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and far less irksome to the patient than any hitherto invented. In conclusion, Mr. Pedley referred to the use of Hammond's splint in cases of surgical division of the jaw for the purpose of facilitating operations on the tongue or floor of the mouth. In such cases it was a good plan, instead of sawing the bone through vertically, to make two oblique cuts, meeting at an angle. In this way the ends of the bone lock into one another and maintain their position more readily.—F. IT. Pedley, M.E.C.S., before Odontological Soc. of Great Britain, in Med. Press.
The Bacilli Of The Mouth.—No more fertile source for bacteria, available to all who care to study them, can be found than the cavity of the mouth. W. D. Miller states, in the Deutsche Med. Wochenschrift for November 27, that if a sharp instrument be introduced between the gum and a tooth, especially if the former be from any cause slightly hypersemic, the scrapings thus obtained leave nothing to be desired in the way of curved bacilli and spirochsetse.
In the first place, there is a comma-bacillus resembling that of cholera, but which Koch has shown to be altogether distinct. No efforts to cultivate it have as yet succeeded. A second fungus, less difficult to cultivate, is a short, plump, somewhat pointed bacterium, of which two are often united at an acute angle. The latter especially occur with rods which are in a state of fission. The fungus is mobile, growing very rapidly at the temperature of the room, and liquefies gelatine to a considerable extent. A third fungus is also a delicate rod, either straight or more or less curved, sometimes to the extent of a semi-circle, so that two placed appropriately produce an O-shaped figure, and sometimes the rodlets are so rolled together that they can scarcely be distinguished from coccospheres. By fission they form coccochains, best seen in old cultures. In these Miller has found neither spore formation nor motion. They are very slow and difficult of culture on gelatine, but do not cause a liquefaction of this substance. Hence, it differs in this respect from the cholera fungus.
Miller has also found in the mouth fungi which are not destroyed by an artificial gastric juice, and these may pass through the stomach into the intestine, and there undergo further development. This may be true of these curved bacilli described, since he has found in his own feces undoubted curved bacilli, especially accompanying a slight diarrhea. But these were as difficult of culture as the curved bacilli found in the mouth. Whence we may infer that the fact of a bacillus being curved is no criterion of its specificity, and that bacteria of this shape occur which have no closer relation to each other than the different bacteria which are found in the shape of cocci. Much more accurate information may, however, be expected from carefully conducted culture experiments.— Medical News.
Syrup Of Dentition.—A compound, with the above as a title, is being ordered of the apothecaries of this city, by prescription. Ordering by title alone generally finds the dispenser unfamiliar with this class of preparations. In the absence of other accessible means it is, of course, only by application to the prescriber or to some druggist who may happen to possess it, that the dispenser can procure the formula. It is proper that as soon as such recipes come into vogue or use they should become, through publication, common property, to the end that all may have equal opportunity.
The writer, on procuring the formula, and being under the impression that it was original in the French Codex, applied to Professor Maisch, who, after examination, very kindly gave the following information:
Dorvault's 1'Officine (but not the French Codex) contains the recipe under the name of "Sirop de Dentition de Delabarre," with a formula very similar to that you gave me, as follows:
R . Juice of fresh tamarinds, 3 gm.
Infusion of saffron (strength 3 percent.), 2"
Tincture of vanilla, 25"
Dorvault says, in a note appended, " The juice of tamarinds may be replaced by the pulp diffused in water" (proportions not given), the fresh juice, of course, not being obtainable.
There being, as will be observed, considerable obscurity in regard to proportion of ingredients in the components of the above, something will have to be assumed by individual judgment in working out an acceptable and nice compound. The preparation will be assigned, naturally, a place among the fanciful, but will attract the attention of the younger members of the medical fraternity by its novelty. The elders, we imagine, will want it but seldom, unless it can be demonstrated that it has something of utility in it. As a placebo it may divert the infant by sweetening the coming tooth, but that it will assuage or mitigate the pain of that sometimes painful process, dentition (if that be the purpose and intention of the preparation), readers will pardon the writer for doubting.— W. B. Thompson, in American Journal of Pharmacy.
