The Project Gutenberg eBook of The Monthly Review of Dental Surgery, No. VIII. October, 1880. Vol. I
    
This ebook is for the use of anyone anywhere in the United States and
most other parts of the world at no cost and with almost no restrictions
whatsoever. You may copy it, give it away or re-use it under the terms
of the Project Gutenberg License included with this ebook or online
at www.gutenberg.org. If you are not located in the United States,
you will have to check the laws of the country where you are located
before using this eBook.

Title: The Monthly Review of Dental Surgery, No. VIII. October, 1880. Vol. I

Author: Various

Editor: Alfred Coleman
        Joseph Walker

Release date: February 17, 2019 [eBook #58903]

Language: English

Credits: Produced by Richard Tonsing and the Online Distributed
        Proofreading Team at http://www.pgdp.net (This file was
        produced from images generously made available by The
        Internet Archive)


*** START OF THE PROJECT GUTENBERG EBOOK THE MONTHLY REVIEW OF DENTAL SURGERY, NO. VIII. OCTOBER, 1880. VOL. I ***




Produced by Richard Tonsing and the Online Distributed
Proofreading Team at http://www.pgdp.net (This file was
produced from images generously made available by The
Internet Archive)









                           THE MONTHLY REVIEW
                                   OF
                            DENTAL SURGERY:
            _THE JOURNAL OF THE BRITISH DENTAL ASSOCIATION_

 ═══════════════════════════════════════════════════════════════════════
 NO. VIII.                   OCTOBER, 1880.                      VOL. I.
 ═══════════════════════════════════════════════════════════════════════


The subjects rightly embraced in a Medical education, and the degree and
manner in which those subjects should be respectively studied, have been
freely discussed in many places during the last few weeks. Dr. Michael
Foster in an “Address in Physiology,”[1] of unsurpassed interest,
contends without contradiction that no medical subject—now that the
entrance upon medical studies is preceded by a tested preliminary
education—need be studied as heretofore as a mere mental training, and
proposes that topographical anatomy, which has hitherto been so studied,
should, to a certain extent, give way in favour of a more complete
knowledge of physiology. The address must, and no doubt will, be read by
all interested in medical education, whether general or special. The
following quotation will answer our present purpose:—

Footnote 1:

  Address in Physiology, delivered at the Annual Meeting of the British
  Medical Association, 1880.—Published in _British Medical Journal_,
  August 21st, 1880.

  “I think I am not overstating the case when I say that, in the two
  years (or less than two years) which the medical student devotes to
  studies other than clinical, 60 or 70 per cent. of his time—in some
  cases even more—is spent on the study of topographical anatomy. That
  study may be regarded in two lights—as a discipline, and as
  practical useful knowledge. The late Dr. Parkes, in a remarkable
  introductory address which he delivered at University College,
  London, many years ago, insisted most strongly that its value as a
  discipline was far higher and more precious than its direct utility;
  and I imagine that the more one reflects on the matter, the more
  clearly this will appear. The details of topographical anatomy have
  this peculiar feature, that, though they can only be learnt with
  infinite pains and labour, unlike other things hard to learn, they
  vanish and flee away with the greatest ease. I would confidently
  appeal to my audience of practical men, how much of the huge mass of
  minute facts, which in their youth they gathered with so much toil,
  remained fresh in their minds two years after they passed the
  portals of the College; and how much now remains to them beyond a
  general view of the parts of the human frame, and a somewhat more
  special knowledge of particular regions, their acquaintance with
  which has been maintained by more or less frequent operations. I
  would confidently ask them what is the ratio, in terms of money or
  any other value, which the time spent in those early anatomical
  struggles—say over the details of the forearm—bears to the amount of
  that knowledge remaining after twenty, or ten, or even five years of
  active practice, or to the actual use to which that knowledge has
  been put.

  “No, it is as a discipline, and not for its practical utility, that
  anatomy has been so useful; and this, indeed, may frequently be
  recognised in the questions set at examinations. When the candidate
  is expected to describe, within the error of a few _millimètres_,
  the structures traversed by a bayonet thrust obliquely through the
  neck, or is invited to reproduce written photographs no less exact
  of the parts which, from skin to skin, underlie a triangle or
  quadrangle drawn in ink on the front or back of the thigh, it is
  clear that the examiner has in view, not the needs of practical
  life, but an easy means of testing the proficiency of the student in
  mnemonic gymnastics. Of the value of anatomy as a discipline, there
  can be no doubt. In past years, it has served as the chief culture
  of the medical student—as the chief means by which the rough
  material coming up to our great medical schools were trained to
  habits of accuracy, of exactness, of patient careful observation;
  and their memories strengthened by exercise for the subsequent
  strain which would have to be put upon them by more strictly
  professional learning. In this aspect, the very sterility of the
  subject was a virtue. The mere fact that the separate details seemed
  to hang loosely, isolated in mental space, held together by no
  theory, by no ideas, inasmuch as it made the learning a harder task,
  increased its disciplinary value. Most wisely did the leaders of our
  profession insist that no trouble or expense should be spared to
  afford the neophyte this preparatory scientific training; and that,
  as far as examinations and the like can go, no pains should be
  spared to compel him to avail himself of the opportunities offered.
  Indeed, viewed as a branch of education, the machinery of anatomical
  instruction has for many years past not been equalled by any.”

Professor Burdon-Sanderson in his introductory lecture, says,—

  “The precious years which immediately precede a man’s entry on
  professional duty, are far too valuable to be wasted in learning
  anything he does not intend to retain.”—_British Medical Journal_,
  October 9th, 1880.

The observations of these most distinguishing physiologists and
teachers, support the view which has been taken respecting the education
of the Dental Surgeon, from the time the College of Surgeons was in 1857
asked to establish a Dental department, up to the determination of the
Dental curriculum by the Medical Council in 1879.

An education equal in degree, but different in kind to that of the
General Surgeon—an education which embraces a knowledge of the general
principles of Medicine and Surgery, and a special, precise, and
practical knowledge of Dental Surgery, was asked and given, the degree
of education progressing as the attendant circumstances allowed, up to
its present advanced condition.

The place assigned by Dr. Michael Foster to topographical Anatomy in
Medical education, will certainly hold good in the education of the
Dental Surgeon. Physiology and Chemistry, subjects now inseparable and
of surpassing interest, are equally necessary to the Special and General
Surgeon.

The position of Medicine and Surgery is not quite parallel. The general
principles of each must be thoroughly known, but it is not necessary
that the Dental Surgeon should be practically acquainted with all the
details that pertain to any other branch of either than that which he
selects to practice. It is not needful that he should become a skilful
midwife or oculist, or that he should be skilled in the treatment in any
other class of diseases than those to the treatment of which he proposes
to devote his life. For if he does acquire such detailed knowledge, it
will, when no longer used, “fade like a raindrop upon a porous stone,”
and the time devoted to the acquisition will have been wasted, and,
perhaps, worse even than wasted, for the subject may have been studied
at the cost of neglect of the practical study of his speciality. It does
not admit of doubt that the high degree of manual skill, without which
the professed dentist is but a shameless pretender, can be acquired
best, perhaps can be fully acquired only during youth; that if the
acquisition be put off till a medical education is completed, the golden
opportunity will have been lost. Mr. Fawcett tells us that the blind may
acquire manual skill sufficient to secure independence, but that it can
be gained only during youth. The adult blind, he says, have a greatly
diminished power of learning.

The time may come when the principles of Medicine and Surgery will be
taught before their special application to any particular class of
disease, and their modification resulting therefrom is entered upon.
Till that time arrive, it will be in the interest of the Dental Surgeon
to study with the utmost care the general principles and their
application to his own speciality, and to acquire, while he can, a very
full and perfect knowledge, practical, as well as scientific, of Dental
Surgery, before he enters upon a detailed study of their application to
any other branch or subject of Medicine or Surgery, the practice of
which he does not propose to follow, and a trustworthy knowledge of
which can not be retained or extended in the absence of continuous
general practice.

The qualified surgeon who has devoted himself to the practice of
dentistry, may be legally qualified to treat any and every kind of case,
but would he be morally right in undertaking the treatment of a case,
say of fever or of stone? all his knowledge of which diseases lies in a
misty memory of facts brought before his notice, and studied for a pass
examination in long past student days. As a matter of fact, the dental
surgeon of necessity limits his practice to his speciality, and the
general surgeon as a further fact, where selection is possible, declines
to take Dental cases, though legally entitled so to do. In the absence
of special training, he cannot be expected to possess the special
knowledge requisite to successful treatment, and to add the Dental to
the over loaded Medical curriculum, would be to greatly increase the
rejections which, in the case of the College of Surgeons, have already
risen to the formidable amount of upwards of thirty per cent. of the
candidates for diplomas. Hence it is that Dr. Michael Foster, in asking
for more physiology, asks for less topographical anatomy.

The Dental curriculum requires for its honest fulfilment, the whole of
the assigned four years, and more must not be attempted in the same four
years, for to repeat the words of Professor Burdon-Sanderson,—“The
precious years which immediately precede a man’s entry on professional
duty, are far too valuable to be wasted in learning anything he does not
intend to retain,” to which may be added, or which his subsequent
occupation will not allow him to retain. If then more medical knowledge
is required of the student than is embraced in the dental curriculum,
more time must be given for its acquisition.




                   Transplantation and Replantation.

                      (_Continued from page 425._)


At the period when transplantation was systematically performed, the
operators kept themselves supplied with an assortment of dried teeth,
_i.e._, sound teeth, obtained generally from the dead subject, to make
use of in case the tooth to be transplanted should not prove adaptable
to its new abode. The process is not spoken favourably of, as the
results were mostly unsatisfactory, but at times such teeth became
perfectly firm, and even resisted the greatest efforts at their removal.
We can hardly for one moment suppose that teeth in the condition these
were could have ever become attached to a living alveolo-dental
membrane, and the difficulty of accounting for this firmness would have
been great indeed, had it not been already solved for us. In
Langenbeck’s Archiv. für Chirurgie, vol. iv., is a paper on “The
Replantation and Transplantation of Teeth,” by Dr. A. Mitscherlich,
which deserves to be better known, and which, apparently, cannot have
come under the observation of those who recently contributed to the
_Lancet_ on the subject, the excuse for which is less, since it has been
translated into English.[2] The author, in addition to much interesting
and original matter, records the following experiment. In the upper jaw
of a dog of a year old, Dr. Mitscherlich inserted into the socket of an
incisor he had removed, a similar tooth taken from a dog’s skull, and
which he retained in _situ_ by means of a silver wire passed through a
hole in the tooth, and a hole bored through the alveolar process of the
jaw. “After six weeks the dog was killed, having been given during the
last few days three grains of picronitrate of potash three times a day;
the carotids were immediately injected. The muscles, like the gums, were
coloured yellow: neither, however, in the implanted tooth nor in the
sound ones was any alteration of colour perceptible. The silver wire was
porous, and no longer held the tooth; it was removed. The tooth was
quite firmly seated, and could not be moved in the least by the fingers.
The gums, as in the remaining teeth, were accurately applied both to the
alveolar process and also to the tooth itself, and nowhere could any
alteration be found in it. The tooth was sawn through lengthways,
together with the upper jaw, with a fine saw, so that the pulp cavity
was laid bare in its whole extent. The latter was only filled with a
little detritus, and no trace of the pulp was discoverable; none of the
injection, too, had been forced into the cavity. The tooth was
everywhere most intimately connected with the surrounding parts, and
suppuration showed itself nowhere. Of the periosteum, on the other hand,
there were only in a few places some small remains discoverable. On the
posterior surface of the tooth two small cavities were visible; the
larger of which lay more towards the point of the fang, and extended to
the pulp cavity; they were filled with a soft substance, and their walls
appeared roundish. These appearances were entirely confirmed by
microscopical examination, inasmuch as only in a few places, especially
on the anterior surface of the tooth, were traces of the periosteum to
be demonstrated; where this was absent the tooth was eaten away, and its
absorption had proceeded in such a manner, that a multitude of globular
elements appeared on the section, resembling the fragments which we find
in ivory pegs which have been bored into bones, and retained in them a
considerable time; in the two above-mentioned cavities the absorption
had proceeded farther and farther, and had at last attained its
above-mentioned great extent. The cementum could still be demonstrated
in certain places, it was, however, absorbed in the greatest part of its
extent. In the cavities of the tooth substance, masses of bone were
embedded, they were applied to the walls of the cavities without any
kind of intermediate substance, and so held the tooth with such
extraordinary firmness. This osseous deposit, which was directly
connected with the alveolar processes, was freely traversed with blood
vessels, which sometimes extended themselves close up to the tooth
substance. It was also so fully developed, that the process had to be
looked upon as fully accomplished, and therefore, a later exfoliation of
the tooth was not to be expected. The dentine itself showed nothing
abnormal.”

