ANATOMY AND HISTOLOGY OF THE MOUTH AND TEETH. By I. NORMAN BROOMELL, D.D.S., Professor of Dental Anatomy and Clinical Dentistry, Philadelphia Dental College, and formerly Dean and Professor of Prosthetic Dentistry, Dental Anatomy, and Histology, Dental Department, Medico-Chirurgical College of Philadelphia; and PHILIPP FISCHELIS, M.D., Associate Professor of Histology and Demonstrator in Embryology, MedicoChirurgical College of Philadelphia. Fifth Edition, revised, with 368 illustrations. Price $3.00. Philadelphia:

P. Blakiston's Son & Co. 1917.

The first part of this well-known work, that dealing with the gross anatomy, has received some revision in regard to form and arrangement. The subject-content has not been altered. The osteology, myology, the vascular and nerve supply of the facial region receive the ordinary description to be found in any one of a number of the briefer works on human anatomy. The second part, that which deals with the histology, histogenesis, and embryology of the dental structures, has not been revised.

There are four most serious and salient adverse criticisms to be made of this work:

(1) The rather recent appreciation of the multiplicity of apical foramina, which has so deep a clinical significance, is apparently completely ignored; indeed, on pages 191 and 361 one is led to be

lieve that each tooth has but a single apical foramen.

(2) The figures throughout the book are frequently too indistinct, and too often lack adequate correlation with the text descriptions. In the first part of the work, the figures illustrating the anatomy of the individual teeth should be made decidedly clearer and sharper, and larger, even at the sacrifice of some of the verbal description.

(3) It is unfortunate that the obsolete and anthropomorphic nomenclature of dental anatomy should be retained. There is no excuse for further delay in accepting the terminology which is in rational harmony with that of comparative anatomy.

(4) The periodontal ligament (misnamed by Broomell and Fischelis) is a structure of such high import to the dentist that it deserves a full discussion. The most serious error of judgment in the putting together of this book is that the student is referred "for full histological description" of this structure to a former edition. In the present (the fifth) edition there are devoted two pages, including one diagrammatic figure, to this topic.

In anticipation of a future revision of the second part of this book there are a number of items which would demand consideration. Nasmyth's membrane is described following the section on the dental pulp and preceding the section on "the alveolo-dental membrane." Logically it should immediately precede the

description of enamel. Contrary to the statement on page 361, lymphatics have been described in the pulp. (DENTAL Cosmos, 1917, p. 436.) Lacunæ are described as normal in the cementum, whereas there is excellent reason to believe that their occurrence there is an indication of a pathological process; the very description by the authors supports the latter view. The consideration of the innervation of the dentin needs amplification. In a subsequent edition it will be interesting to see how Bolk's views on human odontogenesis (DENTAL COSMOS, 1913, p. 1058) will be treated.

The defects and deficiencies of this book have been emphasized because much is expected of a work which has exerted and undoubtedly will exert a wide influence on the personnel of the dental profession. Under the guidance of a teacher of originality and resource, a class would gain from this book the basic information. on dental anatomy and histology which is prerequisite for their future studies.

DENTAL AND ORAL RADIOGRAPHY.

By

JAMES DAVID McCoy. Second Edition. Price $2.50. St. Louis: C. V. Mosby Company, 1918.

The unqualified success of the first edition of this work amply justified the appearance of this second edition. The author has kept his attention focused on the beginner (and we must realize that all practitioners are as yet beginners in this highly important phase of dentistry).

The spirit of McCoy is that of unpretentiousness, a virtue all too sadly lacking in many modern dental publications. The book possesses that trinity of charms -brevity, simplicity, and clarity. choice of terms the author is wisely conservative. He consciously avoids recog

In

nition of such parvenus as radiolucency, radiopacity, etc.

Only in two particulars is one disappointed: one hunts in vain for any mention of stereoscopic radiographs in dentistry, and the crucial chapter-that on the Interpretation of Dental and Oral Radiograms-is far too short. This chapter is the "why" of the whole book, and yet it occupies only about one-twelfth of the text.

This book is needed by every dentist who employs radiography, and is still more urgently needed by those dentists who have not yet resorted to this indispensable adjunct.

A TEXTBOOK OF DENTAL HISTOLOGY AND EMBRYOLOGY, INCLUDING LABORATORY DIRECTIONS. BY FREDERICK BOGUE NOYES, B.A., D.D.S. Professor of Histology, Northwestern University Dental School, 1896-1914; Professor of Histology and Orthodontia, College of Dentistry, University of Illinois, 1914. Second Edition, revised and enlarged. With 337 illustrations and 21 plates. Philadelphia and New York: Lea and Febiger, 1915. Price $4.50.

