, but the more I
tried to please her the more she was determined not to be until her
brother came and told me she was crazy and begged me to charge
it all in the bill. Often enough however we have people who are
not officiall}' crazy, but are nevertheless nearly as bad to get along
with as this old lady was.
Another class of persons who try our patience are the idiosyn-
crats — those having idiosyncrasies — some peculiarity or other about
them which interferes with the proper performance of the opera-
tion in hand. Such for example as the inability to have the rubber
dam applied or to open the mouth properly, or who gag or retch
when paper or a napkin is put in the mouth, or an instrument
touches the tongue; who are unable to swallow or to have the head
in any other position than bolt upright, etc., etc., not including the
common kind of idiosyncrats who positively object to that most hu-
mane of dental instruments, the engine. Nervousness has much
to do with this phase of human nature — again patience and tact
are here indicated and will do much for relief. Somewhat related
to this group is the timid and apprehensive class. Those who con-
fess themselves cowards and who approach the operating room
with fear and trembling, whose dire necessity drives them to the
dentist. If facetious they will call our apartment of relief — wliich
our English friends call the surgery — the chamber of horrors. For-
tunately for these people when they go to the educated dentist
they seldom get what they expect. The idea such people usually
have when they go to a dental establishment is one of blood and
forceps, spittoons, and acute suffering. They are so grateful after-
ward to the gentle and soothing operator for the relief given and
that they still live. Ignorance and nervousness in these cases com-
bine to give so mucl-, unnecessary suffering.
Children too usually come under this head, but there are ex-
ceptions. Some of tl !^ bravest and most sensible patients I have
ever had have been )oung children who cheerfully and willingly
873 THE DENTAL REVIEW.
assisted me in doing the necessary operations. Real little heroes
and heroines submitting, without any fuss, to having teeth ex-
tracted when such was in order. The good conduct of such lit-
tle folk under such trying circumstances, should put to shame
the self-willed babies so many years their seniors.
But in dealing with the little ones ordinarily, much patience and
tact is required on the part of the operator. He must gain their
confidence and avoid as far as possible, consistent with good work,
doing anything that might tend to discourage their going again
to the dentist when required. I am personally opposed to the
expediency of deception under all circumstances. A child so de-
ceived, never forgets the shock, and retains perhaps for life a pre-
judice against our profession — to their injur}' and our less profit.
I will now refer to a class of patients who try our patience
in a peculiar manner. I refer to those who make a fuss over our
charges. In a cosmopolitan practice, such as most of us have
here in Europe, it is inevitable that we have to deal with a great
variet}' of people from different parts of the world, including rep-
resentatives from the back streets of American villages and Eng-
lish provincial towns, as well as those of the highest nobility of
Europe, not excepting, if you please, some of the crowned heads
thereof.
We can't very well have two sets of prices for our work —
one for the rich, the other for the less fortunate because we have
no knowledge of, or interest in their circumstances; we have a
right to charge a reasonable price for our labor and skill, even
though that price may not correspond with the prices in vogue in
the back streets of Squedonk. To avoid such unpleasant discus-
sions, my plan is to always inform in advance. Should the person
in hand by her appearance suggest the possibility of a discussion
over the amount of the indebtedness when presented. Personally
I dislike such discussions very much, and am willing to do all I can
to avoid them.
And now, my friends, we come to that interesting individual,
the deadhead, or, if you please complimentary patient — dentists
as a rule being both benevolent and charitable — it is but natural
that they should have for one reason or another unprofitable clients.
Of course it is a pesonal matter with the dentist; he can do what he
pleases with his own time and material — give it all away if he
chooses, or he can charge his wife's mother as much as any one
ORIGINAL COMMUNICATIONS. 873
else. The laborer is worthy of his hire, but often his disinterested
kindness in giving time and skill without compensation is not ade-
quately appreciated. The time, if he had it to spare, he could easily
find more congenial use for it. One thing peculiar I have noticed
about the D. H., she is often the worst offender in regard to
punctuality. One hates to qualify a benevolent act by reminding
such people of their obligation. There are, however, exceptions
to this rule, who give one full value received in gratitude and nick-
nacks. After all the cheerful giver has some consolation in its own
reward.
I am afraid my fellow sufferers I am myself trying 3'our long
suffering patience too much in this review of some of the trials 3'ou
must be all more or less familiar with. I might refer to many
other kinds of inconsiderate persons who worry the dentist and
make him tired. But I will be brief and only refer en passatit to a
few more such, as for example those who come to the dentist with
unclean mouths, requiring him to clear away the offensive muck
about and between the teeth before he can get at the suspected
places, and I might refer to the inconsiderate person who stands at
your operating door and insists upon seeing you "just for a mo-
ment," and I might here refer to the tactless person, who, having
a prejudice against a brother dentist, is indelicate enough to abuse
him in your presence. Such people, however, in my opinion,
prejudice their own positions instead by doing so and should be
discouraged. And again, I might refer to the person who comes
the influence dodge with a view to her own advantage and who
does not seem to realize what an old dodge it is.
What I have attempted to do, my friends, in this resume is not
to abuse human nature in general, but to present by classification
those who worry us and make us suffer. Much has been written on
dental ethics, the duties and obligation of the dentist, but I have
never seen the other side presented, the duties and obligations of
the patient. Perhaps that is too "large an order." AH the same
we need their cooperation to do good work for them. How fatiguing
it is to work for some people. Blessed is the man who is so strong
in vitality that he is not effected by the absorbing power of such
people. Perhaps it is because I am more impressionable than
many, or because I came into the profession later in life, but the
fact is with me that it makes all the difference in the world at the
end of a day's work the kind of people I have had. It is not a
874 THE DENTAL REVIEW.
question of the work itself to a man of mechanical and artistic
tastes. There is nothing fatiguing about our work, and if we
could choose our clients there is no occupation in my opinion to
equal ours.
There is such a wide field for ingenuity and skill, and for
ambition, and think of the good which is constantly being done
for poor humanity by our profession, and there is the other side
to the question to offset the disagreeable part of our daily life-
Only for this other side, the dentist's life would certainly not be a
happy one. As it is the balance between good and evil, or good
and bad patients, is decidedly on the side of the good. Ours is a
social occupation, and for the time being, at least, we are on inti-
mate personal terms with those who confide their mouths to our
care, and from among those, if so inclined, we can merge the rela-
tionship of dentist and client to that of friendship.
We too have an obligation and a duty to perform as I said be-
fore. The dentist should be a teacher as well as operator. He
can do much good in that way, and he has such a good opportun-
ity. He should keep his morals and principles as clean as his
hands.
The ideal dentist should be a man of honor and dignity and
worthy of every confidence, in fact, a gentleman in the highest sense
of the word. He should always have in view the honor of his pro-
fession and its advancement, and his ambition should be to do all
in his power by his own conduct, to raise it to a higher standard
morally, intellectually and soundly and thus as far as he is able to
make it worthy of recognition and the peer of the most learned
professions.
He should remember that ours is not only a learned profes-
sion, but a useful one as well. It is our mission to save and re-
store and he should not forget that our work is mostly on living tis-
sue and in the mouths of many, extremely sensitive living tissue.
He should be a man of courage, firmness and gentleness and of
course, conscientious. AlTkinds of claptrap cheap-jack methods or
vulgar boasting which tend to lower and degrade us as a profession,
even though the offender be ever so skillful, should have no place,
in his plan of campaign. Boasting is a cheap vulgar and very un-
reliable way to advertise oneself except to advertise such an one
as having very little of the true instincts of a professional man
or a gentleman.
ORIGINAL COMMUNICATIONS. 875
As regards ourselves we who are members of the American Den-
tal Society of Europe, have every reason to be proud of the position
professionally, scientifically and socially, which good and capable
men have earned for it in the past. All honor to them and to those
of the present and future, who will carry to further heights that ban-
ner the poet referred to on which is inscribed the appropriate word
so appropriate here in Switzerland — Excelsior.
DISCUSSION.
Dr. de Trey: I think a great many dentists make a mistake
in not being sufficiently firm with their patients. We have a say-
ing that the patient should bend to the will of the operator and
not the contrary, but the young, inexperienced practitioner has not
sufficient confidence in himself and the consequence is that the pa-
tient takes advantage of the situation. A dentist should be firm,
not rough. Facility in practice is secured by being firm from the
beginning.
Dr. a. Wetzel : My opinion is that dentists can never be too
patient. I have sometimes had nervous people whom I would
have preferred to send away, in fact have often been on the point
of telling them to seek advice elsewhere, but after the lapse of sev-
eral months have been glad that I restrained that inclination. If
a patient goes to a dentist who is willing to humor them a little he
gets a great deal of credit and they recommend him, they appreci-
ate his work and frequently those persons whom they recommend
are the best of patients, and one is able to do for them the very best
work. A dentist must be patient himself, even though he may
sometimes have impatient patients to deal with.
Dr. Monk : That is, use tact.
Dr. Roussy : I should like to draw the attention of the profes-
sion to the influence of the rubber dam on the patient, not only as
a means of keeping their mouths shut, but you will find that as
soon as the dam is applied, they are quiet. Unfortunately I did
not use the dam for some eight or nine years, much to my subse-
quent regret, but for the last six years I use it in nearly every case,
and find it a great relief to put it on as quickly as possible.
Dr. Bryan : In fact you consider it a general anaesthetic.
Dr. Schaffner : I find that dentists may sometimes be too
positive, as in a case I had not long ago, the result of which was
the loss of a patient. I had previously filled a tooth without my
876 THE DENTAL REVIEW.
exactly remembering that it was sensitive. The tooth was not sen-
sitive before, and as we have often observed it became so subse-
quently. I filled the root and applied cold or hot air, when the
patient complained greatl}' of the sensation, but I told her that
there could be no sensitiveness as the tooth was perfectly dead;
the patient resented this idea so strongly that she ultimately left
me, and in considering the matter, it occurred to me that it might
have been perfect]^' rational and coming from the next tooth which
I had previously filled. No doubt such cases occur to others be-
sides myself and provoke us unnecessarily and to our own loss.
Dr. Bryan : It is a good rule to take a patient's word in such
cases, they are no doubt the best judges.
Dr. Jenkins : I think we ought to remember that a nervous
pain which is in one sense no pain, is a real one to the patient.
Where the nerves are excited, the , patient may attribute it to a
wrong cause, but everything that we can possibly do to avoid giv-
ing suffering we should do; I have had my full share of such cases;
people come to me sometimes because they think I treat them
gently. We cannot see any reason for the pain, but where we see
a reaction, we can find out and avoid little things which excite the
nerves of our patient. Even sometimes when they are suffering
from mere nervous excitement, if we can do something to calm their
nerves by conforming to some condition which they think will re-
lieve them, we should do so; we can then do what we like
with them. I think the most troublesome patients are those who
have little the matter with them but whose nerves are unstrung.
Dr. a. V. Elliott : Yes, when people are really delicate and
nervous, we are willing to give in to them, but a lady came to me
on Saturday last, complaining of toothache, and saying I must
not hurt her. " She had been to a dentist in Paris, buthe could not
find anything, but she was sure there was something as the tooth
ached her." I told her that unless she would let me do what I
wanted, I could do nothing for her. She said I must not use the
engine. It was a case of exposed nerve, and I suppose the other
dentist had not been sufficiently firm with her.
Dr. Schaffner : I would like to ask the profession whether
they do not consider it advisable to use morphia in a small dose with
nervous patients ? It produces good effects and the patient can
stand the pain much better.
Dr. de Trey : I am not an advocate for all these things ; they
ORIGINAL COMMUNICATIONS. 877
have been used so largely and the facilities for procuring them are
so easy that it has become quite a mania, especiall}- in Paris, and
I think we ought to avoid the use of morphia as much as possible,
as it may be very bad for our patients. They find the effects so
very agreeable that having once tried it they use it again and
again, and, exaggerating their idea of suffering, use it too much.
We professional men should be careful of such cases.
Dr. Guye (guest): I am of Dr. de Trej^'s opinion. I myself
have used valerian with good results. I do not think it is liable
to do any harm if used in reasonable doses, and having such a bad
taste patients are not likely to use very much of it.
Dr, de Trey: I have taken this myself many times. It should
be taken two or three hours before an operation, and has a very
good effect.
Dr. Bryan : Some one has recently recommended whisky :
that strikes one of Irish extraction very favorably. Is cocaine
generally used by the profession at present ?
Dr. Theo. Frick of Zurich : I have been using cocaine very
much during the last three years, but I know that very much has
been said and written against it. I have injected from 3 to 5 cen-
tigrammes and have never had any bad results as to the general
effect on the patient. I do not keep my solution prepared before-
hand, but get it ready just before I want to use it. It is not of
much importance whether the solution is of 6, 8 or 10 per cent, but
the quantity you inject, and I think 5 centigrammes should be
quite sufficient, except in cases of pericementitis. I know that
many greatly object to injections of cocaine, but I would recom-
mend to colleagues at least to paint the gums with a camel's hair
brush at the margin of the tooth, especially when the cavity goes
up above the gum, and the ligatures have to be pushed up, it can
be done verj^ easily if the gums are first painted in this way.
Dr. Guye : There is one point about which Dr. Elliott spoke
with which I quite agree, and that is the one of having patients
informed that a charge will be made for time lost; in fact, I have
this printed on my engagement cards, and I found that some peo-
ple who were unwilling to keep their appointments were driven
aw^ay by this notice.
Dr. de Trey: With regard to the question of cocaine, I think
it is known to be ten times worse than the morphia in its effect
upon the body. Cocaine attacks the nervous system a great deal
878 THE DENTAL REVIEW.
more than morphia. We should fight against these remedies and
use something else in their stead.
Dr. Frick : In reply to Dr. de Trey's remarks, I believe he
mixes up two things. Persons who have taken cocaine internally
cannot leave that habit, and get taking more and more just as they
used to do with morphine, but I have never heard, either in prac-
tice or in reading, that a subject who had had a cocaine injection
felt the need of cocaine afterward.
Dr. Wetzel : I always find it a good plan, in order to reduce
the sensitiveness, either in preparing or extracting teeth, to engage
the patient in conversation, and you can then excavate or take out
a tooth with little pain ; especially is this so with children.
Dr. Jenkins : I think that any of our colleagues who have not
used cocaine by injection should be cautioned against it. I always
avoid giving it to a very nervous patient. It has a specific action
which we ought to be very careful in producing, as some cannot
bear it. It certainly has a very useful effect used externally.
There are some with whom ether spray will answer very well, and
some with whom a little encouragement will go a long way.
Dr. Roussy : I should like to mention a case which occurred
last year. A patient came to me to have a tooth treated. I told
her that I should use cocaine at the time of inserting the tooth. I
injected 1 centigramme at 3 o'clock in the afternoon. She went
home not feeling very well and was obliged to call in a doctor,
who told her that had she had .3 centigrammes it would have been
her death. Perhaps you have heard of a doctor in Paris who
says that in the use of cocaine much more water should be used.
Since that time I have used cocaine without any trouble, but I put
5 centigrammes for 2 centigrammes and next day I make the op-
eration with a new injection of course ; but I think one cannot be
too careful, as it is a most dangerous thing to use.
Dr. L. J. Mitchell of London : As far as I can see the best
results have been by the combination of hydrochlorate of cocaine
— 3 parts, and 2 parts hydrate of chloral — a ten per cent solution
for an injection, to which I add about a drop of oil of cinnamon.
Hints on Vision.
By Professor Schiess, Basel, Switzerland.
What is health? This question is not readily answered, because
health differs; what is health in a child may not be health in an
ORIGINAL COMMUNICA TIONS. 879
adult, and the health of an old man is not the health of an infant
This can be proven by the eyes. The eyes of a child, ten years
old, possess powers which the eyes of an adult no longer possess.
They have a power of refracting, which the adult eyes do not.
The eyes of the one differ in form from those of the other.
"Seeing " seems, perhaps, a very simple and easy thing to doj
but in reality, it is a very complicated function of this delicate organ.
As long as our eyes do not trouble us, we are, perhaps, unwilling
to believe it, but just as soon as we feel a difficulty in doing our
usual work, we begin to think that this seemingly simple function
may, after all, be a rather complicated one.
The muscular force of a man is greater; he can bear a greater
weight; he can take a longer walk; but the power of accommoda-
tion is much greater in the eye of a child.
This brings us to the chief object of this brief paper.
For seeing, three things are absolutely necessary. First:
there must exist a dioptric system for the creation of a neat image
of objects looked at; secondly: there must be a sensitive plate for
receiving this image; and thirdly: we must have an interpreter of
the image. If any of these factors is wanting or deficient, then
either the sight is not good, or one does not see at all.
The first factor lies in the eyeball and its contents, the cornea,
aqueous humor, crystalline lens, and corpus vitreum; the second in the
retina, and optic nerve, and the third in the brain.
Let us now consider the first factor. Here we must discern
between two points. The one thing possible of the dioptric appa-
ratus is the formation of distinct and neat images of things to be
seen; the other is the possibility to do this for objects at different
distances from the eye.
Everybody knows that the photographer must shorten or
lengthen the focus of his lens, according to its distance from the
object.
If his apparatus is adjusted for a distant mountain, and he
wishes to take an object near him, he must lengthen the tube, or
else the image will be quite confused.
Now we have no apparatus for prolonging our eye; but we do
have something which the photographer hasn't in his apparatus.
We have the power to change the refracting lens; and we in-
crease the refracting power of the system by a contraction of the
ciliary muscle. We can see a near object distinctly.
880 THE DEXTAL REVIEW.
We can express the power of the muscle by comparing it to the
refracting power of a lens. The higher this refracting power is,
the nearer can we approach the object to be seen. If we are
obliged to see small objects, we must bring them as near as possi-
ble.
If small objects are held far away from the ej'e, their retinal
image becomes too small to be seen distinctly. So we see, that in
occupation with small objects we need a powerful accommodation.
Accommodation decreases materially with age. At the age of
ten we have a power of accommodation equal to a convex glass of
fifteen dioptrics; at twenty, it has already diminished to ten; and
at forty-five, it is only four and a half dioptrics. That is to say, we
can approach an object until it is only twenty-two and a half centi-
meters distant, and still distinctly see it. But if one cannot see it at
this distance, and tries to bring it nearer, its image becomes con-
tinually more indistinct and confused. If this diminution is still
greater, we are obliged to hold objects farther away in order to
distinctly see them.
Here is a phenomenon we often see. Some persons hold a
book or a journal far away, and behind the candle or flame. This
state of the eyes we know by the name of presbyopia; and we can
correct the defect by glasses.
The reason of the rapid decrease of accommodation is the hard-
ening of the crystalline lens, and not feebleness of the muscle.
Then every normal eye becomes, at a certain age, deficient for
continual reading, writing, drawing, or any work requiring acute
vision.
As dentistry demands acute vision, and continual straining of
the accommodative apparatus, it will be necessar)' to wear glasses
at an earlier period than in occupations which do not require so
sharp a sight.
It must be especially noted that presbyopia is not a disease; on
the contrary it shows itself only in good and sound eyes.
There is still another formation of the eyeball which demands,
at a still earlier period, the use of glasses. It is hypermeiropia.
This is the state of the eyes whose anteroposterior axis is too
short. Such an eye is not capable of forming a neat image, even
of distant objects without an accommodative effort. It is easy to
see that such an eye is prejudiced in comparison with a normal eye.
The latter can see distant objects without straining its ciliary mus-
OEIGIIVAL COMMUNICATIONS. 881
cle. Then, of course, if a hypermetropic eye wishes to see near
objects, its straining will be stronger, and with the same force of
accommodation, it will be deficient at an earlier period. Strongly
hypermetropic eyes are obliged to wear glasses at a very early
period.
There is still another deficiency in vision, which, at least in its
minor degrees, occurs very often. This is astigmatism. It is a
discordancy in the curvature of the cornea, which in the vertical
and horizontal sense is different. The difference may be a small
one; one dioptric, for example. It can also be larger, amounting
to four, and more dioptrics. The chief consequence of astigmatism
is the formation of a confused image. The acuity of vision will
of course diminish. People with a marked degree of astigmatism
must strain their eyes more than those who have normal e3'es.
Astigmatism can be compensated for by wearing glasses. It is
not many years since we have become acquainted with this
anomaly. The work of investigating this fault of refraction was
done by Bonders, though astigmatism was first observed by Young,
an English philosopher. Let us look once more at the function of
the eye demanded by an occcupation of more subtle nature, such
as dentistry. The eye here requires, above all, a good acuity of
vision, and a good power of accommodation. Acuity of vision suf-
ficient for any ordinary work is found in normal eyes, or so-called
emmetropic cN'es. But eyes diseased with myopia and hyperme-
tropia of a moderate degree can, and do have a sufficient sharpness
of vision. The higher degrees of both just named anomalies will
sooner or later prove troublesome, and an impediment for fine work
in dentistry.
Strongly myopic eyes, too often and continually strained, are
liable to different and dangerous diseases, haemorrhages, dissolu-
tion of the retina, degeneration in the macula and so on. Higher
degrees of hypermetropia will also prove troublesome in doing
steady minute work. It will be necessary to wear glasses at an
age where people with normal eyes do not think of using them.
In the public mind the wearing of glasses is associated with
the loss of sight, and this opinion might prove prejudicial to the
dentist.
It is absolutely necessary to wear compensating glasses; and
glasses should never be taken indifferentl)^ at an optician's shop,
but should always be chosen by a competept physician. This is
882 THE DENTAL REVIEW.
Still more necessary for choosing cj'Iindrical glasses.
Scientific investigation has shown that, as a rule, there is a
strict connection between convergence of the eye and a certain
degree of accommodation. For example : If we converge for an
object twenty centimeters distant, our ciliary muscle, in order that
we may see the object, makes a contraction equal to five dioptrics,
/. e., a. glass whose focal distance is twenty centimeters.
As a rule the accommodative strain is the same in both eyes.
Both ciliary muscles are equally innerved.
In performing dental operations, it seems to me, while looking
into the mouth from the side, generally from the right side of the
patient, the left eye of the patient is nearer the object to be seen
than the right.
The infallible consequence must be that the accommodative
straining of one eye is stronger than that of the other.
Snellen, in Utrecht, has made observations on the possibility of
different accommodation in the two eyes at the same time. This
possibility is within narrow limits.
It will hardly attain dioptry. Even below this mark it will
cause a disagreeable feeling, the strain becoming first troublesome,
and if continued, eventually it becomes insupportable.
If such a position is necessary for a long time, it might be well
to compensate for the difference by glasses. If there is astigma-
tism, the inconvenience might be still more disturbing. The
trouble most often met with, in my opinion, is caused by a repug-
nance quite frequent in hypermetropes, to wear sufficiently strong
glasses.
There is a public prejudice against strong glasses, which for
hypermetropic eyes is quite foolish. There is reason for it in
myopic eyes, where the constant wearing of correcting or super-
correcting glasses cannot be too strongly condemned. Generally
speaking, I think that people are too indifferent in choosing
glasses.
Perhaps these few remarks, gentlemen, have shown you the
importance of careful attention to your eyes ; that they are not
only useful, but more, that it is our duty not to neglect them with
impunity. On the contrary, if proper care be taken, even eyes
seemingly insufficient may do good and useful work.
ORIGINAL COMMUNICATIONS. 883
DISCUSSION.
Dr. Schaffner : I think we dentists have a great responsibil-
ity as far as vision is concerned, for we may be the cause of great
disturbance without knowing it. Sometimes an amalgam or a
cement filling may so inflame the pulp that there is a reflex action
on the ciliary nerve on the one side. One eye will then see further
than the other and the sight be impaired. If we could inquire
whether there is what is called balling of the eye we could in many
cases connect it with a certain amount of " neuralgia " from in-
flamed pulp. That has happened to me. I was at one time under
the care of an oculist, but he never told me the cause of my dis-
turbed sight. I found out for myself by the slight disposition of
the gum to bleed, connected with some sensitiveness of an upper
molar. After the pulp was destroyed the trouble ceased.
Dr. de Trey : I think it very important to use a north light.
When we operate we stand, as a rule, on the right side of the
patient ; this is a great mistake. I change from one side to the
other and find that this gives me a good deal of relief. Dentists,
as a rule, do not place their patients as they ought, and I think
this has a good deal to do with preserving our sight.
Dr. Bryan : We ought to hear something from every one of
those gentlemen who wear glasses.
Dr. Jenkins : I should like to state my experience with and
without glasses. The former has been very short and I should
like to get what light I can from those who have worn them longer.
I have worked my eyes very hard ever since I was a young man,
both in my profession and with reading and writing in the evening.
I have been very fortunate in retaining good sight. I have never
had any difficulty with my eyes, except that they would get tired
at night, but they were always rested in the morning. Five 5'ears
ago I went to an optician and he told me to wear glasses of a cer-
tain kind when I looked at things at a distance, but not at my
work. Four j^ears ago I went to him again and he prescribed
glasses and said that my eyes were not exactl}' alike. I sometimes
forget to use these glasses. I do not feel any strain, but no doubt
I see better with glasses more or less, but I would like to know
from those who have worn glasses longer than I whether it is an
advantage to wear them all the time or to wear them occasionally.
I should like a little advice from some one who is not an oculist.
884 THE DENTAL REVIEW.
Dr. Terry : This question has arisen with me several times.
In filling teeth I have to get up very close to the work, and even
young operators have to do the same. For instance, when one is
working on the posterior surface of a front tooth, the head is thrown
back and one has to get very near. I generally wear glasses when
working and find it a great advantage. It is quite possible that
many people do not realize that they do not see as well as they
ought to.
Dr. Guve : Is Dr. Jenkins long or short-sighted ? I myself
am short- sighted and the glasses which I am wearing were given
me by a skillful optician. I know that for long-sighted persons it
is useful to wear glasses when doing fine work, but not necessary
when looking at a distance. It is especially a great strain on
the eyes in dental work, and I certainly think Dr. Jenkins should
use his glasses while operating.
Dr. Jenkins : I do use them now by my physician's advice.
I am a little near-sighted, rather than long-sighted and never could
see well out of doors at great distance.
Dr. Terry : I have not taken any circumstances into consid-
eration. The question is, should not young men wear glasses gen-
erally in operating?
Dr. Wetzel : When I was in England I saw double-ended
excavators at the depot and thought it was a very good thing to
get two for the same price as one. I was using one of these exca-
vators in preparing a tooth when the patient suddenly jumped and
I ran the instrument into my eye and had to care for it for a week,
almost losing my eye. I need hardly say I have not used a double
excavator since.
Dr. de Trey : The celebrated Professor Defour of Lausanne,
says that those men who have a long sight at a certain age, just when
they begin to feel that they get tired in their work and are obliged
to look too far, it is better for them to wear glasses immediately,
but very light glasses. When I was forty he told me that when I
should be forty-five I should be obliged to wear glasses, and if
even I could work without he would not advise it. I found by try-
ing to do so that my eyes were going very badly. I wanted to
look like a young man and did no.t like to wear glasses before the
patients. It is a very important thing for a long-sighted man to
begin wearing glasses at an early age.
Dr. Rathbun : I do not know much about the eyes, but I
ORIGINAL COMMUNICATIONS. 885
think we London men have a far greater strain than any others;
we work so often from five to six hours a day with artificial hght,
and I find that my eyes get tired like my back and my feet, but if
I keep myself in good physicial condition, and take plenty of exer-
cise, cold baths, etc., my eyes rest up at night same as the rest of
my body. My wife and friends say sometimes that my eyes look like
two holes burnt in a blanket, after I have used them at close
work during the day, they always, however, get rested over night.
The fault I think with dentists lies in the fact that they do not
take sufficient physical exercise.
Dr. Bryan : There are yet quite a number of members in the
audience who wear glasses.
Dr. Guy'e : I think it would be a very good idea for young
dentists to have their eyes examined every year.
Dr. Monk : I was stupid enough to avoid having my eyes seen
to for some time, and now I am obliged to use spectacles all the
time, although I am not old. I think it is a false pride that makes
a man ashamed of wearing glasses.
Dr. a. V. Elliott : My father was an oculist, and I may tell
you that I had some little experience. I do not think it is neces-
sary to wear glasses for everything, nor all the time, but I have
found them of help to me very much. One should, however, not
wear common glasses.
Dr. Bryan : There is a general opinion that the wearing of
glasses is injurious to the eyes, just as many people say they
never had any trouble till the}' went to a dentist.
Dr. a. V. Elliott : A great many people suffer from conges-
tion, a kind of burning more or less in the eyes; they can be bathed
in hot or cold water, which is a sort of healthy stimulant, but in
these cases we must be governed a good deal by common sense
and not use our eyes too much, and get glasses which we find are
the most suitable for our sight.
Dr. Brunton (guest) : I have observed that a watchmaker who
is constantly at his work, uses an eyeglass and the eye which he
uses with the glass is the best one, that is, the strongest eye.
Dr. a. V. Elliott: We use one eye more than the other, and
yet we do not realize that one is better than the other, but such is
the case.
886 THE DENTAL REV^IEW.
Pyrophosphate of Zinc, versus Copper Amalgams.
Bv Dr. E. DeTrey, Vevey, Switzerland.
With the lielp of one of our prominent chemists in Basel, I
have been experimenting several months to find a good plastic
cement.
Some years ago I came to the conclusion that the pyrophos-
phate cements could become permanent and unalterable and could
be employed in practice to save teeth better than any other mate-
rial, provided they were prepared in the proper manner.
I had qualitative and quantitative analyses made of the Ros-
taing cement. Its composition is very simple. It is a combina-
tion of pyrophosphoric or mono-phosphoric acid and oxide of zinc.
There are no traces of anything else.
I desire to refer to some of the chemical rules for obtaining the
best result in the preparation of cements.
For fifteen years I have used Rostaing's cement and had good
success with it; it has had years of trial.
What I have seen of my work during the last ten years is still
in good condition, having undergone no alteration, when it was
prepared exactly according to the laws of chemistry.
Many cements now in the market can be used more or less suc-
cessfully, but they each have a different quantity of water of crys-
tallization in their acid and have to be treated either by boiling
more or less, or by adding water.
In any combination of two bodies, where a new compound is to
be secured, strict laws govern, and if this is not done, the result
does not possess the proper equivalents and is of an entirely differ-
ent nature and very imperfect. It is thus with the pyrophosphates.
The pyrophosphate of zinc is very hard and completely unaltera-
ble in the mouth; it cannot be attacked by organic acids, and the
failure is due to bad manipulation.
I stated that between theory and practice, in the preparation
of these cements, there was quite a difference. Theory alone is
not applicable, and for this reason scientific men seem to be in error.
For instance, if we mix the pure phosphoric acid with the pure
oxide of zinc, the mass suddenly ignites.
The phosphoric acid is one of the most deliquescent bodies in
chemistry, its affinity for water is great.
ORIGINAL COMMUNICATIONS. 887
If we leave it for a short time in the open air, its nature is
■changed, and another compound is formed.
The oxide of zinc has a great affinity for carbonic acid gas, and
is rapidly altered. This being a well known fact, it is easil}' under-
stood that when a fresh bottle of cement is opened, the first mix-
ture of cement will be perfect, but each time the operation is re-
newed the result is worse, and the last half of the contents of the
bottle may be expected to yield unsatisfactor}' results.
The anhydric phosphoric acid, /. e. free from water, is a very
light and white powder, when preserved in a hermetically sealed
glass tube, and becomes rapidly liquid on coming in contact with
the atmosphere, and forms several combinations while uniting
with water.
It is among these numerous combinations that we must find the
proper one, possessing the proper quantit}' of water, to insure suc-
cess in the manipulation of the phosphates.
It may seem ver}' simple to find this combination, but as a mat-
ter of fact it is difficult to do so.
The reason why chemists do not succeed is because they apply
theories and fail to consider the practical side. To obtain good
results, several dentists understanding chemistry thoroughly, should
act in unison with a first-class chemist, who possesses the quali-
ties of perseverance.
The cements now on the market are placed in the hands of den-
tists without sufficient instructions; even the best of cement is of
no value in unskillful hands.
The more perfect a preparation of cement is the more difficult
is its manipulation.
The most important point to retain the durabilit}' and perma-
nence of cements, lies in the preservation of the material when re-
ceived from the depot or preferably direct from the manufacturer.
The American Dental Society of Europe, has since its founda-
tion in Basel twenty years ago considered it a duty to elevate the
profession, which at that time was under the domination of charla-
tanism. Much progress has been made since then, but many den-
tists are still in a condition bordering on ignorance, stagnation and
indecision.
I call on the young members here present, to judge if the old
members have not faithfully served as pioneers in the advance-
888 THE DEXTAL REVIEW.
ment of dentistry in Europe. The young men should follow us in
elevating the standard by performing artistic operations.
Each member of our Society, individually, should consider him-
self as having been selected and received among us to be an honor
by his example and his labors on behalf of this Society.
There is one cloud on the practice of dentistry, the use of amal-
gams. They are as yet a necessary evil, but I hope before long
other material will drive them out of practice among the better
class of dentists.
I desire to say a few words regarding the Sullivan amalgam.
I consider this filling as the last resort as a material to be used
for filling teeth. It is durable when worked with knowledge, but
the dentist who is proud of his work must put it aside entirely if
he considers the aesthetics of the mouth and its sanitary state.
I have used it for about two years, and I felt so ashamed
of my work that I have taken out the most of it. In some cases
this filling material is dissolved rapidly by acid saliva, the teeth
turn entirely black, and the mouth looks like a coal mine. Patients
were complaining about the discoloration of their teeth. It is well
known that the salts and oxides of copper and mercury are poison-
ous to the body. How could it be otherwise with the fine tissues
of the teeth, particularly for delicate children. I am also certain
that many disturbances of the general health are due to it.
Dr. de Trev then verbally added as follows : I am able
to speak with certainty on this subject, having experimented with
this cement for fifteen years, but this cement is a very diffi-
cult one to use, and needs a man to show you exactly how
it should be done ; if you do not follow the chemical rule
your work will not be of any value whatever. When you receive
the cement, take a little basin with some warm sand, then put
little tubes like this [illustrating], you can get them in Geneva, dip
the tubes in the sand, but it must not be heated too much, and it
should never boil. A little too much heat will change the whole
thing. I cannot better compare the salts of phosphorus, than to
the salts of gold. They change from one moment to another, and
there is no wall between the different sorts. A little bit of water
in the phosphoric acid makes immediately another body.
