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once thoroughly stopped, nothing served to ward off death, while, when respiration stopped, even for a minute or two, with artificial respiration there were good chances of recovery * * * Of all anesthetic agents, the quickest and safest, but the most difficult to administer really well, was nitrous oxide. To get its full effect it should be administered pure, all air being rigidly excluded. Deep snoring and an insensitive conjunctiva were the best signs of insensibility. Pregnant and suckling women took gas without any deleterious consequences; children, even those who suffered from chorea, or epilepsy, took it well; great age was no bar, he having given it on one occasion to a woman aged 94. From experiments made on himself, he had learned that just before the loss and the return of consciousness the hearing power was greatly intensified, and he warned surgeons to be careful in their remarks, and advised that the room to be kept as quiet as possible * * * Ether has one great advantage over those anesthetics which depress the heart's action; for the vessels bleed so freely as the operation proceeds that the surgeon is obliged to tie a much larger number; hence there is seldom secondary or even any subsequent hemorrhage to interfere with healing. Chloroform tends to produce syncope; whenever this appeared imminent a few whiffs of nitrite of amyl furnished the quickest means of restoring the heart's action. The anesthetist, besides this drug, ought always to be provided with a pair of tongueforceps, and the instruments necessary for tracheotomy * * * He summed up his remarks as follows: 1. It was well to avoid all anesthetics which tend to depress the heart's action. 2. For short operations nitrous oxide is the best agent. 3. For longer operations, except where it is desirable to avoid hemorrhage, as in some eye operations, or when the cautery was used, ether answers perfectly. 4. The best time for operating is the early morning. 5. The nasal tubes are of little use. 6. Mtrite of amyl is the best cardiac stimulant.—Proceedings Medical Society of London, Med. Times

Affections Of The Gum In Eelation To Other Diseases.—Dr. Kaczorowski {Przeglad Lekarski, Nos. 28 and 29, 1884, and Vratch, No. 32, 1884) draws attention to a connection existing between gingival affections and certain other diseases. In four of his cases chronic gingivitis caused the occurrence of hallucinations, melancholia, nervous excitement, and insanity. Extraction of destroyed teeth and appropriate treatment of the inflamed foul gums were followed, in each of the cases, by restoration to health of the nervous system. Further, the author saw several instances where affection of the gum led to general septicemia. He thinks generally that premature senile debility of the organism may often depend upon dental caries, leading to absorption into the system of septic products of slow decomposition.—London Medical Record.


To The Editor Of The Dental Cosmos:

On the 26th of November I tested the use of hydroclorate of cocaine in dental operations by hypodermic injections, according to a discovery made by Dr. Kichard J. Hall, of Roosevelt Hospital, and at his suggestion, as he was about to have me operate upon an extremely sensitive central incisor. I injected eight minims of a four per cent, solution, as nearly as possible in the infra-orbital foramen,—reached through the mucous membrane of the mouth,—and in about two minutes there was complete anesthesia of the left half of the upper lip and cheek on both the skin and mucous surfaces; also of a portion of the nose, and the left side of the lower border of the £ums, from the median line beyond the bicuspids. I inserted a gum wedge very firmly, causing no pain, and excavated and filled the tooth without giving Dr. Hall a sensation of pain, although before the injection the tooth was exquisitively sensitive. To use the words of Dr. Hall, which I quote from the New York Medical Journal, of December 6, " piercing the mucous membrane with the needle caused pain like the prick of a pin, but its subsequent introduction until it struck the bone and the injection of the solution were not felt."

I have followed up this experiment with a number of others, having more or less success in all of them, particularly with the lower teeth, as I have repeatedly anesthetized all of the teeth on one or the other side of the, jaw, by an injection of eight drops into the inferior dental nerve at the point of its entrance into the ramus of the jaw. We can affect the anterior superior dental nerve by injection at the infra-orbital foramen, and so anesthetize the centrals, cuspid, and bicuspids. I have not yet ascertained what can be done with the superior molars, whose more direct nerve communication is so imbedded in the superior maxillary bone, but, from an experiment made by my brother Spencer, I believe an injection near the roots of those teeth would be efficacious.

Cocaine is apparently a powerful agent, and that suggests caution in its use, as some people would be able to endure much more of it than others. I should not look for harm from an injection of sixteen drops of a four per cent, solution, though, in any case.—Charles A. Nash.

To The Editor Of The Dental Cosmos:

Dr. J. Morgan Howe, in the December number of the Dental Cosmos, writing of the hydrochlorate of cocaine, says that after about two weeks a fungous growth appeared in the solution, which as time passed seemed to destroy the efficacy of the drug. I would suggest for the prevention of this growth the use of the oil of cloves, in the following manner: Add to one drop of the oil of cloves four drops of alcohol; let this stand a few hours, and then put one drop of the preparation to each ounce of the solution of cocaine.—W. G. Foster, Baltimore, Md.

A Lathe "drip."—Having tried several appliances for keeping corundrum wheels wet, all of which were more or less annoying, I hit upon the following plan, which may be of service to others: Take a Squibb ether-can (there are usually plenty of them lying about the office), and solder to it, near the bottom, a tin tube, about one-quarter of an inch in diameter. Then perforate the can through the tube with an old excavator, pointed so as to make a hole about the size of a pin. Fill the tube lightly with absorbent cotton or sponge, allowing it to protrude so as to rub against the stone; then fill the can with water and cork it with a good, soft cork, and it is complete. When it is tightly corked there will be no flow; loosen the cork, and the water will flow, much or little, as you desire. Mine works very nicely, and is always ready for use. Of course, the appliance should have legs to raise it to the proper height.—A. Morsman.







