my "machine" to see whether or not I had been misled by it for the past five years or more.

Accordingly I took a couple of extracted teeth, and without any particular preparation, except to see that I could carry a broach through the apex, I "pumped" my old-fashioned chloro

percha through the canal until it came out in the shape of a little ball on the end of the root. I am sending a radiograph (Fig. 1), and you can judge for yourself whether or not chloro-percha will show in the radiograph.

canals as though it were simply chloropercha.

You will notice two places where the air was caught in the canal, due to the fact that I was in somewhat of a hurry, but the film clearly shows the filling, and by the way, there are no canal points in any of these fillings.

It seems unfortunate that statements of this character should be published so widely as this has been without first getting conclusive proof. Might there not be something wrong with the author's machine, or perhaps with his method of

developing? If I am wrong, I should be glad to know it, but I think I can see a filling in the roots, extending through the apex of the root, and collected in a little ball on the end of the root.

If this experiment is of any value you

have my permission to use it as you wish.

Yours for better root-work,

N. A. DEWITT, D.M.D. CAMBRIDGE, MASS., June 6, 1918.

TO THE EDITOR OF THE DENTAL COSMOS:

Sir, I have had occasion in my practice to see among the American soldiers here quite a large number of cases of pyorrhea alveolaris. The cases were of such a grave nature that they resembled more nearly scurvy than simple pyorrhea. I found the mouths of these men to be in very bad condition from the hygienic standpoint alone, so bad that it was sufficient cause to account for the gum conditions which I found. I know that in the United States there is an important movement for dental prophy

laxis, and trust that by publishing this letter in the DENTAL COSMOS you will convey to the profession the necessity of at once sending to France a dozen prophylaxis nurses who could devote themselves to caring for our men here, who are very sadly in need of their services in very many cases. Surely this is a very small service to ask for our men, who stand so sorely in need of it. Yours very sincerely,

D. S. KRITCHEVSKI.

PARIS, FRANCE, May 25, 1918.

TO THE EDITOR OF THE DENTAL COSMOS:

Sir, I would like to report a that came under my observation while I was stationed at Camp Gordon, Ga.

A ptosis of the left upper eyelid, the onset of which was coincident with an acute attack of neuralgia, was traced to a pulpitis in the left upper second bicuspid.

The disappearance of the neuralgia.

was followed very closely by an abatement of the ptosis with a complete return to normal in less than a week.

None of those in charge of the eye and ear clinic had seen a similar case. Respectfully,

HENRY P. WADSWORTH, M.D., D.D.S., Lt.D.R.C. CAMP MERRITT, N. J., July 8, 1918.

THE meeting was called to order by the president, Dr. Jaquette, at 8.15 P.M.

The minutes of the last meeting and the report of the Council were read by the secretary and approved.

The Secretary read communications from the following, thanking the society for electing them to honorary membership: Dr. J. D. Thomas, Dr. H. C. Register, Dr. E. C. Kirk, and Dr. Thos. C. Stellwagen through his son. These letters were placed on file.

The President then called on Dr. L. A. FAUGHT to read his paper, entitled "Non-cohesive Gold."

[This paper is printed in full at page 685 of the present issue of the Cosmos.]

Dr. OTTO E. INGLIS then read a paper entitled "A Comparison of Office Policies, with Special Reference to Pulp Exposure or Death."

[This paper is printed in full at page 692 of the present issue of the Cosmos.]

DISCUSSIONS OF PAPERS BY DRS.

FAUGHT AND INGLIS.

Dr. H. C. Register. Dr. Faught has given us a most interesting paper on a very old subject, one that appeals to me, however, as being always new, because it continues to mean so much to both the operator and the patient. From clinical observation there is reason to believe that the results obtained from non-cohesive gold fillings are absolutely dependable, providing the cavities are formed along anatomical lines.

