« AnteriorContinuar »
of the Council ; to elect Officers for the ensuing twelve months, and to transact the general business of the College. Such Annual Meeting may be adjourned by resolution thereof from time to time, in case the business brought forward should, from any cause, not be concluded.
XVIII.-The Council may at any time call a Special General Meeting; and they shall at all times be bound to do 80 on the written requisition of ten Members, specifying the nature of the business to be transacted. Notice of the time and place of such Meeting shall be sent to the Members at least fourteen days previously, mentioning the subject to be brought forward ; and no other business shall be introduced at such Meeting.
XIX.-At every meeting of the College, or of the Council, the resolutions of the majority present shall be binding (excepting only in the case referred to in Law 23); and at such meetings the Chairman shall have a casting vote, independently of his vote as a Member of the College, or of the Council, as the case may be. Members of the College residing beyond twenty miles of Charing cross shall be entitled to vote by proxy for the election of Council and Officers ; and upon all questions at General and Special General Meetings upon a poll being demanded in writing signed by five Members. In case of such poll being demanded, it shall be the duty of the Chairman to name a convenient day and hour on which the poll shall be opened and closed.
Law XX cancelled.
XXI.-The Council shall have the power to make Bye-Laws, but such Bye-Laws shall not contravene the spirit of the fundamental laws; fill up vacancies in their own number, and in any of the offices, and transact the general business of the College
XXII.-Every person upon being admitted a Member or an Asso ciate of this College shall sign the following Declaration :
“In consideration of my being admitted a Member or an Associate of the College of Dentists of England, I hereby undertake to agree to and abide by the Laws and Bye-Laws of the said College.
XXIII.—The College shall not be dissolved unless two-thirds of the Members shall vote for its dissolution.
XXIV.-No change shall be made in these Laws, except at a General Meeting of Members of the College specially convened for that purpose.
The following Laws, to become part and parcel of the constitution of the College, were also passed :
MEMBERSHIP.— All Dentists in actual legitimate practice on the 20th day of April, 1859, shall be entitled to become Members of this College without examination. The Council to determine all questions relating to legitimate qualification for membership by such practitioners.
Gentlemen who have not commenced practice as Dentists on the 20th day of April, 1859, shall be required to undergo an examination as to qualification to practise prior to being admitted Members of this College.
The Regulations for examination shall be under the entire control of the Council.
ASSOCIATES.—The Council shall have the power to admit as Associates of the College, without examination, assistants of Dentists, engaged as such, or qualified to be so engaged, on the 20th day of April, 1859.
After the 20th day of April, 1859, no person, except those qualified as above, shall be admitted Associates without passing an examination on dental mechanics. The nature of the examination to be determined by the Council.
Associates of the College and Assistants of Dentists shall be eligible for Membership, upon passing the necessary examination.
A cordial vote of thanks to the Chairman terminated the proceedings.
[Delivered on January 11th, 1859.]
ON PURULENT AFFECTIONS OF THE GUMS AND
MR PRESIDENT AND GENTLEMEN. THERE are few questions in Pathology more involved in obscurity than certain ones relating to that pathological condition, marked by the development in the body of a specific fluid known as pus, and designated by the Medical world as purulent disease. At the same time there is no condition more commonly evident in practice, and concerning which more has been written. Under so many circumstances is the formation of pus a leading process, that the mind of the practitioner is led almost to look upon such formation as a normal occurrence, incident simply to antecedent mischief. .
A wound is inflicted into soft structure; the wound bleeds for a time; the bleeding stops, but the edges of the wound not brought together, and not healing by what is called the first intention, there is soon produced in the open wound a free secretion, very simple in composition, resembling ordinary mucus in its general characters, and serving a protective purpose; shielding, in fact, the open wound from air, and by such conservation arresting that ultimate resolution in death known as the putrefactive change. Or a foreign body is lodged in a deep-seated part, a disintegration of tissue is the result, a cavity forms, and on the surface of that cavity there is set up an analogous change; a simple fluid is produced, and lines the inner wall of the cavity. A short time elapses, and in either case this simple fluid is transformed into the purulent secretion, into pus.