When you have filled all your little tubes, let them crystallize,
and then dip in wax or something to preserve from the air; of
course you don't put it in the warm sun. Then you have always
ORIGINAL COMMUNICATIONS. 889
ready tubes for each filling. In this way you will have even
results all the time. If you work your cement right, you will be
able to work it in about ten minutes any shape you like, but if you
do not know how to use it, of course it crystallizes too quickl}'.
You ma}^ get a little more polish with an agate burnisher, and see
your filling look as good as an}^ gold filling. In mixing the
cement, it is better to use alwaj's a spatula of ivory; steel is the
worst thing. When Professor Picard saw me mixing my cement
on glass, he told me it was the worst thing I could do. The
chemical action is always worked more quickly by heat.
Dr. Picard brought me one day a nice piece of brass, so we
made the mixture, but of course it was attacked by the phosphoric
acid. The cement became good and hard, but it broke. I had
an idea lately to make a plate of brass covered with platina.
Now we are going to put up an apparatus to mix up this cement. I
promised Professor Picard, whose invention it is, not to tell any-
thing about it. In mixing 3'ou must have a good strong heav}'
spatula so that you can work your cement with all your force. We
must nearly neutralize the acid. The best way to obtain this
result in your experiments with the new cement, is to mix it as
thick as possible ; then take it in your mouth, if you get an acid
taste, your cement is not good.
I consider that when we succeed in obtaining a real cement,
like the Rostaing, this kind of work must be paid well; if it is as
good as gold why not charge for it. You take away all the trouble
from the patient, you leave him in the chair perhaps twenty minutes
or half an hour. A great many cements are too porous, but ce-
ment like the Rostaing is not. I afterward use an agate burnisher
and obtain good results.
Dr. Bryan : You can't get their agate burnishers to go in be-
tween the teeth.
Dr. de Trev : It may be a help to dentists to let them know
that I get cement from Worth, the best I think after Rostaing.
Another important thing is to allow your liquid to get cool; when
you have melted your crystal, go to work upon something else — but
of course not too long, because it will darken, but you must have it
cool — or you will not have time to place your cement and of course
not time to polish it.
DISCUSSION.
Dr. a. Wetzel : I should like to say that I used Sullivan's
890 THE DENTAL REVIEW.
amalgam for man}' years, and I shall go on using it, because I liave
seen the result too often. It depends very much on the condition
of the saliva, and if it is acid, the copper amalgams dissolve very
quickly, and also how the amalgam fillings are put in. I use amal-
gam in labial cavities near the gum, on wisdom teeth or even prox-
imal cavities of wisdom teeth or the molars. I generally line the
cavit\'with Sullivan's amalgam and then use another kind on the
top of it. I put the amalgam in very hard, and I find much greater
satisfaction. I have lately tried different experiments with differ-
ent kinds of copper amalgams. I use S. S. White's copper amal-
gam, also Stewart's and Sullivan's copper amalgam. I took differ-
ent copper amalgam and the contraction was much less, however.
I fill the glass tubes with amalgam and find that they contracted.
I put some other amalgam also in tubes and was able to note the
difference.
I have tried Townsend's, Harrison's, Wise and Herbert's, Fletch-
er's & Welsh's. I find that they all contract unlessyou squeeze out all
the mercury. I put in the amalgam pretty soft and afterward
squeeze in some cotton wool which brings the mercury to the top,
and then squeeze out the rest of the mercury beforehand through
chamois leather.
Of course you all know that when the amalgam is put in very
dry it is more difficult to make a filling, but I think it gives
more satisfaction. I found the contraction was very little.
You can take a look at those tubes which have been filled,
and you will see that the surface does not remain smooth when it
is put in wet. I should never like to be without copper amalgam.
Of course there are certain teeth which it would be wrong to
fill with gold. I suppose all these gentlemen have to do the same
thing likely, and use amalgam and cements occasionally.
Dr. Bryan : After three years' use of copper amalgam, I will
not speak on the subject, because I have become so prejudiced,
but if any of the rest of you have anything to say, I should like to
hear it.
Dr. Wetzel : Amalgam fillings with phosphate cement mixed is
called the metallic cement of Florence.
Dr. Rathhun : I use a good deal of copper amalgam, but
only in certain places, and I have done so in the crowns or buccal
cavities of soft back teeth, and when it becomes as black as a
black hat it is doing its work. When we see, as we do, a copper
ORIGINAL COMMUNICATIONS. 801
amalgam very white, it is soft and wearing away. You will see
two stoppings in the same mouth, one white, one jet black ; one is
doing its work and the other not at all. There is one thing that I
would like to point out and that is that copper amalgam will fail
under the gum margin, whether it is the amalgam or whether it is
the tooth that wastes, I can not say. I have stopped long ago from
putting copper amalgam under the gum and put something else
instead. This will, as a rule, find favor.
Dr. E. J. Wetzel of Miihlhouse : The amalgams bought at the
depots vary a great deal, and I do not know if it is made by office
boys or by experienced men, but I think the best thing is for the
dentist to make it himself and take care that it is properly washed.
Dr. a. Wetzel of Paris : I thought the contraction of the
amalgam could be overcome by just putting in solid pieces of
amalgam already set, but I made most of them by putting in silver
wire in the inside of the filling, as perhaps into one of these tubes
I would put in four or five silver wires.
The Cleansing of Teeth.
By L. J. Mitchell, D. D. S., London, England.
Mr. Prcside?it and Gentlemen : — Tn bringing before you this
operation it is my desire to place it in its true position, notwith-
standing that both the subject and more frequently the deposits
about the teeth have antiquity on their side, and in no few cases is
the latter otherwise than strongly marked.
This is considered an elementary operation judging from the
position it occupies in the curriculum of didactic teaching at most
if not all of our dental colleges, and right here its thoroughness
cannot be too strongly impressed upon the students and the neces-
sary manipulative ability acquired for its proper performance, for
though it be considered an operation that any dentist can perform,
how frequent it is that we find it but poorly attempted, and in most
cases but very imperfectly done.
It is an elementary operation and should in all cases be tlie first
one when patients place themselves under our care for treatment,
the alleviation of pain only being excepted. 1 say this in direct
opposition to what we hear and read about first filling an easy or
simple cavity in order to gain a patient's confidence and assurance,
or "get on their blind side," for in no better way can a dentist's
892 THE DENTAL REVIEW.
ability be judged, and an impression either favorable or otlierwise
created, than by the way we conduct this operation, for there is
scarcely another that can be named that gives greater scope for
our individuality than this one.
I shall in no wise touch upon treatment subsequent to the
removal of the deposit, but consider the subject only from a
manipulative and necessary standpoint.
All concur in its necessit}', and two arguments are generally
heard against it. One comes from the few members of our profes-
sion who are constitutionally "tired," and who say, "I have not the
time to do it properly." This statement is usually veracity per-
sonified, for really they have not, for most if not all their time is
fully occupied in wondering where their next patient is to come
from.
The other comes from the busy practitioner who cannot afford
the time, as patients (they say) will not pay a fee commensurate
with the amount of time consumed, and here I take it that our pro-
fessional brethren have neglected to impress upon their patients
the old adage which we may consider in all the numerous opera-
tions we are called upon to perform as an axiom never to be for-
gotten, that "cleanliness is next to godliness," and as soon as
patients are made to understand this, just so soon will they pay the
fee for this as for any other cf their oral requirements.
We hear also that educating patients is a lost art. Well, it
may be, but a little instruction about the judicious use of a tooth-
brush is not all wasted, and the comfort and satisfaction a dentist
derives from it more than compensates him for his outlay of words
if we look at it purely from a selfish standpoint.
The rising generation probably require the most persuasion in
this direction, but it is nearly a dead-heat between parent and
child in this, for it is no uncommon circumstance to see a fond
parent endeavoring to impress upon the son and heir the enormity
of his offense in neglecting his toothbrush, where you can see at a
glance that the parents' teeth have not even a passing acquaintance
with the same.
With our present selection of instruments there is but a feeble
excuse for not rendering the teeth perfectly free from both calcic
and serumal deposit, and whether the operator prefers a pushing,
pulling motion or a combination of both, which I deem preferable,
none will inquire so that the end is thoroughly achieved.
ORJGIXAL COMMUNICA TIONS. 893
Gentlemen, if we had a more general recourse to scalers, the
fallacy of prescribing perfumery in the shape of a mouth wash,
when a disinfectant is more frequently indicated, would not be so
freely indulged in. but the admixture of a drachm of phenate of
soda to the glass of water will render the operation of cleansing
teeth much more agreeable for both patient and dentist.
My course of procedure is to commence with the scalers on the
lingual and approximal surfaces of the last left inferior tooth, com-
ing forward to the median line; this side having been treated as
thoroughly as circumstances will permit, the same operation is
repeated on the right side, after which the buccal approximal and
labial portions are reached in the same way, care being taken to
get entirely around their circumference.
After the lower teeth have been completed, or all done to them
that is at the present time advisable, the attention is then directed
to the palatine and approximal surfaces of the last left superior
tooth and again progressing around the arch to the center; and
exactly the same operation is duplicated on the right side, after
which the buccal approximal and labial surfaces are accorded the
same attention, always commencing on the last tooth no matter
which side is elected to be first treated, for by so doing any
haemorrhage that may be produced is carried awa}- and only con-
ceals from view that part which is of the least importance to us,
the same equally applies to the method adopted for the lower
teeth; by thus contending with this source of hindrance and
annoyance, in the most practicable way, we not only save our
patient discomfort, but herein lies one of the greatest opportunities
for the conservation of our own time and energy, and while realiz-
ing to its fullest extent the important part that the delicate sense
of touch plays throughout this operation, still the aid of vision
only serves to render it the more acute, and enables us to exercise
it to the greatest advantage.
Very frequently it is desirable to return to the lower and upper
arches again, especially where the operation can be properly per-
formed at the one appointment, as this enables us to approach
some of the surfaces under more favorable conditions than was pos-
sible at first, and in some cases several appointments are not only
advisable but absolutely necessary for a thorough cleansing.
Another way in which our most important commodity, "time,"
can be saved is by having our instruments in proper condition and
894 THE DENTAL REVIEW.
then using them for what they were designed and constructed.
When this is done there is greater hope for cleavage between cal-
culus and dentos than where a scaler simply makes an excursion
over the deposit, and only a third class one at that, the inevitable
return journey not being at all conducive to a dentist's health or
longevity.
Care should be exercised to keep the scaler as close to the
tooth as possible. This applies to either a pushing or pulling
motion and will reduce the necessity of cutting away the deposit
to a minimum, and b}' following this course cutting has but rarely
to be resorted to.
Thoroughness must be rigidly adhered to, and this does not
mean that the remote and difficult places of access are to be over-
looked, but that they are to be th-e recipient of the manipulative
skill that their importance demands, which is generally in the
same ratio as their inaccessibility ; and in no place is this better
illustrated tlian in the removal of the deep-seated deposit in pyor-
rhoea cases.
Cocaine can be used to advantage where there is a hypersen-
sitive condition of the tissues attendant upon this disease, but it
is seldom required in the other operations of cleansing where this
affection does not exist.
After the deposits have been removed, the surfaces may now be
polished with pumice stone powder, moistened with peroxide of
hydrogen — that with an acid reaction answering best — applied
with suitable forms of rubber points in the engine; this will
remove any stain that may be left, and render the teeth in a condi-
tion that is least favorable for a new deposition.
I must thank you for so kindly listening to a reiteration of old
principles, oft discussed, and were it not for this opportunity to
present to this meeting a novel remedy of ''incalculable benefit,"
I should have hesitated upon intruding this subject upon you. It
may seem a little late to introduce it here, but that is only to con-
trast the old with the new.
A lady who consulted me about an acute case of gingi-
vitis arising from ridges of dense calcific deposit, well beneath the
free margin of the gum, demurred when I suggested to instru-
mentally remove the cause of her trouble, and told me that only a
short time before she had seen a dentist who carefully examined
her case and prescribed a mouth wash of tincture of cinchona
ORIGINAL COMMUNICATIONS. 895
bark, with instructions to use it freely the first thing upon arising
in the morning, and told her she would soon be all right.
Being a little curious she inquired what would become of all
the tartar, "Oh", the dentist remarked, "never mind about that,
the gums will get healthy and strong and come up around those
teeth and push all that off."
Some Hints on Practice.
By W Mitchell, D. D. S., London, England.
Mr. President and Gentlemen: — Instead of preparing a paper up-
on some one subject which might afford or promote facilities for
padding and mental speculation, I thought the present course more
preferable, inasmuch as it would tend to promote discussion of a
varied and practical nature, which to busy men would most suc-
cessfully accomplish the desired result.
Crown work to-day constitutes quite an important place in our
operative repertoire, notwithstanding the fact that I heard a prom-
inent man speak of metal cap crowns as "a passing fanc3%" and on
another occasion at an annual dental meeting I heard the same
man ask for " a show of hands as to whether crown work should be
considered a justifiable operation." I think the bare fact of such
utterances being tolerated shows conclusively that the claim that
dentistry is a liberal profession is not unfounded.
In the light of past practice I will endeavor if possible to cor-
rect what appears to me to be a few fallacies as regards certain
lines of practice. Having had opportunities of keeping in touch
with most of my own operations, as well as seeing those of others,
I have made some deductions, the working out of which has, I am
sure been a benefit to both my patients and myself.
The use of the Logan crown promoted the comparative obser-
vations I will mention. It was, and by many is still considered
necessary where using a band as an adjunct to a porcelain crown,
to have said band go well up on the root, many advocating that
the alveolar process should be the only limit to the depth of band
beneath the gum margin. Now I must, in the light of past expe-
rience emphatically differ with those who still hold these views ;
for in nearly every case where a band is used its advisabilit)' is ad-
vocated, for one or more of three reasons, viz.: either as a support
for the root itself, which may be a very frail one, or as a supposed
896 THE DENTAL REVIEW.
support for the artificial crown, or as a supposed protection to the
root itself. I have said supposed purposely, for in my own mind I
am rather of the belief that the supposed support either to the root
or crown exists chiefly in the mind of the operator ; and in the first
case it not infrequently promotes just the very condition it is sup-
posed to obviate, by severing the dental ligament, it thereby pro-
motes both an elongation of the root and a recession of the gum,
two very undesirable results which must very surely bring the band
itself painfully into evidence, if it does not entirely reveal its upper
margin, thereby promoting a nidus for the deposit of oral secre-
tions, which will ultimately defeat the ends striven for.
You will gather from the preceding that I am but slightly in fa-
vor of the band system as applied to porcelain crowns. Such is
the case, and when I do use a band I use a very shallow one, to
obviate the disadvantages spoken of and to promote results not to
be obtained by the use of deep bands. I feel justified in making
the assertion that it is next to impossible to make a band one-eighth
of an inch wide fit a root perfectly vertically except in the most ex-
treme cases, or except by the Biittner or some analagous method,
the barbarity of which is enough to condemn it, even if it did not
possess other bad features which must be apparent to you all.
In most cases where a porcelain crown is desirable, a very care-
ful preparation of the root is imperative. This can easily be ac-
complished by most of the various means at our disposal. I pre-
fer to make the end of the root to which the crown is to be fitted
quite concave, then, whether it is an all porcelain crown or one
with metal attachment, it leaves the minimum amount of fitting to
do, viz.: at the circumference of the root. This method of shaping
the root is also an advantage in the final stage, permitting as it
does the minimum amount of setting material when the greatest
perfection of contact with the root is required.
Of all the porcelain crowns 1 have used, I much prefer the Bon-
will, permitting as it does the greatest possible range for restora-
tion of lost tissue, anatomical adaptability, and greatest resistance
for masticating purposes. Right here I would strongly impress
the necessity of a thorough preparation of the pulp canal, and the
discarding of a too prevalent custom of using a stereotyped form of
pin or screw. I have found the necessity of a varied assortment
of anchorage pins, screws of different sizes, roughened pins, round,
oval and flattened, all of which are to be well adapted to the re-
ORIGINAL COMMUNICA TIONS. 897
quirements of the root, and in this, as in the case of the crown,
reliance in cement, that subterfuge of imperfect work, may almost
be considered nil.
The majority of pins as prepared and sold, are too small, and
are usually made of material that does not bear well the exactions
imposed upon them. Dr. W. St. George Elliott, by a series of
careful and exacting experiments, has demonstrated that German
silver is the best material of which to make pins or screws for this
class of work. The wire may be drawn down to the required
sizes, and cut to different threads, not too fine, and somewhat sharp.
Two of these pins may frequently be used in the case of bicuspids,
being soldered together where the crown is to cover them, making
the part in the root to approximate the shape of the tines of a
tuning fork, this prevents any possibility of rotation, and almost
entirely prevents fracture of the pin where the strain is the great-
est. I have brought for your inspection pins and screws of various
kinds, such as I use in my practice.
I find the copper and diamond points valuable adjuncts in the
preparation of porcelain crowns, for enlarging the openings for the
pins, and for countersinking the crown for the retention of a white,
quick-setting amalgam used in the final setting of the crown. I
find after the pin has been set, and the crown adapted, an expedi-
tious way of setting it is by the use of a combination of quick-set-
ting cement and amalgam, as follows: Having first filled the
countersink with amalgam, fill the under side with cement, and
press crown firmly to place. This presses out all surplus cement
from beneath the crown, thereby securing a perfect joint at the cer-
vix, besides saving the time required for cutting out the cement,
and refilling with amalgam, which would be necessary were not the
amalgam used in conjunction with the cement. The operation is
also rendered more cleanly than where the cement is allowed to
exude through the crown.
Where a tooth is to be backed and soldered to a pin, after fit-
ting the pin and adapting a platina or fine gold plate to the face of
the root, these are to be soldered together in the required position,
after which, any final adjustment of the plate to the root may be
made.
After the pin and plate are in the correct position the tooth can
be fitted backed, waxed, invested, soldered and finished. This
method answers all requirements where single teeth are mounted,
898 THE DEXTAL REVIEW.
affording at once an immunity from pain for the patient, better
adaptability of the crown to the root and gum, to say nothing of
the absence of bleeding which is almost inseparable from this class
of operations, when deep bands are used.
As to the permanency of the operation I am fully in a position
to speak, especially as to Logan crowns, having put on the very
first ever used in England, nearly eight years ago. These have
stood the test of time and use very well, and while not having used
the other method, described in detail, quite so long, the possibili-
ties of more perfect adaptation as compared with the Logan crown,
augurs well for it's proving even a more satisfactory. and lasting op-
eration. The fact that it is an operation requiring only from an
hour to an hour and a half for its completion, is a feature that must
recommend itself to the busy man.
I expect to be confronted with the inquiry: If deep bands are
not good where porcelain crowns are used, why are they of service
in the case of metal crowns ?
In reply to any such query I would say, the circumstances un-
der which the different operations are performed are as diverse as
the operations themselves, for we frequently find roots that require
metal crowns, in as bad conditions as it is possible for roots to get,
consistent with any possibility of saving them at all ; it frequently
being necessary to restore them with amalgam, before any attempt
at crowning can be made, and the objections to bands, in detail, do
not hold here, besides, these crowns being nearly always for the
restoration of masticating surface, the occlusion of antagonizing
teeth prevents any tendency to elongation, which is not the case
where we have an overlapping bite as with the anterior teeth.
Other reasons might be given, but I will not detain you with them.
I will here mention a class of practice which to me seems inex-
cusable, viz.: in cases where decay has progressed through the bi-
furcations of molar teeth, we sometimes see this ignored, and
crowns made to fit over the entire roots, as though no separation
had taken place. This leaves the tooth in a very unsanitary con-
dition, and which may eventuate in much trouble, and the collapse
of the operation. My course of procedure in such cases is, where
the separation of the roots is not quite complete, to separate with a
fine fissure bur, and crown as individual roots. In the case of
lower molars where the roots are perfectly solid, I make what is
practically bicuspid crowns, should one root be somewhat loose,
but otherwise in a reasonably good condition, solder both crowns
ORIGINAL COMMUNICATIONS. 899
together at the grinding surface ; this promotes a steadiness which
in most cases is all the shaky root requires to restore it to a state
of comfort and usefulness. In the case of upper molars ; after fit-
ting the bands to the roots, remove in any suitable impression ma-
terial, pour in sand and plaster, then solder them along their entire
length, except where they are to pass beneath the gum, also solder
together at the grinding surface, a very strong and cleanly opera-
tion is the result. In no case would I consider it good practice
where the roots are separated to make one band encompass the de-
tached roots, as it is impossible to secure the requisite amount of
steadiness necessary to a successful operation. This, with the nat-
ural mobility of the roots, will eventuate in their loss, their destruc-
tion being accelerated by the unavoidable accumulation of oral se-
cretions, that are inseparable from this class of operations.
In passing I will allude to a method of restoring to use and
comfort an otherwise very bad tooth. Three years ago, a case pre-
sented itself where a first right inferior molar was decayed through
the distal wall, and down through the bifurcations. With a dia-
mond disc I cut down through the crown, thus separating the roots,
removed the ragged portion attached to the posterior root, pre-
pared, treated and filled anterior portion as if it were a distal cav-
ity in a bicuspid, mounted a gold crown on distal root. The patient
to all appearances has four bicuspids on that side, but she is happy
and what is more, has been quite comfortable and has had good
use of that side ever since, and the work bids fair to last many years.
I will now mention a method of replacing a crown where the
pin has broken off and cannot be removed. Over seven years ago
I hit upon this, which I see has also been discovered by a German
dentist, and spoken of in the April number of the Dental Cosfnos,
but must say the trephines as spoken of there have in my hands
proved a dismal failure, having had a set made when I first used
this method which is as follows: Grind pin and root off to a
common level, then with a, retaining point drill holes to the required
depth around and parallel to the pin, connect these with a fine fis-
sure bur, then fit a tube of suitable metal, German silver preferred,
and proceed to completion as if the tube was the pin. This very
materially simplifies an otherwise difficult operation.
Another method of restoring a porcelain facing where the pin
and backing are intact and cannot be removed, is as follows: Cut
two parallel vertical slots in the backing, to allow the pins of new
tooth to slide into, leaving the pins so that they protrude as far
000 THE DEyTAL REVIEW.
through the backing as possible, then fit and burnish to place a
piece of skin platina over the original backing on the palatal or
lingual side. This fitting must be done e^^rj' neatly, carrying the
new backing just under the gum margin. When this is done a
drop of wax will fasten tlie pins to this casing, re?nove tiery carefully,
and when investing, see that the casing is perfect!}' filled to exclude
borax or solder^ with which the pins can be nicely flushed, finish
in the usual way, a small amount of quick-setting cement is all that
is required in the final adjustment. If a shoulder can be left to
receive the impact of the antagonizing teeth, so much the better.
1 have omitted many of the elementary details of these operations
as they must be contended Mith upon their merits as you are all
undoubtedly aware. Varnish and stearine have been advocated
for the protection of cement filling while crystallizing. I have
found a small amount of stick wax, composed I believe of beeswax
and gum copal, if worked into the surface of the filling with a warm
instrument, before removing the rubber dam, enhances the dur-
ability of the filling.
Many of you have no doubt experienced the same difficulty that
I have in the treatment of alveolar abscess where there is a sinus,
yet the root is impervious to the exit of medicaments. A method
I have used for the past year with considerable success is as fol-
lows: cleanse the root as thoroughly as possible and fill as usual.
The treatment of the sinus is by theinsertion of a gutta-percha point,
pink preferred, dipped in oil of eucalyptus, and of sufficient size
and length to well distend the opening and reach to the seat of
trouble, by leaving the point in situ, I have found a few days would
suffice to effect a cure. Asgranulation proceeds the protruding end
may be cut off by the patient, or a shorter one inserted. This
method is certainly more cleanly than where cotton is used, and the
ease with which the most tortuous sinus -may be followed, will be
a surprise to those who have relied upon other methods.
I have secured very good results from the use of nitrate of silver
crayon upon the hypertrophied gum tissue, wlien caused by the irri-
tation of salivary secretions. After thoroughly cleansing the teeth,
dry the gum margins as thoroughly as possible, then apply the
crayon almost to the point of cauterization. I have rarely found
the second application necessary. For cancriim oris or common
canker sore, touching it with pure nitric acid will prove the best
and most effectual remedy. I have never seen a case where one
application did not effect a cure.
The Dental Review.
Devoted to the Advancement of Dental Science.
Published Monthly.
Editor: A.W.HARLAN, M. D., D. D. S.
ASSOCIATE EDITORS:
Louis Ottofy. D. D. S. C. N. Johnson, L. D. S., D. D. S.
The World's Columbian Dental Congress.
At a meeting held in Chicago at the Grand Pacific Hotel the
Executive Committee of the Congress unanimously elected the fol-
lowing officers :
President, Luther D. Shepard, A. B., D. D. S., D. M. D., Bos-
ton, Mass.; Vice Presidents, W. W. H. Thackston, M. D., D. D.
S., Farmville, Va.; W. H. Morgan, M. D., D. D. S., Nashville,
Tenn.; W. W. Allport, M. D., D. D. S., Chicago, III.; A. L. North-
rop, D. D. S., New York, N. Y.; Edwin T. Darby, M. D., D. D.S.,
Philadelphia, Pa.; C. S. Stockton, D. D. S., Newark, N. J.; H. J.
McKellops, D. D. S., St. Louis, Mo.; J. H. Hatch, D. D. S., San
Francisco, Cal.; J. Taft, M. D., D. D. S., Cincinnati, Ohio; J. B.
Patrick, D. D. S., Charleston, S. C; W. O. Kulp, D. D. S.. Daven-
port, Iowa, and John C. Storey, M. D., D. D. S., Dallas, Texas.
Secretary General, A. W. Harlan, M. D., D. D. S., Chicago, 111.
Assistant Secretaries, Geo. J. Friedrichs, M. D., D. D. S., New Or-
leans, La.; Louis Ottofy, D. D. S., Chicago, 111., and Ralph Dillon^
D. D. S., Chicago, 111. Treasurer, John S. Marshall, M. D., Chi-
cago, 111.
The Herbst Method of Treating Pulps.
It may scarcely seem scientific to oppose any special line of
practice which is apparently based on experimentation by mere
902 THE DEiVTAL REVIEW.
arguments brought forward in the absence of experiments. And
yet we cannot forbear taking issue in the main with the practice of
Dr. Herbst as outlined in a paper read by Dr. C. F. W. Bodecker
before the New York State Dental Society. Briefly stated Dr.
Herbst's treatment of pulps is as follows : Cobalt is applied and
allowed to remain from two to three days. Then the coronal
portion of the pulp is amputated with a large round bur in the en-
gine, leaving the root canals filled with pulp tissue. Over this
pulp stump tin or gold foil is burnished by means of a rotary in-
strument in the engine. Then the remaining portion of the cavity
is filled in the usual way.
We cannot see any reason for believing that cases thus treated wilt
be successful. In the first place cobalt will kill a pulp. It does not
simply paralyze the coronal portion, but it destroys it to the apex
of the root. It accomplishes this just as effectively as does arsenic
employed in the usual form. If Dr. Herbst would wait one or two
weeks after the application, instead of two or three days, he would
find the pulp as dead as the proverbial "door nail." For more
than a year we have used nothing but cobalt in our practice for
the destruction of pulps, and its action is precisely similar to ar-
senious acid, with the possible exception that its application does
not ordinarily cause pain.
We all know, or ought to know, the result of leaving the canals
filled with dead pulp tissue and filling over it. The use of corro-
sive sublimate, as recommended, would probably tend to prevent
sepsis for a time — in fact, the prolonged use of this agent will
mummify a pulp stump quite effectively. But even a mummy is
not safe in the root of a tooth. As soon as it absorbs moisture
through the apex it is a mummy no longer and soon becomes an
abiding place of putrefactive germs.
It is our conviction that the dentist who follows this practice
extensively will reap a lamentable crop of failures, and the chief
danger lies in the fact that it is advocated by reputable men who
have sought to prove its propriety by experiments. It seems to us
that time enough has not elapsed to render the experiments con-
clusive in such a line of practice as the treatment of pulps. A
dead pulp is a treacherous enemy. It will often lie in wait a long
time before manifesting its malignity.
We wish to warn the more confiding members of the profession
against this new method. We believe it will prove on a line with
EDITORIAL. 903
some of the other fads of the past — in truth, it reminds us strongly
of the craze which struck some very reputable members of the pro-
fession years ago when arsenic was hailed by them as the desider-
atum for the treatment of sensitive dentine. We will draw the
mantle of charity over the scenes of those days in offices where
this practice was followed.
We hope that those who are disposed to look with favor on
this new treatment of pulps will " make haste slowly." Mistakes
have been made before. C. N. J.
Northern Illinois Dental Society.
The meeting of the Northern Illinois Dental Societ}^ at Rockford
October 26 and 27, was one of the best in its history. About fifty
dentists were present and the greatest enthusiasm and good feeling
prevailed. Eight interesting papers were read, which will appear in
the Dental Review. One of the most interesting of the clinics
was on the use of noncohesive and cohesive gold by the venerable
Dr. Allport, of Chicago; Dr. Brophy removed a tumor of the upper
maxilla; Dr. Allen, of Freeport, introduced a gold filling, using the
Bonwill mallet; Dr. Ames demonstrated the use of the oxyphos-
phate of copper; Dr. Taggart exhibited a new furnace for use in
crown and bridge work. Among the new appliances was a neat;
small, but powerful motor, recently put on the market for dental
use, by the Chicago Electric Motor Co. The following are the
officers for the ensuing year: E. R. Warner, Chicago, President,
O. A. Chappell, Elgin, Vice President; J. W. Cormany, Mt. Car-
roll, Secretary; M. R. Harned, Rockford, Treasurer; W. P. Rich-
ards, Elgin, Member of the Executive Committee. Aurora was
selected as the next place of meeting, and in view of the World's
Fair at Chicago, the selection of the time was left in the hands of
the executive committee. One good feature of the meeting was
the appointment of a committee of ten, who are to attend the
World's Columbian Dental Congress, make individual reports of its
proceedings, and afterward make a report to the society. Rockford
has now the best hotel in the state, outside of Chicago; "The Nel-
son," recently opened, is perfect in its appointments, having been
constructed at an expense of $250,000. The Illinois State Dental
Society will do well to select Rockford as its place of meeting at
the earliest opportunity.
904 THE DEXTAL REVIEW.
A Library.
Dr. H. J. McKellops, of St. Louis, has been for )'ears collecting
a dental library which will ultimately belong to the dental profes-
sion. He is desirous of purchasing books, pamphlets or journals
if the owners will simply give the title, author's name and year of
publication.
This very commendable action of Dr. McKellops should bring
tenders to him of many isolated, worthless books and pamphlets
which in a collection would be of great value. Look over your old
books and journals and send a description to him at 2630 Washing-
ton Avenue, St. Louis, Mo.
DOMESTIC CORRESPONDENCE.
PoRiAGE LA Prairie, Manitoba, Canada.
September 27, 1892,
Open letter to Dr. T. IV. Brophy, Dean of Chicago College of Dental
Surgery:
Dear Doctor: You will remember my writing to you for the
latest announcement of the Chicago College of Dental Surgery,
and prompt as usual you sent it b}' return mail.
My object was to find out when the Practitioners' Course took
place next year, and I must say I was very much disappointed to
find it began on the 1 1th of April. It would certainly be more to
my interest and also a great many practitioners had it taken place
later on, especially for i8g3.
As there will be a large influx of dentists to the city to attend
the greatest gathering of dentists that has ever taken place, viz.:
the Dental Congress. It would, in my opinion, be very opportune
to have the Practitioners' Course just before or after the Congress.
Say in the month of July. You would then have a very large class,
replenish the coffers of the college, and I take it the practitioners
would hail the opportunity with delight to attend the course while
in the city.
I intended to visit Chicago next year and take in the Dental
Congress, and would like while there to take the Practitioners'
Course to better fit myself in one or two special branches in our
profession, thereby, as the saying is, killing two birds with one
DOMESTIC CORRESPONDENCE. 905
stone, and I think there are more than one in this land of the maple
leaf, besides from all parts of the United States who would attend
if the course were held in July or August. There are a great
many dentists who could not afford to make the two trips in the
same 3'ear.
The course for 1893 could be called "The Columbian Dental
Practitioner's Course." If the date could not be changed, how
would it do to hold a special course and term it as above. I
merely throw out the hint and hope something will evolve from it.
I believe there are a great many old dentists, I mean practitioners,
who never had an opportunity of attending college, who ought, in
justice to themselves and their patients, to take the course, and
who no doubt would do so, if they could while in the city dur-
ing the Columbian Congress.
I hope, dear doctor, you will pardon me for taking the liberty
of addressing 3^ou this letter. I do it in the interest of dentistry
in general and also of my professional brothers who are unable to
keep pace with the gigantic strides which the profession is making
in the present day, unless the}^ take some such course.
Yours very truly,
R. H. Robertson, D. D. S.
REPLY.
R. H. Robertson, D. D. S. :
Dear Sir : Your letter to the Dental Review has been
handed to me ; it expresses the opinion and desire of many den-
tists situated as you are, and it gives me pleasure to make the fol-
lowing reply:
Several months ago the college decided to give a series of
courses to practitioners during the summer of '93. Each of these
courses will continue three weeks, and one course will follow
another up to October 1st.
The instruction given during these courses will embrace all
the latest and most approved methods pertaining to the practical
part of dentistry. Special attention will be given to such branches
as crown and bridge work, the construction of metal plates, the
manipulation of the various materials in filling teeth, the best
methods of making inlays, methods of regulating teeth, the use of
all the latest medicaments in the treatment of diseased conditions,
906 THE DENTAL REVIEW.
and the proper performance of operations in cases calling for sur-
gical interference. The courses will be so arranged that any one
who desires to attend may enter any course during the summer.
The deep interest shown in this post-graduate work is evident,
from the number of letters we have received similar to your own.
Very trul}' yours,
Truman W. Brophy.
REVIEWS AND ABSTRACTS.
Note Book for Dental Students (Dental Anatomy and
Physiology), by James F. Rymer, M. R. C. S., L. D. S., D. D. S.,
Second Edition, London. Published by C. Ash & Sons, Lon-
don, 1892.
