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letting by leeches as the remedy. You will find in that practice but little satisfaction. Dr Arnott, in cases of acute inflammation, from which the suppuration in acute cases originates, would recommend extreme cold-congelation-as the local remedy. It is undeniable that extreme cold is the best local narcotic known, and could it be applied readily cold would be the most powerful local remedy in the hands of the practitioner; but, inasmuch as it is not easily applied, it fails in half its value as an everyday resource.
In these acute stages of disease, the systemic treatment must also be remembered, and such remedies may be used as tend without producing extreme depression, to reduce vascular action, and, most of all, to remove pain. For these two indications, antimony and opium are the grand remedies. In acute inflammation of the dental pulp, in inflammation of the lining of the antrum, in inflammation of the periosteal membrane, it is marvellous to see the effect of a quarter grain of tartarized antimony and a full grain of opium powder. You shall search the Pharmacopoeia till Doomsday, and you shall find no better remedy for the symptoms I have described.
2. When pus has once formed, it is a principle to try no longer to stop its development, but if it is exciting great pressure to set it free by operation, and to support the system to the eliminating work that is before it. You nourish your patient judiciously well now. You nourish him with animal food ; a little wine. You give him fresh air in all the abundance in which it can be procured. If you give him remedies, you prescribe those which shall correct secretion and sustain—the grain dose of quinine, or the ounce of bark decoction; the five or ten minims of dilute mineral acid; or scruple dose of the carbonate of iron. And do not be afraid, either, to begin your supporting plan too soon. There is a mania against supporting remedies out in the world. Let the mania have its swing unheeded. Hecatombs of sick have died under and from depressants ; there was never sick man yet who died from the judicious application of natural supportive measures.
I have said that the first local measure required in these purulent diseases is to give free exit to the purulent exudation. True, and if recovery responds to this, enough has been done. But if the purulent exudation remain, and is clearly kept by a foreign body, as by a necrosed tooth, or portion of necrosed alveolus, clear it is that this foreign body should be removed.
3. About washes and lotions in cases of purulent exudation. If the secretion of pus be very free; if the pus is confined in any cavity as the antrum, but not so confined but that it can be me. chanically washed out, it is proper in both these cases to remove it by washing, for which purpose simple warm water as a wash is the golden lotion. Should à granulating surface from which pus exudes be slow to repair, it may be stimulated by applying to
it a water wash containing one or two grains to the ounce of the sulphate of zinc. Or should a granulating surface put forth an excrescence, such excrescence may be destroyed by caustic. Or should a spongy structure, as the gum, remain soft and vascular, some very simple astringent water (there is nothing better than alum water) may be applied with advantage.
But to invent remedies farther removed from common-sense requirement and simplicity than these simple ones—to mix a crucible of messes together, and like our dog doctor rascal (from whom may the very dogs be preserved !) say, “Here is a lotion of specific power; come, buy : – come, buy;" — this is specific quackery, be its guise and representation what it may.
Lastly, in those purulent affections which seem to have a pure constitutional origin, such, for instance, as the purulent ulceration, or cancrum oris, the treatment from first to last is primarily systemic. Locally, all that can be achieved is to remove foreign bodies in the ulcerated part and to keep the mouth clean by simple water washing.
Medicinally, in these cases much may be done. A gentle aperient is always good; and two remedies at hand appear to exert a special beneficent action. These two remedies are the chlorate of potassa, and the carbonate of iron. The first may be given in doses varying from five to ten grains three times daily ; the second, in the form of syrup, in from ten to twenty grains three times daily. The smallest of these doses may be given to infants of a year old, and either remedy finds a good menstrum in common water.
Hygienically, the treatment will turn on the air respired : this must be free and pure. Next, this treatment must turn on diet. It will be found that the majority of children who suffer from this affection have been kept on starchy foods-on bread, on rice, on gruel, or the immortal tops and bottoms. These must be removed, and simple milk diet substituted. You need think of no other food for these sufferers, if you can secure for them good milk, and plenty of it; the egg and the flesh, the oil and the wine, are all concentrated in this one fluid-this food provided and even ready prepared by the Divine Father.
MONTHLY MEETING, TUESDAY, MAY 3RD,
JAMES HARLEY, ESQ., IN THE CHAIR, Mr Mather, gas engineer, exhibited a self-sustaining gas blowpipe apparatus, invented by himself, for soldering. It consisted of a boiler containing water, which was converted into steam by a small gas burner underneath. The steam (which is the blowing power) was conducted by a pipe through the burner just named, thereby becoming superheated, and passed on to another burner, where it acted as a blowpipe jet with a powerful effect in projecting a flame upon anything requiring soldering. By regulating the quantity of gas burning under the boiler, either a strong deflagrating flame, or a fine pointed one, was obtained, as desired. This apparatus leaves the hands of the workman perfectly free to operate in any way he pleases, and is so portable that every workman in a shop could bave one for his use. It only requires the water to be replenished once in an hour, and it is so arranged that hot water is always ready for it. The cost of it is less than half that of any bellows arrangement for the same purposes, being merely 258. Its powers were exhibited by some articles being soldered with silver in a very clean and rapid manner, and quite to the satisfaction of the chairman and gentlemen present.
