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eise, we increase the size and power of the voluntary muscles ; at the same time we add to the functional ability of the involuntary muscles, and are thus enabled to use this increased power with comfort and safety, while through the processes of respiration and circulation we influence not only the health and strength, but also the growth and development of the whole body.
These beneficial effects were long ago recognized empirically, by the ancients, who, without a trace of scientific knowledge, had learned by observation and experience the great value of muscular movement. Accordingly, we find in the competitive games of the Greeks and Eomans a system of elaborate exercises which brought large numbers of persons to a degree of bodily strength and health which has never since been surpassed. But they neglected altogether the application of these laws to the preservation or to the improvement of the general health. They made the strong stronger and the swift swifter; but they did not apply these to the feeble, the infirm, the deformed, or to the still larger class—the lazy—who, most of all, need to feel their good effects.
The rule of health which prescribes exercise is, of all hygienic rules, the most easily transgressed. To violate it, it is only necessary to disregard it. A sin of omission is always easier than a sin of commission. Intemperance brings its direct and unpleasant results in headache and nervousness; gluttony in indigestion or biliousness; over-work in exhaustion or weakness; but the evils due to want of exercise, though no less grave, are insidious and elusive. Want of appetite, sleeplessness, languor, chilliness, general debility, many more serious ailments, are due directly to this cause, as every experienced physician knows, but are rarely referred to it. It is for this reason that the move in the direction of physical education in our colleges has a broad significance, and should engage the attention and interest of the public at large. Probably no more potent means of elevating the standard of public health can be conceived than the general adoption of some form of" systematic exercise, provided it be properly adapted to the needs of the individual. It is not contended that exercise is beneficial when indiscriminately or carelessly employed. On the contrary, it may be as injurious as it should be helpful. For the tired, overworked or delicate person of sedentary occupation and indolent habits, or for the immature and untrained student suddenly to take up an active or violent form of gymnastics, or one of the recreative sports which makes the greatest possible demand on the heart, lungs, and muscles, is in the highest degree injudicious and reprehensible.
There is no royal road to strength and health, as there is none to knowledge. Bach individual has special needs to be met, special dangers to avoid, and we may now occupy ourselves writh the methods by which these needs can be determined and these dangers pointed out.
In supplying any system of examination, with a view of ascertaining the particular requirements involved in the proper care and development of the body by means of exercise, the object remains the same, whether the plan is applied to a single individual or to a large body, such as the students of a university. The aim is to establish in each case the present condition of the individual by a series of measurements and tests of strength taken in conjunction with his personal and family history, showing at the same time not only his absolute but also his comparative strength, demonstrating his points of special weakness, and indicating, therefore, the direction in which he most needs development. Our recreative and competitive sports, while of the greatest interest and value, do not supply these desiderata for the students. On the contrary, he is too apt under their stimulus to aim at developing himself in precisely the direction in which he least needs it. Having a powerful back and loins, he goes into the boat crew, or being especially strong in the lower limbs, he takes up walking, running, or leaping. Such men, naturally athletic and fond of exercise, need to be guided and directed, sometimes to be restrained; others of sluggish temperament or of studious and scholarly habits must be encouraged and stimulated; but all require to have their work, whether spontaneous or compulsory, directed into proper channels, so that the result will be' a harmonious and symmetrical development of the entire organism. —Extract from Address of Dr. J. Wm. White, Director of Physical Education, University of Pennsylvania.
Avoidance Op Ether Sickness.—Making a patient keep his eyes closed while recovering from the inhalation of ether is a great aid in preventing sickness; for, owing to the patient feeling giddy any object at which he looks appears to sway from side to side; and this, by itself, is sometimes enough to produce a feeling akin to sea-sickness, even in those who have not been anesthetized.—Med. and Surg. Reporter.
HINTS AND QUERIES.
Given a case of loss of lower teeth, beginning at the right lateral and making a clear sweep around to the left, leaving not a remaining tooth, while from the right cuspid to the right third molar inclusive the teeth are in situ and are free from decay: how may artificial substitution be best made? There is but little ridge, the absorption being considerable, after supposed pyorrhea alveolaris, by which the teeth were probably lost.—F. S. Harris.
Lately I have been annoyed by little scars on the palatal portion of my vulcanite plates, and am at a loss to account for them. These scars are irregular in shape, size, and number, and do not seem to affect the fit of the plate, being but the slightest bit lower than the surrounding material; indeed, they may act as airchambers, securing a readier adaptation. They give the surface of the plate a worm-eaten appearance, and it is worthy of note that they are almost invariably found towards the center of the plate. I am using the Bow-spring rubber, and pack with moist heat, steaming with just a little water in a covered vessel, and closing the flask gradually. I very seldom make an air-chamber. Now, what causes these phenomena, and how may they be prevented? Will some one kindly inform me ?—F. S. Harris.