Specialism.—Dr. L. Duncan Bulkley read a paper before the American Academy of Medicine, August, 1884, which was published in the Journal of the American Medical Association for December 13, discussing the relations which those who are practicing and advancing medicine should bear toward the development of its science and art, by developing the separate or special portions of that science and art. The author considers the subject under the headings of, first, specialties, what they are; second, why they exist; third, the relations they bear to the progress of medicine; fourth, the relations they bear to general medical practice; fifth, specialists, or those limiting their practice to a single branch of medicine or class of diseases; sixth, the education necessary for the proper practice of a specialty; seventh, the future of medical specialism. In conclusion, the writer briefly sums up the matters presented in the paper as follows:
1. The science and practice of medicine has, in company with other sciences, become so vast that no one mind is capable of fully grasping every portion of it. 2. Unconsciously its various departments have become divided up, and from natural causes certain men have become prominent in various departments. 3. These so-called specialties in medicine are so great and extensive each, that particular or exclusive attention is now devoted to them, the study and practice in each branch being sufficient to fully occupy one's time. 4. The development of these branches has greatly increased the scope and extent of medical knowledge. 5. Every medical practitioner should be more or less of a specialist, excelling in some particular direction. 6. To properly follow and develop one of these specialties, the medical man should be particularly well educated, theoretically and practically, in general medicine as well as in his special branch. 7. This tendency to specialism in medicine cannot be arrested; but the difficulty tends to solve itself, by the education of practitioners and students in these specialties, so that the majority of simpler cases shall be treated by them, while the more difficult and obscure cases will naturally fall to the specialist who refuses to treat other diseases and confines himself to the practice of a single branch.
Chloroform In Tic Douloureux.—Bartholow, in presenting a case ot tic douloureux to his class, proceeds to make the following remarks on the treatment of this intractable disorder: "There is no fact in therapeutics more striking than the curative effects of a few drops of chloroform injected in the neighborhood of this division of the nerve (the superior maxillary branch of the fifth cranial nerve) when the seat of neuralgia. It is this division which is most frequently affected, and fortunately so, for it is this division which is most easily reached by the following method of treatment: Given a case of tic douloureux involving this nerve, lift the corner of the lip and insert a hypodermic needle at the junction of the mucous membrane of the lip and that of the cavity of the mouth; pass it up till its extremity comes in the neighborhood of the nerve, and inject from five to fifteen minims of chloroform or ether, the former the most efficient. In the majority of cases there is immediate relief from pain, which, if not permanent, lasts a considerable time. I have a patient in Boston who comes to me twice a year to have this injection practiced. In his case no other measures have answered. The relief which he obtains is complete, and lasts never less than six months."—Buffalo Medical and Surgical Journal.
Facts And Their Appreciation.—The tendency has been too great of late years, doubtless from the backward swing of the pendulum away from the old times of authority, to subordinate the reasoning powers to the mere observation of physical processes. It is equivalent to saying—as the vulgar are very much given to saying—that nobody is qualified to criticise a picture unless he can paint a better one himself. We are far from underrating the great debt that modern medicine owes to pure observation; indeed, we are quite in accord with the feeling that, just at this juncture, competent observation is the chief thing needed to advance our art. But we may be allowed to add that it is not the only thing needed. Blocks of stone may be carved with the greatest nicety, but the real work of constructing an edifice is done by him whose hands are entirely unused to the actual play of tools. The parallel must be reversed, it is true, for in material building it is the architect's conception that must precede the mechanical work, while in science the preparation of materials has to go before the constructive process; but the deduction remains obvious that the greatest service is rendered not by him who digs out facts, but by him who welds them together. We must, therefore, deprecate the infatuation which honors only the discoverer and gives the cold shoulder to the critic.—New York Medical Journal.