Footnote 2:

  “Archives of Dentistry,” Edited by Edwin Truman, vol. i., p. 169.

We have quoted the author of the foregoing at some length, as some of
his conclusions upon this interesting experiment might seem antagonistic
to our own. Thus, whilst we agree with him in concluding that a dead
tooth becomes united to a living jaw by a certain amount of absorption
of its fangs by osteoblasts, and a subsequent calcification of such
tissue, we do not believe such process as fully accomplished or
permanent. The valuable researches of Tomes and De Morgan show that
during life a continual process of formation and absorption is taking
place in bone, whilst the former has also pointed out that the process
of absorption in the fangs of temporary teeth is one alternating between
absorption and deposition, though in the end in favour of the former,
_i.e._, that the osteoblasts which effect the absorption of the dentine
often become calcified, but are again eventually decalcified and become
active osteoclasts. What determines these bodies to act, so to speak, in
a positive or a negative capacity would be most interesting to discover,
and, in considering the subject, we can hardly overlook the views of Mr.
Bridgman, who compares the process of bone formation and decalcification
to what occurs in an electrolytic cell, where, by changing the direction
of the current, the electrodes assume precisely opposite functions.

If, then, we could discover the conditions that would preserve the bone
tissue, in connection with the dentine, from undergoing decalcification,
we might, with every prospect of success, transplant dead teeth, but
which, as at present carried out, invariably, we believe, eventually,
suffer the fate of ivory pegs introduced into the extremities of bones
in disunited fractures. Indeed, this result, although more slowly
effected, appears nearly always to follow in those cases where the
transplanted or replanted tooth has lost much of its alveolo-dental
membrane; whether the excising of a portion of the fang, as advocated by
Magitôt, will prove beneficial or otherwise, remains to be seen.

Porcelain teeth having indentations in their fangs have been suggested,
first, we believe, by Mitscherlich,[3] and again by a recent writer in
the _Lancet_. The former actually attempted two cases, and with the
success we should have anticipated, for when after four or five weeks
the caoutchouc splint which retained them in _situ_ was removed they
immediately followed the splint and fell out. “Ossification had not
taken place; the entirely heterogeneous mass of stone had acted as a
foreign body, produced granulation and suppuration, and so prevented
union.”

Footnote 3:

  _Op. Cit._

In conclusion, we think enough has been stated to show that
transplantation or replantation of living teeth, or at all events, of
teeth having living alveolo-dental membrane may be exceptionally carried
out with benefit to the patient; if the chances of permanent success be
not very great the chances of injury are, we believe, small, and have
been greatly exaggerated. No such case has come under our observation,
but then in all we have witnessed, the transplanted or replanted tooth
has never been ligatured or otherwise forcibly retained in its alveolus.
We believe many of the cases of failure, as probably those also of bone
exfoliation, arose from this procedure. A tooth, after either operation,
although at the time perfectly adjusted to its proper position, becomes,
after a day or two, elongated from its socket and less firm; the result
of effusion into the alveolo-dental membrane and about the tooth; as
this material becomes organized it forms, no doubt, the medium of union
between the dental and alveolar portions of that membrane. At all
events, after a week or so the tooth again recedes into its socket, and
as it does so becomes firmer and less sensitive to pressure; if our view
be correct, the employment of a ligature or forcible retention of the
tooth can only be objectionable. A very different matter, however, will
be the adjustment of a plate contrived so as to protect the transplanted
or replanted tooth from violence or pressure until its attachment is
ensured.




                          Mercurial Amalgams.

                          BY M. G. CUNNINGHAM.


  After twenty-five years of stubborn fight supporters of gold as a
  filling for decayed teeth accept the possibility of plastic material
  being in certain cases its superior; throughout this period I have
  been content to hold my peace and act entirely on my own judgment in
  the selection of material, as however, it seems to be the fact that
  a man who uses plastic filling without danger of being termed a
  “quack,” may speak, I would, through your kind agency, convey to
  brother Dentists my method of preparing metallic amalgams, which has
  saved me much trouble and my patients a large number of teeth.

  In using amalgam, the first thing we ought to take into
  consideration is whether that which we are using and calling by that
  name is such, and I venture to say that in a very large number of
  cases it is no amalgam at all, but a concrete admixture of solid
  metals with liquid mercury. In the early days, when metallic
  precipitate of silver was employed, perfect amalgamation was not
  difficult to obtain, provided the precipitate had been in the first
  instance properly washed and carefully stoppered, the minute
  sub-division of the metal and absence of oxidation aiding largely to
  this result. The fillings of the present day are of a totally
  different character, coarse in grain, and of a nature to oxidize on
  even momentary contact with air, they become difficult to amalgamate
  with mercury, which, in itself, is a highly oxidizable metal, so
  that recourse is often had to a glass tube and violent agitation to
  produce that which is at best only a semblance of what it should
  be—a thoroughly homogeneous mass, that upon setting will retain a
  uniform texture and density proportionate to the constituents of
  which the fillings are composed. If, however, to the fillings and
  mercury be added a drop or less of sulphuric acid, either in the
  palm of the hand or mortar, it will be found that the metals will
  almost instantaneously amalgamate, whilst the oxides combining with
  the acid leave a residuum which, by its quantity, clearly shows what
  a very imperfect body could have been a so-called amalgam containing
  only a small portion of them. Washing in pure water at once removes
  all trace of acid, and a thoroughly reliable stopping can be at once
  produced from materials otherwise worse than useless.




          Introductory Lecture to Course on Dental Mechanics.

                           BY DR. J. WALKER.


GENTLEMEN,—The authorities of the Dental Hospital of London have
entrusted to me the heavy responsibility of lecturing on Dental
Mechanics for this present Session of 1880 and 1881. I have undertaken
this post with many misgivings; the subject is so wide and
comprehensive, the study so important to you now, and the effect of good
or bad teaching will so deeply affect your whole life, that I might well
have hesitated before finally accepting the duties that will now devolve
upon me.

I have taken a great interest in this Hospital and School from its early
foundation, when the pupils were few, and the School and Hospital had,
so to speak, to win its spurs; but in passing, I may here remark that
that small class of students, then a new feature in London life, by
their diligence, learning and conduct, have established throughout the
country a name and reputation that you will have to perpetuate. It was
by the combined efforts of the whole profession, and by the fact that
its senior members were able to point back to so many successful
students of this School and Hospital, now earnest practitioners in
nearly every large town of the British Isles, that the leaders of our
department of Surgery were enabled to bring this special branch before
the notice of Parliament, and obtain a Bill which now governs the method
and extent of the classes and hospital practice of all our schools.

As your lecturer, I may perhaps without egotism mention that I was one
of the six gentlemen appointed as the first Assistant Dental Surgeons to
this Hospital, while it was struggling through its first year of active
life. I remained at my post nearly ten years, until driven by increasing
practice to relinquish the work, then, as now, carried on in your
Hospital. It is the knowledge and experience I then gained, and the
lessons I have since learnt as the result of treatment in private
practice, that I have now to offer you—many failures and some successes,
many abortive schemes, and some inventions that have stood the test of
time.

My best thanks are due to the Managing Committee of this Hospital, for
electing me to be the colleague of such men as Alfred Coleman, C. S.
Tomes, and D. Lewis.

Gentlemen, I am fully conscious of the honour, and will do my best, if
health and strength are given me, to redeem in part the loss you have
sustained in the resignation of your late teacher, Mr. James Smith
Turner. I know that you and your companions in hospital practice held
him in high esteem. He has been a true friend to the London Dental
School. He had become a ripe and experienced teacher, one fully alive to
the best manner of treating his subject, passing by what the student
might gain for himself from books, to dwell upon those details that a
man of his experience could so fully grasp. But much as we miss him, we
may yet congratulate ourselves that we have not to mourn over the death
of so good and faithful a friend. He is now as actively at work in
another sphere of Dental life; he is even working harder than ever in
perfecting the work that has so prospered in the hands of Messrs. Tomes
and Turner. He is consolidating the Dental Act of 1878, making every
effort to render the Register of 1881 as perfect as may be, and to raise
the standard of Dental Education throughout Great Britain. That the
number of Dental Schools may be equal to what is now demanded by
students, the schools be sound in teaching power, the men elected as
teachers be conscientious in their newly appointed work, that full and
complete courses on each Dental subject be delivered—these are a few
items of his daily work. The end and object of his endeavours is that
the students in the various schools may gather wider stores of knowledge
during their curriculum, so that the various examining bodies may see
their way to enforce a higher standard of examination than is now
enforced to obtain the L.D.S. Diploma, and the coveted power of
registration.

Those gentlemen who were members of Mr. Turner’s class last year will
join with me in wishing him long life and energy to complete his
self-imposed task.

To come to the special subject of my lecture. At the risk of provoking
the well-known retort of “nothing like leather,” I venture to assert
that no man can ever prove himself a good Dental Surgeon unless he is a
skilled artist in Dental Mechanics. To kindle a spark of my own
enthusiasm for the subject, to fan that spark into a flame that shall
burn brighter and brighter in your life until you lay down the file and
the engraver, with a sense that you have done some good work in the
world, is at once my endeavour and my duty. A painter or sculptor of
eminence in his profession is frequently the leader in the fashionable
world, he is feasted by the city guilds, his company is sought by the
rich and noble, he has the _entrée_ to the literary circles of every
capital, yet the work of the artist is, at best, but to reproduce a
faint imitation of nature in cold marble or on inanimate canvass. The
subjects of your handiwork will be full of life and animation.

What is the necessary training for such accomplishments? A full and
perfect realization of all the forms of human beauty, and of woman’s
beauty in particular. Why do I dwell so much on the complete form of
beauty? Because no face can be perfect in beauty, unless its features
each and all are in harmony. The teeth have a peculiarly marked position
in relation to the features: one missing link in the circle will attract
attention and mar the harmony of an otherwise lovely face, like a false
chord in music.

Projecting, discoloured, irregular, misshapen, crowded teeth, all tend
to destroy symmetry. If so in the natural course of dentition, how much
more in the artificial!

I would urge you all to undertake at starting a thorough study of the
normal bones of the skull.

Normal bones of the face.—In the anatomical class at your general
hospital you will study the bones of the face in considerable detail,
but there your attention will be directed to the common or general
characters of the bones. You will there have to learn the usual shape of
the bones, their processes, ridges, grooves and depressions; you will be
shewn the characters, not only by which you may at once recognise them,
but which you may always recognise in them. I cannot too strongly urge
you to master all these details.

But, Gentlemen, here we have to study these bones in a practical manner;
we have to look upon them as parts of the living countenances of our
patients, and as no two faces are exactly alike, a study of individual
faces is necessary, as a groundwork for your success in practical
mechanical dentistry, and you must study individual specimens of each of
the facial bones. A careless observer of a crowd of negroes might think
they were all alike, because each had a black skin, woolly hair,
retreating foreheads, thick lips and white teeth. But yet a close
observation would quickly tell him in truth there came behind all these
coarse resemblances, minute, but noteworthy differences, differences
which he would be compelled to take note of before intercourse with them
would be possible. In the same way a general anatomist merely points out
to you how all palates are alike, and I want to go farther and shew you
with equal truth how no two are alike, but all differ. Depend upon it,
gentlemen, your usefulness and success will vary with your skill in
perceiving these lesser differences which characterise individuals. The
best name I can give to this study is comparative human anatomy.