I Have a patient, a girl eleven years of age, who is cutting nine teeth at one time, viz., two upper second molars, one lower ditto, four upper bicuspids, and the two upper cuspids. She says she lost, or had extracted, all the temporary teeth at one time. She is a healthy, well-formed girl, but says she "don't enjoy the cutting process a bit." The gums are badly swollen, but, as the teeth do not seem to be in the least irregular, I think she will come out all right. Has any one else seen the like ?—C.
To The Editor Of The Dental Cosmos:
Dear Sir: In the "Hints and Queries" of the August, 1884, number of the Dental Cosmos I replied to the inquiry of the co-respondent " E. C. B." as to the best mode of cleansing and removing dark stains from teeth, and advised the use of sulphuric acid and pulverized pumice. I also suggested that this was the best of all remedies for the treatment of what is known as u Riggs's disease." Having received many letters asking to know more definitely my mode of application and the result of my experience, I have decided, with your permission for space, to state briefly my practice in the treatment of said disease, and all similar affections, for nearly thirty years, during which time I have never varied my treatment, because I have never seen the necessity for doing so. This, to some, may seem an extreme declaration, and an evidence of radical contractedness, especially when uttered in the face of the lengthy discussion on the subject of said disease reported in the September number of the Dental Cosmos, 1884, in which some of the ablest men in the dental profession took part, and none, save one, Dr. L. D. Shepard, of Boston, suggested the remedy of remedies—sulphuric acid.
I will state, at the outset, that I have never seen a case of "4Riggs's disease," pyorrhea, or any disease of the gums of a kindred nature, in which the teeth did not hold the cause.
The disease is an abnormal state of the gums, the effect of a cause not definitely comprehended, but generally supposed to be caused by calcareous or other foreign substance deposited upon the teeth. This being the case, I have considered it of first importance to remove, with suitable instruments, every particle of calcareous or other adherent matter from the crowns, necks, and roots of the teeth affected,—an operation generally requiring from a half to two and a half hours, according to the extent of the disease and the "set" of the teeth. I use only three or four suitably-shaped, smooth-edged instruments,—smooth-edged, not to avoid lacerating or hurting the gums, but to avoid scarring and roughening the surface of the roots and necks of the teeth, which should be preserved as perfectly smooth as possible, for removing successfully every vestige of deposit, never sparing the gums. This is, apparently, a rough and torturous operation, but in reality it is not very painful. I then apply sulphuric acid and pulverized pumice, with a brush of medium texture of bristles and shaped to suit, generally shortened to an inch or an inch and a quarter in length, and from which every other row is cut out, leaving a space between the rows of one-eighth of an inch or more, so that the operation shall be effective upon every surface of toothstructure.
The strength of the acid (pure sulphuric) is varied to suit the respective cases,— the greater the extent of the disease and the more unhealthy the gums, the stronger the solution,—varying from one of acid to ten, twenty, or thirty of water. I use the brush with considerable force (to an observer seemingly intent upon tearing the gums to pieces), fearless of consequences, nothing but good results ever occurring. I always inform my patients that the operation, to be effective, must be forcible and thorough, and that they may expect the gums to be uncomfortable for several days. They accept the explanation and submit, hopeful of good results. After use of the brush and thorough rinsing of the mouth, I inspect carefully to see that every particle of deposit has been removed, and usually make a second examination in the course of two or three days, when, if there be remaining any points of deposit, they can be readily detected and removed. I advise the practice of moderate finger-pressure to the gums, half a dozen times or more daily, until they cease to suppurate, and to be continued daily, as also the use of the brush, to promote absorption and strengthen the gums. The mucous membrane often needs pressure for healthy results, but never needs friction. Consequently, the large majority of tooth-brushes on the market are objectionable and more detrimental than beneficial to the gums when used.
I think I can safely venture to assert, and without fear of successful contradiction, that forty-nine cases out of fifty, treated as above stated, have proved successful, when instructions have been strictly carried out and the patients have been entirely satisfied.
I pointedly advise patients to use the brush several times daily; also to use tooth-picks freely, and to discard all dentifrices as worthless and non-essential for the healthy preservation of dental tissues.
