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Full text of "Dental digest"

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Bental Btgejeit 



TABLE OF CONTENTS 

AND 

GENERAL INDEX FOR VOL XXll. 

JANUARY-DECEMBER, 1916 



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EDITED BY 

GEORGE WCK)D CLAPP. D. D. S. 

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THE DENTISTS' SUPPLY COMPANY 

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TABLE OF CONTENTS, 1916 
VOLUME xxn 



ORIGINAL CONTRIBUTIONS 

PAGE 

A Detachable Cusp for Steele V Facings..* ! M. G. Philups, D.D.S. 763 

Accuracy in Amalgam Restorations : .W. Go'ddard Sherman, D.D.S. 562 

Adjusting Obturators J. E. Kurlander, D.D.S. and H. J. Jaulusz, D.D.S. 217 

American Fair Play 779 

An April Vacation \V. B. Lee, D.D.S. 368 

An Auto Trip, August, 1915 J. M. Miller, D.D.S. 376 

An Intermaxillaiy Splint George Morris Dorrance,D.D.S. 645 

An Outing in the Ozarks B. L. Gamble, D.D.S. 385 

Anatomical Articulation, A Trip Registering the Western Attitude Toward 

Dayton Dunbar Campbell, D.D.S. 79 

Are State Dental Laws Reasonable? Name of Author Known but Withheld 710 

Banquet to Mr. Thomas Forsyth 781 

Better Gold Inlay, A W. Goddard Sherman, D.D.S. 149 

Bleaching Technic of Natural Tooth in the Mouth Louis Englander, D.D.S. 215 

Cast Cusp Gold Crown A. Bruce Coffin, D.D.S. 293 

Closed Mouth Impressions Samuel G. Slt»plee, 4, 74, 139, 290, 413, 498, 567, 700, 764 

Closure of Jaw in Mastication Loomis P. Haskell, D.D.S. 502 

Complete Description of My Most Successful Operation H. M. Demarest, D.D.S. 627 

Conservative and Constructive Treatment of Riggs' Disease M. H. Cazier, M.D. 775 

Correct and Incorrect Cuspid Relations Russell W. Tench, D.D.S. 561 

Cow Bell Method of Casting Aluminum Bases W. Clyde McClelland, D.D.S. 416 

Cuspid Relations, Correct and Incorrect Russell W. Tench, D.D.S. 561 

Delightful Camping Trip Walter S. Cole, D.D.S. 370 

Delightful Vacation and Some Conclusions C. W. Weaver, D.D.S. 362 

Dental Hygienists Edward F. Brown, D.D.S. 284 

Devitalization, Shall we Discontinue Walter S. Kyes, D.D.S. 207 

Eighth Annual Hay Fever Pilgrimage T. M. Robertson, D.D.S. 402 

Evolution of a Prosthodontist Sinclair Weeks, D.D.S. 6 

Exodontia Under Nitrous Oxide and Oxygen Anesthesia, Bertram R. Perkins, D.D.S. 796 
Expansion and Contraction in Plaster and Vulcanite Stewart J. Spence, D.D.S. 491, 557 
Experiments to Determine the Toxicity of Therapeutic Agents in the Treatment of 

Pyorrhea on Normal Cells Grown m Vitro W. F. Spies, D.D.S. 69 

Fate of An " Innocent Bystander" Floy Tolbert Barnard 345 

Fatigue, Its Cause, Nature, and Cure Watson W. Eldridge, M.D. 398 

Finishing Process of Artificial Dentures T. G. Healy, D.D.S. 422 

Food for Dentists Watson W. Eldridge, M.D., 155, 276, 621 

Gold Crown, Cast Cusp A. Bruce Coffin, D.D.S. 293 

Gold Crowns, for Posterior Teeth, Where Bite is Very Close, Technic for Making 

Raymond S. Scovil, D.D.S. 143 

Gold Inlay, A Better W. Goddard Sherman, D.D.S. 149 

Good Time in Pocahontas County, W. Va E. W. Hill, D.D.S. 384 

Great National Movement, A W. G. Ebersole, M.D., D.D.S. 9 

Hunting with Airedale Terriers A. P. Deacon, D.D.S. 351 

Impacted Third Molar Causes Facial Paralysis B. Barrymore Marco, D.D.S. 566 

Important Information from the Dental Protective Association of the United States . 85 

Impressions, Closed Mouth .... Samuel G. Supplee, 4, 74, 139, 290, 413, 498, 567, 700, 764 

iii 



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iv TABLE OF CONTENTS, 1916 

PAGE 

Jaws, Fractured, Treatment of William C. Mogh, D.D.S. i 

Launch Trip, A L. A. Lupton, D.D.S. 386 

Ludwig's Angina Jno. W. Seybold, D.D.S. 483 

My Quest for Pike W. S. Walters, D.D.S. 354 

Natural Cleansing of the Mouth by Natural Means Bernard Feldman, D.D.S. 485 

N. Y. College of Dentistry, Semi-centennial Celebration 410 

Orthodontia of the Deciduous Teeth E. A. Bckue, D.D.S., M.D. 631, 691, 757 

Our Vacation in 1915 J. C. Higgason, D.D.S. 390 

Our Wisconsin River Trip C. F. Stekl, D.D.S. 374 

Out in the Fields C. R. Christopher, D.D.S. 393 

Perfect Articulation in Posterior Bridgework by the Use of Trubyte Molar Blocks 

R. D. Pray, D.D.S. 294 

Problem of Mouth Washes Chas. M. MacKenzie, D.M.D. 625 

Progressive Prosthetic Clinic H. J. Horner, D.D.S., W. J. Holroyd, D.D.S., 

C. J. McChesney, D.D.S. 640 

Progressive Prosthetic Clinic. ...H. C. Werts, D.D.S., F. A. Gallagher, D.D.S. 705, 707 
Pyorrhea, Treatment of, Experiments to Determine the Toxicity of Therapeutic Agents 

in the W. F. Spies, D.D.S. 69 

Rapid and Accurate Method of Soldering the Pin to a Richmond Cap 

J. M. WooDLE, D.D.S. 565 

Rationale of Riggs' Disease Marion Howard Cazier, M.D. 553 

Repairing Carious Teeth Harvey Richmond, D.D.S. 642 

Riggs' Disease, Rationale of Marion Howard Cazier, M.D. 553 

Rugae Victor Lay, D.D.S. 145 

Selection of Teeth N. L. Zimmerman, D.D.S. 424 

Septic Wheel Brush, The "R. R. C." 148 

Shall we Discontinue Devitalization? Walter S. Kyes, D.D.S. 207 

Shoulder Crown and Its Technic Francis C. Jones, D.D.S. 643 

Something Different Edward T. Brunson, D.D.S. 364 

Specific for Poison Oak or Ivy F. L. Dung.\n, D.D.S. 365 

Splint, an Intermaxillary George Morris Dorrance, D.D.S. 645 

Successful Deer Hunt in Massachusetts Charles L. Twichell, D.D.S. 380 

Sugar and Its Effect Upon the Teeth John S. Engs, D.D.S. 146, 212 

Sure Cure and a Pleasant One L. P. Larson, D.D.S. 381 

Technic of Natural Tooth Bleaching in the Mouth Louis Englander, D.D.S. 215 

Technic for Making Gold Crowns for Posterior Teeth in Mouth WTiere the Bite is 

Very Close Raymond S. Scovil, D.D.S. 143 

The Beach or Mountains? L. M. Zimmerman, D.D.S. 372 

The Dentist, The Patient and Oral Prophylaxis Joseph H. Kauffmann, D.D.S. 760 

The First Night in the Woods Paul S. Coleman, D.D.S. 360 

Things That are Said in Dental Journals Hillel Feldman, D.D.S. 219 

To Separate Gold from Platinum S. M. Myers, D.D.S. 427 

Treatment of Fractured Jaws William C. Mogh, D.D.S. i 

Trip Registering the Western Attitude to Anatomical Articulation 

Dayton Dunbar Campbell, D.D.S. 79 

Up the Oswegatchie After Trout H. O. Brown, D.D.S. 405 

Valuable Suggestions in Training Assistants Reported by J. E. Waterbury, D.D.S. 495 

Value of Oysters 708 

Week at Lake Geneva, Wis Elberg N. Johnson, D.D.S. 359 

What a Vacation Did for Me J. H. Bltins, D.D.S. 366 

What I Like About My Dentist "CD. B." 18 

Why a Vacation and Where J. A. McPhail, D.D.S. 394 

Why Discard the Tooth Brush? Ernest C. Dye, A.B., D.D.S. 280 



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TABLE OF CONTENTS, 1916 
BUSINESS BUILDING ARTICLES 



Advice to Those About to Wear Artificial Teeth 249 

Agreement to Surrender Practice Arthur L. H. Street 510 

Always Render Your Best Service 451 

Answer to a Request for Advice 235 

Answers to "B. C. G." 794, 795 

Around the Table 790 

Brother Bill's Letter 33 

Business Side of Dentistr\' 239 

Business Side of Prophylactic and Restorative Practice 

\V. F. Spies, D.D.S., and George Wood Clapp, D.D.S. 19, 94, 435 

Can He Prove It? 453 

Canadian Dental Association 709 

Commercialism and Dentistry Frank L. Platt, D.D.S. 577 

Codperation 658, 659 

Costs of Conducting Dental Practice L. W. D. 721 

Dentistry from a Financial .Vspect Pkrcy A. Ash, D.D.S. 160, 165 

Dentists' Office Hours 241 

Dollars, The 1914 and 1915 308, 309 

Employment of Unlicensed Assistants .\rthitr L. Street 580 

Ethics as It is Lived J. F. Conover, D.D.S., 787 

Fees, How Can You Raise, and Keep the Good Will of a Community? 450 

Fees, Professional I. J. Dresch 719 

Fifty-fifty W. F. DA\as, D.D.S. 296 

Getting the Money 52 

How Can He Better Conditions? **E. S. G." 27 

How to Make a Dentist Happy 238 

How to Make and Save a Competency for Old Age *'N. W. D." 22 

"Josh," A Reply to, in March Digest "R. L. S." 310 

"Josh" Comes Back 171 

Layman's Viewpoint, A Katharine Dodge 648 

Living Costs and Dental Fees L. W. Dunham, D.D.S. 574 

My Way of Figuring the Cost of an Inlay "C. A. G." 31 

Necessity for Keeping Complete Records C. Charles Clark, D.D.S. 300 

Practical Illustration of Success "C. F." D.D.S. 506 

Professional Denture Service — Professional Denture Fees L J. Dri-:sch 719 

Relation of the Dentist to the Manufacturer and Dealer Guy Morgan, D.D.S. 584 

Reply to M. F. R "H. K," 29 

Request for Advice iii 

Saving for the Rainy Day and Old Age Fund " A. H." 517 

Sellmg Denture Service I. J. Dresch 303 

Some Thoughts on the Business Side of Practice D. R. Phelps, D.D.S. 722 

State of Michigan, Supreme Court 725 

Successful Practice of Dentistry Wallace Secxombk, D.D.S. 444, 5x1 

System of Dental Book-keeping F. Z. Ros{>, D.D.S. 103 

The Whole World is a Big Store 449 

What do you Believe? L. W. Dunham, D.D. S. 793 

What I Think Inlays Cost "F. D. H." 98 

What Shall we Charge for Plates? W. J. Holrovd, D.D.S. 226 

Where Have my Profits Gone? Nils Juell, D.D.S. 308 

Who is Responsible for Low Fees? C. Wayne Mingle, D.D.S. 516 

Why I Think it Pays to be Courteous "A. B. D." 5x4 



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▼i TABLE OF CONTENTS, 1916 

PRACTICAL HINTS 

PAGE 

A Gasoline Soldering Outfit 245 

A Good Probe 108 

A Good Temporary Filling 454 

A Kink Worth Knowing in Mending Rubber Plates 5^3 

A Laboratory Hint 1 50 

A Loose Pin Banded Crown Especially Adapted for Upper Lateral Incisors 244 

A Method for the Correct Application of Davis Crown to Roots 114 

A Method of Applying Arsenical Paste 38 

A New Method of Handling Undercuts in Making Metal Plates 314 

A One-Mix Investment for Small Repairs 307 

A Painless Way to Open a Sore Tooth 113 

A Porcelain Jacket Crown 177 

A Time Saving Hint 99 

A Useful Application for Sore Lips While Operating 244 

An Ordinary Hail Screen 113 

Adapting Upper Dentures 732 

Aid in Soldering 292 

An Abscess Lancet 30 

An Aid in Making Large Plumpers 145 

Burning Out Wax 454 

Dissolving Impression Plaster 295 

Extracting a Post From a Frail Root 40 

Facilities for Removing Teeth from a Rubber Plate 99 

Following the Preparation ©f a Bridge Impression 589 

For Quick Devitalizing 731 

For Cases of Gengivitis 799 

For Sensitive Root Canal 313 

For Sound Teeth, that are Sensitive at the Neck 798 

Heater for Water and Spray Bottles 732 

How to Remove Broken Instruments 245 

Hypodermic Syringes 246 

Leaky Vulcanizer 176 

Making Mould (in Ring) Stick to Casting Machine While Casting 588 

Method of Holding Inlay for Polishing 522 

Method of Separating and Regaining Space Where Teeth Have Been Lost for Some Time 39 

Methods of Relieving Pain While Operating ^i^ 

Methods to Facilitate the Attachment of Gold Castings to Steele's Backings 31a 

Mixing Amalgam ^2, 

Nature's Own Anesthetic -j^ 

Plate Quickly Repaired ^-j 

Polishing Crowns -j2 

Preventing the Cracking and Bleeding of Chapped Lips ^ j . 

Removing Steele's Facings ^2 

Rendering Cork Stoppers Impermeable 

Repairing a Broken Goslee Tooth 

Repairing Plaster Casts 

Repairing Punctures in Rubber Dam after Adjusting 

Removing Broken Broach from Root Canal 

Root Canal Filling r^ 

Root Canal Filling Material 

Ruga •••*•'*'' '*^*!'!;;^ ^ 5^ 

Rugae on Plates . ^ 

^ 176 



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TABLE OF CONTENTS, 1916 vH 

PAGE 

Securing Brightness in Aluminum Rubber Plates 317 

Sq)arating Modeling Compound Impressions 178 

Simple Assortment of Casting Rings 454 

Simple Method of Altering Seamless Crown Dies 313 

Simple Procedure in Antrum Operation 588 

Strengthening Plaster Models 178 

The Correct Method for Manipulating Amalgam 731 

TTiree Hints That I Find Practical 38 

To Avoid Bubbles in Casting 544 

To Qean a Glass Slab of Cement 176 

To Do Away With the Very Much Complained o^ Bellows to Splcicrin;5 Outfit 177 

To Facilitate Waxing Parts of Broken Vulcanite'Plates ToiJelher ..'/... 177 

To Finish a Silicate Filllin^. I . . ., * .'..'**.*/. ' . . - ~. . v-t^ .:• .•;-752/ 

To Flow Solder Easily :;:.J.VV :.\.l<.\ . . .\ '.^.i .:. . ] iff 

To Get Proper Results When Uaag Synthetic Porcelain in Pra.ximal Occlusal Cavities 

in Bicuspids and Molars •:*<•: 312 

To Grind Natural Teeth Painlessly '..... .\ ^: .^-: . . 177 

To Make a Beautiful Plate 314 

To Make a Two Piece Shell Crown Serve as Bridge Abutment 176 

To Make Over an Old Bur 454 

To Open Hypodermic Needle 798 

To Prevent Saliva from Getting Into the Handpiece 522 

To Prevent the Softening of Carving Compound in Metal Plates 314 

To Prevent Thumb-Sucking in Children 39 

To Remove an Inlay Model 114 

To Remove Richmond Crown 522 

To Repair a Hole in a Bicuspid or Molar Crown 113 

To Repair Gold Crowns 245 

To Replace Pin Facing on a Bridge Which Has Post Abutments 588 

To Restrict the Flow of Solder 178 

To Save Time During the Use of Silicate Cements 302 

To Splice an Engine Cable 312 

To Stop a Leaky Vulcanizer 176 

To Stop a Leaking Vulcanizer 454 

To Tighten Old Plates 113 

Useful Hints 178 

Use for Worn Joe Dandy Stones or the Knife Edged Stone With Hub in the Centre 522 

Vaseline an Aid in Swaging Shell Crowns 720 

Water and Teeth 40 

WaxedSilk 108 

When Glower Bums Out in the Dentiscope Lamp 1 14 

QUESTIONS AND ANSWERS TO PRACTICAL HINTS 

41, IIS, "6, 179, 180, 246, 316, 455, 523, 733, 734, 799, 300, 301 

DIGESTS 

Artificial Teeth, Advice to Those About to Wear D. W. Barker, D.D.S. 249 

Conversation 182 

Codperation Between the Dentist and the Orthodontist 459 

Dental Surgery 803 

Emetin vs. Surgery in the Treatment of Pyorrhea Thomas N. Hartzell, D.D.S., M.D. 666 

Extragenital Chancres 183 

Food Consumption of Adolescent Boys 802 

Gift to Dental School 642 



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▼iii TABLE OF CONTENTS, 1916 

PAGE 

High Cost of Living 804 

Infection of the Hands and Fingers of Physicians 183 

Management of Children and the Treatment of Teeth 416 

Nature, Manner of Conveyance and Means of Prevention of Infantile Paralysis 

Simon Flexner, M.D. 591 

Oil of Turpentine as a Haemostatic G. Grey Turner, M.D., F.R.C.S. 182 

Partial Dentures W. E. Cummer, D.D.S. 526 

President Butler Appeals for $1,000,000 to Endow Columbia Dental School 458 

Preventive Dentistry and the Dental Nurse Woods Hutchinson, M.D. 529 

Proposed Statement of Aims and Objects -. 247 

Spare the Toothbrush ^jlbB'fiie^inlJj .-^* : •. . . : Woods Hutchinson, M.D. 527 

The Blaster : . •*.; .;:\ / .V •...:.: ...•; i8a 

♦. .* •:• : «:: :*.: "• \ / • •:: • aocrExf «oVe& ■ 

Alabim& tTen\aI Association .*^' . .*.* ^.^ , 203, 271 

American In9d^^*v^IDBeA!41^eacher». . /^ .*2* 5* i ■ •^^ -• • ^ ^^» ^^3 

Arizona SoEiKl^r^ioial Eikhuners.^I .".'.** .1 . .^^ * . sh^. . 271 

Arkansas State Board Dental Examiners 823 

Arkansas State Dental Association 203, 339 

California Board of Dental Examiners 339, 823 

Colorado State Dental Association 339 

Connecticut State Dental Association 271 

District of Columbia, Meeting of Examination Board 67 

Florida State Dental Society 203, 271, 340 

Georgia State Dental Association 271, 340 

Idaho State Dental Association 271 

Illinois State Dental Society 203, 207, 340 

Indiana State Dental Association 271, 340 

Iowa State Board of Dental Examiners 823 

Iowa State Dental Society 203, 271, 340 

Kentucky State Dental Society 271, 340 

Lake Erie Dental Association 203 

Louisiana State Dental Society 273 

Maine Dental Society 340 

Mar>'land State Dental Association 203 

Massachusetts Dental Society 203, 207 

Michigan State Board of Dental Examiners 203, 207, 340 

Minnesota State Dental Association 67, 823 

Mississippi Dental Association 203, 207 

Missouri State Board of Dental Examiners 340 

Montana State Board of Dental Examiners 341 , 823 

National Dental Association 137, 287, 409, 480 

Nebraska State Dental Society 203, 272, 341 

New Jersey State Dental Society 341 

New York College of Dentistry, Semi-Centennial 410 

New York State Dental Society 203, 272, 341 

Northern Ohio Dental Association 341 

North Carolina State Board of Dental Examiners 67, 823 

North Dakota State Board of Dental Examiners 67 

Odontological Society of Western Pennsylvania 204, 272 

Ohio State Dental Association 823 

Pennsylvania Board of Dental Examiners 272, 341, 823 

Rhode Island State Board of Registration 341 

Sixth District Dental Society of New York 203 



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GSNERAL INDEX FOR 1916 



South Carolina State Dental Association 204, 272 

South Dakota State Board of Dental Examiners 67, 823 

Tennessee "Board of Dental Examiners 34^ 

Texas State Dental Association 204, 272, 341 

Tri-State Post Graduate Dental Meeting (Missouri, Kansas, Oklahoma) 203 

Vermont Board of Dental Examiners 272, 342 

Washington University Dental Alumni Association 67 

West Virginia State Dental Association 204, 272 

Wisconsin State Board of Dental Examiners 204, 272, 342 

Wisconsin State Dental Society 67, 272 

EPITOME OF CURRENT DENTAL AND MEDICAL UTERATURE 

42-65, 117-136, 184-202, 251-270, 464-477, 534-553, 590, 607-618, 663-665, 672-688, 805-821 

MISCELLANEOUS 

Obituaries 66, 136, 336, 477 

Book Reviews 66, 607, 689, 822 

Correspondence 

8, 92, 93, "2, 174. 175, 241, 242, 31 1, 315, 531, 572, 641, 653, 654, 660, 661, 729, 730, 783, 784 
Future Events 67, 137, 205, 273, 343, 410, 482, 552, 620, 690, 756 

INDEX BY MONTHS 

January 1-68 July 413-482 

February 69-138 August 483-552 

March 139-206 September 453-620 

April 207-274 October 621-690 

May 275-342 Nov-EicBER 691-756 

June 343-412 December 757-824 

GENERAL INDEX FOR 1916 
VOLUME xxn 

A 

A Biblical Quotation 730 

A Delightful Camping Trq) 370 

A Delightful Vacation and Some Conclusions 362 

A Good Tunc in Pocahontas County, W. Va 384 

A Launch Trip 386 

A Specific for Poison Oak or Ivy 365 

"A. B. D." 514 

A Slam or an Earnest Proposition? 433 

Adams, F. L., D.D.S 311 

Advice to Those About to Wear Artificial Teeth 249 

Agreement to Surrender Practice 510 

"A. H." 517 

Alaska Dental Society 453 

Alien, Dr. J 153 

Always Render Your Best Service 451 

Amalgam Ktetorations, Accuracy in 562 

An April Vacation 368 

An Internuuriliary Splint 645 

An Outing In the Ozarks 385 

Answer to a Query 243 

Answer to a Request for Advice 235 

Answers to "M. F. R." 30, 31 



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X GENERAL INDEX FOR 1916 

PACE 

Answers to " Perplexed" 434 

Angina, Ludwig^s 483 

Are State Dental Laws Reasonable? 710 

Army Dental Corps, New Legislation Affecting 481 

Around the Table 790 

Articulation, Perfect, in Posterior Bridgework by Use of Trubyte Molar Blocks 295 

Artificial Dentures, Finishing Process of 422 

Ash, Percy A^D. D.S 100, 165 

Assistants, Training, Valuable Suggestions in 495 

Assistants, Unlicensed Employment of 580 

Association of Commerce 463 

Avoid Appetizers 28 

B 

" B " 452 

Bachelor, O. D 660 

B. A. G 794 

"B. A. J." 237 

Banquet to Mr. Thomas Forsyth 781 

Barker, D. W., D.D.S 249, 782 

Barnard, Floy Tolbert 345 

"B. C. G." 651 

Beach or Mountains? 372 

Bebyia, F. S., D. M. D 782 

Better Doctoring for Less Money 581 

Bogue, E. A., M.D., D.D.S 631, 691, 757 

Bookkeeping, System of Dental 103 

"Boston" 112 

Braucher, Olga Thimme 533 

Brother Bill's Letter 33 

Brown, Edward F., D.D.S 284 

Brown, H. O., D.D.S 405 

Brunson, Edward T., D.D.S 364 

Buckley, J. P., D.D.S 89 

Bulletin of the Association of Military Dental Surgeons 730 

Bums, J. H., D.D.S 366 

Business Side of Dentistry 239 

Business Side of Restorative and Prophylactic Practice iQ* 94i 435 

C 

Cabot, Richard C, M.D 581 

" C. A. G." 31 

California State Dental Association, Bulletin of the 505 

Campbell, Dayton Dunbar, D.D.S 79 

Can He Prove It? 453 

Canadian Dental Association, 1916 709 

Caries — Repairing Carious Teeth 642 

Caution 311 

Cazier, Marion Howard, M.D 553, 775 

" C. F." 506 

Chamberlain, L.A., D.D.S 172 

Chancres, Extragenital 183 

Change of Color 516 

Ch&teau de Passy 717 



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GSNERAL INDEX FOR 1916 zi 

PAGE 

Christopher, C. R., D.D.S 393 

Oapp, Geoige Wood, D.D.S 19, 94, i59, 435 

Clappison, O. S., D.D.S 601 

Clark, C. Charles, D.D.S 300 

"Clinic," Meaning of the Word 782 

Closed Mouth Impressions 4» 74, i39, 290, 413, 498, 597, 700, 763 

Closure of Jaw in Mastication 502 

Clyde Davis, D.D.S 221 

Coffin, A. Bruce, D.D.S 293 

Cole, Walter S., D.D.S 370 

Coleman, Paul S., D.D.S 360 

Columbia, $125,000 for 795 

Columbia Dental School, President Butler Appeals for $1 ,000,000 to Endow 458 

Colyer, J.F 494 

Commercialism and Dentistry 577 

Complete Description of My Most Successful Operation 627 

Conditional Sale of Dental Fixtures and Furniture 15 

Conovcr, J. F., D.D.S 787 

Conservative and Constructive Treatment of Riggs* Disease 775 

Conversation 182 

Cooperation 658, 659 

Cooperation Between the Dentist and the Orthodontist 459 

Correct and Incorrect Cuspid Relations 561 

Cost of an Inlay, My Way of Figuring 31 

Costsof Conducting Dental Practice 721 

Cotton Brigade 520 

Court Decision, Appellate, on Some Points of Interest in Dental Laws and Their En- 
forcement 460 

Cow-Bell Method of Casting Aluminum Bases 416 

" C. S. L." 1 74 

Cunmier, W. E., D.D.S 526 

D 

Davis, W.F., D.D.S 296 

Deacon, A. P., D.D.S 351 

Deciduous Teeth, Orthodontia of the 631, 691, 757 

Dcmarest, H. M., D.D.S 627 

Dental Economics 587 

Dental Hygienists 284 

Dental Laws, Decision in 460 

Dental Nurse, Preventive Dentistry, and the 529 

Dental Protective Association, Important Information from the 85 

Dental Protective Associations? Why are There Two 288 

Dentistry Among the Troops on the Mexican Border 630 

Dentistry from a Financial Aspect 100, 165 

Dentists' Office Hours 241 

Dentures, New Method of Constructing Full 221 

Detachable Cusp for Steele's Facings 700 

Devitalization, Shall we Discontinue? 207 

Dinshah Dadabhai Dordi ^33, 784 

Do You? 557 

Do You Know That? 644 

Dodge, Elatharine 448 

I>resch, L J 303, 719 



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xii GENERAL INDEX FOR 1916 

PAGE 

Dungan, F. L., D.D.S 365 

Dunham, L. W., D.D.S 514, 710, 793 

"D. W. B." 434 

D. W. H 432 

Duplicates of Dental Publications at Vanderbilt University 718 

Dye, Ernest C, A. B., D.D.S 280 

E 

Efficiency of Tmbyte Teeth 243 

Eighth Annual Hay Fever Pilgrimage 402 

Eldridge, Watson, W., M.D 155, 277, 621, 398 

Emetin vs. Suigery in the Treatment of Pyorrhea 667 

Emplojonent of Unlicensed Assistants 581 

Englander, Louis, D.D.S 215 

Engs, John S., D.D.S 146, 212 

" E. S. G." 27 

Ethics as It is Lived 787 

Evolution of a Prosthodontist 6 

P^xodontia under Nitrous Oxide and Oxygen Anesthesia 769 

Experiments to Determine the Toxicity of Therapeutic Agents in the Treatment of Py- 
orrhea on Animal Cells Grown in Vitro 69 

F 

Failure to Sterilize Instruments as Malpractice 652 

Faison, C. I., D.D.S 30 

Fate of An Innocent Bystander 345 

Fatigue, Cause — Nature and Cure 398 

"F. D. H." 98 

Fees, Dental 574 

Fees, How can you Raise, and Keep the Good Will of the Community 450 

Fees, Professional Denture Service, Professional 719 

Feldman, Bernard, D.D.S 219, 485 

Fifty-fifty 296 

Finishing Process of Artificial Dentures 422 

First Night in the Woods 560 

Flexner, Simon, M.D 591 

Food for Dentists 155,277,621 

Forsyth, Thomas, Banquet to 781 

Forsyth Infirmary for Children 342 

Forsyth Loving Cup, Hartford Men Contribute to 220 

G 

GaUie, D. M., D.D.S 89 

Gamble, B. L., D.D.S 385 

Getting the Money 452 

Gift to Dental School 642 

Gillock, CM., D.D.S 315 

Gold Crowns for Posterior Teeth in Mouth where the Bite is Vcr>' Close 143 

Gold SheD Crown and Post for Short Teeth 455 

Great National Movement 9 

H 

Hartzell, Thomas B., D.D.S 666 

Haskell, Loomis P., D.D.S 502, 716, 778 

Healy. T. G., D.D.S 422 



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GENERAL INDEX FOR 1916 ziu 

PAGE 

Higgason, J. C, D.D.S 39© 

HiU, E. W., D.D.S 384 

Holroyd, W. J.,D.D.S 226,640 

Homer, H. J., D.D.S 640 

How Can He Better Conditions? 27 

How to Make and Save a Competency 22 

"H. K." 29 

Howe, Perry R., D.D.S 782 

Hunting with Airedale Terriers 351 

HunUey, CarroU, C, D.D.S 477 

Hutchinson, Woods, M.D 527, 529 

Hygienists, Dental, First Course for the Training of, in New York 503 

Hygienists, Dental 284 



Impacted Third Molar Causes Facial Paralysis 566 

Importance of Suggestion in Dental Practice 724 

Impressions, Closed Mouth 4, 74» i39> 290, 413, 498, 567, 700, 763 

Indictment Against Dentist Quashed 223 

Infection of the Hands of Physicians 183 

Inlays Cost, What I Think, 98 

"Investing for the Rainy Day " 652 

J 

Jaulusz, H. J., D.D.S 217 

Johnsen, Elberg V., D.D.S 359 

Jones, Francis C, D.D.S 643 

"Josh ", A Reply to, in the March Digest 310 

"Josh" Comes Back 171 

"J.S." 220 

Juell, Nils, D.D.S 293,308 

K 

Kauffmann, Joseph H., D.D.S 760 

Keyes, Frederick A., D.D.S 782 

Kurlander, J. E., D.D.S 219 

Kyes, Walter S., D.D.S 207, 572 



Larson, L. P., D.D.S 381 

Launch Trip, A 386 

Lay, Victor, D.D.S 145 

Layman's Viewpoint, A 648 

Lee, W.B., D.D.S 368 

Letter to a Dentist, An Original 158 

Liquid Petroleum 606 

"L. L." 175 

Living Costs and Dental Fees 575 

"L. R." 434 

Ludwig's Angina 483 

Lupton, L. A., D.D.S 386 

M 

MacKenzie, Chas. M., D.M.D 625 

McChesney, C. J., D.D.S 640 



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xiv GENBRAL INDEX FOR 1916 

PAGE 

McClelland, W. Clyde, D.D.S 416 

McCormlck, Vance C 573 

McPhaU, J. A., D.D.S 394 

Marco, B. Banymore, D.D.S 566 

Marsh, W. E., D.D.S 784 

"Massachusetts" 112 

Mastication, Closure of Jaw in 502 

Miller, J. M., D.D.S 90, 91 , 376 

M. L. C 795 

Mingle, C. W., D.D.S 516 

Mogh, WiUiam C, D.D.S i 

Molar Blocks, Trubyte 294 

Morgan, Guy, D.D.S 584 

Mouth Washes, Problem of 625 

Musings of a Simpleton 656 

My Quest for Pike 354 

Myers, S. M., D.D.S 427 

N 

Nathan, Charles, D.D.S 575, 724 

National Dental Association, Twentieth Annual Session 409 

National Dental License Association 728 

Natural Cleansing of the Mouth by Natural Means 485 

Nature, Manner of Conveyance and Means of Prevention of Infantile Paralysis 591 

New Method of Constructing Full Dentures 321 

Nitrous Oxide and Oxygen Anesthesia, Exodontia Under, 769 

"N. J." 31 

" N. M. D." 22 

O 

Obturators, Adjusting 217 

Ohm, W. H., D.D.S 239 

Oral Prophylaxis, The Dentist, the Patient and, 760 

Orthodontia of the Deciduous Teeth 631 , 691, 757 

Orthodox Orientals and Their Freedom from Pyorrhea Alveolaris 531 

Our Vacation in 1915 390 

Our Wisconsin River Trip 374 

P 

Partial Dentures 526 

Patient Frankly Leaves the Reward to God 241 

Perkins, Bertram R., D.D.S 769 

"Perplexed" 220 

Phelps, D. R., D.D.S 722 

Phillips, M. G., D.D.S 763 

Platinum, Separating Gold From 427 

Piatt, Frank L., D.D.S 577 

Practical Illustration of Success 506 

Practice, Business Side of Prophylactic and Restorative 19 

Pray, K. D., D.D.S 294 

Preventive Dentistry and the Dental Nurse 529 

Prime, J. M., D.D.S 222 

Problem of Mouth Washes 625 

Professional Denture Service or Professional Fees? 719 

Professional Discourtesy 431 



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GENERAL INDEX FOR 1916 zv 

PAGE 

Progressive Prosthetic Clinic 705, 707 

Proof of Malpractice in Dentktr>' 234 

Proposed Statement of Aims and Objects 247 

Pyorrliea Alveolaris, Orthodox Orientals and Their Freedom From 531 

Pyorrhea and the General Health 641 

Pyorrhea, Treatment of, for the General Practitioner , 601 

Q 

QUESTIONS AND ANSWERS .... 41, 115-116, 179, 246, 315, 455-457, S23, 59©, 663, 733 

R 

Rafidin Ahmed, D.D.S 786 

Rapid and Accurate Method of Soldering Pin to Richmond Cap 565 

Rationale of Riggs' Disease 553 

Records, Necessity for Completing Complete 300 

Rdd, J. G., D.D.S 89 

Relation of the Dentist to the Manufacturer and Dealer 584 

Repairing Carious Teeth 642 

Reply to "M. F. R." 29 

Richmond, Harvey. D.D.S 642 

Robertson, T. M., D.D.S 402 

Ross, F. Z., D.D.S 103 

"R. R. C." 148 

Rugae 145 

S 

Saving Time in Impression Taking, 786 

Saving for the Rainy Day and Old Age Fund 517 

Scovil, Raymond, D.D.S 143 

Seccombe, Wallace, D.D.S 305, 444, 511 

Selection of Teeth 424 

Selling Denture Service 303 

Separating Gold from Platinum 427 

Septic Wheel Brush, The 148 

Shearer, William L., D.D.S 172 

Sherman, W. Goddard, D.D.S 149, 562 

Shortage of General Practitioners 78 

Shoulder Crown and Its Technic 643 

"S. H. W." 786 

Some Thoughts on the Business Side of Practice 722 

Something Different 364 

Spare the Toothbrush, Spoil the Joints 527 

Specific for Poison Oak or Ivy 365 

Spence, Stewart J., D.D.S 491, 557 

Spies, W. F., D.D.S 19, 69, 94, 159, 435 

Splint, An Intermaxillar>' 64S» 

Stein, J. J., D.D.S 521 

Stekl, C. F., D.D.S 374 

Street, A. L. H 234, 310, 510, 552, 580 

Strong Man's Song 552 

Successful Deer Hunt in Massachusetts 380 

Successful Practice of Dentistry 305, 444, 511 

Sugar and Its Effect Upon the Teeth 146, 212 

Suggestion in Dental Practice, Importance of 575 



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zvi GENERAL INDEX FOR 1916 

PAGE 

Supplee, Samuel G 4, 74, i39» 290, 413* 498» 567,- 700, 764 

Sure Cure and a Pleasant One 381 

System of Dental Bookkeeping 103 

T 

Taggart Cannot Sue the Dentists Collectively 504 

Taylor, L. C, D.D.S 661 

Tench, Russell W., D.D.S 561 

The Beach or Mountains? 372 

The Blaster 180 

The Fate of An "Innocent Bystander" 345 

The Whole World is a Big Store 449 

Too Busy to Read 206 

Tooth Bleaching, Technicof Natural, in the Mouth 215 

Tooth Brush, Care and Use of the 222 

Tooth Brush? Why Discard the 280 

Towne, Wm. E., D.D.S 237 

Treatment of Fractured Jaws 4 

Trubyte Molar Blocks, Perfect Articulation in Posterior Bridgework by the Use of 294 

Turner, G. Grey, M. S., F. R. C. S 182 . 

Turpentine, Oil of, as a Haemostatic 182 

Twichell, Charles L., D.D.S 380 

Two T>'pical American Faces 573 

U 

Uncle Mack 452 

University Dental School in New York for Columbia 225 

Up the Oswego After Trout 405 

V 

Valuable Suggestions in Training Assistants 495 

Vulcanite, Expansion and Contraction in Plaster and 491 

AV 

Walters, W. S., D.D.S 354 

"Washington ** 112 

Waterbury, J. E., D.D.S 495 

Weaver, C.W., D.D.S 362 

Webster, Guy B., D.D.S 504 

Weed, Thomas M., D.D.S 655 

Week at Lake Geneva, Wisconsin 35v 

Weeks, Sinclair, D.D.S 6 

What a Vacation Did for Me 366 

What Do You Believe? 793 

What I Like About My DenUst 18 

What I Think Inlays Cost 98 

What Shall We Charge for Plates? 226 

Where Have My Profits Gone? 308 

Why a Vacation and Where 394 

Why I Think It Pays to be Courteous 514 

Who is Responsible for Low Fees? 576 

Willcox, W.R 573 

Woodle, J. M., D.D.S 565 

Wrongful Discharge of Dentist 151 

Z 
Zimmerman, L. M., D.D.S *. 424, 372 



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The Dental Digest 

GEORGE WOOD CLAPP, D.D.S., Editor 

Published monthly by The Dentists' Supply Company, Candler Bldg., 
Times Square, 220 West 42d Street, New York, U. S. A., to whom all com- 
munications relative to subscriptions, advertising, etc., should be addressed. 
. Subscription price, including postage, $1.00 per year to all parts of the 
United States, Philippines, Guam, Cuba^ Porto Rico, Mexico and Hawaiian 
Islands. To Canada, $1.40. To all other countries, $1.75. 

Articles intended for publication and correspondence regarding the same 
should be addressed Editor Dental Digest, Candler Bldg., Times Square, 
220 West 42d Street, New York, N. Y. 

The editor and publishers are not responsible for the views of authors ex- 
pressed in these pages. 

Entered as Second Class Matter, at the Post-Ofl5ce at New York City. 
Under the Act of Congress, March 3, 1879. 



Vol. XXII 



JANUARY, I9I6 



No. 1 




TREATMENT OF FRACTURED JAWS 

William C. Mogh, D.D.S., Brooklyn, N.Y. 
Case I 

Patient — Mr. N. Age — 50 years. 

History — ^Was kicked in the face by a horse, causing a compound frac- 
ture of the superior maxilla. Was admitted to the Williamsburg Hos- 
pital, Brooklyn, on July 6th, 1915, in the service of Dr. Robt. Morrison, 
visiting surgeon. 

I was called in on the case by the hospital and found the patient in 
great pain. He had a temperature of 105 and his mouth was a mass of 
splintered bone, process and pus. It took fifteen minutes of steady 
irrigation to get the mouth in a condition before I could see anything at 
all. Upon close examination I foimd the patient to be suffering from a 
compound fracture of the upper maxilla, one break being between the 
lateral incisor and canine of the right side, and the other between the 
lateral incisor and canine on the left side. He had also a simple fracture 
of the mandible on the right side, between the first bicuspid and the 
canine. 

In Figure i we have a diagram of the fracture in the superior maxillae. 

The pain from touch was so great, that the patient had to be taken to 
the operating room, where I took the impression, first having wired the 



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2 THE DENTAL DIGEST 

case, to be sure the parts would not move when the material was forced 
in. From this impression I made a rubber splint which besides covering 
the teeth from the one first bicuspid to the corresponding tooth on the 
other side, also covered the palatal surface of the bone, and held the parts 
tightly in their normal relationship. 

The fracture of the mandible was a simple one as is shown in Figure 2. 




Fig. I. Showing fracture of superior maxilla 




Fig. 2. Showing pK)int of fracture 

I took the impression with modeling compound, holding the two parts 
together. From the model of the impression the gold splint was swaged 
and then cemented on. 

The case was dismissed in sixty days, when the patient was able to 
use his mouth as he had done before the accident. 



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TREATMBNT OF FRACTURED JAWS 3 

Case II 

Patient — ^J. Age — 7 years. 

History — Was run over by a wagon causing a fracture on the right side 
of the mandible. Was admitted to the Williamsburg Hospital, Brooklyn, 
on October i6th, 1915, in the service of Dr. Robt. Morrison visiting 
surgeon. 

Being called upon to take charge of the case I immediately looked for 
crepitis, which I found on the right side of the mandible, as is shown in 
Figure i. 




Fig. I, Case 2. Showing the point of fracture 
T. Temporary molar; 2. Temporary molar; 3. Temporary canine or cuspid; 4. Perman- 
ent lateral incisor; 5. Permanent central incisor; 6. Point of fracture. 




Fig. 2, Case 2. Showing gold splint in place 
I. Gold splint in place cemented to the teeth; 2. • Fracture in perfect contact. 

It being a case of a simple fracture, I took an impression in modeling 
compound, being very careful to have my assistant in the case hold the 
jaw at the angle and the chin, making certain that there would be no 
chance of the patient moving and getting an incorrect impression. I 
then took a bite with soft wax to get good occlusion. The models were 
then made from the impression and bite, and from the model the splint 
was swaged, and then soldered, making a continuous gold splint, as is 
shown in Figure H. 

In thirty-three days I took off the splint, and the patient had once 
more a perfect jaw and bite. 

223 St. Nicholas Ave. 



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4 THE DENTAL DIGEST 

CLOSED MOUTH IMPRESSIONS 

By Samuel G. Supplee, New York 

First Article 
certain preliminary considerations 

When I was graduated from dental college to practical work, plaster was re- 
garded as the only proper material for taking impressions. After a year of 
partial successes mixed with some complete failures, I met a dentist who had 
learned how to whittle and scrape models so that plates made over them would 
stay up. I lunched with a denture patient once and was mortified to see him 
take out his plates "so he could eat." 

I spent some years in the study of anatomical articulation without giving 
much thought to the impressions. Those who followed the published methods 
achieved better success than before, but certain failures of the dentures, not 
connected with articulation, were discomforting. I know now that those fail- 
ures originated in faulty impressions, bites, and models. 

Then Mr. Supplee showed me things about impressions, of which I had 
never dreamed. I saw that the best articulated dentures might fail from unsci- 
entific impression taking and cast making methods. I saw him succeed with 
case after case where I should have stood no chance of success. Sometimes he 
had to try more than once, but he succeeded where from 5 to 15 dentists failed. 
And he succeeded because he has learned how to take impressions and bites 
and pour models and arrange teeth and vulcanize in a scientific manner, 

I am very glad to have the opportunity of bringing the fruits of Mr. Supplee's 
work to the readers of this magazine. I am sure that those who follow his 
methods will achieve greater success than by any other methods I know of. 

When the methods in all steps of denture making become scientific, we shall 
regularly achieve as great successes in this field as in operative work. We shall 
then be much better dentists and shall more nearly fulfil our mission of render- 
ing good service to edentulous patients. — Editor. 

The phrase "taking an impression and pouring a cast" has, for years, 
indicated practically all there was to be said of the technic of preparing 
a foundation on which a plate is constructed. 

'* Fitting a plate " has been the expression to describe the hours of filing 
and trimming after the plate has been vulcanized. 

It has been well said that denture making by the old methods has 
been mostly guesswork, and that the honors have usually gone to the 
best guesser, or to him who was most skillful with scraper, stone or file. 
The arrangement of the teeth by the old methods of occlusion and on the 
old forms of articulators has also been mostly guesswork. 

Among the questions which confront those who wish to do really pro- 
fessional service in dentures are the following: — Shall we aim to obtain 
impressions of the mouth from which to construct dentures in the usual 
way, or shall we construct in the mouth trial plates which will properly 
compress or displace soft tissues and at the same time hold the lips, and 
cheeks out to the positions necessary for restoration of expression and du- 



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CLOSED MOUTH IMPRESSIONS 5 

plicate these in the finished dentures? The second question is: Shall we 
p)our casts in plaster, which expands and which is easily compressed in the 
flask press or by the expanding vulcanite, or shall we pour casts in materials 
which are less subject to changes and less likely to defeat our best efforts? 

In my article entitled "The Importance of Taking Impressions With 
the Mouth Closed and Under Biting Pressure," published in the October 
1914 issue of this magazine, I called attention to the difference between 
an impression with the mouth open and the mouth closed. Many den- 
tists have formed the opinion that the difference between impressions with 
the mouth open and the mouth closed constitutes the secret by which 
those who have made careful studies of mouths and materials have been 
able to make successful dentures for patients for whom all previous den- 
tures have been unsuccessful. 

Many have gained the idea that all they need to insure success is 
water heating apparatus, a set of trays and some modelling compound. 
The results of their impressions with closed mouths and properly heated 
modelling compound has been that their dentures have been more success- 
ful than ever before, but that a certain percentage of these cases has been 
successful for only a short time. The temporary nature of these successes 
has been due to imperfect conceptions of the mouth, of the materials 
employed and the methods best suited to their uses. 

In addition to this, they have not grasped the idea that when no pres- 
sure is appUed to a plate, it rests on the soft tissues, but when biting pres- 
sure is applied, the plate is forced against the soft tissues until they are 
either condensed or displaced into positions and conditions in which the 
soft tissues and the hard tissues bear the strain equally. This is equal- 
izing the tissues to withstand biting strain. The successes mentioned 
above were temporary only because of the employment of improper 
methods in condensing or displacing soft tissues. 

To eliminate guesswork from denture making, one must replace the 
rule of thumb methods of the past in impression and bite taking, arrange- 
ment of the teeth and laboratory work, with the scientific methods now 
offered in all these lines. For instance, both dentists and laboratory 
workers will profit by recognizing that plaster begins to expand as soon as 
it is set, and is easily compressible, and to the extent that it is affected by 
these changes is unreUable. During vulcanization the vulcanite first 
expands then shrinks and finally warps. Unless care is exercised to guard 
against these changes, our finest efforts may be frustrated by failures due 
to change in form of materials. 

These changes in form can be guarded against by properly pouring 
casts of the non-expanding and practically non-compressible materials 
such as Weinstein's Artificial Stone, Spence's Plaster, etc. 



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6 THE DENTAL DIGEST 

In mouths where the muscular attachments are not pronounced and 
the vault and ridges are of equal density all over, we can take impressions 
in plaster, or any other kind of impression material regardless of the size 
of the tray, with the expectation that successful dentures will result. 
But even the prosthetic speciaUsts have been obliged to admit that in 
cases which present difficulties from character of tissue or of form, model- 
Ung compound is far superior to plaster as an impression material. 

In this series of articles I shall outline a technic of diagnosing condi- 
tions in the mouth, of impression taking and of bite making which has 
been successful in many cases where all other forms of techm'c have failed. 
(This article is expected to be continued) 



THE EVOLUTION OF A PROSTHODONTIST 

By Sinclair Weeks, D.D.S., New York 

This article was awarded the Fourth Prize in the Prosthetic Articles Contest. 

Just before entering college to take up my studies in dentistry, I was 
fortunate in meeting a dentist of the old school who was ripe in experience 
as well as years, who offered me a few words of advice which must have 
burned deeply into my sub-conscious memory for they have stayed by 
me for twenty years. They were as follows — *' Young man your success 
in this field will largely depend upon whether or not you possess a mechan- 
ical sense. If you do you can put it to no better use than to cultivate the 
highest degree of skill in the construction of artificial teeth. It takes a 
patient from six months to five years to find out what kind of gold filling 
you have inserted for him, but it only takes a few weeks to find out if you 
have made him a useful set of teeth." 

It was a long time before I fully comprehended the significance of that 
advice and started out to follow it. After I was graduated and went out 
into the world to become acquainted with my chosen profession I found 
the majority of dentists had either, through lack of ability or indifference, 
pulled or pushed this very important branch of dentistry down to a low 
level and belittled it by calling it common plate work and relegated it the 
office girl or an outside laboratory. I determined to meet the very first 
opportunity which should present itself to allow me to perfect myself 
along these lines. Shortly after I went into a laboratory in a small city 
with an ethical man to **work out my salvation." 

I received some pretty severe jolts in the next few weeks when I saw 
many of the important methods of technique which had been quite a 
respectable part of my college education thrust aside and in their place a 

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THE EVOLUTION OF A PROSTHODONTIST 7 

slip-shod trusting-to-luck-method. I was taught that excessive stirring 
of plaster caused great expansion, but I saw it mixed here as one would 
whip cream. I learned at college that the correct way to take a bite 
was to fit plates to casts with a stiff material and build them up with 
compound, but here I saw a roll of beeswax thrust between the jaws and 
the patient told to bite. I had cause to wonder if there was any standard 
of articulation, when I saw teeth set up on the barn door hinge, and when 
I finally dared to offer a mild protest, I was told that I was only talking 
theory and that plate work in reaUty was very simple and that I would 
soon master it, if I cut out the theory and came down to simple practice. 

Experience is not only a great teacher, but it plays an important part 
in raising our standards. When a year or so later, I started in business 
for myself I was glad to be free to carry out some of the ideas which had 
been handed down from the men who had gone before and I learned 
as we all do sooner or later, that there is no short cut to success. After 
trying to take a few short cuts, I got right back to first principles and gave 
up the idea that plate work was "simple," I suppose I must have met 
with a certain degree of success for business began to come my way and 
I began to acquire a reputation as a plate maker. As I look back and 
think about the plates, I turned out I am pretty sure it took more skill to 
manipulate them than it did to construct them. 

As the months went by I began to see the importance of this much 
neglected work; in place of drudgery, I saw that if one really possessed a 
mechanical sense it became more and more pleasant if not really fascin- 
ating. I saw that if one was to consider it serious business it meant care- 
ful study of each step of the process in the construction of a plate. That 
a perfectly fitting denture was never the result of guess work or luck. 
That because a plate might be good enough it was not necessarily just 
right. Two important steps I learned were essential, namely — a perfect 
impression and a perfect bite. This I held to tenaciously and my per- 
severence was rewarded to a satisfying degree. I ajso saw that if I was 
to excel I must go a little farther than the other fellow so I began to carve 
the gums. I always directed the patient's attention to this and it made a 
good impression. I also vulcanized over thin gold foil. This also pleased 
patients. I was careful to see that my plates were as thin as consistent 
with strength. The next year the Anatomical moulds came on the mar- 
ket and this gave me an opportunity to increase prices. I started in to 
educate my patients to see that there was a difference in plates, and in- 
variably foimd that if the pubUc was made to see by frank honest business 
talk that they were getting something better than the ordinary article 
they were perfectly willing to pay for it. Occasionally I would meet a 
patient who thought plates were plates regardless of how they were made 

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8 TH£ DENTAL DIGEST 

and would try to induce me to reduce my fee. I held rigidly to my scale 
of prices and explained to him that if I attempted to economize he would 
be the loser. I recall one man who was in very comfortable circum- 
stances and perfectly able to pay, objecting to my prices and leaving 
the office, saying he would like to have me do the work but that he wo\ild 
never pay that price if he went without teeth all his life. Imagine my 
surprise when he returned to my office a year later and told me he had 
dedded to have the work done. Two years later I moved to a larger 
field with greater opportunities to study improved and up-to-date meth- 
ods. I found as I had in the small city^ but in a much greater degree, a 
broad and unlimited field with opportunity continually pounding at the 
door of the man who could excel in high class plate work. I attended 
lectures and clinics and saw prosthetic dentistry advancing by leaps and 
bounds. I secured the Prosthetic Articulation and mastered the princi- 
ples involved in the Greene-Supplee method of taking compound im- 
pressions, I became dissatisfied with trying to fit stock trays, secured a 
flask and thereafter cast my own trays. 

With the appearance of Trubyte teeth on the market I began to talk 
efficiency as well as appearances. Discarding the illogical and out of date 
temperamental theory I drew an outline of the face and selected the teeth 
according to the Williams classification. By this method I have been 
able to select teeth that will harmonize with facial outline. I always set 
up the teeth on a Gysi articulator and try them in before vulcanizing. I 
finish the upper plate first and insert it to see that the bite is correct with 
the lower teeth which are still in the wax. This enables me to secure a 
perfect articulation. 

At present I carve the gums and insert the rugae. I vulcanize all 
plates over Spence's plaster models to eliminate expansion and secure the 
necessary strength to resist breakage in the flask. I always take time 
(and consider it a most profitable investment) to explain all these ad- 
vantages to my patients. I have no trouble to secure satisfactory com- 
pensation. I hope the next ten years will see prosthetic dentistry solidly 
placed on the high level in the profession where it logically belongs. 



Editor Dental Digest: — 

What is the best thing to do for a three year old girl who breathes 
through the mouth at night and snores as loud as an adult? 

The physician says she has no adenoids. She has been breathing and 
snoring this way for about three weeks. 

W. B. B. 



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A GREAT NATIONAL MOVEMENT 9 

A GREAT NATIONAL MOVEMENT 

Objects and Accomplishments of The National Mouth Hygiene 
Association result in interesting plans for the future 

By W. G. Ebersole, M.D., D.D.S., 
Secretary-Treasurer-General of The N. M. H. A. 

When Miss Cordelia L. O'Neill, who was then principal of Marion 
School in Cleveland, presented to the National Dental Association at its 
meeting in Cleveland in 1911, and later at the Fourth International Con- 
gress on School Hygiene, the twenty-seven members of her class as a 
living demonstration of what Mouth Hygiene could accomplish, the 
establishment of a national association was no longer a question. The 
visible evidence of the physical and mental transformation wrought in 
those children was greeted by the audience with a demonstration of en- 
thusiasm that will never be forgotten by anyone who was present. 

The National Mouth Hygiene Association was formed as an auxiliary 
of the National Dental Association July 28th, 1911 , in order to unite under 
one efficient national organization the various oral hygiene working forces 
of the country. It has already a record of achievement of which both 
the professional and lay members may justly be proud and which should 
enlist the interest and support of the entire dental profession. 

Among many laudable motives back of this national movement are 
the following, which appear in the preamble to the constitution and by- 
laws of the Association, as adopted at a meeting in Washington, D. C, 
last May: 

1. The teaching of Mouth Hygiene and its relation to better health, 
increased mental and physical working efficiency, and consequent greater 
happiness; 

2. To provide both the expert service and the funds necessary to en- 
able the organized dental profession in every community to do those 
things that are for the best interests of its people; 

3. To direct the attention of parents and guardians to the importance 
of dental services especially in childhood; 

4. To eliminate the dental fakirs, charletans and fraudulent adver- 
tisers who subsist on the ignorance and credulity of the public; 

5. To teach Preventive Dentistry and to recommend the employment 
of the highest t)q)e of professional services; 

6. To promote the efficiency of the organized dental profession in- 
dividually and collectively and to give it a wider, more responsive and 
more intelligent field in which to work; 



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10 TH£ DENTAL DIGEST 

7. To bring together actively not only the serious workers in the 
dental profession, but people of all other professions and vocations, and 
to enlist their united interest and cooperation in the expansion of the 
propaganda of Preventive Dentistry and Mouth Hygiene; 

8. To act as a servant, aid and auxiliary, to both the organized dental 
profession and the American public to secure and retain the highest and 
most permanent benefits for all, through the realization of the objects 
first stated: 

The incorporation of the Association under its present title, however, 
didn't take place until the annual meeting of the National Dental Associ- 
ation at Rochester, N. Y., in July, 1914. It is a corporation not for 
profit, and exists, as stated in the paragraphs just quoted, for philanthropic 
ends. 

There is no question but that the influence of the Association has been 
one of the chief forces in bringing about a more enlightened public opinion 
on the subject of Mouth Hygiene in its relation to public health. 

The importance of the movement has been fully recognized by na- 
tional, state and local boards of health, by school boards all over the 
country, and by individuals and organizations interested in social wel- 
fare, while many of the leading men of the dental profession have given 
freely of their time, money and influence. 

The responsiveness of the public has been made evident from the very 
beginning, not only by the interest shown in public dental clinics, but by 
the private donations for their support — notably at Boston, Rochester 
and Cleveland. This evidence, together with such encouraging indica- 
tions as the extensive welfare work under municipal auspices at New York, 
Buffalo, Philadelphia, Detroit and Cincinnati, show the seriousness with 
which need of better Mouth Hygiene is regarded. 

The Assodation has from the first been identified with related health 
organizations. It participated in the Fifteenth International Congress 
on Hygiene and Demography at Washington, in 191 2, conducted a special 
session at the Fourth International Congress on School Hygiene at Buf- 
falo in 1913, and a joint session with the Forty-Second Annual Meeting 
of the American Public Health Association at Jacksonville, Fla., in 1914. 

When Mr. Taft was President of the United States he recognized the 
Association officially, and it has been endorsed by many state and local 
dental societies and prominent leaders in education, social and industrial 
betterment and general hygiene. 

This success of the Association has doubtless been largely due to the 
fact that its founders recognized the need of organization from the outset, 
and elected a body of officers and a Board of Governors, composed of men 
and women whose reputation is a guaranty of an efficient service. 



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A GREAT NATIONAL MOVEMENT 11 

The President of The National Mouth Hygiene Association is Dr. 
Harvey W. Wiley, the great pure food expert, former chief of the U. S. 
Bureau of Chemistry. 

Among the vice presidents are Dr. Rupert Blue, Surgeon-General U. 
S. Public Health Service, and now President of the American Medical 
Association; Dr. W. A. Evans, ex-health commissioner of Chicago, now 
editor of the Health Department of the Chicago Tribune; Dr. Oscar 
Dowling, President of the Louisiana State Board of Health; and William 
R. Malone, President of the Postal Life Insurance Co. 

Turning to the Board of Governors we note such names as those of 
Prof. Irving Fisher of Yale University, Chairman of the Hygiene Refer- 
ence Board; Miss Julia C. Lathrop, Chief of the Children's Bureau of the 
U. S. Department of Labor; while Dr. John W. Kerr, Assistant Surgeon- 
General, U. S. Public Health Service; Mr. Lewis Meriam, Assistant 
Chief of Children's Bureau of the U. S. Department of Labor; Mr. F. B. 
Dressier, Specialist in School Hygiene & Sanitation, Bureau of Education, 
Department of the Interior, have pledged service in research and exten- 
sion work, and several of the U. S. Bureaus have been placed at the dis- 
posal of the Association in promoting its propaganda. 

The working methods of the Association include extensive campaigns 
in different cities for the double purpose of community education and the 
raising of funds, a strong dental publicity department which secures wide 
publication of all news relating to the movement and many highly educa- 
tional articles on Mouth Hygiene; and active cooperation with the work 
of allied organizations. One of the great objectives is the establishment 
of public dental clinics and school clinics in every town and city. 

The prosecution of the work is assisted by the establishment of local 
auxiliaries, the Association furnishing the expert service to organize, 
finance and equip these auxiliaries in a manner which insures definite 
results and continued self -support, and around which can be centred the 
work of each community. Auxiliaries have already been formed at 
Dallas, Texas; Cleveland, Ohio; Washington, D. C; Portland, Oregon; 
Kansas City, Mo.; Dayton O.; Canton, O., and Jacksonville, Fl'a., and 
the Association is proceeding as rapidly as possible to place these on a 
successful working and supporting basis. 

Many other communities have taken steps toward the establishment 
of active auxiliaries and may be expected to follow the examples of those 
already mentioned. Among them are Louisville, Ky.; Joliet, 111.; At- 
lanta, Ga.; Duluth, Minn.; Mobile, Ala., and Lynchburg, Va. 

It is with a great deal of satisfaction that we call attention to our De- 
partment of Extension Lectures under the supervision of Dr. Edwin N. 
Kent (Director of Extension Lectures), Boston, Mass. (330 Dartmouth 



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12 THE DENTAL DIGEST 

St.) This Department is prepared to furnish illustrated lectures suitable 
to the various needs of Mouth Hygiene workers of the country. These 
lectures with a set of thirty- two (32) slides, which have been very care- 
fully selected, are supplied to the organizations or communities desiring 
same at a cost of $2.50 plus express charges both ways; thus making it 
ix)ssible for Mouth Hygiene workers to have at conmiand this kind of 
service at a minimum cost. 

It is evident that the Association has imdertaken a great task and is 
prosecuting it with remarkable vigor. Raising the funds for establishing 
and maintaining such work on a national scale is in itself a large problem. 

One of the most important of all meetings of the Association was held 
in the city of Washington on May 29th of this year. Many matters 
which had been pressing for attention were taken up and measures adopted 
which will strengthen the organization and extend its usefulness. 

The work of the officers was recognized by their reelection. 

The constitution and by-laws were amended to conform to the laws 
of the District of Columbia, and to facilitate the completion of the incor- 
poration of The National Mouth Hygiene Association as a corporation 
not for profit. 

The principal action necessary to conform to law in this connection 
was the creation of a Board of Trustees — this Board to be fifteen in num- 
ber. The thirteen members of the existing Board of Governors, including 
the Secretary-Treasurer-General, were appointed to this Board of Trus- 
tees, the two additional members being the President of the Association 
and the Chairman of the Hygiene & Education Committee of the Na- 
tional Dental Association. 

It was also necessary to change the formal title of the Secretary- 
Treasurer to "Secretary-Treasurer-General." 

Further changes in the constitution were made in order to enable the 
Association to carry out its purposes and policies; and a preamble to the 
constitution was adopted setting forth these purposes and policies as 
given at the outset of this article. 

The general financial problems of the Association also came up for 
consideration and important action taken which is expected in time, to 
result in larger and more dependable sources of revenue for the local and 
national philanthropic work. 

Annual dues of active members were raised from $1.00 to $2.00 and 
new methods adopted for the sale and distribution of Mogene Dental 
Products. 

Many members of the Profession are, of course, familiar with the fact 
that Mogene Dental Cream has for some time been manufactured and dis- 
tributed under supervision and guaranty of The National Mouth Hy- 



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A GREAT NATIONAL MOVEMENT 13 

giene Association, with a binding guaranty that that portion of the pro- 
ceeds of sale receipted by the Association shall be devoted to the Na- 
tional and local philanthropic work in the cause of Mouth Hygiene. 

The Association was led to this action for two reasons; First, because 
it realized that here was a logical and effective means of increasing the 
. fluids available for prosecution of its philanthropic propaganda. Second, 
because it felt the need of a dentifrice which it could conscientiously 
recommend to the general public and the dental profession as one made 
under the supervision and guarantee of The National Mouth Hygiene 
Association. 

Leading dentists throughout the coxmtry had requested the Associ- 
ation to do this, for the protection of the general public, who are imable 
to distinguish between reputable preparations and those containing or- 
dinary commercial chalk, injurious disinfectants and antiseptics or other 
unsatisfactory ingredients. 

The Association did not undertake the actual distribution of Mogene, 
however, until careful study had been given to the subject, and investi- 
gation showed that it was feasible to produce a dentifrice of the requisite 
quality, and to market it successfully. 

It is eminently just and fitting that the Association, which has so 
much encouraged the use of dentifrices, should derive some support from 
their sale, instead of having its philanthropic efforts accrue wholly to the 
private profit of established manufacturers of dental preparations. 
Nothing imdertaken by the Association, however, will be antagonistic 
to the interests of the manufacturers of reputable dental preparations — 
on the contrary, the success of The National Mouth Hygiene movement 
is greatly to their advantage. 

Commercial distribution, of course, implies practical business meth- 
ods, and the plans adopted at the meeting on May 29th will, it is felt, put 
the distribution of Mogene on a soimd and thoroughly satisfactory basis. 

To this end The National Mouth Hygiene Association authorized 
its officers to form an organization to be known as the Mogene Labor- 
atories Company, which will manufacture Mogene Dental Cream and 
also Mogene Tooth Powder under supervision and guaranty of the Asso- 
ciation, and distribute them through regular commercial channels by the 
most efficient methods of modem merchandising. 

In addition, the plan for the distribution of Mogene products provides 
as heretofore for cooperative memberships in The National Mouth Hy- 
giene Association or its auxiliaries, available on payment of One Dollar 
($1.00) by any person interested in promotion of the work. In return he 
receives four full packages of Mogene Dental Cream, which is the regular 
amount delivered at retail for one dollar. 



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14 THE DENTAL DIGEST 

This Cooperative Package has already shown great earning possibil- 
ities to the direct benefit of the local auxiliaries, and should develop tre- 
mendously with full realization of the opportunity by all active members. 

The Cooperative Package, being distributed at the. full retail price 
through the auxiliaries, can be sold at less ''overhead" expense and ap)- 
proximately 50 cents out of every dollar can be applied to the funds avail- 
able for local work. 

It also is of great assistance in soliciting a large Cooperative Member- 
ship — and thus enlisting more and more persons in the cause of Mouth 
Hygiene — because the recipient gets back the full value of his member- 
ship fee in a dentifrice of exceptional merit, and knows that he is at the 
same time contributing half the purchase price to philanthropic work. 

Another important advantage of this package is that it helps the sale 
of Mogene through the regular commercial channels. Those who are 
thus once introduced to Mogene almost invariably become enthusiastic 
users because of its pleasant flavor, entire freedom from grit or other 
injurious ingredients, and its superior cleansing properties. 

The sale of Mogene to the great general public will be prosecuted by 
the most efficient methods of modern merchandising. Especially in 
cities where the local work of the Association is well established. 

Mogene Dental Cream and Tooth Powder will be advertised to the 
public, and placed on sale at reputable drug stores and department stores. 
Each case of one dozen packages will contain a participation certificate 
to be held by the dealer until collected by the authorized local representa- 
tive of The National Mouth Hygiene Association or the local dental 
organization. Return of these certificates to the Executive OflSces of The 
National Mouth Hygiene Association will entitle the local auxiliaries 
to pro rata participation to such funds as may be set aside for the pur- 
pose from the general revenue of the Association. 

This participation plan has been carefully worked out and should 
prove to be better than the benefit checks formerly used. 

In all matters relating to receipt and disbursal of funds, whether from 
contributions, sale of Mogene products or any other source, the Associa- 
tion has made it impossible for any of its present or future officers to ap- 
ply its revenue to any save its recognized philanthropic needs. 

It is not only bound by its incorporation as an association not for 
profit, but by a definite guaranty — ^which has been widely published and 
is printed on the containers of Mogene products — as well as by contracts 
with auxiliaries and other local organizations. 

To make doubly sure, the Association has appointed a National 
Board of Censors composed of the following well-known editors repre- 
senting dental and educational journals and the public press: 



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CONDITIONAL SALE OF DENTAL FIXTURES AND FURNITURE IS 

Dr. C. N. Johnson, Chicago, 111., Editor of The Dental Review, 

A. E. Winship, Boston, Mass., Editor of The Journal of Education. 

Dr. George Wood Clapp, New York City, Editor of The Dental Di- 
gest. 

Wm. C. Bruce, Milwaukee, Wis., Editor of American School Board 
Journal. 

Henry C. Williams, Columbus, Ohio, Editor of The Ohio Teacher. 

Dr. L. P. Bethel, Columbus, Ohio, Editor of The Dental Summary. 

Frank B. Noyes, Washington, D. C, President, Associated Press. 

These gentlemen are empowered to examine the books and records 
of The National Mouth Hygiene Association and its subsidiary organ- 
izations. Should they discover any evidence that the Association is not 
carrying out its obligations to the general public and to the dental pro- 
fession, it is their duty to give such evidence widest publicity in the 
journals which they represent. 

The dental profession has every reason to feel confident that the new 
plans for the manufacture and sale of Mogene products will be of great 
assistance in realizing the high aims and purposes of The National Mouth 
Hygiene Association. 

In conclusion, I cannot be too emphatic in stating that The National 
Mouth Hygiene Association is a corporation not for profit, and will con- 
tinue as the avowed servant of the organized Dental Profession and the 
American People in the effort to advance their highest interests and de- 
serve and secure their unqualified support. 



CONDITIONAL SALE OF DENTAL FIXTURES AND 
FURNITURE 

(New York) Plaintiff claims that he purchased of defendants in April 
1904 furniture and fixtures for which he agreed to pay upwards of $900 
in payments of $20 per month, and that until the full payment of the 
purchase price the title to the furniture was to remain in the defendants; 
that up to January, 1907, he had paid thereon the sum of $492. It 
appears that in 1904 there was some paper writing executed by the par- 
ties; the plaintiff claiming that it embodied the terms of the conditional 
sale above specified. The defendants deny that they sold the furniture 
to the plaintiff, asserting that they simply leased the same to him, and 
that the monthly payment was not to apply on a purchase price, but was 
simply rental for the use of the furniture, and that the plaintiff was not 
to become owner of the furniture in any event. Plaintiff defaulted in the 
payments at this time and defendants made an assignment of the furniture 



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16 THE DENTAL DIGEST 

and fixtures to one Pierce who demanded ix)ssession. The plaintiff 
brought this action contending that under section 65 of the Personal 
Property Law he was entitled to recover from the defendants all the 
moneys he paid to them on the purchase price of the furniture; that the 
defendants having retaken the furniture by the assignment of the lease 
to Pierce, and not having sold the same by public auction, there is due 
plaintiff from the defendants the sum of $492 and interest for six years. 

In the trial court judgment was entered for defendants holding the 
transaction to be merely a lease. On plaintiff's appeal to the Supreme 
Court this decision was reversed, the Court saying: 

"Plaintiff's right to recover depends upon two important conditions, 
viz: First, that he purchased the furniture and was to have title when he 
paid $946; and, second, that the defendants, or their successor in interest, 
retook possession thereof under the contract of sale. It was established 
that no sale of the furniture was had by public auction as provided by 
statute. 

"The testimony on the trial will warrant no other conclusion than that 
the furniture was to become the property of the plaintiff when he paid the 
full purchase price. Treating the moneys paid either as being payments 
on the purchase price or as being rent for the use of the furniture, the 
transaction must be construed as a conditional sale, if upon full payment 
of the amount agreed to be the purchase price title to the furniture was to 
vest in the Vendee.'' (Ostrander v. Bricka, 154 N. Y. S. 786.) 

DENTAL OFFICE SCENE OF TROUBLE 

(Maine) A police officer who entered the reception room of a dentist 
on a matter of personal business does not, though he thereafter greatly 
disturbed the occupant and refused to leave when ordered, become a 
trespasser ab initio, the case being different from that of an officer law- 
fully entering upon property in execution of process, or of a guest entering 
an inn. 

The Supreme Court of Maine so held in Nichols v. Sonia. The facts 
were as follows: 

The defendant on the 2d day of December, 1914, at Bath, with force 
and arms broke and entered the dental office of said Nichols, situated at 
No. 81 Front Street, and thereby greatly disturbed plaintiff in the quiet 
possession of his office, and then and there remained after he had been 
ordered to leave, and vacate the office by the plaintiff. Defendant used 
insulting language, threatened violence, and used slanderous words while 
he remained in the office. 

The evidence disclosed that plaintiff, shortly before half past 10 
o'clock in the evening of the day alleged, was in the operating room of 



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CONDITIONAL SALE OF DENTAL FIXTURES AND FURNITURE 17 

the suite of rooms occupied by him as an office; that the rooms were 
lighted; that plaintiff was there in the transaction of his business; that at 
the hour last named the defendant, a policeman of the city of Bath, 
opened in the usual manner the door giving entrance to the suite of plain- 
tiff, and entered one of the rooms, the door being latched but not locked. 
In this room was the wife of plaintiff. The defendant then made in- 
quiries as to the future disposition of a cause in court which had recently 
been decided in his favor against plaintiff, and, upon receiving a reply, 
indulged in profane language, opprobrious epithets, and charges of per- 
jury, declining to leave the apartment when ordered to do so by plaintiff. 
Suit was brought charging the defendant with trespass. The lower court 
entered a nonsuit and an appeal was taken to the Supreme Court where 
the nonsuit was affirmed. The Court in disposing of the case said, "The 
contention of the plaintiff that the defendant by his conduct became a 
trespasser ab initio^ cannot be entertained. Defendant did not enter in 
the discharge of any of his duties as policeman. His entrance was not 
by authority of law, as is the case of an officer lawfully entering upon 
property in execution of legal process or of a guest entering an inn. The 
office was alight, the hour not unreasonable, the place improper, nor the in- 
quiry impertinent. His errand was one of business, and we must find upon 
the evidence that, if not an invitee, he was in by license of the occupant. 

The exceptions to the order of nonsuit must therefore be overruled. 

Exceptions overruled. (Nichols v. Sonia, 95 A. 209.) 

DENTIST ENGAGED IN SALE OF PROPRIETARY MEDICINES 

(New York). The New York Supreme Court in Kilmer v. Dr. Kil- 
mer & Company has held that an injunction will be allowed to restrain 
a partner in a patent medicine business from receiving and opening any 
mail addressed in a manner from which it appeared that the communica- 
tion was intended for the other member of the firm personally or pro- 
fessionally. 

Prior to 1892 Dr. Andral Kilmer a dentist and Jonas M. Kilmer were 
engaged as copartners in the manufacture and sale of patent medicines. 
In 1892 Andral sold the business to his brother for $40,000. The sale 
included all trade marks, copyrights, labels, wrappers, circulars, pam- 
phlets, etc. Needless to mention the good will of the business was also 
transferred. Andral was to receive 25 per cent, of the profits of the 
business. 

In 1901, Jonas M. Kilmer sold the business to his son Willis Kilmer 
who after engaging in the manufacture of the patent remedies until 1909 
sold the business to a corporation. The corix)ration adopted the name of 
the Dr. Kilmer Company. 



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18 THE DENTAL DIGEST 

Dr. Andral Kilmer brought this suit against the corporation to en- 
join it from using the prefix ''Dr/' or from using his picture and receiving 
mail addressed to Dr. Kilmer. His claim was that the corporation 
wished the general public to believe that he was still connected with it. 
Kilmer asked the court to enjoin the company from receiving and opening 
mail addressed to Dr. Kilmer or even to the Dr. Kilmer Company. The 
court granted the injunction saying that defendant knew, or ought to 
know, that a letter addressed to plaintiff with the prefix ''Doctor" or 
with the word ''Personal" on the envelope was for him. The defendant 
knew or ought to have known, that when a person writes to any address 
containing the name or designation of a professional man that letter con- 
tains a private and confidential communication not intended to pass 
through hands who have no right to know its contents. 

The defendant had the right to manufacture and distribute for sale, 
and advertise the same, all of the medicines originated by Dr. S. Andral 
Kilmer and transferred to Jonas M. Kilmer; it had a right to designate 
them as so originated and compounded by Dr. Kilmer, but it has no right 
to so use the plaintiff's name as to lead the public to believe that he was 
still responsible, by reason of active supervision, for the contents of a 
bottle covered in part by his portrait and name. (Kilmer v. Dr. Kilmer 
Co., IS4 N. Y. S. 982.) 

WHAT I LIKE ABOUT MY DENTIST 
By C. D. B., Plaixfield, N. J. 

Thinking that the results might prove interesting to the readers of 
The Dental Digest, I recently asked a number of women in my home 
town what they liked about their dentists. Their replies I append below 
vjrbatim — they speak for themselves. 

"He doesn't put his whole fist in my mouth." 

"He stops the minute he sees he's hurting me." 

"He arranges his appointments so systematically that I don't have to 
wait long in the ante-room." 

"His waiting room is so cheerful and cosy that I don't mind waiting." 

"He doesn't keep you in the chair until you never want to see him or 
his office again. He believes in shorter appointments and so do I." 

"He's a careful workman, he never blunders." 

"He's a good conversationalist. He helps me to forget I'm having 
my teeth fixed." 

Some of these "reasons why" may seem hardly important but they're 
all actual "women's reasons" and perhaps they'll carry just a suggestion 
for better service to someone. 



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(AINE/y^VILDING 




''Nothing but the very best of instru^ 
merits and materials can give your ability 
the assistance it deserves."— Se/ec^ed. 

THE BUSINESS SmE OF PROPHYLACTIC AND 
RESTORATIVE PRACTICE 

By W. F. Spies, D.D.S., and George Wood Clapp, D.D.S., New York 

FIRST PAPER 

If a prophylactic and restorative practice is financially profitable, it en- 
ables the dentist to render patients important services and to receive 
proper remuneration therefor. If it is not profitable, the dentist will be 
unable to apply to such service a high degree of skill, patients will be de- 
prived of benefits they should enjoy and the dentist will not receive proper 
remuneration for his skill and labor. 

Few dental practices are financially successful save as the result of 
careful attention to their business side. Some practices make money be- 
cause the fees for some kinds of service are higher than is justified by the 
costs of those operations, which is unjust to the patients who receive those 
particular forms of service. In practices where fees are fixed in this way, 
the fees for other forms of seI^dce (such as consultations, treatments, etc.) 
are often disproportionately low, which works injustice to the patients 
who paid the high fees and to the dentist. 

It will be much better for all concerned when fees for the several 
forms of dental service can be determined with justice to all patients and 
to the dentist, so that no one pays more than he should and the dentist 
is always sure of adequate payment for his labors. The object of this 
series of articles is to show how each dentist may learn what each form of 
service costs him and what are the minimum fees which are fair to his pa- 
tients and himself. 

We are unable to fix such fees for any individual dentist, but we have 
kept such detailed records and have access to such office cost reports from 
other dental practices that we are able to state approximately what many 
operations cost dentists in practices where the gross receipts vary from 
$1,500 to $5 ,000. We offer this information in the belief that this form of 
knowledge affords the only intelligent basis for determining minimum 
fees, and in the hopes that it may inspire other dentists to develop exact 
information concerning their own practices. 



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20 THE DENTAL DIGEST 

ESTIMATING OFFICE COSTS 

College costs $i,ooo 

Three years' time at $500 1,500 

$2,500 

Reception Room Investment 102 

Operating Room Investment 820 

Laboratory Investment 130 

$3,552 
Operating Costs: 

Depreciation (10% of first cost of office investment) . $105 
Refunding investment (5% annually of total invest- 
ment) 175 

Rent 334 

Heat 12 

Light 45 

Phone 12 

Laundry 26 

Assistant (?) 

Publicity (cards, tickets, etc.) 10 

Express and postage 12 

Taxes (?) 

Insurance 5 

Magazines and books 10 

Society expenses 15 

Laboratory bills 100 

Supplies other than precious metals 160 

Precious metals 140 

$1,161 

Total practice annually $2,500 

Fig. I. — Illustration of a chart which has been found useful in determining office costs. 
It is here shown as filled in for a well conducted practice with gross receipts of $2,500 
annually. This is believed to be about the average size of practice. 



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BUSINESS SIDE OF PROPHYLACTIC AND RESTORATIVE PRACTICE 21 

THE ELEMENTS OF COSTS 

The cost of any operation to any dentist can be determined only by 
learning what it costs him to conduct his office during each income-hour 
and then multiplying that cost by the hours or fractions thereof involved 
in the operation. If precious metals or teeth were employed, their value 
should be added to the product of the hour-cost and the time. 

The income-hour cost can be easily determined with approximate ac- 
curacy. The items of cost in fitting the dentist for his special vocation, 
and of establishing, equipping and conducting the office should be tabu- 
lated. The form illustrated in Figure i has been extensively used but may 
be modified as desired. 

OFFICE HOURS AND INCOME HOURS 

The hours which the dentist spends at his office may be conveniently 
referred to as office hours. It is believed that under ordinary conditions 
these hours should number about 2,000 per year. Dr. W. J. Holroyd sub- 
mits the following table showing how the number is determined. This 
number of hours permits proper attention to business and to the study and 
recreation which are so necessary to mental advancement and physical 
health: 

365 days 
52 Sundays off 



313 

6 holidays before mentioned 



307 
28 days' vacation 



279 
21 days for dental meetings at different parts of the year 



258 or 37 weeks per year, less ^ day per week, making 
i8i days subtracted 

239^^ 
Multiplied by 8 hours in office 

19 1 6* office hours per year 

Not all of the office hours can be employed in service for which full 
fees can be charged, and some time will be so employed that no fee can 
be charged. Time is usually lost in greeting or dismissing patients, in 

•Very few dentists can take one half day off every week in the year and 28 days' vacation 
and this 19 16 hours will doubtless extend to 2,000 hours. 



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22 THE DENTAL DIGEST 

visits, by friends or business people, in making appointments, in telephone 
calls, in charity work, and in other ways, leaving only about 4 hours a 
day actual income hours. The income-hours afford the only exact and 
satisfactory basis for determining costs and estimating fees. 

Experience seems to show that of 2,000 office hours per year not more 
than 1,000 will be income-producing hours under even the most favorable 
conditions, and in many practices the number will be much less. The 
estimates of costs which follow are based on 1,000 income-hours per year 
in the belief that this number will not often be exceeded. 

CLASSES OF PRACTICE 

In order to render our time records valuable to dentists in determining 
their own operation-costs it has been necessary to divide practices into 
classes to determine the income-hour cost for each class, and then to mul- 
tiply our time records by the income-hour costs. 

Class I practices of less than $2,000 gross receipts annually. 

Class II ptactices of $2,000-2,999 gross receipts annually. 

Class III practices of $3,000-3,999 gross receipts annually. 

Class IV practices of $4,000-4,999 gross receipts annually. 

Class V practices of $5,000-5,999 gross receipts annually. 

It will be found easy to remember the classes if it is observed that the 
class number is the same as the first figure of the total receipts. 
Practices will hereafter be referred to by these numbers. 
{This article will be continued next month) 



HOW TO MAKE AND SAVE A COMPETENCY FOR OLD AGE 

I see in your November number, an article entitled '^ A Compensation 
For Old Age," that has induced me to write these lines, not to find fault 
nor to criticize, for in the main I agree with the writer, and as I have been 
a practitioner of dentistry for over thirty years, I think I can tell the 
beginner a lot. 

This is an age that realizes the power of Corporation or Cooperation, 
and to succeed in our profession to the extent of gaining a competency 
these principles have to be applied — so let us get to work and form a cor- 
poration of the following Stock Holders: — 

ist. Mr, Talent. He is hard to describe, but most anyone can tell 
him after seeing him design and execute some appliance, he is the first 
and most essential party and do not attempt to run business without him. 

2nd. Mr. Like. This does not mean that you have to be dead in 
love with every detail of the profession, but it does mean that you are to 



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HOW TO MAKB AND SAVE A COMPETENCY FOR OLD AGE 23 

look upon it with pride and as a choice and not as a compulsion. It 
means that you are to enjoy seeing things work, and that you really feel 
as though you are doing something worth while. Remember that there 
is no business that does not have its objectionable feature. 

3rd. Mr. Qualify. Be certain that his name is what he says and 
that he keeps, day by day, busy, to keep up with the times and if he 
changes his name, see that it be to Qualifying^ that means continually 
at it. 

4th. Mr, Slick. That means keep at it. Yes, everlastingly at it, 
(but this does not mean that you are to take no rest). The public like 
to patronize a busy man — ^be occupied whether you are or not, profes- 
sionally, you see? 

Sth. Mr. Equip. Supply yourself with a good outfit, especially 
instruments and keep a sharp lookout for the new things that come 
along but be careful not to invest in everything advertised and in noth- 
ing until you are confident it will prove what you want. 

Do not throw away your old instruments entirely to use the new, but 
get such of the new as you can use and appear well. I have some of 
Frank Arnold's make of instruments, especially forceps, that I have had 
from the beginning and they are not plated (as that was before the day of 
plating everything), but for service, for real adaptableness, there has never 
been better made. While I have scores of other forceps, I frequently 
in difficult cases reach for the Old that I kno^ are tried and true — instru- 
ments are like friends. It is well enough to make new friends and try 
them, but do not throw off the old tried and true ones, because they are 
not nickel-plated. 

6th. Mr. Fee. Charge reasonable but compensating fees and make 
no apologies for so doing. 

7th. Mr. Appearance. Keep your office as well as yourself and in- 
struments, sanitary, clean, attractive, but keep an eye on the expendi- 
tures for same. 

Sth. Mr. Relaxation. Take time for recreation and especially the 
one day in the week, the Sabbath — God knew what was best for man 
physically as well as spiritually, and he says "Rest on the Sabbath." 
I have tried it and I know that it is true. Every few years take a week or 
ten days off and go back to the college from which you were graduated — 
visit the old members of your class if they are on your way, and note how 
they are getting on and you will find that you will learn and be improved 
by seeing how some have succeeded better than you, and you will feel a 
sense of pride and encouragement in seeing how much better you have 
done than some others. 

If you live in a country town, go to the city for a vacation, now and 



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24 THE DENTAL DIGEST 

then, and keep your eyes and ears open to all that is to be seen and 
heard. When you get there, get a good nice clean, respectable place to 
stay; this does not mean that you are to go to the swellest hotel there and 
fill your stomach full of things that you are not used to eating, and make 
not only a hog of yourself but a fool as well. Leave off drinks and dopes. 

If you are located in the city go to the country for this vacation. 
Go to the mountains where Him, Bob, Mam, Sal and Beta live and see 
how they spend life. Get a good mountain breeze, and listen to the 
trickling streams. Do not fail to take your fishing tackle along, there is 
nothing that will thrill you like the bite of a trout or black bass. I went 
out the other day and strung up fifteen black bass (beauties they were). 

My boy about eleven years old went with me and he caught two and 
got quite a number of strikes that he failed to land and the other night 
he said to me "Father, I can just feel those fish biting yet, can you?'' 
Yes, and hope to all winter. Try it, but do not spend too much time. 

9th. Mr. Economy, Be economical and I do not mean by that to 
be stingy and stint yourself and family, but keep well within your means 
— have good, well cooked, wholesome food for yourself and family, for it 
is more economical, to say the least, than doctor's bills and drug expenses. 
Wear, and let your family wear good, neat, clean clothes, but in all things 
be not a spendthrift for this will not only take your money but teach your 
family bad habits. 

Do not try to keep up with the fellow who has inherited a lot of money 
and has nothing to do but fool it away. It is well enough to have him 
as a patient, but not as a chum. 

Refrain from useless, hurtful and expensive habits, among which are 
drinking, doping and the use of tobacco. I will specially mention only 
the last named, (but many others bear a similar solution) the use of to- 
bacco does not help your appearance, but quite the reverse. It does not 
help your physical condition, but in many if not in all instances, it is 
hurtful. The pleasure, if any, is more than offset by the displeasure in not 
being able to indulge many times. How about the expense of it? I be- 
gan the use of tobacco by the advice of a physician, about the time I did 
dentistry, and after using it a while I took an inventory of myself on that 
line and I soon saw that it did me no good, but harm. It did not make 
me look any better, nor did it make me smell any better either. 

In that inventory I figured that at the present rate, (about 7 cigars a 
day) it would, within thirty years cost me enough to buy a nice home. 

I quit and to-day I am living, fully paid for, in a nice home saved in 
this way, (just make the calculation and it will amaze you) and I ex- 
pected also to have some boys and I did not want to set them that kind 
of an example and so you see that I will not only be benefited, but future 



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HOW TO MAKE AND SAVE A COMPETENCY FOR OLD AGE 25 

generations also. If you are already a user of it, you will say *' that you 
can not quit it," and I agree with you that it is hard to do, but the only 
way is to quit and stay quit — yes quit, and in twenty years or less you will 
have saved for yourself and family, a nice home, and just think, too, of 
the offensive odor of tobacco you have saved your patients from inhaling. 

loth. Mr. Literature. You should keep some good literature in 
your office for your waiting patients and be certain to read up yourself 
on all current events. A good daily paper and at least two good weekly 
periodicals should be read and at handball JSe-Jti^e/-^ j. ;* 

nth. Mr. Congenial.. Ypu sliQulclJefirn n©t.6nly how to handle pa- 
tients while in the ch^fr^ but how-to iiieci ihtem^rjdce^p^ci^lly-hqw to dis- 
miss them; all this requires kjiackltud,sjtiidy of human nature as you can 
not do with all just alike. ' : »' :»: : /A - •. ^- ,; 

1 2th. Mr. Personality. You should be yourself and not imitative 
nor affected. Do not expect to please everybody for Christ did not do 
that but stand for your rights and principles on all lines and be able to 
give reason for the faith within you. 

13th. Mr. Financier or Mr. Investor. Now, I hope you are not 
superstitious about the number thirteen and if you are you may add 
other Stock Holders, but see that you have at least these named. Do 
not expect this last named party to be so perfect as to make no mistakes 
for he will make them by doing things he ought not do and worse, by not 
doing things he should do, but do not attempt nor expect to succeed so as 
to reach the point set out without this last named partner. 

I look all around me and I see monuments to my folly by doing the 
wrong thing as well as for not doing the right thing. 

Remember that there is but one kind of a man that makes no mis- 
takes and that is A dead man. 

This Stock Holder is hard to describe because times, conditions and 
places vary so much. A very great deal depends upon how you invest 
your money, because years of earnings can be swept from you in the 
twinkling of an eye. No one can tell you how to do this for as above said, 
times, condition and places are not all alike. But for the past twenty 
years investments in real estate have been the safest and best in all sec- 
tions of the country, and is getting better in many sections and especially 
in the South. Good farming, grazing and timber lands have been and 
always will be the best on this line. Shy at mortar and brick or tenant 
property, as they are too much trouble and expense to look after. Run 
from Boom Town property, do not listen to the Boom promoter when he 
tells you that such and such a lot, now covered with brush and sedge 
grass, will eventually bring thousands of dollars, for I tell you from 
personal experience that most of them will not bring the taxes, eventually. 



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26 THE DENTAL DIGEST 

Fear Mining Stock as you would satan and in fact all kinds of stock for 
several reasons! One is, that they contain too much water and what is 
not water, is wind. Remember the earth's surface is about three fourths 
water and too plentiful to pay such a high price for it. 

Loans on lands secured by deeds of trust have always been good and 
always will be if made on good titles and not over half the selling price on 
forced sales. This will yield 6 per cent, and good as gold. I could loan 
thousands aud.tj^ousand&atd^llaj's thus secured. 

Many thi^^-'^ojHeJ fe said abbut financiering, but time and space arc 



. ...HQt.sii^iant.her^.:^.: "; : .-. -/i 
V I :JSi>.^sU5ilb'iJisfe- Stock Hoid:^!- 



dfefs-'Wofk fo^gether continuously and har- 
monio,u§ly,j^oiii augKj to hne ^le:tctlay ty^'a;competency in tangible prop- 
ert^yJfo.-yleltEyou-'a.dufiiacnt'incoSYic 16 s\jtpp\y your needs, say $30,000 
and that even 4 per cent, will yield you $1,200 a year or $100 a month. 

Be not discouraged if you have set your competency at $30,000 in 30 
years if the first years do not yield the thirtieth of this or $1,000 for the 
first $1,000 is the hardest to get and remember that what you save should 
be put to work to help make a part of the next $1 ,000 and so you will 
see that when you have saved $1,000 and put it to work that it pays $50 
a year on the next at 5 per cent, interest and so on. 

The above results can be reached as I can testify from experience, but 
I want to say that it takes **get up'' and "hustle," yes and plenty of it, 
for this is no small matter, it is a man's job, to reach this point and to de- 
fray the heavy expense of keeping and educating a family. It takes a 
head and back-bone and everlastingly sticking to it — you will have to 
pay the price. 

I might speak further about a Competency in Old Age in the way of 
Boys, as I have four of them. It is a very poor boy, when well cared for 
and educated, that is not worth $30,000 to his parents or that could not 
nor would not take care of faithful parents in old age, so if mine pan out 
all right they will be worth $120,000 on a cash basis to say nothing on 
other lines. 

The above is rather long, but it is not imaginary nor speculative, but 
knowledge from actual experience. 

Now, you imagine that I am an old wornout man, but you are er • 
tirely mistaken, for I h^.ve laid up a Competency in strength and youth- 
fulness by observing the Laws of Nature and stouter to-day than when 25 
years of age. Lay up a competency in strength and youthfulness by 
right living and not by idleness and laziness. Very few kill themselves 
by work, but multiplied thousands do by dissipation, anc they say, I am 
working myself to death. 

N. W. D. 



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HOW CAN HB BETTER CONDITIONS? 27 



HOW CAN HE BETTER CONDITIONS? 

Editor Dental Digest: 

I take the liberty of writing you about a subject that is of vital im- 
portance to me, and which gives me no little trouble. 

The dental fees in our little city are the lowest in the state, and if you 
will pardon me for going into details which are excusable when writing 
about a subject of this kind, I will explain the situation as follows: 

H is a town of about 7,000 population and is surrounded by a fine 

back country. There are three dentists here including myself. Dr. 

A has been here in active practice for thirty years, and Dr. B. for 

about 18 years. Dr. A. is about 50 years old and related to a number of 
people in the country. He had the fees down so low that a man can 
hardly make a decent living, unless he is a very fast operator and has a 
wonderful constitution; all of these this man possesses. Our fees are 
as follows: 

Cleaning teeth $ .50 

Amalgams 50 

Gold fillings i . 00 up to $2 . cxj and then a gold crown 

Gold crowns 2.50 to $4.00 

Vulcanite dentures 8.00 to 10.00 

Filling with Amalgan and treatment 1.00 

Porcelain crown 2.00 

Extraction 25 

And all other operations accordingly. 

I have been here for nine years, and during that time I have tried to 
get Dr. A. to raise the fees, and he says that the people will not pay them. 
He gives very long credit and does not try to collect, and this is a great 
drawback to one who wants to run this part of the business in a better 
way. Dr. B. I think, would be willing to raise the fees if A would agree, 
but we have to hold back on account of the latter. This old fellow has 
the most wonderful grip on the people that I ever saw, and they will be- 
lieve anything he says. He guarantees all his work, and no matter how 
long it has held good, he will put it back free of charge. Until three 
years ago he did excellent work, considering his immense patronage. He 
works from six a. m. to eight p. m., and his long hours without rest, are tell- 
ing on him. He is growing very nervous and suffers with terrible head- 
aches in the summer, which causes him to be more irritable, to the loss 
of a patient now and then. 

If he had to sweat over making a bridge a few times, he would charge 
more for his work. He takes an impression of the abutments, and when 
the bridge comes he grinds the teeth to fit the bridge. He keeps single 



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28 THB DENTAL DIGEST 

gold crowns in stock and has all his plate-work done. This way allows 
him to work all the time at the chair at small fees, and being such a fast op- 
erator, his cheap fees will amount to something. And up to two years ago 
he worked all day Sunday; but now 'tis only half that day that he takes. 

I have written in detail about the above man to give you an insight 
into his methods. I have come to the conclusion that only death will 
remedy things, and if it ever does bring relief it will bring it here. This 
man's way of doing is the talk of the fraternity of this state, and if you 
have ever seen a constitution of steel, this man has it. 

I have read of the successful sanitary dental office, but it is not worth 
three cents here where people would wade through filth to get cheap 
work. I have read of the man who was complaining all the time when 
he should work that much faster. But what is there in all this, if, after 
the day is done, you have nothing for your labors, save a tired body and 
are sick at heart. There is plenty of work for us three, but nothing in it. 

Now Doctor, if you will pardon a few remarks as to myself, that you 
may be more ably informed as to the situation here, I will give them. I 
worked my way through one of the first colleges in this state, that I might 
prepare myself to more intelligently practise dentistry. I have been in 
this noble profession long enough to peep over the starvation i>eriod — 
nine years. You know where fees are good, and a young man is not 
getting much to do, they will bridge him over; but when they are low it 
takes many operations to make something. I have sufficient confidence 
in myself, not to overvalue my ability, for none of us ever get to that 
stage where we cannot learn something. I can say that I am a dentist 
who does good work, keeps abreast with the modem methods, a member 
of the dental society, and a slow operator, but thorough. 

I hope you will pardon me for taking so much of your valuable time; 
but if you ever did go into Macedonia to help a fellow, I need your 
assistance to see if you can tell me the best way to better conditions here. 

E. S. G. 

AVOID APPETIZERS 

One group of students had a good dinner without alcoholics, a 
couple of hours later, digestion was found well advanced; another 
group, the same dinner, preceded by a cocktail, digestive processes im- 
perfect, owing to the presence of alcohol. 

Serious and permanent interference with digestion was proved by 
these experiments. The appetizer, so called, is in reality a devitalizer, 
destructive of normal processes of the digestive apparatus and of the 
mental powers in direct proportion to the frequency with which it is 
taken. — Experiments at Yale, 



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A REPLY TO M. F. R. 29 

A REPLY TO M. F. R. 
By H. K. 

In responding to the request of M. F. R. in the November Digest, 
that an ethical man reply to his article, I would say that I believe I have 
at least one qualification for the task: — Namely, that for twenty years 
I have remained an ethical man, in spite of the fact that I have a very 
small practice, along with the responsibilities of a family. Of course, 
advertising holds no temptation to a man of large practice. 

I believe that a brief answer will meet the case of all those who, like 
M. F. R., so freely use the pages of the Digest to advocate disregard of 
the dental code of ethics. All dentists are in honor bound to play the 
game according to the rules. Let the advertising men and the quacks 
take a leaf out of the sportsman's book. All of them know what happens 
to the football player who violates the rules, or to the prize-fighter who 
fouls an opponent. Even in so crooked a game as gambling the unfair 
player is ostracized, simply because he will not abide by the rules of the 
game. 

None of us was born a dentist. We entered the profession by delib- 
erate choice, and so entering found certain rules in vogue, which are 
known as the dental code of ethics. Such rules constitute an integral 
part of the profession. In this respect dentistry is not peculiar, for every 
calling, from law and medicine down to hod-carrying, has its code. True, 
in every calling men are to be found who will not follow the code, which 
has given use to such terms as '* shyster/' '* quack'' and ''scab." The 
unfair man must pay the price. 

Every calling contains men who are devoid of the ethical sense, and 
to preach ethics to them is to cast pearls before swine. If life holds no 
higher ambition than the making of money, then the advertiser and the 
quack are fully justified. But some men are so constituted that they 
care more for the respect of their fellows (and their own self-respect) than 
for money, and would choose to remain poor, rather than degrade a 
profession, and incidentally degrade themselves. If a man can do noth- 
ing to elevate this calling, he should at least .leave it no worse off than he 
found it. Common honesty demands that much. He was not taught 
his profession in order that he might mangle it. 

I am aware that advertising and quackery present the unethical man 
only in his grossest form, and that back of him stands his sly brethren, 
who are forever given to the detraction of their competitors. The latter 
perhaps, are the worst ''scabs" of all. 

Owing to its comparative newness and the grade of men who have 



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30 THB DENTAL DIGEST 

been allowed to matriculate in dental colleges, dentistry contains a far 
larger proportion of unethical men than law or medicine; but, notwith- 
standing the financial success that appears to attend the imethical men, 
signs are not wanting that their days are numbered. The requirements 
of the profession are continually calling for men of higher caliber, and 
ere long the colleges will consult their own interest as well as the interest 
of the profession and the public, by weeding out men who lack compre- 
hension of those finer elements that characterize the truly professional 
man. Until that day, "virtue is its own reward." 

Answer no. 2 to M. F. R. 

Editor Dental Digest:— 

"Can you answer this man," was the heading on a communication 
by M. F. R. I do not know what M. F. R. stands for, but my little 
daughter suggested "Money for Rot." 

It is deplorable to learn that a man whom I suppose has a dental 
college education, can indulge in money-making as described in your last 
issue. 

I think the most of the men who read the Digest will put aside the 
article with a sigh as I do when I glance at our local Sunday newspaper 
supplements with heading such as this — "Have rats souls?" and then a 
half life size picture of the particular "nutty" professor who produced the 
essay. 

M. F. R. says that his shrewd business man got business on the square, 
but what about the "secret" local anesthetic? I have my opinion of M. 
F. R. who feels neglected because the Dental Society to which he perhaps 
paid a dollar or two did not help him out in dull times. I hope M. F. R. 
will rest from future contributions about his wrinkles, for about two years 
exploit in his home city and then report on the permanency of his ad- 
venture. 

N. J., Minneapolis. 



Abscess Lancet: — For an ideal abscess lancet, take a new Duplex 
Safety Razor blade, divide at opening in centre. Make point on one 
end; on other make shank to fit cane socket handle; cement in place. 
Then you have a lancet that will cut without tearing. The lips of 
wound will have tendency to flare open instead of closing up. 

C, I. Faison, D.D.S. 
Dallas, Tex. 



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MY WAY OF FIGURING THB COST OF AN INLAY 31 

MY WAY OF FIGURING THE COST OF AN INLAY 
By C. A. G., Grand Rapids, Mich. 

For many years I managed my ofl&ce in a haphazard way, but one 
fortunate day I ran across the first edition of ** Brother Bill's Letters/' 
After beginning the book, I did not drop it until it was finished and, I can 
assure you, it was a "hip, hip, hurrah! " for Brother Bill. 

My first move toward a better method of managing my ofl&ce was to 
raise my prices for dental services to those received by first class dentists 
in our dty . With fear and trembling and much doubt as to results I made 
the experiment of higher prices on my first new patient. The result was 
so satisfactory that from that time on I became braver and the higher 
prices were soon a fixed habit. 

It is my opinion that the only safe plan for the average dentist to fol- 
low is to place his prices on a par with those of the leading dentists of his 
conununity. Should he be more than an average dentist, a sort of a wiz- 
ard in fact, he may be able to hold his prices above the leading men of 
the profession, but not otherwise. 

My next and most important move was to make a complete refurnish- 
ing of my office, for as the clientele who were to pay the advanced prices 
must come from a wealthier class of people they would demand an up-to- 
date equipment, as well as first class dental services. 

Various plans were adopted by me from time to time for putting my 
business on a permanent financial basis. But all of these were finally 
abatidoned for one which I have termed the salary plan; the adoption of 
which I would recommend to all dentists whether young or old. This 
plan briefly stated, was to put myself on a weekly salary, to which I ad- 
hered as strictly as though I had been in the employ of some other den- 
tist. At first I decided to estimate this salary by the amounts which my 
compeers were receiving and those whom I knew best at that time were 
making from twenty-five to forty dollars per week. I took the highest 
amount, forty dollars, and every Saturday night took home to wifey an 
envelope containing a forty dollar check. This check was to take care 
of all expenses incurred outside of the office. 

In a few months I was able to raise my salary to fifty dollars per 
week and now for a year I have been drawing seventy-five dollars per 
week. It is my ambition to raise this salary to one hundred dollars per 
week after January first, 1916. 

To draw this salary I found it necessary to raise prices from time to 
time and to adopt ethical methods of advertising, which is another story. 



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32 



THE DENTAL DIGEST 



Enthusiasm and the art of salesmanship also entered into these successful 
conditions. 

The second requisite in adopting the salary plan was to decide as to 
the number of hours per day and the number of days per month to be 
spent at work. After careful consideration seven hours a day and twenty 
days a month seemed the average time consumed. 

The overhead expenses of a dental office vary so largely in different 
cases that it is difficult to put a fixed price on this matter. In my own 
case, after figuring rent, investments in equipment and other incidental 
expenses with ten per cent, depreciation of same, I found it cost me 





;:AU-^ii 



"Every Saturday night I took home to wifey an envelope containing a forty-dollar check" 

approximately one dollar an hour, for seven hours a day, for twenty days 
a month. With my salary of seventy-five dollars per week, which figures 
two dollars an hour for the same number of hours and days, I found that 
I must average twenty-one dollars per day, or four hundred and forty 
dollars per month. I am able to do this by making a charge of six dollars 
for the inlay mentioned and a proportionate charge for all other time 
spent by myself at the chair. My assistant does all casting, finishing, 
etc., giving me all my time at the chair which would average four hours, 
a day of hard, nervous work. With these figures it will be seen that I 
have plenty of time for tennis, fishing and traveling in the summer and 
hand ball for exercise in the winter, all of which keep me in fine condition 
physically and mentally. 



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'^o 




iiirninmiiiit«iuNutii(iHiuitiiiiiiNiimiiiiHiiMi^ 



ii 



.^, BROTHER BILES . 
"'" LETTERS Ij 

lUiiiuiiiintiU'luioiuuiuijniuiiHiiitiiiiuvBuuiniiiliiiifiiiiiiNHiiiMrtHRiKiiiivniMM 



My Dear Jim:— 

I note your resentment of my statement that your low fees have 
wrought injustice to yourself and your patients. You admit that your 
fees are low and that you wish they were higher, but you say that as long 
as they are what they are, you are happy in the thought that they have 
done a great deal of "good." 

I've discovered, since reading your letter, that you and I have very 
different meanings for the word *'good." Of course I don't know exactly 
what you mean by **good'' but from your letter I think you mean that 
because of your low fees your patients are better off than they would be 
if you had charged them remunerative fees. 

First, however, I want to give you my idea of doing **good'' to paying 
patients. It is to render them the highest form of service I can, to teach 
them its worth and to charge fees that will make them respect my work 
and me. 

Now your idea of "good'' seems to be in terms of money. Of course 
you don't define it so out loud, or perhaps even in your own thoughts^ 
but if I read your letter correctly you try to be happy in the thought that 
your low fees have saved your patients money. The fifty cents or five 
dollars you let them carry away in their pockets is the expression of your 
idea of doing them "good." 

Your idea might impress me more if I didn't know the town, but 
you must remember that I grew up there and that I know about the 
financial condition of all the prominent people except those who have 
come in since my day. I'm going to use this knowledge to see if I can't 
prove your idea of "good" is wrong. 

When I visited you awhile ago, I watched several of your operations 
for old friends of mine, and I am sure you did not do them "good" in any 
form. Take Harry Herter for example, who owns half the bank and half 
a dozen other things about town. He came in to have you clean his 
teeth, as he does every month. You spent half an hour on his teeth and 
charged him a dollar. I didn't run an instrument up under the bifurca- 



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34 TH£ DENTAL DIGEST 

tion of the upper first molars, where the gum has receded, but I no- 
ticed you didn't give him anything like the amount and kind of service I 
think his mouth needs, and would be much better for receiving. Also, 
you should have charged him $1.75 for the half hour you gave him, and 
then you wouldn't have needed to go down to the office and work that 
evening to make up the loss. It would have been much better for Harry, 
in teeth, if you had put in two hours and charged him $7. 

Perhaps you think saving Harry the spending of the 75 cents you 
didn't charge him, was doing him "good.'* YouVe known and serv^ed 




"If you can make Harry put down his cigar long enough to hold a mirror and let you show 
him what recession in his gums promises" 

Harry for a long time, and some day when you are going by the bank, 
you might go in and say "Harry, I feel that I should like to do you some 
good; here is 75 cents." I've known Harry and his picturesque profanity 
since we were boys, but if you can imagine what he would say, you can 
do better than I. Yet that would be better than the basis on which you 
are serving him. 

I'll tell you what will happen when some bright young dentist who 
understands the proper basis for doing "good" comes to town. He'll 
serve and educate his patients so well that they'll look up to him and 
brag about him. And some day Harry will go in there to get his teeth 
"cleaned " and will get a new experience in service and will pay $5 or more 
for it, and will say to him just as I've heard patients say many times. 



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BROTHER BILL'S LETTERS 3^ 

"Doctor, I wish someone had done this for me years ago/' and go out 
thinking about the service rather than about the fee. 

Take Mrs. Hutchins as another example. You put a mesioocclusal 
inlay in her lower right first molar and seemed quite pleased when you got 
$7 for it. You got all the inlay was worth because it will not do a number 
of very important things it should. As your practice brings in $3,500 
per year, that inlay cost you about $8.40. The occlusal surface was 
practically flat. It wasn't formed to hold the opposing tooth in position, 
or to articulate with it, or to divert the food from the contact point into 
the embrasures and so preserve the papilla. The inlay seemed to fit the 
margins well enough, but the upper molar slides just a little when it oc- 
cludes on the inlay. In a little while that upper molar will move to where 
it doesn't have to slide, and that will be out of proper alignment. I know 
because I've made the same mistake. Food will crowd between the 
contact point and the adjoining tooth because the inlay isn't shaped to 
divert it, and a "meat-hole" will result. 

Now if you had spent 30 minutes more on the occlusal surface of that 
inlay, if you had mounted your counterdie and opposing model so that 
you could have moved them laterally and "chewed out the articulation" 
and then shaped the surface to divert food away from the contact point, 
and charged Mrs. Hutchins the $11 you would have been entitled to at 
your costs, you would have preserved that tooth indefinitely, instead of 
insuring trouble in a few years as you have now. I don't think you did 
Mrs. Hutchins "good." I think, as the boys say, you "did her up good 
and brown," because she's going to lose that tooth 10 years before she 
should, and the money you charged for the work. And that will discredit 
dentistry and you in her eyes. 

If you want to save the Hutchins family money, try the plan I sug- 
gested for Harry Herter. Mr. Hutchins isn't rich, but he is about 100 
times better off than you are, and is a self-respecting merchant. You try 
saving them money at the expense of service they need and let them find it 
out, and see how long you will continue to serve them. They know where 
true economy lies and they are too shrewd to always be fooled about it. 

Of course I know people in the town to whom every dollar is precious. 
There are old Mr. Day and the Allen sisters and half a dozen others whom 
you serve, who haven't a cent to spare, but who are as fine people as any 
in town. They aren't poor people; they're just short of worldly goods. 
You can do fliese people real "good" by rendering them a good quality 
of service at low fees and you ought to be in a financial position where it 
would be a pleasure to you, a little "sweetening," so to speak, of your 
daily labors. 

The trouble is you have mixed your people all up. Because you can 



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36 



TH£ DENTAL DIGEST 



do these people good by serving them at low fees, you have transferred 
that idea to everybody. You treat them all alike. That has been a 
failure for most of your patients and for yourself and your family. 

People like Harry Herter and Mrs. Hutchins have spent their lives 
trying to get value for their money. In all things concerning which they 
have been educated, they know where true economy lies, and they are 
willing to spend $io now to save $25 in five years if you can show them 
the saving. If you can make Harry put down his cigar long enough to 




"Compare the prices paid for toys this Christmas with the prices our parents paid for 

toys for us" 

hold a mirror and let you show him just what recession in his gums prom- 
ises for the future, and then explain what you can do by keeping every 
surface polished and free from irritation, and then that it will take long 
enough to cost him $5 a treatment, he will say **go to it. Doc, go to it.'' 
You would then address yourself to the form of appreciation he under- 
stands, present expense but final economy. And you could feel happy 
in doing it because you will preserve his teeth much longer than you will 
with the present treatment. 

If you had explained to Mrs. Hutchins what the present form of inlay 
at $7 will do to her mouth in from 2 to 3 years, and what the other form 
of inlay might be expected to do, she would probably have thought a mo- 
ment and said ** Doctor are you quite sure it will be worth the difference? '' 
and if you replied, ** Quite sure," she would have said, *^It seems a little 



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BROTHER BILL'S LETTERS 37 

high, but I want to save my teeth, and you may do as you suggest." 
And when she went out with that inlay, you could have been happy in 
the thought that it would serve her indefinitely. 

With proper fees from Harry and Mrs. Hutchins and a hundred 
others, you would be in a financial position to serve old Mr. Day and the 
Allen sisters and a few others at purely nominal fees. 

I contend that your idea of doing "good" is wrong, that you do not 
good but evil to all concerned. It is time to wake up, to take your eyes 
for a moment from teeth and look at people. Observe them in the stores. 
Compare the prices they have paid for toys this Christmas with the 
prices our parents paid for toys for us. Note whether the shoddy toys at 
low prices are bought by even those people who are in moderate circum- 
stances. Ask Mr. Hutchins to tell you: He knows. When I compli- 
mented the appearance of his store, he told me that he now has to carry a 
much better line of goods than formerly or lose his business. Said he "I 
now sell thousands of dollars' worth of goods that I never thought this 
community would buy on account of the high first cost." 

Get your service on a modern basis. Do "good" in teeth to people 
who have money, and in both teeth and money to those who are short on 
worldly goods. 




"NOW BLOW— BLOW HARD" 

In the rear of the nose just above the soft palate are the opening 
of the eustachian tubes leading to the middle ear. Hard blowing of 
the nose may force colonies of bacteria through one of these tubes into 
the middle ear, producing inflammation with resulting ear ache. 

If not at once checked by opening the ear drum and disinfecting 
the ear, deafness may result, or the inflammation may extend into the 
spongy bone of the mastoid process. In the latter case, it is probable 
that a hole will need to be chiseled through the outer layer of the skull, 
the diseased bone excavated, and the cavity sterilized, or death may 
ensue. Many a mother has caused the death of her offspring by put- 
ting a handkerchief to his nose and saying, "Now blow. Blow hard!" 
Mastoid abscesses are serious afflictions, and by no means uncommon. 
One of my friends averages more than one mastoid operation a day 
through the year. Dr. Wm. L. Hooper, Tufts College. — Healthy Home. 



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RAGTiOL Hints 



[This department is in charge of Dr. 
V. C. Smedley, 604 California Bldg., 
Denver, Colo. To avoid unnecessary de- 
lay, Hints, Questions, and Answers should 
be sent direct to him.]* 

A Method of Applying Arsenical Paste. — A safe way to apply 
arsenical paste in a cavity is to take an automatic amalgam carrier, place 
a small piece of cotton in barrel and place the arsenical paste on the 
cotton; it can then be applied without fear of falling on the mucous 
membrane. — George E. Cox, D.D.S., Wilmington, Del. 

