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respiratory, circulatory, digestive, and urinary systems; diseases of the blood and toxic diseases; and, under the various necessary subheadings of each class, acquaints the reader with the exact treatment of each disease by living practitioners and teachers. The most modern methods and remedies employed by eminent physicians of several countries are thus brought together for comparison or contrast, enabling the reader to recognize the differing standpoints from which treatment is pursued, thus widening his grasp of the subject and multiplying his therapeutic resources.

Even to those not engaged in the practice of medicine as a vocation, this book would prove of great interest and value as a concise presentation of the best thoughts of the most distinguished living physicians regarding the treatment of disease. The volume gives evidence of searching revision, of judicious condensation, and of conscientious thoroughness in careful gleaning of the whole field of medical literature in its preparation. A triple index of authors, remedies, and diseases facilitates reference to any subject desired. Paper and typography are all that could be asked.

The Diagnosis And Treatment Of Chronic Nasal Catarrh. By

Geo. M. Lefferts, M.D. 12mo, pp. 49. St. Louis: Lambert &

Co., 1885.

In this brochure Dr. Lefferts outlines the symptoms and treatment of chronic nasal catarrh, after methods accepted by many of the American laryngologists. It is a representative book, therefore, and as such is'well worthy of close perusal. The style of the writer, while somewhat turgid, is that of a man of experience, who knows his subject and who is evidently conscientious. One cannot fail to be struck with the elaborate outfit demanded in these later days to successfully treat diseases of the nasal chamber. In this little book thirty figures are devoted to the illustration of instruments recommended by the author. Those in actual use by the profession which are not alluded to by him are innumerable.

The physician who confines himself to the special study of this and allied affections is in the best sense of the word a specialist.

Transactions Of The Odontological Society Of Pennsylvania, from its Organization, February 1, 1879, to the Close of the Year 1883. Price, cloth, $3.00.

We are in receipt of a copy of the above volume, which is an octavo of 211 pages. It contains the reports of the meetings of the society for five years, from its inception to the close of 1883. The papers read before it include some by Drs. Bssig, Webb, Truman, Kirk, and others, with discussions in regular order, which are of permanent value. A limited number of copies are for sale at the price given above, and may be obtained, of the secretary, Dr. Ambler Tees, No. 548 North Seventeenth street, Philadelphia.

The Physicians' Daily Pocket Eecord, comprising a Yisiting List, many useful Memoranda, Tables, etc. By S. W. Butler, M.D. Nineteenth year. New and thoroughly revised edition, with Metric Posological Table. Edited by D. G. Brinton, M.D. Philadelphia: Office of "The Medical and Surgical Eeporter," 1885. Price, for thirty and sixty patients, $1.50 and $2.00. This Yisiting List is beautifully gotten up, and its publication for nineteen successive years has enabled the publisher to incorporate the information most desired by the practitioner, and to adjust the blank pages to the best advantage. It is "perpetual" in arrangement, and may be used continuously one full year from the date of the first entry.

Pamphlets Eeceived.

Caulk's Dental Annual, devoted to the Collection and Dissemination of Statistics Eelating to the Business and Practice of Dentistry, 1884-85. Octavo, 66 pp. L. D. Caulk, D.D.S., editor and publisher, Camden, Del. Price, 25 cents.

Eeport of a Case of Interstitial Keratitis in a Subject, with probable Hereditary Syphilis. By Charles A. Oliver, M.D., one of the ophthalmic and aural surgeons to St. Mary's Hospital, Philadelphia. Beprinted from the Proceedings of the Philadelphia County Medical Society, October 15f 1884.

Closure of the Jaws and Eemoval of a Tumor. Two Essa}7s delivered before the Illinois State Dental Society. By John J. E. Patrick, Belleville, 111. Toledo, Ohio: Office "Ohio State Journal of Dental Science," 1884.

Irregularities in Human Teeth; or, Dental Teratology. An essay, by John J. E. Patrick, D.D.S., of Belleville, 111. Eead before the Illinois State Dental Society at their Twentieth Annual Session, held in Springfield on the 10th of May, 1884. Eeprint from the Society's Transactions.

