thetic, and is one of the best remedies we have for toothache. It has one serious objection, however, and that is its odor. When that objection to it is removed, it will occupy a very prominent place in our list of remedies. A gentleman who tells me he has had very large experience in the treatment of pyorrhea alveolaris says he has been in the habit of using pulverized nitre. He inserts it between the gum and the tooth, and allows it to dissolve there. I have never used it, but simply give you the testimony of one who says he has had great success with it. Dr. ABBOTT: The best remedy I have ever found in this disease is a very carefully handled, properly adapted instrument. I have never yet found anything that will replace real hygienic operationsthat is, operations which will secure a proper cleansing of the roots of teeth of the irritating substances that collect upon them. No remedy will ever take its place. If these are removed, I will guarantee that in nine cases out of ten the disease will disappear without any antiseptics, disinfectants, astringents, or anything called medicine; and unless this be done all the remedies known to the medical profession will not effect a cure. Dr. I. P. WILSON: Did I understand Dr. Harlan to say that he succeeded in perfect restoration of the lost tissues of the alveolar process and of the gum, and that they firmly united with the teeth again? Dr. HARLAN: I said the restoration of lost tisse was almost certain to follow this careful, persistent, systematic treatment. there is cure there is restoration. It Dr. ATKINSON: I observe that there is always a disposition to push to the ultimate every question and there is a shyness on the part of those who reply to meet the demand. The last question brought me to my feet. Are the hard structures reproduced? That brings out a principle of nutrient activity in production and maintenance of tissue, which, if understood, would answer all these questions satisfactorily. The aphorism is this: reproduction follows the same order of activity as original production of the tissues of the body. I will show any doubting man reproduced alveolar process, and if he were not aware that he was examining for reproduction he would not be able to distinguish between the parts that were original and those that were of the reproduced material. Cleanliness is akin to godliness and godliness is obedience to law, and obedience to law must be spontaneous obedience. If we could get at such a condition as would fulfill all the functional requirements of the body there would be no deterioration anywhere. It would be more profitable to ask questions and get direct answers than to have long preachments on this and that. Statistics are well enough if they are faithfully made. I do not care how faithfully they are made, however, if there is not intelligence enough in the observer to interpret them, they are but worthless ceremonies and dead weights upon you; they are darkness and not light. How many men here could answer the question-What is inflammation? I have never been in a medical convention where there was one who could answer it except by repeating some old red-letter definition. Redness, heat, swelling, pain; that is all you could get out of them and they ring the changes on those. We can have any one of them and not inflammation, and we can have inflammation without one of them at all events,-redness. I have never seen epithelium reproduced. I have never seen muscle reproduced. I will ask any histologist if he has. One histologist that I love dearly says he has. I have seen nerve and bone reproduced so that the finest microscope could not detect the difference. Dr. ABBOTT: I am sorry our friend did not go on in the direction he was going and follow back the changes in the tissue from its normal state into the condition of inflammation again. That is a very interesting process. Around the root of the tooth there is an inflammatory condition going on, brought about by some irritating substance that is located upon or around its root. What does that inflammatory condition consist of? Before a protoplasmic, or rather a bioplasmic mass is converted into any special tissue, it consists of an indifferent or embryonal mass. Nature makes out of this mass the different varieties of tissues required. When inflammation of a part is produced, it is the reconversion of the tissues of that part to their indifferent or embryonal condition, and as the inflammation subsides, the proper tissues are again formed. Dr. DABOLL: I think we do not make a sufficient distinction in the different expressions of this discase. In this disease we have various forms of expression. It may be the same disease all the way through, but we observe constantly differing conditions. In the last ten years I have had more or less experience in the treatment of this disease but have never been able to reproduce the gum or the alveolar tissue where there has been absorption and a recession of the