Let us take some examples of what I mean. The upper jaw bone is the most
complex of all the bones of the face. Looking at its central part or
body we are first of all struck with the cavity in it—the antrum of
Highmore. Now, if you take a hundred bones, you will not be able to find
two antra exactly alike, but they will differ in size, in shape, in
depth, in width, and in size of their angles and inclination of each of
their walls. And all these peculiarities influence the countenance, and
must, therefore, be studied before you can hope to be successful in
replacing the lost dental organs. The high cheek bone of the Scotchman
is a very familiar example of the effect of a variation in the antrum.

The alveolar process.—The natural setting of the teeth varies also in
its depth, thickness, smoothness, irregularity, and most importantly in
its curve, which may be a broad, open semi-circle, or a narrow
semi-ellipse. The nasal process, too, varies as much in different
specimens; you will find differences in length, breadth, in the angle it
forms with the body of the bone, and with the frontal bones; all these
particulars modify the shape of the nose, and as I shall have to point
out to you, no feature is more worthy of your careful study than the
human nose in its numberless varieties. The malar process of this bone
has similar varieties. Notice again the palate plate how it differs in
breadth and arch, and so modifies importantly the roof of the mouth, to
which a denture has been adapted. The malar bones are unlike in
thickness, the size of their angles, length of their offspringing
processes, and in the exact mode of articulation with neighbouring
bones. See too, how frontal bones vary, in one case a broad, bold line
forehead, in another overhanging, in a third narrow and pointed, and you
meet with infinite varieties between these extremes.

In passing to the nasal bones, not only must we notice how they differ
in length and breadth, and the level of their edges, but that the shape
of their arch is constantly varying; it may be broad and rounded, or
narrow and high, even to sharpness. This depends upon the prominence
forward of the bony nasal septum, the interval between the nasal
processes of the upper maxilla, that is to be bridged over the breadth
of the nasal bones, and the exact mode of their articulation with the
upper jaw bone. Not alone does the usual arch differ thus, but most
obviously on the angle it forms with the frontal lines.

From your own observation you will at once grant me that noses vary as
much as families; in fact I am inclined to think that there is a good
deal to be said for Mr. Shandy’s philosophy of noses. The cartilages of
the nose play a most important part in the shape of the organ, and
demand your study as much as the bones. Each variation in the shape of
the nose has a corresponding variety of upper lip, and the correlations
between these two must be most carefully attended to. Granted that these
differences are so numerous, you must admit that the nose must have
primary importance in the estimate of the Dental Surgeon, when called
upon to restore the lost Dental organs. I may remark that although I am
examining noses every day of my life, I have never yet found one
assuming a direct line with the other central lines of the head and
face.

To arrive at a just appreciation of the effect of these bones on the
lines of the face you must examine them in the articulated skeleton, not
in one instance but in many—fifty or even a hundred—make weekly visits
to the Museum of the Royal College of Surgeons, and there examine all
the specimens of articulated skulls and skeletons, until you fully grasp
the meaning of comparative human anatomy—the size, the shape, the
relative acuteness of angles, the proportions of the different parts. It
is this relationship, the articulation of each bone with the other bones
of the skull that is of primary importance to the Dental Surgeon.

The last bone that I shall mention to you this evening is the lower jaw,
perhaps the most important of all. You will all soon be taught that it
has a body, a symphysis, a ramus with its condyle, coronoid process and
sigmoid notch, an alveolar process, and various tubercles, ridges,
spines, grooves, and depressions. But beyond all such facts, be at pains
to notice, gentlemen, how all these various parts differ in different
specimens. The changes in the angle of the bone that are met with at
different ages are notorious, but you will have to learn that the angle
of every adult differs, that each form of countenance has its special
maxillary angle, nor are the depth, thickness, curve, obliquity and
relative prominence of different parts of the bone one whit more
constant, and if you would succeed in fitting artificial dentures to a
lower jaw, these individual peculiarities of the bone must be carefully
studied.

The Dental organs will be presented in full detail by my colleague, Mr.
C. S. Tomes, but I should fail in the one point of my brief sketch, if I
did not refer you to the fact that no circle is found exactly
corresponding with a second in the articulation of the thirty-two teeth
implanted in the maxillary bones. My remarks culminate in this
apparently strange contradiction, no two sets of teeth ever describe the
same circle at any age. The differences in children are only slight, yet
a difference exists; the older the subject, the greater the contrast
visible. Yet harmony exists in the lines of the face; once acknowledge
this and you will perceive the labour and investigation necessary to
make you grasp the subject in its broadest sense.

Take, for instance, a patient at the age of sixty, with edentulous jaws,
requesting artificial dentures to be prepared at your hands. For such
mechanism to be successful in the restoration of the contour of the
face, it will be necessary that it shall harmonise with the features;
you must carry your perception backwards to the appearance that this
face presented when he had only attained the age of thirty: this will be
the art and science expected at your hands.

Not to lengthen this my introductory lecture, by labouring to define the
various types of English faces, when the bones are covered with the soft
parts, I have selected a few outlines of faces such as a sculptor and
painter would study. Cast your eye upward, you will see that each
possesses its own characteristic and alterable features. So in life; and
if you gentlemen are to be true Dental Surgeons, you must rise to the
ideal of artistic mechanics. If I am to benefit you to the full bent of
my wishes, you must study nature in all its variety—nature when
presented to you as destroyed by premature disease and death, to be
restored by your hand to its original conformation. Remember that use
must follow beauty, one cannot be dissevered from the other if you would
obtain results, complete in power of mastication, speech, durability,
and appearance.

To win success in appearance, you must study the irregularities of the
natural projection of circle, and the character of circle. If any
irregularities are observed, take a model cast of the mouth, so that you
can compare the natural organs whilst the artificial are in progress of
arrangement; modify these irregularities, but do not efface their
existence altogether. The general conformation of the Dental organs and
the face must be your special study. The colour of the teeth to be
selected must receive at your hands great care: compare the various
tints at your disposal, ascertain if a perfect self colour, or a tinted,
shaded, or stained tooth is the most pleasing; which will harmonise best
with the complexion, producing a natural effect. It will be your object
to disguise that the new introductions are foreign bodies, endeavour to
make them appear as if they possessed life. Many colours absorb so much
light that at night the appearance they present is black and death-like.
Avoid such shades, select those that reflect light; in many cases the
teeth should be almost transparent. The colour of the hair, the nature
of the complexion will guide you in this endeavour; hair and complexion
must harmonise. A heavy, wavy head of hair, dark and massive, with
bronzed face would indicate a strong shaded tooth, solid in character
and non-transparent, yet a colour that will reflect rather than absorb
the rays of light. A Saxon face with fair hair will strongly puzzle you
at times; the pearl hued, thin and transparent teeth, as a rule, are
appropriate for such a face.

When articulating the dentures, every care must be taken and much
thought and study bestowed to adjust the depth and height of the
superior and inferior dentures to the length and depth, to the thickness
or thinness of the lips. Note and estimate the loss of structure by
absorption, and supply in proportion to the loss.

The circle and projection as above alluded to will be your special
study. Give hours to produce a natural expression. Propose to the
patient a short walk in your operating room; if a good corridor is at
your disposal, so much the better, use it. By so doing you will
ascertain what, if any, old habit of contortion of features is indulged
in by the patient; the character of the laugh, if the lips are raised,
and how much; at times only the tips of the teeth are manifest, at
others the full lip is raised exposing to view the crown of the tooth
and the alveolus, even to the lower margin of the meatus of the nose.
Arrangements equal to all these expressions must be adopted. The how,
will be told you in future lectures.

Then, again, the smile; the smile of a Desdemona and the smile of an
Iago! yet how much in a smile! Harmonise your mechanism so that the
smile of the patient shall be rendered as natural and full of meaning as
art can make it. The movements of the lips and tongue in speech must be
as carefully studied; the eloquence of the orator and the no less
eloquent prattle of a pretty woman. During the visit of your patient
strike out a conversation that shall put him at his ease, and show him
at his best; this will aid you in observing what is required to render
conversation easy to himself and acceptable to his hearers. Notice that
the head is never carried in a perpendicular line with the body; at
times it leans to the right or the left, the effect of this inclination
is to lengthen in appearance the teeth of the incline. Notice also, many
patients have the ungainly habit of twisting the lips out of the natural
line of the head and face.

It is by attention to all these details that the results of your work
will be noble, your claims to reward great, your satisfaction not less
in its kind than that of the sculptor or the painter; whilst they can
only charm the happy, it is yours to relieve the suffering, to alleviate
pain, and even to prolong life and restore lost beauty.




 Special General Meeting of the Midland Counties Branch of the British
                          Dental Association.


A Special General Meeting of the Midland Counties Branch of the British
Dental Association, was held on Wednesday, 6th October, in the Memorial
Hall, Albert Square, Manchester. The President of the branch, H.
Campion, Esq. (Manchester), presided, and there were also present,
Messrs. S. Wormald (Treasurer), Stockport; Dr. W. H. Waite (Secretary),
Liverpool; W. H. Nicol (Leeds); R. E. Stewart (Liverpool); Dr. D. A.
Wormald (Bury); T. Murphy (Bolton); Q. Renshaw (Rochdale); W. H. Ridge
(Stafford); T. Mahonie (Sheffield); B. Harding (Manchester); T. C.
Parson (Clifton); H. Marsh (Manchester); T. Dilcock (Liverpool); D.
Dopson (Liverpool); L. Matheson (Manchester); W. Dykes (Manchester); W.
Headridge (Manchester); J. G. Roberts (Liverpool); W. Taylor (Batley);
W. Shillinglaw (Birkenhead); J. S. Crapper (Hanley); and R. Rogers
(Cheltenham).


                    THE MINUTES OF THE LAST MEETING.

The first business before the meeting was the reading of the minutes of
the last meeting. They were taken as read.

The following letter was read by the Secretary (Dr. W. H. Waite):—

     “_To the Hon. Sec. of the Midland Branch of the British Dental
                             Association._

  “DEAR SIR,—I have much pleasure in informing you, that at a meeting
  of the business Committee of the representative Board of the British
  Dental Association, held on the 1st instant, Edward Saunders, Esq.,
  in the chair, the proposed bye-laws having been approved of, the
  Midland Counties Branch of the British Dental Association was
  formally affiliated with the Central Body.

  “According to the desire of the meeting, I have to convey to you our
  best wishes for the success of your efforts.

                                “Yours very truly,
                                      “JAMES SMITH TURNER,
                            “_Hon. Sec., British Dental Association_.”

The report which was then read by the Secretary, was as follows:—


                           REPORT OF COUNCIL.

As this is a Special, and not an Ordinary General Meeting, and as the
Council have only met once, there is not much upon which they can
report. In accordance with the resolution adopted at the last meeting,
circulars inviting practitioners in the Midland District to join the
Association, were issued to every name on the Register. Up to the first
of August, the Secretary had enrolled 33 members and 6 associates, and
since that date there have been six applications for membership, five of
which the Council have this day admitted, viz., Messrs. R. Rogers,
Cheltenham; T. C. Parson, Clifton, Bristol; T. Wormald, Oldham; B. L.
Harding, Manchester; W. H. Ridge, Stafford. The election of members will
be by ballot, at the Council meeting following the date of application,
and the vote of two-thirds of those present, will be necessary to ensure
election.

A book has been provided for the entry of names of members attending the
meetings, and your Council have further arranged for the admission of
visitors, each member having the privilege to admit two visitors, whose
names and addresses should be entered in a column provided for the
purpose.

The Council have nominated Mr Major Stewart of Liverpool, as first
Vice-President of the branch, and they recommend that the Annual Meeting
in April next be held in Liverpool.

An analysis of the Dentists Register shews that 1,400 names have been
enrolled, of gentlemen engaged in the practice of Dentistry, in the
Midland Counties.

Of these, about half are registered as practising in conjunction with
pharmacy, and of these last, a considerable number—are names not to be
found in the Chemists’ and Druggists’ Directory. Some difficulty is
encountered in attempts to verify cases of incorrect registration on
account of changes of residences, alterations or errors in spelling,
&c., this pertains to both the Dentists’ and Chemists’ Directory, so
that it is not easy to identify positively in all instances. If
gentlemen, who may be aware of the facts in any locality, would be at
the pains to collect them, and submit them in a concise form, so as to
furnish clear and trustworthy evidence of fraudulent registration, it
would be of great service. Any one practising Dentistry, but who is not
on the register, or anyone on the register, who can be shown not to have
been in the practice of dentistry at the date of the Act, these are the
two kinds of error it is desirable to expose.

