For editors do not like to print And the general reader does not care So gather your wits in the smallest space Boil it down. Correspondence. [We do not hold ourselves responsible for the opinions expressed by our Correspondents.] To the Editor of the British Journal of Dental Science.' SIR,-Doubtless many of your readers besides myself must have been puzzled to decipher the meaning of the mystic letters F.S.S., which appeared, in conjunction with a Hibernian L.D.S., in a remarkable advertisement noticed in the last number of your journal. Does it mean that the fortunate possessor is a Fellow of the Semitic Society? or is it a superior degree in Dental Surgery granted by St. George's Hospital; or has the advertiser thought proper to add finishing touches" to his own name? The public must be sorely mystified as to the origin and meaning of the numerous titles-R.D., R.M.D., R.M.S.D., M.D.S., &c., now so ostentatiously displayed. But if this eminent teacher of Dental mechanics from St. George's and the Dental Hospitals, wishes to add another affix to those he now boasts, I would suggest that he should enroll himself as Artium Societatis Socius, an honorable distinction already possessed by Your humble servant, DR. PANGLOSs, L.L.D., A.S.S. We have received several other letters relating to this advertisement. We are decidedly of opinion that its insertion in the daily papers is a distinct breach of the agreement which every recipient of the Dublin diploma undertakes to observe. If this gentleman really desires to obtain pupils, the medical and Dental journals are the best and the only proper means of making known his wishes.-ED. 'B.J.D. S.' To Correspondents. 1. Communications intended for insertion in the ensuing number must be forwarded to the Editor, at the Office, 11, New Burlington Street, London, W. by the 8th and 23rd of the month, or they cannot be published in the ensuing issue; they must also be duly authenticated by the name and address of the writer. 2. We cannot undertake to return communications unless the necessary postage stamps are forwarded. 3. It is earnestly requested of our correspondents that their communications be written on one side of the sheet only; and we also beg to call particular attention to the importance of a carefully-penned signature and address. 4. All communications relative to subscriptions and advertisements are to be addressed to the Publishers, Messrs. J. and A. Churchill, 11, New Burlington Street, London, W. 5. The Journal will be supplied direct from the office on PREPAYMENT of subscriptions as under: Post-office Orders to be made payable at the Regent Street Office, to J. and A. Churchill, 11, New Burlington Street, W. A single number sent on receipt of seven (penny) stamps. Communications have been received from Messrs. Charles Buckland (Sydney, New South Wales), Thos. Fletcher (Warrington), J. R. Bate (Tiverton), Geo. Rogers (Newton Abbot), C. J. Noble (Kensington), Rees Price (London), "Dr. Pangloss," "A Dental Apprentice," "L.D.S.R.C.S." BOOKS AND PAPERS RECEIVED. Minutes of the General Medical Council from Jan. 1st to May 1st, 1881. 'Deformities of the Mouth.' By Oakley Coles. 'Plastics and Plastic Fillings.' By J. Foster Flagg. 'Ohio State Journal of Dental Science.' 'Lancet.' 'Medical Times.' 'British Medical Journal.' " Pharmaceutical Journal.' 'Practitioner.' 'London Medical Record.' 'Journal of the British Dental Association.' NOTICE. We desire that it may be clearly understood that our pages are open to all for free expression of their views on matters connected with our profession. We only ask for terseness of expression and MODERATION in tone. When otherwise unobjectionable, difference of political or other opinion will never be regarded by the Editor as a disqualification for the admission of any communication to the pages of the BRITISH JOURNAL OF DENTAL SCIENCE. British Journal of Dental Science. No. 322. LONDON, JUNE 15, 1881. VOL. XXIV. Dental Surgery and Medicine. ON THE USE AND ABUSE OF SOME OF THE MEDICAMENTS EMPLOYED IN THE LOCAL TREATMENT OF DISEASED DENTAL PULP AND ALVEOLAR ABSCESS. Abstract of a paper read before the Midland Branch of the British Dental Association at the Annual General Meeting held at Liverpool, May 4th, 1881. By LEONARD MATHESON, L.D.S. THE medicaments of which I shall speak are some of those employed, first, in the restoration to a sound condition of diseased dental pulps, and in the preservation of their vitality and health; second, in the devitalisation and removal of diseased pulps; and third, in the treatment of alveolar abscess. And under these three heads I propose to arrange my remarks. (1) Probably the agents hitherto most widely used in the curative treatment of diseased pulps have been creasote and carbolic acid. The most useful application of carbolic acid here is as an escharotic to the surface of the pulp when the latter is exposed. It forms an eschar, excludes the air and septic influences, probably also stimulates the pulp to healthy action, and certainly makes the latter more tolerant of the presence of any dressing or filling which may afterwards be placed in contact with it. Since the introduction of the use of carbolic acid, creasote has to a great extent been discarded-principally on account of its unpleasant odour and taste, and also because it is not such a powerful escharotic as its successor. On the other hand, it possesses, in a greater degree than carbolic acid, two qualities, on account of which some practitioners still give it the