The improved appearance, external and internal, of this book is the only significant change from the 1912 edition. The author has revised the illustrations in particular, and although the alterations have been slight, the publisher has ably co-operated, so that the pictures are very much more distinct than those of the first edition. Thirteen illustrations have been omitted, the book being thereby improved.

No attempt has been made to eliminate the rather serious errors of judgment of the first edition. Unnecessary and inappropriate sections still persist.

The purposes of the book would be more directly and forcibly realized (1) by restricting the attention to dental histology and embryology, and (2) by avoiding the flavor of provincialism, so justly criticized in the DENTAL COSMOS review of the first edition.

The abbreviation or omission of certain generalities of animal morphology (Chapters I, XXV, and XXVI, except the section on the Stomadeum, at the bottom of page 296, which could be incorporated with modifications in the following chapter), the elimination of those chapters (VI to XI, inclusive) which properly belong to a consideration of operative dentistry (although parts of these of histological import not contained elsewhere might be retained and inserted in other chapters), the omission of the chapter (XIX) on bone formation, and the omission of the chapter (XVI) on the pathology of the dental pulp, would free the book from the charge that it contained much matter not pertinent in a textbook on dental histology and embryology, and would emphasize those topics whose popularization it is the aim of the book to promote.

The charge of localism can be evidenced by a large number of details. One of these is that the space given to the epithelial rests within the periodontal ligament is out of all proportion to their histological importance, while their sinister potentiality which would justify this space, as constituting a locus. minoris resistentia, is not considered. The discussion of the distribution of the nerves in the dental pulp in relation to the question of the sensitivity of the dentin is notably insufficient. It contains at page 177 the following quotation: "The most recent work upon this subject was done some ten or twelve years ago by Prof. Carl Huber," entirely ignoring

the work of Mummery, Dependorf, and Fritsch. This is merely one instance where the paucity of references to the literature indicates a lack of familiarity with the work of other men.

In addition to the two general criticisms which have been detailed above, the following miscellanies may be mentioned: Nasmyth's membrane apparently is considered of not sufficient importance to be mentioned. The soft tissues of the mouth (see Chapter XXIV) deserve a far more extensive description than they here receive. Tooth development (Chapter XXVII) and especially the histogenesis of the dental tissues, are all too cursorily treated. In a future edition it will be of interest to see what influence Bolk's observations will have had upon these subjects. The value of the book would be enhanced by a liberal expansion of the index.

In summary, the general impression created by a critical and sympathetic study of this book is that it was written not by a professional histologist, but by a man who is primarily a dental clinician.

ORAL SEPSIS IN ITS RELATIONSHIP TO SYSTEMIC DISEASE. BY WILLIAM W. DUKE, M.D., Ph.B., Kansas City, Mo. Professor of Experimental Medicine in the University of Kansas School of Medicine; Professor in the Department of Medicine in Western Dental College; Visiting Physician to Christian Church Hospital; Consulting Physician to Kansas City General Hospital, Kansas City, Mo., and to St. Margaret's Hospital, Kansas City, Kansas. With 170 illustrations. St. Louis C. V. Mosby Company, 1918. Price $2.50.

The title of this little book makes one instinctively think of F. Billings' "Focal

Infection" (see DENTAL COSMOS, 1917, p. 927). Both works are equally valuable to him who would become conversant with this subject. Duke avows that "The main purpose of this volume has been to assemble facts which show, first of all, that dental sepsis is an extremely common condition, and second, that it may cause serious systemic disorders in many different ways."

The book is essentially a monograph "based upon an experience with more than 1000 carefully studied medical cases observed in a consulting-office practice." Hence much of the material is original, and is accessible nowhere else.

The historical introduction is an interesting reference to a few case histories of Benjamin Rush's. Unfortunately there is no attempt to present in due proportion and true perspective the history of the concept of oral foci of systemic infection. In spite of an admirable bibliography, there is no reference to Miller's epochal researches and conclusions, or to the early and original articles of Wm. Hunter.