Scurvy, pyorrhea, or Riggs's disease, as any one may prefer to term it, like any other disease, is liable to recur more than once in a lifetime,—like causes producing like effects. It is not, or should not be, expected of dentists that they shall treat and cure diseases of the mouth and prevent recurrence any more than it is expected of practitioners of medicine to treat and cure malarial fever and promise no return. We must not attempt to overreach the mark. "Modesty is a virtue." It is not so important to know the cause of a disease as to know how to treat and restore to a normal state. Some things are past finding out quickly, and may remain mysteries to puzzle the comprehending powers of searchers after truth for generations and centuries. So it may be as to the definite and true cause of pyorrhea. It really matters but little, practically, as to what the cause may be, so that we learn how to treat and cure it. It is a disease of no favoritisms,—no respecter of persons. Both sexes, all ages (except the very young), all temperaments, all conditions, are liable to be troubled with it; but, fortunately, it can be cured, and easily. Physicians are expected to treat diseases and eradicate them from the system for the time being. Dentists are expected to do as much, and no more; and it would be presumptuous in them to assume greater powers. We may check the ravages of decay in teeth by filing, drilling, excavating, and filling, and using the brush freely, but we have not been able yet to get at the cause definitely. We know that decay will cause destruction of toothsubstance, and we can remove that cause and save the tooth. So with pyorrhea, or Riggs's disease. We can remove visible, comprehended causes, and check or obliterate for the time being the effect of the cause, but nothing more, and we must not presume to go further. Let us be content to grapple with disease successfully, let the cause be what it may, and we will render a service to suffering humanity commensurate with man's capacity and equal to man's ability to appreciate.
In conclusion, I would say to dentists: Have no fear of injury resulting from a judicious use of sulphuric acid; and will suggest to experiment freely and fearlessly with said acid, and decide as to the merits of the treatment above stated.— B. F. Arrlngton.
Br. J. H. Martindale, of New York city, publishes, in the February number of the Dental Cosmos, " Hints and Queries," an interesting account of his experiment with the muriate of cocaine.
I would venture ,the suggestion that the doctor's experiment came nearer being a success than he at first imagined. No doubt an effect upon the lingual branch of the fifth nerve is even more desirable than one on the dental branch, as the former supplies the gums, and, to a certain extent, the periosteum of the teeth also. While I do not wish to be understood as saying that an arrest of function in the inferior dental nerve is not desirable, I do believe that such effect produced upon the lingual branch is more to be desired.
The conditions under which we extract teeth nowadays preclude the idea of much nervous connection with the dental branch; its chief connection, that with the pulp, having in almost all instances been destroyed by diseases of that organ. Consequently, the chief source of pain must be the irritation of the lingual branch. However, an injection a little higher up than the point suggested in the article will be more likely to affect both branches at the same time, as they are there in closer approximation.
I would like to ask Dr. Martindale if the puncture made by the needle of the hypodermic syringe in that region has been followed by any unpleasant symptoms in any of the cases mentioned ?—W. F. Wegge, Baltimore.
The Walb Method Of Using Hydrochlorate Of Cocaine.—Being associated with Dr. Walb, and having witnessed his method of using cocaine in a large number of cases, I will briefly describe it, as it may prove to be of interest and value to the dental profession. (Darmstadt is, at present, the only place where hydrochlorate of cocaine is manufactured. It is prepared by Mr. E. Merck, who, by the way, has the largest drug house in the world.) It is of interest that this potent drug should be so successfully applied in dentistry by an American in practice at Darmstadt.
Dr. J. Morgan Howe, in the Dental Cosmos for December, and others of the leading members of the profession, report as to the application of the solution to the cavity of the tooth that they fail to get decidedly favorable results. Dr. Walb's method is to inject a two per cent, solution of the hydrochlorate of cocaine hypodermically over the root of the tooth to be operated upon. The full anesthetic effect of the drug is developed in from five to ten minutes, and remains ten to fifteen minutes. Dr. Walb uses it with great success in the extraction of teeth. He frequently extracts a large number at one sitting painlessly, having first made the necessary injections, i. e., usually an injection on each side in the gum above the roots of the teeth, or as many injections as the condition of the patient and the number of teeth to be extracted may indicate. The ordinary hypodermic syringe is used. The doctor also removes live pulps from the teeth without the slightest pain, and without previous treatment. He has used cocaine with great success in excavating sensitive cavities. In very sensitive dentine, and in removing live pulps that are beyond saving, the parts are obtunded in the manner described.
I have seen excellent results from its use. I was recently operating for a lad of fourteen, upon a lower second bicuspid that was decayed to the process upon its distal surface. The pulp was nearly exposed. It was impossible to prepare the cavity in a proper manner, because of its extreme sensitiveness and the irritability of the patient. After an injection of cocaine I had not the slightest difficulty in thoroughly preparing the cavity and making suitable slots for the retention of the filling.
In a large number of cases the results, while not absolutely invariable, have been generally favorable. So far, no ill effects of the drug have been observed. —K. C. Mowbray, M.D., D.D.S., Darmstadt, Germany.