Home Again: A Synopsis of a Tour Abroad. By Edward Borck, A.M., M.D., of St. Louis, Mo., one of the delegates selected to represent the American Medical Association, U.S.A., Mississippi Yalley Medical Society, Missouri State Medical Association, and St. Louis Medical Society, at the International Medical Congress held at Copenhagen, Denmark, from August 10-16, 1884. St. Louis: Printed by J. H. Chambers & Co., 1884.


On Assuring Healthy Dentine Over Endangered Pulps.—In saying endangered pulps, I mean cases where the pulps have but little of the natural covering of dentine in the depths of cavities, which covering is very apt to be more or less tainted by disease,—that is, by the agents that have produced caries.

Let us look at the conditions here existing. There is acid with fermentive action, often in full sway, seeming at first sight to demand the most decided and effective neutralizing and corrective applications. But, just beyond lie some of the most highly and delicately organized tissues of the whole body; fibers, that if rudely set vibrating will be likely to continue or repeat their vibrations in a very serious way; tissue, which if inflamed there is none more doubtful of survival; and we must remember that the life of the pulp means additional years of usefulness to its organ. These circumstances, I fear, are often too little considered in the use of violent or caustic applications. But what should be done? Perhaps my ideas on this point may be best given by mentioning a plan of treatment for such cases that 1 formed, tested, and adopted during the years 1847 and 1848, and which in its general principles 1 have found to be most satisfactory up to the present time. Of course, since that date new materials have been added to our list of available correctives for diseased conditions.

After first removing the loosest debris, I applied a mild antacid such as aqua calcis, or a solution of bicarbonate of soda, after thorough saturation with which I treated the cavity for the correction of fermentive elements by the application of a solution of chloride of calcium, and also very dilute creasote (we now have several substitutes for that). The cavity was then dried and sealed up for from two to three weeks, when it was opened and the mild saturation repeated, adding perhaps a mild astringent, such as tannic acid in#weak solution, to the latter application. Then it was sealed up again, generally for a longer period, and the dressing was repeated at proper intervals until permanent health of dentine was assured.

JSTdw, with these mild correctives we have a greater chance of avoiding undue irritation of the pulp than with stronger applications; but they will be more or less transient in their effect, and therefore will require frequent repetition, which may be less frequent as the dentine gains in soundness and health. By this method we help nature in the line of her preference,—that is, to protect rather than injure a vital point, keeping the disease in check to give her opportunity.

It may be, and has sometimes been, said that this treatment is very troublesome, and why not make one strong application and trust that nature will do the rest? I reply that the great objection is that while a strong or caustic dressing is not always lasting in corrective influence, it adds vastly to the possibilities, if it does not make sure, that the reparative action of the pulp will be interfered with, resulting in failure of the ultimate object of secondary deposit. Instances of this sort are often seen in practice; and in my observation the proportion of success of the mild repetition plan is far beyond that of the single capping practice.

Of course there will be some chance of non-success in many attempts to save the pulp, depending often on constitutional as well as local causes, and both may be obscure. The best and most promising efforts may be thwarted by neglect of the patient to report at proper times, or by interruption of the general health. Or, again, when cases are nearly ready for a permanent operation, they may be piratically appropriated by some person who very probably will speak lightly of the treatment that has brought the teeth into condition for his profitable seizure. But still our highest duty is to save life rather than to destroy or endanger it.

Eepresentative cases might be related from a large number with various phases, but to describe them minutely would task both your time and patience. Plaster of Paris was first used as a cap for the exposed portion. Oxide of tin was also mixed with the gutta-percha.