From a casual examination of this little note book we are led to
think that it will be quite useful to the student, especially during
lecture hours.
It seems quite up to date and is very handy in size, with good
type and scarcely any errors in its make-up, with a good index.
The work is scarcely fitted for more than the undergraduate work
of a student, and this will be the field of its greatest usefulness.
La Revista Medico Chirurgica is a new journal in the Spanish
language, published in New York by J. Shepherd Clark Co.,
designed to circulate in the Spanish American countries among
physicians, surgeons, dentists, druggists and pharmacists. The
first number is very interesting, the dental portion being contrib-
uted by Drs. R. B. Winder and Geo. Evans. The journal is the Span-
ish official organ of the Pan-American Medical Congress to be held
in Washington, D. C, September 5, 1893.
pamphlets received.
The desirability of extraction of the six-year-old molar, J. B.
Davenport, Paris, with discussions thereon at the British Dental
Association, 1892.
De la Syphilis et de ses Manifestations Buccales, des dangers
de contagion attaches a la profession de M^decin-Dentiste. These
pr^sent^e pour I'obtention du grade de M^decin-Chirurgien-
Dentiste, par Charles Fleischmann, Assistant de clinique a I'licole
PRACTICAL NOTES. 907
dentaire de Geneve, Geneve, Imprimerie Centrale Genevoise,
Boulevard James-Fazy IT. 1892.
Southern Women in the Recent Educational Movement in the
South. Reverend A. D. Mayo, M. A., Government Printing Office.
History of Higher Education in Massachusetts, by George
G. Rush, Ph. D., Ibid.
PRACTICAL NOTES.
Matrices.*
By George J. Dennis, M. D., D, D. S., Chicago, III.
Matrices are instruments which may, and do, find a practical
application in the hands of a majority of the more progressive den-
tists. They have become necessities where the insertion of gold
fillings on the distal approximal sides of the molar and bicuspid
teeth is practiced, and no dentist's stock of instruments can be said
to be complete until it contains a matrix of some form. Their use-
fulness has been questioned again and again. They have been
the subject of as much discussion as any instruments with which
we have to do, yet they still retain their place among the more
useful instruments at our command. They have been highly
lauded, and just as severely condemned, until it remains for each
one to decide for himself whether they shall be useful in his hands.
The chief advantages possessed by matrices, are their economy
of time, labor, and of the suffering of the patient, together with the
possibility of performing operations which would be precluded
without their aid.
It is claimed that although matrices do possess these qualities,
their disadvantages are so great that few operations performed with
them are successful. The reasons stated are that the borders,
especially cervical borders, are not thoroughly filled, owing to the
impossibility of filling angles well, that if gold is used as the filling
material, it cannot be placed securely in the cavity, or condensed
perfectly against the tooth wall, because of the yielding of the
walls of the matrix; that there is too great a danger of fracture of
the enamel margins, and that a proper contour of the tooth, neces-
sary to the preservation of the interdental space cannot be pro-
duced.
* Read before the Northern Illinois Dental Society. Oct. 27. 1893.
908 THE DEXTAL REVIEW.
That there is a certain truth in these statements against the
use of matrices, cannot be doubted. They cannot, however,
with justice, be said to be the fault of the matrices, but rather
must be attributed to careless manipulation on the part of the
operator. The reason for so much discussion in regard to their use-
fulness, from the standpoint of the writer, lies in their proper or im-
proper application to each individual case. In the application of
any instrument good judgment is necessary and the conditions as
they present themselves must be studied. This is especially true
of the application of matrices; for instance, the width of the space
between the approximating teeth where the cavity is situated, the
extent of the cavity toward the neck of the tooth, the lateral extent
of the cavity, whether the lateral margins are closely together or
some distance apart, the shape of the tooth, whether bell crowned
or not, the space on the opposite side of the tooth ope-
rated on, the occlusion, and the loss of one or more teeth in the
immediate vicinity, as well as other conditions present in each
case — all those must be considered.
To be properly used, matrices should be made of some tough,
flexible and elastic material, and as thin as possible. when
placed in position they should conform themselves approximately
to the shape of the teeth as they existed originally ; they should
be capable of being held firmly in position in such a manner that
there can be no slipping or moving from the beginning to the end
of the operation ; they must be springy, and yield slightly to
lateral pressure, as the gold or other material is impacted against
them. It is self-evident that they should be wide enough to
extend beyond the cervical borders, and in most cases should
extend beyond the morsal surfaces. The surfaces looking into the
cavity should be well polished to act as reflectors, and to give a
finished surface to the filling. Polished surfaces also permit ready
removal at the close of the operation. If matrices possess these
qualities, and are then placed in position without pressure upon
the enamel margins, and are held in position tightly enough to
prevent slipping, and yet yield sufficiently to allow the filling
material to be forced slightly between them and the margins of the
cavities; if the enamel margins are prepared according to the
principles announced by Dr. Black, the matrices will prove invalu-
able assistants, and he who uses them will find an economy of time,
Jibor and of nervous energy which will certainly be appreciated
PRACTICAL NOTES. 909
On the other hand, if matrices are made of an inflexible,
unyielding metal and unpolished; if they are held tightly in posi-
tion with their surfaces, in close contact with the borders of the
cavity, or so loosely that they slip and slide from their original
position ; if the enamel margins are either extensively beveled,
or thin edges of enamel are permitted to remain ; if no considera-
tion of tooth form has entered into the shaping of matrices ; or if
the filling material is not well impacted against the tooth and
against the walls of matrices; if the sides of the filling have not
been carried up a little higher than the center as the operation
has progressed, then failure in the use of matrices will be the
inevitable result, and these instruments will be condemned when
it has been the operator who has been at fault.
These instruments must be used carefully and skillfull}', and
each case must be studied with regard to the conditions present.
If this is done, matrices will receive the approval of all dentists,
and the results will justify their more extensive application.
In conclusion your essayist has prepared models illustrating
various forms of matrices, which have proven useful in his prac-
tice. They are inventions of Dr. D. B. Freeman, Dr. C. E.
Esterly, of Lawrence, Kas., Dr. H. P. Booth, of Wisconsin, Dr. J.
H. Reed, of Lancaster, Wis., Dr Call, of Peoria, 111., Dr. Brophy,
Dr. Guilford, of Philadelphia, Dr- Hewitt, of Chicago, Dr Wood-
ward, Dr. Weirich, Dr. Creager, Dr. Pinney, and Dr. Jack.
Southern Illinois Dental Society.
report of the supervisor of clinics.
Air. President and Gentlemen. — As your Supervisor of Clinics I
beg to submit the following report :
Dr. A. H. Rainey, of Centralia, demonstrated the use of a prep-
aration of his own for painless minor surgery. The medicine was
used hypodermically in the gums of several patients, when the tis-
sues were in various stages of inflammation, and the roots of sev-
eral teeth removed, to the general satisfaction of those operated
for.
910 THE DENTAL REVIEW.
The formula he claims contains no cocaine, though the active
principle of his compound is similar in effect thereto. There was
no nausea apparent.
Dr. R; H. Canine, of East St. Louis, filled the posterior surface
of a right superior first bicuspid, with cement and amalgam mixed
together. The pulp was slightl}' exposed in process of excavation
and was thought bj' the operator, not to be in favorable condition
for immediate filling, but was completed by the advice of our pres-
ident. The Supervisor thinks the pulp should have received more
careful treatment. Patient was suffering some when dismissed.
Patient's name is C. E. Burnett.
Dr. T. W. Pritchett was to fill a pulp canal, but upon investiga-
tion found a too copious purulent discharge through apical foramen
for immediate filling, and after disinfection the canal was dressed
with eugenol and patient dismissed.
In this connection I would mention a very unique contrivance
of Prof. J. C. Blair, of Louisville, Ky., with which the above root
canal was disinfected by fumigation with iodoform, and which is so
constructed as to pass atmosphere overheated iodoform.
The clinic of your humble servant, " Painless Extraction of
Pulps," could not be had for lack of suitable case, and will be ex-
hibited on some future occasion.
Other clinics were not had on account of the absence of opera-
tors. (God forgive 'em.) '
The clinic of Dr. G. A. McMillen, " Making and Adjusting a
Bridge before the Society," was skillfully done and consisted of a
porcelain faced first biscuspid suspended between a porcelain
faced cuspid which was fixed with a platinum dowel post and a
hollow second bicuspid gold crown fixed with cement. The clinic
was performed under difficulty, as the plate had to be hammered
from coin and platinum pins and posts.
Of appliances there was on exhibition by myself a new blow-
pipe designed for the use of gasoline-gas, for jewelers and
dentists situated where other kinds are not available.
Dr. T. W. Pritchett showed us how to adjust a clamp in connec-
tion with napkins and other white substances calculated to obviate
the use of the dam, in short operations, which reflects no light, and
serves at times to darken the oral cavity.
J. G. Dixon, Supervisor of Clinics.
MEMORANDA. 911
MEMORANDA.
Have you used Thio-resorcin ?
Dr. George H. Chance was in Chicago recently.
Dr. D. R. Jennings, of Cleveland, spent a week in Chicago recently.
Col. W. J. Younger, of California, was in Chicago during dedication week.
Mr. O. H. Fox, class of '61, Dental School of London, was in Chicago
recently.
The dentists of Rockford, turned out to a man at the recent meeting held in
that city.
Dr. S. B. Brown, of Fort Wayne, Ind., was a visitor to the dedication cere-
monies in October.
A dental college for women will soon be opened in Stockholm, Sweden. Dr.
Elena Lenin will be the dean.
Dr. T. E. Weeks, of Minneapolis, and G. W. Dennis, of La Salle, were in the
World's Fair city recently.
The Drntal Review will issue a daily edition during the session of the
World's Columbian Dental Congress next year.
Phenyl acetic acid. Internal antiseptic in ten drop doses, dissolved 1 to 6 in
alcohol in 1 oz. water. Used locally to paint ulcers and patches in the mouth.
Mrs. Kate C. Moody, formerly of Mendota, 111., has permanently removed to
328 S. Spring St., Los Angeles, Cal. Dr. J. D. Moody, who is still located at
Mendota, also intends to locate in Los Angeles eventually.
Camphoric acid, colorless crystals, CgHu (CO. OH)s. Soluble in alcohol
ether, fats 50, oils 50, sparingly in water. Applied to ulcers in ^ to 1-3 per cent.
Paint the surface with a pencil. Price, 80 cents per oz.
Acid cinnamic. Cj Hs. C. H. C. N. C. O. OH. Soluble in hot water, alcohol
ether. Insoluble in cold water. Used as a spray in five percent alcoholic solu-
tion, or in emulsion in a neutral oil. Price per oz., $3.
Dr. Geo. Martin, of Oakland, Cal., recently passed through Chicago on his
way to Oakland, having just returned from Calcutta, India, where the prospects
for a dentist were not as glorious as they had been represented.
Among the most remarkable inventions at the recent paper exhibit at Berlin
was a set of paper teeth made' by a Lubeck dentist in 1878. They have been in
constant use for more than thirteen years, and show absolutely no wear whatever.
Among recent visitors to Chicago were: Drs. L. S. Davenport, or Moorhead,
Minn., T. E. Weeks, Minneapolis, F. H. Mcintosh. Bloomington, 111., J. W.
Cormany, Mt. Carroll, 111., C. A. Kitchen, Rockford, 111., and R. M. Pearce. of
Rock Island. 111.
Prim, a chemical expert, has determined by scientific investigation that the
air of London is purest at about thirty or forty feet from the ground ; lower than
that the dust is encountered, and higher than that the smoke from the chimneys
reaches.
912 THE DENTAL REVIEW.
Catching's Compendium for 1892, will be out on time immediately after the
holidays. The energetic editor is hard at work on the volume, which will be one
of the souvenirs of America that our transatlantic friends can carry home with
them next year.
MORE APPROPRIATE.
Shallow: "Why, just read that sign : 'Dental Parlors.' Isn't it absurd lo
call a dental room a parlor ?" Deepe: "Why, it is probably the painter's mistake.
He meant drawing room." — Boston Courier.
Dr. J. A. Houser, sixty years old, a dentist, from Charleston, VV. Va., who
was in the city attending the dedicatory excercises, dropped dead in front of
527 Wabash avenue about nine o'clock in the morning. It is supposed that
death was caused by heart disease. The body was taken to the morgue.
FOR OZ.ENA.
lodol, tannic acid and borax are to be mixed in equal parts and used as a
snufi five or six times a day. As improvement is noted the snuff is to be used
three times daily.
CALIFORNIA STATE BOARD OF DENTAL EXAMINERS.
At the last annual meeting, Aug. 4th, of the California State Board of Dental
Examiners the following officers were elected : J. L. Asay, M. D., of San Jose,
President, and J. D. Hodgen, D. D. S., of San Francisco, Secretary.
The new Chicago University, with its $5,000,000 to insure its success and
perpetuity, seems to be fully alive to the importance of university extension,
and starts out with a well-organized system with a large number of centers
established throughout the west and northwest. This is generally understood to
be a means of extending as far as can be the benefits of education to people at
their homes.
So many people are found whose educational privileges were not what they
wished in earlier days, and who are now glad to avail themselves of these exten-
sion privileges to better inform themselves in almost any direction they may
choose. The studies or readings are so arranged that even the busiest of men
can employ a few moments each day in improvement in the direction most de-
sired, and it is surprising what wonderful results can be obtained by a half hour
or an hour so spent each day.
In the specific study of dentistry and sciences collateral thereto, under such
a system requires a course especially arranged. This the Post-Graduate Dental
Association falling into line with the popular idea of home study for men settled
and absorbed in their business and professional cares, is doing for the dental pro-
fession. It is a worthy movement, and is being encouraged on every hand. Sub-
scribe to the course and read whether you are ambitious for the honors of their
degrees or not. Every reader will be a better man and dentist, and that should
be inducement enough.
How many men we all know who have gained a wonderful knowledge entirely
by such methods, and without guide or direction in such studies, and limited in
quantity and quality of books, became men of fame and renown. How much bet-
MEMORANDA. 913
ter can such things be accomplished under competent direction and advice as to
what to read and how.
AN IMPOSTER.
It has just come to my notice that the vender of a certain extensively adver-
tised local anaesthetic has been using my name, (possibly others also), to further
his sales. He professes to have a letter from me containing a recommendation
of the preparation and an order for several ounces.
To be perfectly plain the man is a liar. There is no other word for it. I
have never used the preparation, have never seen it, have never ordered any of
it. I do not use a compound for local anaesthesia, the contents of which are
kept secret; I do not impose on my friends by inducing them to use it; I do not
write quack recommendations; I have never written this man at all.
C. N. Johnson.
FACIAL NEURALGIA.
Professor Liebrich recommends the following :
51 Butyl-chloral, gr. xl to Ixxv
Alcohol rect. f 3 ijss
Glycerini f 3 v
Aquae dist q s Ad. f § iv
M Sig. from two to four teaspoonfuls. P. R. N.
SO'JTHERN ILLINOIS DENTAL SOCIETY.
The Southern Illinois Dental Society met at Mount Vernon, October 18th,
with President C. C Corbett in the chair.
The society held an interesting session. The clinics were instructive, the
papers interesting and ably discussed. Edwardsville was selected as the next
place of meeting.
The following were elected as officers for the ensuing year: J. G. Dickson,
of McLeansboro, President; W. H. Damron, of Mt. Vernon, Vice President; L.
B. Torrence, of Chester, Secretary; L. Betts, of DuQuoin, Treasurer.
Time of meeting, third Tuesday in October, 1893, subject to change by execu-
tive committee. L. B. Torrence, D. D. S.,
Secretary.
We do not hesitate to say there are but few men in dentistry who would not
be benefited by a systematic course of reading such as has been and will be
further inaugurated by the Post-Graduate Dental Association. The A course in
particular, at least so far as Black's Anatomy of the Human Teeth is concerned,
forms one of the most essential features in the proper understanding of most opera-
tions the dentist is called upon to perform. It is only a few years since such a
book was in existence. It is to be regretted that many practitioners of dentistry
have but an obscure idea of the intimate structure and internal formation of the
organs they are called upon to care for. Anyone whose dental training and edu-
cation in this direction has been neglected from any cause should never consider
it too late to mend; and to the graduate whose college training embraced and
made duly important this work as a fundamental principle, a review of Dr.
Black's work is always refreshing and beneficial.
One hour a day systematically employed in such reading at home will do
914 THE DENTAL REVIEW.
more to fix in the mind desirable knowledge than the cramming which is neces-
sarily a part of a college course where so much has to be compressed into the
time allotted. We should advise almost any one inclined to take up a course of
reading to take the A course by all means as one which cannot fail to be of great
benefit.
'ancient HINDOO vaccination.
At a meeting of the Epidemiological Society (Lancet, Feb. 29, 1892), Dr_
Pringle quoted a remarkable passage from an ancient Hindoo work, which
showed that true vaccination was known and practiced in India centuries before
the birth of Jenner : " The smallpox produced from the udder of a cow will be
of the same mild nature as the original disease, * * * the pock should be of
a good color, filled with a clear liquid, and surrounded by a circle of red. * * *
There will be only slight fever of one, two, or three days, but no fear need be
entertained of smallpox so long as life endures." Pasteur's attenuation of virus
by successive cultures has been applied in India for hundreds of years to inocula-
tions with variolous lymph, which the document in question directed to be taken
from " the most favorable cases," and he has seen series of such selected inocula-
tions in which there was no general eruption, and the local phenomena were
scarcely distinguishable from those of vaccination. — Medical and Surgical
Reporter.
FEMALE ASSISTANTS TO DENTISTS.
"It is to the young woman of good breeding who has been favored with edu-
cational advantages, who has no special artistic gift of nature which she can culti-
vate, that the opportunity opens to become a most useful adjunct to an honorable
profession and fill a demand in the great industrial hive for which she is emi-
nently fitted." That is what Dr. Norman W. Kingsley, late dean of the New
York College of Dentistry, a man of world-wide fame in the profession, said to a
New York Sun reporter of the position of assistant in the office of a dentist. A
place of this kind offers one of those rare openings where a cultivated woman,
thrown suddenly upon her own resources, may enter, without special preparation,
upon a suitable occupation. The question of woman assistants has been attract-
ing considerable attention among members of the dental profession recently.
The woman assistant is to the dentist what the nurse is to the doctor. She
possesses those qualities necessary to supplement his and make his complement
of service. In a prolonged case of treatment, after the doctor has devised the
proper methods to pursue, it belongs to the assistant to bestow the daily atten.
tion, remove the splints in cases of irregularity, allay the inflammation that may
arise, and give a full measure of sympathy. She sees the patients as they come
in, makes all the appointments, and attends to the correspondence and books.
She relieves the doctor's cares in many ways, enabling him to devote his time to
the highest branches of the profession. In some instances she becomes expert
enough to carry on the practice successfully during his absence.
PROGRAMME OF THE MINNEAPOLIS DENTAL SOCIETY.
Officers— Dr. F. E. Hansen, President; Dr. J. W. Pemberthy, Vice Presi-
dent; Dr. G. W. Avery, Secretary; Dr. C. M. Colby, Treasurer.
OBITUAR Y. 915
Executive Committee— Dr. W. N. Murray, Dr. M. G. Jenison, Dr. L. D.
Leonard.
Membership Committee — Dr. F. H. Brimmer, Dr. C. L. Sargent, Dr. H.B.
Tillotson.
September 21. — Dr. F. E. Hansen, "President's Address."
October 19. — Dr. W. A. Spaulding, "Dentistry in Europe and America."
Discussion opened by Dr. VanDuzee, St. Paul, Dr. Loughridge.
November 10. — Dr. T. E. Weeks, "Conservation of Pulpless Teeth." (Illus-
trated). Discussion opened by Dr. Stearns, Zumbrota, Dr. Dickinson.
December 21. — Dr. E. F. Clark, "What is best." Discussion opened by Dr.
Parker, Dr. Pemberthy.
January 18. — Dr. E. H. Angle, "An Hour with the Fathers of Dentistry."
(Illustrated.) Discussion opened by Dr. Bausman, Dr. Keid
February 15. — Dr. F, E. Twitchell, "The Camera in the Professions." Dis-
cussion opened by Dr. Sudduth, Dr. Colby.
March 15. — Dr. W. X. Sudduth, "Infection." Discussion opened by Dr.
Bailey, Dr. Leonard.
April 10. — Dr. A. E. Peck, "Art and Utility." Discussion opened by Dr.
Knight, Dr. St. John.
May 17. — "Experiences in Professional Life." Election of Officers.
Reserve Papers — Dr. W. P. Dickinson, Subject not announced; Dr. F. H.
Brimmer, Subject not announced.
OBITUARY
C. M. WiLKiE, D. D. S.
A cablegram from Paris to relatives in this city announced the death of Dr.
Charles M. Wilkie yesterday. This will be sad intelligence to the many friends
of Dr. Wilkie who know him well and who will not easily forget the generous hos-
pitality which he so much delighted to extend to his American acquaintances, and
of other nationalities in Paris.
Dr. Wilkie's native place was in Northern New York, near Watertown.
Some three years prior to his majority he entered the dental office of Dr.
Coe, Jefferson Co., N. Y. There he received his initiary training in the profes-
sion of his choice and a year or two later, he entered the Pennsylvania Dental
College, where he graduated. In the winter of '01 he located in Aurora, 111. He
continued in the practice of his profession here till the fall of 1878, when he sold
out his practice and went to France, locating in Paris finally.
During the last twelve years he has occupied a prominent place among
American dentists in that city. His success was phenomenal in building up an
extensive practice.
He leaves a widow and two grown daughters.
FREDERICK R. SUGGITT, D. D. S.
Whereas: Death has again invaded the ranks of the Odontographic Society
and taken from qur midst an esteemed member, one who but recently finished his
916 THE DENTAL REVIEW.
dental education and began his professional life, be it.
Resolved, that in the death of our friend and colaborer, Dr. Frederick R.
Suggitt, one has been taken whom it has been our pleasure to know but a compara-
tively short time; but one who has won our respect and esteem as an earnest up-
right man, and a devoted member of the dental profession, and whose loss we
most deeply regret. And be it further
Resolved, that our sincere sympathy is hereby extended to the family and
friends, who have been so suddenly bereft of a dear one, and that these resolu-
tions be spread upon our record and copies sent to the several dental journals.
(Signed) Don M. Gallie, 1
R. B. TuLLER, > Conunittee.
E. A. RoYCE, )
H. H. SiLLiMAN, M. D., D. D. S.
As we go to press we learn of the sudden death of Dr. H. H. Silliman, of
Chenoa, 111.
He was thrown from his buggy while driving a spirited horse and only sur-
vived the accident for a few hours.
He was a graduate of the Chicago College of Dental Surgery, class of '89,
also of Rush Medical College '91, and was engaged in the practice of dentistry at
Chenoa.
We deeply deplore his loss. He was a young man full of promise and occu-
pied a high position in his profession for one so young.
We condole with his wife and family so suddenly bereft of the idol of their
affection and adoration.
THE
DENTAL REVIEW.
Vol. VI. CHICAGO, DECEMBER 15, 1892. No. 13
ORIGINAL COMMUNICATIONS.
Local Anesthetics.*
By E. L. Clifford, D. D. S., Chicago, III.
Mr. President and gentlemen of the Northern Illinois Dental
Society. — " Perhaps no result from the field of scientific experi-
mentation ever came upon the world more suddenly, or more com-
pletely fitted for immediate employment than the discovery of
surgical anaesthesia. Its advent was heralded by no signals
which gave notice of the mighty power for good which it was des-
tined to exert. Its presence, after the first few successful demon-
strations, seemed as natural as the sunlight, and when experience
had more fully known the laws which govern this condition, its use
became almost immediately established in the community which
witnessed its birth. Those who were instrumental in its introduc-
tion have mostly passed away, and a new generation has since
come upon the scene." — Upon occasions like this, and when we
are favored with such audiences as are yearly furnished by this
society, it is not deemed important or necessary to enter minutely
into historical facts. Suffice it to say, our specialty glories in the
acknowledgment b}'' other branches of medical science that to
dentistry is accorded the credit, and when the five great surgeons
of the east, assisted by Dr. Morton, performed their first capital
operation in the Massachusetts General Hospital without pain, the
long procession passed out and down the stairways little realizing
then the value of the gift bestowed upon mankind, and which, can
hardly now, even after the lapse of nearly half a century, be suf-
*Read before the Northern Illinois Dental Society, October. 1893.
918 THE DEXTAL REVIEW
ficiently appreciated. However much they may have differed on
minor points, it was conceded that this operation (an amputation
of tlie thigh) was a demonstration, whicli, from its magnitude,
would carry to the scientific world a conviction, not merely of a
possibility, but of the certainty, safety, and the completeness of
the insensibility capable of being produced during the severest
surgical procedures. And although the first operation, in which
the attempt was made to produce anaesthesia by the administra-
tion of ether was unsuccessful, we are of the opinion that the large
painting executed by Hinckley, of Washington, D. C, the subject
of which was this memorable incident in the history of anaesthe-
sia, should be secured and exhibited at the approaching World's
Columbian Dental Congress, as a reminder that to the new world,
and to the specialty of dentistry in particular, belong the glories
which hover around this great boon to suffering humanity.
The first formal presentation to the world of the successful
use of artificially produced anaesthesia in a capital operation, fell to
the lot of the late Dr. Hy. J. Bigelow, of Boston, of whom Dr. Oli-
ver Wendell Holmes speaks as follows: "He had the sagacity to
see the far-reaching prospects of the new discovery, the courage
as well as the shrewdness to support the claims of the adventurous
dentist's startling, at first almost incredible announcement. Every
possible effort was made to dislodge the infant anaesthesia from
its cradle in the Massachusetts Hospital, but there remains the fact
that all over the wide world patients were shrieking under the sur-
geon's knife and saw — operator and victim alike ignorant of the
relief in store for them, at the ver}' moment when Dr. Bigelow was
unfolding in my library the first paper ever witten on the subject,
and saying to me as he did so, that within a fortnight the news of
the discovery would be all over Europe." The gift of the profes-
sion which forms the true link between science and philanthropy,
a profession distinguished alike for its scientific attainments and
its usefulness.
The introduction of ether as an anaesthetic into the practice of
surgery found a most interesting epoch in the history of medical
science, completely revolutionizing the methods once in use, and
introducing to operative surgery a range of delicate manipulation
that is the marvel of our generation. The safety of the popular
anaesthetics, ether and chloroform, is so well established as to need
no advocacy of their claims, and when in competent hands, under
ORIGINAL COMMUXICATIOKS. 919
proper conditions, their use may be pronounced as generally harm-
less. The medical profession, thus armed with potent anaesthetics,
the blessed effect of painless operations were soon apparent ; occa-
sional fatalities however followed their free use, and an alarm of
warning was sounded, a sense of fear was awakened, and very soon
modifications were devised by various medical authorities. In Lon-
don, the A. C. E. mixture found its birth, and in Vienna, another
iavorite combination first saw the light.
Possibly no one field of surgery has done more to popularize
and bring into a general, and I might almost say a common use,
anaesthetics, than the diseases of women. In this field their appli-
cation is certainly most general and humane. Under their influ-
ence the most wonderful operations in laparotomy have been made
possible, and the results in the relief from suffering, and the radical
cure of disease, are among the triumphs of modern surgery. The
use of anaesthetics to mitigate the pains of labor, met with stout
opposition from the conservative element of the profession, and for
a long time it found but little favor among some of the leading ob-
stetricians, among whom were Meigs, of Philadelphia; Barnes,
Montgomery and Ramsbotham, in England; and Seebold and
Scanzini, in Germany. In 1853, however. Queen Victoria gave a
new impetus to the practice by her great influence in submitting to
its use in the birth of Prince Leopold, and again in ISoV at the
birth of the Princess Beatrice. The result of this notable example
did much to make the use of anaesthetics popular in parturition."
It has been said that "life is the greatest of human blessings,"
and " health the greatest stimulant to earthly enjo}ments." To
preserve the one and to procure the other is the object of all work
in the profession of medicine, but unfortunatel}' " the goal of our
ambition and desire is almost at the end of human capacity." " It
is doubtful if man's intellect, great as it is, can ever compass all
that he so earnestly desires, yet by constant and faithful work he
may approach nearer and nearer to its consummation." "The
science of medicine has kept pace with, if it has not outstripped all
other sciences." " In every part of the habitable world blessed
with the light of civilization, active, busy members, endowed with
high culture, and incited b)- the noblest resolves, are enthusiastic-
ally engaged in unraveling the mysteries of disease and seeking the
means and methods of treatment for the mitigation and relief of
suffering and the prolongation of life.
920 THE DENTAL KEVIEtV.
To the specialty of dentistry is accorded the supervision and
care of that portion of the human organism, second in importance
to no other portion, in becoming a factor for good or evil in pro-
moting this desired end. Unfortunately for this division of the
field of labor, pain, and suffering has been in the past almost a syno-
nym for the dental office. It has caused many valuable patients to
slip through our hands; it has been the cause of many healthy
and vigorous constitutions descending the ladder of physiological
perfection, until finally a system was undermined, comfort depre-
ciated, and perhaps life itself shortened because of the fear felt of
the operating chair, and a consequent lack of these organs so very
essential to perfect mastication, digestion, and nutrition.
To obviate this condition of affairs an immense amount of
brain substance has been spent in-order that the public would find
the dental office freed of manv of its terrors. It was this same
motive that prompted the many dentists that have evolved from
nature's storehouses the gift that has already been launched upon
the professional sea. It is this same motive that is now inciting
to action, and prompting the workers in the field today, to bring
forth from that engorged womb still greater gifts that will tend to
obviate the disagreeable points in practice. It will follow then as
a natural sequence that perfection has not been reached. We
must acknowledge at this time the many defects and objections to
the system of general anaesthesia as understood by us at present,
and in fact it would seem as almost an unsurmountable objection
in dental practice that an}^ agent used for the purposes of our
specialty should have the power of obliterating the consciousness of
our subjects. The very nature of our surroundings, and the edu-
cational status of graduates who have received our degree in the
past, forbid its general acceptance and use. Hence busy and
searching minds are at work to find a pure and safe agent that will
act only upon the parts to which it is applied. Such agents are
known to us as local anaesthetics, and such conditions are recog-
nized under the head of local anaesthesia.
In this field an immense amount of experimentation has
been carried on in all the divisions of special practice, and may
we not hope that when the perfect agent is at last found, that it
too, like its illustrious progenitors, may claim for its birthright and
home, the special division of dentistry ? I say work has been
carried on, with more or less success, in this line in the special
ORIGINAL COMMUNICATIONS. 921
divisions and branches of medicine, for when we come to search
the literature of general medicine we can but be struck with aston-
ishment at the paucity of such articles at our command. The rea-
son possibly is more evident than we would at first imagine.
General practice does not deal so nearly to the domain of minor
surgery as almost any of the different specialties and particularly
so is dentistry, rich in the fact that almost every operation in the
past has been more or less of a surgical nature and consequently
has been accompanied with more or less pain and annoyance.
We trust that such will not always be the case and we predict
that it will not when we fully appreciate and acknowledge the re-
lationship and the dependence of the special to the general.
Among the earliest processes brought to our attention for
producing local anaesthesia may be mentioned the application
of cold, or what is termed the freezing process. It was proposed
and introduced by Dr. Richardson who described it as the ap-
plication of a volatile liquid, having a boiling point at or below
blood heat, in a state of fine subdivision or spray to the parts,
resulting in a rapid evaporation of the volatile fluid, conjoined with
so great an evolution of heat force from the surface to which the
spra5'is applied, that the blood cannot supply the equivalent loss.
Momentary death, and consequent insensibility follows; res-
toration occurring when the spra)' is withdrawn and the blood
again allowed to find its way through the tissues affected. The
liquids used are absolute ether, rhigoline and bromide of ethyl.
The rationale of its action being that the intense cold produced
deprives the nerves of their power to transmit impressions to the
sensorium. It has not been difficult to point out objections to this
method. In the hands of the inexperienced it is easy to involve too
great an amount of tissue or to force the freezing process to too
great an extent in the tissues involved so that the life forces are
not equal to the emergency and restoration to a normal condition
impossible. Again the extreme pain attending the first applica-
tion of the freezing process has been a barrier to its universal
employment, as well as some unfortunate sloughs that the chagrined
operator has been called upon to face. Other agents were peri-
odically brought to notice, and varying results were heralded to an
expectant and impatient profession, but since Roller rescued
from oblivion and gave a practicable application to Neiman's dis-
covery of 1800, the alkaloid cocaine has kept the experimental
922 THE DENTAL REVIEW.
world busy and our literature teems with their investigations— and
if any here present wish an interesting subject to study — one
ladened with conflict and contradiction, I think their appetites can
be fully appeased and satisfied with this potent, harmless (?) ad-
dition to our newer pharmacology. For instance, as late as 1884
we find a writer in the London Lancet making use of the following
language: '■ The great excellence of cocaine consists in the limi-
tation of its action to the tissues to which it is applied. No
doubt other s3'mptoms at a distance do result from the external
application of the anaesthetic, but they are for the most part insig-
nificant and by no means dangerous." * * * "The contem-
plation of a few facts of this kind leads us to think of the Ultima
Thule of anaesthetics as likely to be not one of the least splendid
triumphs of science."
The same writer goes on to say that '-'no doubt much remains
to be worked out before the full value is given to this latest addi-
tion to our armamentarium, and before a full explanation of the
mode of action of the drug in the one particular respect for which
it is in so great a demand can be given." And verily we add that
in the light of later investigation and experience he prophesied
well. In the ardent enthusiasm which attended the introduction
of such a promising remedy it was not strange that extravagant
claims should be made for it, nor that many should be disap-
pointed in their attempts to verify its claims. In this way the pos-
sibilities of a new drug, and its permanent place as a therapeutic
agent are determined. Cocaine has certainly proven of the greatest
utility in affections and operations upon the eye and all mucous
membranes — as the ear, larynx, oral and nasal passages, but it is
subject to great limitation in its application to other parts, and we
might say to the parts above mentioned, under certain pathological
conditions. The anxiety felt in the specialty of dentistry for the
possession of an agent that would rob the practice of the immense
amount of prejudice which attaches to it, as a consequence of pain
led to hurried and sometimes unfortunate applications of this agent.