Duke conscientiously recognizes the dental aspects of the problem, and enters into hearty co-operation with the dental practitioner. Nevertheless his discussion of the etiology and pathology of pyorrhea alveolaris is the poorest section of the book. Nowhere does he seem to realize the fundamental significance of that precocious senile alveolar atrophy signalized by Talbot, Hopewell-Smith, Maurice Roy, and many others, and clearly recognized even in 1778 by John Hunter

("Natural History of the Human Teeth," pt. 2, chap. 2). It was unnecessary in this chapter to refer to Endamoeba gingivalis; but if reference to it were to be made, it is absolutely inexcusable to imply priority in the study of this for Bass and Johns, and to ignore Smith and Barrett.

Duke does not accept Rosenow's contentions of the selective tissue affinities of the streptococci so unconditionally as does Billings. The former recognizes that these views are in no way necessary for the acceptance of the importance of oral foci of infection. An interesting phase of this question is the attention given by Duke to the influence of disease in other parts upon oral health and disease (cf. DENTAL COSMOS, 1918: L. M. S. Miner, p. 234, and W. Ashley Cooper, p. 530). The importance of this viewpoint has been entirely overshadowed by the volume of the evidence offered for the converse proposition.

The most novel part (Chapter VI) of Duke's monograph is the emphasis laid upon anaphylactic phenomena as a possible explanation of many systemic disturbances attributable ultimately to oral infectious foci. This view, while not entirely new (cf. DENTAL COSMOS, 1917: W. S. Hewitt, p. 43; N. P. Barnes, p. 353, and Wm. M. Wright, p. 354), still has never before received the recognition and elaboration we find in this book.

There are 170 illustrations, all well reproduced from roentgenograms of cases of dental infection. The mechanical make-up and appearance of the book are very satisfactory.

[Lancet, London, March 30, 1918.] Non-union of War Fractures of the Mandible. By PERCIVAL P. COLE.

The fundamental principle that shapes the procedure of what may be termed the "ideal" school is the restoration of the normal arch and the maintenance of accurate occlusion. In this spirit Cole has dealt with 270 cases. The total of ununited fractures numbers 30, an inclusive non-union percentage of approximately 11. Of these 30 cases union was in 12 absolutely hopeless, judged by no matter how exacting a standard. The resulting exclusive figure is approximately 7 per cent. These figures are ample justification of ideal aims. The ultimate and only test of a successful treatment of a jaw fracture should be a functional one-the patient's ability to masticate ordinary foods. Subjective must take precedence of objective signs. In general terms it may be stated that if both the masseters maintain attachment to the one fragment, disability is relatively slight.

A short summary of the methods employed to remedy these cases of non-union follows. Plating has a very small sphere of usefulness, owing to the fact that necessary contact cannot be secured without traction. In cases of old mal-union with considerable deformity the only possible method of dealing with the fragments may be to wire them immediately. Where wiring is practicable, success may reasonably be regarded as certain. Where free autogenous bone-graft has been resorted to, success is practically assured in at least 60 per cent. of cases. The results obtained by pedicled grafts are rapid and certain. To such an extent is this so that in cases of non-union amenable to this treatment success can be practically guaranteed.

Cole summarizes and concludes as follows: The results obtained by the operative treatment of non-union must be concisely summarized thus: Thirty cases have been sub

jected to operation; in 2 cases the operation has been abandoned as impracticable. Of the remaining 28. cases, 10 have been operated on too recently to permit of any definite statement as to the results obtained. Of the 18 cases whose fate is known, 13 have been completely successful, 2 have been considerably improved, while the other 3 must be regarded as failures. Thus it will be seen that the percentage of success is over 70. There has been no mortality, and post-anesthetic complications have been entirely absent. In all but 2 cases ether has been administered by intratracheal insufflation. The results are such, in a word, as to justify the conclusion that no patient so afflicted should be discharged until operation has not only been offered to, but urged upon him. The functional disability associated with ununited fracture of the mandible is, in the vast majority of cases, an unnecessary disability. [Dental Items of Interest, New York City, March 1918.]

Clasped Partial Dentures Versus Bridge
Work. BY HART J. GOSLEE.
[Dental Items of Interest, New York City,
February 1918.]

Mobile Bridges. BY L. GORMSEN.

The realization of the danger of local oral disease as a focus for systemic infection finds an expression in the renaissance of interest in prosthetic appliances. Never did the line between "plate work" and "bridge work" seem more arbitrary than it does today. The one requisite which is exacted of these types of restorations is that they be removable. This feature not only permits of thorough cleansing, but also allows the employment of retaining devices which do not necessitate the devitalization of healthy teeth. In this light the two articles given above become of great value.

In Goslee's opinion, the usefulness of fixed