RESUSCITATION FROM CHLOROFORM SYNCOPE BY INVERSION OF THE BODY.

THE following case seems to be worthy of record as furnishing another conclusive instance of the value of the postural treatment in cases of chloroform syncope. On October 31st, 1880, I removed a uterine polypus from Mrs. M-. She was placed deeply under the influence of chloroform by her regular attendant, and took it well. A much larger one shortly afterwards protruded, which I attempted to remove on March 6th. She was again [placed under the influence of chloroform by the same gentleman. His galvanic apparatus was out of order, but from our former experience we antipicated no danger. I had just passed a portion of my hand into the vagina, and was about to apply the écraseur, when the pulse suddenly stopped. Respiration ceased almost simultaneously. The lower jaw dropped, the tongue lay between the teeth, and she became more deadly pale than she had previously been. Percussion of the heart, artificial respiration by Sylvester's method, cold affusion, and the subcutaneous injection of ether were successively tried, but without avail. Three or four minutes elapsed while I was thus occupied, and no trace of circulation returned. I then seized her by the shoulders and placed her head upon the floor, while my friend and his assistant elevated her legs. In about a minute, or possibly less, I noticed pulsation in the neck, and replaced her on the bed. There was now distinct cardiac action, but respiration remained in abeyance, and the pulsation grew gradually more feeble. I re-inverted her, and retained her in that position for about two minutes. There was now strong palpitation, and in a short time a few gasps followed, just as in infant resuscitation. There were also several distinct clonic convulsions of the right side. The respiration gradually became natural, and after about five minutes of quiet sleep she awoke, of course quite unconscious of the whole occurrence. We thought it advisable to defer the operation, and she has had no bad symptoms since.

How far the interference with the genital organs was provocative of the syncope I am unable to say. Experience tends to show that operations on the testicle are not thus provocative, if the choroform narcosis be deep enough; and midwifery experience is against such a presumption.

The injection of ether under the circumstances is evidently open to discussion, on the point as to whether its powerful stimulating properties might not be counterbalanced by the addition to the narcosis. One cannot discuss such questions

very carefully during such an emergency. I would gladly have the opinion of your readers. The patient was certainly, to all appearance, dead for three or four minutes, and the inversion of the body certainly saved her. If I were ever in such a condition, I should wish that, after the position of the tongue had been ascertained to be favorable, and a strong shock or two of galvanism to my phrenic nerves had been tried, I should immediately be inverted.-J. THORBURN, M.D., Manchester.-Brit. Med. Journ.

SALICYLIC ACID.

BUT few therapeutic agents meet as many wants in Dental practice as does this acid. It is not highly soluble or it would doubtless be used oftener than it is. It is so mild in its local action, in comparison with carbolic acid, that the Dentist fails to have the confidence in it that he has in the latter; yet in some respects it is quite as active and efficient. It dissolves in very many saline solutions much more freely than in water, and on this account it readily dissolves in the fluids of the mouth when used as a local application. It very readily and freely cauterises aphthous ulcers on the mucous membrane of the mouth, and that without the severe pain following the use of carbolic acid. When in perfect solution it is quite as good a disinfectant as carbolic acid. To effect this solution we have been in the habit of combining it with small portions of carbonate of soda and white sugar. Thus combined we have a most excellent preparation for spongy gums, with fetid or ammoniacal breaths. It may be used with the brush and gargled, or, better, applied to the throat with an atomiser.

The 'Louisville News,' some time ago, gave a formula, which, the editor claims, gives a perfect solution, "the best solution of salicylic acid he has ever used." For some purposes, it is so important that it be in solution that this formula should be adopted and kept by all Dental practitioners. The preparation may be made thus:-Take of salicylic acid 640 grains; citrate of potash 960 grains; glycerine 3 fluid ounces; simple elixir sufficient to make a pint. Dissolve the citrate in the glycerine by the aid of a gentle heat, then stir in the acid, continuing the heat till it is completely dissolved. When cool add the simple elixir

till the whole measures one pint, and strain. This solution contains five grains of salicylic acid to each fluid drachm, and it can be mixed in any proportions with water without precipitation.

We have given the formula for this solution in a shape we thought better for our readers, who may not be familiar with the art of prescription writing, while it will answer equally as well for others. Any of our readers can have it prepared at a drug store. If less than a pint is wanted the figures can be changed to any extent, while the proportions are carefully kept. When used in the cavity of the antrum, this solution will ordinarily bear dilution. As a disinfectant in hollow teeth it may be applied in full strength. But we need not enumerate. When a perfectly reliable solution of the acid is thus obtained our readers can each think of hundreds of cases where it will prove both useful and convenient.-Ohio State Journal of Dental Science.

Dental News and Critical Reports.

ODONTO-CHIRURGICAL SOCIETY.

MARCH 11TH, 1881.