A substance possessing such power for good must of necessity be a
substance that should be handled with care and skill. Like the in-
troduction of the general anaesthetics, chloroform and ether, the use
of cocaine as a local anaesthetic was destined to meet with danger-
ous and disastrous results, and this fact has followed as a bug-
bear at the heels of this brilliant and happy innovation; and yet
ORIGINAL COMMUNICATIONS. 923r.
few of us have found this objection a sufficiently grave one to prove
a barrier to its use.
Though we occasionally hear the note of warning, and here
and there a fatal case has been reported, their proportion has not
increased with the prevalence of the drug, while its use has be-
come so universal among the specialists in particular that it is to
be doubted, if there are many of the latter who could now be in-
duced to do without it. In fact the subject of local anaesthesia,
as practiced to-day by almost all specialists, can hardly be separat-
ed from the study of cocaine, as no new agent of any value has
been introduced up to this time that has proven a more efficient
local anaesthetic per se. The last number of the TJierapeutic
Gazette however informs us that a new coca base has recentl}' been^
isolated by Giesel from the leaves of the small leaved coca plant
of Java, which, if the experiment so far conducted can be taken as-
an indication, promises some interest to the profession in the fu-
ture. According to this journal Liebermann has proved that this
base is benzoyl and tropine, which bears no relation to the cocaine
groups, but is, chemically, closely related to atropine, and the
conclusions were, that, in its local action, the new alkaloid is a
connecting link between the true local anaesthetic (cocaine) and
the "anaesthetica dolorosa" of Liebreich.
In the paper here spoken of, which was read before the sec-
tion of pharmacology and therapeutics in the British Medical As-
sociation, the author recounts nineteen experiments made with the
hydrochlorate of tropsin, the alkaloid itself being insoluble in
water. (Note — For brevity the name "Tropsin" is offered by the
Ther. Gaz.) Of these 11) experiments, 5 were upon frogs; 8
upon rabbits; and 6 upon the human subject. The object of the
experiment seems to have been to establish the difference of po-
tential between tropsin and cocaine.
The result of those experiments are recounted as follows :
On frogs :
1. Tropsin is less than half as toxic as cocaine.
2. It produces local anaesthesia more rapidly.
3. Individual susceptibility to the drug varies but little, and
so unexpected poisoning, from a small dose, seldom, if ever, occurs.
4. Recovery is quicker from tropsin than from cocaine.
5. Symptoms of irritation do not follow its use.
024 THE DENTAL REVIEW.
Experiments on rabbits shoiv :
1. But slight individual susceptibility to its toxic action.
There is, however, some individual difference in the nerve centers
most affected in different cases.
2. Tropsin is much less than half as toxic to rabbits as
cocaine.
3. Cardiac depressant action is less marked, and even after
still-stand has been produced, the heart may be recovered b}' elec-
trical stimulation.
4. Complete anaethesia is more quickl}' produced by tropsin,
but is of shorter duration.
5. After instillation into the eye, a slight hyperaemia may be
produced for a few moments, but no other signs of irritation and no
ischaemia.
G. Mydriasis is inconstant and slight,
7. A toxic dose of tropsin produces, like cocaine, a marked
rise of temperature.
^^. Daily repetition of the dose causes marked diuresis, but
urine is normal sa\'e for low specific gravity and pale color.
Practical tests on the human subject :
Professor Schirugger, of Berlin, after several months' experi-
ence with tropsin in eye-surgery reports that:
1. A three per cent solution produces complete corneal anaes-
thesia more rapidly than cocaine. Iridectomy could be done pain-
lessly two minutes after putting three drops in the eye.
2. Anaethesia lasts from three to six minutes for each instil-
lation, and no further prolongation can be produced save by a fresh
dose.
:J. Mydriasis is absent, or but slight.
4. Ischaemia never occurs, but sometimes there is a passing
slight hypera-mia, and a little smarting unless normal saline solu-
tion be used as a solvent.
5. No injurious symptoms were ever observed.
6. In removal of foreign bodies, tropsin seems, from its
quicker action, far preferable to cocaine.
Dr. Silex, assistant in the polyclinic, has obtained similar re-
sults and has painlessly performed tenotomy within half a minute
from applying a 3 per cent solution of tropsin." {Ther. Gaz.)
Unfortunately for the dental specialist, all of these experi-
ments upon the human subject have been made by the local appli-
ORIGINAL COMMUNICATIONS. 925
cation of the agent and not by its direct introduction into the cir-
culation; and the manner of its application in the frogs and rab-
bits is not definitely stated. It is to be presumed, however, that
in the two latter, hypodermatic injection was the method, and
hence some comparisons can be drawn. We are all aware that
direct local application of cocaine to the eye has been attended with
few, if any, complications, and we shall await with interest further
experimentation with this new agent when introduced by some
other route for medication in the human subject. These facts,
however, prove interesting in showing that it is a possibility of the
near future of being placed in possession of an agent that may
prove efficient without many of the drawbacks which have attached
to our most general agent. Cocaine has so occupied the profes-
sional mind as the best local anaesthetic for the last few years, that
other drugs possessing in a minor degree this important therapeu-
tic action have, to a certain extent, been cast into the shade. The
fact, however, is pertinent to all of you, that cocaine alone is not
the ideal anaesthetic for average practitioners of dentistry to-day,
and hence a substitute is greedily sought for, and in the absence
•of this substitute many combinations have been made and used,
and almost every one of them has its advocates, promoters and de-
fenders. This longing for an efficient, speedy and safe local anaes-
thetic has been the cause of man}^ secret nostrums and prepara-
tions being promiscuously and boldly advertised and placed upon
the market, and it is only necessary to refer you to recent papers
.and exposures in the Cosmos and other journals to attract your at-
tention to the danger of such preparations and the villainous
greed for name and money of some of their originators.
In the face of such a statement it is nevertheless true that there
are some agents which may be combined to intensify the action of
an)' single medicament as well as to correct some of their individ-
ual, poisonous results. For this purpose our literature is rich in
formulae tending toward this end. Cocaine has been combined
with antiseptics and analgesics almost to an unlimited extent. First
it was learned that an aqueous solution would soon be contaminated
by fungi, decompositions and vegetable growths, and some preven-
tive was sought for. For this purpose different agents have been
used, such as alcohol, chloroform, salicylic acid, boric acid, phenic
acid, etc. The latest agent that I have seen recommended for this
purpose is acetanilid, the claim being made that it preserves the
92r. TJJE DEXTAL REI'IEIV.
solutions even when added in very minute doses, and, moreover, it
is devoid of any noxious action upon the medicaments. Then some
agent was sought for to intensify and prolong its anaesthetic prop-
erties— for this purpose phenic acid, choral hydrate, menthol, oil of
cloves, camphor, antipyrine, etc., have been used. Then some cor-
rective was searched for, and to this end the sulphate of atropia
plays an important part as a cardiac respiratory and spinal stimu-
lant, as also whisky, brandy, and aromatic spirits of ammonia taken
before the administration. It is not, I feel, necessary to tire you at
this time with formula? or directions as to the special application
of any given preparation. These you will find to your heart's content
in the journals, and very neatly classified in Catching's Compendi-
ums. I told you, I believe, in a previous paper that I was a stickler
for the adaptation of the knowledge obtained from the general pro-
fession of medicine to the speciality of our choice. The object of
this is two-fold: First, that our education may be sufficient unto
the evils of our calling, and second, that in possessing such an edu-
cation we will be carried above the dilemma's of the mere routin-
ists. Hence, it seems to me we might gain some good solid infor-
mation by studying for a while the conclusions that have been
reached by writers in our general literature. They have met
obstacles that we can avoid, they have been able to formulate a
system of practice by which we may profit.
By a correspondence, numbering many letters, to the bright
lights in general and special medicine. Prof. L. H. Adler, of Phila-
delphia, was enabled to collect and profit by the experiences of a
host of competent men, the results of which led him to the follow-
ing conclusions, which have received the approbation of the pro-
fession : 1st. /« minor surgery cocaine is valuable in all operations,
hypodermatically, in which the circulation can temporarily be ar-
rested, and in which free bleeding can be encouraged, at the com-
pletion of the operation. Freshl}' prepared solutions only should
be used, and they combined with some mild antiseptic, preferably
boric acid. The syringe should be perfectly aseptic ; a four per
cent solution is of sufficient strength for hypodermatic use. Where
the circulation cannot be controlled, extreme caution should be ob-
served. In anal operations cocaine is of little value and when used
must be employed with caution. The quantity of the medicament
required to produce anaesthesia varies with the operation and its
extent ; as a rule, for ordinary minor operations from twenty-five
ORIGINAL COMMUNICATIONS. 927
to forty minims of a four per cent solution are needed, and the
length of time from three to ten minutes. Individual susceptibility
to the toxic influence of cocaine is a complication of sufficiently
frequent occurrence to make one use the drug with care and cau-
tion. The danger of the cocaine habit should not be forgotten.
2d. In genito-urinary surgery cocaine is to be used with more than
ordinary care, as it is in this class of cases that the untoward ef-
fects of the drug have been most frequently noted. Hd. In gynae-
cological practice the drug has but a limited field of usefulness.
As a rule in this class of cases, general anaesthesia is to be pre-
ferred, as the patient's knowledge of the exposure of her person is
often quite sufficient to unnerve her and might be the means of
frustrating the surgeon's work. 4th. In the field of ophthalmology
the surgeon finds in cocaine the anaesthetic par excellence. In no
other department of surgery do we find its use so widespread and
its application so entirely satisfactory. In operations upon the
ear, nose and throat cocaine is of great value as a local anaesthetic.
Likewise Dr. Magitot has formulated the following rules which
should govern the employment of cocaine as an anaesthetic :
1. The dose injected should be appropriate to the extent of
the surface desired to render insensitive. It should not exceed in
any case 1 to 1^ grains.
2. It should not be administered in cases of heart disease,
in chronic affections of the respiratory apparatus, or in nervous
subjects.
3. It should be injected into the interior and not under the
derm of the mucous membrane or skin.
4. The injections should always be given in a recumbent
position, and the patient only be raised when the operation is to
be performed upon the head and mouth, and then only after an-
aesthesia is complete.
5. The cocaine should be absolutely pure, its mixture with
other alkalies forming highly poisonous compounds.
6. It should be injected in divided doses, with a few minutes'
interval : " Fractional injection," renders it possible to guard
against the production of sudden symptoms of poisoning. — {Ther.
Gazelle. )
A study of the foregoing will certainly make us more familiar
with the symptomatology of cocaine toxicology, and consequently
fortify us against the advancement of untoward symptoms. Es-
928 THE DEA'TAL REVIEW.
pecially is this of interest to us in our special department, as what
has been said in regard to the genito-urinary field of surgery, may
with equal force be applied to the mouth. Experience has shown
that doses well borne by other regions cannot be tolerated in the
mouth or urethra. It has also shown that in highly inflamed tis-
sues little or no anaesthetic effect is produced, and my experience
has been much more unsatisfactory with this agent in the lower
jaw than in the upper. I am satisfied that many of the practical
points will develop from the discussion, and hence I have pur-
posely avoided many points that have occurred to me, and which
also may possibly have suggested themselves to you. Such being
the case I will await 3''our discussion.
Dentists as Hobbyists.*
By M. R. Harned, D. D. S , Rockford, III.
M\' object in this paper is not to attack any one's hobby or hob-
bies especially, but to point out some of the common tendencies of
dentists which detract from our usefulness, to ourselves, to our
patients and to our profession.
I feel that there is a growing tendency among us to become
cranks, or at least cranky, to get into ruts, or run to extremes.
If this made us specialists it might not be criticised, but instead it
simply makes us narrow-minded without benefiting any one.
We are inclined to think (especially if we are kept pretty
busy) that our way is the only right way of doing a thing,
and that in reality we are the dentist of this part of the country. We
try to impress this upon our patients, not only this, but we even try
to make each other think so, to such an extent that we can hardly
take a pointer from another.
Our society, being for mutual aid, has a tendency to overcome
this, and yet it may do no harm, and I hope good to point out some
of onx faults, that we may not overlook them entirely. In under-
taking this I realize that it is mucli easier to criticise than to cor-
rect.
In our methods of attaining results we must necessarily vary
according to circumstances. One man has lots of patients to fill
in the short hours of the day, while another has lots of hours to fill
*Read before the Northern Illinois Dental Society, October, 1892.
ORIGINAL COMMUNICATIONS. ijO'J
in the "short of patients during the day." The one strives "to ac-
commodate all and make as much as possible, while the other strives
to be always busy, and make what he can."
So we are apt to vary in treatment of teeth. One man never
finds it necessary to extract an}' tooth that is solid in the jaw. In
many cases he treats and retreats the case until he finally perceives
a slight improvement, or imagines he does, or he may possibly ef-
fect a partial cure, but at so great a sacrifice, in suffering and goes off
to the general health of the patient, that the loss of the tooth would
have been nothing in comparison, or he continues treatments until
the patient becomes disgusted, worn out with suffering and retreats
to some other man who has more sympathy or sense and who re-
lieves him of the offending member. He goes away with a lighter
heart, head and pocketbook, and says that "if these pesk}' scamps
had less theor}' and more sense they'd make men happier."
The next dentist pulls everything that has ached. He goes on
the principle of the army surgeon that "dead men tell no tales,"
and if the tooth is out the patient won't be coming back saying,
"Doc. that tooth you filled is akin."
With regard to the matter of treating pulpless teeth men run
to extremes similarly. One argues that there is no use of filling a
dead tooth, and especially one that has abscessed, for " when the
nerve is gone the life of the tooth is gone and it is only a foreign
substance, and sooner or later will abscess and be thrown off simi-
lar to a sliver in soft parts." But it seems to me that when these
men see teeth of this sort, and many of them, as they must, that
have done good service for ten, twenty or thirt}' years, that they
would think it at least worth trying. One of their determinations
seems to be to forget these cases.
Likewise in treatment of pulps. The one saves everything
(or tries to) on the principle that if the pulp is of any use (and had
it not been it would not have been there) it should be saved. The
other man kills every pulp that he can get near. The first never
has any trouble with pulps that have been capped, the other has
nothing but trouble with them ; he never caps them now, and makes
the statement, "that it is our duty to know beforehand if they will
give trouble," on the principle that if there is a shadow of a doubt
he kills the pulp and throws the responsibility upon the patient.
In the matter of filling teeth we find extremes again. One
man says, have nothing but gold in the teeth if }ou want to save
1)30 THE DENTAL REVIEW.
them. The}- carr\- it to the extent that the}' sacrifice their health
in building up monuments of folly in inacessible places, their pa-
tients' nerves are shattered, their health injured and their teeth
ruined. The dentist seems not to recognize the fact that a good
amalgam filling is much better than a poor gold one, even though it
doesn't fill professional pockets so rapidl}'.
Another extremist plasters cement and stuffs amalgam so in-
discriminately that he disgraces a good servant.
Another great hobby, and this seems mostly confined to col-
leges and ma}' have a good influence in making new practitioners
careful, is the application of the rubber dam for minor operations,
such as arsenical applications, small and accessible cavities, in
fact, for everything, and one of the first questions asked students
is, what is the first thing to be done in an operation ; the invariable
answer is, apply the rubber dam.
Gentlemen, is it not better to show the patient a little mercy,
and not subject them to this gagging process in minor operations
requiring but little time where the cavity can be kept perfectl}' dry
and work properly done without it ?
When we look at some of the monuments of our predecessors,
who never saw a rubber dam, that have stood thirty to fifty years
and preserved the teeth perfectly, we think it b}' no means always
necessary.
In the use of anaesthetics we see the same crankiness exempli-
fied. Here is the heroic man who never uses any anaesthetic, no
necessity for it ; all nonsense and too dangerous ; but you will
usually find that this individual don't want to stand any pain him-
self, and wants to take an anaesthetic when he gets a shave, or if he
don't he kicks all the time at being hurt so. The next man uses
any and* every anaesthetic indiscriminately, not because of great
sympathy for patients, but for the revenue.
Some hear of a new mode of applying a remedy or a new rem-
edy, without giving it a trial condemn it as being bad or dangerous
practice, while others jump at everything new and use it indis-
criminately, finally condemn it because it won't do everything.
But of all the crankiness of dentists, of all the places where
they '^ kno7C' all aboiit it," there is nothing compares with the re-
placement of lost teeth or crowns. This one finds that the Logan
crown is good enough for him and his patients, and he attains
good results. The next will have nothing but gold or gold with
ORIGINAL COMMUXICA TIONS. <)31
porcelain face. He tells you how rapidly a root gives out if it is
not banded, how the cement washes out and the root decays and
stinks ; he says nothing of the many poorly fitting bands he has
put into the mouth that irritate and aggravate the tissues about
and cause an inflammation that elevates the root ; he does not say
a vvord about the many bands that were utterl}' useless and worse
than that ; but there is time enough yet.
In supplying lost teeth this one condemns the bridge as a
scheme to rob the patient, and says that they do more harm
than good; they are filthy things at best. He finds no use for
them because plates are perfectly satisfactory to him and his pa-
tients; this man usually finds no necessity for more than one kind
of plate, and that rubber or celluloid, only makes it in one form,
and that usuall}' suction.
But here is another man who clasps everything in the form
of a plate, then he "knows where they are," for a little while
at least, then the clasped teeth get sore, so it is almost impossi-
ble to wear the appliance, or they loosen up from continued ag-
gravation of the gum, and others have to be attached, and so all
are ruined.
Others find no use for anything but gum teeth; others still
for nothing but plain teeth. With some there is nothing but a
rubber plate, and others nothing but celluloid ; still others who
can see no good in any plate except one of metal, gold, alumi-
num, etc.
But here is the man who has no use for plates, except for
full dentures. He bridges everything, attaching them to anything;
"it is the only way to supply lost teeth." He cuts and slashes
right and left. No tooth is too good to be cut off in the front
of the mouth for a bridge attachment; "hardly any tooth is good
enough to hold a filling, the best thing is to crown it."
He may turn in another direction and band everything. Here
he meets with disaster, for in ninety-nine cases out of a hundred
there are but two teeth in the mouth in natural form that can
be successfully banded, the lateral and cuspid.
Others condemn the whole performance as bad, pernicious,
etc., while others draw the line on a band of any kind, except in
crowning, but having seen them do good service for ten years, I
believe that in favorable cases, it is conservative and good practice
to band a cuspid or lateral instead of cutting it off, for if the band
932 THE DEXTAL REVIEW.
fails after several years' service, the root is not injured and can be
utilized just as well, and will last just as long as if it had not been
banded, and all will last much longer than if a plate had been worn
in proximity to the teeth.
Another hobby of dentists is that we are all fine mechanics,
more than that we are all inventors, and the "little schemes of our
own are to be seen and heard of on every hand. It is " really
wonderful what a lot of smart men we are, and yet how few dis-
cover it."
Now in this I am just as severe on myself as on anybody else,
and deserve it just as much, perhaps more. My idea is not to
hurt any one's feelings, but to act as a spur to glide us on to a bet-
ter and broader understanding of things that we may practice more
intelligently and conservatively, be more conscientious in our prac-
tice and in our statements to our patients, and to each other, thus
the better fulfilling our mission in life.
Professional Ethics — Presidknt's Address.*
By E. J. Perky, D. D. S., Chicago, III.
It ma}' be truly said, I think, that the qualit}' of dentistry ren-
dered in a community can be determined by the attitude of the
dentists in that community toward what we may term professional
ethics. I therefore think it well for us to study the lessons taught
by this question.
This society does not require its members to be governed by
an\' code of ethics. Yet the founders of this association are ethical
men, and no doubt expected eventually to see all who belong here
join the State society and be subject to its code. It is not my in-
tention, however, to raise the issue as to the value of a code to us
as a society, or the propriety of our having one, but to make a
statement of the fact of the value of ethical culture to us as indi-
vidual dentists.
What is ethics ?
Webster defines ethics as ''The science of human duty." "The
rules of practice in respect to a single class of human actions," etc.
Professional ethics, as applied to us, therefore, is the adapta-
tion of these principles to our conduct as dentists. W^e are, then,
considering the subject in this relation only.
*Read before the Northern Illinois Dental Society, October, 189^.
ORIGINAL COMMUNICATIONS. 983
It may be observed in passing that it is difficult to see how
a man can be professionally honorable and morally bad, or how a
dishonest man can be an honest dentist. It is said of some politi-
cians that they are currupt politically but honest officially. You
can believe it if you wish. I cannot.
Professional ethics cannot be written out. No set rules are
necessary to govern the truly ethical gentleman. The rules may
limit his misconduct, but like true politeness, it springs from his
heart, and he rises higher than the written code. It is the char-
acter of the man. He is run by principles, not by rules. The
subject, then, is not definable in words and can only be written of-
What ethics has done for our profession it has also done for the
dentist. Ethics has transformed our calling from a mere mechan-
ical trade to a noble and useful profession. With this develop-
ment has come the progressive spirit and the professional brother-
hood, more strongly marked in our calling than in any other. So
the dignity and security of our profession can best be maintained
by the fullest appreciation of the value of ethical culture.
When the hearts of our forefathers were opened, when this
spirit struck them, their laboratories and operating rooms were
opened also. These in the dark days of our history were locked
up. Every man got what he could and kept what he got. We
had no journals, no literature, no text-books, no colleges, no dental
societies, absolutely no fraternit3\ Every man lived to himself ;
he grew jealous, selfish, narrow, ignorant and, of course, conceited.
Sometimes he was a peculiar person, had certain mannerisms, and
his peculiarities were as distinctive and marked as a quaker or cow-
boy. Now the father of all this sort of thing, in the last analysis
is selfishness and conceit. Ethics is the opposite of this. We cannot
do without each other. With the organization of the first dental
society up to the present time, our science has grown in usefulness
to mankind and kept pace with evolution of our time. Our pro-
fession, besides its great usefulness, has been spoken of as the es-
sentially polite profession. Politeness is synonomous with ethics,
it attends civilization and exists only where it is. Ethics organ-
ized our dental societies, edits our journals, established our col-
leges, wrote our text-books, diffused knowledge, exchanged experi-
ences, tabulated and formulated facts, and taught us the lesson of
fraternity, until to-day we present to the world all the inherent
qualities of a profession. And what the science of ethics has done
934 THE DENTAL REVIEW.
for our calling it has also done, even in a larger measure, for the
dentist himself.
The professional man is possessed of technical learning which
separates him from other business men and gives him the immense
advantage over the laity of being the sole judge of the value of his
services, he maj' do the wrong thing or the right, his patient cannot
be the judge, then, at least, he may be well equipped in every
way or not, he may avail himself of every means to be abreast with
the latest and best thoughts, read dental literature, attend dental
societies, etc., or he may not do his duty to his practice in these
respects, his patients cannot judge of his competency, and because
of the helplessness of the laity in these respects the professional
man should be truly ethical.
Ethics teaches us to make things plain to our patients. An
honest man don't quote Latin terms to impress a helpless, hapless
victim. The ethical man carries a big lamp, it is light, not dark or
mysterious about him. Science is common sense formulated. The
priest or preacher who seeks to impress his hearers with mysteries
is a quack or mountebank, he is himself ignorant and dishonest, a
pretender.
Ethics teaches us to give freely our experience to our brother
dentists. The principle which Hyppocrates put forth, that all knowl-
edge of the healing art be freely given to all who sought it, is the
basal one for us to-daj'.
This principle of giving to the profession what you may have
found is right, and greatly enriches the giver. Give what you may
to the profession, you are still enormously in debt.
The great bulk of all that you do know has been given to you
on this very principle, besides you always get more back than you
give away. Ethical culture takes away envy, jealousy; removes the
scales from the eyes; gives away your secrets, and brings an enor-
mous return. Love gets into hatred's place; praise sits in royal
dignity where jealousy held sway, and the man grows, grows broad-
er, and honors his calling and his community, and is steadily him-
self the greatest gainer.
The value of dental societies to us cannot be spoken of too
highly.
It is a sad sight to see men grown gray in practice after having
achieved a position of honor, suddenly drop by the wayside and let
the great procession tramp over them in its onward march. You
ORIGINAL COMMUNICATIONS. 935
are never too old to be benefited b}- associations, and if you drop
them you will be faking a step to the rear, and the young and pro-
gressive man will cut you out, and ought to. There is not a den-
tist in the State, however high has been his position, or however
humble his place in the profession, but what can contribute to, and
receive great value from a dental society if he will but join and at-
tend. He may not be able to measure up or write it down. He re-
ceives it unconsciously, if he catches the fraternal spirit. Let him
strive to do this and I warrant you he will go to work on his stud-
ies. And ere long he won't worry about the restrictions of any
code of ethics. The value of fraternity cannot be overstated
hardl}-.
I always say when returning home from a dental meeting, that
I will never miss another one. I love to grasp my brother dentist
by the hand; I feel better and nobler after having greeted frater-
nally my brother dentists. I can truly say that some of my dearest
friends are dentists, practicing not many blocks away from me.
The fraternal feature is well pronounced in this society. I once be-
longed to a dental society in which there were but two dentists, my-
self and a neighboring dentist. We had clinics, papers and dis-
cussions, and there grew up between us a friendship which is warm
to-day.
The deduction then is that the rectitude of purpose and frater-
nal spirit, made possible by ethical culture is the door through
which comes all these benefits.
Let us make this meeting not only useful but fraternal, and
hence more useful, that we may love to come ourselves and draw
others into our ranks. And if we shall become ethical dentists we
shall also become ethical men.
Methods Old and New.*
By G. W. Denn'is, M. D., LaSalle, III.
The practice of our calling is composed of petty details, and
much of our success is based upon a close study of them. We
enter our offices each morning, we excavate, we fill, we extirpate
pulps, insert dentures, extract occasionally, and, while operations
of each class bear a strong family resemblance, still there is, after
all, a great variation. They are alike, and yet not alike.
* Read before the Northern Illinois Dental Society, October, 1892.
93G THE DEXTAL REVIEW.
We cannot work by a pattern ; each operation is dependent
upon our skill and judgment, upon our abilit}^ to adapt ourselves
to circumstances. The minor details of practice are constantly
changing, methods that seemed perfection may, in a brief period,
be swept away and their place be taken b}^ ideas that seem the in-
spiration of genius; they, too, to be abandoned in course of time
for something still more advanced, and so on ad infiniturn. Thus
it is that a study of these minor matters never becomes stale to
those really interested in their work. In the course of a year the
number of our different operations will become wonderfully num-
erous; in a decade, they are as the leaves of the forest.
For their durability, and for the comfort experienced by the
patient, we are in a large measure responsible, therefore it be-
hooves us that we be painstaking, and that we embrace every op-
portunity for advancement. "Ignorance of the law excuseth no
man," and if our neighbor has a better plan than ourselves let us
learn it. For such reasons should we assemble together in society
meetings, subscribe liberally to the literature of the profession, and
grasp every means of improvement, not forgetting to add our own
mite, if opportunity offer. To the mind of the uninitiated, it is a
very simple thing to fill a tooth or construct a plate, and it is to be
feared that some dentists take the same view of the case. True it
is not difficult to perform these operations after a fashion, but to
attain a success that is as close to perfection as possible calls for
all the energies of brain and body, not only of the individual, but
of all who are willing to think and work in earnest ; for he who is
content to rest complacently in the ruts of by-gone methods, can
never hope to attain more than limited success. We cannot safely
follow the practice of fifty years back, as most operations of that
period would be considered very much behind the age now.
However, there are a few notable exceptions — for instance,
the suction plate for retaining full, and in some cases partial, den-
tures. We have no advance or improvement to report, and this
would seem a better plan for replacing lost teeth than some of the
more modern practices. Suppose an anterior tooth be lost, root
included, and the adjoining teeth sound and in good general con-
dition, what better can you do than to insert a well-fitting suction
plate as small and thin as circumstances will allow? You surely
would not grind down good sound teeth to cap for a bridge, or
do worse and attach with bands, for of all the mistakes of
ORIGINAL COMMUNICATIONS. 937
modern dentistr}' the band cemented upon sound teeth is ap-
parently the greatest.
This process seems to have been accepted by but a small por-
tion of the profession and to have been abandoned b}^ most, even of
these. Bridge work, in the hands of those really competent and
having every facility, whose patients have abundant means, and
where conditions in the case are favorable, is good practice, but as
followed by the incompetent and avaricious, becomes a disgrace
and reproach. Such malpractice should be frowned down.
A case that recently came under the observation of the writer
will serve to illustrate.
The patient was a young lady of moderate means. She had
lost the second bicuspid on the left and both bicuspids upon the
right of the upper jaw. Two bridges had been inserted, that upon
the left being composed of a misshapen, ill-fitting cap, with clums}^
second bicuspid attached, the cap being placed upon the first bi-
cuspid, which had been ground off as far as the patient's feelings
would allow, and, as the teeth were very dense and sensitive, the
cap had to be made very thin, and though worn but a few months,
had a hole through the grinding surface. The bridge on the right
had been fastened upon the first molar in a similar manner, and as two
teeth were to be supported, he had placed a heavy band around the
cuspid, ruthlessly cutting away between the cuspid and lateral incisor
to gain the necessary room. Both bridges had come off in a few
months, and all the poor girl had to show for her time, mone}' and
suffering was some worthless bits of mouth jewelry (which she car-
ried in her pocket) and four badly mutilated teeth, at least two of
them completely ruined. I have seen work nearly as bad from the
hands of a college professor, who actually demonstrated bridge
work at the college. Would a dentist be justified, in the operation
just described, if he made a success of it, and would it be possible
to make it a success without capping the cuspid on the right and
the first molar on the left ? Judging from my own observation and
the reports of others, about one piece of bridge work in fifty is a
success in every sense of the word. It is against the laws or possi-
bilities of nature for one or two teeth to perform the duties or bear
the strain intended for a much larger number. But the case is
different where crown work is concerned.
The improvements made in the last few years make almost a
certainty of this work, when prop'.>rly performed. In gold cap
938 THE DEXTAL REVIEW.
crowns the principal features are to obtain correct articulation and
to see that a tight fit is made at the collar, the root should be
beveled so that the higher the crown is forced, the closer the
adaptation, care being taken that the collar does not extend so
far beneath the gum as to cause irritation. But while the bicuspids
are not apt to be conical in shape, the conditions are more trying
with the six anterior teeth, and the difficulty of adapting a crown,
at once artistic and durable, requires great skill and patience.
We have as yet no tool that will quickly and properly reduce
the root, and the operator is obliged to use what ever he can best
adapt to circumstances of the case in hand. Apparentl}' many
make no effort to reduce roots to a proper condition, and where
this is omitted the results cannot fail to disappoint both patient
and operator.
To attempt to adapt a collar, having parallel sides, to a
root, conical in form, is unscientific, unsanitary and unphysiologi-
cal.
Ifthe band fits closely to the portion of the root having the
greatest diameter, a V shaped space will be left to be a cache
for debris, that may happen to be forced beneath the free edge of
the gum, together with the exudates from the constantly irritated
tissue, and it is only a matter of time when such an operation must
fail.
For those not having the requisite time and patience to prop-
erly prepare the root, I will offer a substitute, which I have proved
worthy b}' the test of time. It is also applicable to cases where
the root is short or badly decayed, aud, though perhaps not origi-
nal, or new, will bear repetition. When a root decays, it does so
from within outward, the cementum being a good protection.
Now, if the outer third of the root is carefully cleansed down to th
sound substance, or, if a sound root, if it be reamed out, and if, in
either case it is then beveled off to the cementum, and a lining of
strong amalgam is inserted, you will get both strength for the
root, and protection from caries. A band within the root, strength-
ens as much as a band without.
The alloy must be quick setting, if the operation is to be finished
at one sitting, and the opening for the admission of the post
should be but little larger than the post itself, in fact an opening
can be left through the amalgam and the post gradually forced up
to form the channel, then after it is withdrawn and barbed it will
ORIGINAL COMMUNICATIONS. 939
fit SO closely that but little cement can be used, and another ad-
vantage is, that the crown being forced up while the amalgam is
soft, the amalgam will conform to the shape of the cervical portion
of the crown, thus making a very close joint, which will not allow
of the disintegration of cement, at any very rapid rate.
This plan may not seem to be scientific enough for the minds
of many, but it will succeed in probably more cases and for a lon-
ger time than any other method of setting porcelain crowns, except
in these cases adapted for proper fitting of collars. The Logan
crown was intended to be used in the foregoing description. With
the exception of the porcelain faced Richmond crown, probably no
stronger or more durable operation can be made than the Logan
(with collar attachment), where circumstances are favorable. A con-
venient method of adjusting this work is as follows: Cut the root
off squarely, a short distance (perhaps 1-32 of an inch) below the
gum line and enlarge the canal to just receive the post, then grind
the cervical end of the crown to fit the root, and secure align-
ment.
The crown should be larger at the neck than the end
of the root. After grinding properly into place, proceed to level or
smooth the sides of the root, and make a close fitting band, adjust
the band and slightly oil it, mix oxyphosphate quite thick and place
over the cervical end of the crown, and entering the post into
the root canal push the crown up against the band, and withdraw
carefully. You will now have an impress of the band in the oxvphos-
phate and after the cement hardens proceed to grind the crown
smoothly down and slightly beveling, all around to the mark in the
cement, then try it and if it needs more grinding it can be done, but
it should go to place on first trial usually and make a very close fit,
as the gold collar will stretch slightly. Then set with the cement,
as it could not escape if mixed thick, and you will have a joint
nearl}' or quite impervious to moisture and a fine support for both
crown and root, practically one piece. A very important matter in
porcelain crown setting is to have the channel for the post small
enough, so that after barbing the post, it will be difficult to remove
it, without the presence of cement.
Another very important matter in crown work, as also in
the management of all kinds of pulpless teeth is the ability
to properly treat conditions adverse to the welfare, of such
teeth.
940 THE DENTAl. REVIEW.
Old methods were to dose liberally with carbolic acid without
reference to conditions, fill the root if at all, with gold or tin (and
in many cases with cotton), consequently success was anything but
assured. It is but a very few years since the most successful or
modern methods has been generally adopted, and it needs to be in-
troduced into a great many offices still. Almost daily, evidence is
seen, of relics of barbarism, in the shape of badly filled root canals,
or in many cases no filling at all. It was the fortune of the writer
to operate for a lady, a few days since, whose mouth contained some
very clever specimens of the operator's skill. Among the rest, were
two dead teeth, one of which was giving slight trouble, the other,
in an active state of eruption. The latter tooth, being opened into,
revealed a cotton, root filling in the usual odorous state.