1. Three Hints That I Find Practical. — ^Buy a one quart Thermos 
bottle and have warm water at your chair for three days with one heating. 

2. In large canals when pulp is difficult to remove, place two small 
broaches in holder at once and remove the pulp first time. 

3. In using arsenic in deep interproximal cavities always have a 
piece of temporary stopping tight against gingival margin, then apply 
treatment and cement. This forces away any overhanging tissue from 
cavity and does away entirely with dangers of arsenical poisoning. — 
A. C. Sloan, D.D.S., Baldwin, Wis. 

To Keep Water Sterile for Hypodermic Work. — Sterile water 
for hypodermic work can be kept clean by using the glass dome of the 
'^Nontoxo Sterilizer" to cover a ground glass stoppered bottle of four 
or six ounces, bottle to be used on a clean glass slab. Makes a fairly 
good joint to keep out **bugs.'' — M. V. Baker, D.D.S., Marysville, 
Wash. 

To Compensate for Shrinkage in a Large Gold Inlay. — Where 
a cast gold inlay is to be made for a cavity involving the mesial, occlusal 
and distal surfaces of a bicuspid or molar, if there is any shrinkage the 
inlay will invariably show a defective line at the gingival margins. To 
overcome this, the gingival margins of the cavity should be quite freely 
beveled so that the inlay will cover them with a lap joint instead of a 
butt joint. Even if there is a slight shrinkage the thin lap of gold can be 
burnished down to the cavity margin so that when cemented the inlay 
will perfectly seal the cavity. — I. D., The Denial Review. 

*In order to make this department as live, entertaining and helpful as possible, questions 
and answers, as well as hints of a practical nature, are solicited. 



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PRACTICAL HINTS 39 

To Prevent Thumb-Sucking in Children. — Dr. Geo. H. Hen- 
derson calls attention to a very ingenious method of preventing thumb- 
sucking suggested to him by Dr. Truman W. Brophy. Make a paste- 
board cuff of the right size and length to slip on the arm, small enough 
not to slip off the hand. Sew cotton or other material on the edge to 
prevent it from irritating the hand. It can be boimd with adhesive tape 
or straps and buckles. This will prevent any use of the elbow, and it is 
much more humane than the use of bitter drugs and other such expedi- 
ents. — The Dental Review, 

Method of Separating and Regaining Space Where Teeth 
HAVE Been Lost for Sometime. — Cases are often presented to us 
where it is desirable to reclaim the use of a root that has lost its crown. 
However, upon examination, we find that the crowns of the teeth ad- 
joining the space have drifted out of normal contact with their neighbors 
to a point where it is not possible to place a crown of sufficient width and 
size. This condition may be obviated by using an old but effective 
method which is as follows: Place the end of an elm stick in a vise and 
compress imtil it can be slipped into the space to be separated, and sawed 
off short enough to avoid interfering with the articulation. In cases 
where a very short root is to be reclaimed, a piece of softened gutta 
percha may be placed over the root end to force the gum tissue away and 
the wedge inserted over it. Sufficient expansion of the wood will take 
place as soon as the saliva comes in contact with it, to produce a gradual 
and quite comfortable separation which will continue for several hours. 
It is well not to force this wedge in too tightly, since a too rapid separa- 
tion will result with much discomfort to the patient. In most cases one 
wedge worn from twenty-four to forty-eight hours will provide the de- 
sired space, while in some cases two wedges may be necessary. 

This method not only has the effect of producing a separation but has 
a far more important one, i.e., forcing the drifted adjoining teeth back 
into firm contact and tilting their occluding surfaces into correct align- 
ment and articulation, thereby eliminating one of the fertile causes of 
pyorrhea pockets. There need *be no fear of Fosing the space obtained, 
while the crown is being made and adapted, since the wedge may be 
removed and replaced as often as necessary. Hickory was formerly 
recommended for making these compressed wedges, but I have found that 
ielm is better since it is a soft wood that will admit of considerable com- 
pression without splitting, and will take up moisture more rapidly. — 
Lewis G. Watkins, D.D.S., Detroit, Mich. 

A Time-Saving Hint. — ^When treating, and in some cases, when 
filling, an upper tooth, excepting the second and third molars, a cloth 



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40 TH£ DENTAL DIGEST 

napkin can be secured with a clamp to a tooth distally located from the 
one to be operated upon, and by placing a cotton roll under the lip or 
cheek, as the case may be, all moisture is excluded from the field of 
operation for a sufficient length of time to enable you to render the service 
required. This method can be adopted in most cases, but of course some 
cases cannot be managed in this way, requiring the rubber dam. Anyone 
making use of the napkin as indicated above will save much valuable 
time, and cause less discomfort to the patient. — H. A. Cross, D.D.S., 
Chicago, 111. — The Denial Review. 

Extracting a Post from a Frail Root. — In ?xtractmg a post from 
a frail root with a post puller there is always danger of splitting the root. 
The likelihood of this happening may be reduced to the minimum by 
taking a piece of twenty-eight-gauge German silver plate, cut a hole 
through it large enough to pass over the post and trim into a disk about 
the size of the root face. This disk may then be placed on the root with 
post projecting through its centre. The post puller may then be placed 
in position and as it is tightened the part of the instrument which is 
intended to bear on the root rests against the metal disk and does not 
slip or spread and the post may be drawn with safety. If the face of the 
root is uneven from decay, a bit of base-plate gutta percha may be 
molded into the cavity, the disk pressed into place and chilled with cold 
water, giving an even base for the instrument to press against. — ^J. A. 
Bullard, D.D.S., Chicago, lU.—The Denial Review. 

Water and Teeth. — As a general rule, water with high total solid 
residue, including a large amount of calcium salts, is not favorable to the 
health. The soundness of the teeth, however, is in direct proportion to 
the degree of hardness of the water used in the locality in question. The 
finest dentition was found in districts where the water contained mag- 
nesium as well as calcium salts. The former are stated to harden the 
enamel. — Rose, Giorn. farm. Chim.; Ghent, Abslr. {British Journal of 
Denial Science.) 

Rendering Cork Stoppers Impermeable.— In order to render cork 
stoppers impermeable to alcohol and acids, they are dipped in a cold 
solution of rubber in chloroform, and allowed to dry in the air until the 
chloroform has evaporated. Another method consists in dipping the 
corks into very hot, though not boiling, paraffin for about five minutes, 
and allowing them to dry thoroughly. — Journ. Denlaire Beige. (British 
Journal of Denial Science) 



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QUBSTIONS AND ANSWERS 41 

QUESTIONS AND ANSWERS 

Question. — Some time ago I attempted to prepare and fill some cavities 
for a relative (a boy of 8 years). He was rather unruly and so I had his 
sister take him to another dentist, as I could see no way to prepare the 
cavities except by using the dental engine. The cavities to be filled 
were small pit and fissure cavities where an explorer would enter nicely. 

When the boy returned I was informed by his sister that no engine 
was used and all four ist molars were filled. Looks like a miracle to me. 
I felt a bit delicate about the matter and asked no questions. Can you 
suggest how such a stunt can be performed? Hope I have made a clear 
impression as to the class of cavity. No other instrument than an ex- 
plorer would enter for me. — R. C. M. 

Answer. — ^Very frequently occlusal cavities that barely receive the 
p)oint of an explorer will have the enamel pretty well undermined by 
decayed dentine and in such cases the enamel can be quite easily broken 
down with small sharp chisels and firm hand pressure, when the softened 
dentine can be scooped out fairly well with spoon excavators; sufficiently 
at any rate, to hold a filling for a few months or a few years. In fact I 
think the main part of the opening up of all such cavities should be done 
without the use of the dental engine. But unless the engine be used to 
finish the operation, I think the preparation is apt to be quite incom- 
plete, and it is more than likely that you will be called upon to refill those 
cavities at some future time. — ^V. C. S. 

Answer. — Will you add to your advice to '*H. B. W.'' in Septem- 
ber issue. See to it that no iodine comes in contact with the tissues of 
oral cavity (and all cleansing fluids have iodine) ; after repeated cleansing 
he will see a marked improvement. — M. H. Cazier, M.D., Chicago. 

Answer. — In reply to the inquiry of "R. C. M." (page 646, October 
Digest), would say that if he will use a preparation that is sold under the 
name of Velvo Phenox his troubles with children's teeth will be over. I 
have used it very freely in all sensitive cavities for several years. It is 
harmless. Stop it in with cement for two days before operating. — ^D. W. 
Barker, D.D.S., Brooklyn, N. Y. 

Question/ — Referring to question signed "R. C, Wisconsin": It is not 
the policy of this magazine to publish any contribution not signed (for 
the publisher) with full name and address of sender. — V. C. S. 



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42 THE DENTAL DIGEST 



AN EPITOME OF CURRENT DENTAL AND MEDICAL 
LITERATURE 

[The Journal of the National Denial Association, November, 1915] 

Contents 

G. V. Black, M.D., D.D.S., Sc.D., LL.D. 

Original Communications 

Greene Vardiman Black. By Charles E. Bentley, D.D.S. 

The Research Department 

The Organization of the Research Institute of the N. D. A. 
By-Laws of the Research Institute of the N. D. A. 

The Building and Endowment Fund Plan for the Research Institute of the N. D. A. 
Research Department Announcements. 
Dr. Greene Vardiman Black. By Weston A. Price, D.D.S. 
Report of the Scientific Foundation and Research Conunission to the N. D. A. 
•Report of the Minnesota Division of the Scientific Foundation and Research Commission. 

By Thomas B. Hartzell, D.M.D., M.D.; Arthur T. Henrici, M.D.; Harold J. Leonard 

D.D.S., B.A. 
The First Report of a Study of the Composition and Properties of the Cements now in Use 

in Dentistry. By Marcus L. Ward, D.D.S.; Ralph M. McCormick, B.S. 

Proceedings of the House of Delegates 

President's Address. By Donald Mackay Gallie, D.D.S. 

First Session. 

Proceedings of the Board of Trustees. 

National Dental Association — Secretary's Cash Book. 

Itemized Statement of Dbbursements. 

Report of the Treasurer of the N. D. A. 

Editorial 

Greeting. By Thomas P. Hinman, President. 

Greene Vardiman Black. By H. E. Friesell. 

The Panama-Pacific Dental Congress. By Arthur M. Flood. 

Conunercialism vs. Professional Ethics. 

REPORT OF THE MINNESOTA DIVISION OF THE SCIENTIFIC FOUNDATION 
AND RESEARCH COMMISSION 

Oral infection, whether in the form of apical abscesses or pyorrhea, 
is frequently the sole cause of arthritis and rheumatic affections of the 
muscles and nerves as well as joints, and seems, when present, to be 
always an associated cause where the rheumatism is of streptococcal origin. 
An arthritis once started by tonsillitis or similar large foci, can be kept 
going by an oral infection so slight as to be scarcely recogm'zable in the 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 43 

radiograph, and systemic diseases are continued by surprisingly shallow 
gingivitis, even when the larger local foci, doubtless the originators of 
the trouble, are removed. 

Our experience in private practice, as well as in the cases shown by the 
tables, has taught us that these rheumatic and arthritic conditions are 
markedly improved by removing the local foci. 

Great emphasis should be laid on the complete extirpation of infected 
foci in all cases. It is not sufficient that the mouth or tonsils appear well' 
from the outside. A minute examination with every means available is 
necessary. With the aid of the X-Ray and careful exploration it is still 
difficult to find all foci about the teeth. Without these aids it is im- 
possible. When a physician refers a patient suflfering from rheimiatism 
or other of the diseases liable to come from dental infection, it is impossible 
for the dentist to make a complete determination without the use of the 
X-Ray. It is our experience and the experience of others who use the 
X-Ray a good deal that the majority of dental abscesses give no clinical 
sign of their existence. The teeth are not sore, no swelling or palpable 
soft spot at the root end reveals what the radiograph shows and what 
the subsequent operation confirms. It is not uncommon to find ab- 
cesses shown in the radiographs in cases in which there are no breaks in the 
continuity of the pulpal wall, as under crowns, fillings, or even sound teeth. 

Experience with a radiograph also shows that a very large propor- 
tion of artificially filled roots subsequently become abscessed. A study 
made by Dr. Henry Ulrich of this city of a thousand radiographs taken 
at random indicated that over 70 per cent, of the artificially filled roots 
were abscessed. It has been very rare that we have extracted a tooth 
which showed an abscess in the radiograph and failed to get streptococci 
when we cultured from the root end. 

It is amazing to find in well cared for mouths how much pyorrhea may 
exist without being evident except to painstaking exploration. To those 
familiar with the systemic results coming from pyorrhea in such large 
proportion of cases and even from a slight pyorrhea, the careless ignoring 
and overlooking of such trouble on the part of most dentists, seems noth- 
ing less than malpractice. 

In all the cases which we have tested for bacteria, the streptococcus 
viridens has been found in pyorrhea pockets and apical abscesses. Since 
we have used the greatest precautions to prevent contamination from 
the gum margin by searing them, there would seem to be no question but 
that this organism is constantly present in such lesions. Whether it is 
the etiologic micro-organism in the oral lesion or not, it is present and 
there can be no doubt that it or its toxins pass thence into the circulation 
and cause arthritis and rheumatic conditions. 



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44 THE DENTAL DIGEST 

The use of vaccines, however, is liable to create a confidence in them 
which is likely to make the dentist less careful in eliminating all local 
foci, and until such local foci are removed it can hardly be expected that 
a vaccine will give any permanent relief. In most of the cases where we 
were sure that all local foci were removed, the recovery was sujQSciently 
rapid and complete to indicate that vaccine was not needed. 

The heart cases studied are mostly endocarditis as evidenced by 
valvular disease, usually insufficiency of the mitral valve . Most of these 
are connected with rheumatic trouble. 

In our table of hospital patients, thirty-five cases had a diagnosis 
indicating endocarditis. Of these, twenty-three had or had had rheu- 
matism, two had tuberculosis, nine were associated with nephritis, and 
three with neuritis. The association of endocarditis with rheumatic 
conditions is well known, this table merely serves to emphasize it. Of 
the thirty-one cases who had or had had rheumatism, twenty-three had 
endocarditis. All of these were wholly rheumatic cases, not complicated 
by tuberculosis or syphilis. 

The known and apparent relation of these heart lesions to rheumatic 
conditions, the fact that all have dental infections, and the fact that so 
large a proportion of the cases studied — thirty-five out of sixty-six — 
have endocardial lesions, seems to us to be good clinical evidence of the 
relation of such lesions to local infective foci of the dental type. 

The response to treatment by foci removal in these cases is slow, but 
in the great majority of cases is marked. These lesions are much like 
the bony deformities of arthritis, in that although the disease may be 
cured the scars remain and a heart valve once injured by inflammation is 
always there after leaky and insufficient. The best that can be done is 
to stop the progress of the disease and allow the heart to compensate. 
Careful rest and slow building are necessary and quick results cannot be 
expected. 

The cases which have yielded us the most satisfactory results during 
the last year have been those diagnosed as gastric ulcer. 

[The Denial Register, November, 1915] 
Contents 

Event and Comment. 

First General Annual Report of the Dental Department. 

A Tribute to Dr. Chester Twitchell Stockwell. 

Porcelain Facings. 

Is Boric Acid Good for Babies? 

The Importance of Sound Temporary Teeth to Facial Growth and Development. 

Memorial Resolution. 

Indents. 

Announcements. 

Meetinp3. 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 45 

[Tlie Dental Cosmos, December, 1915] 

Original Communications 

A Rational Appliance for the Correction of Palatal Defects, Based on Original Studies of 

the Action of the Muscles of the Soft Palate. By W. H. O. McGehee, D.D.S., M. D. 
Modern Attachments for Bridge Work and Stabilizers for Loose Teeth. By Jas. K. (Jur- 

gess, D.D.S. 
*Oral Infections. By Nathaniel Gildersleeve, M.D. 
*A System of Making Jacket Porcelain Crowns Without Fusing. By L. E. Custer, A.M., 

D.D.S. 
The Relation of Dentistry to Neurology. By Christopher C. Beling, M. D. 
President's Address (Pennsylvania State Dental Society). By James G. Lane, D.D.S. 
President's Address (New Jersey State Dental Society). By Walter F. Barry, D.D.S. 

Correspondence 

.\dvance Notice of the Use of the Fluid Extracts of Umckaloabo and Chijitse in the Treat- 
ment of Pyorrhea Alveolaris. 

Proceedings of Societies 

Pennsylvania State Dental Society. 
New Jersey State Dental Society. 

Dentistry and the War 
American Ambulance Hospital — Dental Department. First General Annual Report. 



Editorial Department 

Re-discovery. 

Review of Current Dental Literature. 

Periscope. 

Hints, Queries, and Comments. 

ORAL INFECTIONS 
By Nathaniel Gildersleeve, M. D., Phil.adelphia, Pa. 

(Read before the Pennsylvania State Dental Society, at its annual meeting, Reading, 

June 22, 1915) 

CAUSES FOR LACK OF PRESENT KNOWLEDGE OF MANY ORAL INFECTIONS 

This lack of knowledge, it might be stated, is due primarily to four 
causes: 

(i) Lack of interest exhibited by physicians in local diseases of the 
oral cavity. 

(2) Lack of scientific education in a large proportion of dentists, 
owing to which fact they have been handicapped in recognizing and 
properly differentiating various infectious conditions of the mouth. 
Those who have Qualified are in many respects self-educated, it being but 



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46 THE DENTAL DIGEST 

fair to state that the dental practitioner cannot be blamed so much as the 
dental schools, since sufficient emphasis has not been laid on this very 
important branch of oral medicine and surgery. This unfortunate con- 
dition of aflairs is being corrected at the present time, and when the four 
years' course is instituted in the various dental colleges, the student will 
have better training in this as well as all other branches making up the 
curriculum of our dental colleges. 

(3) There has always existed an inexcusable lack of cooperation on 
the part of medical and dental practitioners. The professional relation- 
ships of these two bodies of men dealing with diseases of the human 
economy are yearly becoming closer, each group recognizing more and 
more fully the fact that they cannot work to the best advantage of their 
patients without this essential cooperation. 

(4) The fourth factor of importance is one which can only be over- 
come by constant investigation, namely, there are numerous organisms 
constantly existing in the oral cavity the true significance of which have 
not been determined, owing to the fact that endeavors aimed toward 
the isolation of some of these microscopic plants and animals have not 
as yet been attended with success; furthermore, the importance of some 
which have been isolated has undoubtedly not been fully recognized, due 
partially to the haphazard way in which they have been handled by many 
workers, and partially to the fact that some of the diseased conditions 
cannot be reproduced in lower animals. 

A RATION.\L APPLIANXE FOR THE CORRECTION OF PALATAL DEFECTS, 
BASED ON ORIGINAL STUDIES OF THE ACTION OF THE MUSCLES 
OF THE SOW PALATE 

By W. H. O. McGehee, D.D.S., M.D., Cincinnati, Ohio 
REQUIREMENTS OF A SUCCESSFUL OBTURATOR 

It is now readily seen that a successful obturator should be capable, 
not only of upward and downward movements, but, in order that it 
may remain in perfect adaptation to the boundaries of the cleft under 
all circumstances, should really possess six distinct movements, that is 
to say, vertical (upward and downward), antero-posterior (forward and 
backward), and lateral (right and left). The appliance described is 
designed with this idea in view, and is presented to the profession after 
adequate and successful trial in many clinical cases. 

THE NEW CLEFT PALATE APPLIANCE, AND A NEW TECHNIQUE 
FOR MAKING IT 

The appliance suggested consists of a metal or vulcanite plate with 

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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 47 

clasps, vulcanized or soldered into the heel of which is a clasp-metal 
extension, on which rests the hard-rubber obturator. From the centre 
of the metal extension projects upward through the obturator a screw- 
cut gold post with a nut on its end. Vulcanized into the hollow portion 
of the obturator is a flexible clasp metal tongue, through which the up- 
right screw post previously mentioned passes and in contact with which 
it is held by means of the nut on its end. On the under surface of this 
metal tongue is a small gold hook, to which is attached one end of a 
spiral spring, the other end hooking around the upright screw-cut post. 
Another spiral spring extends from a similar hook, vulcanized into the 
posterior part of the upper hollow portion of the obturator, to the same 
upright post. 

A SYSTEM OF MAKING JACKET PORCELAIN CROWNS WITHOUT 

FUSING 

By L. E. Custer, A.M., D.D.S., Dayton, Ohio 
ADVANTAGES OF THE PORCELAIN JACKET CROWN 

The jacket crown possesses certain features which easily place it at 
the head of all other forms of porcelain crowns. First, the strength and 
durability of this crown is testified to by every dentist who has made one. 
Dr. W. A. Capon of Philadelphia says, ^* After many years of experience 
with different kinds of porcelain jacket crowns, I am glad that I was 
fortunate enough to recognize their efl&ciency early in my practice. 
When a root has been crowned to death and considered only fit for ex- 
traction, a jacket crown will give it renewed life and vigor in the majority 
of cases, if it is decently firm in its socket." 

Dr. Edward B. Spalding of Detroit says, *^The all-porcelain jacket 
crown and its modifications have displaced all other forms of porcelain 
crowns in my practice. The gum tissue is always more healthy about a 
carefully fitted and flush joint than where a band is used." 

Dr. George Schneider of Chicago says, ''There are two vital points 
in favor of the jacket crown, namely, first it is not necessary to remove the 
natural crown in whole; second, you do not endanger the root by en- 
larging the canal for the retention of a post." 

Dr. H. E. Jenkins of Ironton, Ohio, whom I have seen repeatedly 
drive a canine jacket crown of his own make through an inch pine board 
without damage to the crown, maintains and proves that it possesses 
strength above any other form of porcelain crown. 

The strength of the jacket crown is due largely to the natural post of 
dentin within it, which is a part of the tooth itself. Where caries has 
left but little dentin, this is reinforced by a platino-iridium post occupying 



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48 THE DENTAL DIGEST 

approximately the pulpal space of the tooth. We have never seen or 
heard of a root split under a jacket crown. This cannot be said of any- 
other form of porcelain crown. 

A second advantage of the jacket crown, as pointed out by Dr. 
Spalding, is that it makes a flush joint with the root at the cervix. A 
metal band with its uncertain fit is thus done away with. 

The third advantage is the esthetic appearance of the completed 
crown. The entire crown itself performs the functions of a band, thus 
eliminating the unsightly metal band at the gum line. 

The disadvantages of the jacket crown lie entirely in the technique 
of its construction. The operator must be skilled in the working of 
porcelain, and I know of no procedure in dentistry that requires so high 
a degree of skill and patience as the making of a porcelain jacket crown. 
The platinum coping requires skill and time in its formation, the selection 
and fusing of the proper shade of porcelain requires years of experience, 
and then often at the last minute the esthetic appearance of the whole 
appliance may be spoiled by overfusing. Another objection is the 
amount of time consumed in the baking method. 

It is a system or procedure in which the objections just enumerated 
are overcome that I herewith present, and since I am the inventor of the 
first electric oven, it may seem strange that I advocate a method which 
does not require an oven, nor does it require any special instruments. 
It will also be noticed that many steps of the technique are old and more 
or less familiar to everyone. 

[Items of Interest, December, 1915] 

Exclusive Contributions 

Is Tartar a Cause of Pyorrhea Alveolaris? T}ie Logical Test Applied. By G. F. Logan, 

D.D.S. 
Note on SUnding Amoeba in Dry Smears, from Cases of Pyorrhea. By Thomas LeClear. 

ProstJwdontia 

"The Application of the Chayes Parallelometer, the Parallelodrill and Attachments in the 
Conservation of the Common Reciprocal Functions of the Teeth Which are Used as Piers 
for Bridgework." By Herman E. S. Chayes, D.D.S. 

Orthodontia 

Some Principles of Retention. By Martin Dewey, M.D., D.D.S. 
Discussion of Dr. Dewey's Paper. 

Society Papers 

♦Blood Findings in 162 Consecutive Cases of Chronic Oral Infection Associated with Teeth. 
Bv Wm. H. G. Logan. 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 49 

•Oral Sepsis as Related to Systemic Disease. By W. H. Strietmann, M.D. 
Operative Procedures in Relation to Dental Caries and Diseases of the Investing Tissues. 
By Arthur D. Black, A.M., D.M., D.D.S. 

BLOOD FINDINGS IN 162 CONSECUTIVE CASES OF CHRONIC ORAL INFECTION 
ASSOCIATED WITH TEETH 

By Wm. H. G. Logan 

{Read before the Panama-Pacific Dental Congress j San Francisco ^ California, Section VI, 

September i, 191 5) 

In the examinations made in 100 out of 162 cases blood changes had 
occurred that were held to be the sequence of chronic oral infections 
associated with teeth. 

ANEMIA 

That neither pronounced nor moderate anemia was commonly 
associated with chrom'c oral infections in this series, as claimed by many 
authors; however pronounced anemia was found once. 

leucopenia 

That leucopenia was more constant than leucocytosis in pyorrhea 
cases where the blood findings were abnormal; furthermore, leucopenia 
was more frequent in those cases where the pyorrhea pockets did not 
involve the root ends and in the absence of periapical focal infection 
without discharging sinuses. 

LEUCOCYTOSIS 

That leucocytosis when associated with pyorrhea cases was most 
frequent where the pyorrhea pockets extended nearly to or did involve 
the root ends. 

That abnormal blood findings were present in forty-eight of the one 
hundred and ten pyorrhea cases examined. Full urinalysis was made of 
all pyorrhea cases although not here reported. 

That leucocytosis was present in forty-seven of the fifty-two cases 
of {periapical infections without discharging sinuses — but that leucopenia 
does occur under the same conditions is presented in Group 6. Let the 
foregoing statement be not misconstrued to mean that either leucocytosis 
or leucopenia is always present when a chronic periapical infection with- 
out a discharging sinus is found, for periods arise when the effect of the 
infective biproducts is so slight that its result is not manifested in a 
blood change. But, since severe secondary infections could occur during 
this period, a focal infection although producing no characteristic blood 



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50 THE DENTAL DIGEST 

change must always be looked upon as a menace to the health of the 
patient and its eradication demanded. 

PERIAPICAL INFECTIONS 

One may have a pulpless tooth present without a rarefied periapical 
area and at the same time have a chronic infective process in the rem- 
nants of pulp tissue, which I have found in three cases to be account- 
able for a serious secondary effect. 

Nor can one with any degree of assurance eradicate periapical in- 
fections by the mere extraction of teeth unless it be accompanied by a 
currettement. Therefore it becomes necessary to do something more 
than to extract teeth or amputate roots and do an indifferent curettement 
to secure positive elimination of focal infections associated with teeth. 

ORAL SEPSIS AS RELATED TO SYSTEMIC DISEASE 

W. H. Strietmann, M.D., Oakland, California 
(Read before the Panama-Pacific Dental Congress^ Section II y September 7, igiS») 

ETIOLOGY OF ROOT ABSCESSES 

Let US consider on the other hand the etiology of root abscesses. 
Here I would have you consider earnestly the causative factors spoken 
of by Martin H. Fischer. He calls attention to the fact primarily that 
teeth are living structures. All of us know that living tissue of any kind 
is infinitely more resistant to infection than dead tissue. Hence any 
procedure which would tend to interfere with the vitality of the tooth 
or its surrounding structures must of necessity lower resistance to in- 
fection and predispose to local disease. Under this heading we must 
place the use of arsenic and strong antiseptics such as phenol tricresol, 
etc. These substances destroy bacteria no doubt, but they destroy 
living tissue as well. 

Then comes the process known as devitalizing a tooth. The popular 
conception is that this process removes the nerve from the pulp canal, 
but as Fischer has pointed out, it also removes the nutrient artery from 
the centre of a tooth, which naturally results in the death of the tooth 
centrally, again producing a favorable ground for the growth of bacteria. 
With the central canal deprived of its blood supply the pericementiun 
alone is left to nourish the tooth, a thing which at best could be but very 
imperfectly done, but with an existing pyorrhoea or the further dental 
operation of placing a crown which necessitates the grinding away of the 
convex sides of projecting portions of the teeth, thus destroying many 
living cells again, it becomes an impossibility. Further the snugly fitting 
crown causes a pressure necrosis of the underlying cells. Infection in- 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 51 

variably occurs around such crowns and the primary focus of possible 
subsequent systemic disease is planted. 

The foregoing is not intended in any way to reflect upon the technique 
of the dentist, the sterilization of hands and instruments, etc., for I am 
firmly convinced that this precaution is becoming general among them. 
Likewise devitalizing may be necessary for certain dental procedures now 
in use, but I trust the inexhaustible ingenuity of the dental profession 
will soon find a way to do without this method of treatment and indeed, 
it is well known that dentists abhor the full gold crown as much as the 
physicians, but find themselves compelled to use it in order to '*save a 
tooth." 

[The International Journal of Orthodontia, November, 19 15] 

Contents 

The Etiology and Treatment of Some Types of Deflected Nasal Septum. By Martin Dewey, 

D.D.S., M.D., Kansas City, Mo. 
The History of Orthodontia (Continued). By Bernhard W. Weinberger, D.D.S., New York 

City. 
Treatment of A Class II, Division i Case. By W. G. Barr, D.D.S., Wichita, Kas. 
A Case History from Practice. By Hugh G. Tanzey D.D.S., Kansas City, Mo. 

Current Orthodontic Literature 
Some Infections of the Head and Their Causes. By J. Sheldon Clark, M.D.. Freeport, III. 

Editorials 

Dr. Stanton's Instrument for Surveying the Dental Arch. 

Some Disputed Points in Orthodontic Treatment. 

Dental and Medical Newspaper and Magazine Advertising. 

[The Western Dental Journal, November, 1915] 

Original Contributions 

Conductive Anesthesia. By Dr. Arthur E. Smith. 

R6sum6 of the Conductive Anesthesia Clinic. By Dr. Hinman. 

Ethics and Good Taste. By Dr. C. C. Allen. 

[Dominion Dental Journal, November, 1915] 
Contents 

Original Communications 

Clean Hands. By Jas. M. Magee, D.D.S., L.D.S., St. John, N.B. 
Addresses of Welcome, New Brunswick Dental Society. 
Replies to addresses. 



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52 THE DENTAL DIGEST 

President's Address—New Brunswick Dental Association. By W. P. Bonnell, D.D.S., 

L.D.S. 
A Trip in War Times. By A. W. Thornton, D.D.S., L.D.S., Montreal. 

Denial Societies 

Reports of Committees, New Brunswick Dental Society. 

The Annual Convention of the New Brunswick Dental Society. 

Oral Hygiene Conference in Toronto. 

Toronto Dental Society. 

Canadian Army Dental Corps. 

National Dental Association. 

Editorial 

*Desensitizing Dentine with Paraform. 

The Annual Fee of the Royal College of Dental Surgeons of Ontario. 
Quebec Again Refuses to Enter Dominion Dental Council. 
Dr. J. Burkhart Appointed. 
Editorial Notes. 

Selections 



Army Forms and Regimental Teeth. 
Dental Treatment for the Troops. 

Reviews 
Alveolodental Pyorrhea. By Chas. C. Bass, M.D. 



Obituary 



The late Dr. Chas. W. Brown. 
The late Dr. W. T. Stuart. 



DESENSITIZING DENTINE WITH PARAFORM 

Equal parts of paraform and cocaine crystals were moistened to a 
paste with oil of cloves and applied to an almost exposed pulp of a first 
permanent molar of a child ten years old. The pulp had to be devital- 
ized, so it was first used to try the effect of cocaine and paraform on it. 
The paste was sealed into the cavity with cement for about a week. There 
was neither pain nor soreness during that time. When the dressing was 
removed the decalcified dentine which had been exceedingly sensitive was 
readily excavated without pain, and the horns of the pulp cut with free- 
dom, though the tissue was quite sensitive below. The same application 
was made in many deep cavities in which there was no pulp exposure; in 
very few of these was there the slightest discomfort, and in most cases 
happy results on the dentine. In shallow cavities there is less need of the 
cocaine and greater difficulty in sealing, so less cocaine may be used and 
more paraform. The proportion of cocaine and paraform is governed 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL UTERATURE 53 

by the state of the sensitiveness of the pulp and the nearness to it. The 
length of time to leave the application is governed by the amount brought 
into actual contact with vital dentine. In shallow cavities equal parts 
of the cement powder and paraform may be mixed with the liquid and 
inserted, but if the pulp has been irritated for any reason much less 
paraform must be used. If a small amount of the paraform is brought 
in contact with the tooth's surface, then leave it even weeks, but on the 
other hand if a large percentage has been brought in contact then days 
may suffice. It is wise to remove whatever decay possible before apply- 
ing, but if success does not come with one application and there has been 
no irritation increase the percentage in another application. The pene- 
tration of the drug is not very deep, one or two millimeters is the limit, 
and it does not spread laterally more than the anastomosis of the tubules. 
If it is applied to one surface of a tooth it won't desensitize the opposite 
surface. 

If the profession will carefully test out the value of paraform as a 
means of desensitizing dentine and report the results it will not be long 
until its true place will be known to all. An ounce bottle of paraform 
costs about thirty cents. It is a yellowish-white crystalline powder, 
with a peculiar odor. Try it. 

[The Dental Outlook, December, 1915] 

Original Communications 

•Treatment and Filling of Root Canals. By Dr. R. Ottolengui. 
Balanced Alloys. By N. K. Garhart. 
Dentistry and System. By S. Herder, D.D.S. 
"Sweatshop Dentists." By Dr. M. Schneer. 
The Dental Student and the Profession. By Morris Zucker. 
Gateways of Infection. 

A Mother's Thought on the War. By Bert Ullad. 
Our Good Friend, the Dentist. By Arthur Brooks Baker. 
Monthly Report of Legislation Committee of the Allied Dental Council. 
Hold Man and Woman Practicing Without Licenses. 

TREATMENT AND FU-LING OF ROOT CANALS 
By R. Ottolengui, New York 
The Alternative for the Surgical Treatment of Root Ends is Ionization 

The action of the electric current in an electrolyte is to split it up 
chemically into simpler materials which move to their respective elec- 
trodes. These materials are called ions. The ion is the conveyor of 
electricity; hence the ion which travels to the anode is called the anion, 
and the ion which goes to the cathode is called the cation. The use of 



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54 THE DENTAL DIGEST 

medicaments by ionization has been much more studied abroad than by 
American dentists. Clinical results are sufficiently satisfactory to 
make it highly probable that in the ionization of tissues through the 
canals of teeth we have a very promising method of controlling even 
serious infectious conditions. 

Abroad the method employed mainly is to use a platinum point as 
the anode, and to flood the canal with chloride of zinc. The method 
advocated by Rhein and others in this country, and thus far the only 
method tested by myself, is to use an anode of pure zinc and to flood the 
canal with normal salt solution. When a current is passed through an 
electrolyte containing a salt in solution the metals, or metallic radicals 
move from the anode to the cathode; thus by using the zinc point as the 
anode, the ions pass from the zinc through the apical foramen and act 
upon the tissues about and beyond the apex. 

Tests out of the mouth easily demonstrate that the result, say upon a 
bit of beef, is much the same as where chloride of zinc is used; markedly 
escharotic. In twenty minutes a cubic quarter inch of fresh beef may 
thus be so disintegrated by ionization that it can be easily macerated be- 
tween the thumb and the forefinger. Hence if a true granuloma be 
present in the apical space, caused by septic infection, this granuloma 
may thus be destroyed, and the theory is that it is then absorbed and 
slowly replaced by normal tissue. 

It is also claimed that ionization with the zinc used in combinaton 
with normal salt, will sterilize dentine and cementum, as well as the tissues 
about and beyond the apical foramen. 

[The Texas Dental Journal, November, 1915] 

Original Communications 

Some Practical Points. 

Thirty-first Annual Convention of the Texas State Dental Association. 

Professional Ethics. 

Dental Radiography. 

Taking Impressions. 

[The Pacific Dental Gazette, November, 1915] 
Contents 

Original Articles 

Local Anesthesia in Dental Surgery. By Otteson. 
A Symposium on the Ameba Buccal is. By Gray. 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 55 

Editorial 
A Pedagogic Duty or a Necessity? 

Reviews of Domestic and Foreign Dental Literature 

Mouth Hygiene. 

Selections 

The Significance to the Dentist of Oral Infections in Their Relation to Systemic Disorders. 

By Gibner. 
The Relation of the Internal Secretory Organs to Malocclusion, Facial Deformity, and Dental 

Disease. By Grieves. 



Mercurial Stomatitis. 



Reminiscences by Dr. Asay. 



Dental Excerpts 
Special Article 



[Oral Health, November, 1915] 

Photograph, Major A. A. Smith, Acting Chief Dental Surgeon, C.A.D.C. 
*The Progress of the Research Commission of the National Dental Association. By Weston 

A. Price, D.D.S., M.S., Cleveland. 
Six Years of X-Ray in Dentistry. By Stephen Palmer, D.D.S., Poughkeepsie. 
Quarterly Report, Canadian Army Dental Corps. 
Society Announcements. 

Summary of Dental Laws of Canadian Provinces. 
The Compendium. 
The Active Service Roll. 
Multum in Parvo. 
Editorial. 

THE PROGRESS OF THE RESEARCH COMMISSION OF THE NATION.AL DENTAL 

ASSOCIATION 

By Weston A. PiacE, D.D.S., M.S., Cleveland, Ohio 

The research department is giving support to the solving of metal- 
lurgical problems, and I think I am justified in telling you that one 
third of the platinum used in the world is used in the practice and art of 
dentistry, and do you realize that for the dental profession it amounts 
to $2,500,000 annually? If we would utilize the opportunity and the 
information we have on the tungsten product which has been developed 
through our Research Commission, it would result in great benefit and 
good to the dental profession. This metal is six times as strong as iridio- 
platinum; it has a melting point nearly twice as high as that of platinum ; 
its elasticity is twice as great as that of steel. It has a hardness so much 



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56 THE DENTAL DIGEST 

greater than that of steel that the management of the General Electric 
Company is responsible for the statement that one tungsten point will 
outwear two hundred steel points. It is a metal that does not lose its 
elasticity when you heat it. This metal is available for any man in this 
room for use in making posts for crowns and for casting bridges upon. 
It is so stiff and rigid that you can make a framework of it and cast about 
it and control the contraction that will take place in casting a bridge with 
its abutments, all at the same time. You may use it for orthodontia 
appliances either by the method which has been presented by Dr. Robin- 
son or by the standard methods. 

Relative to the application of the metal in orthodontia appliances, 
I am advised that it is destined to supplant largely the metals that are 
in use up to this time for orthodontic work. With its greater elasticity, 
you can make attachments to it with hard gold solder. It has the 
property of enormous strength; it does not break off like clasp metal 
wires by crystallization. You m^y use wire that is so much smaller 
that it seems incredible for it to accomplish the work it does. 

Any dentist who will write to the commission can get the metal. We 
are furnishing it to the profession at what it costs us to produce it, 
and ultimately the manufacturers will make it. The selling price is 
virtually one sixth of that of platinum for the same weight. 

In the last two or three months our research department has been 
able to furnish the profession enough tungsten to supplant the use of 
platinum to go far toward paying for the research expense that the com- 
mission has gone to for that particular line of research work. (Applause.) 

There are only a few who know about it, because you have not read 
the recent issues of the Journal of the National Dental Association with 
reference to the research work we have been doing in regard to this metal. 

As to palladium, it requires no special preparation. Any man can 
send to the American Platinum Works, New Jersey, and buy palladium 
for $48 an ounce. You can get twice the bulk for the same weight that 
you can with platinum. You can make it equivalent to platinum at 
$26 an ounce. 

{British Dental Journal, November i, 191 5] 

Contents 

Original Communications 

A Review of Recent Researches concerning the Nature of Dental Caries. By W. H. 
Jones (Downing College, Cambridge), B. A. Cantab., L.D.S., Eng. 
* Presidential Inaugural Address. 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 57 

Selected Article 
" Diagnosis of Ulcers of the Tongue." By E. C. Hughes, M.C., F.R.C.S. 

Editorial 
•Annual Report of Chief Medical Officer, Board of Education, for 1914. 

News and Comments 

Lord Derby's Appeal. 
The War. 

Contents of this Number. 
The National Insurance Act. 
The Royal Dental Hospital. 
The Dental Curriculum. 
Christmas-in-Wartime Sale. 
Chronic Cervical Adenitis. 

The Dental Profession and the War 

Four Brothers. 

Second-Lieutenant R. H. Basker, L.D.S., Killed in Action. 

Exhibition or Fracture Apparatus at the Royal Society of Medicine. 

A Prophylactic Interdental Splint. 

Professor Dr. Dependorf killed. 

Germany's Need of Dentists. 

Dundee Dental Hospital. 

Current Dental Literature. 

PRESIDENTIAL INAUGURAL ADDRESS* 
By Reginald E. Bascombe, L.D.S., Eng. 

Each day we notice the slow but sure progress that is being made, 
and this war has already done more than the last decade of peace to teach 
a great national lesson — that "the care of the teeth'* is the very hypo- 
thesis upon which health, strength, the power to endure, the length of 
life itself wholly and entirely depend. So, out of evil comes good; the 
powers that be have discovered in a time of stress that this war will be a 
true case of survival of the fittest, that half the troubles of the soldier 
are due to want of knowledge, that the care of the teeth comes before all 
else; and so with feverish haste nearly three millions of men are being 
put under the skilful treatment of the specialist. Here let me remark in 
parenthesis that it is the duty of every qualified practitioner, while 
doing his utmost for the men who go forth to save our homes, at the 
same time to teach each man with care and patience the necessity for 
constant cleanliness and annual supervision at the hands of the qualified 
dentist. 

These common soldiers are for the most part splendid men with 

•Delivered before the Eastern counties Branch at Bury St. Edmund's on September 24, 1915. 

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58 THB DENTAL DIGEST 

hearts of gold, and I have been overwhelmed by the tokens of gratitude 
which I have received at their hands. So many men have spoken of 
their gratitude to the Government which has enabled their eyes to be 
opened, and oft I have heard it said, "If only my parents had taught me 
to clean my teeth! I thought, indeed, that dentists were only to remove 
teeth when at last they became unbearable by reason of the pain they 
gave!*' So here is a boon to mankind; the hour of peril has caused the 
slow-geared cogs of evolution to leap forward half a century. These men 
will never forget, and they will see that their children profit by the lessons 
which they are being taught to-day. Mr. Bailey is a man who gave 
his all freely to help in the great fight to enable our profession to take that 
high position which it has earned for itself by self-sacrificing endeavor. 
He deserves our gratitude for his honest convictions as to the necessity 
of systematic dental treatment for the poor. The fervor for the cause 
he has inspired by his efforts is echoed in the clinics we see springing up 
around us. 

ANNUAL REPORT OF CHIEF MEDICAL OFFICER, BOARD OF EDUCATION 

FOR 19 14 

In regard to the Dental Treatment Scheme, 130 areas are now sanc- 
tioned, as compared with 88 in the preceding year, and that no fewer than 
195 organized dental clinics now exist, as compared with 150 in the pre- 
ceding year. The number of dentists employed was approximately 200, 
of whom but 51 were full-time officers. The report calculates that the 
provision is sufficient to undertake the treatment of 37s, 000 children. In 
London alone upward of 42,000 children are now provided for annually, 
an increase of nearly 11,000 as compared with the preceding year, and 
this in spite of war difficulties. 

Over and above the ordinary stationary dental clinics, "traveling 
clinics" have been instituted in Devon, Norfolk, and the West Riding 
of Yorkshire; in Norfolk the dental work is actually carried out in a 
dental caravan, though to our disappointment little is said as to whether 
this plan is a success or not. In Devonshire and the West Riding of 
Yorkshire the dental equipment is carried from place to place. 

[British Dental Journal, November 15, 1915] 

Original Communications 

A Review of Recent Researches concerning the Nature of Dental Caries. By W. H. Jones 

(Downing College, Cambridge), B. A. Cantab., L.D.S., Eng. 
Surgical Prosthesis of the Jaws. By H. Watson Turner, M.R.C.S., L.R.C.P., L.D.S. 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 59 

Editorial 
"On Surgical Prosthesis." 

News and Comments 

Dentists and Lord Derby's Recruiting Appeal. 
Contents of this Number. 
The R. C. S. Museum Demonstrations. 
To Photographers. 
L. C. C. Economies. 

A Medical Officer on Unqualified Practice. 
Tokyo Dental College. 
^Russian Women Dentists. 

The Dental Profession and the War 

Dental Pupil Killed in Action. 

The Kaiser's Dentist. 

Dental Student Promoted. 

House of Commons — Answers to Questions. 

The Case of Dental Students. 

The Position of Dentists at War Hospitals. 

Dentistry for the Troops at Doncaster. 

Dentists' War Relief Fund. 

RUSSIAN WOMEN DENTISTS 

In view of our growing interest in Russian affairs, a note on dental 
conditions in that great Empire may be opportune. In Russia dentistry 
is regarded as one of the best professions for women, who are estimated 
to constitute 90 per cent, of dental practitioners. The chief school is the 
Dental College at Petrograd, which has 600 students, less than 5 per 
cent, of whom are men. There are also large dental colleges at Moscow, 
Odessa, Kiev, and Warsaw. Before entering upon the three years' 
dental course the student is required to have matriculated. The fees 
amount to £20 per year and the State diploma costs £2, a license to 
practise being only granted on proof of qualification. The first year's 
studies are devoted to mechanical dentistry; in subsequent years the 
student does clinical work from 10 to 5, and lectures follow until 9 p.m. 
Examinations are held every month. The lecturers at Petrograd num- 
ber about twelve and come from the Imperial University Faculty of 
Medicine, while the ten demonstrators are chiefly women. For both 
medicine and dentistry fees in Russia are considerably lower than in this 
coimtry, and hours of work are also longer. Men seem to prefer to enter 
the medical profession, and it is said that even in the capital city of 
Petrograd the men dentists of standing do not number more than half- 
a-dozen. 



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60 THE DENTAL DIGEST 

[New York Medical Journal, November 27, iQisl 
REMEDIABLE DEFECTS IN SCHOOL CHILDREN 

Supplement No. 25 to the Public Health Reports for July 30, 1915, 
consists of a study of school hygiene in Manatee County, Fla., by Surgeon 
J. A. Nydegger. After describing the country, the school buildings, 
their environment, drainage, outhouses, drinking and lighting facilities, 
ventilation, etc., the writer takes up the health of the children. Apart 
from trachoma, the treatment of which requires great care and patience, 
together with the personal attention of the surgeon, the principal troubles 
found were adenoids, enlarged tonsils, defective teeth, and hookworm. 
The writer points out that the special object of his survey was to investi- 
gate communicable disease, but that other conditions were also studied, 
including ground itch, deformities of the back and limbs, defective vision 
and hearing, poor physique, dullness and backwardness, etc. 

In the 1,684 school children examined, says Surgeon Nydegger in his 
report, 426 or 26.03 P^r cent., had defective teeth, ranging from a single 
tooth to three or four or more. A condition of the teeth noted to exist 
in the children of several schools, but mostly in the town schools, was the 
loss of the enamel from a portion of the surface of one tooth or several 
teeth in one individual. In some cases the enamel was noticed to have 
disappeared from the entire biting surfaces, while in others it was de- 
stroyed elsewhere. It is believed that this condition results from the 
prolonged action of acids on the teeth, such as would be brought about 
largely by the consumption of oranges and grape fruit, extending over a 
long period. The good result of dental inspection of school children was 
well exhibited in the Sarasota schools, where it was instituted during the 
present year. In the 279 children examined at the time of the visit but 
one case of defective teeth was discovered. This is in decided contrast 
with the findings at the Palmetto schools, which showed 22 per cent, 
of the children to be suffering from defective teeth. It would have 
been interesting to have had a special note on the teeth of colored 
children. 

Two hundred and seventy-four children, or 16.2 per cent., had en- 
larged tonsils, while 164 children, or 9 per cent., had adenoids. There 
was a noticeable difference in the proportion of enlarged tonsils observed 
in school children in towns from those in the rural schools, in favor of the 
latter. The children examined in the colored schools, numbering 243, 
were noted to be particularly exempt from enlarged tonsils and adenoids. 
Two hundred and thirty- three children, or 13.24 per cent, of the total 
number examined, had adenoids. The figures show a preponderance of 
5.6 per cent, more cases in the town schools than in the county schools. 

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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 61 

In 243 children examined in the two colored schools there were 13 cases, 
or 5.3 per cent. 

We have found this report on adenoids, enlarged tonsils, and de- 
fective teeth of special interest because these conditions would never be 
met with by a medical inspector if the general intelligence of the com- 
munity was what it should be. It seems to us that the dentists and phy- 
sicians in various parts of the country should organize some sort of an 
educational campaign, having for its object the bringing of the children 
for inspection every six months or so. Oral and pharyngeal lesions have 
a direct bearing on the nutrition and growth of the child and the treat- 
ment should really be prophylactic only and begin at the time of weaning. 
Surgeon Nydegger's best impressions of his survey, however, were con- 
veyed by the joyous, laughing, romping assemblages of happy school 
children encountered at each school visited, which of itself was proof 
sufficient of generally well nourished and vigorous bodies. It was a 
real treat, he says, to mingle with these alert and vivacious young Ameri- 
cans, so intent on catching each word spoken to them. 

ACADEMIC FREEDOM 

In his annual report to the trustees of Columbia University, President 
Nicholas Murray Butler tells of numerous criticisms of public utterances 
of members of the faculty which have reached him from outside the 
university. These criticisms are, as a rule, based on incorrect or garbled 
reports of what the professor really said, or indicate a desire on the part 
of the critic to use the university as a medium for some particular propa- 
ganda. The critic usually demands the instant removal of the offending 
faculty member from the roll of the imiversity. 

In conmienting on this regrettable attitude. Professor Butler wisely 
says: "The last thing that many persons want is freedom of speech or 
of anything else unless its exercise happens to accord with their somewhat 
violent and passionate predilections." 

There is a tendency in medicine toward the same kind of criticism as 
that complained of by President Butler, and in medical publications we 
must carefully conserve freedom of speech and of views if we expect to 
make progress. We must, above all else, avoid the suppression of truth 
through the exercise of the "somewhat violent and passionate pre- 
dilections " of those who would limit the freedom of speech in medicine 
within the compass of their own narrow knowledge and sympathies. 

[Journal American Medical Association, November 13, 1915] 
THE LOCALIZATION OF STREPTOCOCCI 

The relation to infection of the affinity of bacteria for certain tissues 



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62 THB DBNTAL DIGEST 

was discussed recently in these columns.^ It was pointed out that many 
of the pathogenic bacteria in their localization manifest a special affinity 
for some particular tissue or tissues. This elective localization may be 
conceived to be due to the circumstance that the conditions for growth 
are more favorable in some tissues than in others. On account of 
differences in metabolism and chemical composition, there is no doubt 
that different tissues and places in the body present radically different 
conditions for bacterial growth and activity. It was pointed out, further, 
that the work of Forssner and especially the more recent work of Rose- 
now have established that among the streptococci, which have the power 
to invade many tissues and to cause a variety of infections, strains may 
appear which, when introduced into the blood, are found to localize by 
preference in certain tissues. It his article in this issue of The Journal^ 
Rosenow^ presents a summary of the results of his experiments of elective 
localization of streptococci obtained from a wide range of human infec- 
tions and injected intravenously into dogs and rabbits. The animals 
were killed soon after the injection, and the facts as to localization of the 
streptococci determined by systematic, careful examination of the whole 
body. Obviously this method gives a much better idea of early localiza- 
tion than can be obtained if only the animals that die are examined. 

Stated in the simplest way, the results obtained by Rosenow with his 
method show (i) that streptococci isolated from active lesions in different 
human organs and tissues, in many instances, have a pronounced affinity 
for the corresponding organs and tissues in rabbits and dogs, and (2) that 
streptococci isolated from the tonsils and pyorrheal pockets in persons 
with active streptococcal infection in the interior of the body may have 
the same sort of affinities as the streptococci from the internal lesions. 
In the light of these results, many of which are striking indeed, as may be 
seen at a glance from the table in Rosenow*s article, human strepto- 
coccus infections acquire new interest because a road now opens to a 
better understanding of their genesis and of the difficulties of curing them 
by the specific means now in use. Obviously a chief danger from chronic 
foci in which streptococci are present, of which those in the tonsils and 
about the teeth appear to be the most important because the most com- 
mon, seems to depend on the fact that in such foci, even when quiescent, 
streptococci may get into biochemical conditions which fit them for in- 
vasion of the blood, to be followed by localization in some tissues rather 
than in others. Persons going about with chronic, more or less latent 

'The Relation of Selective Tissue Affinity to Infection, editorial, The Journal A. M. A., 
Sept. 26, 1915, p. 1 1 14. 

*Rosenow, E. C: Elective Localization of Streptococci, The Journal A. M, ^4., this 
issue, p. 1687. 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 63 

fod of this character, consequently, are not only dangerous to themselves 
in that what one may call internal streptococcal metastasis may occur at 
any time, but they are also undoubtedly dangerous to others because 
they scatter about them streptococci of specialized pathogenic possi- 
bilities. Hence the efforts now made to detect and then to obliterate 
all forms of focal infection in the mouth and throat as well as elsewhere 
in the body, for preventive as well as curative purposes, besides being in 
accord with sound reasoning from general principles, here receive the 
support also of strong experimental evidence. When we consider the 
wide range of action of pathogenic streptococci, the great variety of 
disease due to their localizations in different tissues according to what 
Rosenow's work indicates are states of special "elective aflBmities," no 
effort should be spared that in any way will tend to reduce the supply of 
such streptococci and lessen the chance of infection. 

PYORRHEA DUE TO ORGANISMS OTHER THAN THE AMEBAS 
By George Howard Hoxie, A.M., M.D., Kansas City, Mo. 

Since the publication of the work of Bass and Johns on pyorrhea, 
there has seemed to be a tendency among dentists and many medical 
men to administer emetin in all cases of dental infections without estab- 
lishing the presence of the endameba. That the endameba is not the 
cause of all cases diagnosed as pyorrhea by competent dentists is shown 
by this following summary of a case treated by this author. 

W2 have to do with a recurrent fever of about seventeen days' dura- 
tion. The focus has been the alveolar processes and the mucosa of the 
mouth, from which the body has been invaded. The particular parts, 
aside from the mouth, which have shown evidences of infection, have 
been the left knee (bursitis) and the anal fold (abscesses). The length 
of the attacks has varied from three to ten days. The organisms most 
constantly found have been a diplo-streptococcus and a mold. The 
disease has proved resistant to arsenic (salvarsan, arsacetin and the tri- 
oxid), the salicylates and other systemic and local germicides, as well as 
to vaccines, both autogenous and stock, single, as well as mixed. 

The question of great interest is whether we have to do with an 
organism showing a cycle of from fourteen to seventeen days, or whether 
it is a case of temporary immunity. Repeated examinations have failed 
to reveal any amebas. Animal inoculation was negative. 

To me it would appear that the causative organism is one which is 
ordinarily nonpathogenic, but which has acquired parasitic power in the 
tissues of this patient. 

It is perhaps needless to say that all the conventional drugs have been 
used at one time or another by the various physicians who have treated 



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64 THE DBNTAL DIGEST 

the patient. The dentists employed have been the best in the dty. The 
case was worked up from the dermatologic standpoint by Dr. R. L. Sut- 
ton, and published under the caption ''Periadenitis Mucosa Necrotica 
Recurrens." The diagnosis of pyorrhea was given by all the dental 
attendants, including Dr. Frederick Hecker, the author of a monograph 
on that subject. 
1334 RiALTO Building. 

[Deuisches Archiv. fur Klinische Medizin, Leipsig, July 20] 
MECHANISM OF INJURY FROM GETTING CHILLED 

Auf recht presents an imposing array of testimony culled from old and 
modem writers to reaffirm the important part played by getting chilled 
in the genesis of various diseases and morbid processes. He then reports 
various experiments on rabbits, all of which confirms his assumption 
that the chilling causes coagulation of fibrin in the blood stream in the 
part chilled. The cause of the coagulation is the injury done to the 
white corpuscles by the cold. The coagulation obstructs the flow through 
the peripheral vessels involved and the blood is liable to back up into the 
liver, kidneys, and gastric mucosa. The most striking changes were 
found in the lungs, the coagulation of fibrin entailing microscopic hem- 
orrhage into the interstitial tissue. This occurred in a pronounced form 
when the hind part of the rabbit was thrice dipped into ice water for ten 
minutes. The blood chilled in this way passes in the directest way to the 
arterial circulation in the lungs. The obstruction of vessels by the coagu- 
lated fibrin after chilling may be transitory and harmless, but, on the other 
hand, it may provide a culture medium for germs and explain pneu- 
monia developing after exposure to cold. The hyperemia in the internal 
organs may also cooperate in the disturbances following chilling. 

[Journal American Medical Association, November 20, 191 5] 

[Berliner Klinische Wochenschrift, October 11] 
CANCER OF THE MOUTH AND RADIUM TREATMENT 

Sticker reports fifteen cases in most of which malignant disease of 
the mouth retrogressed under radium treatment without scars or mutila- 
tion. The list includes some cases of recurrence after operations. He 
declares further that radiotherapy is preferable to surgical treatment in 
many cases for technical reasons and also from the standpoint of im- 
munity. This statement is based on experimental research which demon- 
strated that it is possible to induce an implantation tumor on laboratory 



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AN EPITOMB OF CURRENT DENTAL AND MEDICAL LITERATURE 65 

animals in various different organs and points, inoculated all at the same 
time, but that, after having been once successfully inoculated, it is 
impossible to induce further growths by later implantation of tumor cells 
at any point. After complete excision of the implantation tumor, how- 
ever, a new implant "takes" at any and every point inoculated all at the 
same time. On the other hand, if the implantation tumor was only 
partly excised and it continued to grow, subsequent implantations gave 
constantly negative results. These experimental data correspond to what 
is observed in the clinic during the period preceding metastasis. The 
cancer long remains solitary, and, especially with cancer in mucous mem- 
branes, notwithstanding the constant opportunities for implantation of 
tumor cells farther along, the mucosa beyond is generally free from 
metastases, even with extensive ulceration. After vaginal hysterectomy 
for cancer of the uterus, he continues, recurrence in the vagina is not 
uncommon, while metastases in the vagina, with the uterine cancer still 
present, are extremely rare. 

These and similar data cited are alleged to explain why radiotherapy is 
more promising in certain cases than surgical removal of the focus. 
Under the radiotherapy, the cancer cells being gradually destroyed and 
passing into the circulation, cause a lively production of antibodies, and 
these protecting substances combat the growth of any new cancer cells. 
The antibodies thus generated are similar in nature to the autolysates of 
cancer cells which some are using now in treatment of cancer. None of 
the experiences in this line reported to date, however, make the distinc- 
tion which he emphasizes between the periods before and during meta- 
stasis. The nonheeding of this fundamental distinction readily explains 
the unsatisfactory results to date. It is by no means immaterial whether 
the tumor autolysates are taken from the body while it is still engaged in 
producing antibodies, that is, during the premetastasis stage, or whether 
the material is not taken until after the body has lost its capacity for 
antibody production. 

He describes his fifteen cases in detail; in three the cancer was on the 
tongue and the radium induced a clinical cure. In one case, only seven 
twelve-hour exposures, all at night, accomplished the purpose, the cancer- 
ous crater healing completely in a few weeks. In seven cases the cancer 
was in the lower jaw and in five others in the upper jaw. The radium was 
fastened in a plate made to fit over the upper or lower teeth. One patient 
wore this for thirty nights' exposures, and it did not interfere with his 
sleep. In two other cases the cancer was a recurrence after one or several 
operations. By modifying the tooth-plate-holder it was possible to 
apply the rays in various directions thus facilitating the cure. 



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Simplex Hand Book of Dental Materia Medica and Therapeutics. 
By Alfred and Wesley Barrett. Oblong i6mo. 350 pages. 
Price, $1.75 net. Publisher, Peter Reilly, Philadelphia, Pa. 

A simple, tabulated classification of Drugs and Remedies used in 
Dental Operations and the Treatment of Dental Diseases; specially 
adapted to the requirements of students and busy practitioners. 

A great mass of facts are brought together in alphabetical order 
which will be appreciated and save valuable time in making reference. 

The authors have spared no pains in endeavoring to make this the 
best work of its kind. 



BOOKS RECEIVED 

Carnegie Endowment for International Peace, Division of Inter- 
course and Education, Publication No. 7. For Better Relations 
With Our Latin American Neighbors. A Journey to South 
America. By Robert Bacon, Washington, D. C. 

Carnegie Endowment for International Peace, Founded Decem- 
ber 14, 1910. Year Book for 19JS, Washington, D. C. 



DR. DWIGHT TRACY 

Dr. Dwight Tracy died November 7, 191 5. He was well known in 
New York City and was most successful in his profession. 
Dr. Tracy leaves a son who is also a dentist of note. 

A. STILL WELL 

Mr. A. Stillwell, a valued employee of The Temple-Pattison Co., Ltd., 
Ont., Canada, died Friday November 26th, 191 5 after a very painful 
illness. 

He was a man who took a great interest in the welfare of the dentist, 
and was the oldest dental salesman in the Dominion of Canada. He 
was connected with the old firm of the S. B. Chandler Co., over 28 
years ago, and ever since that time he has been identified with the den- 
tal supply business. The Temple-Pattison Company deeply feel his loss, 
as must, also, his numerous friends. 



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SOCIETY NOTES 67 

SOCIETY NOTES 

District of Columbia. 

The next examination of applicants for license to practise in the District of Columbia, will 
be held at the George Washington University, Washington, January 3-6, 191 6. Appli- 
cations should be in the hands of the secretary two weeks before the date of the examina- 
tion. Fee $10— Stakr Parsons, 1309 L Street, N. W., Washington, Secretary. 

Minnesota. 

The thirty-third annual convention of the Minnesota State Dental Association will be 
held at the University of Minnesota, in Minneapolis, February 11-12, 1916. — Max 
E. EiiNST, 614 Lowry Bldg., St. Paul, Minn., Secretary. 

The annual meeting of the American Institute of Dental Teachers will be held at 
Hotel Radisson, Minneapolis, January 25, 26, and 27, 1916. — ^J. F. Biddle, Secretary, 

Missouri. 

The next meeting of the Washington University Dental Alumni Association will be held 
at the University Dental School, February 21-22, 1916. — H. M. Fisher, Metropolitan 
Bldg., St. Louis, Mo., Secretary. 

North Carolina. 

The next meeting of the North Carolina State Board of Dental Examiners will be held 
at Salisbury, N. C, begiiming promptly at 9.00 o'clock on Thursday, January 13, 191 6. 
For further information and application blanks address the Secretary, F. L. Hunt, Ashe- 
ville, N. C. 

North Dakota 

The next meeting of the North Dakota State Board of Dental Examiners will be held 
at Fargo, N. Dak., January 11, 1916. For further information address, W. E. Hock- 
ing, Devil's Lake, N. D. 

South Dakota. 

The South Dakota State Board of Dental Examiners will hold its next meeting at Sioux 
Falls, So. Dak., January 11, 1916, at 9 a.m. sharp, continuing three days. All appli- 
cations must be in the hands of the Secretary by January ist. Fee $25. Aris L. 
Revell, Lead, So. Dak., Secretary. 

Wisconsin. 

The next meeting of the Wisconsin State Dental Society will be held in Wausau, Wis., 
July 11-13, 1916. — ^Theo. L. Gilbertson, Secretary. 



FUTURE EVENTS 



January 3-6, 19 16. — Board of Dental Examiners for the District of Columbia, George Wash- 
ington University, Washington. — Starr Parsons, 1309 L Street, N. W., Secretary. 

January 11, 1916. — South Dakota State Board of Dental Examiners, Sioux Falls, So. Dak. — 
Aris L. Revell, Lead, S. D., Secretary. 

January 10-13, 1916. — Montana State Board Dental Examiners. — G. A. Chevigney, Secre- 
tary. 

January 11, 1916. — North Dakota State Board of Dental Examiners, Fargo, N. Dakota. — 
W. E. Hocking, Devils Lake, N. D., Secretary. 



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68 THE DENTAL DIGEST 

January 13, 1916. — ^North Carolina State Board of Dental Examiners, Salisbury, N. C. — 

F. L. Hunt, Asheville, N. C, Secreiary, 
January 25-27, 1916. — American Institute of Dental Teachers, Minneapolis, Minn. — ^J. F. 

BiDDLE, Secretary-Treasurer, 
January 28-29, 1916. — Annual Clinic of the Chicago Dental Society, Hotel La Salle, Chicago, 

lU. — Percy B. D. Idler, 30 No. Michigan Ave., Secretary. 
February 11-12, 1916. — ^The thirty-third Annual Meeting of the Minnesota State Dental 

Association, at the University of Minnesota, Minneapolis. — Max E. Ernst, 614 Lowr>' 

Bldg., St. Paul, Minn., Secretary. 
February 16-18, 1916. — ^The tenth annual clinic, Manufacturers' and Dealers' Exhibit of the 

Marquette University Dental Alumni Association, Milwaukee Auditorium, Milwaukee, 

Wis. — V. A. Smith, Secretary. 
February 21-22, 19 16. — Golden Jubilee of the Washington University Dental School, at the 

Dental School, 29th and Locust Sts., St., Louis Mo.— H. M. Fisher, Metropolitan Bldg., 

Secretary. 
February 23-24, 1916. — Central Pennsylvania Dental Society, Johnstown, Pa. — Chairman 

Exhibit Committee, C. A. Matthews. 
March 20-26, 19 16. — ^The Tri-State Post Graduate Dental Meeting (Missouri, Kansas, Okla- 
homa), Kansas City, Mo. — C. L. Lawrence, Enid, Okla., Secretary. 
April 4-7, 1916. — Dental Manufacturers' Club, Chicago, 111. Meeting in the Banquet 

Hall, Auditorium Hotel. — Chairman Exhibit Committee^ A. C. Clark, Grand Crossing, 

Chicago. 
April 14-16, 1916. — ^West Vii^inia State Dental Association, Kanawha Hotel, Charleston. 
May, 1916. — Indiana State Dental Association, Claypool Hotel, Indianapolis, Ind. — A. R. 

Ross, Secreiary. 
May 2-4, 1916. — Iowa State Dental Society, Des Moines, la. H. A. Elmquist, Des 

Moines, la., Chairman of Exhibit. 
June, 191 6. — Florida State Dental Society, Orlando, Fla. — M. C. Izlar, Corres. Secy. 
July 11-13, 19 16. — ^Wbconsin State Dental Society Meeting, Wausau, Wis. — ^Theo. L. Gil- 

bertson. Secretary. 
October, 18-20, 1916. — Viiginia State Dental Association, Richmond, Va. — C. B. Gifford, 

Norfolk, Va., Corresponding Secretary. 



IMPORTANT POSTPONEMENT 

The meeting of the National Association of Dental Faculties which was to have been held 
in Minneapolis, January 28r-29, 1916, has been postponed to meet in Louisville in July, 1916. 
The exact dates will be announced later. 

B. Holly Smith, Chairman Ex. Com. 
N. A. D. F. 



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The Dental Digest 

GEORGE WOOD GLAPP, D.D.S., Editor 

Published monthly by The Dentists' Supply Company, Candler Bldg., 
Times Square, 220 West 42d Street, New York, U. S. A., to whom all com- 
munications relative to subscriptions, advertising, etc., should be addressed. 

Subscription price, including postage, $1.00 per year to all parts of the 
United States, Philippines, Guam, Cuba, Porto Rico, Mexico and Hawaiian 
Islands. To Canada, $1.40. To all other countries, $1.75. 

Articles intended for publication and correspondence regarding the same 
should be addressed Editor Dental Digest, Candler Bldg., Times Square, 
220 West 42d Street, New York, N. Y. 

The editor and publishers are not responsible for the views of authors ex- 
pressed in these pages. 

Entered as Second Class Matter, at the Post-Office at New York City. 
Under the Act of Congress, March 3, 1879. 



Vol. XXI 1 



FEBRUARY, 1916 



No. 2 




TICLE3 



EXPERIMENTS TO DETERMINE THE 
TOXICITY OF THERAPEUTIC AGENTS 
IN THE TREATMENT OF PYORRHEA 
ON ANIMAL CELLS GROWN IN VITRO 

By W. F. Spies, D.D.S., New York 

In the therapeutic treatment of all infectious conditions and of in- 
flammations, the objects sought are threefold; first, to reduce the power 
of the attacking micro-organism, at least to the point of harmlessness; 
second, to accomplish the object with the minimum of irritation or dis- 
turbance of local tissue cells; third, to restore normal circulation of the 
blood and lymph. 

In previous investigations to determine the efficiency of any particular 
preparation or method of treatment of such conditions, only one or two 
of the objects enumerated have usually been considered. Estimations 
of the germicidal efficiency of therapeutic agents have been frequently 
made and recommendations for use have been based upon them, without 
sufficient thought of the effect of such agents upon the tissue cells. 

There have been no satisfactory laboratory methods for determining 
the effects of germicides and antiseptics upon living tissues, and of re- 
cording the effects so that they may be available to all. It is apparent 
that the minute tissue effects of the substances employed as antiseptics 



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70 THE DENTAL DIGEST 

or germicides should be determined by exact laboratory methods rather 
than the unorganized, individual observation upon which we have 
heretofore depended. 

With the successful growth of animal tissue cells outside of the body, 
there came opportunities for testing the germicidal efficiency and tissue 
toxicity of various therapeutic agents used in the treatment of human in- 
fections. Before entering into a detailed consideration of the experi- 
ments in toxicity, it may be interesting to review briefly the application 
of the principles mentioned in the first paragraph to the treatment of 
pyorrhea. 

Pyorrhea is inflammation of the tissues surrounding the roots of the 
teeth. In treating this condition, the therapeutic agents which have the 
highest germicidal efficiency with minimum toxic or tissue destroying 
properties should be selected. It is, of course, most desirable to destroy 
or render ineffective the pathogenic or pus-producing bacteria or other 
micro-organisms which may be present in a pyorrhea pocket. On the 
other hand, it is important that the indolent cells lining a pyorrhea pKDckct 
shall be so stimulated that they will promptly resume their normal 
activities. The use of powerful irritants defeats this purpose rather than 
aids it. The effect of such agents is to destroy the inflamed cells lining 
the pocket, to increase the area of inflammation and to retard the process 
of repair. 

HISTORICAL 

The later researches on the cultivation of tissue cells outside the body 
were developments from the original studies by Roux on surviving cells 
when isolated from the animal organism. It was here that the need for 
study of cell activities brought about efforts toward the prolongation of 
their life. A similar need led Harrison to further develop the method to 
the end that proofs of the origin of nerve fibres might be obtained. Com- 
plete isolation of the growing nerve from other tissue cells was a pre- 
requisite. 

The necessity for supplying nutrient material to the cells during 
growth brought about the utilization of various forms of lymph and 
blood plasma in the artificial cell cultures. It might be said that the 
present methods are largely based upon the work done by Dr. M. T. Bur- 
rows, in the Sheffield Biological Laboratory in Yale, 1910. In later re- 
searches, fresh, unclotted blood plasma served as a nutrient fluid for the 
cell cultures. 

With the greater improvement in details of the technique made by 
Carrel and Burrows, there came the final procedure, which has had a wide 
application in attempts to solve a variety of problems. Thus, the meth- 
ods of tissue cell cultures have been easily adapted to the study of an- 



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TOXICITY OF THERAPEUTIC AGENTS IN PYORRHEA 71 

atomical, pathological and physiological problems. Carrel has applied 
it to the solution of problems in surgery and for estimating the various 
methods of preserving tissues. Lambert and Hanes have used it for the 
study of cytotoxins, while Murphy has made excellent use of the process 
in efforts to solve problems in immunity in tumor growth. 

It remained for those who have undertaken the investigations about 
to be reported, to apply this procedure to the problems of determining 
the relative toxicity of germicidal and antiseptic agents upon tissue cell 
cultures. Prior to these studies, the only available laboratory procedures 
for the determination of. toxicity of such products consisted in the sub- 
cutaneous injections of dilutions of them into animals, particularly white 
mice, the end reaction being the death or survival of the animal. This 
latter procedure constituted a more or less satisfactory process for deter- 
mining the massive toxic doses of the agent or preparation in question. 
The results, however, constituted no satisfactory indication of the actual 
toxicity of any degree of dilution. Nor could the effects upon in- 
dividual cells or small groups of cells be measured. It is obvious that the 
results of tests with massive doses would be entirely inappropriate for the 
determination of the finer degrees of toxic action against small groups of 
tissue cells, such as would be affected in the application of any therapeutic 
agent in the treatment of pyorrhea. 

In the development of the method of testing tissue cell toxicity by the 
use of cell cultures, much time was spent in preliminary investigations. 
From these investigations, a procedure which gave reasonably satisfactory 
results was finally determined. The following is a description of the 
technique of that method. 

TECHNIQUE 

The medium for growing the tissue was obtained in the following way. 
The blood was collected from the jugular vein of a chicken by means of a 
sterilized cannula which had been previously immersed in olive oil. The 
blood was allowed to flow into a sterile thin glass test tube. Small pieces 
of ice were put around the base of the test tube on the dissecting table, so 
as to chill the blood immediately and prevent coagulation. When about 
half full, the tube was put in a dish of ice. About eight test tubes of 
blood were collected each time. As soon as possible these test tubes were 
packed in ice in a centrifuge tube and centrifuged for five minutes at 2,700 
revolutions per minute. The clear plasma was then drawn off with a 
pipette and put in another small sterile test tube and the tube corked. 
These corked tubes were kept on ice until ready for use. Plasma kept 
in this way was found to produce good growth even when it was a month 
old. 



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72 TH£ DBNTAL DIGEST 

In these tests, two parts of plasma were diluted with one part of 
Ringer's solution* and a drop of this medium was put on a cover slip with 
a piece of tissue and coagulation took place in a very short time. A hol- 
low ground slide ringed with vaseline was then inverted over the cover 
slip. The cover slip was sealed to the slide with hot paraffin. The slides 
were kept in an incubator at 39° C. 

The tissue for these tests was obtained from chick embryos 10-15 
days old. The tissue was cut up into very small pieces under a magnify- 
ing lense. Sterile black paraffin in Petri dishes was found to give a better 
cutting surface than glass. 

Portions of this finely divided tissue were transferred on the blade of 
the scalpel to sterile watch glasses containing i cc. of sterile Ringer's 
solution. These watch glasses were contained in sterile Petri dishes as a 
protection. 

The substances to be tested were tincture of iodine (U. S. Ph.) and 
dentinol. These were diluted with Ringer's solution in the proportion 
of I of dentinol or iodine to 49 of Ringer's solution written as follows: 
I — 50, and in i — 100, i — 200, i — 400. The addition of i cc. of the dilu- 
tion to I cc. of Ringer's solution containing the tissue gave the required 
dilutions. The tissue obtained from the chick embryos was exposed to 
the test substance for five minutes. It was then transferred by means of 
a pipette to another Petri dish containing 15 cc. of Ringer's solution to 
wash the tissue. These Petri dishes were then placed in the incubator 
until ready for planting. All these operations were done in a warm room 
and the solutions coming in contact with the tissue were warmed to 
prevent chilling it. Also all preparations for the test were made before- 
hand, so as to have the time elapsing between the cutting up of the tissue 
and the planting and placing in the incubator as short as possible. 

RESULTS OF A REPRESENTATIVE TEST 

The material tested and the results of a representative test are given 
in the table below and show the growth or non-growth of the tissue in the 
different dilutions on five minutes' exposure. 

— No growth 
-h Growth 
Dentinol 5 Minutes* Exposure 

Specimen 
No. I Xo. 2 No. 3 

1-50 + + + 

I— 100 + + + 

1—200 -h -\- -f 

1—400 -f -I- -f- 

*Ringer's Solution is Sodium Chloride 0.7%, Calcium Chloride 0.025%, Potassium Chlor- 
ide 0.03%, Distilled Water 



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TO PREVENT MODEL FROM BREAKING 73 

TmcTURE OF Iodine (U. S. Ph.) 5 Minutes' Exposure 

Specimen 
No. I No. 2 No. 3 

1—50 + "~ ~ 

I — 100 — + — 

I — 200 + + — 

1—400 -f + + 

CONTROL 

Tissue not treated + -f + 

The results indicate that under these conditions, a dilution of den- 
tinol I in 50, is as free from toxic action as a dilution of iodine i in 400. 

SUMMARY 

A study of the literature on tissue cultivation and the results of the 
foregoing tests bring out several very important points: 

1. The primary object in growing tissue outside of the animal body 
is that it may be microscopically observed in the living condition. 

2. Interesting observations on cell division and many other problems 
are better studied by using the method of tissue cultivation. 

3. The culture methods offer a promising means for the study of the 
response of cells to directive stimuli. 

4. That wound healing could be imitated in culture. 

5. A satisfactory method has been developed for the comparative 
estimation of the toxic effects of antiseptic and germicidal agents upon 
tissue cells by the use of the cell culture method. 

6. In the treatment of pyorrhea the therapeutic agents which have 
the highest germicidal efficiency with minimum toxic or tissue destroying 
prof)erties should be selected. 

BIBLIOGRAPHY 

1. Roux — Virchow's Archiv. Bd. 114 — 1888. 

2. Harrison — ^Trans. Cong, of Am. P. & S., Vol. IX, 1913. 

3. Burrows — ^Trans. Cong, of Am. P. & S., Vol. IX, 1913. 

4. Carrel and Burrows — ^Joum. Exp. Med., 191 1 — xiii. 

5. Carrel and Burrows — Joum. Exp. Med., 1911 — xiv. 

6. Carrel— Joum. Exp. Med.— Vol. XVIII— 1913. 

7. Burrows — ^Joum. Am. Med. Ass*n., 1910 — Iv. 

8. Carrel — ^Joum. Am. Med. Ass'n., 191 2 — lix. 

9. Lambert and Hanes — Joum. Exp. Med., 1911 — xiv. 
10. Murphy — ^Journ. Am. Med. Ass*n., 19 13 — xvii. 



TO PREVENT MODEL FROM BREAKING 

Most plate makers, occasionally break model of lower case, at 
angle, in separating flask preparatory to removing wax. This will be 
avoided by prying flask apart in front (at toe) instead of in the back 
(or heel). The action is like a hinge and naturally unhooks model. 

Will S. Kelly, D.D.S., Wilkes-Barre, Pa. 



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74 TH£ DENTAL DIGEST 

CLOSED MOUTH IMPRESSIONS* 

By Samuel G. Supplee, New York, N. Y. 
second paper 

diagnosis of the conditions in the mouth 

It is very important to diagnose conditions in the mouth very care- 
fully before starting to take your impression, for facts gained in this 
examination will be of great value to you in fitting your tray, taking the 
bite and finishing the plate as well as allowing for the settling of the 
denture. 

In view of the fact that it is desirable to retain the upper denture 
principally by means of adhesion by contact, it naturally follows that the 
larger the area covered by the plate, the greater will be the retentive 
power. The smaller the mouth, the more difficult it is to secure the 
desired retention. 

THE AREA OF THE PLATE 

In examining the mouth it is important that we shall plan to make 
the plate cover as much area as the existing conditions will permit. 
This applies particularly to the length of the plate, antero-posterially. 
When the ridge is hard in front, the plate can extend to the edge of the 
vibrating portion of the soft palate. 

When the ridge is soft in front, it must extend beyond the hard palate 
far enough so that the edge of the plate may press upon the soft palate 
and embed itself sufficiently to compensate for the amount the soft ridge 
will give when pressure is brought to bear on the front teeth. 

By the old method of plate work, we should be limited in extending a 
plate back as far as desirable owing to nausea, but by observing the 
principles outlined this difficulty is eliminated. 

POINTS FOR DIAGNOSIS 

Every mouth should be examined in the following respects: 
The character and extent of soft and hard tissues overlying the hard 
palate. Several pounds' pressure should be exerted with the tip of the 
finger to disclose any hard bone hidden under the mucous membrane, 
that proper relief can be placed on the model to allow for the settling of 
the denture. It is surprising how many hundred plates are failures due 
to lack of the proper relief in the median line which Dr. Haskell called 
particular attention to many years ago. 



*This article began in the January 191 6 issue. 



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CLOSED MOUTH IMPRESSIONS 



75 



Where the vibrating portion of the soft palate begins. 

The character and extent of soft tissue if in the region of the ridges. 

The location and strength of the muscular attachments on the buccal 
and labial border of the upper ridge and both sides of the lower ridge. 

The space between the tuberosities of the upper ridge and the coronoid 
process and rami when the mouth is opened and closed. 

METHODS OF DIAGNOSIS 

Examinations should be made with the index finger with the mouth 
open and closed. 

All unusual conditions should be recorded on a chart. They will aid 
in making the dentures or in satisfying the patient. 

The chart used at the Gysi school of articulation is reproduced on 
this page. It foUows very closely Dr. McLeran's design. 





Chart for Arti6cial Dentures (After that compiled by Dr. McLeran, Omaha, Neb.) 

In making this diagnosis it is advisable never to look into the mouth 
until you have made a careful examination with the index finger wh^e 
having the patient open and close a number of times. By using the 
point of the finger as a measuring instrument, you are able to get a very 
complete idea of the possible height of the rim of the proposed plate. 

By using heavy pressure with the index finger, you can determine the 
depth and area of the movable tissue overlying the rear half of the hard 
palate, and the conditions of the ridge in the region of the eight front 



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76 THE DENTAL DIGEST 

teeth. This should guide you as to the length of the plate antero- 
posterially. 

The knowledge of these conditions will be of great value to you in 
case you should have trouble in securing the desired results. 

HIGH AND LOW RIMS 

The height of the rim will be determined by the range of movements of 
the attachments when the mouth is open and closed. If the action is 
short and strong, your rim should be low. If long and weak, your rim 
should be high. 

VULCANITE AND METAL PLATES 

If the entire vault and ridges are extremely hard and flat and the 
muscles attached close to the crest of the ridge, it is advisable to make a 
rubber plate for the patient to wear at least a year or so until the action 
of rubber causes the tissues to become softer, at which time a metal plate 
can be made with better results. 

If the mouth has a tendency to soft ridges and an excess amount of 
soft tissue in the vault, it is wise to advise the patient to have a metal 
plate. 

A temporary gold lined plate should be made for the patient to wear 
for a year to partially reduce the inflammation before making the metal 
plate. 

If the patient is limited in means, very good results can be secured by 
refitting the old rubber plate and lining it with foil gold as a temporary 
plate for six months, to reduce the inflammation before making a gold or 
metal plate. 

If the old rubber plate fits fairly well, place a gold lining in it without 
changing, as the shrinkage of the rubber plus the thickness of the lining 
will improve the fit sufficiently to last till the inflammation from the 
rubber is materially reduced before making a metal plate. 

It is very unfortunate that so few dentists spend the necessary time 
to induce the patients to have metal plates. 

From general observation the one great reason for this has been that 
they could not be so sure of securing a well-fi.tting denture. 

There are three principal causes for this existing condition: 

First, so little attention has been given to essentials of an impression 
that comparatively few plates would be a success were it not for the fact 
that the inflammation created by the rubber in contact with the tissue 
will compensate for the deficiencies. 

Second, most metal plates are made for patients after they have been 
wearing either a temporary rubber plate, or because the mouth has been 
inflamed by wearing a rubber plate too long. 



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CLOSED MOUTH IMPRESSIONS 77 

If a well fitting gold plate is placed in a mouth of this kind, it is only 
a short time when the inflammation is materially reduced and the plate 
does not fit. 

As the gold plates have been made from the same imperfect impres- 
sions as rubber, and the fit was no better to start with, they certainly 
have a decided disadvantage as they have a tendency to reduce inflamma- 
tion rather than to cause it. 

Third, most gold plates have been swaged of metal heavier than 28 
gauge and it is very difiicult to make this material conform to the minute 
details of the model. 

There are many ways in which these difficulties can be overcome, and 
they will be outlined more fully in a, chapter on metal plates. 

There are recent improvements by which we can cast and condense 
an aluminum plate from an artificial stone model and then eliminate the 
contraction by using a putty or shot swage to drive it to an accurate fit 
and incidentally further condense the metal. 

The triple refined aluminum which can now be secured has prac- 
tically eliminated all the former troubles of distintegration. 

In this way we are able to eliminate many of the difficulties due to 
the expansion and shrinkage of rubber and make a cheap durable plate 
which on the whole is far superior to rubber. 

HISTORY OF THE CASE 

It is well to go into the history of the case in hand before promising 
the patient quick and positive results, for the question of muscle strain 
and muscular development will play a prominent part in view of the 
fact that we are going to use the muscles indirectly to hold our plates in 
their proper position. 

GRADUAL DEVELOPMENTS 

If the patient has been masticating for a number of years on a few 
miscellaneous teeth with the jaw abnormally closed, or masticating on 
one side only, or gone without teeth entirely, we cannot expect to open 
the bite and place the jaws in their correct position and expect them 
to be fully efficient and remain in the same corelation after the muscles 
have been fully developed in their new position. 

This development should be accomplished in stages if we are to 
expect to pve our patient the comfortable use of the plates during the 
development period. I shall attempt to deal with this subject in the 
chapter on ** Muscle and Tissue Development." 

The ignorance of this subject has been the cause of considerable loss 
in the average dental practice, as many dentists have made two or more 
sets of plates for patients, carrying them through this development stage 



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78 THE DEHTAL DIGEST 

without knowing it, before securing permanent results, yet have received 
only one fee and have wound up with a dissatisfied patient, complaining 
because the plates were not made right the first time. 

If conditions had been properly understood, arrangements could have 
been made for the patient to have comfort during the development stage, 
and pay for the dentures necessary to accomplish the desired results. 
This article is expected to be continued. 



SHORTAGE OF DENTAL PRACTITIONERS 

The institution of a diploma in dental surgery took place compara- 
tively recently in this country. The result is that the number of qualified 
dentists is far short of the requirements of the population, and that a large 
number of unqualified men practice. They are not prevented from doing 
this, but they must not call themselves dentists. This is a very small 
drawback, as they can exhibit sets of teeth and call themselves "tooth 
specialists." At a meeting of the General Medical Council, Mr. Tomes, 
chairman of the Dental Education and Examination Committee, sub- 
mitted a report on the shortage of dentists. Communications had been 
made with the various licensing bodies for the possibility or curtailment 
of the curriculum without lowering the standard of dental practice. 
Some of the bodies questioned the existence of any shortage, pointing out 
that many qualified men are not fully occupied, the public being uncon- 
vinced of their advantage over the unqualified. Attention was also 
drawn to the lowering of the social status which arose from the intrusion 
of great numbers of unqualified persons, and to the fact that business 
men who had acquainted themselves with the existing state of things 
often considered that from a business point of view qualification was 
worthless or even a hindrance, and so did not put their sons at dental 
schools. The Incorporated Dental Hospital of Ireland alone considered 
the possibility that the simpler dental requirements sought by the poorer 
classes might perhaps be met by a lower grade of practitioner, though 
this was also suggested in one of several letters sent by private prac- 
titioners. The main conclusion was that no appreciable increase in the 
members of the dental profession can be looked for until the law gives 
further protection to the qualified man against the unqualified. A very 
insidious form of deception was pointed out. An unqualified man dare 
not put on his plate "dental surgeon," as this would render him liable to 
prosecution. This is avoided by putting beneath his name "dental 
surgery," which can be done with impunity.— /t^ttrwa/ American 
Medical Association, 



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WESTERN ATTITUDE TO ANATOMICAL ARTICULATION 70 

A TRIP REGISTERING THE WESTERN ATTITUDE TO 
ANATOMICAL ARTICULATION 

By Dayton Dunbar Cabipbell, D.D.S., Kansas City, Mo. 

While in Kansas City conducting a class in Conductive Anesthesia, 
Dr. Arthur E. Smith of Cleveland suggested the trip. Having learned 
that I was to be one of the essayists of the Montana State Dental Asso- 
ciation in July and that I planned to be at the Panama-Pacific Dental 
Congress in September, he said, "why not teach the Gysi method of 
Anatomical Articulation during the interval?" 

Acting upon this suggestion, a small, strong, trunk was packed with 
dental materials, and appurtenances not readily found in every city, 
Gysi Adaptable Articulator, a steropticon, Spencers Plaster Compound, 
SoreFs Cement, pure aluminum ingots, nearly two hundred and fifty 
lantern slides, etc. 

At the meeting in Helena I constructed a full upper and lower set 
of dentures upon vulcanite bases for one of the oldest members of the 
Montana State Association. The Gysi Adaptable Articulator and 
Trubyte teeth were used. Trubyte teeth were employed in every case 
throughout the trip. 

The following Monday found me in Spokane, Wash., where I brought 
to Mr. R. A. Monro's attention some of the results of my efforts in 
Anatomical Articulation (I carried exhibits on four Simplex Articulators). 

Dr. Munro's interest secured an audience of about fifty dentists that 
Monday evening. The lantern lecture, the clinical material, and a free 
and informal discussion, made possible a very pleasant evening. At the 
close of the session, an opportunity was afforded those interested to 
join a class in Anatomical Articulation. 

On account of such brief notice, many who expressed a desire to join 
these classes, were unable to arrange their professional engagements, so 
as to avail themselves of the opportunity. 

It might be well to interpolate here that the writer was not idle while 
the classes were not in session. The most enjoyable part of my trip 
was spent in the various oflSces of these men assisting with difficult cases. 
Dr. R. I. Vandewall, of Seattle and Dr. Leland D. Jones of San Diego 
each had a case in which the patient presented a mouth with soft flabby 
ridges in the region extending from I'.uspid to bicuspid. This tissue 
was injected with a local anesthetic and \ :*.th a pair of heavy gum scissors, 
cut away bodily. Such treatment leaves the part, after a period of two 
of two or three weeks, in a condition to receive a denture that will be 
permanent and eminently satisfactory. 



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80 THE DENTAL DIGEST 

Dr. Francis R. Fisk secured a large, well lighted room in the Old 
National Bank Building where we met every afternoon for four days. 
Two full upper and lower sets of dentures were made for different pa- 
tients, one upon the Gysi Adaptable Articulator and the other upon the 
Gysi Simplex using the face bow, by the double vulcanization process; 
the other, a cast aluminum base for the upper and lower vulcanite. The 
evening of July 26th was spent before a called meeting of the Seattle 
Dental Society. Here we had the pleasure of renewing our acquaintance 
with Dr. C. J. Stansbery and that of meeting Dr. Frank W. Hergert 
who were members of the second Gysi class in Anatomical Articulation. 
Dr. Leo M. Trowbridge an upper classman of my college days gave us a 
splendid impression of the city and its boulevards and contributed largely 
to the enjoyment of our stay. Through the kindly assistance volun- 
teered by Dr. Hergert and Dr. Stansbery, the Seattle class was organized 
without any particular effort on my part. The writer felt not a little 
complimented with the regular attendance of these two men, who were as 
familiar with the Gysi methods as the writer himself. 

Although I have traveled somewhat extensively during my short 
career as a dentist, I have never visited in any other city where there 
were so many well lighted and cleanly kept offices, neatly gowned 
assistants, and broad, open minded dentists, as I found in Seattle. 

The course in Seattle was started with a lecture on the 26th but was 
not completed until the following week. 

In the meantime I visited Vancouver, British Columbia, to lecture 
before the Vancouver Dental Society on Tuesday evening. Here one 
of my Gysi classmates, Dr. W. H. Thompson, rendered indispensable 
assistance in organizing the class. Here could be seen at any time, sol- 
diers in uniform getting ready to ship for the war. Great difficulty was 
experienced in passing my lantern slides through the customs. Prac- 
tically no attention was given to the rest of my paraphernalia. 

Through the courtesy of Mr. J. W. Henderson, manager of The 
Temple-Pattison Co., a room adjoining their dental depot was secured. 
It was from Mr. Basil Bayne of the Bayne Bros. Dental Laboratory that 
we learned to xnilcanize gold-dust rubber in the spoon end of a wax 
spatula by heating slowly and until it became fluid. By this method a 
tooth may be attached to a plate in five minutes where otherwise it 
would take an hour and a half. Other rubbers cannojt be used since they 
contain no aluminum; the heat conducting element is essential. 

Some of the dentists in this class were so enthusiastic with this work 
that they wrote to their confreres, in Victoria suggesting that they 
organize a similar class. In the meantime I returned to Seattle and 
proceeded with the work there. 



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WESTERN ATTITUDE TO ANATOMICAL ARTICULATION 81 

There were thirteen bonafide members to the Victoria class including 
Dr. Knight who does not appear in the picture, together with each man's 
student assistant. These students acting as apprentices are thereby 
fulfilling some of the dental requirements of the Dominion. This class 
was held in the Garesche Building adjacent to the offices of Dr. A. J. 
Garesche whose services and courtesies were much appreciated. Dr. 
H. LeRoy Burgess was a former classmate of mine in the Kansas City 
Dental College. Our hair-raising drive over Mt. Malahat in his power- 
ful McLaughlin on high speed, and our little dinner at the beach with 
the other members of the class, will not soon be forgotten. 




The classes in Portland, San Diego, Salt Lake City, and Denver 
were held from four to six in the afternoon and from seven to ten in the 
evening. We regret that these hours together with the rush of work, 
necessarily eliminated the photographer. 

Those in the Portland class were Dr. Treve Jones, Dr. W. C. Adams, 
Dr. Chapin F. Laudervale, Benj. E. Gulick, and Dr. Clyde Mount of 
Oregon City. It was here that I had the pleasure of discussing Dr. J. 
Leon Williams' book on "A New Classification of Artificial Teeth." 

While the Panama-Pacific Congress was not as large as some other 
dental meetings previously attended, every clinic and every lecture was 
well attended and several of these were, by request, repeated. This 
was particularly true of Dr. C. J. R. Engstrom's motion pictures showing 



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82 



TH£ DENTAL DIGEST 



the use of the Gysi Adaptable Articulator. Here we had the 
pleasure of serving as a clinician in Dr. Frank W. Hergert's section, on 
**The Gysi Methods of Anatomical Articulation." 

The men specially interested in Prosthetic procedure quite naturally 
became well acquainted with each other in discussing the relative merits 
of the Greene Method of Impression taking and the new Hall method of 
perfected plaster impressions. Dr. Rupert E. Hall of Houston, Texas, 




Front Row, left to right: Dr. F. J. Lenz; Dr. G. J. Whitfield; Patient; Dr. C. J. Stans- 
bery; Dr. D. D. Campbell; Dr. F. W. Hergert; Miss Moore; Dr. C. H. Wharton 

Back Row, left to right: Dr. D. W. Bennett; Dr. N. H. Smith; Dr. W. S. Padget; Dr. 
L. M. Trowbridge; Dr. W. L. Harrison; Dr. R. I. Vandewall; Dr. E S. Sweeney; Dr. C.R. 
Oman; Dr. H. W. Appleby; Dr. L. E. A. Hooey; Dr. E. B. Edgers; Dr. B. S. McCord 

maintained that no material which offers resistance to the tissues was 
suitable for taking impressions, and claimed that the apparent success of 
the Greene method, was due to the fact that its use produced a vacuum 
over the entire maxillary surface or intaglio of the impression save on the 
periphery or the well massaged borders and post-dammed palate. This 
small vacuum over the entire surface of the impression, constitutes an 
element of unconscious deception, deceiving not only the patient but 
also the dentist himself. The vast majority of those questioned by the 
writer, admitted that they had never constructed a denture that fitted so 



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WESTERN ATTITUDE TO ANATOMICAL ARTICULATION 



83 



tightly and snugly after a few days' time as the tested compound im- 
pression. 

I should like to mention here one lesson that I have learned thoroughly, 
viz. ; that no patient should be given a demonstration tending to show 
how very satisfactorily his completed denture will be retained — rather, 
that more stress should be laid upon the personal equation represented in 
the patient. The patient should learn that successful dentures are pro- 




Front Row, left to right: Dr. G. Dier; Dr. W. F. Fraser; Dr. A. J. Garesche; Dr. D. D. 
Campbell; Dr. Lewis Hall; Dr. A. H. Tanner 

Back Row, left to right: Dr. S. G. Clemence; Mr. J. Crossan; Dr. H. H. Hare; Dr. H. 
LeRoy Burgess; Dr. E. H. Griffith; Dr. Alf. J. Thomas; Dr. H. J. Henderson 

duced through two equal factors; constructive on the part of the operator 
and adaptive on the part of the one operated on. 

The San Diego class composed of Drs. H. C. Collins, Leland D. Jones, 
Chas. G. Giddings, W. E. Allen, L. A. Viersen, J. L. Ross, W. Harmon 
Hall, F. J. Holt, L. G. Jones, Emma T. Reed, Kent Kerch and the 
following laboratory men: Drs. Alexander Swab, Frank V. Clayton, S. 
A. King, was held in the American National Bank Building. The class 
work here, in Salt Lake and in Denver, differed from that of the other 
cities in this respect, that instead of using the Gysi ^^ Simplex'' Articula- 
tor, the new Hall was substituted. Two full upper and lower dentures 



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84 



THE DENTAL DIGEST 



were made for our patient upon the Gysi Adaptable and the Hall Articula- 
tor. In this manner the class was enabled to compare the relative merits 
of each. One of the special features of this class was the construction of 
two casts, pure aluminum bases, one being swaged upon the original 
Spence's cast (after having been polished), to correct the contraction due 
to the physical properties of the aluminum; the other being inserted with- 
out this precaution. Needless to say, the base which was not swaged 
was in no sense a perfect adaptation. 

Upon our arrival at Salt Lake City, we found the dentists in a very 
receptive mood, due to the efforts of Dr. Fred W. Meakin and my former 




First Row, left to right: Dr. T. R. Peden; Dr. J. E. Black 

Second Row, left to right: Dr. W. R. Spencer; Dr. Wm. H. Thompson; Dr. D. D. 
Campbell; Dr. R. L. Coldwell; Dr. P. D. MacSween 

Third Row, left to right: Grant (Patient); Dr. T. W. Snipes; Dr. Basil Bayne; Dr. H. 
T. Minogue; Dr. S. C. E. Muirhead; Dr. H. E. Thomas; Dr. J. W. Henderson; Dr. F. Pol- 
lock; Dr. R. S. Hanna 



classmate Dr. Arthur C. Wherry. A class was soon organized with the 
following additional members, Drs. R. L. Folsom, A. C. Gartman, W. A. 
Marshall, Hyrum Bergstrom, R. E. Wight, Geo. F. Richards, Jr., C, 
W. Bird. 



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INFORMATION FROM THE DENTAL PROTECTIVE ASSOCUTION 85 

Dr. R. E. Wight, in an unguarded moment, told us we did not know 
how to mix plaster and proceeded to prove his contention. The method 
is as follows: 

Place the desired quantity of plaster in a dry plaster bowl and instead 
of letting water from the faucet run into it, completely submerge the bowl 
and its contents. Set aside and watch until the bubbles cease to rise, 
pour off the excess of water and the mix is correct. To further demon- 
strate that the affinity of the plaster for water has been satisfied, and that 
there is no expansion, pour the mix into a two ounce glass beaker, the 
mix being perfect, the beaker will crack. Try it your way. 

The last class was held in Denver with the following members en- 
rolled: Drs. A. Clay Withers, Kent K. Cross, Anna M. Buell, V. Clyde 
Smedley, J. Larkin Howell, Ezra E. Schaefer, Richard C. Hughes. 

This class formed a Campbell Study Club and has had two meetings 
since my departure. Reports of these meetings are sent to me with ques- 
tions along Prosthetic lines. These are answered and suggestions made 
and work outlined for the ensuing month. 

In all of the classes when discussing the new classification of teeth, 
stress was laid upon the manner in which teeth should be selected for 
individual requirements. Plane and autochrome lantern slides were 
effectively employed to show how in that much neglected field of Es- 
thetics and Contour, the best results may be obtained. 

The writer *s judgment, based upon the general responsiveness with 
which the courses met, is that the dentists who thrive in the midst of 
competition, realize that they must master some method of Anatomical 
Articulation. 

729 Shukert Bldg. 



IMPORTANT INFORMATION FROM THE DENTAL PROTECTIVE 
ASSOCIATION OF THE UNITED STATES 

At the Annual Meeting of the Dental Protective Association of the 
United States, held at the Hotel La Salle in the city of Chicago, on Mon- 
day, December 20, 1915, the Secretary was requested to prepare a plain 
statement for publication in the different dental Journals, giving such 
facts as would be of general interest to the profession, and setting forth 
the status of the members of the Association with reference to the pending 
Taggart litigation. 

NEW LIST OF MEMBERS IN GOOD STANDING 

During the past year the Board of Directors revised the list of mem- 
bers, eliminating from the new mailing list the names of those who were 



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86 THE DENTAL DIGEST 

known to be dead, out of practice, or who did not pay the assessment 
levied in about 1898. On December 10, 191S1 the latter were notified 
and given an opportunity to place themselves in good standing in the 
Association by paying the $10 assessment. A few took advantage of 
this and remitted the amount; those who did not do so were dropped 
from the list. 

NEXT TO THE LARGEST DENTAL ORGANIZATION IN THE WORLD 

The new list of members in good standing now contains the names of 
8,050 practicing dentists. These members are scattered geographically. 
A glance at the list would seem to reveal the fact that almost every town 
and city in the United States has one or more representatives in the 
Association. With the one exception of the re-organized National 
Dental Association, the Dental Protective Association of the United 
States is the largest Dental Organization in the world; and the best 
feature of all is that the total assets, as reported by the Treasurer at the 
last Annual Meeting, amount to $35,508.37. Of this amount $26,000 
is invested in approved municipal bonds; $6,000 is in individual notes 
secured by a corporation note for three times the amount; and the 
balance is in ready cash in a checking and savings account in the North- 
ern Trust Company of Chicago. Thus it will be seen that the Dental 
Protective Association of the United States is a live, healthy organiza- 
tion, standing ready, as it has always done in the past, to defend its 
members against the unjust demands of patentees whose claims are 
worthless. 

THE association's AGREEMENT WITH DOCTOR W. H. TAGGART 

This brings us to a discussion of the status of our members with 
reference to the Taggart litigation. On December 5, 1910, the Board of 
Directors of the Dental Protective Association of the United States 
recognizing the value of the Taggart Method of Casting, after much 
discussion and many conferences, entered into an agreement with Doctor 
W. H. Taggart, a member of the Association in good standing and the sole 
owner of certain patents on this new and original method of making 
dental inlays and the like, by the terms of which members of the Associa- 
tion could obtain the permission to practice the Taggart Method of 
Casting for the life-time of the patents (seventeen years) with any ma- 
chine he may then be using for the cash sum of $15. This agreement also 
provided that any member of the profession who joined the Association 
within the time specified could procure such permission on the same terms. 
The time limit of this agreement expired, except for recent graduates, 
on February 9, 1913. 



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INFORMATION FROM THE DENTAL PROTECTIVE ASSOCIATION 87 

STATUS OF RECENT GRADUATES 

A clause in the agreement provided as follows: '^That those who 
entered the profession within one year from the date of the first court 
decision sustaining the validity of patents heretofore mentioned shall 
pay $15 for the permission to practice the Taggart Method of Casting; 
those that enter the profession from year to year thereafter shall have 
the fee reduced by as many dollars as the number of years elapsed since 
the first court decision sustaining the validity of said patents. One year 
from the date of graduating or entrance into the profession, in all cases, 
shall be given in which to pay the stipulated fee." The phrase "en- 
trance into the profession" has been interpreted by the Attorney for 
the Association as meaning that an individual enters the profession when 
he takes the State Board examination, receives his license to practice 
and has it recorded, whether he actually begins practice at the time or 
not. This explanation is here given for the benefit of the many recent 
graduates who are desirous of information regarding their standing under 
the terms of the Association's agreement with Doctor Taggart. 

OWNERSHIP OF A TAGGART MACHINE CARRIES WITH IT THE PERMISSION 

TO USE THE METHOD 

During the time from December 5, 19 10 to February 9, 19 13, when 
the terms of the agreement were open to not only our members, but to 
the entire profession, there were over 4,200 practicing dentists who 
availed themselves of the terms and paid the $15. At this time Doctor 
Taggart was offering- his casting machine for sale. This could be pur- 
chased through the Association for $75 cash, or direct for $100 cash. A 
great many of our members purchased the machine direct from Doctor 
Taggart before the agreement was made; a few subsequently purchased 
it through the Association. A considerable number of dentists, who were 
not members of the Association, also purchased the machine direct. 
The right to use the Taggart Method of Casting went with the purchase 
of a machine from whatever source; and the ownership of a machine 
to-day carries with it the permission to use the Method. This informa- 
tion is given and emphasized here for the benefit of those dentists who 
own a Taggart Casting Machine. Those of our members who purchased 
the machine must remember that whoever owns the machine to-day, no 
matter where or how it was purchased, holds the sole right to use the 
Method. In other words a machine cannot be sold to another and the 
former owner retain the privilege of using the Method. 

STATUS OF MEMBERS IN TAGGART LITIGATION 

This question is frequently asked: Where does the individual stand, 
with reference to the pending Taggart litigation, who is a member of 



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88 THE DENTAL DIGEST 

this Association in good standing and who did not accept the terms of the 
agreement with Doctor Taggart before the time limit expired? In reply 
to this important question, we will say that every member was notified 
individually and through the Dental Journals, not only once but several 
times, of the opportunity afforded by the terms of the agreement; and 
those who did not Siccept forfeiled their right to protection, from this source 
by this Association, They are hereby so notified that they may either 
settle direct with Doctor Taggart or make whatever other arrangements 
they see fit to protect themselves from the Taggart patents. 

The question has also been raised as to the right of a member of this 
Association, who did accept the terms of the agreement with Doctor 
Taggart, to join other Associations organized primarily to fight Doctor 
Taggart. Every member of the Dental Protective Association of the 
United States who accepted the $15 proposition, agreed by signing the 
by-laws, to abide by the same. Under Section XIII of said by-laws, the 
third paragraph reads as follows: "If said $15 be paid before the entry 
of any decree or judgment finding any of Doctor Taggart's patents men- 
tioned above in said agreement valid or granting damages for infringe- 
ment thereof, the member is free to practice the Method with any machine 
he may then be using, and after the date of said decree or judgment, the 
member is not to purchase or use machines infringing Doctor Taggart's 
machine patents, except as aforesaid, and no member of the Association is 
to defend or join in or contribute to the defense of any suit upon any of said 
patents while practicing the Method under such permission from Doctor 
Taggart,'' In this connection it may be stated that this agreement 
with Doctor Taggart was no voluntary effort on his part; and after he 
finally consented to what he felt was practically giving the method away 
($15 for 17 years amounts to about 88 cents a year) he demanded this 
clause on the contention that he would not grant a man the right to use 
the Method for practically nothing and leave him free to contribute 
several times the amount, if he so desired, to defeat him in court of his 
just due. The Board of Directors recognized the justice of this demand 
and consented to it. Thus this question is answered here in full. 

MAY DENTISTS NOW JOIN THIS ASSOCIATION? 

It is frequently asked if the doors of the Dental Protective Association 
of the United States are now closed to the profession, or if members of the 
profession may join at this time. In reply to this question we will say 
that, subject to the approval of the Board of Directors any member of 
the Dental Profession may become a member of the Association on pay- 
ment to the Treasurer of a membership fee of $10, and subscribing to the 
by-laws of the Association; but it must be with the distinct understand- 



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INFORMATION FROM THE DENTAL PROTECTIVE ASSOCIATION 89 

ing that the time limit of the agreement with Doctor Taggart has expired, 
except, as previously mentioned, for recent graduates or those who have 
not been in the practice of dentistry for more than one year. 

WHY DENTISTS ARE JOINING AT THIS TIME 

Though no immunity can be offered by this Association at this time 
from Doctor Taggart, except to recent graduates; nevertheless, dentists 
are joining the Association for the protection afforded from other sources. 
There has scarcely been a time since 1888, when the Dental Protective 
Association of the United States was first organized, when the Association 
has not had pending more or less patent litigation. It has been success- 
ful in all of its suits to date. There must be a reason for this. We believe 
it is due to the fact that the Association was organized on the right basis; 
for the sole purpose of defending its members against abuse by patentees 
whose claims were worthless, and not to defraud any man of his just due. 
The United States Government, through its patent ofl5ce, grants patents 
to individuals whom it believes have something worthy, new, and original. 
In this manner it encourages inventive genius. It would be wrong for 
any Association to attempt to fight all patents, dental or otherwise, 
regardless of their merit. Such is not the policy of the Dental Protective 
Association of the United States; but let it be remembered, thai it 
stands to-day^ as it has stood for nearly twenty-eight years j like a stone wall 
between its members and patent abuse. 

At the present time the Association is defending one of its members 
who has been sued for infringing a patent on a set of instruments for 
scaling teeth. In the opinion of the Board of Directors the principle 
involved in the patent, and on which it is based, is neither new nor 
original; and they felt that it would be dangerous for the members and 
the profession to have said patent validated in court. Therefore, they 
have directed the attorney to assume full defense of the suit on behalf of 
the Association. 

In this brief article we have endeavored to cover and explain, so far 
as possible, all points which may arise now that the Taggart and other 
litigation is pending, in order to thoroughly inform the membership of 
the Association, and incidentally others in the profession who may be 
interested; and to avoid unnecessary correspondence. However, should 
anyone want further information or desire to join the Association, they 
may address the Secretary, 39 South State Street, Chicago, 111. 

Byorderof the Board of Directors: J. G. Reed, President. 

J. P. Buckley, V.-Pres. & Sec'y. 



D. M. Gallie, Treasurer. 



Chicago, January 4, 1916. 



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DEDICATION OF THE MILLER MEMORIAL MONUMENT 

The Ohio State Dental Society Meeting for 191 5 was one of 
especial interest as it was the scene of the Dedication of the 
Miller Memorial Statue, a monument raised by the united 
eflforts of the dental societies of Ohio, though nearly every state 
contributed to this monument. The statue is situated near the 
library building, on the campus of the Ohio State University. 

The memorial was unveiled by Miss Annie Brooks, of Alex- 
andria, Ohio. The assembly afterward gathered in the chapel 
of the university where an address was delivered by Dr. E. C. 
Kirk, Philadelphia; remarks were also made by Dr. T. W. 
Brophy, Chicago; Dr. N. S. Hoff, Ann Arbor; Dr. Thos. P. 
Hinman, Atlanta; Prof. G. W. Knight, of the Ohio State 
University and by others. 

Dr. Miller was born August i, 1853 near Alexandria, Ohio. 
He entered the University of Michigan the fall of 1871 and took 
his degree of Bachelor of Arts June, 1875. Deciding to adopt 
as his profession that of mathematical physics — he went to 
Scotland and studied in the Edinburgh University under Sir 
William Thomson. His health failing him through over-work, 
he sought rest, and it was during this period of recuperation that 
he met in Berlin, Dr. F. P. Abbot, who was the representative 
American dentist in that city. It was through Dr. Abbot's 
influence that he decided to return to America and take the 
dental course, graduating from the University of Pennsylvania 
in 1879. 

Later he was called to accept the office of Dean of the 
Dental Department of the University of Michigan. 

He practised abroad extensively as well as wrote volumin- 
ously, being the author of over one hundred books, and articles 
on every phase of dentistry. 

A year previous to his death, Kaiser Wilhelm had conferred 
upon him the rank of priv>'^ medical councilor. 



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STATUE OF DR. WILLOUGHY DAYTON MILLER 




Born, August i, 1853. Died, July 27, 1907 



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92 THE DENTAL DIGEST 

CORRESPONDENCE 

Editor Dental Digest: 

(In answer to L. B. Brown October Digest, page 632). If Cookville, 
Tenn., is as hot a place as some parts of Australia, it is quite possible 
that the worm arrived in that tooth per medium of a blow fly. 

Some years ago I was practicing in a town that was very hot and where 
the above fly was a pest. One day I had extracted a tooth and laid it 
down while I did something else, probably to console the patient. I was 
young at the time and perhaps nervous, but my astonishment was great 
when on going to remove the tooth out of sight I saw a worm in the 
cavity and one on the root. 

For days I began to wonder if the gentleman was right who traveled 
selling pills that you " simply placed in your decayed tooth which removed 
the worm that caused decay and toothache.'' 

It was sometime before I thought of the above explanation. 
I am yours sincerely, 

J. Kempthorne, 
Atherton, Marrickville, N. S. W., Australia. 

ANSWER TO G. F. LOGAN, D.D.S.* 

Books on pathology and surgery recognize two causes of disease, 
namely, predisposing and exciting. Dr. Logan recognizes only one, 
therefore he is wrong. {See Items of Interest^ December, 1915). 

Dr. Logan states that we all know that tartar is not the cause of 
pyorrhea. Now I have never seen a case of pyorrhea where tartar was 
not present or had been present long enough to cause the pyorrhea; but 
some dentists do not find it and therefore say it is not present. 

I have a patient who had been treated for pyorrhea and at the last 
visit he made to his former dentist, he told the patient he did not have 
any tartar on his teeth; two days after the last visit to his former den- 
tist he applied to me for treatment and I found sanguinary tartar (hard 
brown tartar) under the gum on ten or eleven of his teeth. If pyorrhea 
is caused by tartar, tartar must be the cause of pyorrhea. 

