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are not permitted to roam very far in the fields of abstruse deduction before it becomes necessary to turn back again to the teeth themselves, and in the visible phenomena of their diseases, or of their orderly development, or equally orderly wearing out, seek a confirmation or refutal of that which we had deduced from previous experience; and, because the dentist is so tied to his teeth, there are some within our ranks, and many without, who raise the question whether it is not presumption to speak of ourselves as a part of the great medical body. We must be content to let the slur pass by. The fact that the dentist has to deal with the peculiar kind of human organ which calls more for the mechanical operator's interference than any other part of the body, is not a fundamental fact that should necessarily lower our usefulness, or define our standing, or cut us off from other relations. If any one had such a notion, the admirably chosen and charmingly presented remarks of the president of the Academy of Medicine to-night might stand as a sufficient refutation of it. But the fact is we are all aiming at one thing. Here are men and women and children with bodies fearfully and wonderfully made, composed of a great variety of organs, so blended together that if one member suffers all the members suffer with it; and it requires the services of a very large number of careful, skillful, earnest, serious men to combat the troubles and difficulties which human flesh is heir to; and whether the man test urine, or trephine a skull, or pass a catheter, or prescribe a regimen for a sick room; or whether he seat you in his chair and remove a decayed portion of a useful tooth, and put something else there that will restore the organ to its former integrity,—whether he does one. of these things or the other, what difference does it make? If the well being of all parts of the human body and the proper performance of all its functions in this world is worth having, then the question only needs to be asked, Are these men ministering to that or not? If they are, they are members of the fellowship who minister to it in all the various ways known to the great science of medicine.

Perhaps this is too long a statement of what seems so plain. Nevertheless, one often has the fact forced upon him that just such an explanation needs to be made. Let me in conclusion say, that while we are glad to be so cordially received not only into the rooms but into the fellowship of our brethren of the Academy of Medicine, we feel at the same time that those who claim to occupy a position in the ranks of scientific medicine, no matter what that position may be, take upon themselves a large responsibility. I am not sure how far, but I am sure that very far, I speak the sentiments of all who are here, and of all the better portion of the dentists throughout the world, when I say that every year there grows more upon us the impression of the absolute necessity for a knowledge not only of dental art, but for the mastery and familiar application of all science that in any way has a bearing upon this art, or upon the objects of this art. We are ashamed to have it thought that we merely manipulate the dental organs; to have it supposed that it is enough for us to make a trade of our daily operating, and then cast it out of our minds and give it no further thought. We are ashamed to have that supposed, not because we feel that it is true, but because we feel that the supposition does us wrong. This society had its origin, and has its continued existence, in the effort of dentists to know all that may be known which has any bearing upon our work; that is to say, to add science to art. We do not care in what quarter of the world or in what branch of human science some new discovery may be made; we only care to know that, coming from the East or from the West, from the North or from the South, from things familiar or things wholly new, here is something born yesterday and announced to-day, which has an application to the dentists' art,—another item added to that science which, while it comes after our art, is nevertheless the mistress of our art. Follow the history of dentistry for the last twenty-five years, and you will see that there is no body of men who minister to the necessities and diseases of the human body who more readily welcome and grasp whatever, in any of the branches of science, may possibly contribute to the better performance of their function.

Mr. President and gentlemen of the Odontological Society, if I have grown warm and boasted too much, forgive me. The boasting is at an end. You laid upon me this pleasant task of responding to the welcome of the evening, and while I had arranged in my mind such a response as I thought might befit the words of welcome that would greet us, I found, as I sat here, that the welcome was so much more cordial and prolonged and broadened than I had fancied it might be that I have run away from my preparations; but if I have spoken with more warmth and at greater length than I had intended, I hope I have only spoken the thoughts of your minds and the sentiments of your hearts.

Pesident Jarvie. Gentlemen, we will now hear from Dr. John AWyeth in regard to some operations upon the mouth and jaws.

Dr. Wyeth. Mr. President and gentlemen, when I was invited to come here and present some cases of surgical operations upon the mouth and jaws, I looked over my note-book of the last twelve months in order to select some typical cases of lesions of the palate, tongue, upper or lower jaw, that might interest you, and I will briefly report eight operations. I shall not take up much of your time, as I desire you to look at the cases rather than to be talked to about them, because with respect to diseases of the buccal cavity you undoubtedly know as much as I.

Case I. This young lady, nineteen years old, had a congenital cleft in the palate, and grew up with a bad articulation and faulty pronunciation, her speech having the nasal sound or twang so common in these cases. When I first saw the patient, last April, the hydrochlorate of cocaine was being introduced as a local anesthetic, and I determined to try it in her case. With a camel's-hair brush I applied a four per cent, solution every five minutes for half an hour, painting it upon the edges of the fissure and over the entire arch of the palate and fauces. Complete anesthesia of the parts was obtained, and a greater degree of toleration in the muscles of the palate than I have ever been able get with other anesthetics. We know that the reflex movements of the palate cannot be completely controlled in ether or chloroform narcosis, but in this instance, with the patient's volition aided by the cocaine, the control was perfect. The patient held the tongue-depressor, and was of great service to me and Dr. Wardwell, who assisted. The edges of the cleft were freshened, the sutures introduced and tied, and the palatoglossus, palato-pharyngeus, and levator palati muscles of either side were divided. In cutting these the patient experienced some pain, because I was working outside of the zone of local anesthesia. The union was perfect—as you see!

