of the lesions of the dentine, or from embolism of the vessels of the pulp, &c.

Another point in favour of their pathological origin is the fact that their presence in the pulp produces more or less of neuralgic pain. To exemplify this, I here show you two or three out of a number of cases I have come across, where the presence of secondary hard formations in the pulp was the cause of severe neuralgic pain. Case No. 1, Lady, æt. 40. Had suffered greatly for two years from neuralgic pains in head and neck, which she attributed to a M., her Dentist in England having refused to extract it, although asked repeatedly to do so, averring there was nothing wrong with it. On examination, I discovered a small amalgam filling on one of the approximal surfaces, while the encircling gum seemed very loosely adherent to the neck of tooth. On tapping the tooth it was pretty painful. Suspecting the presence of pulp nodules, I decided to extract the tooth. On splitting open the pulp cavity the cause of the trouble was at once apparent, calcification of the entire pulp having taken place, with the exception of the radical portions, upon which this calcified mass must have pressed, and caused great irritation. The cementum of palatine root was dead, and had a deposit of tartar upon it, nearly to the extremity of root. The pathology of this case would probably be this. The gradual deposit of tartar on palatine root would first irritate the periosteum, and through it the pulp, which would speedily set up calcific changes in this organ; as the tartar spread over the root, the periosteum, along with the cementum, would be destroyed; the stopping in all probability would also produce a certain amount of irritation. Case No. 2, Man, æt. 38, had suffered great pain for three weeks in M, accompanied by temporal neuralgia. The tooth, excepting a slight fissure on crown, appeared perfectly sound and healthy, and I wished him to try it a little longer, but he would not, so I extracted it. The tooth, on account of its density and hardness, I had the greatest difficulty in splitting, on accomplishing which I found three pretty large nodules in the pulp cavity, which, I have no doubt, were the cause of all the suffering, as there has been no return of the pain since the extraction of tooth, now more than a year ago. Case No. 3, Female, æt. 18, Tooth M, carious on distal surface, without exposure of pulp. Patient had suffered very severely for four months from temporo-occipital neuralgia, which she thought arose from this tooth. The teeth being crowded I decided to extract. On opening pulp cavity there was exposed to view a large calcification of the pulp.

There has been no return of the pain here either after extraction.

The most frequent cause of calcific change in the pulp is caries; then comes periostitis, abrasion, and erosion. As we all know, neuralgia is a frequent accompaniment of chronic inflammation of the pulp. In all such cases which I have examined, I have invariably found small nodules present in the pulp, and have often wondered whether they have not a good deal to do with the neuralgia incident to such cases, and would like to hear the opinions of the members in regard to this.

Hospital Reports and Case-Book.

A CASE OF REFLEX PAIN.

By WALTER SHEPHARD, Esq., L.D.S.

THE following case of "Reflex Sensation," being so definite, induces me to send it to your journal as one of interest. A patient, aged 36, visited me for the purpose of having a first inferior molar extracted, having, as he described, "suffered continuous pain in it for some days." Upon examination I found the tooth perfectly sound; its neighbours also being perfect and alike insensible to various tests, led me to suppose the pain to proceed, by "reflex action," from its antagonist upper tooth. On examining the first superior molar it was in appearance "sound," but on forcing a probe between it and the second molar, I detected a deep-seated cervical cavity; the tooth was also painful to tests. Still, the patient tenaciously held to the idea of the pain proceeding from the lower tooth. On inhaling cold air he described the pain in it to be "intense," also that the tooth felt "raised in its socket," and that " he had never suffered any inconvenience in the upper tooth."

The case was a most decided one of reflected pain, and on extracting the superior molar I found it deeply decayed posteriorly, with an exposed pulp. The extraction afforded instant relief.

10, Devonshire Terrace,

Forest Hill, S.E.

British Journal of Dental Science.

LONDON, MARCH 1, 1881.

THE proceedings of the General Medical Council, reported in our last issue, have been commented on at considerable length by all the medical journals, the general tone of the remarks showing but little appreciation for the collective wisdom of that body. We reproduce below, for the edification of our readers, articles on this subject taken from the 'British Medical Journal,' the Lancet,' the Medical Press and Circular,' and the Pharmaceutical Journal.'