It need scarcely be stated that an increase of members, both of the
Central Association, and its separate branches, is absolutely necessary
to enable the Executive to carry out the provisions of the Act, and
there is little doubt that with moderate effort, we may all succeed in
inducing others to join. The Association is destined to represent the
profession in the future, and it is our business to make its
representative character a living reality, and not a mere empty name.

Mr. J. S. CRAPPER (Hanley), moved the adoption of the report. It was
seconded by Mr. Headridge (Manchester), and carried.

Mr. Major STEWART, of Liverpool, said that as his name had been
mentioned in the report, he begged to thank them for the honour they had
conferred on him by electing him Vice-President of the branch. He
thanked them, on behalf of his brethren in Liverpool, for the honour the
Society had conferred on them.


                        THE PRESIDENT’S ADDRESS.

The PRESIDENT then delivered his address, and said:—

Gentlemen,—It is my pleasing duty in the first place to thank you, not
only for the kindness you have shown in electing me to the responsible
position of President of your Branch, but also for having given me the
honour of being the First President of the First Branch of the British
Dental Association.

I need scarcely say that the fact of our meeting here to-day as we are
now doing is a subject for congratulation, and the presence of so many,
and the distance some of you have come, proves the interest you take in
the great movement of the day, which has called into existence the
central Society of which we now form a branch.

Every new movement is sure to give rise to more or less excitement and
sometimes to great expectations, and I must, therefore, beg, first for
myself, your kind forbearance for my numerous shortcomings, of which I
am only too conscious; and secondly, for your society I must also ask
your kind consideration, if at the first it seems to you scarcely to
come up to the high standard of your anticipations, requesting you to
remember that it is still in its infancy, that it has commenced its
existence under difficulties, and I regret to say, not without some
opposition. It will, therefore, require care and energy, not only on the
part of the Executive body, but also in each individual member, to bring
it to that state of maturity we all are anxious to see it attain. I feel
certain from your presence here to-day that you have the interest of the
Society at heart, but I venture to remind you that the simply feeling an
interest in a thing is not sufficient in itself to command success.
_That_ is a result which requires, especially in these days, both energy
and labour, and we must never forget that our future position and
progress as a Society, will mainly depend on our own individual efforts,
since we are each of us an individual unit, the aggregate of which units
forms the Society itself.

It would be natural for you to expect in this, the first introductory
paper, a history of the origin and objects of the Society, but these
were so ably treated of by the worthy Secretary of the Society on his
visit to Manchester, and so many of you were present at the London
meetings, and so much has been already written on the subject, that it
would not only be superfluous but also presumptuous for me to attempt
what has already been done by others so much more competent than myself,
and I am therefore deprived of what would have been an interesting topic
for an address; but although the past and the present have thus been
taken from me, there still remains the future; and as I hope that in
that future our Midland branch will ultimately form a not unimportant
unit, I will therefore restrict what I have to say mainly to the subject
of the branch itself, and in doing so must crave your kind indulgence
for the many imperfections in my efforts, urging as my excuse the little
time that numerous professional and other engagements leave at my
disposal.

Here, I think, we may congratulate ourselves, that we exist as a branch
of the British Dental Association and not as an independent Society, for
I am sure we all feel that the scheme for the elevation of our
profession to its proper position, which that Society has been formed to
promote, has been most judiciously planned, and has thus far been most
efficiently carried out—a scheme, which whilst it in no way discourages
the attainment of the higher qualification of full membership of the
Royal College of Surgeons, in those who are anxious to distinguish
themselves, and possess the means and opportunity for so doing, provides
an efficient education in all those scientific and practical subjects
which it is necessary for a Dentist to know, and by means of the Dental
Diploma, affords the public a guarantee that the possessor of that
diploma has passed through a curriculum of such a standard as fully to
qualify him for the practice of the branch of surgery which he
professes. Nor must we allow to pass unnoticed the utter unselfishness
of its promoters, who laboured out of pure love for their profession,
knowing that they could never expect to see the good result of their
labours in their lifetime, unlike the man who is said to have remarked
that he never could see the good posterity had done for him that he need
trouble himself about posterity: and as was the case with many of those
grand memorials of the loving zeal and devotion of our ancestors, those
noble cathedrals with which so many parts of our country are adorned,
one generation was satisfied if they were able to lay the foundations
and were permitted to see some portion of the superstructure erected
during their lifetime, so in like manner, we must wait and not be
discouraged if we are unable to see the full development of the present
movement, but should consider it a privilege to be permitted to assist
in however humble a degree, in taking part in what we fondly and
reasonably hope will prove the formation of a grand future for our
branch of surgery.

To our Secretary and Treasurer are due, I believe, the credit of having
originated the branch, and I take this opportunity of saying that I am
unable in any way to claim a portion of that credit for myself, for I
gather from a letter in one of the journals, that I was not only
believed to have been one of the promoters, but that I was thought to
have been guilty of an act of discourtesy in what I had done, or rather
in what I had not done. I knew nothing of the project till I received a
printed circular inviting my co-operation, and it was not till after the
lapse of many weeks that I found myself able to join in the scheme. The
promoters worked hard in drafting the bye-laws and arranging the other
necessary preliminaries, but I am sure I may say for them that they feel
amply rewarded by seeing their pet child, over which they have laboured
so long, fully recognised as a legitimate offspring of the British
Dental Association.

The objects of the branch, you see by the bye-laws, are fourfold:—

1. To render assistance, as far as possible, in carrying out the
provisions of the Dentists Act.

2. The general consideration of subjects affecting the interests of the
profession.

3. The reading and discussion of papers on Dental Surgery and Mechanics.

4. The cultivation of a generous professional spirit amongst
practitioners throughout the district.

With respect to the first object, I think the purport of the Act is so
clear that it requires but few remarks from me. It is impossible to draw
any definite line where the help of an unqualified person must cease and
that of the duly qualified practitioner commence. Any one who dresses a
wound or a bruise, or reduces a dislocation, practises surgery, and no
one could for a moment imagine that a law would ever be passed to
prevent his doing so; and in like manner, we could not expect that the
legislature would ever allow the drawing of a tooth or any other similar
operation to be made a penal action, although the person so doing may be
said to be practising Dentistry; but as soon as any one endeavours to
make the public believe he is a qualified practitioner, by assuming the
title of Dentist or any other name implying the possession of the Dental
diploma, so soon he becomes amenable to the law; the act thus
guaranteeing to the public, that _for the future_, any one who claims
the professional title shall of necessity have obtained the necessary
qualification. Any person, or any number of persons, who may wish to put
the act in force in any particular case can do so, but before taking
action it will be necessary to obtain the sanction of the Medical
Council. This at first sight may seem to be an unnecessary precaution,
yet I think on further consideration you will admit that it is a very
wise provision, as it entirely prevents the possibility of any one being
proceeded against from personal pique or any other improper motive; and
if in any case it is thought desirable that a person’s name should be
removed from the register, all that is necessary is to collect
sufficient _reliable_ evidence, and transmit it to the central board in
London, who will bring the matter before the Medical Council, the only
body by whom such action can be taken. And in cases where these
proceedings may be necessary, I am sure they can be carried out without
earning for ourselves the opprobrium of acting as spies or professional
police, which some have already been willing to assign to us.

With regard to the second object of the Society, we must all feel that
the interests of the profession will at times require the careful
consideration of its members, and necessitate the existence of some
organised body which shall be able to act with the authority of the bulk
of its members, and for this, no better scheme can be devised than the
one we are now so much interested in—the formation of a central society,
with recognised branches in the more distant parts of the country,
constituting an organisation by which the feeling of the majority of the
profession may at any time be ascertained on any question that may arise
bearing on the well being of the profession.

In the third object, “The reading and discussion of papers on Dental
Surgery and Mechanics,” the surgery you will notice is placed first, and
justly so, as the higher branch; though in early times, and I fear even
to a more recent date, the order in importance was more frequently
reversed in practice. The mere mechanical calling of former times—for in
its infancy Dentistry was little else—has now been developed into a
profession and gained admission within the sacred portals of the College
in Lincoln’s Inn Fields, and it is for the present and future
generations to prove by the exercise of their highest mental as well as
mechanical faculties, that the profession is worthy of the position
which has been accorded to it.

It has been noticed by those who most frequently attend the meetings of
our speciality, that papers on mechanical subjects are more easily
procured, and often prove more attractive than those on surgical
subjects, but this will no doubt become less as the educational
facilities of the present day are brought to bear more and more on the
whole body of the profession. Surely the preservation of the natural
organs is of far more importance and value to the patient than the
substitution of others, however efficiently supplied.

What should we think of the surgeon who allowed himself to be deterred
from directing all his energies to the preservation and restoration to
health, of a diseased or injured limb, by the thought that an artificial
substitute could be provided for it. No! No! Whatever our politics may
be let our surgery be conservative. Far be it from me to appear to
undervalue any branch of my profession, for no one can have been long in
practice without having experienced the well earned gratification
derived from noticing the relief from pain, and in many instances the
perfect restoration to health, that follows the substitution of
efficient members in the place of useless and diseased ones; but far
greater is the credit and higher the appreciation of the patient, when
the diseased natural organs themselves can be preserved and restored to
a state of efficiency; and how great are the facilities for so doing in
the present day, compared with the early reminiscences of many of our
older brethren. All of us who were fortunate enough to hear the
interesting paper read before the General Meeting of the Society in
August last, must have been forcibly struck with the contrast between
the paucity and quality of the instruments there mentioned, and the
appliances of the present day. What would have been the feelings—I might
almost say the bewilderment of the practitioner therein described, could
he have been transported into one of the large depôts with which we are
so familiar. The numerous and beautifully adapted instruments for the
variety of operations unknown in those days. The admirably adjusted
forces for each form of tooth, the endless variety of excavators and
pluggers, the wonderfully delicate nerve extractors, the rubber dam and
its adjustments, the saliva pump, the electric mallet, the improvement
in our chairs, and that greatest of all boons, both to patient and
operator, the Morrison engine, the name of the inventor of which
valuable instrument, ought to be indelibly inscribed in letters of gold
in the Archives of Dentistry, to say nothing of the application of
vulcanite and celluloid, and the many ingenious appliances for the
workshop. Surely these should lead us to value the benefits we enjoy,
and teach us to strive to use them to the best of our ability, not
influenced by the thought of self-glorification in attempting to surpass
all others, in the performance of this or that brilliant operation, but
ever remembering that the ultimate aim of all our efforts should be the
increased amount of good which we are thereby enabled to accomplish for
the benefit of our suffering fellow-creatures.

Although the _Transactions_ of the Odontological Society contain a very
voluminous and valuable collection of papers bearing on one speciality,
there still remain numerous subjects and modes of operating which may be
made productive of profitable discussion. Such are the replantation of
teeth now attracting so much attention, the erosion of the surfaces of
the teeth of which so little is known in the present day. The various
improvements in the materials for filling, and amongst a variety of
subjects, far too numerous to be mentioned here, the startling
announcement of the so-called New Departure Creed.

As this last is a subject which I think we all feel greatly interested
in, and also bears on the branch of Dentistry which we are now
considering, I will venture a few remarks on some of the articles of the
accepted and new departure creeds as tabulated in the _Dental Cosmos_.

I am not aware that the so-called accepted creed has been the recognised
standard of practice in this country. The doctrine that gold, and
nothing but gold, should be used for permanent fillings, has certainly
been extensively promulgated by those of our Transatlantic brethren who
have settled in this country; and I cannot but look upon this new
departure, as the natural reaction which might be expected to follow the
over anxiety to build up large adhesive gold fillings, on fragments of
weak and often disorganized teeth, totally unsuited for such an
operation; but until I can see some stronger reason than has been
hitherto adduced by the advocates of this new departure, I must, in any
case suitable for a good gold filling, confess my unwillingness to
abandon for any other of the fillings now in use, a material that we
know from past experience is capable, when judiciously applied, of
preserving and restoring to a state of efficiency, in some cases for a
period of twenty years or even for a much longer time, teeth which
otherwise would have been lost in about the same number of months. For
the efficient use of this material much must of course depend on the
manipulative ability of the operator, but it has often seemed to me a
matter of doubt, whether, in the case of those large adhesive gold
fillings, the patient has received an equivalent for the tedious and
necessarily expensive operation that has been undergone.