If tartar is not the cause what is the use of removing the tartar to 
cure the pyorrhea or before curing pyorrhea why not cure the pyorrhea 
then remove the tartar? It is not ix)ssible. I have never seen a case 
of pyorrhea alleviated to any extent or cured where tartar was present, 
and that should be proof enough that tartar is the cause of pyorrhea. 

Tartar is the cause of expulsive gingivitis. I do not like the word 

•Items of Interest, Dec., 1915. 



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CORRESPONDENCE 93 

pyorrhea as it is generally used, as expulsive gingivitis is a better term. 
Many dentists use the word pyorrhea whether pus is present or not. 
Now I believe pus must be present to use the word pyorrhea properly. 

C. Wayne Mingle, D.D.S., 
December 26, 1915 731 W. Erie Ave., Philadelphia, Pa. 

Editor Dental Digest: 

I should like to inquire of you through the Digest, what foundation, 
in fact, there is for the current rumor that conductive anesthesia of the 
mandible is apt to result in permanent anesthesia of some of the parts. 

I am perfectly familiar with the answer that Thoma and Fischer give 
to this question, but somehow I keep hearing of dentists who have heard 
that a friend of a friend's friend had such a case. 

Do you suppose that such rumors have been passed along by dentists 
who did not possess the skill or the nerve to employ conductive 
anesthesia? 

Do you think that sufficient time has elapsed since the introduction 
of this method to make the judgment of Thoma and Fischer absolutely 
authoritative and final on this point? 

Yours very truly, 

A. 

Editor Dental Digest: 

On page 8 of the January Digest the question is asked, *'What is 
the best thing to do for a child three years old who breathes through the 
mouth nights and snores as loud as an adult? W. B. B." 

Ttike two strips of surgeon's plaster, f in. wide and i in. long, have 
her turn the lips in, close the mouth tight, stick the two strips on each 
side of centre, sealing the mouth tight so she will breathe through the 
nose. In the morning take hold of one comer and pull the plaster off. 
This metliod continued nights for several years will form the habit of 
correct breathing and prevent the cHld from having colds every few 
days. Nine tenths of the colds children have can be prevented by this 
process. The child will sleep better and enjoy better general health. 

Levi C. Taylor, 
Hartford, Conn. 



Editor Dental Digest: 

Can you inform me what to put into an electric sterilizer to keep 
the investment from rusting? 

B. F. M. 



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fTINE/y^VILDING 




**Nothing but the very best of instru- 
ments and materials can give your ability 
the assistance it deserves." — Selected. 



THE BUSINESS SIDE OF PROPHYLACTIC AND 
RESTORATIVE PRACTICE* 

By W. F. Spies, D.D.S., and George Wood Clapp, D.D.S., New York 

SECOND PAPER 
AVERAGE INCOME HOUR FEES 

Analysis of reports from a considerable number of dental practices 
in different parts of the United States seems to show that the following 
minimum fees are necessary for each of i,ooo annual income hours to 
maintain these practices in their present conditions.! These fees are 
exclusive of the costs of teeth and precious metals. 

$1.45 
2.22 

3 13 

3 94 
4.89 

DIFFERENT FORMS OF SERVICE 

The forms of dental service concerning which we are able to offer 
time reports and income-hour costs for different classes of practice include 
the more common forms of service comprised under the general headings 
Prophylaxis and Restoration, and thus include treatment of inflammation 
of the soft tissues surrounding the teeth, repair of decayed teeth and 
replacement of missing teeth. No figures are offered for the operations 
of orthodontia, oral surgery and full denture making. 

PROPHYLACTIC PRACTICE 

The word prophylaxis means ''prevention" and prophylactic ser\dce 
in dentistry is devoted to preventing inflammation of the soft tissues 
and decay of the teeth. Obviously the best way to prevent further 
encroachment is to remove the causes of the pathological conditions. 

*This article began in the January, 191 6, number. 

tThese figures are taken from the forthcoming book "Profital)le Practice." 



Class 


I 


Practices 


Class 


II 


Practices 


Class 


in 


Practices 


Class 


IV 


Practices 


Class 


v 


Practices 



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PROPHYLACTIC AND RESTORATIVE PRACTICE 95 

Probably the commonest and simplest manifestation of a pathological 
condition of the soft tissues surrounding the teeth is first seen as a slight 
reddening of the free margins of the gums. If this condition is rightly 
diagnosed it usually responds readily to proper treatment. If the causes 
are not removed, and proper treatment instituted, the inflammation 
progresses with resulting loss of the tissues surrounding the teeth and 
final loss of the teeth. 

Prophylactic dental service comprises the removal of deposits upon 




Fig. I. An illustration of a beginning case of Pyorrhea 

the teeth, polishing the teeth, medicinal aid to the soft tissues and the 
mstitution of intelligent home treatment by the patient. 

SIMPLE PROPHYLACTIC CASES 

Simple prophylactic cases present inflammation of the margins of 
the gums due to the presence of deposits about the necks of the teeth. 
They are cases which a ** cleaning '' has usually been expected to relieve. 
The great trouble has generally been that the importance of the inflam- 
mation has been underestimated and the '^cleaning" has been insufii- 
ciently thorough. 

If the standard of this form of professional service be the removal of 
all irritants which caused the inflammation, and the polishing of all 
surfaces of all teeth to a condition which renders them acceptable to 
the soft tissues and protects them against decay of the enamel, it may 



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96 THE DENTAL DIGEST 

be asserted that proper prophylactic service cannot be rendered in 
the short time usually devoted to a ** cleaning/' 

The following reports are from the records of cases at the Pyorrhocide 
Clinic. The work was performed by different operators who naturally 
work at different speeds, and the averages are probably very close to the 
time that would be required by a dentist of moderate speed who had 
instructed himself in the proper technic. The treatment of all these 




Fig. 2. An intermediate case of Pyorrhea 

cases was identical. It consisted of removal of deposits by instrumenta- 
tion, of polishing by means of wood points and a polishing medium, and 
an average of 5 applications of Dentinol. 

Thirty-one simple cases required from i to 6 hours each with a total 
of 131 hours and an average of 4 hours and 20 minutes, divided into 
sittings of about 30 minutes each. 

The cost of these treatments involves the overhead charges, the 
remuneration and the cost of materials, except precious metals. 

The cost of these treatments to the dentist may be tabulated as follows: 

Minimum Class I 

Hourly fee $1 45 

Total cost 6.30 

INTERMEDIATE CASES 

In intermediate cases the inflammation is more extensive than in 
simple cases, there is infection and pus flow and some pocket formation, 



Class II 


Class III 


Class IV 


Class V 


$2.22 


S S'^S 


$ 3-94 


$4.89 


9.60 


13. 55 


1705 


21.20 



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PROPHYLACTIC AND RESTORATIVE PRACTICE 



97 



but the teeth have not been loosened beyond the power of again becoming 
firm without splinting. 

The treatment was identical in character with that in the simple 
cases except that more time was required for each. Seventy-nine cases 
required a total of 742 hours, with an average of 9 hours, 25 minutes 
divided into numerous sittings. 

The costs in these cases would be as follows: 

Minimum Cls 

Hourly fee $1 

Total cost 



5l 


Class II Class III 


Class IV 


Class V 


•45 


$ 2.22 $ 3.13 


S 3 94 


$4.89 


•70 
^DVA 


20.90 29.48 
.NCED CASES 


37.10 


46.15 



Advanced cases are marked by considerable amounts of extensive 
pocket formation and pus flow, and loss of the soft and hard tissues sup- 
porting the teeth, so that the teeth are often too loose to again become firm 
without splinting. 




Fig. 3. An advanced case of Pyorrhea 

Nine advanced cases in which the teeth were not splinted were 
treated in the same manner as the simple and intermediate cases, but 
required a total of 189 hours, or 21 hours each. The costs of these cases 
would be as follows; 



Minimum 


Class I 


Class n 


Class in 


Class IV 


Class V 


Hourly fee . . . 


. ' . $ 1.45 


$ 2.22 


$ 3.13 


$ 3.94 


$4.89 


Total cost . . . 


30.45 


46.60 


65.75 


83.74 


102.69 



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98 THE DENTAL DIGEST 

Twenty advanced cases requiring prophylactic treatment and splints 
required a total of 420 hours at the chair, an average of 21 hours; a total 
of 96 hours of laboratory, an average of 4 hours 48 minutes per case; and 
a total cost for precious metal and teeth of $369.25, an average cost of 
$18.45 P^r case. . 

In the following table, the laboratory time is estimated at the same 
cost as chair time. 



Minimum Class I Class II Class III Class IV Class V 

Hourly fee $ i.4S $2.22 % 3-^3 $3 94 $489 

Chair time 30. 45 46.60 65. 

Laboratory time .... 6.95 10.65 15. 

Materials 18.45 18.45 18. 

Total cost 55.85 75.70 99. 

To be continued. 



75 83.75 102.70 

00 18.90 23.45 

45 18.45 18.45 

20 1 21. 10 144 60 



WHAT I THINK INLAYS COST 
By F. D. H.. Lampasas, Texas 

(Discussing the answers to, ** What will it cost you to fill this tooth.'') 
In the December issue of the Digest, in answer to, ** What will it cost 
you to fill this tooth," there are published nine answers, with estimated 
costs running from $3.70 to $13. As each of these estimates seem to be 
figured very closely, and as there is such a wide difference, it must mean 
that there is a fallacy somewhere and that when it comes to actual cost 
we are all up in the air, and any kind of a guess would be more accurate 
than these figures. It is easy enough to tell what an operation has cost 
us after it is done, but it is impossible to tell what it will cost before it is 
done. Not one of these answers take into consideration the possibility of 
a failure in casting or fitting, and I am sure we all have them. Quite 
recently I had six large inlays of about an equal size and accessibility to 
insert, five of them were put in with very little trouble, but the sixth was 
cast four times before I was satisfied. Now, according to the estimates 
published, I should charge several times as much for the sixth inlay as 
any of the others. There are many cases where more time is consumed 
in filling in a very small inlay, than one that is much larger, but the pa- 
tient does not take this into consideration, and we cannot get as much for 
it. The prize answer has, as an item of expense, $1,200 for dental mech- 
anic; this should not properly be considered, as this department should 
be self-sustaining; but if this is considered, how can we say which is pay- 
ing the $3 or $5 an hour, the laboratory or the chair? It is possible that 



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PROPHYLACTIC AND RESTORATIVE PRACTICE 99 

the laboratory man is losing money for us, if so, our charges must be 
increased in proportion. The prize answer figures fifty minutes for 
investing, dehydrating and casting; all this should take only about ten 
minutes of actual time consumed, as the waiting time might be profitably 
used for something else. The time of a man qualified for manual labor 
only, is worth something like twenty-five cents an hour; but, should he 
spend several years at college, costing him, including the time spent, 
$3,000, he is then in a position, by his superior knowledge, to earn, say 
$3 an hour. If this $3,000 is considered in this estimate of expense, and 
time still put at $3 an hour, there is a doubling up, and we are making 
the patient pay for the money spent which enabled us to charge him for 
such valuable time. Again, if we put $3,000 for college work, we should 
also include time and money spent for preliminary education, as without 
this we could not get the college work. Also ones wearing apparel is just 
as necessary an item of expense as magazines. This course of logic can 
be carried on indefinitely, but it seems to me, that more of these things 
should be considered, save what our time is actually worth, considering 
that we have, by preliminary work and expense, made it valuable. 
Brother Bill or father, has already settled for these preliminary items, and 
we have repaid him in love and affection and the account is closed. The 
question now is: what will this filling cost us as we are now situated? 
Burying the past, looking to the future, we start, with our present quali- 
fications, to clear $3,000 a year. We examine the cavity, but are unable 
to say what time will be required to fix it, we estimate the time from 
previous records, and place it at ninety minutes of actual work, upon the 
basis of one thousand producing hours a year. To earn the three thous- 
and dollars, each hour must bring us in $3. But from an actual record 
of oflSce expenses, let us place the figure at $1,000; (It does not cost me 
nearly so much and I have a larger than a $3,000 practice). Upon this 
basis we should get $4 an hour for our work, or $6 for completing the in- 
lay; in my opinion, about the amount an average person will stand for 
such work without kicking. 



Facilities in Removing Teeth from a Rubber Plate. — Put the 
plate in boiling water, keep it there for five minutes while boiling. You 
will then find the rubber soft and easy to remove the teeth with any 
pointed tool. While secured from cracking, they are removed thor- 
oughly clean from rubber. 

Brooklyn Dental Laboratory. 



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100 TH£ DENTAL DIGEST 



DENTISTRY FROM A HNANCIAL ASPECT* 
By Percy A. Ash, D.D.S. 

EdUor ^* Commonwealth Denial Review,'* Lecturer and Examiner University of Sydney, Etc. 

When your Hon. Secretary conveyed to me your very kind invitation 
to read a paper before this Society, he suggested the subjects of finance 
and dental jurisprudence, from which I gathered that you, like the great 
majority of dental practitioners, are pleased to hear something occasion- 
ally a little off the beaten track of technical and scientific dentistry. I 
regard it as a great compliment that you think me capable of writing an 
interesting article upon such subjects, but, as the time at my disposal 
must of necessity be limited, I shall leave the question of dental juris- 
prudence quite out of consideration, and deal with financial affairs. Per- 
haps, in order to justify myself, I should repeat that, before taking up the 
study of dentistry, I spent six years in banking and commercial pursuits, 
and subsequently went through four years in law as a duly articled clerk 
to a solicitor, during which time I had opportunity of becoming well ac- 
quainted with both the practical and theoretical aspects of money matters 
as well as with the legal position in relation thereto. 

In trying to decide what line of argument would prove most attractive 
to you, I have been greatly help)ed by some letters I received from dentists 
after the publication of my series of articles on ** Financial investments." 
Among the many requests which came to hand, four appealed to me more 
than others, and I thought I could not do better than confine my remarks 
to them this evening. They are: — 

1. Can you tell me how to succeed in practice? 

2. If you write again on matters of finance, will you set out the 
advantages of keeping a bank account, and also let us have some definite 
information as to why cheques are "crossed," the word "bearer" struck 
out, etc. 

3. Explain to us, if you can, how some men who have money to lend 
receive high rates of interest on good securities. 

4. Will you give us a method of book-keeping whereby we can as- 
certain at any time just how we stand financially? 

Any one of these requests involves a subject large enough to occupy 
an evening, but as they are all very important, I shall endeavor to say a 
little upon each. The most difficult one to answer is No. I. 

* (Read before the Odontological Society of Victoria, Sydney, Australia.) 



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DENTISTRY FROM A FINANCIAL ASPECT 101 

HOW TO SUCCEED IN PRACTICE 

We may safely assume that the person who asked this question had in 
his mind the monetary asj)ect of dentistry. We are forced to admit that, 
in the commercial age in which we live, a man^s success in life is deter- 
mined largely by the amount of money he makes. Though it is fre- 
quently very difficult to accomplish much without money, still the acqui- 
sition of it must not be looked upon as the main aspiration of human 
existence. What man of any genuiiie spirit want;? to befcome rich through 
the beneficence of other people? What tind'of ^^ mind is it which is al- 
ways craving for a* substantial legacy- under ^scme wealthy pcrson^s will, 
or for a windfall frbrh-somewhei'e/v/hidh' will- enaiile him ttt live in 'ease, 
without the expenditure ofd Fca^onatile ^.nfount o! {ihtsical* and mental 
energy? No man with arr^bition Of th5 right -sort hofi^es for finahcidl gain 
on such terms; he desires to work for what he gets, to make his money 
off his own bat, so to sj)eak, and to honestly accumulate enough during 
his years of health and strength to see him through. Within the limits of 
our own profession, some of us may be high-minded enough to regard as 
successful anyone who has made a valuable contribution to the sum total 
of scientific knowledge, or who has reached the position of a prominent 
teacher in a reputable university or college, but, so far as the average man 
on the street is concerned, success in a professional or business calling is 
measured in money. Taking that, then, as the correct interpretation 
of my correspondent's enquiry, I shall set out on the rather thankless task 
of instructing others how to conduct their own business, and in the effort, 
it will be necessary to mention many commonplace details, which, though 
apparently insignificant, have to be reckoned with in the practice of den- 
tistry where the personal equation is so much in evidence. 

When you are asked to advise another how to succeed, the greatest 
difficulty you encounted is an insufficient knowledge of the qualities of the 
person seeking your help. If you have been successful yourself (presum- 
ing, of course, that you have always been honest), you naturally dilate 
on the many elements which have contributed to that end; but, more 
than likely, as you proceed, you will discover that your enquirer lacks 
most of the qualifications which you have found indispensable. It may 
be that some practitioner, whose career you have watched for years, will 
ask your advice; you know from experience why he has failed, but yet you 
hesitate to say so. For instance, it requires much courage to tell him that 
he lacks refinement, but yet you feel that there- in chiefly lies the reason 
of his failure. There is no occupation that I know of -not excluding 
medicine — where a good manner counts for so much as in dentistry, and 
by this I mean a manner that is inborn and not assumed, for the real 
is very readily distinguishable from the imitation, by people of gentle 



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102 THE DENTAL DIGEST 

birth. The fact is that very many of us in life are misfits; some in the 
profession should be at something which calls for more muscle and less 
brains; some who are in commercial enterprises lack the necessary quali- 
fications to stand up against the keen competition in that class of business; 
some are born to follow and not to lead, and hence should be in positions 
where there is always a head to refer to. 

H. Y. Braddon, in his book on "Business Principles and Practice/' 
touching on thia feafiir^ of^J^ujuan activity, says: — "In point of fact, in 
the large concerrff the j^tOrlajax^r; banks, companies or other, there is al- 
'. wajiS;rc)Qii^at.tbe top.. .JQne of the depre^sipg features of business is the 
V'^elatc^d^OacrgHniviilJef.tff felfiricd torlers.who ^X UJ>^Jt$jd by temperament 
or lack;Qf.jTi«i:ital iiccoutremenj:, X^ g^l YP/y. ff^r. Then, too, there are 
those. (iWsV.h^TOily •'fewer, rwio stei>puuof ihe ranks as the result of 
intemperance or dishonesty. A really sound, well-trained business man 
need never wait long for a fairly good appointment. There is always 
room for him somewhere. The severe competition for places is amongst 
the mediocrities. From the employers' side it is always worth while to 
pay a good man well. Cheap men are rarely worth the outlay, especially 
if they are working discontentedly.'' 

Men may have brilliant careers at universities; they may be what 
is generally known as "well-read men," and be the possessors of dis- 
tinguished degrees, and yet be unable to make any headway in the cold, 
hard struggle for existence; that is to say, they have extraordinary capa- 
city for absorbing the writings of others, but have no originality. While 
in all the professions to-day the possession of a degree from a University 
of repute is very properly accepted as e\adence of proficiency, still it does 
not always carry the special qualifications necessary to success. Above 
all things, a man must have some natural ability. In no profession, prob- 
ably, is this more noticeable than in law. As we look around us we see 
some barristers who have successfully passed examinations but are not 
blessed with that intuitive ability which counts for so much; others are 
able to add to their legal knowledge, keen powers of perception, ready 
wit, the natural facility to grasp an opportunity the moment it arises, 
and many other attributes which contribute to success. The one bar- 
rister conducts his case, relying almost entirely on his knowledge of law, 
which he gained from books and Acts of Parliament; the other, in addi- 
tion to those qualifications, brings his personal resourcefulness to bear, 
observes the slightest discrepancy which arises during the progress of the 
case, snaps it up and makes capital out of it. The same conditions hold 
good very largely in our own profession. 

The Australian Journal of Dentistry. 
{To be continued) 



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A SYSTEM OF DENTAL BOOK-KEEPING 103 

A SYSTEM OF DENTAL BOOK-KEEPING 

By F. a. Ross, D.D.S., Gilroy, Cal. 

My object in this article will be to outline a system of dental book- 

^ping which six years' use in practice has demonstrated to be simple, 

^ ^^omical, complete in all essentials, and to require a minimum of time 

^,. ^ effort on the part of the dentist. The system is not wholly original 

lu ^ rne, being rather an amplification of a stock system on the market in 

^t^. ^^-leaf ledger form, from which I have evolved the other details as I 

K ^^1 a requirement for them in my practice. 

V/^^CJ^mong the advantages of this system are the following: it leaves 

H^^ing to the memory, even for an hour; it enables one to strike a 

^\lce or check up his volume of business for any period of time, a 

T^t^t, month or year, in a few minutes' time; it requires only a few 

minutes' time daily, and an occasional couple of hours, say once a month, 

to index and transfer accounts and enter new leaves. 

The first item in the system consists of a 4 x 6 in. sheet of paper, 
ruled as in Fig. i, and which I call the day tag. On assuming business 
for the day I slip one of these sheets into the type-writer, noting the 
date in the space above the horizontal lines. Thereafter, during the day, 
upon dismissing a patient, and before beginning the next operation^ I jot 
down in the lower space the name of the patient just dismissed, with a 
note, in detail, of the operation performed, together with the charge 
therefore, and credit any amount paid, in the spaces provided by the 
ruling at the right hand side of the sheet. This I do with each suc- 
ceeding case throughout the day, and by using abbreviations in noting 
down the operations I find that one line is usually all that is required per 
patient, so that a sheet is usually sufficient to record all operations for 
one day. The use of the typewriter of course makes for economy of 
space. While its use is a refinement, and makes for neatness, order, and 
legibility, it is not essential. The notations can be made in pencil, and 
the sheet kept on the cabinet beside the chair if preferred. I did it that 
way for three or four years before I had a typewriter. 

Now let us take a sample day's run in the oflSce, and see how it works. 
Our first appointment in the morning is with Mr. Jones, for whom we 
devitalize the right upper first molar, and put in an amalgam filling in the 
left upper second bicuspid. We record it thus: F. Jones, T. 3, N. O. A. 
13- T. stands for treatment; N. for novocain (denoting that I used 
peridental anaesthesia for pulp removal) ; 3 denotes the number of the 
tooth operated upon, as found on the i)age in the ledger devoted to Mr. 
Jones's case. Similarly, A. means amalgam, and the number denotes the 
tooth. He also paid a deposit. 



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104 THE DENTAL DIGEST 

JANUARY I, I916 



F. Jones, T. N. 3; A. 13 

H. Johnson 

Willie Hooper, sed. Ir. 19 ... 

Mrs. J. Smith, G. 9, analg. . 

Mr. Willson, scaling, emet. Alcresta 

Miss Allen, r. c. f. cr. pr. 5 

Mr. White, ext. 2-3, N20 ... 

Rent, $30 



Fig. I. The Day Tag 



4.50 


2S.CX> 




13.50 


■50 




9.00 




5 00 


5.00 


3 00 




3 50 


3SO 



$25.50 



$47.00 



Our next appointment is with Mrs. Smith, for whom we insert a gold 
filling in the left superior central. We also used analgesia in the 
preparation of this cavity. Hence, ''Mrs. Smith, G. 9, analg." But 
during the time Mrs. Smith was in the chair Mr. Johnson called and paid 
his account of $13.50. We put that on the tag then and there. We are 
pretty busy with that gold filling in Mrs. Smith's mouth, but that is all 
the more reason why we stop and jot it down. If we wait till after 5 
P.M. it may slip our mind, and so lay grounds for future trouble when we 
send Johnson another statement and he comes in and declares he paid us, 
and we don't remember it nor have any record of it. Also little Willie 
Hooper came in with a toothache during the time we were busy with Mrs. 
Smith's case, and we sealed in a sedative treatment to keep him com- 
fortable until another day when we could give him more attention. So 
we slip in a memorandum on our day tag, and thus perhaps save our- 
selves 50c. which we possibly would have forgotten to charge up to the 
account if we had waited until after our day's work was done before 
making up our record of the day's transactions, from memory. 

Our next patient is Mr. Willson, a pyorrhea case. We scale some of 
his teeth, apply emetine solution, and prescribe a course of Alcresta 
tablets. He paid $5 on account. 

I wish to interpolate here that I find a second operating chair a great 
help in handling such cases as Willie's, which come in during the progress 
of a long operation. It minimizes the time lost by the interruption. 
Also, I wish to mention another thing which saves a great deal of time 
and lost motion. That is the use of an examination record. I use the 
Allen examination book, making a thorough examination of the teeth at 
the first sitting, outlining on the cut of the teeth given on each page the 
cavities found, treatments necessary, etc., also noting down any estimate 
made, agreements about payment of account, etc. Then at all subse- 
quent sittings I work from this chart, checking off each piece of work as 
it is completed and noting any changes made from the original plan of the 
work. This saves time hunting around the mouth to see what to do next, 
avoids overlooking concealed cavities which were found in the first 



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SYSTEM OF DENTAL BOOK-KEEPING 



105 



diligent examination, and is a first hand memory tickler regarding the 
details of the case that one would not purposely overlook, but which are 
soon and easily forgotten. Estimates and agreements are later trans- 
ferred to the permanent case record in the ledger. 



JANUARY 



1916 



January 1 
2 
3 

4 
5 
6 
8 

9 
10 
II 
12 
13 
15 
16 

17 
18 

19 
20 
22 
23 
24 
25 
26 

27 
29 
30 
31 



Rec'd 


Booked 


$37 50 


$30.00 


500 


23.00 


550 


22.00 


13 50 


19 50 


26.00 


20.00 


18.00 


11.00 


7.00 


24.00 


300 


14-50 




28.50 




20.50 


6.50 


29.50 




5.00 


1. 00 


21.50 


19 50 


43 00 


6.00 


22.00 


107.00 


43.00 


1500 


32.00 




14-50 


S-oo 


29.00 


129.00 


30.50 


8.50 


29.00 


20.50 


14 50 


5.00 


19 50 


26.00 


30.00 


67.50 


51.00 


6.50 


16.00 


14.00 


22.00 



$552.50! $671.50 
Fig. No. 2. Bkiifiister cash and bill card (pink) for adding up totals 

The other items on our day tag show that we filled the root canals 
in the right upper first bicuspid, for Miss Allen, and prepared the tooth 
to receive a crown; also extracted the right upper first and second molars 
for Mr. White, using nitrous oxid oxygen anesthesia for the operation. 
He paid in full. 

Thus we note down on our day tag all the transactions of the day 
each in turn and at the moment, and at the close of the day's work add up 
the totals in the charge and credit columns. After transferring the 
items on the day tag to the individual records in the ledger, the day tags 
are filed in a drawer in the desk until the end of the month. Then I use 
a Bannister cash and bill card (pink) on which to add up the totals of all 
the day tags of the month, thus securing totals showing all charges and 
receipts for the month (Fig. 2). The day tags and the pink card, I then 
place in another drawer along with tags and cards of previous months. 
At the end of the year, by simply adding up the twelve totals shown on 
the pink cards I have a summary of receipts and charges for the year. 



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106 



THB DENTAL DIGEST 



We now come to the case records. For this purpose I use a modifica- 
tion of the loose leaf ledger made by the Workman Manufacturing Com- 
pany, 1 200 W. Monroe St., Chicago. They call it their No. O special. 
My objections to their original stock record sheets are that there is some 
needless repetition in the headings; there are some headings I do not 
need, and some not given that I do need; I prefer a different arrangement 
of the headings; the original is provided with case record ruling on one 
side only. Therefore I had them print leaves to order (Fig. 3) which 
meet my requirements very much better, and by having both sides alike 
provides double the record space in a given bulk of sheets. I had these 




=0 


IBS 


III lllilVIV^'l'.') ■- V ^TTil 




ffl^AS^M "^ Jf9-^'d^^. 












^H'»'fJH» 


II IIP IN - 


bM 


UsiLi- a 


f'k' 4f a . 


tttfi 






































































* 


-- 



Fig. No. 3. Loose leaf ledger 

printed before I took up the use of nitrous oxid. My next order will 
provide headings to include analgesia and anesthesia. I now make a 
note of its use in the ** Remarks" column. 

The manner of making up the case record is obvious from illustration 
No. 3, We have the patient's name and address, together with a memo- 
randum of the amount of his contract and terms of payment. There is 
a space to note by whom he was referred to us. We have entered the 
first item o£ Mr. Jones's account, as taken from our sample day tag. 
Succeeding operations will be entered from other day tags as the case 
progresses. 

The accounts in this loose leaf ledger are self indexed by means of 
yellow sheets having the letters of the alphabet arranged on projecting 
celluloid tabs, and the account leaves under each index sheet are arranged 
with projecting tabs on which the name of the patient is written so that 
it is instantly found upon opening the ledger at the proper index sheet. 



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A SYSTEM OF DENTAL BOOK-KEEPING 107 

Thus, to find the account of our first patient, Mr. Jones, we open our 
ledger at the celluloid tab "J." Without turning a single leaf, we see 
the name we are looking for on the projecting tab. 

Also, all the other current accounts of patients whose names begin 
with J. are before us at a glance. 

Accounts are kept in the original binder as long as active, or until 
paid. About once a month, or whenever convenient, paid accounts are 
removed and placed in another binder, called the transfer binder. Be- 
fore inserting into the second binder the projecting tabs are cut off. A 
photographer's print trimmer facilitates this operation, and gives a 
true edge to the leaves. The transferred leaves are paged numerically, 
and for this purpose I use a Bates numbering machine for the sake of 
neatness and legibility, though it can be done \/ith pen and ink if one 
does not wish to invest in a numbering machine. 

The name on each account that is thus transferred is entered on the 
yellow indexing sheet in the original ledger, together with its page num- 
ber, under vowel headings which make it possible to find a name in a 
minimum amount of time. Thus an account, whether active or closed, 
can be found in the one ledger, and located in a few seconds' time. 

By thus transferring closed accounts, the original binder is reserved 
for active accounts, and when sending out statements at the end of the 
month it is not necessary to search through a large volume of accounts 
and weed out the active from the closed. In fact, I usually run through 
the ledger in a few minutes and type down on a plain sheet of paper, in 
alphabetical order, all the accounts requiring statements, and then 
make out statements from this list. By preserving this list, and at the 
next statement period adding the new accounts that have accumulated 
during the month, I reduce the task of statement rendering to a minimum. 

Of course, in this system, one could, if preferred, substitute the card 
system for the loose leaf ledger. The principal advantage of the ledger 
is the reduction of bulk. One transfer binder will hold a thousand or 
fifteen hundred sheets. The binder posts are added to in sections as the 
binder fills up, and it is optional how many leaves are put into one volimoie. 
The difference in volume between 1,500 sheets and a similar number of 
cards, with indexes, is considerable. 

The only other item in the system is an ordinary double ruled cash 
book in which are entered the receipts shown on the day tags, together 
with expense items as they occur. On adding up at the end of the month, 
the total in the cash book should tally with that on the pink card in the 
"Received" column. If it fails to do so, the month's Receipts can be 
checked up on the day tags and the error found. 

By having pink tags ruled to order, another column could be added to 



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108 THE DENTAL DIGEST 

include the expense account. At present I keep this only in the cash 
book. 

At first, upon reading this over, it may seem as though there is con- 
siderable labor involved in this method. I have gone more or less into 
detail, and it may sound complicated in the telling, but in actual use the 
amount of time it requires is negligible. A few seconds after each opera- 
tion, with five or ten minutes at the end of the day, and a couple of hours 
every month or so is all the time required, and it is time well spent I be- 
lieve, considering the results it yields. 

As a matter of fact, the whole thing can be turned over to an office 
girl, with the exception of the notations on the day tags. A thoroughly 
trained girl might even be entrusted with that too, but as office girls go I 
would prefer to attend to that myself. With all items correctly entered 
on the day tag, the girl's errors in entry can always be traced and cor- 
rected. Personally I prefer to attend to my own bookkeeping, limiting 
the girl's share in that to bill sending and looking up the accounts of 
people who call to settle while I am busy at the chair. 

I have been prompted to present this article by the fact that several 
of my dentist friends, happening to see my system, have asked me to 
explain it to them, and upon my doing so have given it their thorough 
endorsement, and have adopted it in their own practice. Since it 
appealed so strongly to those who have seen it, it occurred to me that 
perhaps there might be others who would be glad to learn of it. 

Should any of my fellow Digest readers find any helpful suggestions 
in this article, I shall be well repaid for the effort spent in its preparation. 

First National Bank Bldg. 



TWO GOOD PRACTICAL HINTS 

Waxed Silk : — Purcjiase yourself a ball of silk twist or silkateen 
from your dry goods store; place same in cup with sufficient beeswax 
to cover when melted, boil thread in wax for one minute, remove 
your thread and let cool. Then you have a fine ball of waxed thread 
through and through, always ready for your use. 

Good Probe: — Remove wood from common lead pencil, take a 
stiff piece of wire, bend one end so as to make a handle; on the other 
end use small binding wire; fasten the graphite removed from pencil; 
sharpen graphite. Then you have a probe with which you can push 
your melted gold around without it adhering to probe. 

C. I. Faison, D.D.S., Dallas, Tex. 



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ESTABLISHED METHOD OF TREATMENT 109 



ESTABLISHED METHODS OF TREATMENTS MUST 
BE FOLLOWED 

. {Wisconsin). — In the case of Allen v. Voje, recently tried in the 
)^^sconsin supreme court, the principle was laid down that a physician or 
^ ^^tist in treating a patient must follow the established methods of 
<i>^ .^^tment. A departure from approved methods in general use, if it 
^^^ ^^^s the patient, will render him liable, however good his intention 
"^^^-^O^ have been. It is however, not necessary that a physician or 
\\ ^5t adhere to ancient methods of treatment. He must keep abreast 
^\ie times. Some standard by which to determine the propriety of 
Xx^utment must be adopted; otherwise experiments will take the place 
of skill, and the reckless experimentalist the place of the educated, 
experienced practitioner. When the case is one as to which a system 
^{ treatment has been followed for a long time, there should be no de- 
parture from it, unless the surgeon who does it is prepared to take the 
^sk of establishing by his success the propriety and safety of his experi- 
ment. The rule protects the community against reckless experiments 
while it admits the adoption of new remedies and modes of treatment 
only vrhen their benefits have been demonstrated, or when, from the 
^ecessity of the case, the surgeon or physician must be left to the exer- 
^^•se of his own skill and experience. The skilfulness of a physician in 
^^^Tiosis and treatment should be tested by the rule of his own school. 
-ft seems to be a sound and reasonable rule and well established by the 
^-O-o Titles that the treatment of a physician or dentist of one particular 
^^^-^J is to be tested by the general principles and practices of his school 
• , ^^ not by those of other schools, and that a physician, surgeon or dentist 
^^Vand to exercise such reasonable care and skill as is possessed and 
Qf ^^ised by physicians, surgeons and dentists generally in good standing 
^j^^ ^^« same system or school of practice, or treatment in the locality 
q{ ^^ommunity of his practice, having due regard to the advanced state 
^r» *Ve school or science of treatment at the time of such treatment. 
xq ^^^ a patient selects one of the many schools of treatment and healing 
^^^^^^rve him, he thereby accepts and adopts the kind of treatment 

^^^ he is treated, when questioned in a court of justice, should be 
^d by the evidence of those who are trained or skilled in that school 



v^^ ^ ^Tion to that school or class, and the care, skill, and diligence with 
^lass. (Allen v. Voje, 114 Wis., i). 



PROFESSIONAL CONDUCT 



{Kentucky). — Kentucky Statutes, providing that the board of health 
^^y suspend or revoke a physician's or dentist's license, (i) for the pres- 

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110 THE DENTAL DIGEST 

entation to the board of any license which was illegally or fraudulently 
obtained, or the practice of fraud in passing an examination; (2) for the 
commission of a criminal abortion, or conviction of a felony involving 
moral turpitude; (3) for chronic or persistent inebriety, or addiction to a 
drug habit to an extent which disqualifies him to practice with safety to 
the people; (4) or for other grossly unprofessional or dishonorable conduct 
of a character likely to deceive or defraud the public is construed to create 
a definite standard by which professional conduct may be measured, and 
is a valid exercise of the police power. 

And although a physician or dentist may violate the professional 
code by advertising, his act will not constitute a ground for revoking his 
license, unless his conduct is dishonorable, fraudulent, and involves moral 
turpitude within the contemplation of the above statute. (Forman v. 
State Board of Health, 162 S. W., 796.) 

PAYMENT OF PROFESSIONAL SERVICES 

(Mimtesola). — Where defendant requested plaintiff, a dentist, to 
render defendant's niece professional services, who was a member of his 
household, her parents having been divorced and did not inform plaintiff 
that the patient was not his daughter or that he did not expect to pay for 
the services, he is chargeable for the value of the services rendered under 
an implied promise. (Bigelow v. Hall, 152 N. W., 763.) 

CURATIVE PROPERTIES OF MEDICINE 

(Federal). — One may not be convicted under the Food and Drug Act, 
merely because he advocates a theory of medicine which at the time has 
not received the sanction of the profession ; but one guilty of fraud may not 
escape conviction merely because some one may honestly believe in the 
theory which he fraudulently set forth. In United States v. American 
Laboratories defendant was prosecuted on the ground of having fraudu- 
lently advertised the curative properties of certain patent medicines. 
The defense was that the medicines contained curative properties as ad- 
vertised. 

A jury in the United States District Court found the defendant 
guilty of fraud in advertising its medicines to contain properties which 
as a matter of fact was mere belief and speculation. The court held it 
unlawful to advertise any medicine as a cure unless known to be positive 
(U. S. V. American Laboratories, 222 Fed., 105.) 

COUNTY NOT LIABLE FOR SERVICES 

(Georgia). — Where a dentist, at the instance and upon the request of 
the sheriff, performs a dental operation upon one who is a prisoner in the 



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A REQUEST FOR ADVICE 111 

custody of such sherifT, an action cannot be maintained by the dentist 
against the county to recover the value of such services. (C. T. Nolan 
V. Cobb County, 8i S. E., 124.) 



A REQUEST FOR ADVICE 

Editor Dental Digest: 

I have been for some time very much interested in your articles on 
the business side of dentistry, and am sending a more or less disconnected 
request for advice. 

I have many hours that should be filled, that are riot, and want my 
practice to come from the good I may render my patients by rendering 
to them such services as I would want rendered to me or my mother or 
my wife. 

For such honest services I want an honest fee. 

You probably know as well as I that many men with large practices 
render services, to the patients who trust them, that would not be passed 
in the school in which I received my dental education, Harvard. 

By such work, to my mind, the patient is not getting the services to 
which he is entitled or a square deal. 

The public is ignorant as to the proper care of the teeth, and the 
results following the neglect of such care. 

If I use printer's ink in educating them along those lines, and to such 
as come under my care, as a result of such use of said ink. render the best 
services I am capable of, in an honest effort to help them by putting their 
teeth in good condition, am I not as ethical in a broad sense, as the society 
man who puts into their mouths such work as we all see, and takes good 
money for it? 

I feel that fees are much too low for real honest work and that may 
be the reason why we see so much work that is not what it should be and 
is a disgrace to the profession. 

How can a man properly cleanse the teeth for $1? 

How can he treat and fill, properly, a molar for $3? 

How can he use a high grade alloy like Twentieth Century, carve, 
contour, line with cement and polish for $1 or $1.50? 

How many of them let the girl at the tooth counter pick out the teeth 
and the dental laboratory make the denture? 

How many of them try to tell the patient that the alloy filling is a 
means of restoring the teeth to comfort and usefulness and that it mav be 



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112 THE DENTAL DIGEST 

much better for them than a gold crown, and many times takes as much 
time and skill, and is worth money to them, the patient? 

How many of them are telling the patient that they are selling services 
and not fillings, and will charge as much or more for a so-called silver 
filling, if it takes time, than for a small gold one? 

How many of them are trying to get an)^ more for their services than 
they did lo or more years ago? Shouldn't they? 

What is the difference between a so-called honest ethical dentist and 
an honest unethical one. I mean honest with himself and his patient? 

Do you not think a man who uses printer's ink can be as honest with 
his patients as one who does not? 

We must live and if it is an honest living what's the difference? 

If you were in practice and it was necessary' to increase your produc- 
ing time, what would you do. 

Very truly yours, 
Massachusetts. 

Rditor Dental Digest*: 

Having read the Digest for several years, it has occurred to me that 
you might know some dentist in or about Boston who has put into prac- 
tice the ideas expressed in the Digest in regard to fees. About a dozen 
of the dentists in this county have formed a society, and we have been 
looking around for someone who would be willing to give us a talk on 
those lines. If you could suggest anyone whom we might get in touch 
with, it will be much appreciated. I wish to congratulate you on the 
work the Digest is doing in this direction. I believe it has done more 
for the advancement of dentistry than all the other journals combined. 

Sincerely yours, 

Boston. 

CAN ANYONE GIVE INFORMATION? 

Editor Dental Digest: 

I am one of the satisfied Digest family. 

I wish you to let us have some information on how to choose a dental 
location. You have told us how to increase fees and save time, but in 
looking for a location, I want to know just how to go at it. Points to 
take into consideration, etc. 

Yours very truly, 

Washington. 

* If our readers know of anyone who has put into effect the business building suggestions 
of The Dental Digest the editor will be glad to have him address " Boston," care of The Dental 
Digest, 220 W. 4 2d St., New York. 



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fkmoL Hints 



[This department is in charge of Dr. 
V. C. Smedley, 604 California Bldg., 
Denver, Colo. To avoid unnecessary de- 
lay, Hints, Questions, and Answers should 
be sent direct to him,]* 

A Painless Way to Open a Sore Tooth. — In opening up a very sore 
tooth when the patient cannot stand the pressure of the bur, I find the 
following method very good. Take your dentimeter and make a wire 
loop as if taking a measurement for a crown. Then let your assistant 
pull on the dentimeter while you open up the tooth. Or better yet, let 
the patient help you by holding dentimeter, then if it hurts they will 
equalize the pressure by pulling a little harder. — James J. Jones, D.D.S., 
Scottsbluff, Nebr. 

To Repair a Hole in a Bicuspid or Molar Crown. — Take a clean 
piece of asbestos paper and cut out a disc that will fit inside the band. 
Place occlusal surface on something flat and press the disc down firmly 
and evenly. Moisten several pieces of asbestos and fill up the crown. 
Place on a charcoal block and turn on the flame of the blowpipe. Cut a 
piece of solder large enough to cover the hole and place it in position. Flux 
well and turn on the heat. When the solder starts to curl on the edge, 
turn it down with a pointed slate pencil, and keep applying the heat until 
the solder is caught all around. With a little practice, you can drag 
solder around almost any place with an ordinary slate pencil. If the 
crown is on a bridge, wrap the bridge with asbestos paper, wiring it on, 
and proceed as above. 

An Ordinary Hail Screen. — If you are afraid that your investment 
will crack and pull away when soldering a big bridge, invest the bridge 
on a piece of hail screen cut to suit the case. A piece of hail screen also 
makes a very handy thing to place over the spider of your gas or gasolene 
stove on which to place an investment of any kind. — Harry M. Tweedy, 
D.D.S., Smith Centre, Kansas. 

To Tighten Old Plates. — If you want to delight the next patient 
for whom you repair an upper plate, just previous to investing, flow a 
rounded **bead" or ridge of wax just inside the border clear around the 
periphery of the plate. 

*ln order to make this department as live, entertaining and helpful as possible, question? 
and answers, as well as hints of a practical nature, are solicited. 



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114 THE DENTAL DIGEST 

Did you ever notice blisters on the plate where a bubble was, in repair 
jobs? Well, that is what happens in this case. The wax bums out and 
the rubber expands there. — ^J. F. Adams, D.D.S., Clinton, Ind. 

To Remove an Inlay Model from a Difficult Cavity. — ^Hold the 
end of a piece of number 40 copper wire in the flame of an alcohol lamp 
until a globule of metal is melted on it. Seize the wire about a sixteenth of 
an inch from the end with a pair of dressing pliers. Heat the pliers until 
the globule is hot, place it against the wax model permitting the metal to 
melt into the wax, and cool it. Force applied to the wire now will cause 
the wax model to leave the cavity along the lines of least resistance. The 
wire may now be cut close to the wax and the sprue attached. — F. H. 
Miller, D.D.S., Aylmer, Ont. 

[I would suggest the substitution of gold for the copper wire here, as 
the globule of copper would mar your finished inlay, if it happened to be 
cast into an exposed portion of same. — V. C. S.] 

When Glower Burns out in the Dentiscope Lamp. — ^To avoid 
delay and inconvenience while waiting for a new burner from supply 
house, remove lighting device from the ground glass shade and turn on the 
current; when the heater is at the maximum temperature touch the 
broken glower together and it will fuse at the break; have used one glower 
over a year that has broken several times. — George E. Cox, D.D.S., 
Wilmington, Delaware. 

A Method for the Correct Application of Davis Crowns to 
Roots. — To prevent failures due to displacement of crown and weakening 
of cement during process of cementation, caused by movement when 
holding crown with fingers. After the root is treated and filled, grind 
root as usual, apply post to root, having collar on post flush with surface 
of root, apply crown and grind wh«re necessary, and after obtaining the 
conditions necessary for an ideal substitute of the missing tooth, cement 
the post in the root. Then attach the crown to post and root with gutta- 
percha, obtaining correct alignment of crown before hardening of gutta- 
percha. If opposing tooth strikes the crown, grind at this point. (If 
crown becomes loosened during grinding re-attach with gutta-percha.) 
After hardening of gutta-percha and conditions are ideal, take impression 
(not bite) of crown and adjacent teeth with modelling compound, chill 
and remove. Remove crown and all gutta-percha, dry with chloroform 
and hot air. Apply crown to root with cement, place impression over 
crown and apply steady pressure, until cement has hardened. Remove 
impression and trim away aft excess of cemeftit. If the technic is still 
fully performed and all moisture excluded you will get results impossible 
with the old method of holding with the fingers. This method consumes 



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QUESTIONS AND ANSWERS 115 

more time but it pays in the end. — Monreith Hollway, D.D.S., Buffalo, 

N.Y. 

Extracting a Post from a Frail Root. — In extracting a post 
from a frail root with a post puller there is always danger of splitting 
the root. The likelihood of this happening may be reduced to the 
minimimi by taking a piece of twenty-eight gauge German silver plate, 
cut a hole through it large enough to pass over the post and trim into 
a disk about the size of the root face. This disk may then be placed 
on the root with post projecting through its center. The post puller 
may then be placed in position and as it is tightened the part of the 
instrument which is intended to bear on the root rests against the metal 
disk and does not slip or spread and the post may be drawn with safety. 
If the face of the root is uneven from decay, a bit of base-plate gutta 
percha may be molded into the cavity, the disk pressed into place and 
chilled with cold water, giving an even base for the instrument to press 
against. — ^J. A. Bullard, D.D.S., Chicago, 111. —The Denial Review, 



QUESTIONS AND ANSWERS 

Question No. i. — ^What metal is best for castings, to be used under 
gold crowns, for the purpose of building up badly decayed roots to support 
crowns? Would there be danger in using coin silver, containing ten per 
cent, copper, in case the crown failed and exposed the coin silver to the 
secretions of the mouth? 

Question No. 2. — Would like the name and address of an insurance 
company, that insures dentists against malpractice suits. I believe every 
dentist should carry such insurance, when our doctors are blaming crowns, 
and bridges, whether they are sanitary or not, for case after case of sys- 
temic disease. — G. W. 

Answer No. i. — I see no serious objection to the use of coin silver for 
the purp)ose you suggest, though I cannot speak from experience with it. 
I do, however, use pure silver for this purpose and find it entirely satis- 
factory. 

Answer No. 2. — I am told by an insurance man here that any of the 
companies carrying protective policies for physicians and surgeons insure 
dentists on the same basis. There are probably other companies doing 
the same thing, but he gives me the names of these: Fidelity & Casualty 
Co., and Maryland Casualty Co. Rate $15 per thousand. Limit 
$5,000 for one suit and limit $15,000 for one year, — V. C. S. 

Question. — Will you please give me a simple method of employing the 
aqua regia-ferric process of separating gold or gold alloy from platinum.-— 
C. B. K. 



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116 THE DENTAL DIGEST 

Answer. — ^Answering your question on how to separate platinum 
from gold alloy. First add silver to reduce alloy to 6k. Dissolve silver 
and copper with nitric acid and wash residue thoroughly in water. Dis- 
solve residue, which should now be pure gold and platinum, in aqua regia 
(one part hydrochloric and two parts nitric acid). Precipitate gold with 
sulphate of iron. Filter and wash. Precipitate platinum with solution 
of ammoniae. Filter and heat in crucible to white heat, just burning 
filter paper out. This when cool gives you sponge platinum which had 
best be sent to a platinum refiner to melt and roll. — V. C. S. 

Answer. — In Practical Hints, November issue of the Dental Di- 
gest, Dr. M. M. Brown, of Macon, Miss., under hint number three, 
refers to the use of a sheet of bibulous paper for squeezing out the excess 
of mercury from amalgam. A better way still is not to have any excess 
mercury in the amalgam. Secure a little mortar and pestle, first pour 
the desired amount of mercury in the mortar, then a little alloy, and mix 
in; then continue to add alloy until all mercury is mixed in to a firm mass; 
take amalgam from mortar with fingers to a piece of rubber dam, in this 
rub rapidly in palm of hand in order to evenly unite all particles of alloy 
and mercury. In this way you have a perfect mixture and a clean filling 
material. — M. L. Brockington, Florence, So. Car. 

Answer. — In the November issue of the Dental Digest I find a 
recommendation of atomized alcohol for cleaning the synthetic slab and 
eyeglasses. I have found another excellent use for this alcohol, namely 
cleaning mouth mirrors which have become dirty in any way from use in 
the mouth. While I am working for the same patient I do not claim to 
sterilize my mirrors by this method. The alcohol when wiped off takes 
whatever dirt there was with it, and leaves the mirror clean and clear 
which is a great aid to one who works almost entirely with the mirror. — 
Horatio C. Meriam, D.M.D., Salem, Mass. 

Answer. — In the last issue of the Digest I read about coating strips 
and discs with soap to facilitate polishing hy doing away with unneces- 
sary friction and to also aid in recovering the otherwise wasted gold. 
Would say that I have long been using cocoa butter for this purpose and 
believe it better. It is put up in handy form and less objectionable to the 
patient. Also instead of coating engine belt with beeswax and resin to 
make it hold tightly, try slipping a small rubber band into the pulley 
groove on both engine and handpiece. It will work. You can run the 
belt more loosely thereby prolonging its life and saving wear on all bear- 
ings concerned. The belt dressing previously mentioned doubtless would 
dirty the belt and leave a bad streak on your white coat should the belt 
chance to rub the latter as is often the case.— F. W. M. 



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AN EPITOME OP CURRENT DENTAL AND MEDICAL LITERATURE 117 



AN EPITOME OF CURRENT DENTAL AND MEDICAL 
LITERATURE 

[The Dental Review^ January, 1916] 

Contents 

Original Communications 

*The Dental Pulp and Periapical Tissue: Diagnosb and Prognosis of Their More Common 
Pathologic Conditions. By William H. G. Logan. 

The Business Side of Dentistry. By Guy F. Corley. 

Root Canal Preparation. By J. R. Callahan. 

Why Some Fillings Fail. By R. Rodgers. 
•Extraction of Teeth as a Surgical Operation. By E. L. Teskey. 

Proceedings of Societies 

Illinois State Dental Society, Fifty-first Annual Meeting Held at Peoria, May 11-14, 191 5. 
Wisconsin State Dental Society, Forty-fifth Annual Meeting Held at Oconomowoc, July 

Chicago Dental Society. 



Editorial 



The Best Year Yet. 
Practical Hints Memoranda. 



THE DENTAL PULP AND PERIAPICAL TISSUES: DIAGNOSIS AND PROGNOSIS 
OF THEIR MORE COMMON PATHOLOGIC CONDITIONS 

By William H. G. Logan, M.D., D.D.S., Chicago, III. 

Cardinal symptoms and findings accompanying that contraindicate 
the efort to save the pulp's vitality when the root ends are fully formed, 

A. — ^All pulps exposed by dental caries should be considered infected, 
therefore removal in every instance is indicated. B. — When a pulp has 
been exposed by accident and the tissue injured, for example, by exca- 
vator or bur, the vitality of the pulp cannot be permanently maintained. 
C. — Remove the dental pulp in those cases where carious dentin is found 
lying in contact with it. D. — When the paroxysms of pain have been of 
one or two hours' duration or have become constant and occur with or 
without the application of a known irritant and are most pronounced at 
night, the prognosis of this pulp's vitality is hopeless. E. — When a tooth 
becomes sore under pressure as result of a periapical inflammation caused 
by the pulp disease spreading by continuity to the tissues beyond the root 
end, begin treatment that is to terminate in the filling of the root canal. 
F. — Every pulp should be removed when the pain is momentarily re- 
lieved by the application of cold water. 

In the application of the above statement, let it be remembered they 



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118 THB DENTAL DIGEST 

only have reference to pulp diseases in teeth that have reached full 
development. 

Pulp capping with our present technic should be looked upon as a 
doubtful procedure in all cases after the root end has formed. I believe 
to cap a pulp that has been exposed by either dental caries or from the 
removal of carious dentin that was lying in contact with the pulp is to 
court positive failure. However, many careful operators have suc- 
cessfully capped pulps before the root end had fully formed, that were 
exposed in the process of cavity preparation by opening through a thin 
layer of normal dentin. I believe there is an agreement that it is wise 
in many instances to cap pulps for the purpose of maintaining the pulp's 
vitality as long as possible, when we wish the benefit of the activity of 
the odontoblastic cells to complete root end development. 

EXTRACTIONS OF TEETH AS A SURGICAL OPERATION 
By E. L. Teskey, Shabonna, III. 

Impress on the patient that the extraction of a tooth is no simple 
operation, that it requires skill and care and that the result may be serious 
if not properly performed; then quiet the pain, put the tooth at ease, 
give a cathartic and send him home until the next day. On his return 
proceed to prepare the mouth by cleaning all the teeth, washing out the 
nose and throat, rendering the field as aseptic as possible. That this 
cannot be complete is no reason that it should not be attempted. Have 
all instruments and hands sterilized as carefully as for a major operation; 
now proceed as the case indicates, using a general or local anesthetic as 
desired. Be sure that there will be no pain and that you will have plenty 
of time to do the work thoroughly. Remove all of the tooth, using no 
more force than is needed, and if it is necessary to lacerate the gum, 
dissect it out of the way, so that there will be no contusion of the soft 
tissue. Carefully wash out the wound with sterile water and replace the 
gum tissue in normal position; dismissing the patient for the day. The 
patient should be fed with soft food until the wound is healed. The 
dentist should see the case every day until there is no danger of a second- 
ary infection. 

I know you will say that the patient will object to the trouble and be 
unwilling to pay for it, but I believe that when the patient understands 
the seriousness and importance of the operation these would be second- 
ary considerations. In the meantime work toward this end. 

Within my memory the public went to the jewelers an 1 traveling 
peddlers for their glasses, but now the oculist has no trouble in getting 
good fees for his services and the patient is satisfied. The first thing is 
to realize the seriousness of the operation ourselves and then educate 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 119 

the public. This is an age of education; the people are awaiting the 
teachers; it is up to you. 

In conclusion I can see it in no other light than that the general 
surgeon is either a charlatan and working for effect, or the dentist is 
careless and not giving the people the best that is in him. 

[The Dental Cosmos^ January, 1916] 

Original Communications 

♦Mandibular Anesthesia. By Theodor Blum, D.D.S., M. D. 
The Application of Local Anesthesia to Dentistry. By Leo Stern, D.D.?. 
Indications for and Construction of Fixed or Removable Bridge Work. By Thomas P. 

Hinman, D.D.S. 
The Importance of Biology as Applied to Dentistr>'. By Dr. Ch. F. L. Nord. 
The Germicidal Efficiency of Some Copper Cements Used in Dental Work. By R. F. 

Bacon, Ph. D. 
A Contribution to the Study of Faces. By L. G. Singleton, D.D.S. 
*The Irrationality of Bacterial Vaccines in the Treatment of Pyorrhea Alveolaris. By A. H. 

Merritt, D.D.S. 
Practical Value of Mouth Hygiene. By H. W. Wiley, M.D. 



Correspondence 



A Rejoinder by Dr. Rhein. 
"Square Deal" Examinations. 



Proceedings of Societies 

Pennsylvania State Dental Society. 
Susquehanna Dental Association of Pennsylvania. 

Editorial Department 

Retrogressive Reform. 

Legal Protection of the Examinee. 

Bibliographical. 

Review of Current Dental Literature. 

Periscope. 

Hints, Queries, and Comments. 

MANDIBULAR ANESTHESIA 

By Theodor Blum, D.D.S., M.D., New York 
Oral Surgeon and Dental R'dnigenologist, New York Post Graduate Medical School and Hospital 

writer's TECHNIC 

I will now describe the technic of mandibular anesthesia which I 
am accustomed to teach. It is similar to SeidePs method, modified only 
by using the index finger of the left hand for palpation and the right 
hand for injecting on the right side, and vice versa; the bevel of the heavy 
steel needle is turned toward the nerves and away from the bone. 



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120 THE DENTAL DIGEST 

Let us say, for example, that we wish to give a mandibular injection 
on the right side. The patient is requested to open his mouth, and with 
the index finger of the left hand, the external oblique line is found. Now 
the ball of the same finger is placed over the retro-molar triangle in such 
a manner that the fingernail touches the internal oblique line; this 
finger is moved slightly laterally to free the internal oblique line — ^iii 
which position the finger remains throughout the injection — ^and the 
area is painted with iodin; the syringe, is grasped with the right hand, 
like a pen, and the needle is run i cm. above the occlusal plane of the 
lower jaw through the soft tissues directly to the internal oblique line; 
the needle is retracted somewhat, so as to release it from the periosteum, 
and moved — the syringe is in nearly sagittal direction — mesiaUy until 
one finds no more resistance to proceeding backward, i, e, when, after 
passing the internal oblique line, one arrives at the mesial aspect of the 
ascending ramus. About five drops (0.3 cc.) of the solution are injected, 
to anesthetize the lingual nerve. The point of the needle is placed in 
contact with the mesial aspect of the ascending ramus by turning the 
syringe to the opposite side, and remains so while going backward a little 
over 2 cm., all told. The point of the needle is now in the upper half 
of the mandibular sulcus, where we inject the remainder of the solution 
(1.5 cc). 

To anesthetize the left side, the right hand is used as a guide, and the 
syringe is held with the left. A little practice will overcome the difficulty 
of working with the left hand. 

In a few minutes, upon questioning, the patient will state that his lip 
and tongue feel numb — ''swollen, hot, cold, empty, like electricity, with- 
out feeling," etc. In almost every case the molars, bicuspids, and the 
cuspids are completely anesthetized in from ten to twenty minutes. 
Before starting to operate, the mucous membrane is tested by compressing 
the gingiva with a pair of pliers on the buccal side of the cuspid and the 
tooth one wishes to work upon, and lingually. If, after twenty minutes, 
pain is felt in the cuspid region, a second mandibular injection must be 
given. In case the buccal mucous membrane in the molar and bicuspid 
region only is sensitive, i, e. if supplied by the long buccal nerve, this 
part must be desensitized with a horizontal injection in the apical region 
of these teeth. In infected cases conductive anesthesia of the long 
buccal nerve may be resorted to, injecting beneath the mucous mem- 
brane of the cheek below Steno's duct (Williger). 

The anastomoses of the inferior dental, lingual, and mental nerves 
explain why the middle portion of the lower jaw with the incisor teeth 
is not anesthetized. To obtain complete anesthesia of half of the lower 
jaw the mental foramen of the opposite side must be injected — ^also 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 121 

lingually at the median line. I have found mandibular anesthesia to 
last over two hours. 

THE IRRATIONALITY OF BACTERIAL VACCINES IN THE TREATMENT OF 

PYORRHEA ALVEOLARIS 

By Arthur H. Merritt, D.D.S., New York, N. Y. 
The author of this able article sums up his conclusions as follows. 

CONCLUSIONS 

The irrationality of the use of bacterial vaccines in the treatment of 
pyorrheji is proved : — 

(i) The exceeding complexity of the bacterial flora of pyorrhea 
alveolaris, of which comparatively little is known. 

(2) The absolute lack of evidence that any of the organisms present 
sustain a causal relation to the disease. 

(3) The imreasonableness of expecting a vaccine to affect favorably 
a disease when the organisms associated with it are practically beyond the 
influence of the antibodies contained in the blood and lymph, as they 
are in pyorrheal pockets. 

(4) The impossibility, with our present cultural methods and limited 
knowledge, of preparing a vaccine which would be at all representative 
of the bacteriology of the disease. 

(5) The evidence already at hand which indicates that there is no 
qualitative difference between the bacteriology of pyorrhea and that of 
the normal mouth, and that the difference noted is a quantitative one 
only. 

(6) The probability that the infection in pyorrhea is purely second- 
ary. 

(7) The absence of any proof that pyorrhea which has not yielded 
to local treatment can be cured by vaccines, or that their use will prevent 
recurrence. 

(8) The inadvisability of resorting to a complicated and uncertain 
form of treatment when simpler and more efficient methods are avail- 
able. 

(9) The fact that pyorrhea "can be cured by instrumentation, pro- 
viding only that it be skilfully done. 

When dentists realize that pyorrhea is a preventable disease; that, 
in its early stages, it is easily and permanently cured; that only those 
cases are hopeless that are long neglected; that no drug or vaccine ever 
will, of itself, cure the disease, and that dependence must be placed upon 
local treatment, they will have taken the first step toward eliminating, 
from the mouths of their patients, the chief of mouth infections. 



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122 THE DENTAL DIGEST 

[Dental Items of Interest, January, 1916] 
Contents 
Exclusive Contributions 

The Compressed-Air Obtunder. By Raymond E. Ingalls, D.D.S. 

Prosthodontia 

Technique for a Simple Bridge, By Herman £. S. Chayes, D.D.S. 

Orthodontia 

Report of Cases Given Before the Annual Meeting of American Society of Orthodpntists at 

Toronto, Ontario. By W. G. Barr, D.D.S. 
Reports of Clinics Before the American Society of Orthodontists at Toronto, July, 1914. 
Demonstration. By Victor Hugo Jackson, M.A., M.D., D.D.S. 

Society Papers 

Some Suggestions in Securing Adequate and Uniform Dental Legislation. By Homer C. 

Brown, D.D.S. 
The Mission of the International Dental Federation. By N. S. Jenkins, D.D.S. 
Some Refractories Used in Dentistry. Guy Stillman Millberry, D.D.S. 
The Educational Value of Oral Hygiene in the Army. Edwin Payne Tignor, M.D., D.D.S. 
The Importance of Mouth Hygiene During Infancy and Early Childhood. By Horace L. 

Howe, D.D.S., D.M.D. 

[The Dental Summary, December, 1915] 

Contents 

*Precanccrous Conditions of the Face and Mouth. By John W. Means. 
Porcelain-faced Molar Crown. By R. J. Rinehart. 
Inlays, Gold and Synthetic Cement Restoration. By S. F. Jocobi. 
The Care of the Deciduous Teeth. By I. W. Copeland. 
The Business Side of Dentistry. By W. A. Meis. 
Modelling Compound-Plaster Impressions. By T. D. Dow. 
Prevention and Reproduction. By William Conrad. 
Conductive Anesthesia. By George T. Gregg. 
Wanted — Better Dentists. By Frederic R. Henshaw. 
President's Address. By A. W. McCullough. 
Prohibitive Dentistry. By Edwin S. Hulley. 

Editorial 
Old Time Dentists. 

PRECANCEROUS CONDITIONS OF THE FACE AND MOUTH 
By John W. Means, D.D.S., M.D., Columbus, Omo 

First: Most cancers of the face and oral region have in the be- 
ginning passed through a benign stage which is termed precancerous. 
Second: One of the most significant things in the study of cancer is 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 123 

the fact that the cells making up this growth in no way differ from the 
young cells which are normally elaborated to repair any defect. 

Third: There are certain conditions which are commonly benign 
but which are very prone to become malignant. 

Fourth: We cannot tell which one will become cancer and which 
will remain benign; nor can we tell the time at which the change has 
occurred. 

Fifth: One hundred per cent, cures result from removal in the pre- 
cancerous and even the early cancerous stage and a rapid decrease in this 
percentage follows procrastination. 

Sixth: Removal by surgical means is by far the safest method and 
is practically without disfigurement or inconvenience. 

In conclusion, then, let me emphasize the thought that the responsi- 
bility of the dentist is greater than that of the physician in that 
his work brings him in more frequent contact with the lesions of the oral 
cavity. 

[The Dental Summary, January, 1916] 
Contents 

The Shoulder Crown. By George S. Hershey. 
Gold Inlays as Bridge Abutments. By H. U. Shepherd. 
Malplaced and Impacted Third Molars. By L. G. Noel. 
Root Canal Filling. By H. L. Werts. 

Cast Base Dowel Crowns vs. Ground Joint and Shell Crowns. By J. A. Gardner. 
Porcelain- Jacket Crown. By George T. Gregg. 
A Plea for More Efficiency and Better Fees. By Charles A. Tavel. 
A Sane System of Keeping Burs. By R. C. Simmons. 
Crown and Bridge Work. By W. O. Hulick. 
Advice to Those About to Wear Artificial Teeth. By D. W. Barker. 
Mouth Infection as a Source of Systemic Disease. By Frank B. Walker. 
The Sterilization of Dental Instruments. By H. £. Hasseltine. 
Distilling Apparatus. By M. M. Brown. 
*A Cleft Palate Case. By G. B. Speer. 
Mandibular Conductive Anesthesia. By H. F. Koontz. 
Report of Committee on Dental Literature. By A. C. Barclay, T. A. Hogan, and J. D. 

Whiteman. 
Dentistry, in its Progress Through the Century, to Stomatology as a Science. By James 

Truman. 
A Loose Pin Banded Crown for Upper Lateral Incisors. By B. A. Wright. 
A Great National Movement. By W. G. Ebersole. 
Some Reminiscences. By W. J. Burger. 
Prophylaxis. By Franklin B. Roberts. 

Editorial 

The Recent Meeting of the Ohio State Dental Society. 
Research Institute of the National Dental Association. 
Special American Hospital in Paris for Wounds of the Face and Jaws. 



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124 THE DENTAL DIGEST 

A CLEFT PALATE CASE 
By Dr. G. B. Speer, Los Angeles, California 

Let us say Case No. i, Donald , age 22, came to my office Novem- 
ber, 1 9 14; had two rubber vellums, was never able to wear either with 
comfort, in either talking or eating; in fact, could talk plainer without- 
After examination he followed my directions and went to the Angeles 
Hospital. Next morning at eight o'clock, I did a Brophy operation- 
He remained in the hospital one week, went home and reported to my 
office for removal of lead plates and sutures. He now can talk to strangers 
and be understood. In his own words, he says he thinks a school teacher 
can now imderstand him and he is going to go to night school. He also 
says people do not notice his lip any more and he can whistle, a thing he 
always wanted to do but could not. 

When I look at this result and I wonder why at this age of human 
progress and surgical successes, when we can almost say a man's success 
is only limited by his imagination, for we must remember that he who 
seeks to discover must first learn to imagine, and the surgeon's hand only 
does the work guided by the imagination brain, and all that is necessary 
is to look into that mouth and imagine the shape that palate should be. 
Then with his hands he constructs out of the tissues already there a 
palate, shaping it as it should be, true to nature, and as the potter 
modeling his clay has to allow a sufficient excess to allow for the shrinkage, 
so we allow for the contractions in the healing, and we have a vellum 
worthy of the name; and as I pen these few words, there arises in my 
memory a vision of a kindly face, surmounted by gray hair and I can 
almost see the kindly eyes and hear the kindly voice of Doctor Brophy, 
the originator of the Brophy operation, saying that the time for rubber 
velliuns was past years and years ago, and I go further and say there 
never was a time for them, for surgery should have preceded them, and 
there would never be need or cause for such an article and rubber vellum, 
germ-breeding pens would never have been heard of. 
Story Building 

PROPHYLAXIS* 
By Dr. Franklin B. Roberts, Pittsburg, Pa. 

A prophylaxis treatment requires time and in order to give the patient 
a thorough treatment the fee charged must be in accord with the time 
necessary to do the work thoroughly. First of all, remove all deposits. 
A mixture of carmi cleanser, glycerine, a drop of essence of peppermint 
and, in some cases, a few drops of peroxide I find makes a good paste for 
polishing. A little rubber cup made by Young & Co., I find excellent 

*Clinic at Odontological Society of W. Pa., 1915. 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 125 

for use with the engine. This little cup holds the paste, does not cut or 
irritate the gum, is soft and not harsh and still removes all stains. The 
disclosing solution is used after which all surfaces are gone over with the 
hand polisher and wooden points. For deep cusps the little brush used 
on the engine is useful. The approximal surfaces can be polished very 
thoroughly by using the Kuroris silk ribbon smeared with the paste. 
For the high polish the carmi lustro is used, keeping both tooth and lustro 
dry. The mouth is now thoroughly syringed with an antiseptic solution 
and your time is well spent. This treatment, in my experience, I find 
much appreciated by my patients, and should be repeated every two or 
three months as the case may be to give the patient the best results. 



[The Dental Outlook, January, 1916] 
Contents 
Original Communications 

•Importance of X-Ray Diagnosis in Dentistry. By A. M. Nodine, D.D.S. 
Discussion of Dr. Nodine's Paper. By Dr. L. Harris. 

The Regents, Dental Education and the Allied Dental Council. By M. William, D.D.S. 
Dental College by next October. 
Monthly Report of Legislation Committee of the Allied Dental Council. 

Editorial 

1Q16 — ^A Retrospect and a Forecast. 
Letters to the Editor. 

Book Review 

Simplex Handbook of Dental Materia Medica and Therapeutics. 
Students* Department. 
Society Activities. 

IMPORTANCE OF X-RAY DIAGNOSIS IN DENTISTRY 

By Alonzo Milton Nodine, D.D.S. 

Oral Surgeon and Dental Consultant ^ French Hospital; Assistant Dental Radiologist, New 
York Throaty Nose^ and Lung Hospital 

In the field of oral surgery, we find the wrecks and wreckage of care- 
less, unsanitary, septic, and sometimes almost criminal dentistry. I 
find almost 75 per cent, of the oral surgery I do is the result of bad 
dentistry. 

When these patients come to the oral surgeon — the Court of Last 
Appeal — to save their health and perhaps their life, imagine the responsi- 
bility when perhaps the skilled efforts of all others of the healing art have 
given no relief. Imagine the carnage that would ensue did the oral 



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126 THE DENTAL DIGEST 

surgeon not first have radiographs of the teeth and jaws, charts, and 
surveys of these organs. 

It would seem almost impossible for oral surgery to have attained 
the high standard of excellence it now has attained if the use of the X-ray 
had been denied it. 

The limitless conditions in which radiographs serve the oral surgeons 
are too numerous to mention. But oral surgery answers that question 
too frequently asked, *'What are we going to do with those teeth whose 
root canals we cannot fill?" 

Oral surgery tells us to fill those canals as far as possible, and then 
resect the roots. Oral surgery also answers that other question asked, 
**What are we going to do with those teeth which we cannot cure 
of a chronic apical abscess? " Disinfect and fill the root canals, and oral 
surgery will cut out the granuloma and resect the septic eroded root end. 

But only by the frequent and consistent employment of the X-ray 
is it possible for the oral surgeon to know how far the canal is filled and 
the extent of the apical infection. 

[The Texas Dental Journal, December, 1915] 
Contents 
Original Communications 



Prevention of Decay. 

Oral Surgery. 

Cotton and Explosives. 



With Our Contemporaries 



A Consideration of Some of the Present Tendencies in Dentistry. 

Pellagra. 

The Rotary Code of Ethics for Business Men of all Lines. 

Personal Observations on the Brophy Plan of Dealing with Complete Clefts of the Lip and 

Palate. 
Tests of Leaking Amalgam Fillings. 
Cavity Toilet Preparations to the Insertion of Synthetic Porcelain. 

[The Dental Register, December, 191 5] 

Contents 

Event and Comment. 

Professional Ideals. 

The Tooth Brush. 

How Should Dentists Advise? 

The Human Mouth. 

Bibliography. 

Index to Volume LXTX. 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 12? 

[Oral Healthy December, 1915] 

Photograph— The late W. T. Stuart, M.D. 

♦Centralized Dental Clinics for Children. By Harold DeW. Cross, D.M.D., Boston. 
*Localized Dental Clinics for Children. By Wallace Seccombe, D.D.S., Toronto. 

Color of the Teeth. By F. H. Orton, D.D.S., Minneapolis. 

Interproximal Space and Tooth Form. By Charles E. Woodbury, D.D.S., Council Bluffs. 

Fibrous Foodstuffs and Certain Diseases. 

Obituary. 

Active Service Roll. 

Photograph, Dr. Harvey J. Burkhart, Director Rochester Dental Dispensary. 

Editorial. 

CENTRALIZED DENTAL CLINICS FOR CHILDREN 
By Harold DeW. Cross, D.M.D. 
{Director^ The Forsyth Dental Infirmary^ Boston) 

The Forsyth extends its benefits to all children of Boston and its 
suburbs under sixteen years of age whose pecuniary circumstances pre- 
clude their securing the services of a private dentist. At the present 
time this pecuniary eligibility is based upon maximum of $4 per week 
per person in the family. That is, if the family income is $20 for a family 
of five, the children of the family become eligible. The number of 
children at present cared for is between four and five hundrec^per day. 
This number will be gradually increased. A charge is made of five cents 
for each visit. 

The question of localized clinics was very carefully considered by the 
Trustees before the plan of a central clinic was finally adopted. The 
local clinics were considered unsatisfactory because (a) It was exceed- 
ingly difficult to control the attendance of the operator. They were 
liable to come late, to leave early, and possibly not to come at all. Very 
strict supervision was found necessary to improve punctual and full 
attendance, (b) It was almost impossible to exact an equal standard 
of work done in the different clinics. This diflference of standard quickly 
became known and clinics were patronized or neglected according to the 
standard of work and equipment supplied, (c) A suitable equipment 
meant an expensive reduplication of plant. This necessarily occurred 
no matter how inadequate the equipment of a given plant might be. 
It further meant an idle equipment in many instances for certain hours 
of the day. (d) It was found that the trained dental practitioner was 
obliged to waste a greater or less part of his time in clerical or nursing 
work and by attending to other duties than his strictly professional 
services, (e) It was found to be exceedingly difl&cult to regulate the 
purchase and cost of supplies and to check their application, (f) And 
lastly, it was found that the providing of hygienic and septic quarters 
was almost impossible. 



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12S THB DENTAL DI6BST 

LOCALIZED DENTAL CLINICS FOR CHILDREN 
By Wallace Seccombe, D.D.S., Toronto 

The advantages of Dental Clinics established in the school buildings 
may be summarized as follows: 

1. The plan is less costly. 

2. School discipline gives control of child for treatment as well as 
follow-up service. 

3. Through the assistance of the school teacher, the daily cleansing 
of the mouth by the child may be checked up. 

4. In the acquiring of good dental habits of mastication and oral 
cleanliness, the child is usually influenced more by the teacher than by 
the parent. 

5. Complete dental statistics regarding oral conditions are only to 
be obtained through the systematic dental examination of children in the 
school building. 

6. Schools are becoming more and more educating centres for the 
conrniimity in which they are situated. 

7. Dental operators are under same regulations regarding hours and 
discipline as are members of the teaching staff. 

Disadvantages of a central clinic as they appear to the writer are: 

1. The necessity of children traveling long distances with the con- 
sequent expense of transportation. Ten cents for car fares each visit is 
a hardship to those who are too poor to pay for regular dental service. 

2. In cases of younger children, the inconvenience and expense of 
an older person accompanying the child each sitting. 

3. Lack of control of the child regarding subsequent sittings and the 
impossibility of the daily follow-up. 

4. Lack of cooperation between school, home and dental clinic. 

In presenting these facts for your consideration, the writer has no 
thought of minimizing the possible advantages of a central clinic plan, 
but would urge, in view of our experience in Toronto, the many advan- 
tages of following the school system which has already been thoroughly 
tried across the water and found most practical and efficient. 

[New York Medical Journal, December 25, 1915] 

DECAYED TEETH AND CANCER 

By Alonzo Milton Nodine, D.D.S., New York. 

Oral Surgeon and Denial Consultant^ French Hospital; Assistant Dental Radiologist, New 
York Throaty Nose, and Lung Hospital 

One woman out of seven and one man out of eleven, after the age 
of thirty-five years die of cancer in England. Cancer is sixth in the list 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 129 

of diseases that cause death in the United States; there has been an 
average of 73,800 deaths from cancer for the last ten years. In New 
York State, in 1913, 9,528 deaths were caused by cancer. Cancer 
caused over nine times as many deaths as typhoid fever. In 189 1, cancer 
caused 3,000 deaths. In twenty years the death rate has increased 
166.66 per cent. If this rate continues for another twenty years, the 
death rate from cancer will be more than from consumption. 

Different estimates indicate that from nine to 26.3 per cent, of all 
cancers are found on the tongue. Still others declare that one seventh 
to two fifths of all cancers are found in the mouth, tongue, lips, or jaws. 
Most of these cancers are on exposed surfaces where they should be 
discovered early, operated upon, and cured. Equally significant is the 
estimate that one third to one half of all cancers are foimd in the stomach 
and duodenum. 

Whatever may be the underlying, imdiscovered cause of cancer, there 
seems to be no question that the exciting cause is irritation. This irrita- 
tion may be caused by chemicals, bums, injuries, or inflammatory dis- 
eased conditions. Dynamite is harmless until irritated; and whatever 
causes cancer is harmless until irritated. The two regions of the body 
most subjected to chronic irritation are the mouth and the stomach. 

Cancer is one of the diseases for which modem civilization is held 
responsible. Furthermore tooth decay is the most widespread and 
prevalent disease for which modem civilization is responsible. Eighty 
to ninety-eight per cent, of the school children of the United States have 
decayed teeth, and there is little doubt that the same rate prevails with 
the adult population. Decayed teeth are due, to a very great extent, 
to our modem demineralized, devitamized diet, as well as to haste in 
eating, nervous tension, lack of exercise, methods of cooking, and all that 
goes with our manner of living. 

The particular irritation that is frequently found to cause cancer in 
the mouth is the sharp edge of a decayed, wom, misplaced, or tartar 
covered tooth. The constant rubbing of the tongue, cheek, or lips over 
such a tooth produces an abrasion, an abrasion develops into a sore, and 
from a sore it may pass on through various stages to cancer. The 
irritation produced by the sharp edge of a broken or poorly fitting plate, 
bridge, crown, or filling has caused cancer of the mouth. 

Cancerous growths may also spring from the irritated and injured 
gum surroimding decayed and broken down teeth. Polyps grow from 
irritated tooth pulps. Bony growths result from chronic inflammation 
of the covering of tooth roots. Injury to the bony support of teeth by 
extraction has resulted in the development of cancerous growths in 
these locations. 



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130 THB DENTAL DIGBST 

The chronic irritation of an abscessed tooth, the irritation of decayed 
roots, impacted teeth and unerupted teeth, lower the resistance of the 
surrounding tissue and invite the development of cancer. Diseased and 
uncleansed teeth and gums are sufficiently irritating to produce inflamma- 
tion and ulceration of any part of the mouth. It is not unreasonable to 
believe that conditions such as these produce cancer of the mouth. 

That there are other causes which produce cancer of the mouth and 
jaws is unquestioned, but it must not be lost sight of that in such con- 
ditions, as have been described lie the possibilities of cancer. In fact, 
there are records of a great number of cases which show that cancer has 
developed from such conditions. There is the classical example of Gen- 
eral Grant. 

In New York State, in 1913, 291 deaths occurred from cancer of the 
mouth, and in January, 1914, thirty deaths 1 Mayo, Moynihan, and 
other surgeons and stomach specialists estimate that 45 to 90 per cent., 
perhaps all cases of cancer of the stomach, originate at the site of an ulcer 
of the stomach or duodenum. 

Among the most frequent causes of ulcer of the stomach are unmasti- 
cated food, too much food, and the constant swallowing of the contents of 
a diseased and unclean mouth. Food is not chewed or bolted either from 
habit or haste, or because decayed, diseased, deformed, or deficient teeth 
make proper chewing difficult, if not impossible. 

Large quantities of unchewed food, and the microorganisms and toxins 
from diseased, decayed teeth and gums injure the lining of the stomach 
either by impaction or stagnation, or else change or disorganize the pro- 
duction of the digestive secretions. The coating of the stomach also 
becomes infected during these resting periods between meals, when the 
hydrochloric acid is not poured into the stomach. The function of the 
hydrochloric acid is to neutralize, retard, and destroy the dangerous 
microorganisms and their toxins taken in with food. 

The abnormal decomposition of food in the stomach due to the inter- 
ference with production of the proper amount of hydrochloric acid, 
results in the manufacture from food of other acids, such as lactic, acetic, 
and butyric. These make the scomach excessively acid. This highly 
acid condition is sufficiently irritating to injure the coating of the stomach 
and cause gastric ulcer. A large amount of food, or hard unchewed food 
entering such a stomach, the churning movements further increase the 
irritation already begun by the abnormal acids. 

Rosenow has experimentally proved that one particular microorgan- 
ism found in unhealthy mouths is capable, when carried by the blood, 
of lodging in the wall of the stomach and producing gastric ulcer. 

The employment of the X-ray by the dentist assists in the discovery 



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AN BPITOM£ OF CURRENT DENTAL AND MEDICAL LITERATURE 131 

of cancerous and precancerous conditions. This diagnostic agent should 
be more frequently employed by physicians and dentists in all cases of 
suspicious swellings and enlargements. 

A great amount of evidence shows that one of the most certain meas- 
ures to prevent cancer, either in the mouth or stomach, is sound, clean 
teeth. Lost teeth should be replaced with artificial substitutes so that 
food may be properly chewed. In addition, dental defects should be 
corrected, decayed teeth should be treated and filled, and all unreclaimable 
teeth or roots removed; and all artificial fixtures, such as bridgework or 
plates should be made smooth, sanitary, and unirritating. Diseased 
gums should be treated to prevent the oozing into the mouth of pus and 
poisonous toxins that are found in such foul conditions. Tartar should 
be removed from the teeth frequently and thoroughly, and the teeth 
cleansed and polished by a dentist or dental nurse. Finally, teeth should 
be brushed carefully and thoroughly with a good tooth paste, powder, or 
lime water, or lemon juice and water, after eating and upon going to bed. 

RONTGEN DISCOVERY AND ITS RECENT DEVELOPMENT AND FUTURE 

POSSIBILITIES 

By W. D. Coolidge, M. D., Schenectady, N. Y. 

Early attempts to show diffraction, refraction, and reflection had 
all failed. In 191 2, Lane predicted that if the X-rays were passed 
through a crystal, interference effects would be produced just as they 
are when ordinary light falls on a Rowland grating. The experiment 
was tried by Freidrich and Knipping and proved completely successful. 

Bragg later showed that regular reflection of X-rays can be made to 
take place from the cleavage surfaces of crystals. A secondary wavelet 
spreads out from each atom as a primary wave passes over it. 

The work of Laue and Bragg has made it possible to measure the wave 
length of the X-rays, and shows them to be a transverse vibration travel- 
ing with the velocity of light and with a wave length about one ten 
thousandth that of ordinary light. 

Moseley and Darwin have found that each element, when placed in 
the path of X-rays of sufficiently high penetration, gives off secondary 
rays with a wave length characteristic of the particular substance in 
question. This serves, not only as a useful method of analysis, but also 
as the basis of a logical method for grouping the elements. 

FUTURE POSSIBILITIES 

I. As our source of X-rays become more and more intense, new 
fields of usefulness are opening up The germicidal and sterilizing action 
may be commercially useful in connection with food products, etc. 



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132 THE DENTAL DIGEST 

2. They may be useful as an ionizing agent to bring about chemical 
reactions. 

3. It is now possible to produce cathode rays having a velocity 
comparable with that of the most rapidly moving beta rays from the 
radioactive substances, and, at the same time, we get X-rays comparable 
in penetrating power with the most penetrating gamma rays. We are 
also able to produce canal rays which are like the alpha rays, except 
that they have lower velocity. These three, together with metallic lead, 
constitute the decomposition products of radioactive substances, and it 
therefore seems possible that we may some day be able to produce these 
radioactive substances synthetically. 

4. As we are- now able to put energy into the atom, and as we are 
now getting more and more of an insight into the structure of the atom, 
it does not seem too much to hope that we shall some day be able to 
transmute the elements at will and to store up large quantities of available 
energy in small masses. 

5. It seems probable that such work as that now being done by the 
physicist, on alpha ray scattering and with the X-ray spectrometer, will 
lead to much higher efficiency of X-ray production. The desirability of 
this is obvious when we think that at present we are able to utilize only 
about 0.2 per cent, of the energy which is put into the tube. 

This means that if we could raise this efficiency to 100 per cent, and 
could suitably direct the rays, we should put into the tube, for say a 
stomach plate, not four kilowatts, but only eight watts. In other words, 
we should then need in the tube much less energy than we now consume 
in the ordinary hand battery flash lamp. I do not mean to give the 
impression that the work of the physicist has yet revealed a method 
for making the transformation of electrical X-ray energy much more 
efficient than it is now; but it does seem probable that with more detailed 
knowledge of the mechanism of X-ray production, and this means more 
knowledge of the structure of the atom, that we shall some day be able to 
help ourselves in this direction. 

6. Another dream which should come true some day, is the pro- 
duction of a substance capable of making a screen say a thousand times 
more sensitive than anything we have now. For relatively little is known 
about the mechanism of fluorescence. The whole subject is one of the 
greatest interest and undoubtedly stands in very close relation to the 
production of secondary X-rays. Seeing, as we now do, the widest 
range in the fluorescent power shown by different substances, and 
with the mechanism so little understood, it does not seem too 
much to hope that the efficiency of this energy transformation may 
also be tremendously increased. Most, if not all the energy 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 133 

absorbed by the screen is now transformed, but the amount aosorbed 
very small. 

%^ 7. Similarly, it does not seem too much to hope that, with our rapidly 

^ ising knowledge of characteristic radiations, we shall some day see a 

^. raphic plate in which a much larger fraction of the X-ray energy 

V- ed with a corresponding increase in speed. From the diagnostic 

^v '- ^^ increase in screen and plate sensitiveness is perhaps much 

^ desired than is a more powerful or more efficient sources of 

^e former would reduce the danger, while the main effect of 

.ould be on the pocket book. 

With the ability to get, as we now can, characteristic radiations 

i definite wave length, the germicidal and physiological actions can be 

scientifically studied, with the possibility of finding out whether there is, 

for a definite purpose, any specificity of action so that a certain cell 

responds more strongly to a certain wave length than to any other. 

[New York Medical Journal, January 8, 19 16] 

[Presse MidicaL October 25, 191 5] 

FRACTURES OF THE INFERIOR MAXILLARY BONE IN MILITARY 

PRACTICE 

By L. Imbert and P. Real 

From experience with a large number of cases the authors have been 
led to establish a clinical division into fractures of the anterior group, in 
which the line of fracture is somewhere between the canine teeth and the 
midline, and fractures of the posterior group, in which it is lateral to the 
canine teeth. In the former group the displacement is not sufficient to 
cause overlapping of the fragments, the teeth on the side of the fracture 
practically retain their normal relationship to the upper teeth, and the 
functional result, provided that bony union takes place, is not very bad. 
In fractures of the posterior group, on the other hand, a symmetry results 
from overlapping of the fragments. The chin is displaced toward the 
fractured side and the unaffected side appears more prominent, though 
regular in profile. Again, there may be abnormal prominence on the 
affected side, due partly to outward displacement of the short fragment, 
partly to swelling of the soft tissues, and perhaps partly to the presence 
of callus. Behind this prominence, the profile appears flattened, owing 
to obliquity of the short fragment and disappearance of the angle of the 
jaw from the surface. An important sign of this variety of fracture is 
elicited by taking three points on either side of the jaw — the angle, 
condyle, and midline — and joining these by imaginary lines. 



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134 THE DENTAL DIGEST 

[Medical Record, January 8, 1916] 

FECAL INFECTIONS 

Drs. W. C. Mayes, W. Wilson, and C. F. Wilson of Memphis, from 
their limited experience, drew the following conclusions: (i) That many 
diseases, the etiology of which has been obscure, are undoubtedly due to 
metastasis or absorption of toxins from a primary focal infection. (2) 
We do not believe that we have done our whole duty to a patient by 
simply treating the results of a metastatic infection or the symptoms of 
toxic absorption. (3) It is absolutely essential to remove the primary 
focus when possible or at least overcome the infection in the same in 
order to conserve the best body economy. (4) That in the diseases due 
to focal infection, if a cure is not effected by the removal of a diseased 
focus, or if further metastasis occurs, the focus removed was not the 
causative or only causative focus, and a further search should be made 
with a view to its removal or cure. (5) That if the focus cannot 
be removed, or the infection in the same controlled, for anatomical rea- 
sons, often the removal of a diseased tonsil, draining an apical dental 
abscess, or accessory nasal sinuses will allow the body economy to so 
recuperate that a cure will occur in the original offending focus. (6) 
That an innocent appearing tonsil may be the focus, and that the search 
for the offending focus is not complete without exhausting every aid of 
the laboratory. X-ray, and our own diagnostic ability. 

[New York State Journal of Medicine, December, 1915] 

CONCERNLXG MOUTH INFECTIONS AS RELATED TO SYSTEMIC DISEASE 
By S. Marx White, B.S., M.D. 

The problem of eradication of dental foci of infection differs radically 
from that presented in the tonsils. In the case of the tonsil, the clinical 
evidences of infection may be difficult to secure. One who has sys- 
tematically attempted to eradicate focal infections will be often called 
upon to insist upon the removal of a fairly innocent-looking pair of tonsils 
even in the face of statements by competent nose and throat surgeons 
that the tonsils do not appear diseased. We frequently see infection 
arising from tonsils which are small, buried and adherent to the pillars 
and that show no external sign of inflammation, except possibly a streak 
of reddening along the pillar. Such tonsils are as frequently the source 
of systemic dissemination as the frankly and evidently inflamed ones. 
Where such tonsils exist and where there is no clear evidence of some 
other focal infection, the need for tonsillectomy rests more upon whether 
there is evidence of systemic infection from some focus than upon the 
apparent condition of the tonsil itself. As a result of this attitude we 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 135 

have been frequentiy rewarded by having the pathologist, after removal 
of the tonsils, find definite evidences of active inflammation were lacking. 

At the present time, we have no more definite clinical criteria of in- 
fection in the tonsils than I have outlined above. The demonstration of 
streptococci and other organisms on the surface or in the crypts of tonsils 
in clinical cases is conclusive only of their existence there. No certain 
means of securing uncontaminated cultures from the depth of tonsils, 
clinically, is known to the writer. 

The case is very different as concerns the teeth and jaws. Here the 
dentist can, by proper heat and electricity tests, determine whether 
teeth are living ones or not: and the rontgenogram, with proper technic 
and experience, can give evidences suggestive of infective processes 
about the teeth or anywhere in the tissues of the jaw. The technic and 
details of rontgenographic study are matters for the technician, and a 
large experience is necessary before a properly qualified opinion can be 
expressed. 

While the ordinary root abscess is easy of recognition, a great deal 
remains to be learned as to the significance of the minor grades of absorp- 
tion about the roots. It appears to be true also that in many instances a 
focus of infection has been absorbed, and restitution of the tissues of 
the alveolar process has occurred, leaving a modified rontgenographic 
field. The nature and significance of these modifications still remains 
to be worked out. 

It would appear to be a simple matter, once abscesses or infected teeth 
have been found, to decide what procedure should be adopted; but, on 
the one hand, the clinician, anxious to eradicate all foci of infection, de- 
mands that infected teeth be extracted: the dentist, anxious to retain 
the best occlusal surfaces and masticating mechanism for the patients, 
desires to remove only the infected tissues and retain as much as possible 
of the tooth. The application to each individual case should be deter- 
mined, not by the physician alone, nor by the dentist alone, but by both 
together, giving proper consideration to the needs of the patient, the 
possibility of the dental procedures to eradicate all infection and still 
retain a masticating surface, and finally, the ability of the individual 
dental operator involved, so far as securing results is concerned. 

Dentists have built up a marvelous mechanical perfection in crown 
and bridge work, but at the same time have developed conditions inviting 
infection of the alveolar process. Because so often free from local symp- 
toms and signs, this infection has remained hidden until brought to light 
by the rontgenogram. The infection must be eradicated, but so far as 
possible, our patients must be spared the inconvenience and disability of 
artificial teeth, and the conservative dentist must learn as far as possible 



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136 THE DENTAL DIGEST 

to eradicate the infection and spare the tooth. In this problem the 
physician has a vital interest. 

One additional point needs particular attention by the physician. 
It is that, if extraction or other operative work is to be employed, care 
should be exercised not to overdo or to attack too many foci at one time. 
In this field the infections are usually very chronic, and there is no urgent 
demand for the immediate eradication of all foci. 

Two considerations demand that all foci should not be eradicated at 
once. The first is that in case vaccines or bacterins are needed, if all foci 
have been eradicated and attempts at cultivation of bacteria have failed 
or gone awry, material for culture can no longer be secured. 

Secondly, the measures necessary for elimination of the infection fre- 
quently stir up and increase the infection at the time and there is con- 
siderable danger, particularly in heavily infected individuals, of opening 
up many channels of infection, of severe local reactions, sometimes with 
necrosis, and frequently of aggravating a multiple joint infection, or 
even an endocardial or myocardial involvement. These dangers are real, 
and we have had several illustrations of the folly of attempting to eradi- 
cate multiple foci at one time. Here again it is necessary that the 
physician and dentist confer and take fully into account such possibilities. 



DEATHS 

Harrison, Dr. H. H., died at Wheeling, W. Va., December 17, 
1915, in his 76th year. 

Allen, Dr. Chas. H., died December 30th, 1915, at New Milford, 
Conn., from the result of an accident. Dr. Allen was bom at Norwalk 
on March 8, 1859 and came to New Milford 35 years ago to practise 
dentistry. He lived a quiet, forceful life, building up a reputation for 
efficiency in his profession. He is very much mourned by his many 
friends. 

Ervin, J. J. Dr., died December 23rd, 1915, at Elmira, N. Y. Dr. 
Ervin was born in Elmira, N. Y., June ist, 1886. He was educated in 
the schools of Elmira and graduated from the University of Pennsyl- 
vania in 1907. 

He was a member of the Elmira Dental Society, Sixth District 
Society of New York and the National Dental Society. 



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FUTURE EVENTS 137 



AN INVITATION 

The National Dental Association and all ethical dentists will be heartily welcomed by 
the profession, the business men and the citizens of Louisville at the twentieth annual con- 
vention of this organization, to be held in our city four days conmiencing Tuesday, July 25, 
1916. 

The First Regiment Armory, in whose 54,000 square feet of floor space the exhibition will 
l)e held; the public school building, in whose thirteen commodious rooms the clinics will be 
held; Keith's and Macauley's theatres, the auditoriums of the Seelbach and Watterson hotels, 
where section meetings will be held, are within a radius of 100 yards, and with the approval of 
President Hinman, the most convenient arrangements e\'er provided have been made for the 
forthcoming dental convention. 

The Kentucky Dental Association will hold its annual meeting, to close Monday, July 
24th. The National Association of Dental Examiners will hold its convention, arranging to 
close Monday, July 24th. The three Greek letter dental fraternities will hold their annual 
conventions Monday July 24th. 

Louisville is the ideal convention city of America, convenient of access from all points of 
the country, abundant in its hotel accommodations and affording innumerable side attrac- 
tions of interest. 

The local committees are planning a series of entertainments commensura tewith Ken- 
tucky's reputation for hospitality, and the ladies especially who attend the convention will be 
guests at innumerable social functions. 

Local Conunittee — W. T. Farrar, Chairman, 519 Starks Building, Louisville, Ky.; John 
H. Buschemeyer, Mayor of Louisville; Fred W. Keisker, President Louisville Convention 
and Publicity League; Thos. J. Smith, President Louisville Board of Trade; Richard II. 
Menefee, President Louisville Commercial Club; W. H. Stacy, President Kentucky State 
Dental Association; H. B. Tileson, Max M. Ebel, W. M. Randall, R. F. Canine, J. W. Clark, 
E. A. R. Torsch, I. H. Harrington, W. E. Grant, Ed. M. Kettig. 



FUTURE EVENTS 



February 11-12, 1916. — The thirty-third Annual Meeting of the Minnesota State Dental 
Association, at the University of Minnesota, Minneapolis.— Max E. Ernst, 614 Lowry 
Bldg., St. Paul, Minn., Secretary. 

February 16-18, 1916. — The Tenth Annual Clinic, Manufacturers' and Dealers* Exhibit of 
the Marquette University Dental Alumni Association, Milwaukee Auditorium, Mil- 
waukee, Wis. — V. A. Smith, Secretary, 

February 18-19, 1916. — Buffalo Alumni Association, Hotel Iroquois, Buffalo, N. Y. — Grv 
M. FiERO, Buffalo, Chairman Executive Committee, 

F*ebruary 21-22, 1916. — Golden Jubilee of the Washington University Dental School, at the 
Dental School, 29th and Locust Sts., St. Louis, Mo. — H. M. Fisher, Metropolitan Bldg., 
Secrelary. 

February 23-24, 1916. — Central Pennsylvania Dental Society, Johnstown, Pa. — C. A. 
Matthews, Chairman Exhibit Committee. 

March 14, 1916. — Fox River Valley Dental Society, Appleton, Wis. — R. J. Chady, Oshkosh, 
Wb., Secretary, 

March 20-26, 1916. — TheTri-State Post Graduate Dental Meeting (Missouri, Kansas, Okla- 
homa), Kansas City, Mo. — C. L. Lawrence, Enid, Okla., Secretary. 

March 23-25, 1916. — Sixth District Dental Society, Binghamton, N. Y., Hotel Bennett. — 
William A. Ogden, Chairman Arrangement Committee. 

March 25, 1916. — Maryland State Dental Association, Baltimore, Md. — F. F. Drew, 
Baltimore, Md., Secretary. 



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138 THE DENTAL DIGEST 



April 4-7, 191 6. — Dental Manufacturers' Club, Chicago, III. Meeting in the Banquet Hall, 

Auditorium Hotel. — Chairman ExhiM Committee, A. C. Clark, Grand Crossing, Chicago. 
April II, 1916. — Alabama Dental Association, Mobile, Ala. 
April 13-15, 1916. — Michigan State Dental Society, Detroit, Michigan. — Clare G. Bates, 

Secretary. 
April 12-14, 191 6. — West Virginia State Dental Association, Kanawha Hotel, Charleston. 
May, 1916. — LAke Erie Dental Association, Erie, Pa. — J. F. Smith, Secretary, 
May, 1916. — Susquehanna Dental Association, Scranton, Pa. — Geo. C. Knox, 30 Dime 

Bank Bldg., Scranton, Pa., Recording Secretary. 
May, 1916. — Indiana State Dental Association, Claypool Hotel, Indianapolis, Ind. — A. R. 

Ross, Secretary. 
May 2-4, 19 1 6. — Iowa State Dental Society, Des Moines, la. H. A. Elmquist, Des Moines, 

la., Chairman of Exhibit. 
May 3-5, 1916. — Massachusetts Dental Society, Boston, Mass. — A. H. St. C. Chase 

Boston, Mass., Secretary. 
May 9-10, 1916. — North Dakota State Dental Association. — A. Hallenberg, Faigo, No. 

Dak., Chairman Exhibit Committee. 
May 9-12, 1916. — Texas State Dental Association, Dallas, Tex. — W. O. Talbot, Fort 

Worth, Tex., Secretary. 
May 9-12, 1916. — Illinois State Dental Society, Springfield, Mass. — Henry L. Whipple, 

Quincy, Mass., Secretary. 
May 1 1-13, 1916.— Dental Society of the State of New York, Hotel Ten Eyck, Albany, N. Y.— 

A. P. BuRKHART, 52 Genesee St., Albany, N. Y.., Secretary. 
June, 1916. — Florida State Dental Society, Orlando, Fla. — M. C. Izlar, Corresponding 

Secretary. 
June 1-3, 1916. — Northern Ohio Dental Association, Cleveland, O. — Clarence D. Peck, 

Sandusky, O., Secretary. 
June 8-10, 1916. — Georgia State Dental Society, Macon, Ga. M. M. Forbes, Candler 

Bldg., Atlanta, Ga., Secretary. 
June 13-15, 1916. — Connecticut State Dental Association, Hotel Griswold, New London, 

Conn. — Elwyn R. Bryant, New Haven, Conn., Secretary. 
June 20-22, 1916. — New Hampshire Dental Society, Lake Sunapee, 2^-Nipi Park Lodge, — 

Lisbon, N. H,-J. E. Collins, Chairman Exhibit Committee. 
June 27-29, 1916. — Pennsylvania State Dental Society, Pittsburgh, Pa. — Luther M. 

Weaver, 7103 Woodland Ave., Philadelphia, Pa., Secretary. 
June 28-30, 191 6. — North Carolina State Dental Society, Asheville, N. C. — R. M. 

Squires, Wake Forest, N. C, Secretary. 
July II, 1916. — South Carolina State Dental Association, Chick's Springs, S. C. — Ernest 

C. Dye, Greenville, S. C, Secretary. 
July 11-13, 1916. — Wisconsin State Dental Society Meeting, Wausau. — Theodore L. 

Gilbertson, Secretary. 
July 12-15, 1916. — ^New Jersey State Dental Society, Asbury Park, N. J. — ^John C. 

Forsyth, Trenton, N. J., Secretary. 
July 20-23, 191 6. — American Society of Orthodontists. Address communications to F. M. 

Castro, 520 Rose Bldg., Cleveland, Ohio. 
July 25-28, 1 9 16. — National Dental Association, ist Regiment Armory, Louisville, Ky. — 

Otto U. King, Huntington, Ind., Secretary. 
October 18-20, 1916. — Virginia State Dental Association, Richmond, Va. — C. B. Gifford, 

Norfolk, Va., Corresponding Secretary. 



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The Dental Digest 

GEORGE WOOD CLAPP, D.D.Sm Editor 

Published monthly by The Dentists' Supply Company, Candler Bldg., 
Times Square, 220 West 42d Street, New York, U. S. A., to whom all com- 
munications relative to subscriptions, advertising, etc., should be addressed. 

Subscription price, including postage, $1.00 per year to all parts of the 
United States, Philippines, Guam, Cuba, Porto Rico, Mexico and Hawaiian 
Islaiids. To Canada, $1.40. To all other countries, $1.75. 

Articles intended for publication and correspondence regarding the same 
shoold be addressed Editor Dental Digest, Candler Bldg., Times Square, 
220. West 42d Street, New York, N. Y. 

The editor and publishers are not responsible for the views of authors ex- 
pressed in these pages. 

Entered as Second Class Matter, at the Post-Office* at New York City. 
Under the Act of Congress, March 3, iSyg. ^'-. 



Vol. XXII 



MARCH, 1916 



No. 3 




CLOSED MOUTH IMPRESSIONS* 

By Samuel G. Supplee, New York, N. Y. 



THIRD PAPER 

The more I study impression taking the more I become convinced that 
while proper manipulation of modelling compound is not all of impres- 
sion taking, there can be no first class impression without proper manip- 
ulation of modelling compound. 

Furthermore, I feel quite sure that the old method of heating a. pan of 
water over a flame and dropping compound into it to be softened is not 
only no t the best means of preparing the compound for the impression , but 
that it is so far inferior to more recent methods of heating water for this 
pur})ose, that only by constant attention to the compound while heating 
thus can it be properly softened. 

Mr. Supplee has done much to perfect methods of preparing the com- 
pound for impression taking as well as to improve the methods for its 
use in the mouth. — Editor. 

VALUABLE HINTS ON THE USE OF MODELLING COMPOUND 
FLOWING AND FLEXIBLE CONDITIONS 

To use modelling compound successfully, one must understand what 
kind to use and the conditions of its use. 

When Perfection Modelling compound is heated in water to between 

*This article began in the January, 1916, number. 



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140 THE DENTAL DIGEST 

i6o and 170 degrees, it will conform to either soft or hard tissue with 
slight pressure, and will not be hot enough to cause discomfort. 

This makes it possible to insert into the mouth when itis at a flowing 
consistency, and permits the muscles to trim the margins of the denture 
without straining the muscles. Pressure must not be applied to the 
compound till it has passed from this flowing state into what I call **the 
flexible state" when it can be bent without distorting the outline form of 




'A satisfactory water heating apparatus 

the margins. This is a very important point in taking impressions of 
practically all uppers and many lowers. 

Most compounds contain too much gum; and as a result do not reach 
the flowing state until heated above a temperature suitable for use in the 
mouth. They become tough and stringy at lower temperatures. 

This toughness has a tendency to improperly displace tissue and may 
prevent a satisfactory impression of soft ridges and the buccal and 
labial attachments of the upper and lower jaws are easily displaced. 

MOVABLE SOFT TISSUE ON THE BUCCAL AND LABL\L BORDER 

Surrounding the base of each muscular attachment to the ridge is 
movable soft tissue on which pressure can be brought to bear in such way 
as to aid in the retention of a denture and increase the comfort of the 
patient in masticating. 



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CLOSfiD MOOta IM»R£SSl6lfS 141 

In the average mouth, this movable soft tissue covers an area varying 
from J to J of an inch wide over the buccal and labial border, and gener- 
ally comes down to within J of an inch or less of what may be called the 
occlusal surface of the ridge. 

The form of this soft tissue is readily changed by the movement of 
the muscles in passing from their rear to their forward position. 

Dentures which are to be permanently successful must be trimmed by 
the muscles in passing from their rear position to their forward position 
while the compound is in a flowing state. The compound must then 
be permitted to partially set, so that it will pass from the flowing state 
to the flexible state. Finger pressure can be then exerted without caus- 
ing the compound to flow. By means of this flnger pressure, the com- 
pound can be brought to bear on the movable soft tissue without dis- 
placing the muscular attachments or compressing them in a distended 
position. In the average case, one minute should elapse after the muscle 
trimming before finger pressure should be brought to bear over the buccal 
and labial border. 

If finger pressure is brought to bear when compound is in a flowing 
state, it will force the compound upward and so change the form of the 
margin that the bearing will be on the muscle too far from its point of 
attachment to the ridge, and will pull or improperly displace the movable 
soft tissue. The muscular attachment will respond to this pressure and 
will release the pull on the movable soft tissue; as a result the plate will 
cease to be in contact with the soft tissue and the muscle will then move 
back and forth beneath the edge and will displace the denture. 

PRESSURE ON THE MOVABLE SOFT TISSUE SURROUNDING THE BASE OF THE 
MUSCULAR ATTACHMENT IS IMPORTANT 

If an impression is taken with the mouth closed and pressure is 
brought to bear on the movable soft tissue that surrounds the attachment 
of the muscle to the ridge (less than yV oi an inch on the muscle itself,) 
it will not materially interfere with the free movement of the muscle 
When the mouth is opened, there will be a pull on the movable soft tissue 
by the muscle that will cause it to seal the edge more firmly, so that the 
wider the mouth is opened, the more firmly the joint with the plate will 
be sealed by the tissue. 

Inasmuch as the mouth is closed or within one quarter of an inch of 
being so without biting pressure being applied 75 per cent, or more of the 
time, the soft tissue is under light pressure three-quarters of the time 
and under heavy pressure when masticating, say one quarter of the 
time. 

Movable soft tissue will sustain a considerable pressure without the 



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142 THB DENTAL DIGEST 

circulation being affected and will form a contact with the plate at all 
times, which is of great benefit to the patient. 

The amount of pressure should be sufficient to embed the buccal and 
labial border of the impression into the soft tissue. When such pressure 
is being exerted during the finishing of the impression the thickness of the 
compound and the amount of resistance offered by the compound must be 
considered; by referring to illustrations you will note the different for- 
mation which can be given to the compound, in the same mouth. The 
illustrations show different thicknesses of compound overlaying the 
buccal surface of the ridge in the cuspid region, where the greatest 
change in the shape of the compound is possible. 

A simple experiment to learn what pressure may be applied, is to warm 
a small piece of compound about i of an inch thick, and wait until it 
has passed into the flexible state. Then hold it between the tip of the 




No. I No. 2 No. 3 

Modifications of the form of an impression by pressure. Three impressions from one mouth 

No. I. Illustrates muscle trimmed impression with no pressure over buccal border. 

No. 2. Muscle trimmed with thicker margin but pressure exerted over the buccal bor- 
der when the mouth was closed and under biting pressure. Modelling compound was at 
the proper consistency and represents the necessary contour for finished denture. 

No. 3. Muscle trimmed. Pressure was applied when compound was too soft. The 
rim was forced higher than is desired in the denture. The rim is flared outward by the 
improperly displaced muscular attachments 

thumb and the index finger, and by using the index finger of the other 
hand note how much pressure is necessary to embed the compound 
slightly into the soft tissue. 

TO AVOID TEMPORARY RESULTS 

If excess pressure is brought to bear on this tissue, it will often produce 
a plate that will be exceedingly tight to start with; but in a short time the 
tissue will respond, and the patient will experience a looseness of the 
denture without it necessarily dropping from place. This, in some cases, 
will cause a loss of confidence, and the psychological effect is such that the 
patient will be dissatisfied with what would otherwise have been a very 
satisfactory denture. In many cases where the distortion has been very 
great, the plate will be absolutely useless. 

It is far better to have too light a pressure than too heavy. The 
former will improve in fit within a day, while the latter will become less 
firm in two or three weeks. 

{To be continued) 



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TECHNIC FOR MAKING GOLD CROWNS 143 



TECHNIC FOR MAKING GOLD CROWNS FOR POSTERIOR 
TEETH IN MOUTH WHERE THE BITE IS VERY CLOSE 

By Raymond S. Scovil, D.D.S., Johnstown, N. Y. 

After the proper grinding of a tooth for a gold crown, there are three 
things that I take into consideration in making the crown. 

(i) The relation of the occlusal surface of the crown to the tooth 
that strikes it in masticating. 

(2) The technic and shape of the crown to the other teeth. 

(3) The kind of a crown that is easiest made and still keep the first 
two principles that I have mentioned. 

In a mouth where the teeth come together naturally and the bite 
is light I make a seamless gold crown, the occlusal surface of which can 
easily be carved to articulate perfectly with the contending teeth. In 
cases where the bite was very heavy and the teeth all worn smooth by 
mastication I usually made the two-piece cap and band crown. Now 
after considerable experimenting I have been able to make a cast gold 
crown that has the appearance of a natural tooth. When I say appear- 
ance, I mean the occlusal surface of the crown has the same striking effects 
as a natural tooth, the carving of it is the same as natural teeth and the 
labial and the lingual sides are the same. In this crown after it has been 
poKshed, there can be seen no dividing line between the cap and the band, 
and it has all the graceful lines and curves of a natural tooth that a two 
piece crown cannot always have. 

Recently a man came into my office to have work done. After exam- 
ining his teeth I found that he had a lower second molar to be crowned. 
The bite was very heavy and all his lower posterior teeth were worn 
smooth as a result of inveterate plug tobacco chewing. To this case I 
made the cast gold crown which took in actual time not including hard- 
ening of plaster, about one-half an hour. 

When this crown was finished it could have stood a test against any 
seamless or two-piece crown in appearances or masticating properties. 

In making this kind of a crown I use the following method. After 
the impression has been taken and the model has been mounted upon 
the articulator, I take the dentimeter and take a wire measurement of the 
tooth while the patient is in the office and then I compare it with the 
tooth on the plaster model which I had just mounted. If they agree I 
take a fine pointed instrument and carve the gum margin in the usual 
way, but a small fraction of an inch deeper. I then make a gold band to 
fit the tooth snugly paying careful attention to allow the ends of the 
bands to overlap each other when soldering, and also to have the band a 



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144 THB DBIITAL DIOBST 

small fraction of an inch higher than the top of the ground tooth. I then 
with the pliers contour the band paying good attention to appearance to 
lines on the labial and lingual sides. 

I then take some inlay wax and soften it and place it gently on the 
top of the tooth with band around and close the bite together giving very 
careful attention to the sliding bite as well as the natural bite, straight up 
and down. I then separate the bite and begin to carve the wax. In 
trimming the wax at the top edge, extend the wax over the band a little. 
If you find that the band has not been properly contoured you can 




n db 



Illus. No. I Ulus. No. 2 

remedy this by building it out with wax. Another important thing to 
remember is to allow a small scale of wax to extend over the seam, where 
the band was soldered, on the outride of the band. Often in casting, the 
solder at the joint will run and the joint will be very weak. Now if the 
solder should run it would be resoldered in casting. 

After the wax has been properly carved and shaped remove the band 
with the wax together and cut all excess wax from the inside of the band. 

The next and most important step is the investing of this whole 
construction. Remember the band and the wax top are invested to- 
gether. In investing this construction do not insert the sprue wire in 
the top of the occlusal surface (see Illus. No. i). There is a possibility 
in casting that solder will run on the outside of the band where it is not 
needed, also a possibility of solder running on the inside of the band 
making it almost impossible to put on the tooth in the mouth without a 
lot of grinding. 

Insert the sprue wire between the gold band into the back of the wax 
crisp (see Illus. No. 2) and when the gold and solder are run into casting 
it will only run where wax was on the band. After this precaution in- 
vest in the usual manner and after investment is sufficiently hard and dry 
place in heater and burn out wax. Take 22 karat gold and an equal 
amount of solder and melt over the sprue hole and when gold is the color 
of white heat cast in usual manner. The casting apparatus that I use is 
nothing more than a two inch gas pipe filled with wet asbestos; with this 
I force the gold into the sprue hole in the casting ring. Any ordinary 
casting apparatus will do. 