The Chairman said that the invention displayed much ingenuity on the part of Mr Mather. He was sure the members present appreciated Mr Mather's kindness in bringing it forward this evening, and in their name he begged to thank him for having done so.
Mr Rymer said it had just come to his knowledge that a large number of members were under the impression that the ordinary meetings of the College would be immediately discontinued, in consequence of the resolutions passed at the last Special General Meeting. This was a misapprehension. The meetings announced for the Session would of necessity be held, and these would not terminate until after the Meeting of Members on the first Tuesday in June. Mr Rymer proceeded to place the meeting in possession of very interesting information with regard to the exertions of several gentlemen during many months past towards forming a School of Dental Science, wherein a thorough practical knowledge of Dental Surgery and Mechanics in all their branches would be taught. The School was, however, entirely independent of the College of Dentists, but the instruction to be afforded would include the requirements of the Body of Examiners of the College as well as those of any other Examining Board in this country or elsewhere. A Committee of noblemen and gentlemen were also about to make arrangements for opening an Infirmary for Diseases of the Teeth, and he believed they would so co-operate with the Faculty of the Metropolitan School of Dental Science, as to secure mutual advantages.
Mr Humby then read a paper on TAKING IMPRESSIONS OF THE MOUTH, of which the following is a summary :-A CORRECT IMPRESSION of the mouth is essential to success in the adaptation of artificial teeth. Many materials have been, and are still, used in taking impressions. The most common is pure bee's-wax. This is spoken of in a work published so far back as 1757 (more than a hundred years ago) by a Monsieur Bourdeau. But plaster of Paris, a mixture of bee's-wax and rosin, gutta percha, and other substances find their advocates respectively amongst dental practitioners. I believe one and all to be objectionable. There is, however, a material which I have found answer the purpose in every particular, namely, the plastic compound introduced by Mr Stent, of Coventry street. With this composition I have never found any difficulty in obtaining an impression, even in the most unpromising case. I do not mean to say that I have always been successful with the model trays in general use, as there are cases where I have been unable to get an impression with them, but I have overcome the obstacle by means of a small invention of my own, which I will explain to you. The invention consists in adapting a tray so as to render it capable of being rendered broader or narrower at pleasure. The advantages are these : In a case where the alveolar ridge is broad and the mouth small, the plastic compound may be introduced into the mouth most conveniently, the tray being partially closed, and when in the mouth expanded to the required breadth. The front part of the tray is movable by means of a screw, so that in cases where remaining teeth project unduly, room may be made for them. The composition can be pressed into the palate by turning the thumbscrew attached to the handle. Lastly, three sizes only of the tray are required by the practitioner, as each can easily be enlarged or diminished.
Mr Humby exhibited then several difficult impressions he had taken with the improved tray and Stent's compound, including one of a very remarkable case of cleft palate, and concluded by thanking the members for the attention with which they had received his observations.
The Chairman remarked that the tray alluded to by Mr Humby had been illustrated and explained in the DENTAL REVIEW ;' nevertheless he felt indebted to Mr Humby for exhibiting to the meeting the invention itself. He was, however, of opinion that cases were extremely rare where correct impressions could not be taken with ordinary trays and pure wax.
Mr Finzi considered that Mr Humby had exercised considerable ingenuity in the adaptation of his model tray.
Mr Rymer thought that pure wax was preferable to every other substance in taking impressions, and as he was generally sufficiently successful with it, he doubted whether he should employ any other material unless superiority was clearly proved. He had tried a composition very similar in appearance to that placed in his hand by Mr Humby, but he found that it required a high temperature to soften it, and that it was necessary to obtain the impression whilst the composition retained such great heat that few patients could endure it. In one case, of an old sea captain, he remembered its employment had been followed by exclamations condemnatory of the unpleasant sensation caused by the heat, in strong terms which he would not then repeat.
Mr Humby said that the composition alluded to by Mr Rymer was quite different to Mr Stent's; in proof of this Mr Humby softened some of the latter in presence of the meeting, and Mr Rymer acknowledged that the materials were not the same, as the objectionable heat spoken of by the latter gentleman was manifestly not present in the compound exhibited by Mr Humby, although it was rendered sufficiently soft to take any impression.
After some further remarks from Mr W. Perkins, Mr Hockley, and others, the Chairman proposed a vote of thanks to Mr Humby for the paper he had read, which was carried unanimously, and the meeting adjourned to Tuesday, June 6th.