The choice between contour fillings and separation of the teeth in the
case of approximal cavities, must, I think, depend in a measure on the
aptitude and judgment of the operator, since the two plans when
successfully performed, may be made equally efficient. The latter
however—separation—seems to afford greater facilities for operating, and
also for cleanliness in those patients who are unable or unwilling to
devote the time and attention necessary for that object.

The professed incompatibility of gold as a filling material with tooth
bone, seems to me to be at variance with the frequent success which we
all must have experienced, in the use of that filling in cavities on the
labial surface of the roots of the upper incisors. I mention this
particular position as being easy of access for operating, and also as
being one where the enamel, tooth bone, gold, and saliva, are in
constant contact with each other. In those cases where the success of
the operation has not equalled our expectations, in endeavouring to
estimate the probable incompatibility of the filling material as a cause
of failure, it is, I think, necessary to consider whether in the
ordinary operation for filling, the whole of the diseased dentine has
been so thoroughly removed, as to admit of its proving a satisfactory
test case, for the microscope reveals to us a change in the dentine in
the sides of a decayed cavity, even when it appears sound to the eye,
and also to the feel of the instrument; and in those portions of the
margin of the cavity which we undercut for the retention of the filling,
we have the dentine not only denuded of its nutrient covering, the
periosteum, but also deprived of its nutrition from the pulp by the
severance of the tubes of the dentine, and the intervention of the
filling material, and in this deteriorated condition, in all probability
still exposed to the continuous action of the same deleterious
influences (whatever they may have been) which first caused the decay;
and I cannot but think that the failure when it occurs, is in a greater
measure due to the above named causes, rather than to the
incompatibility of the gold with the tooth bone; but with all the
success that has attended the use of gold for so many years, we must
still, I am sure, be willing to admit the want of a perfect plastic
filling, which shall be able to withstand the friction of mastication,
and also the deleterious action of the fluids of the mouth.

The dictum that, “a tooth that can be so treated as to be satisfactorily
filled with anything, is worth filling,” is one, I think, that all who
value conservative surgery must readily agree with.

That “unskilful and unscrupulous Dentists fill with tin covered with
gold, thereby causing galvanic action, pulpitis, death of the pulp,
abscess, and loss of the tooth,” has certainly not been an accepted
creed in this country, for I was early taught the use of this material
both alone, and in combination with gold, when I first commenced the
study of my profession with Mr. Sheffield, of Exeter, and long
experience, and the retention of a tin filling in my own mouth, in a
perfect condition for over five-and-twenty years, has fully proved to me
the value of this metal. When used in combination with gold, and exposed
to contact with the fluids of the mouth, it certainly undergoes a
chemical change, becoming nearly black in colour, but without staining
the tooth as some amalgams do; it also becomes harder, and cuts harsh
like an amalgam filling, but the change does not appear to cause any
alteration in its bulk, or in any respect to interfere with its
efficiency as a filling, nor have I ever found it produce any of the
evils suggested in the creed, and I cannot but think that it would be
more used, were it not for the universal prejudice that exists in the
mind of the public in favour of gold, partly arising from the magical
charm which resides in the word gold, and partly from the nothing but
gold theory (if I may so call it), which has been so largely spread by
our American brethren.

That “a filling may be the best known for a tooth and yet leak badly,”
seems a simple admission that in some cases bad is the best that we can
do for them. If experience has taught us anything, it certainly has
proved that it is the leak which does the mischief; and as in warfare no
fortress is considered stronger than its weakest part, so is it with a
tooth that is filled. A small leaking point will soon undermine the
filling, and prove its ruin.

The statement that “gutta-percha _properly used_ is the _most permanent_
filling material we possess,” must make us wish to know the meaning of
the words, “properly used,” for the rapidity with which it wears away,
in any position in which it is subjected to friction in mastication,
seems to me to prevent the possibility of its ever being permanent.

The force of the article which says that “a poor gutta-percha filling,
_in its proper place_, is better than a _good_ gold one,” seems to
depend on the question as to what is the proper place for a gutta-percha
filling: surely not the place where we can insert a good gold plug, if
by “good,” is meant one that is not only solid, but also sufficiently
tight to exclude all moisture from the cavity.

It certainly is rather startling to hear from the country from which
have come the severest criticisms on the use and the users of amalgam
fillings, the admission that “amalgam per se, is an excellent filling
material.” With amalgams, as with the other plastic materials, a
_perfect_ filling of its kind has yet to be discovered, for a measure of
uncertainty seems to exist in all of them; but as a proof that an
amalgam _may_ make a good useful filling, I can say that I have seen
more than one apparently in a perfect condition after thirty years’
wear, and I cannot but think that much of the discredit attaching to its
use, arises from its being the filling we naturally have recourse to in
all cases of doubt and difficulty.

That “the use of plastic filling material tends to lower the standard of
Dentistry, thereby diminishing its sphere of usefulness,” is scarcely a
fair way of stating the matter. The indiscriminate use of them would
certainly do so, but the judicious selection of them in cases unsuited
for the use of gold, need not necessarily interfere with the acquirement
of the manipulative ability necessary for making good gold fillings, nor
is it desirable that it should do so, as the power of manipulation
required for the successful use of gold, must tend to perfect the powers
of the operator in the use of all plastic materials, and must thus
extend the sphere of usefulness of that Dentistry which has for its
standard of excellency, ability to save teeth.

Time has only permitted me very briefly to notice some portions of this
new creed, to show that it contains much that might be productive of
profitable discussion, but I think from what has been said, we may
reasonably conclude that each material has its own particular
advantages, and that until we are in possession of a filling suitable
for universal application, a judicious selection is necessary on the
part of the operator in each particular case.

The fourth, and not the least important object of the society is “the
cultivation of a generous professional spirit amongst practitioners
throughout the district,” and to this I hope may be added throughout the
whole body of the profession; for the knowledge that we are branches of
one central society, should lead to a feeling of fellowship not only
with the members of the parent society, but also with the members of the
other branches, and surely it is not too much to hope, that with the
extension of the Society and its branches, and the feeling of
professional brotherhood thereby engendered, we may see the gradual
increase of that Christian charity which “thinketh no evil,” and which
would scorn all attempts at self-exaltation, by the disparagement of the
efforts and qualifications of a fellow practitioner, which I fear has
been greatly encouraged by the isolation that has so long existed in our
speciality.

Nor must we omit to notice the great benefit to be derived from the
friendly discussion of subjects in which we are all mutually interested,
not only to the profession at large, but also to each one individually,
for which of us in his early days has not felt the wish that he had
thought of this or that other mode of treatment in some particular case;
and what more likely to impress new ideas on the memory, or, to use a
familiar expression, make us “have them at our fingers’ ends” (the place
where surely they are wanted when operating), than the friendly
discussion of them which it is one of the objects of our Society to
encourage?

The President of the Western branch has held out to us the hand of
fellowship, which I am sure I need not ask your permission to be allowed
to reciprocate most fully—not only in the wish for their future
prosperity, but also in the assurance that any of their members who may
have an opportunity of attending our meetings, will at all times receive
that cordial welcome which it should be our greatest pleasure to extend
to all the members of our Society and its branches, thus realizing one
of the great objects of our Association, and proving not only by our
words, but also by our actions, that we are anxious to encourage that
professional intercourse which must tend not only to our mutual benefit,
but also to that of the community at large; and if, as their President
remarked, it is a pleasure to them to think that in the formation of our
branch we show “the benefits resulting from the good example they have
set us,” it is no less a subject of congratulation to us to know that
they have at last recognised the good which is likely to accrue, both to
themselves and to the profession generally, by following our example,
and forming themselves into a local branch of the British Dental
Association.

And now, fearing that I have already trespassed too long on your time
and forbearance, it only remains for me to thank you for the kind
reception you have accorded me, and to express the belief that, although
the barque which we have so successfully launched will probably meet
with the usual amount of storms and difficulties, still the old
proverbial “long pull and a strong pull and a pull all together,” in
which you are so able and willing to join, will carry it securely
through the many undercurrents and quicksands which may threaten it on
its course, and secure what we all so ardently hope for—a useful, as
well as a long and prosperous career, for the Midland Branch of the
British Dental Association.

                  *       *       *       *       *

Mr. MAHONIE (Sheffield), moved a vote of thanks to the President for his
able and eloquent address, and in doing so, said that when the
Association was weak, Mr. Campion had come to their aid in a very
courteous manner, and they were now asked to give him their heartiest
thanks for the paper which they had just heard read. The paper was one
which would last more than a year. It was very instructive, and he (Mr.
Mahonie) thought that Mr. Campion was eminently capable of giving them
instructions in the way of Dental Reform. He moved “That the best thanks
of this meeting be given to the President of the Midland Counties Branch
of the British Dental Association, for the able and eloquent paper which
he had just read.”

Mr. W. H. Nicol (Leeds), seconded the motion in suitable terms.

Dr. W. H. Waite in supporting the motion, said that it was a very great
privilege for them to have such a President as they had in Mr. Campion.
His wisdom had been of great service in superintending the efforts which
the Executive have had to put forth. They had been delighted that
morning with the interesting and instructive address which Mr. Campion
had given them, but most of all with the very high and generous tone
that breathed throughout the whole of the address, and he (Dr. Waite)
thought Mr. Campion had struck a key-note which, when the address came
to be printed, would vibrate not only throughout the Midland Counties of
England, but through every country where the Dental profession was
carried on. The motion was carried with much enthusiasm, and the meeting
then adjourned till the afternoon.

                  *       *       *       *       *

The Members assembled in the Memorial Hall at 2.30 p.m., Mr. Campion in
the chair.

The PRESIDENT stated that some idea had been started of bringing
specimens to the meeting, and in order to show what curiosities might be
casually collected, he offered a few specimens to the notice of the
Members.

Mr. ROFF KING, Shrewsbury, then read a paper on “Modelling and Modelling
Composition.”

Mr. J. S. CRAPPER (Hanley) read a paper, entitled “New Ideas in
Mechanical Dentistry,” and exhibited specimens of teeth which had been
manufactured by a new process and sent to him to exhibit.

The SECRETARY read a paper received from Mr. F. Richardson, Derby—“Has
Vaccination any Effect on the Degeneration of the Teeth?”

Mr. H. MARSH (Manchester) read a paper on the “Use of Nitrous Oxide
Gas.”

Mr. MURPHY desired to ask the Chairman whether Licentiates in Dental
Surgery were legally responsible if a patient expired whilst under the
influence of the nitrous oxide gas, or subsequently to the
administration.

In the discussion which followed, there appeared to be a unanimous
opinion amongst those present that Licentiates were not responsible, but
that it would be impossible to define such a position.

The SECRETARY read a letter from Mr. Kyan of Preston, in which that
gentleman expressed his regret at his inability to be present, and hoped
the Members would have a successful meeting.

Mr. RENSHAW moved a vote of thanks to those gentlemen who had furnished
them with such interesting and instructive papers.

Dr. D. A. WORMALD, in seconding the resolution, said they could, with a
little energy and support, make that Society very successful, and as a
representative body on behalf of their profession in the Midland
Counties, they could maintain such a position that it would become an
honour to belong to it.

The CHAIRMAN remarked that it was no light work to prepare such papers
as they had heard read; much time and trouble must have been spent in
the digest of the various subjects. He gave the hearty thanks of the
meeting to the contributors of those papers.

The resolution was carried unanimously.

Mr. Major STEWART proposed a vote of thanks to Mr. Campion for
presiding.

Mr. KING seconded the motion, which was carried unanimously.

The CHAIRMAN (Mr. Campion) returned his best thanks for the kind
reception and assistance the Members had rendered him whilst in the
chair.


                              THE DINNER.

