« PreviousContinue »
nently. The cavity was syringed with a ten per cent, solution of carbolic acid. The syringing was continued every other day for a month. By May 20 it had healed; there was no discharge, and the patient looked and felt better. On February 6,1885,1 saw Miss M • she was then quite well.—Dr. Morton Smale, in British Medical Journal.
Pathogenesis Op Eachitis.—Dr. M. Kassowitz is publishing a valuable systematic paper on "Normal Ossification, and the Diseases of the Bony System in Eachitis and Hereditary Syphilis," of which the second division of the second part, on the "Pathogenesis of Eachitis," appears in the last issue of the Medizinische Jahrbucher (1884, Heft IV). The results of clinical observation and experiment upon animals are quoted in support of the view of the local origin of the disease. With regard to the view that the deficient resorpt?on of the lime-salts is due simply to the fact that it is hindered by diseases of the digestive apparatus, dyspepsia, and catarrh of the stomach or intestinal tract, he calls attention to the following facts;
1. That rachitis extremely frequently is developed intra uterum, where neither digestive disorders nor insufficient resorption of the lime-salts brought to the fetus in the maternal fluids can be assigned.
2. That rachitis, as is shown by experience and the testimony of numerous observers, very commonly shows itself in children possessed of normal digestion and who enjoy a good bodily condition of nutrition.
3. That in the summer months, just when disorders of the digestive apparatus prevail in children, the number and intensity of cases of rachitis diminish gradually and in a most striking manner.
4. That, finally, other conditions, which are in no wise connected with the digestion and resorption of lime-salts, such as bad hygiene of dwellings, syphilis, etc., favor the development of rachitis in a most remarkable degree.
After considering other theories of pathogenesis, the article concludes with the following propositions:
1. That the deficiency of lime of rachitic bones is called forth, singly and alone, by the local inflammatory process.
2. But the local process in the bones in turn has its origin in some preceding anomalous conditions of the entire organism.—Phila. Med. Times.
The Influence Of Sex On The Frequency Of Dental Caries.— Dr. Y. Galippe considers that, generally speaking, the density of the teeth in women is less than in men. It has long been recognized that pregnancy diminishes the density of the teeth, but Galippe considers that this aptitude for dental caries frequently coincides with puberty, and is accentuated by each succeeding pregnancy. The cause of this he attributes, in common with Landouzy, to the lowered degree of alkalinity of the fluids of the body. In this connection it is interesting to note the frequency of biliary lithiasis and of mitral stenosis, which seem to be closely connected with the genital life of the female.
This diminished amount of alkalinity in the female seems to have two factors, the one dynamic or functional, the other organic or anatomical. From the dynamic or functional point of view, the nutrition of the woman is retarded; from the anatomical or organic point of view, the blood of man contains more corpuscles than the blood of woman; therefore, the fluids of the body in man are more alkaline than in woman. To satisfy himself on these points, and as having a direct bearing upon the teeth, Dr. Galippe made a large series of observations in hospitals upon the reactions of the saliva in pregnant and newly-delivered women, and in nurses as well. The result was that the saliva was found to be acid in a majority of the cases. Another set of observations was between men and women in comparable conditions, where the saliva was less frequently alkaline in women than in men, and where it was frequently acid. When the alkalinity existed, it was often so feeble as to be totally inadequate for the saturation of the acids which form in the mouth. The elimination of carbonic acid is greater in man than in woman; it is nearly double at the period of puberty.
Dr. Galippe in one case observed the saliva become acid during the menstruation, and accompanied by malaise. Besides these local phenomena, during menstruation the impulse of the heart is stronger, respiration is accelerated, and the amount of urea diminished. It is not to the frequent acidity of the saliva alone that this predisposition to dental caries is due. As has already been said, generally speaking the teeth of women have a density that is inferior to those of men; that is to say, they contain less mineral matter, and therefore the co-efficient of density is inferior. Now, if we take the woman at the period of parturition, we see how prejudicial this inferiority becomes.
