Miscellanea.

ROUND ABOUT NEW YORK AND PHILADELPHIA.

By LAWRENCE VANDERPANT, L.D.S.I.

HAVING realised my dreams, achieved the ambition that has smouldered within me, any time this last quarter of a century, viz. that of visiting the continent of America, I am now anxious to deliver myself of some of the many delightful impressions my visit and sojourn have afforded; but I will endeavour to confine myself as far as possible, and that briefly, to matter of immediate interest to your readers, viz. "tooth-lore and its concomitants."

I have been here now two months, and continue hour by hour only to marvel--to convey any idea from a British point of view, of the grandeur and magnificence of this country, of the wonderful intelligence displayed in supplying the requirements of mind and body, the refinement and true "gentility" of this people, is beyond the capacity of your correspondent to describe. But it may not perhaps be out of place to state, for the guidance of many of your readers who may be in doubt where to spend their summer vacation, that they can arrange on this side of the Atlantic with more economy, facility, convalescent effect, and ensure life-long memories of delight, than by the same expenditure in Switzerland, France, Scotland, or Ireland. My esteemed friends, Messrs. Cook and Son, furnish a return ticket to Philadelphia or Boston for £20, direct from Victoria Docks, London, or Liverpool, or Glasgow (from the two latter ports the fare is somewhat more). You enjoy, in the glorious Atlantic voyage, all the luxuries, and more, of a firstclass Continental hotel, and if the tourist be an abstainer from intoxicants-which I recommend American travellers to be the above sum will include all his expenses for about a month, the duration of his ocean journey out and home. A uniform hotel rate throughout the States of $3 to $3 50c. (i.e. 12s. to 15s.) per diem for all charges of board, lodging, and attendance can be relied on, and with a sum of £40, a tour may be made, including New York, Philadelphia, Baltimore, Washington, Albany, and Saratoga, up the beautiful Hudson River by boat, and Boston also, by steamer from New York, so that a traveller, in about seven weeks, from

London and back, will have visited and seen much of interest, not only of the Continent, but of the world.

The profession here meets you with oysters and lager beer at every turn, for everybody's oral cavity is enriched with auric embellishment. The first American I came in contact with, a pilot, who boarded our ship on Sunday, had his two centrals and a lateral at least two thirds restored by a contour cohesive-gold filling; and, in reply to me, gave a very intelligent description of the operation, explaining how the rubber dam and mallet were used, the peculiar advantage of adhesive or aullier "cohesive gold," as they invariably style it here, and the gratitude and pleasure he felt in the successful result of the work; and what struck me forcibly was the strong prejudice he had for artificial teeth. The replica of this may be found with every other class-the police (who by the way are great swells here, having an emolument of of $1200 per annum), assistants in stores, &c. The astoundding freedom, one of the great characteristics of the country, is most agreeably displayed by the manner in which the Dentists treat your visit. My introduction has been, in many cases, merely the statement "that I am an English practitioner and seeking enlightenment." That has been sufficient, without any exception, both here and in Philadelphia, to afford me the opportunity of witnessing their operations for hours at a time. These courteous and hospitable gentlemen will voluntarily introduce you to their professional friends, scientific meetings, the colleges, and, "tell it not in Gath,” to some wonderful combinations of oysters and scollops in a palatial restaurant at the end of a fully occupied Dental day. The visitor is struck by the all-absorbing interest shown in the profession by its members, the firm and affectionate friendship that exists among them, and the interest they feel in each other's work. Their offices-they designate their workrooms so-are freely open, and the patients appear pleased than otherwise at the interest their particular case excites.

A word about their rooms. They are generally three magnificent saloons such as, in the imperial days of the Tuilleries, would be worthy even of that palatial roof. The third will be the office, with a light screen partially surrounding one, two, or three operating chairs, as the case may be. When the office is in "full blast," there will probably be three, four, or more assistants; everything that ingenuity can devise is done to save labour and time. As they are here very badly off for domestic servants, the door is as frequently as not opened by a professor and M.D., or by a nigger, who tells you the "doctor is straight away in his office." If the patient has an appointment she divests herself of her external habiliments,

and walks straight to the chair, and work is preceded by very few words of greeting or otherwise. The system of maintaining regularity and punctuality in appointments is rigidly observed, so that you do not see a crowd of patients in a Dental office, as is the case in London, &c. In many cases the operator charges for the time occupied in treating a mouth, which may vary from five to fifty dollars an hour. Differing from an English Dentist, the American works in a light linen jacket and frequently slippers; he is particular to take his midday meal, and when he is fatigued he acquaints his patient of the fact, and makes an appointment for another day. In this way it will be obvious the advantage of (when conscientiously carried out) calculating by time rather than by amount of work done. Many gentlemen adopt a specialty to the exclusion of all others; thus, some only extract teeth, and I have seen them firmly decline to do a simple filling or adjust an artificial denture; another only cleans, scales, treating in connection therewith; and I believe there are practitioners who do not even possess the means of either extracting a tooth or taking a model of the mouth. It is impossible for one to understand American practice, unless they comprehend the high scientific and honorable position the profession holds in the opinion of the masses; indeed, from my limited opportunity of judgment, I believe the Dental holds a higher one as a public necessity, and I may say socially, than the practice of medicine and surgery.