A Reprint from the Transactions of the Illinois State Dental Society for 1884 contains two articles contributed by prominent men of the dental profession who are opposed to the generally accepted theory that defective enamel of the teeth is the result of constitutional disturbances. Professor W. H. Eames, author of the first article, says:

"It is not due to constitutional disturbances affecting the epithelial structures, such as measles, eruptive fevers, mercury, syphilis, eclampsia, etc., which are supposed to cause an arrest of development and a consequent defective enamel structure, but to a blight or death of the ameloblast, or, in cases of fissures, a ' rupture,' being the result of a separation of the ameloblastic layer."

It would seem from the above that heredity, evolutionary processes, or something else is back of all opposing influences and diseases which act upon the protoplasmic matter that is to become part of the enamel organ, causing blight or death. As the matter in that organ is living matter, it is, of course, subject to death, but what causes the death of one or more living cells Professor Eames does not satisfactorily make evident when he tells us that "the succession of furrows observed may be accounted for by assuming that there is a period of rest for the incoming tooth; the cells (absorbent cells), acting upon the enamel when the tooth is at a period of rest, form a furrow or groove across the surface. When the period of growth sets in the tooth shoots onward, and a portion of unaffected enamel passes beyond the reach of their influence, forming a ridge; again a period of rest sets in, and again the cells act upon the enamel brought in immediate contact, and another furrow is formed. Thus, any number of furrows and ridges are VOL. xxvii.—5.

formed, dependent upon the continuance of the abnormal action of these cells. As this action is due to systemic conditions, all teeth in contact with the organ at the time are alike acted upon; hence the relative position of the markings on the incisors and canine teeth."

I am inclined to think that the normal action of the absorbents never produces unsightly marks and grooves on enamel of the permanent set of teeth. I have, however, seen the enamel discolored and somewhat disintegrated on emerging from the gum after the removal of roots of the deciduous teeth, but I attributed this to ulceration, and not to the action of absorbents, whose function is not to attack the hard, or even soft, tissues without just cause. There can be no good cause for destruction of the enamel, while their action in removing roots of the first to make room for the second set is reasonable and according to a law of the organism, resulting in a change in the dental apparatus of the child to that of the man, which is as great a necessity for the perfection of the adult as the metamorphosis of the larva in the chrysalis state for the perfection of the imago, or the tadpole for that of the frog.

But we are told that it is the abnormal—not normal—action of the absorbents that does the mischief, "the cells acting upon the enamel when the tooth is at a period of rest." Professor Eames also says that abnormal action of absorbents "is due to systemic conditions." He certainly did not refer to measles, eruptive fevers, eclampsia, or any similar condition, for that would have landed him squarely on the old theory. What these systemic conditions are we are not informed. If he had in mind healthy conditions, the wonder is the greater, for it is hard to get a conception of a being having healthy organs, one of which preys upon some other organ.

Let us imagine that the assumed habit of alternation of action of the enamel organ be transferred to the absorbent organ. The latter would then act normally upon the roots of the outgoing teeth for a period, and then act a6-normally upon the incoming set for another period, grooving the enamel. This would be followed by a period of rest, and a ridge of enamel would be formed before abnormal action again took place, and thus furrow after furrow and ridge after ridge would, most mysteriously, come into view. This supposition, however absurd it may seem to be, would, without doubt, as readily be received by that class of dentists and physicians who have an idea that there is connected with the most mysterious phenomena of life something of a supernatural character. When such persevering searchers after hidden causes discover vitality, an unfathomable mystery, or anything that appears to be supernatural, all investigation comes suddenly to an end.

If, now, the absorbents take on abnormal action just long enough to plow a furrow, and then come to a state of rest during the formation of an enamel ridge, the work of marring the tooth must be guided by a little intangible deity residing within the dental apparatus. Perhaps this view of the mystery is objectionable. We then have no other recourse left us but to fall upon states and conditions of the system for an explanation; for Professor Eames tells us that the abnormal action "is due to systemic conditions," and that drives us to the discouraging conclusion that the profession is no wiser for the theory.

The second essay referred to at the beginning of this article was written by my brother, Professor L. C. Ingersoll, of Keokuk, Iowa, dean of the Dental Department of the Iowa State University. He joins hands with Professor W. H. Eames,—not in his theory, however, but in opposing the old theory, hoping thereby to establish one of his own, which in his judgment "will sufficiently account for all observed cases." My brother having consented to the publication of my views on the stand he has taken, I herewith present them in connection with some remarks on Professor Eames's theory, having the kindest feeling toward both these gentlemen.

After treating in a light manner the arguments that have been urged in favor of the old theory, by comparing the grooves and ridges on the teeth with the imbricated order of ridges in a cow's horn, the rings and constrictions in the barrel of a goose quill, and other similar examples that have been published from time to time by unthoughtful dentists, Professor Ingersoll says:

"Now, if it is possible for you to disabuse your minds of so erroneous a theory, after cherishing it long, you will be prepared to consider another theory, and to mark its coincidence with well-known facts. The statement of the new theory is this: that these markings do not occur during the follicular development, but are the result of chemical action occuring after the development of the crown, and after its emergence through the gum. The fact of the erosion of the enamel at the margin of the gum, in the form of a groove, is one of universal observation. It may be considered an accepted fact that a horizontal groove or line may thus be produced along the labial or buccal face of a tooth, and also, as sometimes seen, on the lingual faces. This dissolving of enamel in a horizontal line, at the margin of the gum, may occur at any period during the emergence of the crown—at the time when the point of a cuspid has just made its appearance, or when half the crown is seen. In the latter case the marking will appear on the fully developed tooth, midway between the point of the cusp and the margin of the gum."

The statement that these markings are "the result of chemical

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