The pregnant woman who does not receive, by means of a special alimentation, the elements necessary for the formation of the different tissues which constitute the fetus, and particularly the osseous system, may sustain her first labor; but if these pregnancies be repeated without special care and alimentation, by drawing upon her own economy—her pericliteral economy—we see a series of disturbances occur, of which dental caries is the most marked.—Gazette des Hopitaux.
Eemarkable Ke-implantation Of A Tooth.—Dr. Bestion relates (Gazette des Hopitaux, January 17) a case which is probably unique as regards the length of time in which a tooth remained without replacement after being forced out of its socket. A sailor while engaged in securing a vessel placed the rope in his mouth in order to have a hand free. A comrade inadvertently tightening this rope forced out upon the deck the lower left median incisor. After some searching the tooth was found, but it was not until seventeen hours after the accident that the sailor related his adventure to Dr. Bestion, producing his tooth in a state of absolute dryness. After soaking it in water for a few minutes and then drying it, Dr. Bestion replaced it, the operation causing pain and some hemorrhage. The tooth keeping in pretty straight, no bandage was applied, the only precaution taken being to substitute for the biscuit soft bread, which for the early days was moistened with water or wine. At the date of the report—that is to say, three months after its replacement—the tooth was found to be quite solidly in place, the only change observable being a diminution of the brilliancy of the surface. Dr. Bestion cannot find any case on record in which a tooth had been successfully replaced after a later period than four hours had elapsed. This is related by Magitot as occurring in a child ten years of age. This author also relates several examples of this time having elapsed in his operations in which the tooth has been intentionally drawn and replaced after the diseased parts had been excised. He also relates the case of a laborious removal of a wisdom tooth, that necessitated the preliminary extraction of the second molar,' which was re-implanted about four hours after the operation.—Med. Times and Gazette.
The Eelations Between The Teeth And The UTERm—Dr. S. W. Caldwell, of Trenton, Tenn., publishes the following peculiar case in the Mississippi Valley Medical Monthly, January 10, 1885:
Becently, while spending the night in the sick-room, I had as company a married daughter of my patient, an intelligent lady aged about thirty-two years, who related the following—to me—most singular phenomenon. Said she: "I am the mother of five living children, one dead. My terms of gestation are unmarked by anything unusual. My labors last about eight hours on an average. My last came on as usual with me—pain beginning in the back, passing down to the lower part of my bowels. When I had been in labor about an hour, the pain suddenly ceased in my back and womb, but set up in a tooth that had been aching several times during the past nine months. The pain was paroxysmal, coming andgoingjust asitdidin the womb. The pain was in my tooth when my physician came, and he wanted to extract it, but it being one of but few remaining molars, 1 said to him that the cavity in it was small, and that I wanted to have it filled—couldn't he put something in it and stop the aching? He put cotton saturated with chloroform into the cavity. The pain left the tooth to appear in the back and womb; but the effect soon passed off; the pain in a few minutes returned to the tooth, to be again and again relieved by the chloroform. The doctor said no progress was being made in the labor, and that in his opinion none would be until that tooth was removed." "Did he say he had ever seen or heard of such a case before?" "ISTo, sir. Twelve hours had now passed; none of my former labors had gone over eight—generally six hours terminated them. I had become, I thought, exhausted, and asked the doctor to extract my tooth, which he did, and my baby was born in an hour."
The attending physician in the above case, with whom I was personally well acquainted, died not long after, so that I cannot have his history of it. My knowledge of the lady, though, justifies me in giving full credence to her statement.—Medical and Surgical Reporter.
Dental Alterations In Morphia-maniacs.—M. Combes calls attention to the teeth of those unfortunates who abuse the use of morphine. When they become saturated with the drug it attacks, first, the molars on their grinding surfaces, where it makes a deep cavity. It goes next to the bicuspids, then to the cuspids, and in these last it excavates quite a deep cavity. This decay does not seem to be painful, and it is not accompanied with periostitis, but it proceeds with great rapidity. M. Combes has noticed the entire set of teeth affected in a year after he saw the first one decayed. This destruction of the teeth coincides with the loss of the hair. The advice given is to suppress the dose of morphine little by little, and use hydrotherapia. For the local state a wash is recommended of a solution of iodide of potassium.—Phil. Med. Times.