Removable Teeth.—At the last meeting of the Odontological Society of Great Britain, Mr. Willoughby Weiss related the following remarkable case of salivary calculus surrounding the three lower incisors, and showed a model of the mouth. The patient, a woman, first came to him in April, 1881; her mouth was in a very dirty and neglected state; there was a good deal of tartar about the teeth, but especially about the root of the lower left central incisor, which was entirely surrounded by the deposit. The tooth was loose, and could be removed and replaced by the finger. She refused to have anything done, and was not seen again until June, 1882, when the right central incisor was found to be affected in the same way. She again refused to submit to any treatment, and disappeared until July, 1883, when the left lateral incisor was found to be similarly affected. During this time she had suffered no pain, and was able to masticate fairly, although all three teeth could be removed and replanted at will. About January, 1884, the gums began to be tender, and about the beginning of May she had to take out the loose teeth while eating, replacing them afterwards, because, as she said, their absence affected her speech. At last, in July, 1884, she allowed Mr. Weiss to remove the three teeth, together with the right lateral incisor, which was becoming loose, and an artificial denture was fitted. The peculiarity of the case was not the amount of the tartar, but the way in which it was deposited around each tooth, so that each one, as it were, locked its neighbor in its place.—British Med. Jour.
Tearing Op The Dental Nerves In Persistent Neuralgia.— M. Monpd has successfully treated two cases of obstinate dental neuralgia by tearing the extremity of the dental nerve. The first patient has remained perfectly free from pain during thirteen months. M. Monod trephined the ramus of the inferior maxilla by Warren's process; neuralgia reappeared at the end of six months, and was localized at the mental foramen. M. Monod then trephined the bone behind the mental foramen, adopting Jules Koux's process; the nerve was then torn, and the patient was rapidly cured. The second patient was treated in the same way; hitherto successful; but the operation is too recent to pronounce it a positive cure. Stretching the inferior dental nerve has been proved successful in one case only, by M. Mark See. Tearing the nerve has resulted in cure in thirteen cases. The same operation has been performed on the infraorbital nerve with satisfactory results. —British Medical Journal.
Gouty Teeth.—Dr. Saundby showed a patient, the subject of chronic constitutional gout, and also plaster-casts, to illustrate the type of teeth seen in gouty persons, where these structures are worn down so as to be very little above the surface of the gum. He regarded this peculiarity as quite characteristic, and of great diagnostic value in many cases of obscure disease, depending upon the gouty diathesis. He referred to a recent statement by Dr. Dyce Duckworth, that, out of one hundred typical cases of gout examined by him, the teeth were sound and well formed, and expressed his dissent from the general accuracy of the conclusion drawn from that observation.—British Med. Journal
Facial Neuralgia Treated By Nerve Vibration.—Dr. William H. Neale, of London, reports a case of severe facial neuralgia successfully treated by nerve vibration, or percussion. He used the small, flat ivory disk, with about ninety vibrations to the second, applying it to the primary seat of pain. After an application of about eight minutes the pain at that point had entirely disappeared. The disk was then moved until another painful spot was found, and the percussion again performed. Each day the painful points were sought" out and percussed until the patient entirely recovered.— Practitioner.
To Cure An Abscess Without A Cicatrix.—Dr. Quinlan uses a silver wire, passed through the abscess before it has reached the skin, and retained there. It acts as a drain, he says, and has never failed in his hands.—Med. and Surg. Reporter.
Sub-mucous Injections Of Chloroform.—M. Gaspard Guillot contributes his personal observations on this subject in a letter to the Progres Medical. He recommends the treatment in cases of obstinate dental neuralgia and alveolar abscess. Two or three drops should usually be injected at a time. The writer refers to the extensive experience of Dr. Doss, wTho has given a large number of the injections with perfect success. The pain was quickly subdued, and no bad results followed.—New York Medical Journal.
Japanese Teeth.—At the last meeting of the Odontological Society of Great Britain, Dr. St. George Elliott exhibited and presented to the museum some very curious artificial dentures of Japanese manufacture, j These people had derived most of their technical and scientific knowledge from the Chinese, but in this matter they were far in advance of their teachers; for whilst the latter could only carve a row of incisors and fasten them to the teeth on either side, the Japanese could make thoroughly serviceable dentures, and had been acquainted with the fixing of dentures by suction for about two hundred years. The exhibited teeth were mounted on hard wood; the front teeth were made from quartz pebbles, carefully ground down, but the process of mastication was performed by copper nails, which occupied the place of the molars. One of these dentures had been in use for fifteen years. Dr. Elliott gave a very interesting account of the way in which they were made and fitted, which caused considerable wonderment at the ingenuity displayed.—Medical Press.