WALTER CAMPBELL, ESQ., L.D.S., President, in the Chair. THE discussion on Mr. Watson's paper " On Secondary Hard Formation in Pulp Cavities; their Physiology and Pathological Signification," was opened by Dr. SMITH, who said that he had been much pleased with the exhaustive and practical way in which the subject had been dealt with. The matter was one of much importance in Dental Surgery. There seemed to be no doubt of the power of the pulp to produce hard tissue; and if it could do so, and interpose a protective barrier of the kind between itself and the inroad of caries, it was very desirable that the conservation instead of the destruction of the pulp should be our object in stopping a tooth. He had many specimens of the consolidation of the pulp going on when protected by a superjacent stopping -several of these sections being made while Mr. Biggs was his assistant, and who was now present, and Dr. S. he had no

* See page 202.

ODONTO-CHIRURGICAL SOCIETY.

doubt would remember their being cut. Mr. Watson had alluded to the dentine of repair being an effort of nature to limit diseased action. This was also a most interesting point for consideration, as it occurred not in the pulp only, but also in the dentine itself, as shown by Mr. Tomes so long ago as in 1845 or 1846, when lecturing in Middlesex Hospital; while Mr. Nasmyth, of this city, had before, or about that time, shown the same thing to occur; and Professor Goodsir followed him by showing it to occur in ordinary bone, in the same manner that the tissues were consolidated round an abscess forming in the soft parts. It became a question, however, whether such solidification was solely protective in its nature, or whether, by cutting off the vital supply of an isolated portion of a tooth, it did not lead to its death and subsequent decomposition-whether, in short, it was a cause as well as an effect of what is called caries. Caries, Dr. S. said, was involving many separate processes; and the late Mr. Liston's a very indefinite term, definition of it was not a bad one, when he held it to be the result of the vital powers of bone being so low as not to be able to repair, but high enough to prevent the throwing off of dead substance. There was another circumstance indicated in Mr. Watson's paper, namely, the unmistakable vitality of the fully developed tooth, and the vital nature of its diseases. This seemed manifested from its earliest existence, when the dental germ, the mere inflection from the oral mucous membrane of its associated structures, began the formation and building up of the complicated and highly sensitive tooth; and at its later stages of existence, and when attacked by disease, the development of new tissue, whatever modifications of this tissue might, according to the integrity or powers of the odontoblasts, be produced, still showed that a vital action was going on as well in the separative efforts made as it was fairly presumable was at work in producing the phenomena of the disease itself. Dr. Smith considered the thanks of the society due to Mr. Watson for his communication.

Mr. MACLEOD said he rather felt inclined to be less hopeful of the beneficial effects resulting from secondary deposition in our attempts to preserve the vitality of the major portion of the pulp, to say nothing of the difficulty of artificially inducing this conservative action. It was said that, when the pulp was irritated, nature threw out a protective covering; but even under the most favorable form of irritation-viz., attrition-uniform, and therefore healthy, calcification was by no means the invariable result. No later than last week he had seen a mouth in which the

teeth were much worn on their cutting and grinding surfaces. He had occasion to open into several of the pulp cavities, and not a vestige of secondary deposition was to be found. This was not an isolated case in his experience. In those specimens brought forward by Mr. Watson the calcification was generally irregular, taking the form of excrescences from the primary dentine or of nodules embedded in the pulp, the result being not preservation, but death. If, then, the results were so unsatisfactory when the agent of irritation was so gentle and gradual, would it be wise to expect better results when the agent was more sudden in its application and more irritating in its quality, as any capping, however bland, must be?

The PRESIDENT said that there could be no difference of opinion, he thought, as to the importance of Mr. Watson's paper. The difficulty in the meantime, considering their present knowledge, was to arrive at useful and accurate conclusions, so as to enable them to find out whether there were nodules in the pulp cavities. He had no doubt that further research in this line would result in useful knowledge to them all if they could ascertain correctly, or with a certain measure of correctness, whether there were secondary dentine formations in the shape of nodules or excrescences in the pulp chamber. In that way they would know better how to treat a tooth. He did not think that very much could be done to save the pulp of a tooth which had been the cause of severe neuralgia. He had tried on several such occasions to conserve the pulp, but he did not remember having succeeded. In his view there was no doubt that those secondary dentine formations had a great deal to do with the severe neuralgia from which patients so frequently suffered. A few days ago he had a patient whe had suffered extreme pain from neuralgia on the right side. He had been to Edinburgh and consulted some professor, and after consulting several local medical men, he was sent by one of them to him (the President) about a fortnight ago. He extracted two of his teeth, and he took the liberty of sending them to their young and zealous friend, Mr. Watson, for examination. The patient was considerably relieved after the extraction of those two teeth, but in three or four days after, the pain began again on the same side. The patient call his attention. to another tooth which he thought had something to do with the neuralgia, and he found on examination that it was also carious-not much, but quite enough to produce extreme suffering. He extracted that tooth also, and sent it to Mr. Watson. He had no doubt that the patient had been relieved by the removal of the tooth.