One rather extreme case I might mention, occurring in 1854, A young man aged 25, upper left first molar having a large and deep cavity on the mesial side, wTith the pulp covered only very thinly by softened and disintegrated remains of dentine. But the pulp was apparently uninjured, and on inquiry I found there had been no pain, and nothing to indicate the existence of inflammation in any degree, which was an encouragement to give the pulp every chance to live and protect itself b}T secondary dentine. I saturated the cavity first with aqua calcis about half strength; then with solution of chloride calcium; but this causing slight sensation, I reapplied the aqua calcis with the effect of stopping pain. I then applied a mild non-irritating antiseptic in proportion about as follows, viz.: A wood creasote (at that time the best known antiseptic of its kind), one drop to one drachm of alcohol, adding two drachms of water, after which I dried the cavity and covered the depth over the pulp with a mixture of oxide of zinc, five parts to one of gutta-percha mixed with its bulk of yellow wax, which I placed carefully, without pressure, and filling up the cavity with the gutta-percha and oxide of zinc mixture, melting the wax. After two months I unsealed the cavity, repeated the antiseptic with the addition of a trace of tannic acid; this at first caused sensation, which was readily dispelled by aqua calcis. I then dried and sealed up the cavity; at the end of four months repeating the above treatment, twice again after six months, and finally after about eight months, making more than two years in all, when there was a firm, hard, almost transparent floor of new dentine, from which the former disintegrated material was readily brushed off by a light touch of an instrument. After placing an inert non-conducting material (a piece of fine white silk saturated with wax) at the depth of the cavity, I filled with gold. Two years afterwards a small cavity occurred on the distal side of the same tooth, which on preparing to fill I found as sensitive to the instrument as if it had been the first cavity the tooth ever had, proving the unimpaired vitality of the organ, which continued several years after and during the life of the patient.—Dr. Jacob L. Williams, before Section on Oral and Dental Surgery, American Medical Association, in Jour. American Med. Association.

Treatment Of Fracture Of The Inferior Maxilla.—The most common site for fracture of the lower jaw was close to the canine tooth, for the bone narrowed somewhat at that point, and the depth of the socket of that tooth tended still further to weaken it; the next most common seats of fracture were through the angle and through the neck of the condyle. Multiple fractures were very common, and the existence of a second or third fracture should only be negatived after careful search. It was chiefly in the treatment of the more complicated cases that the aid of the dental surgeon was sought. Three-fourths of the eases of fracture of the jaw would get well under any simple treatment, and very few of these came under the notice of the dental surgeon. At Guy's Hospital, Mr. Bryant used for such cases a splint made of several thicknesses of plaster of Paris bandage, accurately molded to the outer surface of the chin and jaw, and fixed by means of a four-tailed bandage. This splint was light, efficient, and easy of application, but he thought the .modification of Hammond's splint, which he would describe, would be pleasanter for the patient, and would give equally good results. Mr. Pedley then described the ordinary Hammond's splint. This was only required where there were multiple fractures, or where there was obstinate displacement. The first step in the preparation of the splint was the taking of models of the upper and lower jaws, and this was in severe cases no easy matter, even to a dentist. Then casts had to be obtained from these models. That at the lower jaw might have to be sawn across at the point of fracture, and the fragments adjusted to their proper positions. A loop of wire is then framed on the corrected model of the lower jaw, passing behind the last tooth on each side, and accurately fitting the necks of the teeth at the margin of the gums. The wire collar thus prepared is slipped over the teeth of the fractured jaw by reducing the displacement, and is secured to the teeth by means of binding wire passed between each tooth. In the modification of this splint in use at Guy's the necessity for model-taking and soldering was dispensed with; it was especially applicable when the fracture was situated anteriorly, and the displacement was not very marked. Instead of the main wire passing behind the last tooth on each side, it was passed between the bicuspids or any teeth posterior to them. The point of the wire was passed between the teeth on one side, across the tongue, and between the corresponding teeth on the other side. The portion of the wire lying on the tongue was then bent against the necks of the teeth on the lingual aspect; binding wire was next passed between all the teeth opposite which the main wire lay, except those contiguous to the fracture, and the loops tightened up in the usual way. The ends of the main wire were either twisted together, or passed through a small piece of closely-fitting metal tubing, bent over in opposite directions and cut off short. This was the better plan, as there was less chance of displacing the fragments. The patient can now open and close the jaws without pain or risk of injury. The splint should be worn for six weeks, or longer if necessary. In cases where firmly implanted teeth do not exist in each fragment of the fractured bone, Hammond's splint was not applicable, and some other form, such as Gunning's, must be used; but for all cases in which it could be applied it was as efficient as

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