I have seen many fillings of the operators of long ago doing continued service for upward of three-quarters of a century; and I have a few of my own made by this method, still "holding the fort" after forty-odd years of service. I shall endeavor to show how non-cohesive gold foil in the form of cylinders and tape saves teeth, and why it appeals to me as being the one universal method to use where gold is indicated.

Gold does not undergo any physical or chemical change in the mouth; it is compatable with living structure, and when used in non-cohesive form for filling teeth its thermal conductivity is lessened and the vital dentin is stimulated to throw out a plasma, which seals the tubules, and this in turn also acts as a non-conductor; also, packing the gold in this form saves time in the construction of the filling, and protects the margins against mechanical injury while filling.

Of course the laws leading up to such a consummation must be observed. We meet with many cases of natural secondary dentin protection in cases of accidental exposure or mechanical attrition where the conditions are favorable. I recall a case where the entire enamel of the labial surface of the upper left central incisor and a part of the lateral were destroyed by the chemical action of a "sour drop" remaining on these surfaces over night. The patient pushed the acid candy there with his tongue, and went to sleep. This was practically a case of acute erosion. The merging of the enamel endings into the

Gold fillings, cohesive from start to finish, are in my judgment unreliable for very long service, on account of the injury to the tooth, especially the dentin, in placing the filling.

Porcelain and pure gold inlays may add longevity to carious teeth when at long-service insoluble cement is found, for the cement in this class of work is the material that saves the tooth. Guttapercha is quite limited in its application but a most compatible material, while the cements are all temporary.

Probably seventy-five per cent. of the teeth filled are filled with amalgam. Of this total probably twenty-five per cent. give a service of ten years. Ten years is not a long service, yet it proves that alloy fillings will save teeth aided by the protection of this same deposit of plasma by the dentin fibrils. When we get a perfectly balanced, chemically combined amalgam that is unchangeable, we shall have still better results.

So we are left the one method as demonstrated in actual service for making fillings which will last three-quarters of a century or more, namely, soft or noncohesive gold in the form of cylinders and tape as described by Dr. Faught. I think Dr. Faught is in error regarding Abbey's non-cohesive gold foil remaining non-cohesive under all conditions. Dr. George Ellis demonstrated to me many years before his death that by annealing each leaf separately on both sides to a cherry red the surface treatment given the foil in its manufacture was burned off, and the foil regained its cohesiveness. Dr. Inglis' paper fits into Faught's, the two forming an interesting symposium upon early treatment.

Dr.

He calls attention to the importance of early discovery of cavities, and their immediate filling, even to pinhead cavities. This in my judgment is wise treat

ment, and non-cohesive gold in the form of cylinders and tape is the best material. for such restorations.

Dr. Inglis also calls attention to the use of the electric mouth lamp in locating approximal cavities. The use of the electric mouth lamp has given me much satisfaction in this class of examinations. By using a black muslin cover thrown over the heads of patient and operator, thereby excluding the light-practically a dark-room-the electric lamp, exposed on one side only by using a guard, illuminates the teeth so perfectly that any carious spot present in the incising teeth -from cuspid to cuspid-is immediately brought to view.

In large breaks in bicuspids and molars some experience is required to note the absence of the natural translucency, but the discolored border and knuckling contact show up immediately.

Many cavities thus found are very extensive, and yet are passed over without detection by the ordinary examination with an exploring needle. Many approximal cavities thus discovered necessitate cutting through the occlusal wall, thereby forming a compound cavity. I will briefly outline my method of restoring a complicated cavity with non-cohesive and cohesive gold combined. The cavity is formed with a flat base at the cervical wall. Do not undercut near enamel, for enamel thus treated is limitedly devitalized-and this, in my judgment, is largely the cause of so many failures of fillings at the cervical margin.

The buccal and palatine cavity walls are slightly beveled outwardly, thereby retaining the enamel rods in normal strength from periphery to dento-enamel junction. The cavity in the occlusal wall is terminated in a dovetail anchorage spreading laterally, with straight walls extending through the whole depth of the enamel to the occlusal step, and at times slightly grooved in the dentin.