After the tooth was reduced to a condition of comfort and
healthfulness the other tooth was attacked. This was an upper
molar, the lingual root was about half full of gutta-percha (no
chlora-percha being present), while the buccal roots were both
entirely empty. Here was a man who had narrowly escaped suc-
cess, his operative work being good, but for lack of a little knowl-
edge and care he lost the confidence and patronage of a desirable
patient, together with the annoyance of failure.
A dental journal printed only fou)- years since, transcribes the
controversy indulged in at an eastern dental society meeting,
where a number of representative men were discussing the import-
ant matter of root fillings.
One stated that he was careful to remove all the nerve, but left
the roots open; another advocated cotton, and still another thought
cotton all right, but would add carbolated cosmoline. Not one
spoke in favor of chloro-percha, and remember they were repre-
sentative men, and this but four years ago. All cannot be expected
to conform to one idea, nor to be successful with one material, but
the merits of chloro-percha, followed by the core seem so great,
the means so perfectly adapted to the end, that it appears strange
that the whole profession is not, for once, united upon the point.
Very seldom indeed should a failure be recorded where proper
sanitary precautions have been observed, followed by a filling with
this admirable substance. In filling small and medium sized
roots it is well to have two bottles of chloro-percha, one quite thin,
so as to be forced to the end of the root easily; have the bottle as
close to the work as possible, dip a small smooth broach in the
ORIGINAL COMMUNICATIONS. 941
seniiliquid and quickly carry to the canal, holding the instrument
horizontally to prevent the chloro-percha from dropping, place in
the canal, and pump as far and as rapidly as possible, repeating
until the canal is flooded as far up as the broach will go, then
place a piece of crude rubber over the orifice of the canal and
press quickly and forcibly with a pumping motion for considerable
time or until the material reaches the apex of the root, of which
the patient will apprise you; then proceed in same manner with
the thicker solution, finishing with the cone. But previous to this
we should see that we have an aseptic condition in the premises,
and that nothing remains of the pulp to mar our happiness in the
future.
Remnants of nerve filaments left at the apex of the canal,
whether by the "knocking out" process, or attempts at removal,
with or by the aid of injections of cocaine or other obtundents,
are more tJireatening to ultimate success than would be a septic
condition, as the latter will be corrected before the filling is in-
serted, while the former is covered up and forgotten, to create
trouble after a time.
The only certaiii manner of treating recently devitalized teeth,
is to allow sufficient time for a complete removal of the entire
nerve tissue, after which the canal should be thoroughly filled with
an indestructible substance.
It is better to wait too long than to be too hasty, and I am of
the opinion that, as a rule, from fourteen to twenty-one days are
required for the devitalization and sloughing, necessary to the
perfect removal of the contents of the canal, while often a much
longer time should elapse in those cases where the pulp does not
readily succumb to the action of arsenic.
In these cases a root dressing should be applied of a nature to
partly counteract the effect of the decomposition of nerve tis-
sue, a temporary filling inserted, with a definite time arranged for
the return of the patient for examination.
It is not desirable to have a decomposed pulp for removal, and
foul canal for disinfection, but even that is better than to pen up
portions of the nerve tissue when the filling is inserted, as with our
present facilities, putrescent pulp canals lose their terrors.
A few years since carbolic acid was the dependence of most
dentists for such purposes. Practice has greatly changed and
should the progressive practitioner be asked "what remedy (if you
94-2 THE DEXTAL REVIEW.
were obliged to confine yourself to a single one) would you select,"
what would be the answer ? Personally my choice would be per-
oxide of hydrogen.
If allowed two I would choose in addition to the above — oil
cassia. In other words, I consider these two agents by far the
most Jiearly a specific for all the varied conditions that are pre-
sented in the management of pulpless teeth.
The action of peroxide of hydrogen being both mechanical
and therapeutic, it is of benefit not only in septic conditions, but
is also a great aid in ridding cavities or canals of debris of more
benign character, but which it is necessary to remove, while the oil
cassia is efificacious both in early stages with inflamed conditions
(which frequently yield with magical rapidity under its influence)
and is one of the best antiseptics in existence.
The old method of noncohesive gold fillings, with hand pres-
sure, has now fallen into disuse, but if the testimony of those
familiar with the practice be accepted, it is a most reliable mode of
preventing tooth decay. There is no doubt that a mixture of
handpacking with the, oftentimes, heroic malleting of the present,
would be judicious. Many operators pride themselves upon the
fact that they use the mallet upon every portion of the filling, be-
ginning with the first piece and only ceasing when the last particle
is driven home; the patient has expired. In this matter much
judgment is called for. The strain on the cavity walls, the danger
to the cervical margin, and last but not least, the excessive strain
upon the nervous system of delicate patients require that we
should be as careful of the quantity and quality of our malleting as
possible. Try it yourselves, fellow dentists, for an hour or two.
There seems to be a sentiment growing among the members
of the profession in favor of mechanical mallets. It is difficult to
obtain sufficient harmony between the minds of operator and the
assistant (where one is employed) to insure satisfactory results in
all cases; heavy blows are likely to fall where light ones are de-
sired, and fractures or imperfect condensation may result. If the
operator both guides the instrument, and handles his own mallet,
he finds, in obscure cavities and awkward positions that he is at
great disadvantage. While I am aware that many, probably a
majority, of dentists use hand malleting, and I have used the same
myself largely, yet I believe that it is not only the slowest and most
awkward manner of accomplishing the purpose, but that the result-
ORIGINAL COMMUNICATIONS. 943
ant operation is not so reliable. Probably the electric mallet is in
all respects the most perfect, not only in excellence of work, but in
speed as well. I believe that contour fillings should be made of
cohesive foil, gold that is made and sent from the manufac-
tory as cohesive. It has been frequently stated that noncohesive
foil can be made just as cohesive as the other simpl}^ by anneal-
ing. It is said then to be just the same. If this is so why use
noncohesive, for certain it is that many do prefer this form.
As a matter of fact, there is a very decided difference and one
that, it seems to me, any dentist can realize by simply testing it
with care and noting the matter in his mind. Noncohesive gold
requires very much more annealing than the cohesive, and cannot
be wrought into a dense, strong filling without receiving more
malleting than is necessary with the cohesive, and is more liable to
flake off, though for simple cavities is more desirable on account
of its softness and consequent ease of adaptation to cavity walls,
which qualities it retains to a marked degree even after consider-
able annealing.
In the line of combination fillings a few operators have of late
reported favorably upon gold and amalgam. For frail teeth with
cavities reaching very deeply beneath the gum, and especiall}^ where
accompanied with an attenuation of the cavity that would render
obscure operations doubl}^ difficult, this combination works per-
fectly.
It has been called slovenly and is said to lead to careless
habits. This is a mistake, as a slovenly man could never obtain
favorable results, and if it tends to carelessness it follows that the
operation must needs be very simple and easy. If this is the case
why do many good operators acknowledge that they cannot make
a success of it. There is really not so much difficulty about the
work, after it is understood, but seems to be mysterious to some at
first. While therapeutic conditions may conduce somewhat
toward the splendid results that follow the intelligent practice
of this method, it is more probable that the perfect joint made
by confining a somewhat plastic material, with the matrix, and
malleting the same into position, together with the absorption of
the mercury by the gold, has much more effect.
Just a word about copper amalgam. My own experience has
been somewhat at variance with that of some who have written up-
on the subject. I found no lack of edge strength, in the common
944 THE DEKTAL REVIEW.
acceptation of the wood, but in many cases it crumbled or washed,
very badly, not onl)^ at the edges, but over the entire cavity. I one
day found two fillings side by side in the same mouth, the condi-
tions of which were not the same, one being very black and perfect,
while the other was lighter colored and crumbling away. I became
convinced that these results were not caused by certain conditions
of the mouth, but by the mode of manipulation while preparing for
insertion. I then made some experiments which have caused me
to believe that certain fixed modes of preparing the filling will pro-
duce certain results, irrespective of oral conditions. Although I
have almost ceased to use it on account of the color, still I believe
it to be less black than it has been painted, and capable of doing
good service in obscure corners.
Alloys and amalgams of various forms, have always met with
opposition and disparagement, from a large percentage of the pro-
fession. This opposition arose partl}'^ from an advocacy of "noth-
ing but' gold " in some cases, and from ignorance of the proper
manner of manipulating the material in others.
It was said (and the same is claimed to-da}') that amalgam
would shrink, would bulge, had no edge strength, wouldn't preserve
teeth, etc. If the formula is a good one the manufacturer has done
his duty, if we prepare the cavity properly and pack the material
solidly, contour, and finish well, we will get good results. Amalgam
has its place as well as gold, and the dentist who refuses to use it
(under all circumstances whatsoever), does not do his patrons jus-
tice. In many cases even small cavities should be filled with the
mallet, as small amalgam fillings are more subject to failure than
are large ones. If, for any reason, you may find it necessary to in-
sert a small or medium sized amalgam filling in (for instance) a
posterior cavity in a superior cuspid, with the cavity coming through
the lingual wall. (Filling in these cavities seem to be more liable
to failure than are the average imperfect packing being the proba-
ble cause.)
Just slip a thin narrow strip of steel between the teeth,
wedging it over against the cuspid. Cotton touched with sandarac
will do for this purpose. Mix the amalgam with as little mercury
as possible, press in a chamois skin, and inserting small pieces, one
after the other, pack with the mallet until completed, and if you
force in a small piece or two of Watt's crystal gold it will do no
ORIGINAL COMMUNICATIONS. 945
harm; then if polished after hardening will be all the better, and
keep a better color also.
Quite a number of excellent recipes have been formulated for
capping exposed pulps. One of the best, for cases of full expos-
ure, is, prepare the cavity as full)' as possible without causing the
patient excessive pain, and cap with arsenic. That probably is the
best material for these extreme cases. Where a thin layer of soft-
ened dentine overlays the pulp, some operators line the cavity with
a very thin mixture of oxyphosphate. So far as the ultimate re-
sult is concerned they had better have used the arsenic. The best
plan (after the soft dentine is rendered antiseptic) probably, is to
varnish the cavity and line with oxychloride or oxysulphate of
zinc, which should be allowed ample time for hardening before in-
serting a filling upon it.
But these operations become very uncertain after the pulp has
been the seat of pain and inflammation for any considerable time.
Temporary work has become altogether too common ; putrescent
pulps beneath cement fillings are not conducive to a high standard
of dentistry, although cement serves many useful purposes if
rightly manipulated, and (could we devise means for the protec-
tion of fillings of this material, for a considerable length of time)
it would doubtless be as lasting, and a better protection for cavities
than an}' other filling material extant.
Employment of the Post in Anchoring Fillings.*
By C. J. Underwood, D. D. S , Elgin, III.
I see the programme tells me I am to speak on employment of
the post in anchoring fillings. If you were to judge the future by
the past you might anticipate my paper to be a worse chestnut
than it is, for they have had me on the list now three times for
irregularities of the teeth, and the paper is still in embryo. But
that is an error. It should be post. It may, however, not be
amiss to remark that we may employ the post in anchoring fillings;
in that we may profit by the mistakes of the past. At first I took
it to be t3'pographical error and felt some resentment, but when I
come to copy my efforts from the original I concluded it was a
scriptographed innominata, and that the compositor was entitled
to a vote of thanks for mastering so much of it.
*Read before the Northern Illinois Dental Society, October, 1892.
916 THE DENTAL REVIEW.
In preparing this paper I have abjured books and journals,
and anything and everj^thing that may have been written on the
subject, and endeavored to adhere closely to the actual details of
the operation, just as I do the work in my practice.
I do this for two reasons : (1st.) If, happil}', my practice em-
braces aught of value, some one may be benefited by it. And,
(2d.) If my practice is faulty and unscientific, I may be benefited
by your criticism.
I will consider but three cases, or three classes of cases :
(1st.) A proximal cavity involving the cutting edge in a de-
vitalized incisor or cuspid.
(2d.) The same with a living and healthy pulp.
(3d.) An anterior proximal cavity in a devitalized bicuspid.
Case 1st. We find a large anterior proximal cavity in a de-
vitalized central incisor, involving one-fourth the cutting edge.
After filling the root and cutting away frail margins we find
the cone of the tooth gone and a thin plate of enamel in front,
giving little promise of safe support for a large filling reaching, as
it will, to the cutting edge. A post is indicated; not a
screw or How post, but a triangular platinum wire post,
always cemented in. And to obviate the annoyance and often
disastrous consequences of the post being in the way, I bend
it in such a way as to carry it well back into the cavity, down
through the center of the tooth to a point near the cutting edge,
where it curves outward to a point near the corner to be restored.
The post is shaped before setting to an abrupt point, at the end to-
ward the cutting edge, this being accomplished by flattening the
wire at the end and then cutting off the corner at an angle of 44
to 60°.
The post is thus out of the way in the body of the filling,
yet retaining its full size and strength to near the cutting edge, and
here the taper is so short that the maximum amount of strength
is secured, with the minimum amount of post. I then cut the
usual groove at the base of the cavity, to prevent slipping of the
filling ; and a longitudinal groove to receive a part of the lateral
strain.
The sample I have prepared is very nearly a typical case and
I trust it will serve as a key to my awkward description.
Case 2. Is the same sort of a cavity in a ' live ' tooth.
ORIGINAL COMMUNICATIONS. 947
There being no circumference to the cavity, but only a base,
resort is had to the post — or pin or lug if you please.
I take a very small bur and drill a hole nearly through the
tooth toward the distal side, and at right-angles with the long
axis of the root, at a safe distance from the nerve and from the cut-
ting edge. Then I enlarge with a slightly larger bur till it is as
large as the thickness of the tooth would suggest or justify and
cement a properly shaped pin in place, slightl}' bent at the point
of emergence from the tooth, toward the corner to be restored,
thereby affording a better grip for the gold, and also being more
out of the way while building base of filling. A groove is also cut
in base of this cavity as in case 1.
Case 3. Is a large anterior proximal cavity in a biscuspid, a
filling in the buccal portion of which will show, and should there-
fore be of gold.
An all-gold filling is contra-indicated both by size of cavity
and extent of deca}^ at cervix, and by the general!}', attenuated con-
dition of the patient's pocketbook.
I put in a compound filling, the lingual portion and bod}' of
the filling, amalgam and the buccal portion that shows subsequent-
1)', with gold.
I use a post here for two reasons — to secure greater certainty
for retention, and to avoid bringing the amalgam in contact with
the buccal wall of the cavity, thereby discoloring it.
The post is prepared as before — beveled sharply to a point
from the point of emergence from the cement, and is placed near
the center of the cavity, the point reaching the proximal surface of
filling.
In cementing it in place, the cement is carried well into the
buccal portion of the cavity, the lingual portion being left free for
the reception of the amalgam. It will thus be seen that the post
supplies the place of the buccal wall to the amalgam filling and the
amalgam affords easy retention for the gold at the subsequent
sitting.
The effect of an old-gold filling is thus secured at a great sav-
ing of time and trouble and in my judgment accomplishing a bet-
ter result.
I think this covers all the uses of the post wherein would be
likely to suggest anything new or instructive.
I wish to say before closing I never use a screw-post.
948 THE DEXTAL REVIEW.
The threads weaken it.
It is no stronger at the point of emergence from the tooth than
at the point. Besides, in screwing it to place you are liable to frac-
ture the enamel.
Treatment of the Deciduous Teeth.*
Bv L. E. Gordon, D. D. S., Chester, III.
There is nothing more worthy of attention by the dental pro-
fession than the subject of the preservation of the deciduous teeth.
That we should go to the source of the trouble and try to understand
the remote causes of decay in these temporary organs and thereby
endeavor to institute means for the prevention of dental caries
hardly any one will deny.
Many times a dentist is questioned by the better class of patients
in regard to the care of the teeth; in such cases it is well to have
at command a general idea of how this may be done and be able to
explain satisfactorily something about it.
The growth of the jaws takes place in several ways in order to
give room for the permanent teeth, one of its modes of growth is
by a movement of the temporary crowns bodily forward toward the
buccal or lingual surface "but not until the roots of the deciduous
teeth have been more or less absorbed can this take place; then the
alveolar wall above the crown of the deciduous tooth is wholly or
partially reabsorbed and the crown moves toward the lingual or
buccal surface also pushing the gum before it. When the teeth have
attained the desired position the alveolar wall is again formed un-
der the gum and thus an increase of transverse and antero-posterior
diameter of the arch takes place. Very often the permanent teeth
come through the gums presenting their buccal or lingual face in-
stead of their cutting or grinding borders. When the temporary tooth
was absent for a long period then the permanent tooth appears
in the line of the temporary, representing the smaller arch, this ten-
dency of the permanent teeth, under the condition of premature ex-
traction of the deciduous ones, may be taken advantage of in those
cases, where there is too much fullness of the dental arch, espe-
cially of its anterior })ortion."
It seems that I should say something in regard to its im-
portance, for until it is conceded important by dentists themselves
*Read before the Southern Illinois Dental Society, October 1892.
ORIGINAL COMMUNICATIONS. 949
it will grow into importance very slowly in the minds of fathers
and mothers. It is certainly true that the public has been educated
up to the present point in dental matters by dental practitioners
themselves, but on this particular subject a great deal of preaching
is still necessary; for while a number of families among the well-to-do-
of our cities have their children's temporary teeth attended to, the
greater mass (consisting of about nine-tenths) regard it as of no
consequence, and the result is intense dental pain endured by
children, loss of sleep, and waste of sympathy by parents, and last
but not least, the loss of the aching organ, and a diseased stom-
ach, caused by their not having the organs to masticate their
food properly, which causes numerous affections. I wish that
every parent was obliged by natural law to suffer all the pain en-
dured by these little ones, resulting from decay of their deciduous,
teeth.
It is the duty of every parent to give by inheritance good,
sound dentures to their children and enforce such hygienic and
remedial measures as will preserve them until nature calls for their
removal.
I will only mention briefly what these remedial measures should
be : healthy parents, and the use of phosphates and lime salts,
and after they are developed, frequent cleansing with a soft brush
and the use of waxed thread drawn between them, as decay is
mostly on proximal surfaces, to remove foreign substances from
them.
These reasons I have given are sufficient for the preservation
of the deciduous teeth. Now to find out the best way to do it, I
shall give the results of my own experience and judgment.
That the presence of healthy deciduous teeth in the jaws until
the natural development of the permanent set is necessary for the
evolution of the jaws and teeth, I have no doubt; and that decid-
uous teeth may be extracted before the proper time and yet a good
development of these organs take place in many instances, I also
believe, but on the other hand I can see an arrest of development
of the jaws, produced by premature extraction.
I never extract dead roots with or without crowns unless com-
pelled by the parent or the impossibility to control the child, as it
causes absorption of the alveolus, and a retarding of the eruption
of the permanent teeth, and irregularity — but open them as you
would an abscessed tooth and fill if allowed to keep them until the
<(5(i THE DENTAL REVIEW.
proper time of eruption of the permanent; but there is great dam-
age done by leaving full formed deciduous teeth in the jaws too
long. If not extracted tlie permanent ones may not erupt.
If a child comes to me for the first time with teeth that need
extracting, also those that need plugging, I perform the latter
operation first, if possible; when I once get the confidence of a
child by having performed painless operations, then it will not be
destroyed by a painful one, if we do not deceive the child. There
are children I cannot manage, and don't believe any one can,
but they are few if the parents will not meddle. Give the child
short sittings, say from fifteen to thirty minutes, according to their
age and endurance. What time is lost in brevity must be made
up by frequency.
I find that operations on children's teeth are not as successful
as a rule as upon those of adults. One reason is the necessary
imperfect manipulations, in many cases, to avoid all pain possible.
Children three years old and upward have been brought to
me to have teeth extracted on account of toothache; I always save
them if possible, rather than extract. To do this I find much pa-
tience is required. In the first place I get the confidence of the
little ones, avoid any movement that gives it pain, I 7iever deceive
them and try not to fatigue them. I find it is not a desirable prac-
tice to have, (so far as money or comfort is concerned) nothing
but a sense of duty urges me on; I do not intend to fatigue j'ou
with the process of evolution, but tell you what my present practice
is, being as it is the result of my mistakes and successes by di-
verse methods.
Deciduous teeth are full of vitality ; the microscopical organs
composing them are active, and if the plug is not in contact with its
walls reabsorption may take place and the pulp become irritated
or exposed. It is well to remove superficial decay, especially on
proximal surfaces.
Dr. Arthur's plan is to separate so as to be as self-cleansing as
possible, but I don't believe in this, or anything of that heroic
kind, as it lays bare the gum septum and causes food to push down
on it, setting up inflammation, etc., which is as bad as toothache.
In some cases alveolar abscess may be cured — not by the
.heroic treatment of adults, but by merely cleansing the cavity with
peroxide and alcohol as a disinfectant.
Filling the roots must be done as circumstances dictate, as the
ORIGINAL COMMUNICATIONS. 951
roots "may be one-half absorbed" and filling of such roots will un-
doubtedly interfere with the growth of the permanent tooth and
cause premature decay and absorption of the deciduous tooth)
when not more than one year will probably elapse before these
teeth will be replaced. If ulceration appears I open; if it still per-
sists I extract.
The pulp when exposed may be destroyed in the usual man-
ner, but its extirpation postponed for ten or twelve days so as to
avoid pain, and even longer if it is necessary; saturate well with
alcohol and cover with a loose cotton plug.
Care must be used not to wound the pulp mass or its horns,
that occup}' a large portion of the pulp chamber, for they are ex-
posed in many crown cavities. When they are recently exposed at
a small orifice I cap them with chloro-percha; this hardens quickly
and a permanent plug can at once be inserted.
The thorough removal of decay must not be insisted on when
accompanied with pain. Its removal is alwa5's desirable and
should be done when it will not prevent the accomplishment of
our object, but a half loaf is better than no bread at all, therefore
there may be cases where but little of the decay can be removed.
Saturation of the carious bone with alcohol will render it less liable
to deca3% and if the margins of the cavity are cut away until the
healthy dentine is reached decay will proceed very slowly under a
water-tight plug. This class I fill with cement.
There is a certain class of deciduous teeth found in the
mouths of dyspeptic children, which are the hardest to preserve but
seem to be the least sensitive. These teeth are seen to have rough,
uneven enamel and cutting edges, with white spots in the teeth.
It is well in these cases to advise parents (especially for girls) to
change their food and give them a mouth-wash to use night and
morning. I have found Pond's extract diluted with water equal
parts to answer all purposes. Filling these teeth seems to do but
little good unless strengthened by some means, as they soon decay
and leave the mouth in a bad state and will surely injure the per-
manent teeth.
952 THE DENTAL REVIEW.
Ulitis.*
By Thomas L. Gilmer, M. D., D. D, S., Chicago, 111.
Ulitis is a term which may be made to cover a large number of
pathological conditions, but is by no means definite, other than in-
dicating the tissue involved.
The word is of Greek origin and means inflammation of the
gums, and according to medical dictionaries has its synonym in
gingivitis, which is from the Latin.
I think the two words, ulitis and gingivitis are very commonly
used by the profession interchangeably. However, there seems to
be a tendency on the part of some to make ulitis a general term^
while gingivitis is used more especially to designate inflammation
of that part of the gum which rests next to the teeth known as the
free margins.
Histologically, gum tissue is composed of a dense layer of
epithelial cells, resting upon a layer of connective tissue, in both
of which is imbedded a rich supply of nutrient vessels. The rela-
tion of the gum to the teeth is that of contiguity; with the mucous
membrane of the cheek, fauces, and of the peridental membrane,
and periosteum, it is that of continuity.
Directly, other than through mechanical injuries, diseases of
the teeth have no influence on the gums. But indirectly, through
the medium of the peridental membrane, the gums are subject to
serious inflammations. Indirectly also, the gums often participate
in inflammation originating in the mucous membrane of the cheek
and fauces bearing relation of continuity.
Anything interfering with the natural physiological action of
the gums may cause ulitis; however, it is the experience of den-
tists who have given the subject attention that there is no tissue in
the body which will, without remonstrance, bear rougher usage;
indeed, a considerable amount of friction is essential to its health.
It may be, that in times past when coarser food was used, the mas-
tication of it supplied sufficient friction; but at the present time
when most articles of diet are prepared for the table in the softest
possible manner, friction by some artificial means is necessary.
Normal gum tissue is comparatively insensible to pain, even
when pricked by sharp or prodded by dull instruments, but when
*Read before the Chicago Dental Society.
ORIGINAL COMMUNICATIONS.^ 953
inflamed it takes on hyperaesthesia to an excessive degree. Owing
to its rich supply of nerves and blood vessels, gum tissue, is rap-
idly repaired and, as before said, it tolerates abuses to a marked
degree. This is the more surprising when we reflect that the
mouth is one of the most favorable places for the multiplication and
growth of microorganisms, making the opportunity for autoinfec-
tion so great.
Mycologists tell us that pathogenic as well as nonpathogenic
organisms are present everywhere, and we know that unless anti-
septic precautions are taken, breaks in the skin very frequently
result in inflammation, while incisions or injuries of the gum gen-
erally heal with no indication of inflammation. Why this differ-
ence, when the gum is under more favorable circumstances for
infection, has not been definitely settled.
It is thought by some that the saliva as it comes from the
ducts has antiseptic qualities, rendering the poisonous products of
the plants innocuous. Others believe that the cells of the mouth
have b}' long-continued fights, acquired sufficient power of resist-
ance to tolerate the presence of pathogenic organisims without
prejudicial effect much as the general system eventually tolerates
certain drugs in large doses, which at first would have caused
death. Again it is thought by others that there is a constant fight
going on in the mouth between the harmless and harmful varieties
of microorganisms, largely in favor of the former. Miller quotes
authorities who find but few pus-forming organisms in the mouth,
which gives color to the belief that this last theory may be correct,
at least to a certain degree. It is altogether probable that each
theory contains a part of the truth, and that all combined more
fully explain the question.
Inflammation of the gums may be expressions of dis-
ease affecting the whole S3'stem, such as S3'philis, scorbutus,
mercuralization or exanthemata, or from continuit}' of tissue
as pericementitis, the so-called pyorrhoea alveolaris, osteitis
tonsilitis, etc., or it may arise from traumatism from malignant and
nonmalignant epuloid growths, or from aphtha\ Among the more
common causes of ulitis, excepting perhaps that caused by pyor-
rhoea alveolaris and pericementitis, are accumulations of tartar,
wedges for separating teeth, rubber dam, and appliances for its
retention, temporary approximal fillings, poorly shaped interdental
spaces either natural or caused by improperly shaped fillings, lac-
954 THE DEXTAL REVIEW.
eration of gums while polishing fillings, the lodgment of insoluble
particles between the gum and the necks of the teeth, such as
parts of toothpicks, the inner shells of peanuts, insoluble den-
tifrices, polishing powders, by the eruption of third lower molars
where there is lack of space, the careless use of arsenic, plates for
artificial teeth, badl}- fitted crowns and unscientifically constructed
bridges, and last but not least the lack of friction and of personal
cleanliness.
I pass over without discussion several of the above named
causes of ulitis because their treatment is either self-evident or be-
cause they are so seldom seen as to need but mere mention in a
paper of this kind.
Whether aphtha* is a specific disease of the mucous membrane
of the mouth and gums, or is an expression of a disease in some
other organ or part of the body is a question. I incline to the be-
lief that it is a disease of the mouth, caused by specific organisms.
One reason for this conclusion is that it seemingly yields perma-
nentl}' to certain local antiseptic treatment, that is, to the use of
the water of the oil of cassia. Aphthous ulcers rarely originate in
the gum, but there is a class which is frequently found at the
duplicature of the gum and the mucous membrane, the inflamma-
tion of which generally extends into the gum tissue. This class of
aphtha,' is too well known to need description. Formerly I used
internal as well as local treatment for these ulcers, but at present
depend wholly upon the water of the oil of cassia applied locally.
Another form of ulitis resembling aphtha^ but if aphtha of
wholly a different type, is described as follows : Patient presents
with gums somewhat swollen, very red, exceedingly painful to
touch, thick ropy saliva and foul breath. Upon closer examina-
tion the gums appear to be covered with minute ulcers or abra-
sions, and overlying the entire gum is a thin film of yellowish
white substance having the appearance where it has accumulated
more thickh', of being coagulated albumen, but under the micro-
scope is found to be cast off epithelial cells, microorganims and
mucus. I have not seen an exact description of this condition,
though have frequently met it clinically. I believe it to be a
catarrhal inflammation of the gums. Usually it is only transitory,
yielding readily to antiseptic treatment.
A good deal has been said lately regarding injuries done to
the gums in the interproximate spaces, in consequence of unsci-
ORIGINAL COMMUNICATIONS. 955
entifically shaped fillings, the use of wooden toothpicks, temporary
fillings, etc. I am of the opinion that we may profitably continue
the discussion of this phase of the subject. It is certainly not
uncommon to have patients complain bitterly of extreme sensi-
tiveness between certain teeth which have been filled, and upon
examination we easily comprehend the cause. In a majority
of cases the cause may be removed by sufficient separation by
wedging of the teeth, and by the restoration of the contours.
There are some cases which are not so easily cured, such as this
for instance: two molars on the lower jaw, one of the teeth hav-
ing been filled and imperfectly contoured; the other being only
about two-thirds the length of the former, giving such shape to
the space between the two as will permit the lodgment and re-
tention of particles of food in it, making pressure upon the gum
and causing inflammation.
Inflammation of the gums caused while polishing fillings, both
by laceration of the tissue and by the leaving of insoluble particles
between the teeth and gums is not uncommon. Besides the tem-
porary injury resulting from the use of polishing strips, discs, files,
etc., there is often serious permanent injur}' done by them in the
destruction of the gum septum, which may result in depression in
the gum between the teeth, affording opportunity for the lodgment
of irritating substances which not only cause gingivitis, but injury
to the peridental membrane as well. In order to remove insoluble
substances left from polishing fillings, it is desirable to forcibly
syringe the parts with warm water.
Gingivitis from badly fitting crowns and from unscientifically con-
structed bridges is yearly becoming more common. It is the excep-
tion rather than the rule to find a perfectly fitted crown. It is really a
difficult task to perfectly fit bands to all roots. Had we always
typical cases it would be different, but these are not the rule. It
is probable that the future will show that this kind of work (imper-
fect crown and bridge work) will prove a fruitful cause of inflam-
mation, not only of the gums, but of the peridental membrane.
Usually in such cases the treatment indicated is the removal of the
crown or bridge and the more perfect adaptation of it. Inflamma-
tion of the gum on the lingual side of the teeth in the mouths of
persons who wear partial artificial dentures may sometimes be ac-
counted for by lateral motion of the plates, the rough edges of the
septum of the plates resting between the teeth, and the poor care ex-
956 THE DEXTAL REVIEW.
ercised by the wearer. There is a form of ulitis which is ver}' common
and usually results from lack of care and lack of friction. The
degree of inflammation varies from that exhibited by a slight red-
dening of the edges of the free margins of the gums to great ve-
nous congestion of the entire gingival border, v/hich bleeds at the
merest touch. There ma}' or may not be accumulations of tartar,
but ahvaj's more or less of soft deposits about the necks and be-
tween the teeth ; sometimes there is a bright line of granulation
tissue at the margins of the gums and the breath is offensive. This
condition of the gums is treated by thorough cleansing, by scarifi-
cation of the festoons and by the application of a solution of the
chloride of zinc. But in order to insure anything like a permanent
cure the cooperation of the patient is necessary, as the teeth and
gums must be thoroughly brushed at least twice a day. To do this
I prescribe listerine and water of each .^iji and direct the patient to
first thoroughly brush with water and then as thoroughly repeat
the operation with the wash. By this means I secure a good deal
of friction and very thorough cleansing.
Ulitis caused by the difficult eruption of the lower third molar
is often very serious; it is not uncommon to see the inflammation so
intense that the jaws are nearly closed by muscular induration, and,
indeed, necrosis may follow. The pressure of the incoming tooth,
or the insinuation of irritants between the gum and the incoming
tooth, are primary causes which ma}' be augmented by the striking
of the upper surface of the gum by the opposing tooth. If the in-
flammation be great when the patient is first seen, it is well to make
antiseptic and palliative applications and antiphlogistic treatment,
at the same time giving the parts rest by slightly separating the
upper from the lower teeth, using for this purpose phosphate of
zinc on the cutting edges of the teeth. When there is a subsi-
dence of the active conditions I remove either the gum over the
tooth or the tooth itself, as the case indicates. Formerly I re-
moved the gum by the use of curved scissors, latterly have em-
ployed with great satisfaction the electric cautery, forming the
electrode into a shape so as to remove all the tissue I wish to cut
away at one application of the cautery, using cocaine to lessen the
pain. This method is easier for the operator, less painful to the
patient and more satisfactory to both. I have left out of considera-
tion much that properly belongs to the subject, lest the length of
my paper should unduly try your patience.
ORIGINAL COMMUNICATIONS. 957
Hypertrophy of the Oral Mucous Membrane.*
By Louis Ottofy, D. D. S., Chicago, III.
The mucous membrane of the oral cavity is subject to a num-
ber of affections; but these are principally confined to that por-
tion of it known as the gingivae or gums. The consideration of
the affections of the gingivae is not included in this paper.