In the evening a dinner was held at the Queen’s Hotel, Mr. Campion
presiding, Mr. Major Stewart in the vice-chair.

The CHAIRMAN proposed the health of “The Queen and the rest of the Royal
Family.”

Mr. MAHONIE then gave a recitation from Shakespeare.

Mr. Major STEWART in rising to propose the toast of the President of the
branch said—It is my pleasing duty as your Vice-President to propose
this toast. I find our worthy Chairman took his M.R.C.S. degree in 1856,
I therefore regard him as the father of the profession in this district
of England; those who were present this morning heard his inaugural
address. Those words were words of wisdom, and were addressed not only
to the older, but also to the younger members of our Branch Association.
His address will be read with pleasure by members of our profession in
England and America. With regard to the chairmanship of this branch, I
think it would have been wise if Mr. Campion had been elected for three
years, until we were more consolidated. I am glad to see so many members
from this district present this evening, and will now conclude by asking
you to drink a bumper to the long life and successful career of our
Chairman. The toast was accepted most loyally.

The CHAIRMAN in responding said, gentlemen, you must have listened to my
voice sufficiently to-day—this is my last appearance before you this
session. Our Secretary has promised to allow me to enjoy myself, _otium
cum dignitate_, after I have returned my best thanks. It is with great
diffidence I respond to this toast, I really feel the difficulty
increased tenfold by the kind manner in which you, sir, have proposed,
and my friends accepted this toast. One word in regard to sub-branches—I
can see no reason why such large towns as Liverpool and Manchester
should not establish sub-branches; frequent meetings, say once a month,
could be held for an exchange of thoughts and methods of operation in
our department of Surgery, in which we are all interested; so
constituted, they would be private societies, to which any member of our
branch might be admitted. The great event of the next year will be the
meeting of the International Medical Congress, held in London during
August. This Congress has held its meetings every alternate year for the
last twelve years. The London members of the Medical profession have
taken it up very warmly, and are making preparations, which must result
in giving the Congress such a reception as will be worthy of our
capital.

The President of the Dental section is Mr. Edwin Saunders, whilst the
Vice-Presidents are Mr. John Tomes, and Mr. Spence Bate, Mr. C. S. Tomes
acts as Secretary, to all of whom we are much indebted for their
untiring efforts in raising our department of Surgery to its present
position. I trust that our branch will be well represented at this
Congress.

Another subject I will broach is the establishment of a Dental School in
Manchester. If such a school is formed it should be in concert with the
Manchester Medical School at the New Victoria University. When the
charter was first granted for the formation of a university, a medical
school was not included, but there appears very little doubt that in the
course of time such school will be established; let us then wait
patiently until we can thoroughly and efficiently carry out such an
undertaking.

I am sorry I cannot introduce you to a Dental hospital; this is to be
deplored, more especially as we took a prominent part in Dental reform
for the good of Dental practitioners. If younger and more able men will
commence the work, they shall receive my heartiest support and
co-operation. I must now conclude by expressing regret that I have not
the gift of speech, that I might explain to you the warm feelings I have
in regard to the reception you have given me, and the kind manner in
which you have drunk my health.

Dr. D. A. WORMALD sang “The Spinning Wheel.”

Dr. WORMALD, in proposing “The British Dental Association,” said: Mr.
President, and gentlemen, this toast is one, I am sure, you will drink
with the utmost cordiality. Those who sit round this board, and have
taken a part during the past few years in the politics of our
profession, must experience a feeling of congratulation that we are able
to meet to-night, and realize the fact that at last we occupy a
recognized position. We need re-organization, and we need a central
body, and the British Dental Association is that recognized body, and
demands our support and assistance. Well, join that Association, and do
what you can to lift up the profession from the low level in which we
have been placed, and raise it to a much higher level. We need, as your
President so kindly put it this afternoon, a higher professional tone,
and a more generous feeling towards our brethren; and that can only be
obtained by coming more and more in contact with each other, and through
the influence of such an organization as this we are met to commence,
which will assist in placing our profession in a position which it
should long ago have occupied. Many of those who are now in our ranks
may not see the full result of our labours, but depend upon this, that
our labours will be recognised in the great difference which will show
itself more and more in this country between those who are worthily
following their calling, and those who indulge in non-professional
practices. The British Dental Association will become strong and
durable, and then we may be sure that under the wisdom and the guidance
of those who have piloted our steps so far, we may safely follow them
wherever they lead, and so lay a foundation upon which the rising
generation may build up their professional career, and help to raise the
status of our profession. That profession is worthy of all the time and
attention that any honourable gentleman will give it, if he will follow
his calling worthily, and serving the interests of a suffering public.
In connection with this toast, Mr. Chairman, my friend Dr. Waite, will
have the pleasure of responding, and I have the greatest pleasure in
coupling his name with it.

Dr. WAITE responding, said, Mr. President, Mr. Vice-President, and
gentlemen, it is to me both a pleasure and a pride to be permitted to
respond to the toast of the “British Dental Association.” I am not much
of a believer in post-prandial oratory. The period of replenishment for
the physical energies, should be a period of repose for the energies
intellectual, or perhaps better still, a time of refreshment, by
agreeable and amusing conversation. That Englishmen should be fond of
dining together, is natural and characteristic; that they should be
almost equally prone to after dinner speechifying is somewhat
surprising. It is well, however, when the usages imposed by custom can
be observed, without making a too serious demand upon our drowsy powers,
and fortunately we have a condition of things existing at the present
time which, when fairly estimated, is calculated to awaken agreeable
reflections, and inspire us with salutary hopes.

Within the short space of five years, events have occurred with
astonishing rapidity, that have substantially and permanently altered
the position of the Dental profession, not alone in its relation to the
general public, but also in its internal organisation, and the mutual
relation of individuals to the whole body. These events may be
classified in three distinct items, and in each we shall find elements
of progress largely preponderating. First of all, most of you will
recall the feeling which prevailed when the idea of obtaining an Act of
Parliament was invoked at the Manchester meeting of 1875—it was not
regarded exactly as an utopian idea, but certainly we felt it to be
something almost too good to hope for. Well, in less than three years
from that time the Dentists Act was passed, and now, after two years
experience and consideration, we are able to discover what it is we have
obtained, though it is all too soon as yet, to realise (except very
partially) the practical benefits the Act is destined to confer. This
much, however, we know. We have a legal status. We have legal rights and
privileges. We are admitted to the fellowship of the honourable and
learned professions. These three points are assured, and we should see
to it, that we interpose no barrier of professional character or conduct
between ourselves and the privileges our Act bestows. We know, moreover,
that there are secured for those who will come after us, more
substantial benefits of education, of practice, of public appreciation,
such as none of us have been permitted to enjoy. This is the
characteristic feature of the Dentists Act. Its noblest provisions are
for posterity. No change, nor circumstance, can deprive any who have
assisted in passing this Act, of the pure satisfaction of knowing that
they have helped to hand on the profession of Dental Surgery in a far
better condition than that in which they received it. Many have
contributed in various ways, whose share in the work will be forgotten,
but the work remains. Identified with the whole of the movement, the
names of Tomes and Turner will be preserved and revered for many, many
years, yet withal the abundant reasons for personal gratification which
those gentlemen have, I am sure they rejoice a thousand fold more over
the results achieved, than they do at any honour or advantage accruing
to themselves. Take it as it stands, acknowledging its few
imperfections, and recognising its many decided benefits, we have as
good an Act as we had any right to expect, and as good as it was
possible for us to get.

One of the hindrances to Dental advancement has hitherto been the
scarcity of educational facilities, and the small proportion of
practitioners who possessed any Dental qualification. At the time to
which reference has already been made, there were only some 300
gentlemen in the whole of Great Britain who held a Dental diploma. There
was only one licensing body in the country which granted Dental
certificates. Now we have 630 gentlemen holding recognised Dental
qualifications, viz., of London about 400, Edinburgh 16, Dublin 180,
Glasgow 33, and the three last mentioned bodies are offering to
gentlemen in practice, the opportunity of examination, _sine curriculo_,
upon thoroughly reasonable and accessible terms. Not only so, the
Colleges of Ireland and Scotland have caused their certificates to
possess a peculiar value, in the careful provision they have made, for
preventing unprofessional practices on the part of their licentiates.

I am certainly astonished that the number of practitioners who have
already availed themselves of these facilities is so small. I know that
this matter of obtaining a Qualification is regarded variously by
different persons, but nothing is more certain than the growing tendency
toward accredited qualification as indispensable to professional status;
the public are rapidly becoming aware (and it is our business to educate
the public in this matter) that the operations of Dental Surgery cannot
be safely entrusted to uneducated heads or hands, and as a guarantee of
something like the necessary knowledge and skill, the public are
beginning to understand the value of a purely Dental Qualification. The
larger the number of Licentiates the more quickly the public will be
taught, and ere long the unqualified Dentist will become a mere historic
fact.

The all important feature of recent progress is the British Dental
Association. The Dental body has been afflicted with inherent weakness
through the want of organisation, a weakness that paralyses, and at the
same time, a weakness endowed with remarkable power, the power of
successfully defeating efforts toward general reformation. So long as we
were isolated and detached it is not wonderful that we were selfish and
afraid of one another, but a new era has dawned. We have an Association
to which all are eligible, where all can meet on the common ground of
professional brotherhood and intercourse. The control of the
Association, embracing the future welfare of the whole body, is
committed to a Board constituted on a representative basis. None need be
excluded from participation, save by their own poverty of professional
spirit, a poverty exhibited alike by persistent recourse to
unprofessional practice, and by selfish indifference to professional
politics. There may be a kind of superiority in having a large practice,
or in holding a high scientific position, but unless I am greatly
mistaken the true superiority is that which overleaps all selfish
considerations, and delights in consecrating whatever power or position
we may have to the elevation and improvement of the whole profession.
Thank God we have men who have been inspired with a large measure of
true professional spirit. Men who could think for themselves and hold
their own opinions, but who at the same time have been large-hearted
enough to merge minor differences in the pursuit of one grand object.
Such men as Edwin Saunders, John Tomes, J. Smith-Turner, T. A. Rogers,
A. Coleman, Dr. Walker, our esteemed President, and many others, stand
forth as examples of _true_ as distinct from _sham_ superiority.

The facilities now afforded by our separate branches have removed the
excuse so often urged when all the meetings took place in London, and
there is practically no obstacle to our speedy improvement. We possess
advantages of a political nature quite equal to those existing in any
kindred profession.

These are the bare facts of the present time; they furnish material for
much thankfulness and for cheerful anticipation. They are the foundation
on which our future must be erected. What that future is to be depends
on what we mean to be. The scaffolding is up, the materials are ready.
Willing hearts and willing hands are needed to complete the edifice.
There is a sublime principle working through the whole human family, the
operation of which no individual can withstand. It was formulated by the
Founder of the grandest system the world has ever known, and this is the
formula—

     “Whosoever would be chief among you, let him be your servant.”

Mr. MAHONIE, in proposing the toast of “Sir John Lubbock, and the
promoters of the Dentists Act,” said:—No words of mine can add
additional lustre to the names—Sir John Lubbock, Mr. John Tomes, Mr.
James Smith Turner. These men have earned a name for themselves which
neither crayons nor oils—not even if they were placed in cathedral
aisles—could add more; these men have laboured much—laboured hard; I beg
to propose their health.

Captain ROGERS, in responding, spoke of the great triumph Sir John
Lubbock had accomplished in passing Bills connected with science, this
Parliament. He had great pleasure in thanking them for the hearty manner
in which they had received the names of these gentlemen connected with
Dental Reform.