Your readers are all thoroughly familiar with the use of the dental engine, the rubber dam, and many with the hydraulic raising chair, the Morison bracket, the use of the mallet in plugging, and the taking of models in plaster. I will briefly mention points of practice that I have not seen in Europe.

1st. The use of plaster, to the exclusion of all other means, in all and every case, however complicated, in taking models of the mouth, the advantages of which, as an old and experienced mechanic, I am unable to comprehend.

2nd. The universal mode of cohesive filling, the childlike confidence in its efficacy, the great simplicity and rapidity by which a large and complicated cavity is restored, the trifling infliction to the patient, and the substantial result attained. To effect this truly marvellous work an instrument, I imagine little known in Europe, is used, i.e. the "electric mallet." I cannot conveniently describe it, but may merely say it possesses no inherent quality from complicated construction, liability to get out of gear, or difficulty in manipulation, to prevent it becoming a sine quá non to every advanced oral surgeon. I witnessed at the clinic

at S. S. White's in New York, on Tuesday, Dr. Webb build up the whole crown of a superior molar, saving a small portion of the buccal wall, using half an ounce of foil, thickness thirty to sixty grains to leaf; some use as high as 120, not beaten, but rolled. This operation will be described in Johnston Brothers' interesting Monthly Dental Miscellany.' This ingenious implement emanates from the fertile brain of my friend Dr. Bonwill, of Philadelphia, who was sixteen years in bringing his idea to a practical issue, but with almost tears in his eyes he (Dr. Bonwill), after showing me all the various mechanical stages his work had passed through during the number of years occupied, took his engine and exclaimed, "Here I murdered my electric mallet." The means by which he claims to have been guilty of this mortal sin is by an arrangement, adjustable to any dental engine, of an automatic mallet of marvellous simplicity, and capable of regulating force of blow. The disadvantages would be that the lathe motion of foot is requisite, and probably its use would be more exhausting to the operator; still it will, undoubtedly, with the electric, supersede the hand mallet. While on this subject I cannot refrain from calling attention and expressing surprise that an automatic mallet, invented by Mr. Kirby, of Bedford, and beautifully constructed by Messrs. Ash and Sons, is not more in vogue. I used one for some years, and have lent it to first-class operators, who after a little experience have preferred it to any others. I wish I had one now; it was an inexpensive affair, but possessed many advantages. Bear in mind we this side of the Atlantic do not possess, although nearly so, an entire monopoly of inventive capacity.

Two new systems of restoring crowns by pivoting are in great commendation, i.e. the "Bonwill" and "Richmond." The former is a very simple one-by means of an appropriately drilled and internally curved (for the reception and retention of the amalgam) mineral crown, suitable cavity or cavities in the pulp canals, strong platina plate pins, the mineral crown and natural root fitted accurately to each other, the whole united by amalgam. I have seen patients masticate orange-wood sticks with molars adjusted by this plan, and I certainly think your strong English teeth (Ash's or Lemale's) would be better adapted than the softer and more friable body of ours. The Richmond plan consists of arranging a crown of thin gold or platina plate to the débris of tooth to be replaced; a model of the tooth is taken after the accuracy of the fit to the margins of the root is effected -a tailor's thimble tightly fitting to the finger conveys an idea at this stage. A model of occlusion or antagonism is

obtained by filling the "thimble" with plaster, it is then returned to the mechanic for the arrangement of a metallic masticating surface. A pin may or may not be arranged to pass into pulp canal, and the final operation consists in uniting the gold crown to the natural remains of the tooth by overfilling the "thimble" with phosphate oxychloride cement, and driving the whole home by mallet over the root and beneath the margin of the gum. This plan is in great favour, and certainly displays a very workmanlike result with great strength.

I am not prepared to say much in respect of mechanical Dentistry, for this reason, that I have seen but little, and believe the subject is little cared or thought about by the leading men; but I must candidly aver that I believe in Europe the work in every way reaches a higher standard of perfection, both as to result and the means of attaining; for instance, that beautiful flask arrangement of Messrs. Ash's, known as the "Bennet," and " Bell and Turner," are quite unknown, and when I referred them to the English catalogue they were astonished and concluded to order some straightaway. One thing in justice I must remark, the fees for artificial work are very small comparatively, and that they invariably use gum teeth and gum sections, arranged with great taste and skill. The show-case fraternity, of which there are a vast crowd in this city, and a few advertisers do thorough justice to their patients in mechanical work, and at a very small cost.

A new cast metal is being introduced, called "Reiss's." It claims advantages over rubber, celluloid, and Dr. Blandy's old cheoplasty. Dr. Reiss at the Clinic, exhibited some beautiful compound work of the metal with continuous gum and celluloid; it is in high favour with some of our leaders, but I doubt if it finds great favour on your side. Celluloid is an important industry, many persons wearing collars and cuffs manufactured of it, as also watch-cases, of course white in colour.

It would be easy and interesting to continue to scribble, but I have already become wearisome. Much might be said of the colleges and hospitals at Philadelphia; the department of Dentistry at the Pennsylvania University seems to me to be. the ne plus ultra of an Alma Mater. I think in the "office " there are upwards of forty chairs, with every appliance, in the highest state of perfection, including the mechanical department. The same description applies to the two other colleges, only they are smaller.

On the first Tuesday in every month there is a clinic at S. S. White's Depôt in New York, at which operations