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RUGAE 145 

After the casting is cool and the cast taken out, cut out sprue and 
ix>lish. After the crown is polished you will wonder where the dividing 
line is. When you put the crown in the mouth you will find that it is the 
best fiUingy and the best looking and has the best occlusal surface of any 
crown you have made. You will also find out later that it is the best 
wearing crown you have ever put in. This method of making of cast gold 
holds true of all posterior teeth. 



RUGAE 
By Victor Lay, D.D.S., Buffalo, N. Y. 

It seems that rugae are not only desirable, but quite necessary. It is 
said that the tip of the tongue is the most sensitive spot in the human 
anatomy. If this is true, then the tongue will aid speech and mastication, 
and will feel more at ease, when it is in contact with a close reproduction 
of the Almighty-designed surface. 

To satisfy yourself, try some experiments on your own palatal surface, 
using a smooth wax base Dlate, first — then add some wax rugae and note 
the difference. 

To be of any service, the rugae must be well forward, beginning with 
a central ruga just behind the central teeth, and running distally in the 
median line. From this the other rugae radiate, and should imitate the 
characteristics of the case at hand. 

To produce this effect, the trial plate (teeth set up) is removed from the 
model, and the rugae traced onto the palatal surface of the plate with a 
hot wax spatula, using one of the pink waxes which cools to the desired 
hardness. First produce the central ridge, then imitate the character- 
istics appearing on the model. The proper sharpness and accuracy is 
obtained by trimming the wax with a sharp knife. Smooth by waving 
over the flame. Thin sheet tin is now burnished over the surface, the 
plate being on the model. A rubber eraser makes a good burnisher. 
Turn up several lugs on the edge of the tin to engage the plaster when 
the upper half of the flask is filled. This is not especially new, but may 
be of some assistance to someone. 



AN AID IN MAKING LARGE PLUMPERS 

In making large plumpers, a piece of old vulcanite plate is shaped 
up approximately to fill the space in the investment and wrapped in a 
hot water sheet. This will prevent porosity.— F. H. B., The Dental 
Cosmos. 



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146 THE DENTAL DIGEST 

SUGAR AND ITS EFFECT UPON THE TEETH 

By John S. Engs, D.D.S., Oakland, Cal. 

As the things with which we are in daily contact are sometimes passed 
unobserved, so precautions, which if taken in time would often prevent 
disease, are disregarded because of their very commonplaceness and sim- 
plicity. **But it is the little things in life that count," and as stick upon 
stick and stone upon stone great structures rise, so our bodies grow, cell 
by cell being formed from food taken by the growing organism. 

Like many other destructive processes which are probably acceler- 
ated by the strenuous life of to-day, caries of teeth, or tooth decay, is on 
the increase. So universal is its presence, that an English doctor, James 
Wheatley, said that measures to check its advance are as much needed 
as are measures to check the spread of tuberculosis. He said also, that 
consumption of candies and sweets is greater than at any time in history, 
a state of things which he disapproves of strongly. Another authority, 
J. Hopewell Smith of London, said, parents should not allow children to 
indulge in sweetmeats; if they must eat them, then only those made of 
pure sugars free from adulterations should be employed; eating them at, 
not between meals. (I think if I were to advise as to the kind of sugar 
to use in making candy for children, I would not say "pure sugar," be- 
cause by that is understood refined sugar, but rather use crude sugar or 
cane syrup, for it contains all the food element of the juice of the sugar 
cane, which has been found to be capable of furnishing body building 
material and sufficient energy to enable the user to subsist on it entirely, 
during long periods when engaged at hard manual labor, to the exclusion 
of all other food materials. Such sugar will make "panoche" a favorite 
mixture with school girls and also drawn candy with which we were all 
more or less familiar some years ago.) He expressed it as his opinion, 
that the confectionery factories and the wares of street venders should 
be placed under State control. England leads the world in the consump- 
tion of sugar per capita; the United States comes next. Does not that 
offer us food for thought? 

SUGAR 

When used in reasonable amounts sugar is one of our most valuable 
food products. It furnishes both heat for the body and working power 
for the muscles. Practical demonstration has shown that it also possesses 
stimulating properties which enable us to tide over periods when without 
it, the body would succumb to fatigue. But used in excess as it is to-day 
all over the world, particularly in England and the United States, it is 



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SUGAR AND ITS EFFECT UPON THE TEETH 147 

beKeved to be detrimental to our health and destructive to the osseous 
tissues of the body. 

Most of the bad effects of sugar are due to its use in greater amounts 
than 3 to 4 ounces per day. It is not locally harmful to the teeth, but is 
injurious to them through its action upon the digestive system and meta- 
bolism. Like starch, sugar is fattening. When consumed in large quan- 
tities the excess is transformed into fat and stored away as reserve 
material. While a very active child may bum up a large amount of 
carbohydrates to supply energy for his play, a less active one would soon 
feel the effect of overindulgence in sugar and sweetmeats, through indi- 
gestion and an overloading of the excretory organs. 

The chief tissues concerned in the elimination of waste material from 
the body are the skin, lungs and air passages (including the mouth and 
nose), the kidneys, liver and intestines. Interference with the elimin- 
ative powers of the three latter is especially apt to throw extra work on 
the skin, lungs and air passages. This gives the sour wine odor in the 
breath of diabetics. The peculiar foul odor of the breath and skin in foe- 
cal intoxication indicates that the mucous membrane of the mouth, throat, 
nose and gums is doing the elimination work that should have been done 
by the intestines. The failure of the kidneys to do their proper elimin- 
atory work is apt to find expression in the skin, lungs, nose, mouth and 
gums. It is a matter of common observation that sugar and sweetened 
food is apt to ferment in the stomach and intestines. There are so many 
illustrations of the refusal of the system to utilize large amounts of sugar 
that we should take warning from them. They show that the consump- 
tion of candy can easily be carried too far. 

FERMENTATION 

Sugar, by which is understood the sugar of commerce, cane sugar, is 
one of the carbohydrates and like starch, is transformable into invert- 
sugar or glucose which is fermentable. It is open to three different fer- 
mentations; the alcoholic, the lactic acid and the acetic acid. The sec- 
ond or lactic add is at present of greatest interest to the dentist, because 
to it is attributed the destruction of tooth substance that occurs in dental 
caries. How far this is true we do not at present know. Some still think 
that decay is entirely due to the action of lactic acid; while to others — 
myself included — conditions in decayed teeth are continually presenting 
themselves that cannot be explained in a satisfactory manner by the 
theory of Miller. It is for that reason that I take the liberty to present 
this paper in an effort to show why it is believed that an excessive con- 
sumption of sugar may bring on, or serve as a contributory cause, of 
caries, in an entirely different manner from that which we have been 



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148 THB DENTAL DIGEST 

taught; and that its action may be from the inside and not as we are 
generaUy led to believe, entirely from the outside, beginning at the enamel. 

ACTION UPON TEETH 

Explanations to account for the baneful effect of excessive sugar eating 
upon the teeth usually tend to show that ultimately, the oral secretion is 
modified or that substances develop in it that attack first the enamel and 
then the dentin. 

A more recent hypothesis has been offered, however, based on the belief 
that faults of nutrition, or faulty metabolism is at the root of the evil; 
and that absence of lime in sufficient quantity in our daily food or exces- 
sive elimination of the same, from the body is the cause. This condition 
is believed to be due to the action of sugar, through its affinity for lime, 
or to a general acidosis of the system that may result from many causes, 
one of which is the excessive use of sugar, particularly amongst growing 
children. 
I2TH & Broadway. 

(To be cofUimied.) 



THE SEPTIC WHEEL-BRUSH 
By R. R. C. 

Dr. Feldman's indictment of the tooth-brush may be somewhat over- 
drawn, but if it is, it is on the safe side. He deserves credit for provoking 
discussion of that subject. 

There is another brush that should be indicted and its use stopped, and 
that is the engine wheel-brush used by some dentists for the purpose of 
cleaning burs and broaches. 

This rapidly revolving brush cleans (?) from the burs and broaches 
the filthy, septic debris that accumulates on them in their use and thor- 
oughly distributes it in the air of the office breathed by the dentist and 
his patients. 

A better way is to sterilize burs that are worth it and use broaches in 
but one case. Broaches are not expensive. 

Whether a dentist uses this method or the brush-wheel is an indication 
of his inteUigence. 



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A BETTER GOLD INLAY 149 

A BETTER GOLD INLAY 
By W. Goddard Sherman D.D.S., Providence, R. I. 

There are numerous methods of constructing gold inlays, each per- 
haps possessing one or more points of superiority over another and yet by 
reason of some fault during the process, failing to produce a restoration 
which is perfect in every respect, especially at the margins. 

I consider the margins of gold inlays or any other filling material the 
most important factor in effecting a successful operation. 

Some of the contributory causes of so-called failures, I believe from ob- 
servance, are: — inaccuracy of investment materials by expansion or con- 
traction; amount and fineness of gold used in proportion to the size of 
the inlay; faulty impressions of cavities for indirect method and the 
peculiar manifestations of various kinds of inlay wax used for the direct 
method. 

K the margins of the average gold fillings and inlays — especially cast 
inlays — ^be examined under a strong magnif jdng glass or by the use of a 
delicate explorer, a break in the continuity may be detected. 

I believe the most accurate results in casting are obtained by the in- 
direct method, using amalgam dies. 

However, by the following method, which I have employed for some 
time, I find it possible to construct inlays surpassing those resulting from 
any other method, and also excelling gold fillings without endangering the 
enamel margins which spell " Success '' or "Failure." 

The following is the method and technic I have formulated. 

The cavity should be prepared as per rule for inlays with walls diverg- 
ing slightly more than for cast inlays. All enamel margins should be 
left sharp and well defined. 

The cavity is now to be moistened or oiled and an impression taken 
with warmed modeling compound. The compound is then to be chilled 
and carefully removed and examined to see if all margins are clearly 
recorded in the impression. A bite in wax is then taken and patient 
dismissed. 

A die of amalgam is made from the impression and by the aid of wax 
bite moxmted on an anatomical articulator. From the amalgam die is 
taken any number of impressions in modeling compound until accuracy 
is assured. A cement die is then made and after being separated from 
the impression is invested in either modeling compound or plaster to 
strengthen the mass and protect any frail walls. 

Gold foil is now to be packed into the cavity by hand pressure only 
and tooth restored to desired contour and occlusion. 



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150 THE DENTAL DIGEST 

Filling may be removed from cement die and tried-in in amalgam die 
from time to time to govern size, contour, etc. 

Great care is to be exercised during packing against margins and quite 
a surplus should be used. A flat gold-burnisher is then to be used to aid 
in condensing the entire surface, following the rule of burnishing toward 
and not away from margins. 

When filling is completed the cement die with filling in place is thor- 
oughly dried out and then heated in a Bunsen flame until it assumes a 
cherry-red color. 

The inlay when cool is placed in amalgam die properly seated and 
given final trimming, shaping and polishing except at margins where a 
fine feather edge is to be left. Inlay is now ready to be inserted for 
try-in in the mouth and if found correct (it will be correct if preparation 
of cavity and impression were correct) it is removed and preparations 
made for cementing. Depending upon the case, undercuts may or may 
not be necessary. 

A thin, smooth mix of a good inlay cement is used after sterilizing and 
drying cavity and inlay is inserted to place with considerable hand pres- 
sure. Do not use a malleL While the cement is still soft burnish the 
margins. The final finish may be given at this or a subsequent sitting. 
Use only very fine abrasives and avoid strips and discs as much as possi- 
ble. The burnisher properly used for final finishing is the ideal instru- 
ment. 

The result will be a gold inlay with margins nearer perfect than I 
believe possible to obtain with any other filling material or process. The 
gold is harder than a well condensed gold filling, yet soft enough to be 
easily manipulated at margins without evil results. 

Of the advantages of this method it might be stated that for large res- 
torations it is much easier for the patient and less tiresome for the oper- 
ator with the added advantage that the inlay is practically finished when 
inserted, requiring only a final burnishing of margins. 

By the use of this method where large gold filUngs are indicated, more 
satisfactory operations will result and much time and energy will be 
saved. 

171 Westminster St. 



A Laboratory Hint. — ^When working with wax in the laboratory, 
use a large common school slate for a bench cover. It will catch all 
pieces and drops of melted wax and when removed leaves the bench 
clean and ready for the next work. Wax spots on a bench may be very 
annoying when gold work is being done. — Pacific Dental Gazette. 



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WRONGFUL DISCHARGE OF DENTIST 151 

WRONGFUL DISCHARGE OF DENTIST 

(Georgia) One who is employed as a dentist by a dental association 
or company, and who is discharged, has the right of electing either of three 
remedies: (i) He may bring an immediate action for any special injury 
received from the discharge; (2) He may wait until the expiration of the 
term for which he was employed, and sue for the entire amount due him 
under the contract; or (3) He may treat the contract as rescinded and 
seek to recover upon quantum meruit the value of the services actually 
performed. Reasonably construed, the present suit is an action to 
recover the value of the plaintiff's services for the entire term fixed by 
the contract, though it was brought before the expiration of the term; 
and a finding for the plaintiff was not supported by the evidence. Proof 
that the plaintiff was willing to perform the services for the unexpired 
j>art of the term, and that the value of the services as fixed by the contract 
amounted to $137.30 would not authorize a recovery of that amount, 
where it appeared that the suit was brought prior to the expiration of the 
term. (Continental Ass'n v. Lee, 85 S. E. 790.) 

LIABILITY OF HOSPITAL FOR NEGLIGENCE IN CARING FOR PATIENTS 

{California) Though the case of Wilbur v. Emergency Hospital 
decided by the District Court of Appeal of California turned on the 
sufficiency of the evidence, and makes no final determination of any very 
important legal questions, the facts are quite interesting, and under other 
drciunstances might well involve matters of serious legal import. The 
action was instituted for recovery of damages for the death of plaintiff's 
18 year old son, who, at the time of his decease, was a patient in defen- 
dant's hospital. He was suffering from an infected jaw bone and during 
the first week of his treatment was under the care of a special nurse, who 
devoted all her time to attending him. She prepared a solution of bichlor- 
ide of mercury for use in disinfecting the thermometer with which she 
took her patient's temperature, and on leaving, at the end of a week, 
when it was thought that her services were no longer necessary, she left 
the mixture on a chiffonier in the patient's room. Sometime later, one 
of the hospital nurses entered the room and saw young Wilbur just getting 
back into bed, and was told by him that he had drunk the contents of the 
glass on the chiffonier. Antidotes were administered, and the young 
man, on being q^estioned, stated that he had no such feelings or symp- 
toms as usually attend bichloride of mercury poisoning. He died about 
fifteen hours later. The court holds that the evidence is insufficient to 
show that his death resulted from swallowing the contents of the glass, 
and the circumstances and symptoms were just as consistent with the 



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152 THE DENTAL DIGEST 

theory that the liquid might have been thrown out of the window as 
with the drinking of it by deceased, and that his statements to the nurse 
were inadmissible as evidence that he actually drank the poison. (Wil- 
bur V. Emergency Hospital, 154 Pac. 155.) 

MINOR RESPONSIBLE FOR PROFESSIONAL SERVICES 

(Louisiana) Where a minor, who has reached a stage of maturity 
calculated to deceive a person of ordinary prudence, deceives a dentist 
as to his age, and asserts that he is of full age, and induces the dentist 
to render him professional services, and accepts the benefits thereof, he 
cannot deny that he was of full age, and escape the obligation of the 
contract. (Lake v. Perry, 49 So. 569.) 

CAN A SERVANT BE CONSIDERED IN THE EMPLOY OF HIS MASTER WHILE 

TAKING A HOLIDAY? 

(California) A wealthy gentleman by the name of E. W. Cowell died 
in March, 191 1, leaving a will which gave to all of the employees of a 
certain dental supply company in which he was interested, and who had 
been in said employ for twenty years, the sum of $1,000 each, "and to all 
who have worked over ten years the sum of $500 each; ... In all 
cases these dates are as of January i, 19 11." Frank Tralago, claiming 
to be entitled to a portion under this provision, which was opposed partly 
on the ground that petitioner was not engaged in the employment of the 
designated company on January i, 191 1. It was conceded that this was 
a holiday, and petitioner was not actually at work. The evidence went 
to show that he had been paid off the day before, and did not again return 
to work for some little time after the first of the year. The Supreme 
Court of California passing on this question in In re CowelFs Estate, 
adjudges it as being rather too technical a construction of the will, as 
testator must have known that the day designated was a holiday, and 
could hardly have meant to defeat his own purpose of rewarding faith- 
ful employees by insertion of a condition which would make this im- 
possible. Tralago was held entitled to a $500 share of testator's property. 
(In re CoweD's Estate, 149 Pac. 809.) 

SALE OF DENTAL FIXTURES 

(Georgia) Where, in a contract for the sale of dental office fixtures 
and supplies the purchaser agrees to make a partial cash payment and 
give notes for the balance, the seller to retain title until the full purchase 
money is paid, tender on the terms of the buyer's compliance with the 
contract will not have the effect of transferring the title to the purchaser. 
If the buyer refuses to make the partial payment and give the notes as 



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A NEW METHOD OF CONSTRUCTING ARTIFICIAL DENTURES 153 

called for by the terms of sale, or to accept any possession or control of 
the property, no title passes to him, and the seller's remedy is not for 
the purchase price of the chattel, but for the breach of the contract. 
(Bridges & Murphy v. McFarland, 85 S. E. 856.) 



EXTRACT FROM "A NEW METHOD OF CONSTRUCTING 
ARTIFICIAL DENTURES"* 

By Doctor J. Allen, 1856 

It may be interesting to dentists to-day to read what a prominent dentist pub- 
lished in book form, something over a half a century ago, for distribution to the pub- 
lic and for the instruction of the public in his particular line of work. Dr. Allen must 
have thought that the public knew a great deal about anatomy, because he does 
not hesitate to use technical terms freely, either for the purpose of instructing them 
or impressing them without instructing. — EDrros. 

THE FACE 

"Is formed of diflferent muscles, which give it shape and expression. 
These muscles rest upon the teeth and alveolar processes, which sustain 
them in their proper position. 

"When the teeth are lost, and a consequent absorption of the alveolus 
takes place, the muscles fall in, or become sunken in a greater or less 
degree, according to the temperament of the person. If the lymphatic 
predominates, the change will be but slight. If nervous sanguine, it may 
be very great. 

"There are four points of the face which the mere insertion of teeth 
does not always restore, viz: one upon each side, beneath the molar or 
cheek bone; and one upon each side of the base of the nose, in a line 
toward the front portion of the malar bone. 

"The muscles situated upon the sides of the face, and which rest 
upon the molar or back teeth, are the Zygomaticus Major, Masseter, and 
Buccinator. The loss of the above teeth cause these muscles to fall in. 

"The principle muscles which form the front portion of the face 
and lips are the Zygomaticus Minor, Levator labii superioris alaeque 
nasi and Orbicularis oris. 

"These rest upon the front, eye, and Bicuspid teeth;, which, when 
lost, allow the muscles to sink in, thereby changing the form and expres- 
sion of the mouth. 

"The insertion of the front teeth, will, in a great measure bring out 
the lips, but there are two muscles in the front portion of the face which 
cannot, in many cases, be thus restored to their original position; one 
♦Courtesy of C. A. Heller. 



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154 THE DENTAL DIGEST 

is the Zygomaticus minor, which arises from the front part of the malar 
bone, and is inserted into the upper lip above the angle of the mouth. 
The other is the Levator labii superioris alaeque nasi, which arises from 
the nasal process and from the edge of the orbit above the infra-orbital 
foramen. It is inserted into the ala nasi or wing of the nose and upp)er 

lip. 

"The attachments before mentioned, applied to these four points of 
the face, beneath the muscles just described, bring out that narrow- 
ness and sunken expression about the upper lip, and cheeks, to the 
same breadth and fulness which they formerly displayed, thus 
restoring the original, pleasing and natural expression. These attach- 
ments for restoring the form of the face were first constructed by the 
subscriber, some eight years since, and they have been constantly worn 
by various persons with ease and comfort ever since that period. They 
were first formed of gold plates by being stamped to the requisite form, 
and attached to the main plate and teeth. The plates are now covered 
with the compound, of which the artificial gum is formed, and which 
renders the denture, when thus constructed, far more perfect than the 
previous mode. 

"The perfection to which this style of work has been brought by the 
Author, has induced him to devote his exclusive attention to the con- 
struction of full and partial Sets of Teeth; in doing which he pledges 
himself to carry out faithfully the principles here set forth." 

J. Allen, 
No. 30 Bond Street, New York. 



Editor Dental Digest: 

My little daughter is two and a half years old and has only 10 teeth, 
4 upper incisors and 2 molars and only the two lower indsors and 2 
molars. She has not been sick, but is nervous, fidgety and will not 
sleep all night. She was just 16 months old before she had a tooth. 
I can see where the unerupted teeth are, but am at a loss to explain 
just why they do not erupt. Her appetite is good but the poor "kid" 
cannot properly masticate her food. 

Now what can be done to help these teeth erupt? I do not think to 
lance the gimis would help, owing to the thickness of gum tissue. 

Trusting some one can explain about the delayed eruption of the 
teeth of the two and a half year old girl, I am. 

Fraternally yours, 

M. 



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FOOD FOR DENTISTS 155 

FOOD FOR DENTISTS 

By Watson W. Eldridge, M.D., New Rochelle, N. Y. 

The author of this paper is particularly well fitted to write upon ail- 
ments arising in the alimentary canal. He is a member of the Gastro-en- 
terological Clinic of New York University and Bellcvue Medical College, 
and comes into contact with many cases of systemic depression arising 
from lowered tone and impaired function in the intestines. 

He has prepared this paper by my request because I am growing more 
and more to realize the importance of maintaining health and efficiency, 
and the necessity of physiological exercise to this end. — Editor. 

INFLUENCE OF THE HABITS OF THE DENTIST ON THE HEALTH 
OF THE ALIMENTARY TRACT 

FIRST PAPER 

Are you lazy? Do you often feel that to-day's work is too great 
an effort to be undertaken? When you are bent over a patient do you 
sometimes feel that it would be a relief just to sit down and do nothing? 
Do you become restless and want to do something else, anything, except 
that which you are doing? Do you enjoy your meals or do you eat 
mechanically, or worse still do you often feel that food is repulsive? 
Does your night's sleep refresh you or do you arise in the morning feeling 
tired and xuifit and xmprepared to cope with the day's work? 

ONE SOURCE OF LAZINESS 

Such lack of vitality as has been described above may result from 
lack of tone in the intestinal tract, from incomplete digestion and the 
absorption into the body of intestinal poisons. It may be corrected by 
physiological stimulation of the weakened functions. 

The normal functioning of the alimentary tract is chiefly dependent 
on four things, i. e., muscular tone, digestive secretions, proper position 
of the various parts of the tract, and proper food intake. The first three 
of these cardinal factors are influenced both separately and collectively 
by a number of conditions which are under the control of the individual. 
One of the chief of these conditions would seem to be of especial interest 
to dentists because of its close connection with their occupation. It is 
that of "sedentary habit." 

SEDENTARY HABIT, TOXEMIA AND GROUCHES 

"Sedentary habit" is present in the history of practically all cases 
of fecal stasis or of intestinal toxemia, which come under observation. 
The profession of dentistry falls undoubtedly into the class of sedentary 



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156 THE DENTAL DIGEST 

occupations. The dentist spends all of his producing hours indoors, and 
in the larger part of them he is working in an uncomfortable, cramped, 
position, over the operating chair or the laboratory table. Fresh air 
and exercise form practically no part of his daily routine. His field of 
operation is extremely narrow and limited, affording him none of the 
opportunity for systemic prophylaxis that comes to the man whose 
occupation requires activity in the great outdoors. 

** Sedentary habit" once begun, rapidly develops into a vicious circle, 
and unless the individual is forewarned and takes pains to combat this 
development he will sooner or later drift into that class of pitied speci- 
mens known as dyspeptics — hypochondriacs or just plain "grouches." 

LIMITED EXERCISE AND THE VICIOUS SPIRAL 

Let us follow, for a moment, this vicious circle of which we have 
spoken, and watch its development. Let us suppose that practicaDy 
all of the time for a week or more the dentist has been indoors, busy over 
his operating chair during the larger part of his working hours. The 
exerdse which he has taken consisted of the trips between office and 
reception room, between home and office which are usually situated in 
comparative proximity, movements in the abbreviated radius of the 
operating room or laboratory, and an occasional trip to the theatre in 
the evening, perhaps made in the stuffy atmosphere of a public convey- 
ance. Exerdse of this sort has required little muscular activity. What 
there is has been confined to a very limited group of muscles and has 
therefore been little better than no exerdse at all. Muscles constitute 
about half the body weight and what takes place in them profoundly 
influences the remainder of the body organs. Lack of "muscular meta- 
bolism," if I may use that expression, naturally follows absence of muscu- 
lar exercise, much to the detriment of the rest of the body. As the result 
of lack of exerdse the dentist's muscular tone often becomes subnormal 
and by its influence on the rest of the body causes a lowering in tone of 
the musculature of the intestinal tract. Peristalsis is delayed and weak- 
ened as is also the secretion of the digestive juices. The food mass, 
which should have been excreted within about seventy hours from the 
time of ingestion is still in the intestinal tract. It has long since under- 
gone complete or partial digestion and the residue which has no nutritive 
value should have been eliminated. Remaining in the large intestine, 
it frequently forms a splendid culture media for all sorts of micro- 
organisms among which are some of the putrefactive enzymes. These 
agents become active and produce chemical changes in the fecal mass 
which liberate toxins of various kinds. These are absorbed and sent, 
via the drculation, all over the body, affecting the different organs and 



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FOOD FOR DENTISTS 157 

centres in a manner which impairs their functional activity. Digestion 
which is already poor through the slowing up of the necessary functional 
activities due to lack of exerdse, becomes poorer. The appetite fails or 
disappears. The individual becomes easily fatigued and complains of 
feeling mentally and physically lazy. 

THE WAY OUT 

The natural, physiological and most beneficial prophylactic and 
corrective of this condition is to take sufficient exercise involving the 
whole body, and in fresh air outdoors. This will restore and maintain 
good general muscular tone and through that proper tonicity of the 
intestinal musculature. A game of tennis or gplf, a "hike" or rowing is 
better than any artificial stimulation. 

Physical exercise is much more than simply a means of developing 
muscular strength. Forty-two per cent, of the body weight is made 
up of muscles, and their activity very greatly influences all the rest of 
the body organs. Exercise strengthens the heart and blood vessels 
which are called on to send more blood to the working muscles. It 
deepens the respiration as the lungs are called on for more work. It 
improves the appetite and helps the body to get rid of waste products. 
It makes the brain clearer and the spirits lighter. 

Every one should provide for some form of regular physical exercise 
if his work does not require energetic muscular effort. Exercise in the 
open air such as walking, not loitering, snow shoeing, skating, riding, and 
games of various sorts are ideal ways of keeping the muscular system 
and the whole body in good working order. 

The exercise must not, however, be too strenuous. It must not be 
carried past the point of moderate fatigue and must not be violent in 
character. The one extreme of too violent exercise is as undesirable as 
the other extreme of too little. 

THE BODY AS A FURNACE 

The human body must be regarded as in much the same light as the 
household furnace. As with the furnace, the fuel must be fed at regular 
intervals and it must be of the proper kind, but, of equal importance, is 
the timely removal of the ashes, in the proper manner. Let the ashes 
remain in the fire bed and the function of the furnace becomes greatly 
impaired. The draught is obstructed and the heat of the fire become 
progressively less. The situation in the human body, when proper care 
is not taken to establish a metabolic equilibrium, becomes quite analagous 
to that in the furnace. 

It may be argued that cathartics and laxatives can be used as re- 



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158 THE DENTAL DIGEST 

quired to establish entero-colonic activity, but the answer to this is that 
this means affords only temporary relief at best, its final result being the 
development of the cathartic habit, which is as bad or worse than the 
sedentary habit. A function which should be normal and will respond to 
natural causes, cannot be activated indefinitely with artificial stimuli. 
Take the right amount of exercise, regularly, and it is not likely you 
will have any need for other therapeusis. You will feel better, look 
better and be better. The chief causes of your complaints will disappear. 

{To be continued) 



AN ORIGINAL LETTER TO A DENTIST* 

Dr. G. M., III., Oct. 9th 1905. 

Dear Sir: 
I find of a necesary that I must have some thing did to my teeth, I Can 
not say just what, or weather any more than good advice, but providing 
I shall make up my mind to have any teeth Extracted, Can you have 
yourself provided with a positively, I was going to say painless article. 
a gum freezer to make num. Can this be did under any circumstance. 
Or is it a say say, saying. 

I have of course had teeth extracted at times successfully so far as that 
work was did. but so severe pain. As my nerve system has been so 
shocked for years this is why I want to know if can be in tirly over come 
without taking gas, which I should prefir not to do. 
I have had this past week an other dreadful attact of mewralga caused by 
catching cold in these teeth, they are no how whole any more, a number 
with the crumbling tops intirley gon; and yet they are aparently im- 
planted in the jaw generally solid as rocks, this is why I fear and dread 
the process, if they was loose & rigley I should not hesitate. I will prob- 
ley place in my order for Friday perhaps a bout half past ten. I mean an 
order to taulk with you if you are not busey. I am trying to draw the 
information nice as I can so there will not be so much swelling and soar- 
ness. in this spell it reach such a degree at one tooth Root as to cause an 
abcess to form which, came to a head, on the gum in side. You may 
conclude of course that I suffered much Pain in this, and to press on the 
gum at this place feels as if there was a sack or cusion like, this I hope to 
have in better shape By Friday. I do not know sure but think this was 
the Eye tooth as we call it. 
I wish they was in the Bottom of the Sea any way. 
We hope you are all well. 
I will try and kep up courage to come and see you any way. 

Respfully Yours 
*Nwue withheld by request. . 



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Seest thou a man diligent in business? 
He shall stand before kings; he shall not 
stand before mean men. 

— Proverbs xxli, 29, 

THE BUSINESS SIDE OF PROPHYLACTIC AND 
RESTORATIVE PRACTICE* 

By W. F. Spies, D.D.S., and George Wood Clapp, D.D.S., New York 

RESTORATIVE DENTISTRY 
THIRD PAPER 

By restorative work is here meant all those operations which are 
employed in restoring the natural teeth to a condition of masticating 
eflSdency, and replacing lost teeth. This includes the treatment and 
filling of roots when necessary, the restoration of crowns to proper con- 
tact with adjacent teeth and articulation with opposing teeth, either by 
means of fillings or porcelain or gold crowns. 

It is obvious that in making records for this sort of service, some stan- 
dard of excellence must be established, since these operations may be 
performed in much less time if the quality of service is not to be con- 
sidered. Thus if roots are to be carelessly or hurriedly treated, if inlays 
or crowns are not to be contoured to contact and carved to articulating 
and masticating efficiency, the cost of each operation will be much less. 
It is of little use to estimate on the cost of an inferior quality of service, 
since it usually brings the mouth to a worse condition than the first, 
within a brief period of time. 

A SCHEME FOR COMPUTING COSTS OF RESTORATIVE OPERATIONS 

Our experience in the relatively new field of keeping accurate costs 
of dental operations has enabled us to devise classifications which we 
believe may be adopted by dentists generally to the end that the costs of 
operations may be computed by different dentists on a simUar basis. 
This permits comparison between different computations to the benefit 
of aU. 

As in most other activities, we have learned only by experience, and 
while we are now computing costs according to this classification, there 
are numerous items concerning which we have no data. We hope to be 

*This article began in the January 191 6 number. 



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160 



THE DENTAL DIGEST 



able to offer such data in the future, and in the meantime shall be glad 
to have the cooperation of all dentists who desire to see some intelligent 
classification for costs generally adopted. 

PULP EXTIRPATION AND ROOT FILLING 

This class of work presents three general divisions — one in which the 
pulp must be removed from a sound tooth that it may be used as an abut- 
ment, another in which decay is present without exposure, and a third 
in which there is an exposed or putrescent pulp. In cases of inflamed 
pulps, palliative treatment may be necessary before devitalization and 
post-operative treatment after extirpation. Illustration No. 4 presents 
the three conditions of the teeth and it is believed that the form below 
it enables the dentist to record the time of each step of the operation. 
He can then compute the cost by multiplying the income-hour fee by the 
time. 



I 



7. Number of Cases 

8. Average Time 

9. Average Cost 



Fig. 4. Illustration and fonn 

(0 
Time Report: 

1. Palliative Tr. . . 4. Extirpate .... 

2. Appl. As. . . . s. Post Tr 

3. Pressure Anes. . 6. Filling 

(Incisors, Bicuspids and Molars). 

*Our records at present show the following: 

No. 8. Devitalizing healthy anterior teeth for abutments, no cavities. 

Forty-eight cases from three dentists. Total time for all cases 42 hours, 

divided as follows: 

Application of Arsenious Acid and pressure anesthesia ....... 12 hours 

Removals of pulps and post-operative treatment 17 " 

Filling roots 13 " 

42 hours 

Average time 52 minutes. In each of these cases a cavity was drilled 
into the sound tooth structure and Arsenious Acid sealed in from 24 to 48 
hours. An exposure of the pulp was then made, pressure anesthesia 
applied, the pulp removed. Cost as per table following: 

Class I Class U Class III Class IV Class V 

Minimum hourly fee $1.45 $2.22 $3.13 $3.94 $4.89 

Average cost . . 1.30 1.91 2.60 3.38 4.16 

*The numbers given to these operations correspond to the numbers in Chapter 16, "Profit- 
able Practice," from which they are taken. 



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BrSINESS SIDE OF PROPHYLACTIC AlTD RESTORATIVE PRACTICE 161 

No. lo. Soothing pulpitis, removing anterior pulps, filling canals. 
Forty-one cases from 30 dentists. Average time 45 minutes. Costs as 
per table following: 

Class I Class II Class III Class IV Class V 

Minimum hourly fee $i-45 $2.22 $3- 13 $3-94 4-^9 

Average cost . . 1.12 1.63 2.25 2.92 3.50 

No. 7. Devitalizing healthy anterior teeth and filling roots, no ex- 
posure, pressure anesthesia. Sixty cases from 50 dentists. Average time 
30 minutes. The records do not show whether or not there were cavities 
in the teeth, and to this extent are indefinite. Costs as per table follow- 
ing: 

Class I Class U Class III Class IV Class V 

Minimum hourly fee $i-45 $2.22 $3 -13 S3 -94 $4-^ 

Average cost . . . .72 i.ii 1.56 1.97 2.44 

No. 9. Removal of exposed, anterior pulps, not inflamed, pressure 
anesthesia, filling canals. 59 cases from 50 dentists. Average time 25 
minutes. Costs as per table following: 

Class I Class II Class III Class IV Qass V 

Minimum hourly fee $145 $2.22 $3- 13 $3-94 $4 89 

Average cost ... .62 .75 1.25 1.62 2.00 

No. II. Treating putrescent anterior canals and filling roots. 53 

cases from 46 dentists. Average time i hour and 15 minutes. Average 

cost as per table. 

Class I Class II Class IH Class IV Class V 

Minimum hourly fee $145 $2.22 $3- 13 S3. 94 $4 89 

Average cost ... 1.87 2.25 3.75 4.85 6.co 

Technic same as No. 8, 20 bicuspids from three dentists. 

Application of Arsenious Acid and pressure anesthesia 5 hours 

Extirpation and post-operative treatment 12 " 

Root filling 9 " 

Average time i hour 18 minutes. Cost as per table following: 

Class I Class II Class III Class IV Class V 

Minimum hourly fee $i-45 $2.22 ^3-^3 $3-94 $4 89 

Average cost . . 1.95 2.34 3.90 5.07 6.24 

No. 12. Removing healthy bicuspid and molar pulps. 218 cas23 
from 60 dentists. Average time 65 minutes. Costs as per table following : 

Class I Class II Class III Class IV Class V 

Minimum hourly fee $i-45 $2.22 $3-^3 S3 94 $4-^ 

Average cost . . . 1.62 1.95 3.25 4.22 5.20 

Technic same as No. 8, 12 molars from 3 dentists. 

Application of Arsenious Acid and pressure anesthesia 7 hours 

Extirpation of pulps and post-operative treatment 7 " 

Root filling: 8 " 



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162 



THE DENTAL DIGEST 



Average time i hour and 50 minutes. Cost as per table following : 
Class I Class II Class III Class IV Class V 

Minimum hourly fee $i-45 $2.22 $3- 13 $3-94 $4-^9 

Average cost ... 2.75 4.07 5.50 7.15 8.80 

No. 13. Treating putrescent molars and filling roots. 92 cases 
from 40 dentists. Averjige time i hour and 45 minutes. Costs as per 
table following: 

Class I aass IT Class III Class TV Class V 

Minimum hourly fee $i-45 $2.22 $3-^3 $3-94 $4-8q 

Average cost . . . 2.62 3.85 5.25 7.15 8.80 

No. 15. Treating putrescent molars, filling roots, filling crowns with 
amalgam. 49 cases from 40 dentists. Average time 2 hours, 10 minutes. 
Costs as per table following: 

Class I Class II Class III Class IV Chiss V 

Minimum hourly fee $i-45 $2.22 %3-iS $3-94 $4-89 

Average cost . . . 3.25 3.90 6.50 8.45 10.40 

No. 16. Treating putrescent teeth, kind of teeth and care in treat- 
ment not specified. 93 cases, 20 dentists. Average time i hour, 25 
minutes. Costs as per table following: 

Class I Class II Class III Class IV CUss V 

Minimum hourly fee $1 ■ 45 $2.22 $3 • 13 S3 ■ 94 $4-89 

Average cost . 2.12 3. 11 4.25 5.52 6.80 

CLASSIFICATION OF CAVITIES 

It is believed advisable to follow the cavity classification of Dr. 
Thos. E. Weeks, as given in the American Text-book of Operative Dentistry. 
The illustrations are doubtless sufficient without description. 







nius. No. 4. 



7 8 

Fillings in simple cavities 




Time Report: 

1. Cav. Prep 5. Number of cases 

2. Introduction 6. Average time 

3. Wax model 7. Average material 

4. Laboratory 8. Average cost 

(Gold, Foil, Inlay, Alloy, and Cement) 

Our records at present show the following: 

No. 25. Simple amalgam or cement fillings. 473 cases from 
dentists. Average time 25 minutes. Costs as per table following: 



65 



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BUSraESS SIDE OF PROPHYLACTIC AND RESTORATIVE PRACTICE 163 





Class I 


Class II 


Class III 


Class IV 


Class V 


Minimum hourly fee 


$1.45 


$2.22 


^3-^3 


$3.94 


S4.89 


Average cost . . . 


.62 


.89 


I-2S 


1.62 


2.00 



The term "simple" is here employed to describe a filling involving 
only one surface of a tooth. No records of the care exercised in any of 
the steps are available. Three hundred and nineteen of these fillings 
were reported as averaging 30 minutes, but 87 were reported by one 
dentist as reqiiiring only 10 minutes each, which reduced the general 
average. Such variation in records emphasizes the fact that each dentist 
should compile his own time records as a basis for his own minimum fees. 

No. 30. Simple gold foil fillings. 42 cases from 15 dentists. Aver- 
age time 30 minutes. Costs, exclusive of gold, as per following table. 

Class I Class II Class III Class IV Class V 

Minimum hourly fee $i-45 $2.22 $3- 13 $3-94 $4-89 

Average cost ... .72 i.ii 1.56 1.97 2.44 

No. 32. Simple gold inlays. 72 cases from 40 dentists. Average 
time I hour, 20 minutes. Costs, exclusive of gold, as per table folloi;ring: 

Class I Class H Class III Class IV Class V 

Minimum hourly fee $i-45 $2.22 $3- 13 $3-94 $4-89 

Average cost . 2.00 2.96 4.00 5.20 6.40 






II 12 

lllus. No. 5. Fillings in compound cavities 

Time Report: 

1. Cav. Prep 5. Number of cases 

2. Introduction 6. Average time 

3. Wax model 7. Average Material 

4. Laboratory 8. Average cost 

(Gold, Foil, Inlay, Alloy, and Cement) 

No. 26. Compound amalgam and cement fillings. 161 cases from 
60 dentists. Average time 45 minutes. Costs, as per table following. 
The term '* compound" is here employed to indicate a filling restoring 
two or more surfaces of a tooth. 

Class I Qass II Class III Class IV Class V 

Minimum hourly fee $145 $2.22 $3- 13 S3 -94 ^4-89 

Average cost ... 1.12 1.63 2.25 2.92 3.60 

No. 33. Compound geld inlays. 95 cases from 10 dentists. Aver- 
age time, I hour 55 minutes. Cost, exclusive of gold, as per table 
following. 



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164 THE DENTAL DIGEST 





Class I 


Class II 


Class III 


Class IV 


Class V 


Minimum hourly fee 


$1-45 


$2.22 


$3- 13 


$3-94 


^.89 


Average cost . . . 


2.87 


4.22 


5.75 


7.47 


9.20 



No. 34. Extensive gold inlays, character not otherwise specified, 
16 cases, average time 3 hours, 20 minutes. Costs, exclusive of gold, 
as per table following: 

Class I aass II Class III Class IV Class V 

Minimum hourly fee $i-45 $2.22 tS-^S $3 94 $4 -89 

Average cost 5.00 7.40 10. co 13. 00 16. co 

No. 35. Finely carved and contoured gold inlays in bicuspids and 
molars. 52 cases from one dentist. Average time, 2 hours 45 minutes. 
Costs, exclusive of gold as per table following. The gold cost, on the 
average, $1.20 per inlay. 

Class I Class II Class III 

Minimum hourly fee $1-45 $2.22 S3. 13 

Average cost ... 4.12 6.07 8.25 

To be cofUintied. 



Class IV 


Class V 


S3-94 


S4.89 


10.72 


13 20 



Editor Dental Digest: 

In the various articles pro and con on dental advertising as pub- 
lished in the Digest the past year, one point seems to have been missed. 
Suppose it were perfectly legitimate for all dentists to advertise and all 
dentists did so, what advantage would one have over another? If one 
were not capable of good advertising could he not revert to a professional 
advertisement writer and thus do as good advertising as the other fellow, 
and all advertising being equal would there not be a large expense thus 
added to the dental profession without any advantage to any one party? 
Any dentist of good morals, of fair workmenship, attentive to business, 
associating with only the best of associates and being conspicuous in 
public affairs need not even see wolf tracks within a hundred miles of his 
office or home, and a country crossroads may be his place of business. 
I might add that a man of good morals is necessarily one clean in person 
and office. 

Any author of an article written the past year in the Digest com- 
plaining of poor business and professional abuse by the other fellow can 
diagnose his case in these last few lines and can if he will prescribe for 
himself successfully. 

One who has been through the mill and did diagnose himself. 

R. A. W. 



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DENTISTRY FROM A FINANCIAL ASPECT 165 

DENTISTRY FROM A FINANCIAL ASPECT* 

By Percy A. Ash, D.D.S. 

Editor "CommonweaUh Dental Review f'' Lecturer and Examiner University of Sydney, Etc, 

The dentist who, so to speak, can only do what he was actually taught 
while at college will be a partial, if not a complete, failure. There is 
probably no vocation which affords so much scope for personal ingenuity 
as the mechanical side of dentistry. Think of the many cases presented 
to you which are quite different to any you have seen before. Each must 
be dealt with entirely in its own merits. Fixed and removable bridges, 
vulcanite and metal plates, inlay abutments, and many other methods im- 
mediately flit through your mind, and upon your ability to grasp quickly 
and intelligently all the alternatives, and eventually decide on the one 
which will give the best service, combined with the greatest comfort, will 
depend the measure of success which you have in practice. 

Dentistry cannot always be carried out on the definite lines set out in 
books any more than particular business enterprises can invariably be 
built up on the old-fashioned lines. Braddon, again, on this point says, 
''A torpid mind, fatal in business, will cling desperately to the established 
methods. Hating change, a quick, original mind will always be ready at 
any rate to weigh new ideas and to sympathetically appreciate the possi- 
bilities of suggested innovations." 

There are many details in connection with the conduct of a dental 
practice which count for a great deal, and are often neglected, either 
through carelessness or the lack of a proper knowledge of the fitness of 
things. If a patient telephones for an appointment, and especially if he 
asks for a definite time which will suit his convenience, is it not worth while 
to personally speak to him after your secretary has taken the message, 
and arrange something suitable to him? It gives him an excellent im- 
pression of the interest you take in those who consult you. If a friend 
sends a patient to you, surely the first thing to do is to thank him for his 
kindness; the omission of it is an unpardonable offence. When a new 
patient arrives at your rooms, spare a moment to greet him yourself, and, 
if he is there by appointment, do not keep him waiting; in any case, if 
he is in pain, assure him that, irrespective of inconvenience to yourself, 
you will see him within a few minutes and endeavor to make him comfort- 
able. Many such small matters might be mentioned which are fre- 
quently overlooked. There is no room in the dental profession for the 
man who is casual; he must be ever on the alert, and make the most of 
every chance. Those who, in other walks of life as well as our own, ex- 
^Continued from February Digest. 



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166 THB DENTAL DIGEST 

cuse their failures on the ground that business generally is bad and money 
scarce, are very often themselves to blame. It is idle to talk of the good 
old times which will never return. The world is full of opportunities; 
they come knocking at our doors every day. The quicjc and intelligent 
man takes hold of them, the pessimist fails to see them, while the drone 
does not trouble himself one way or the other. 

A feature of great importance in any business or profession is the 
ability to properly conduct correspondence. Few things are noticed 
more by an educated man than the receipt of a letter badly constructed 
and with faulty spelling. Bear in mind that professional men are ex- 
pected to be educated to the extent, at least, that they can correctly ex- 
press themselves in the language they speak. It is regrettable to have to 
admit that there are very many who cannot; and here let me say that 
they should fill in all the spare time at their disposal in improving them- 
selves in that direction. It is no disgrace that through force of circum- 
stances one has not had the advantages of a good education in early life, 
but it is unpardonable not to try and make up the deficiency later when 
one has the means at his disposal. Surely the ability to properly speak 
and capably state one's thoughts on paper is one of the essentials toward 
success; it certainly is one of the greatest assets which a man can have who 
intends to follow an occupation in life which will bring him in personal 
contact with people of refinement, and I presume that all of us aspire to 
have that class of people for our patients. It is a constant source of sur- 
prise to me why so many comparatively young men seriously lacking in 
this way do not spend some of their evenings attending classes of instruc- 
tion, or else studying in private with capable tutors. 

The point I want to make in mentioning such matters as these is that 
very many of us are either wilfully or unconsciously blind to our own short- 
comings, and, as a result, we have to suffer. In other words, we fail for 
one reason or another to take accurate stock of ourselves. We are ready 
enough to pronounce that some other class of business failed because the 
manager of it was incompetent; but for our own failures, we lay the blame 
anywhere but at our own doors. It is no use attempting to decry the 
successful practitioner on the other side of the street by saying that you 
are as good a man as he is, and that your professional qualifications were 
obtained at schools equal in standard to those where he took his degrees, 
for the fact remains that he has succeeded and you have failed. The 
thing to do is to ascertain accurately his personal qualities, and then 
compare his methods of conducting a practice with your own. Many of 
us have attractive points which have never been developed. A good plan 
would be to spend some of the money we otherwise waste in seeking the 
help of those competent to bring out those latent qualities to the best 



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DENTISTRY FROM A FINANCIAL ASPECT 167 

advantage. Money is given us to make good use of, and surely it can be 
put to few better purposes than to assist in the development of char- 
acter and those many personal accomplishments essential to success. 

Someone has written that the way to succeed is to work hard and 
advertise. The necessity for hard work, especially in these exceptional 
times of war and distress, when it is gradually becoming a more difficult 
problem to make two ends meet, is beyond argument; but the question of 
advertising is one that is, and always will be, open to much contention 
in so far as professional men are concerned. The style so objectionable is 
the hideous signboard or the flaring announcement in public print, more 
especially when statements are made not in accordance with fact. It 
has been said that the advertising which never shows in a magazine or 
on a signboard has more influence on individual lives than all the wonder- 
ful public array of words with which we are all so familiar. What 
constitutes legitimate advertising within the profession of dentistry is a 
matter too large to go into this evening. Each man must decide for 
himself, but let him make his decision, if possible, after closely studying 
the methods of practitioners who have built up successful practices upon 
lines recognized by all around them to be highly ethical. 

It may appear to some members of the profession that my remarks so 
far have consisted largely of platitudes and preaching. They may say 
that they already know all I have remarked, and have found it of no avail. 
They may also say that they have read the sayings of philosophers and 
commercial magnates, and have found them of no practical use. That is 
just the point I wanted to lead up to. If some of us have heard and read 
these wise words, uttered in many instances by men who have climbed to 
the top of the tree, and have not found them a help on the road to success 
in practice, well, then, we should be brave enough to look the whole mat- 
ter squarely in the face, admit that we have missed our vocation in life, 
and then, with that energy and determination which characterizes the 
British race, relinquish dentistry and try our fortunes elsewhere. That 
is the sum total of the whole argument, and there is no need to speak fur- 
ther upon it. 

BANKING ACCOUNTS 

No person whose financial transactions amount to any sum worth 
mentioning should fail to have a current banking account. Very many 
people get their monetary affairs into a state of chaos by keeping their 
accoimts in their pockets, so to speak. We shall again take the case of 
the careless professional man who does not understand bookkeeping, and 
thinks that a bank pass book will be a nuisance to him. Rather than 
employ pii accountant, he simply receives and pays out bis money as occa- 



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168 THB DENTAL DIGEST 

sion arises. A patient pays him ten guineas, which he puts into his 
pocket. An hour or two later a tradesman calls with a bill for £5-10-6. 
He pays it out of the ten guineas he has received, and simply puts the 
receipt on a file. He receives and pays money in the same manner month 
after month, and so long as he can put his hand in his pocket for what he 
wants, he is satisfied that he is keeping on the right side. He probably 
notes down on scraps of paper what patients owe him, but keeps no accur- 
ate records of his own debts, and therefore frequently receives more or 
less of a shock when his creditors present him with statements of their 
claims. If he happens to have sufficient money about him when one of 
them calls, he will perhaps pay on the spot; if not, he will say to call again. 
It is quite certain that a man with a practice or business of any extent 
cannot ascertain at short notice how he stands without keeping proper 
accounts, and it is also certain that, with the methods of exchange as we 
have them now, he cannot conduct his affairs satisfactorily without 
keeping an account at a bank. In making this last remark, I have par- 
ticularly in mind the system of giving cheques. In Australia, especially, 
the custom of settlement by cheque, instead of bank notes or coin of the 
realm, has now become so firmly established that one is practically forced 
to adopt the system, and the adoption of it necessitates, of course, a bank- 
ing account. Whether you pay all your own debts in cash or not, you 
will find that the great majority of other business people do not. They 
will pay you by cheque, and how are you to get value for those cheques 
imless you pass them through your banking account. To be sure, some 
few of them may be "open" cheques and be drawn on the local bank, in 
which case you or your secretary could obtain cash over the counter; 
but by far the greater number will be "crossed" or drawn on a bank 
away from the part in which you reside. By an " open " cheque is meant 
one that is payable to the bearer of it, that is not crossed, not made 
specially payable to any particular person, or restricted in any way; in 
other words, a cheque which, if picked up by a stranger, or even stolen, is 
payable to the person who presents it, provided, of course, the drawer has 
sufficient funds to meet it. Any drawer of a cheque has the right to 
request his bank to refuse payment of it if, for instance, it has been stolen 
or lost; but, at the same time, it is very questionable if the bank could 
be held liable should it pay the same by mistake, assuming that it was 
properly drawn; in fact, a bank always requires a written request to stop 
payment, and a clause is usually embodied in that request to the effect 
that the bank shall be held harmless in the event of the cheque being paid 
in error. Also, the instructions to stop payment will not hold good 
against any person who has obtained it in good faith and given value for it. 
Such a person c^n recover either from the bank or the drawer. 



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DENTISTRY FROM A FINANCIAL ASPECT 169 

If, then, you decide to keep a bank account, it is most important that 
all money you receive in connection with your business transactions 
passes through that account — not merely the cheques and the larger 
amounts in notes and gold, but the humble odd half-crowns also. On 
the other hand, let all your paymfenta bb bV cKeq\fft \>f out of some loose 
cash which you have on hand, but which *forms part of a previous amount 
which you drew '^oiit- for 'sundry duXrent exper.Ses. -As -you 3w5Il be cou'^ 
stantly disbursing small sums for 6M pufposfe bf aftotH^r", It Ts Veil fo 
draw a cheque for, say,»£5»for'|>efty cash, and. g^t'ch'aAj^^'^fdjrnt, to be 
paid out as required. If yotrcafre tcrkfcep £f tecdiy <5f 411 the trifles so paid 
out, for your own information, well and good, but it will not affect the 
balancing of your bank account. Many practitioners (myself included) 
do not worry over the details of petty cash. If you keep the amount 
for that purpose in your own pocket, you will know that it all has been 
rightly disposed of; but if your secretary has charge of it and you have 
authorized her to use it, as necessary, without special reference to 
you on each occasion, then it would be better for her to keep a record of 
all payments, as much for her own satisfaction as for your information. 

If you understand little or nothing in regard to keeping and balancing 
a proper cash book kept free of charge to yourself. Each customer is 
entitled to receive from the bank a pass book, which sets out proper 
details of all amounts received and paid away. If, therefore, you pay 
all you receive into your account, and draw cheques for all you want, 
you can, by merely obtaining your pass book from time to time, ascertain 
exactly how you stand; that is to say, you would go through the book, 
check the amounts charged against you with those in the butts of your 
cheque book, and then, allowing for any cheque unpresented, merely 
subtract the one side from the other. It is better, under such cir- 
cumstances, to draw your cheques in favor of the persons you pay, or 
else the name of the goods you are obtaining instead of in favor of 
numbers, as at any time you will then be able to search through your 
pass book and ascertain the amount of money you have paid to par- 
ticular persons or for specific goods within a given time. 

Bear in mind that cheques are not a legal tender, but the custom of 
giving them has now become so firmly established that few persons refuse 
genuine ones in the ordinary course of business. It would be as well to 
say a few words here regarding the use of cheques, particularly in refer- 
ence to restricting the negotiability of them, as this is a subject of which 
the average man knows comparatively little, and one which he should 
fully understand, for he probably adopts the practice in some way or 
other very frequently. 

A "cheque" may be defined as a draft or order for money payable to 



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170 THB DENTAL DIGEST 

bearer, drawn on a banker; or, to give a definition in legal phraseology, 

it is an order upon a bank by a customer requesting the bank to pay a 

sum of money on demand to the person named, or to his order, or to the 

bearer of the cheque. Note the last few words of this definition very 

carefully, as they carina greajid^ pf meaning. The request to the bank 

is to pay the amount *td th^p^slW haffted, or to his order, or to the bearer 

W* th*e»clie(itfe..*Yo!UJ\Aft ieflierfberithit tbeJjisuaJrcieque form runs, 
• • •••• • •• ••«••• ••••••■•• ••••••• 

*'Pay .*..*..*.*.*.** or* beaief.''" The 'drawer* iS dt'perf^ct liberty to place 
in the irfteryejiijifcjBpaDoe a nurnbftr,:tha>najiiO of any person, the words 
'* self, "*^^ cash,'' of any omers'fie i^she^aliffj'soTong as he does not strike 
out the word '^bearer," the amount is payable to anyone. K the word 
"bearer" is struck out and "order" written above it, the payee (that is 
the person in whose favor the cheque is drawn) must endorse it. Strictly 
speaking, the payee should authorize the bank by written order on the 
back of the cheque, to pay the money to a third party, if he wishes that 
done; but the custom has become firmly established, and now has the 
force of law, for the payee to merely sign his name on the back (i. e., to 
endorse). Care must be taken to see that the endorsement corresponds 
with the name as written on the front. If, for instance, the cheque 
is drawn in favor of James R. Williams, it must be endorsed that way. 
It may be that the payee's correct name is John R. Williams (the mistake 
being on the part of the drawer), in which case the endorsement should 
be "James R. Williams," with the correct signature following under- 
neath. In such cases, however, should the endorsement not be exactly 
the same as on the front, the bank may, of its own knowledge, be sure 
that the cheque has passed into the right hands and may certify to that 
effect by writing under the signature "endorsement satisfactory," and 
then either pay it if drawn on that office, or else forward it to its destina- 
tion. The same conditions apply if the word "bearer" is struck out 
without writing "order" above. It is obviously wrong, as is sometimes 
done by inexperienced persons, to draw a cheque in favor of a number or 
anything in abstract terms, and strike out "bearer," as in such case no 
endorsement can be required. 

There is one point in connection with the matter which must not be 
overlooked. Many people think that if they draw a cheque in favor of a 
person and strike out "bearer," it devolves upon the bank to be satisfied 
that the endorsement is actually the signature of the payee, thus being 
assured that the cheque, at least, had passed through his hands. That is 
not so. In New South Wales, at all events, if the endorsement 
purports to be the same as on the face, the banker is justified in paying 
the cheque; in other words, if the cheque is drawn in favor of E. C. 
Forsathe and "£• C. Forsathe" appears on the back of it when presented 



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"JOSH" COMES BACK 171 

for payment, the banker's responsibility ends there. There is con- 
siderable protection in the system, however, inasmuch as if anyone has 
come by the cheque dishonestly, and writes the payee's name on the 
back, he is guilty of forgery, and will be dealt with accordingly. 

Should a cheque be stolen the owner will naturally make all the 
eflFort he can to recover it; but if it has passed into the hands of an 
innocent holder who, in the course of legitimate business, has given value 
for it, that holder can, as I have indicated previously, insist upon pay- 
ment to himself by the bank, provided the cheque is properly drawn and 
otherwise in order when presented. — The Australian Journal of Dentistry, 



"JOSH" COMES BACK 



Below we reproduce answers we have received to the article which 
appeared last month and was signed 'Country Dentist" in which the 
Podunk individual says, **What are you going to do when they say 
they can get crowns from the other fellow for $5.00? " Read this answer; 
it's worth the time. 

TO "country dentist" 

I am practising in the country and I formerly '^charged them at the 
gate." I did a big business; the rough necks and K. M.'s were all for 
me and they loudly sang my praises. At the end of each year of this 
kind of practising I found that there was very little left for "doc" after 
the bills had been paid. 

Little "Doc Fist" across the street still puts on his bridge work at 
four dollars per, but I have changed my plan of doing business entirely 
and I do not have time to worry about the fellow practitioner. There 
is not a set fee in this office and all work is priced from the minimum up, 
with the accent very decidedly on the up. The first thing that is dis- 
cussed when the patient enters the office is the fee, and of course the 
service is rendered according to the fee. There are plenty of people in a 
country town who will pay a fee that will entitle them to receive real 
dental work, but it is a question of salesmanship and enlightening them 
along the line of the different methods of doing this work. Use sample 
work and with this work use some salesmanship. No sane person would 
expect you to place a cast crown for the same price as a plier crown made 
in twenty minutes. This holds true of your operative work. Of course 
you can "put in a silver filling" and let them slip you a dollar, or you can 
discuss this matter with the patient before the operation, and quite likely 
you make an amalgam restoration for three dollars. Ignorance of the 



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172 THE DENTAL DIGEST 

laity causes the trouble with the fee question and it is not so much the 
fault of the "fellow across the street." Try it, doctor, it won't do any 
harm to tell them that you can give them something better for more 
money. Amalgam properly placed and polished is worth more than a 
dollar and, honestly, that is about the only reason so much of the amalgam 
is not polished and properly finished. Get the flat fee out of your head. 
I do not wish to pose as a braggard and do not wish to do any vain- 
glorious boasting, so the editor will allow me to sign "Josh." 

Curtis, Neb., Jan. i, 1916. — Dr. J. M. Prime, Omaha, Neb. — ^Dear 
Doctor: I can not help but comment on what the "Country Dentist" 
has to say in regard to fees. He wants to know how to get more than 
$5 for a crown, when his competitor, or colleague rather, gets $5. Then, 
after he asks how, he turns around and says it can not be done. He 
don't care who says so. He reminds me of the Irishman who went to 
the circus to see a camel. He had heard about them, but had never 
seen one. When he saw it he turned to Pat and said, "Oh, hell, there 
ain't no such animal as that." 

It evidently seems that this country dentist is in a rut and is destined 
to stay there until the cows come home. Some day, though, he may 
wake up and some one may be able to show him wherein he is wrong. At 
this time, however, it would be a waste of time and space. 

Yours truly, 

L. A. Chamberlin. 

THE COUNTRY DENTIST 

My Dear Brother: I do not know who you are, but truly, I want 
to know you. Firstly, I shall say, "Let there be light. And there was 
light." Secondly, I want you to know that my feeling toward any man 
who will endeavor daily to perform an impossibiUty is one of love and 
pity. Will you kindly permit me to know you that I may have the 
privilege of helping you? There isn't anything in my heart except to be 
of service to my fellow brother. 

I shall expect to see your name given me in next month's Journal, 
after which I shall answer your questions to the best of my ability. 

Truly and sincerely, 

William L. Shearer. 

ANSWER TO country DENTIST 

In your reply, Mr. Country Dentist, to Dr. Shearer's article in Prac- 
tical Hints in the November Journal, you ask what you would do when a 
farmer comes in your office and wants a gold crown for $5 when your 



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"JOSH" COMES BACK 173 

charge for a crown is $6 and another man comes in and wants a plate for 
$io when your price is $15. 

I will tell you what I would do and what I do do. I would step back 
and look Mr. Farmer square in the eye and give him one of the biggest 
talks on first class dentistry he ever heard and I would tell him the 
difference between a $5 tin can crown made from some faker's die plate 
and a real sure enough crown which you have properly fitted around the 
gingivae, contoured and carved to occlusion, and nine out of ten he will 
pay you your price and be a booster instead of a knocker. The farmer of 
to-day is not the farmer of yesterday any more than the dentist of to-day 
is the dentist of yesterday, and they are willing to pay for anything if 
they are not being held up. 

After you give Mr. Farmer this talk, go into your laboratory and heave 
your die plates out of the window (using care not to strike the head of 
some passerby) and get to work and make good your talk to Mr. Farmer 
and show him the difference between your crowns and a $5 crown. If 
you don't happen to have one on hand you will usually find one in his 
mouth, and that is the best place to compare them. 

Why is it a different proposition in the country than in the dty? I'll 
tell you. It is because most of us don't want to spend the time to talk 
to these people and tell them what they are getting. Most people want 
just as good work as they can get and are willing to pay for it if they 
think they are getting their money's worth. Give them the best there is 
in you and they will stay by you. If you are not giving them as good 
service as they can get elsewhere, you had better get busy and prepare 
yourself so you can, or some of those young fellows will come in and walk 
away with the bacon while you sit in the comer of your office pulling on 
an old cob pipe saying, "These young fellows don't know anything." 
You just quit knocking and get busy. 

If the big men in the cities can do these things, why can't we be big 
men in the country? We CAN, and I don't care who says we can't! 

A Brother Country Dentist. 
Nebraska Denial Journal 



lie 



'Smokers' Patches" in the Mouth. — ^Landouzy describes these 
as consisting of whitish lines or triangular patches extending from the 
juncture of the lips to the first molar. These are also known as smoker's 
commissural patches. They are found exclusively in syphilitics. To- 
bacco is merely the local irritant which causes the patches to develop 
in the predisposed. — Presse Medicate, {Medical Record.) 



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174 THE DENTAL DIGEST 



CORRESPONDENCE 

Editor Dental Digest: 

Will you kindly ask the profession the following questions in your 
next issue. I am looking for the honest ones, the sore ones, also the few 
I am sorry to say are the fakirs. 
Dr. Surgeon Dentist: 

1. What is meant by Ethical Dentist? 

2. Do you or do you not know any that are Ethical in the real sense 
of the word? 

3. If you yourself are, then will you show at least one hundred of 
your contracts so that your claim may be disproved? 

These questions have been generated through the several debates that 
appear from time to time in the Digest Advertising vs. Ethics as per- 
taining to dentistry. 

C. S. L. 

REPLIES TO E. S. G.* 

Dear Brother E. S. G.: 

After glancing at the table of prices you receive for your labor, I can 
readily believe they are the "lowest in the state,'' regardless of what state 
you are in. I am also forced to believe you when you say it gives you ** no 
little trouble." However, I can't sympathize with you for it's all your 
own fault and not the "old man's." 

I can't account for a town of 7,000 and only three dentists unless it 
is because they are so disgusted with 50 cent cleanings and fillings that 
they either go somewhere else for their work, or possibly may not have it 
done at all. If you are doing fifty cent fillings and cleaning you have 
no right to ask more. If not, you have no right to do it for that. 

Supposing you were to go into a store and upon being told the price 
of an article you told the proprietor you could get it cheaper from Rears 
and Sanbrick. Do you think he would at once become a veritable lick- 
spittal and get on his knees and beg you to take the goods at no profit just 
to keep your patronage? Would you have much respect for him if he 
did? No, I think not; yet, that is just what you are doing. 

The thing for you to do is to raise the standard of the work and show 
them the difference, then you won't have any trouble in getting a fair 
price. Do your work your best and charge a fair price. Don't be afraid 
to talk to them, but make them see that they get just what they pay for, 
be it in dentistry or fish-hooks. 

Probably the reason your people don't demand a sanitary office is 

•January Digest, page 27. 



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CORRBSPONDENCB 17S 

because they never saw one. Let yours be the first and they won't be 
slow to reali^ the advantages. 

Did you ever hear of a dentist being starved out because his prices 
were too high? No, No, Brother! this is what you really hear. They 
say, '*He is all-fired high but he does good work and so most of us go to 
him." 

One more point — about that stock of crowns. Of course there always 
will be men who do business that way, and then just across the street 
there will be men more conscientious but with no backbone who will try 
to compete with them and then mourn their sad plight. You are no bet- 
ter than those you consider your competitors, so if you want to get out of 
the old man's class all -'ou have to do is to brace up and do better work 
and charge for it. 

"Waste not your hour, nor in vain pursuit 
Of this and that endeavor and dispute; 
Better be jocund with the fruitful grape 
Than sadden after none, or bitter fruit." 

F. L. K. 

Editor Dental Digest: 

Dr. E. S. G. in the January Digest has my sympathy. We have a 
town of less than 7,000 and it supports 8 dentists. He says his is in a 
town of 7,000 and 3 dentists. If I was looking for a location I would 
endeavor to locate in his town and would take his scale of prices and 
multiply them by three just for a starter, for in a town of that size there 
are enough that would pay it. Of course a person would have to do a 
great deal of talking at the chair, but I would also start a dental educa- 
tion campaign. I would ask the other dentists to enter into it, in giving 
talks to the school children and the various clubs. If they would not 
enter into it, I would go it alone. If patients ever came to me and said 
they could get an amalgam filling for 50 per cent, where I charged $1.50, 
I would shoot it back at them so quick that it would startle them, that 
they can go out and buy a horse for $25 or one for $125, or even $500, 
and if they wanted a $25 horse go to him. However, there is no limit to 
the number of arguments that can be brought out. E. S. G. is in the 
heart of a gold mine and does not know it. If I were he I would go to 
my office to-morrow morning (no I would stop and do it now) make a 
resolution to make or break, then put a sign in front of my chair some- 
thing like this "Ask my prices before having work done and avoid mis- 
understandings. Take nothing for granted." This I would do in 
justice to those who had been patronizing me and knew the prices I had 
been charging. L. L. 



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KA6Ti(AL Hints 



[This department is in charge of Dr. 
V. C. Smedley, 604 California Bldg., 
Denver, Colo. To avoid unnecessary de- 
lay, Hints, Questions, and Answers should 
be sent direct to him.]* 

Leaky Vulcanizer. — Get a package of Dixon's stove polish: shave 
off a teaspoonful and pulverize it. Mix it with equal parts of glycerine 
and water. The mixture should be about the consistency of cream. 
Paint it on the packing of the vulcanizer with a small brush. A very thin 
layer is usually sufficient. Repeat when necessary. — D. W. Barker, 
D.D.S., Brooklyn, N. Y. 

To Improve Gasoline. — Should gasoline not work well in blow-pipe, 
not giving a brush-flame on account of exposure to air, add a little sul- 
phuric ether and see the life it gets. — C. M. Bremerman, D.D.S., Cali- 
fornia, Mo. 

Rugae on Plates. — ^After flask is opened, wax removed, take suit- 
able carving instnmients and different sizes of ball burnishers, and carve 
rugae on plaster in the half containing teeth. Burnish tin-foil over this, 
pack and vulcanize. It takes only a few minutes, and you are well 
repaid for your trouble. — H. L. Entriken, D.D.S., Enid, Okla. 

To Stop a Leaky Vulcanizer. — Wet rim of cup with water and 
sprinkle Wilson's corega freely on same. Close at once. This is my 
original way when "necessity was the mother of invention.'' — P. C. 
CuRRAN, D.D.S., La Crosse, Wis. 

To Clean a Glass Slab of Cement. — I always put my glass slab 
when through with (as I have several) in a bowl of water and it remains 
therein until the next morning when I take my plate brush and put glass 
under water faucet. Cement readily comes off and leaves slab in fine 
condition.— Dr. O. B. Shedd, D.D.S., Weedsport, N. Y. 

To Make a Two Piece Shell Crown Serve as Bridge Abutment. 
— In making two piece shell crowns to serve as bridge abutments, place 
seam of band on either mesial or distal surface of root so as to have entire 
seam included in solder area of adjacent dummy. — J. E. Ruzicka, D.D.S., 
Plainview, Neb. 

*ln order to make this department as live, entertaining and helpful as possible, questions 
and answers, as well as hints of a practical nature, are solicited. 



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PRACTICAL mNTS 177 

To Facilitate Waxing Parts of Broken Vulcanite Plates 
Together. — Hold parts of broken vulcanite plate in correct apposition 
with hands, and with wax spatula in mouth, melt wax and drop with piece 
of tooth-pick across break. — N. L. Davies, D.D.S., Seattle, Wash. 

To Do Away Altogether with the Very Much-Complained-of 
Bellows to a Soldering Outfit. — Get a small rotary air pump and 
fasten it to the wall in line with a motor (electric or water), a sewing 
machine belt to transmit the power if an electric motor is used. Place 
a switch near the blow-pipe and cut in on the line so when it is turned off 
the motor can be turned to first speed; to start fire simply turn switch 
and apply match. Am using it with a gasoUne generator with absolute 
success. — V. C. Stockberger, D.D.S., Syracuse, Ind. 

To Grind Natural Teeth Painlessly. — Much of the discomfort 
in the use of stones is occasioned by the jarring or vibration of the stone 
against the tooth. If the tooth is held firmly in the socket or against 
one wall of the socket with the thumb or finger of the left hand wliile 
grinding down enamel or opening cavities with stones it will minimize 
the discomfort immeasurably. Of course it is understood that all stones 
should run smoothly and true and that a stream of water should flow on 
them while cutting. If these precautions are taken, any ordinary case 
of grinding can be done painlessly. — E. D., The Denial Review, 

To Flow Solder Easily. — If the solder is cut into long strips instead 
of short pieces, it can be used to better advantage. Heat the case up, 
and taking hold of one end of the strip with tweezers, hold the other end 
close to the piece to be soldered and direct the flame on it. As it melts 
feed it down into the joints or wherever you wish it to flow. In this way 
you can see what you are doing, and the solder may be fed into a deep 
depression or built up into any desired bulk in precisely the form that is 
required. If the solder is not flowing properly, dip the heated end of the 
strip in powdered borax, and this will flux it and make it flow smoothly. 
—J. W. J., The Dental Review, 

Root-Canal Filling Material. — Gutta-percha base plate, weight 
one half ounce. Saturated solution of thymol and eucalyptol, measure 
one half ounce. Dissolve gutta-percha in chloroform; add thymol and 
eucalyptol and mix thoroughly. Allow chloroform to evaporate. Dry 
the tooth thoroughly and work the above into the canals with a warm 
broach, forcing to apex with a soft piece of rubber and insert gutta- 
percha point. — The Pacific Dental Gazette. 

A Porcelain Jacket Crown. — This method of making a porcelain 
jacket crown is as follows: 



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178 THE DENTAL DIGEST 

First: Remove enamel with stones and burs. 

Second: Take impression with ferrule containing modeling com- 
position. 

Third: Fill impression with cement. 

Fourth: Take bite and place cement model in bite and place on 
articulator. 

Fifth: Burnish i-iooo platinum on cement model of end of tooth. 

Sixth: Bake porcelain on platinum matrix. — G. T. Gregg, D.D.S., 
The Dental Summary, 

Useful Hints. — In the repair of vulcanite there is no need of waxing 
up nor using the press. In the case of a broken plate, grind each side 
of the fracture one quarter inch, very thin at the fracture, and pack with 
hot spatula, rubbing on small pieces and flask. If a tooth is to be replaced 
hold it in place with the lingers, having filed away some of the vulcanite 
and pack with hot spatula and flask. — ^L. P. Haskell, The Pacific 
Denial Gazette, 

To Restrict the Flow of Solder. — In soldiering gold, when it is 
desired to restrict the flow to a certain area with a sharp lead pencil 
draw a line around the desired area. The solder will not flow past the 
line. — The Dental Register. 

Strengthening Plaster Models. — For strengthening thin plaster 
models so that they can withstand the pressure exerted in flasking, etc., 
light and thin brass wire netting as employed for sieves is cut to suitable 
length and breadth and embedded in the plaster while pouring. To 
strengthen a bridge abutment on a plaster model, a little roll of wire 
netting is inserted as a core when the cast is being poured. — ZahnaerzUiche 
Rundschau, The Dental Cosmos, 

Separating Modeling Compound Impressions. — In taking model- 
ing compound impressions, the compound may easily be separated from 
the cast if the impression is painted with a thin solution of shellac before 
it is poured. A most perfect impression may be obtained if the compound 
be vaselined and held under a stream of hot water for a few seconds just 
before the impression is taken. — R. Davis, Dental Review, 

To Save Time and the Proper Method to Repair a Plate. — If 
the plate is cracked two thirds of the way, hold together until crack is 
closed, then with sticky wax and alcohol flame flow sufficient wax over 
same and let cool. Then make plaster model, and after it has set remove 
plate and break in two. Take fissure bur and cut \ inch of old rubber out 
of each side of break, then with same bur cut dovetail grooves on either 
side about \ inch apart, then wipe clean with a pledget of cotton and 



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QUESTIONS AND ANSWERS 179 

chloroform. Replace parts of plate on model being sure they are down 
where they fit on same. Hold same with left hand and with small pieces 
of rubber and a clean hot spatula, keeping spatula hot with alcohol flame, 
proceed to work rubber into grooves until even with surface of plate, 
then stretch another piece of rubber over groove, smooth to proper thick- 
ness, and the whole is ready for flasking. When vulcanized it can b^ 
finished in a few minutes. I repair all my plates in this manner. A new 
gimi front can be put on in the same way. The plate will never break 
where the new rubber has been inserted, and if care is exercised the plate 
will positively undergo no change to cause a misfit. — ^Alfred Frazer 
Kennedy, D.D.S., Walter, Okla. 

[I approve absolutely of this method of making repairs. I find it 
imnecessary, however, to cut any dovetails, or wipe with chloroform 
either when surfaces receiving new rubber are freshly cut and free from 
wax or other foreign substance. I prefer also bridging the crack with 
pieces of match stick held with sticky wax at each end, putting no wax 
directly upon crack, at least until after parts are firmly held in place by 
match sticks, permitting one to turn plate over examining crack from 
both sides to see that it is correctly closed. In hand packing repairs in 
this way, it should be kept in mind that spatula must be as hot as rubber 
will stand without burning; when same may be spread on like butter; 
provided the right kind of rubber is used. I find Doherty's maroon about 
the best that I have tried for this purpose. Black rubber can scarcely be 
used for this purpose at all, and some makes of maroon and red are not 
much better. V. C. S.] 



QUESTIONS AND ANSWERS 

Question. — ^Please advise the best way to make a duplicate rubber 
plate without taking another impression. (That is, put new red and 
pink rubber in plate).— H. L. R., Granton, Wis. 

Answer. — Flow as much wax over old plate as you think you will 
polish off in finishing new rubber; flask case just as you would if it were 
a new case, all wax. After plaster has set thoroughly, heat up very 
gradually until case is hot enough to have softened old rubber somewhat, 
but not to char it. Now flask may be opened cautiously, and old rubber 
taken out; some of the teeth may stick in the rubber, but these can be 
easily removed, placed in their respective places, and case packed as 
usual. Impression may be taken inside on old plate, excess of impression 
material trimmed off, and a re-adaptation secured as above. — V. C. S. 



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THE BLASTER 

in ni fi in T by b. c. forbes 

I have kaied more men than all the armies of the world. 

I have blighted more homes than all the plagues of history. 

I have robbed more children of their birthright than all the thieves 
ever born. 

I blast careers. 

I am the parent of untold poverty. 

I breed diseases. 

I spread misery wherever I go. 

I am oftentimes the inciter of the recklessness that strews the world 
with accidents and catastrophes. 

I am the most subtle, the most insinuating, the most alluring of 
tempters. 

I wear the guise of joy — of happiness, of gaiety, of goodfellowship. 

I promise pleasures. 

I deliver death. 

I charm the rich as easily as the p>oor. 

I am embraced by the educated as often as by the ignorant. 

I speak every language. 

I know every clime. 

I am as old as history. 

I am mightier than kings and emperors. 

I have driven rulers from their thrones and overturned dynasties. 

I can render the strongest armies imf)otent. 

I can sap nations. 

I rejoice in bringing dishonor and degradation. 

I fill prisons. 

I fill insane asylums to overflowing. 

I feed hospitals with patients. 

I cause more divorces than jealousy can claim. 

I am equally f)owerful in undoing women as in wrecking men. 

I am welcomed in every class of society. 

I am given a place at the tables of the most cultured and the most 
exclusive. 

I am as eagerly sought after by the poorest and the most ignor- 
ant. 



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DIGESTS 181 

I am so prized that no function of State, no brilliant social gathering, 
no great public dinner is accounted complete without my presence. 

I am coveted by many governments for the revenue I yield them. 

I consume, however, more wealth than has been spent in building all 
the railroads and all the steamships of the world. 

I am the costliest inhabitant in every nation. 

I and my activities call for the expenditure of unreckonable millions 
for prisons and for police forces and courts, for hospitals and for doctors 
and for nurses, for insane asylums, for almshouses, for orphanages. 

I am, however, beginning to be seen in my real colors. 

I am being subjected to scientij5c investigation — and found wanting. 

I am falling into moral disrepute. 

I can no longer fool the wise. 

I have received a body blow from the economic regeneration pre- 
cipitated by the war. 

I have been discovered to be the arch-foe of progress, of strength, of 
eflfort, of eflSdency. 

I have been drummed out of one country with beneficent results which 
have astounded a world blind to my real character. 

I have been curbed in another empire where long I held sway among 
the masses — ^men and women — impoverishing them grievously. 

I have been barred from nineteen States in this great commonwealth, 
but though many believe they foresee my doom from end to end of the 
land, I still have many powerful friends whose pockets I fill with my blood 
money, but whose lives and families I wreck sooner or later. 

I have all the forces of evil on my side, and I shall fight to the last 
ditch. 

I can prevail so long as I am allowed to wear my mask. 

I cannot hope to endure for a day if I be revealed in all my real 
hideousness. 

I, therefore, summon every enemy of the State, every enemy of the 
home, every enemy of family life, every enemy of happiness, every enemy 
of progress, every enemy of decency, every enemy of honor, every enemy 
of health, every enemy of all that makes life worth while — I summon all 
these, my supporters and my worshippers, to enrol themselves under my 
banner of skull and cross bones and so battle for me that I, the arch 
enemy of mankind and of civilization, shall be victorious over every 
agency of righteousness. 

Who am I? 

I am drink. — North American. 



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182 THB DENTAL DIGEST 

OIL OF TURPENTINE AS A HAEMOSTATIC 

By G. Grey Turner, M.S.Durh., F.R.C.S. 

A severe case of bleeding after an operation on the elbow resisted all 
treatment until the wound was packed with gauze soaked in oil of tur- 
pentine. The haemorrhage which previously had been severe and long 
continued, at once ceased. The successful use of the oil has been proved 
on many other occasions. Its chief sphere of usefulness as a haemostatic 
is in cases of secondary haemorrhage. It is of no use until the area to be 
treated has been thoroughly freed from blood clot and d6bris; and it is 
especially valuable in those cases in which no bleeding point can be 
caught, but in which the haemorrhage is nevertheless alarming. The oil 
is an antiseptic, and gauze saturated with it keeps wonderfully sweet, 
while by its action on the living tissues it gives rise to a slimy pus which 
greatly- facilitates the removal of the gauze in the course of forty-eight 
hours. The only local inconvenience to which it may give rise is some 
blistering of the skin, which need not occur if care is exercised in its 
application. Its use is not limited to limbs; for bleeding from a tooth 
socket the author knows of nothing that is its equal. Doubt is expressed 
as to the value of oil of turpentine as a haemostatic when taken by the 
mouth. — Lancet, July 31, 1915. 

CONVERSATION 

A dentist of my acquaintance who attributes a large measure of his 
success to his punctilious attention to the "little things" prides himself 
on his ability to taXkjusi enough to his patients. 

Not so much as to bore them nor so little as to make the silence 
oppressive. Nothing focuses the mind of the patient more strongly 
upon the task at hand than sQence. Nothing makes the patient long to 
get away from the dentist's oflSce and never see it or the dentist again 
more than too much trite talk. 

As in most things, the happy mediimi is the perfect virtue. 

Talk of pleasant things, of interesting things. Avoid the weather 
and other commonplace topics that tend to boredom. Study the inter- 
ests of your patients where possible and talk about them. Talk baseball 
to the boys, political or business conditions to the men and affairs of local 
interest to the women. Be up on current events — a good newspaper 
will keep you so — and be able to converse easily on a variety of subjects. 
Don't overdo the matter, know when not to talk, and don't ask questions 
when your patient's mouth is occupied with hand or instrument. 

Greet your patient with a smile, talk to him entertainingly, but not too 
much, while he is in the chair and give him a pleasant " good-bye." It pays. 



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DIGESTS 183 

INFECTION OF THE HANDS AND FINGERS OF PHYSICIANS 

Hddenhain states that during thirty-one years in which he has 
practised surgery he has been injured innumerable times and in all cus- 
tomary ways, in the course of operation on subjects with sepsis and had 
never once become infected. He began after a while to regard himself 
as inunime. However, with a rich experience he had never seen a 
surgical infection in any colleague or assistant in his own sphere of in- 
fluence. Nevertheless he has seen numerous infections in surgeons from 
other clinics. The author's only prophylactic after an injury was to 
keep the hand and arm in complete rest for twenty-four to forty-eight 
hours. Once a colleague came to him for a dressing for an autopsy 
woimd, and he ordered immobilization. Returning from an absence 
of several days he found the man dead. He had removed the dressing 
and very soon after experienced a chill. The author believes firmly that 
immobilization for forty-eight hours after these traumatisms would 
result in a great reduction of morbidity and mortality among surgeons. 
At the last moment the author had a most corroboratory test of his 
theories in his own person. After one day's immobilization, following an 
injury he felt it his duty to do a certain amoimt of typewriting. He soon 
developed a chill and local infection which laid him up for a month and 
caused him much misery. He was fortimate in escaping a general 
infection. — MUnchener medizinische Wochenschrift {Medical Record) 

EXTRAGENITAL CHANCRES 

Henry Kennedy Gaskill says it is manifestly impossible to determine 
with any degree of accuracy the comparative frequency of extragenital 
chancres. The only place in which this could be approximately estimated 
would be in the army and navy; here careful statistics of all venereal 
diseases are made and the utmost care is taken to prevent their con- 
traction. Unless there is a well-maintained correlation between the 
several departments that treat syphilis the value of statistics is entirely 
lost. As a rule in the histories of cases recorded as having been treated 
no reference is made to the situation of the chancres. The writer thinks 
we are prone to minimize the danger to which doctors and dentists are 
subjected, particularly the latter. With the modem ideas of antisepsis, 
the dentists of to-day are sterilizing each instrument after every patient, 
but this does not mitigate the risk of personal inoculation! For their 
own sakes, dentists should be trained to recognize the appearance of the 
mucous patch while in college. At present, to a very large extent, they 
obtain their information only from books, and colored plates, not from 
living patients. — New York Medical Journal, 



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184 THE DENTAL DIGEST 

AN EPITOME OF CURRENT DENTAL AND MEDICAL 
LITERATURE 

[The Dental Review, February, 1916] 
Original Communications 

What Shall We Do with Pulpless Teeth. By Thomas B. Hartzell. 
•The Treatment of Sinuses of the Head by Means of Bismuth Paste. By Emil G. Beck. 
A Consideration of the Problems Involved in Removable Bridge Work. By Karl G. 

Rnoche. 
President's Address. Our Opportunity. By W. C. M'Wethy. 

Proceedings of Societies 

Minnesota State Dental Association, Thirty-second Annual Meeting, Held at Minneapolis, 

June II, 12, 1915. 
Odontological Society of Chicago. 
Chicago Dental Society. 
Northern Illinois Dental Society, Twenty-eighth Annual Meeting, Held at Freeport, Illinois, 

October 20, 21, 1915. 

Editorial 
The Widening Sphere of Dental Journalism. 

Editor's Desk 

Answer Your Letters. 

THE TREATMENT OF SINUSES OF THE HEAD BY MEANS OF BISMUTH PASTE* 
By Emil G. Beck, M. D., Chicago, III. 

Practically all sinuses are preceded by abscesses, and therefore a 
sinus is nothing else than a shriveled abscess cavity. Many believe that 
sinuses, especially rectal, are channels caused by pus burrowing through 
narrow spaces from one part of the body to another. I am convinced 
that a sinus starts from an infection in either the bony structure or the 
parenchymatous organs and after the formation of an abscess, the pus 
spreads in the direction of least resistance and opens into either the skin 
or the bowels, the urinary bladder, or even the gall-bladder. After 
evacuation the cavity gradually shrinks and the sinus forms. 

When the abscesses spread in various directions, they form multi- 
locular abscesses, sometimes communicating, and at other times not, so 
that an astonishing network of sinuses may result. This fact was not 
known until it was demonstrated by radiograms of the injected sinuses. 

♦Read before the Odontological Society of Chicago, October, iqij;. 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 185 

"The method, as you know, consists of injecting with a glass or metal 
syringe a quantity of bismuth paste into an opening of a sinus until one 
feels reasonably certain that all ramifications have been filled. The 
paste, thus injected, will rapidly congeal and remain in the sinuses long 
enough to permit of taking a radiograph. 

"A glance at the radiographs in which the network of tortuous sinuses 
is clearly shown teaches us its advantages. We can all recall instances 
in which such a radiograph would have been of great assistance, and 
would have spared many an unfortunate a useless operation. 

"Formerly we had to rely upon the probe or the colored fluids as 
pathfinders of sinuses, but these served as guides during the operation, 
while, only with this new method, are we able to make a correct ana- 
tomical diagnosis before an operation is decided upon, and thus we are 
able to discriminate between operable and non-operable cases. 

"If an operation is decided upon, then the procedure is carried out 
with more thoroughness and precision, as we can work with definite 
plans before us." 

Suppurative sinuses about the jaws very often communicate with the 
cavities of the accessory sinuses. Here they are not nearly so extensive 
as elsewhere in the body. 

Sinuses frequently follow injury, such as gunshot wounds and frac- 
tures. Another type is from postoperative infections, after drainage, or 
even after clean operation. 

Surgical operations for sinuses in the past have proven very un- 
satisfactory. In my brother's and my series of some i,8oo cases 
treated with bismuth injections, there were some which had lasted many 
years and had resisted all surgical treatment; one case had lasted sixty 
years, two others forty years. Since the introduction of bismuth paste, 
we have been able to separate the operable from the inoperable cases 
atnd thus avoid useless operations. The majority of the cases thus 
treated heal up without surgical invention. Sixty per cent, have gotten 
well. 

WHAT SHALL WE DO WITH PULPLESS TEETH? 

By Thomas B. Hartzell, M.D., D.M.D. 

Research Professor of Mouih Infections^ School of Medicine; Professor of Oral Surgery and 

Clinical Pathology, College of Dentistry 

First and foremost, is the sterile well-filled tooth a menace? My 
answer to that question is most emphatically, no. However, the pulp- 
less tooth of the future must be handled by vastly diflferent methods 
than the methods of the past to escape condemnation. We, as a pro- 



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186 ,THE DBHTAL DIGEST 

fession, will have to give to the care of the pulpless tooth or the tooth to 
be devitalized, hours of time, where in the past, we have slurred it over 
with little consideration. To accurately remove the pulp, where re- 
moval is possible, and fill and protect root canals of a molar, means the 
work oftentimes of two or three hours, and to remove root filling from an 
imperfectly filled root and purify and re-fiU the canals, may involve 
double that expenditure of time. The question which confronts us is, 
are we willing to educate our patients to the need of this work and do it 
in such a manner as to protect them from serious damage? If we are not, 
we must face the issue which is extraction for all teeth in which decay 
has exposed the pulp to infection. For that other type of case, in which 
bridge work must be placed, we are confronted by the necessity for apply- 
ing bridges to our teeth in such a manner that the pulps may be preserved. 
I here present for your study a common example in which a crown has 
been placed upon a vital tooth, which subsequently died. Some of the 
worst cases of infection that it has been my fortune to see have resulted 
from the death of teeth which were not devitalized previous to crowning. 
The presence or absence of abscess depends upon two things primarily, 
the admission of micro-organisms to the tissues and the decrease of 
resistance of the individual who has long been sensitized to them by 
absorption of their poisons into the circulation from some focal point 
or their constant ingestion in the saliva. The recorded cases of the 
speaker, of vital teeth showing abscess for two years, and of C. J. Grieves 
of Baltimore for one year is fifty vital teeth showing abscess. 

During the past winter I have noted thirty cases of teeth which were 
bearing crowns, which teeth had subsequently died as the result of in- 
fection and extra stress placed upon them in bridges. Infections re- 
sulting from death of pulps under bridges always cause the loss of the 
bridge, whereas roots from which the pulps have been removed and 
properly treated from the standpoint of asepsis, which undergo the mis- 
fortune of abscess, frequently may be saved. It seems to me that we 
should all endeavor to perfect ourselves in a method or methods which 
will lead to few infections through the dental path. In other words, 
close the door to infection. 

I have record of one hundred and fifty teeth which were found to 
contain dead pulps which teeth were perfect as to their structure, pre- 
senting no decay or abrasion, the death of the pulps having been produced 
by some influence not known to the patient. I have also record of and 
can show you a lantern slide of teeth that are apparently abscessed, pre- 
senting a clear area of rarefaction about the root ends which contained, 
when examined, vital pulps. In fact, I have two recent cases in which 
we have large abscesses involving a lateral and central, which in operat- 



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AN EPITOME OF CURREHT DENTAL AND MEDICAL UTERATURE 187 

ing to shell out the abscess sack, exposed both the central and lateral 
root tips leaving them standing in view, the central containing a living 
pulp in seemingly good health with the pulp of normal color and vital. 
Therefore, we have evidence to show that the focus of infection about 
teeth does not necessarily depend upon destruction of the pulp itself. 
The one hundred and fifty devitalized teeth just mentioned doubtless 
were devitalized by the admission into the circulation of the pulps of 
bacterial emboli. Possibly, as most of them were abscessed, the abscess 
commenced in the apex of the socket, because the apex of the socket is 
the most likely place for bacterial emboli to lodge whether the tooth be 
vital or non-vital. The anatomical relations favor the deposition of 
bacterial emboli in the apices of the tooth's socket because some of the 
vessels there are terminal. If bacterial emboli lodge and multiply in the 
terminal vessels, which supply the tissues about a root end, the result is 
abscess whether the tooth be vital or pulpless. 

[The Dental Cosmos, February, 1916] 

Original Communications 

Mottled Teeth: An Endemic Developmental Imperfection of the Enamel of the Teeth 
Heretofore Unknown in the Literature of Dentistry. By G. V. Black, M.D., D.D.S. 
Sc.D., LL.D., and Frederick S. McKay, D.D.S. 
The Treatment of Pyorrhea Alveolaris with Emetin Hydrochlorid. By Lionel SherrifiF, 

Suigical Dentist. 
♦Ankylosis of the Jaw. By John B. Murphy, M.D., F.R.C.S. (Eng.), F.A.C.S., and PhQip 

H. Kreuscher, A.M., M.D. 
•The Mercurial Treatment of Pyorrhea Alveolaris. By C. S. Copeland, D.D.S. 
•A Further Study of Some Etiolo^ cal Factors of Malocclusion. By Milo Helhnan, D.D.S. 
Some Considerations for the Dental Practitioner in Employing Vaccine Treatment. By 

George C. KQsel, M.D., D.D.S. 
The Uses and Advantages of X-rays as an Aid to Diagnosis. By Charles A. Clark, L.D.S.I. 
A Comparison of Inkys with Fillings. By H. W. C. Badecker, B.S., D.D.S., M.D. 

ANKYLOSIS OF THE JAW 
By John B. Muhfhy, M.D., F.R.C.S. (Enc.) FJV.C.S., 

AND 

Philip H. Kreuschek, A.M., M.D., Chicago 

This analysis of twenty-three cases covers the four varieties of anky- 
losis that occur in or about the temporo-mandibular articulation, viz. : 

(a) Intra-articular bony ankylosis. 

(b) Intra-articular fibrous ankylosis. 

(c) Sub-zygomatic cicatricial fixations. 

(d) Inter-alveolar buccal fixations. 

The technique for the formation of new joints may be divided into 



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188 THE DENTAL DIGEST 

seven diflferent stages, each of which has been initiated or created by the 
work of a single individual and followed by the succeeding schools. These 
stages are: 

(i) The formation of flail joints, especially of the shoulder and 
elbow (Langenbeck, Oilier, Julius Wolff, and others). These were de- 
sired sequences following resections of tuberculous and syphilitic joints, 
and joints destroyed by pus infections. 

(2) The restoration of motion in a bony ankylosed joint by the inter- 
position of muscle and fibrous tissue between the separated ends at the 
joint, as in the mandible (Helferich, 1893). 

(3) False joints developing after bone operations in the neighborhood 
of joints (Lorenz). 

(4) The transplantation of pedicled flaps of fascia and fat and capsule 
with the production of movable sliding serous surface joints (Murphy, 
1902) in the mandible, shoulder, elbow, wrist, finger, hip, knee, ankle, and 
toe articulations. 

(5) The homo-transplantation of the articular ends and surfaces of 
bone (Lexer, 1906), particularly in the knee. 

(6) The transplantation of detached fat and fascia (Lexer). 

(7) The interposition of foreign material to make the joint, from 
Pean's metallic joint down to Kraske, Baumgarten, Roser, and Baer's 
hetero-visceral implantations. 

The fourth stage, as outlined by Murphy, is a transplantation of 
pedicled flaps of fascia with fat and capsule. It is the one which has 
given practically one hundred per cent, movable joints, and is applicable 
in nearly every joint of the body where the peri-articular tissues have 
not been destroyed by some previous operative procedure or destructive 
pathologic process. It would be gratifying if the free fascia and fat 
transplantation of Lexer, mentioned under stage 6, would with future 
experience sustain the good results which its originator predicts for it. 
Judging from our experience we believe that it will not meet the require- 
ments in weight-bearing joints. 

The insertion of foreign material or heteroplasties are doomed to 
disappear from this field of work, as experience has shown that foreign 
absorbable material, if aseptic, must eventually be supplanted by con- 
nective tissue; while a flexible flail joint may result, a movable sliding 
joint cannot be obtained from such an interposition. The foreign ma- 
terial, when it is septic, is always a detriment rather than an aid in the 
formation of a movable joint. Non-absorbable metal materials can 
be serviceable only under very few favorable conditions. (See Chlum- 
aky's experiments.) 

In Murphy's work on the arthroplasties of the temporo-mandibular 



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AN EPITOMB OF CURRENT DENTAL AND MEDICAL LITERATURE 189 

articulation the cases may be divided as stated above, viz: (a) The 
intra-articular bony ankylosis (true ankylosis); (b) the intra-articular 
fibrous ankylosis; (c) sub-zygoma tic cicatricial fixations, and (d) inter- 
alveolar buccal fixations. 

Under c belong the fixations in the sub-zygomatic zone, resulting in 
scar tissue which binds the coronoid process to the cranium. Under d 
belong the cicatricial fixations due to sloughing of muscle and mucosa 
in the mouth or cheek. 

ROUTES OF INVASION 

The four routes of infection invasion into or surrounding the temporo- 
mandibular articulation may be given thus: 

First, and most frequent: An extension of the suppuration from the 
middle ear (cases No. i. No. 4, No. 7). 

Second: A mandibular osteitis or osteomyelitis extending to the 
glenoid cavity. 

Third: A metastasis from foci of infection within the mouth or else- 
where in the body (cases No. 2, No. 3, No. 9, No. 10, No. 19, No. 20), 
or part of a general metastatic arthritis (case No. 11). 

Fourth: It may result from a transmitted trauma from the tip of 
the chin to the articulation, giving a traumatic osseous fibrous arthritis 
(cases No. 6, No. 14, No. 15, No. 17). 

The glenoid fossa alone may be involved in the ankylosis, or the bony 
bridge may extend forward to include the zygomatic and coronoid pro- 
cesses. 

The most common cause of the ankylosis is a middle-ear suppuration 
in which the infection may pass in five different directions: First, back- 
ward into the mastoid; second, through the posterior wall of the petrous 
bone into the posterior cerebral fossa; third, it may penetrate the attic 
of the ear and form an abscess in the middle cerebral fossa or rupture 
externally just above the tip of the ear; fourth, it may burrow forward 
and rupture into the glenoid cavity or pass over the base of the zygomatic 
process into the mandibular articulation; fifth, it may burrow forward 
into the sub-zygomatic temporal muscle and produce an extensive 
phlegmonous myositis, with subsequent cicatricial contraction binding 
the coronoid process and inhibiting mandibular motion. 

In the cases of para-articular fixation the condition is usually caused 
by (i) a sloughing of the mucosa of the cheek, such as follows typhoid 
fever, scarlet fever, measles, infection of the alveolar processes; (2) in- 
fection of the scalp or cranium or infections from the mouth into the 
temporo-mandibular fossa which produce a destruction of the fascia and 
temporal muscle. 



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190 THS DENTAL DIGEST 

A FURTHER STUDY OF SOME ETIOLOGICAL FACTORS OF MALOCCLUSION 

By Milo Hellman, D.D.S., New York, N. Y. 

(Read before the Eastern Association of Graduates of tke Angle School of Orthodontia, at Us 
annual meeting, New York, M-^ly 20, XQ15) 

RiSUMfi 

Dr. Hellman sums up the evidence which he brings forth in this 
article as follows: 

(i) That malocclusion of the teeth is found to be intimately related 
to conditions that interfere with normal breast-feeding. Of 134 cases 
examined, 83 per cent, were found to be bottle-fed. 

(2) That results obtained by experimentation demonstrate that 
definite anomalies in the teeth and jaws may be produced in lower 
mammals by artificial disturbances created in the internal secretory 
glands. 

(3) That a close relationship is found to exist between malocclusion 
of the teeth in the human being and such anomalies of the denture as are 
produced by experimental disturbances of the internal secretory ap- 
paratus. Of 149 cases of malocclusion examined, there were 65 mal- 
formations in the enamel-covering of the teeth; 19 anomalies in the 
size and form of the teeth; 98 irregularities in the shedding of the decid- 
uous teeth, and in irregularities in the eruption of the permanent series. 

It may therefore be concluded that of the numerous factors that enter 
into the etiologic problem of malocclusion of the teeth, internal secretion 
is the one which may, in a large measure, account for many mysteries 
that perplex the orthodontist. The appreciation of the paramount 
importance of this factor will be evident in proportion as more knowl- 
edge is gained with reference to the profound working of this most wonder- 
ful system of glands. 

THE MERCURIAL TREATMENT OF PYORRHEA ALVEOLARIS 
By C. S. Copeland, D.D.S., Rochester, N. Y. 

The nlany "cures" for pyorrhea alveolaris which have been presented 
to the dental profession during the past few years have demonstrated 
that we are alive to the importance of combating this dreadful disease 
and its secondary systemic infections. Each has had its fair and im- 
partial trial and been found wanting, yet each has contributed its small 
mite to the process of elimination and to the survival of the fittest. 
That local instrumentation and treatment has not been eliminated in 
this contest is conceded by all contestants. That mercuric sucdnimid 
properly injected and combined with local treatment effects a cure in all 
but hopeless cases I have demonstrated to my complete satisfaction. 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 191 

Systemic infections secondary to pyorrhea are also cured by this treat- 
ment 

While my experience and investigations with this mercurial treatment 
have been limited to the above cases, they certainly verify the reports 
of Dr. Wright and Dr. White of the Portsmouth Navy Yard. To those 
who expect a few injections of mercuric sucdnimid alone to cure pyorrhea, 
let me again emphasize the absolute necessity for careful local instru- 
mentation and treatment, for it is only by this combination that such 
wonderful results have been obtained. For the benefit of those who do 
not understand the technique of mercurial injections, it is described here 
in full, just as I saw it carried out by Dr. Wright while at the Portsmouth 
Navy Yard. This technique is simple and easily mastered, and as all 
dentists have the legal right to administer any and all of the drugs in 
the pharmacopoeia, either locally or systemically, there is absolutely no 
reason why they should not make their own injections. In the case of 
female patients, only a small area need be exposed, the rest of the body 
being draped with sheeting by an assistant. 

TECHNIQUE 

The syringe used is made by Burroughs, Wellcome & Co., all glass, 
and holding forty minims. The needles used are No. 26, intra-muscular, 
for the above syringe. 

Syringe and needle are sterilized before using. The solutions are so 
made that gr. 1/5 of mercuric sucdnimid is dissolved in four minims of 
hot, sterile distilled water. . 

The site of injection is the buttock, using alternating sides for suc- 
ceeding injections. The skin is sterilized with tincture of iodin. The 
method of inserting the needle is as follows: The needle butt is held be- 
tween the thumb and third finger with the index finger over the butt, the 
shaft of the needle to be perpendicular to the skin surface, the point 
about three inches distant from it. With a quick, forceful, downward 
thrust, the needle is driven deeply into the substance of the gluteal mus- 
cles, from point to butt. Then into the syringe as many minims of the 
sterile mercuric solution as represent the desired dose, are drawn; if it 
is to be gr. 5/5, minims xx will be required. Then the syringe tip is in- 
serted into the socket of the needle, and the injection is made slowly. 
The needle is withdrawn, and tincture of iodin is applied to the point 
of injection. The injections are to be repeated every seventh day. 

In conclusion let me say that I believe the profession and humanity 
are greatly indebted to Dr. Barton Lisle Wright, surgeon U. S. Navy, for 
this wonderful discovery. It seems that at last we have conquered a 
disease that has puzzled and endangered the human race from time im- 



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102 THB DENTAL DIGBST 

memorial. Perhaps the most satisfactory part of this discovery is that 
the discoverer is an American, an officer in that most efficient organiza- 
tion, the United States Navy. 



[The Dental OtUlook, February, 1916] 

Original Communications 

♦The Relationship of the Pediatrist and the Dentist. By G. R. Pisek, M.D. 
Impression Method for Edentulous Mouths, with Modeling Compound. By Dr. J. P. Ruyl. 
A Suggestion. By H. Schwamm, D.D.S., LL.B. 
The Purpose of Our Dental Societies and Their Official Organ, "The Dental Outlook." 

By S. Herder, D.D.S. 
Quality and Quantity. By Dr. M. Schneer. 
Mounting of Crown and Bridgework. By Goslee. 
Hails Awakened Health Conscience. 
Monthly Report of Legislation Committee of The Allied Dental Council. 

Editorial 
Proposed New Law Regulating Administration of General Anesthetics by Dentists. 
THE RELATION OF PEDIATRIST AND DENTIST 
By G. R. Pisek, M.D., New York 

It is a sad fact shown by a committee of the A. M. A. that 48.8 per 
cent, of the children of rural communities and 33.50 per cent, of city 
children were found to have defective teeth, and we are only now just 
beginning to scratch the surface very feebly with a few dental clinics to 
correct these defects. The physicians need the whole-souled cooperation 
of dentists in the care of the mouth of the child. It must be admitted 
that the dentists have not given of their best to the child. The rank and 
file of the dental profession as a whole, have not supported in practice the 
contention that the primary teeth should be carefully preserved. Ex- 
traction is too often resorted to where a filling could have been placed if 
the necessary time and patience were used. 

There is a need for dentists who are willing to devote attention to the 
mouths of children, and who would take charge in the same manner as 
the physician would in cases of specific illness. There should be more 
personal cooperation between the physician and the dentist, particularly 
in the cases to be mentioned later in which other therapeutic aids besides 
the orthodontic are necessary to affect the well being of the child. 

Physicians in the last few years have had their attention forcibly 
called to the foci of infection, which may occur in or about the mouth. 
They are aware of the fact that a number of diseases heretofore of ob- 
scure etiology may be attributed to pus pockets at the roots of teeth. 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 193 

In fact the pendulum is perhaps swinging too far in this one direction, 
but nevertheless attention is well centred upon the hygiene of the mouth 
and the dental profession should be prepared and ready to cooperate 
with physicians, seeking advice for their patients. The effort must centre 
Itself in the prevention of dental caries and Rigg's disease. Early and 
serious dietetic errors during infancy and the early years of life have a 
marked effect on the production of irregular dentition, deformed and 
carious teeth. The dentist should be able to recognize the effects of 
improper diet in the mouth, and be capable of recognizing that the con- 
dition is due to dietetic error. 

The dentist need not and should not attempt to regulate the feedings 
of children, but he should have a clear conception of the scientific founda- 
tions of the art, so that he may be able to detect the evidences of improper 
feeding and direct his patient into the right channels for correction. 

The maternal nutrition of the infant commences at conception. The 
developing ovum at first absorbs nutriment from the fluids by which it is 
surrounded, but as the organism develops it attaches itself to the wall of 
the uterus and through it obtains food. As organization becomes more 
complex the placenta is formed, and gradually the circulation of the blood 
is established. When birth occurs a sudden change in the method of 
obtaining food takes place. The mother now supplies it from the breasts 
instead of through the placenta. At first she secretes colostrum, but 
this is soon displaced by milk which she supplies until teeth are cut and the 
infant is ready for solid food. During the time the infant is at the breast 
its digestive organs are slowly assimiing the form of those of the adult 
and are gradually developing their functions, as is shown by the ability 
to take solid food a littie at a time. During the time the digestive organs 
are developing Nature sees that the infant has food that is specially 
suited to it. 

The reason why foods that do not contain fresh milk are not suc- 
cessful in the long run for feeding infants, is that they do not have the 
property of adapting themselves to the changing stomach and keeping it 
prof)erly at work. Unmodified cow's milk disagrees with most young 
infants because of the character of the solid formed from it when it comes 
in contact with the pepsin of the stomach. 

Most important from the dental standpoint is the fact that, the true 
growth of the body — the formation of muscle and bone — is absolutely 
dependent on the proteid obtained from the food, which is represented 
by lean meat, eggs, curd of milk, gluten of cereal, etc. If this element 
of the food is deficient, a weakened constitution will result, although the 
infant may gain in weight rapidly if there is sufficient sugar present. If 
there is enough proteid, but insufficient sugar and fat in the food, stunting 



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194 THE DENTAL DIGEST 

will follow because the proteid cannot'be stored up as new tissue, but must 
be used for the current needs of the body, which would normally be met 
by the sugar and fat. 

Again the dentist should be able to differentiate the syphilitic teeth 
of the second dentition from the irregular, deformed teeth occurring in 
the mouths of children with mental deficiencies. 

From the pediatrician's standpoint the dentist should recollect that 
children who are artificially fed, have generally weaker teeth. 

[Dominion Dental Journal, January, 1916] 
Contents 

Original Communications 

•Systemic Disorders as the Result of Oral Sepsis. By Andrew J. McDonagh, D.D.S., L.D.S., 

Toronto, Ont. 
Abscess of the Antrum. By E. C. McDonald, D.D.S., Toronto, Ont. 
A Better Knowledge of Dental Pathology Desirable. By F. H. Krueger, D.D.S., L.D. S., 

Toronto, Ont. 
An Antrum Case of Long Standing. By A. E. Webster, M.D., D.D.S. 
Amalgam Technique. 

A Trip in War Times. By A. W. Thornton, D.D.S., L.D.S., Montreal, Que. 
Duty and Responsibility of Members of Faculty Council of the Royal College of Dental 

Surgeons of Ontario. By A. E. Webster, D.D.S., L.D.S., M.D., Dean. 
The Recently Embarked Overseas Draft of the Canadian Army Dental Corps. By James M. 

Magec, D.D.S., L.D.S., St. John, N. B. 

Dental Societies 

Ontario Oral Hygiene Conference. 
Toronto Dental Society. 
Medical Inspection Department, Calgary. 
"Canada." By Mark G. McElhinney. 

Editorial 

Dental Students Who Enlist. 

Military Convalescent Hospitals in Canada. 

The Dentist is More than a Mechanic. 

Correspondence 
Letter from Jos. Nolin. 

Obituary 
Clarence R. Minns, D.D.S., L.D.S. 

SYSTEMIC DISORDERS AS THE RESULT OF ORAL SEPSIS 
By Andrew J. McDonagh, D.D.S., L.D.S., Toronto, Ont. 

If a tooth has an abscess encompassing the end of the root, which is 
apparently encysted, at the end of the roots of the teeth immediately 



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AN EPITOMB OF CURRENT DENTAL AND MEDICAL LITERATURE 19$ 

adjoining that tooth, although the teeth are alive and perfectly healthy, 
will be found the same micro-organisms as are contained in the abscess, 
showing that the micro-organisms have penetrated the walls of the abscess 
and invaded the contiguous tissues, showing also a probable avenue into 
the circulation. Now, the harm which may be done if these organisms 
enter the circulation either by this avenue or any other avenue which we 
will speak of later on, may be done either by destroying the blood itself; 
in other words, by haemolyzing it, or the harm may be done by the blood 
stream carrying these organisms to distant parts of the body, where they 
will find congenial habitation, notably in the heart, the joints and cellular 
tissue. There is a great difference in opinion between pathologists as to 
the proportion of alveolar abscesses which contain haemolytic organisms, 
Hartzell claiming that in his investigations only one in two hundred 
abscesses contained haemolytic organisms. This great difference of 
opinion possibly is accounted for by the different manner in which investi- 
gators culture their organisms, but in my experience there is this to say, 
if the organism in a blind abscess is a haemolytic organism, the abscess 
is much smaller and much more difficult to find by X-ray. This probably 
is due to the difference in the pyogenic qualities of the two organisms. 

In making and reading radiographs our difficulties are enhanced, be- 
cause an abscess caused by an infected pulp canal does not always form 
at the end of a root, does not always form in a position easily detected in 
a skiagram; in other words, the root very often hides the abscess, and 
your only guide is the condition of the lineadura and your knowledge of 
the appearance a healthy root ought to have. This is exceptionally true 
of the molars on which the abscess often forms at the bifurcation of the 
roots, and is an exceedingly virulent abscess. A man to make a diagnosis 
should never absolutely rely upon his skiagram; he must use either 
thermal changes or high pressure electric current, or both, to help in his 
work. Just one word more about abscesses on the teeth. It is not 
unusual for a man examining a patient's mouth to base his diagnosis on 
that which is most apparent, namely, sinuses and visable concretions. 
Nothing in this field is more deceiving or more disappointing. Multiple 
abscesses discharging through sinuses into the mouth are not as bad as 
one abscess (so-called blind abscess) which has no sinus, the whole con- 
tents of which must be absorbed by the surrounding tissue, and we must 
not forget that in this case the surrounding tissue is composed of highly 
vascular cancellous bone. 

These blind abscesses very often, in fact, in the majority of cases, do 
not cause any great discomfort to the patient; the teeth are not sore, the 
gums are not swollen, and if you make a single X-ray plate of all the 
teeth ancl the jaws pf the mouth you may not discover the abscess. 



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196 THE DENTAL DIGEST 

Another fact which is sometimes overlooked is that organisms contained 
at the end of the different teeth roots in the mouth may be, and very 
often are, as different as possible in different localities in the same mouth; 
that is, you may have at the end of one of the centrals a non-haemolytic 
streptococcus veridans, and at the end of a bicuspid root a haemolytic 
streptococcus, and so on, consequently every root and every abscess sac 
must be made sterile. 

[Journal American Medical Association^ January 15, 1916] 

THE ACTION OF COCAIN 

Aside from its action as a local anesthetic, and its stimulating and 
then depressing action on various parts of the central nervous system, 
cocain has three effects which have especially aroused the interest of 
clinicians and pharmacologists. These are the dilation of the pupil, the 
local constriction of certain blood vessels, and the acceleration of the 
heart sometimes seen in cases of poisoning by this drug. The first two 
are of very practical importance. Cocain is in constant use as a mydri- 
atic, and extensive use is also made of its constricting action on the dilated 
vessels of the conjunctiva, etc. Its advantages as a local anesthetic 
over its more recent rivals are in part attributed to its local vasoconstrict- 
ing effect. Since the introduction of mixtures of novocain, etc., and 
epinephrin, however, this inherent advantage of cocain has become of less 
importance; the epinephrin adds to these mixtures an important action 
not p)ossessed by the anesthetics alone. 