The oral mucous membrane is continuous with the external
covering of the body at the beginning of the alimentary canal ;
it can be traced, commencing at the lower lip, covering its inter-
nal surface ; it is then reflected upon the external surface of the
inferior maxillary bone ; at the juncture of the bone and soft tis-
sues it forms several folds, one opposite the center of the mouth,
the fraenum of the lower lip, and one on each side correspond-
ing to the location of the second bicuspid tooth, which may prop-
erly be designated as the inferio}- buccinator frcenum. Passing
upward on the inferior maxillary bone the mucous membrane
reaches the necks of the teeth, passes between them and around
the last tooth on each side, it then continues down on the posterior
surface of the bone, forming directly in the center, immediately
behind the central incisors, a fold, the fraenum linguae ; it then
forms the floor of the mouth, is reflected upon the tongue, cov-
ering its base, sides, and dorsum, continuing back, it becomes the
mucous membrane of the fauces, larynx, pharynx, etc. Beginning
at the juncture of the upper lip with the skin, the mucous mem-
brane lines the internal part of the lip, and at its juncture with the
superior maxillary bone, forms several folds ; one directly in the
center of the mouth, above and in front of the central incisors, the
fraenum of the upper lip, and one on each side corresponding to
the location of the second bicuspid tooth, the superior buccinator
frcEnum; it then covers the external surface of the superior maxil-
lary bone, passes between the teeth and behind the last tooth on
each side, covers the palate, and in being reflected upon the mus-
cles attached to the posterior part of the palatal processes of the
superior maxillary bones, becomes the soft palate, it is then con-
tinuous with the lining membrane of the nostrils, the various sin-
uses, lachrymal ducts, Eustachian tubes, etc. Strictl}' speaking,
the gum is that portion of the mucous membrane of the mouth,
covering the hard tissues; that is, the maxillary bones. In no
*Read before the Chicago Dental Society, Nov. 1, 1893.
958 THE DENTAL REVIEW.
Other part of the body do we find osseous structures covered by
mucous membrane.
That portion of the mucous membrane known as the gum is
most frequently subject to diseases; this, in some measure, is due
to the fact that (1) this portion of the mucous membrane has a
much lower vitality, and (2) that it is more frequently exposed to
abrasion and injury by reason of its unyielding basis and its more
ready contact with hard substances contained in food, and (3) also
as a result of the deleterious effects of whatever abnormal condi-
tions may exist about the teeth, the interdental spaces or cervical
margins.
It is surprising that the delicate mucous membrane, which is
so frequently exposed to dangerous influences and is the habitat of
many species of countless numbers of microorganisms, is not more
frequently the seat of disease. The diseases to which the mucous
membranes of the mouth (the gums excepted) is liable are gener-
ally either of a local inflammatory nature, due to long-continued
irritation, abrasion and eventual infection, or to constitutional dis-
turbances. The inflammations are catarrhal, croupous, diph-
theritic, ulcerative and gangrenous. While among other affections
we have : Aphtha:?, aphthous or follicular ulceration, cancrum oris,
cellulitis, gummata, epithelioma, tubercular ulcers, mucous plaques,
adhesions of the mucous membrane and the gums, scorbutic, gas-
tric, syphilitic and mercurial stomatitis.
While hypertrophy of the gums, alveolar processes and maxil-
lary bones has been noted with sufficient frequency to deserve
record as pathological conditions, hypertrophy of those portions of
the mucous membranes of the oral cavity, to which I am about to
direct your attention, is not described in any pathological work.
It is a well-known physiological condition that the muscula-
ture of the lips and cheeks during mastication is constantly en-
gaged in an effort to maintain the food on the masticating surfaces
of the teeth ; in order to accomplish this the muscles involved are
continually contracting and relaxing, and thus forcing the food
from the outer vestibule into the inner, where the tongue is making
a similar effort to force the food into the outer vestibule ; if these
acts are uniform and constant the result naturally follows that the
food must remain on the masticating surfaces of the teeth. If the
teeth have been lost on one side of the mouth, the food which
escapes on that side into the outer vestibule is forced into the inner
ORIGINAL COMMUNICATIONS. 9r)9
vestibule by the constant, energetic and forcible contractions of the
buccinator muscle, when the presence of food is there recognized
by the tongue it is placed onto the masticating surfaces of the
teeth of the other side. If the teeth are absent on both sides the
buccinator muscles of both sides, during mastication, are constantly
contracting in order to prevent the food from escaping into the
outer vestibule and to enable the tongue to gather the food and
form the bolus. This constant excessive exercise of the muscula-
ture of the malae is followed by the deposition of fat, an increase of
the aereolar tissue and muscular fibers, resulting in a true hyper-
trophical condition of the cheeks and the mucous membrane.
All dental practitioners have observed more or less marked
cases of this character. In two instances, now within my recollec-
tion, where the loss of all the teeth on one side, above and below,
posterior to the cuspid, had been of some years' standing, the en-
largement of the malar tissues was so marked that when the mouth
was closed and the lips, cheeks and tongue were at rest, the malae
could be observed to have increased in size until the entire space
formerly occupied by the teeth was filled with tissue which was
even in contact with the tongue. In one of these cases the diam-
eter of the normal cheek opposite the second molar was a fraction
less than one-half an inch, while the diameter of the abnormal tis-
sue had increased to \yi inches.
Some difficulties are always encountered in the substitution of
artificial teeth in these cases, the constant effort of the buccinators
to fill the spaces formerly occupied by teeth has resulted in the de-
velopment of considerable muscular power, and this materially in-
terferes with the retention of artificial dentures. As a general rule,
the buccinator fraenum is well marked and considerably developed;
when this is the case, a corresponding depression in the substitute
should be provided for. In one of the cases above referred to, it
was impossible for several months to close the mouth without first
raising the cheeks by means of the fingers or running the risk of
lacerating the mucous membrane. Eventually, however, the hy-
pertrophied mucous membrane receded, became reduced in extent,
so that at the end of a year, if the dentures were removed and when
all the soft tissues of the mouth were in repose, the space occupied by
the artificial teeth could be plainly seen ; that is, the mucous
membrane did not at once relax into the space usually occupied by
the artificial teeth. This hypertrophied condition is the cause of
060 THE DE.XTAL REVIEW.
many of the difficulties encountered in the retention of artificial
teeth in old age, especially if the mouth has been in a " for rent "
condition for many years. Hypertrophy of the mucous membrane
is not so marked when all the teeth have been removed, as when
only those of one side have been lost, and, as far as I am aware,
the enlargement never extends beyond the filling up of the vacant
space, or until the cheeks are in contact with the tongue, which ob-
viates any further necessity for enlargement. Because of this self-
limiting nature of the hypertroph}', no surgical interference is ever
resorted to.
In connection with this subject I desire to relate a case iden-
tically the opposite to the condition just described — a case of atro-
phy of the mucous membrane and superior maxillary bones.
A lady, about forty years of a^e, had at various times teeth
removed until she had lost all of the lower bicuspids and molars,
and all of the upper incisors. This was the condition seven years
ago. An upper plate having four incisors was inserted. The
lower incisors and cuspids were the only teeth coming in
contact with the upper denture; gradually they pressed the plate
up, until some absorption had taken place, and at the same time,
the lower six anterior teeth acted as a wedge passing between the
upper cuspids and spreading the upper arch. As a natural conse-
quence the plate became loosened, and the teeth were driven up; the
lady then made a small roll of muslin which she placed above the
artificial incisors, but as the same conditions existed the teeth were
forced up still further, thus necessitating the addition of more
muslin, until, at the present time, the size of the roll when moist
is six-eighths of an inch in length and five-eighths of an inch in
diameter. As a remedy lower and upper partial dentures were
constructed. To prevent the upper plate from being too heavy,
the rubber filling this space was made hollow, by packing the in-
terior with cotton. The absorption of the osseous tissue was so
extensive that the entire surface, where the underlying nerve trunk
was almost exposed, is exquisitely sensitive. As the lower denture
prevents the impingement of the lower anterior teeth on the upper
plate, I believe that the process of absorption is arrested.
PROCEEDINGS OF SOCIETIES. 961
PROCEEDINGS OF SOCIETIES.
Chicago Dental Society.
Regular meeting, November 2, 1892, Dr. J. W. Wassail, Presi-
dent, in the chair.
Dr. Louis Ottofy read a paper entitled "Hypertrophy of the
Mucous Membrane of the Mouth.
Dr. C. S. Case, (opening the discussion): Mr. President and
Gentlemen: When I was asked about a week ago to open the dis-
cussion on this paper, I tried in every way I could to have Dr.
Ottofy let me off because of the high-sounding title he has given to
the paper. I do not know that I know anything about the subject.
I heard a portion of the paper read to-day by Dr. Ottofy, but have
had no time to think of the subject myself. Still there are two
things in the paper that to me, so far as giving a definite name to
them, are new, and that is relative to hypertrophy of the mucous
membrane of the mouth so called by the essayist, and the name
for the buccinator fraenum. I believe that anatomists have
not recognized the attachment or fold of the buccinator muscle
sufficiently often to satisfy them to give that name or any
name distinctly to it. Every dentist, of course, is aware that the
buccinator muscle attaches to the superior and inferior maxilla so
as to form a fold, but this does not always occur. Just before
coming here to-night, while sitting with some gentlemen before we
commenced to dine, I went around the party and examined four
mouths with a view of ascertaining the relation of the fold which
the essayist terms the "buccinator fraenum" on the lower side.
Of the four mouths I examined, one gentleman had a fold upon one
side and none had it upon the other (lower). Another one of 'the
party had no fold of the muscle on either side of the mouth, and
another had quite a prominent distinct fold of the buccinator mus-
cle upon one side only. The same was so with the fourth gentle-
man. All dentists have recognized this peculiarity of the buccina-
tor muscle, sending out fasciculi of that muscle, producing quite a
prominent attachment to the bone upon one side. I think it oc-
curs more often on the upper side, and it is possible that a name
should be given to it recognizing that fact which occurs so fre-
quently. The practical part to us is that recognition should always
be taken of this in constructing artificial dentures, especially on the
;)62 THE DENTAL REVIEW.
lower side. Wherever it occurs it is usuall}' marked by the im-
pression which is taken in plaster and will often leave a sufficient
depression at that point to enable the dentist to mark it well
enough so as to cut awaj^ sufficient of the plate in order that it will
not recede on that account.
In regard to hypertrophy of the mucous membrane, dentists
have all recognized that enlargement of the cheek or a tendency
toward falling in of the mucous membrane of the cheek where
teeth have been extracted, due to the muscular effort during mas-
tication or from a general tendency of the tissue always to fill
space in that way. Whether this is true of hypertrophy of the
mucous membrane I cannot say, because I do not know; but the
very fact that the tissues and the muscles tend to force themselves
into this space, tend to drop toward the maxilla after it has be-
come absorbed and occup}' these spaces, makes it oftentimes quite
a difficult thing to retain lower dentures in position if the
muscles have been allowed to retain that place for any length of
time. I think this is largely due to the fact that dentists do not
shape the borders and the buccal and labial surfaces of the arti-
ficial dentures properly. We find in almost every instance in
which artificial dentures are constructed, instead of taking the
natural shape of the original gums, that they take or assume a
shape that is entirely unnatural — a bulging out, if you please, of
the surface of the plate, both anteriorly and along the border. If
I may go to the blackboard, I would like to explain one particu-
lar feature which seems to me quite practical in regard to that.
Let us suppose that we make a transverse section of the jaw at
the second molar of the lower side. The gum starts out there and
forms a very distinct prominence or ridge, and then drops mark-
edly in and back again similar to that (illustrating) along the buc-
cal surface of the jaw. You can confirm that by putting it along
the side of the lower jaw, you feel distinctly the permanent ridge
dropping back on the anterior surface of the lower side. If I
should make a transverse section of that I would find that the
contour of the natural gums would be a decided depression at
at that point, and then starting in this (pointing to blackboard)
direction. The muscles have been in the habit, if you please, of
laying in over that depression both on the anterior side and along
the buccal surface. But what is the shape of the plate that is
constructed ? A rubber plate. I think you will more often find
PROCEEDINGS OE SOCIETIES. 963
that the plate is shaped in this direction (illustrating) on the side
than otherwise — at least, it has a rounded portion, and this portion
is cut away in order not to rest upon the muscle in the position
which 3'ou see. You take any lower denture and insert it into the
mouth, if the muscles have been in the habit of dropping into
that surface, instead of hitting the plate, the tendency of the mus-
cles is to drop underneath the plate and lift it up; whereas if it
had a depression at that point the muscles would fold in upon it
and tend not onl}- by their influence in holding it in position, but
would produce an atmospheric force that tends alwa3's to hold a
plate because the air does not extend beyond. Of course, this ten-
dency of the muscles is increased by any force which might have
produced a hypertrophied condition, as the essayist has maintained,
under those circumstances.
Dr. T. L. Gilmer read a paper on "Ulitis."
Dr. George J. Dennis, (opening the discussion): Mr. Presi-
dent: In the first place, I desire to express my appreciation of
both the papers, and in regard to ulitis, the subject upon which Dr.
Gilmer has written, I must say that Dr. Gilmer has so thoroughly
covered the subject that he has left ver}' little for me to discuss.
Ulitis, however, ma}^ be idiopathic or symptomatic. The line be-
tween the idiopathic and symptomatic forms is so obscure in many
cases that it is difficult to pronounce them either the one or the other.
For instance, the disease that Dr. Gilmer spoke of, aphthae, is one
that is very difficult to pronounce as being either idiopathic or
symptomatic. We find inflammations of the gums are caused by
mechanical means in many cases, and under this head we may
class all inflammations arising from decay, that is, inflammation
where we have an hypertrophy of the mucous membrane which
extends into the cavity of the tooth before the operation of filling.
The edge of a proximal cavity may be roughened, and that will
produce such an irritation that in a short time a small tumor will
be formed which will rise into the cavity and partially, if not en-
tirel}', fill it. Again, we have hypertrophies coming more under
the head of Dr. Ottofy's paper, but yet in the form of inflam-
mation which maj- be designated as ulitis, that is, an hyper-
trophy of the mucous membrane around the necks of the teeth
caused by badly fitting dentures. In many cases partial dentures
are constructed so that they do not come up close to the teeth.
When such is the case we find that there is an elevation of the
904 THE DEXTAL REVIEW.
mucous membrane usually more marked in the upper jaw, and
find it passing down between the plate and the teeth, sometimes
almost to the morsal of the teeth. The same thing very frequently
occurs in the lower jaw, although not to the same extent as in
the upper. In connection with crowns and bridges we find that
wherever bands are placed around the teeth eventually there will
be more or less inflammation. I prefer myself to place bands
around teeth for crowns. The objections, however, made by Dr.
Case to the use of bands around the necks of teeth are well taken.
We very often do have irritation from a well-fitting band. In
many cases the irritation of the gums is quite marked and the
gums very painful. If we had any substitute for bands, or any-
thing that would be better, I should certainly use it.
Other mechanical causes of inflammation of the gums are the
use of wooden toothpicks, by which pieces may be broken off and
remaining beneath the festoon of the gums cause intense inflamma-
tion. Other hard pieces of wood or peanut shells or materials of
that kind are frequently found as well. In this connection I wish
to speak of a case that occurred in my own mouth in which a wood-
en toothpick was used. I suffered with intense pain for two weeks
with it. The toothpick was forced between the first molar and
second bicuspid. I did not know it was there, except that the pain
afterward became so intense that I supposed that death of one of
the pulps in one of the teeth was the cause. After suffering two
weeks the toothpick was found after taking out the fillings in the
two teeth. It is needless to say that no dead pulp was found.
In regard to the saliva being an antiseptic and preventing the
formation of septic diseases of the mouth, I cannot give my assent
to that. I believe in the theory, however, that the tissues of the
mouth have, by long-continued usage in fighting against different
forces that we find in the mouth, become hardened in a great de-
gree, and that they become in that way more capable of resisting:
injuries and inflammations. Furthermore, I believe in another
theory, namely, that the constant irrigation of the mouth by the sa-
liva is a greater influence in increasing the resistance of the gums
to septic as well as other inflammations. We have in addition to
those diseases that are thoroughly symptomatic, syphilitic, scor-
butic and mercurial diseases, as well as affections caused by lead
poisoning. Tonsilitis is another inflammation that is symptomatic
PROCEEDINGS OF SOCIETIES. 965
in a great degree. The inflammations arising from exanthematous
diseases are also symptomatic.
In regard to badly fitting plates I may return to that. I wish
to speak of the suction chambers we find in plates, they are a pro-
lific cause of chronic inflammations of the mucous membrane of
the mouth ; and I may add that rubber plates, in themselves, are
also very prolific causes of inflammations of the mouth. These in-
flammations are seen constantly and need very little more than to
be mentioned.
Interdental spaces have received so much attention at the
hands of Dr. Black and others that I will not refer to this phase of
the subject at the present time.
In addition to the inflammation mentioned by Drs. Gilmer and
Ottofy, I find in looking over the literature of the subject an in-
flammation that is peculiar in many respects and is new tome, and
it is a proliferating ulitis found in the mouth of pregnant women.
We find tumors of a fibrocellular nature extending along the buc-
cal surfaces of the gums, well formed at the fourth to the sixth
month of pregnancy and present almost the appearance of cancer,
till finally after the delivery of the child they disappear without any
especial treatment in the second or fourth month after delivery.
There is another form of inflammation of the gums that I no-
ticed in looking over the literature, which was given the name of
stomatitis and pharyngitis and spoken of by Dr. Garretson.
It occurred in a man forty years of age. For fifteen months
there was gradual swelling of the glands of the throat, and an in-
flammation of the mucous membrane of the mouth and pharynx.
There was flaccidity and haemorrhage of the gums, swelling of the
axillary and inguinal glands, also of the liver and spleen. No cause
could be ascribed except overwork, both mental and physical. The
throat was of special interest, for over its surface were spread
numerous medullary elevations which had a smooth shiny appear-
ance ; both tonsils were enlarged with the appearance of dense
medullary knots. All secretions of the mouth and larynx were in-
creased. Reaction was acid ; no previous disease of the mouth or
throat. The attack of pharyngitis came on only after enlargenu nt
of the lymphatic glands of the neck, and with their increase or dim-
inution the throat became worse or better. The peculiarity of this
case was that under iron and quinine the patient recovered.
In another class of cases I have noticed the peculiar appear-
966 THE DEXT.IL REVIEIV.
ance which has been noted b^' Dr. Gihiier, as occurring without
any especial general disease. In my own cases the swelling and
inflammation of the mucous membrane around the teeth with
bleeding and intense pain oftentimes, not alwaj's, was associated
in most cases with other diseases. For instance, I have noticed it
in cases where there has been hip-joint disease or in rachitic pa-
tients. I have noticed it in patients who had had Pott's disease,
and I have had it also called to my attention by physicians who are
in active practice. The same condition is noted in typhoid fever
and is one of the marked features of that disease.
Dr. T. W. Brophv: I was very much pleased with the papers
and also with what has been said in the discussion. It seems to
me the paper on "ulitis" should have been read first, as it very
frequently precedes hypertrophy of the mucous membrane of the
mouth. We have not had papers of this kind presented to the
society for a number of years. I expected that in the discussion
of the first paper Dr. Case would say something about the hyper-
trophies which very frequently result from the retention of tempo-
rary dentures too long. It is a fact well known to every observing
dentist, that artificial temporary dentures that have been in use for
six or eight months are a fVuitful cause of hypertrophy of the mu-
cous membrane — so much so that in some instances they lead to
quite marked extension of growths upon the surfaces of the ridges.
It has been my duty during the last few years to remove compara-
tively large sections of growths of hypertrophies of the gums
which have come on slowly from temporary artificial dentures long
beyond the time when they should have been replaced by better
fitting ones. I say temporary artificial dentures. I think every set
of artificial teeth is a temporary affair, no matter what it is made of
and no matter how well it may be made. At the end of one or
two years — five years at the longest — the natural order is for the
alveolar ridges to atrophy as time goes on after the loss of the nat-
.ural teeth, and atrophy permits the artificial denture to settle
down or up, as the case may be, until the borders of the plate im-
pinge upon the mucous surfaces at points where they should not.
Often the result is hypertrophy of the mucous membrane, and
where this ends nobody can foresee. So frequently does it hap-
pen that these irritations lead to abnormal developments of a ma-
lignant type, which terminate only in death.
The second paper, speaking of ulitis, or an inflammatory condi-
PROCEEDINGS OF SOCIETIES. 967
tionof the gum tissue, is tome an interesting one, and many of the
causes of this inflammation of the gum tissue were given. The gentle-
man who opened the discussion (Dr. Dennis) on the paper enumer-
ated a number of other causes; but he omitted speaking of an inflam-
mation of the tissue which comes from the effects of phosphorus.
We see Httle of that in this city, but in the East inflammation
of the gums and affections of the maxillary bones, particularly the
lower one, are very common. Whether this is due mainly to the
inhalation of phosphorus and its action through the circulation or
its local action has never been settled. Phosphorus has a special
predilection for the lower jaw and gum tissue of that jaw. In act-
ing upon these tissues it leads to the loss of teeth the same as from
the poison of murcury, or ptyalism. This has been a purely path-
ological discussion this evening. There has been nothing said in
regard to treatment except what was stated by the second paper
as to local applications for the purpose of cleansing mucous
surfaces, etc. I have one suggestion to offer in regard to the
treatment of inflammation of the gums from any cause — namely,
first to remove the cause of the disturbance, then resort to free
blood-letting of the tissues, allowing the excess of blood to es-
cape and thus permit the circulation to go on normally.
Dr. L. L. Davis: There is one cause of inflammation of the
gums that has not been mentioned by either of the essayists and
which I think of just now because I have so recently read a paper
on the subject. It is excessive tobacco smoking or chewing. It
is not strictly an hypertrophy in cases of chewing, but more an
atrophy.
Dr. p. J. Kester : I hold in my hand casts which I took
last Saturday and which are the type of cases we are all meeting
with. These casts show clearly the effects of trying to cleanse the
teeth with a wooden toothpick. I have claimed for some time that
the use of the wooden toothpick, perhaps more than anything
else, has brought about an inflammatory condition of the gums
which is very common. I refer now to an hypertrophy of the gum.
It is not an hypertrophy of the gum proper, but rather an exostotic
formation, an enlargement of the alveolar ridge itself, which I
believe is due to the irritation of the peridental membrane by the
presence of insoluble substances. Of course, tartar will produce
that condition. An accumulation of tartar about the necks of
teeth will impinge upon the membrane sufficiently to produce
968 THE DENTAL REVIEW.
slight inflammation of the periosteum overlying the process which
will proliferate bone tissue, and the use of the wooden toothpick
has become so marked in my mind, that as at one time I felt I
could distinguish a set of teeth that were cleansed with soap, so I
have come to the conclusion I can tell a set of teeth in ihe
mouth wherein the wooden toothpick has been habitually us"d.
The cast which you see is a poor one, because I did not have nerve
enough to take a plaster impression of the mouth, as the patient
was a stranger. It shows, however, that the alveolar border is en-
larged, and at one point of the bicuspids on the right side, it
shows a granulated condition, which is not in the gum itself, but a
projection from the alveolar process. The gum is thickened, and
the interpro.ximal spaces have been entirely destroyed. The sep-
tum between the gum is gone, and the opening between the teeth
is perhaps one-eighth or one-quarter of an inch in some cases.
This seems a very small matter. The wooden toothpick is so com-
mon that it is found everywhere, and is constantly being placed
before us. Wooden toothpicks are simply of no benefit; you get
particles of the wood between your teeth and if you get sufficient
of them you have to take something to remove them. We ought
to instruct our patients to the effect that there is a certain element
of danger attending their use. It is not a cleanly thing to be chew-
ing and picking out particles of mucous membrane, as it does not
cleanse the teeth at all. What can be done with a jaw after it has
gotten in this condition is for you to say. If the patient came to
you at an early age you might treat the condition so that the gums
would approach the normal.
Dr. G. S. Salomon : I do not know that I have very much to
say on the subjects that have been brought before us this evening.
There is one matter that has been overlooked altogether by both
the essayists, and that is the modern way of most of the dentists
of inserting crowns. I have reference to ready-made crowns and
Logan crowns. I think there is nothing as poor for the dentist as
a Logan crown. I think the space left between the crown and
root causes more inflammation of the gum than anything else I
know of. A poorly fitting band may cause inflammation and it does
so, but the space which is filled up by cement and the cement
afterward washed out gradually will cause more irritation than in-
flammation of the gum. Ulitis is one of the great dangers in
dentistry, and I think our dental depots are to blame to a great
PROCEEDINGS OF SOCIETIES. 969
extent because they are offering such things to the dentist as will
make him slovenly in his work. These dentists would be much
better men if they did not have ready-made and Logan crowns to
select from. If teeth were crowned properly and the bands fitted
to the roots and students taught how to fit bands properly, we
would have less ulitis than we have to-day. I thmk it is often a
cause of hypertrophy of the gums as well. Dr. Dennis remarked
that a cavity under the gums would cause hypertrophy of them,
and I think the space between a Logan crown and the root of a
tooth will cause the same condition.
There is one more phase of the subject that I desire to touch up-
on, which is often a cause of inflammation of the gum when we can-
not assign a reason for it. I had a case not long ago in which I tried
to retain a tooth in the mouth. I finally had to extract the tooth.
The tooth was perfect in ever}^ respect, except the patient was suffer-
ing intense pain and inflammation of the inner portion of the
gum. I extracted the tooth, and to my astonishment after the
tooth was out I discovered that the tooth was pushed out at the
end of the root and pushed up under the gum. Had I known what
it was at the time I first saw the case I might have saved the tooth.
So in this way we may lose teeth and not know where the trouble
originated.
Dr. C. F. Hartt : Dr. Gilmer spoke of friction in his paper,
I have for a long time, although I do not know whether it is wise
to do so, recommended my patients to chew gum — the old-fashioned
spruce gum. I think that if there is any injurious effect that conies
from chewing gum, it is from a loss of saliva. I believe the teeth of
gum chewers are not as much decayed as the teeth of those who
do not use it and their gums are harder and better.
Dr. Gilmer recommends the removal of badly fitting bands
and crowns for the cure of inflammation. That frequently is neces-
sary, but I am in the habit, when a patient conies to me with inflam-
mation of the gums, of taking a sharp file, and filing down all the
little inequalities I can find and burnishing the crown over again.
Frequently it is all that is necessary.
Dr. Ottofv (closing the discussion): I wish to refer to two
points not mentioned by those who discussed the subject. Notice
the distinction I made between the " gums " and the " mucous mem-
brane." In looking up the literature I have not found anywhere
a statement of a conclusive way to determine where the "gum"
970 THE DENTAL REVIEW,
ends and where the "mucous membrane" begins. I make the
distinction, that the "gums " extend as far as mucous membrane
closely covers bony structures. Such tissue as the "gums" is not
found anywhere else in mucous tracts.
The other point to which I wish to call your attention is, that
some of you seem to have the impression that hypertrophy of the
mucous membrane of the mouth is a pathological condition, which
it is not. An hypertrophied condition of the mucous membrane
and of the entire cheek may be perfectly physiological ; hypertro-
phy means over nutrition ; as for instance, after a full meal when
the liver is active, it is in an hypertrophied condition, which is
temporary.
If for any reason the vascular system is deranged and the heart
is doing an extra amount of work, the muscular tissue of the heart
is increased and we have an hypertrophied condition of the heart,
not necessarily a pathological condition. The cheeks are normally
overfed but not in a diseased state.
Dr. Brophy : If a part is hypertrophied, is it in an abnormal
condition ?
Dr. Ottofy : I would not say that this is an unhealthy condi-
tion. The fact that an organ has become enlarged, but is perform-
ing its function properly, may be pathological but is not necessa-
rily an unhealthy condition.
I do not wish to convey the idea that when mucous membranes
are hypertrophied, they are in a diseased condition.
The Dental Review.
Devoted to the Advancement of Dental Science.
Published Monthly.
Editor: A. W. HARLAN, M. D., D. D. S.
ASSOCIATE EDITORS:
Louis Ottofy. D. D. S. C. N. Johnson, L. D. S., D. D. S.
The Dental Congress.
The Executive Committee of the Columbian Dental Congress
having selected officers for this and other countries and filled nearly
all of the committees provided for by the constitution and by-laws
now appeals to the dental profession of the United States and
foreign countries for a generous effort in the field of exhibition of
new inventions and discoveries of any kind in the range of prothe-
sis, operative dentistry, or in fact all departments of science and
practice. It is hoped that no country will fail to send a representa-
tive to this congress to participate in the sessions as essayist, discus-
sion, exhibitor or speaker on some subject in which he is especially
interested.
Advance registration is especially desirable, as by that means
we can more certainly tell how to provide accommodations for visi-
tors and members. The local committee of arrangements, headed
by the chairman, will assist in procuring rooms and board from the
highest price to the lowest.
Do not have any hesitancy in telling the committee exactly what
you want and how much you desire to pay, per day or week, as the
city will be pretty well crowded nearly all the time during which
the Exposition will remain open. August is the one month when
the city of Chicago is least crowded by her own residents
and there will be no difficulty about getting accommodations at
that time. We hope that nothing will prevent the fullest attend-
ance from the profession at home and abroad.
9:2 THE DEXTAL REl'IEW.
To THE Readers of the Dental Review,
In severing my connection as associate editor of this publica-
tion, I desire to express to the editor, the several past and present
members of the editorial staff and publishers my sincere apprecia-
tion of their universal courtesy during the past six years. I regret
that circumstances compel ni}' resignation from the position which
I have had the pleasure and privilege to occupy during the past
six years. I also desire to bespeak for the Dental Review un-
limited success, and a continuation and extension of its sphere of
usefulness. May the profession be more worthy and dentists
better as a result of its existence. .
I trust the readers and contributors, will overlook my many
errors during the past six years.
Chicago, November 15, 1892.
Louis Ottokv.
The Congress.
Now that the permanent officers have been elected for the
coming Congress, and have settled down to work with a will, we may
look for even greater advancement than that made in the past.
They are taking up the work where the original committee left off,
and in passing we wish to pay a high tribute to the members of
that committee individually and collectively. Few men in the pro-
fession have the slightest conception of the immense amount of
work accomplished by that body. The members sacrificed time,
labor, energy, and money, to further the interests of the Congress,
and they were men whose time was valuable, whose labor is never
trivial, and whose energy could profitably have been expended for
personal benefit.
The profession owes them its sincere thanks, and should give
due credit to them for any success that may accompany the Con-
gress, on account of the proper impulses they have infused into the
project ever since its inception.
The officers have accepted a great responsibility in pledging
themselves to carry out the plans of the Congress to a successful
issue, and judging from the energy with which they are beginning,
the profession need have little fear of the result.
In fact everything looks favorable for the most pronounced
success. Every day adds new features and new enthusiasm, and
EDITORIAL. 973
we do not believe that ever before in the history of dentistry has
there been such a uniform sentiment in favor of any one project as
exists in regard to this Congress. Not only are v^^e in America en-
thusiastic over it, but foreign nations are fast catching the spirit of
the idea, and are organizing with a view to an active participation.
Foreign presidents have been appointed for every country having
dental representation, and in nearly all cases acceptances have al-
ready been received. Foreign dental journals are endorsing it ed-
itorially and otherwise, and urging their readers to attend and take
part in the proceedings. Dental societies in Paris and elsewhere
have passed resolutions in its favor and are arranging to send dele-
gates.
America must feel proud of the interest she is awakening in
the professional ranks of all nations, and American dentistry will
be placed on trial as it never has been before. The profession of
other countries expect a great deal of us at this meeting and we
must not disappoint them. The brightest minds from abroad will
be with us and we must give them something of value to think
about. We must not rely too much on the reputation of American
dentistry to carry us through, for just at this point we wish to em-
phasize the fact that America has not altogether a monopoly of
dental excellence. There are many progressive men in other coun-
tries who will put us to the blush unless we do something of unu-
sual merit.
This will be no ordinary meeting and no ordinary preparation
will suffice for it. Once more we appeal to our friends to leave
nothing undone which will add in any measure to the ultimate suc-
cess of this undertaking. C. N. J.
FvORRHfEA AlVEOLARIS.
Anything that will add to the resources of the dentist in
arresting the flow of pus from the pockets around roots of teeth
must be considered advantageous to the recipient and user as
well.
For a period of ten months we have been using the following
solution in the manner indicated : After the roots have been
cleansed of all deposits (when present), the edges of the alveolar
process have been scraped with small spoon excavators, breaking
down the necrotic process as far as possible. Following this the
974 THE DENTAL KEVIEIV.
pockets have been syringed with H. 0_, until the debris has been
removed.
Now, take twelve minims of oil of cassia and add to sixteen
ounces of distilled water. Agitate this from time to time for a few
days at a temperature of 70° F. , or upward. Very soon the oil
will be dissolved in the water.
To each ounce of the above add five minims of the officinal
dilute sulphuric acid. Agitate this until thoroughly dissolved.
This solution is to be injected into the pockets carefully and
slowly, having previously dried them as well as possible with paper
cones.
The solution is astringent and stimulating and according to
the latest experiments it is a bactericide of positive value. Should
the teeth feel sensitive the mouth may be rinsed with lime water
or soda water or any other alkaline fluid as weak ammonia water or
soap water.
We have continued this treatment at intervals of four days for
from four to five weeks with most excellent results.
In all cases where the teeth are very loose they must be made
firm by wiring with pure gold wire or banding them with narrow
gold or platinum bands cemented to the teeth.
When the acidity is too pronounced the treatment is alter-
nated with a 2 per cent solution of zinc iodide in water. When
there is much inflammation in the beginning of the treatment,
washing the pockets with boroglycerine water one to ten for four
or five days consecutively will be of advantage. When great
pain is felt on account of the depth of the pockets inject one
minim of vinum opii into each pocket when the pain will quickly
subshde. Holding hot water in the mouth from three to five
minutes will also relieve pain.
Close of the Volume.
The Dental Review begs to announce that the sixth volume
is finished with the current number. Our readers, we feel sure
must appreciate the fact that the labor of editing a volume of a
thousand pages yearly is no light task to assume in connection
with daily practice and other duties to perform. We must leave
to the appreciative or cursory reader the estimate of the value of
such work, and on our part we promise that the year to come will
EDITORIAL. 975
furnish the readers of this journal more and varied matter than it
has been our lot to present before. If you have not renewed your
subscription, now is the time to make up your mind, for 1893 will
soon be with us.
Merry ChristiMas and A Happy New Year.
To one and all, at home and abroad, we extend the compli-
ments of the season, and it is our hope that many readers of this
journal will come to the World's Columbian Dental Congress,
1893. All will have a hearty welcome and the best intellectual
treat of the century will be offered them. Chicago will don her
holiday attire for six months, from May 1st to November 1st, 1893.
Come prepared to stay a month at least and you will not regret
the time and expense. It will be education and recreation com-
bined.
University Extension Lecture Course.
An effort is being made to have a popular course of six lec-
tures on some scientific subject, to be chosen by representatives
from each of the dental societies of the city of Chicago. At pre-
sent about one hundred tickets have been spoken for by dentists.
