thus treated I removed twenty-one pulp stones. She had suffered from insomnia to such an extent that she was unable to sleep more than an hour at a time for two years. Dr. Merritt (closing the discussion). I have only a few words to say in closing. In the first place, I do not pretend to know it all. On the contrary, I know that I do not know much about pyorrhea, but I am interested in knowing more. I assume that you are also; and the best way to learn is to get together and exchange ideas, as we have done tonight. There have been some questions asked that I shall not be able to answer. Many more might be asked to which the wisest of us could not reply. We all ought to know more about pyorrhea than we know, and if we did we would do better work for our patients than we are doing; and the only way in which we are going to accomplish this is by realizing our ignorance, and taking steps to correct it. In I myself realize that pyorrhea alveolaris is a very unsatisfactory term. this paper I at first used the word periodontoclasia, but upon reflection I went back to the old term, because I did not want to confuse your minds by the introduction of a new word. As to the relation of pyorrhea to systemic infection, I can only say that I do not know. That it plays an important part there is no doubt, but just what it is, or just how it influences prognosis or acts as an exciting or predisposing cause, I do not know. Now as to the question of reattachment: What the nature of it is, no one can say. There has never been a histological examination made of regenerated tissues of this kind. That they are the same as those tissues replaced I do not believe, but that they answer the purpose is true. That reattachment takes place there is no doubt, and if it does not in a given case it is because the conditions have not been met; it may be through faulty technique, or it may have been because of conditions which no human being could control. We are dealing with an environment constantly charged with organisms and food débris. When Dr. Lee tells his patients that pyorrhea is incurable, I believe he is doing them and the profession an injustice. Pyorrhea is a curable disease, though it may, through long neglect, reach an incurable stage. The sooner that this fact finds its way into the minds of the profession the better it will be for our patients. A rising vote of thanks was given Dr. Merritt, and the meeting adjourned at 10.30 P.M. THE DENTAL COSMOS A MONTHLY RECORD OF DENTAL SCIENCE. Devoted to the Interests of the Profession. EDWARD C. KIRK, D.D.S., Sc.D., LL.D., Editor. L. PIERCE ANTHONY, D.D.S., Associate Editor. PUBLISHED BY THE S. S. WHITE DENTAL MFG. CO., PHILADELPHIA, PA. SUBSCRIPTION PRICE, including postage, $1.00 a year to all parts of the United States, Hawaiian Islands, the Philippines, Guam, Porto Rico, Virgin Islands, Cuba, and Mexico. . Canada, $1.40. To other foreign countries, $1.75 a year. Original contributions, society reports, and other correspondence intended for publication should be addressed to the EDITOR, Lock Box 1615, Philadelphia, Pa. Subscriptions and communications relating to advertisements should be addressed to the BUSINESS MANAGER of the DENTAL COSMOS, Lock Box 1615, Philadelphia, Pa. PHILADELPHIA, JULY 1918. EDITORIAL DEPARTMENT Oral Sepsis. THERE has probably never appeared in medical or dental literature an article which has had a more profound influence on the thought and action of the medical and dental professions than the article by Sir William Hunter entitled "The Rôle of Sepsis and of Antisepsis in Medicine," which appeared in the Lancet for January 1911, and which we have republished at page 585 of the present issue. It has been an invariable rule of the DENTAL COSMOS not to republish matter which has appeared elsewhere, but we feel that we are warranted in breaking this long-established rule in the present instance by the importance of the paper in question, and also the desirability from the historical standpoint of permanently recording this epoch-making address in strictly dental literature. While there have been numerous references in dental literature to Dr. Hunter's paper, there are doubtless many in the profession who have never read the original address, but there is probably not a member of the profession whose methods of practice have not been materially affected as the result of the profound impression which Dr. Hunter's paper made upon both the medical and dental professions. When the paper first appeared there was a wave of indignation and even resentment toward the severe indictment which Dr. Hunter made against certain practices in dentistry, and these practices were ably defended by many who were unwilling to accept such a wholesale condemnation of the methods of dental practice which were then in vogue; but no amount of argument could gainsay the evident truth of the soundness of the principles underlying Dr. Hunter's criticism of certain dental operative procedures. At that time we presented an editorial dealing with the article in question, but our attention was focused more particularly on a review