There has been much discussion as to just how cocain brings about 
dilatation of the pupil and the local constriction of blood vessels. For 
many years the view has been current that it stimulates the. endings of 
the sympathetic nerves in the iris. This view was based chiefly on the 
observation that after these nerves were cut and allowed to degenerate, 
cocain had a much less dilating effect on the pupil, or none at all. This 
explanation has never been entirely satisfactory; all writers have had 
to admit that it does not explain all the observed facts. It has been 
accepted, however, as the more plausible explanation for the major part 
of the facts, and recent writers seem to have been little disturbed by the 
facts which it does not explain. The other actions, the vasoconstricting 
and the acceleration of the heart, have not been the subject of much inves- 
tigation, but there has been a tendency to explain them also as a result 
of an increased activity of sympathetic nerve endings.* In fact, cocain 
is now frequently grouped with epinephrin as a drug having a selective 

♦Meyer, H. H., and Gottlieb, R,: Pharmacology, Clinical and Experimental, p. 158. 

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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 197 

Stimulating action on the endings of the true sympathetic nervous 
system.* 

It appears, however, from recent work carried out by Kuroda,t in 
the pharmacologic laboratory of Professor Cushny of London, that such 
a generalization was premature and not sufficiently well supported by 
experimental facts. Kuroda showed that the action of cocain differs 
widely from that of epinephrin or sympathetic nerve stimulation: thus 
it dilates the vessels when perfused through an organ, whereas epinephrin 
or sympathetic nerve stimulation causes an intense constriction; it de- 
presses the action of the isolated heart, whereas sympathetic nerve stimu- 
lation or epinephrin powerfully stimulates this organ; small doses of 
cocain augment the activity of the intestine, and large doses depress it, 
whereas with epinephrin or sympathetic nerve stimulation there is only 
a depression. There is a similar lack of correspondence between the 
action of cocain and of epinephrin or sympathetic nerve stimulation in 
the case of the stomach, uterus, bladder, and salivary glands. In nearly 
all cases, cocain was found first to increase the activity of unstriated 
muscle and then to depress it, whatever may be the nature of the sym- 
pathetic control; in some instances the phase of increased activity was 
not observed. In view of these results and the fact that the explanation 
that the dilatation of the pupil results from a stimulation of the endings 
of the sympathetic nerve has always been regarded as inadequate, Kuroda 
argues that the dilatation of the pupil under cocain also arises from a 
direct depressing action of the drug on the muscle of the iris. The 
vasoconstricting action of cocain which is seen when the drug is applied 
directly to a congested mucous membrane is not so readily explained, but 
it is evidently of a different character from that caused by epinephrin or 
sympathetic nerve stimulation; the effects of the latter agencies are 
very evident in isolated organs, and are always readily obtained, whereas 
cocain causes a dilation of blood vessels under similar conditions. The 
acceleration of the heart in the intact animal is evidently not analogous 
to the action of epinephrin; it may be due to an action on the central 
nervous system. 

At first thought it may seem rather discouraging that there should 
still be so much doubt as to the true action of such a widely used mydriatic 
as cocain; but it should be remembered that such problems are very 
complex and that the number of men seriously working to elucidate 
them are few. 

•See, for example, Wolfsohn, J. M. : The Normal and Pathologic Physiology of the Visceral 
Nervous System, The Journal A. M. A., May i6, 1914, p. 1535. 

fKuioda: Jour. Phannacol. and Exper. Therap., 191^, vii, 423. 

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198 THB DBNTAL DIGEST 

[Journal American Medical Association^ January 22, 1916] 

THE TECHNIC OF ORAL HYGIENE 

''Dentistry, which is a highly specialized branch of surgery, should 
use the two factors, asepsis and anesthesia, which have made possible 
the wonders of modem surgery, with skill and precision equal to that of 
surgeons." This is the theme emphasized by Hasseltine* of the United 
States Public Health Service as the result of an investigation, imdertaken 
at the request of prominent dentists, to work out a detailed method for 
sterilizing dental instruments and appliances, keeping in mind the im- 
portant factors simplicity, efficiency, and duration of the process of 
sterilization. Any one trained in modem methods of asepsis who has 
watched the technic at present employed in the usual routine of dental 
treatment will have observed the errors which are almost inevitably 
allowed to creep in, and the attendant possibility of bacterial contamina- 
tion and transmission of infection from one patient to another. The 
entire question of oral sepsis and mouth hygiene has been put into even 
greater prominence of late by the attention centred on the unexplored 
possibilities of infection through the mouth. The situation has been 
analyzed by the statement that "from the standpoint of efficiency the 
modern mouth is out of adjustment with modem conditions — or, perhaps 
we should say, modem conditions are out of adjustment with it. Not- 
withstanding the numerous bacteria that flourish within its portals, 
mouth secretions and the mucous membranes do not seem to have the 
protecting power which is often manifest in other regions of the body 
and which protects an animal in a state of nature, "t 

The danger from focal infections in which streptococci are present in 
the tonsils and about the teeth is becoming more widely appreciated now 
that the possibilities for harm in such chronic foci are being recognized 
on the basis of careful scientific investigation. In referring to what may 
be called "internal streptococcal metastasis" attended by the localization 
of mouth streptococci in the interior of the body, it was pointed out 
recetitlyj that the efforts now made to detect and then to obliterate all 
forms of focal infection in the mouth and throat as well as elsewhere in 
the body, for preventive as well as curative purposes, besides being in 
accord with sound reasoning from general principles, receive the support 
also of strong experimental evidence. 

As illustrations of the possibility of transmission of mouth organisms 

♦Hasseltine, H.E.: The Sterilization of Dentallnstruments, Bull. loi, Hyg. Lab., U. S. 
P. H. S., 1915, p. 53. 

tHow to Live, New York, Funk and Wagnalls, 1915, p. 78. 

JThe Localization of Strept99p9fij editori^, Jhe /oj4fftfU A. M. A., Nqy, X^, i§i$, p. 173a, 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 199 

from one person to another through the medium of dental practices, 
Hasseltine* mentions the placing of sterilized instruments on a swinging 
tray or glass plate which has not been sterilized, the cleaning of burs on 
a scratch wheel which has not been sterilized since the burs used on the 
previous patient have been cleaned on it, and the frequent handling of 
the cable of the dental engine, which receives contamination from one 
patient through the operator's hands and in turn returns a portion of this 
contamination to the operator's hands when used on subsequent patients. 
These familiar errors, as Hasseltine expresses it, emphasize the necessity 
of having everything which comes in contact with the instruments or 
hands of the operator free from organisms obtained from previous patients 
in order to prevent transmission of infection from one patient to another. 
Every dentist or oral surgeon will find useful hints and practical sug- 
gestions in the outcome of the investigation of the Hygienic Laboratory.! 
The reconunendations for the sterilization of dental instruments point 
out that moist heat is our best disinfecting agent for the sterilization of 
all metal instruments. For the destruction of nonspore-bearing bacteria, 
moist heat at 80 C. (176 F.) is nearly as efficient as boiling, and for 
practical purposes can be used in place of boiling. Instruments con- 
structed of metal, whose complicated mechanism has heretofore caused 
them to be considered as nonsterilizable, can be sterilized by moist heat, 
provided the water is removed from them by immersing in alcohol sub- 
sequent to sterilization. Instruments whose construction does not 
permit of boiling can be sterilized by chemical disinfectants. In the 
latter procedure, immersion in 5 per cent, solution of phenol (carbolic 
add) for at least sixty minutes is recommended; and in those cases in 
which the mechanical construction makes it difficult to remove excess of 
water, instruments can be placed in 95 per cent, alcohol for a few minutes 
to remove water, and then allowed to dry. 

The courses of instruction in dental surgery of to-day are giving atten- 
tion to the bacteriology of the subject and its relation to mouth hygiene 
as well as to general health. It is, however, a distinct advantage to have 
the practical results of actual tests of sterilizing agents ' available for 
professional men who have Uttle opportunity for personal experience 
in the laboratory work involved. Hasseltine well remarks that the 
student usually forms the opinion that any sterilizing agent is effective, 
and does not learn to check his sterilization by bacteriologic tests. For 
this reason he believes that in dental schools and clinics there is need for 
the giving of more practical instruction in the methods of sterilization, 
and the subsequent testing of these by bacteriologic methods. 

*0p. cU. fApplications for the publication referred to should be addressed to the Sur- 
geon General, U. S. Public Health Service, Washington, D.C. 



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200 THB DBNTAL DIGEST 

[Journal American Medical Associaiiony February 5, 1916] 
(British Medical Journal, January i, 1916) 

TREATMENT OF INFECTED GUNSHOT WOUNDS 

Army surgeons, according to Gray, have been compelled, since this 
war began, to acknowledge the ineflSdency of antiseptics when used as a 
preventive or for disinfecting agents in badly infected, lacerated woimds. 
Until applications were employed which stimulated a concentration of 
the general defensive forces of the body in and around the wound, no 
real advance in treatment was made. It mattered not what kind or what 
strength of antiseptic, pure and simple, was used, the infection ran a 
fairly definite course of fairly definite duration, which varied merely 
according to the patient's power of resistance. While the importance 
of free drainage was speedily acknowledged, quite a long time passed 
before there was any satisfactory recognition of the fact that the resisting 
agencies of the patient's own body are far more effective in dealing with 
a local infection than any purely antiseptic solution, powder, or paste 
introduced into it from without. It has been proved that the use of salt 
solutions applied in various ways, fulfils all the striking claims made for 
it by Wright. Hypertonic saline dressing, especially in the form now 
known as the ''tablet and gauze pack," fulfils all desiderata better than 
any other yet applied. 

After the wound has been cleaned by operation, all the recesses of the 
woimd should be sought out by the finger, and filled, fairly firmly, 
with gauze wrung out of 5 to 10 per cent, salt solution, in the folds 
of which are placed numerous tablets of salt. Blood clot which may form 
during the packing should be wiped away. The gauze should be packed 
in concertina-wise, a tablet being placed between every third or fourth 
fold. A fairly large, fenestrated rubber tube is placed so as to reach 
to the deepest part of the main cavity, which is then filled with gauze 
and tablets. The dressing is made flush with the skin and the tube pro- 
jects slightly from its midst. The surrounding skin is painted with 
solution of iodin or other antiseptic application. Two or three layers of 
gauze are then used to cover the woimd and surroimding skin. A suitable 
amount of absorbent cottonwool is applied and a bandage wound on 
smoothly and firmly. 

[The Internalional Journal of Orthodontia, January, 1916] 
Contents 

Original Articles 

Suggestions in X-ray Technic for the Orthodontist. By Dr. James David McCoy, Los 
Angeles, Calif. 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 201 

An Effective Method for the Mesial or Distal Movement of Individual Teeth in the Arch. 

By Harry E. Kelsey, D.D.S., Baltimore, Md. 
Treatment by the Orthodontist Supplementing that by the Rhinologist. By A. H. Ketcham, 

D.D.S., Denver, Colo. 
The Technic of Accurate Impression Taking. By Samuel J. Lewis, D.D.S., Kalamazoo, 

Mich. 
The History of Orthodontia (Continued). By Bemhard W. Weinberger, D.D.S., New York 

City. 

Editorials 

Cooperation between the Dentist and the Orthodontist. 
Bands vs. Ligature. 

The Teaching of Orthodontia in Dental Colleges. 
The Esthetic Side of Orthodontia. 

[Pacific Dental Gazette, January, 191 6] 
Original Articles 

Efficiency in Tooth Brushing. By Engstrom. 

Dental Pediatrics. By Gurley. 

The First Plaster Impression, and First Suction Plate. By Haskell. 

pAlitorial 
Are Root Canals Being Overtreated? 

Selections 

Chemical Studies of Relations of Micro-Organisms to Dental Caries. Gies and Collaborators. 
A Pressing Need in Dentistry. By Johnson. 

Practical Suggestions 
Conducted by John C. Hopkins, D.D.S. 

Dental Excerpts 

Concerning Inlays. By Hinman. 

The Financial Ally of the Pyorrhea Specialist. By Endelman. 

Mercury Chlorid in Surgery. 

[The Denial Summary, February, 19 16] 

Regular Contributions 

Suggestion and Auto-suggestion in its Relation to Dentistry. By W. F. Stone. 

Split Matrix and Amalgam Filling. By Drs. Barclay and McCready. 

How to Sterilize the Tooth Brush. By Hugh W. MacMillan. 

Dental Pathology and its Relation to Systemic Disease. By T. A. Leonard. 

Correlating Conditions Common to Nose, Throat, and Oral Surgery. By E. B. Cayce. 

Porcelain Inlays. By F. B. Roberts. 

Impression Taking, Using Modeling Compound. By J. V. Howard. 

What All Dentists Should Know About Orthodontia. By W. E. Lundy. 



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202 THE DENTAL DIGEST 

Dates of Some Old Dental Patents. By H. L. Ambler. 

President's Address. By David P. Houston. 

Some Thoughts on Education. By Henr>' W. Morgan. 

Pyorrhea. By A. ClifTord Braly. 

Some Dental Hints. By J. B. Kelly. 

The Sterilization of Dental Instruments. By H. E. Hasseltine. 

A Review of Some Drugs Old and New. By S. F. M. Hirsch. 

Dentistry, in its Progress Through the Century, to Stomatology as a Science. By James 

Truman. 
Plastic Surgery of the Face. By W. A. Bryan. 
Local Anesthesia in Dentistry. By B. H. Johnson. 



[Dental Items of Interest^ February, 1916] 
Exclusive Conlributions 

Origin and Metastatic Importance of Chronic Oral Infections. By E. J. Eisen, D.D.S.; 

R. H. Ivy, M.D., D.D.S. 
A Short Cut in the Indirect Method of Making Cast (>old Inlays. By Louis Herbst, D.D.S. 

Radiodontia 

"Bad Canal Work"; What ShaU We Do About it? By Howard R. Raper, D.D.S. 

Society Papers 

An Acidimetric Study of the Saliva and Its Relation to Diet and Caries. By John Albert 

Marshall. 
Medical Superstitions. By Garrett Newkirk. 
The Professional Side of Dentistry. By Frank P. Duflfy, D.D.S. 

[The Texas Dental Journal^ January, 1916] 
Original Communications 

The Evolution of Prosthetic Dentistry. 
The Bigness of Little Things. 
The Dentist: Who Is He? 

With Our Contemporaries 

Modern Attachments for Bridge Work. 

Malarial Mosquitoes as the Food of Bats. 

Should All Teeth Be Saved? 

Operative Procedures in Relation to Dental Caries and Diseases of the Investing Tissues. 

Relationship Between Medicine and I)entistr\'. 

Porcelain-Faced Molar Cro\N-n. 

Gold Inlays with Synthetic Cement Inserts. 

Hemorrhage, Post-Operative — The Use of Coagulose as a Prophylactic. 



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SOCIETY NOTES 203 

SOCIETY NOTES 

Alabama. 

The next meeting of the Alabama Dental Association will be held at Mobile, Ala., April 
II, 1916. — J. A. Blue, Birmingham, Ala., Secretary, 

Arkansas. 

The next meeting of the Arkansas State Dental Association will be held at Little Rock, 
Ark., March 28-30, 1916. — Wm. B. Dorman, Nashville, Secretary, 

Florida. 

The next meeting of the Florida State Dental Society will take place at Orlando, Fla., 
June 21, 1916. — M. C. Izlar, Ocala, Fla., Secretary. 

Ilunois. 

The Illinois State Dental Society will hold its next meeting at Springfield, 111., May 
9-12, 1916. — Henry L. Whipple, Quincy, TIL, Secretary. 

Iowa. 

The next meeting of the Iowa State Dental Society will take place at Des Moines, Iowa, 
May 2-4. — H. A. Elmquist, Des Moines, Iowa, Chairman of Exhibit. 

Maryland. 

The next meeting of the Maryland State Dental Association will be held in Baltimore, 
Md., March 25, 1916. — F. F. Drew, Baltimore, Md., Secretary. 

Massachusetts. 

The next meeting of the Massachusetts Dental Society will be held in Boston, Mass. 
May 3-5, 1916. — A. H. St. C. Chase, Boston, Mass., Secretary. 

Michigan. 

The Michigan State Board of Dental Examiners will meet in the Dental College at Ann 
Arbor, June 19, 1916, at eight o'clock a.m.; for application blanks apply to E. O. Gillespie, 
Stephenson, Mich., Secretary-Treasurer. 

Mississippi. 

The next meeting of the Mississippi Dental Association will be held at Jackson* Miss., 
May 1-3, 1916. M. B. Varnado, Osyka, Miss., Secretary. 

Missouri, Kansas, Oklahoma. 

The Tri-State Post Graduate Dental meeting will be held at Kansas City, Mo., March 
20-26, 1916. — C. L. Lawrence, Enid, Okla., Secretary. 

Nebraska. 

The Nebraska State Dental Society will hold its next meeting in Lincoln, Nebr., May 
16-18, 1916. — H. E. King, Omaha, Nebr., Secretary. 

New York. 

The Dental Society of the State of New York wall hold its next meeting at the Hotel 
Ten Eyck, Albany, N. Y., May 11-13, 1916. — A. P. Burkhart, 52 Genesee St., Albany, 
N. Y., Secretary. 

New York. 

The next meeting of the Sixth District Dental Society of New York will be held at Hotel 
Bennett, Binghamton, N. Y., March 23-25, 1916. — William A. Ogden, Chairman 
Arrangement Committee. 

Pennsylvania. 

The fifty-third annual meeting of the Lake Erie Dental Association will be held at Hotel 
Bartlett, Cambridge Springs, Pa., May 18-20, 1916.— J. F. Smith, 120 W. i8th St., Erie, 
Pa., Secretary. 



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204 THS DENTAL DIGEST 

South Carolina. 

The forty-sixth annual meeting of the South Carolina State Dental Association will be 
held at Chick's Springs, So. Car., July 11-13, 1916.— Ernest C. Dye, Greenville, So. 
Car., Secretary. 

Texas. 

The Texas State Dental Association will hold its next meeting at Dallas, Texas, May 
9-12, 1916.— W. O. Talbot, Fort Worth, Texas, Secretary. 

West Virginia. 

The next meeting of the West Virginia State Dental Association will be held at the 
Kanawha Hotel, Charleston, W. Va., April 12-14, 1916.— J. W. Parsons, Huntington, 
W. Va., Secretary. 

Wisconsin. 

The meeting of the Wisconsin State Board of Dental Examiners will be held at the Mar- 
quette Dental College, Cor. 9th and Wells St., Milwaukee, Wis., June 14, 1916, commenc- 
ing at nine o'clock. — F. A. Tate, Daniels Blk., Rice Lake, Wis., Secretary, 

AMERICAN INSTITUTE OF DENTAL TEACHERS 

At the last annual meeting of the American Institute of Dental Teachers held at Minne- 
apolis, Minn., January 25-27, 1916, the following officers were elected: President, Dr. 
Shirley W. Bowles, 1616 I Street, Washington, D. C; Vice-President, Dr. John F. Biddle, 
517 Arch Street, Pittsburgh, Pa.; Secretary-Treasurer, Dr. Abram Hoffman, 529 Franklin 
Street, Buffalo, N. Y.; Executive Board, Dr. A. W. Thornton, Montreal, Canada, Dr. R. W. 
Bunting, Ann Arbor, Michigan, and Dr. A. D. Black, Chicago, 111. 

The next annual meeting will be held at Philadelphia, January 23, 24, 25, 191 7. 

ODONTOLOGICAL SOCIETY OF WESTERN PENNSYLVANIA 

The thirty-fifth annual meeting of the Odontological Society of Western Pennsylvania 
will be held at the Monongahela House, Pittsburgh, Pa., Tuesday and Wednesday, April 
II and 12, 1916. 

The first regular session of the society will open on Tuesday at 10 a.m. The Executive 
Council will meet at the Hotel at 9.30 a.m. for the transaction of business in the interest of 
the society. The clinics and exhibits will be at the Monongahela House. Exhibitors are 
cordially invited to visit this meeting, and requested to make early reservation for space. 

A cordial invitation is extended to all ethical dentists in Pennsylvania and adjoining 
states. 

King S. Perry, Secretary. 
719 Jenkins Bldg., Pittsburgh, Pa. 



PATENTS 

1112561, Tooth brush, Edwin H. Rodell, Cummings, N. D. 

1 112847, Centered mold for dental castings, Heinrich Schweitzer, New York, N. Y. 

46510, Design, Sanitary tooth cleaner, Edwin G. Over, Fort Worth, Texas. 

1113752, Dental handpiece, Alexander Campbell, Los Angeles, Cal. 

1 1 13325, Implement for forming metal backs for artificial teeth, Ernest D. R. Garden, Los 

Angeles, Cal. 
1 1 14624, Tooth straightening appliance, A. G. Meier, St. Louis, Mo. 
1 1 14646, Tooth brush, Lajos Pap, Arad, Austria-Hungary. 
1114291, Orthodontic appliance, Ray D. Robinson, Los Angeles, Cal. 
1115061, Tooth brush holder, John B. Foster, Newark, N. J. 



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FUTURE EVBNTS 205 

m5779} Dental flask and means for dosing and fastening the parts thereof, George Bninton, 

Leeds, England. 
1 1 16056, Apparatus for fumigating dental cavities, Henri Grasset, Paris, France. 
1 1 15678, Dental casting apparatus, W. B. C. Kaiser, Hamburg, Germany. 
1116310, Sanitary dental tray, N. A. Maser, Vineland, N. J. 
1115718, Dental instrument, Wm. H. Mosley, Toronto, Ont., Canada. 
1 1 16868, Saliva ejector, A. A. Anzelewitz, New York, N. Y. 
1116371, Artificial denture, Ernest C. Bennett, New York, N. Y. 
1 1 16497, Tooth bridge, Friedrich Schreiber, Berlin, Germany. 
1 1 17660, Dental apparatus, John M. Gilmore, Chicago, HI. 

II 17701, Dental syringe, F. L. Piatt, G. N. Hein, and R. R. Impey, San Francisco, Cal. 
111727s, Dental impression tray, S. G. Supplee, East Orange, N. J. 

11 17276, Taking partial impressions for artificial dentures, S. G. Supplee, East Orange, N. J. 

1 1 17277, Heating apparatus, S. G. Supplee, East Orange, N. J. 

II 17928, Attachment for dental impression cups, W. J. Thurmond, Columbus, Ga. 

46650, Design, Tooth brush. Jay Laven^on, Philadelphia, Pa. 

1118183, Blowpipe apparatus, W. C. Buckham, Jersey City, N. J. 

1118301, Filling teeth, Thomas B. Magill, Kansas City, Mo. 

1118156, Making a tooth brush, Joseph Schoepe, New York, N. Y. 

T 1 18703, Dental bridgework, George W. Todd, Omaha, Nebr. 

Copies of above patents may be obtained for fifteen cents each, by addressing John A. 
Saul, Solicitor of Patents, Fendall Building, Washington, D. C. 



FUTURE EVENTS 



March 14, 1916. — Fox River Valley Dental Society, Appleton, Wis. — R. J. Chady, Oshkosh, 

Wis., Secretary. 
March 20-26, 1916. — ^The Tri-State Post Graduate Dental Meeting (Missouri, Kansas, 

Oklahoma), Kansas City, Mo. — C. L. Lawkence, Enid, Okla., Secretary. 
March 23-25, 1916. — Sixth District Dental Society, Binghamton, N. Y., Hotel Bennett. — 

William A. Ogden, Chairman Arrangement Committee, 
March 25, 1916. — Maryland State Dental Association, Baltimore, Md. — F. F. Drew, Balti- 
more, Md., Secretary. 
April 4-7, 1916. — Dental Manufacturers' Club, Chicago, 111. Meeting in the Banquet Hall, 

Auditorium Hotel. — Chairman Exhibit Committee, A. C. Clark, Grand Crossing, Chicago. 
April II, 1916. — Alabama Dental Association, Mobile, Ala. 

April 12-14, 1916. — West Virginia State Dental Association, Kanawha Hotel, Charleston. 
April 13-15, 1916. — Michigan State Dental Society, Detroit, Michigan. — Clare G. Bates, 

Secretary. 
May, 1916. — Susquehanna Dental Association, Scranton, Pa. — Geo. C. ELnox, 30 Dime 

Bank Bldg., Scranton, Pa., Recording Secretary. 
May, 1916. — Indiana State Dental Association, Claypool Hotel, Indianapolis, Ind. — A. R, 

Ross, Secretary. 
May 2-4, 1916. — Iowa State Dental Society, Des Moines, la. — H. A. Elmquist, Des Moines, 

la.. Chairman of Exhibit. 
May 3-5, 1916. — Massachusetts Dental Society, Boston, Mass. — A. H. St. C. Chase, Boston, 

Mass., Secretary. 
May 9-10, 1916. — North Dakota State Dental Association. — A. Hallenberg, Fargo, No. 

Dak., Chairman Exhibit Committee. 
May 9-12, 1916. — Texas State Dental Association, Dallas, Tex. — ^W. O. Talbot, Fort Worth, 

Tex., Secretary. 
May 9-12, 1916. — Illinois State Dental Society, Springfield, 111. — Henry L. Whipple, 

Quincy, HI., Secretary. 



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206 THE DENTAL DIGEST 

May 11-13, 1916. — Dental Society of the State of New York, Hotel Ten Eyck, Albany , N, Y. 

— A. P. BuRKHART, 52 Genesee St., Albany, N. Y., Secretary. 
May 16-18, 1916. — Nebraska State Dental Society, Lincoln, Neb. — H. E. King, Omaha, 

Neb., Secretary. 
May 18-20, 1916. — ^Lake Erie Dental Association, Hotel Bartlett, Cambridge Springs, Erie, 

Pa. — J. F. Smith, Secretary. 
June 1-3, 1916. — Northern Ohio Dental Association, Cleveland, O. — Clarence D. Peck, 

Sandusky, O., Secretary. 
June 8r-io, 1916. — Georgia State Dental Society, Macon, Ga. — M. M. Forbes, Candler 

Bldg., Atlanta, Ga., Secretary. 
June 13-15, 1916. — Connecticut State Dental Association, Hotel Griswold, New London, 

Conn. — Elwyn R. Bryant, New Haven, Conn., Secretary. 
June 21,1916. — Florida State Dental Society, Orlando, Fla. — M. C. Izlar, Corresponding 

Secretary. 
June 20-22, 191 6. — New Hampshire Dental Society, Lake Sunapee, Zoo-Nipi Park Lodge, 

Lisbon, N. H. — J. E. Collins, Chairman Exhibit Committee. 
June 27-29, 1916. — Pennsylvania State Dental Society, Pittsburgh, Pa. — Luther M. 

Wea\'er, 7103 Woodland Ave., Philadelphia, Pa., Secretary. 
June 28-30, 1916. — North Carolina State Dental Society, Asheville, N. C. — R. M. Squires, 

Wake Forest, N. C, Secretary. 
July 11-13, 1916. — South Carolina State Dental Association, Chick's Springs, S. C. — Ernest 

C. Dye, Greenville, S. C, Secretary. 
July 11-13, 1916. — Wisconsin State Dental Society Meeting, Wausau. — Theodore L. 

Gilberton, Secretary. 
July 12-15, 1916. — New Jersey State Dental Society, Asbury Park, N. J. — John C. Forsyth, 

Trenton, N. J., Secretary. 
July 25-28, 19 1 6. — National Dental Association, ist Regiment Armory, LouisWUe, Ky.- ^ 

Otto U. King, Huntington, Ind., Secretary. 
October 18-20, 191 6. — Virginia State Dental Association, Richmond, Va. — C. B. Gifford, 

Norfolk, Va., Corresponding Secretary. 
January 23-25, 191 7. — American Institute of Dental Teachers, Minneapolis, Minn. — Abrau 

Hoffman, 529 Franklin St., Buffalo, Secretary-Treasurer. 



TOO BUSY TO READ? 



''An hour with a book would have brought to his mind 
The secret that took him a whole year to find. 
The facts that he learned at enormous expense 
Were all on a library shelf to commence. 
Alas! for our hero; too busy to read, 
He was also too busy, it proved, to succeed. 

"We may win without credit or backing or style, 
We may win without energy, skill or a smile. 
Without patience or aptitude, purpose or wit — 
We may even succeed if we're lacking in grit; 
But take it from me as a mighty safe hint — 
A civilized man cannot win without print.'' 

— Unknown, Copied from Iowa State Bulletin. 



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CONTENTS FOR APRIL, 1916 

CONTRIBUTED ARTICLES 

PAOB 

Shall we Discontinue Devitalization ? Walter S. Kyes, D.D.S. 207 

Sugar and its Effect upon the Teeth John S. Engs, D.D.S. 212 

A Technique of Natural Tooth Bleaching in the Mouth 

Louis Englander, D.D.S. 215 

Adjusting Obturators. . . J. E. Kurlander, D.D.S., and H. J. Jaulusz, D.D.S. 217 

Things that are Said in Dental Journals Hillel Feldman, D.D.S. 219 

Hartford Men Contribute to Forsyth Loving Cup 220 

New Method of Constructing Full Dentures Clyde Davis, D.D.S. 221 

Indictment Against Dentist Quashed 223 

First University Dental School in New York, for Columbia 225 

BUSINESS BXnLDING 

What Shall We Charge for Plates? ■;226; Proof of Malpractice in Dentistry, 234; 
Answer to a Request for Advice, 235; How to Make a Dentist Happy, 238; 
The Business Side of Dentistry, 2395 The Dentist's Office Hours, 241; This 
Patient Frankly Leaves the Reward to God, 241; The Efficiency of the "Trubyte 
Teeth," 243; Dr. Williams Needs Teeth, 225. 

PRACTICAL HINTS 244-246 

DIGESTS 

Proposed Statements of Aims and Objects, 247; Advice to Those About to Wear 
Artificial Teeth, 249. 

AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE ..251-270 

SOCIETY NOTES 271 

FUTURE EVENTS 2 73 

INDEX TO ADVERTISING SECTION 50 



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Its safe chalk "base" free from harsh, 
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The Dental Digest 

GEORGE WOOD GLAPP, D.D.Sm Editor 

Published monthly by The Dentkts' Supply Company, Candler Bldg., 
Times Square, 220 West 42d Street, >{ew York, U. S. A., to whom all com- 
munications relative to subscriptions, ^dvdrtiSiifg; e^c, Vtip^jld be addressed. 

Subscription price, including postage, %l.td pet ^eit t6 all parts of the 
United States, Phili})ptnes, Guam, Cuba, »Port(^ ^^q,. Mexica ajid.I}ftw^iiAP. 
Islands. To Canada, $^,40. To iV olfit^r cou«it^i^:$x.7S; :• :\ '•• ; • v 

Articles intended for publication arid corresporide^nce regarding 'tlie Sailie ' 
should be addressed EDiTOil t)^i5ft:AL'Di6E^T,.Candi^t"^©ldg:,;Tii|ife5 Square, 
220 West 42d Street, New Yixk'^Ni'Y. • :'■*'" ?,,• vJ^'--- f : '•.•* -.•' :.. 

The editor and publishers are not responsible for the views of authors ex- 
pressed in these pages. 

Entered as Second Class Matter, at the Post-Office at New York City. 
Under the Act of Congress, March 3, 1879. 



Vol. XX H 



APRIL, 1916 



No. 4 




TICLE5 



SHALL WE DISCONTINUE 
DEVITALIZATION? 

By Walter S. Kyes, D.D.S., Parser, S. D. 

A number of yea.rs ago there came into my office a young man for 
whom I treated and crowned a lateral incisor. Some time later he again 
appeared at the door of my office with several places on his heretofore 
smiling and pleasant visage, badly bruised and discolored until his face 
seemed almost as expressionless and quite as black as a stove lid. The 
crown of gold was missing. I noticed this before I made the hasty study 
of the varying shades of his countenance, which observation was probably 
due to the presence in my mind of what might be termed conunerdalism. 
When I speak of commercialism I mean that force which, if not properly 
controlled, will get so hopelessly scrambled with our ethics. 

The young man's selfpossession was deeply disturbed. In confusion 
he inserted his index finger in his vest pocket and took therefrom the 
missing tooth. I did not ask how it happened; the storm clouds on his 
face conveyed to me the information more plainly than could words. 

I seated him in the operating chair and in the course of a few minutes 
he gave me the details which led up to the loss of the lateral incisor. 

It seemed that since his previous visit, he had, through frugality and 
inheritance, become the owner of a tract of land. The correct location of 



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208 THE DENTAL DIGEST 

one of the surrounding fences was in dispute, and in the effort to straighten 
the matter out with his neighbor he had overlooked the majesty of the 
law and its innumerable avenues for the absorption of wealth in the 
settlement of such cases, and had made use of more convenient and prime- 
val methods at**BaliH jt^dtoeilted in his present disfigurement. 

fitted 
a gold 
crown oji aji ^tep^F. tootji. . Qt^ijigi^^ J; examined the apex of the 
tootJijaiuJ IjyasiiieUghted to liStejthjaJatil^^ end of the root, beauti- 

fully rounding out the apex was the tip of a pink guttai>ercha point, placed 
with painstaking care exactly where the college professors taught us they 
should be placed. 

This was the first root canal filling operation of my own that I had 
ever had the privilege of examining under such favorable conditions and 
it was highly gratifying to me, if not to my patient. 

Just how many root canals I have filled so well, I shall never know. 
Perhaps the lack of this information will add years to my life and mayhap, 
happiness to the years. However, as time has passed and my opportu- 
nities for observation have increased, I have been deeply impressed with 
the fact that the roots of our treated teeth, like our interproximal spaces, 
cover a multitude of short comings. 

After making this confession, which I trust will prove adequate for 
the most critical minds, I want to discuss briefly the substance of a paper 
read by Henry L. Ulrich, M. D., before the Minnesota Academy of Medi- 
cine, and later published in the Journal-Lancet, November, 1915. 

I have no hope or desire to add to or detract from the value of the 
paper; neither shall I endeavor to corroborate nor contradict any of the 
statements made there-in, my object in discussing it being none other 
than to get the matter before the readers of the Digest and making such 
comments as my experience and observation as a practising dentist have 
taught me. 

The paper is entitled "Streptococcicosis." The author, taking all re- 
sponsibility for the terminology and giving a nimiber of reasons forsodoing. 

The two main factors which the writer states he wishes to bring out 
in the study are, '^The diversity of clinical manifestations of 'strepto- 
coccal focal diseases,' and 'The significance of the blind apical abscess 
in' streptococcal focal diseases." 

Speaking of the doctrine of focal infections the writer states that, "It 
is the tremendous extent of distribution, its adaptability to a variety of 
foci, its protean clinical manifestations, which have given the strepto- 
coccus this important distinction. "Another very important fact co- 
existing with this doctrine is the splendid demonstration of the laws of 



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SHALL WE DISCONTHOTE DBVITALIZATION? 209 

mutation, virulence, and selective actions which these mutants exercise 
in establishing fod. 

It would seem that these foci of infection are established without 
regard for race, color or location, being foimd in all the organs more or 
less, including the tonsils, ulcers of the stomach and the appendix and 
**last but not least in importance, the blind abscesses at the roots of de- 
vitalized teeth." 

"The root abscess," continues the writer, "is far more important, far 
more significant, than has heretofore been realized. If it were possible 
to tabulate all the fod outside the respiratory tract, or lUther outside the 
tonsils, the root abscesses of devitalized teeth would lead the list by a 
large majority." 

"Fifty cases in which blind apical abscesses were present, the cultures 
of which abscesses gave types of streptococd, were analysed as to age, 
sex and clinical findings." 

The author groups these fifty cases into five groups and two sub-groups 
three of which I will use for illustration. 

1. Rheumatoid group (24 cases). 

2. Cardiovascular group (5 cases). 

3. Asthenic group (11 cases). 

Speaking of the cUnical pathogenidty in group i the author states, 
"There were several instances in which no results were obtained by the 
removal of the tonsils alone. Not until the dental lesions were destroyed 
was there prompt restitution. Other cases reported the removal of the 
tonsils and all other foci except the mouth fod. The reduction of these 
again gave quick response. The use of vaccines prepared from bacteria 
prepared from apical lesions, gave focal reactions, which is abundant 
proof of spedfidty. In some instances the removal of some of the fod 
of the mouth gave partial relief. On removal of all fod in the mouth, 
including teeth of a suspicious appearance, complete and permanent 
results were obtained." 

In discussing group 2 the author states that, "The proliferation 
action of streptococd on vascular endotheUum may well give rise to a 
form of endarteritis resulting in general sclerosis with or without subse- 
quent hypertension." • 

I quote ako the following in regard to gitjup 2 "The value of the 
skiagraph of the mouth in establishing an additional or remaining depot 
of focal infection in streptococcal disease is unquestioned. The apical 
abscess may be the only focus left, the evacuation of which will permit 
of the re-establishment of renewed integrity of all parts. 

"It may hold the balance of power in the struggle of the body for com- 
plete sterilization." 



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210 THE DENTAL DIGEST 

The writer then quotes some figures founded on his investigations 
which are both interesting and appalling to the dental profession. 

After examining the rontgenographic films of 387 cases in which 997 
teeth came under suspicion, he deducts the following. **By conservative 
interpretation, 737 root abscesses were seen. There were present 806 
artificially devitalized teeth, of these 545 had blind abscesses at the tip 
of the roots, and 191 abscesses were present on teeth devitalized either 
by accident or pulp destruction by caries." About the only consolatory 
feature of these figures is, that the dental profession was not apparently 
responsible for the 191 abscesses that resulted from caries and accident. 

It occurs to me that it would require further study and a closer analy- 
sis of the cases examined to prove that our best efforts in the matter of 
root canal filling are wrought with such calamitous failure and with such 
possible deleterious effects on the health of our clientele. 

It is a well known fact that certain practitioners follow out with vary- 
ing degrees of effort and sincerity, certain methods of pulp devitalization 
and root canal treatment. 

For instance, we have those who adhere to the chloro-percha and gutta 
percha point method of root canal filling under the protection of the 
rubber dam and various antiseptic agents; again we have those operators 
whose proud boast is that they have not had a roll of rubber dam in their 
office for a number of years and have treated teeth continuously. 

There are also a vast number of operators who use the various mummi- 
fying agents, with and without the use of the rubber dam. 

The pressure anesthesia method of pulp removal has a host of adher- 
ents who are more or less skilled in the removal of pulp debris without the 
rubber dam. 

Others are as equally enthusiastic about the use of medicated pastes 
and mixtures of medicinal agents for root canal fillings. 

The writer knows of several offices where hundreds of teeth are treated 
every month and no attempt whatever is made to remove the pulp or to 
fill the root canals. 

The question that presents itself is, what method of treatment and 
root canal filling was made use of in the 737 root abscesses observed by 
Dr. Ulrich? 

It is highly probable that this information could not be obtained from 
cases selected at random, but the information would be available if the 
cases of a single operator using a particular method were observed, and in 
this manner the best method could be arrived at, providing such a one 
exists. 

Further elucidating the author continues, "The prevention of such ab- 
scesses entails a new dental attitude. It is my impression that in the 



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POSTPONBD ARTICLES 211 

days when dentists removed pnlpless teeth, the statistics of chronic rheu- 
matoid conditions were much lower than to-day." 

The only way in which this impression could be verified would be to 
produce the rheumatoid and dental statistics together with those covering 
the increase in population for a certain period which is in all probability 
more difficult than to fill correctly, a root canal. 

"Chronic rheumatoid conditions are decidedly on the increase and I 
attribute it to the prevalent custom of dentists to save teeth," continues 
the writer. If this attribution proves true it will necessarily revise the 
teachings of both medicine and dentistry in the matter of the preservation 
of the teeth. 

After stating that the apical abscess in his opinion is hematogenous in 
origin, and that "The devitalization of teeth, which entails the destruction 
of nerve and blood supply to the apex and contiguous bone areas, produces 
a locus resistentiae minoris, with lowered oxygen pressure, thereby creat- 
ing an ideal nidus for streptococcal growth. We are compelled by the 
logic of the situation to condemn all efforts at devitalization by dentists, 
and strongly to urge extraction of teeth which need removal of pulp." 

He then dtes the findings of Drs. Best and Da\ds who oppose this 
view, and who collected 135 cases where the root canal fillings were 
done by " other dentists." They reported 1 28 defective root canal fillings 
with 103 abscesses. It is perhaps needless to here remark that had these 
investigative gentlemen collected cases from among their own clientele, 
their contribution to dentistry would have probably been of much more 
value. 

We would have at least known the method of root canal filling em- 
ployed and might have been a littie nearer the solution of the problem. 
As it is, their investigations only go to prove that the correct filling of a 
root canal by "other dentists" is merely an accident and that 25 out of 
128 defective root canal fillings were not abscessed, which should at least 
lead us to believe that not all our efforts along this line result in failure. 

There is no questioning the fact that Dr. Ulrich has thrown a bomb 
into the quietude and prosperity of our professional citadel which calls for 
some very thorough and painstaking investigation on our part, the ulti- 
mate outcome of which will be watched with deep interest by the medical 
as well as the dental profession. 



POSTPONED ARTICLES 

It has been necessary to postpone the installments of Mr. Supplee's 
and Dr. Spies' articles until the May issue. — The Editor. 



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212 THE DENTAL DIGEST 

SUGAR AND ITS EFFECT UPON THE TEETH 

By John S. Engs, D.D.S., Oakland, Cal. 
{Concluded from March issue) 

LIME, MAGNESIUM AND PHOSPHORUS 

Before going farther perhaps it would be well to explain that lime 
like all other elements of our foods, is held in solution in the blood which 
carries it to all parts of the body. The insoluble calcium phosphate is 
believed to be absorbed by the blood in the same loose chemical com- 
bination with a protein that is found before absorption in the casein of 
milk and the yolk of an egg. According to Bunge the casein and caseino- 
gen of cow's milk contain more Ume to the litre than does lime water. 
** Little is known" he says, "regarding the form in which caldimi exists 
in food materials and at present differentiation between the different 
groups of calcium compound eaten cannot be made. Metabolism ex- 
periments indicate that a healthy man, accustomed to a full diet requires 
about 0.7 grams of calciimi oxide per day for equilibrium." Experi- 
mental dietary studies have shown that it is entirely feasible to increase 
largely the calcium and phosphorus intake by a more liberal use of milk 
in the dietary. The same may be said of various milk products in which 
the calcium and phosphorus products are largely or wholly retained, 
such for example as junket, koumiss, buttermilk or cream. Calcium, 
magnesium and phosphorus in proper combination and in sufficient 
quantity are absolutely essential to the formation of good bones and 
teeth. It is important that the normal amount of calcium and magne- 
sium salts should be absorbed by the growing organism during infancy 
and childhood, when the skeleton is growing rapidly. The absence of 
sufficient fat in the food, and also it is believed, the presence of a greatly 
excessive amount, tends to deprive the growing body of its normal supply 
of calcium and magnesium salts, and is one of the factors in the produc- 
tion of nutritional disorders. Phosphorus, like calcium, is an important 
constituent of the bones of the active tissues and also of the body fluids. 
Calcium phosphate is the chief mineral ingredient of the bones, and is sup- 
posed to constitute about three-fourths of the entire ash of the body. It is 
essential for the growth of new tissues that phosphorus should be stored 
as well as nitrogen. The importance of phosphorus as building material 
is strikingly illustrated by nature, in the way she provides milk rich in 
that substance to the young of rapidly growing animals. Not only do 
these salts enter into the structure of bones and teeth, but their presence 
in sufficient quantity in other tissues is absolutely essential, to insure the 



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SUGAR AND ITS EFFECT UPON THE TEETH 213 

normal functional activities of the most important organs of the body, 
particularly the heart. So we see that anything tending to reduce the 
normal amount of these three substances available in the blood stream 
not only has a detrimental influence upon the osseous system of the body, 
but is also likely to have its effect upon the very seat of vitality itself. 

ITS AFFINITY FOR LIME 

Someone has said that refined sugar possesses a strong affinity for Ume, 
and when present in large quantity in solution in the blood stream, it 
causes a reduction in the available lime in the blood by combining with 
it to form sucrates of lime, so that if food containing sufficient lime is 
not taken with our daily meals to maintain the proper balance, the blood 
to preserve that balance is forced to extract it from that supply which is 
stored up in the bones and teeth thus weakening their structure. This 
seems quite plausible, though it is not what we may call a scientific state- 
ment; nor does it satisfy the minds of deeper thinkers. It has also been 
suggested that the blood may become supersaturated with the sugar in 
solution that is consumed in excess of the body needs, and that the blood 
being thus surcharged has no room for other food elements required by 
the tissues, consequently they are starved. That the teeth can be thus 
affected will entail the belief that nourishment of the teeth goes on after 
they are fully formed — a fact that some of the more eminent educators 
like Black, deny. 

METABOLISM IN DENTIN 

The word metabolism is used to designate both that building up and 
breaking down of tissue which biologists express respectively by the 
terms anaboUsm and catabolism. Prof. Torrey of Reed College assures 
me that both processes go on together in all tissues. The cataboKc 
are particularly obvious in old age, the anabolic particularly obvious 
in youth. He does not consider '*old age a bacterial matter." It 
seems to him to be '*a definitely metabolic affair; the balance shifting 
from a generally uphill to a generally downhill course." Having fairly 
good evidence of a constructive metabolism in those cases of hyperdenti- 
fication that we frequently find upon examination of teeth subject to 
external stimuli — bearing in mind this fact, that both the building up 
process and the breaking down, are subject to influences that tend to 
throw the balance one way or the other, is it not probable that some such 
cause, as lack of proper nutrition, would be likely to shift the balance 
towards the breaking down side, and thus cause either decalcification or 
degeneration of tissue in the dentin? 

That changes in the structure of dentin do occur in completely formed 
teeth, is shown in the hyperdentification that results from external stimu- 



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214 THB DENTAL DIGEST 

lation to which they are subjected for long periods of time. We do not 
know how or where the lime employed was obtained, suffice it to say, 
that some means of conveyance exists. I contend that if lime can be 
deposited 'in formed dentin, means for its removal are likewise possible, 
should the occasion arise. 

Dr. Harvey W. Wiley in response to a letter from me, said amongst 
other things, '1 am glad to note that the dentists of the country are be- 
ginning to understand that bad teeth are largely due to faults of meta- 
bolism, rather than exclusively to heredity and lack of care." He said 
also in a previous communication, " I do not believe that dentists can long 
hold to the fact that bacterial activities are the sole cause of dental decay. 
A condition of acidosis in the body would probably be more effective in 
causing decay of the teeth than bacterial activity." 

In 1894 Dr. W. G. A. Bonwill read before the N. Y. Odontological 
Society a paper entitled **A New Era in Dental Practice." I quote 
from it — " Medical men can well ask for preventive medicine, for every 
honest M.D. soon learns to give less and less medicine," — *^We, as 
dentists have an entirely different field, for we have millions coming to 
us where no law of prevention can be applied. We can only save and 
restore the lost structure by our cunning and art." *'But there is much 
that can be done to check caries in its very indpiency, and that without 
fiUing." 

** If we must link ourselves at all with the medical men, let us emulate 
their example in one thing at least — anticipative medicine or as they 
have it, preventive medicine." 

While it is true there are "millions coming to us," whose teeth have 
yielded so much to the ravages of decay that there seems no hope of 
saving them, yet, in the light of modern research and results obtained 
in the last few years, I think if we could have Dr. Bonwill with us to- 
day, he would not have to say, that *'no law of prevention" can be ap- 
plied to them. 

If we can but bring ourselves to consider teeth in the same light that 
we do other tissues of the body, subject to structural change and under 
the influence of those centres that control nutrition, then I think we shall 
find a way and a means, to arrest decay in teeth already attacked, and to 
prevent it by care in the selection of food for our growing children, seeing 
to it that their food furnishes all the necessary tooth building elements, 
calcium, phosphorus and magnesium in particular, which are found in 
available form in milk, greens (fresh or cooked), vegetables of all kinds, 
the unprocessed cereals and fruits and substituting these for sugar, white 
bread and cake. 

Encourage the manufacturers to produce pure, unadulterated food 



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A TECHNIQUE OF NATURAL TOOTH BLEACHING IN THE MOUTH 215 

preparations, by personally demanding them of your dealer in preference 
to the ready cooked, ready chewed and predigested truck that is made 
for lazy people. 

If we suflfer from tooth decay or any ailment of the teeth either we or 
our parents are largely to blame, nine times out of ten. We are given 
teeth to use in masticating our food, not entirely for ornament, and 
many of us have forgotten how or have never learned to use them. We 
have glands that secrete digestive juices but no time is given those juices 
to act, food is washed down into the stomach by a deluge of liquid taken 
after each mouthful of food before it is properly broken up and mixed 
with the saliva. 

An extra burden is thus thrust uix)n the stomach, and semi-digested 
food lies fermenting in the bowels giving off poisonous elements that 
little by little lay the foundation for our old acquaintance, pyorrhoea 
alveolaris. 



A TECHNIQUE OF NATURAL TOOTH BLEACHING 
IN THE MOUTH 

By Louis Englander, D.D.S., Philadelphia, Pa. 

The restoration and maintenance of a natural live tooth appearance in 
a discolored, devitalized tooth is a procedure which has been overlooked 
to a large degree by the dental practitioner. 

Esthetically, to keep a tooth life-like is a necessity. Especially is this 
true of the anterior teeth. Upon it depends in a large measure, the suc- 
cess of a porcelain inlay or a synthetic filling. Dentists hesitate to 
attempt the bleaching of the teeth, believing that it is only temporary 
and that the discoloration will return. 

To know the cause of the discoloration will aid in the permanent re- 
storation of the color. The enamel is composed almost entirely of inor- 
ganic matter and is translucent. It is the dentine which gives the shade 
or color to the teeth. The dentine is composed of a solid organic matrix 
containing a large percentage of inorganic matter. This is pierced by 
minute canals or tubules which radiate from a central cavity. The 
minute canals or dentinal tubules are occupied in life by protoplasmic 
processes from the odontoblastic cells which form the outer layer of the 
pulp. It is in these tubules that the discoioratioa occurs, and into which 
the bleaching agent must penetrate. 

The discoloration of dentine is due to three causes; hemoglobin, me- 



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2t6 THE DENTAL DIGEST 

tallic and carious. When extirpating the pulp, espedally if the tooth 
has been opened from the side or back, care must be taken that all of the 
hom of the pulp is removed. Any blood resulting from an apical hem- 
orrhage and all carious d6bris must be thoroughly removed mechanicaUy. 
\fter this has been accomplished, we may then enter upon the bleaching 
of the tooth. 

As a bleaching agent, the writer has found that either Dioxygen or 
Perhydrol is the most convenient and satisfactory to use, and, if manipu- 
lated proi>erly, success will result in all cases. In using Dioxygen place 
about one and one half fluid drams of the H2O in a test tube and heat 
slowly over a small flame of a Bunsen burner, holding the test tube at an 
angle of about 30 degrees, and concentrate the fluid to about 10 minims. 
Some of this is then placed in the tooth cavity on a small pledget of cotton. 
Several blasts of hot air are blown upon it in the direction of the greatest 
discoloration. Repeat this operation two or three times. Where a 
compressed air blast is used, be very careful not to direct the hot blast 
against the enamel too long, as it will burn the enamel and produce a 
brown discoloration which cannot be removed. If the color is not re- 
stored at one sitting, place a pledget of cotton containing the concen- 
trated H2O2 in the cavity and seal it up with temporary stopping or 
cement. Have the patient return in about five days and the improve- 
ment in color will be manifest. In case the restoration of shade has not 
been complete, repeat the operation. Three such treatments usually 
suffice. 

Perhydrol (Merck) is about 30° H2 O2 by weight, and has the advan- 
tage over Dioxygen in that it can be appUed without boiling. Should 
the Perhydrol become weaker through age, it can be boiled and the 
strength regained. In using either Dioxygen or Perhydrol, it is advisable 
to place the rubber dam over the tooth to be bleached, and also to be 
careful not to get any on the fingers, as these strong bleaching agents 
attack the tissues. Never apply either of these strong medicants to a 
vital tooth. 

Now that the dead tissue in the dentinal tubules has been bleached, 
and the desired color restx)red, the tooth should be wiped out with alcohol, 
thoroughly dried, and a light yellow cement placed directly against the 
dentine, which will seal the tubules. For this I have found Harvard 
Cement No. 4 most suitable. The tooth can then be filled with whatever 
material desired. 

I have cases under my observation which were treated in this manner 
more than eight years ago, and they still have the same live tooth appear- 
ance. 



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ADJUSTING OBTURATORS 



217 



ADJUSTING OBTURATORS 

By J. E. KuRLANDER, D.D.S. AND H. J. Jaulusz, D.D.S. 
Cleveland, O. 

In making and adjusting obturators to remedy the inconvenience of 
patients afflicted with cleft palate, not only should the dentist know the 
history of the patient and the causes which bring about this condition, 
but by careful study of the case in hand he should form some idea of the 
part which the five pairs of muscles controlling these parts play in their 
impaired physiological functions. These muscles as well as those of the 
tongue, the hyoid bone and the pharnyx, take part in deglutition, pre- 
venting the food from passing into the larynx and nasal cavity and in 
forcing the same into the oesophagus in the act of swallowing. 




Elus. No. I. Impression of cleft in plaster 

Cleft palate may be divided into two classes, namely, congenital and 
acquired. The first or congenital is brought about either from deficiency 
in the supply of lime salts to the maxillae of the foetus, thereby produc- 
ing malformation of the parts and that in the absence of any diseased 
condition brought about by syphilitic taint on the part of the parents. 
Acquired cleft palate is brought about by wounds inflicted on the parts, 
as well as from niunerous other causes. In the case under consideration, 
the cleft in the palate was due to hereditary syphilis. 

The patient, a young man 22 years of age, came to me with a V- 
shaped cleft which widened posterially, the uvula and about two-thirds 
of the palate processes of the superior maxillae being absent. His 
speech was so indistinct that it was with diificulty that he could be under- 
stood when talking, the sound passing through the nose. He was also 
greatly annoyed by food passing through the deft into the nasal fossae 
during mastication and deglutition. 



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218 



THE DENTAL DIGEST 




nius. No. 2. Gold crowns adjusted to the two superior bicuspids with platinum posts 

soldered on 




Dlus. No. 3. Side view of obturator, showing hinge 




Illus Nq- 4- View of plaster model with obturator in place 

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THINGS THAT ARE SAID IN DENTAL JOURNALS 219 

T first took an impression of the cleft in plaster; removing this I filled 
the deft with soft wax and took a plaster impression of the mouth. 
Having taken these two impressions, I made and adjusted gold crowns 
to the two superior second bicuspids — to the palatine surface of each of 
which a platinum post about an inch in length was soldered. Taking 
another impression with the crowns adjusted, I made a model of same 
and casting an aluminum plate formed grooves in the palatine surface of 
it, in which the posts on the crowns would fit, and which helped to sup- 
port the plate in position. 

I next made an extension to the plate to fill in the cleft posterior to 
it and to substitute the absent uvula, making the same of aluminum, 
which was also cast. I made a gold hinge, one-half of which was vul- 
canized to the heel of the plate and the other half to the anterior edge of 
the extension. On the anterior palatine edge of the extension was a pro- 
jection of aluminum, which when the plate and the extension was in the 
mouth, caught on the end of the gold post which was vulcanized to the 
palatine surface of the heel of the plate, and thereby prevented the forc- 
ing of the extension by the muscles too far into the post nasal vault. 
The protection which this applicance when in position afforded the pa- 
tient in mastication and deglutition were complete, and his speech was so 
greatly corrected that he could be plainly understood when talking, and 
he was transformed from the village fool, as he was called, to a man 
whose speech was so fully corrected as to render any impediment in it 
scarcely noticeable. 

2496 E. 9th St. 



THINGS THAT ARE SAID IN DENTAL JOURNALS 

By Hillel Feldman, D.D.S., Bronx, N. Y. 

It seems there is no limit to the things that some professional men can 
get themselves to say in a Dental Journal. 

In the January issue of the Dental Digest "W.B.B." asks "what is 
the best thing to do for a child three years old who breathes through the 
mouth nights and snores as loud as an adult? " 

In the February issue followed a short note in answer to ''W.B.B." 
from the pen of **Levi C. Taylor" which is the cause of my writing this. 

The February correspondent gives "W.B.B." the very elegant coun- 
sel of binding the child's lips with adhesive plaster, '* tight," so that the 
child will be compelled to breathe through the nose! Presto! Doesn't 
that solve the question? Truly ''the pen is mightier than the sword"! 



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220 THB DENTAL DIGEST 

(Why not melt paraffine over the adhesive plaster so as to make an herme- 
tical seal out of the operation?) In the morning, behold, Levi C. Taylor 
says *^you remove the adhesive plaster by taking hold of one comer." 
Isn't that an advance in scientific research? 

I sometimes wonder why the medical professional holds in such light 
esteem the members of the dental profession. How, pray, can I censure 
them when they read such edifying epistles from dentists as the reply to 
''W.B.B."? 

If W.B.B.'s patient breathes through the mouth at night, a good 
rhinologist should be consulted. The latter may find it necessary to 
further invite into the consultation, an orthodontist. I am sure it is a 
simple physical defect that can be remedied. But until it is remedied the 
child's breathing should not be interfered with by any such outlandish 
methods as plastering up the mouth. Breathing through the mouth is 
not a voluntary, acquired, habit, but rather a condition forced upon in- 
dividuals by physical imperfection of the naso-pharynx, constriction of 
the ajtiterior nares with attendant constriction of the bones of the anterior 
area of the face, or from deflected nasal septum, to say nothing of the 
presence of adenoid growths in the posterior passages. 



HARTFORD MEN CONTRIBUTE TO FORSYTH LOVING CUP 

In an editorial in the Oral Hygiene magazine, edited by W. W. Belcher, 
D.D.S., of Rochester, an article appeared asking that all dentists send 
not over 25 cents for the purchase of a loving cup to be presented to 
Thomas A. Forsyth, as a testimonial of the esteem in which he was held 
by the dentists. 

A list of the dentists in Hartford was prepared and presented to each 
as far as known. If all the dentists in our different cities and towns 
respond as quickly and in such numbers as the city of Hartford, the 
loving cup will certainly be presented to Dr. Forsyth very shortly. 



Editor Dental Digest: 

Can any of your readers give a remedy for a baby sucking her lips? 
JS. 

Editor Dental Digest: 

Will some of your readers please give a formula for cleaning impres- 
sion trays? 

Perplexed. 



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NEW METHOD OF CONSTRUCTING FULL DENTURES 221 

NEW METHOD OF CONSTRUCTING FULL DENTURES 

By Clyde Davis, D.D.S., Lincoln, Nebraska 

I have a method which I wish to give the dental profession for its 
consideration, of constructing a full denture, either single or double, that 
I have never read of and I believe the idea or the application of the idea 
is original. I have tried it out in our infirmary and proven that it is 
possible to get suction for all plates, both upper and lower, in every in- 
stance where the mouth approaches normal. 

Stated in a nutshell, the method involves the complete abandonment 
of the model of the mouth and the plate is vulcanized on a cast which 
is the negative of an adhering base plate. Given as briefly as possible 
the method is as follows. 

An impression is taken of the mouth and the cast made, which should 
be somewhere near correct, but it is not necessary to take any great 
pains with it. It should give the outline of the completed plate and par- 
tially represent the conditions of the mouth. In fact, in some instances 
even this is not necessary provided you have a dummy cast of plaster, 
metal or celluloid, which is somewhere near the size of the mouth, but 
should be a trifle larger in every direction. Having secured an approx- 
imately correct model a specially prepared base plate which is very thin 
and when warm is very pliable, is readily shaped over this model. This 
base plate will probably not show suction when placed in the mouth and 
pressed to position. If it is far wrong, take it out, warm it over a flame 
and press to place in the mouth. As soon as a little suction begins to 
show up, instruct the patient to keep the mouth closed and suck the 
plate as tightly as possible. The warmth of the mouth will change this 
until close adaption results and strong suction will appear. This may be 
assisted by manipulating with the fingers and it is particularly necessary 
with the trial base plate on the lower jaw. When this suction has been 
secured it will be found that this trial plate will not fit the original cast 
even though it is a perfect model of the mouth. It will be found that no 
impression of the mouth can be taken which this adhering base plate 
will fit, which proves my contention of the past twenty years, that a 
plate made from a perfect cast of the mouth seldom has adhesion. I have 
always spoiled my casts up to this time in order to get adhesion. Now I 
am asking you to throw them away altogether. 

Coming back to the case where you have one or both adhering trial 
base plates in the mouth, I then take the bite in the usual way for that 
kind of a case using the built up bite on these base plates. Plaster of 
Paris is then mixed up ready for use and the trial plates hastily removed 



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222 THE DENTAL DIGEST 

from the mouth and filled with plaster. These are then mounted on the 
articulator and the case proceeds in the usual way. In these casts which 
are poured up you have the negative of an adhering base plate which . 
is by no means a model of the mouth. Every plate made by this method, 
both upper and lower, adheres as would the trial base plates. This method 
of making an adhering denture without vulcanizing on a cast of the mouth 
has many side issues which I haven't time to go into at present. SuflSce 
it to say that by this method we can construct a denture, if necessary/ 
without having taken an impression of the mouth, using an approximate 
dijjnmy to start the shape of the base plate, completing its form in the 
mouth assisted by the body temperature which must slightly affect the 
specially prepared base plate. The plaster which is poured into these 
adhering base plates should be a little below body temperature in order 
that they may not give and change shape under the weight of the poured 
in model. The base plates should be given a thin coat of quickly drying 
ether varnish, before pouring the plaster and then painted over with a 
very thin solution of soap. This gives a smooth cast and the base plate 
by warming can be easily removed from the cast. This matter can be 
tested out by anyone if they will try the base plate back in the mouth 
after it has been removed from this cast and it will be found that the 
adhesion is still there. If you will take the base plate and warm it and 
place in over the original cast of the mouth and press it into place and 
then try it in the mouth, it will be found that the adhesion has been de- 
stroyed. Allow this base plate to remain in the mouth and get warm, and 
adhesion again takes place. Taking it out of the mouth it will be found 
to fit the cast which has been poured into the base plate and does not fit 
the cast of the mouth. 

You will see more about this method later on. 

University of Nebraska 



CARE AND USE OF THE TOOTH BRUSH 

Pour boiling water on your brush occasionally. Keep it in a large 
mouth bottle in which you have a saturated solution of boric acid Make 
new solution once a week. Request your patients to bring their 
brushes to the office with them and you take the brush, holding it prop- 
erly in your own hand, and brush their teeth. You can teach them 
the correct use of the brush no other way so well. Be very sure you 
are capable of teaching this important truth. It is an acknowledged 
fact that improper use of the brush is but little better, if any, than no 
use at all. 

J. M. Prime. 



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INDICTMENT AGAINST DENTIST QUASHED 223 

INDICTMENT AGAINST DENTIST QUASHED 

{Federal) The vigilance of the government in putting an end to the 
drug trafl&c in the United States is presented in a large variety of recent 
cases. Among them the case of United States v, Freedman stands out 
prominently. Defendant Freedman, a dentist was indicted for having 
dispensed morphine sulphate in other than the regular course of his pro- 
fessional practice, that is to say he used the drug in quantities more than 
was necessary for a patient's use. 

The defense interposed was that the law contained no language 
governing the question of necessary quantity. The law in specific terms 
enumerates the requirements imposed on those who handle the drug in 
making a sale, such as filing a dupKcate with the Commissioner of Internal 
Revenue, etc., but nothing is said with relation to selhng or using the 
drugs in quantities more than necessary to meet the needs of a patient. 

The court quashed the charges against the defendant. Quoting the 
court, Judge McCall said: "I fail to find in the act of Congress under 
examination any language making the doing of the things with which 
the defendant is charged a violation of law. In other words, there is no 
limit fixed to the amount of said drugs that a physician, druggist or 
dentist may prescribe, nor is there any duty imposed upon him, and the 
name and address of the patient, except those to whom he may personally 
administer, and that he must preserve the records of two years. For 
failing to do either of these things he is not indicted." The indictment 
was quashed. (United States v. Freedman, 224 Fed. 276.) 

EXCLUSION OF POISON FROM MAILS 

(Federal) Post Office Department Order No. 2923 by the Post- 
master General prohibiting the mailing of poisonous compositions except 
for transmission in the domestic mails from manufacturer or dealer 
to licensed physicians, surgeons, pharmacists^ and dentists, held invaUd, 
as beyond the jurisdiction of the Postmaster General. (Bruce v. United 
States, 120 C. C. A. 370.) 

VETERINARY DENTISTS AMENABLE TO THE GENERAL DENTAL LAWS 

(North Dakota) The North Dakota Supreme Court has, by a recent 
decision, held veterinary dentists to be subject to the North Dakota 
Laws having application to other dentists. It is quite clear that the 
legislative intent was to afford to animals the same degree of surgical 
skill as is by the state dental laws guaranteed to man. The defendant in 
State V. Ramsey was convicted in the County Court of Cass County of 
the crime of wilfully and unlawfully practising veterinary dentistry with- 



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224 THE DENTAL DIGEST 

out a license. He was a student under a Doctor Milan. It seems that 
defendant performed all dental work under Doctor Milan, doing the 
mechanical work such as extracting teeth and filling them. 

Defendant's contention was that he was immune from the law in 
view of the fact that he was not engaged in the profession of dentistry 
as conmionly understood but in the profession of veterinary dentistry 
and that as the law makes no specific reference to veterinary dentistry 
it was not intended to have any application to such profession. 

The defendant was convicted in the trial court it having been held 
that he was subject to the general dental laws. On appeal, the Supreme 
Court affirmed the holding of the lower court. (State v, Ramsey, 154 
N. W. 732.) 

FRAUD ON MEDICAL EXAMINERS PUNISHABLE 

(Iowa) The Iowa Code provides that any person who shall present 
to the board of medical examiners a fraudulent or false diploma, or one 
of which he is not the rightful owner, for the purpose of securing a certi- 
ficate permitting him to practise medicine or dentistry or shall file or 
attempt to file with the county recorder the certificate of another as his 
own, or who shall falsely personate any one to whom a certificate has 
been granted, or who shall practise medicine, surgery, or obstetrics or 
dentistry without obtaining and filing the required certificate, or who 
continues to so practise after the revocation of his certificate, shall be 
guilty of a misdemeanor. 

Under this law one Charles Edmund was indicted for having loaned 
his certificate to a fellow named McAninch. McAninch proposed to 
practise under such certificate. Edmund and McAninch were both 
tried and convicted in the same trial. This Edmund claimed to be error 
on the part of the trial court. The Supreme Court on reviewing the case 
however held that such procedure was regular. (State v. Edmund, 154 
N. W. 473.) 

LICENSE LAW CONSTITUTIONAL 

(Wisconsin) The statute providing for the licensing of all persons 
practising medicine, surgery, dentistry or osteopathy for fee or compensa- 
tion and imposing a fine for practising without a license is constitutional 
and within the legislative power. (Arnold v, Schmidt, 143 N. W. 1055.) 

SELLING MORPHINE WITHOUT PRESCRIPTION 

(Georgia) One who sells morphine not on the order of a licensed 
physician, dentist, or veterinary surgeon, is guilty of a misdemeanor, 
whether he is the proprietor of the drug store, or merely the employee of 
such proprietor. (Oppenheim v. State, 77 S. E. 652.) 



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FIRST UNIVERSITY DENTAL SCHOOL FOR COLUMBIA 225 

FIRST UNIVERSITY DENTAL SCHOOL IN 
NEW YORK FOR COLUMBIA 

Dental Course to be Allied with College of 
Physiclans and Surgeons 

Realizing the importance of the teeth and mouth infections to sys- 
temic disease, the Faculty of the College of Physicians and Surgeons have 
unanimously voted in favor of the establishment of a dental department, 
to be connected with the medical school. A committee of prominent 
dentists of the .dty have presented plans to the Medical Faculty which 
have been approved. 

The school of dentistry will be closely associated with the medical 
school and the admission requirements will be the same as the medical. 
The course will be four years, the first two years the same as those in 
medidne, thus giving the dental student a thorough knowledge of the 
fimdamental sdences necessary to the practice of a spedalty of medidne. 
At the end of the second year the dental student will give all his time to 
the study of dental subjects, namely, operative dentistry, prosthetic 
dentistry, oral surgery and oral pathology, orthodontia, etc., and the more 
technical part of the work required for the well trained dental surgeon. 
This new school will be the first university dental school in New York 
City and the second in the State. It will give the first four year course 
of dentistry ever given in the Empire State. 



DR. WILLIAMS NEEDS TEETH 

In the course of our studies in tooth form, we have need of a good 
many natural anterior teeth, not decayed to an extent which destroys the 
form. 

If you have any such and wish to aid Dr. Williams in his work for the 
benefit of the whole profession, will you not please forward them to Dr. 
J. Leon Williams, in my care? I will gladly pay the express charges or 
refund any postage you may paiy. 

The importance of this request is seen when it is remembered that it 
was such a contribution of teeth from Dr. Friesell, that enabled Dr. 
Williams to put his discovery of typal forms into definite terms. 

George Wood Clapp. 




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(TINE^BVILDING 




The only business which is good busi- 
ness is that business which tends to build 
the man while the man is building the 
business. — ''Neptune'' — Nebr, Dent, Jour, 



WHAT SHALL WE CHARGE FOR PLATES? 

By W. J. HoLROYD, D.D.S., Pittsburgh, Pa. 

Whoever shows us what it costs us to render professional service, 
benefits each of us who is not doing himself justice and each patient who 
is not receiving justice in the form of adequate service. 

A long study of this subject of patients, service and fees, has con- 
vinced me that when dentists are sufficiently paid to permit them to do 
their best for each p>atient, we shall see such a wave of technical advance- 
ment as no generation of dentists has yet witnessed. Here and there a 
man is divining his opportunities and rising to his possibilities. Ac- 
quaintance with several such cases shows that the p>atients are even 
more delighted with the results of such a course than are the dentists 
with the increased income. 

Dr. Holroyd's figures deal in a practical way with one phase of service 
which greatly needs such treatment. Answer him if you wish, but first 
time yourself on work well done, that you may know whereof you speak. 
— Editor. 

FOREWORD 

From a high authority — President Pritchett, of the Carnegie Founda- 
tion — we leam that the medical profession scarcely pays now, and tends 
to pay even less. "It is becoming more and more a profession to which 
men give themselves from ideals of public service, recognizing that the 
average practitioner is to obtain little more than a comfortable living, 
and in many cases not even that. The parent who seeks for his son a 
remunerative occupation should look elsewhere." 

Everybody knows that teaching does not pay and preaching pays 
still less, while literature — if you measure the tcftal bulk of the time 
expended against the gross receipts — represents a positive deficit. There 
remains the law, in which a sufficiently agile youth may now and then 
overtake a fortune, but the grand prizes are few and the average income 
is about equal to that of a good carpenter. 

Dentistry may be classed with the above. 

Thus, of the old professions, none pay. A diligent and skilful man 
may make a comfortable living and keep up the premiums on his life 
insurance. Why then do practitioners of the learned profession persist 



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WHAT SHALL WE CHARGE FOR PLATES 227 

in trying to make them pay? How much they might simplify pro- 
fessional life by going in frankly for '* ideals of public service" with a 
reasonable pension! Probably there are more furtive Socialists among 
professional men than professed ones among workingmen. 
So much for Prof. Pritchett. 

From the above it would seem that the men in the professions have 
not a very desirable financial outlook for the future. It does not be- 
hoove dentists to stay dormant, but to agitate a movement wherein such 
conditions may be remedied. We cannot pretend to do it in the other 
professions, but we can help our own to a very material extent — treat 
it as merchants treat bad conditions in their business — by analysis, con- 
trast, and comparison. We can get at the cause and then outline a 
policy that will bring order out of chaos. 

The habit of "Studying the Cost of Conducting a Business," is going 
on all over the country. It is only right that we dentists should fall in 
line and study our own profession, with a view of securing for ourselves 
proper remuneration, because if we don't we shall go to the wall. A man 
is more sure of himself, and has more confidence and poise in quoting 
prices, if he knows what he is talking about. A man who has '* timed'' 
himself on different operations knows why he is asking a higher price for 
work than the dentist who charges a certain price for no other reason than 
that it is the custom. Considering that a dentist of lo years* standing 
is only averaging $1,250, nel income per year and the cost of living still 
going higher, a thinking dentist realizes that something must be done, in 
order to hold his footing among men of the same standing in other voca- 
tions. 

There has been an awakening all over the country among the dentists, 
in regard to the right minimum prices of different pieces of work manu- 
factured by the dentist and an earnest demand for authentic data to 
work from has been vigorously solicited. 

Dentists want to know. There are now some live men in the pro- 
fession and they are no longer content with just making no better living 
than a carpenter, a bricklayer, or a draughtsman. Considering that they 
have spent so much money and time for their education and have more 
responsibility, being dentist, educator, salesman, and bookkeeper, they 
are justified in wanting more remuneration than the artisan whose 
responsibility is shouldered by his employer. 

Dentists have a right to know what fees they are entitled to and until 
they do, dentistry will not stand where it belongs, for in order to attract 
the best brains to it, it must also be possible for a man to make something 
more than a living. 



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228 TH£ DENTAL DIGEST 

Only I per cent, of the men in our profession to-day are highly 
schooled. Why should a business man who has gotten along to where 
he can afford to send his boy to common school, high school, preparatory 
school and then college, let that same boy after all that education, take 
up a profession that yields approximately only $125 a month after being 
10 years in business. You would not let one of your own boys do it. 
You would say yourself, *'No son, after all that schooling, you must take 
up something that will yield better returns. " Thus we have an instance of 
a highly cultivated brain being lost to the profession. In a Yale graduat- 
ing class of 300 or more — 160 proposed to be lawyers; the rest were 
divided between medicine, architecture, engineers, etc.; not one of the 
whole class said he would take up dentistry. True, some dentists have 
made signal financial success without business education, but they 
did it in spite of non-education, not because of it. How infinitely better 
might they have been had they had that education. We all regret it. 
Therefore we must get better remuneration for our work, if we would get 
this class of man into the profession. 

Times are changing more rapidly now than ten years ago and dentistry 
is also changing very rapidly. The average dentist cannot keep up with 
it. It costs every dentist more to-day to conduGt business than 10 
years ago and still his prices for work remain the same, and he has 
to do more work to make it up. Right there he is going back — out of 
date. Therefore, we are going to show him how he may help himself. 

Remember these words throughout all of this article — Contrast and 
Comparison — everything is governed by it. If a man were on an island 
and he had no one to compare himself with, he would not know whether 
he were stout or thin, long or short, strong or weak, fast or slow. We 
don't know whether a building is tall until we compare it with another, 
or whether our salary is large or small unless compared with someone 
else, and so on down the list. The world is governed by contrast and 
comparison a thousand times a day. They are all about us and men use 
them constantly in the day's work — that is, all men but dentists. It 
does not seem to have entered their craniums as yet. 

We are going to contrast the wearing value and prices of our work, 
with the value and price of other goods tendered by merchants, weighing 
service for service. Contrast the following: 

If a patient pays $30 for a suit and it wears for one season, why should 
he expect your $30 piece of work to last 10 years. 

If you buy two pairs of shoes at $5 a pair and they last one year, why 
can't you ask $10 for a good gold crown, lasting 10 years? 

If a workingman pays 50 cents for a theatre ticket, for one night, he 
can afford to pay $3 for a good amalgam filling, lasting 10 years. 



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WHAT SHALL WE CHARGE FOR PLATES 



229 



If a lady in ordinary circumstances can aflford to pay $75 for a medium 
class set of furs, which she only wears a few hours per week for four 
months a year, she can afford to pay $60 for good, well articulated, care- 
fully made dentures, which she wears all the time, and on which she 
will eat 10,000 meals in 10 years. 

Contrast and Comparison — ^ponder it. Open your eyes. 

According to Dun's report, the expense of living has gone up 50 
per cent, in the last 10 years. This includes the living of dentists, also. 
That is, your $150 only goes as far now as $100 did 10 years ago, and if 
your prices in dentistry remain the same you have to work half as hard 
again to accomplish the same results, in a given time as you did 10 years 
ago. Think about this. 

Even if you had raised your prices 50 per cent, that $5 crown to $7.50, 
$15 plates to $22.50, 50 cent extractions to 75 cents, and so on, you would 
only be in the same position as you were 10 years ago, and not advancing 
any. As it is you charge the same prices and have to work half as hard 
again and then you just stay in the same place. No gain as your reward 
In fact you are going back, because you cannot save anything and are 
getting older. 

Let me give an instance in our own profession by comparing some of 
the expenses of two offices of 10 years ago and to-day. 



1902 




191 2 












Rents 33 % more 


Telephone .... 


None 


Telephone . . 






$ so per yr. 


Office girl .... 


$ S per wk. 


Office girl . . 






8 per wk. 


Foot engine .... 


36 


Electric engine 






150 


Foot lathe. 


16 


Electric lathe . 






35 


Brass cuspidor . . 


3.50 


Fountain cuspidor 






40 


Dental chair .... 


125 


Dental chair 






i8s 


Cabinets 


60 


Cabinets . . 






150 


Foot Bellows .... 


5 


Compressor 






12 


Porcelain furnace 


None 


Porcelain Furnace 




100 


Switchboard . . . 


None 


Switchboard with appliances 250 


Typewriter .... 


None 


Typewriter . . 






100 



And so on ad infinitum. The list could be made much longer, but the 
above is enough for example. In the office described in the first column, 
such equipment was not looked upon askance 10 years ago, but woe 
betide the up-to-date man of to-day who has not the articles in the second 
colunm. He cannot claim to be up-to-date if he hasn't them, as they 
are now necessities. But few men have them, because most men can't 
afford them. The prices gotten in their practices do not justify the 
outlay. They haven't any money left. Some dentists are up-to-date 
enough to go to conventions, where the Dental Manufacturers have their 
exhibits and look with envy upon the new appliances designed by experts 
in the profession. They would like to bring their offices up to date, yet 
they keep on plodding at their work in the old way, never dreaming that 



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230 THB DENTAL DIGEST 

they can alter their patients' viewpoint just as other merchants have 
altered their patrons' viewpoint. 

Remember the merchants have spent thousands of dollars educating 
people to imderstand, appreciate and follow the styles. There used to be 
summer and winter clothes — we all remember them. Now, there are 
four seasons and they have even stopped the ladies from interchanging 
their dresses — they have now to dress in ''tones." This "education** 
includes dentists' wives. 

FOR DENTISTS 

Financial success is all a matter of educating the patient and studying 
costs, and raising prices so you can buy these new labor saving appliances 
and become up to date. Remember that the manufacturer is the man 
who places the price on everything in your office. You were told the price 
and you paid or left it. But the majority of dentists allow their patients 
to quote the price of work. We are not salesmen, just mere order takers. 
Patients say the price is too much and we cut the price to suit their 
pocketbooks — in the face of the fact that they are paying other manu- 
facturers $1 where we get 25 cents. 

Now it has been proven that to maintain an office as above (2nd col- 
umn) and constantly keep in touch with new improvements, takes 50 
cents on the dollar of gross receipts at present average prices, before the 
dentist has anything left for himself. To make a larger percentage on 
the dollar, he will have to charge more all along the line for his work. To 
do this intelligently he will have to go to the trouble of ** timing" himself 
during different operations. If he does that, he will not need any one 
to beg him to change his viewpoint. 

All business men and manufacturers put a price on their product, 
based on quality of labor and the ti?ne it takes, and no trouble is too great 
that enables them to get results. They sit up nights and have meetings 
and call in cost experts to help them. This brings us to the analysis 
of the heading of this paper. 

What should we conscientiously charge for plates — what should be 
the minimum price? 

Some time ago, we sent broadcast to 35,000 dentists, through the 
Courtesy of Oral Hygeine^ a time chart for plates, asking dentists to 
fill in the time required for the different steps and return to us for com- 
pilation and averaging. We have received a great deal of help and this 
article will give you the results. Although it emphatically demonstrates 
that the dentists need to be taught how to do things for their own good, 
some men must have thought the timing was intended to be a race — to 
see how quickly they could do a certain specified piece of work — ^and some 



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WHAT SHALL WE CHARGE FOR PLATES 231 

again have been very conservative and have gotten together a very fair 
average of "times.*' 

The timing of operations means an average of many times (say 20), 
and when a man writes that he can paint an impression, pour model and 
mix his plaster right, so that it has no bubbles and every particle of 
plaster comes in contact with water in two minutes and then separate 
and build up trial base plate, according to the latest accepted standard, 
in three minutes, and at this rate make a whole upper denture in i hour, 
47 minutes, then his records are not to be put down to average with 
other conservative men, who do the work more thoroughly. Such 
timing is not correct and it is a reflection on the compilers' intelligence to 
quote his figures in averaging. 

The average time from more than 150 reliable statistics results as 
follows: 

CHAIR TIME 

Time consumed in making contract for plate: 

Examination and consultation 30 minutes 

Taking impression 15 " 

Taking bite 20 " 

Trial plate fitted 30 

Fitting denture in mouth 15 " 

There shows an average of 4 trips for plate to be adjusted, sometimes to be 
scraped and troubles at other times imaginary, but consuming time about 

20 minutes each visit 80 ** 

LABORATORY TIME 

Painting impression and pouring model 12 minutes 

Separating and making trial base plate 20 " 

Mounting on articulator 10 " 

Selecting teeth 15 " 

Articulating 46 " 

Final waxing 25 " 

Investing 20 " 

Packing, putting in and taking from vulcanizer. (Does not include time for 

actual vulcanizing) 90 " 

Scraping and polishing 60 " 

60)488 

8 hrs. 8 min. 
Percentage of makeovers 25 per cent 2 " 

10" 

These times are compiled from quite a number of dentists and prove 
that work can be averaged to such an extent that a basis of price can be 
arrived at. Remember, this sending out to 35,000 dentists for data was 
never done before, and proved quite a task and if any skeptics differ with 
any of the above statistics, I shall be glad to be corrected if they will go 
to the same amount of trouble. 



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232 THB DENTAL DIGEST 

Now if it takes 50 cents on the dollar to conduct an up-to-date office 
and if you only charge $20 for a plate and it takes you 10 hours to make 
It, you can readily see that it costs you $10 to make that plate, counting 
material and overhead expenses (which lots of dentists never think about), 
leaving practically $1 per hour for yourself, which sum a jobbing plumber 
demands when he comes to open your sink. A tile setter gets 62^ cents 
per hour. After spending your money and 3 years for education and tak- 
ing all the responsibilities of business worries and building up your prac- 
tice, ask yourself if you are not worth more than $1 per hour net. Some 
of the mechanics' wages are only a few cents less per hour and they have 
no overhead responsibility. 

You might say the laboratory does a lot of it and it is really not your 
time. I can get a plate made for $3 and charge $15, that is $12 profit. 
This way of figuring is not right. Too many dentists figure that way. 
Overhead charges and running expenses must be put against the first 
price, and considering that the dentist is made responsible for any work 
that does not fit and any makeovers must come out of his own pocket, 
he must charge and receive the profit as if he had made the whole plate 
himself. If the dentist has to stand the brunt of mistakes of other 
people whom he employs, he at least is entitled to the profits of their 
labor. It is so all over the conunercial world. A dentist of 10 years' 
practice should be earning $6 per hour gross — earning $3 net per hour. 

Another point of vital importance. It has been conceded, after a 
lengthy canvass of the foremost men of the profession and accountants 
and cost experts on the side, that highly specialized laboratory work 
should command as much pay as work at the chair. 

This special problem of whether the laboratory charges should be 
charged at the same price as chair time was put up to the representative 
of one of the largest cost expert firms of Pittsburgh, who handles the 
business of large corporations, and his decision, after giving the point 
much thought, was decidedly in the affirmative. Large law firms do it, 
the work of subordinates' work is charged the head of the firm's prices, and 
the head of the firm takes the responsibihty. The principle is the same 
in our case. Other instances can be given in architects' and engineers' 
offices, etc., which proves enough precedent, and considering that these 
cost experts have studied such points as these and that these decisions 
are accepted by banks and the commercial world in general, we are only 
showing our ignorance by doing otherwise. Such a course will only 
prove our undoing. 

It has also been brought out in another paper that the productive 
time in an office for one year is only / fioo hours ; the dentist may be in his 
office 2,500 hours but the losses, including time exceeding that con- 



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WHAT SHALL WE CHARGE FOR PLATES 233 

tracted for, makeovers, times for consultations and charity work — 
cut down the actual producing hours to an alarming extent. One thou- 
sand hours have to stand the brunt of the charges. 

Therefore, the foregoing brings us to the crucial point that lo hours' 
work on a single vulcanite plate at $6 per hour is $60, which is the mini- 
mum price that ought to be charged, gold plates in proportion, con- 
sidering the knowledge which is put into a properly fitting denture. 
This leaves $30 for yourself. 

This price, gentlemen, is what single rubber dentures will bring when 
the dentists wake up to the cost of conducting their practices and a 
knowledge of what is their due. There are more dentists who have 
realized these facts and are charging these prices than you would imagine, 
and at that, the patient is not paying one whit more than he pays for 
other things, considering value dollar for dollar. The poor man who 
scrapes his money together and pays $250 for a piano pays the salesman 
$125 profit. If it takes the salesman one hour to sell him that piano that 
workingman pays him $125 for one hour's work and that salesman does 
not shed any tears over it either. The poorest working people can and 
do afford and pay the various dealers a bigger rate of profit for various 
articles than they do the dentist, considering the length of service ren- 
dered. It is estimated that the dentist only asks 25 cents on the dollar 
compared with other men in other business. Yes and even less. Instead ' 
of being called D.D.S. we ought to be called D.P.P. — ^Department of 
Public Philanthropy. 

It is not just, considering the knowledge required, that a dentist 
should receive only the pay of a good workingman or artisan. This 
fact explains, as a Dean of a college once said, why after 5 years a good 
many graduated dentists drop out of practice into other callings. A 
good many dentists in the farming districts, who complain of cheap 
prices, claim their class of patients could not pay these prices, but do 
you find the merchants of the city reducing prices of farmers' neces- 
sities on that account? The farmers pay the merchant the same price 
and ratio ot profit as does the workingman in the city. Every other line 
of business from pins to automobiles is now controlled by interests that 
have educated (a little at a time) the masses (including dentists) to pay 
considerably more than was paid 10 years ago. That is an accepted fact 
but the prices of dental work have not changed to an appreciable extent 
in the last 15 years . 

It bespeaks a lack of business acumen and a laxity in keeping up with 
the times on the dentists' part. Dentists may protest and say proper 
fees can't be gotten, but they are being gotten by the ones that are 
"waking up," who are determined to secure a competence in their old age. 



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234 THB DENTAL DIGEST 

A word about this competence. A competence is at least $30,000, 
which yields, at 4 per cent., $1,200 yearly, or $100 a month. Ask your- 
self, have you got it or are you saving it? If you are saving anything 
at all it is not from making plates, and it behooves you to study which 
department of practice you are losing money in, and plates is one of them. 

The remedy is — start to-day. When the next patient for a plate 
comes to you, do not give him any limit, say (to start the propaganda) 
that he can have any price up to $60, and then he will naturally want to 
know the difference, then show him the anatomical articulator, the new 
rubbers and the new teeth and it's up to you to work the salesmanship 
stunt just as it is worked on you. Don't keep on quoting $10, $12, and 
$15 eternally. Sell service and you will be surprised within six months 
what a material change you can bring about among the very people you 
are now working for. Start to-day and then shortly you will be able to 
fit up an oflSice such as you have dreamed of — and keep things going along 
these lines. 



PROOF OF MALPRACTICE IN DENTISTRY 

In recently affirming judgment, a Chicago dental company in favor of a 
patient for $1,000, as recovery for injuries claimed to have been sustained 
by the latter by reason of negligent performance of dental work done for 
her by defendant's employee, the Illinois Appellate Court decided that 
malpractice was sufficiently established by proof that the employee 
negligently bored through the roots of four of plaintiflF's teeth into the 
alveolar process or bony tissues of the jaw, thereby causing a painful 
condition, which required long treatment and rendered impracticable 
the placing of a permanent dental bridge. Incidentally, the Appellate 
Court held that it was not improper to permit an expert witness to testify 
in plaintiff's favor as to the condition of the bore in plaintiff's teeth the 
year following the treatment by defendant's employee, without requiring 
plaintiff to first show that no one else had treated the teeth in the mean- 
time, since it was open to defendant to show that the condition of plain- 
tiff's teeth was aggravated by anything for which defendant was not re- 
sponsible, if there was any such aggravation. 

A. L. H. Street, 

St. Paul, Minn. 




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ANSWER TO A REQUEST FOR ADVICE 235 



ANSWER TO A REQUEST FOR ADVICE 

I am opposed to any advertising which makes any mention of the 
dentist's personal skill, special methods, etc. 

I don't believe the restrictive adjectives "fraudulent" or "mislead- 
ing" as applied to statements will have any practical value. It is not 
anyone's business, in particular, to stop such statements, and the door 
will be just as wide open as ever. 

If this society wants to accomplish something let it change the word- 
ing to something like the following: "Any member making any refer- 
ence to his own personal skill, to special methods, etc., or advertising ser- 
vice at lower fees than he expects to receive for a fair grade of service, shall 
be brought before such and such a conmiittee and if the charge is sustained 
shall be suspended for 90 days and for a third offense, suspended per- 
manently." 

In other words what is needed is not publicity for the dentist's special 
qualifications, but for dentistry as a means of good service. — Editor. 

Editor Dental Digest: 

Will you kindly allow me to answer **A Request for Advice" by 
** Massachusetts'' in February Digest. His whole list of questions sum- 
marized, is that he believes in honorable publicity, and wants to know 
why he can't use it, and retain the respect of other dentists. 

During my 32 years as a dentist and reader of dental journals, this 
same proposition has been presented in various forms, and nothing 
practical has ever come of it. 

It is certainly time for a clear answer to be given, so that every den- 
tist may understand. 

The Code of Ethics, Art. 2, Sec. 2, says: "It is unprofessional to 
resort to public advertisements," etc. 

There is your answer, and that certainly has been approved by every 
dental society in this country by the adoption of their code of ethics. 
Moreover, it will never be changed by societies who have adopted it, for 
good and sufficient reasons of their own, and any discussion with that 
end in view is as useless now as it has been in the past. You may think 
this an unreasonable assertion, but let us look at the facts. Let us look 
at dental organization as it exists to-day. 

Most all of the State Dental Societies belong to the National organi- 
ation, and aU have practicaUy the same code of ethics. We will look 
into the organization of one state dental society knowing that it is but 
similar to all the other states; the knowledge of one will be knowledge for 
all. 

I have before me the by-laws of the Wisconsin State Dental Society. 
This society is incorporated, and its executive council ''has absolute 
control of the entire business*' of the society, and may sit with closed 



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236 THE DENTAL DIGEST 

doors. This council consists of twelve active members, of whom the 
president, secretary and treasurer of the society shall constitute a part 
and these shall be the officers of the council. Three members of the coun- 
cil are elected each year and serve for there years. The president pre- 
sides at all meetings of the coimcil and can call special meetings at the 
written request of three of its members. Seven members constitute a 
quorum and the majority rules. A majority of the Executive Coimcil 
of twelve members is seven, a majority of a quorum of seven members is 
four. Thus from four to seven members of the council constitute the 
determining power concerning absolutely all the business of the society. 

As to the powers of the Executive Council I wiQ quote by-law Art. 2, 
Sec. I. 

**The Executive Council shall have absolute control of the entire 
business of the society and may sit with closed doors. Any member of 
the Society desiring to bring any matter of business before the council 
may do so in writing and appear in behalf of such measure, by consent 
of the Executive Council.'' 

The Executive Council is further empowered to elect all standing 
committees, which are, Dental Science and Literature, Dental Art and 
Invention, Publication Committee, Program Committee, Clinic Com- 
mittee, Board of Censors, Infraction of Code of Ethics, Local Committee 
of Arrangements; also select the place of annual meeting. In case of the 
absence of the president and vice-presidents, the council shall fill their 
places. The council shall pass on the expenditure of all moneys of the 
society. It may authorize certain officers or committees to expend 
money for specific purposes. They shall appoint annuaUy an auditing 
committee from their own number to examine the books of the secretary 
and treasurer. 

While there are still other powers granted the council, the above is 
sufficient to show that the membership has empowered the council with 
absolute authority in all matters of business that concerns the society. 

The ordinary member may vote once a year for the society's officers. 

May be appointed by the Council on some conmiittee. 

May attend the annual meeting. 

Shall pay dues. This is the extent of his society organization privilege 
and usefulness. So here is the present plan of Dental Society organiza- 
tion. What do you think of it? 

Now if the code of ethics is to be changed by dental societies as now 
organized, by granting and defining honorable advertising from the 
twelve dentists governing the state society, what are the prospects? It 
has been a long road to their present position and they are satisfied. The 
proposed change would endanger the present line-up of prestige and 



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ANSWER TO A REQUEST FOR ADVICE 237 

personally it could not appeal to them. Every society member has 
signed the Constitution and By-laws, as well as the Code of Ethics, and 
no council dentist could champion such change without censure and loss 
of prestige among his fellows. Unquestionably the road is closed for 
recognition of honorable advertising by the self-styled ethical societies. 

The power of the executive council is supreme. The twelve dentists 
direct all things professional in the state. They say the dental profession 
will not endorse this or that — they know — ^because they are the profession 
— at least the controUing force invested with authorized power. 

Those who believe in honorable publicity in dentistry should remember 
that it is utterly useless to expect dental societies, as now organized, to 
recognize it, and there remains just one thing to do, and that is to organize 
dental societies in all the states that do recognize honorable pubUcity in 
dentistry, not only as professional, but ethical and reputable as well. 

Until this is done, any dentist who uses honorable pubUcity of any 
kind, will be looked upon by the profession as improfessional, unethical 
and disreputable, the same as they have been during the past 50 years. 

Dentists in Wisconsin last year organized and incorporated the 
Modem Ethical Dental Society of Wisconsin. They adopted the same 
code of ethics as that of the other society, except in regard to that pertain- 
ing to advertising; and instead have adopted the following as Sec. 2: 

**It shall be unprofessional for any dentist to circulate or advertise 
fraudulent or misleading statements as to the skiU of the operator, the 
quality of materials, drugs or medicines used or methods practised." 

You will see from this that this Society regards all other publicity as 
proper. 

A similar society has been organized in Michigan and Indiana and 
dentists in several other states are now considering such an organization. 
We would suggest to all those who believe in honorable pubUcity to find 
other dentists in their state who hold the same views, and then organize 
a Modem Ethical Dental Society in their state. They then wiU be in a 
position, unhampered by a tyrannical code, to conduct their dental busi- 
ness in accordance with the dictates of their own conscience. 

I wiU be glad to help in any way I can to encourage such organizations 
for it is our hope that the time is not far distant when there may be or- 
ganized a National Modem Ethical Dental Society. B. A. J. 



The weak worry so much about the future than they never get a 
foothold in the present. One cannot do efficient work if his mind is 
filled with fear pictures of what may happen a year or two years from 
now. A mind filled with mental images is asleep to present opportu- 
nities. — ^Wm. E. Towne, in The Healthy Home, 



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238 THE DENTAL DIGEST 

HOW TO MAKE A DENTIST HAPPY 

Feb. 26, 1916. 
Editor Dental Digest: — 

I am enclosing a short article which was placed in our local pap)er 
some time ago and you are welcome to use it if it is worth the 
space. It certainly has had a fine reaction here without getting 
any one peeved. I wish to congratulate you on the good stuflf we 
get in the Dental Digest. 

Yours truly, 

W. H. OnM. 

There are a nimiber of ways to make a dentist happy but the following 
procedure will always appeal to his humor and bring back to him, with 
vividness and rejoicing, that moment when he received the inspiration to 
study dentistry. 

As a prospective patient put off your dental work just as long as you 
can so that the teeth will be badly broken down and filthy. They will 
then be harder to fill or crown, more painful and in general less satisfac- 
tory. Next find out if he guarantees his work for twenty years or fifty 
years. A reputable physician doesn't do this but a dentist ought to. 
Be sure to insist on getting the best work, which takes most time and 
best material, for the lowest cost. You can't buy a $20 suit for $10 in a 
clothing store or a Cadillac for the price of a Ford, but of course in den- 
tistry it is different. 

Upon seating yourself in the dental chair, inform the dentist how 
nervous and fussy you are, how brave you used to be and that you don't 
mind anything but the drilling. As soon as you feel the slightest indica- 
tion of pain grab his hand and make him apologize. About this time 
get pale around the gills and pretend to faint; this will cause a delay and 
you can tell your friends how much time you have to spend in the dental 
office. Don't let hitn drill very thoroughly because this hurts and insures 
better work. Do not attempt to keep your second appointment, after the 
teeth have been temporarily treated and ache stopped. The dentist's 
time isn't worth much and he won't care, especially if he had to deny 
someone else the opportunity of coming because of your appointment. 

When the work is finished don't pay for it because he doesn't need 
money. He gets his gold and materials as premiums especially since the 
European war. Tell him you will pay when you can spare it. From 
then on do not go near the office for at least a year or two and avoid 
him as much as possible. After he has sent you several statements and 
threatens to employ an attorney, call or send someone to settle the ac- 



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THE BUSINESS SIDE OF DENTISTRY 239 

count. Be sure to tell him that the work was very unsatisfactory and 
has been aching day and night ever since it was completed and that you 
expected to have someone else do it over again. This will make the 
dentist regret that he was so rude in trying to get his money. If you 
make this part of the story strong enough he probably will cancel the debt 
entirely and pay you in addition for your inconvenience and humiliation. 

W. H. Ohm, D.D.S. 



THE BUSINESS SIDE OF DENTISTRY* 

By J. J. Simmons, D.D.S. , Dallas, Texas. 

The boomerang will come around and strike your own head in time. 
In this connection I would add, that he who is wise in his own conceit 
becomes a liar as sure as the night follows day. True wisdom is as modest 
as a virgin, as timid as a fawn, and as generous as the light of the sun. 
It knows no selfishness, and he who possesses it doesn't lie. 

Charity should be exercised in our labors. The Lord said the poor ye 
have with you always. Twenty-five per cent, of mankind works and 
takes care of the other 75 per cent., hence you should do your share. 

With reference to fees, I would say that, as a whole, the dentist earns 
what he gets, yet he alone is responsible for the .existing conditions if he 
does not receive enough for his services. 

A capital plan to raise prices is to spend spare time in self-improvement 
not only as regards the profession, but along all avenues of Ufe. Reading 
enables one to keep in touch with the happenings of the day and develops 
as well a pleasing personality, and one's personality is one of the greatest 
assets in securing and retaining a clientele to be desired. 

Regular exercise and vacations tbne up the system and strengthen 
one morally, mentally and physically. Correct habits enable the dentist 
to render better service to his patients and attract the better class. 

Breadth of thought toward your professional brethren makes the 
business of dentistry more genteel to us, to them, and beyond doubt it 
raises us in the estimation of the laity. 

CLOSING REMARKS (dR. SIMMONS) 

One of the things that seems to be rather uppermost in the minds of 

all of you is, '* How to get the money "? Now I don't have much thought 

of money. I have fixed a rule for myself, and if you will permit a little 

personal reference — I work while I work and play while I play. One of 

*Abstract from paper presented at January meeting of the Dallas County Dental Society. 



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240 THE DENTAL DIGEST 

the best tributes my mother ever paid me was when she said that she had 
never heard me discuss my business. Leave your business at your office; 
don't take it home and go to bed with it; it won't help at all. Leave your 
business at the office. 

When you go into a department store, did you ever notice how the 
young lady who waits on you always says, "Cash or charge"? Now 
have your business fixed so that you will be able to make money out of it. 
If you haven't the nerve to ask your customers for the money, you ought 
to hire somebody to do it for you. Now I have a little red-headed stenog- 
rapher in my office who has one fixed idea in her mind, and that is "get 
the money," and if you should walk into my office and ask to see me 
about professional services she would walk right up to you and say, "Do 
you want to make a deposit"? She never lets them get by, I don't care 
who it is. 

In our desire to accomplish things in this life brings to mind a little 
story which I remember and which may be worth something to you. 
There was once a dog named Jack who lived in a neighborhood where 
there were a lot of dogs just a Uttle bit bigger than he was and every time 
he got away from home these dogs would tear out after him and he would 
tear out home. He just couldn't stand the pressure; it was too much for 
him. His master decided to go away and started on his journey. So 
Jack thought he would like to go and started out following just behind, 
and every now and then some dogs would run out and almost eat him up 
and then leave him, and he would have to run and catch up with the wa- 
gon again. One day while they were on the journey and Jack was running 
alongside he dropped into a bear trap and before he knew he had hit the 
bottom. He looked all around and then he saw the bear.. He knew he 
was cornered and so he said to himself: "Now, Jack, you have been a little 
coward all of your life; you've never had any nerve; right here's where you 
will have to fight for your Ufe — you are going to mix up with this bear;" 
and so when he had said this to himself he felt better and he started in 
and for once in his life Jack made a fair fight and came out victor. He 
was so pleased with himself that he started in from that time on and he 
whipped every big dog he came across and he made up his mind that 
when he got back home he was going to whip that old crowd. He had 
found his place — he had become a victor by having adjusted himself 
after having found his place, and Jack died a beloved and brave dog. 

It is just as easy for every dentist in the city of Dallas to make a 
good business man, if we will just assert ourselves and use our talents, 
use good judgment. 

Get up every morning with one word in your mind, "Deposit," and if 
you will do that you will get the money. — The Texas Denial Journal, 



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THIS PATIENT FRANKLY LEAVES THE REWARD TO GOD 241 



THE DENTIST'S OFFICE HOURS 

The following table received from Fawcett & Fawcett, Brooklyn, 
shows that all of this agitation about the number of office hours, number 
of income hours, overhead expense, remuneration, average fees and that 
sort of thing, is entirely unnecessary. 

Do you see the catch? 

365 Days in the year — 24 hours each. 

122 Sleep 8 hours. 

243 

122 Pleasure 8 hours. 

121 
52 Sundays. 

69 

26 Saturdays J days. 

43 

14 Vacation. 

29 

13 Legal Holidays. 

16 

15 Lunch. 

I O Yom Kipur. 
Hence you do no work at all in the 365 days from actual accounting. 



THIS PATIENT FRANKLY LEAVES THE REWARD TO GOD* 

It isn't often that a patient speaks his mind right out in this way, but 
many of them practise the belief that God is the one to reward the den- 
tist. 

This letter was received by a prominent dentist in India. — Editor. 

Drs. Smith Bros. 
American Dentists 
Sir:— 

I have been suffering from tooth disease for a very long time, I will 

give below the present state of my teeth and humbly request you to 

•Courtesy of Dr. W. P. Heaney. 



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242 THE DENTAL DIGEST 

kindly give me free advise for which God will reward you. I have used 
all sorts of medicines but failed. Blood always comes out from the roots 
of my teeth. If the gums are pressed with finger ends a kind of matter 
pus comes the smell of which is bad, consequently very bad smell comes 
out always from my mouth, but do not feel any pain, of course they 
shake a little. My age is 30. The material like cement which is at- 
tached to the gums have all gone. My digestive power is very weak and 
irregular. I think the reason of it are that food which I eat are mixed 
with blood when chewing to get into the belly, thus causing indigestion. 
Also when laughing and feel a slight hurt into my face, blood comes out 
which smells bad. 

I beg you kindly send a prescription for which act of kindness I will 
ever remain ever gratefully yours. 

I remain yours 



Editor Dental Digest: — 

On page 815, December 191 5 Digest is an article taken from Deutsche 
Medizinische Wochenschrijt^ August 19, and called '* Fatal Case of Pyor- 
rhea Alveolaris." 

The history of that case, as it reads, is very near like one in my own 
practice in the winter of 191 3. Man about thirty-five years of age. 
The trouble looked like a very severe case of pyorrhea. I first extracted 
upper left ist bicuspid, then in about two weeks the second bicuspid. 
They would not heal up. Very foul breath. I soon found out it was 
something I had never met with before, so I took him to a M.D. He 
was as puzzled as I was, and the patient finally lost all the teeth on left 
side clear up to and including the right central. The gums would not 
yield to treatment, and continued to discharge. In the meantime, 
the patient had fever, lost over fifty pounds in weight, when all of a 
sudden (forty-eight hours), he developed very severe ulcers of throat. 
He came in to see the M. D. and he called me and when I went in he 

said: '*Dr. J. , I have found the trouble. This man has syphilis." 

(This was about three months after I first saw the patient.) He pro- 
ceeded to treat for same and was pleased to soon see improvement. The 
gums soon healed up and this winter I made the patient a partial denture, 
and he seems to be all right (to outward appearances) again. He claims 
never to have had any venereal disease. 

E. G. J. 



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AN ANSWER TO A QUERY 243 

THE EFFICIENCY OF THE "TRUBYTE TEETH" 

By George W. Weld, D.D.S., M.D., New York City 

I am prompted to relate the history of one case of a full upper and 
lower denture which would seem to emphasize the importance and ne- 
cessity in certain cases, at least, of making use of the **Trubyte" teeth in 
conjunction with the Gysi Adaptable Articulator. Mr. U. R. called upon 
me March 5th, 1915, for consultation. He informed me that during the 
past five years he had seven sets of teeth made by as many different den- 
tists and that he was almost discouraged of ever finding a dentist who 
could make him a set that he could wear with comfort and usefulness. 

On examination, I found one of the most difficult cases that had ever 
come under my observation. 

In company with my patient, I called upon Dr. James P. Ruyl for 
consultation and help. Proper measurements were taken and the appro- 
priate teeth selected. The teeth were articulated and ground up a la 
Gysi, and inserted in the mouth. 

I am now able to report that the gentleman was enthusiastic over the 
result saying "I am convinced as you told me, in the beginning, that 
the Trubyte Teeth and the Gysi articulators have proved indispensable 
in my case, for proper comfort, and efficient mastication purposes." 



AN ANSWER TO A QUERY 

What metal is best for castings, to be used under gold crowns, for 
the purpose of building up badly decayed roots to support crowns? 
Would there be danger in using coin silver, containing 10 per cent, copper, 
in case the crown failed and exposed the coin silver to the secretions of 
the mouth? 

In answer to above (page 115, February issue of Dental Digest) — 
would suggest using Westoria New Metal, in preference to coin silver or 
an alloy of silver as this will not corrode when exposed to saliva and also is 
much cheaper than silver. We very frequently cast practically a whole 
tooth out of it, and I have never seen a case where it corroded. — B. C. 
Taylor, North Wilkesboro, N. C. 



One of our correspondents handed us the following which we con- 
sider worth time for reflection: "Income is the result and measure of 
ideas and effort. '* It looks logical if you consider the business side of 
dentistry as a part of the aforesaid ideas. — Nebraska Dental Journal. 



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siGTicM. Urns 



[This department is in charge of Dr. 
V. C. Smedley, 604 California Bldg., 
Denver, Colo. To avoid unnecessary de- 
lay, Hints, Questions, and Answers should 
be sent direct to him.]* 

Securing Brightness in Aluminum-Rubber Plates.— The hydro- 
gen sulfid liberated in vulcanizing has a tendency to darken the aluminum 
in alimiiniun-rubber plates. To avoid this, the aluminum base-plate is 
covered with shellac or sandarac. — Zahnaenztliche Rundschau {The 
Dental Cosmos.) 

A Useful Application for Sore Lips While Operating . — A little 
collodion is very useful to apply to sore lips before beginning to operate. 
It takes out the soreness, protects the lips, and they heal rapidly after 
the application. It is also useful to wounds on the hands, reducing the 
danger of infection and washing will not remove it. — Pacific Dental 
Gazette, 

Repairing Punctures in Rubber Dam After Adjusting. — ^Take a 
piece of surgeon's adhesive plaster of the proper size, slightly warm it 
and cover the punctures. It will effectually seal the opening. — Pacific 
Dental Gazette. 

A Loose Pin Banded Crown Especially Adapted for Upper 
Lateral Incisors. — Prepare the root the same as for a Richmond, being 
certain that you have the enamel removed and not beveled. Fit band 
and trim to contour or outline of gum. Then remove band, place on end 
of block of soft wood and place crown in band and swage slightly. The 
crown should be a trifle larger than the band and ground to a very slight 
bevel before swaging; then place band on root again, after having ground 
crown to fit root, and swage again directly against the root. Then re- 
move and if you wish gold partition between crown and root, cut disk to 
fit about to the centre of the band vertically; again replace band and press 
disk up against root. Take impression, remove, invest and solder disk 
into band, using as little solder as possible. Then remove and drill hole 
large enough to receive pin, but not the collar; replace band on root, press 
pin in up to collar and with sharp pointed instrument outline collar, re- 
move and cut to outline. You are now ready to polish and cement. 

♦In order to make this department as live, entertaining, and helpful as possible, ques- 
tions and answers, as well as hints of a practical nature, are solicited. 



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PRACTICAL HINTS 245 

Having root dried, fill hole in crown with cement and place pin part way, 
then put some cement on both sides of centre disk in band; then fill hole 
in root and put on the crown and you have a crown as serviceable as any, 
and in case of repair, easily and quickly done. — B. A. Wright, D.D.S., 
Latrobe, Pa, The Dental Summary, 

To Repair Gold Crowns. — ^To repair crack or hole in gold crown, 
burnish over same piece 22 or 24 karat gold sufficiently large to cover 
space; flow upon same 14 or 18 karat gold solder, place it upon crack or 
hole with soldered portion in contact with latter, hold together with pliers, 
heat gently, and patch will adhere readily to crown. — J. A. Richards, 
D.D.S., BfoomeWs ''Practical Dentistry r 

A Gasolene Soldering Outfit. — Necessity is the mother of this 
little discovery, which may be of some benefit to other practitioners. If 
no gas supply is available for soldering, one has to depend on one of the 
various gasolene outfits for the laboratory. Anyone who has stood on 
one foot over a hot blowpipe on a hot summer day, pumping bellows with 
the other, can appreciate the relief this arrangement will -afford. 
A Red Devil water motor, costing $3; a Vernon rotary compressor, 
costing $7.50, and a Buffalo gasolene gas tank and blowpipe are secured. 
The pulley wheel is removed from the Vernon compressor, and a sleeve 
connection made connecting the axle of the compressor and the water 
motor, thereby obtaining a direct shaft drive. The compressor and the 
gasolene tank are then connected with tubing of the desired length. Then 
the water is turned on the motor, and with the correct quantity of gasolene 
at the proper temperature in the tank, soldering can be done with the 
same comfort as with a gas outfit. I am using this arrangement every 
day, and find it to work perfectly. — C. G. Baker, Act. Dent. Surg., U. S. 
Army, The Dental Cosmos. 

How TO Remove Broken Instruments. — For difficulties of removing 
the fragment of an instnunent from a root canal, — especially if it has 
become embedded in the apical third, — and the inadequacy of the gen- 
erally advised means for removal, I would recommend section of the root, 
guided by the aim of saving as much tooth structure as possible. My 
method of operation consists in turning over a flap of mucous membrane 
under local anesthesia, and making a windowlike opening in the alveolus 
with the aid of a fine, sharp chisel; the location of this opening to be de- 
termined by the x-ray picture. The root thus exposed is opened in its 
long axis with a fine rosehead bur, the embedded instrument is quickly 
exposed to view, and pushed out in the direction of the pulp chamber with 
stout, curved sounds. In order to avoid an oversight or swallowing of the 
broken instrument, a pellet of cotton has been previously introduced into 



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246 THE DENTAL DIGEST 

the pulp chamber in order to engage the fragment upon removal. The 
incision in the root is then fi^ed with tin, gold or amalgam, the limien of 
the canal being preserved by a sound previously introduced into the canal. 
If the canal has been opened up to the apical foramen, this sound is super- 
fluous, as an hermetic sealing of the canal is desirable. The field of opera- 
tion is carefully cleansed and sterilized, and the wound in the mucous 
membrane closed by a suture. This operation is, of course, most favor- 
ably indicated in single-rooted teeth. It has the advantage over resection 
of the root apex, as recommended by Williger (see Dental Cosmos, No- 
vember, 191 2, p. 1289), that the amount of injury inflicted upon the 
tooth is very small, a slit of i mm. breadth being sufficient, and that a 
very small portion only of alveolar bone need be removed, since the 
broken instrument is removed by way of the pulp chamber. — E. Schus- 
ter, Leipsig, Deutsche Monatssckrift fuer Zaknheilkunde. {American 
Denial Journal.) 

Hypodermic Syringes. — If your all-metal hypodermic syringe 
'* leaks back," take out the leather washer and replace with a strand or 
two of asbestos *'rope." This answers the purpose better than leather, 
and will stand boiling without materially affecting same. — J. Fred 
Gordon, Albury, N. S. W., Commonwealth Dental Review. 



QUESTIONS AND ANSWERS 

Question. — Will you or some of your readers tell me if the glass or 
formaldehyde sterilizer for dental instruments is efficient and thorough? 
I saw much advertising for different makes of that kind of sterilizer 
several years ago, but in the last year or so I haven't seen any, or any 
writing at all, about them. 