preference. It is much more penetrating, carrying its effects more deeply into the substance of the tissues to which it is applied, and it is also more persistent-its aseptic virtue VOL. XXIV. 42 is not so quickly diffused or absorbed as is that of carbolic acid. But another medicament, possessing these qualities of penetration and persistence is oil of cloves. To most patients its odour and taste are not objectionable, and this combines, together with the fact that it is both an antiseptic and sedative, to make it a valuable drug. In two classes of cases it is especially useful. First, where, owing to irritation of the pulp, there has been occasional uneasiness and slight aching in a tooth for a few minutes or an hour or two, at a time. In the great majority of such cases there is no need whatever for any stronger measure than the application of a sedative, and one or two dressings of oil of cloves, on spongoid or paper-fibre lint, under soft gutta percha or Fletcher's Artificial Dentine, generally suffice to produce a cure. Very frequently the symptoms described above occur without there being any exposure of the pulp, indeed, the latter is often found covered by a layer of comparatively sound dentine, and it is therefore essential to success that the medicament applied should penetrate the dentine in order effectually to act upon the pulp. The second class of cases referred to, is where a large mass of softened and intensely sensitive dentine is found overlying the pulp. Here it is frequently impossible to cut away the sensitive mass at once, but a single dressing of oil of cloves left in the tooth for a day or two under a temporary stopping usually makes the removal of the decayed tissue quite bearable. In the conditions just particularised-namely, irritation of the pulp and hypersensitive dentine-the penetrating quality of the oil makes it far more efficacious than carbolic acid. Besides oil of cloves, I have for some time been using, under similar circumstances, Fletcher's Carbolised Resin (a preparation of carbolic acid and resin, held in solution by chloroform), with the action of which I have been much pleased. It possesses in a remarkable degree the power of reducing the acute sensitiveness of the soft pulpy mass of decalcified tissue so often found in young teeth attacked largely by decay, appearing to dry it up and harden it, and making it comparatively insensible to the stroke of the excavator. And as a direct application to the pulp when exposed it is very efficacious, both in allaying irritation and in restoring the exposed surface when diseased to a sound condition. One not infrequently meets with cases where caries has laid bare the pulp, but where there is no history of acute inflammation, or of odontalgia, beyond a few minutes' occasional aching caused by the pressure of food or the contact of hot or cold fluids. At the same time there is almost invariably more or less congestion of the exposed part, and sometimes superficial ulceration giving rise to a slight ichorous discharge. To save such pulps is not always an easy matter, but I have found, even in such extreme cases, satisfactory results to follow the application (generally made more than once) of carbolised resin. (2) To pass now from the consideration of those medicaments used in the conservative treatment of the dental pulp, to those which are employed in the devitalisation of that organ, and in the treatment of the tooth subsequent to the removal of its pulp, the drug next to be mentioned is arsenious acid, as being without question the most effectual agent we possess for destroying the vitality of the dental pulp. Of the various forms in which this escharotic is appliedwhether alone or in conjunction with other drugs-whether made up with carbolic acid, oil of cloves, or some other vehicle into a paste, or used in the form of a dry powder-I need not here speak in detail. I have not myself found in the combination of morphia with arsenic the marked advantage which some practitioners speak of. I have made use of such a combination not infrequently, but I cannot say that I have noticed much if any difference in the percentage of cases where pain has been set up by the application-as compared with such a percentage in those cases where arsenic has been used alone. But though doubtful as to whether the morphia is of any real service, I am inclined to think that the tannin is sometimes of use. The destructive inflammation set up in the pulp by arsenic sometimes results in the rapid softening and disintegration of that tissue, whereby its removal is made a matter of more than usual difficulty. Tannin, to some extent I think, prevents this, by combining with the fibrinous elements of the pulp, and thereby giving it, even after it is devitalised, a tougher consistence a state in which it is more easily got hold of and removed. I believe that a favourite mode of using arsenious acid is in the form of a paste, but on the whole the dry powder is much to be preferred, as in most cases it is decidedly more manageable. When a paste is used it should be a stiff one, so that it will only go just where it is wanted. The great and, to my mind, fatal objection to the preparation known as Baldock's Paste, is its extreme softness, which makes it flow in any direction open to it upon the application of the least pressure. The method of using arsenic which I find the most generally successful is the following:-After a free removal of decayed tissue, care being taken on the one hand not to |