of the paper which was published in Current Literature, and which was a flagrant attempt at sensationalism and a palpable misinterpretation of the author's views. Dr. Hunter was particuarly severe in his criticism of crown and bridge work as practiced in European countries under the name of "American dentistry," a catch phrase which has long been used by incompetent charlatans throughout Europe in exploiting the ignorant and credulous, but which has no relation to the better type of dentistry as it is practiced in America. Many of Dr. Hunter's critics directed their defense of the then prevalent methods of practice at this particular phase of the article, which the reader will readily see is but incident to the broad question under consideration. That Dr. Hunter's criticism of crown and bridge work as then practiced was well founded has been fully exemplified in the almost complete change in the methods practiced by present-day crown and bridge workers. After the first wave of resentment against this criticism of our methods of practice had spent its force, it was soon recognized by the thinking members of the profession that the criticism, although a severe one, was just, and a calm and sober consideration of the question involved resulted in the awakening of the profes sion to the necessity of a proper consideration of the principles laid down by Dr. Hunter. Truly it is an ill wind that blows no good, and one of the greatest goods that came from this epoch-making effort was the immediate and complete recognition which came from the medical profession of the potentiality for evil present in septic oral conditions-a contention which the dental profession had long endeavored to impress upon their medical brethren. Indeed, the medical profession recognized these potentialities for evil with such enthusiasm that we began to see medical men everywhere ascribing to mouth conditions almost every disease which they could not readily diagnose, and advocating, even urging, the indiscriminate extraction of teeth, and, as a matter of fact, this overenthusiastic acceptation of oral sepsis and faulty dentistry as the possible cause of many puzzling conditions met with by the medical practitioner is not yet on the wane. The most enthusiastic champions of dental hygiene as an important factor in general bodily health could not have hoped for such an overwhelming acceptance of all for which they had contended, but unfortunately this recognition of dentistry was entirely from the negative viewpoint of the baneful effects of improper dental practice. The medical profession as a whole has not yet conceded the contention of dentistry with regard to the beneficial results of proper methods of dental practice on the bodily health. Some of the more thoughtful men of the medical profession, however, have come to realize what an important rôle preventive dentistry must play if we are to realize all that is hoped for from preventive medicine. Indeed, it was none other than Dr. Charles H. Mayo who said, "It is evident that the next great step in medical progress in the line of preventive medicine should be made by the dentists. The question is, Will they do it?" The dental profession has taken that step, and we feel confident in making the assertion that it has long since cast aside its septic swaddling-clothes. One of the most beneficial results coming from this wholesale. indictment of empirical dental practices by Dr. Hunter was the impetus given to research work and the study of dental conditions in their relationship to systemic diseases, until today the profes sion is wide awake to the fact that the mechanical aspect of dentistry, while an important one, can properly serve its purpose only when practiced with a full knowledge of the physiological functioning of the mouth as an important organ of the bodily economy. We believe also that this paper was the indirect source of considerable stimulus to the oral hygiene propaganda which has been so zealously promulgated by the dental profession in recent years. We respectfully urge all our readers to study carefully Dr. Hunter's paper, and although it is some seven years since its first appearance, we feel that it is just as timely now as when it was originally published. We are still of the opinion as expressed in 1911 when we first made editorial reference to the paper in question: "While some of the statements made by Dr. Hunter are perhaps rather excessive, they are on the whole, we believe, in accordance with the general facts of the situation. Though the truth is frequently unpleasant, it is never unwholesome, and if the stimulus of Dr. Hunter's pointed criticism shall arouse the organized dental profession to renewed activity in the effort to eradicate the ignorant and incompetent practice of dentistry, he will have conferred a boon upon humanity." We believe now that Dr. Hunter's paper accomplished all and even more than we hoped for it at that time. "l'Aide Confraternelle" Honor Roll. IN response to our appeal in the January issue we have received the following additional contributions to "l'Aide Confraternelle": |