That which appeared in the British Medical Journal' is a temperate statement of the case from the point of view of the British Dental Association, and is in marked contrast to the decidedly intemperate utterances of the Medical Press.' The writer appears, however, to lay great stress upon two points which we do not consider at all material to the issue. First, he assumes that the opinion given by Mr. Bowen, whom the Council consulted last summer, was favorable to the interpretation of the Act which was put forward by the British Dental Association on the authority of Mr. Fitzgerald. This assumption appears to us to be opposed to all probability. If we suppose that "the opinions (of Mr. Fitzgerald and Mr. Bowen) were not in any material degree dissimilar," we must also believe that the Council was strongly opposed to the demands of the British Dental Association, and determined to thwart them if possible. But it has been evident throughout that, at all events, a majority of the Council was favorably disposed towards the Association, and quite willing to meet its wishes if only this could be done with a sufficient show of authority. But if, on the other hand, we suppose that the opinion of Mr. Bowen, although agreeing on some points with that of Mr. Fitzgerald, did differ from it materially in others, or that its dicta on some crucial points were expressed with so much

hesitation as to make it valueless as a basis for decided action, then it is evident that to have published such an opinion would only have added greater uncertainty to an already sufficiently complicated question. Under these circumstancs the Council did well to withhold the document and to postpone action until it had obtained such legal directions as would fully absolve it from undue responsibility. When these directions were received they proved to be opposed to the demands of the Association, and the Council acted upon them with evident unwillingness; had they agreed with the views of Mr. Fitzgerald we believe they would have been received much more readily. We leave our readers to judge which is the more probable explanation, that put forward in the report of the Business Committee of the British Dental Association and repeated in the article we are now referring to, or that which we are ourselves disposed to favour. We hope that one of these days all doubt may be set at rest by the publication of Mr. Bowen's opinion; meanwhile, we think it would have been wiser to have ignored it altogether.

Then the writer goes on to point out that the Association, or rather its leaders, in their former character as members of the Dental Reform Committee, is not responsible for the clause on the interpretation of which all this labour has been spent. This is true enough, but although the Association is not responsible for the clause, it is responsible for the line of action taken upon it. It is responsible for having neglected the real point to be decided, viz. what constitutes bona fide practice, in order to follow out what the Business Committee now admits to have been "a secondary issue." The Committee say, in their report, "The Register still requires to be cleared of the names of those who were not in bona fide practice on July 22nd, 1878, but who gained entrance thereon by fraud." But this might as well have been done first as last, and the delay which has taken place has given the intruders an advantage of which they will not be slow to avail themselves.

The Lancet' article, which is chiefly remarkable for a certain ponderous affectation of wit which the Editor is rather fond of assuming, need not detain us, so we will devote

our remaining space to a brief comment on the highly amusing extract from the Medical Press.' Not that the Editor of that journal intends it to be amusing, he is evidently very much in earnest. It will be remembered that he took some pains in searching the Register,' and sent in a list of his own to supplement that of the Association. As a specimen of smart writing this article is excellent, but, as usually happens in this style of composition, the writer overreaches himself and misses his mark. We cannot afford space for a detailed criticism, and this is not necessary; one example must serve as a specimen of the whole. The writer quotes the 13th and 35th Sections of the Act, relating to fraudulent registration, and then quotes Dr. Aquilla Smith and Dr. Acland as having stated that it was no part of the Council's business to prevent fraudulent registration. If our readers will refer to the report of the proceedings, they will find that what was really said was this, that the Dental Committee having stated in its report that it could not impute legal fraud to any of those who had obtained registration, the Council was bound by that statement; else, as Mr. Ouvry remarked, it must be prepared to resift all the evidence on which the report of the Committee was founded. Had the Dental Committee found that fraud had been practised, the Council would not have hesitated to act upon the finding.

We have no wish to constitute ourselves the champion of the General Medical Council; it has on more than one occasion fairly exposed itself to adverse criticism, but we do not consider that it has earned the unmeasured abuse which the Editor of the Medical Press' thinks fit to heap upon it. We are much more inclined to agree with the Business Committee of the British Dental Association, who state in their report-" Of this we may feel assured, that the Medical Council have discharged their duties in the administration of the Dentists Act faithfully and to the best of their ability, and we owe them our thanks for the thorough manner in which the cases submitted have been investigated." This was also the opinion of the whole Executive Body, as is shown by the resolution which will be found at p. 236, and

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