In order to pay all the expenses of the course, one hundred
and sixty tickets will have to be sold. As this is strictly speaking
a dental circle, we appeal to our readers in Cook county to take
an interest in it, and make it a success at the outset. Any funds
remaining in the hands of the committee will be devoted to a pro-
per object — perhaps to the organization of another course at a
later period. Will you join this movement? If so send a postal
card to Dr. C. E. Bentley, corner State and Van Buren Streets,
Chicago.
DOMESTIC CORRESPONDENCE.
DENTISTRY IN GUATEMALA.
Letter from Geo. S. Nason, D. D. S., Omaha, Neb.
To the Editor of the Dental Review.
Dear Sir: — Guatemala or more properly speaking, Santiago
de Guatemala, is the capital of a republic of the same name. It is
a wonderfully interesting city and country but comparatively little
976 THE DENTAL REITEU'-.
known to the average citizen of the United States. I was a resi-
dent of the city of Guatemala for nearly a year, actively engaged
in the practice of dentistry, and became quite familiar with the
country's conditions, its people and their customs and characteris-
tics. The western coast is washed b}' the waters of the Pacific
Ocean, while a small area of the eastern portion abuts on the gulf
of Honduras, hence it enjoys a great versatility of climate with its
hot zones, temperate regions, and at times, decidedly cool localities.
It was a Spanish colony until 1821, when it became an inde-
pendent republic, and according to the census of 1880, contained
1,224,602 inhabitants. It is largely a mountainous country, but
richly watered. On the western side of the Sierras the verdure
is short and the streams, while very numerous, are consequently
small and rapid, but on the eastern side a number of the rivers
attain a ver}' considerable development. There are a number
of extensive lakes in Guatemala, and though some of the strata
of the uplands are essentially metalliferous, there are but few
mines of importance. There is some silver, lead, coal, marble,
but not in sufficient quantities to create any stir in the commer-
cial world.
The climate, excepting in the oozy lowlands along the coast,
is considered preeminently healthful. The hottest months are
April and May. In the summer (one month), the rainy season,
the mornings almost invariabl}' break with a clear sky, but al-
ways about midday the clouds begin to gather in great cumulous
piles, and soon the lightning flashes, thunder roars, and rain pours
down, forming rivers everywhere.
The fauna of Guatemala is closely allied to that of the
tropics, and is almost devoid of animals man considers danger-
ous, the jaguar being the nearest to this. Mexican deer have a
wide range, and there are tapirs, wild hogs and honey bears, rats,
rabbits and hares. The country is ricli in birds, from the king
vulture down to humming birds of wondrous plumage. The buz-
zard (in Spanish so-pho-lo-te, as near as I can spell it) predomi-
nates, as they are protected by the government (the only thing
that is), owing to their doing the entire scavenger work of the
country. There are alligators in great variety, bats, salamanders,
frogs, and toads.
The general character of the country induces a voluminous
profusion of insect life — after having scratched and smacked for
DOMESTIC CORRESPONDENCE. 977
a year, we hardly know which is most abundant the flea or mos-
quito. The city of Guatemala is the capital, and has about 60,000
inhabitants, and is well supplied with trambeas (street cars), elec-
tric lights, telephones, etc.
It is situated high above the sea in the midst of a fertile meseta
and is quite healthy. It is surrounded almost completely by bar-
rareas or ravines. It has wide, regular streets with roomy suburbs
like old Spanish-American towns. The houses, generally one-story,
are permanently and comfortably constructed, many with commodi-
ous courts and gardens. The plaza major is what we would
call the public square. It contains the venerable cathedral built
in 1*730, besides the Government buildings and public offices.
There are a number of large churches, the La Mercy with its
bleak image of the Virgin being reverenced greatly by the Indians.
Santo Domingo is the oldest place of worship in the town. There
are a number of educational and benevolent institutions, an excel-
lent museum, theaters, Palaceo de Toros (for bull fights), and two
fortresses.
The city's incredible prosperity has caused it to be dubbed,
especially by visitors and speculators from the States, as the Paris
of Central America. It has rail communication with the Pacific,
but not with the Atlantic, Honduras or Mexico, yet drives a most
thrifty trade with all. There are several cigar, cigarette, wool and
cotton factories. The coffee export is tlie chipf source of revenue,
although they realize considerable from bananas, sugar, gutta-
percha and hides.
As to the relative value of mone)', exchange fluctuating daily,
week in and week out, I think 35 per cent would be about right,
that is, between native silver and banknotes. Government money
not being worth the paper it is written upon. During my residence
in Guatemala the Government issued $3,000,000 which at first was
worth 100 cents on the dollar, but in less than two weeks it would
not serve to pay custom duties, and a dollar would not buy a ten-
cent postage stamp ; in fact, the Government repudiated its own
currency.
Dentistry is in a flourishing state, there being three American
and several native dentists in the cit}^
A vast difference between prices and skill of the American vs.
Guatemalaker dentist. For a full upper and lower on rubber the
American receives $100 (native money), while the native takes
978 THE DEXTAL REVIEW.
whatever he can get a la some American dentists I know of. Gold
and Richmond crowns, $50 : gold fillings, from $5 up ; amalgam
and cement, $5 ; extracting (with pain), $1 ; with cocaine, ;^2.
REVIEWS AND ABSTRACTS.
Mercuric Chloride ix Alcoholic Solutions.*
As dispenser to the Roj'al infirmar}- Mr. Johnson has to pre-
pare large quantities of dilute aqueous solutions of mercuric chlo-
ride, and he sought a method of obtaining such solutions with the
greatest expedition and accurac) . To weigh out and triturate the
mercuric chloride becomes tedious when large quantities of such
surgical solutions as 1 in .'500, 1 in 1,000, 1 in 2,000, etc., are con-
stantl}' in demand, and most dispensers keep, it is believed,
stronger solutions on hand from which to prepare the more dilute.
The chloride is soluble enough in man}' media, such as glycer-
ine, ether, absolute alcohol, rectified and methylated spirits, and
sufficiently strong solutions are easily, prepared from any of the
above solvents for the purpose in hand. Such a solution in gly-
cerine of the strength recommended in Martindale — viz., HgClj 2
parts, gl3'cerine by weight 3 parts — is convenient, since 1 fluid
drachm mixed with 4 pints of water equals a solution 1 in 1,000;
btit this solution, though apparently stable, is viscid and difficult
to handle with accuracy and speed. A solution in ether, though
apparently fairly stable, is liable to evaporate, thereby becoming
of uncertain strength. Alcohol, either as absolute alcohol, recti-
fied, or methylated spirit (280 grains in 4 fluid oz., of which 1 fluid
drachm mixed with 1 pint of water equals 1 in a, 000) is the most
convenient solvent and is used, it is believed, widely in hospitals
and surgeries. Unfortunately, however, the spirituous solution is
unstable. A reduction of the chloride takes place even while the
solution is being effected, and though never of large amount — often,
indeed, very insignificant — is sufficient to lead to inaccuracy. A
large number of experiments with solutions of the strength named
went to prove that the reduction of the mercuric chloride was
influenced by several causes, such as (1) strength of the spirit
employed, (2) kind and quality of the spirit, (3) exposure of the
♦Abstract of paper read by J. R. Johnson at a meeting of the Liverpool
Pharmaceutical Students' Society. From the Chemist and Druggist.
REVIE]VS AXD ABSTRACTS. 979
solution to light, (4) method of preparation, (5) length of time
the solution was kept, etc. The amount of reduction was always
indefinite and most uncertain.
The precipitate varied in appearance from flocculent thick
masses to a finel}^ crystalline and amorphous powder. In three
similar solutions prepared at the same time and in the same man-
ner, and allowed to stand for the same time (ten daj's), the re-
duction varied from 0.31 gramme to 0.18 gramme. The precipi-
tate consisted for the most part of mercurious chloride, though
organic compounds of mercurosum also were present. The re-
duction was generally less in absolute alcohol than in rectified
or methylated spirit. In the latter solvent the deposit was often
colored and flocculent, and of considerable depth. Light greatly
influenced the solution. Exposed to direct sunlight, the deposit
formed comparatively rapidly and in considerable quantit3\ It
was found that the less the light, the less the deposit. Solutions
kept altogether in the dark were often almost free from reduc-
tion. Agitation and large bulk of the solution appeared to favor
the decomposition, and the deposit was usually greater when the
solution was prepared by trituration of the salt in the solvent
than when the solution was effected by warmth. It was found
that the presence of ammonium and other inorganic chlorides was
of no use in preventing the reduction, and that the addition of
such compounds as chloroform, chloral, etc., to the extent of 1 per
cent onlj^ aided it.
After many fruitless experiments, free chlorine was passed through the solu-
tion for a short space of time with excellent results, with absolute alcohol, alco-
hol, methylated alcohol, or with 1 per cent CHCI3 ; though the deposit varied in
every case, complete re-solution of the deposit occurred at once when the chlorine
was passed through. Each of the solutions had been prepared in a similar man-
ner, and at the same time, and were of the strength already indicated.
The solution through which chlorine has been passed for five or ten minutes,
or until very faintly colored, remains perfectly bright and stable. Under ordinary
conditions of light and temperature, the solution keeps clear and unaltered for
any length of time; but if exposed to direct sunlight, a very slight reduction oc-
curs after some time. The chlorine is generated in abundance from two or three
drachms of chlorinated lime, to which dilute HCl is added, and a simple piece of
apparatus may be readily improvised and kept on hand for the purpose. Spirit
so chlorinated keeps indefinitely and is of the greatest utility. A question, how-
ever, arose as to whether the minute amount of free chlorine present would in
any way interfere with the germicidal powers of the aqueous solution made there-
from, and though at first sight it appeared to be unlikely that any such result
would follow, the opinion of Sir Joseph Lister was asked. He wrote thus:
980 THE DENTAL REVIEW.
Glenelg, N. B., Sept. 24, 1892.
Mv De.\r Sir : Your letter has been forwarded to me to this place. I have
no hesitation in answering your question to the effect that the presence of the
minute quantity of free chlorine cannot possibly interfere with the antiseptic ac-
tion of the bichloride. If it had any effect at all, it would be to enhance the an-
tiseptic efficacy. It might possibly make the solution act slightly more upon the
steel of the instruments. I may remark that, as the result of recent investiga-
tions, I have for some months past abandoned the use of the bichloride in favor of
our old friend carbolic acid. It has been shown that a 1 to 40 solution of
carbolic acid is really superior in actual germicidal power for such organisms as
cause inconvenience in surgery, as compared with any solution of bichloride that
could be used for surgical purposes. *****
Believe me, sincerely yours,
Joseph Lister.
P. S. — For purifying instruments and sponges, and the skin of the part to
be operated upon, a 1 to 20 solution of carbolic acid is, of course, used.
Although Sir Joseph Lister has abandoned the use of bichloride of mercury
in favor of carbolic acid, the former is still largely used, though we may expect
many to follow the example of the great surgeon in giving it up. There appears
to be some uncertainty as to the effect of heat upon aqueous solutions of mercuric
chloride. In "Martindale" there is a statement, concluding with a note of inter-
rogation, that "heat reduces the salt to calomel." Mr. Rushton Parker, one of
the honorary surgeons to the Royal infirmary, was anxious to be assured on this
point, and as the result of many experiments, performed quantitatively, Mr.
Johnson could not detect the slightest reduction of the chloride in such solutions
as 1 in 500, 1 in 1,000, 1 in 2,000, etc., even after submitting to prolonged
boiling.
Histology, Patholog}', and Bacteriology. A Manual for Students
and Practitioners. By Burnett S. Beach, M. D., Lecturer on
Histology, Pathology, and Bacteriology, New York Polyclinic.
Series edited by Bern B. Gallaudet M. D., Demonstrator of
Anatomy, College of Physicians and Surgeons, New York, etc.
Philadelphia, Lea Bros. & Co., Price, $1.00.
This Booklet is indispensable to the student in dentistry no less
than to the student in medicine, for whom it was specially prepared.
The whole series is a most valuable adjunct in gaining a medical
education. The old-fashioned way of toiling through voluminous
works, for the essentials which were obscured by page after
page of pedantic lucubrations has happily been displaced by this
modern and sensible way. The subjects are presented in the best
manner to be clearly understood and memorized. The language
is direct, and the description concise. The matter is up to date,
and the most authoritative writers only are drawn upon. There
can be only praise for the author's ingeniousness in the condensa-
tion of so many points in his significant questions and pithy an-
swers. The dental curriculum comprises all the subjects treated
PRACTICAL NOTES. 981
and some of the chapters will have particular interest to dental
students. The portion of the work devoted to bacteriology and
the technique of cultivation, furnishes the busy practitioner a
digest of the most recent advances in this important and ever
interesting department of science.
IJOOKS RECEIVED.
An Artist in Crime. By R. Ottolengui, paper, price 50 cents.
G. P. Putnam's Sons, New York, 1892.
A very pleasing story, well told and having an absorbing inter-
est from the opening page to the close.
Transactions of the Illinois State Dental Society, 1892.
Louis Ottofy, Secretar}', Chicago. Published by H. D. Justi &
Son, 66 Madison street, Chicago, 111. Pages, 198. Cloth.
Transactions of the Alumni Association of the Chicago
College of Dental Surgery. Eighth annual meeting held in
Chicago. Ulysses G. Poyer, D. D. S., Secretary.
Published by the Association.
PRACTICAL NOTES.
Case Reported by Dr. W. F. Green, So. Evanston, III.
Case. Miss W., aged 18, suffered from severe and continued
headaches, for which she was being treated. Glasses had been
fitted, with partial relief, and she was then referred to me for treat-
ment of her teeth. Upon examination I found two bad pulp ex-
posures— one in the right lower second molar, the other in the left
upper second bicuspid, and a small one in the left upper second
molar, which I have subsequently capped with gutta-percha and
filled with cement.
Aug. 12. I applied a paste composed of the following :
'^,. Arsenious acid C P.
Creosote (Wood) add q. s. ft. paste.
(Sealed it in with cement.)
Aug. 13. Removed the paste, washed with ferri dialyzed, then
applied glycerite of tannin and sealed it in with Gilbert's stopping.
982 THE DEXTAL REVIEW.
Aug. 1(5. I applied the same kind of paste to the bicuspid
and sealed in the same wa}-.
Aug. IS. Removed the paste from the bicuspid and treated
and sealed in the same waj' as the molar.
Aug. 2U. I removed the pulp entire from the molar, washed
with peroxide of hydrogen till reaction ceased, then dried and
dressed canals with oil of cassia. At this time I could go but a
very short distance from the pulp chamber into the canals without
causing severe pain, yet the pulp was as large as any-^that is
normal in size.
Aug. 24. Removed the pulp entire from the bicuspid and
treated it the same as the molar — in which I again changed the
dressing, washing with peroxide and dressing canals as before.
The molar at this sitting was very sensitive to pressure and the
reaction from peroxide was excessive.
Aug. 21). I removed the dressing from both teeth, washed
with peroxide of hydrogen, dried and redressed the bicuspid same
as before. But in the molar I dressed canals which were very sen-
sitive if I passed a certain point with carbolic acid 95 per cent.
Response to pressure same as before.
Aug 31. Removed dressing from bicuspid, washed with per-
oxide, dried and filled canal with chloro and gutta-percha. It re-
mained slightly sensitive for a few days, when it gradually sub-
sided, and the tooth now (Oct. .3) has a large contour gold filling,
comprising the entire buccal half, and it is as useful as any tooth
she has.
Sept. 2. Removed dressing from molar, washed with peroxide
and redressed same as before. Sensitiveness increased and extrac-
tion was recommended, but patient would not consent.
Sept. h. Removed dressing and treated same as before. The
reaction from peroxide was excessive. Tooth extremely sensitive.
Cocaine crystals were added to the root canal dressing. Ex-
traction was again recommended and flatly refused.
Sept. 7. Suffering intensely. Patient completely worn out.
Would not consent to gas, so I applied a 10 per cent cocaine solu-
tion of choral and camphor to the dried gums, waited five minutes
and then removed the distal root (the crown crushing in), leaving
the mesial root in situ, for the removal of which all pleading and
arguments on the part of the lady's parents and myself failed, so
she was given one-fourth grain morphia sulph. hypodermically and
PRACTICAL .VOTES. 983
ordered to bed — then late in the evening. The next morning pa-
tient felt better, but complained of numbness on right side of inf.
max., extending from just in front of the angle along its lower
border to the mesial line, thence up to the mucous membrane of
the lip, thence back to the angle of the mouth and then in an irreg-
ular line to the point of commencement.
Patient suffered more or less pain in the socket and jaw till
Sept. I3th, when I gave her gas and extracted the remaining root,
after which she gradually recovered from the pain but the socket
has failed to heal over or fill up. Several spiculae of bone have been
discharged from it having the appearance of necrosed bone.
At the time the numbness was first noticed it was complete
there being no response to pricking with scalpel or pinching, and
when blindfolded neither to heat or cold.
At this time Oct. 3d the numbness has decreased in area to the
size of a silver dollar and involving the integument just over the
external dental foramen and is as complete as at first. It has not
decreased any in size within the past week. The gum looks normal
and has just begun to throw out granulations.
She washes the socket with listerine in water two or three
times daily.
Now in this tooth arsenic was in only twenty-four hours, when
it was removed and the cavity washed with ferri dialyzed, and
in the bicuspid it remained for forty-eight hours, with different re-
sults. The first a total failure, the second a success so far. Upon
examining the distal root after extraction I found it very short
and the canal as large at the apical foramen as at the pulp
chamber.
The mesial one was normal, a little curved, with a large apical
foramen.
Through these the arsenic must have passed, destroying the
peridental membrane and affecting the process also.
Did the arsenic affect some of the sensory fibers of the inf.
dent, nerve ? or did the cocaine solution of chloral and camphor ?
I think not, as there is no loss of sensation in the gums, mu-
cous membrane of lips or cheek, or in any of the teeth of that
side.
Will this complete loss of sensation be permanent?
9S4
THE DENTAL REl'IEW.
Fig. 1.
Separating Teeth.
Separating teeth for filling by "tying the cotton in" has been
my practice so many years, that I had come to believe that it
was in vogue with most of the dental profession, but frequent
demonstration at societ}- clinics and elsewhere
seems to prove the contrary. The idea is sim-
ple, but very effective compared with the com-
mon use of cotton alone. It consists in placing
waxed floss silk between the teeth before pack-
ing the cotton into the cavity, then drawing
the two ends together and tying as in Figure 1.
For the bicuspids and molars, a large white cotton string
may be used in connection with a long roll of
cotton, quite firmly twisted, packing the ends
in at each side (Fig. 2), which, when tied,
will form a cotton circle around the contact
points of the two teeth, making it impossible,
when properly adjusted, for it to move from
its position.
Practice and judgment will be necessary in order to gain the
best results in all cases. The advantages of the method are:
1. The pressure is positive, moving the teeth in a short time with
comparatively little soreness. 2. The danger of the compress slip-
ping from its position and impinging on the gum septum is re-
duced to a minimum. 3. It causes the least pain and incon-
venience to patients. J. Austin Dunn, D. D. S.
Chicago.
Fig. 2.
Peculiar Condition of the Mouth Where Plates are Worn.*
By Dk. R. E. M.ercklein, Milwaukee, Wisconsin.
There are cases where temporary plates are worn too long; in
such cases the mouth becomes fungoid. I have seen cases where
there were two to three folds of fungoid tissues underneath the up-
per lip; there was so to speak two or three false lips. Such a
mouth is in a very bad condition to receive a plate thereafter, as it
is very hard to reduce this fungoid or spongy condition to normal.
There are other cases where temporary plates are worn one, two
*Read before the Wisconsin State Dental Society.
PRACTICAL NOTES. 985
or three years and very little absorption of the ridge has taken
place, the mouth being in a healthy condition. As soon as they
get a permanent set in, from one to three months, so much absorp-
tion takes place that the plate is a great deal too large and ought
to be made over to have it fit. There are also places where per-
manent plates are worn and for some reason or other the}' require
to get a new set. The dentist taking the impression in plaster of
Paris it being an accurate impression, he runs his model and fin-
ishes the plate. When he comes to adjust the plate he finds that
the plate is too large. In such cases the mucous membrane is
thickened or spongy, and from the impression of plaster, be it
chemical or mechanical, I am not prepared to sa}', the mucous
membrane from the time the impression is taken to the time the
plate is inserted, is reduced to its normal or nearly normal condi-
tion, this being the reason why the plate does not fit when
inserted; such is vsxy observation. I think that the ma-
jority of failures of the cases last spoken of could be avoided by
taking two impressions about a week apart and making the plate
over the model from the last impression. I get very good results
in the cases last spoken of in this way.
Two years ago, at the meeting at Appleton, a dentist stated that
where a person wore an old rubber plate and it was replaced by an
aluminum one. the aluminum plate would not fit. This is not only
the case with aluminum but with all other kinds of plates where
the mucous membrane is thickened or a spongy condition of the
gums is present.
? -? ?
QUERY TO BE ANSWERED P.\ THE EDITOR.
If an upper second molar with putrescent pulp is presented,
and you decide to treat and fill roots, how would you proceed in
detail? The patient in good health, and mouth otherwise in good
condition.
Answer. Appl}' the rubber dam and wash the crown with a
saturated solution of sodium fluo-silicate. Open the pulp cham-
ber with clean sterilized drills. Wash the pulp chamber with
equal parts of proxide of hydrogen and 1-lOOOth solution of bi-
986 THE DENTAL REVIEW.
chloride of mercury. Do not attempt the removal of the putres^
cent pulp at this time. Apply two small pellets of cotton wet
with myrtol and cassia equal parts ; introduce over these a piece
of blotting paper wet with liquid vaseline and seal the cavity with
soft gutta-percha. Make a perforation with a hot instrument
through the gutta-percha, not producing pressure. If the tooth is
elongated or protruding from the socket carefully counterirritate
the gum with tincture of capsicum and chloroform equal parts.
At the end of four or five days it will be safe to remove the
dressing under the strictest antiseptic precautions and remove the
remains of the pulp from the roots. They are to be carefully
freed from all animal matter, and washed with boro-glycerine water
one in ten. Fill the roots loosely with shreds of cotton wet with
myrtol alone, adding to it to correct the taste some oil of cloves or
wintergreen. Seal the cavity carefully as before in the same man-
ner. Leave the case for ten days when, in nearly every instance,
the roots may be filled with safety to the patient.
The reason for perforating the gutta-percha plug is to be cer-
tain of the escape of any gas formed or to be formed and to insure
against the error of producing pressure on the apical end of the
root. In some cases it may do to remove the whole pulp at the
first visit, but the safer plan is to sterilize the contents of the root
and the root itself by the use of drugs before the attempt is
made to remove it. If pus oozed out of the pulp chamber when it
was opened the removal of it is indicated, but instruments should
not be passed high up in the roots, at all events, during the first
sitting.
Broaches should be scrupulously clean. The roots must be ab-
solutely dry, using cold air instead of hot to effect this object.
When ready to fill the roots, moisten their interior with eucalyptol,
or cajuput. Then introduce chloro-percha, working it into the
roots with a smooth broach; afterward take gutta-percha cones,
cold, sticking a small pointed instrument into the large end and
force them home. If the buccal roots are too fine to receive
cones.be careful to work all the chloro-percha possible into the
roots and then force, with a blunt-ended instrument softened gutta-
percha into the roots with a churning motion until you feel sure
that theyar.e well filled. If there is no good reason to the contrary,
the crown cavity may be filled at once ; otherwise wait a few days.
PRACTICAL NOTES. 987
ANSWER NO. 2.
Having adjusted the rubber dam, carefully remove all debris
from pulp chamber. The pulp canals are cleansed with cotton
shreds wrapped upon smooth broaches of proper size for easy in-
sertion into the openings. This operation must be repeated time
and time again until the cotton shreds show no traces of putrescent
matter. The canals are now washed, first with chloroform then
with alcohol to absorb all possible moisture, after which hot air is
employed. Shreds of cotton saturated with myrtol are placed in
each root and the opening sealed with gutta-percha to exclude
moisture. In twenty-four hours remove myrtol and seal oil of cas-
sia into the cavity as before, rubber dam always being used to pre-
vent moisture from gaining access. This may remain in the pulp
cavity for three or four days, when if all is "quietness and peace'"
the roots will be found nice and sweet and ready for the filling. If,
however, any soreness should supervene, another application of the
oil of cassia should be made and more time given.
Everything being in readiness for the filling, moisten the
sides of the pulp canal walls with cajuput or eucalyptol to facili-
tate the passage of chloro-percha which is now pumped into the
canals. Follow this with gutta-percha cones which have been pre-
viously fitted to the canals, soften the gutta-percha with heat, place
in the pulp chamber a ball of soft rubber and by pressure upon the
rubber with some blunt instrument force the chloro-percha up un-
til the patient gives evidence of pain, when jou may feel reasonably
certain that those roots are filled.
Success depends fully as much upon the mechanical skill and
conscientious, painstaking thoroughness with which these roots are
cleansed and afterward filled as upon the therapeutic value of the
medicaments employed.
This method of procedure will apply to anjof the teeth as well
as to the upper second molar.
A. W. McCandless.
MEMORANDA.
Died at his home in Buffalo, New York, H. A. Birdsal), D. D. S., December
13, 18!)2.
We can offer a good position in China to an exceptionally good operator under
thirty years of age.
988 THE DENTAL REVIEW.
Dr. Black's work on dental anatomy has commenced to appear as a serial in
le Progres Dentaire, Paris.
Dr. George Edwin Hunt, of Indianapolis, has gone and got married to Miss
Morrison, of Indianapolis. We extend our best wishes.
Dr. Norman W. Kingsley is the only dentist named so far on the list of the
American Subcommittee for the Medical Congress at Rome, Italy, September
24th to October 1st, 18.3.
The word comes from Paris that many ere getting ready to come to America
next year. English pocket dictionaries are the correct thing, fastened to a cane
or umbrella. We are brushing up our French and German and are eating
Malaga raisins (de California) tons les jours.
Dr. W. Jarvie. speaking at the banquet of the American Academy of Dental
Science, said: "One thing I desire to impress upon you to-night is that there must
be no division of interests next year. All should work to make tlie Dental Con
GREss a great success. For years we may not have another opportunity to show
the progress of dentistry in America. This is cur inning and we should make it
count for all it is worth."
FOR INFLUENZA.
One-fourth grain protiodide of mercury pills, one twice daily after meals for
two days, then three per day for a week — omitting a week and resume for two or
three weeks.
If any redness of the gums is noticed, stop at once. This is, in some respects
a new treatment for influenza.
LEAD IN TARTARIC AND CITRIC ACIDS.
Buchet has examined a number of commercial samples, and has found that
fourteen of them contained combined lead, amounting to 0.03G3 per cent, and
metallic lead to the extent of 0.0071 per cent. The combined lead was probably
in the state of sulphate and the metallic lead had been rubbed off the evaporating
pans by stirring. — Pharm. Zeilung.
DANGER SIGNS.
There have been danger signals warning the public against the too common
use of the coal lar preparations, known as antipyrine, phenacitine, acetanilid and
antikamnia. They are being used not only by physicians in many nervous disor-
ders, but very generally by sufferers without consultation. The drugs are ordered
direct at the drug store, and taken at once in five and ten grain doses. They re-
duce the temperature of the body, and hence they temporarily relieve headache
and fever, but the reduction in temperature is effected by the disorganization of
the red corpuscles of the blood. This is one of the most deadly poisonous effects
that can be cast into the system, and the continued results must be of a most serious
nature. In influenza and grip they have been given on every side, and the patients
knowing their names rush to the drug store upon the first symptoms of any cold or
complaint that resembles the old attack. The truth is these drugs have only a
limited use, and that is in severe cases of headache and very high fevers. Even
then they should be given under advice, as they may seriously affect the heart
otherwise. They should never be taken continuously or a worse trouble will fol-
low when the blood is impaired by their use
MEMORANDA. 939
HYPERTROPHY OF THE MUCOUS MEMBRANE OF THE UPPER LIP.
The case I am about to describe is of interest, not only because examples of
hypertrophy of the mucous membrane of the lips are by no means of common oc-
currence, but because it illustrates the tendency to recurrence of these tumors in
situ after removal by operation, unless that procedure is efficiently carried out.
A. M. , a male inmate of Broadmoor Asylum, drew my attention to the
existence of a small pendulous growth arising from the inner surface of his upper
lip, a little to the left of the fraenum and extending in an outward direction for the
space of about an inch. The growth was not noticeable when the lips were closed,
but presented a somewhat unsightly appearance when the patient spoke or laughed.
It had been slowly increasing in size, and latterly had become a source of annoy-
ance to him during mastication. Previous to his admission here he tells me he
had been troubled with a similar growth in the same situation, which he removed
himself with a pair of scissors. A cure, however, was not effected, since, very soon
after the wound had healed, the growth again began to make its appearance, and
had now become troublesome in the respect I have mentioned. Recognizing the
case to be one of hypertrophy of the mucous membrane, from the nodular and
shotty character of the contents of the tumor, I decided upon removing it with the
knife. This I did by means of an incision carried around the base of the tumor,
taking care not to encroach upon the free margin of the lip. Having removed the
superabundant tissue, I noticed several small yellowish-white bodies about the
size of a split pea (the hypertrophied labial glands) scattered over the surface of
the wound. These I removed carefully by means of a pair of dissecting forceps and
then closed the wound with horsehair sutures. The wound healed by first inten-
tion, leaving no deformity, and although it is now some months since the opera-
tion, there is no sign of a recurrence of the growth. Mr. Bryant has shown that
this hypertrophy is due to an overgrowth of the labial glands, and that unless these
are all removed the growth is likely to recur. When my patient performed the
operation on himself, several of the hypertrophied glands must have escaped re-
moval, and I have no doubt it is to this fact that the recurrence of the growth iti
silH is to be attributed. — The Lancet.
DEATH AFTER AN AN.-ESTHETIC.
Dr. C. Norman Hamper, Resident Medical Officer at the North-West London
Hospital, forwards us the following notes of the case of a woman, aged forty, who
died on the operating table on September 5th at that institution, after the admin-
istration of an anaethetic. About 8 o'clock on the evening of September oth, the
woman was brought to the hospital in a collapsed, though conscious, condition.
She was almost pulseless, so ether was injected hypodermically. On examining
the right inguinal region an donated, hard swelling was diagnosed, so I immedi-
ately sent for one of the visiting surgeons. Pending his arrival, I learned that on
the 3d instant she had had a strain, and that she was taken ill almost immediately
after. She had vomited ill-smelling (faecal) matter from the Sunday. On the ar-
rival of Mr. Brodie, one-sixth of a grain of morphine was injected, and, the hus-
band having been interrogated, it was decided to operate. Ether, by means of
Clover's apparatus, was at first tried, but, as it caused such violent coughing, it
was discontinued, and chloroform (Duncan and Flockhart's) was substituted ; but
990 THE DE.VTAL REVIEW.
after about five minutes, the patient being anaesthetised, the administration of
ether was recommenced, and was continued for about twenty-five minutes, during
which lime ether had to be injected twice. At the conclusion of this period the
operation, save the stitching of the wound and its dressing, was completed, her
pulse and respirations became very weak, and she died fifteen minutes after the
ansesthetic had been discontinued. Just before dying she articulated sounds and
moved, which I think can be construed as returning consciousness. The verdict
was understood to be " Death from misadventure," the jury regretting that the
patient was not earlier subjected to treatment, but attaching no blame to the hos-
pital. Dr. Thomas's attention was drawn to the fact that the patient did not die
during administration of the anaesthetic. — Brilish Med'ual Journal.
OBITUARY.
H. H. SiLLiM.^N, M: D., D. D. S.
We briefly referred to the sudden death of Dr. Silliman, in our issue of last
month. The following biographical sketch is from one of the local papers of
Chenoa:
Herbert Haynes Silliman was the eldest son of Col. and Mrs. E. C. Silliman
and was born near Dunlap, Peoria county, July 5, 1808. He came to Chenoa
with his parents in 1872 and has since been a resident of this city. He graduated
from the public schools in this city and entered the office of Dr. Gallahue to pre-
pare himself for dentistry. He then went to Chicago where he graduated from
the Chicago College of Dental Surgery, class of '89, and also from Rush Medical
College, class of '90. In April 1890 he began the practice of his profession in this
city. He soon obtained a lucrative business and gave evidence of being a neat
and skillful workman. March 1st, of the present year, he was married to Miss
Florence Birdsel, of Prairieton, Ind., a most estimable young lady who has gained
many friends since coming here. "Bert," as he was familiarly known, was con-
sidered more than ordinarily bright from his early boyhood and was a general
favorite with his teachers and playmates at school. He has always been a lead-
ing factor among the young people of the city in social life and no gathering
seemed complete without him. Pleasant, jovial, free-hearted, hev/as the most gen-
ial of companions and never wavered in his loyalty to a friend. He and his
young wife were devoted to each other and their handsome home was almost a
paradise to them. He was the soul of honor and integrity; all his dealings with his
fellowman being conducted in a straightforward manner. In a business sense his
future prospects were very bright and he bid fair to become noted in his profes-
sion.
He was junior 'deacon of Chenoa lodge No. 292, A. F. & A. M., member ol
Star of Bethlehem chapter 114, order of Eastern Star, Chenoa chapter No. 143,
Royal Arch Masons, and of St. Paul commandery, Knights Templar of Fairbury.
Though young in masonry he was very zealous in the cause and would have be-
come one of its brightest lights.
GENERAL INDEX.