Chloroform And Water As A Hemostatic Agent.—Dr. Spark recommends highly as a hemostatic agent chloroform and water in the following proportions: Chloroform 2 parts, water 100 parts. He claims that it acts with a rapidity that is truly marvelous; it has not the slightest disagreeable taste; it has no escharotic action; it is always at hand and made instantly; its cost is very slight; and there is nothing disagreeable in its application to interfere with the surgeon. In ail operations upon the mouth and throat he uses this alone as a hemostatic. Recently in removing a sequestrum from the inferior maxilla, which was of the size of a large chestnut, by its use no blood was lost in what is usually a very bloody operation. A simple washing arrested all tendency to hemorrhage. In tonsilotomy, simply gargling the part or using the atomized spray is sufficient to prevent the loss of blood.—Jour, de Medecine.
A New Hemostatic.—At a recent meeting of the Academy of Medicine, at Paris, Professor Bonafoux read a paper upon a powder which possesses great hemostatic powers, and is capable, it is said, of arresting the bleeding of large arteries, so that it will prove serviceable in important surgical operations. This powder is composed of equal parts of colophony, carbon, and gum-arabic. Experiments have been tried with it on the brachial artery in man and on the smaller vessels, on the carotid of the horse and other blood vessels of the same animal, with marked success. It has always prevented consecutive hemorrhage. The application can be lifted in the course of two or three days, when the vessels are found to be completely obliterated.
Practice Of Dentistry In France.—Notwithstanding the severe laws to prevent the practice of the medical art in France, the dentists have no regulation, and any one who likes can set up as dentist. There are practically no restrictions to their giving nitrous oxide, and, indeed, chloroform. This is partly owing to there being no official school of dentistry in France. Since American dentists have come so much abroad they have helped to start no less than two independent schools of dentistry in Paris, that are well attended, but have no legal existence. Prof. Brouardel, who is president of the Commission of Hygiene, tells us that there is a prospect of a bill being passed to regulate the practice of dentistry in France. There are a number of projects,—one to recognize one of the two excellent schools, to which are attached as professors several American dentists, and another to allow the practice of dentistry to remain free; but a third one is the most likely to go on record shortly as a law. It is to the effect that all dentists must at least take the lower medical degree (officier de sante) or become doctors of medicine, so that future dentists will be as good as doctors.—T. Linn, M.D., in Phil. Med. Times.
Vol. XXVII. PHILADELPHIA, OCTOBER, 1885. No. 10.
BY A. MOBSMAN, M.D., D.D.S., IOWA CITY, IOWA.
(Continued from page 535.)
PART FIRST.— PREDISPONENTS.
2. Errors Of Calcification.
Preliminary Considerations.—By calcification of the teeth, or dentinification, as it is sometimes called, is meant the metamorphosis of soft tissue, formed as to shape into hard tissue,—the dentine and enamel of the tooth. The period covered fey the process antedates eruption, and has no reference in this paper to subsequent changes in the tooth.
We are concerned in this connection with the manner in which this change occurs, the time of its continuance, and the place or places upon the matrix where the first hardening begins. The substance of both the dentine and enamel is represented in soft tissues, and the crown of the tooth is fully formed both in shape and size before hardening begins. The process of hardening is similar to ossification of bone in a matrix of cartilage. A point or points of deposit are formed, and from these the calcification extendsin all directions until the once soft tissue has become entirely changed by the impregnation of lime-salts throughout its substance, it (the soft tissue) becoming the organic matter of the tooth, which we can again isolate by treatment with acids, and which again when so isolated represents the size and form of the tooth. This should not convey the impression that the hard tissue or lime-salts are simply deposited in the meshes or fibers of this organic matter. No union could be more intimate. Both are changed so as to lose their identity, and are merged into the new substances which we call dentine and enamel. Vol. xxvu.—37.