Also would like to know of a practical way of sterilizing handpieces. 
— H. E. S. 

Answer. — The formaldehyde sterilizer (preferably the glass one) is in 
quite general use, I understand, to keep instruments in weak solution 
after they have been sterilized by boiling. The solution strong enough 
for sterilization has quite a disagreeable odor. I know of one case where 
a dentist used it for sterilization for a year or two, dipping his hands into 
the liquid daily until his hands became sore and remained so for a number 
of weeks— formaldehyde poisoning he thought. 

I believe the most practical way to sterilize handpieces is to immerse 
them in 60 per cent, alcohol. Let them run in same for a minute between 
patients and then let them soak in it over night. Wipe off and oil before 
using, as alcohol kills the lubricant. — V. C. S. 



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PROPOSED STATEMENT OF AIMS 

n n n ml ahd objects- 

FEDERATION OF MEDICAL ECONOMIC LEAGUES 

This statement, taken from The Medical Economist's Official Organ 
of the Federation of Medical Economic Leagues, contains some sugges- 
tions of more than passing interest to dentists, and especially the refer- 
ence to administration of anaesthetics. The whole thing is worth your 
perusal as it shows a movement in medical circles which looks like ''busi- 
ness." — Editor. 

The Federation of Medical Economic Leagues has for its objects the 
protection and promotion of the economic and professional interests of all 
medical men, the increase of the usefulness of the medical body to the 
community, and the conservation of the public welfare. Holding that 
these objects are not opposed, but, on the contrary, are intimately con- 
nected with one another; that the public is best served when the economic 
and social status of the medical profession is conmiensurate with the im- 
portance of its communal duties; and that the important changes which 
have taken place and are still taking place in our social organization re- 
quire a careful readjustment of medical practice to accord with the needs 
of the times: — the Federation declares its aims to be the following: 

I. To organize the profession on a democratic basis, creating a 
medical body politic that shall include all legal practitioners of medicine; 
to the end that both its external and its internal adjustments may be 
developed as the true interests of the public and the profession require. 

n. To study the economics of medical practice in its modern develop- 
ments, and the means of adapting its present conditions to changing social 
requirements. 

III. To publicly represent the medical profession, and to inform the 
community of its legitimate needs and aspirations; we holding that want 
of general information is the occasion of much present maladjustment. 

IV. To promote and foster in our own ranks that spirit of justness 
and fairness in our mutual and civic relations that will render formal 
codes of ethics unnecessary. 

V. To secure for the practitioner proper recognition and just com- 
pensation for his work; and to equalize the burdens of communal charity, 
which the present system inequitably disposes to our disadvantage. 

♦Submitted by the special Conmiittee, Feb. i, 191 6. 



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248 THB DENTAL DIGEST 

VI. To oppose any curtailment of the necessary rights and privileges 
accorded to physicians who conform to legal requirements. 

VII. To cooperate whenever possible with dvic and private bodies 
whose endeavors bear relationship to the public health or to medical 
practice; to favor the enactment and enforcement of just and uniform 
medical laws; and to oppose medical legislation that is detrimental to the 
public interest, or improperly encroaches on medical practice. 

VIII. To« raise the standard of medical education of licensed practi- 
tioners as well as of undergraduates; to which end the opportunities for 
observation and study that are afforded by public institutions should be 
open to the profession at large, and not be monopolized by a few individ- 
uals. 

The more^immediate objects of the Federation of Medical Economic 
Leagues in New York are : 

1. To discourage and gradually to abolish the present system of volun- 
teer medical work in our public and private medical institutions, which is 
inefficient and unjust to the workers; and to substitute therefore a system 
which shall place the community work done by the medical profession on 
the same plane as that done by other members of the body politic. We 
hold that medical services in hospitals, dispensaries, and similar institu- 
tions should be paid for, as all other services are paid for. 

2. To uphold and support the health authorities in all their legitimate 
activities in sanitation and disease prophylaxis, but to oppose their en- 
trance into the field of disease treatment. The public charities depart- 
ment can and should take care of the indigent sick; and we regard the 
establishment of public clinics by the Health Department for the treat- 
ment of special diseases as an unnecessary expense which pauperizes the 
community and injures the medical profession. 

3. To oppose the indiscriminate administration of medical charity 
by public and semi-public institutions; to enforce the principle that, 
when supplied without honest investigation and on the same basis as any 
other poor relief, it is detrimental to the entire conununity; and to secure 
the enactment and enforcement of efficient regulations for this purpose 
in the place of the present ineffective law. 

4. To oppose all projected laws or amendments of laws that would 
permit individuals not possessed of the prerequisite educational require- 
ments, and not examined and licensed by the State as practitioners of 
medicine, to practice medicine in any form or under any subterfuge, or 
to assume any of the duties or responsibilities of physicians. 

5. To safeguard the rights and promote the equitable interests of 
medical men under the various enacted and projected schemes of State 



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ADVICE TO THOSE ABOUT TO WEAR ARTIFICIAL TEETH 249 

Industrial and State Health Insurance; and to prevent the individual 
exploitation of medical practitioners in them by corporate interests. 

6. To gradually extend to all licensed physicians, under proper safe- 
guards, the facilities for caring for their patients in, and the opportunities 
for study and improvement afforded by, the public medical institutions 
of the dty and state; we holding that a license by the state to practice 
medicine in the commimity at large necessarily connotes the ability to 
care for its individual members when they have become public charges. 



ADVICE TO THOSE ABOUT TO WEAR ARTIFICIAL TEETH 

By D. W. Barker, M. D. S., Brooklyn, N. Y. 

The advice here given has been a help to others and may be a help 
to you. You are now about to begin to learn to do something you have 
never done before — to use an artificial substitute for natural organs 
(teeth) and, however perfect they may be, they are not equal to the 
natural teeth, nor are they used in the same way. 

Do not expect to acquire facility in the use of these new things at once. 
That comes only by practice, patience and time. You cannot learn it in 
a few days, or a few weeks. You will learn it a little at a time, day by day, 
gradually acquiring conunand over them. In a month or two you should 
acquire a considerable degree of skiU. Above all, do not become dis- 
couraged and get the notion that your experience is in any way different 
from that of other beginners. All others who wear artificial teeth have 
to go through this process of self education. The dentist may do his 
part perfectly, but this is something that you have to do for yourself; 
no one can do it for you, and unless you do it your teeth will not be a 
success. You should not allow yourself to get into the habit of leaving 
the teeth out. To do so is to incur a distinct loss, for no one ever learned 
to use a set of teeth by wearing them in the pocket or the bureau drawer. 
You can learn to use them only by using them, just as a child learns to 
walk by walking, though imperfectly at first. 

There are two things that will take you longer to learn than anything 
eke, namely, talking and eating. I will consider them separately. In 
speaking there are certain sounds that are apt to be more difficult than 
others; s, x, ch and sh are the worst. A good way to overcome this diffi- 
culty is to practise reading aloud. Do it alone so there will be none to 
attract your attention. Read slowly and make it a point to enunciate 
each syllable distinctly. When you meet with a word that bothers you, 
stop and say it over and over until you can say it distinctly. Remember 



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250 THE DENTAL DIGEST 

you are training the muscles to obey the will very much as a child does 
in learning to talk. The more this simple and easy exercise is practised 
the quicker you will be able to speak distinctly. Following this plan 
most of the difficulties of speech will disappear in a few days. 

Learning to eat with them will take you somewhat longer, but the 
principle is the same. Don't expect to eat your first meal with your new 
teeth just as you did with your natural teeth, nor just as someone else 
does who has worn artificial teeth for many years, for you won't do it; no 
one ever does it. I used to know a dentist who would tell his patients 
not to yield to the temptation to take out their teeth at their first meal 
and they would not want to take them out the second time. This I 
consider bad advice, because the patient is apt to become discouraged at 
his failures, and get the idea that there is something wrong with the teeth 
or himself. If you become discouraged and lose confidence in your 
ability, the teeth will not be the success that they should be. Therefore, 
I would not advise a beginner to try to do too much at first. If you only 
eat part of the first meal with them you are doing very well. Gradually 
increase the length of time at each meal, eating slowly, and in a few days 
with increased confidence and control, which comes by practice, the whole 
meal can be essayed. Even then you will find you are learning something 
more every day and as the days pass an increased efficiency is acquired. 
If you attempt to bite upon a hard substance, like an apple or an ear 
of com, you will probably trip them, for this is a severe strain upon the 
suction. It may be accomplished, however, by pressing the apple firmly 
upward against the teeth at the moment of biting upon it. This may be 
tested with the finger, and it will be found quite impossible to trip them. 

Some people acquire a habit (after their teeth have been extracted) 
of holding a handkerchief over the mouth when in the act of laughing. 
If you have such a habit you should break yourself of it at once, for the 
action directs the attention of the observer to the mouth; if you do not 
make the motion no one will think of looking there. 

"Shall I keep them in at night?'' is a question often asked by a be- 
ginner. To this I answer, ** Xo, not right away, because they would keep 
you awake. But after you have become accustomed to them you may 
try it if you think you would be more comfortable. It is just as you 
find it most comfortable. " 

If you find that your plate makes a sore spot, usually somewhere 
along the edge, this is not an indication that the plate does not fit prop- 
erly, but merely that there is a little too much pressure at that particular 
spot which should be relieved by filing off a little. Almost all new plates 
have to be relieved in this way. Return to the dentist while the place 
is sore (not after it has gotten well) and he will know how much to file it off. 



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AN EPITOMB OF CURRENT DSNTAL AND MEDICAL LITERATURE 251 

Your artificial teeth should be kept dean. To do this they should 
be carefully and thoroughly scrubbed with a stiff brush several times a 
day (after each meal if practicable). A tooth brush is not a good brush 
for this purpose. A small hand scrub brush is much better. 

In conclusion, I wish to urge you to give no heed to the teasing or 
joking comments of your friends. In most cases it has no serious mean- 
ing, but may arouse dissatisfaction in your mind where no cause for dis- 
satisfaction really exists. — The Dental Summary. 



AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 

[The Denial Cosmos, March, 191 6] 
Original Communications 

War Dental Surgery: Some Cases of Maxillo-facial Injuries Treated in the Dental Section 

of the American Ambulance at Neuilly (Paris), France. By Dr. 'Geo. B. Hayes. 
•The Innervation of Dentin. By J. Howard Mummery, D.Sc., M.R.C.S., L.D.S. 
The Porcelain Inlay in Europe. By N. S. Jenkins, D.D.S. 

The Evolution of the Human Face and Its Relation to Head Form. By Dr. E. A. Hooton. 
The Design and Retention of Partial Dentures. (I). By Douglas Gabell, M.R.C.S., L.R.C.P. 

L.D.S. 
Sanitary Dental Cuspidors on Board Ships. By J. D. Halleck, B.S., D.D.S. 
The Importance of Biology as Applied to Dentistry. (II). By Dr. Ch. F. L. Nord. 
Precautions to be Observed in the Care of Mouth Infections with Regard to the Preservation 

of Health. By W. Stirling Hewitt, D.D.S. 
Methods of Teaching Orthodontics to Dental Students. By S. H. Guilford, A.M., D.D.S., 

Ph.D. 
Public Dental Services. By Walter Harrison, L.D.S., D.M.D. 
The Germicidal Efficiency of Dental Cements. By Paul Poetschke. 
Prophylactic Treatment at Different Ages. By Prof. Albin Lenhardtson. 

THE INNERVATION OF DENTIN 

By J. Howard Mummery, D.S.C, M.R.C.S., L.D.S. 

POINTS DEMONSTRATED BY THE WRITER'S PREPARATIONS 

(i) That, at all events in actively growing teeth, there is a considera- 
ble supply of non-meduUated or efferent fibers to the tooth pulp, which 
are derived from sympathetic ganglia and not concerned in any way with 
the sensitiveness of the dentin, their ultimate fibrils probably being dis- 
tributed to the coats of the bloodvessels and the secreting cells of the 
pulp; whether any fibers of this system enter the dentinal tubes it seems 
impossible to determine. 

(2) That at the comua of the tooth pulp, the bundles of medullated 
nerve fibers lose their medullary sheath and neurolemma, and the axis 



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252 THB DBIITAL DIGEST 

cylinder expands into a spreading mass of neurofibrils, which can be 
traced directly to the dentinal tubes, which they enter. 

(3) That in young, growing teeth, these fibers at the comua are very 
abundant, and have a wavy course; they appear to consist of bundles of 
neurofibrils in many instances, and these vary much in diameter, the 
further divisions of these bxmdles probably taking place in the tubes of 
the dentin. 

(4) That at the lateral portions of the pulp, the neurofibrils passing 
from the main nerve trunks enter into an intricate plexus beneath the 
odontoblasts, and are again collected into larger strands of neurofibrils, 
which mostly pass directly into the dentinal tubes. They also demon- 
strate the different appearances of these strands of fibrils, some being 
large and showing bead-like enlargements at intervals, other finer fibers 
having a minutely dotted appearance. 

(5) That where the pulp is separated from the dentin, the nerve fibers 
seem to be pulled out from the pulp and from the dentinal tubes, and 
stretch across the interval, evidently under considerable tension. 

(6) That .the nerve fibers enter the dentinal tubes in company with 
the dentinal fibril. 

THE IMPORTANCE OF BIOLOGY AS APPLIED TO DENTISTRY 
By Dr. Ch. F. L. Nord, Gorincheh, Holland 

CONCLUSIONS 
In closing, I wish to draw the following conclusions: 
(i) The decline of the teeth must especially be ascribed to panmixia, 

and cannot be considered as a symptom of degeneration according to the 

present stage of biological science. 

(2) The connection between anomalies of the teeth and other deformi- 
ties (hair and eye diseases, deft plate, etc.) is probably caused by the 
inferior quality of a certain hereditary variant, which is the cause of all 
these anomalies. 

(3) Anomalies of the teeth, so far as they are not brought about by 
apparent external causes, must be considered as hereditary, and it is there- 
fore of great importance to make a careful researjch into the facial relations 
of the family of the patient before beginning treatment. 

(4) Whereas dental anomalies of all possible grades may be inherited, 
and whereas it is very probable that there is a correlation disturbance in 
the relationship of the upper to the lower jaw which may involve aU di- 
mensions, we must, in the treatment of those anomalies, resort to extrac- 
tion, and we must also consider as biologically incorrect the standpoint 
of Angle's school, viz., that in the restoration of normal occlusion and 
normal facial relation's, extraction is at all times unnecessary. 



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AN EPITOMB OF CURRENT DENTAL AND MEDICAL LITERATURE 253 

PUBLIC DENTAL SERVICE 
By Walter Harrison, L.D.S., Eng., D.M.D. Harv., Brighton, Eng. 

The movement of public dental service must be national, in the sense 
that those who are eligible for treatment, even in remote villages, should 
be able to avail themselves of the privileges. 

The fundamental principles in a public dental service should be: 

1. The service should be entirely controlled by the profession. 

2. Every reputable registered dentist in the district should have the 
option of joining the staff. 

3. The profession (by means of a committee) should decide who are 
suitable persons to receive the benefit. • 

4. The fees should be fixed by the local practitioners. 

THE FIRST ''public DENTAL SERVICE." 

The "Brighton and District Public Dental Service" is formed to 
check "the admitted evils of excessive medical charity and misuse of 
hospitals," and enable certain sections of the community, who are unable 
to pay the ordinary fees, to obtain dental attention by registered dentists, 
at modified fees, and by a system of payment by instalments, through 
the means of an organization under the control of the local members of 
the profession. 

[The Dental Review, March, 1916] 

Original Communications 

What IS the Matter with Dentistry in St. Louis? By Clarence O. Simpson. 

President's Address. By E. A. Boyce. 

Some Recent Tendencies in Practice. By Arthur G. Smith. 

Three Years and Some More. By Franklin B. Clemmer. 

Chemical Treatment for Pyorrhea Alveolaris-Necrotic Tissue. By J. S. Bridges. 

Proceedings of Societies 

Chicago Dental Society. 

St. Louis Dental Society, October 12, 191 5. 

Editorial 
Dental Service in the Public Schools of Chicago. 

[The Dental Summary, March, 1916I 
Regular Contributions 

The Place of the Silicates in Dentistry. By Charles C. Voelker. 

A One Tooth Bridge. By D. D. Smith. 

Root Resection and Apical Canal Filling After Resection. By Carl D. Lucas. 

A New Retainer for Pyorrhetic Tooth. By Alden J. Bush. 

Some Problems in Mounting Artificial Dentures. By George H. Wilson. 

The Anatomy of the Oral Cavity in its Relation to Local Anesthesia. By Hugh W. Mac- 

MiUan. 
President's Address. By Edward C. Mills. 



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254 THB DENTAL DIGEST 

*Soine of the Cases Dental Surgeons Treat in the European War. By A. M. Fauntkroy. 

Historical Sketches and a Few Items m Practice. By J. G. Templeton. 
♦The Oral Prophylaxis Treatment vs. "Cleaning Teeth." By Gillette Hayden. 

A Sand Sterilizer. By C. S. Starkweather. 

SOME OF THE CASES DENTAL SURGEONS TREAT IN THE EUROPEAN WAR* 
By Surgeon A. M. Fauntleroy, U. S. N., WashiKgton, D. C. 

"One of the most striking features of the value; of a dentist in the or- 
ganization of a military hospital is shown in the results obtained by sur- 
gical cooperation with the dentists at the American ambulance in con- 
nection with the mutilating wounds of the face (Illustrated). These 
wounded always show compound fractures of the upper or lower jaw, 
with a variable amount of loss of substance. They represent a class of 
cases which extends over a period of months before a final operation is 
performed which completes the result. A wound of this character is 
considerably hampered at first with reference to the healing process on 
account of the secretions from the mouth and the necessary feeding of 
the patient. At the first operation these ragged and mutilating wounds 
are treated by the careful trinmiing away with scissors of the sloughing 
areas. In this procedure the vermilion border of the lip is preserved as 
much as possible, and then the tissues are loosely brought together with 
sutures and protected by a loose dressing, which has to be changed sev- 
eral times a day. 

The preliminary steps of the operation consist of shaving the face and 
neck, scrubbing with green soap and water, followed by 70 per cent, 
alcohol. As the mouth secretions are profuse and the bleeding rather 
free, it will be necessary to provide means for the prompt removal of this 
mixed fluid from the pharynx during the operation in oi*der not only to 
prevent strangulation but also the inhalation of septic material which 
may cause pneumonia. This is best accomplished by a simple water- 
suction apparatus secured to a faucet in the operating room and having a 
long tube attached which ends in a good sized catheter. This latter is 
held in the pharynx by an assistant during the operation, and the fluid is 
thus removed as it accumulates. 

The most that is hoped for from the first operation is that the soft 
parts will unite in such a way as to admit of correcting any serious de- 
formity later on by means of a final plastic operation. There are usually 
three stages in the general operative procedure. The first stage consists of 

*To give our readers something of an idea of some of the face and jaw wounds that the 
army dental surgeon, in the European war, has to treat, we copy this description from the 
' * Report on the Medico-Military aspects of the European War," by Surgeon A. M. Fauntleroy, 
U. S. N., which has just been published. — Editor. 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 255 

bringing the soft parts loosely together, as indicated above. Usually 
there is so much loss of bony substance that no effort can be made at this 
time to unite the fractured ends of the bone. 

After the soft parts have united, the second or dental stage is begun. 
A metal bridge is anchored, by the dentist, on whatever teeth remain at 
the ends of the fragments. This bridge may be temporary at first for the 
purpose of simply holding the loose fragments in a steady position in the 
mouth. Gradually a scar will form over the ends of these fragments and 
the continuity of the mucous membrane of the mouth is slowly restored 
over the scar thus formed. The condition of the parts at this time is 
fairly satisfactory although there may be considerable puckering as a 
result of the partial or complete healing of, the original wound. Once 
the mucous membrane has grown over the scar between the bone frag- 
ments the third stage of the operation may be attempted. This consists, 
first, of a plastic procedure, which is directed toward as complete a res- 
toration of the face as is compatible with the destructive effects of the 
original wound and the available skin in the immediate neighborhood of 
the scars. The second step consists in the removal of a portion of a rib, 
or of the tibia, which is then transplanted to complete the bony continuity 
of the jaw beneath the bridge. 

In proceeding with the plastic op)eration on the skin, it may be neces- 
sary to partially remove the scar so as to bring about a better readjustment 
of the tissues. Injury to the newly formed mucous membrane must be 
carefully avoided, but if it is necessary to incise it, or if accidentally 
wounded, it must be carefully sutured. Having outlined the plastic 
work by the formation of suitable skin flaps, the ends of the bony frag- 
ments are carefully dissected free from the scar tissue so that no injury 
results to the underlying mucous membrane. The ends of these frag- 
ments are now freshened by either beveling or grooving. An accurate 
estimate is then made of the bone required to bridge the gap and a suit- 
able piece of rib with periosteum may be resected, or a portion of the tibia 
with its periosteum may be removed, according to the preference of the 
operator. 

There are several ways of securing the transplanted bone in place. 
It may be beveled and fitted into corresponding grooves at the ends of the 
fragments; it may be drilled and sutured in position with chromic gut; or, 
if the conditions are favorable, some form of bony inset may be attempted 
along the lines of a mortise and tenon joint. Having fixed the bone in 
place, the skin flaps are sutured and boric acid dusted over the suture 
lines. The after-treatment consists of careful liquid feeding and frequent 
mouth washing. 



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256 THE DENTAL DIGEST 

THE ORAL PROPHYLAXIS TREATMENT VS. "CLEANING TEETH" 
By Gillette Hayden, D.D.S., Columbus, Ohio 

The advantages of the oral prophylaxis treatment over the usual 
process of cleaning teeth are: 

First: The treatment given is definitely aimed at the elimination from 
the mouth of all d6bris. 

Second: The tooth surfaces are rendered smooth so that d6bris will 
not adhere so readily to them, and the patient therefore can more accur- 
ately care for the mouth and teeth. 

Third: The patient is stimulated to give better attention to the 
mouth and teeth because of the frequent treatment at the hands of the 
dentist. 

Fourth: If any cavity development occurs, or any dental operation 
becomes faulty, or any adverse condition of the mouth develops, the den- 
tist has an opportunity to discover such a condition in its early stages. 

Fifth: The teeth and their investing tissues are maintained in such a 
state of health that their resistance to disease will be normally high. 
Thus to a great degree decay of the teeth and loss of their investing tissues 
through disease are prevented, as are also those systemic diseases which 
result from mouth infection. 

[The Dental Outlook, March, 1916] 
Original Communications 

The Present Status of Oral Sepsis, Its Relation to Systemic Disease — J. Grossman, M.D. 

Discussion of Dr. Grossman's Paper. By M. Grossman, M.D. 

A Small Inlay Becomes a Large Outlay. By L. Eliasberg, D.D.S. 

On the Admission of Dentists to Our Societies — A Reply to "Quality and Quantity." 

M. H. Feldman, D.D.S. 
Concerning the Teeth. 

[The Dental Register] 
Contents 

Event and Comment. 

The Shortage of Platinum. 

Efficiency in Tooth Brushing. 

Fixed Laws Governing Dental Amalgams. 

Diagnostic Methods for Anesthesia. 

The Dentist and the Orthodontist. 

Some Refraction 

Some Refractories Used in Dentistry. 

Succinimid of Mercury. 

Indents. 

[The Texas Dental Journal, February, 19 16] 
Original Communications 
The Business Side of Dentistry. 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 257 
With Our Contemporaries 

Malplaced and Impacted Third Molars. 

Pulpless Teeth. 

Hilitary Surgery. 

Cavity Preparation. 

Dr. Edward Livingston Trudeau. 

The Educational Value of Oral Hygiene in the Army. 

Advice to Those About to Wear Artificial Teeth. 

[The IfUernatianal Journal of Orthodontia, February, 1916] 

Original Articles 

Students as Orthodontists. By Adelbert Femald) D.M.D., Boston, Mass. 
Jurisprudence. By Elmer D. Brothers, B.S., L.L.B., Chicago, Ills. 
♦A Plea for Conservation of the Cementum. By F. Hecker, B.S., D.D.S., A.M., M.D. 
History of Orthodontia (Continued). By Bemhard W. Weinberger, D.D.S., New York City. 
Case History. By H. C. Pollock, D.D.S., St. Louis, Mo. 

A PLEA FOR CONSERVATION OF THE CEMENTUM 
By F. Hecker, B.S., D.D.S., A.M., M.D. 
Director of Research Laboratory of the Dewey School of Orthodontia, Kansas City, Mo, 

The object of this paper is a plea for less heroic instrumentation and 
greater conservation of the cementum on the roots of teeth affected by 
pyorrhea alveolaris. Wlien a failure of union between the peridental 
membrane and the root of the tooth occurs after heroic instrumentation 
has been instituted, it is not because the peridental membrane has been 
removed in its entirety for, on scaling the roots of the teeth, only the 
ends of the fibers attached to the cementum have been cut and partially 
removed, while the fibers of the alveolar surface are often intact. The 
failure of union results because the operator, in his heroic scaling, has 
removed the basal layer of the cementum, and the dentin of the root of 
the tooth is exposed. Even if a few islands of the cementum are left on 
the root of the tooth, the area of destruction of the cementum is propor- 
tionately so great that the remaining cementoblasts (or lacunae) are un- 
able to regenerate the cementum tp such an extent as to replace the 
destroyed cementum. 

The popular teaching at the present is that the peridental membrane 
carries in its substance the cementoblasts and that the development of the 
cementum is dependent on the peridental membrane. This teaching the 
author believes is not correct, for the reason that the peridental mem- 
brane histologically is an exact counterpart of the periosteum. One 
needs to do nothing more than examine a slide made from a section which 
shows the root of the tooth in situ in the alveolus to be convinced that 
such is the case. And further, the author believes it is impossible fqr one 
to place the pointer of the eye-piece at a definite point, and state that the 
tissue at one point is peridental membrane, while that at an adjoining 



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258 THB DBNTAL DIGBST 

point it is periosteum, for histologically there is no evidence on which one 
can make an actual diflferentiation. In lieu of the work done by Mac- 
Ewen of Scotland, in which he shows, by experimental evidence, that 
the periosteum does not carry osteoblasts in its substance, and further 
that the function of the periosteum relative to the formation of new bone 
is that of a limiting membrane; the author, in his examination of a large 
number of slides of sections which he has made of the root of the tooth in 
the alveolus taken from the human mouth in the morgue, has not, up to 
the present, observed any free cells in the substance of the peridental 
membrane in the vicinity of the cementum, which morphologically re- 
sembles the cementoblasts described by Black and Noyes. The periden- 
tal membrane, the author believes, is a limiting membrane for the cemen- 
tum and the alveolus. Vitally, the fibers of the peridental membrane 
have a direct affinity for the cementum and if the cementum is absent the 
fibers do not find a surface which is adapted to their need, and no union 
occurs. 

[Dominion Denial Journal, February, 1916] 

Original Communicalions 

Anocain. By E. W. Paul, D.D.S., L.D.S., Toronto. 

The Advantages and Risks of Combined Local and General Anaesthesia. By W. H. B. 

Aikins, M.D., Toronto. 
The Combined Use of Local and General Anaesthetics and the use of Adrenalin. By Dr. 

D. J. Gibb Wishart, Toronto. 
Mr. Barker's Method of Spinal Anaesthesia. By C. H. Hair. 
Gas and Oxygen Analgesia. By Dr. H. R. Holme, Toronto. 
Ether. By Dr. J. F. L. Killoran, Toronto. 

*The Methods of Resuscitation in Anaesthesia. By Dr. T. R. Hanley, Toronto. 
Anaesthetics. By E. W. Paul, D.D.S., L.D.S., Toronto. 
It Pays to Care for the Soldiers' Teeth. By Lieut.-Col. Hendrie. 

THE METHODS OF RESUSCITATION IN ANAESTHESIA 
Dr. T. R. Hanley, Toronto 

The methods of resuscitation have been interpreted by me to mean 
the treatment of the dangers which arise during anaesthesia as well as the 
actual treatment of suspended animation. 

I intend to bring to your notice some of the commoner dangers arising 
during anaesthesia and follow them up by suggestions which have proven 
in my experience to be most beneficial. 

Broadly speaking, then, the dangers met with in anaesthesia may be 
divided into two groups: 

(i) Respiratory failure. 

(2) Cardiac failure. 
The Causes of Respiratory Failure — 

I. Blocking of the air passages by foreign materials, such as blood, 
vomitus, mucus, etc. 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 259 

Treatment — must be preventive — 

(a) Always ask the patient before beginning your anaesthetic about 
the presence of artificial teeth. 

During the introduction try and prevent vomiting. If the patient 
does vomit, turn his head to one side and tile the shoulder; if necessary. 
lower the head of the table. 

(b) Mucus. — If it is anticipated for any reason, such as bronchitis, 
tuberculosis, give atropine gr. i / loo half an hour before operation. If 
the patient does develop mucus and the accompanying cyanosis tends to 
become alarming, give the patient more air or oxygen, and use more 
anaesthetic proportionately. If the patient stops breathing use Shafer's 
method of resuscitation. 

(c) Blood, — Try to get it to drain out by placing the head well over 
to the side. Put a piece of gauze in the corner of the mouth. In mouth 
operations use Johnston's apparatus and pack the throat. In nose 
operations, such as radical antrum, place a plug in the posterior naso- 
pharynx. 

(d) Anatomical Ahnormalities. — Spurs, adenoids, goitre, etc. 

(e) Spasm of the muscles at the base of the tongue. Spasms of the 
aryteno-epiglottidean folds in the larynx and general spasm of the respira- 
tory muscles. 

See that the head is in the best possible position for free breathing. Let 
them assume the natural position in which they sleep. Some patients are 
roimd shouldered and breathe better with a pillow under the head. In 
some cases it is well to place the nasal tube in position reaching as far as 
the upper border of the epiglottis. Sometimes, holding the jaw forward 
from behind the angle so that the tongue muscles are on the stretch, tends 
to raise the base of the tongue from the posterior pharyngeal wall — and 
will suffice. As a last resort, use the mouth gag and pull the tongue for- 
ward with a pair of forceps. 

If spasm of the muscles of the lamyx is due to a flake of mucus, which 
is sometimes the, case, let the patient have a few breaths of air and do not 
push the anaesthetic. If due to irritation from strong vapor, give more 
air or oxygen. 

(f) Position of the Patient, — ^Absolutely prone as in laminectomy, 
trephining, cerebellar tumor, kidney operations, etc. ; the obvious treat- 
ment is to inunediately change the position. 

(g) Toxic action of the anasthetic, 

1. Early. — Relative overdose. 

2. Late. — Overdose causing a paralysis of the centre in the medulla. 
In either case, act quickly — open the jaws, pull the tongue forward, 

sweep the fingers around the. posterior pharynx and see that no foreign 



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260 THE DENTAL DIGEST 

matter is blocking the air passages. Try artificial respiration, and if air 
is entering the lungs no further anxiety may be felt on that point. If air 
does not enter, push the tongue forward from the base by placing the 
forefinger in the mouth and again try your artificial respiration. If that 
doesn't help matters, tracheotomy should be performed and artificial 
respiration carried on for at least one hour, providing the patient has not 
revived in the meantime. 

At the same time as you are using Sylvester's method have an assistant 
use rhythmical tongue traction (Laborde). 

(h) Where shock is anticipated, or the general condition of the pa- 
tient is below par, it is well to start interstitial salines at the beginning of 
the operation, and not wait until the patient is in extremis. 

(i) In sudden severe haemorrhage, stop your anaesthetic, give your 
salines by the Aeedle into the vein, and lower the head of the table. 

(j) Exophthalmic operations, mastoids empyema, erect posture for 
nose and throat operations, use very light anaesthesia. Do not abolish 
the reflexes completely. 
Cardiac failure may be due to: 

1. Extrinsic causes other than overdose. 

2. Toxic action of the anaesthetic. 
Extrinsic causes, 

(a) Fright — at the very beginning of the anaesthetic — a very common 
cause, you will remember, in pre-anaesthetic days; use morphia gr. J- J 
before the operation. Try always to win the confidence of your patient. 

(b) Feeble condition of the patient from exhausting diseases, consti- 
tutional dyscrasia, etc. Proper choice of anaesthetic, care in the adminis- 
tration and proper preparation beforehand will obviate these to some 
extent. 

(c) Shock from operation, such as a re-section of bowels, cutting the 
spermatic cord, rectal operations, etc. Reflex of threatened vomiting, 
especially with chloroform, and position of the patient must all be thought 
of and properly met. 

Toxic action of ancesthetic. 

1. Syncope in the early stages, more especially with chloroform, 
owing to relative overdose or cardiac inhibition caused by strong vapor 
irritating the laryngeal branches of the vagus nerve. 

2. Later syncope from overdose, causing paralysis of the centre in 
the medulla or of the cardiac muscle and its intrinsic ganglia. 

Treatment: Lower the head (invert children), open the mouth, draw 
out the tongue, and while you do Sylvester's method of artificial respira- 
tion have an assistant do rhythmical tongue traction of Laborde. 

Have the nurse give whatever stimulants you may think necessary. I 



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AN EPITOME OF^CURRENT DENTAL AND MEDICAL LITERATURE 261 

prefer camphor grs. lo, pituitary extract i cc, or strychnia gr. ^ in the 
order named. 

If the abdomen is open, have the surgeon gently massage the heart. 

Electrical stimulus to the side of the neck is recommended in the hope 
of influencing the phrenic nerve, but the result is doubtful, considering, as 
we must, the close proximity of the vagus. 

The pulmotor, lauded so greatly a few years ago, has, I think, been 
relegated to the museum, but a new instrument has been devised which 
promises good results and will bear a thorough trial. 

Injection of strychnia directly into the heart muscle may be done as a 
last resort, but I don't see that it has much to commend it. 

[Oral Health J February, 19 16] 

Contents 

Photograph, Dr. Thomas L. Gihner, Chicago, 111. 
*Chronic Oral Infections and Their Relation to Diseases in Other Parts. By Thos. L. 

Gihner, M.D., D.D.S., Sc.D., Chicago. 
Resume of Discussion of Dr. Gilmer's Paper. 

Local Anesthesia With Use of Anocain. By B. R. Gardiner, D.D.S., Toronto. 
Impressions of the Twenty- third Annual Meeting of American Institute of Dental Teachers. 

By Thomas Cowling, D.D.S., Toronto. 
Address Delivered to Toronto Dentists by Major Clayton, Acting Chief Dental Surgeon, 

Canadian Army Dental Corps. 
Great Need for Reading Matter at the Front. 

Splint for Fractured Mandible. By William Heqidon Pearson, D.D.S., Norfolk. Va. 
Chicago Dental Society's Fifty-second Meeting. By W. B. Amy, D J).S., Toronto. 

CHRONIC ORAL INFECTIONS AND THEIR RELATION TO 

DISEASES IN OTHER PARTS 

By Thomas L. Gilmer, M.D., D.D.S., Sc.D. 

The preliminary report made by Dr. A. M. Moody, bacteriologist, St. 
Luke's Hospital. This study is for the purpose of determining, so far as 
possible, the effect on animals injected with strains of freshly isolated 
streptococci from chronic alveolar abscesses. In this work strains of 
streptococcus viridans, isolated from alveolar abscesses in fifteen patients 
suffering from various pathological conditions, have been injected into a 
total of forty-seven rabbits. 

The streptococcus viridans in every instance is the predominating 
organism, and that in only one instance was the staphylococcus found, 
and then just an occasional colony was present. 

Of the fifteen patients with chronic alveolar abscesses six had also 
pyorrhea; eight had rheumatism, one each acute gastric ulcer, neuritis, 
myocarditis, mitral endocarditis, and nephritis. Rosenow's technique, 
in a large measure, has been followed in these studies. The exceptions 
are two, i. e. (i) The doses of streptococci have, in all instances, been less 
than two billion, and in most cases between one-half and one billion. 



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262 THX DSNTAL DI0B8T 

These are approximate numbers. (2) The animals have been allowed to 
live a longer time after injection. 

The gross pathological lesions present in the forty-seven rabbits are 
given below. The microscopical examinations of these have not as yet 
been completed, but in so far as these observations have progressed, the 
gross diagnoses have been confirmed. Following is the table of Rosenow 
in the animals autopsied: 

Appendicitis was present in 2% 

Hemorrhage of stomach 40% 

Ulcer of stomach 13% 

Ulcer of duodenum 2% 

Hemorrhage or pus in gall bladder 13% 

Hemorrhage in pancreas 15% 

Hemorrhage into peritoneum 5% 

Arthritis and periostitis 40% 

Endocarditis .....* 28% 

Pericarditis 5% 

Myocarditis 5% 

Nephritis 30% 

Hemorrhages or other lesions of the lungs 10% 

Hemorrhages into the skin 2% 

Tongue 0% 

Eye 4% 

Hemorrhages into jaw 20% 

The hemorrhages into the jaw have not been previously described, 
except in a paper on experimental scurvy by Jackson and Moody before 
the American Association of Pathologists and Bacteriologists in St. Louis, 
April, 1915. These hemorrhages occur beneath the periosteum of the 
lower jaw before the central incisors. Occasionally they occur on only 
one side, but may be present on both. 

This series is too small to draw any definite conclusions. They, 
however, indicate a certain amount of selective localization for the strep- 
tococcus viridans isolated from chronic alveolar abscesses. To be more 
specific, these organisms produced gross evidences of muscle involvement 
in 60 pfer cent., joint and bone, aside from the jaw, in 40 per cent.; stom- 
ach in 40 per cent., kidney in 30 per cent., and jaw in 20 per cent.* 

We occasionally find what I have termed atypical alveolar abscesses, 
the lateral abscess of black on the sides of the roots of teeth having live 
pulps. 

Black believed that these abscesses were due to acute pyorrhea alveo- 
laris attacks, the infection extending from the gingival border root-wise 
through a narrow channel on the side of the root. 

Since Moody and I have found in 20 per cent, of our cases sub-perios- 
teal hemorrhages in the jaws, I am inclined to believe that similar hemor- 

*The above experimental work was done in St. Luke's Hospital Laboratory. 



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AN BPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 2<»3 

rhages may be found in the peridental membrane. If hemorrhages are 
caused by the streptococcus in the periosteum, may it not cause a like 
condition in the peridental membrane as well? 

Since the area involved in hemorrhage may later become abscessed, 
then if the peridental membrane participates in like hemorrhages we have 
a seeming scientific solution of the atypical alveolar abscess. As yet we 
have not examined the peridental membrane for hemorrhages, but intend 
to look for them in this organ. 

[New York Medical Journal, February 12, 19 16] 

EMETINE IN HEMOPTYSIS IN CHEST WOUNDS 

J. Dupont and J. Troisier, in Btdletins el mlmoires de la Socitti midicale 
des hSpiiaux de Paris, November 27, 1914, report three cases of pene- 
trating rifle bullet wounds of the thorax with hemoptysis, in which eme- 
tine was used with results apparently as satisfactory as those already re- 
ported by several observers of the hemoptysis of pulmonary tuberculosis. 
In the first case, with a wound at the base of the left lung, arterial blood 
was being abundantly expectorated upon admission, and the man was 
dyspnoeic and oppressed, and presented signs of a slight hemothorax. 
The condition persisting throughout the night in spite of the dressing 
applied, a subcutaneous injection of two thirds of a grain (0.04 gram) of 
emetine hydrocholoride was given. In the afternoon the bloody expec- 
toration showed marked reduction, and in the succeeding night ceased 
almost completely. A week later, the patient was discharged in excellent 
condition. In a second similar case, a single injection of emetine was 
also followed in a few hours by cessation of bloody expectoration. In the 
third case, that of a man wounded a week before, bloody expectoration 
had been continuous, and auscultation revealed a tendency to consolida- 
tion of the lower portions of the lungs, with crepitant riles. 

A MOUTH WASH IN GRIPPE 
Dr. Beverley Robinson, in an original communication on the Treat- 
ment of grippe in this issue of the Journal, page 293, recommends as a 
mouth wash and gargle the well known liquor antisepticus alkalinus. 
Doctor Robinson informs us that even more efficacious is a mixture de- 
vised by his friend, Dr. Augustus Wadsworth, and published in a com- 
munication, Mcftith Disinfection, in the Prophylaxis and Treatment of 
Pneumonia, in the Journal of Infectious Diseases for October, 1906, page 
774. The formula is as follows: 

]J Sodium chloride (C.P.) 5ss; 

Sodium bicarbonate (C. P.) gr. x; 

Water (dist.) gij; 

Glycerin gj; 



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264 THE DENTAL DIGEST 

Alcohol . Jv; 

Menthol / «*K^-J. 

Oil of wintergreen gtt. iij; 

Oil of cinnamon gtt. ij; 

Oil of eucalyptus gtt. v; 

Tinct. cudbear 5Jss; 

Tinct. rhatany 5^- 

M. Sig.: Dilute with an equal volume of water. 

In preparing-.this solution, remarks Doctor Wadsworth, the salts should 
be dissolved in the water before adding alcohol. Even when carefully 
made up, a cloudiness or precipitate may appear in the solution, on ac- 
count of the presence of rhatany. By adding two or three of the flavoring 
oils a less pronounced taste is obtained than when only one is used. 

[New York Medical Journal^ March 4, 191 6] 

RECOVERY OF STREPTOCOCCUS VIRIDANS FROM NEW YORK STREET DUST 

By William C. Thuo, M.D., New York 

{From the Departmeni of Clinical Pathology, Cornell Medical College, New York.) 

In view of the almost universal presence of Streptococcus viridans in 
infections of the wral cavity and of the respiratory tract — note the work 
of Hastings, Cecil, and others and its almost constant presence on the tips 
of the roots of teeth extracted from patients with chronic infectious arthri- 
tis, the recovery of this particular microorganism from the out of door dust 
seems a matter worthy of investigation. While we believe that such in- 
fections are transmitted, in the great majority of cases, from person to 
person by contact, sneezing, and expectoration, still it seems to be within 
the range of possibility that the streptococcus may be spread by the dust. 
That this dust is inhaled in large amounts no one will deny. 

The true Streptococcus viridans has been recovered from dust collected 
from a balcony twenty feet above the street level, and some of the 
strains are pathogenic for rats. It is possible, too, that this streptococcus 
may come from the dried feces of domestic animals, particularly the horse, 
since some of the strains fermr.nt some of the same carbohydrate as Strep- 
toccocus equinus does, for example. 

[Journal American Medical Association, February 12, 1916] 

THIONIN as a diagnostic stain in PYORRHEA ALVEOLARIS 
Martin Dupray, B.S., M.S., Columbia, Mo. 

I have seen no mention in the literature on endamebas in pyorrhea 
alveolaris of the use of thionin as a diagnostic stain for the endameba. 
In the past fifteen months while doing microscopic work for several den- 
tists in this city, it has been my privilege to examine a large number of 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 265 

slides of alveolar exudate for endamebas and other organisms. Most of 
the preparations were stained before being examined, and the stain used 
in the majority of cases was thionin. The stain was prepared according 
to the following formula: 

Thionin 0.5 gm. 

Distilled water loo.oc.c. 

Phenol (carbolic acid) crystals 2.0 gm. 

This solution must be prepared fresh every three or four months. 

To prepare the slide, a smear is made of the exudate as with other pus 
and dried in the air. The smear is then fixed in the flame and stained a 
few seconds while still warm with the thionin solution. The stain is 
washed off with water and the slide dried. It may be mounted in balsam 
with a cover glass, or examined direct in immersion oil as desired. The 
endamebas are stained quite distinctly by this method. The cytoplasm 
is stained a Ught purplish violet and the nuclei a deeper reddish violet. 
Ingested blood corpuscles and other material undergoing digestion in the 
body of the organism are stained nearly black. The pus cells in the smear 
are stained a light blue, with their nuclei a deeper blue. Bacteria are 
also well stained, the fusiform bacilli and spirillas being especially plain. 
The endamebas stand out quite distinctly in the smear, and are easily 
recognized. A person accustomed to the use of the microscope can usually 
see them easily with the low power (two- thirds or 16 mm.) objective, using 
the high power only for verification; hence a considerable area of the smear 
can be covered in a short time. 

I have found the stained preparations much more reliable than un- 
stained preparations, and much quicker, on account of the time con- 
sumed in examining an unstained slide. Thionin has also given more 
uniform results than the double staining method with fuchsin and methy- 
lene blue, and the stain is made more quickly and easily. 

This stain does not give good histologic pictures of the endamebas and 
is recommended only as a diagnostic stain, for which purpose it gives very 
plain pictures of both the endamebas and the bacteria. 

[Journal American Medical Association ^ February 19, 1916] 
THE TOXITY OF ARSENOUS AND ARSENIC ACID 

Compounds of arsenic are becoming so prominent in therapy, and the 
t3T>es of arsenic products for use in medicine have become so diverse, that 
any information bearing on their possible mode of action should be wel- 
come. The familiar derivative of arsenic which early found its way into 
use both as a drug and as a poison is the white arsenous oxid, often itself 
spoken of simply as arsenic. The salts of arsenous add are also employed, 
as in Fowler's solution. Arsenic action is not due to the element, but to 



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2M THB DBNTAL DIGEST 

the ion of arsenous acid, HjAsO,. Organic arsenic compounds in which 
the metallic atom is attached directly to carbon are only feebly toxic. 
In the course of time, within the body they seem to yield more or less 
arsenous acid, a reaction which may suffice to explain any pharmacologic 
potency possessed by the organic derivatives. It is a somewhat unex- 
pected fact that the closely related arsenic acid H3ASO4, its anhydrid 
and its salts are far less poisonous than is arsenous add. This statement 
has now and then been disputed, but only recently again substantiated 
at the pharmacologic institute of the University of Berlin by Joachimo- 
glu. The relatively greater toxicity of arsenous in comparison with 
arsenic acid could be demonstrated by the proportion of 10:6 in the case 
of the lethal dose required for intravenous injection in animals. Perfusion 
experiments with isolated frogs' hearts indicated the arsenous compounds 
to be 300 times as harmful as those of arsenic acid. In the case of the 
isolated intestine the contrast, though plain, was not equally striking. 
This has raised the question why there should be a marked disproportion 
in the relative toxicity of comparable quantities of arsenic and arsenous 
acids, depending on the mode in which the test is made. The explanation 
proposed is as follows: The toxicity of the arsenic add depends on the 
reducing power of the tissues with which it comes into contact. By this 
means it is converted into the very poisonous arsenous compound. Some 
individual organs or tissues have comparatively slight reducing potency. 
In the isolated heart, for example, arsenic acid exhibits little toxidty. 
Throughout the living organism as a whole the reduction of arsenic add 
appears to be far more readily accomplished; hence, after intravenous 
administration of the ordinarily less nocuous derivative, it may become 
more toxic so promptly by conversion to arsenous acid that the real diflfer- 
ence between these related arsenic derivatives is no longer conspicuous. 
This may also explain some of the uncertainty or confusion which has 
existed in the past in respect to the comparative action of the two sub- 
stances. 

[Journal American Medical Association, February 19, 1916] 

(Afnerican Journal Medical Sciences) 
TONSILLAR ENDAMEBIASIS AND THYROID DISTURBANCES 

Tonsillar lesions of an infective cryptic character were found by the 
authors in 22.8 per cent.; and nasal together with tonsillar lesions existed 
in 90 per cent, of 362 goitrous individuals examined from this standpoint. 
In typically diseased tonsils, out of thirty-four cases examined micro- 
scopically, 97 per cent, were found to harbor Endanueba gingivcUis (gros) 
in the tonsillar crypts. Of sixteen individuals of this group who after 
treatment by means of emetine hydrochlorid were reexamined, thirteen, or 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 267 

8 1 per cent., were shown no longer to have eYidamebas in the cryptal con- 
tents. In twenty-three persons to whom emetine was administered a 
reduction in the bulk of the goitre was appreciable in eighteen; and of 
seven dysthyroid cases included in this group of those treated, six were 
benefited in degrees varying from slight amelioration to apparent cure. 

{Archiv fiir Kindnheilkunde, Stuttgart^ November 2, 1915) 
mCH ARCmNG PALATE 

Landsberger comments on the disturbances almost inevitable when 
the palate runs up abnormally high. The nasal passages are interfered 
with by it and mouth breathing is inevitable. It also entails a ten- 
dency to a vacuimi in the nasopharynx wl^ch acts injuriously on the ear 
and on the local circulation. The spyace inside this part of the skull is also 
encroached on by the high palate. The disturbances from the latter are 
often ascribed to the adenoids frequently found with it. Another serious 
trouble from it is the resulting abnormal development of the teeth. The 
germinal buds do not develop centrifugally, as in normal conditions, but 
straight downward. The condition can be remedied by straightening the 
roof of the mouth, forcing its sides apart and thus bringing the concave 
palate down to be more nearly flat. He gives illustrations of a spring 
and screw apparatus for the purpose. It is worn between the teeth, forc- 
ing the rows apart. It does not interfere with speaking or eating, and an 
actor wore it without interfering with his professional work. The benefit 
in children was almost miraculous in some cases. Deafness subsided, as 
also asthma and the headaches which had tormented the children for 
years. Abnormal salivation was also arrested, and a tendency to coryza. 
tonsillitis and bronchitis, while the general growth was promoted. All 
these changes are readily explained by the differences seen in the roentgen- 
ograms taken before and after wearing the brace. 

[Journal American Medical Association, March 4, 1916] 
THE INTERRJELATION BETWEEN SALIVARY AND GASTRIC DIGESTION 

Physiologists have long known that the starch-digesting enzyme pre- 
sent in the saliva of man is destroyed as soon as it is exposed to even small 
concentrations of **free" hydrochloric add, or, in terms of modem chemi- 
cal interpretation, hydrogen ions present in the stomach. From the 
standpoint of a useful performance on the part of the starch-digesting 
saliva, the ready inhibition of its effectiveness as a digestive agent was 
somewhat mystifying when it was first discovered; for the duration of 
amylolytic activity appeared to be restricted essentially to the very brief 
period during which the foods are retained in the mouth, masticated and 
swallowed. Subsequently it was ascertained that the actual sequence of 
events within the stomach does not compel an immediate mixing of the 



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268 THB DENTAL DIOBST 

entering contents with the gastric juice which is being secreted. The 
mass that is swallowed in successive portions accumulates at first in the 
fundus of the stomach; and since in the absence of vigorous muscular 
movements in that region the contents are penetrated with great difficulty 
by the gastric secretion which is continually being poured out by the 
walls of the stomach, salivary digestion can actually proceed for a con- 
siderable time without serious interruption. In view of the rapidity with 
which the salivary enzyme can convert starch into soluble sugar, the pre- 
liminary digestion of carbohydrates can therefore usually be completed 
before destruction of the effective agent in the saliva takes place. Dr. 
Maxwell of the physiologic laboratory at the University of Melbourne, 
has suggested a further fimction of the salivary enzyme which he believes 
to be of importance for the later digestive processes. It has long been 
known that many substances in suspension or in coUoidal solution have 
the power of absorbing enzymes, thereby inhibiting their activity. Max- 
well has found experimentally that although unboiled starch administered 
in the form of intact grains does not hinder the action of pepsin, peptic 
digestion may be delayed in the presence of colloidal starch solutions 
through absorption of the proteolytic enzyme. The time interval for the 
peptic digestion may, for example, be increased fourfold in the presence 
of a 2 per cent, starch solution. There is a stage in the progressive di- 
gestive disruption of the starch molecule at which the capacity of absorp- 
tion of pepsin is lost. This is coincident with the appearance of dextrins, 
even before sugars are formed. In accord with the foregoing it is actually 
found that cooked farinaceous foods — rice, potato, bread, porridge, etc. 
— all hinder peptic digestion if they are not first subjected to the salivary 
digestion. The inhibition of peptic activity by carbohydrates like gum 
acacia is not prevented by a previous contact with saliva for the reason 
that they are not digested by it. The positive feature to which Maxwell 
has drawn attention has been summarized by the statement that the 
saliva of man, by virtue of its enzyme ptyalin or amylase, plays a consid- 
erable part in aiding gastric digestion by hydrolyzing colloidal starch 
which would otherwise absorb pepsin. 

FACTS ABOUT THE BEHAVIOR OF THYMOL IN THE BODY 

In connection with the treatment of hookworm disease and comparable 
forms of intestinal infection with parasitic invaders, considerable promi- 
nence has been given to the use of thymol (methylisopropylphenol), a 
phenol derivative obtained commercially from oil of ajowan and occurring 
in oil of horsemint, oil of thyme and some other volatile oils. Thymol is 
an antiseptic comparable in many ways to phenol and the cresols, but it is 
less soluble in water, and for this reason has been supposed to be absorbed 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 269 

with greater difficulty from the alimentary tract. The latter assumption 
has made it seem more valuable as an antiseptic for use in the gastro- 
intestinal tube because of the protection from direct intoxication by the 
drug thereby afforded to the organism as a whole while the parasite is 
being destroyed. Owing to the solubility of thymol in oils, it has re- 
peatedly been urged that, when the drug is U5td. fatty substances should 
be avoided in the diet, in order to avert nndue:abs^rption.of.thc. l^r^e. 
doses required for anthelmintic effects. One nught expect th9,tXccttii- 
j)ound with these prop)erties wQuld reappe^ar. in considerable jqygyajities 
in the feces after its administratioi^ byViral paths. Inwstiga?tions.jii the 
Hygienic Laboratory of the U. S. Public Health Service have shown, 
however, that only insignificant amounts of ingested thymol are excreted 
in this way. This would indicate that thymol is almost completely ab- 
sorbed from the alimentary tract and must therefore be oxidized in the 
body or excreted in the urine. Seidell has therefore directed attention 
to the behavior of the compound after absorption. It has long been 
known that absorbed thymol may reappear in the urine as a glycuronate, 
just as other alcoholic derivatives conjugate with glycuronic acid in the 
metabolism. A careful study of the fate of thymol gave promise of dis- 
closing the mechanism of its action on hookworms, and consequently, of 
indicating the path to be followed in developing drugs of greater potency 
and safety than thymol. Even now it is being urged that the oil of 
chenopodium or oil of American wormseed be thus employed. The 
supply of thymol is said to be extremely limited at present, and the oil of 
chenopodium is regarded as generally safer. Seidell has found that less 
than so per cent, of the thymol administered either to experimental ani- 
mals or to human patients who received the thymol treatment for hook- 
worms reappears in the urine. This result, in connection with the pre- 
viously mentioned experiments on the determination of thymol in the 
feces, shows that of the thymol administered, from one half to two thirds 
is apparently destroyed or fixed in the body. A similar fate is suggested 
for compounds of related type, such as the simpler phenols. No satis- 
factory explanation has as yet been found for this apparent disappearance 
of administered phenols. With respect to the fraction that is not reex- 
creted as glycuronate, it has been surmised that it may be temporarily 
fixed by the tissues or eliminated by volatilization with the expired air. 
This is mere conjecture without any supporting evidence. From a 
practical standpoint there is significance in Seidell's finding that the sim- 
ultaneous administration of olive oil with thymol apparently caused 
very slight if any effect on the percentage of excreted drug. In his opin- 
ion it is a question, therefore, whether oils really increase the amount of 
absorption or only the rate. 



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270 TUB DBKTAL DIGEST 

[Medical Record, February 19, 1916] 

CHLORAMINE IN THE TREATMENT OF WOUNDS OF THE MOUTH AND JAWS 
A. R. Fisher says that the septic character of all gunshot wounds in- 
volving the mouth and the disadvantages attending the use of the com- 
mon antiseptics, led.hioa.tot try chloramine (toluene sodium sulphochlora- 
raide) in se^nfn.•*dL3es; frxe!Ke|ngfcompound fractures of the jaw and two 
'..••:• flesh jwptmds viyqiyiife3the.inojith.. A two ppr^^nt. aqueous solution of 
• • ftn^agtotV^ vS^m Icm jrrigajbon; jffi^&A yf^t&mwi out every hour during 
the ^^;&nrl:a8*ofCrn as^ possible ^ucui^liie night. Chloramine besides 
being V^Joi^firfiiVantiseptic^his jtlfe of penetrating the tissues, 

and is not so readily neutralized by albuminous discharges as the simpler 
chemical antiseptics. It is bland and non-irritant. While the number 
of cases treated was small the results were most encouraging. 

[Denial Items of Interest, March, 1916] 
Exclusive ContrilnUions 

Antihygienic Conditions of the Oral Cavity and Dental Maladies, May Lead Not Only to 
Tuberculous Infection but to Many Other Systemic Maladies. By N. L. Castiglia, D.D.S. 

The Etiology and Treatment of Pyorrhea Alveolaris. By G. Chisohn, D.D.S. 

Further Facts Regarding Succinimide of Mercury as a Cure for Pyorrhea. By Dr. Georpc 
H. Reed, A.A., Dental Surgeon, U.S.N. 

Ther Average Dentist and Root Canal Work. By Samuel Lang, D.D.S. 

Orthodontia 

Dr. Edward H. Angle's Pin and Tube Appliance. By A. H. Ketcham, D.D.S. 

Prosthodontia 

Anatomical Dentures. By Seimaro Shimura, D.D.S. 

Resiliency as Opposed to Rigidity in Artificial Teeth. By R. Morse Withycombe. 

Society Papers 
Therapeutic and Surgical Treatment of Roots and the Adjacent Tissues. By J. F.Biddle, D.D.S. 
The Restoration of Masticatory Function with Carved Gold Inlays. By Rodrigues Otto- 

lengui, M.D.S., LL.D., D.D.S. 
An Informal Talk on Inlays. By'Dr. E. S. Tracy. 
Oral Hygiene and Its Relation to Better Health Conditions. By J. P. Delvin, D.D.S. 

[British Dental Journal, February 16, 1916] 
Original Communications 

Valedictory Address. By G. Northcroft, L.D.S. Eng., D.D.S. Mich. 

A Case of Impetigo Contagia cured by the Extraction of Septic Teeth. By W. Nicholson, 

L.R.C.P., M.R.C.S., L.D.S. Eng. 
Alum Wool. By J. T. Hall, L.D.S.L 
Gestant Composite Odontomes. A Case Reported by Mr. A. Barritt, L.D.S. Eng. 

Abstracts and Translations 

Mastication and Food Utilization. 

Sterilizing Dental Instruments. 

Oxpara for Filling Root Canals. 

Case of Associated Jaw and Lid Movement. By Captain A. W. Ormond, F.R.C.S. 



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SOCIETY NOTES 271 



SOCIETY NOTES 

Alabama. 

The next meeting of the Alabama Dental Association will be held at Mobile, Ala., April 
II, 1916. — ^J. A. Blue, Binningham, Ala., Secretary, 

Arizona. 

The next meeting of the Arizona Board of Dental Examiners will be held in Phoenix, 
Ariz., October 9-15, 1916. — Eugene McGuire, 302 Noll Bldg., Phoenix, Secretary. 

Connecticut. 

The Connecticut State Dental Association will meet in New London, Conn., at Hotel 
Griswold, June 13-15, 1916. — Elwyn R. Bryant, New Haven, Conn., Secretary. 

Florida. 

The next meeting of the Florida State Dental Society will take place at Orlando, Fla. 
June 21, 1916. — M. C. Izlar, Ocala, Fla., Secretary. 

Georgia. 

The forty-seventh annual meeting of the Geoi^gia State Dental Association, will be held 
at Macon, Ga., June 8-10, 1916, beginning at 11 a.m. Thursday, June 8th. — M. M. 
Forbes, 803 Candler Bldg., Atlanta, Ga., Secretary. 

Idaho. 

The next meeting of the Idaho State Dental Society, will be held at Boise, June, 1916. — 
R. J. Cruse, Pocatello, Idaho, Secretary, 

Illinois. 

The Illinois State Dental Society will hold its next meeting at Springfield, 111., May 9-1 2» 
1916. — Henry L. Whipple, Quincy, 111., Secretary. 

Indiana. 

The fifty-eighth annual meeting of the Indiana State Dental Association will be held at 
the Claypool Hotel, Indianapolis, May 16-18, 1916. — A. R. Ross, Lafayette, Secretary. 

Iowa. 

The next meeting of the Iowa State Dental Society will take place at Des Moines, Iowa, 
May 2-4. — H. A. Elmquist, Des Moines, Iowa, Chairman of Exhibit. 

Kentucky. 

The Kentucky State Dental Society, will hold its next meeting at Louisville, July 24, 
1916. — W. T. Farrar, 519 Starks Bldg. Louisville, Ky., Secretary. 

The next meeting of the National Dental Association will be held in the ist Regiment 
Armory, Louisville, Ky., July 25-28, 1916. — Otto U. KiNG„Huntington, Ind., Secretary. 

Massachusetts. 

The next meeting of the Massachusetts Dental Society will be held in Boston, Mass., 
May 3-5, 1 916. — A. H. St. C. Chase, Boston, Mass., Secretary. 

Michigan. 

The Michigan State Board of Dental Examiners will meet in the Dental College at Ann 
Arbor, June 19, 1916, at eight o'clock a.m.; for application blanks apply to E. O. 
Gillespie, Stephenson, Mich., Secretary-Trecuurer. 

Mississippi. 
. The next meeting of the Mississippi Dental Association will be held at Jackson, Miss., 
May 1-3, 1916. — M. B. Varnado, Osyka, Miss., Secretary. 



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272 THE DENTAL DIGEST 

Nebraska. 

The Nebraska State Dental Society will hold its next meeting in Lincoln, Nebr., May 
16-18, 1916. — H. E. King, Omaha, Nebr., Secretary, 

New York. 

The Dental Society of the State of New York will hold its next meeting at the Hotel 
Ten Eyck, Albany, N. Y., May 11-13, 1916.— A. P. Burkhart, 52 Genesee St., Albany, 
N. Y., Secretary. 

Pennsylvania. 

The fifty-third annual meeting of the Lake Erie Dental .Association will be held at Hotej 
Bartlett, Cambridge Springs, Pa., May iSr-jo, 1916 — ^J. F. Smith, 120 W. i8th St., Erie, 
Pa., Secretary. 

The thirty-fifth annual meeting of the Odontological Society of Western Pennsylvania 
will be held at the Monongahela House, Pittsburgh, Pa., Tuesday and Wednesday, April 
II and 12, 1916.— King S. Perry, 719 Jenkins Bldg., Pittsburgh, Pa., Secretary. 

The next regular examination of the Pennsylvania Board of Dental Examiners will be 
held in the Musical Fund Hall in Philadelphia, and the College of Pharmacy Building 
in Pittsburgh, on June 14-17, 19 16. The practical work vnW be held at the Philadelphia 
Dental College in Philadelphia, and the University of Pittsburgh in Pittsburgh, on the 
first day, June 14th, the operative work being held at eight- thirty a.m., and the prosthetic 
work at one-thirty p.m. — Alexander H. Reynolds, 4630 Chester Ave., Philadelphia, 
Pa., Secretary. 

South Carolina. 

The forty-sixth annual meeting of the South Carolina State Dental Association will be 
held at Chick's Springs, So. Car., July 11-13, 1916. — Ernest C. Dye, Greenville, So. 
Car., Secretary. 

TlEXAS. 

The Texas State Dental Association will hold its next meeting at Dallas, Texas, May 
9-12, 1916. — W. O. Talbot, Fort Worth, Texas, Secretary. 

Vermont. 

The next meeting of the Vermont Board of Dental Examiners, for the examination of 
candidates to practise in Vermont, will be held at the State-house, Montpelier, June 26-28, 
191 6. — Harry F. Hamilton, Newport, Vt., Secretary. 

West Virginia. 

The next meeting of the West Virginia State Dental Association will be held at the 
Kanawha Hotel, Charleston, W. Va., April 12-14, 1916. — J. W. Parsons, Huntington, 
W. Va., Secretary. 

Wisconsin. 

The meeting of the Wisconsin State Board of Dental Examiners will be held at the Mar- 
quette Dental College, Cor. 9th and Wells St., Milwaukee, Wis., June 14, 1916, commenc- 
ing at nine o'clock. — F. A. Tate, Daniels Blk., Rice Lake, Wis., Secretary. 

The next meeting of the Wisconsin State Dental Society will be held in Wausau, Wis., 
July 11-13, 1916. — ^Theo. L. Gilbertson, Secretary. 



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FUTURE EVENTS 273 



The Louisiana State Dental Society 

LAKE /CHARLES 
OVES V^IOMPANY 

The Louisiana State Dental Society will hold their annual meeting in Lake Charles, one 
of Louisiana's most picturesque cities, May 1-3, 191 6. An exceptionally unique, interesting 
and instructive program has been arranged, and all visiting ethicAl dentists as might de 
sire to attend are cordially invited. — ^J. Crimen Zeidler, Suite 11 29 Maison Blanche Bldg., 
New Orleans, La., Secretary. 



FUTURE EVENTS 



April 4-7, 1916. — Dental Manufacturers' Club, Chicago, 111. Meeting in the Banquet Hall, 

Auditorium Hotel. — Chairman Exhibit Committee, A. C. Clark, Grand Crossing, Chicago, 
April II, 1916. — Alabama Dental Association, Mobile, Ala. — J. A. Blue, Birmingham, 

Ala., Secretary, 
April 11-12, 191 6. — Odontological Society of Western Pennsylvania, Monongahela House, 

Pittsburgh, Pa. — King S. Perry, 719 Jenkins Bldg., Pittsburgh, Secretary. 
April 12-14, 19 1 6. — West Virginia State Dental Association, Kanawha Hotel, Charleston, 

W. Va.— J. W. Parsons, Secretary. 
April 13-15, 1916. — Michigan State Dental Society, Detroit, Michigan. — Clare G. Bates, 

Secretary. 
May 2-4, 191 6. — Iowa State Dental Society, Des Moines, la. — H. A. Elmql'ist, Des Moines, 

la., Chairman of Exhibit. 
May 3-5, 1916. — Massachusetts Dental Society, Boston, Mass. — A. H. St. C. Chase, Boston, 

Mass., Secretary. 
May 8-10, 191 6. — Ontario Dental Society, College Bldg., Toronto, Can. 
May 9-10, 1916. — North Dakota State Dental Association. — A. Hallenberc, Fargo, No. 

Dak., Chairman Exhibit Committee. 
May 9-12, 1916. — ^Texas State Dental Association, Dallas, Tex. — W! O. Talbot, Fort Worth, 

Tex., Secretary. 
May 9-12, 191 6. — Illinois State Dental Society, Springfield, 111. — Henry L. Whipple, 

Quincy, 111., Secretary. 
May 11-13, 1916. — Dental Society of the State of New York, Hotel Ten Eyck, Albany, N. Y. 

— A. P. Burkhart, 52 Genesee St., Albany, N. Y., Secretary. 
May, 16-18, 1916. — Susquehanna Dental Association, Young Men's Hebrew Association 

Bldg., Scranton, Pa. — Geo. C. Knox, 30 Dime Bank Bldg., Scranton, Pa., Recording 

Secretary. 
May 16-18, 1916. — Nebraska State Dental Society, Lincoln, Neb. — H. E. King, Omaha, 

Neb., Secretary. 
May 17-18, 1916. — Indiana State Dental Association, Claypool Hotel, Indianapolis. — A. R. 

Ross, Lafayette, Secretary. 
May i8r-20, 1916. — Lake Erie Dental Association, Hotel Bartlett, Cambridge Springs, Erie, 

Pa. — J. F. Smith, Secretary. 
June 1916. — Utah State Dental Society, Salt Lake City. — E. C. Fairweather, Salt Lake 

City, Utah, Secretary. 
June 1-3, 1916, — Northern Ohio Dental Association, Cleveland, O. — Clarence D. Peck, 

Sandusky, O., Secretary. 
June &-10, 1916. — Georgia State Dental Society, Macon, Ga. — M. M. Forbes, Candler 

Bldg., Atlanta, Ga., Secretary. 



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274 THE DENTAL DIGEST 

June 13-15, 1916. — Connecticut State Dental Association, Hotel Griswold, New London, 

Conn. — Elwyn R. Bryant, New Haven, Conn., Secrdary, 
June 14, 1916. — South Carolina State Board of Dental Examiners will be held at Jefferson 

Hotel, Columbia, S. C. — R. L. Spencer, Bennettsville, S. C, Secretary. 
June 21, 1916. — Florida State Dental Society, Orlando, Fla. — M. C. Izlar, Corresponding 

Secretary, 
June 20-22, 1916. — New Hampshire Dental Society, Lake Sunapee, Zoo-Nipi Park Lodge, 

Lisbon, N. H. — J. E. Collins, Chairman Exhibit Committee. 
Juj.e 26, 1916. — North Carolina State Board of Dental Examiners, Battery Park Hotel, 

Asheville, N. C. — F. L. Hunt, Asheville, Secretary. 
June 27-29, 1916. — Pennsylvania State Dental Society, Pittsburgh, Pa. — Luther M. 

Weaver, .103 Woodland Ave., Philadelphia, Pa., Secretary. 
June 28-30, 1916. — North Carolina State Dental Society, Asheville, N. C. — R. M. Squires, 

Wake Forest, N. C, Secretary. 
June 29-July 30, 191 6. — Maine Board of Dental Examiners. — ^Harold L. Eicmons, Masonic 

Bldg., Saco, Me., Secretary. 
July 11-13, 1916. — South Carolina State Dental Association, Chick*s Springs, S. C. — ^Ernest 

C. Dye, Greenville, S. C, Secretary. 
July 11-13, 1916. — ^Wisconsin State Dental Society Meeting, Wausau. — ^Theodore L. Gil- 

berton. Secretary. 
July 12-15, 19 1 6. — New Jersey State Dental Society, Asbury Park, N. J. — ^John C. Forsyth. 

Trenton, N. J., Secretary. 
July 20-22, 19 16. — American Society of Orthodontists, Pittsburgh, Pa. Address communica- 
tions to F. M. Casto, 520 Rose Bldg., Cleveland, O. 
July 24, 1916. — Kentucky State Dental Society, Louisville Ky. — W. T. Farrar, 519 Starks 

Bldg., Louisville, Secretary. 
July 25-28, 1916. — National Dental Association, ist Regiment Armory, Louisville, Ky. — 

Otto U. King, Huntington, Ind., Secretary. 
October 9-15, 1916. — Arizona , Board of Dental Examiners, Phoenix, Ariz. — Eugene Mc- 

Guire, 302 Noll Bldg., Phoenix, Secretary. 
October i8r-20, 19 16. — ^Virginia State Dental Association, Richmond, Va. — C. B. Gotord, 

Norfolk, Va., Corresponding Secretary. 
January 23-25, 191 7. — American Institute of Dental Teachers, Philadelphia, Pa. — Abram 

TiorFMAN, 529 Franklin St., Buffalo, N. Y., Secretary-Treasurer. 



FOLLYGRAPHS 

By Oscar Schleif 



Consultation, operation. 
A sweet tooth usually needs filling. 
Love one another, but not another one. 
It's the trying, not the doing, that counts. 
There's many a gossip twixt the cup and the lip. 
None can think time, but who has lived it. 
Laugh if the world will borrow, weep if you get a loan. 
What truth is stranger than that facts make fiction, and fiction cer- 
tainly is a fact? — Physical Culture, 



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The Dental Digest 

GBORGB WOOD GLAPP, D.D.S., Editor 

Published monthly by The Dentists' Supply Company, Candler Bldg., 
Times Square, 220 West 42d Street, New York, U. S. A., to whom all com- 
munications relative to subscriptions, advertising, etc., should be addressed. 

Subscription price, including postage, $1.00 per year to all parts of the 
United States, Philippines, Guam, Cuba, Porto Rico, Mexico and Hawaiian 
Islands. To Canada, $1.40. To all other countries, $1.75. 

Articles intended for publication and correspondence regarding the same 
should be addressed Editor Dental Digest, Candler Bldg., Times Square, 
220 West 42d Street, New York, N. Y. 

The editor and publishers are not responsible for the views of authors ex- 
pressed in these pages. 

Entered as Second Class Matter, at the Post-OflSce at New York City. 
Under the Act of Congress, March 3, 1879. 



Vol. XXI 1 



MAY, 1916 



No. 5 




FOOD FOR DENTISTS* 

By Watson W. Eldridge, M.D., New York 

IVe recently learned, by practical experience, that wonderful benefit 
results from a course of diet which does away with constipation. So 
great has been my own benefit, that I'd like to have all understand the 
relations between constipation and ill health, and then between correc- 
tion of the trouble and joy in lixang, so I got Dr. Eldridge to prepare 
these articles. Compare the story told in this one with some of your 
own experiences. — Editor. 

EFFECT OF CONSTIPATION ON THE NERVOUS SYSTEM AND THE MENTALITY 

SECOND PAPER 

Of all the abnormal conditions which afflict mankind by their oc- 
currence in the himian body, probably none receives as little thoughtful 
attention by the individual, as chronic constipation. One would sup- 
pose, that, in view of the many lamentable conditions which are secondary 
to, and superimposed on, this primary condition, the subject would re- 
ceive more interested attention from the public in general. It is probably 
due to ignorance of the consequences that leads most of us to neglect 
the primarily simple condition of constipation until after the almost 
disastrous results have become apparent. 
* Continued from March Digest 



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276 THE DENTAL DIGEST 

I have shown in a previous article how easily the vicious cycle of 
constipation may become established by being induced through sedentary 
habits and I gave the prophylaxis of this condition. 

SOME RESULTS OF CONSTIPATION 

We now have to consider some of the results of a well established 
chronic intestinal stasis, and in this paper only those relating to the 
nervous system will be discussed. These run all the way from a simple 
mental stupidity, to epilepsy and include loss of concentration, loss of 
intellectual productive ability, various manifestations of hysteria, chorea 
(of which St. Vitus' dance is one manifestation), neuritis, myalgia, 
(pain in the muscles, of which intercostal neuralgia is a specimen), 
sciatica, lumbago, and mental x)bsessions. 

PROCESS, CONNECTING CAUSE AND RESULT 

To the layman it is a far cry from constipation to epUepsy or lumbago 
but let us see '^ the wheels go round," and observe the connection. 

Beside the digestion produced by the enzymes of the stomach and 
intestines there occurs in every man a digestion brought about by the 
action of the bacteria which normally live and thrive in the digestive 
tract. These bacteria are useful and necessary, inasmuch as they are 
the only means the human organism possesses with which to produce 
complete digestion. The digestive juices and enzymes excreted by the 
various glands along the alimentary tract carry the digestive process to a 
certain point only, and were it not for the presence of the bacteria in the 
lower parts of the canal a large amount of nutritive material would be 
wasted. It is even doubtful if life could be long sustained on the amount 
of nutritive material absorbed from the products of the enzyme, diges- 
tion alone. There are bacilli which convert starches into sugar, others 
which emulsify fats, still others which transform albumin into peptones, 
etc. The action of the microbes is, however, not limited to that; in 
contradistinction to the gastric and intestinal enzymes, it goes much 
farther in the splitting of the albuminous molecule and finally we have, 
as a by-production, such toxic substances as the leucomaines, neurin, 
and muscarin, and the ptomaines, cadaverin and putrescin, and many 
others. As Combe says " — the microbes intervene actively in all the 
digestive processes, but beside their undeniably useful role it is also un- 
deniable that their action transforms the digestive canal even in the 
normal state into a receptacle and constant laboratory of poisons." 
Under normal conditions these poisons are taken care of by the body's 
defense organization which consists of three separate systems, i. e., the 
intestinal mucosa, the liver, and the various glands of internal secretion. 



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FOOD FOR DENTISTS 



277 



These are all conceded to have an antitoxic function and the exercise of 
this function prevents the intestinal toxins from producing their harmful 
influence on the body organism, when these tvxins are produced in moderate 
and normal amount only. In constipation, these toxic bodies are present 
in excessive amounts. Not only is the toxic material which should have 
been evacuated, retained, but this very retention provides a splendid 
media m which the bacteria are stimulated to increased activity and 
greater amounts of toxins are produced to be added to these already 
present. When this process has developed to a certain point the anti- 




He has become very irritable, is easily angered; and anything but a pleasant companion 
to those associated with him in his work 

toxic function of the intestinal lining, or mucosa, is overwhelmed and 
the poisons are absorbed into the portal circulation. The liver then soon 
becomes surcharged with the toxins and, after a certain enlargement due 
to its effort to stem the tide of toxic material, its function in turn be- 
comes weakened, and is defeated in the fight to prevent the passage 
of these bodies, and they escape into the general circulation. The 
antitoxic bodies in the bloodstream, which have been provided by the 
glands of internal secretion (thyroid, suprarenals, etc.), now take up 
the battle and for awhile the onward march of the toxins is arrested, 
but sooner or later the antibodies are in their turn overwhelmed and the 
individual then develops a true toxemia, cither acute or chronic, but 



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278 THE DENTAL DIGEST 

usually the latter, because the defensive system keeps up the fight and 
succeeds in nine cases out of ten in preventing such a profound toxemia 
that the patient becomes acutely ill. 

Now the question arises as to what effect on the body organism is 
produced by the presence in the blood stream of these toxic materials? 
It has been shown that with their other detrimental activities they attack 
not only the peripheral nerves but the nerve centres as well. The 
sequence, severity, and character of the nervous symptomatology pro- 
duced is directly dependent respectively, on the time the toxin attacks a 
particular site, the virulence of the toxin itself, and the part of the 
nervous system attacked. Affections of the peripheral nerves and nerve 
terminations produce neuritis, muscular pains and perversions of the 
sensory nerves, lumbago, and may induce skin lesion§ such as herjjes 
zoster or "shingles*' (eruption along the course of a nerve). If the nerve 
trunks are affected, sciatica, neuralgia, headaches, and their similitudes 
may result; while more deep seated attacks, delivered at the nerve 
centres, may produce paralyses of various sorts, pseudo-epilepsy, and 
last but by no means least, mental disturbances may result and we see 
apprehensions, obsessions, melancholia, loss of concentration, changes 
in character and characteristics and psychic disorders too niunerous to 
mention. 



Let me quote you a typical case history of one of the so-called nervous 
patients. He complains of not having felt well for some time, but 
without any idea as to the cause of the trouble. He has grown pale 
and listless. Appetite is poor and he has some headache and vertigo. 
He may have had "sinking spells'' in which he actuaUy lost conscious- 
ness or felt that he was going to. He has become very irritable and 
sullen, is easily angered and his character may have changed from that 
of an optimist to that of a pessimist. He has spells of melancholia, and 
is troubled alternately with insomnia and lethargy. He may have had 
no apparent symptoms of indigestion and will tell the physician his 
stomach is all right. Close questioning may elicit the information that 
he sometimes has spells of belching after meals and may pass quantities 
of gas by rectum. He has reached the point where he can no longer do 
a full day's work at the office, due to mental and physical exhaustion 
which follows a comparatively small amount of work. He cannot con- 
centrate his mind on the details of his business and he has become any- 
thing but a pleasant companion to his family and those associated with 
him in his work. He has probably been "constipated, off and on" for 
several months or years but he "always takes a dose of salts" or some 



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FOOD FOR DENTISTS 



279 



patent cathartic pill which **fixes it up all right" so that he has "no trouble 
that way." 



INCORRECT DIAGNOSIS 



The diversity and multitude of symptoms enumerated by this com- 
plaining and grouchy patient will give the physician much embarrassment 
in forming a diagnosis. All the organic systems seem to be involved 
except the digestive system, but it is this very multiplied and diversified 




^$»*^'^f»0S Pf^^ 



The patient becomes actually ill 



quantity of symptoms that should lead to an investigation of the digestive 
tract. From the ignorant or too busy physician the patient will be told 
that it is because he has a nervous constitution and will be advised not 
to worry over it. It is just this sort of case that should receive the 
closest attention. The stools, urine and stomach contents should 
be careftdly examined. The physician should question the patient in 
great detail so as to bring out history points which the patient may have 
overlooked. Careful methods of examination will usually reveal con- 
stipation to be the cause of these numerous and diverse symptoms and 
the patient who supposed he would be afflicted the rest of his life, owing 
to a "nervous constitution," will be far on the road toward relief. 

To he continued 



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280 THB DSNTAL DIGSST 



WHY DISCARD THE TOOTH BRUSH? IT CAN BE EASILY 

STERILIZED 

By Ernest C. Dye, A.B., D.D.S., Greenville, S. C. 

I suppose the best possible comment I can make on this article is that 
after reading it I threw away all the tooth brushes in my family and 
provided each member with a glass jar containing a little formalin. 
Now, when I look at them, I feel that we are not unnecessarily and care- 
lessly adding to the collection of germs already in our mouths. — 
Editos. 

"More than a million organisms have been found by bacteriologists 
on the bristles of eight out of twelve tooth brushes, after they had been 
once used. A number comparable with that found in sewage." This 
statement so alarmed Dr. Bernard Feldman of N. J. that he advocates 
discarding the tooth brush and giving us as its substitute ** The clean fore- 
finger" which is a custom of semi-civilized and barbarous nations. 

Is it not strange that Dr. Feldman should accept the statements 
and experiments of these bacteriologists and then reject their remedy 
without any consideration? Does his substitute better conditions? 

Here follows the article from which the good Doctor quotes in his 
"Menance of the Tooth Brush":— 

"Recent experiments show that the great majority of tooth brushes 
are in a disgusting stage of uncleanliness and so ladened with germs that 
they are capable of spreading all sorts of disease. A brief ablution under 
the tap or in a tumbler after using is all the cleansing the average tooth 
brush ever receives and this is totally inadequate to render it reasonably 
clean. In these experiments each of twelve sterile brushes was once 
used, rinsed ten times in a tumbler of water and after standing twelve 
hours all the bristles were removed with sterile forceps and examined for 
germs. In eight out of twelve cases, more than a million organisms were 
found, a number comparable with that found in sewage. The brushes 
examined had been used by persons suffering from diseases of the teeth 
and gimis. But four brushes used by persons with apparently healthy 
mouths revealed almost as large a number of bacteria. Antiseptic pow- 
ders and pastes are helpful in keeping brushes clean; but even they are 
not sufficient. 

" Experiments with seven such preparations showed that there ¥ras 
an appreciable reduction in the number of organisms, with two others 
there was practically no change, while with three others there was no 
appreciable improvement. 

" What makes the tooth brush particularly dangerous is that each 
bristle point acts as an inoculating needle in carrying the microbes 



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WHY DISCARD THS TOOTH BRUSH? 281 

into the delicate membranes of the gums. As the brush should be used 
at least twice a day, the gums get no chance to throw off one infection 
before another is forced upon them. Dr. Ernest C. Dye of Greenville, 
S. C, has invented a tooth brush with a hollow handle to meet these 
difficulties. As soon as the brush has been used the bristle end is un- 
screwed and stuck into the hollow handle. In the inside of the handle 
a few drops of formaldehyde or some other powerful disinfectant are 
kept. The fumes of the disinfectant sterilize the brush before the next 
use. The same results may be obtained by keeping the ordinary tooth 
brush in a wide necked bottle or fruit jar or any receptacle which can 
hold the brush and a few drops of sterilizer. It must be air tight." 

This article was written by Drs. Smale and Jones of London, England. 
The former a dentist, the latter a bacteriologist in the employ of the 
British Government. It first appeared in the Star Co. of London, copied 
in this country by the New York Sunday American, Dec. 6, 1914, and 
then by various papers throughout the United States and Canada. 

Why discard the tooth brush? Let us ask the following questions. 
Which would be the easier task, to teach the public to unlearn something 
that it is accustomed to, and adopt a measure which is novel, or to 
improve that which it now has? We rather think the latter plan more 
feasible; therefore let us sterilize the tooth brush. 

The medical profession has taught the necessity of precaution and 
sanitation, and as the result of this we are "screening" against the in- 
sidious mosquito and the house-fly. Civic authorities are most careful 
in the inspection of "backyards" and places that breed germs and 
disease. The "public drinking cup" is no longer tolerated, thus a 
"consciousness" has been created which demands sanitation and 
sterilization. 

Drs. Smale and Jones have shown that the bristles of septic tooth 
brushes act as inoculating needles, and that the germs found on them 
will produce disease. They are the authors of the following article: 

"Bacteriology of Tooth Brushes" {British Medical Journal 1910J: 
"It is claimed by Smale and Jones that a tooth brush becomes septic 
after one using. Each hair becomes an inoculating needle and the 
person using it may be vaccinated with such germs as flourish on it. The 
tooth brush therefore, as popularly used by the ignorant for many months; 
may be the origin of pyorrhoea alveolaris, gastritis, and arthritis. The 
prevalent tooth powders and tooth pastes as commonly used do not 
render the tooth brush aseptic and even a solution of i in 20 carbolic 
acid is not effectual. The authorities insist that all tooth brushes should 
be boiled for five minutes before and after use. A new tooth brush can 
be used each day. Those wishing for a more prolonged use of a tooth 



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282 THE DENTAL DIGEST 

brush can rinse the brush m tricresol (i per cent.) or allow it to stand 
between use in formalin (lo per cent.). 

"A tooth brush sterilizer can be made very readily with practically no 
expense, even by the uninitiated. 

**A11 that is needed is ^a wide necked bottle or a fruit jar/ place in 
it a few drops of formaldehyde on cotton. Now the tooth brush, and 
cork up air tight. In less than an hour's time all organisms will have 
been killed. The brush is put into the sterilizer while it is damp. 

" The writer has used such a sterilizer for three years, with good re- 
sults; there is no injury to the handle, nor the bristles of the brush (as 
claimed by Dr. Feldman, bone and celluloid handled brushes being 
used). Neither is there any injury to the teeth nor the soft tissues. 
The brush is held under the tap or rinsed in a glass of water before 
using." 

"An Aseptic Tooth Brush" (BriHsh Medical Journal 1913). "In 
1910 Dr. D. W. Carmalt Jones and Mr. Herbert Smale read a joint 
paper before the British Medical Association on some points of the 
'Bacteriology of Tooth Brushes' in which they advocated the sterili- 
zation of those articles, because it appeared to them that even in an in- 
fected cavity such as the mouth, it was preferable that an instrument, 
which is so used that it may scarify the gums, should not convey any 
additional organisms directly into the wound. This appears to have 
attracted some attention in America, and Dr. Carmalt Jones and Mr. 
Smale informs us that an American dentist, Dr. Ernest C. Dye of Green- 
ville, S. C, has devised a tooth brush, which is efficiently sterilized by 
formalin vapor. It consists of a cylinder closed at one end by a hemi- 
spherical cap, which contains wool soaked in formalin and kept in place 
by wire gauze; the other end carries the brush which is screwed on for 
use and after use is reversed and screwed inside the cylinder, where it is 
exposed to the formalin vapor and rendered sterile. A more practical 
modification, is they consider, the use of a long cylinder in which an 
ordinary tooth brush is damp when put into the cylinder and all ordinary 
mouth organisms are killed." 

Further experiments were carried on by Dr. Wm. Litterer, A. M., 
Ph.C. M.D., Bacteriologist of Vanderbilt University, also for the State 
of Tennessee (See May 1913 and May 1915 issues of Items of Interest). 
The following were the results obtained: — 

"The results of my experiments with your aseptic tooth brush are as 
follows: — 

"Experiments were made with full strength of formalin (formal- 
dehyde gas 40 per cent, in water), I used the following bacteria to test 
the germicidal power: 



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WHY DISCARD TKfi TOOTH BRUSH? 283 

"i. Streptococcus pyogenes. 

"2. Staphylococcus pyogenes aureus. 

"3. Bacillus typhosus. 

"4. Pneumococcus. 

"The following method was employed: — 

The brush was rendered sterile by superheated steam (Auto Clave). 
The brush was dipped into a pure culture of (i) Streptococcus pyogenes, 
and was then returned to the receptacle to be acted upon by the formal- 
dehyde gas. AJl of the above germs were treated in like manner and 
in every instance double controls used. Both positive and negative 
controls. The result was that complete sterilization was effective in 
less than an hour's time. By drying the brush with the bacteria adhering 
to it the effectiveness of the sterilization was greatly impaired. The 
above results were obtained by using only the full strength formalin. 
No dilutions were used. The question as to whether it would be too 
irritating to the gums can be answered in the negative, if the brush was 
rinsed in water before using. The method appears to be a very effective 
and unique way of sterilizing a tooth brush and in my opinion should be 
seriously considered by the dental profession." 

It is to be hoped that this discussion of the unsanitary condition of 
the tooth brush will be continued until the dental profession takes a 
stand for the "sterilized tooth brush." 

The immortal Miller a generation ago proved conclusively that 
the mouth contains hosts of germs and that they are capable of pro- 
ducing decay and disease. Will not this generation go a step farther 
and demand that the instrument with which we brush our teeth and 
gimis "shall be clean? " 

Can the dental profession take the **next step" that Dr. Mayo speaks 
of and leave the tooth brush in its present filthy condition? 

REFERENCES 

Items oflfUeresi, May 1913, May 1915. 

Pittsburg Sunday Post, Dec. 6, 1914. 

Scientific American, Mar. 13, 1915. 

The Dental Cosmos, 191 1. 

British Medical Journal, 19 13. 

SotUh Carolina State Journal, 1913. 

Oral Hygiene, Mar. 1915. "Menace of the Toothbrush." 

The Literary Digest, 191 5. 



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284 THE DENTAL DIGEST 



DENTAL HYGIENISTS 

By Edward F. Brown 

Secretary, Dental Group, Advisory Council Committee on Child Hygiene, 
New York City Health Department 

A monograph of the Department of Health of the City of New York 
states that it is safe to assume tliat not less than ninety per centum 
(832,500) of school children of the city are in need ot dental treatment. 

It may be said that this situation is due to imperfect tooth structure, 
the causes of which lie partly at least in prenatal mal-hygiene, improper 
feeding of children, lack of cleansing and neglect to prevent progressive 
decay by early professional treatment. 

The insidious character of tooth decay and disease is becoming 
increasingly apparent from the scientific relationships being drawn be- 
tween mal-hygiene and disease. 

There are hardly enough licensed dentists to repair the dental ills 
of the school population alone. 

This situation, engaging the attention of school hygienists, has di- 
rected attention to new means of attacking this problem. 

It was apparent that little was to be expected from curative channels 
in any effective programme of action. Prevention is the keynote of 
modem health work. Inasmuch as the prophylactic principles of den- 
tistry are defined, it was patent that the solution lay in this direction. 

For some time Dr. Alfred C. Fones of Bridgeport had been success- 
fully experimenting in the use of so-called ** dental hygienists" or speci- 
ally trained women who give surface treatment to the teeth of school 
children. 

Last spring Dr. Philip Van Ingen, chairman of the Committee 
on Child Hygiene of the Advisory Council of the Health Department 
of New York, in conference with the Health Commissioner, appointed 
the following members of the Advisory Council of the Department a 
committee to study, report and recommend as to the desirability of 
utilizing dental hygienists in New York: Dr. Herbert L. Wheeler, 
Chairman, Dr. M. L. Rhein, Dr. Homer C. Croscup, Dr. Arthur H. 
Merritt, Dr. Henry C. Ferris, and Edward F. Brown of the Bureau of 
Welfare of School Children, Association for Improving the Condition 
of the Poor, as Secretary. 

The Committee held a number of meetings, and on February 8, 1916, 
submitted the following unanimously: 

"The sub-committee on dental hygienists held three meetings, at 
which time the question of dental hygienists was thoroughly discussed. 



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DENTAL HYGIENISTS 285 

The committee now begs leave respectfully to report that a trial of 
surface cleansing of teeth of school children with accompanying instruc- 
tion in oral hygiene be commenced at the earliest possible moment in 
one or more centres, preferably public schools, provided that the work 
be done by specially and adequately trained persons and under the' 
supervision of competent directors." 

On February 17, 19 16, the whole Committee on Child Hygiene of 
the Advisory Council ratified the report and reconunendations of the 
sub-committee. 

Dr. Haven Emerson, Commissioner of Health, has evidenced the 
keenest interest in this work and it appears probable that at an early 
date some nurses will be assigned to this work. 

At one time there appeared to be some question as to the legality 
of employing dental hygienists. The question was submitted to the 
Corporation Counsel by the Health Commissioner who reported that 
there is nothing in the dental law to prevent the use of dental hygienists. 

In order, however, to avoid any possibility of untrained persons enter- 
ing upon the work without proper safeguards to prevent fraud, ineffici- 
ency and exploitation, the legislature passed a bill (Senate Bill No. 391) 
which has just been signed by Governor Whitman, the provisions of 
which on this subject are as follows: 

"Any dental dispensary or infirmary legally incorporated and reg- 
istered by the regents, and maintaining a proper standard and equip- 
ment may establish for women students a course of study in oral hygiene. 
All such students upon entrance shall present evidence of attendance of 
one year in high schools and may be graduated in one year as dental 
hygienists, upon complying with the preliminary requirements to ex- 
amination by the board, which are: 

A. A fee of five dollars. 

B. Evidence that they are at least twenty years of age and of good 
moral character. 

C. That they have complied with and fulfilled the preliminary and 
professional requirements and the requirements of the statute. 

After having satisfactorily passed such examination they shall be 
registered and licensed as dental hygienists by the regents under such 
rules as the regents shall prescribe. 

Any licensed dentist, public institution or school authorities may 
employ such licensed and registered dental hygienists. Such dental 
hygienists may remove lime deposits, accretions and stains from the 
exposed surfaces of the teeth, but shall not perform any other operation 
on the teeth or tissues of the mouth. They may operate in the office of 
any licensed dentist, or in any public institution or in the schools, under 



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286 



TH£ DENTAL DIGEST 



the general direction or supervision of a licensed dentist, but nothing 
herein shall be construed as authorizing any dental hygienist perform- 
ing any operation in the mouth without supervision. The regents may 
revoke the license of any licensed dentist who shall permit any dental 
hygienist operating under his supervision to perform any operation other 
than that permitted under the provisions of this section." 

This law follows the enactment of similar ones in Massachusetts 
and Connecticut. With these progressive steps taken, it is to be hoped 
that through prevention we will preclude the possibility of another 
generation of children growing up, 90 per cent, of whom will be exposed 
to the havoc wrought by diseased and rotting teeth. 



OUR ANNUAL GOOD FELLOWSHIP DINNER, 1916 




This is the picture of the Annual Good Fellowship Dinner given at 
the end of the Clinic and Exhibit of the Marquette Alumni meeting 
each year. We had some stunts on the stage and as we drank our 
famous beer we sang our college songs and then flew away like the 
swallows to meet again next year. Dr. Albert Frackelton. 



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THE CLINICS AT THB NATIONAL MEETING 287 



THE CLINICS AT THE NATIONAL MEETING 

For many years the meetings of the National Dental Association were 
conducted without clinics. It was deemed that the dignity of that body 
would be lowered by demonstrations by mechanics to show how to do 
things. The entire time of the sessions was given over to scientific and 
near-scientific papers and their discussion. 

Now the success of all dental meetings, including the National, is 
measured by the number and character of its clinics as much as, or even 
more than by the papers that are read. 

Hence a foreword anent the clinical programme for the meeting of the 
National at Louisville in July, will not be without interest. 

In the first place, the fact that Dr. Wm. H. G. Logan of Chicago is 
National Chairman of Clinics gives assurance that this feature will be of 
the highest order of excellence and that the plan of its conduct will be an 
example of organization such as he alone is master of. 

Though the details are not yet complete, the following may be given 
out as the frame work of the plan which has practically been decided 
upon. 

On Wednesday afternoon from 1 130 to 5, at Keith's Theater (seating 
capacity 3,000, ventilated with washed and refrigerated air — ^important 
items in July) there will be given fifteen-minute lectures illustrated with 
stereopticon and moving pictures, on subjects of the most vital interest 
to dental practitioners of to-day, and by men specially selected for their 
knowledge and their ability to impart it in effective concentrated fifteen- 
minute doses. 

Ftiday morning at 9:30, and until 12:30, a sectional Progressive 
Clinic will be conducted in the balcony of the Armory which will present 
some new and novel features in the way of a progressive clinic. The 
arrangements will be such that everybody will see every clinic without 
discomfort or inconvenience. 

These clinics are to be given by dentists residing in the district of the 
National in which Louisville is located and comprises the States of Michi- 
gan, Indiana, Kentucky and Tennessee. 

There will also be surgical clinics by men of national reputation, at 
the City Hospital. 

Altogether the clinical programme offered at the 1916 meeting of the 
National Dental Association will be worth a Sabbath day's journey with 
part of Saturday and Monday if necessary, to come to Louisville in July 
to see, even if you saw or heard nothing else. 



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288 THB DBNTAL DIGEST 



WHY ARE THERE TWO DENTAL PROTECTIVE ASSOCIATIONS? 

Since the recent publication of the report of the Dental Protective 
Association of the United States, the question has been asked many 
times: "Why are there two dental protective organizations? " 

When the Dental Protective Association entered into its agreement 
with Dr. Taggart, by the terms of which Dr. Taggart agreed to license 
its members to use the process disclosed in his patents, for the sum of 
$15, and by which it agreed not to participate in, or contribute to, the 
defense of any dentist against whom Dr. Taggart might bring suit for 
infringement of his patents, there was brought about in the dental world 
a condition which is, in itself, an answer to the above question. 

We quote from the article published in various dental journals, 
which is dated January 3, 191 6, which, among other things, sets forth 
the status of the members of the Dentral Protective Association with 
reference to the pending Taggart litigation: 

"The question is frequently asked: Where does the individual 
stand, with reference to the pending Taggart litigation, who is a member 
of this Association in good standing and who did not accept the terms of 
the agreement with Dr. Taggart before the time limit expired? In reply 
to this important question we will say that every member was notified 
individually and through the dental journals, not once but several 
times, of the opportunity afforded by the terms of the agreement; and 
those who did not accept forfeited their rights to protection from this 
source, by this association. They are hereby notified that they may either 
settle direct with Dr. Taggart or MAKE WHATEVER OTHER AR- 
RANGEMENTS THEY SEE FIT TO PROTECT THEMSELVES 
FROM THE TAGGART PATENTS." 

The last sentence in the above quoted paragraph is the main reason 
and answer for the second dental protective organization. 

After the agreement with Dr. Taggart was effected by the Dental 
Protective Association, and after the dentists of the country had been 
given a suitable opportunity to avail themselves of its privileges, if they 
so desired, and the time in which they might do so had elapsed. Dr. 
Taggart commenced a campaign to coUect money. 

Using roimd figures, about 10 per cent, of the dentists of the country 
availed themselves of the opportunity afforded by the Dental Protective 
Association, and the other 90 per cent, did not. There were just two 
things which this 90 per cent, might do: the one, to submit and pay; 
the other, to organize and test out the validity of the Taggart patents. 

A group of Chicago Dentists decided to adopt the latter course, and 



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WHY ARE TH£R£ TWO DBNTAL PROTECTIVE ASSOCIATIONS? 289 

at a meeting held at the Grand Pacific Hotel in June, of 1914, The 
Dentists' Mutual Protective Alliance came into being. 

The purpose of the Dentists' Mutual Protective Alliance is the pro- 
tection of its members against process patent exploitation. While the 
immediate work in hand is the Taggart litigation, yet its real purpose 
is to be in the field, big and strong and ready to defend the dental pro- 
fession against all those who have unadjudicated process patents to 
exploit. This position is assured by the provisions of its By-laws, which 
reads as follows: "No process patent shall be compromised." 

Immediately after organization,, the management of the Dentists' 
Mutual Protective Alliance took up the work of testing the validity of 
the Taggart patents. In this connection it may not be understood by 
all dentists just how or just what must be proven to invalidate a patent. 
When a patent is granted by the United States Patent Office, it is as- 
sumed that whatever is claimed therein, is new or novel. If it can be 
proven beyond a reasonable doubt that whatever is claimed therein as 
new or novel was in use more than two years prior to the date of the 
patent, the patent falls. 

The work of the Alliance has been to show that the processes dis- 
closed in Dr. Taggart's patents, were in use more than two years prior to 
the date of his patents, or prior to 1905. To this end the case has been* 
twenty days in Court; the attorneys of the Alliance have visited most 
of the states of the Union from Pennsylvania to Arizona, getting together 
evidence; while the trial was in progress last June, they had more than 
120 people in attendance, either directly or indirectly, as witnesses. 

The triaJ lasted weU into July, when it became apparent to the 
Court that the end was a long way off, and he, therefore, adjourned the 
case until the Fall Term, subject to call. During the winter there 
have been several days of argument on motions, and the like, and it is 
probable that the main case will be caJled at an early date. 

The present case is what is known as a test case, and an Appellate 
Court decision in the pending litigation will be, in effect, binding through- 
out the^United States. Should Dr. Taggart be successful in this litigation, 
the question to those who do not have Taggart licenses, will be: "How 
much do you owe Dr. Taggart?" On the other hand, if the Alliance is 
successful, the Taggart patents fall. 

This is said to be the largest and most important piece of dental patent 
litigation that was ever before a Federal Court for adjudication. The 
Dentists' Mutual Protective Alliance is the only organization in the 
field in a position to take the part of 90 per cent, of the dentists of the 
country in that litigation. This would seem to be a sufficient reason 
for the second dental organization. 



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290 TH£ DENTAL DIGEST 

CLOSED MOUTH IMPRESSIONS* 

By Samuel G. Supplee, New York, N. Y. 

FOURTH paper 

proper use of the bunsen burner 

A Bunsen flame presents three distinct temperatures. 

The tip of the flame is the hottest part; and if it is brought directly 
into contact with the modelling compound, it will cause the surface to 
sizzle or bubble. 

The middle of the flame is what might be termed medium warm; 
compound passed a little way into the side of the flame will be heated 
slowly, and to a uniform consistency by moving it back and forth. 

The base of the flame is the coolest part. The material can be passed 
into this part of the flame more slowly without danger of bubbles and 
blisters, and the heat will be transmitted to a greater depth without 
causing the surface to flow. 

Each one of these three distinct temperatures, properly applied, is 
of great value to the operator. 

THE proper size OF FLAME 

A small Bunsen like the one attached to the Supplee outfit illustrated 
in the March issue should be used. 

The Supplee Bimsen has a little cock attached to the frame to regulate 
the exact height of the flame. 

The flame should be a clear blue, and should not be over one inch 
from the mouth of the burner to the tip of the flame. 

A flame of greater volume will not be so easily controlled. Many 
impressions are spoiled when the attempt is made to transform them 
from an impression with the mouth open to one with the mouth closed, 
by using too large a flame and by permitting the flame to glance so that 
it will heat a portion of the impression that it is desirable not to change. 

PREVENTING THE COMPOUND ADHERING TO THE FINGERS 

As compound cools from the surface and is exceedingly sticky when 
in a flowing state, the Supplee heating apparatus is so designed that the 
hot and cold water pans are close together, and a glass spatula is furnished 
for raising the compound from the bottom of the heater pan when in a 
semi-flowing state. 

It is vital that the spatula with the compound be quickly immersed 

•This article began in the January, 191 6, number 



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CLOSED MOUTH IMPRESSIONS 291 

in cold water and the fingers must be wet before an attempt is made 
to remove the compound from the spatula. Otherwise, one will have 
considerable trouble with the material sticking to the fingers. 

If the water in which the compound is heated is hotter than 170 de- 
grees, the compound will become very sticky and will adhere to fingers 
even if they are wet. It is well to cool it before proceeding, as this will 
save time. 

This stickiness can be avoided by letting the compound lie in water 
at 160** for five or ten minutes. 

In taking compound from hot water always reach to the bottom of 
the pan and scoop up the compound on the end of the glass spatula. 
Then with two or three deft turns of the spatula, lift out enough com- 
pound for an impression and give it a quick dip into the cold water pan 
before attempting to remove the compound from the spatula with wet 
fingers. 

The thin film of hardened surface compound will not be sticky. By 
slightly kneading the material, this film is dissolved and will become of 
the same consistency as the rest of the mass. 

Avoid touching compound that has been heated over the flame with 
either dry or wet fingers. Dip it in water first, but avoid permitting the 
impression tray to come in contact with the hot water, as aluminum 
absorbs the heat rapidly. 

An impression tray that has lain in water of 165 degrees cannot be 
inserted in the average mouth without burning the patient or causing 
discomfort. It will also retard the setting of the compound. 

EUMINATING THE ROCKING OF AN UPPER IMPRESSION 

During the manipulation of compound, one may cause an impression 
to rock. 

There are a number of ways to eliminate this condition. The method 
to be employed must be determined by the case in hand. 

Where the ridge is hard and the muscular attachments are definite 
in their action, heat the surface of the water to about 170 or 175 degrees. 
Fill a Spooner self-fillicfg syringe with hot water two or three times and 
empty it so as to thoroughly heat the bulb and metal part. Then fill 
it with hot water and suspend the impression over the pan heels down 
and force the water to strike over the centre of the palatal portion and 
flow to the bottom of the ridge in front and off at both sides for half a 
minute. Quickly pass into the mouth and gently but firmly place up to 
position by bringing pressure with the index finger under the centre of the 
tray and have the patient make the face movements. Hold firm until 
thoroughly set. 



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292 THS DENTAL DIGEST 

If the rock should develop after you have established the biting 
block, or the plane of occlusion, follow the same technique as already 
described and place the tray in the mouth and have the patient bite it 
up to place with a gentle but firm pressure, and make face movements. 

Before doing this adjusting, one must be sure that the occlusal sur- 
face of the compound biting block is flat and smooth in the molar and 
bicuspid region. If the opposing cusps are embedded in it to a depth of 
even half the thickness of a cardboard, it will interfere with the proper 
correction of the impression. 

HOW COMPOUND CAN BE SPOILED 

There are many ways in which compound can be six)iled, a few of 
which are as follows: 

First, by over-heating. As soon as compound has lain in boiling 
water for a few minutes, it will not only lose its quick setting qualities, 
but when it does set, it will not be hard. 

If left lying in water of over i8o degrees for half an hour or more, it 
will not set quickly or nearly so hard. 

Compound should never be used a second time. 

When a cast has been poured into a compound impression, the plaster 
seems to extract or neutralize some of its qualities so that it not only sets 
slower, but is more difficult to work and will not secure the best results. 

Many impressions are failures for this reason alone. They are easily 
bent and will be changed materially by the lips when taking them out 
of the mouth. 

After compound has lain in water of 120 degrees or more for over five 
hours, it will lose many of its qualities for quick accurate work. 

GLOSSING CASTS 

By using a ver\^ thin solution of model separating varnish or water- 
glass and applying it over the surface quickly with a brush, you will 
give to the cast a smooth surface which is conducive to a better finish 
on the completed denture. 

Last, but not least, ice-water or cold air should always be used in 
cooling compound before taking it out of the mouth, in order that there 
may be no changes where the margins are thin. 



Aid in Soldering. — Use the base of an inverted gas mantel as a 
soldering base. Place it on your asbestos soldering block. The flame 
will have easy access to all parts of investment, and you will lessen your 
troubles to nil. — Nils Juell, D.D.S., Minneapolis, Minn. 



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CAST-CUSP GOLD CROWN 



295 



CAST-CUSP GOLD CROWN 

By a. Bruce Coffin, D.D.S., Apache, Okla. 

Prepare root in the usual manner, leaving the stump in the shape of 
a cone or at least with parallel sides; grind off occlusal surface so that 
there will be a space of at least i§ mm. between it and the occluding 
teeth at all positions of the mandible. Make band in the form of a cone 
after the method of Dr, Prothero which, briefly, is as follows: 




Take card-board 5 inches by 2^ inches and near the bottom of the 
left margin, make another mark (b). Using the lower mark (a) as a 
centre make the arc of a circle starting from the upper mark (b). To 
mark gold plate for cutting band, take wire root measurement, cut and 
bend to conform to the curve of the arc on card and mark the length 
from (b) on the arc. Place gold plate on the card with the left margin 
of the gold on the left margin of the card and the lower edge of the plate 
(if it be a rectangular piece), bisecting the arc at the mark indicating the 
length of the wire measurement (c). Now with the gold plate held firmly 
in place mark the arc (c) on the plate; with a straight edge bisecting the 
(a) and (c) mark end of band; with radius extended the width you wish 
the band mark second arc on plate (d e). 

Fit band to root, contour and set band in place on stump. See that 
the end of band does not interfere with occlusion. Warm inlay wax 
and place in occlusal portion of band and have patient bite firmly to- 
gether. Have patient bite in lateral occlusion and by any possible 
movement of the mandible bite down wax. Tack wax to band with 



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294 THB DENTAL DIGEST 

hot instrument at several places on the periphery of band but do not 
touch occlusal portion of wax. Cool wax, remove band with wax in 
place and pour band full of investment compound. You may now 
dismiss patient. 

When investment is hard, carve occlusal portion of crown in the wax. 
Do not add wax to the occlusal portion but, of course, wax may be cut 
away wherever necessary, leaving the original occlusal wax where you 
wish the crown to come in contact with the occluding tooth. In adding 
wax, if it becomes necessary, use a color contrasting with the original so 
that if the occlusion has been interfered with it may be detected. Cast 
by usual method. 

By this method no articulator is needed. It is not necessary to 
refit the carved wax crown on the tooth — ^if indeed it were possible to 
do so without distorting the wax, provided the band was properly fitted. 
By filling the band with investment compound the wax is prevented from 
being pushed farther into the band thus interfering with the occlusion 
and also preventing the cast crown from going to place. 

By this method, with acquired skill, a perfect anatomical crown 
may be made quickly and easily. 



PERFECT ARTICULATION IN POSTERIOR BRID6EW0RK BT 
THE USE OF TRUBYTE MOLAR BLOCKS 

R. D. Pray, D.D.S., Sheridan, Oregon 

The ideal place for restorations of this character are where the 
teeth on the same side, both upper and lower, are to be replaced. Any 
restoration back of the cuspids can be made with the molar blocks. 
If one or more teeth are to be used, simply cut off the teeth with a sep- 
arating disk, saving the remaining teeth for some future case. In 
using the blocks, for work of this character, you will turn out bridge- 
work that is pleasing to the eye and anatomically correct in principle. 
The time used and the expense will be less than if you had used all 
gold, and the final result will astonish you. For illustration take two 
molar blocks, articulate them between the fingers, then look ahead.and 
figure how you can obtain that result on your next case. 

There is nothing difficult about using the molar blocks and I believe 
that the idea has great possibilities for originality in the operator's 
technique, and the range of use will depend entirely upon the individual's 
mechanical ability. 



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PERFECT ARTICULATION IN POSTERIOR BRIDGEWORK 295 

METHOD OF PROCEDURE 

Make your abutments in the regular manner, take your bite and im- 
pression and mount on an anatomical articulator. Determine size and 
shade of blocks to be used. Then grind the ends of block imtil they fit 
snugly between abutments, taking care that the articulation is perfect. 
Now remove blocks and with a small stone cut out the undercuts in the 
diatoric blocks, then grind the ends that lie next to each abutment at 
about a 45 degree bevel — which will allow for the strength of backing 
attachment to crowns. Now soften your inlay wax and press into the 
back of block, taking care that the wax goes well up into the holes, shape 
up wax flush with edge of block, or for added strength let wax extend a 
trifle below edge. Invest wax impression and cast with your scrap gold. 
This backing can be cast in one piece or in sections-as you like — ^possibly 
the casting in sections would be easier and more accurate. At the 
final soldering they will be all joined in one piece. 

After the casting operation, smooth the backing until it will go into 
place easily, then wax all parts into their correct positions on the arti- 
culator, remove blocks, invest the case and solder. Polish the work, 
cement on backings and you have a beautifully finished piece of bridge- 
work with perfect articulation. 

When you cut a tooth off the blocks, before laying it aside for future 
use, make a die and counter die of it so that you can carry out the ana- 
tomical feature on the crown abutment that is to take its place. 

In using the upper and lower blocks, it will not be necessary to do 
much grinding as the teeth will be found to articulate perfectly. And 
in cases where the blocks are to articulate with the natural teeth, you 
will find that they will articulate easier than any tooth that can be 
used, and the natural appearance of the case, when finished, will more 
than compensate you for the care taken. 



Dissolvable Impression Plaster. — F. Duijvensz recommends a 
mixture of two parts of potato flour and ten parts of plaster of Paris to 
make a dissolvable impression plaster. The potato flour must be very 
dry. The mix is made with cold water to which a pinch of table salt is 
added. After having been assembled, the impression is coated with a 
solution of one part of potassium or sodium silicate (waterglass) in three 
parts of water, and the cast is poured. After the cast has set, the im- 
pression is dissolved away in boiling water. — British Journal of Dental 
Science. 



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{nNE/(/5viLDING 




The only business which is good busi- 
ness is that business which tends to build 
the man while the man is building the 
business.— **A^ep/i//ie"—Ne*r. Dent. Jour, 



FIFTY-FIFTY 

W. F. Davis, D.M.D., New York City 

Two or three weeks ago I felt that I needed a little rest from business, 
and decided that I would visit one of my old classmates, who soon after 
his graduation had located in a town a couple of hundred miles north 
of me. I had never heard of his death or removal from the original 
location and therefore decided that he must have remained there. I 
thought I would take a chance anyhow, as it was a pleasant section of 
country and I had never visited it. 

Dave Brown was one of the brightest, most capable and most popular 
members of the class. He was ambitious, full of energy and everybody 
prophesied a briUiant future for him. 

On reaching my destination I readily found Dave's office. It was 
centrally located, over the post-office. As I entered the office Dave 
came out from his little laboratory and met me with a questioning "what 
can-I-do-for-you" look that changed almost instantly to recogm'tion. 

"Great Heavens, Tom! You dear old fellow! I can't tell you how 
glad I am to see you. Sit right down and tell me all about yourself, 
and the rest of the boys. IVe been sort of side-tracked up here and 
haven't kept in touch with the rest of the class. My, but I'm glad to 
see you." 