Extensive molar contours may receive two grooves, one on each side of the cavity from tuberosity to dentin in alignment with enamel rods, made with a fissure bur to half its width. A planished copper matrix, sufficiently wide to include the cavity from the cervical wall to

just within the contact point with adjoining tooth, is ligated to the tooth and burnished from the inside to contour form against the adjoining tooth. If the dentin is sensitive or the pulpal wall thin, the dentin is given a coating of para-chloro-percha. This immediately relieves all irritation of the exposed dentin, and obviates thermal shock. The cylinders are laid on the cervical wall with one end in contact with the pulpal wall, and the other end against the matrix.

The cylinders are placed with special pliers in regular order, and packed under a pellet of bibulous paper with special pliers and hand pressure, and later with a plugger in the mechanical mallet, until the cavity is filled even with the occlusal step. This is quickly done; then several pieces, as required, of mat gold unannealed are packed over the entire gold floor and into the occlusal dovetail, this being followed by several layers as required of annealed cohesive mat gold, carefully packed by hand and mallet force. Rolled cohesive gold from No. 30 or 60 up to 120, cut in size to easily lie in the cavity, is now used.

The gold is laid in laminæ from the locking dovetail to the adjoining tooth, and packed as tightly as possible. This slightly wedges the teeth apart as the packing is done, and sufficient space is gained to allow a Gordon White saw to pass through the excess, permitting complete finishing, and return of the tooth to its knuckling contact. This latter part of the work is most advantageously done a few days later, as the teeth having responded to the wedging process do not constantly spring together during the finishing. The death of the pulp seems likely to spell the doom of a tooth, first, because of the tooth's physical inefficiency to maintain itself-and consequently disintegration, aside from caries, takes place; and second, the septic foci formed by decomposition of the organic matter, which includes the pulp and onethird the dentin, are in the light of recent investigations likely to force extraction in spite of apparent comfort.

Devitalization and disintegration are synonymous terms as applied to devital

ized teeth, and until original research points a way to safe treatment of rootcanals, we must bend our effort toward pulp conservation.

Dr. Inglis. In approximal cavities in incisors I occasionally use a combination of non-cohesive and cohesive gold. The gold is used in ropes or tape packed so as to fill an entire angle from the pulpal wall out, each mass being thoroughly condensed. Successive masses so packed finally leave an accessible unfilled concavity into which cohesive gold is placed as a key to complete the filling. This is much easier than to attempt to turn in non-cohesive gold with the small pyramidal plugger used for that purpose.

Dr. S. B. Luckie. I have not had as much experience with non-cohesive gold foil as my friend Dr. Faught has, although we probably entered practice at about the same time. I did for many years, however, at the suggestion of Dr. Bonwill, use Abbey's foil, both the noncohesive and the cohesive. In seeing Dr. Bonwill operate, I learned that he could put in contour fillings with Abbey's noncohesive foil. I attempted it, and feel that I succeeded very well; but my principal success has been with the two kinds of gold, the non-cohesive in the cervical portion of the cavity, and the cohesive for the buccal and labial walls and the remaining portion of the cavity, somewhat as described by Dr. Inglis. In the use of non-cohesive gold foil, there is no doubt that it is more compatible with the dentin than cohesive gold, which is more stubborn, and requires more force to adapt it to the walls of the cavity. By lining the cavity with the non-cohesive gold, as brought out by Dr. Register, the dentin has an opportunity to heal.

In regard to Dr. Inglis' paper, I think the whole gist of it brings us right back to the fact that we must practice prophylaxis. We must not only practice it, but teach the importance of it. As for educating the public, as suggested by the essayist, I do not think the method proposed would be a successful one. It appears to me that if the laity will not listen to the words of the family dentist they would hardly be influenced by what they might read in the public press. It