Abnormal menstruation, cause of tooth ache,
680
Abscess of antrum with cases and treatment,
99
Address, Massachusetts State Dental Society,
816
Address, President's, British Dental Associa-
tion, 809
Address, President's, British Dental Associa-
tion, Western Branch. 734
Address, President's, Chicago Dental Society
390
Address. President's, Illinois State Dental So-
ciety, 462. 498
Address, President's, Nebraska State Dental
Society. 637
Address. President's, Northern Illinois Den-
tal Society. 932
Address. President's, Southern Dental Asso-
ciation. 639
Address, President's, Wisconsin State Dental
Society, 788
Address to the Odontographic Society of Chi-
cago, 214
Adenoid growths, 162
Adjourned. 691
Advertising " professors ". 528. 7E8
Advice, extraordinary, dental, 311
Advisory Council, World's Columbian Dental
Congress. 764
Aluminum, 374
Aluminum, a new and practical use for, 435
Aluminum amalgam, 547
Aluminum foil. 548
Amalgam, aluminum 547
Amalgam and gold, combining, 765
Amalgam, copper, 773. 886
American Academy of Dental Science. 830
American College of Dental Surgery. 335, 526
American Dental Association, 156, 434, 436, 529,
608, 611. 645
American Dental Association, transactions of
the, 1891. 170
American Dental Society of Europe, 432, 439,
83(1
An old idea useful. 50
Anatomy and physiology, dental, 906
Anatomy, comparative. 45
Anatomy, syllabus for study of dental, 739
Anaesthetic, death after an, 989
Anaesthetic, properties of cocaine as an, 529
Anaesthetics, local, 917
Anchoring tlllings, employment of the post in,
945
Annual meetings, the, 575
Annual outflow, the. 239
Annual report of tlie Postmaster-General, 66
Antisepsis, mouth. 530
Antiseptic Dentistry. 537, 571
Antrum, abscess of the, with cases and treat-
ment, 99
Application and Influence of force In ortho-
dontia, the, 615
Archives of Dentixin/, exit, 158
Arkansas'deiitists, 526
Antrum, diseases of ttie. 220
Art and invention, dental, 547, 582
Art of dentistry, the. 342
Artlflelal dentm-es. retention of entire, 197
Artist ill crime, an 981
Aitzney. zene. 173
Asaprol. 729
Atkinsonian Dental Society of Chicago, 185
Bactericidal property of blood-serum, on the
alleged. 258
Bactericides, essential oil vapors as. 760
Bacteriology. Histology, Pathology and. 980
Baltimore College of Dental Surgery, 334
Base plate, the ideal dental. 5-;9
Biological teaching in colleges. 616
Blood-serum, on the alleged bactericidal prop-
erty of. 258
Blow at dental colleges not situated In Michi-
gan, 49
Blow pijie, a new, 550
Books, 555
Books, the use of. 83
Books received. 981
Boston Dental College. 678
Bridge work, crown and. 636
Bridge work improvements in, 469. 509
Bridge work, syllabus for study of crown and,
749
Brief treatise on the common diseases of
the maxillary sinus. 'M)
British Dental Association, president's ad-
dress. 809
British Dental Association (Western Branch)
president's address. 734
British Dental Association, Western Branch,
732
Brooklyn Dental Society, 518
Bu.sy dentist, useful hints for the, 826
Calculus, salivary and sanguinary, 408
California State Board of Dental Examiners,
912
Califorrda State Dental Association. 757
California, university of, college of denti.stry,
173
Canal fillings, remarks on root. 23
Care of the deciduous teeth, 632
Caries, dental, 255
Ca.s.sia, testing oil of. 79
Catching's Compendium of Dentistry for 1891,
248.328
Caution. 396
Cavity stoppers. 548
Census bill, dentists and the, 612
Central Dental Association of Northern New
Jersey, 184
Characters, a glance at familiar, 702
Charity. 255
Chart of typical forms of constitutional Irreg-
ularities of the teeth. 324
Chicago, address to the Odontographic Society
of, ^14
Chicago College of Dental Surgery— dental de-
partment of Lake Forest Cniverslty, 328,
341
Chicago College of Dental Surgery, transac-
tions of the Alumni a.ssoclallon of the, 981
Chicago Dental Club. 255
Chicago, detit.il colleges In. 830
Chicago Dental Society, '28. 1.32, 220, 239, '290,
341, 311(1. 396. 437, 657, 716. 801. 961
Chicago Dental Society, President's annual
address. 4, 390
992
THE DENTAL REVIEW.
Children, care of the teeth of orphan, 76
Children, mouth breathing, 759
Chronic rhinitis, 829
Cincinnati College of Medicine and Surgery-
dental department, 606
Cincinnati, university of, department of
dentistry. 326.
Cinnamon, a destroyer of disease germs, 186
Citric acid, lead In tartaric and, 998
Cleanliness, habits of, 349
Cleansing of teeth, the, 891
Clinics, 309.
Clinics, report of supervisor, Illinois State
Dental Society. 545
Clinics, report of supervisor Southern Illinois
Dental Society. 90;)
Close of the volume, 974
Cocaine. 925
Cocaine— its anaesthetic properties, 529
Cocaine, preventing the toxic etfects of, 253
Cocaine, rules forailministratlon of, 256
College Commencements. Dental.
Anierlt iTi College of Deiital Surgery. 335
Baltimore College of Dental Surgery. 334
Boston Dental College, 678
Chicago College of Dental Surgery. 328
Cincinnati College of Medicine and Sur-
gery—dental department. 606
Dental Department— Columbian Univer-
.sltv. 3.37
Dental Department— Howard University,
337
Dental Department— State University of
Iowa. 326
Dental Department— Tennessee Medical
College, 337
Dental Department— University of Mary-
land. :«0
Dental Department— Vanderbllt Univer-
sity. 336
Deiiartment of Dentistry— University of
Cincinnati. 326
German American Dental College. 523
Hi)mii'n[i;itlilc Hospital College— Dental
Department. .523
Indiana Dental College. 249
Kansiis City Dental College, 248
Louisville ('(illege of Dentistry. 756
Melianv School of Dentl.stry, 249
Missouri Dental College, 332
National Cniversity. (;()7
New Yi.rk College of Dentistry. 331
Northwestern College ot Dental Surgery,
418
Pennsylvania College of Dental Surgery,
249
Philadelphia Dental College. 329
Royal College of Dental Surgeons of On-
tario, 419
Southern Medical College— Dental De-
partment. 251
United .States Dental College. 341
Unlversltvof California— College of Den-
tlstrv. 173
University of Michigan. (M7. 677.
University of Penn.sylvania— dental de-
partment. 523
Western Dental College, 3:^, 418
College, new dental. 525. 7.57, 829.
College of Dentistry, University of Callforida,
173
Colleges, graduates of dental. 158
Colleges not located In Michigan, a blow at
dental, 49
Colleges, the endowment of dental. 155
Colorado <;ol<l. 185
Columbian Dental Congress, World's, 48, 156,
663, 761, 8:«. 971. 972
Columbian University, dental department,
337
Combining amalgam and gold, 765
Commencements, Dental Coilege—sec College
ComnieiK'enR'iits. dental.
Common detects in tlie insertion of gold, 238
Conipaiative anatomy. 45
Conductivity of heat by lilling materials, 181
Congenital tissure of the palate, mechaidcal
treatment of 261
Congress, address of the committee on the
dental. 761.
Congress, dental, topics for di.scusslon, 832.
Congress, the dental 663. 971. 972.
Congress, the medical of 1893, 50.
Congress, World's Columbian Dental, 48.
Congress, 1893. 156.
Conservation of energy, recreation and the,
276.
Consistency, thou art, etc., 395.
Contour ttillngs— what they should be 458,
501.
Copper Amalgam. 773, 886.
Copper, oxypliosphate of. 547
Correction that does not correct, 816
Correctlveness, 732
Cotton as a root filling. 394
Cotton pellet roller. 549
Ccesols as disinfectants, iysol. 62
Crown and bridge vvorlt. 509, 636
Crown and bridge work, borders between the
natural and artificial. 161
Crown and bridge work, syllabus for .study of,
749
Crown with improvements 469, 509
Currents from the main, 323
Dead teeth, a vision of. 847
Death after an ana'sthetlc, 989
Deatli from pentai, 828
Deciduous teeth, care of the, 6.S2
Deciduous teeth, treatment of the, 948
Delaved. 311
Delta Sigma Delta fraternity, 154, 609.
Density of dentine, 776
Dental advice extraordinary. 311
Dental anatomy and itliysloiogy, 906
Dental anatomv, syllabus for .study of, 739
Dental art and invention, 547,582
Dental caries, 215
Dental College Commencements, sec College
Commencements, dental
Dental coll('t;es. graduates of 156
r>eiit;ilcolle'j;es. Clilcafio. 830
Dental Colleges not located In Michigan, a
blow at. 49
Dental colleges, the endowment of, 1,55
Dental Congress, address of the committee on
the, 761
Dental Congress, to[)lcs for discussion, 832
Dental Congress. World's Columbian, 48, 156,
663.761.8:^2.971,972
Dental department, Columbian University,
337
Dental deriartment. Homoeopathic Hospital
College. 523
Dental department, Howard University, ,337
Dental department, National Unlvenslty. 607
Dental department. Northwestern University,
418
Dental dep.-irtment. Southern Medical Col-
lege, 251
Dental department. State University of Iowa,
326
Dental department, Tennessee Medical Col-
lege. 337
Dental Department, University of Maryland,
330
Dental Department, University of Michigan,
607, 677
GENERAL INDEX.
993
Dental Department, University of Pennsylva-
nia, 523
Dental Department, Vanderbilt University,
33G
Dental diseases, prevention of, 349
Dental education, 67. 553
Dental education, some thoughts on, 16, 17, 69
Dental Inlirmary patients, 173
Dental Journal, Hungarian, 158
Dental Journal, the. 676
Dental Journals, two, new, 677
Dental law for Washington, 602
Dental legislation, 464, 505
Dental medicines, their specific action, and
when indicated. 797
Dental operations, failures of 280, 290
Dental practice, how I got a start in, 51
Dental Protective Association, 163
Dental pulp, the Immediate and painless ex-
tirpation of the. 14
Dental Review, to the readers of the. 972
Dental science and literature. 552, 580
Dental students. 815
Dental students, matriculate examination of,
Denies sapientlae. 81
Dentine and "nerve," enamel, 1
Dentine, density of, 776
Dentist, useful hints for the busy, 826
Dentistry, antiseptic. 537
Dentistry, history of. 430
Dentistry in Guatemala. 975
Dentistry, mechanical, 174
Dentistry, needed reforms in the practice of,
454. 487
Dentists as hobbyists. 928
Dentists, female assistants to, 914
Dentition in Infants, 834
Dento-gyiirecology, 254
Dentures, retention of entire artificial, 197
Department of Dentistry, University of Cin-
cinnati. 320
Dinner to the Executive Committee of the
World's Columbian Dental Congress by
the five united dental societies of Chicago
—The speeches. 106
Disease, evolution of. 253
Disease germs, cinnamon a destroyer of, 186
Diseases of the antrum. 220
Disinfectants, the cresols as. iysol. 62
Disinfection, method of sanitary aullioritles of
Paris. 438
Does it pay? 73'1
Education, dental. 67, 553
Education, thoughts on dental. 16, 769
Effect of electricity on filled teeth, 827
Electric appllMUces. 548. 551. 554
Electricity in dental practice. 323
Electricity in the operating room, 25
Elongated teeth, replanting. 251
Empyema of the maxillary sinus. 284
Enamel at tlie gingival line, 567, 623
Enamel, dentine and ••nerve." 1
Enamel edges, preparation of, 282.
Energy, recreation and the con.servatlon of,
276
Endowment of dental colleges, the, 155
England's titled doctors. 255
Epitlielloniatous appearance due to an upper
full artificial denture, lingual ulceration
of an. 218
Errors. 254
Essential oil vapors as bactericides. 760
Essential oils, the purification of reslnlfied,
435
Essentials of histology, the. 738
Estimation of the profession by the public,
the, 4
Ethics, professional, 932
Europhen, the therapeutic value of, 255
Evolution of disease, 253
Executive Committee of the World's Colum-
bian Dental Congress— Dinner to, 166
Exit Archives of Dentistry. 158
Extirpation of the dental pulp, the immediate
and painless, 14
Extracts from an address before the Massa-
chusetts State Dental Society, 816
Facial neuralgia. 362, 716
Failures of dental operations, 280, 290
False teeth, mummy with. 77
Female assistants to dentists. 914
Filled teeth, effects of electricity on, 827
Filling, cotton as a root. 394
Filling, manipulation of gold for, 366
Filling materials, conductivity of heat by, 181
Filling with crystal gold on the surface of
amalgam, 801
Fillings, 19
Fillings, contour, what they should be, 458,
501
Fillings, employment of the post in anchoring,
945
Fillings, remarks on root canal, 23
Fillings, surface protection for plastic, 187
First District Dental Society, anniversary meet-
ing of the. 81
First District Dental Society of Illinois, 831
First District Dental Society of New York, 156,
518. 593
First Di.3trict Dental Society of New York.
amendments to By-Laws. 257
First District Dental Society of New York,
clinics. 164
First permanent molar, the, 681
Foil, aluminum, 548
Force in orthodontia, influence of, 615
German-American dental college. 523
Germs, cinnamon a destroyer of disease, 186
Gingival line, enamel at the, 567, 623
Glance at familiar characters. 702
Gold, a common defect in the insertion of, 238
Gold, Colorado. 185
Gold, combining amalgam and, 765
Gold for filling, manipulation of. 366
(Graduates of dental colleges, 158
Groups, the theory of. 157
Guatemala, dentistry in, 975
Gum septum, injuiies to the, 451
Gums, Riggs' disease of the, 778
Hand lotion, 253
Havden Dental Society of Chicago, 185. 256
Heat, conductivity of, by filling materials. 181
Herbst method of treating pulps, the, 901
Hints on vision. 878
Histologv. 554. 734
Histology, I'atliology and Bacteriology, 980
History of dentistry. 430
Hobbyists, denti.sts as. 928
Honifeopathlc Hospital College. Dental depart-
ment. 503
How I got a start In dental practice, 51
How to read. 91
Howard University, dental department, 337
Hnngarlan Dental Journal. 168
Hygiene, oral. 349
Hypertrophy of the oral mucous membrane,
957. 961 , .
Hypertrophy ot the mucous membrane of the
upper lip. '.ts'.i
Hypnotism as applied In dentl.'itry, 6.s.s
Illinois State Board of Dental Examiners,
tenth annual report of the, 415
994
THE DEXTAL REVIEW.
Illinois State Dental Society, 257, 311,340. 473,
526, 55U
Illinois State Dental Society Transactions of
the, 1892. 981
Illustrations, ficing 1 ; 189, 190. 191. 193, 194,
195. 19ti. 197, 199, 26S. 269, 270. 271. 272. 273.
274. 275, 324. 378, 386. 387. 388. 389. 532. 5;«.
534. 535. .536. 564, 565. 618. 620. 621, 622, 623,
624. 625. 626. 627. 984
Immediate and painless extirpation of the
dental pulp, the, 14
Imposition. 537
Improvements in porcelain, crown and bridge
work. 469
Indiana Dental College. 249
Indiana State Dental Association, 434, 609
Infants, dentition in. 834
Intirmarv jiatients, dental, 173
Influenza, for. 98S
Interproximate spaces. 423. 441
Introductory lectures to medical students. .354
Insertion of gold, a common defect in the. 238
Invention, dental art and, 547
Iowa State University of, dental department,
326
Irregularities of the teeth, 162
Irregularities, surgical treatment of, 858
Japanese <lentlstry. 760
Journal. Hungarian dental. 15S
Journal literature, the, 89
Journals, two new dental, 677
Jurisprudence, dental, 604
Kansas City Dental College. 248
Kansas State Dental As.sociatlon. 185.
Kentucky State Dental Association, 528
Law for Washington. D. C, dental, 602
Laws State Dental. 606
Lead in tartaric and citric acids, 988
Legislation, dental. 464. 505
Letter trom H. H. John.son. 312
Letter from New York, 56, 159, 240, 314, 398,
516, 593. 664
Letter from Portage La Prairie, Manitoba,
904
Letter from Portage La Prairie, reply to, 905
Library, a. 904
Lingual ulceration of an epithellomatous
appearance due to an upper full artificial
denture, 218
Literature, dental science and, 552
Literature, the journal. 89
Lip. hypertrophy of the mucous membrane of
the. 989
Local ariiesthetlcs. 917
Looks like success. 516
Loose teeth, treatment of, 516
Lotion for the hand, 253
Louisville College of Dentistry, 756
Lysol, the cresols as disinfectants, 62
Making a name, 212
Mallet, universal, 550
Management of pulpless teeth, the, 419
March of progress, the. 662
Maryland, University of, dental department,
3^0
Materia medica and therapeutics, 826
Matrices. 9(17
Massachusetts, history of higher education in
616. 9(J7
Massachusetts, State Dental Society, address
816
Matriculate examliuition of dental students
9, 28
Maxillary sinus, a brief treatise on the com-
mon diseases of the 200
Maxillary siims. empyemia of the 284
MeclianU-al dentistry 174
Meelianical treatment of congenital fissure of
palate. 261
Medical ('onKre;=s. 1893. the. 50
Medical .'Students, introductory lectures to, 354
Medicines, dental, their action 797
Meetings, the annual 515
Meharry. School of Dentistry 249
Membrane, hypertrophy of the oral mucous
957. 961
Membrane of the upper lip, hypertrophy of
the mucous 989
Memoranda 74, 183, 252, 338, 426, 525, 607, 678,
756, 828. 911
Men in society, young. 893
Mercuric chloride In alcoholic solution 978
Merry Christmas and a happy new year, 975
Methods, old and new, 935
Michigan, a blow at dental colleges not located
in, 49
Michigan, history of higher education in, 616
Michigan, university of, dental department,
607. 677
Minneapolis Dental Society, programme of
the. 914
MInnesotM. report of dental examiners. 173
Minne.sota State Dental Association, 45, 525, 830
Missouri Dental College. 185, 332
Ml.s.souri State Dental Association, 433, 759
Molar, the lirsl permanent, 681
Mouth, antisepsis, !"i;-)0
Mouth, breathing. 162. 759
Mouth, wliere jiiates are worn, peculiar condi-
tion of the. 984
Mucous membrane, hypertrophy of the oral,
957. 961
Mucous membrane of the upper lip, hypertro-
phy of the, 989
Mummy with false teeth, 77
Name, making a. 212
National Association of Dental Examiners,
440. 713
National Association of Dental Faculties, 610,
709
National University, dental department, 607
Nebraska state Dental Society, 254
Necrology, 78
Nerve, enamel, dentine and. 1
Nerves, the ex-sectlon of. .556
Neuralgia, facial. 362. 717. 913
Neuralgia, removal of Gasserian ganglion for
cure of. 412
New and old methods, 935
New book for dental students,(Dental Anatony
and Physiology), 9(X)
New dental journals, two, 677
New Jersey, Central Dental Association of
Northern, 184
New York college of denll.stry,33l
New York, dental society of the State of. 342
New York, letter from, 56, 159, 240, 314, .398, 516,
593, 664
North Dakota, second annual report of the
board f)f examiners of. 516
North Dakota State Dental Society. 611, 759
Northern Illinois Dental Society, 903
Northern Illinois Dental Society, President's
address. 932
Northern Olilo Dental Association, 343, 610
Northwestern college of dental surgery. 524
Northwestern University, dental department,
418
GENERAL INDEX.
995
Odontologlcal Society In New York, 516
Odontologlcal Society of Pennsylvania. 79
Odontographlo Society of Cliicago, 80, 185
Odontographic Society of Chicago, address to
the, 214
Odontographic Society of Chicago, resolutions,
758
Office practice. 44
Ohio State Dental Society, 836.
Oil vapors as bactericides, essential, 760
Oils, the purification of resinifled essential, 435
Old and new methods, 935
Omaha Dental Society, 526
Operating room, electricity in the, 25
Operations, failures of dental, 280, 290.
Oral nygiene, 349
Oral mucous membrane, hypertrophy of the,
957, 961
Oregon, dentists to organize in, 527
Orplian children, care of the teeth of, 96
Orthodontia, 531. 559
Orthopedische Behandlung der Sattelnase, 601
Outflow, the annual, 239
Oxyphosphate of copper, 547
Ozaena, 912
Painless extirpation of the dental pulp, the
immediate and, 14
Pamphlets received, 66, 173, 325, 415, 516, 606,
906
Palate, mechanical treatment of congenital
fissure of the. 261
Pan- American Medical Congress, 329
Pathology and bacteriology, histology and, 980
Patience, patients and, 867
Ji'atients and patience. 867
Pennsylvania college of dental surgery. 249
Pennsylvania, Odontologlcal Society of, 79
Pennsylvania, university of, dental depart-
ment. 529
Pental. death from. 828
Permanent molar, the first, 681
Philadelphia dental college, 326
Physiology, dental anatomy add. 906
Plastic fillings, surface protection for, 187
Plastics, 793
Plates are worn, peculiar conditions of the
mouth where, 984
Porcelain bridge and crown work. Improve-
ments In. 469. 509
Post-Uraduate Dental Association, 76, 254, 613,
739
Post-graduate study. 93. 132. 397, 613, 761, 912,
Post in anchoring fillings, employment of the,
945
Postmaster (Jeneral. annual report of the, 66
Practice, how I got a start in dental, 51
Practice of dentistry, needed reforms, 454, 487
Practice, some hints on. 895
Practitioners' courses. 904, 905
President's address British Dental Associa-
tion. 809
President's address, British Dental Associa-
tion. Western Branch. 734
President's address Chicago Dental Society,
390
President's address, Illinois State Dental So-
ciety, 462
President's address, Illinois State Dental So-
ciety, discussion, 49H
President's address, Nebraska State Dental
Society, 637
President's address. Northern Illinois Dental
Society. 932
President's address, Wisconsin State Dental
Society, 788
President's annual address, Chicago Dental
Society, 4
Priority in the use of the screw for regulat-
ing teeth, 384
Prison Congress, report of, 616
Profession by the public, estimation of the,-
Professional ethics. 932
Progress of dentisty, 342
Progress, the march of. 662
Protection for plastic fillings. 187
Proximate contact, form of 444
Public, the estimation of the profession by
the, 4
Pulp capping, pulpitis and, 716
Pulp, how to treat putrescent, 985
Pulp, the immediate and painless extirpation
of the dental. 14
Pulps, treating by Herbst's method, 901
Pulpitis, 370
Pulpitis and pulp capping, 716
Pulpless teeth, the management of, 419
Putrescent pulp, how to treat, 985
Pyorrhoea alveolaries, 973
Pyorrhoea alveolaris, or Riggs' disease of the
gums, 778
Pyrophosphate of Zinc versus copper amal-
gam, 887
Queries, 74, 252, 985
Questions and answers, dental, 172
Read, how to, 91
Recent contributions to the diagnosis and
treatment of empyenila of the maxillary
siims, 284
Recreation, 277
Recreation and the conservation of energy,
276
Regulating teeth, priority in the use of the
screw in, 385
Remarks on root canal filling. 23
Replanting elongated teeth, 251
Report of the committee on dental art and in-
vention, 547
Report of the committee on dental science
and literature, 552
Report of the Supervisor of Clinics of Illinois
State Dental Society, 545
Reciulrements, schedule of, before Board of
Dental Examiners, Illinois, 415
Retention of entire artificial dentures, 197
Retirement of Dr. Ottofy from Dental Re-
viEW staff, 972
Review Internationale Dental Odontolosrlque,
676
Resorcln, therapeutically. 65
Riggs'. disease of the gums. 778
Root fillings, remarks on. 23
Root clamps. 550
Root filling, cotton as a, 894
Root trimmer, 549
Rhinitis, chronic, 829
Royal College of Dental Surgeons of Ontario,
419
Rubber plates, flexible, 758
Salivary and sanguinary calculus. 408
Sanguinary calculus, salivary and 408
Sapientiae, dentes, 81
Sattelnase. die orthopa'dis de behandlung
der. 601
Science and literature, dental, 552
Scientists International Directory, 616
Screw for regulating. 385
Second hand teetli. 77
Sensation, loss of, 981
Separating teeth, 984
Slims, a brief treatise on the common dis-
eases of the maxillary, 200
996
THE DEXTAL REVIEW.
Sinus, enipj-enilii of the maxillary. 281
Six-year molar, desirability of the extraction
of the. itOi)
Society, youn}? men In, 393
Some hints on i)ractiee, 895
Some needed reforms in the practice of den-
tistry. 454. 4S7
Some thoughts on dental education. 16
Some thoughts on manipulation of gold for
fllling. 366
Somnal. 259
Southern Dental Association, the. 591
Southern Dental Association and Tennessee
Dental Association. 638
Southern Illinois Dental Society. 234. 829. 913
Southern Illinois Dental Society, clinics. 9(19
Southern Medical College, dental department.
251
Southern women in the recent educational
movement. 907 *
Spaces, the interproximate, 441, 448. 473
Specialties. 664
St. Louis Dental Society, 78
Students, dental. 815
Students, matriculate examination of dental.
Students' Quiz series, materia medica and
tnerapeutics. the. 826
Study, post-graduate. 93. 132
Surface protecticui for plastic fillings. 187
Surgical treatment of irregularities. 858
Syllabus of crown and bridge work. 749
Syllabus of dental anatomy. 739
Syphilis and Its manifestations in the mouth,
906
Tallc about toothache. 790
Tartaric and citric adds, lead in, 988
Teaching In colleges. 616
Tennessee Dental Association, 639
Tennessee Medical College, dental depart-
ment. 337
Teeth, care of the deciduous, 637
Teeth, cleansing of. 891
Teeth, replanting elongated, 251
Teeth, second hand. 77
Teeth, separating, 984
Teeth, treatment of deciduous, 948
Therapeutics, materia medica and, 826
Theory of groui)s. the. 157
Thoughts on the density of dentine, 776
Thoughts on dental education, 769
Thumb sucking. 162
Tobacco. Its use and effects, 628, 654
Too much matter, 159
Toothache, 341
Toothache, a talk about. 790
Toothache caused by abnormal menstruation,
680
Toxic effects of cocaine, prevention of, 253
Transactions of the American Dental Associa-
tion, thirty-tirst ainmai session, 170
Transformlsm, some thoughts on, 160
Treatise on dental jurisprudence, 604
Treatment of the deciduous teeth. 948
Trifacial neuralgia, removal of Gasserian
ganglion for cure of, 412
Tropsin. 923
Two cases or removal of the Gasserian gang-
lion througli the floor of the skull for tri-
facial neuralgia, 412
Ulceration of an epithelioma tous appearance
due to an upper full artificial denture, lin-
gual, 218
Ulltls. 952,96;S
University extension. 651
Utdversity extension lecture course, 975
University of California, college of dentl.stry,
173
University of Michigan, 607, 677
University Df Pennsylvania, dental depart-
ment. 523
Use of books, the, 83
U.seful, an old idea. 50
Useful hints for the bu.sy dentist, 826
Vaccination, ancient Hindoo, 914
Valedictory address. 416
Vanderbilt University, dental department, 336
Virginia Stale Dental Association, 8.S0
Vision, hints on. 878
Vision of dead teeth, a. 847
Volume, close of the, 974
Washington, D. C. dental law for, 602
Western Branch British Dental Association,
732
Western Dental College, 333, 418
What next? 515
Winter evenings. 730
Wisconsin State Dental Society, 525. 612
WIseonsni State Dental Society, President's
address. 7H8
Woman's Advl.soryCouncil, World's Columbian
I)t*ntal Congress. 764
World's Columbian Dental Congress, 396, 527,
592, 901
World's Columbian Dental Congress, advisory
council, 764
World's Columbian Dental Congress, commit-
tees of the. 843
World's Columbian Dental Congre.ss, dinner to
the executive committee of the, 106
World's Columbian Dental Congress, Woman's
advisory couticil, 764
World's Columbian meeting, 48
Young men In society, 393
Zene Artzney, 173
BIOGRAPHICAL INDEX.
Allen. Geo., 164
Allport. W. W.. 32. 39, 44. 140
Ames. W. B.. 197. 545. 586
Andrews. Edmund. 412
Angle, E. H., 45, 385
Arnold, Otto 354
Baldwin, A. E., 231, 303
Ball. W. C. C.,397
Barton. W.J. .126
Bennett. 0. G. 19
Black. G. V. 83, 129. 227, 229, 2.30,231, 441, 481,
484. 485. 504. 567, 572
Blair. E. K.. 464
Bropliv. T. W. 132, 144. 149. 220, 224. 226. 229,
230, 232. 482. 499, 556. 574, 582, 585, 660, 723,
906. 966. 970
Brown, E. Family. 469
Brown, G. V. I.. 187
Bryan, L. C, 853, 855, 858, 876
Campbell. J.. 546
Case. C. S.. 161. 531, 567, 570, 615, 961
Cattell, D. M.. 390. 545, 722.
Chittenden, C. C. 790
Clifford, E. L.. 214, 917
Cole. H. J.. 632
Collins. J. W., .545
Conrad, William. 487, 491, 497, 540, 571
Corbett. C. C..236
Cormany. J. W., 454. 481. 496, 498
Costner, H. A., 484. 546, 721
Crawford. J. Y. 114
Crissman, I. B. 577
Crouse, J. N., 35, 127, 138, 142, 800, 477, 484.
545, 806
Gushing, G. H., 128, 458, 498, 582. 584, 585, 586.
Damon. W. H.. 235
Davis. L. L.. 561. 629. 661, 967
Dennis, G. J., 41, 806, 907, 963
Dennis. G. W. 935
De Trey. E.. 853. 854, 856, 857. 863, 875. 876, 883,
884. 886
Dickson. J. G.. 569. 580, 91
Dodge, ,T. Smith, 160
Dubois. M. Paul. 339
Dunn, J. A. 546, 984
Flllott. A. v., 854. 867. 876, 884
Entsmlnger, G. W.. 235
Farrar.J. N.. 163
Fernandez, E. M. .'*., 148
Flllebrown. T.. 688
Fisher. .T. W.,546
Foster. M.W.. 125
Freeman. A. W., .366, 801
Freeman, 1. A.. 223, 292, 370
Frlck. Theo..877
French, E. C, 786
Gallle.D. M.. 723. 793
Gattrell, J. H., 734
Gillette, E. A., 776
Gilmer, T. L., 181, 546,554,574,655,716,952.
Gordon. E. L.,948
Green, W. F., 981
Harlan, A. W., 37, 142, 276,296,362,446,555,
575. 656. 726. 805.
Harned, M. R.. 928
Harper. J. G. 237. 547. 575
Hartt. C. F., 36, 40. 44,45, 135, 139,660,726, 808,
969
Raskins, G.W., 374.
Heitzmann. Carl. 160
Hodgen. J. D., 769
Hugenschmldt. A. C, 218
Hunt. A. O., 123
Ingersoll. L. C, 128
Jenkins. C. W., 847. 856, 876. 883
Johnson, C. N., 4. 29, 37, 473, 546, 581, 720
Johnson, H. H., 311
Kester, P. J.. 301. 480, 719, 773, 967
Kingsley, N. W.. 162
Kitchen, C. A., 479, 574
Koch, C. R. E., 505
Lawrence. R. N.. 131
LeCron, D. 0. M., 547
McCandless, W. A., 547, 987
McCausey, G. H., 1, 7U2
McCoy, J. C, 14
McKellops. H. J., 117, 491, 512, 561, 582
McMlUen, G. A.. 236, 546
Msercklein, R. E.. 984
Mariner, J. Frank. 547
Matteson. A. E., 546, 563, 589, 804
MaWhlnney, E.. 16
Mitchell. D. J.. 854, 855, 878, 891
Mitchell. W.. 895
Molvneaux. G.. 261
Morgenthau. G. L.. 225. 284
Morrison, W. N., 235, 749
Nason, A. W.. 6.37
Nason. G. S., 636, 975
Newklrk. G.. 299, 300, 807, 537, 579, 582, 658
Noble, H. B., 130
North, Gustavus. 172
Noyes, Edmund, 9, 29, 42, 136. 305, 494, 503, 552.
670
Ottofy, Louis, 134, 224, 659. 957, 969, 970, 972
Palmer, E.. 797
Patrick. J. J. R.. 415, 509, 512. 559, 561, 586
Pelrce, C. N., 160
Penney, A. D., 236
998
THE DENTAL REVIEW.
Perry, E. J., 5. 547. 932
Prlchett.T . W.. 234. 251, 546
Pruyn, C. P., 802
Qulnby, H. C, 809
Reld, J. G..31. 134. 149, 229. 231, 290. 571, 583,802
RIchter. Erich, 173
Robertson. R. H., 905
Royce, £. A., 765, 803
Sage. Frank W., 56
Salomon, (i. S., 25. 294, 306, 9G8
Schless. Prof.. 878
Bchuhmann, H. H.. 200. 220. 233
Shepard, L. D., 112. 130. 817
Sitherwood, G. D.. 481. 495. 582
Stevens. W. A.. 107, 485, 497, 583
Storev. .1. C. 120
Stubbletield. 1). R.. 161
Swain. E. D., 32, 280, 307, 501, 563, 577, 583, 584,
654
Swartz, M. W., 778
Taft, .J.. 107, 428
Taggart. W. H.. 462
Taylor. C. R.. 481, 493. 500
Terry, C. T., 854, 857. 884
Tuller, R. B., 93, 132, 149, 725, 80
Underwood, C. J., 945
Walker. W. W., 110
Wallls. C. J. B..323
Warner. E. R.. 33
Warren, G. W., 212
Wassail, J. W., 132. 135, 148, 349
Weeks. T. E., 571. 623
Wetzel, A.. 889. 891
Wetzel. E. .1.. 891
WetzelJ. E.. 8.54. a57, 864, 875, 884
White. (Jordon. 639
Wlborg. H. B.,430
Wilson, I. P.. 99
Wooley, .f. H., 136,681,804
Zeublln, Charles N., 651
Zlnn, (i. E..827
•' Ex,' 62, 170, 247, 322. 407. 523, 601, 6"6
OBITUARY.
Allen. John, 827
Bazler. A. J., 348
Brownlee, (i. E., 440
Cooper. Charles. 186
Dunaver, Harry f;.. 530
Emery. .1. (irant. 440
(Jarber. S. A.. 836
Kautsky. E. J., 440
Kingsbury. C. A., 838
Kirk, Reuben. I., 440
Mcintosh, U. D.. 260
Moffett. A. (f.. 440
Morse. Harold Wlscott. 186
Noyes. Mary S. W., 186
Pasedach, Herman, 440
Porter, Noah. 260
Rankle. I). W., J86. 348. 440
Sllllman. H. H.. 916. 990
Su(?gltt, F. R.. 915
Swasey. .Joseph A., 82, 259. 348, 44"
Ward, E. B. 440
WUkle. C. M., 915
Witt. William. 440
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