We gossiped for an hour or so about old times. I told Dave about 
myself, where I was located, my business, my family, and my plans for 
the future. Then I said: "Tell me all about yourself, Dave. How has 
the world been treating you?" 

"Tom, I think a kind Providence sent you to me, to-day. I can 
unburden my heart to you as I cannot to any other living person. Tom, 
I'm scared. Of course, you don't know why or what about. I'll tell 
you. I was 63 years of age last month. I've been practising here 42 
years. I am doing work now for the grandchildren of some of my first 
patients. You know when I graduated, I was considered the best oper- 
ator in the class. I was fond .of operating and proud of my ability. I 



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PIPTY-PIPTY 



297 



was also good in what we then called 'mechanicar dentistry. It's 
'prosthetic' now. When I located here I was well equipped to do good 
work. I was fully determined to do nothing but good work and I have 
lived up to that determination. I have always given good, conscientious 
service. Every week I see in the mouths of some of my old patients, 
gold fillings that I put there fifteen and twenty years ago, and that are 
still in good condition. I have given the community the very best that 
was in me. They know it, and appreciate it. The people here in A — 




"I'm on the down grade. I'm slipping. My hair is almost white" 



like ilie. They respect me. They trust me and they know they can 
depend on what I tell them. They ask my advice about many other 
matters than dentistry. I am really a popular citizen. The voters 
elect me to some minor town office occasionaUy, such as school trustee, 
board of health, and such like. I am quite in demand as an after dinner 
speaker. I don't know that I have an enemy in town. I sometimes 
wish I did have some enemies. It would at least show that I had some 
aggressiveness." 

I remarked that what he had told me thus far would seem to indicate 
that he was ideally located. "It looks so, doesn't it, Tom? I'll show 
you some of the other side. I'm on the down grade. I'm slipping. My 
hair is almost white. My eyes are failing me and my hand is a little 



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296 THE DENTAL DIGEST 

unsteady. They caU me 'Old Dr. Brown.' And the other day I over- 
heard one lady remark to another. 'Don't you think Dr. Brown is 
failing?' I am failing. I am growing old. When I think of the future 
I am frightened. I know what you are thinking. You think I had a 
good practice for all these years and that I have saved some every year 
and that it is time for me to retire from practice and spend the rest of 
my life in ease and comfort. That is as it should be. Every dentist 
should be able to retire at 60. I know it now. I didn't forty years 
ago, and the knowledge only recently came to me and it has come too 
late. When I located here the conditions were unusually favorable, 
and I had a good practice from the very start It increased until it 
was as good as any practice in the coimtry. Naturally, I was pleased 
at my success. I married and raised a family. We lived as well as 
any family of moderate means in the town. I was very well satisfied 
with myself. My ambition died an unnatural death. As my children 
grew older and my expenses increased, my income did not. My practice 
stood still. It was at flood tide, soon to ebb. Sometimes the thought 
came to me that my income from it was not as large as it should be, 
considering the amount of work I did. I know now why I didn't get 
more money out of my practice. I was careless in charging and care- 
less in coUecting. Do you remember how Professor B — used to solemnly 
warn us students against 'commercializing the profession.' It was a 
nice, mouth-filling expression, and I really thought it was valuable 
advice. I tried to foUow it, and because I followed it I am a poor man 
to-day. I have lost thousands of dollars through failure to charge a 
proper fee, and sometimes because I failed to charge at all. I have lost 
other thousands through loose methods of collection. I was afraid to 
offend people by sending them bills too promptly. I sent bills once in 
six months — ^many times once a year. People died, moved away, went 
into bankruptcy, and I lost. If I had been in the habit of sending 
biUs once in 60 days, or certainly every quarter, I should have collected 
most of this money." 

"But, Dave," I interrupted: "Why did you allow yourself to drift 
along in this manner so long? When you first saw your practice decreas- 
ing, why didn't you find out the reason, and get a little system started 
to stop any further loss?" 

"It was that same fallacy about 'Commercializing the profession.' 
I thought it would not be dignified or professional. And I really did 
not know just what to do. I have got most of my ideas about 'Business 
in Dentistry' from my most dangerous competitor. He located here 
about two years ago. He was right out of college, just as I was when 
I came here. He is a first-class workman, a nice fellow, dignified, but 



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PIPTY-PIPTY 



299 



always pleasant We are very good friends, and always have been. He 
has secured a good many of my old patients, but I know in almost every 
case he has advised them to remain with me, and has only taken them 
because they had lost confidence in me on account of my growing old, 
and would have gone elsewhere if he did not take them. He always 
speaks highly of me and of my work. I drop into his office quite often 
and he comes to mine, and we have compared methods and systems. 
He has some advanced ideas about business in dentistry, and says mine 
are all wrong. He has the most complete and accurate system of charg- 
ing. Every operation is charged on the basis of the time taken and the 




'V^ 'I .'i/Jti^t fif-^l^ 



"I'm starting in on the theory that dentistry should be on a 50-50 basis — fifty professional, 

and fifty business" 

material used. He sends bills the first of every month, and expects to 
have them paid promptly. Think of that! If I should do such a thing 
my old patients would think I had lost my mind. I told him so, and 
sprung that warning about 'Commercializing the profession.' 'That's 
nine tenths bunk,' said he. 'I have as much regard for my profession 
as any man, and I wouldn't do anything to disgrace it, but I am not in 
dentistry strictly for my health. It's my business, and it must give me 
a living. I give my patients good work, the best service in my power to 
give. I charge them a reasonable fee for this service, and I expect them 
to pay, and pay promptly. Why not? My butcher, and my grocery- 
man, and my plumber expect their bills paid promptly the first of every 
month. Why shouldn't mine be paid as often and as promptly? You're 



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300 THE DENTAL DIGEST 

all wrong, Dr. Brown. You started wrong and I suppose it is too late 
for you to make a radical change. I'm starting in on the theory that 
dentistry should be on a '50-50' basis — fifty professional and fifty busi- 
ness. It must not only give me a living for the present, but enable me 
to put aside something for the future. If it won't do that, I'll quit and 
take up something that will.' That was a presentation of dentistry 
from a new point of view, and most especially the '50-50' idea. It's the 
right point of view, but it has come to me too late. Don't you see that 
it has, Tom?" 

I was puzzled to know what to say, what advice to give, but sug- 
gested that there must be some way out. 

"If there is, I have failed to discover it, and I have racked my brains 
to find one," said Dave. "It's useless to raise my prices after all these 
years. I'd be afraid to do it. I've got to keep up my present mode of 
living. Any visible attempts at economy would be business suicide. 
Rats desert a sinking ship, you know. I own a house but it is only p)artly 
paid for. I could get along with a smaller, cheaper one, but there you 
are again confessing failure. I dare not risk it. I know my friends 
think I am prosperous. They think I don't care to have very much 
practice; that I am pretty nearly ready to retire. I ought to be, but 
I can't, Tom, I can't. Can't you understand why I said I was 'scared'. 
It is pretty nearly a tragedy. Why didn't somebody tell me about 
that '50-50' idea forty years ago? It would have made just the difference 
between prosperity and failure." 

I had to leave Dave, but I have had a heavy heart whenever I have 
thought of him and his future. I wonder if there are not many others 
whose future looks as dark as his, all because they were not taught that 
dentistry was a business as well as a profession? 



THE NECESSITY FOR KEEPING COMPLETE RECORDS 

By C. Charles Clark, D.D.S., Kansas City, Mo. 

One of the most difficult things for the ordinary professional man 
to do, is to get his debit and credit records in any sort of shape, and 
some have not the necessary help to do this many times unpleasant work. 
When one gets through with a difficult operation, it is easy to allow the 
making of a record to go over until the next day, so any innovation looking 
toward simplifying the method of keeping these records will be appre- 
ciated. 

There are several reasons why you should keep your records so that 



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THE NECESSITY FOR KEEPING COMPLETE RECORDS 301 

they can be understood, not only by you, but by others, in case there 
arises a dispute as to what was done and what was not done by you. 

For instance, it had always been the habit of the writer, until he 
learned better, to arbitrate his accounts, on any pretext whatever made 
by the patient, but he found he made no friends by that course of proce- 
dure, but on the contrary people considered him easy, so he sought a 
better way, and found that there were a number of systems, the most 
common, being one with pictures of teeth. It is true that you can 
mark black spots on the teeth, but that is in addition to the written 
record of the charges, and serves no additional purpose. 

The record should be so written that when read, it forms a picture 
in the mind of the patient at once, without further explanation. The 
teeth pictures occupy a great deal of space, which could be used to 
better advantage. 

Did it ever occur to you that in other dignified callings, they do 
not use characters to represent the sales? However, they may have 
some particular code, which is used as a simplification of their written 
record, which can be explained so that when a disputed account is 
brought into court, there can be no question of its meaning. 

The writer has noted three kinds of accounts, cash, book and notes. 
Cash is the ideal business, and one that exists in a very few cases; open 
accoimts, the delusion and snare that has caused many a professional 
man to end his days in penury and want; and the negotiable note, or 
contract, which will permit you to raise money before its maturity, if you 
desire. 

When it comes to collection of your outstanding indebtedness, a 
third party can do better for you as a usual thing, and the reason for 
this is that they have a range of emotions to play on that you can't even 
mention, and they seldom hesitate to use everything at their command 
to turn the debits into cash. 

And I want to repeat that you should have an understanding with 
your patient at the earliest possible moment regarding your fees. At 
that time he is seeking your services, so then is the most opportune 
moment to arrange for future payment. 

When your patient asks you what your work will come to, make him 
an estimate, computed on whatever system you may use; most of us 
have a hit or miss system; we claim to charge so much per hour, or per- 
haps so much a tooth, but I find that some work I am doing at less than 
five dollars per hour, and other work at as high as twenty-five dollars per 
hour, so I am trying to see where I can mend this. 

It IS a fact that for some classes of work the patient will pay more than 
for others, because, as between precious stones, more is paid for the dia- 



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302 THE DENTAL DIOBST 

mond than for the opal, so it is between different fonns of service. The 
pictures of the values are different in the patient's mind, and it is hard 
to change these pictures. 

However, we should study and strive by every honorable means to 
arrive at a correct system, so that we may charge fairly. 

On my ledger, I especially note the manner of payment, when, where 
, and how to be made, and I find it a good plan. 

It is well to know what your patient can pay, for obviously you 
wouldn't try to talk a laborer's child into a thousand dollar case of ortho- 
dontia, and yet you would not hesitate to tell a prosperous business 
man that he should spend a thousand dollars on his child and proceed 
to show him why. 

"Yield unto Caesar that which is Caesar's" but unto me that which 
is mine, is a lesson to all of us. And say what you will, you and I often 
work for supposedly deserving people for less than we should and these 
people could pay as well as some others of whom we ask more. 

I have heard it said that a professional man's work was worth in 
proportion to what his patients were able to pay. And in a great 
many instances you will lose patients unless you charge them well. A 
fee that keeps you always laboring, and only permits you to eke out an 
existence, will never permit you or any of those dependent on you, to 
get the rubber tire habit. 

I presume that there are a great many who have good records, but 
if you have not you are cheating yourself and casting a certain amount of 
discredit upon the profession of which we want you to be an honorable 
member. 

621 CoiiMERCE Bldg. 



To Sav'e Time During the Use of Silicate Cebients. — ^The ma- 
jority of silicate fillings are placed in the upper teeth while the rubber-dam 
is in position. To save time the dam has been drawn down and tied with 
a ligature and then cut off. This sometimes strains the rubber so that 
leakage occurs, and when finishing it is sometimes annoying to control the 
loose margins, and there is also danger of moistening the filling. As a 
substitute for this procedure the following has proved valuable: During 
the hardening of the cement, turn up the lower edge of the dam and pin it 
securely to the upper edge on both sides. The patient can now talk, 
expectorate, etc., as though the dam were not in position, and even other 
work can be done. 

When finishing is in order, the dam is turned down and the work com- 
fortably proceeded with.— Otto E. Inglis, Philadelphia, Pa., The Denial 
Cosmos, 



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SELLING DENTURE SERVICE 303 

SELLING DENTURE SERVICE 

I. J. Dresch, Toledo, Ohio 

Although artificial dentures were the first mechanical restorations 
made by dentists, denture work is to-day the most poorly paid branch 
of dentistry. Notwithstanding the great advancement of the work 
it is not as remunerative to-day as it was fifty years ago. To a majority 
of dentists with a practice of ^{3,000 or more, denture work is actually 
unprofitable. These statements may seem far fetched, even a trifle 
pessimistic, but they are hard, cold facts, which must be squarely faced 
and eliminated before denture fees can be placed on a proper basis. 

In comparison with denture work, a fair fee is received for crown 
and bridge work, fillings, inlays, etc. Is there any legitimate reason 
why the other forms of work should be more profitable than denture 
work? Most assuredly there is not. Then why do such conditions 
exist? Let us take an example. Suppose you have a case for a cast gold 
inlay; you are extremely careful to apply the most thorough and scientific 
knowledge in the cavity preparation, and in securing normal occlusion. 
When you have set the inlay you are paid for the material used, general 
expense, and your time plus — ^your knowledge. You have been paid 
for your professional knowledge. Now on the other hand suppose a 
full upper denture is to be made. Perhaps an ordinary plaster impr&sion 
is taken with the mouth open, then the patient is instructed to close 
the jaws on a roll of wax for the bite. That is as far as the patient's 
knowledge of the work goes and to the patient the service is as mechanical 
as the Bertillon system of recording thumb prints; and the patient pays 
for the service as such. To place denture work on a financial parity with 
other branches of dentistry it is necessary for the dentist to be paid for 
material, general expense and time plus knowledge. In other words 
denture work must be placed on a professional basis before the dentist 
can expect professional fees. 

Here is how three dentists of a city in the middle West placed their 
fees for denture work on a professional basis. In the same city there 
are more than one hundred dentists. The average fee for a denture is 
$12 and for an upper and lower $20. Twenty of the most progressive 
dentists were asked if they endeavored to sell anatomical articulation 
to the patient? If they had become acquainted with the closed mouth 
method of impression taking and if they explained the beauty of Truby te 
teeth to the patient? The astounding result was that seventeen out 
of the twenty answered all three questions in the negative. When 
asked why they made no effort to sell such service the answers were varied. 



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304 THB DENTAL DIGEST 

One said, ''What is the use? It goes over the patient's head" another 
"I do not have time." But all agreed that as a general rule they never 
thought of trying to sell anything better. The three dentists who 
answered the questions in the affirmative said they always explained the 
merits of articulation, scientific impressions and Trubyte teeth. That 
they had no trouble in persuading eighty per cent, of the patients 
to accept the better service. One said he did not think it would be fair 
to the patient to go ahead with the ordinary work and not explain the 
better things. These three dentists average $50 for an upper and lower. 
They said they often received $60 but the fee would be somewhat re- 
duced for some of their old patients, and those not financially able to 
pay well. 

One was asked how he presented his selling talk to the patient. 
His answer ought to mean increased fees for many dentists. "First of 
all I explain the difference between an impression taken with the mouth 
open, and one that is taken with the mouth closed. The average patient 
is interested in how the work will be done so I take time to make aU 
perfectly clear to the patient. Then I show the difference between oc- 
clusion and articulation. Two specimen cases are best for that; one set 
arranged the old way and mounted on a plain line articulator, the other 
set anatomically articulated and mounted on a Gysi Simplex. These 
specimens make it easy for the patient to understand what articulation 
means. Of course I show the beauty and efficiency of Trubyte teeth, 
the moulds and shadings as compared with other teeth, and there are 
very few patients who do not readily see their superiority." 

This dentist has been in the same location seventeen years. His 
office is in the residential district of a middle class of people. He has 
increased his denture fees one hundred per cent, in the last five years, 
and he is not what could be called a good salesman; just a good con- 
scientious dentist who has been rendering service. He has found that 
people in moderate circumstances will i>ay for service; and he has placed 
his dentiu-e work on a professional basis and is being paid professional 
fees. He is being paid for material^ general expense and time, plus — 
put the plus — ^in your denture fee. 

360 Spitzer Bldg. 



Bad teeth and ill-kept gums not only look bad, and feel uncomfort- 
able if not painful, but they let in more serious disease like rheumatism, 
chronic sepsis, and tuberculosis. It doesn't pay to "let the teeth go." 

—The Healthy Home. 



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THE SUCCESSFXTL PRACTICE OF DENTISTRY 30S 

THE SUCCESSFUL PRACTICE OF DENTISTRY* 

By Wallace Seccombe, D.D.S., Professor Preventive Dentistry 

AND Dental Economics, Royal College of Dental 

Surgeons, Toronto 

This excellent article is worthy of careful reading by every dentist who 
desires to combine good professional and good business methods. — 
Editor. 

There was never a time when more exacting demands were made 
upon the dental surgeon than the present. Changes in the science and 
practice of dentistry are so rapid that a practitioner may become old- 
fashioned in j&ve years. Fifteen years ago the younger members of 
the profession were universally considered more modern in their prac- 
tice than were the older graduates. That time has passed. Advances 
have been so rapid that it is not now a question of being old or young, 
but whether you are abreast of the times. The advantage has gradually 
passed from the younger graduate to the older man, who is familiar 
with the best thought of the profession and is able to bring his wider 
experience to bear upon modem methods of practice. 

The standard of dental service is being continually raised. The 
dental graduate who leaves college to-day with the impression that 
he can settle down comfortably to the practice of dentistry, dispose 
of his college texts, ignore dental magazines and dental meetings, stamps 
himself, at the very outset, as a complete failure. Likewise, the older 
practitioner who has failed to study the later dental works and has thought 
himself too busy to attend dental conventions is also a failure. He 
does not render that high quality of service which his years of experi- 
ence would otherwise make possible. 

Heretofore, there have been those who have argued that the prac- 
tice of dentistry would never assume the importance of that of medi- 
cine, because in the one case a tooth was at stake and in the other a 
life. The logic of that argument has been destroyed through the dis- 
coveries of science, that the presence of rheumatism, neuritis, endo- 
carditis, gastric ulcer, nephritis, and other systemic lesions are due, in 
many cases, to local foci of infection about the roots of teeth. Rose- 
now has established conclusively the facts concerning the transmuta- 
tion of streptococci, the organism having, in one instance, an affinity 
for the joints; in another, for the appendix, or in still another for the 
stomach. 

•Read before London Dental Society, 24th February, 191 6. 
Read before Toronto Dental Society, 13th March, 19 16. 
Read before Hamilton Dental Society, 15th March, 10 16. 



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306 THB DBRTAL DIGEST 

For many years the dental profession has recognized the relation- 
ship between septic conditions in the oral cavity and many systemic 
diseases, but that knowledge has been based largely upon clinical experi- 
ence. Through the observations of Hunter and Osier, and the ex- 
periments of Rosenow, Billings, Gilmer and others, the direct rela- 
tionship between local foci of infection in the oral cavity and systemic 
conditions of disease has been scientifically shown. The result is that 
leading members of the medical profession have come to regard den- 
tistry as a most important factor in preventive medicine. 

Now what does all this mean? It means that the practice of den- 
tistry is a matter not of saving the teeth alone, but of preserving life 
and health. It means that much of the present practice of dentistry 
will be revolutionized. As a profession we shall have to adopt an en- 
tirely different attitude toward the question of the vitality of the teeth 
and the treatment of those roots that are comfortable and apparently 
healthy, and yet are maintaining a source of systemic infection. It 
means that the public will appreciate the importance of aseptic root 
canal work, and will, because of the vital issues at stake, demand that 
dental service be rendered in conformity with the most advanced me- 
thods of practice, and be more willing to pay adequately for that service. 

Now let us turn for a moment and ask ourselves the question: What 
is the successful practice of dentistry? The successful practice of 
dentistry might be defined thus, the rendering of the best possible 
service, under the most agreeable conditions, and the acquirement of 
fair remuneration for the service so rendered. 

When we speak of "rendering the best possible service" we are 
dealing with a variable factor. The service rendered by one dentist 
may be a very diflferent service to that rendered by another, though 
in each case the service may have been *' the best possible." It is like- 
wise true that circumstances may compel, in dififerent patients, diflFerent 
treatment of similar conditions, and though the operator be the same, 
and though he may render the best possible service under the circum- 
stances, the service rendered in each case may vary. 

Rendering service is, after all, the most important factor in suc- 
cessful practice. Unfortunately, skill and success are by no means 
synonymous, though a distinct relationship exists between them. Bet- 
ter dentistry makes for success, and success encourages better dentistry. 

There are many dentists, skilled in the science of dentistry, who 
fail entirely in the successful conduct of a dental practice. Upon the 
other hand there are those possessing only average skiU, who apply 
correct principles in the management and control of practice, and who, 
therefore, meet with a fair measure of success. Every member oi the 



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THE SUCCESSFXTL PRACTICE OF DENTISTRY 307 

profession should aim to be, not only a skilful dentist but a successful 
dentist. 

The recognition of the successful dentist is much easier than his 
analysis. Under the microscope he proves a most elusive individual, 
and consequently we will approach our subject from the synthetic 
standpoint and study a few of the factors which make for success. To 
attempt any set formula would be as foolish as it is impossible. Thought- 
less imitation must be avoided, for, after all, the greatest success for 
any man is the highest and. best possible development of himself. We 
are not, upon this occasion, so much concerned about the creation of 
some fanciful character that we may emulate, as we are anxious to study 
the fimdamentals upon which success is built, that we may, each in his 
own way, endeavor to apply these principles to his individual problems 
and harmonize daily conduct with those laws which govern successful 
practice. 

It is interesting to study the evolution of the dental professions' 
attitude toward this question. In the early days attention was focused 
upon the service to be rendered to the exclusion of almost every other 
consideration. Later the thought of the profession was directed toward 
the rendering of the service imder the most agreeable conditions. This 
naturally led to the study and use of every approved means for the 
relief of pain, the acquirement of the best dental equipment, and the 
adoption of well appointed and pleasant office surroundings. 

The third requisite is equally essential to successful practice, namely, 
the acquirement of a fair equivalent for the service rendered. An 
equivalent to be fair must be intelligently fixed. Haphazard methods 
in this important matter works nothing but injustice to both patient 
and operator. It is simply a question of equivalents. To render a 
service without proper remuneration is unfair to the operator. To 
secure a fee without rendering the best possible service is equally unfair 
to the patient. In either case an element of dishonesty enters and 
failure results. Unless economic law operates successful practice is 
impossible. 

{To be continued in the July issue) 



A One-mdc Investment for Suall Repairs. — ^Invest the full flask 
and just previous to the setting of the piaster place a piece of tissue 
paper over the repair, cover over with the balance of the plaster and put 
the top of the flask on. Quick and safe.— A. M. Gordon, Brisbane, Q.— 
Commonwealth Dental Review. 



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306 



THE DENTAL DIGEST 



« WHERE HAVE MY PROFITS GONE?" 

By Nils Juell, D.D.S., Minneapolis, Minn. 




The 1914 Dollar 

In 1915, my '* 1914 Dollar " was published and now I am pleased to 
present, my 19 15 Edition. 

Your observant readers will probably notice that I cut my operating 
expense considerably, and that I must have increased my credit in the 
bank. 

The items are taken from my ledger. Many accounts which show 
up on my books minutely, have been put together under one heading, as 
"Personal Expenditures, Entertainment, and Charity." I did not 
attempt to change it this year, as it would have made comparison more 
difficult. 

I see, however, many ways in which it can be improved, and will 
show that in some future "attempt," 



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WHBRE HAVE MY PROFITS GONE? 



309 



One item of interest is perhaps the change of "Automobile" to "Sav- 
ing's Account." Instead of owning an automobile, I hired one, when 
needed, as they are very cheap in our cosmopolitan city. Such biUs 
were charged up to "Entertainment." Our small loss of bad accounts 
can be credited to personal attention instead of trusting so-called Agen- 
cies. "Discounts" perhaps needs explanation. 




The 191S Dollar 

Discounts are given when a patient can't stand the price. One 
regular cost-price-system prevails, and is discounted in certain instances, 
and same discount charged to "Expense." Could properly be charged 
to Advertising account. 

Life Insurance, Investments, and Saving's Account represents the 
"Rainy Day Stuff." The balance is spent to make supply houses happy 
and to keep the wolf from the door. 

In conclusion, I wish to thank the Digest for the many good points 
I have received from Brother Bill. 



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310 THE DENTAL DIGEST 



A REPLY TO "JOSH" AND "R. A, W." IN THE MARCH DIGEST* 

"Josh" encourages the elimination of "rough necks" and "K. M.'s"; 
And now comes "R. A. W." with the discovery that any dentist could 
advertise his practice or employ an expert ad-man to do it and "Lo! 
and behold" all dentists are again on equal plane (commercially) with 
an added burden of expense. 

My Dear Doctors : The law of " the survival of the fittest " is acknowl- 
edged as unalterable, and if we choose to "hobble" the progress of our 
profession to take care of unfortunate fellow practitioners then pray tell 
me if we are honestly honest to the public at large? 

All people are not "nearly rich" and all people cannot afford to pay 
$3 .GO for alloy fillings or $ i o.oo f or crowns. It is a foolish business doctrine 
that teaches "to H — with the poor." And now think this over too; 
many advertising dentists are doing good conscientious work, with large 
incomes on a moderate fee basis, not by a process of filching patients 
from other dentists, but by teaching the "common folks" the value of 
good teeth together with an inducement to have their work done. In- 
creased patronage takes care of the office income, and lots of laymen 
are better off while the profession needn't feel injured. Let us not 
forget that Dentistry is the only profession in the world that is compelled 
to sell a visible "commodity" along with a professional service. — R. L. S. 



PROVING NEGLIGENCE OF DENTIST 

By a. L. H. Street, St. Paul, Minn. 

When suit is brought against a dentist for damages claimed to have 
been sustained by a patient through negligence in the way in which work 
has been done, resulting in a fracture of the jawbone, it becomes an 
important matter whether the law casts the burden on the dentist to 
affirmatively establish the fact that he was not negligent and that the 
fracture resulted from some condition of the jaw, of which he was justly 
Ignorant, or whether the burden is on the patient to affirmatively show 
the contrary. If the former proposition were true, it would be more 
difficult for the dentist to exonerate himself from liability in many 
cases. All the patient would be required to show would be that in ex- 
tracting a tooth, defendant broke the patient's jaw. In a lawsuit re- 
cently before the Illinois Appellate Court (Blodgett v. Nevius, 189 
Illinois Appellate Court Reports, 545) this precise situation occurred. 

♦Pages 164 and 171. 



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CAUTIOlf 311 

Plaintiff rested his case on mere proof that his jaw was broken in the 
extraction of a tooth, and was denied recovery. In short, the court 
held, and this seems to be generally recognized law, that there is no 
presximption of want of due care or proper skill on the part of the dentist 
merely because of the fracture. The suing patient must go farther 
and show that the break would not have occurred except from some negli- 
gent or unskillful act on the part of the dental surgeon. 

RIGHT TO RECOVER FOR DENTAL SERVICES 

There can be no recovery in New York for dental services where 
plaintiff fails to show that when he performed the services he was duly 
licensed to practise his profession, according to a decision of the New 
York Supreme Court handed down in the case of O'Beime vs. Carey, 
150 New York Supplement 666. This decision means more than that 
an unlicensed dentist cannot recover for work done; it means that even 
a licensed dentist must aflSrmatively establish the fact that he has been 
duly registered. In the latter case, the dentist's assumption that the 
patient who is sued will not controvert the fact that a license has been 
issued is apt to result in an adverse judgment, unless respect is paid 
for the decision announced in the cited case. 



CAUTION 

Editor Dental Digest: West Tampa, Fla., March 30, 1916. 

New York City. 
Dear Sir: 

As a matter of warning to your readers will you kindly publish that 
a man giving the name of J. B. Boone, has been in this vicinity represent- 
ing himself as a general agent of The Dentists' Supply Co. and other 
manufacturers and soliciting orders on which he collects a payment and 
departs. He also represents that he has second-hand goods in first class 
condition, which he offers at a low price, collecting a first payment. 

He is about 45 years of age, walks with a cane and owing to a weakness 
in back or legs walks with difficulty. He frequently asks dentists the 
cost of having a full upper plate and lower partial plate, using that as a 
bait for a large order. 

I wrote to one manufacturer whom he claims to represent and they 
disclaim his connection. 

Several have notified me of their failure to receive goods ordered from 
him. Yours truly, 

F. L. Adams, Secretary 
Tampa District Dental Society. 



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RAGTIOL HI^^■s 



[This department is in charge of Dr. 
V. C. Smedley, 604 California Bldg., 
Denver, Colo. To avoid unnecessary de- 
lay, Hints, Questions, and Answers should 
be sent direct to him.]* 

Polishing Crowns. — I have prepared a dozen clothes pins to fit 
various sized crowns, and find that in polishing crowns, these clothes 
pins hold better and are more satisfactory than any crown-holder now 
on the market. — Nils Juell, D.D.S., Minneapolis, Minn. 

To Splice an Engine Cable. — Take the end of the cable that is 
to be drawn into the other, and at a point about an inch from the end 
pick up a single thread and pull it out; proceed all around the cable 
until there are six threads sticking out from the side of the cable an inch 
from the end. Cut these ends off. The end of the cable is then about 
half the size originally, and may be drawn into the other end in the usual 
way and sewn down neatly.— D. W. Barker, D.D.S., Brooklyn, N. Y. 

Methods to Facilitate the Attachment of Gou> Castings to 
Steele's Backings. — Select backing projecting beyond facing, about 
one-sixteenth of an inch. Trim backing flush with facing except at the 
four comers where little lugs are left which are bent toward surface of 
backing, to be covered by the casting (care must be taken not to bend 
backing away from facing). When the gold cast is cast against the 
backing, it is held firmly in place by the lugs. Another way is to select 
a backing flush with facing after trimming and then punch four small 
holes in backing which are countersunk on surface toward facing. When 
waxed up holes must be full of wax, flush with surface. The casting 
will be securely attached to backing by the undercuts caused by counter- 
sinking, eliminating the necessity of soldering lugs to backing. — M. 
Hollway, D.D.S., Buffalo, N. Y. 

To Get Proper Results When Using Synthetic Porcelain in 
Proximal Occlusal Cavities in Bicuspids and Molars. — Take a 
steel matrix band and coat it well with flexible collodion and apply same 
to tooth with the matrix retainer. The synthetic material may then 
be packed in, same as amalgam, giving a very hard and dense filling with 
no discoloration. The celluloid strip or matrix will not cKng to the 
cervical margin. — George E. Cox, D.D.S., Wilmington, Del. 

*In order to make this department as live, entertaining, and helpful as possible, ques- 
tions and answers, as well as hints of a practical nature, are solicited. 

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PRACTICAL HINTS 313 

For Sensitive Root Canal.— For cases where the root canal is ex- 
tremely sensitive after removing live pulps from anterior teeth, moisten 
the canal with a 50 per cent. sol. of silver nitrate. Care must be taken 
not to get the medicament too close to the apex. — M. Williams, D.D.S., 
Wheaton, Minn. 

Nature's Own Anesthetic. — Cavities can be outlined and prepared 
up to the point of convenience form or retention pits without adjusting 
the dam, if the operation is painless or as nearly so as is possible, as is the 
case if a constant stream of warm water is sprayed upon the bur or cutting 
instrument at all times. Not only does this allay pain but it keeps the 
field of operation clean. — Pacific Dental Gazette, 

Repairing Plaster Casts. — Celluloid is dissolved in equal parts of 
camphor and ether, enough to make a creamy mixture. The parts of the 
cast are perfectly dried, painted with this solution, firmly united, and 
allowed to dry. This celluloid mixture is insoluble in water, and does not 
suffer by vulcanization. — La Odontologia Peruana, ( — The Dental Cosmos.) 

Methods of Relieving Pain While Operating on a Sore Tooth. 
— ^Use pressure in the various directions to ascertain if soreness is in a 
particular side or root. UsuaUy a ligature can be passed around the 
tooth"with little discomfort. If this is impossible, use small orthodontia 
wire. Fasten at the side that is sorest. It is well to make a loop for 
the finger to pass through while pulling. If lateral pressure caused in 
this way produces pain, use two ligatures or wires, fastened at opposite 
sides of tooth, then bring the ends together over occlusal or incisal, and 
thus get a straight pull. Often a firm grasp with thmnb and forefinger 
will suffice, approximating teeth serving to steady the grasp. Modelling 
compoimd placed against the teeth, and allowed to cool, (one piece 
lingually and one labially or bucally, and held with thumb and fore- 
finger), aids greatly in supporting loose or sore teeth while operative 
work is done. — K. K. Cross, D.D.S., Denver, Colo. 

Simple Method of Altering Seamless Crown Dies. — ^Am using 
a Sharpens seamless crown outfit, and sometimes find that the tooth forms 
are too wide, or that the cusps or fissures need slight altering. I find 
that a simple way to correct or change these tooth forms is to run up 
the die in the usual manner, split the die, and oil the tooth impression. 
I then put the die together again, and fill it with a medium mix of plaster 
of Paris. While this is still soft I insert a tooth pick or metal post in 
the same position as we find it in the regular rubber tooth form. When 
the plaster has set, I remove it from the die and make whatever changes 



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314 THE DSNTAL DIGEST 

are necessary by carving it. Then I put it on the rubber base, the 
same as a regular rubber tooth form, and pour a new die over the plaster 
model. I then make the crown in the usual manner with very satis- 
factory results. — ^Fpank Mayer, D.D.S,, Grafton, Wis. 

To Make a Beautiful Plate. — In a case of upper extraction for 
a full plate ^here there is marked protrusion and while patient is under 
somnoform or ether, after teeth are out, cut a layer of gum tissue and 
process" off from first bicuspid on one side to the first bicuspid on the 
other side, with a curved pair of shears. This will make it possible to 
make a beautiful plate. I have performed the above operation in several 
cases with gratifying results. — M. Willmms, D.D.S., Wheaton, Minn. 

To Save Time and Material :.n Investing Inlay Models. — 
Set the inlay flask on a piece of rubber dam that has been placed on a 
piece of plate glass, which, if the ena of the flask is true, will make a 
water tight joint. With a syringe, about half fill the flask with water 
and add the investment compound, making the mix in the flask. Then 
invest the model as usual. If not enough water has been used, a few 
drops may be added. A very little experience will teach one exactly 
how much. A lot of time and probably 75 per cent, of the material is 
saved. — F. H. Miller, Aylmer, Ont, Can. 

To Prevent the Softening of Carving Compound in Making 
Crowns by Hood Method. — ^When the lowest crown is ready for the 
metal, oil the surface well. It will be found that the oil will keep the 
hot metal from spoiling the sharp lines on model. — ^J. C. Tinsley, Lynch- 
burg, Va. 

A New Method of Handling Undercuts in Making Metal 
Plates. — Treat the impression with separating fluid, run the undercuts. 
Now smooth this up so that they will draw straight away from the 
finished model. Treat these with separating fluid and run model. The 
model will now be in two or more parts. Place parts in their correct 
position and invest in sand mould. Knock out model. The parts re- 
presenting the undercuts will remain in the mould. These may be re- 
moved with care without disturbing the model. Now proceed with 
the hot zinc. — ^J. C. Tinsley, Lynchburg, Va. 

Preventing the Cracking and Bleeding of Chapped Lips. — 
When a patient presents with chapped lips, which would crack and bleed 
if stretched, the lips are coated with resinol ointment. The lips will 
then be soft and pliable, and will stretch without cracking and bleeding. 
— S. M. Myers, Teooas Dental Journal. (Jm Dental Cosmos) 



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QUESTIONS AND ANSWERS 315 

QUESTIONS AND ANSWERS 

Question. — ^As a subscriber to the Dental Digest I would like to ask 
you what you consider a good every day '^ root filler? " I shall appreciate 
an early reply. — ^J. S. 

Answer. — I use and can recommend, chloro-percha pumped into 
canals with twist broach rotated backwards, followed by guttapercha 
canal points as near diameter of canals at apex as can be selected, points 
being carried in and melted off at about apical third of canal with hot 
plugger. Pulpal two thirds of canal and pulp chamber being filled with 
Flagg's Ox Chloride Cement.— V. C. S. 

Question. — I have been bothered for some time by deterioration of 
rubber tubing, bags, etc. Please answer through your "Practical Hints " 
in the Dental Digest if you know of any way to prevent same. — ^A. D. D. 

Answer. — Treating with strong ammonia fumes occasionally will 
retain or restore life to anything made of rubber, if it is not too dead. — 
V. C. S. 



Editor Practical Hints: 

In a recent issue of the Digest, I noticed a suggestion in regard to 
the opening of a lame tooth, using a dentimeter and ligature. That is 
a very good method, but what seems to me a better one is the use of 
conductive or infiltrative anesthesia. 

In a case that presented for treatment a few days ago, I was con- 
fronted with an upper second molar with both pulp and peridental 
membrane highly inflamed. Two injections of novocain, one buccally 
and another lingually, enabled me not only to open the tooth, but also 
to remove the inflamed contents absolutely painlessly. 

While I do not make a practice of removing pulps from multi-rooted 
teeth by novocain anesthesia, I do highly endorse conductive and in- 
filtration anesthesia for such purpose in the single rooted teeth, and in 
conditions similar to case cited above. 

Yours truly, 

C. M. Gillock, D.D.S., LaRussell, Mo. 



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MANAGEMENT OF CHILDREN AND THE 
1-^ ^^ TREATMENT OF THEIR TEETH 

By Clarence R. Minns, D.D.S., Toronto 

TREATMENT OF EXPOSED PULPS IN VITAL TEETH 

In a great majority of cases, unless the pulp is too extensively ex- 
posed, I invariably resort to pulp-capping. First carefully excavate 
the decalcified tissue and dry cavity, cauterize with phenol. Then 
cover the exposure with a paste of oxidized zinc and oil of cloves. Next 
take a small piece of paper just large enough to cover the floor of the 
cavity, mix a thin mixture of oxy-phosphate of zinc cement and place 
it on one side of the paper and place the cement side down in contact with 
the cavity seat, gently tapping it to place so as to avoid pressure. Now 
the cavity may be carefully filled with copper cement. Now if the pulp 
should die in one of these cases, and we have the patient under our car^ 
continually, we have a fairly easy condition to cope with; an easier 
one, to my idea, than what the extirpation and removal of a vital pulp 
from a deciduous tooth is. 

In a very lew cases, however, it is absolutely necessary to extirpate 
the pulp, and there are two methods open in most cases. The first 
one is reasonably safe, but a rather slow and diflftcult operation. The 
second one is fairly easy and quick, but rather dangerous, unless one 
remembers well the prospective dates of complete calcification and of 
commencement of decalcification of the roots of temporary teeth. 

We wiU first consider the safe and most reliable method, the use 
of phenol. This is a somewhat slow and tedious operation, and gen- 
erally requires from three to five sittings. At the first sitting, seal in 
phenol in contact with the pulp after having enlarged the exposure. 
At the next sitting, after from three days to a week, it is often found 
that the pulp can be removed entirely from the chamber. Then force 
phenol into the root canals, using pressure with raw vulcanite, and 
leave for three or four days. At the third sitting, usually by carefully 
manipulating the broach, the pulp may be all removed, although it 
may take a couple of additional sittings in some cases. 

The second method of procedure is the use of a very limited quan- 
tity of arsenic, and as these teeth are very susceptible to its action, it 
should never be left more than twelve hours. In connection with 



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TRBATMENT OF CHILDREN'S TEETH 317 

the use of arsenic, it is necessary to remember that in temporary molars, 
generally speaking, the roots are completely calcified at the third year 
and decalgification does not commence till the seventh or eighth year. 
After twelve hours the pulp can usually be removed with barbed broaches. 
The canals are dried out and flooded with a solution of silver nitrate. 
The roots are then filled with a paste of calcium phosphate and creosote. 
The cavity in the tooth can then be filled with copper cement if it is 
not too large. 

If the cavity included two thirds or more of the crown, the crown 
should be ground down, leaving a saucer-shaped cavity which is stained 
with silver nitrate. 

PUTRESCENT PULPS 

Teeth with putrescent pulps should have the canals thoroughly 
cleansed and a mild treatment of formo-cresol sealed for a few days. 
If the conditions are favorable at the next sitting, the canals should 
be dried and stained with silver nitrate and the cavity filled, if not 
too large, or the crown ground off and the remains painted with silver 
nitrate. 

ABSCESS WITH SINUS 

All decay and pulp d6bris should be removed and the sinus cautiously 
washed out with sterile water, followed by a Uttle oil of cloves or creosote, 
using pressure with raw vulcanite to force it through. The tooth should 
be sealed up and left for three or four days, when in most cases the 
sinus will have healed, for these cases respond very readily to treat- 
ment. Mechanical and medicinal treatment should follow, and when 
in a healthy condition it should be similarly treated to the other pulpless 
teeth. 

In extracting for children, it is only wise to extract teeth which are 
loose due to the absorption of roots, or those in which the pulp having 
died and the permanent successor can be detected as forcing its way up 
to place. Also any case in which severe abscess contraindicate further 
retention. If only loose teeth are to be removed, there is very little 
need for an anaesthetic, although a local anaesthetic can be quite nicely 
used. In cases of extensive extraction or of bad abscessed conditions, 
somnoform perhaps gives the best results. — Oral Health. 



Securing Brightness in Aluminum-Rubber Plates. — The hydro- 
gen sulfid liberated in vulcanizing has a tendency to darken the aluminum 
in aluminum-rubber plates. To avoid this, the aluminum base-plate is 
covered with shellac or sandarac. — The Dental Cosmos. 



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318 THE DENTAL DIGEST 

EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 

[Practical Denial Journal, March, 1916] 

Original Papers 

Inheritance of Malocclusion From a Biological Standpoint. By T. G. Duckworth, D.D.S. 
Historical Sketches and a Few Items in Practice. By J. G. Templeton, A.M., D.D.S. 
The Oral Prophylaxis Treatment vs. Cleaning Teeth. By Gillette Hayden, D.D.S. 
Cooperation Between the Dentist and the Orthodontist. By Martin Dewey, D.D.S. 
•Correlating Conditions Common to Nose, Throat and Oral Surgery. By E. B. Cayce, 

M.D. 
"Bad Canal Work": What Shall We Do About It? By Howard P. Raper, D.D.S. 

CORRELATING CONDITIONS COMMON TO NOSE, THROAT AND 

ORAL CAVITY 

By E. B. Cayce, M. D., Nashville, Tenn. 

We are coming to see more clearly all the time from observations of 
such men as Drs. Billings and Rosenow, in their work along the line of 
focal infections, the importance of examining thoroughly the gums and 
alveolar processes in searching for the focus of infection, at the same 
time the tonsils and sinuses and middle ear are being examined for 
the same. Dr. Rosenow says that a radiograph is necessary before we 
can say positively that alveolar processes are not harboring such a focus. 

The cause of infection must be removed, whether by the dentist or 
by the medical practitioner, either general or special. 

MOUTH BREATHING 

One of the most frequent causes of conditions in the correction of 
which both dentist and ear, nose and throat surgeon play a part is 
mouth breathing. This most generally occurs in children who have 
hypertrophied adenoid tissue in the epi-pharynx, which, if uncorrected, 
later on produces the results so often seen, namely, a narrow arch, high 
palate, protruding teeth, shortened upper lip, contracted, undeveloped 
nose. 

The time to remove hypertrophied adenoid tissue is when it first 
begins to give symptoms. In reply to the statement so often made 
**that the adenoids will disappear,^' we would say that it is true they 
atrophy to a great extent about the age of fourteen to sixteen, and the 
posterior nares will become larger, so that the nasal stenosis is less 
apparent, but you have, as sequelae, oftentimes many disfiguring re- 
sults, among them the malocclusion of teeth, which requires time and 
patience to rectify, if it can be done at all. 

Another late result of adenoids is the pathology in the nose, such as 
deviations of the septum, which is explained by the fact that the nose 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 319 

is the last part of the face to develop, and the nasal septum is turned 
from its natural course by the abnormally high palate. It seeks the 
way of least resistance and you have either a thickened septum or one 
deviated on one or both sides. 

TONSILS 

In connection with the adenoid, we naturally think of the tonsils and 
these are of special interest to the oral surgeon, as it is impossible to 
have a healthy mouth with infected tonsils. They should be looked 
after closely in any case of pyorrhea alveolaris, or where teeth show a 
too rapid tendency to deteriorate. 

As a matter of interest, I will now quote you some figures made from 
examinations of 53 tonsils from whose crypts smears were made and 
these compare closely with infections reported from investigations in 
pyorrhea alveolaris. 

In a series of 53 cases in the last three months we have found that 
50 cases where the smear was positive were staphylococcic and only 13 
single infections — 18 cases of streptococcic infections with not a sin- 
gle pure culture. 

THE ANTRUM OF fflGHMORE 

Now we come to speak of the most frequently infected of aU sinuses 
of the nose — antrum of Highmore — because of its size and the location 
of its OS, as well as frequency of infection through the alveolar processes. 

It is generally claimed by authorities on rhinology that only a smaU 
percentage of infected antrums were of dental origin, but my experi- 
ence since I have been having a radiograph in every case of infected 
antrum has shown me that a very large majority are of dental origin. 

It is useless to open and drain an antrum if you have infection from 
the teeth, and especially is this true when infection occurs around the 
second bicuspids and molars. I do not feel that any man is justified 
in operating on an antrum without a radiograph. 

[The Internalional Journal of Orthodontia , March, 19 16] 

Original Articles 

Face Facts. A Clinical Study of Dcnto-Facial Deformities. By B. E. Lischer, D.M.D., 

St. Louis, Mo. 
The Teeth as Factors in the Economy of the Animal Kingdom. By Martin Dewey, D.D.S., 

Kansas City, Mo. 
Orthodontia — Its Place in Dental Education. By Lawrence W. Baker, D.M.D., Boston, 

Mass. 
Inheritance of Malocclusion from a Biological Standpoint. By T. G. Duckworth, D.D.S., 

San Antonio, Texas 



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320 THE DENTAL DIGEST 

A Case of Neutroclusion, Complicated by Extreme Distoversion of the Upper Central In- 
cisors, and Redundancy of Number. By Urling C. Ruckstuhl, D.D.S., St Louis, Mo. 

Gaining and Keeping the Child's Confidence Duriag Orthodontic Treatment By Raymond 
L. Webster, D.M.D., Providence, R. I. 

[The Denial Cosmos, April, 1916] 
Original Communications 

The Endamoebe and Pyorrhea Alveolaris. By Percy R. Howe, A.B., D.D.S. 

The Orthodontia Respiration Shield. By A. L. Johnson, D.M.D. 

A Technique That Will Make Perfect Amalgam Fillings Possible. By Wm. E. Harper, 

D.D.S. 
*A Few Conditions of Common Interest Both to the Dental Surgeon and the Nose-and- 
Throat Specialist By Wm. T. Patton, Ph.C, M.D., F.A.C.S. 

War Dental Surgery: Some Cases of Maxillo-facial Injuries Treated in the Dental Section 
of the American Ambulance at Neuilly (Paris, France.) (11.) By Dr. Geo. B Hayes. 

The Inflammatory Tissues of the Gingival Margin and Periodontal Membrane: Treat- 
ment by Ionic Medication. By Ernest Sturridge, L.D.S., D.D.S. 

The Present Status of Emetin m the Treatment of Pyorrhea. By Edmund N. Beall, D.D.S. 

The Design and Retention of Partial Dentures. (11.) By Douglas GabeU, M.R.C.S., 
L.R.C.P., L.D.S. 

The So-called "Innervation" of the Dentin: An Epicriticism. By A. Ho[>ewell-Sniith, 
L.R.C.P., M.R.C.S., L.D.S. 

Radiodermatitis Following X-Ray Examination of the Teeth. By Geo. M. MacKee, M.D. 

The Culture Value of a Dental Education. By Booker N. Hargis, D.D.S. 

Hygiene and the Dentbt. By Prof. Irving Fisher 

Correspondence 

An Instance of "Re-discovery" 

A FEW CONDITIONS OF COMMON INTEREST, BOTH TO THE DENTAL 
SURGEON AND THE NOSE-AND-THROAT SPECIALIST 

By William T. Patton, Ph.C., M.D., F.A.C.S., New Orleans, La. 
MAXILLARY SINUSITIS OF DENTAL ORIGIN 

The antrum of Highmore, or maxillary sinus, has long been and is 
at present considered to be, to some extent, the field of the dental sur- 
geon. Dental surgeons such as Brophy claim that about 70 per cent, 
of maxillary sinusitis is of dental origin. On the other hand, Cryer 
estimates 29 per cent., Richards 30 per cent., other authorities as low as 
8 per cent. Skillem states that about 25 per cent, is the correct average. 

Anatomy. This sinus is situated in the superior maxillary bone 
in the form of a pyramid, with the apex extending outward into the malar 
process. The maxillary sinus is bounded anteriorly by the canine fossa, 
superiorly by the orbital plate, internally by the lateral wall of the nose, 
and posteriorly by the spheno-maxillary fossa. An angle of the pyramid 
extends downward, which is known as the palatal fossa. Some authors 
state that this inferior border in the normal maxillary sinus is even with 



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AH EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 321 

the floor of the nares. That is not true; in normal subjects it always 
extends below the nasal border, except in the most anterior portion. 
This is of great importance in the event of maxillary sinusitis, because 
it is this portion of the floor that is most intimately associated with this 
disease. 

The feature of greatest importance is the relation of the floor of the 
sinus to the teeth. Here lies the genesis of disease of the maxillary sinus 
of dental origin. 

The floor of the sinus descends very abruptly until it meets the first 
and second premolars, these being the teeth most intimately associated 
with the floor of the antrum. The sinus floor then ascends as it extends 
posteriorly, so that the third molar is farther away than the second molar. 
The roots of the second premolar and the first molar are in closer ap- 
proximation to the mucous membrane of the sinus than the roots of any ^ 
other teeth. 

The sinus floor recedes as it goes back and ascends as it comes for- 
ward, so that the second premolar and the first molar are in closer 
proximity to the sinus than any of the other teeth. In certain individuals 
who exhibit very little dental caries, a maxillary sinusitis may be pres- 
ent, while in other patients, whose teeth are very much more carious, 
there exists no trace of a sinusitis. 

In some individuals the walls are so thin that practically nothing 
but the mucous membrane intervenes, and very little resistance is offered 
to sinus involvement from diseased teeth. 

The boundaries of the norma.1 maxillary sinus are slightly below the 
floor of the nose, extending to the orbital plate; externally, to the 
articulation with the malar bone; posteriorly, along that part of the 
maxillary bone until it articulates with the pterygoid process. Anom- 
alies are formed by the negative pressure of expiration and inspiration, 
causing a variation in the length and depth of the sinus. This theory 
in regard to etiology has been substantiated in cases of children with 
adenoids and enlarged tonsils that cause mouth-breathing, the attendant 
lack of pressure resulting in abnormally small sinuses. Children who 
cannot breathe through the nose properly have abnormally small sinuses. 

The normal covering between the top of the root and the floor of the 
sinus is the periosteum of the root, the cancellated bony structure of the 
floor of the sinus, and the mucous membrane; therefore when the mucous 
membrane becomes infected, it will sooner or later infect the whole cavity. 

Etiology. It was previously supposed that carious teeth caused all 
infections of the antrum. It has been shown, however, by recent in- 
vestigators, that this is merely one of a number of causes. 

Infections of the maxillary sinus occur in three ways: (i) They are 



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322 THE DENTAL DIGEST 

communicated to the sinus by direct continuity from one tissue to 
another; (2) they are carried by the blood vessels and nerves; (3) they 
are conmiunicated by means of the lymphatic vessels. 

It has been conclusively demonstrated that infection may travel 
through an apparently healthy bone froi;n a diseased area to another 
tissue without the bone through which it passes showing microscopically 
any signs of disease; in other words, the bone which forms a medium 
of communication of the infection is absolutely healthy. This has been 
demonstrated by microscopic as weU as macroscopic examinations. 

Of the acute conditions causing maxillary sinusitis, we will first of 
all discuss abscess at the root of a tooth. Such an abscess, of course, 
is due to a dead pulp which by progression ultimately infects the sinus. 

It seems that as this infection travels upward through the bone, it 
reaches the periosteum and passes through it without causing very marked 
periosteitis; but the lymphatic canals transmit the inflammation, and 
convey the toxins directly through these medullary spaces of the bone 
until they strike the floor of the antrum, resulting in dental irritation, 
with purulent inflammation of the fibrous tissue, and final breaking- 
down and gradual suppuration, which does not occur imtil permanent 
pathological changes have taken place. These are the cases which cause 
the greatest amount of confusion to the rhinologist and to the dental 
surgeon. 

The author would say that only about 20 per cent, of antrum trouble 
is caused from teeth. 

The most common cause of antral disease is infection through the nose 
by direct continuity of the tissue. This surmise is substantiated by the 
observation that the great majority of cases clear up after simple washing 
of the antrum a few times with a Douglas trocar. 

In chronic sinusitis, of course, we have to look out for involvement of 
other sinuses draining into the antrum, which at first acts as a reservoir; 
then by combined irritation the mucous membrane becomes diseased, and 
chronic sinusitis results. It also seems that the bone is more often in- 
volved in chronic cases, which renders careful surgical intervention all the 
more necessary. 

It has been my practice, whenever I suspect antrum involvement, to 
make a complete examination of the nose, after first shrinking the tissues 
with cocain. If no pus is visible, suction is used and again an examina- 
tion is made. Transillumination is useful, but very uncertain. If 
nothing definite is disclosed, the antrum is washed out, which is a simple 
procedure, and the only positive way of making a diagnosis. Even then 
we must not expect always to find any quantity of pus in washings, 
which are often only slightly turbid. If, however, cultures be made 



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AN EKTOMS OF CURRENT DENTAL AND MEDICAL LITERATURE 323 

therefrom, one will be surprised to find a pure culture of one of the pyo- 
genic organisms. Several washings will relieve the symptoms. 

If the case does not clear up after several washings, I always have the 
teeth looked after by a competent dentist, and have a skiagraph taken, 
showing the condition of the roots of the teeth and of old crowns. If the 
skiagraph shows disease of a tooth in the vicinity of the antrum, I do not 
advise extracting the tooth, imless it is already badly diseased. Any 
competent dentist should be able to eradicate the disease, and save the 
tooth; then I depend on intra-nasal treatment. Of course, if the antrum 
is full of polyps, and its mucous membrane is badly diseased, it will be 
necessary to do more radical work, and here the author prefers the Cald- 
well-Luc operation, which is easily performed under local anesthesia. A 
good exposure is made of the inner lining of the antrum, and the wound 
usually heals in a short time. 

In closing, I would again emphasize my contention that the nose and 
throat surgeon and the dentist should cooperate more closely, and I am 
sure we could be more certain of our diagnosis, and the patients of both 
the dentist and the surgeon would be greatly benefited. 

[The Dental Review, April, 1916] 

Original Communications 

The Problem of Dental Education in Uie Light of the Public Demand. By Edward C. Kirk. 
Root Canal Treatment and Filling. By George C. Poundstone. 
*Something on Oral Prophylaxis. By F. H. Skinner 
The Menagerie of the Mouth. By B. J. Cigrand. 
Some Observations on Bridgework. By H. F. D'Oench 
Facts, Fads, and Follies Concerning Pyorrhea. By C. E. Bentley. 

SOMETHING ON ORAL PROPHYLAXIS 
By F. H. Skinner, D.D.S., Chicago 

SOME ETIOLOGICAL FACTORS OF PYORRHEA 

Pyorrhea is caused directly by infectious substances lodging and re- 
maining on the tooth surfaces themselves. There are a great many causes 
which lessen the resistance of the soft tissues and bony support of the 
teeth, thereby making it possible for local infection to take place. The 
most prominent of these I consider malocclusion, which is due to many 
causes. In some cases, normal occlusion can be obtained only by ortho- 
dontia. When cusps articulate with portions of the teeth other than 
those designed for them by Nature, they produce an unnatural force 
which bruises the peridental membrane. In the mouth of the average 
person who has reached thirty-five or forty years of age, some portions of 
the teeth have worn down more rapidly than others, and the por- 



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324 THE DBNTAL DIGEST 

tions not worn down usually cause a side pressure on the opposing teeth, 
thus injuring the peridental membrane and causing absorption of the pro- 
cess or else forcing the teeth apart at the contact points, which allows 
fibrous foods to impinge on the crest of the gum septum. Some other 
causes of irritation which reduce resistance are imperfectly formed enamel 
surfaces or those which have become etched from accumulations being 
left upon them imtil add fermentation has taken place; fillings improperly 
finished at the gingival margins or fillings which cannot be made smooth, 
such as all the phosphates and some of the silicate cements; banded 
crowns and regulating appliances, which cause a great deal of irritation, 
if carelessly fitted, and bands which fit, but which have been driven up 
until they impinge the peridental membrane. 

When the first permanent molar has been extracted, there is a tendency 
for the space to become closed and for the opposing teeth to elongate. The 
teeth posterior to the space come forward as a result of the pulling on 
the fibers due to the formation of scar tissue where the tooth was drawn. 
In a short time, malocclusion produces a force which causes the remaining 
teeth to tilt still more, and in a few months, most of the stress of mastica- 
tion is brought to bear on the under side of the tilting tooth, bruising the 
peridental membrane at this point. Here also is usually found an accu- 
mulation which is a source of infection to the already injured tissues, and 
pyorrhea results. Unless the full space is maintained by the proper 
interlocking of the cusps of the remaining teeth, I believe it is perfectly 
legitimate to cut into the tooth at each end of the space and insert a 
bridge, preferably of the spur and inlay type. This method of making a 
short bridge maintains the space and occlusion and yet allows a little 
movement of the teeth in the alveolus without the danger of loosening the 
inlays. I do not believe in devitalization when it can possibly be avoided. 

[The Dental Register, March, 1916] 
Contents 

Event and Comment. 

Sir Frederic William Hewitt. 

Method of Making Cast Gold Inlays. 

Some Recent Tendencies in Practice. 

High Pressure Anesthesia. 

A Half Century of Antiseptic Surgery. 

Indents. 

Announcements. 

Obituary. 

[The Journal of the Allied Dental Societies, March, 1916] 

Contents 
The Journal Conference. By S. E. Davenport, Jr., D.M.D. 



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AH EPITOMB OF CURRENT DENTAL AND MEDICAL LITERATURE 325 

Emetin Versus Suiigery in the Treatment of Pyorrhea. By Thomas B. Hartzell, M.D., 

D.M.D. 
The Elimination of Pain in Dental Operations. An Estimate of the Various Measures 

with Special Reference to Conductive Anesthesia. By John Egbert Nyman, D.D.S. 
•Further Nutritive Studies of Dentition. By William J. Gies and Collaborators. 
Oral Abscesses. By Kurt H. Thoma, D.M.D. 

Report of Society Meetings 

First District Dental Society, S. N. Y., Oct. i8, 1915. 
First District Dental Society, S. N. Y., Jan. 3, 1916. 
Boston and Tufts Dental Alumni Association, Feb. 9, 1916. 

Editorial Department 

War and Dental Service. 

A Dental School of Columbia University. 

Current Dental Literature. Compiled by Arthur H. Merritt, D.D.S. 

Notes on Dental Practice. Compiled by William D. Tracy, D.D.S. 

FURTHUR NUTRITIVE STUDIES OF DENTITION ♦ 
By Wiluam J. Gies and Collaborators 

I. Studies of internal secretions in their relation to the development 
and condition of the teeth. 2. Effects of feeding glandular tissues, 
preparations and extracts. 

SUMMARY OF GENERAL CONCLUSIONS TO SECTION I 

Feeding experiments (24) of extended duration (20-99 days), with 
glandular tissues, preparations and extracts (12 kinds), on white rats (97), 
yielded results which suggest that possibly the proportions of calcium in 
both the dry (total solid) and mineral (ash) portions of the incisor teeth 
were decreased by some of the treatments — pineal gland, salivary gland, 
and thyroid gland, particularly — and increased by treatment with 
testicle. 

A general tendency to decreased proportionate content of calcium in 
the teeth of the treated rats was concomitant with general diminution 
of growth rate, and with smaller gross gain in weight by the end of the 
experiments. 

There were no definite effects on the dimensions, curvature, or weights 
(total solids, organic matter, ash) of the incisor teeth that could be as- 

*From the Biochemical Laboratory of Columbia University, at the College of Physicians 
and Surgeons, New York. 

[Being an abstract of the three sections of the fifth annual report, by William J. Giles and 
collaborators, on investigations under the auspices of the Research Conunittee of the Dental 
Society of the State of New York, Dr. Wm. B. Dunning, chairman; and of the first annual 
report on investigations under the auspices of the Scientific Foundation and Research Com- 
mission of the National Dental Association, Dr. Weston A. Price, chairman; originally pub- 
lished in the Transactions of the Dental Society of the State of New York, 1915, pp. 161-223.] 



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326 THB DENTAL DIGEST 

cribed directly to the glandular treatment; although, in accord with the 
prevailing preponderance in body-weight of the control rats, the teeth of 
the control rats were somewhat heavier, in the main, than those of the 
"treated" animals. 

The results are regarded as suggestive, not as conclusive. The ex- 
periments will be repeated and extended. 

II. Studies of the influence of imbalanced diets on dentition, i . On 
the general influence of dietary conditions and other nutritional factors 
on the development and state of the teeth. 

III. Studies of the influence of unbalanced diets on dentition. 2 . A 
chemical study of nutritive factors in the development of teeth and bones, 
with special reference to the influence of hydrochloric and P-hydroxy- 
butyric acids, and the effects of dietary deficiencies of calcium and phos- 
phorus. 

SUMMARY OF GENERAL CONCLUSIONS 

1. P-Hydroxybutyric acid (combined), administered with food to 
a young dog, to the extent of 227 gm., during a period of 180 days, pro- 
duced no effect upon the appearance, rate of growth, or chenjical com- 
position of the teeth. 

2. A total of 84.12 gm. of hydrochloric add (combined), administered 
in food to a young dog during a period of 180 days, retarded the develop- 
ment of the teeth, but did not affect the chemical composition of the 
teeth. Two puppies, that received 20 and 16 gm., respectively, of hy- 
drochloric acid (combined), during a period of 63 days, showed impaired 
development, but no differences in the chemical composition, of the 
teeth. No superficial deterioration of the teeth was observed, in these 
tests, as a result of the ingestion of either the P-hydroxybutyric add or 
the hydrochloric acid. 

3. A diet of meat, sugar, cracker-meal, and lard, ordinarily consid- 
ered to be poor in caldum, failed to affect the development and the 
chemical composition of the teeth of three puppies, during a feeding period 
of 127 days. 

4. A diet consisting of a small amount of milk, meat, sugar, cracker- 
meal, and lard, calculated to provide less than half the amount of phos- 
phorus physiologically required by dogs, produced a slight degree of 
"demineralization" of the indsors of two puppies, during a feeding 
period of 149 days. At the end of this period the indsors and canines 
of these puppies appeared more worn at the tips than the corresponding 
teeth of the control animals. 

5. Young rats when fed a ration providing 3 mgm. of caldum (as Ca) 
per animal per day, for a period of 70-85 days, exhibited loss of appetite, 



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AN EPITOMB OF CURRENT DENTAL AND MEDICAL LITERATURE 327 

Stunted growth, and poor development of the whole organism. The 
bones and the teeth were unusually soft and fragile. "Demineraliza- 
tion" of both teeth and bones was very pronounced. The average 
difference between the ash-yield from dry teeth of the control rats and 
of the rats deprived of calcium was 8.5 per cent.; it was 20 per cent, in 
the case of the bones. There was an increase in organic matter corres- 
pK)nding to this decrease in mineral matter. There were losses of 2-4 
per cent, of calcium, and of 2 per cent, of phosphorus, in the dry teeth. 
There was also a loss in the magnesium content. The composition of 
the ash from the teeth varied but little. The loss of calcium, phosphorus, 
and magnesium was more pronounced in the bones. 

6. A ration providing 7 mgm. of phosphorus (as P) per animal per 
day, when administered to young rats for 70-90 days, led to stunted 
growth and to poor development of bones and teeth. The effects were 
not as severe, however, as they were in the cases of caldimi deprivation. 
There was a distinct loss of mineral matter from the teeth and from 
the bones, the loss of calcium having been more pronounced than that 
of phosphorus. 

7. A ration poor in magnesium, that provided only 1.2 mgm. of that 
element per rat per day, was without any noticeable effects, during a 
period of 70 days, upon the development and the composition of the 
teeth and bones of three yoimg rats. 

There were no definite effects on the dimensions, curvature, or 
weights of the incisor teeth of the rats that could be ascribed directly 
to the dietary treatment; although, in accord with the prevailing pre- 
ponderence in body-weight of the control rats, the teeth of the control 
rata were somewhat heavier than those of the "treated" animals. 

[The Dental Summary, April, 1916] 

CofUents 

Regular Contribulions 

Resistance and Retention Form in Cavity Preparation. By W. H. O. McGchee. 
How to Make a Pin for a Crown. By R. B. Braswell. 

Acquired and Congenital Cases of Perforation. By J. E. K.urlander and H. J. Jaulusz. 
President's Address. By W. L. Myer. 
Business Side of Dentistry. By John O. Zubrod. 
Amalgam. By C. A. Priest. 
The Treatment of Pyorrhea. By J. P. CarmichaeL 
First University Dental School in New York for Colimibia. 

The Opportunity of the Dentist in Connection with Cancer, By Hermann B. Gessner. 
The Emitine Error. By Jules J. Sarrazin. 
The Story of a Set of Teeth. By Loomis P. Haskell. 
♦Gold Crown in Removable Bridge Work. By P. A. Gould. 



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328 THB DBNTAL DIGEST 

Miller Memorial Insert. 
Miller Memorial Unveiling. 

GOLD CROWN IN REMOVABLE BRIDGE WORK* 
By Dr. P. A. Gould, Gibsonburg, Ohio 

The object of this Clinic is to show how attachments may be made 
to teeth to hold removable dentures in place in such a manner that 
they may be of the greatest service that it is possible to attain, and 
not cause any irritation to the teeth to which they are attached. To 
make an attachment that is substantial enough to stand the service that 
may be required of it and at the same time be built within the space 
occupied by the teeth in a full denture, we must first take a survey 
of conditions that may exist. 

It is well known that all surgical operations are subject to a return 
of irritation by constitutional disorders that may be developed from other 
infections. Also that this irritation to parts that have been subjected to 
traumatism, or surgery, when brought under the influence of toxemia, will 
at times develop pathogenic bacteria that have a severe eflFect upon con- 
stitutional disorders. 

How little we think of these physiological conditions that may be 
developed, when performing surgical operations such as extracting a pulp 
and nerve, then filling the root canals! 

Scientific research has shown that too generous uses of antiseptic 
medicaments produce an irritation by destroying healthy tissues and 
hence become of no value in preventing infection. 

It is an established fact that sterile blood and its products can do 
more to heal a wound than any dressing or treatment that the doctor 
may give it; this is a very important thing to consider when we have 
sterile blood present. 

Root canals that are sterile should be allowed to heal under these 
conditions, the sterile blood being forced back through the foramen of the 
root and held there with a dessicative substance that will allow nature 
to heal itself and at the same time prevent and not cause any infection. 

Should the operator allow the hemorrhage to continue until it stops 
of its own accord, a serum will work itself into the apices of the roots. 
This will have to be removed, or it will produce an abscess as soon as 
some constitutional disorder presents a medium for it to develop pyogenic 
micro-organisms. 

A root that may have been well filled may also have like abscessed 
conditions produced from a mechanical irritation caused by an injury, 
or by being constantly irritated a little by some form of a prosthetic 
attachment, or an unsanitary condition. 

♦ Clinic Ohio State Dental Society. 



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AH BPITOMB OF CURRENT DENTAL AND MEDICAL LITERATURE 329 

[Dental Items of ItUerest, 1916] 

Exclusive Contributions 

Sequelae of DentaA Infections in the Maxills By A. Berger, D.D.S. 

Successful Treatment of Apical Abscesses by Ionization. By Marcus Straussberg, D.D.S. 

Orthodontia 
The Advantages of Early Treatment. By Dr. Milton T. Watson. 

Prosthodontia 
New Method of Constructing Full Dentures. By Clyde Davis, B.S., M.D., D.D.S. 

Radiodoniia 
" The X-Rays in Oral Surgery." By Howard R. Raper, D.D.S. 

Society Papers 

Commercialized Education and the "Itinerant Instructor." A Study of the Conditions 
Under Which the Practicing Dental Surgeon Sometimes Receives Post-Graduate In- 
struction. By Herbert J. Samuels, D.D.S. 

Cavity Preparation for the Gold Inlay. By J. V. Conzett, D.D.S. 

Peridental Anesthesia— Intra-osseous Method. By Frank L. Piatt, D.D.S. 

[The Dental Outlook, April, 1916] 

Original Communications 

Seelyc-Whitney Bill. 

Shall We Legalize the Dental Hygienist? By M. William, D.D.S. 

Remarks by Dr. Harris. 

Remarks by Dr. Ratner. 

Remarks by Dr. Caiman. 

Editorial 

The Whitney-Seelye Bill. 

Letter to the Editor. 

Resolutions on the Seelye- Whitney Bill, Adopted by the Council and Its Indorsement by 

the Affiliated Societies. 
Resolutions on the McCue-Foley Bill, Adopted by the Council and the Affiliated Societies. 

[The Journal of the National Dental Association, March, 1916] 

Contents 

Thos. P. Hinman, D.D.S. Frontispiece. 

Original Communications 

Evolution of Bodily Movement of Teeth. By Carl B. Case, D.D.S. 

•The Pathological Significance of Impacted and Unerupted Teeth. By Chalmers J. Lyons, 
D.D.SC. 



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330 THE DSNTAL DIGSST 

The Research Department 

*A Development of Practical Substitutes for Platinum and Its Alloys, with Special Reference 
to Alloys of Tungsten and Molybdenum. By Frank Alfred Fahrenwald. 
Multiple Apical Foramina of Tooth RooU. ^y Dr. J. R. Callahan. 

Legislative Department 

Present Status of Dental Legislation. By Homer C. Brown, D.D.S. 

Hearing Before the Committee on Military Affairs. 

Statement of First Lieut. Edwin P. Tignor, Dental Corps. 

Statement of Dr. C. B. Giflford. 

General Gorgas' Hearing. 

Ruling on Harrison Narcotic Law. 

Excerpt From Army and Navy Register, February 6, 191 6. 

Resolutions Adopted by Columbus Academy of Medicine. 

St. Louis Medical Society Endorses Proposed Legislation. 

Editorial Department 

Opening of the Research Institute of the National Dental Association. 

Preparedness — How Does It Aflfect You? 

Why the Dental Profession is Entitled to Rank. 

THE PATHOLOGICAL SIGNIFICANCE OF IMPACTED AND 
UNERUPTED TEETH* 

By Chalmers J. Lyons, D.D.Sc., Ann Arbor, Mich. 

The writer has observed four cases of epilepsy where there has been 
no return of the trouble after a period of eighteen months following the 
removal of the impacted third molars. Whether the impacted teeth 
were the whole etiological factors in these epileptic conditions, or only 
secondary it is difficult to state. In only one out of the four cases was 
any further treatment followed and in this case bromides were given, 
but the attending physician gives credit for the immunity from the 
nervous disturbance, to the removal of the impacted teeth. 

It is not to be thought of for one moment that all cases of epilepsy 
may be benefited by the removal of impacted teeth. 

Neither can other forms of extreme nervous disturbances be benefited 
in every case by their removal. 

The writer believes, however, that impacted teeth should be con- 
sidered as a possible etiological factor in the diagnosis and treatment 
of many of the obscure nervous diseases wherein the trifacial nerve and 
its many ramifications may possibly be involved. 

In some cases of impacted third nature molars the acute inflammatory 
conditions may be of such a violent nature that the operation for their 
immediate removal will be contra-indicated. 

*(Read before the National Dental Association.) 

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Air BPITOMB OF CURRBNT DSHTAL AND MEDICAL LITERATURE 331 

Theories for the solution of the cause of cysts have been advanced 
such as irritation from the unerupted tooth, failure in evolution of the 
tooth, etc., but all seem to meet with some objections. There are cer- 
tain clinical facts, however, which are of vital interest to the dentist. 

ist. These cysts are associated with unerupted teeth. 

2nd, The vast majority of examples of this affection occur in patients 
under thirty years of age. 

3rd. These growths occur at or shortly after the period, when the 
affected tooth should imder ordinary circumstances be erupted. 

4th. All unerupted teeth are by no means associated with cysts, but 
they should be held in suspicion. 

{The Research Department) 

A DEVELOPMENT OF PRACTICAL SUBSTITUTES FOR PLATINUM AND ITS 

ALLOYS, WITH SPECIAL REFERENCE TO ALLOYS 

OF TUNGSTEN AND MOLYBDENUM 

By Frank Alfred Fahsenwald, Cleveland, Ohio 
VI. SUMMARY AND CONCLUSIONS 

With regard to the degree of accuracy with which temperatures 
could be measured in these experiments; it must be pointed out that the 
object was not to establish these critical points for direct transference 
to any commercial plant (for different types of apparatus would necessi- 
tate a determination of these conditions to suit each individual case), 
but to determine their existence and influence. It would also be of no 
avail to locate these critical ranges because every different set of appar- 
atus and conditions would require a new standardization. 

In these experiments, however, the temperatures necessary to pro- 
duce a certain degree of crystallization were considered as being located 
with a fair degree of accuracy, in so far as this may not be qualified by 
the existence of working conditions which were far from ideal. 

As to the measurement of forging temperatures no claim is made for 
more than close approximations, for this was properly not a one-man 
operation, and was performed by the writer with one eye to the optical 
pyrometer the other on the millimeter scale, one hand on the pyrometer 
rheostats, the other using a hammer on the upper electrode, while the 
heating current was controlled by one foot on a lever regulating the trans- 
former and rheostat. 

The experimental work resolved itself into three parts, each being 
marked by a different method of attack, necessitated by limitations 
encountered as the work progressed under previously adopted methods. 
The first part consisted of experiments on binary combinations of 



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332 THE DENTAL DIGEST 

those of the metals which it was feasible to consider, and the melting 
points of which lay within the limits of ordinary fusion methods. The 
results of these experiments, performed as indicated therein, lead to the 
conclusion that metals or alloys of metals outside of the precious-metal 
groups, are unsuitable as substitutes for platinum. 

The gold and silver alloys of palladium have been found to be excellent 
substitutes for platinum in its softer forms, and while not so chemically 
resistant, fill all requirements where conditions are not too rigid. 

The second part develops the fact that except in two respects, pure 
ductile tungsten, and, to a lesser degree molybdenum, meet all of the 
specifications of a practical substitute for platinum and its alloys. These 
two defects are its ease of oxidation, and the difficulty with which it can 
be soldered; and they have been overcome by coating with a predous 
metal or alloy, the resulting material being in many ways far superior to 
platinum or its alloys. 

This material has met with instant demand, is in many cases replacing 
the best platinum-iridium alloys, and permits the performance of work 
which has been impossible with the materials hitherto available. 

The third part described the theoretical and practical considerations 
involved in the manufacture of wrought tungsten and molybdenum, and 
gives results of the proper application of a similar method in the labora- 
tory production of their alloys. 

Wrought tungsten and molybdemmi were produced on a laboratory- 
scale, but no success attended the attempted production of alloys of 
tungsten with gold and palladium; while on the other hand, the alloys of 
the tungsten-molybdenum series were produced in wrought form. These 
operations were governed entirely by metallographic control, and their 
success suggests the possible application of a similar method in a treat- 
ment of such metals as iridium, tantalum, rhodium, osmium, etc., in 
combination with each other, or with tungsten or molybdenum, which 
may result in the production of alloys possessing properties far superior 
to those of any material now available. 

[The Dominion Dental Journal, March, 1916] 

Original Communications 

♦Crown and Bridge Work— Safe and Sane. By A. W. Thornton, D.D.S., L.D.S., Montreal. 
President's Address— Canadian Oral Prophylactic Association. By A. J. McDonagh, D.D.S., 
L.D.S., Toronto. 

Dental Societies 

Report of Educational Committee, Canadian Oral Prophylactic Association. 
Secretar>'-Treasurer's Rejiort. 



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AN EPITOME OF CURRENT DENTAL AND MEDICAL LITERATURE 333 

New Departure in Progressive Methods of Education. 

Preliminary and Professional Educational Requirements of the Provincial Dental Board of 
Nova Scotia. 

CROWN AND BRIDGE WORK— SAFE AND SANE 
By a. W. Thornton, D.D.S., L.D.S., Montreal, Que. 

1. Should the extent of fixed bridges be limited in extent? My 
opinion is that fixed bridges should be limited in extent to the regions 
including the cuspids and incisors and to those forms of bridges the 
construction of which admits of cleansing by ordinary means. 

2. The question of devitalization: Is it safe? Is it sane? Is there 
a limit here also? If we accept Black's teaching: "A tooth from which 
the pulp has been removed seems never again to recover/' then we are 
forced to the conclusion that devitalization should be limited to those 
cases in which the diminished efficiency of the devitalized tooth or 
teeth is more than compensated for by the increased efficiency of the 
remaining natural teeth and the appliance attached to the devitalized 
tooth or teeth. 

If fixed bridge work is to be limited in its extent, then, naturally, 
the adoption of removable appliances must be extended. With the 
means at our disposal now of limiting the amount of foreign matter in 
making small partial plates with the various attachments with which 
you are all familiar, I am convinced that safer and saner methods of 
practice are now within reach of the man doing work for the ordinary 
people of any conmiunity. The use of easily applied materials very 
closely simulating the appearance of the natural gums will, I believe, 
give a great impetus not only to prosthetic work generally, but to safe, 
sane, clean, easily made, comparatively cheap removable appliances. 

[New York Medical Journal, March i8, 1916] 

I'ERSONNEL OF AN AMERICAN BASE HOSPITAL IN WAR TIME 

The experience of some of the nations now at war should serve as a 
solemn warning to us to see that injured soldiers do not lose their lives or 
their limbs for want of competent surgeons. Adequate organization 
should be made in times of peace, insists the Journal of the Michigan 
State Medical Society for January, 1916. Supplies and instruments, 
owned by the government, should be stored in accessible locations. 
Units should be organized and should meet annually. Crile suggests the 
following unit adequate to serve a base hospital of 500 beds: Chief 
surgeon; five associate surgeons, each in charge of 100 beds; three assis- 
tant surgeons; orthopedic surgeon; three anesthetists; pathologist and 
assistant; internist; neurologist, oculist; two dentists; two rontgenologists; 



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334 THB DSN TAL DI6SST 

secretary and record clerk; two stenographers; fifty nurses. Would it 
not be well for the profession of this State to take the necessary steps to 
organize several such units? 

RECURRENT PARALYSIS OF THE FACIAL NERVE 
By J. Ramsay Hunt, M.D. 

The recurrent or relapsing facial palsy associated with pain in the ear 
and occipital region is, therefore, merely a peripheral paralysis of the 
seventh nerve, in which is manifested a peculiar tendency to multiple at- 
tacks or recurrences. The symptomatology corresponds in all its es- 
sentials to the more usual type in which there is but a single attack, and 
similar etiologic factors are also in evidence. Some emphasis may be 
placed on the theory of a narrow exit at the stylomastoid foramen, which 
was advanced by Despaigne in explanation of these recurrences, and 
which might predispose the nerve compression from very slight inflamma- 
tory cause. Such an anomaly might well be inherited. This, however, 
is only an ingenious theory, and calls for more definite pathologic con- 
firmation. Occasionally there is a history of diabetes, so that this pos- 
sibility should always be considered. Most of the cases are of infectious 
or refrigeration origin. In the infectious and rheumatic groups there is 
simply a constitutional tendency to peculiar local reactions to cold or in- 
fections, which expresses itself in terms of facial palsy, very similar to 
that which is observed in tonsillitis, sore throat, lumbago, sciatica and 
other rheumatic manifestations, with their well-known tendency to re- 
currences. A pathologic theory of the rheumatic or refrigeration palsies, 
advocated by many, is that of a perineuritis of the facial nerve similar to 
brachial and sciatic perineuritis of rheumatic origin. Such a lesion would 
be favored by the exposed situation of the nerve, any swelling of its 
structure within the fallopian aqueduct being immediately registered as 
pressure palsy, a result which would naturally be enhanced by the pres- 
ence of a congentially narrow canal. This theory would explain some 
of the familial and hereditary types which are occasionally observed, 
the constitutional tendency or diathesis being also transmitted. 

Facial palsy as a sequela of the migraine attack, the facioplegic 
migraine of some writers, is not a clinical entity. At the present time 
there are no adequate reasons for the acceptance of such a clinical type. 
The Rossolimo case which forms the chief support of this teaching is 
evidently only a recurrent facial palsy with marked sensory symptoms in 
a woman afflicted, with migraine, and one searches the literature in vain 
for examples of a true facioplegic migraine. Furthermore, the frag- 
mentary case report of Hatchek, which is sometimes spoken of as a 
periodic facial palsy, as this term was used by Moebius to describe the 



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AN EPITOM£ OF CURRENT DENTAL AND MEDICAL LITERATURE 335 

periodical oculomotor palsies, is an equally erroneous interpretation. 
The relapses in the Hatchek case, conservatively interpreted, represent 
nothing more than pressure or traction of the facial nerve, this giving 
rise to intermittence in the paralysis, an occurrence which is by no means 
rare as a forerunner of permanent palsy in cases of subtentorial tumors. 
If the facial nerve has any relation to migraine, which is so well established 
in the case of the ocular nerves, this relationship has yet to be demon- 
strated. The cases thus far cited do not furnish sufficient grounds for 
any such assumption. Therefore titles like "periodic facial palsy" and 
'^facioplegic migraine" are misnomers which have crept into some of the 
best monographs dealing with this subject.. Such terms are misleading 
and denote nothing more than transient intermittent facial palsy as a 
focal symptom of basal tumor in the one case, and the not uncommon 
relapsing facial palsy associated with pain in the other. It is of course 
self-evident that migraine and facial palsy, both of which are common 
affections, may be encountered in the same individual but are etiologically 
distinct. 

[Medical Record, March i8, 1916] 

[Berliner Klinische Wochenschrifly January 24, 1916] 
THE PALATE AND ADENOIDS 

Lublinski affirms that now and then children with adenoids fail to im- 
prove after not only the nasopharynx, but the nose itself has been cleared 
out. That is to say, the child continues to breathe through its mouth, 
with all the resulting damage to ear, larynx and trachea. But the feason 
is obvious, for examination in such cases will reveal a high narrow palate 
in place of the normal broad, low one. The higher and steeper this 
palate, the narrower the nose, and the higher its floor. As a result air 
which enters such a nose enters with difficulty the nasopharynx, which is, 
at the same time, partly occluded below by the low placed velum palate. 
It is in such a nasopharynx that adenoids form, and complete the ob- 
struction, so that only the mouth remains for breathing. It is therefore 
readily apparent that removal of adenoids is only a step in the direction 
of the restoration of natural respiration. In discussing the mechanism of 
this condition the author does not mention the relationship which is be- 
lieved to subsist between high palate and deflected septum. For him the 
problem, because bound up in the development of the upper dental arch, 
is one for the oral surgeon, for dental orthopedics. This solution of the 
problem is not of recent origin — in fact, it goes back at least thirty years. 
The ordinary devices for spreading the upper jaw in the interest of proper 
alignment of the teeth also tend to overcome the high, steep palate. 



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DR. JACOB WESLST GREENE 
Bom January 18, 1839, Died February 27, 1916 

In the passing of Dr. Jacob Wesley Greene, the dental pro- 
fession has lost one of its most esteemed and well known members, 
who for more than fifty years gave his best efforts to the public. 
He was bom in Harrison County, near DePaw, Indiana. He 
worked his way through high school and college and later studied 
dentistry in New Albany, Indiana and Louisville, Kentucky. 




When the Civil War broke out, he served as Union Soldier. 
Later he located in New Albany, Indiana, where he married Miss 
Ann Eliza Pitt. In i866 he removed to Chillicothe, Mo. 

About eighteen years ago he, with his brother, Dr. P. T. 
Greene, improvised the Greene System of Special Test-Method 
Impression taking and Plate Work. 

He possessed great strength of character, a student, always 
ahead of his time in thought. He lived to see many of his ideas 
become generally popular. 



336 



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Prosthetic Dentistry. By James Harrison Prothero, Professor of 
Prosthetic Technic, Prosthetic Dentistry and Metallurgy, in North- 
western University Dental School, Chicago. Second Edition, Revised 
and enlarged, 1,200 pages, 1,400 Illustrations, Medico Dental Publish- 
ing Co., Chicago, and C. Ash & Sons, London. 

The author has dealt with the essentials in four main subjects of 
prothesis, denture, crown and bridge and inlay constructions with suffi- 
cient elaborations to enable the beginner to acquire a theoretical and 
practical knowledge of them and to extend the knowledge of the average 
practitioner. A synopsis of color principles has been included, and illus- 
trated, and a section on metallurgy has been incorporated. A section on 
the history of prosthesis has also been added, as a means of outlining the 
growth and practice in this field. 

It is impossible, in the space of a review, to discuss more than a few 
points of excellence in so voluminous a work. 

The first thing of especial interest which the writer notes is that the 
author employs Dr. Black's term ** residual ridges" to indicate that por- 
tion of the edentulous jaw often spoken of as the alveolar process, even 
when no process remains. It seems that this term, ** residual ridges," is 
sufficiently accurate to justify general application and use. 

On page 63, in giving the 4th condition in which the use of plaster foi 
impressions is most strongly indicated, the author specifies, 

'* Fourth — in edentulous cases where the mucous and sub-mucous 
tissues are thick and elastic, particularly in the palatine portion of the 
mouth. When such a condition prevails, the tissues, if compressed uni- 
formly, as when modelling compound is used, assert their resiliency, on 
pressure being relieved, which breaks the peripheral adaptation of the 
impression, and later on, of the denture that may be constructed when 
such an impression is used as a basis." The writer of this review be- 
lieves that with the more recent methods of manipulating modelling 
compound, this indication for the use of plaster no longer holds with any- 
thing like its former force, and when modelling compound impressions of 
edentulous jaws are properly taken, they are more successful, on the 
average, than plaster impressions. The author says, on page 81, '*In 
probably 70% of the edentulous cases presenting, compound can be used 
to better advantage than plaster." 



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338 THE DENTAL DIGEST 

Chapter 17 presents in considerable detail, illustrations and descrip- 
tive discussions of the human masticatory mechanism and imparts much 
useful information. Speaking of the view so extensively held, that it is 
not worth while to reproduce in an articulator the individual or average 
jaw movements, the author says: **This view is entirely unscientific 
as well as unwarranted in practice . . . unless the teeth are so 
assembled as to permit of anatomic movements other than simple oc- 
clusion at the time of constructing the denture, the habit of confining 
masticatory effort to the hinge movement alone becomes permanently 
fijKd long before any perceptible change occurs in the condyle paths." 

In Chapter 18 entitled, 'Construction of Full Dentures, Anatomic 
Method," the author deals extensively with Christiansen's method of de- 
termining the forward inclination of the condyle path by protruding the 
jaw or by moving it laterally, the Snow Face Bow for transferring bites 
to the articulator and the New Century Articulator. The Gysi methods 
and appliances are described in the following chapter. 

The author gives Dr. Williams extended credit for his work in anterior 
tooth forms, and Dr. Gysi credit for producing greatly improved forms of 
bicuspids and molars. Dr. Prothero reproduces illustrations of famous 
statues exemplifying different types of face and mentioning the different 
forms of Trubyte teeth which would be required to harmonize with them. 

On pages 380 and 381, under suggestions as to the selection of colors 
in teeth, it is to be regretted that the author did not go into greater detail, 
in affording instruction in the very delicate and beautiful color scheme 
which nature has arranged in the natural teeth, and which has now been 
reproduced in artificial teeth in greater degree than ever before. 

On page 393, under the heading, "Arranging and occluding the 
teeth," the author develops the balancing contact between the upper and 
lower second molars and says that, "When developed, no other contact is 
required on that side between that point and the opposite lateral or 
cuspid tooth." It is always unsafe to trust to memory, but this state- 
ment seems to the writer much less complete than the statement that Dr. 
Prothero made to him some years ago, when he first taught the writer the 
principles of articulation. If memory serves correctly. Dr. Prothero 
taught the writer the advantages of balancing contact from bicuspids to 
molars on the balancing side. 

Under the heading "Flask Closing" the writer deals with the im- 
portant subject of placing the right amount of vulcanite in the flask, to 
avoid alteration or destruction of the form of the model. He shows it is 
not uncommon for such force to be applied to the nuts of the flask as to 
exert a pressure of more than 4 tons on the plaster model. He states that 
no more than five pounds should be applied to the end of the wrench 



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SOCIETY NOTES 339 

handle in closing the flask, and that even this limited force yields a pres- 
sure of over 800 pounds on the cast. He offers relatively exact methods 
for determining the proper amount of rubber to be used for any case. 

In the vniter's opinion, it is to be regretted that a book which will 
find a place in so many libraries should not deal more extensively with the 
differences between articulation as exhibited in natural dentures and 
articulation as it must be exhibited in full artificial dentures; with the 
difference, in form between natural and artificial teeth; with what con- 
stitutes the depth of the bite in teeth; with the influence of the depth of 
the bite upon the stability and functioning power of the dentures and 
with the formation of unglazed cutting and grinding facets on the oc- 
clusal surfaces of the bicuspids and molars. This information would have 
been of interest and value to many students and practitioners of pros- 
thetic dentistry. 

The construction and practice of making gold and porcelain inlays are 
extensively illustrated and described. 

Chapter 32, 140 pages long, presents a brief outline of metaUurgy in 
what the author describes as an effort to point out those essential physical 
and chemical properties and peculiarities of metals, which, if overlooked 
or misunderstood by the Prosthesist, might result in mishaps of more or 
less serious character. 

The last 100 pages is devoted to a brief history of Prosthetic Dentistry 
and an index which it seems should be very complete. 

The book gives evidence of an enormous amount of careful and in- 
telligent labor by the author. It is filled with good things and is a 
valuable contribution to the literature of the profession. It will form a 
helpful addition to any dentist's library. 



SOCIETY NOTES 

Arkansas. 

The Arkansas State Board of Dental Examiners will hold an examination at the Marion 
Hotel in Little Rock, Arkansas, June 29th to July i, 1916. Applicants must be graduates 
of reputable Dental Schools. Application and fee should be in the hands of the secre- 
tary two weeks before examination. — I. M. Sternberg, Fort Smith, Ark., Secretary . 

Calipornia. 

The next meeting of the Board of Dental Examiners of California will be held in San 
Francisco beginning June 2, 1916. This examination will be followed by one in Los 
Angeles, beginning June i6th. — C. A. Herrick, San Francisco, Secretary. 

Colorado. 

The thirtieth annual meeting of the Colorado State Dental Association will be held at 
the Cliff House, Manitou, June 15-17, 1916. Exhibitors will please address F. P. 
Wells, Exchange Bank Bldg., Colorado Springs. — Earl W. Spencer, Pope Block, 
Pueblo, Colo., Secretary. 



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340 THE DENTAL DIGEST 

Connecticut. 

The Connecticut State Dental Association will meet in New London, Conn., at Hotel 
Griswold, June 13-15, 1916. — Elvvyn R. Bryant, New Haven, Conn., Secretary. 
The Dental Commissioners of the State of Connecticut will meet at Hartford, June 22, 
23 and 24, 1916, to examine applicants for license to practise dentistr>', and for the 
transaction of any other business projxir to come before them. — Edwaju) Eberle, 902 
Main St., Hartford, Conn., Recorder. 

Florida. 

The next meeting of the Florida State Dental Society will take place at Orlando, Fla., 
June 21, 1916. — M. C. Izlar, Ocala, Fla., Secretary. 

Georgia. 

The forty-seventh annual meeting of the Georgia State Dental Association, will be held 
at Macon, Ga., June 8-10, 1916, beginning at 11 a.m. Thursday, June 8th. — M. M. 
Forbes, 803 Candler Bldg., Atlanta, Ga., Secretary. 

Idaho. 

The next meeting of the Idaho State Dental Society, will be held at Boise, June, 1916. — 
R. J. Cruse, Pocatello, Idaho, Secretary. 

Illinois. 

The Illinois State Dental Society will hold its next meeting at Springfield, 111., May 9-12, 
1916. — Henry L. Whipple, Quincy, III., Secretary. 

The Illinois State Board of Dental Examiners will hold their next examination at the 
Northwestern University Dental School, 31 W. Lake St., Chicago, June 15th at 9 a.m. — 
O. H. Seifert, Springfield, III., Secretary. 

Indiana. 

The fifty-eighth annual meeting of the Indiana State Dental .Association will be held at 
the Claypool Hotel, Indianapolis, May 16-18, 1916. — A. R. Ross, Lafayette, Secretary. 

Iowa. 

The next meeting of the Iowa State Board of Dental Examiners for the examination of 
applicants will be held at Iowa City, Iowa, commencing Monday at nine o'clock a.m., 
June 5, 1916 — J. A. West, Des Moines, Iowa, Secretary. 

Kentucky 

The Kentucky State Dental Society, will hold its next meeting at LouisWlle, July 24, 
1916 — W. T. Farrar, 519 Starks Bldg., I^uisville, Ky., Secretary. 
The next meeting of the National Dental Association will be held in the ist Regiment 
Armory, LouisviHe, Ky., July 25-28, 1916. — Otto U. King, Huntington, Ind., Secretary. 

Maine. 

The fifty-first annual meeting of the Maine Dental Society will lie held at the Rangeley 
Lake House, Rangeley, Maine, June 26-28, 1916. — I. E. Pendleton, Lewiston, Maine, 
Secretary. 

Michigan. 

The Michigan State Board of Dental Examiners will meet in the Dental College at Ann 
Arbor, June 19, 1916, at eight o'clock a.m. For application blanks apply to E. O. 
Gillespie, Stephenson, Mich., Secretary-Treasurer. 

Missouri. 

The next regular meeting of the Missouri State Board of Dental Examiners, for examining 
applicants to practise dentistry in Missouri, will be held in Jefferson City, June 12-14, 
1916. — V. R. McClt:, Cameron, Mo., Secretary. 



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SOCIETY NOTES 341 

Montana. 

The Montana State Board of Dental Examiners will hold their Annual Session for examin- 
ations at Helena, Mont., July 10-13, 1916. — G. A. Chevigny, 107 Clark Blk., Butte, 
Mont., Secretary. 

Nebrasela. 

The Nebraska State Dental Society will hold its next meeting in Lincoln, Nebr., May 
t6-i8, 1916. — H. E. King, Omaha, Xebr., Secretary. 

Xew Jersey. 

The forty-sixth annual convention of the New Jersey State Dental Society will be held 
at Asbury Park, N. J., on July 12, 13, 14, and 15, 1916. — John C. Forsyth, 430 East 
State St., Trenton, N. J., Secretary. 

New York. 

The Dental Society of the State of New York will hold its next meeting at the Hotel 
Ten Eyck, Albany, N. Y., May 11-13, 1916. — A. P. Burkhart, 52 Genesee St., Albany, 
N. Y., Secretary. 

Ohio. 

The Northern Ohio Dental Association will hold its annual session at Hotel Statler, 
Cleveland, June 1-3, 1916. — Clarence D. Peck, Sandusky, O., Secretary. 

Pennsylvania. 

The fifty-third annual meeting of the I^ke Erie Dental Association will be held at Hotel 
Bartlett, Cambridge Springs, Pa., May 18-20, 1916. — J. F. Smith, 120 VV. 18th St., Erie, 
Pa., Secretary. 

The next regular examination of the Pennsylvania Board of Dental Examiners will be 
held in the Musical Fund Hall in Philadelphia, and the College of Pharmacy Building 
in Pittsburgh, on June 14-17, 1916. The practical work will be held at the Philadelphia 
Dental College in Philadelphia, and the University of Pittsburgh in Pittsburgh, on the 
first day, June 14th, the operative work at eight-thirty a.m., the prosthetic work at one- 
thirty P.M. — Alexander H. Reynolds, 4630 Chester Ave., Philadelphia, Pa., Secretary. 

Rhode Island. 

The next meeting of the Rhode Island State Board of Registration in Dentistry, for the 
examination of candidates, will be held at the State House in Providence, June 27-29, 
19 16, beginning each day at 9 a.m. Only graduates of a reputable Medical or Dental 
College are admitted to this examination. — Wm. B. Rogers, 171 Westminster St., 
Providence, R. I., Secretary. 

South Carolina. 

The forty-sixth annual meeting of the South Carolina State Dental Association will be 
held at Chick's Springs, So. Car., July 11-13, iQi^- — Ernest C. Dye, Greenville, So. 
Car., Secretary. 

Tennessee. 

The next meeting of the Tennessee Board of Dental Examiners will be held at Nashville, 
Tenn., commencing Monday at 10 a.m., June 12th, and continuing through Friday, 
June i6th. For full information and application blanks apply to Walter G. Hutchison, 
308 Eve Bldg., Nashville, Tenn., Secretary. 

The Tennessee State Dental Association meets in Knoxville, Tenn., June 20-22, 1916. — 
H. C. Maxey, 908 Exchange Bldg., Memphis, Tenn., Secretary. 

Texas. 

The Texas State Dental Association will hold its next meeting at Dallas, Texas, May 
9-12, 1916. — W. O. Talbot, Fort Worth, Texas, Secretary. 



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342 THE DENTAL DIGEST 

Vermont. 

The next meeting of the Vermont Board of Dental Examiners, for the examination of 
candidates to practise in X'ermont, will be held at the Statehouse, Montpelier, June 26-28, 
19 16. — Harry V. Hamilton, Newport, Vt., Secretary. 

Wisconsin. 

The meeting of the Wisconsin State Board of Dental Examiners will be held at the Mar- 
quette Dental College, Cor. 9th and Wells St., Milwaukee, Wis., June 14, 1916, commenc- 
ing at nine o'clock. — F. A. Tate, Daniels Blk., Rice 1.4ike, Wis., Secretary. 
The next meeting of the Wisconsin Stale Dental StK'iety will Ije held in Wausau, Wis., 
July 1 1 -1 3, 19 1 6. — Theo. L. Gilbertson, Secretary, 



THE FORSYTH INFIRMARY FOR CHILDREN 

PERMANENT STAFF APPOINTMENTS 

An examination of graduates in Dentistry (of less than three years' standing), for ap- 
pointments to positions on the Permanent Staff for full and one-half time service will lie held 
early in June at the Infirmary. 

Appointments will Ix; made for one or two years as follows: 

Full time service requiring every day, 8 hours per day, with one afternoon off a week, at 
a salary of $1,000 [)er year. 

One-half time service requiring 3 J hours per day either forenoon or afternoon, at a salar>' 
of $400 per year. 

These appointments will be made subject to satisfying the requirements of the Massa- 
chusetts State Board of Registration in Dentistry. 

Members of this staff will }ye entitled to the advantages of reports and clinics by experts 
in the various branches of dentistry from different parts of the world, in addition to the 
numerous regular clinics and lectures. 

The operators on this staff have the advantage of the clinics and lectures of the Post 
Graduate School of Orthodontia. 

All material and necessary operating instruments will be furnished; up-to-date apparatus 
including electric engines, sterile instrument trays, fountain cuspidors, compressed air and 
modem opera ting-room- type lavatories are available for use. 

A diploma of service will be issued to each member of this staff who has completed this 
term to the satisfaction of the Trustees. 

Applications for the above positions should be made not later than May 15th. Informa- 
tion will be gladly furnished to any one interested, also the date of the examination. 

Harold DeW. Cross, D.M.D., Director, 140 The Fenway, Boston, Mass. 

UNDERGRADUATE ASSISTANTS 

During the months of June, July, .\ugust, and September an opportunity is offered by 
the Trustees of the Forsyth Dental Infirmary for Children to a, limited number of under- 
graduate students to act as assistants in the clinics of the Infirmary. This privilege permits 
a student to obtain unusual clinical advantages in the various departments of the institution 
where Operative Dentistry, Orthodontia, Nose, and Throat, Oral Surgery. Radiography, 
Pathological Diagnosis, and Research Work are continually carried on. 

Operators' gowns and all instruments are furnished. Over three hundred children arc 
treated daily. 

For further details apply before May 15th to the Director, Harold DeW. Cross, D.M.D., 
140 The Fenway, Boston. 



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FUTURE EVENTS 343 



FUTURE EVENTS 

May 11-13, 1916. — Dental Society of the State of New York, Hotel Ten Eyck, Albany, N. Y. 

— A. P. BuRKHART, 52 Genesee St., Albany, N. Y., Secretary. 
May 16-18, 19 1 6. — Susquehanna Dental Association, Young Men's Hebrew Association 

Bidg., Scranton, Pa. — Geo. C. Knox, 30 Dime Bank Bldg., Scranton, Pa., Secretary. 
Alay i6-i8, 1916. — Nebraska State Dental Society, Lincoln, Neb. — ^H. E. King, Omaha, 

Neb., Secretary, 
May 17-18, 1916. — Indiana State Dental Association, Claypool Hotel, Indianapolis. — A. R. 

Ross, Lafayette, Secretary, 
May 18-20, 1Q16. — Lake Erie Dental Association, Hotel Bartlett, Cambridge Springs, Erie, 

Pa.— J. F. Smith, Secretary. 
June 1916. — Utah State Dental Society, Salt Lake City. — E. C. Fairweather, Salt Lake 

City, Utah, Secretary. 
June 1-3, 1916. — Northern Ohio Dental Association, Cleveland, O. — Clarence D. Peck, 

Sandusky, O., Secretary. 
June 5, 1916. — Iowa State Board of Dental Examiners, Iowa City, Iowa. — J. A. West, 

Des Moines, Iowa, Secretary. 
June 5-8, 1916. — Board of Dental Examiners of the District of Columbia. — Starr Par.sons, 

1309 L St., N. W., Washington, D. C, Secretary. 
June 8-10, 1916. — Georgia State Dental Society, Macon, Ga. — M. M. Forbes, Candler 

Bldg., Atlanta, Ga., Secretary. 
June 12, 1916. — ^Tennessee Board of Dental Examiners, Nashville, Tenn. — ^Walter G. 

Hutchison, 308 F^ve Bldg., Nashville, Tenn., Secretary. 
June 12-14, 19^6. — Missouri State Board of Dental Examiners, Jefferson City. — ^V. R. 

McCue, Cameron, Mo., Secretary. 
June 12-17, 1916. — Indiana Board of Examiners Indianapolis, Ind. — Fred J. Prow, Bloom- 

ington, Ind., Secretary. 
June 13-15, 19 16. — Connecticut State Dental Association, Hotel Griswold, New London, 

Conn. — Elwyn R. Bryant, New Haven, Conn., Secretary. 
June 14, 191 6. — South Carolina State Board of Dental Examiners at Jefferson Hotel, 

Columbia, S. C. — R. L. Spencer, Bennettsville, S. C, Secretary. 
June 15, 1916. — Illinois State Board of Dental Examiners, Northwestern University Dental 

School, 31 W. Lake St., Chicago. — O. H. Seifert, Springfield, 111., Secretary. 
June 15-16, 1916. — ^Thirtieth annual meeting of the Colorado State Dental Association, 

Cliff House, Manitou. Exhibitors will please address Dr. F. P. Wells, Exchange Bank 

Bldg., Colorado Springs. — Earl W. Spencer, Pope Block, Pueblo, Colo., Secretary. 
June 20-22, 1916. — Tennessee State Dental Association, Knoxville, Tenn. — H. C. Maxev, 

Memphis, Tenn., Secretary. 
June 20-22, 1916. — New Hampshire Dental Society, Lake Sunapee, Zoo-Nipi Park Lodge, 

Lisbon, N. H. — J. E. Collins, Chairman Exhibit Committee. 
June 21, 191 6. — Florida State Dental Society, Orlando, Fla. — M. C. Izlar, Secretary. 
June 22-24, 1916. — Dental Commissioners of the State of Connecticut, Hartford, to examine 

applicants for license to practise dentistry. — I^dward Eberle, Recorder. 
June 26-28,, 19 1 6. — The fifty-first annual meeting of the Maine Dental Society, Rangeley 

Lake House, Rangeley, Maine. — I. E. Pendleton, Lewiston, Maine., Secretary. 
June 26, 1916. — North Carolina State Board of DentSl E.xaminers, Battery Park Hotel, 

Asheville, N. C. — F. L. Hunt, Asheville, Secretary. 
June 27-29, 1916. — Pennsylvania State Dental Society, Pittsburgh, Pa. — Luther M. 

Weaver, 103 Woodland Ave., Philadelphia, Pa., Secretary. 
June 27-29, 1916. — Rhode Island State Board of Registration in Dentistry, State House, 

Providence. — Wm. B. Rogers, 171 Westminster St., Providence, R. I., Secretary. 
June 28-30, 1916. — North Carolina State Dental Society, Asheville, N. C. — R. M. Squires, 

Wake Forest, N. C, Secretary. 



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344 THE DENTAL DIGEST 

June 29-July ist, 1916.— Maine Board of DenUl Examiners.— Harold L. Emmons, Masonic 
Bldg., Saco, Me., Secretary. 

June 29-July I, 1916. — Arkansas State Board of Dental Examiners, Marion Hotel, Little 
Rock, Arkansas. — I. M. Sternberg, Fort Smith, Ark., Secretary. 

July 10-13, 19 1 6. — Montana State Board of Dental Examiners, Annual Session for examina- 
tions at Helena, Mont. — G. A. Chevigny, 107 Clark Blk., Butte, Mont., Secretary. 

July 11-13, 1916. — South Carolina State Dental Association, Chick's Springs, S. C. — Ernest 
C. Dye, Greenville, S. C, Secretary. 

July 11-13, 1916. — Wisconsin State Dental Society Meeting, Wausau. — Theodore L. Gil- 
bertson. Secretary. 

July 12-15, 1916. — New Jersey State Dental Society, Asbury Park, N. J., — John C. Forsyth, 
Trenton, N. J., Secretary. 

July 20-22, 1916. — ^American Society of Orthodontists, Pittsburgh, Pa. Address communica- 
tions to F. M. Casto, 520 Rose Bldg., Cleveland, O. 

July 24, 1 91 6.— Kentucky State Dental Society, Louisville, Ky.— W. T. Farrar, 519 Starks 
Bldg., Louisville, Secretary. 

July 25-28, 19 16. — National Dental Association, 1st Regiment Armory, Louisville, Ky. — 
Otto U. King, Huntington, Ind., Secretary. 

October 9^15, 1916. — Arizona Board of Dental Examiners, Phoenix, Ariz. — Eugene Mc- 
Guire, 302 Noll Bldg., Phoenix, Secretary. 

October 18-20, 1916. — Virginia State Dental Association, Richmond, Va.— C. B. Giffqrd, 
Norfolk, Va., Corresponding Secretary. 

January 23-25, 191 7.— American Institute of DenUl Teachers, Philadelphia, Pa.— Abram 
Hoffman, 529 Franklin St., Buffalo, N. Y., Secretary-Treasurer. 



STATEMENT OP THE OWNERSHIP, MANAGEMENT, CIRCULATION, ETC., 

OF THE DENTAL DIGEST, APRIL 1, 1916, PUBLISHED MONTHLY AT 

NEW YORK, N. Y., REQUIRED BY THE ACT OF AUGUST 24, 1912 

NAME OF POST-OPFICE ADDRESS 

Pw^/uAer, Tbe Dentists' Supply Company Times Square, 220 W. 42nd St., New York 

Editor, George Wood Clapp New Rochellc, N. Y. 

Managing Editor, George Wood Clapp New Rochelle, N. Y. 

Business Manager, George Wood Clapp New Rochelle, N. Y. 

Owners: Stockholders holding one per cent, or more of total amount of stock 

NAME OF POST-OFFICE ADDRESS 

The Dentists* Supply Company 220 West 42nd St., New York, N. Y. 

George H. Whiteley York, Pa. 

Dean C. Osborne 1347 Dean St., Brooklyn, N. Y. 

Sade E. L. Osborne 1347 Dean St., Brooklyn, N. Y. 

John R. Sheppard 15s Riverside Drive. New York 

Gertrude L. Frantz New Rochelle, N. Y. 

Leroy Frantz New Rochelle, N. Y. 

Gertrude L. Frantz, Trustee for T. Harold Frantz . . . New Rochelle, N. Y. 
Gertrude L. Frantz, Trustee for Horace G. Frantz . . . Colorado Springs, Colo. 

Viola F. Good New Rochelle, N. Y. 

Ethel F. Tomb Springfield, Mass. 

Mabel G. De Sanno Oak Lane, Philadelphia, Pa. 

DE Trey & Co^ Ltd 13 Denman St., London, Enjf. 

de Trey & Co., Ltd. is a corporation organized under the laws of England, with authorized capital stock of 
500,000 shares of One Pound each, ownership of which is scattered over a considerable part of Europe and includes 
a long list of names unknown to us, and probably a number of banks and other corporations. 
Known bondholders, mortgagees and other security holders holding one per cent, or more of total amount of bonds 

mortgages, or other securities 
None • 

THE DENTISTS' SUPPLY COMPANY 

John R. Sheppard, Sec*y &• Treas. 
Sworn and subscribed before me this 20th day of March, igi6 

[seal] Herbert V. Dike, My commission expires March 30. 1916. 

Notary Public New York County No. 836 
Register's No. 611 7 



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The Dental Digest 

G£ORG£ WOOD GLAPP, D.D.Sm Editor 

Published monthly by The Dentists' , Supply Company, Candler Bldg., 
Times Square, 220 West 42d Street, NewjYoflgj,.Ui]S. A, Yif V^om all com- 
munications relative to subscriptions, advfertifii&g* fefc. j* SRoiiki be addressed. 

Subscription price, induding postaae, •Jjxxj pel* ye^rj^^al} |)€wte.Qf..thft. 
United States, Philippineg, Ojj^iti,'\^ubU,:HottO Rfcct, »|fexlca:^rfi^lltfvjaii^n : 
Islands. To Canada, $1.40. ' To dll*otfier*cbimtries, $iljS- .* ' ' ' 

Articles intended for publicationj^nSi J:<5<fe§^oAdencc,r^a54lp8*^lJ^jS^me 
should be addressed Editor DFiiTii WDest; handler •B!^,t'iimcs*'SqifaFe, 
220 West 42d Street, New York, N. Y. 

The editor and publishers are not responsible for the views of authors ex- 
pressed in these pages. 

Entered as Second Class Matter, at the Post-OflBice at New York City. 
Under the Act of Congress, March 3, 1879. 



Vol. XXII 



JUNE, 1916 



No. 6 



THE FATE OF AN "INNOCENT BYSTANDER" 

By Floy Tolbert Barnard, Kelso, Wash. 

IS THERE really a dentist somewhere that has to be lured off on 
even a one-day vacation? If there is, why do you not get a pic- 
ture of him to print in your June 
Vacation number of the Digest? I 
supposed they were as extinct as the 
Ichthyornis, that ancient bird reputed 
to have had "sharp conical teeth set 
in sockets." A picture of the man 
ought to be as interesting as the illus- 
tration of that worthy bird, of the 
order of Odontotormae. All the den- 
tists I ever knew about were more in 
need of being suppressed ! I am not a 
dentist at all, myself, but I am the wife 
of one, the cousin of another, and have 
for friends still others, and my experi- 
ence has been one of ever recurring days 
of vagrant fishing or hunting or im- 
promptu picnics. I admit those days 
appear to refresh the dentists whether 
they go singly or in squads, but I 
would like to recount to you the fate of 
innocent bystanders, as myself for instance, when Dr. Barnard goes a-fishing. 
He went last Sunday with friends and they took me along. We did 




We come to "those green-robed senators 
of mighty woods" — Keats. 



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THE DENTAL DIGEST 




Seriously at work 



not actually go until Sunday morning, but the upheaval of preparations 
began the preceding Friday when I discovered Dr. Barnard going through 

his chiffonier in the methodi- 
cal and orderly manner of a 
passing cyclone. 
' ***S0iat are you looking 
?or7-'^r- asked. 
: " My fly-book," said he. 

"It is on the shelf of the 
hall closet," quoth I, and re- 
signed myself to the worst. 

At noon Dr. Barnard 
hardly took time to eat his 
luncheon. He spent the time 
hunting up rods and reels, fish- 
baskets, coats, hob-nailed boots and all the things known to the minds 
of fishing dentists. And great was the hunt thereof! Most of the things 
were right where he had put them away, but he seems to get part of his 
recreation by revolving through the house like a human egg beater. All 
things were swept into his wake, and some things did survive. But he 
was happy! The tension of nerve fatigue acounulated through several 
vacationless weeks gradually trans- 
ferred itself from his face to mine! 

Friday night he arrived late to 
dinner, but he began telling me about 
the wonderful new flies he had lin- 
gered to buy, before he had the door 
open. As near as I could make out 
those flies were such favorites with 
mountain trout that they — the trout 
— would fairly pursue one up to the 
tall timber if his rod were but baited 
with one of them. They were flies 
that I am fully convinced no "fish- 
in' "dentist should be without. Great 
flies, those. I have not been able to 
figure out, even yet, why Dr. Bar- 
nard bought several cans of salmon 
eggs, and then went out in the garden 
and dug up a lot of ghastly worms, 
when he had those irresistible flies. But he did, while dinner got even 
colder; then he came in (I supposed he had left the worms outside, some- 



i 

[ 


i 


i^ 


^«M^^^^^K^^H 


i^; ■ 


5 


^^■.■^. 