Case II was almost analogous to this, excepting that it was complicated with an osseus fissure, for the closure of which the periosteum was lifted and slid to the median Hue and sutured,—the result being union throughout.

There are some men in your profession and in mine who are doing good work in remedying these deformities of the palate, and I may state that there is considerable difference of opinion between them in regard to the propriety of the operation. I have only operated upon two patients for cleft palate, and those were during the last twelve months. Both operations have been successful; and while I do not claim any great credit for success in this branch of operative surgery, there is one feature in connection with these cases that encourages me, and that is the improvement in articulation. When I first spoke with this little woman I could not understand one-tenth of what she said. Now I can understand everything she says; and her friends, who are better able to judge than I, appreciate the fact that there is a marked improvement in this respect.

I will finish this subject by showing you these instruments, for which we all are indebted to a member of your profe8sion,-my good friend, Dr. Goodwillie,-and I consider them the perfection of instruments in the surgery of the palate. The fact is that, if I have stolen his thunder, I have armed myself with his instruments, and tried to get some credit by using them successfully.

Case III. This man I operated upon a week ago to-day, in my ward in Mount Sinai Hospital, for cyst of the antrum. Two years ago he first had pain in the region of the antrum of High more, and went to some dispensary, but was not treated particularly for that, and it went on until July last, when he came into the hospital. A colleague of mine made a puncture in the antrum of Highmore in front of and above the anterior upper molar that discharged a little fluid very much like the white of an egg. His diagnosis was a cyst of the antrum of Highmore, but he did nothing more at that time. The disease progressed, and gave the patient a great deal of annoyance and no little pain. A week ago the patient was etherized, and I made an incision from the corner of the mouth to the angle of the jaw, passing parallel with and below the duct of Steno. I then extracted the two bicuspids, and with a gouge removed a portion of the anterior wall of the antrum. The cavity of the antrum was then packed with iodoformized gauze. The wound in the cheek was united by first intention. My hope was to destroy this cyst by the process of inflammation. If this primary operation does not succeed, I will have to remove a greater part of the upper jaw and dissect out the cyst-wall.

Case TV was that of a lady twenty-three years old, who had had an abscess in the antrum of Highmore for thirteen years. I drilled into the cavity through the place from whence the anterior molar had been extracted, and found pus. The cause of the abscess was found to be an extra tooth lying loose in the antrum. I removed it and the patient was rapidly cured.

Case V was that of a boy six years, old, with necrosis of the left lower jaw near the angle. A large piece of bone was removed and a cure effected.

Case YI I think is one of more interest to you. This boy came under my care a year ago. He had at that time a little tumor growing upon the anterior part of the alveolus, which was suspected of being a sarcoma, and upon examining a little of it under the microscope I found it was. The little fellow was anesthetized, and I split his lip down through the median line; made an incision around to the angle of the jaw, and removed about two inches of the boneWhat is astonishing to me, and anatomically interesting, is the fact that the opposing parts of the upper and lower jaws are in perfect line, and in masticating he brings the upper and lower teeth together, although no prosthetic apparatus has been inserted.

Case Til. This young man had a tooth extracted from the left side of the lower jaw in 1883, and soon after that an abscess formed just opposite the point where the tooth had been extracted. Six or eight months after the tooth was removed he called upon me to treat the abscess, which had been opened. All I did at that time was to put a dressing on it and send him to the country. When he returned the abscess was entirely healed, and it gave him no further trouble until about six weeks ago. A month prior to that date he noticed that a swelling was occurring in the same place as before, and by the time he arrived in New York City the second abscess had opened spontaneously. Last week I etherized him, and cut out all the diseased tissue. I went down to the bone, not doubting that I would find an abscess cavity in the lower jaw; but although I exposed the bone in front and back of the place where the tooth had been extracted, I did not see a sign of necrosis.

Dr. Abbott. What tooth was extracted?

Dr. Wyeth. The anterior molar.

Dr. Abbott. How old is the patient?

Dr. Wyeth. Twenty-one.

Dr. Abbott. Had he ever lost a tooth from that side before?

Dr. Wyeth. He says not.

Dr. Abbott. There may be a wisdom tooth back there, doctor.

Dr. Wyeth. I think not. I examined the jaw thoroughly.

Case YIII was a man from Western New York who came under my care a year ago for tie-douloureux in the left inferior dental nerve. I trephined the jaw at the angle and extracted a half inch of the nerve. The patient was immediately relieved, and at last accounts was well.

Dr. J. Morgan Howe. Mr. President, 1 have been very much interested in the presentation of these cases by Dr. Wyeth, and I feel like asking a great many questions regarding them, but will limit my queries to one or two on the subject of cleft palate. The doctor says he has operated upon but two cases, but I am sure he must have studied the subject a great deal, judging from the beautiful results, surgically considered, that we have witnessed to-night. Will he kindly tell us of his experience with regard to the degree or amount of improvement in speech. I believe none of us heard this young lady speak; and I would like to ask him how much improvement there is, how much may be expected, and what estimation he has for these operations as a remedy for the defect of speech incident to cleft palate; also, whether there are any indications that would contra-indicate operations for cleft palate. I think the doctor can enlighten us some if he will be so kind as to give us his ideas on this

subject.

Dr Wyeth. In regard to indications for the operation, my expe\ you know, very limited, and I am not really an fait in the

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