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was ordered to be injected into the abscess every four hours. This was followed by a decrease in the temperature of one degree each day for three days. The patient then refused to submit to the further use of the remedy at that time, as the evolution of the gas, by distending the sac, caused pain. An increase in the pulse rate and an elevation in the temperature immediately followed. On the fourth day afterwards the pulse was 101 and the temperature 104°.
The peroxide was again used as before, and the pulse and temperature again rapidly fell, but through the obstinacy of the patient the treatment could not be carried out with any degree of satisfaction; still the fact was established that the remedy antisepticized the pus and evacuated the sac, as indicated by the rapid improvement in the symptoms.
Another case was that of a little girl, aged eleven years, with an abscess originating from the right inferior first molar and extending into the tissues of the neck, accompanied with extensive swelling and tenderness, but with no acute pain. The swelling of the parts had followed an attack of severe pain in the tooth and jaw, from which she had suffered three weeks previously. For a week the jaws had been closed, and the only food taken each day was a little milk. The child had been confined to bed for a part of the time, and when presented for treatment looked decidedly ill. The tooth was extracted under ether, and the pus cavity found to extend downwards three inches below the margin of the gum. Yery little purulent matter followed the extraction of the tooth, but on injecting the pocket with the peroxide large quantities were evacuated. The injections were continued once daily for six days, when the patient was pronounced cured, all discharge having ceased, and the swelling nearly disappeared. Under the ordinary treatment I should have expected to have seen the trouble continue for a much longer period, and perhaps to have seen the abscess point low down on the neck.
One other case was that of a lad nine years of age, who had received an injury of the inferior jaw by a fall from his bycicle, resulting in an extensive acute periostitis, involving the teeth and jaw from the second temporary molar of the left side to the ramus of the jaw on the right side. All of the teeth between these points were loose; pus exuded from the gums at the necks of the teeth, and I feared extensive necrosis. The treatment adopted was injections of peroxide beneath the gum at all points where pus was found to» exude. The condition at the anterior part of the mouth began to» improve at once, but opposite the first permanent molar at the lower margin of the jaw it was necessary a few days later to open an abscess which was about to point there. The injections were kept Vol. Xxvii—38.
up for two weeks; all discharge had then ceased, and the teeth had become firm.
Dr. Harlan has recently called attention to the use of this agent in purulent conditions affecting the maxillary sinus,* and I would suggest that it will be found equally valuable in the hands of the surgeon in nearly every variety of suppurative inflammation, especially in periostitis, necrosis, and deep-seated abscesses, where there is difficulty in completely evacuating the purulent matter by the ordinary means.
THE TREATMENT OF DENTAL LESIONS BY COMPRESSED
BY H. C. REGISTER, M.D., PHILADELPHIA, PA.
Warm air has been used to a limited extent in the surface-drying of cavities by means of the hot-air syringe, but compressed warm air has a much wider range of application, and compressed warmed dried air has a still greater range. Some of its uses in a general way I will briefly indicate: As an obtundent of sensitive dentine in the preparation of cavities; for the thorough removal of moisture from both vital and devitalized teeth before filling; the antiseptic treatment of devitalized teeth and roots; the thorough drying of roots before attaching artificial crowns, making a hermetically sealed joint; in putrescent conditions of the teeth—especially useful when associated with peridental ulceration; in the bleaching of discolored teeth; in the treatment of fistulae and abscesses; in ulcerations of the antrum and nasal passages; in recession of the gums and pyorrhea alveolaris, etc. By this means the detached gum can be lifted from the tooth by a steady jet of air, allowing an inspection of the parts and the removal of the calculus. By the same apparatus anesthesia may be produced by atomization, rendering operations on the gums painless. By the same means fillings of the oxychloride or phosphate of zinc can be perfectly crystallized before the fluids of the mouth are allowed to come in contact with them.
In bleaching discolored teeth, the greatest cause of failure, I apprehend, has been the presence of moisture in the dentine, preventing the absorption of the bleaching agent, and which the mere drying out by absorbents or even with the ordinary hot-air syringe does not affect. By gently forcing into the cavity an uninterrupted stream of warmed air under pressure, it reaches the terminal ends of the tubuli in both crown and root. If the bleaching agent is then introduced it will permeate the organ throughout its extent. I have seen discolored teeth of many years' standing thus restored to within a few shades of their healthy neighbors in less than thirty minutes.
* Archives of Dentistry, page 204, May, 1885.
Sensitive and hypersensitive dentine is effectually obtunded by a careful application of warmed air at blood heat. The application in such cases requires care to avoid pain at the outset. The air should be kept at about blood heat and the jet under ready control. In some cases it may be well to secure a surface effect from one of the obtunders in common use, such as carbolic acid, tannin, or atropia, after which the warm air can be used; and just in proportion as the moisture is removed, just in that proportion has insensibility been produced.
In putrescent conditions the air should be heated to from 100° to 125° F., and the current maintaind until every particle of decomposed matter is rendered innocuous by thorough drying. In such cases I have never seen subsequent peridental irritation, and if in this condition the tooth be hermetically sealed, safety from further trouble is assured.