The nature of this transformation is the point most obscure. Like the first formed and simple fluid, the new product can have but one source: it must be derived from blood; the vessels supplying the locality in which the pus is presented must needs yield the material, for were this not the fact the formation could not be continuous. The secretion (for, for the moment, we may call pus a secretion) must be eliminated in the capillary system of vessels. A section of capillary surface has taken on glandular function, and a secreted fluid is the consequence.
The analogy which exists between the purulent secretion and blood itself further establishes the source of the secretion. The pus, like blood, contains albumen, contains a body having some resemblances to fibrine, contains water, contains corpuscles resembling intimately the white blood cell; it contains fat, contains salts common to blood, as carbonates, phosphates, and chlorides, especially chloride of sodium ; contains sometimes iron, and to complete the parity, possesses in the normal state an alkaline reaction. What definition shall we give to a fluid so singularly constituted, let us venture on a bold description; let us express in a sentence a whole book in disease ; let us call pus, modified blood, and purulent exudation modified hæmorrhage.
We must not, however, in this generalizing spirit be led to the opinion that pus is exuded from blood as pus. We protect ourselves from this error in again representing the pus-secreting surface as a glandular surface; and in stating that the blood, leaving its channels as blood, is transformed into the purulent fluid at the suppurating part.
At the same time we must not be led into the error of presuming that the formation of pus is an act purely local; and that blood out of which pus is produced is normal in all its characters.
These views would, either one or other, be equally extreme; nor is it easy, even admitting this, to indicate the precise relationship which obtains between disordered conditions of blood and affections marked by purulent formations. It is, perhaps, the nearest approach to the truth that can be made in the present state of our knowledge to say ;
That there are conditions of blood in which, irrespective of local injury or disease, the tendency to purulent transformation is broadly marked.
That in normal states of blood there are local changes which are capable, by an effect exercised on the blood supplied simply to the local part itself, of exciting a purulent secretion in such part, the compounds of which secretion are derived from blood.
That there are certain states of body in which there is general disposition of blood to purulent secretion, and at the same time in the body certain local points in which the formation of purulent secretion is largely favoured: or, to put the whole question into one proposition, that pus cannot be produced without blood as the supplying food, and organized structure as the transforming medium.
An illustration of the first of these conditions is given in the instance of what is called feruncular epidemic, i.e. where a disposition to the formation of pus, in form of abscess or boil, extends over a whole country. Here the general demonstration of the fact, and the variation of place in the bodies of affected persons, proves the mode of production to be general, and the local affection to be mainly accidental.
An illustration of the second of the conditions named is supplied in the instance of simple suppuration of a wound in a healthy person.
An illustration of the third variety is offered in cases where, in unhealthy states of body, the suppurative tendency is developed in the immediate vicinity of a portion of diseased structure ; as when, during depraved health, abscess and ulcerative suppuration occur around teeth which are necrosed or carious.
Now that I have enumerated and illustrated these three relationships between the blood and the secretion produced out of it called pus, I have said all, pretty well, that is really known. I could certainly lead you into very refined pathological argument on these relationships ; but then I should be leading you from the practical teachings of these lectures for no more desirable a purpose than display of erudition, and this too on topics which could not, by all the erudition in the world, be fully explained at the present time. I shall therefore leave the points I have laid down as a curt summary of what is known; adding only one more observation bearing on what has preceded.
While we cannot trace out the nature of that condition of the blood which gives rise to purulent formations, we are informed by observation of the external conditions which foster it. We have learnt that the pus-producing disposition is an indication of deterioration of blood. We see that when the system is enfeebled, whether by diathesis hereditarily supplied, as by the strumous diathesis—whether by epidemic influences-or whether by deprivation of nitrogenous food or the inhalation of bad air—that under these circumstances the tendency to purulent deposit in local structures is marked, and that, in extreme instances of the kind named, the act of suppuration may take its absolute origin from blood thus depraved.
Hence we have reduced almost to a principle in medicine, the saying that suppurative tendency is a sign of an impaired or vitiated nutrition. Hence also we reason in speculative argument, that pus is blood transformed into a lower form of organization, and we adduce in evidence of this view, that the purulent fluid is incapable of organic construction, and that animals in which the respiration, the circulation, and the animal tem