gum. In cases where there was an exudation of pus and a loosening of the teeth, where pockets were formed by the side of the root, and there was no recession of the gum, I have been able to restore the tooth to its normal condition, with restoration of the alveolar process, because we had the condition to admit of it. I do not think there is any question but that we can restore the alveolar process where we have enough of the periosteum left. I have been very much interested in the discussion of the papers and hope that we have got some new remedies which may help us in the treatment of this disease, which has come to be a very common one for dentists to deal with. Dr. PEIRCE: I want to congratulate this Association on an evidence of progress. We have discussed this paper, and Riggs's name has not been mentioned. A few weeks ago a lady came to my office in quite an excited condition. She said she had been spending three weeks in New York, and had occasion to call upon a dentist there who told her she had Riggs's disease. She asked me where she had got it. She said, "I have not seen Riggs, and I don't know where I could have gotten the disease." SECTION V. ANATOMY, HISTOLOGY, AND MICROSCOPY. Action of Arsenious Acid upon Dentinal and Pulp Tissue. THE PAPER BY C. F. W. BÖDECKER, OF THE SECTION. HE action of arsenious acid upon the dental tissues has for a long time been a disputed question, and the changes effected by the poison when applied to the cavity of a tooth were thought to be confined to the pulp-tissue; although Dr. Clowes, of New York City, showed, several years ago, that an application of arsenious acid to the dentine of a tooth far from the pulp, would lead to the same result as if the agent was placed directly upon the organ, the only difference being that its action in the former instance was not so rapid. In 1879, Dr. A. Witzel, of Germany, published an extensive work on the diseases of the dental pulp. In this he claims that a pulp, if not too much inflamed, can be treated with arsenious acid, its coronal portion amputated, and the remaining pulp-stump preserved. This doctrine has created a great deal of controversy in this country, although in Germany it seems to have been almost universally accepted. I have followed this line of treatment in sixteen cases, in an experimental way, selecting teeth which I was able to examine from time to time. I should not have used this method in so many cases, had not the first experiment misled me in such a manner that at the present time I am unable to explain it. The case was as follows: in November, 1879, a healthy young lady, over eleven years of age, presented herself for the correction of an irregularity. The front teeth of both the upper and lower jaws were overlapping each other, and although the arches were pretty well developed there was not room enough for thirty-two teeth. therefore decided to remove the sixth-year molars as soon as the second molars began to make their appearance. Three of the sixthyear molars were well preserved, but the left lower one was largely decayed, and gave the patient trouble whenever anything sweet or sour entered the cavity; but the pain ceased as soon as the irritant was removed. Pressure in the vicinity of the pulp-chamber produced no pain. All these were signs that the pulp was in a tolerably healthy condition and admirably adapted to an experiment with arsenious acid in the manner described by Witzel. The details of the operation, concisely stated, are as follows: After the cavity has been cleaned of decay, the pulp is exposed and an application of is made for about five minutes, the arsenious acid paste is laid directly upon the pulp, and the cavity is hermetically sealed.. After twentyfour hours the temporary plug is removed, a sharp, new bur which has been disinfected is put into the engine, and with a few quick revolutions of the bur the coronal portion of the pulp is amputated. The pulp-chamber is then syringed with a five per cent. solution of carbolic acid in water until the bleeding has ceased, when the cavity is dried, the pulp-stumps touched with the carbolic acid and tannin solution mentioned above, then with a carbolized solution of mastic, and still after this with a pulp varnish composed of collodion, guttapercha, and a little carbolic acid. The pulp-stumps are then capped with carbolic acid cement, the formula of which is as follows: R.-Acid. carbolic., 0.50 gins. Alcohol. absolut., 0.20 gms. To this add an equal volume of the zinc chloride used in oxychloride fillings; and to a sufficient quantity of this mixture add oxide of zinc, and mix to the consistence of thick cream. Six months after the operation I saw the patient and removed the four teeth mentioned above. On opening the roots of the left lower molar, to my surprise, I found the amputated pulp-stumps alive. Without delay they were prepared for the microscope and examined. The nerve-fibres of both these specimens showed nothing abnormal; |