In pyorrhea alveolaris the disengaged folds of gum may be thrown back by a steady jet so that an examination may be made, which would otherwise be impracticable, and the progress of the disease may frequently be retarded, and in some cases a cure effected, by forcing medicinal agents by atomization into the pockets. Fistulous tracts which refuse to heal under ordinary treatment yield when the medicinal agent is forced through them under air pressure. In a word, nothing since the introduction of the rubber-dam and dental engine has given me such positive results as warmed compressed air.
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CONOEENIHG SEPAEATOES. To The Editor Of The Dental Cosmos:
It is to be regretted that in the carefully and laboriously prepared article in the August number of the Dental Cosmos, on the history of the screw separator, Dr. Perry should have failed to mention the fact that from 1878 or 79 to the spring of 1882 he did no work on the separator practically, however much of "a thinking" he may
have kept up.
He was only aroused to again begin work upon the instrument by seeing my model in an incomplete stage in the hands of Dr. C. h. Browne, and for nearly an entire year he frequently borrowed and used this instrument.
The separators designed by me were first publicly exhibited before the profession on May 6, 1884, at the clinic at the depot of The S. S. White Dental Manufacturing Co. So I fail to understand Dr. Perry's statement that he knew nothing of them, for he was present on that date at the evening meeting of the First District Dental Society.
One might easily infer from the article that the haste was such to get a separator called the Perry separator on the market that only a few weeks after it appeared it had to be withdrawn to be improved.
Had Dr. Perry been frank with me, as I certainly meant to be with him, I should gladly have shown him over a few of the difficulties of which he complains in this article, and which I necessarily have met.
Some of these difficulties have been conquered, though at the expense of more than forty different instruments constructed during the experiments, which have extended over a period of perhaps five years.
The S. S. White Dental Manufacturing Co. requested my models in May, 1884, for the purpose of manufacture, but I did not think that the instruments had been sufficiently tested to justify me in acceding to the request, and I shortly left for Europe. In a very few months the advertisements of the Perry separators appeared, with the results mentioned.
However, now that he has undertaken to perfect what may fairly be called the Perry separator,—i. e., the instrument with double screws,—-I have great confidence, from my knowledge of his skill and ingenuity, that Dr. Perry will present the profession with a really valuable appliance, and I give him my sincere good wishes for that end.
E. A. Bogue.
No. 29 East Twentieth Street,
C0EEECTI0H FEOM DE. PEIEOE. To The Editor Of The Dental Cosmos:
The report of my remarks before the New Jersey State Dental Society, published in the September number of the Dental Cosmos, is on the whole very satisfactory; but in the third paragraph, page 525, the proof-reader, by a very natural transposition of the sentence, has made me speak of the Echinus as Aristotle's lantern, when it is only the pentagonal pyramid, which consists of five teeth embraced in their sockets, constituting the oral apparatus of this animal, that is so termed.
C. NT. Peirce.
Philadelphia, September 14, 1885.
PROCEEDINGS OF RENTAL SOCIETIES.
AMEEIOAN DENTAL ASSOCIATION -TWENTY-FIFTH ANNUAL
Second Day.—Morning Session (Continued).
Sections I and II not being ready to report, Section III, Dental Literature and Nomenclature, was called.
Dr. Atkinson read a paper entitled "Eipening and Kipeness," which was a description of his view of the process of development by the awakening of the latent energy in atoms, which are assumed to be unoriginated eternal bodies having motic and static possibilities; following the successive steps through the formation of the molecule, the corpuscle, tissue, organ, and system; and then tracing the various forms in which matter is presented to the consciousness of man through ether, gas, vapor, cloud, water, colloid, and solid.
Dr. Taft, chairman of the section, reported also a paper by Dr. W. O. Kulp, of Davenport, Iowa.
Dr. Kulp then read his paper, which was entitled "Nomenclature," and which, after referring briefly to the lack of a systematic nomenclature, proceeded as follows:
Eecognizing this lack of system, and having the fact of the necessity of some uniform method forced upon me as a teacher in this branch of our profession, I adopted a nomenclature in operative dentistry which proved highly satisfactory to me in the final examination of my classes, and I have reason to believe is fully as satisfactory to the majority of the individual members of the classes. I therefore present it to the profession through this body, at least as an aid in the right direction, if not adopted as I present it as a whole:
Names of the Teeth.
1st. Central Incisors, right and left, upper and lower.
2d. Lateral Incisors, right and left, upper and lower.
3d. Cuspids, right and left, upper and lower.
4th. Bicuspids, 1st and 2d, right and left, upper and lower.
5th. 1st Molars, right and left, upper and lower.
6th. 2d Molars, right and left, upper and lower.
7th. 3d Molars, right and left, upper and lower.
The Surfaces of the Teeth are divided as follows:
1st. Including the six anterior teeth, above and below (Incisors and Cuspids).
1st. Labial surface.
2d. Lingual surface.
3d. Proximal surface.
4th. Occluding surface. 2d. Bicuspids and Molars, above and below.