Mr T MURPHY in proposing the “Manchester School of Medicine” said:—I
have had put into my hands a toast to propose, which is so intimately
connected with our branch of the profession, that it will require no
eulogy on my part for it to be received with acclamation, I mean the
Manchester Royal School of Medicine. Perhaps it will not be out of place
if I give you a short outline of its history. It was founded by the late
Mr. T. Turner in the year 1824; it was known for many years as the Pine
Street School. In 1850 a second school was established, and being
connected as I then was with a hospital in this city, I can well
remember the jealousy there was about the subjects that were sent out;
first one school and then another complaining that they were not getting
their fair share, and I must admit that the leaning was towards the old
school, which I think got, on the whole, rather more than its share. In
1858 the founders of the rival schools came to the conclusion that the
interests of the students would be best promoted by an amalgamation,
forgetting their differences and working together for the common weal.
In this way, from the Union of the Pine Street and Chatham Street
Schools, that school arose which has been long known as the Manchester
School of Medicine. For sixteen years the work was carried on in
Faulkden Street with difficulty both with regard to accommodation and
light. About the year 1872, a meeting of the Owen’s College authorities
met the leading Members of the medical staff, and it was agreed that it
would be for the welfare of the School if it were handed over to the
Owen’s College authorities. The result has been the erection of one of
the finest Medical Schools in the kingdom, replete with everything
necessary for the study of medicine. The course of instruction not only
enables students to qualify for College and Hall, but affords the more
aspiring every facility for qualifying themselves for the higher
distinctions of their profession. When I mention the names of Turner,
Jordan, Wilson, Smith, Wilkinson, Bradley, Southam, and last, but not
least, the celebrated Dalton, and others, who have gone; Gamgee, Watson,
Williamson, Roscoe, Roberts, Morgan, Lund, Simpson, Ransome, and other
able men, who are at present at the helm, can there be a doubt about the
quality of the education given? and, in conclusion, is it too much to
ask that before long we should have established in this city, and in
connection with the Victoria University, a Dental School where we can
send our sons to receive at the hands of these able men the necessary
training to fit them for the practice of Dentistry.

Mr. MARSH returned thanks for the toast; he trusted some day Mr. Campion
would be appointed Consulting Dental Surgeon to the Manchester School of
Medicine.

Dr. WAITE proposed “Success to the Western Counties Association,”
coupling with it the name of Mr. J. C. Parson, of Clifton.

Mr. PARSON having responded, the proceedings terminated.




                            Correspondence.


We do not hold ourselves responsible for the views expressed by our
Correspondents.


                      MR. SEWILL ON DENTAL CARIES.
       TO THE EDITORS OF THE “MONTHLY REVIEW OF DENTAL SURGERY.”

SIRS,—While thanking you for your courteous notice of my contribution to
the second edition of Dr. Fothergill’s work, permit me to point out that
my contribution was not intended as an exhaustive discussion of the
subject of dental caries. I was asked to write only upon the “Hygiene of
the Teeth,” and to indicate to the medical practitioner the means
available for the prevention of dental disease. In accordance with the
scheme of the work it was requisite to explain the etiology and
pathology of caries in order to make clear the _rationale_ of treatment,
and therefore, with brevity consistent with the limited space at my
disposal, I did so, adopting mainly what is termed the “chemical” theory
of the disease. This view, as you remark, is certainly “theoretical,”
but I venture to say it approaches as nearly to demonstration as need
be. I certainly do not hesitate to accept it as fact, and I felt more
bound to adopt it in the present instance, seeing, at least, that upon
this theory both the prophylaxis of caries as well as our treatment of
the disease seem based.

I should be glad to see a discussion of the subject started in your
columns or at the Odontological Society.

         6, Wimpole Street,                 Yours faithfully,
             September 30th, 1880.                HENRY SEWILL.




               Birmingham Dental Hospital, Broad Street.


Consulting Physician.—James Sawyer, M.D., Lond., M.R.C.P., Physician to
the Queen’s Hospital.

Consulting Surgeon.—James West, F.R.C.S., Senior Surgeon to the Queen’s
Hospital.

Consulting Dentists.—Thomas H. English, Adams Parkes, L.D.S.Eng.

Surgeon Chloroformist.—F. H. Maberley, M.R.C.S.

Dental Surgeons.—Charles Sims, L.D.S.Eng., Wednesdays; H. Breward Neale,
L.D.S.I., Tuesdays and Thursdays; F. H. Batchelor, L.D.S.I., Mondays and
Fridays; F. E. Huxley, M.R.C.S.Eng., L.D.S. Edin.; Saturdays.

Hon. Treasurer.—W. Udal, Esq.

Bankers.—Lloyd’s Banking Company, High Street.

Hon. Sec.—Allen Edwards, 82, New Street.




                       DENTAL HOSPITAL OF EXETER.

         CASES TREATED FROM JUNE 14TH TO SEPTEMBER 30TH, 1880.


                           { Children under 14               309
       Extractions.        { Adults                          641
                           { Under Nitrous Oxide and Ether    29
       Gold Stoppings                                         45
       White Foil ditto                                       37
       Plastic ditto                                         127
       Miscellaneous cases                                   129
                                                           —————
                                        Total              1,317
                                                           —————

                                               HENRY BROWNE-MASON,
                                                             _Hon. Sec._




                          White Nickel Bronze.


The pure white tint of nickel, its inoxidisability, and, therefore, the
ease with which it is kept clean, have caused it to come into general
use for metal fittings, especially those of vessels and carriages, as
well as for the bright parts of engines and machines. But, on account of
the relatively high price hitherto obtained by nickel, it has been
employed chiefly in the state of electro-deposit.

Nickel-plating is effected by two processes, one hot and the other cold.
In the former a solution of sulphate of nickel is used in an enamel
cast-iron trough. This is the more rapid method, but its results are not
so satisfactory as in the cold process. The latter is effected with a
bath of double sulphate of nickel and ammonia, the articles to be
nickelised being suspended by a platinum wire attached to the positive
pole of the battery, while a plate of pure nickel, to restore the metal
to the bath, is put in connection with the negative pole. The
nickelisation thus produced, though it requires a longer time than the
other process is finer and more durable.

There are, however, several objections to nickel-plating. The process is
injurious to the workmen engaged in it. The thin coating of nickel is
liable to peel off, and in the case of parts exposed to wear, or even
with cleanings, in course of time, the nickel becomes so worn off at the
edges as to expose the base metal beneath. Besides, nickelisation does
not entirely prevent the oxidisation of steel and iron.

A French Company, La Société Française Anonyme de Nickel, briefly
referred to in connection with the Applied Science Exhibition, Paris,
are endeavouring to supersede the nickelisation of brass and copper by
the use of solid nickel bronze, which is thus obtained. The ore,
_garnierite_, extensive deposits of which exist in New Caledonia, the
French penal settlement, is worked by Messrs. John Higginson and Co., of
Noumea, the _concessionaires_. It is by them subjected to a roasting on
preliminary fusion, which forms a regulus, containing from 60 to 70 per
cent. of metallic nickel. This substance is shipped to the works of the
company at Septemes, near Marseilles, where it is smelted into ingots
and granule, containing 99½ per cent, of pure nickel, and ¼ per cent, of
utilisable metallic substances. The extent of the mineral deposits in
New Caledonia, the reduction in the cost of freight owing to the
concentration of metal through the preliminary fusion, and the economy
effected by the new methods of reduction devised by M. Jules Garnier,
enable the company to sell the pure metal at about one-half the price it
obtained three years ago.

For a long time past, efforts have been made to work nickel, but without
success, until the present year, because it was found too brittle; now,
however, pure nickel has been rolled and forged; cups, knives, and other
articles have been formed of it. As a rule, the pure nickel is formed by
the founder with various proportions of copper, zinc, and tin, according
to circumstance, to form nickel bronze; but at least 20 per cent. of
nickel is required to secure inoxidisability, and to give the desired
tint. All articles that are now made of brass or copper nickelised may
be produced in solid white nickel bronze, by the same processes, and
with the same plant, and at practically the same cost; they are also 20
per cent. stronger, so that in many cases they may be made so much
lighter. The great strength and the property of non-oxidisation render
this alloy eminently suitable for mathematical and musical instruments.
A small quantity of nickel added to steel increases its hardness, and
renders it inoxidisable, while edge-tools made of the alloy stand better
than those of ordinary steel. A nickel bell metal is also found to give
good results. The Paris Exhibition of 1878 proved the action of a
totally new system of metallurgy in connection with this beautiful
metal, and that of 1879 showed its practical introduction into most
branches of manufacturing industry.—_Journal of the Society of Arts._




                           TO CORRESPONDENTS.


  All communications intended for the Editors should be addressed to
    them at 22, Grosvenor Street, Grosvenor Square.

  All inquiries respecting Advertisements and Subscriptions should be
    sent to GEORGE BUTCHER, 4, Crane Court, Fleet Street, E.C.

------------------------------------------------------------------------




                          TRANSCRIBER’S NOTES


 1. Silently corrected typographical errors and variations in spelling.
 2. Retained anachronistic, non-standard, and uncertain spellings as
      printed.
 3. Footnotes have been re-indexed using numbers.
 4. Enclosed italics font in _underscores_.





End of Project Gutenberg's The Monthly Review of Dental Surgery, by Various



*** END OF THE PROJECT GUTENBERG EBOOK THE MONTHLY REVIEW OF DENTAL SURGERY, NO. VIII. OCTOBER, 1880. VOL. I ***


    

Updated editions will replace the previous one—the old editions will
be renamed.

Creating the works from print editions not protected by U.S. copyright
law means that no one owns a United States copyright in these works,
so the Foundation (and you!) can copy and distribute it in the United
States without permission and without paying copyright
royalties. Special rules, set forth in the General Terms of Use part
of this license, apply to copying and distributing Project
Gutenberg™ electronic works to protect the PROJECT GUTENBERG™
concept and trademark. Project Gutenberg is a registered trademark,
and may not be used if you charge for an eBook, except by following
the terms of the trademark license, including paying royalties for use
of the Project Gutenberg trademark. If you do not charge anything for
copies of this eBook, complying with the trademark license is very
easy. You may use this eBook for nearly any purpose such as creation
of derivative works, reports, performances and research. Project
Gutenberg eBooks may be modified and printed and given away—you may
do practically ANYTHING in the United States with eBooks not protected
by U.S. copyright law. Redistribution is subject to the trademark
license, especially commercial redistribution.


START: FULL LICENSE

THE FULL PROJECT GUTENBERG LICENSE

PLEASE READ THIS BEFORE YOU DISTRIBUTE OR USE THIS WORK

To protect the Project Gutenberg™ mission of promoting the free
distribution of electronic works, by using or distributing this work
(or any other work associated in any way with the phrase “Project
Gutenberg”), you agree to comply with all the terms of the Full
Project Gutenberg™ License available with this file or online at
www.gutenberg.org/license.

Section 1. General Terms of Use and Redistributing Project Gutenberg™
electronic works

1.A. By reading or using any part of this Project Gutenberg™
electronic work, you indicate that you have read, understand, agree to
and accept all the terms of this license and intellectual property
(trademark/copyright) agreement. If you do not agree to abide by all
the terms of this agreement, you must cease using and return or
destroy all copies of Project Gutenberg™ electronic works in your
possession. If you paid a fee for obtaining a copy of or access to a
Project Gutenberg™ electronic work and you do not agree to be bound
by the terms of this agreement, you may obtain a refund from the person
or entity to whom you paid the fee as set forth in paragraph 1.E.8.

1.B. “Project Gutenberg” is a registered trademark. It may only be
used on or associated in any way with an electronic work by people who
agree to be bound by the terms of this agreement. There are a few
things that you can do with most Project Gutenberg™ electronic works
even without complying with the full terms of this agreement. See
paragraph 1.C below. There are a lot of things you can do with Project
Gutenberg™ electronic works if you follow the terms of this
agreement and help preserve free future access to Project Gutenberg™
electronic works. See paragraph 1.E below.

1.C. The Project Gutenberg Literary Archive Foundation (“the
Foundation” or PGLAF), owns a compilation copyright in the collection
of Project Gutenberg™ electronic works. Nearly all the individual
works in the collection are in the public domain in the United
States. If an individual work is unprotected by copyright law in the
United States and you are located in the United States, we do not
claim a right to prevent you from copying, distributing, performing,
displaying or creating derivative works based on the work as long as
all references to Project Gutenberg are removed. Of course, we hope
that you will support the Project Gutenberg™ mission of promoting
free access to electronic works by freely sharing Project Gutenberg™
works in compliance with the terms of this agreement for keeping the
Project Gutenberg™ name associated with the work. You can easily
comply with the terms of this agreement by keeping this work in the
same format with its attached full Project Gutenberg™ License when
you share it without charge with others.