''^H^^B 



Such scenes as this ' do truly re-create" 



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THE FATE OP AN "INNOCENT BYSTANDER" 



347 




Our favorite spot 



where) and put the new wonder flies in his fly-book, and put the book on 
the chafing-dish tray, from whence no one dared to remove it to the 
equally accessible closet shelf. 
After which he ate his dinner. 
Saturday noon he added a 
fly or two he had overlooked, 
to his collection, and started 
to " get things together." He 
got out the one-day camp 
stove — it looks like a toaster 
on stilts — and put it on the 
window seat in the dining 
room for a nucleus around 
which to* assemble his para- 
phemaUa. With it he put a 

huge frying pan with a handle three feet long, and the other things (that 
you most likely litter your house with when you go a-fishing). 

Saturday night he managed to get home a little early. He wanted 
to see to the bacon and coffee and condensed milk; the butter, the olives, 
the bread and other plain things that we take along to eat with the fish 
he gets for us to fry. I could pack them for him, but he prefers to do it 
himself; then he knows he has enough along to tide us over should we be 
unable to get back in the evening, as we were planning to do. In fact, if 

for some unthinkable reason 
we should have to stay for six 
months, we could get along 
very nicely on the things Dr. 
Barnard takes along for about 
twelve hours. 

About eleven o'clock I 
went into the living room for 
something and fell over what 
appeared to be dozens of hob- 
nail boots, but when I inves- 
tigated they were only the 
usual two boots! It was 
merely Dr. Barnard's arrange- 
ment of them that gave the 
multiple effect. With them I found a rug for me to sit on while he 
fishes (I am no angler), a battered hat, a camera, with a dozen plate 
holders, a kodak with several rolls of film, a tripod, and some other things, 
such as sweaters, coats, soap and matches. We expected to be gone a 




The afterglow 



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THE DENTAL DIGEST 



whole vacation, you must remember, — a whole long day, and it is well 
to be— PREPARED! 

I sat by the mound with something of the feeling I am told travelers 
have when surveying the mound-like ruins of Nineveh — that ** rejoicing 
city that dwelt carelessly!'' Layard says of the ruined city that it is 
now a "stem shap)eless mound," and that he is unable to give any form 
to the "rude heaps on which he is gazing, — in desolation," He has my 
comprehending sympathy. 

About midnight Dr. Barnard went to bed for a few minutes. Then 
he thought of something he had almost forgotten and prowled around 
for another space of time. At the witching hour of two he happened to 
remember the ray-filter for his camera. It took him several minutes to 
locate it, and I think he did really try to be quiet. At last, along about 
dawn, sleep did actually descend upon the festively troubled hbuse, — at 
almost the same minute the alarm — alarum! clock "went oflf." 

Dr. Barnard was evidently much refreshed by his brief philander 
with sleep. He was out in the kitchen in a "jiffy" starting the breakfast, 
while I tried to get my eyes opened enough to find my blue flannel middy. 
But in the course of what seemed like a century to me I got myself dressed 
and went yawning to the dining room, where I became wide awake with 

great suddenness. For behold ! 
Slithering across the oak floor in 
slimy hieroglyphs was an army of 
worms! They had escaped from the 
inadequate can in which Dr. Barnard 
had put them and were seeking the 
eight points of the compass with all 
possible speed. 

I shouted to Friend Husband to 
come instantly and mobilize the 
wretched army. He came, and I re- 
gret to say he was in no wise horrified : 
indeed he was smitten with unseemly 
levity. But he scrambled around 
over the floor picking them up — in 
m^^ the interest of fishing preparedness. 

|PI|k^: y, / , He even recited for my benefit the 

Nothing to think of; only look ^'^^^^ beginning "Nobody loves me " 

and ended in a diet of "Two slick 
ones and a woolly one." Also, he stopped once to bet me anything 
that one of two parallel worrums would beat the other to cover under 
the sideboard. But he eventually had them all corralled and we 




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THE FATE OF AN "INNOCENT BYSTANDER" 349 

finished our breakfast just as our friends honked festively from the 
street. 

Dr. Barnard carried out his van load of provisions for the day, to 
add to the six months' supplies Mr. Ames had thought advisable to take 
along in case of emergency and we were off. Mrs. Ames had a sort of a 
hunted look. I fancy she had been falling over "rude heaps" of fishing 
equipment for several days, too. 

However, the morning was glorious, and the day did certainly promise 
to be "fine," so we put all memory of the late tumult behind us to enjoy 
the twenty-five mile ride through the low coast mountains. We passed 
through bits of woodland that suggested Pan and wood-nymphs and 
dryads, and we forgot prosy every day things and began to be as joyous 
as the men, almost! 

It was the second of April and the air was cleansingly chill. Galleons 
of stately morning clouds sped across the sky on far adventures; hemlock, 
cedar, fir, and all their pleasant kin were adding pale green tips to their 
dark sombre green of other seasons; the alders, just beginning to bud, were 
etched beautifully against the surrounding "evergreens" that keep a cool 
dusky gloom on even the sunniest day. The far-flung song of the meadow- 
lark led the morning matins of the birds, and we all — involuntarily — 
became silent for a little space and in that little devotional silence tense 
muscles and taut nerves relaxed, the peace and the "abundant life" that 
are the gifts of a mountain morning refreshed us all, and we felt at one 
with every living thing for the remainder of our drive. Early spring in 
the mountains is like no other time and place. There is a singular com- 
bination of silence and sound; the stillness of the hills themselves is undis- 
turbed by the surf-like murmur of the trees, the infinitesimal choir of 
insect sounds, the lyric songs and harmonic calls of many birds, and the 
challenge of mountain streams luring from near and far with haunting 
echoes of every voice that you have loved. 

When we reached camp it was still amazingly early. The three fisher 
folk — for Mrs. Ames fishes — put their rods together and selected with 
stupendous solemnity and importance, each the fly of his choice, and then 
"for fear" stuck some other flies in their several hat and cap bands, and 
some despondent worms in their pockets along with a can of salmon eggs, 
after which they adjusted their baskets and I thought I was going to have 
a chance to loaf on a rug, and sleep or "meditate lickety split" like Tagore 
is said to do ! I have always wanted to try it, but my hope continues to be 
deferred. They wanted me to go along to get some pictures of them. 

I listened with all the intelligence I could muster to Dr. Barnard's 
involved explanations about the mechanism of the two cameras, accepted 
the pack of heavy plates and an extra roll of films and set out after them. 



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350 THE DENTAL DIGEST 

I would not have to work so hard if I only would learn to fish. (You said, 
Dr. Clapp, in the Editor's Corner of the March Digest that " the merest 
dub could learn to catch some kinds of fish/' Pardon me! I have tried 
and I cannot.) 

When I had used up the supply of plates and all the fihns, they mis- 
quoted scripture at me; they said "Now lettest we our servant depart in 
peace" and I started back, — alone! 

Some one called after me to be careful not to fall on the rocks. I was 
quite touched by the unexpected solicitude, until I heard the reason! 
** You might break the plates." 

When I got back to my rug I was too tired to meditate. I slept in- 
stead. I woke up much happier, but himgry. It was half past twelve. I 
took a stroll. It was two. I went back to my rug faint with hunger. 
I read. It was a quarter to three. I was about to rob the hampers 
when they returned each with a "catch" I was expected "for to admire 
and for to see." I obligingly admired until I was breathless and pre- 
tended to believe the three thrilling tales of adventure until at lOj^st they 
were almost satisfied. Then the men started a fire and went down to the 
stream to clean the "feesh." We, Mrs. Ames and I got out the bread 
— "and all," — and presently we were frying fish; the coffee was done and 
we ate our dinner. Good? Never was a banquet better. 

After dinner and a smoke Dr. Barnard took the camera and departed 
thence for more pictures, being doubtful of my luck along that line. 
When he came back the day was far spent, and we started home. We 
stopped for a picture of the sunset — afterglow — and then drove on 
through the dusk, reaching home in the blue starry dark. 

And this one day of recreation is like unto the many we take from 
earliest spring to latest autumn. They do truly re-create. Dr. Bar- 
nard comes home from each of them ready to do a Marathon to his office 
the following morning. 

And I? I call on the woman who "comes in" and we excavate my 
bungalow from the "rude heaps." And I still doubt your inference that 
there are Doctors of Dentistry who prefer to sit at home and be "perfect 
ladies," to going for an outing under blue spring skies for a day now and 
then — friends with the winds and the sun and even the sunburn! Men 
who forget that the brown dirt under their feet is a bit of the Planet 
earth, as wonderfully interesting as Mars or Jupiter. Men who become 
so absorbed in Man's inventions that they forget God's handiwork, and 
are so busy making a living that they forget the gift of life and the 
"Le/ go^' for a Day and Just Live, power that flows to the man who 
knows how to "let go" for a day and just live. If there is one I hope 
lie reforms. 



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HUNTING WITH AIRBDALE TERRIERS 



351 



HUNTING WITH AIREDALE 
TERRIERS 

By a. p. Deacon, D.D.S., 
Willows, Cal. 

I THINK every man has a hobby 
and mine is dogs, with a capital 
D. For years I had bull terriers, 
but about ten years ago, I began to 
hear a great deal about Airedales, so 
decided to get a pair, and after giving 
them a good trial, I found that I had 
the "Ideal Dog" good for any pur- 
pose. I sp)end a month every Fall in 
the mountains with a few friends and 
our families and my pack of hunting 
Airedales. 

The lion I got one afternoon while 
fishing. I had four dogs along, they found his track and treed him after 
ashort run. I pelted him with rocks not having a gun along, until I knocked 
him out of the tree, and the dogs caught and killed him on the ground. 




The bear skin and myself 




No. 2 
" Pictures Nos. i and 2 are skin of the largest bear I ever killed " 

Last November in Siskiyou Co., we caught the six bears in Picture 
No. 4 with myself and the dogs. The two large ones in the centre were 



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THE DENTAL DIGEST 




No. 3 
I grabbed him by the tail and pulled him down 



terrors to run and fight. I had ahnost the same experience with each; 
they ran and fought in thick birch and rocks aU day. One would not stop 

and I was lucky to get a shot at 
him as he climbed over a log. I 
hit him in the neck [with a .35 
Remington, breaking it and killing 
him almost instantly. The other 
got away and as it was near dark 
and I had quite a ways to go, I 
had to quit and go to camp. The 
next morning we were up before 
daybreak, as I had to go and find 
the dogs, Mrs. Deacon decided to 
go with me, and after a couple of hours* ride, we heard the dogs 
barking. Riding down to where they were, we found the bear up a 
tree, and every dog trying to climb up to him. I tied the horses and 
while I held the eight dogs, "some job," so that the bear would not 
fall on them, Mrs. Deacon put a '^35" through his head and our fun 
was over and hard work on our hands to get him to camp. The 
other four we treed on different days, and as none of them were 
very big, I climbed the trees and shoved them out with a pole, and 
let the dogs kill them and they made "some scrap." No. 3 was taken 
during one of the fights; he started up a tree and I grabbed him by the 
tail and pulled him down. Nos. i and 2 are skins of the largest bear I 
ever killed, was after him for two years off and on, before I could get the 
dogs on his track, when it was fresh and in a good country. They treed 
him in one hour and forty minutes; he was very fat, weighing 590 lbs. 

Nos. 5 and 6 are 
of my little son and 
the result of some 
of our hunts. 

I take the whole 
family along and 
we certainly enjoy 
life amongst the 
mighty mountains 
with their snow 
capped summits, 
towering pines and 
ice cold, clear, trout streams and I store up energy enough to last me 
until the next fall. 

When old Jack Frost will come again the leaves begin to turn red, and 




No. 4 
Six bears, myself and the dogs 



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HUNTING WITH AIREDALE TERRIERS 



353 




No. 5 
Some of the results of our hunts 



the air tingles with the first 

breath of the coming winter. 

Then the red Gods begin to 

call, and, as I try to work, the 

smell of the pines will come to 

my nostrils, a picture of the 

camp, the bear steaks and fried 

trout and the woods and moun- 
tains will flash over my mental 

vision, and men on horses and 

the dogs in full cry will appear and I wake out of my reverie, to find 

that I am nervous 
and tired out. Then 
I close my office, tell 
my wife I have "The 
Call of the Wild'' and 
on the morrow we are 
packed and away to 
spend a month close 
to the bosom of 
mother nature, and to 
forget molars, inlays, 
anatomical articula- 
tion and the whole 




No. 6 
My little son, very proud 



blamed work for a while until nature takes away that tired feeling that 
comes to us all who work too long 
without play. 

Never was there a truer saying 
than "All work and no play, makes 
Jack a dull boy.'' Don't allow your- 
self to be a "dull boy," but take a 
good long, restful vacation. 





No. 7 
'Treed!" 



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354 



THS DENTAL DIGBST 



^ 


=LJJ ^^ 



Our cabin 



MY QUEST FOR PIKE 

By Dr. W. S. Walters, 
W. LaFayette, Ind. 

If you can read this stor>' and 
look at these pictures without 
wanting to close up the office 
right now and try for one of these 
fish and eat some of Mrs. 
Cobum's cakes and real maple 
syrup, you can do more than I 
can. How many things besides 
work there are in life and how 
well worth while some of them 
are. — EIditor. 

IT WAS tradition, inheritance and environment that made me a 
disciple of Izaak Walton, but, with the exception of a few auto- 
fishing trips over the border into Michigan for lake bass fishing, 
my efforts have been confined to central Indiana, my natural range since 
bu*th. And I always have had a "hankerin' '' to go up north and tackle 
the great northern pike and "muskies." 

Last July 2nd, my pal, Ray Southworth and I purchased tickets for 
Grand View, Wisconsin, 500 miles north of Chicago. We had several 
hours to spend in the Windy City so we bought some more fishing tackle, 
though we already had plenty, took the Pullman sleeper at six in the 
evening for Ashland, Wis., via Milwaukee. The train was two hours late 
so we had to spend the day in Ashland and the result was we bought some 




The layout of our cabin 

more fishing tackle. Grand View being only 23 miles from Ashland we 
soon arrived and loaded our baggage into Johnnie Sales' big wagon for the 



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MY QUEST FOR PIKE 



355 



nine mile trip to Diamond Lake. Time for trip 2 45. A rain storm was 
just over and the sun was breaking through the scurrying clouds. I shall 
never forget the wild ride over the trail, up and down hill, through forests 
of giant spruce trees 200 feet tall, over the territory that the great forest 
fire of two years ago devastated. We, who had never seen a wild deer out 
of captivity were keenly alert to see one of the beautiful animals in its 
native haunts. 

Just at dark we arrived at Diamond Lake where we were greeted by 
the regular reception committee, King, a large Airedale and Colonel, as 
fine a specimen of the coUie as I ever expect to see, who were destined to 
become our friends for our 
short two weeks of stay. Next 
in line appeared our genial 
host. Cash Cobum, who as- 
signed us to our cabin. There 
were five cabins on the clear- 
ing and we had one all to 
ourselves. Met Dr. Arnold, 
a dentist of St. Paul, Minn. 

Diamond Lake is shaped 
like the letter L, each arm 
being about two miles long, 
the camp is at the north end 
of one arm. The nearest 
neighbor is at the extreme 
other end of the lake. One 
quarter of a mile from this 
end is Crystal Lake. The sand 
of its beaches is white like 
granulated sugar and its 
waters contain only bass. 
North of our camp, one and a 
half miles, is Porcupine (or Porky) Lake, stocked with bass and great 
northern pike. West, two miles, is Spring Lake containing nothing but 
mountain trout (my! how they can fight). Three miles away lays 
South-West Lake, yours for the walled eyed pike. So you see you can 
choose the length of your hike and the kind of fish you want to catch. 
If you don't care a rap what kind or size, then fish in Diamond Lake; 
the largest Muskie taken there weighed eighty-seven (87) pounds and 
was caught by "Skinnie Robinson*' one of my fellow townsmen, and the 
smallest. Oh! well, why mention the unpleasant things? 

Our first day's trip was over to Porky where we caught a seven and a 




W. S. Walters on the firing line 



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356 



THE DENTAL DIGEST 




Walters and Ray "kidding" 



nine pK)und pike, eleven four and five pK)und bass and pike and about noon 
1 hooked an '*01d Codger'' (large pike) and the sport was on. Down in 

the bottom of the boat I 
went on my knees (although 
that is not a habitual posi- 
tion of mine) locking my 
legs under the boat seat, as 
I had no desire to explore 
the forty foot depths below 
me, away went my line for 
about eighty feet and back 
I would bring him only to 
have another vicious racing 
of the reel; getting a little 
careless I got a crack on the end of one finger from the reel handle that 
made the blood fly. An injury of this nature happening in my ofiice 
would have sent me to the hospital but while fishing, NEVER! After 
fifteen minutes of this I got "friend Pike*' alongside and called for Ray — 
who had been performing nobly at the oars keeping the boat out in deep 
water to get the gaff (we had a Marble clamping gaff with two heavily 
toothed jaws) and bring him on board; Ray made a fair catch just back 
of his head and in less than 
twenty seconds our gaff was 
reduced to a bunch of junk. 
You have all had your 
fun trying to take out an im- 
pacted third molar, but if 
you ever tackle one of the 
thirty (or more) pound pike 
you will realize that the 
tooth was " dead easy." No, 
I did not say we landed him, 
for it did not improve his 
feelings any to take about 
half his scales off with that 
gaff, and his next run was 
one of about 125 feet and he 
was still going when the line 
broke and along with it my 
heart, for I sure did think View from the cabin 

he was mine, having the two No. 8 hooks fairly fastened in his upper 
jaw. When I regained my breath the first thing that met my eye was 




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MY QUEST FOR PIKE 



357 




Three of a kind 



Ray's revolver in his belt, which he brought along to shoot the "big ones'' 

with, there are moments in one's life when he is forgetful, this was one of 

them. Then again it has 

always been my fishing 

policy to let the largest, 

nicest fish get away for 

" seed." Else we might not 

have a good crop for next 

year. 

After losing several pet 

baits and the breaking of 

our $30 test lines we sent 

over to St. Paul for some 

more "fishing tackle." Our 

usual routine was to get out of the hay at 6 130, slip into our bathing suits, 

run 200 rods down to the lake, with the dogs snapping at our bare shanks, 

and take a plunge in that cold lake water (and you sure were awake for 

several hours at least) take a good rub down and then breakfast was 

ready. Buckwheat cakes, real maple syrup made right there, ba- 
con, eggs, oatmeal and coffee. 
Sounds like a lot and it was a 
lot, but you put it all away and 
wonder how you did it so 
easily. Then you grab up your 
tackle and hike to the chosen 
lake for the day's fishing. 
You fish every day rain or 
shine and you eat fish every day 
and you do not tire of them 
either, for Mrs. . Cobum can 
cook fish in so many different 
styles that they always seem 
like a new dish. I cannot see 
the sense of going to a swell 
summer resort for an outing 
when there are places like this, 
where you can get meals that 
are unequalled anywhere, have 
nice clean sanitary beds, all the 
boat accommodations in all 

these various lakes for the rate of $10 per week. I could write the 

Digest full about this trip but there were others who also had an outing 




This six pounder caught on the first day 
encouraged us 



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358 



THE DENTAL DIGEST 



just as interesting. This trip worked so hard 
days' return trip the first week of September. 




Walters in action 

coming months in talking it all over with your 
worth a whole lot. (Sometimes it 
is better than the fishing; you 
catch such ''big ones." No in- 
sinuations. — Editor.) 

Our West-Central Dental So- 
ciety are making preparations for 
their famous annual ''chicken-nic" 
which you all read about last 
year.* June 28th is the date. 
Some states have us beaten for 
fishing but when it comes to 
'* Chickens'' well old Indiana is 
"there." 

Greeting to you all and wish- 
ing you the outings you all so 
well deserve, 

You-Know-Me, 

Walters. 



on me that I made a ten 
This time I met Dr. A. 
P. Grunn, a Chicago 
dentist there. So you 
see no camp is com- 
plete without one or 
more D.D.S's. Am I 
going back this year? 
Well, I sure am, even 
if I have to sell the 
old dental engine to 
get to go. 

While you get the 
immediate benefits 
and enjoyment from 
this trip the pleasure 
you have at home the 
friends as an audience is 




C. Cobum, Mrs. Coburn, Nellie Cobum, 
King and the Colonel 



*In the September, i9is,Dental Digest, Dr. Walters gave us a description of the " First 
Annual Chickenic" of West Central Dental Society. He then promised us a vacation story 
and this is it. 



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A WEEK AT LAKE GENEVA, WISCONSIN 



359 



A WEEK AT LAKE GENEVA, WISCONSIN 




Editor Dental Digest: 

Four years ago I tried to get a friend of mine to take his wife and two 
little boys and join my wife and I for a week or ten days at Lake Geneva, 
Wisconsin. 

He told me he had not had a vacation for sixteen years and neither 
could he afford to take one now or felt he needed one very bad. But, in 
consideration for his wife who was not very well, he decided to join us. 
We took a cottage on the quiet side of the lake where we could sit on the 
porch and look out over the hills surrounding that body of water. 

A prettier you will not find .in the Middle West anywhere. 

Besides our daily baths in that clear, clean water where the whole 
shore is either sandy or rocky, making bathing enjoyable all around, 
especially for those who can swim. We planned long walks around that 
picturesque lake with my old 4 x 5 camera as an excuse for exploring out 
of the way places. 

We secured many pretty pictures of which the cow picture is a sample. 
The boys learned to swim and the wife made a good beginning. My 
friend became so enthusiastic that he has never missed taking a vacation 
since, as he found it was not time wasted as we all find after once having 
tried it. 

Yours very truly, 

Elberg N. Johnsen. 



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360 



THE DENTAL DIGEST 



THE FIRST NIGHT IN THE WOODS 

Paul S. Coleman, D.D.S., Wilburton, Okla. 

(It can only happen in eastern Oklahoma — where the P. G. plan originated) 

WHEN I found out that I could leave my office and go camping 
for a week or two, or attend an Oklahoma Post Graduate meet- 
ing and get back and find that my practice had not deserted me 
and gone over to the other fellow, I realized there was really something in 
being a dentist after all and of late I make it a point to absent myself 
from my office at least four weeks each year and spend the time in pleas- 
ures that suit me most; thus one sunny June morning during the past 
summer found me well on my way to a little stream situated in the hill 
country of Eastern Oklahoma and far away from the nearest railroad, 
away from civilization and away from the everyday grind of the office 

and out for a week 
of "just nothing 
to do but loaf,'' 
fish a little — and 
take it easy in 
general. 

After a day of 
jogging along the 
trail and winding 
through ravines 
and over rocky 
hills at sunset we 
arrived at our 




The creek, where we threw in a few bank hooks and tied the lines 
to the overhanging branches 



destination, tired but happy, and after spreading our thirty by thirty 
fly sheet, hung all round with mosquito netting until it reached the 
ground, our wives who had been busy with the gasoline stove called 
us for supper and such a supper! Pan-cakes, bacon and eggs along 
with a squirrel which had been killed on the road, made our hearts 
happy and life indeed seemed worth living. The meal over and the 
pipes lit, we strolled along the creek banks and watched a full moon slowly 
rise after which a few bank hooks were thrown in and the lines tied to 
overhanging branches we went back to camp, and found our folding 
cots spread out all ready to turn in and looking inviting with white 
sheets and pillows. 

Once turned in, we lay looking up into the branches of an elm or live 
oak while old "daddy *' bullfrog over upon the other bank began to make 
the woods ring with his deep bass and the tree frogs chimed in with a 



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THE FIRST NIGHT IN THE WOODS 



361 



rippling treble. We are just closing thought and slumber hangs heavy, 
when over on a riffle we hear a slight splash followed by a heavier one 
and we rouse over and look out through the moonlight to see a handsome 
stag followed by several does wading carefully into the water while he 
lifts one foot and then the other throwing sprays in all directions. He 
enjoys himself, his companions stare at the white thing over on our 
bank with a wondering look, as if asking '^what is that anyway!'^ Even 
in the closed season a bunch of deer is "too much'' and my companion 
raises to reach for his thirty-thirty, but, with one creak from the folding 
cot there comes a splash and a shuffle and our visitors have departed. We 
lay for a long time and listened, finally giving up, and to the chimes of 
"Old Daddy" we lose all consciousness and all thoughts that there ever 
was such a thing as a dental office with its musty and antiseptic smells 
and trials, and dream of a rocky trail, squirrel and deer and it is only 
when a bright sun comes stealthily over the eastern horizon, we stretch 
a leg and an arm and then yawn and turn over for a cat nap,, just that 
last long drowsy moment before waking — but what's that sound ! we are 
wide awake now — there it is again, we are near no house yet it sounds like 
a farm yard and an old gobbler is making the morning ring with his gobble 
and every now and then a pit-pit sounds close by. We think of our 




An unusual catch 

Winchesters again, but, there that cot creaks again and with a parting 
pit-pit and a rustle our early visitors have also departed. There is no 
more sleeping, so we get busy with our plans, and with a delicious break- 
fast helped along with a large channel cat from one of the bank lines, we 
are ready for the first day in (he woods. 



One impulse from a vernal wood 
May teach you more of man, 

Of moral evil and of good, 
Than all the sages can. — Wordsworth. 



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362 



THB DBIITAL DIGB8T 




A DELIGHTFUL VACATION AND SOME CONCLUSIONS 
By C. W. Weaver, D.D.S., Indianapolis, Ind. 

THIS in reply to your request for vacation articles. In my esti- 
mation this movement of yours is the greatest ever and its 
importance cannot be measured by words. 
There are many who will consider this statement absurd. Of these 
I will ask this question. Are not the greater number of articles 
written for dental magazines, either instructions or descriptions 

of methods whereby the den- 
tist may better serve his 
patients? Now how do you 
expect a man to serve some 
one else who first of all cannot 
serve or help himself? 

There is nothing that helps 
to broaden the scope more 
than traveling and goodness 
knows the average dentist 
needs his "scope'' broadened. 
Out of my 5 years of prac- 
tice, the last summers have found me in the mountains from 6 to 9 
weeks. The younger practitioners ask me how I can afford it while the 
gray beards sadly wag their heads and mumble something about 
"neglecting business '* and "never being successful." 

Let me say right here that if being successful means that I spend 6 
days a week for the better part of my life in a dental office, that my view 
of the world would be re- 
stricted to that motley array 
of dirty roofs and chimney 
tops, that confronts me each 
day from my office window; 
that I be denied the pleasure 
of strolling through the for- 
ests and over the mountains, 
feasting my eyes upon the 
wonders of nature uncontami- 
nated by the hand of man; 
I say, if that be success then 



Franconia Notch, Echo Lake 




The Falls at the Basin, Franconia Notch 



my only prayer is "Oh Lord let me be unsuccessful." 

A trip across Lake Erie and Ontario, down the beautiful St. Lawrence 



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A DELIGHTFUL VACATION AND SOME CONCLUSIONS 



363 



through the Thousand Islands to Montreal, thence a day's ride southeast 
will find you in the Green Mountains of old Vermont. You have stepped 
out of your dinky sphere into a 
wonderful new world and such 
a trip for a tired dentist. 

What is that continual 
swish, swish that awakens you 
on the second morning of your 
journey? Is it that confounded 
cuspidor getting ready to over- 
flow again? No, No, that is 
merely the waves being plowed 
asunder by the swift moving 
boat. And that beautiful odor 




Lake WiUoughby, Vt. 



that drifts in through your stateroom window, have they scrubbed down 
the decks with cologne? No, No, only fresh air, my brother. That 
poor old factory that has been insulted so long by the odor of drugs, 
onions and decaying teeth is now being treated to a dose of ozone. 

What a change a few weeks will make; catching a glimpse of yourself 
in the mirror, you wonder if the tanned smiling countenance that looks 
back at you belongs to the same grouch, who, two weeks ago informed 
Mrs. Smith that there wasn^t a dentist on God's green earth who could 
make a set of teeth to suit her. 

Why shucks! you feel this morning that you could make a set of teeth 
for a hare lipped hippopotamus if you had to, but you don't have to, 
for you have decided to spend the morning at a *'much more important 
task," namely "trout fishing." 

What fisherman could resist the temptation to go forth into the clear, 

cool morning air and follow 
the sparkling noisy mountain 
brook as it rushes over the 
rocks, leaps miniature falls 
and widens out into cool deep 
pools under the mountain for- 
ests. In these deep pools and 
under these falls is right where 
you're going to "get 'em too, 
believe me;" also let me say 
that a mess of brook trout 
is a king's dish and has any- 
thing in the fish line beaten to death. 

By the time the first two weeks have passed, that office back home is a 




The Flume, Franconia Notch 



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364 THE DENTAL DIGEST 

mere haze in your memory, unyielding abscesses are things of the past, 
your brain is being healed by the process of nature and you are now 
beginning to assume the looks and actions of a regular human being. 

This happy condition exists until about a week before time to return, 
then a restlessness creeps into your veins, slight at first, but ever increas- 
ing. A hankering, as it were, to get back into the harness. 

This feeling is appeased only when you unlock your office door, open 
the window, knock the dust off the furniture and prepare to "go to it" 
with more vim and energy than ever before. 



SOMETHING DIFFERENT 

By Edward T. Brunson, D.D.S., Ogden, Iowa • 

IT WAS in the early part of June and the call of the wild was arraying 
itself against the routine of the dental office. 
I mentally examined different vacation possibilities, and had 
viewed the one of two weeks camping on the river banks, as the one best 
suited for our needs, conditions, conveniences and finances. My wife 
thoroughly spoiled my partial decision, by bringing one of her ladies' 
magazines, and reading a sketch of a newly married couple's honeymoon, 
taken afoot in the form of a long hike. 

We discussed the possibilities of applying the idea to our own case, 
using it as a change from all our former customs in the line of vacations. 
Before we dropped the subject, we accepted the suggestion, and planned 
to send the two younger children to my wife's sister for a two weeks' visit; 
from there they would go to my wife's parents, where we would meet 
them. The older boy had made arrangements to accept a summer's job 
on a farm, so we would be free to take the hike by ourselves. 

Saturday, June 26, 1915, was an exceeding long day, for we were 
all ready to start on our vacation as soon as I had finished my last ap- 
pointment. As it was, we did not get started till 2 :i 2 p.m. 

We each carried an all-wool blanket, and we also took some rations 
along to use in case of an emergency. These consisted of dry foods for 
two reasons, namely, they were lighter to carry, and being dry, there was 
less chance of their deteriorating. 

We had been taking walks almost daily, to put ourselves in good 
condition; and we had also both received benefit from attending an extra 
large garden. I will say here, if anyone cares to sample our last year's 
vacation, don't neglect to prepare by some similar training, for the exer- 
tions of a hike that continues day after day, for if you are like us (and 



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SOMETHING DIFFERENT 365 

you probably axe) you will not care to stop to lay around any place very 
long for rest. The desire to see the country that lays just ahead, will 
urge you on, even though you realize that a day's rest would be a benefit. 

Between 2:12 and 5 p.m., we covered eight miles, and spent the night 
with some friends in Pilot Mound. Sunday morning at eight o'clock we 
started on, and ate our dinner at half past eleven in Dayton. We un- 
rolled our blankets in the park and spent about an hour resting in the 
shade of the trees. At five o'clock we had a surprise at finding an old 
acquaintance on a farm eight miles south of Ft. Dodge, where we stayed 
for the night. Monday we took dinner with my sister in Ft. Dodge, 
and at five o'clock we stopped at a farm six miles from Humboldt, to 
see a black cocker spaniel and her puppies. My wife in her talk with the 
lady of the house, learned that we had stopped at the home of a chum 
of my wife's oldest sister. We were invited to spend the night with 
them and we were very pleasantly entertained. Tuesday night we 
stopped about five miles from Rolfe, and that was the only place where 
we were grudgingly received on the whole trip. The people were Danes 
and suspicious of strangers. When we were ready to start the following 
morning, the lady having learned what my wife's maiden name was, 
realized that she had known my father-in-law, when he had lived at Rolfe, 
and she was very profuse in her apologies, and even asked us not to start 
till later in the day. 

In such varied ways we travelled — sometimes over prairie roads, 
sometimes through timber or along beautiful streams, sometimes follow- 
ing the railroad track for a few miles. When we reached the home of 
my wife's parents in Emmetsburg, we felt that the hike was far ahead of 
anything we had before tried. We spent about two weeks with relatives; 
did some fishing and returned home again ready to take up the routine of 
office and house work, with clearer minds and stronger muscles. 



A SPECIFIC FOR POISON OAK OR IVY 

I have found through tests on numerous friends this simuner that 
a solution of Chinosol is practically a specific for poison oak or ivy. 
One tablet dissolved in a quart of water, or for convenience | tablet in 
8 ounces, makes a i: 1000 solution. The tablets come 12 in a package 
at $.50.— F. L. Duncan, D. D. S., Hollisier, Cat, 



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366 THE DENTAL DIGEST 

WHAT A VACATION DID FOR ME 

By J. H. Burns, D.D.S., Hutchinson, Minn. 

BEGINNING, as I now remember, at about 12 years of age up 
to 27, I had been troubled with constipation, and bad enough 
so that several times each year I would get cramps in bowel re- 
gion that were nothing to smile about. 

I always had been fond of hunting and fishing, and longed for a trip 
to the north woods. So when a M.D. friend asked me to go and also 
informed me that it would be a good relief for my ailment, I went. 

The first day we packed in 15 miles and the days following made from 
15 to 20 miles hunting, and thus for 3 weeks. I never ate so much, slept 
so sound, or walked so much and still I gained 12 lbs. Since the first 
day of that trip I have had no pains, the old trouble disappeared and 
I have since felt as a man should. That trip took place in Nov. 1907. I 
have been going ever since. 

I used to think that I couldn't afford these vacations. Now I think 
that I cannot afford to miss them. One man said that you can do 12 
months' work in 11 months better than you can do it in 12. I fully 
agree with him, I have tried it for several years. 

Robt. W. Service, in one of his poems says: 

" When nature calls a show down, and you pay the bill, 
Time has got a little bill — get wise while yet you may, 
For the debit side's increasing, in a most alarming way; 
The things you had no right to do, the things you should a'done 
They're all put down: It's up to you to pay for everyone." 

Naturally man is a lover of out-door sports. It's the call of the wild. 
Then I say go camping, hunting, fishing, canoeing or what not, where you 
can build yourself a bed of boughs, inject into your lungs the pure ozone 
of that unadulterated air. You'll eat, sleep, and feel like a new man, 
and on your return you can do better work, more work, and more than 
all, you will feel like working. 

So many men think that they have to lay up that little fortune during 
the first few years of life, that they may retire and take one long vacation, 
and it surely will be. When that time comes they are not satisfied, they 
begin to realize that they have missed something, a something which in 
their few remaining years they can never get. 

I started to retire several years ago, while still a young man, retiring 
as it appears to me on the installment plan, a few weeks each year, and 
by so doing, hope to be able to work that much longer. 

See how we took our vacation, on opposite page. 



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WHAT A VACATION DID FOR ME 



367 




■/ ■ .r^ 




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368 



THS DENTAL DIGEST 



AN APRIL VACATION 
By W. B. Lee,.D.D.S., Eugene, Oregon 

WHILE the month of April is a little in advance of the usual time 
for vacations, we choose this period of fourteen days from April 
first, which is the opening date for trout in our district, in order 
to catch the number of fish that the law allows in Oregon and get away 
from root canals so that our nervous system will not forsake us entirely. 

Bright and early we began to load our dunnage upon a four horse 
hack, for Oregon roads are a trifle muddy yet, especially after the first 
twelve miles. It is sometimes a long way from the bottom of the holes 
and the wheels will be just one circle of mud, while the rear axle drags on 

the level. We walk as 
the hack is all that the 
horses wish to pull over 
the mountain. We have 
started for Triangle Lake 
a distance of twenty-four 
miles, a good ten hours 
away. 

We reach Slayter's 
store about three o'clock 
and get a big meal which 
is certainly enjoyable, as 



• ■»*/' 





Happy Day Lodge 



we have eaten an early breakfast and walked up a five mile hill through 
the mud. Two days before, this would have seemed an impossibility 
but the great out-doors is in our blood and our efforts seem untiring. 
After our repast, we are again happy and again satisfied with life, for 
will not a few more miles bring us to the lake? Ah! the Lake! A 
beautiful body of water, the covering of nine-hundred and ninety acres 
of land, it is surrounded by tree-covered mountains. . 

We purchase our groceries, hams and other supplies here. The cook 
makes sure that he has sufficient amount for he has watched us consume 
Mrs. Slay ter's. bounteous dinner and he must be prepared for the worst. 

We are now fortified against hunger so again hitch up our four horse 
team and move onward. The steeds, accustomed to these hardships, 
soon bring us to our cabins where we unload and send them back to 
Slayter's. 

Maybe we are perspiring from our work and going without coats or 
again perhaps it is raining, but we are prepared for either emergency, as 
the weather is always erratic at this time of the year. In either condition 



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AN APRIL VACATION 



369 



we are happy and sure to be hungry so the first thoughts are of fire-wood. 
We may have a store of fine dry wood or we may not find even kindling 
wood depending entirely upon chance that some weary wayfarer may 
have spent some cozy days therein. ^ 

Everyone sleeps like an innocent chiy, our bunks are boards with 
fern-leaves and grass under the army blankets. We are tired and 
thoughts of the morrow bring pleasant anticipation of fishing for those 
delicious little mountain trout. 

The morning may bring sun or rain, what care we! however, to be on 
the safe side, we put in our shoes for sun, and boots and slickers for rain. 
The angle worms we have brought from the Williamette Valley are soon 
dangling from a bamboo pole. You can put three hooks on each line and 
it is a safe bet that you will get three trout every other cast. Did I 
say Cast? Am afraid that some of these true bass sports will call this 
first degree murder, but fish are so plentiful here that it does not take a 
full day to bag the limit of seventy-five. After a few days of catching 
so many you become satisfied and are ready to quit early in the day. 
The other boats may be near and we can sing or have political discussions 
without interfering the least with the running of the trout. 

The strange part about this lake is that the fish will not bite here ex- 
cept in April and November, though they are caught above and below 
almost any time of the year. In August or any other month the trout 
are seen jumping all day long but nothing will tempt them to take a hook. 

As the mud hens make music (?) for oui ears and sport for our twenty- 
two calibre rifle, they are artful dodgers and go out of sight at the crack 
of the gun; you look up thinking it has been driven into the mud, but 
a few rods away he 
comes up with the 
same original yell. 
Cranes and ducks 
are seen; some- 
times the most 
of the migratory 
birds have started 
north thirty days 
before. 

Four of us 
salted down over ^^^""^^^ L^^^' ^^^«^" 

two thousand fish for our friends and ourselves. These little fish are 
easily canned and like salmon, there are no bones when they are boiled. 
A lemon and a can of this delicacy is very palatable during the sum- 
mer for luncheons and every bite brings back pleasant memories of a 




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370 THE DENTAL DIGEST 

delightful fortnight. At the end of that time town is beginning to call 
and a comfortable bed wiU be a luxury indeed. Even the dental chair 
and cabinet will be home sights and you will feel naturally for the 
engine throttle, your lungs are full of ozone, your mind cleared of its 
clouds and you are a strong man again, ready for everyone's troubles. 



A DELIGHTFUL CAMPING TRIP 

By Walter S. Cole, D.D.S., Bradford, Vt. 

THIS is the story of a pleasant camping trip taken last August, 
the ideal time as the roads are at their best, dog day weather 
passed, and the berry season at its full height. The trip was 
made by auto and we travelled over five hundred miles. 

Ever since I was a boy I have had a longing to go camping and as the 
opportunity never came then, I am renewing my youth now each year 
with my wife and three children. 

No other place affords better opportunities for such outings than the 
three northern New England States. One can have a diversity of scen- 
ery and air; mountains, rivers, valleys, lakes, woods and ocean, and all 
can be enjoyed in a ten day trip, or less, if necessary. 

Few dentists who are blessed with families can afford to spend any 
time at hotels for a vacation; the auto gives the whole family an outing 
with very little expense, in fact, fifty dollars will cover the expense for ja 
party of five, three being kiddies (outfit excluded). My outfit consists 
of a 9 X 12 ft. 6 oz. duck tent, which is very light and takes very little 
space, a fly 12 X i6 ft. lo oz. duck, this gives the best protection from 
rain and wind; and being extended four feet at the front of the tent, gives 
us extra room, and is fastened by the aid of an extra pole to the auto, it 
being placed longitudinally in front of the tent and affords us the use of it 
for clothing, etc. I also have a large piece of oil cloth 15x15 feet, this is 
laid for a floor covering and is fastened up the sides of tent by hooks; 
this excludes everything from an ant to a rattlesnake and also protects 
us from dampness. This and some five yards of mosquito netting for 
the front of tent and the fly are the essential things for comfort. 

For easy packing we cut the ridge pole in the centre and screwed a 
large flat hinge 12 inches long on the under side which enabled us to fold 
it thus about the same length as the upright poles; all are fastened to- 
gether by window cord. Those are painted black to make them less 
conspicuous as they and the tent, except the fly, are carried on the running 
board. We put the tent in a black oil cloth bag for the same reason. 



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A DELIGHTFUL CAMPING TRIP 371 

For a bed we took the ticking from a single and a double mattress, these 
were obtained from two hair mattresses which I had made over. The 
tent being pitched, I hike to the nearest farmhouse, telling the farmer 
what we were doing and asked for the loan of enough hay to fill our mat- 
tresses, which we will return when leaving camp. We have never met a 
farmer who refused us, in fact, we have made many warm friends on our 
trips. We placed these at the closed end of tent and smoothed them as 
evenly as possible. Since disposing of my horses, I made use of their 
blankets by placing them over these mattresses and upon them some 
sheets and we had a good comfortable bed large enough for all. Gray 
blankets and steamer rugs give us ample top coverings. A small sofa 
pillow and pillow slip was provided for each one. This does away with 
cumbersome, heavy mattresses, and the empty ticks take no room and 
are of little weight. 

For cooking outfit we took two chafing dishes and used condensed 
alcohol for fuel, these were carried in a telescope grip with knives, forks, 
spoons, cups, paper plates and napkins, etc. 

A second telescope grip was used for food stuflF, using a large cake tin 
with the cover up. We also carried a sewing table, three camp chairs, a 
ten quart pail for water, an electric light, each a bathing suit, rubbers, a 
change of underclothing, etc., all of which filled three dress suit cases. 
Also a good supply of food such as bacon, that which is put up in glass 
jars, a four quart pail of eggs, packed in corn flakes, also a four quart 
pail of boiled potatoes, cereals, butter, soups, etc. In packing, we placed 
the sewing table at the bottom space between seats, then the telescope 
grips, then the dress suit cases and over all the fly. Camp chairs were 
placed between the grips. 

Leaving home at 8 a.m. we had our first meal at the Crawford Notch, 
allowing ourselves ample time to see the hotels at Bethlehem and Bretton 
Woods. One could write a book on this beautiful spot but time will not 
suffice. After dinner we slowly wended our way down through the 
Notch stopping many times to see the beautiful water falls and ere long 
we were passing through Bartlett, Intervail and Conway. Here we left 
the state road for Tamworth, at which place a friend had invited us to 
pitch our tent at " Pines on the Hill " a small hotel at the summit of a hill, 
commanding a beautiful view of Mt. Chocorua and the surrounding 
country. The following morning, Saturday, we headed for Portland. 
On reaching Sebago Lake and seeing a beautiful camp site, we decided to 
pitch tent for the second night. Sunday morning found us in Portland 
and after seeing many places of interest we started for Old Orchard, 
arriving in time to have a good turkey dinner. For the remainder of our 
trip we had our dinners at restaurants, except one. This was the only 



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372 THE DENTAL DIGEST 

dinner for which we paid over fifty cents. Two days were spent at Old 
Orchard and two at York Beach, and the seventh day found us in Ports- 
mouth, New Hampshire, and that night was spent in the town of Farm- 
ington, coming by way of Dover and Rochester. The next day was spent 
on Lake Winnipesaukee and the ninth day found us home by way of 
Plymouth and the Franconia Notch. 

Here is a trip worth while for after taking five similar outings I con- 
sider this one the best and no dentist is too poor to take advantage of it. 

I wish I could persuade every dentist to take a camping vacation; in 
no way can one be brought closer to nature One may not want to break 
camp as often as we did, but this can be done to his own liking. Try 
and come this way this coming year. Doctor, and if I can give you any 
further information, I shall be only too pleased to do so. 



THE BEACH OR MOUNTAINS? 

By L. M. Zimm£rman, D.D.S., Portland, Oregon 

YES, I finally decided to take that vacation! I was probably a 
Star member of that class of **busy" dentists who could not 
see how they could possibly "waste'' two weeks of their precious 
time out of their offices! However, I have discovered that tired nerves 
are not a good business asset, and when I burn holes in my crowns about 
every third trial and have to spend a lot of time angling for broken 
broaches in mesio-lingual roots of lower second molars, I immediately 
climb the attic stairs armed with my wife's sewing machine oil, and pro- 
ceed to place my reel and fishing paraphernalia in order. 

If you live in Oregon (and I extend my sympathies to my Kansas 
brothers), the first question is "Which? Beach or mountains?" Per- 
sonally, if I am pinned to a choice, I will take the mountains every time, 
but doubly best are those who can have both in one, and if you will follow 
me I can lead you over the steepest of mountain trails which ends abruptly 
in the Sea. The Tillamook line from Portland to the beach is rough and 
wild but beautiful in its untouched grandeur, and a six hour ride takes 
you the whole way. 

Our party last summer was composed of a Portland business man, 
myself and our wives. (Don't forget the wives — if they're the right sort 
that can climb the trails and carry a fishing rod!) Two weeks is little 
enough time to sample even once the different varieties of nerve tonics 
offered at the end of the Tillamook line. Details are of course out of the 
question. The beach held our interest at first, with the heaving surf 



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THE BEACH OR MOUNTAINS? 373 

carrying us light as corks, and the stinging spray in our eyes and nostrils. 
However, I must say it takes practice and about 97° in the shade to 
really enjoy the surf! 

The next to tempt us was the rod and line, and here certainly lies the 
great attraction of any outing. (Now, of course I don't expect you to 
believe this part of my tale!) Our first experience for sea fish yielded 
twelve beauties netting about twenty-five pounds. They were off the 
rocks about twenty-five or thirty feet down, mostly rock cod. But in all 
our fishing experience there was nothing to equal our trips back in the 
mountains up the Miami River. To Stand in the current nearly waist 
deep while a twelve inch trout plays with a hundred feet of enameled silk 
is a tonic worthy of a king; and while we didn't get many big ones there 
were hundreds of "legal" size anxious to try our flies. 

Clams and crabs were to be had in abundance when the tide was right, 
but since my experience last summer I am strongly opposed to either 
clams or crabs as a regular article of diet! The clams were dug with 
narrow spades, and when you know just where to go, the digging soon 
yields big returns. The crabs were not so easy to get, but it was great 
fun fishing them out of the holes in the rocks with our long handled rakes. 
A full grown crab *s not a very sociable creature when dragged from his 
nest among rocks, and in fact is likely to become quite hostile if overtures 
are made to reconcile him to his new surroundings. 

It was all over too soon, but when I reached the office on Monday 
morning, it seemed as if months had passed, and I remember vaguely 
wondering whether my patients had all deserted me and if my old friends 
were still in town. A little guarded inquiry soon revealed the fact that 
I had never been missed! Such is life! 

It was only two weeks, yet I acquired a healthy coat of tan, a reservoir 
of rested nerve cells, and a host of memories — the details of which make 
excellent conversational matter, and may be varied according to the 
audience! 

Yes, we are going again this year; in fact three weeks will find us for 
a week end at the head waters of the Kalama River — but that'll be another 
story! 




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374 



THE DENTAL DIGEST 



OUR WISCONSIN RIVER TRIP 
By C. F. Stekl, D.D.S., Rice Lake, Wis. 




W 



Outfit we use here 



"HILE reading the June number of the 
Dental Digest, an idea came to me 
that maybe a few of "the boys'' might 
be glad to hear of a trip we took down the good 
old "Wiscons^." The trip was planned and exe- 
cuted during the summer months of 1914 by Wm. 
Schmidt of Two Rivers, Wisconsin, and author. 

The start was made from Lake Vieux Desert, 
the headwaters of the " Wisconse," whose glorious 
waters tumble and turn kitty corner through the 
state until they empty into the " Father of Waters " 
the Mississippi, at Prairie du Chien. Lake* Vieux 
Desert, one of the most beautiful lakes of the north, is situated in north- 
eastern Wisconsin with arms extending into Michigan. Splendid 
fishing is to be had, pike, bass, pickerel and muskalonge. We spent a 
few days here, fishing and exploring the wilds of the virgin north. 

Then we began our down-stream trip. The first twenty miles is little 
more than a twisting, turning creek with hardly enough water to float 
the canoe. She soon widened out, however, and by noon, we had fair 
sailing. We often saw deer, who startled by the approach of a man 
gave one look and bounded away to the forest fastnesses. Ducks were in 
abundance and we enjoyed watching the young scurry to cover while the 
canny moth- 
er bird at- 
tempted to 
draw us 
away from 
their hiding 
place. Our 
only grum- 
ble was that 
it was not 
duck season 
for duck- 
stew is rel- 
ished by the 

best of men especially when cooked in the woods. We passed numerous bass 
lakes where we often tried our luck and gladdened our repast by fresh fish. 




Big Rock, the Dells 



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OUR WISCONSIN RIVER TRIP 



375 




A fair load when portaging 



Our first real experience came when about fifty miles above Rhine- 
lander we met with Rainbow Rapids. We ran the upper part, but when 
it came to the horseshoe bend, we concluded we 
had better not tempt fate. An easy portage was 
made here, we passed numerous trout streams and 
the catching of the game beauties was one of our 
big events. Going up Sugar Camp Creek, we 
spent a few days on Dam Lake, a hardly known 
lake about twelve miles southeast of Eagle River. 
Pikes were in abundance and were well enjoyed. 

We passed through Rhinelander taking a few 
days to visit North Pelican Lake and to replenish 
our supplies. Another hair raiser, we met at Nigger 
Island Rapids. If anyone is in search of hair- 
raising stunts, just try running rapids in a canoe. It is great sport and it 
gives your hair plenty of exercise. We passed through Tomahawk where 
at Kings Dam a marine railway is in operation. As we pass Merril, Wau- 

sau, the land becomes less wild and more farms 
in evidence. We often had stews and roast 
corn from them. As we approach Kilbourn 
we pass the Dells. There is no more beautiful 
scenery in the country than that contained in 
the Dells. We spent a most pleasant day 
" taking in '• those natural beauties, The Anvil, 
The Witches Gulch, Stand Rock, Cold Water 
Canyon and many others too numerous to 
mention. As our time was nearly up we re- 
luctantly left these beauties and again started 
down stream. We passed Kilbourn, the lower 
Dells and Portage. We drew the canoe out of 
the water at Merrimac, for there is not much of 
interest below. I can say we spent the time, three weeks and three days, 
in a most healthful and ever wonder seeing manner. We had hard work 
to do, portaging twenty-eight dams, but this seemed as play. We had slept 
in hay marshes on sand banks and bed rock and again in most beautiful 
surroundings. Although inexpensive, costing us less than $15 apiece, we 
had a most wonderful trip, not only for health and sport, but the trip 
acted as an object lesson in natural geography and showed us that the 
beauties of dear old Wisconsin State were such as to be never forgotten. 




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J7i 



IHB DSaXAL n^BST 




AH AUTO TRIP, AUGUST, 1915 
By J. M. Miller, D.D.S., Eugexe, Ore. 

SEVERAL months before the time of the International Dental 
Congress at San Francisco, the thought came to me to make 
the trip one of pleasure for the entire family, and combine the 
sunmier outing ^nth the wonders of the Exposition. So when I purchased 
my big 5 passenger touring Peace car, I kept my good eye ever toward 
the San Francisco goal, and when we left our garage with camp outfit and 
provisions it was a jolly little party, full of expectancy that started up the 
little hill on high. 

On the front seat beside me, sat the son, age seven, on the back seat 
was the daughter, age nine, and the wife, age — (figures only given con- 
fidentially). We carried a small tent in case of rain but did not use it. 
A very comfortable bed was made by lifting the two seats and supporting 
them by two iron bars laid on the backs of the seats, the foot rest was 
completed by hooking a piece of canvas, hammock-like from the end of 
these iron bars to the wind shield. We also carried a folding cot which, 

when properly blanketed 
and placed beside the 
auto, furnished a fine 
position for viewing the 
wonders of the starry 
heavens. He who has 
not slept out under the 
open sky has missed one 
of life's keen pleasures. 
"Ours" A travelling box 

strapped to the trunk 
rack was filled with cooking utensils and food. A friend in a wholesale 
grocery house donated a large bag of canned goods for which I wrote 




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AW AUTO TRIP, AUGUST, 1915 377 

him en route and thanked hrai. If "Uncle Bill" can get any pointers 
from the following, he is welcome. It ran something like this: 

"Dear Hennery: 

Them little fish you give us in the little flat cans what said they was 
done in oil by the French, seemed to be in bad when opened, they wuz all 
dead so crowded in together, their heads ofi and quite some odor yes, but 
we wuz so hungery we et them eny how; Hoaping you air the same etc. 

"J. M." 

Our blankets were carried in a large canvas bag on the running board. 
A fishing rod, hand axe, camera water bag and Oregon-California road 
book about completed the outfit, unless mention should be made of some 
pockets made of cloth with a flap which the good wife had tacked to the 
inside of the rear doors. These were very handy for soap, talcum powder, 
combs and tooth brushes — ^in separate pockets if you please. 

After the first night out we rested well. We followed the Pacific 
Highway south to a little town in southern Oregon called Goldhill. 
(Couldn't see any significance in the name.) Here we took a side trip 
to Crater Lake. This wonderful spot, which the Government has seen 
fit to enclose as a National Park, is well worth a trip across the continent 
to see. We spent a day here feasting our eyes on this freak of nature 
with its beautiful indigo lake, s miles in diameter and a thousand feet 
below rim of the mountain walls which surround it. 

After a bath in this clear cold lake, a boat ride and fishing, we climbed 
the long tiresome mountain trail to the top with much misgiving of the 
knees, broiled our fish, packed up and began the long coast down the 
several thousand feet we climbed the day before. Instead of returning 
to Goldhill we took the road by way of Fort Klamath, Klamath Lakes 
and Klamath Falls — on down into California. 

Toward the close of each day we began to look for a good camping 
place and a farmhouse where milk and eggs could be procured. The big 
feed of the day came at evening when more time could be given than at 
the noon lunch which was just a cold bite. Yet I shall never forget many 
of our breakfasts of broiled bacon and toast flavored with a little charcoal 
and the cold milk from the bucket left over night in the mountain stream 
near by. 

At one time we selected a camp by the road side near a stream and 
trees where a ranchman gave us some goat's milk and fresh venison. 
Now if a breakfast of broiled venison and trimmings does not place a 
dentist in a very optimistic mood, at peace with the world, and make him 
forget putrescent canals, then surely he is beyond human help — ^prognosis 



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378 



THE DENTAL DIGEST 



unfavorable. I afteroard sent this kind man a little picture we took at 
his place and on the back I quoted these lines— "ril build my house by 
the side of the road, and be a friend to man/* 

We were glad to note 
the kindness and courtesy 
of fellow tourists along the 
road, always passing with 
a salute and when mending 
a tire, being offered assis- 
tance. 

After travelling one en- 
tire day on monotonous 
narrow winding mountain 
roads, we descended into 




Travelling along with Nature 



the Sacramento Valley at Redding at about 9 p.m., found the thermometer 
at 109 and were told, while having the gas tank filled, that it had been 
120 that day I How we welcomed next day the cool ocean breezes, as 
we approached upper San Francisco Bay, and in honor of the event I 
drew hot water from the radiator and under the shade of some eucal>ptus 
trees t(X)k a much needed shave, the children scrubbed their faces and the 
wife indulged in talcum powder. We drove the machine on a ferry boat 
at Vallejo and, after a pleasant cool ride of two and a half hours, landed 
in San Francisco. 

After selecting a furnished apartment on Van Ness Ave., we returned 
to the ways of the civilized world, had a bath in a porcelain tub and slept 




Preparing the "big feed of the day" 

in beds; but even with all windows open the rooms seemed close after a 
week's sleeping out in the open. 

After the dental congress and sighf seeing at the exposition, we were 



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AN AUTO TRIP, AUGUST, 1915 379 

all keen for the return trip which took us a new route for the first two 
thirds of the journey. It led near the Pacific Ocean and there the famous 
red wood forests. The scenery was grand and inspiring and the ocean 
views from some of the mountain roads will never be forgotten. The 
night we camped in the great forest filled us with awe. Here silence 
reigned supreme. The tops of these old monarchs many hundred years 
old towering above us so high seemed to reach the very stars. 

One interesting feature of the entire trip was the wanderlust that 
made us anxious every morning to get started for new scenery and the 
unknown before us. 

No accident of any moment marred the trip, although on one of the 
narrow mountain roads we had a narrow escape when I took my eye 
only for a second from the "straight (?) and narrow way/' when a sinking 
feeling and a scream from my little girl caused down brakes. Luckily 
the rear wheel held and after the family had jumped to safety, I backed 
the car on to the road again. It was somewhat exciting to see the loose 
stones roll down the mountain side, and I profited by the experience. 

One other time we were very anxious for a few minutes. Near 
Crescent City in Northern California, the road leads on to the beach at 
low tide for a five mile spin. Such fine sport on the hard smooth sand, 
no speed limit and the breakers roaring near by. We stopped only a 
few moments to get a picture and then noticed the car had settled into 
wet sand nearly over the tires and yet not quite touching the rims. I 
was much surprised to find that the trusty little engine could not even 
budge the wheels held in this vice-like grip. So the tide was coming in. 
We became alarmed. A farmer's team appeared in the distance and 
while I was getting my rope ready, the honor of the rescue must be given 
to wifey, for she and the children began digging the wet sand away in 
front of the wheels and I pulled out unaided just as the team came 
alongside. Again the tenderfoot learned his lesson, and you may be sure 
afterward on the beach "the little Ford rambled right along." 

When a few days afterward our familiar hills came in view, we wel- 
comed the sight of home. The trip was not only a great pleasure but a 
benefit to us all in storing up energy for the winter's work — not time lost 
from the office, but time and health gained. 



MORNING ROBINS' SONG 

By Stanton A. Brown 



There's a cheerful sort of something 

In the robins' morning song. 
Makes life seem more worth living, 

And a sad day seem less long. — Dumb Animals. 



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380 



THB DBNTAL DIGEST 




Our camp near Beaver Pond 



SUCCESSFUL DEER HUNT IN MASSACHUSETTS 

By Charles L. Twichell, D.D.S., Warren, Mass. 

THEY say, "All work and no play makes Jack a dull boy," and I 
know that a dentist gets pretty tired of root canals and nervous 
patients, **who have lost their nerve." Therefore a well-spent 
vacation is a most profitable investment for the dentist. 

So the third week in November we set aside, it being the open 
season for hunting deer in Massachusetts. 

My Pal and I decided 
to camp out that week 
and by planning all 
through the summer the 
arrangements were 
made. There was just 
one thing to worry us, 
the weather. We 
thought it would be 
pretty cold. 

When the day ar- 
rived for our departure 
we were oflf with a lo x 12 Barker balloon silk tent, weight 5 lbs., and 
our blankets and food supply for a week. 

We were driven to a place called Beaver Pond near the town of Ware. 
Having first obtained a permit from the farmer to camp on his land, and 
to cut wood for a camp-fire, my Pal and I enjoyed one of the most en- 
joyable vacations that we 
ever spent. As you will 
see, each picture tells a 
story by itself. 

The first day was spent 
making camp and we had 
it all completed by noon. 
Hungry. A dinner in the 
Waldorf had nothing on 
us, and best of all, no after 
dinner appointments. 

My Pal, who has had 
some experience camping, certainly knew how to build a camp-fire. 
The evenings were spent watching the fire, swapping stories and a visit 
occasionally from the farmer or some member of his family. 



fBHP 


■HBumH^^iri 


^^^^^^m^9^9Q' 


^9 ^ •# ^^^^^^^^^K^^I^H 



My pal and I 



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A SURE CURE AND A PLEASANT ONE 



381 



As the fire grew dim early, we would roll ourselves up in our blankets, 
for we were to be up early in the morning. Up we were at four o'clock, 
made a hasty breakfast 
and were out on the deer 
run before daybreak. Re- 
turning to our camp at 
noon time tired, happy 
and hungry, when we pre- 
pared our dinner it was 
fit for a king. 

Saw several deer but 
did not get a shot until 
the last day that being 
Saturday at 7 A. m., my 
Pal being the lucky man. Our hats went up in the air and our hurrahs 
were heard for miles around. 

This certainly is the only sport for a dentist — being in the open air, 
after being confined to his office for a year. 




My pal's lucky shot 



A SURE CURE AND A PLEASANT ONE 

Dear Readers of Dental Digest: 

The best cure I ever found for laziness and tired feeling is a vacation 

of some kind. A vacation? Yes, anywhere, just so you get away from 

your office work and 
the people round about 
you. Go where you 
can sleep just as long 
as you care to; rise just 
as early as you like, 
and dress just anyway 
to be comfortable. Be 
sure to take a lot of 
good luck with you, so 
when you go fishing, 

you will get a nice mess for your dinner. 

This is just what my wife and I do every season — my, but it is jolly 

fun. After being in the water and splashing around, especially before 

breakfast! We enjoy our meals wonderfully and you feel so spry, one 

don't know what has come over him. 

We have an "Overland" roadster, and when we get our camping 




Resting and meditating" 



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382 



THE DENTAL DIGEST 




Away from all trials and cares" 



outfit, bathing suits and big hats, we are ready for our jouraey. There 
is no fuss about sporty gowns for my wife, but we just see that we have 
enough money along to get eatables and gasoline. 

We usually go to Ottertail County, Minn., that is the county in which 

I was born, and it is a 
beautiful country, 
about 200 miles from 
our town, Finley, No. 
Dak. 

We spend our time 
either at Battle Lake 
or Ottertail Lake. 
When we go to Otter- 
tail Lake we stay at 
our cousin's camp, 
Rev. Kvale and fam- 
ily. They come every season clear from Orfordville, Wisconsin, to camp 
at Ottertail Lake. I am not such a great water bird as my wife is, but she 
and the Kvale children are in the first thing before breakfast and the last 
thing in the evening. We sleep on a big open porch and to sleep one night 
in the open where there is fresh air all around and you can hear the water 
dashing against the rocks and shore is so soothing. One never wakes up 
with a headache or a drowsy feeling. 
I want to describe Ottertail Lake to 
you. It's about 15 miles long and 10 
miles wide and the Red River runs 
through it. Near our camp is the 
county Sanitarium, a fine building just 
finished two years ago. The finest 
thing about this lake is that you can 
walk out over a half a mile before you 
come to what the people there called 
" The break off " so there was no danger 
whatever in allowing children to play 
there alone. Some days we take our lunch and our paraphernalia and 
go to some other lake (my wife calls this an "expedition"), stay all day 
and fish and roam around the woods. One really feels as though he 
were exploring a new country in some places where the brush is so 
thick. I am sending you a clipping of my wife and I on a rock we 
discovered on an island on one of these little lakes; we were just resting 
and meditating a little when we took this, and, by the way, all of our 
pictures where we are both on, we took by using a string to snap it. See! 




Just "we two" enjojdng it 



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A SURE CURE AND A PLEASANT ONE 



383 



you don't need a photographer along. Another one is of us again and 
the mess of fish we caught once we were out, and the third is myself in 
the boat. 




"Our Catch" 

You can just bet we were glad we spent two weeks enjoying ourselves 
in this manner, away from all trials and cares and especially from my 
office work. And it did my wife just heaps of good. When we arrived 
home she just loved to do her home duties once again. 

A rest like this every summer is the best remedy when one is tired 
and discouraged. Don't ever go alone, be sure to take your wife along, 
if you are lucky enough to have one, if not, take your sweetheart, and 
you that have both a wife and children, by all means take them all along. 
You will enjoy it so much more. 

Come, let us all go and have a good rest and when you get back you 
will love your work all the more for having done so. 

Your D.D.S. Brother 

L. P. Larson, 

Finley, No. Dak. 




Fishing in Springtime 



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384 



THB DENTAL DIGEST 



GOOD TIMES IN POCAHONTAS COUNTY 




Boys, this is what puts pounds of fat on a fellow's chops. Try it. Good times 
in Pocahontas County, W. Va. 




Camp life in the wilds of Pocahontas County. The old Gibson camp, 
fishing is fine.— E. W. Hill, D.D.S., Morgantown, W. Va. 



Trout 



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AN OUTING IN THB OZARKS 385 

AN OUTING IN THE OZARKS 

By B. L. Gamble, D.D.S., Coffeyville, Kan. 

THIS article is intended especially for the brother dentist who 
thinks he cannot afiford to take his family and enjoy a real out- 
ing for at least a couple of weeks, during the warm months of the 
year. 

Our family consists of — self, wife and four children, two giris and two 
boys, but the older giri electing to go elsewhere, left five of us for the 
camping party. We began planning our vacation early in the summer, 
I think shortly after we received the vacation number of the Dental 
Digest, and selected the Ozarks for 
place as it is the very best place in all 
the Middle West for recreation; moun- 
tains, bbating, bathing, fishing and all 
that goes to make up the pleasures of 
out-door life. 

As we were all in favor of camping 
out, the first thing purchased was a 
tent 9 X 12 in size which was bought at a ing a a 

bargain sale for $7.34, a small gasoline stove, camp chairs, stools, etc., 
were ordered shipped from the nearest wholesale point to our camping 
place. This outfit cost $6.50. 

A few days before we started on our outing (which was the last two 

weeks in August) we had our tent, 
canoe, etc., shipped so they would be 
there when we arrived. 

When we were ready to go we 
packed three trunks with bed clothes, 
cooking utensils, fishing tackle, bathing 
suits, etc., and these were checked as 

baggage without extra cost to destina- 
The boys punting . . 

We arrived at the beautiful little Ozark town with its green hills for 
background and the silvery Elk River describing a horse-shoe below it. 
On Monday morning and before noon a camping site was found on the 
banks of a beautiful little creek a short distance from where it emptied 
into the river. Under some immense sycamore trees we pitched our tent 
and nearby purchased two bales of fine new prairie hay which was spread 
on floor of the tent and also stuffed into bed ticks which the good wife had 
prepared for our use, and in a surprisingly short time we were cooking our 




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THE DENTAL DIGEST 



first meal under the trees and our real vacation was on. We found that 
we could buy everything we wanted in groceries, garden products, milk, 
butter, eggs, fruit, etc., close at hand for less than we had paid for them 
at home and they had the advantage of being fresh. Space forbids me 
going into the details of our outing but we fished, bathed, boated and 
climbed mountains to our heart's content. 

We caught plenty of the finny tribe too — but we always licked the. 
platter clean, for they were so good and you get so hungry when you live 
in the open as we did. 

We returned home the first week in September, happy, rested, healthy 
and feeling that our vacation was a real outing and at nominal expense, 
as exclusive of carfare it cost us very little more than if we had remained 
at home. 



A LAUNCH TRIP 

By L. a. Lupton, D.D.S., Seattle, Wash. 




"The Maud" 

OUR party of five was composed of Mr. Stafford, a retired farmer, 
formerly of Winnipeg, Canada, a man seventy years of age, 
but not too old to go out with the boys and have as much fun 
as any of them, his son, Mr. Earl Stafford, a young expert mechanician, 
Mr. John Huffman, a young man about twenty-two, and Mr. George 
Foulds, the youngest, all neighbors and friends, who with myself made 
up the crew of the gallant boat Maudj which I purchased a couple of 
years ago. Her engine is a seven-horse power one-cylinder, two cycle 
gas engine, and drives the boat along at the rate of ten miles an hour. 
The Staffords have an auto, and the boys took our eats and bed 



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A LAUNCH TRIP 387 

clothing down to the boat in the afternoon, and we went off on our voyage 
in the evening. 

We lit our lights and had them in their places. The law required a 
red light on the starboard side, a green one on the port side, a white one 
near the bow, and a white one at the stern, raised on a pole several feet 
above the cabin. We placed the bedding and eatables in the lockers 
under the seats, and at 7 :io p. m. Earl started theengine, Georgeand John 
loosened her moorings and the Maud slipped gracefully into Shileshole 
Bay. I was at the wheel. 

The next half hour was uneventful. There was a little cove ahead 
where I had seen a little dock a year ago, and I thought it would be .a 
good place to tie up for the night, as the place was fairly well protected 
from wind and waves. 

When we came to the cove, which we recognized by the fireplace at 
the brick yard, as it was commencing to get dark by this time, we 
headed in. Earl took a position at the bow and signaled me with the 
signal bell, for we had previously made up a code of signals to suit our- 
selves. In this way we ran up to within two rods of the shore, but there 
was no dock there at all; so I concluded that I must have been mis- 
taken about its location, and decided to go ahead to Richmond Beach. 
This was where we made our mistake, as it would have been much 
better to have thrown out the anchor where we were for the night. We 
found out the next day that the little dock had been there, but was 
taken out. We had gone on only about fifteen minutes when our 
troubles commenced. 

Our little skiff, twelve feet long, and although new, rather poorly 
constructed, was trailing behind the launch. We had fastened it to the 
launch with a strong rope, but it broke loose. Fortunately I happened 
to see it at the time and reversed the engine. It was dark but the boys 
managed to keep it in sight until we got alongside, but, by this time it 
was about two thirds full of water and almost swamped. I stopped the 
engine and threw out the anchor, and while Mr. Stafford held a lantern, 
the other four of us wrestled with the skiff, and it was some wrestling 
match, too. We first lashed the near side to the launch, but that only 
made matters worse, as the far side dipped to the waves and caught water 
faster than we could bail it out. 

In spite of our efforts, the boats smashed together and half broke the 
gunwale of the skiff. Finally John managed to reach out and after a 
great deal of effort secured a rope to the outside of the skiff, and by the 
aid of this we kept it level enough to bail out most of the water. We 
found the boat was leaking badly, and decided to haul it up on deck over 
the bow. We were so exhausted from our work that we were hardly 



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388 THB DENTAL DIGEST 

able to haul it on deck, and it took a half hour to secure it firmly with 
ropes. 

We didn't like to proceed over the rough waters with the skiflf across 
the bows, as it would be a wind catcher and wouldn't help to balance the 
launch. So we decided to remain where we were for the night. We 
now, having time to look around, discovered that the pole with the 
stern light had snapped and disappeared in the water. 

We arranged our quilts and blankets so that two would sleep on the 
floor and three on boards laid across between the seats. We cast lots 
and the lower berth fell to John and I. The Maud was rolling consider- 
ably when we retired, and we were all a little nervous, to say the least. 
But every fellow was laughing and had a joke to tell. The rest slept all 
right, but I was worrying for fear the anchor would pull loose or the rope 
break and we would be thrown upon the shore. 

About a half hour before daybreak I managed to fall off to sleep but 
just as the gray dawn appeared one of the boys awoke and it was good 
night for the rest of us. John pulled in the anchor and coiled up the 
rope; Earl cranked the engine and at 4:15 a.m. we started ahead and a 
half hour later, when opposite Richmond Beach, we headed westward 
across the sound, toward the north end of BainKridge Island. The wind 
had gone down somewhat and it was not so rough as when we started, but 
before we got across we found it pretty choppy, and changed our course 
to northwest so as not to get the full force of the waves on the broadside. 
In less than an hour we had arrived near the shore of the mainland, north 
of Bainbridge Island. The sun came up in all its glory and shone on a 
fine sand beach, an ideal place to camp. We cast anchor about 150 
yards from shore, in about a fathom and a half of water. 

The skiff was launched and with one passenger and one to row at a 
trip and tipping the boat over to empty the water at each landing, we 
were soon landed. We built a fire between two drift logs under the green 
boughs of the trees that line the shore. Behind us was a green bank of 
thick foliage and before us was the white sand of the shore and the blue 
waters of Puget Sound, which by this time had calmed down so that the 
waves in the distance looked like ripples glistening in the morning sun. 
We placed our pancake griddles between the logs and over the fire and 
made and fried the flapjacks while the other boys brought water from a 
clear, cold, bubbling spring and made the coffee and fried the bacon and 
set the table. When my stack of cakes was about a foot high, five hungry 
mariners stuck their feet under the driftwood board that served as table, 
and soon the board was all that was left. About this time, we noticed 
that the tide had receded so far that the launch was only about two rods 
from the shore, so we got the skiff and rowed out, but, by the time we got 



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A LAUNCH TRIP 



389 



to it, the keel was in the sand, and we could not shove it oflF, so we knew 
that there was nothing to do but to wait until the tide came back. We 
had landed at 5:30 a.m., and it was 140 p.m. when the tide came in far 
enough to float our craft again. We propped the boat up with planks so 
she would not roll over when the water went from under her and then sat 
down on the sand and basked in the sunshine for a few hours. We put 
the skiff upside down on the shore and it soon dried off so that John put- 
tied up the leaks, and I put a fresh coat of paint on. We had little 
trouble with the skiff leaking after that. George and I cleaned out the 
launch and hung out the bedding to air. We rigged up a distress flag 
and posed for a kodak picture. We had just finished lunch when our 
vessel once more floated free, and a few shoves with the pike pole sent us 
off again. At 4 p.m. we arrived at a well protected cove called Manzaneta 




" We rigged up a distress flag and posed for a kodak picture " 

and decided to cast anchor. At 6:30 the next morning we were on our 
way. 

Our course now was due south in the passage called Port Orchard, 
which lies between the island and the main land. At about 8 a.m. we 
sighted the Old Soldiers* home, and knew we were nearing the Bremerton 
U. S. Navy Yard. We cast anchor just west of Bremerton and soon had 
breakfast. At about noon we started toward Seattle. After leaving 
Port Orchard we had calm waters until we got into the Sound again, 
between Blake Island and Blake Rock. We found it quite rough and 
decided not to cross over till the next morning, so we turned into a cove 
and landed at Port Blakely, a sawmill town, but soon noticed that the 
wind had gone down and I looked out over the Sound with a pair of glasses 
and it didn't look bad at all. So we started on again and in an hour and 
forty minutes (7 :io p.m.) we were back home again in Shileshole Bay. 



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390 



THE DENTAL DIGEST 



OUR VACATION IN 191S 
By J. C. HiGGASON, D.D.S., Danville, III. 

IN 1914 my family and I denied ourselves a vacation because we 
were planning to have a long one in 1915 by taking in the Panama 
Exposition. Work had been rather strenuous and I was in need of 
the vacation when the eagerly longed-for time arrived. We enjoyed it 
for several weeks before it really began, by our joyous anticipation and 

preparation for what 
was in store for us, 
and May 25, 1915, we 
locked up shop for two 
months and started 
on ouf first trip for 
the West. We lived 
in a small country 
town far from the 
city, where every- 
thing was always 
quiet and dull, so this 
kind of a change was 
just to our likjng. We 
had planned well and 




Our pride and joy celebrating with her uncle 



were well provided for our trip so we spent a few days seeing the 
sights and enjoying ourselves at different towns and points of inter- 
est along the way. Denver, Colorado and Manitou Springs, Salt Lake 
City, Portland, 
Redlands, Los An- 
geles, San Francisco 
and the Fair. 

Everywhere we 
met agreeable, court- 
e o u s , interesting 
people who helped 
us fill the fleeting 
days with pleasure 
and showed us that 
in the main 
people are kind, con- 
siderate and sympa- 
thetic. The swinging bridge in the Royal Gorge, Colo. 




X« 




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OUR VACATION IN 1915 



391 




In California we found many friends and acquaintances who were 
eager to show us California's wonderful resources and development, her 
splendid orchards and enchanting homes, her beautiful flowers and scen- 
ery, and her fertile 
valleys and good 
roads, all of which we 
enjoyed immensely. 

We spent only one 
week at the exposi- 
tion and I shall not 
try to give any de- 
scription of it nor of 
any of the other places 
ive visited, for those 
w^ho did not see them 
have read far better 
descriptions than I 
could write, but I will ^^^ ^^ ^^^"^ ^^"^^^" Springs 

say we enjoyed it all, also our little side trips and excursion into the 
mountains, woods and canyons, but most of all the scenery through the 
Rockies. The vastness, bigness and grandeur of the mountains is inspir- 
ing and uplifting. Their magnitude impresses one with his own littleness 
and insignificance, and of the existence of a higher and unseen Power, 
and of his need to adjust his habits and living so that he may come in 

^__^ _^ touch with this won- 

yi X derful Power that its 

W g force may flow 

through him and be 
directed into noble 
and useful channels. 

The time fairly 
flew and our two 
months were soon 
gone and I was back 
at the chair with new 
energy and inspira- 
tion. 

I am sending along 
a few of the pictures 
we took with our 
folding Brownie. Anyone taking a vacation or pleasure trip should take 
along a caiftera, for it not only affords much pleasure on the trip but it 




At the base of the flag pole at Fort Douglas, 
Salt I^ke City 



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392 



THE DENTAL DIGEST 



helps one, as the months and years grind on, to enjoy again and again, 
the pleasures of their happy holiday. 

The best thing about our vacation was the fact that almost as soon 
as I locked the office door I forgot root canals, troublesome plates and 
everything else that goes into the day 's grind in a dental oflBce , and thought 
of them no more until I unlocked it again two months later, at which 
time I felt like a new man, rejuvenated and enriched, not only physically, 
but mentally and morally as well, by the rest, recreation, association and 
inspiration of our jolly time and trip. 

As to dollars and cents, I am sure it paid in that way too. In the 
first place it was worth all it cost and more, but we are still enjoying it. 
Besides that, when I came back I could do more work and do it better; 
I was able to meet my patients with a more cheerful face and manner; 
I had more patience and had lost most of the grouch that had begun to 
get hold of me. It raised the respect in which I was held by my patients 
and friends, and all these things help the financial side of the business 
along. 




"The Blue Hole," Jamaica 



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OUT IN THE FIELDS 



393 



OUT IN THE FIELDS 

By C. R. Christopher, D.D.S., Brooklyn, N. Y. 

"The little cares that fretted me, 

I lost them yesterday, 
Among the fields above the sea, 

Among the winds at play. 
Among the lowing of the herds, 

The rustling of the trees, 
Among the singing of the birds, 

The hunmiing of the bees. 

"The foolish fears of what might pass 

I cast them all away 
Among the clover-scented grass. 

Among the new mown hay, 
Among the hushing of the corn, 

Where drowsy poppies nod. 
Where ill thoughts die and good are bom — 

Out in the fields with God:'— Selected. 




North end of Christopher 
veranda 




T 



SHE first day after school closes sees 
"My old Dutch'' and the coming 
men head for "The Christopher," 
situated at East Varick, N. Y., a hamlet on 
the shore of Cayuga Lake. Two weeks later, 
the writer leaves for the same place. Our 
summer home has a garden and is planted 
South side, facing shore ^ ^^ spring and worked by all the crew 

while we are there. There are fruit trees and small fruits which keep 
our table supplied for the summer. 
The lake is just across the road and 
is four miles wide at this place. 
One can see the village of Aurora 
on the Eastern shore with the tow- 
ers of Wells College shining in the 
afternoon sun. At night the moon 
unrolls her carpet from her counter 
on the hill across the lake to our ^he Christopher 

porch. Cornell University is twenty-five miles up the lake, a run we 

often make in our motor boat and 
sometimes camp on the way. The 
entire cost is less than it would be to 
remain in the city. As I close the 
office for two months the expense is 
cut at this end. When I began to 
do this I thought it would make 
some difference in my income, but 
find it did not, so have continued 





The motor boat, Paddy 



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394 



THB DENTAL DIGEST 



it. Perhaps the thing that counted most was the enthusiasm and vim 
with which I took up my work the winter following my first two months' 
summer vacation, and which stayed by me throughout the time until 
the next summer. 



WHY A VACATION AND WHERE? 

By J. A. McPhail, D.D.S., Blanchester, Ohio 

I AM an average dentist, in an average Ohio town of 2,000, and have 
been in practice twelve years. During that time I have observed 
that dentists in general are good fellows and hard workers. Being 
good fellows they seldom save money, and being hard workers they need 
vacations often, but seldom take them. The editor of this magazine 
has done much to improve our financial condition, and now he has 
launched a propaganda to make all dentists take a vacation. Every man 
be he dentist or not says to himself, "when I get so much money I am 
going to take it easy.'' 

My advice to every dentist is, to train himself, so that he can forget 
his work for a brief spell each year, or oftener. The man who gives him- 
self this training dur- 
ing the early years of 
his practice, will not 
champ the bit if he is 
indisposed for a week, 
or away from his office 
a short time. You 
should love your 
work, and enjoy it, 
but that does not say 
you should sleep with 
it or have it for a con- 
stant companion. 

About four years 
ago I passed a tennis 
court in Boston two 




Take the children with you 



or three times a day during a very hot month, and every time I passed, 
there was always someone playing. It seemed to me a lot of foolishness 
for able bodied men to be trifling away their time chasing a tennis ball. 
One day as I passed this court an old gentleman was walking slowly ahead 
of me, and hearing footsteps behind him, he stopped, and waited for me. 
He smiled and remarked that it was a hot day. As we walked along he 



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WHY A VACATION AND WHERE? 



395 



said '* there is a fine tennis court** and as I agreed with him, he explained 
further, that some of the keenest and hardest working men in Boston 
played there every day. To stay in the game he said a man must keep 
himself physically fit. 

I had been interested in vacations and athletics for dentists ever since 
I had been in practice, 
and the remark of this 
old gentleman made 
an impression on me 
and set me thinking. 
This I know to be 
true, that as you ad- 
vance in years you 
become less interested 
in various sports and 
amusements. The 
point I wish to im- 
press upon you is the 
fact that it is folly to 
defer your vacation until the flowers of spring fade, and ill health and 
the family doctor decide where you shall spend your vacation, and how 
you shall spend it. Decide on a vacation now and make it one that 
suits your needs and one that you may enjoy to the fullest. 




^^j^niv..t:*V:..v>,:^.« 



Just enjoying it all 



WHY YOU SHOULD TAKE A VACATION 

(i) To store up energy, and rest overworked parts of your body. 

(2) Health and energy give you poise and prestige. How many sick 
dentists do you know who are successful? 

(3) A vacation makes all things new — even your own office will be 
more attractive. 

(4) Absence from duty gives you an opportunity to forget your duties, 

if you so desire. As 
long as you permit 
your work to decide 
what you shall do you 
are a slave. If after 
an absence of a few 
days, or a week, you 
get restless and make 
life miserable for 
everybody, you poor 

An outing on the shores of Lake Pepin, Wis. slave, yOU are tO be 




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396 TH£ DENTAL DIOBST 

pitied, for your work is your master. As the years qiiietly pass you 
will find it even more difficult to cut the cord that binds you. Too 
constant companionship with work is not healthful. 

(5) Our work is in-doors whether the weather is pleasant or not, and 
much energy is absorbed from every member of our profession. If we 
are constantly giving out and not storing up energy, it is only a question 
of years until our voltage is lowered and the lights grow dim. 

(6) Our work brings us in contact with much oral filth, much of it of a 
pathogenic nature, and it is a matter of common sense on our part, to 
make the fortress of our bodies, as impregnable as possible. 

(7) Lastly to give that woman and family, (and they should come 
first) pleasure and health also. 

HOW AND WHERE TO SPEND A VACATION 

Dentists like other beings differ in tastes and temperaments. What 
spells rest to one man is a bore to another. Until recently I usually spent 
my vacation near my birth-place, which happens to be Walkerton, 
Ont. In a weak moment, a lady from Minnesota consented to become 
my wife, and since then where I spend my vacation depends largely upon 
my abiUty to convince my wife of the many advantages to be derived 
from a vacation in Canada, over one in Minnesota. If any of my fellow 
laborers has had an experience similar to this, he will appreciate the fact, 
that a vacation is a serious thing. My vacation usually starts as soon as I 
can work in my garden. 

To say you cannot find time or afford to take a vacation is admitting 
three things: (i) You do not appreciate the value of a vacation sensibly 
spent. (2) If you cannot find time you do not systematize your work or 
work is still your master. (3) If you cannot afford a vacation then you 
are evidently not paying attention to the business articles in the Digest 
and other magazines. Please get rid of the idea that a vacation is an ex- 
pensive luxury. Board walks, big cities and popular summer resorts do 
not necessarily make a vacation. There may be a delightful, inexpensive 
spot, ten miles from your office that is just the spot for YOU. 

Six or eight weeks before I start on my vacation I mail cards something 
Uke this to all my patients: 

"Dr. McPhail announces that he will close his office from July ist to Aug. ist for the 
purpose of taking a vacation. Those desiring his professional services will please come in 
now, as plans for his vacation have been made and cannot be changed because of unfinished 
work." 

These cards I have found from an experience of seven years stimulate 
my work. My patients all know I am going away, and when I am going. 
Many have work done, who would have put it off if they thought I would 



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WHY A VACATION AND WHERE? 



397 




Boating on the St. Clair Flats 



be home, when they had trouble. Very little work will go elsewhere 
on a hot summer month. Your best patients always come in, and they 
are glad you are going away, because what results in your physical better- 
ment will benefit them. • • :••. " ^ '^ ;/ 

With these announcement cards I^^erfteh-mail carcfs stating when pa- 
tient had his last wo*k done/ - 'A. VatcatioA'give^ i^t\i ^leilcHd tecuee Jot 
collecting accounts. • "' :"'!>» ' ' ' '' \^' ' 

When the day for my vaciition Comei^, 1 c^se mjc ^botapdt feav^ my 
office as happy as a 
school boy. When I 
work, I work Hard, 
and when I leave my 
office I simply forget 
that I am a dentist. 
A game of ball with 
the children, a picnic 
or a fishing trip will 
find me ready to take 
part. To sit on a 
bank of a quiet stream 
back in what appears 
to be an impenetrable forest, and just fish, whether the fishing is good or 
not, is certainly restful and joyous. To go through life unable to enjoy 
nature and all out of doors is a great misfortune. On my vacation I 
want to do as Edwin Markham does in his beautiful poem. 

FRIENDS WITH LIFE 

Give me green rafters and the quiet hills, 
Where peace will mix a philter for my ills- 
Rafters of cedar and sycamore, 
Where I can stretch out on the fragrant floor. 
And see them peer — the softly stepping shapes — 
B> the still pool where hang the tart wild grapes. 

There on the hills of summer let me lie 

On the cool grass in friendship with the sky. 

Let me lie there in love with earth and sun, 

And wonder up at the lightfoot winds that run, 

Stirring the delicate edges of the trees. 

And shaking down a music of the seas. 

Bring some old book — "The Romaunt of the Rose," 
A song through which the wine of morning blows. 
Let me stretch out at friends with life at last, 
Forgetting all the clamors of the past — 
The broken dream, the flying word unjust, 
The failure, and the friendship gone to dust. 



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THE DEHTAL DIGEST 



FATIGUE. ITS CAUSE, NATURE, AND CURE 

By W-.NV. Eldridge, Jr,, M.D.. New York. X. Y. 
•/ V: z^* vj ;..: : : 

The flUrts ih tKi^ranicleMebviiodhy of the thoughtful attention of even* 
It rnSan!* Th^- thO^^ ^rect^weh^im lytyreefi cuntmuttl vork and fatigue. 

•* •*a2idiIie>Vnt^n^t{ tlije^^oniMiqrCb^V^^?*^^)^*'^''^ ^"^ 

J ^•rnerita]^andph^«i^a] failure. ** ** ••• ••• 

* r ; : /^ ^^n^UHre for q vjMKit*M, 3ij4v^ a^ a^ expense, may not be jus- 
**• **tiriW. • R^r^ as4itf ih\V^Qne^t Ji^}|ie*.^|alth and eflftcieno' of the 
bread winner of the family, it may be the height of wisdom. 

f>ne sentence in thi> article should register in each of our brains **The 
average of time rer^uired for a complete restoration is greater than that 
ref quired to produce exhaustion/' 

Wednesday or Saturday afternoons off all summer and at least a 
month of rest away from everything dental, may mean longer life, better 
spirits and disposition, more intelligent and better work. Tr>' it as an 
investment. — Kditor. 

THE final effect of cumulative or excessive fatigue is to wreck the 
human organism. The only known method of preventing fa- 
tigue becoming cumulative, is to properly proportion working 
and rest periods. The only way to repair the wrecked organism is through 
a long rest. 

DIRECT AND INDIRECT F.\TIGUE 

The cause of fatigue may be direct or indirect or both. By a direct 
cause, is meant the exertion of a portion of the anatomy that produces a 
fatigue in the particular part used. By an indirect cause is meant any 
influence such as disease, inanition, or exertion of any portion of the ana- 
tomy that induces a fatigue in some indirectly associated part. 

As one of the simplest examples of direct fatigue consider the exhaus- 
tion of power in muscular tissue following muscular effort 

THE CHEMISTRY IN FATIGUE 

Laboratory experimentation shows that if a muscle be stimulated 
repeatedly, its contractions at first increase even if the stimulus remains 
of the same strength: then they gradually decrease until as complete 
exhaustion is approached, the contractions become more prolonged, less 
active, and finally cease altogether. 

The chemistry of the changes in the muscle which caused fatigue is 
not fully understood and is far too complicated to be described here. 
Suffice it to say that the carbohydrates become oxidized; the amount of 
glycogen diminishes; the reaction of the muscle becomes increasingly acid ; 
and with acid saturation, complete exhaustion supervenes. No one 



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FATIGUE. ITS CAUSE, NATURE, AND CURE 



399 



knows why this chemical change takes place in fatigue. Observation 
shows only that it does. 

In proof of the assertion that the chemical change is responsible for the 
production of the fatigue, there has been withd awn from the circulation 
of a thoroughly fatigued dog, a certain quantity of b'ood, containing 
supposedly the material produced by the muscle fatigue, and this blood 
has been introduced into the circulation of a fresh, thoroughly rested dog 
of the same species, weight, build, color, etc. Such injections have pro- 
duced in the second dog, after a short time, all the signs and symptoms 
of a marked fatigue. 




Away from everything dental 
RECUPERATION ONLY THROUGH REST 

All experimentation has, however, revealed no process by which the 
pre-active state of the muscle can be produced other than by the natural 
process of rest, and the average total length of time required for a com- 
plete restoration is greater than that required to produce exhaustion. 

NECESSITY OF MORE REST THAN WORK 

It can therefore be readily seen that an individual who has exhausted 
his musculature by repeated periods of physical exertion will not, during 
the usual amount of time allowed for recuperation, return to a complete 
pre-active condition. Thus, although following a hard day's labor, the 
individual usually enjoys the benefit of a night's rest, he is not completely 
restored. Each successive day's work, leaves him with a slightly lessened 
degree of recuperation which becomes cumulative in effect producing a 
gradual decline in efficiency until at the end of a prolonged season of 



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400 THE DENTAL DIGEST 

activity the condition is reached where the only means to restore the 
exhausted organism to normal vigor is a fairly complete and continuous 
rest. 

CHARACTER OF MENTAL FATIGUE 

In a general way, the same procedure observed in the phenomena of 
the fatigue of muscular tissue, takes place in the fatigue produced in any 
of the body systems. There are variations in detail of the physiolog>^ 
and chemistry, but the end results are practically the same and certainly 
the only means available for a complete restoration is identical, namely 
rest. The same general principles apply to fatigue following mental 




Take a vacation, a long enough one — Take a restful one 

activity. It is, moreover, almost impossible to consider any one body 
system as a separate unit in observing the effects of fatigue, inasmuch as 
the systems are all so inter-dependent and co-relative. The consideration 
of any direct fatigue leads naturally to the observation of the co-existent 
fatigue in other systems which is indirectly induced by the primary fatigue 
of the system undergoing exertion. 

SYSTEMIC EFFECTS OF MENTAL FATIGUE 

A man having spent ten or eleven months of practically continuous 
mental effort becomes fatigued to a marked degree, due to the cumulative 
effect of each day's work, but he does not feel tired in his organ of thought 
alone. While his brain may be the seat of his chief weariness, he is 
nevertheless, quite tired throughout his whole anatomy. His circulation 
may possibly have become "sluggish,'^ his digestion may be, and probably 



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FATIGUE. ITS CAUSE, NATURE, AND CURE 401 

IS far below par, and he may have lost some weight and developed some 
''flabbiness'' in his muscles. These are all evidences of indirect fatigue, 
the results of fatigue of the brain from direct mental effort. 

A CAUSE OF SUDDEN BREAK DOWNS 

It often happens, also, that a physiological fatigue may become 
almost, if not quite, complete, before consciously registered, so that the 
individual may reach the point of complete physical or mental prostration 
before being aware that he is suffering from fatigue. This fact is illus- 
trated by the sudden complete breakdown of intelligent business and 
professional men, in the midst of a season of unusual activity. This 
occurrence seems to be contrary to the logical course of events; but it is 
easily accounted for by taking into consideration the effect of certain 
artificial stimuli. Intense interest, emotional or intellectual excitement, 
anxiety, urgent anticipation will act as effectively in the production of 
artificial stimulation as the drug stimulants, alcohol, caffeine, cocaine, etc., 
and will succeed in keeping the various body functions at an apparently 
normal state of efficiency until the period is reached finally and suddenly 
where there remains practically nothing to form a basis for stimulation. 
At this point the functional activity ceases suddenly, and the individual 
is, temporarily at least, a human wreck. 

The natural and logical conclusion from these facts is to so regulate 
time and work that one can appropriate to rest and recuperation the 
necessary amount of time yearly to overcome the cumulative effect of 
daily fatigue. This will, in the long run, increase the efficiency and 
maintain a greater degree of health. 

Take a vacation. 

Take a long enough one. 

Take a restful one. 







Js^PMi 


■ ' 












Bft^ M 


mmmmm^ 




^^- m 


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Bft^^^^^^^^^^^^^^^^^^l 


l^M 


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SHlaJm ^^Hl^^^l 



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THE DSHTAL DIGEST 




Cupid drives a car 



"EIGHTH ANNUAL HAY FEVER 
PILGRIMAGE" 

By T. M. Robertson, D.D.S., 

COFFEYVILLE, KaNS. 

WHEN our small boy comes 
in and with a look of ex- 
pectancy announces " that 
the rag-weed is almost in bloom/* 
that is a signal to pack up. 
Because of the distance from the short grass country of Kansas to 
the Hay Fever Quarantine Line of Minnesota, we usually make the trip 
by rail, but this year we decided to travel by easy stages in the auto. 

A box five feet long containing our cooking outfit was fastened to the 
running board on one side 
of the car. Our tent, a 9 x 
12, we took along for camp- 
ing in good weather. We 
did not carry poles but 
fastened one side to the top 
of the car, then drawing it 
over the car, fastened the 
other side to convenient 
trees or fence posts. The 
bed for "Cupid'' and the 
boy, we made by annexing 
the front cushions to the back seat, where they slept fine with the ex- 
ception of the first night, when "Cupid" fell out, giving a "Big Ben" 
alarm, which rescued her from the camping box where she had lodged. 
A large folding cot by the side of the car made up the rest of the 

Pullman equipment. 

Just one objection was 
registered to this camp 
life by the feminine mem- 
ber of the party, which 
was, that we neglected to 
bring along the bath tub. 
After the third camp we 
made hotels, owing to the 
heavy dew and fog as we 
traveledalongtheMissouri 
and Mississippi Valle}^, 







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Brook trout fishing 




Brook trout for dinner 



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'EIGHTH ANNUAL HAY FEVER PILGRIMAGE" 



403 



The fifth day at noon 
brought us to Duluth. 
The greatest advantage 
in travelling by auto, we 
found, was in the oppor- 
tunity to compare the 
farming communities as 
we traveled through, also 
the side-trips, such as the 
Soldiers' Home at Leaven- 
worth, Kansas, one of the 




Camping on the moose trip 




Four mile portage on the moose trip 



most beautiful grounds in the United States, and the few hours spent in 
Omaha, Sioux City, Minneapolis, with its fine boulevard system, connecting 
its numerous lakes. A trip to the capitol at St. Paul, and the $25,000,000 

Steel Plant in Duluth, also 
the beautiful Boulevard 
Drive in that city. 

Duluth being the end of 
the Auto Road, we stored 
our car, which so far, had 
not called for a repair, not 
even a puncture, in a dis- 
tance of 1,012 miles and 
taking a small steamer The 
America left for Grand 
Morais, Minn., 120 miles 
down the north shore of Lake Superior. During this 10 hour trip the 
boat stops at every httle fishing settlement to put off mail, two or three 
passengers, some groceries, and perhaps a box of Copenhagan snuflf, all 
of which go to shore in a small 
skiff. A real treat to watch 
the people of Kansas who had 
not seen a boat since rag- weed 
season last year. 

At Grand Morais, where we 
built our "Sneezers Cabin '* 
five years ago, we call home, 
making our fishing trip from 
here. 

On one trip into the "Nat- 
ional Forest and Game Re- 
serve" we carried a Ught canoe 




Trout fishing was good at this camp 



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404 



THE DENTAL DIGEST 




Sneezer's cabin 



and tent and camped on a moose traiL 
We were well paid for our hard jour- 
ney, for we saw ten moose. 

Owing to ** stage fright" when the 
moose appeared, we failed to get 
good kodak pictures, although we 
chased one which had decided to out 
swim the canoe, a good half mile, 
before it swam to shore and dis- 
appeared in the woods. 
We found no need of bromides to make us sleep, or any necessity of 

taking an appetizer along, for our appetites 

come to us the j&rst day out, on journeys 

such as these. 

On our return trip to Kansas we came 

through Wisconsin crossing the Mississippi 

at Red Wing, Minn., then through Des 

Moines and Kansas City, on home. For 

a distance of 200 miles through Iowa we 

left two deep tracks through the mud, but 

from Kansas City home, the roads were 

fine and we landed safely and still without 

a puncture. 

JUNE 
By Timothy C. Murphy 



The sweet wind sweeps across the fields, 

New cut the grass is lying, 
Where vanquished Spring to Summer yields, 

June's golden flags are flying. 

Fair flows the river^s gleaming tide, 
The copse and meadow meeting, 

And feathered folk on every side. 
Send forth a morning greeting. 





"We don't want to go home'* 



One of our camps 

The spider's web of pearl is hung, 
The wild rose bush adorning, 

Where many a dew-kissed rose 
has flung, 
Its glory to the morning. 

Swift speeds the swallow's fleet- 
ing wing. 
The zephyr's course pursuing. 
Like love-lorn swains the robins 
sing, 
Their madrjVals of wooing. 

When Nature's charms are thus 
in tune. 
And lightly pass the hours, 
Then knows the world that it is 
June, 
The month of birds and 
flowers. — Dumb Animals. 



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UP THE OSWEGATCHIE AFTER TROUT 



405 




XJP THE OSWEGATCHIE AFTER TROUT 

By H. O. Brown, D.D.S., Waterloo, N. Y. 

FOR a week we had been gathering fish worms because Northern 
New York does not have that beast. 
On Thursday p.m. Mr. Wm. Bell, "Dick" for short, and 
myself, shouldered our pack baskets and headed for the station, where we 
boarded the train for Watertown, via Syracuse. Arriving there we at 
once sought the "hay" as we knew there was a 
hard day ahead of us. 

Bright and early the next morning we were on 
our way, stopping only at Carthage for a few 
minutes, where we fell in with five more disciples 
of "Izaak Walton." But these men were out of 
our class. They were putting up at a Hotel, while 
our destination was a shack ten miles up the 
Oswegatchie. 

At Benson Mines we left the train and boarded 
the Northeastern limited. It consisted of a trolley 
car in which a marine engine had been installed, 
and one could hear that engine complain for miles. 
However, it pulled into Wanakeena on time (as 
there was no schedule), and we piled off. 

Here we obtained our supplies of bacon, potatoes, sugar, coffee, con- 
densed milk and milk chocolate. Who has eaten a bar of chocolate 
after fishing three or four hours? All right, you know how good it is then, 
and if you haven't, try it. 

Before getting the grub, we had weighed our packs and they tipped 

the scales at 50 lbs. each. They told us 
it was only three miles by trail to smooth 
water, where we intended to get a canoe, 
but I'll swear it was thirty. If you doubt 
me, step out of your office, shoulder a 60 
lb. pack, and climb over a rough trail for 
three miles, over rocks, logs, etc., around 

trees and washouts. Many were the 
Washing up the dishes ^.^^ ^^ ^^ ^^^^^ ^^^ ^^^^ ^^^ 

pretended to be watching the river as it boiled over the rocks below us, 
for the trail followed the river. It was truly a pretty sight to see the 
water rushing and foaming over the rocks, whirling around a corner or 
smoothing out into a deep pool where we knew the "big fellows" were 



"Dick" 




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406 



THE DENTAL DIGEST 




lying in the shade of an overhanging rock, and we longed to "wet a line," 

but we knew that we had an eight mile paddle after we left Inlet, so we 

would again shoulder the pack and start on, one carrying the bait and 

the other, the lantern. 
After what seemed hours 
we saw the tops of some 
buildings, and Dick told 
me we were nearly there. 
On arriving at the 
house we hunted up the 
owner, stowed our packs 
in the centre and climbed 
into the canoe, Dick in 
After water for coffee the bow and I in the 

stern. We pushed off and were on the last lap. 

The scene which opened up to us as we rounded the first bend was a 

beautiful one indeed. Here we caught our longest view of the river, and 

not over loo yards at that. It was as still as a mill pond, and the shadows 

of the bushes were reflected on its quiet surface. Away in the distance 

lay a mountain, at the base of which lay the open camp which we expected 

to make our hotel. 

From here on the stream narrowed. Most of the time it was from 

lo to 15 feet wide, and ran smoothly, but in 

places it would narrow up and become swift. 

In places it was only wide enough for the canoe 

to pass and so crooked that we would scarcely 

get the canoe straight from one turn before we 

would be obliged to turn again. 

About half-way up "High Rock" loomed up 

out of the "burnings" like a sentinel on duty, 

and from its top one could see for miles over the 

flat country covered with "second growth," and 

trace the river which wound snake-like away in 

either direction. 

"Seven Pines," seven trees from one base. 

we passed four times before it was really behind 

us so tortuous was the river. 

It was a welcome sight indeed when rounding 

a bend in the river we came suddenly in sight of our camp, which lay a 

couple of rods back and up from the stream. Landing, we at once set the 

camp to rights, cut firewood, balsam boughs, and prepared supper. After a 

short smoke we rolled into our sleeping bags, and slept the sleep of the just. 




Seven Pines 



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UP THE OSWEGATCmE AFTER TROUT 



407 




A little supper 



I was suddenly awakened by a revolver shot. Jumping up I saw 
Dick's flash light focused on a corner and a smoking gun in his hand. 
" Torky ' trying to eat us out of house and home," he said. A few minutes 
later I heard a gnawing and scratching outside and 
we both got up. Without waiting for shoes, clothes 
or anything, we grabbed our flash lights and guns, 
and rushed out of the shack. Dick went one way 
and I the other. By the time I had gotten around 
I saw him running off through the woods, shooting 
and yelling at every jump, but by the time I caught 
him Mr. Porky had gotten safely away, and we re- 
turned to camp to sleep undisturbed until morning. 
After breakfast the next morning we left camp, 
and paddled up-stream several miles, catching a 
few but spending most of our time pulling logs out 
of the stream, so in the future we could go undis- 
turbed. Toward noon we reached a dam and were 
obliged to stop as the river above was a tangled 
mass of logs. Here we waited, ate our lunch and started back. 

I climbed out on "Our Rock" while Dick went below to fish "Glory 
Hole," and both succeeded in landing several beauties. Getting back 
into the boat we allowed it to drift down, holding the overhanging 
branches against the boat with our knees while we dropped our bait over a 
likely hole. Often we would land and fish from an overhanging tree or rock 
or bank. In this way many were added to our catch. 
At one place we came upon six young fellows 
from a Ranger School, who were wading waist deep 
in the icy water. How they stood it I don't know, 
but they were there fishing with raw meat and 
having the time of their lives. 

In the evening we could hear deer "blowing" 
all around us and the banks at every open place 
looked like a barn yard so thick were their tracks. 
One day we saw a fox running along the bank 
ahead of us. 

To say that we lived high would mean nothing 

to one who has not tasted trout just out of the 

water, but only try it and you will see how it goes. 

All too soon Monday morning came, and we were obliged to break 

camp and start back. Rounding a bend we came suddenly upon four 

deer who had urgent business elsewhere and by the way they left no one 

would imagine they were going to keep an appointment with a dentist. 




Yours truly 



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408 



THE DENTAL DIGEST 



We found an entirely different story coming back and as we had lots 
of time we let the canoe drift some of the time, while we took fl>'ing shots 
at blackbirds but caused little disturbance. 

Arriving at Inlet we again shouldered our packs, which were now much 
lighter and headed for Wanakeena, secured dinner and pulled out for 
Syracuse. 

Late that night we pulled into Syracuse, tired, hungry and dirty, but 
happy. We left our packs at the station and headed for a Hotel. As 
we walked up to the desk at the Onondaga, we were the centre of attrac- 
tion, and the clerk gave us the " twice over'' before he gave us our **room 
and bath." Even the bell boy was skeptical until we ** shelled out" 
liberally and then he could not do enough for us. 




A NAUTICAL PARTY 

^ A capital ship for an ocean trip 

Was the " Walloping Window-blind;" 
No gale that blew dismayed her crew 

Or troubled the captain's mind. 
The man at the wheel was taught to feel 

Contempt for the wildest blow, 
And it often appeared, when the weather had cleared, 
That he'd been in his bunk below." 

— Charles E. Carryl. 



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ANNOUNCEMENTS 409 



ANNOUNCEMENTS 



NATIONAL DENTAL ASSOCIATION. GENERAL PLAN FOR THE 
TWENTIETH ANNUAL SESSION 

While no sensational changes are contemplated in the general plan for this annual session 
for the National held in Ixjuisville, July 25, 26, 27, 28th, there are a number of decided im- 
provements which will be inaugurated. 

OUTLINE AND LOCATION OF SESSIONS 

The first day will begin with registering all members and guests, at the spacious First 
Regiment Armory rotunda. Such facilities will be provided which will make registration a 
pleasure. The ladies will register on the mezzanine floor of the Seelbach Hotel which will be 
their headquarters and from which all entertainments will start. 

Opening Session will be held in Keith's Theatre, seating more than 3,000 very comfortably. 
This theatre is artificially cooled to the temperature of 65 degrees during sunmier months and 
of its acoustic properties Dr. Thomas Hinman had this to say, after a recent inspection, " No- 
where, with the exception of the Mormon Temple at Salt Lake City, have I observed such 
wonderful acoustic properties." 

All general sessions and some special sectional meetings will be held in this theatre whic'.i 
is diagonally across the street from registration headquarters, one block from Seelbach Hotel 
and one half block from the Watterson and Hermitage hotels. 

The splendid auditoriums of the Seelbach and Watterson Hotels will be used for sectional 
meetings as well as McCauley's Theatre, across the street from the Seellxich. 

NOTABLE CLINICS ON WEDNESDAY 

Perhaps the greatest treat the profession has ever enjoyed will be provided on Wednesday 
afternoon when under the supervision and direction of Dr. W. H. G. Logan, four hours and 
one half will be devoted to "Illustrated Lecture Clinics," presented by men of acknowledged 
authority upon the subjects on which they are to speak. 

This is a new feature of a National meeting and affords every member in attendance an 
equal opportunity to hear and see the same good clinics and when the profession is assured 
that Dr. Logan has complete charge of this branch of the meeting it warrants us to expect 
something out of the ordinary. 

MORE CLINICS ON FRIDAY MORNING 

The great balcony of the First Regiment Armory will be divided into twenty-seven sections, 
each to seat from one hundred and twenty-five to one hundred and fifty members and visitors. 
There will be twenty -seven clinicians, divided into three branches of dentistry and the outline 
is so arranged that every man, by remaining in his seat, will see every one of the twenty-seven 
clinics in the morning allotted for this branch of the work. 

ANOTHER ATTRACTIVE NEW FEATURE 

A feature of special interest to many members of the National will be the joint meeting 
of the Inter State Anesthetists, a strong body of both medical and dental men having s[>ecial 
interest in anesthesia. A strong programme for a joint meeting has been arranged, including 
the following men, Drs. Long, McMillan, Denman, Brophy, Riethmueller, Thoma, and 
Yager. 

SOMETHING ABOUT ACCOMMODATIONS 

From some source the expression of fear has reached the Local Committee on Arrange- 
ments that Louisville did not have accommodations for a large meeting; to all such fearing 
friends, we submit the following queries? 



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410 THE DENTAL DIGEST 

Do You Know that Louisville has sixteen splendid hoteb with a iolal of 3,000 rooms, not 
to mention the score of lesser hotels for those who prefer to live modestly? 

Do You Know that Louisville*s Y. M. C. A., Y. M. H^ A., Y. W. C. A. can furnish quarters 
for hundreds of tourists who prefer that kind of accommodation? Do You Know that Louis- 
ville has entertained some of the largest conventions in the country in a most acceptable 
manner, notable among them, the International Sunday School Convention, with eight 
thousand registered delegates; National Canners, with from three to four thousand have met 
in Louisville for three consecutive years in preference to other larger and competing cities; 
the great "Saenger-Fest" which brought thousands to Louisville; Knight Templars, Shriners 
and a host of the largest gatherings of commercial, political or religious nature in America. 
This she would be unable to do, were it not for her extensive hotel acconmiodations and genial 
southern, Kentucky branch of Hospitality. 

A series of entertainments is being arranged for, with the assistance of a Ladies' Committee, 
composed of the wives of each Local Committeeman, which will so completely take up the 
time of visiting ladies that their husbands will be relieved entirely of the responsibility of 
providing entertainment. 

Among the entertainments for the ladies are the following: Sight-seeing auto trip with 
luncheon at the Country Club; boat ride upon the beautiful Ohio River; shopping tour 
through Louisville's handsome department stores; trip to Fountain Ferry Park with theatre 
and lunch and others. 

" You'U Feel At Home In Louisville." 



NEW YORK COLLEGE OF DENTISTRY— SEMI-CENTENNIAL 

CELEBRATION 

The authorities of the New York College of Dentistry are making arrangements to cele- 
brate the Semi-Centennial of the Institution on Tuesday, Wednesday and Thursday, June 
13th, 14th and isth. 

The programme will include Essa)rs and Clinics at the College Buildings on Tuesday; a 
Reunion, Reception and Banquet at Delmonico's on Wednesday evening and Commence- 
ment Exercises at Carnegie Hall on Thursday evening. 

It is hoped that it will be possible to reach all the alumni and to communicate to them 
the cordial invitation of their alma mater to rejoice with her in the completion of half a 
century of activity and usefulness. But, if any graduate should faU to receive the com- 
munication which the Committee will send out, he will confer a favor, if he will communi- 
cate with the undersigned. 

Dr. J. OsTRAU Taylor, Sec'y 

576 Fifth Avenue, 



New York City. 



FUTURE EVENTS 



June 12, 1916. — ^Tennessee Board of Dental Examiners, Nashville, Tenn. — Walter G. 
Hutchison, 308 Eve Bldg., Nashvdlle, Tenn., Secretary. 

June 12-14, 1916. — ^Missouri State Board of Dental Examiners, Jefferson City. — ^V. R. 
McCuE, Cameron, Mo., Secretary. 

June 12-17, 1916. — Indiana Board of Dental Examiners, Indianapolis, Ind. — Fred J. Prow, 
Bloomington, Ind., Secretary. 

June 13-15, 1916. — Connecticut State Dental Association, Hotel Griswold, New London, 
Conn. — Elwyn R. Bryant, New Haven, Conn., Secretary. 

June 14, 1916.— South Carolina State Board of Dental Examiners at Jefferson Hotel, Col- 
umbia, S. C. — R. L. Spencer, Bennettsville, S. C, Secretary. 

June IS, 1916. — ^Illinois State Board of Dental Examiners, Northwestern University Dental 
School, 31 W. Lake St., Chicago.— O. H. Seitert, Springfield, HI., Secretary. 



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FUTURE EVENTS 411 

June 15-16, 1916. — ^Thirtieth annual meeting of the Colorado State Dental Association, 

Cliff House, Manitou. Exhibitors will please address Dr. F. P. Wells, Exchange Bank 

Bldg., Colorado Springs. — Earl W. Spencer, Pope Block, Pueblo, Colo., Secretary. 
June 16-20, 1916. — Florida State Board of Dental Examiners, San Juan Hotel. — W. G. 

Mason, Tampa, Florida. 
June 20-22, 1916. — ^Tennessee State Dental Association, Knoxville, Teim. — H. C. Maxey, 

Memphis, Tenn., Secretary. 
June 20-22, 19 16. — New Hampshire Dental Society, Lake Sunapee, Zoo-Nipi Park Lodge, 

Lisbon, N. H. — ^J. E. Collins, Chairman Exhibit Committee. 
June 21, 1916. — Florida State Dental Society, Orlando, Fla. — M. C. Izlar, Secretary. 
June 22-24, 1916. — Dental Commissioners of the State of Connecticut, Hartford,