1.D. The copyright laws of the place where you are located also govern
what you can do with this work. Copyright laws in most countries are
in a constant state of change. If you are outside the United States,
check the laws of your country in addition to the terms of this
agreement before downloading, copying, displaying, performing,
distributing or creating derivative works based on this work or any
other Project Gutenberg™ work. The Foundation makes no
representations concerning the copyright status of any work in any
country other than the United States.

1.E. Unless you have removed all references to Project Gutenberg:

1.E.1. The following sentence, with active links to, or other
immediate access to, the full Project Gutenberg™ License must appear
prominently whenever any copy of a Project Gutenberg™ work (any work
on which the phrase “Project Gutenberg” appears, or with which the
phrase “Project Gutenberg” is associated) is accessed, displayed,
performed, viewed, copied or distributed:

    This eBook is for the use of anyone anywhere in the United States and most
    other parts of the world at no cost and with almost no restrictions
    whatsoever. You may copy it, give it away or re-use it under the terms
    of the Project Gutenberg License included with this eBook or online
    at www.gutenberg.org. If you
    are not located in the United States, you will have to check the laws
    of the country where you are located before using this eBook.
  
1.E.2. If an individual Project Gutenberg™ electronic work is
derived from texts not protected by U.S. copyright law (does not
contain a notice indicating that it is posted with permission of the
copyright holder), the work can be copied and distributed to anyone in
the United States without paying any fees or charges. If you are
redistributing or providing access to a work with the phrase “Project
Gutenberg” associated with or appearing on the work, you must comply
either with the requirements of paragraphs 1.E.1 through 1.E.7 or
obtain permission for the use of the work and the Project Gutenberg™
trademark as set forth in paragraphs 1.E.8 or 1.E.9.

1.E.3. If an individual Project Gutenberg™ electronic work is posted
with the permission of the copyright holder, your use and distribution
must comply with both paragraphs 1.E.1 through 1.E.7 and any
additional terms imposed by the copyright holder. Additional terms
will be linked to the Project Gutenberg™ License for all works
posted with the permission of the copyright holder found at the
beginning of this work.

1.E.4. Do not unlink or detach or remove the full Project Gutenberg™
License terms from this work, or any files containing a part of this
work or any other work associated with Project Gutenberg™.

1.E.5. Do not copy, display, perform, distribute or redistribute this
electronic work, or any part of this electronic work, without
prominently displaying the sentence set forth in paragraph 1.E.1 with
active links or immediate access to the full terms of the Project
Gutenberg™ License.

1.E.6. You may convert to and distribute this work in any binary,
compressed, marked up, nonproprietary or proprietary form, including
any word processing or hypertext form. However, if you provide access
to or distribute copies of a Project Gutenberg™ work in a format
other than “Plain Vanilla ASCII” or other format used in the official
version posted on the official Project Gutenberg™ website
(www.gutenberg.org), you must, at no additional cost, fee or expense
to the user, provide a copy, a means of exporting a copy, or a means
of obtaining a copy upon request, of the work in its original “Plain
Vanilla ASCII” or other form. Any alternate format must include the
full Project Gutenberg™ License as specified in paragraph 1.E.1.

1.E.7. Do not charge a fee for access to, viewing, displaying,
performing, copying or distributing any Project Gutenberg™ works
unless you comply with paragraph 1.E.8 or 1.E.9.

1.E.8. You may charge a reasonable fee for copies of or providing
access to or distributing Project Gutenberg™ electronic works
provided that:

    • You pay a royalty fee of 20% of the gross profits you derive from
        the use of Project Gutenberg™ works calculated using the method
        you already use to calculate your applicable taxes. The fee is owed
        to the owner of the Project Gutenberg™ trademark, but he has
        agreed to donate royalties under this paragraph to the Project
        Gutenberg Literary Archive Foundation. Royalty payments must be paid
        within 60 days following each date on which you prepare (or are
        legally required to prepare) your periodic tax returns. Royalty
        payments should be clearly marked as such and sent to the Project
        Gutenberg Literary Archive Foundation at the address specified in
        Section 4, “Information about donations to the Project Gutenberg
        Literary Archive Foundation.”
    
    • You provide a full refund of any money paid by a user who notifies
        you in writing (or by e-mail) within 30 days of receipt that s/he
        does not agree to the terms of the full Project Gutenberg™
        License. You must require such a user to return or destroy all
        copies of the works possessed in a physical medium and discontinue
        all use of and all access to other copies of Project Gutenberg™
        works.
    
    • You provide, in accordance with paragraph 1.F.3, a full refund of
        any money paid for a work or a replacement copy, if a defect in the
        electronic work is discovered and reported to you within 90 days of
        receipt of the work.
    
    • You comply with all other terms of this agreement for free
        distribution of Project Gutenberg™ works.
    

1.E.9. If you wish to charge a fee or distribute a Project
Gutenberg™ electronic work or group of works on different terms than
are set forth in this agreement, you must obtain permission in writing
from the Project Gutenberg Literary Archive Foundation, the manager of
the Project Gutenberg™ trademark. Contact the Foundation as set
forth in Section 3 below.

1.F.

1.F.1. Project Gutenberg volunteers and employees expend considerable
effort to identify, do copyright research on, transcribe and proofread
works not protected by U.S. copyright law in creating the Project
Gutenberg™ collection. Despite these efforts, Project Gutenberg™
electronic works, and the medium on which they may be stored, may
contain “Defects,” such as, but not limited to, incomplete, inaccurate
or corrupt data, transcription errors, a copyright or other
intellectual property infringement, a defective or damaged disk or
other medium, a computer virus, or computer codes that damage or
cannot be read by your equipment.

1.F.2. LIMITED WARRANTY, DISCLAIMER OF DAMAGES - Except for the “Right
of Replacement or Refund” described in paragraph 1.F.3, the Project
Gutenberg Literary Archive Foundation, the owner of the Project
Gutenberg™ trademark, and any other party distributing a Project
Gutenberg™ electronic work under this agreement, disclaim all
liability to you for damages, costs and expenses, including legal
fees. YOU AGREE THAT YOU HAVE NO REMEDIES FOR NEGLIGENCE, STRICT
LIABILITY, BREACH OF WARRANTY OR BREACH OF CONTRACT EXCEPT THOSE
PROVIDED IN PARAGRAPH 1.F.3. YOU AGREE THAT THE FOUNDATION, THE
TRADEMARK OWNER, AND ANY DISTRIBUTOR UNDER THIS AGREEMENT WILL NOT BE
LIABLE TO YOU FOR ACTUAL, DIRECT, INDIRECT, CONSEQUENTIAL, PUNITIVE OR
INCIDENTAL DAMAGES EVEN IF YOU GIVE NOTICE OF THE POSSIBILITY OF SUCH
DAMAGE.

1.F.3. LIMITED RIGHT OF REPLACEMENT OR REFUND - If you discover a
defect in this electronic work within 90 days of receiving it, you can
receive a refund of the money (if any) you paid for it by sending a
written explanation to the person you received the work from. If you
received the work on a physical medium, you must return the medium
with your written explanation. The person or entity that provided you
with the defective work may elect to provide a replacement copy in
lieu of a refund. If you received the work electronically, the person
or entity providing it to you may choose to give you a second
opportunity to receive the work electronically in lieu of a refund. If
the second copy is also defective, you may demand a refund in writing
without further opportunities to fix the problem.

1.F.4. Except for the limited right of replacement or refund set forth
in paragraph 1.F.3, this work is provided to you ‘AS-IS’, WITH NO
OTHER WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED, INCLUDING BUT NOT
LIMITED TO WARRANTIES OF MERCHANTABILITY OR FITNESS FOR ANY PURPOSE.

1.F.5. Some states do not allow disclaimers of certain implied
warranties or the exclusion or limitation of certain types of
damages. If any disclaimer or limitation set forth in this agreement
violates the law of the state applicable to this agreement, the
agreement shall be interpreted to make the maximum disclaimer or
limitation permitted by the applicable state law. The invalidity or
unenforceability of any provision of this agreement shall not void the
remaining provisions.

1.F.6. INDEMNITY - You agree to indemnify and hold the Foundation, the
trademark owner, any agent or employee of the Foundation, anyone
providing copies of Project Gutenberg™ electronic works in
accordance with this agreement, and any volunteers associated with the
production, promotion and distribution of Project Gutenberg™
electronic works, harmless from all liability, costs and expenses,
including legal fees, that arise directly or indirectly from any of
the following which you do or cause to occur: (a) distribution of this
or any Project Gutenberg™ work, (b) alteration, modification, or
additions or deletions to any Project Gutenberg™ work, and (c) any
Defect you cause.

Section 2. Information about the Mission of Project Gutenberg™

Project Gutenberg™ is synonymous with the free distribution of
electronic works in formats readable by the widest variety of
computers including obsolete, old, middle-aged and new computers. It
exists because of the efforts of hundreds of volunteers and donations
from people in all walks of life.

Volunteers and financial support to provide volunteers with the
assistance they need are critical to reaching Project Gutenberg™’s
goals and ensuring that the Project Gutenberg™ collection will
remain freely available for generations to come. In 2001, the Project
Gutenberg Literary Archive Foundation was created to provide a secure
and permanent future for Project Gutenberg™ and future
generations. To learn more about the Project Gutenberg Literary
Archive Foundation and how your efforts and donations can help, see
Sections 3 and 4 and the Foundation information page at www.gutenberg.org.

Section 3. Information about the Project Gutenberg Literary Archive Foundation

The Project Gutenberg Literary Archive Foundation is a non-profit
501(c)(3) educational corporation organized under the laws of the
state of Mississippi and granted tax exempt status by the Internal
Revenue Service. The Foundation’s EIN or federal tax identification
number is 64-6221541. Contributions to the Project Gutenberg Literary
Archive Foundation are tax deductible to the full extent permitted by
U.S. federal laws and your state’s laws.

The Foundation’s business office is located at 809 North 1500 West,
Salt Lake City, UT 84116, (801) 596-1887. Email contact links and up
to date contact information can be found at the Foundation’s website
and official page at www.gutenberg.org/contact

Section 4. Information about Donations to the Project Gutenberg
Literary Archive Foundation

Project Gutenberg™ depends upon and cannot survive without widespread
public support and donations to carry out its mission of
increasing the number of public domain and licensed works that can be
freely distributed in machine-readable form accessible by the widest
array of equipment including outdated equipment. Many small donations
($1 to $5,000) are particularly important to maintaining tax exempt
status with the IRS.

The Foundation is committed to complying with the laws regulating
charities and charitable donations in all 50 states of the United
States. Compliance requirements are not uniform and it takes a
considerable effort, much paperwork and many fees to meet and keep up
with these requirements. We do not solicit donations in locations
where we have not received written confirmation of compliance. To SEND
DONATIONS or determine the status of compliance for any particular state
visit www.gutenberg.org/donate.

While we cannot and do not solicit contributions from states where we
have not met the solicitation requirements, we know of no prohibition
against accepting unsolicited donations from donors in such states who
approach us with offers to donate.

International donations are gratefully accepted, but we cannot make
any statements concerning tax treatment of donations received from
outside the United States. U.S. laws alone swamp our small staff.

Please check the Project Gutenberg web pages for current donation
methods and addresses. Donations are accepted in a number of other
ways including checks, online payments and credit card donations. To
donate, please visit: www.gutenberg.org/donate.

Section 5. General Information About Project Gutenberg™ electronic works

Professor Michael S. Hart was the originator of the Project
Gutenberg™ concept of a library of electronic works that could be
freely shared with anyone. For forty years, he produced and
distributed Project Gutenberg™ eBooks with only a loose network of
volunteer support.

Project Gutenberg™ eBooks are often created from several printed
editions, all of which are confirmed as not protected by copyright in
the U.S. unless a copyright notice is included. Thus, we do not
necessarily keep eBooks in compliance with any particular paper
edition.

Most people start at our website which has the main PG search
facility: www.gutenberg.org.

This website includes information about Project Gutenberg™,
including how to make donations to the Project Gutenberg Literary
Archive Foundation, how to help produce our new eBooks, and how to
subscribe to our email newsletter to hear about new eBooks.