on No. 00, using a light touch. As soon as a paper becomes clogged or worn out it is discarded for a fresh piece. Old sheets are used in grinding prior to polishing. As soon as the first surface is ground true it must be finished on No. 0000. Two pieces of this grade are rubbed face to face to remove large particles before grinding the section thereon. Polishing is done on the smooth side of a piece of sandpaper, the paper pulp constituting the buffing surface. Final polishing can be performed on a piece of smooth groundglass, on the palm of the hand or on a razor strop.

After grinding and polishing one surface, the section must be removed (dissolving the shellac in alcohol) and re-cemented prior to grinding and polishing its second surface.

After this the technique of mounting is the same as for ground sections prepared by any other method.

[Laryngoscope, St. Louis, February 1918.] Macroglossia Lymphangioma, with Report of Case. BY R. D. SLEIGHT AND W. HAUGHEY.

The case was that of a girl, age six, of Polish birth. Family history was negative. The growth was first noticed at the age of six months, sequent to clipping the frenuin linguæ. The tongue, which usually is soft to the touch and nearly normal in size, with a spreading, superficial growth, is subject to marked enlargement by exacerbations occurring at irregular intervals. These are too infrequent as yet to justify operation.

The principal value of this report is the general discussion of the condition and the references to the literature of the subject, for which the case report serves only as a text.

[Medical Record, New York City, June 1, 1918.] True Pruritus Ani: Its Association with Pyorrhea Alveolaris. By E. JAY CLEMONS. True pruritus ani is the percolation of infection from within the rectal mucosa into the loose subcutaneous tissue of the anal canal. The organism which is the etiological factor in this condition is a streptococcus. The nature of the organism leads Clemons to believe that the rectal mucosa is not the primary site of infection. This view is fur

ther confirmed to his satisfaction by the fact that in studying cases of true pruritus ani it is found that the patients are suffering from pyorrhea alveolaris.

Clemons failed to identify the streptococcal strain obtainable in the lesion. In other studies S. fecalis has been found. If this latter strain were proved to be the responsible agent, it would go far to exculpate the oral infection, because the streptococci of pyorrhetic pockets only rarely or never belong to the strain of S. fecalis.

[Annals of Otology, Rhinology, and Laryngology, St. Louis, December 1917.] Dentigerous Cysts, with Report of Case. BY IRA FRANK.

The case is that of a boy, age twelve and one-half, in whom there was first noticed at the age of six a swelling of the left maxilla just beneath the naso-labial fold. The growth was never painful; it increased slowly in size until at the time of presentation it equaled that of a small plum. The left second incisor, canine, and premolars had never erupted. The overlying mucosa was normal, and there was no glandular involvement. Palpation re vealed a parchment-like crepitation. A radiograph distinctly showed a cyst with three of the missing teeth. Upon removal the cyst was found to be 3 x 3 x 2 cm. in size. Its outer wall was whitish and smooth, its inner surface pink. The wall was 3 mm. thick. Three rather small but well formed teeth

were found. The microscopic picture was typical, and showed evidence of acute and subacute inflammation.

[Annals of Surgery, Philadelphia, July 1918.] Fibrin Paper as a Hemostatic Agent. By SAMUEL CLARK HARVEY.

Tissues and tissue products have proved themselves in recent years to be most efficient in stopping bleeding from multiple small vessels, from vessels in delicate tissue, and from sinuses. The peculiar advantage in the use of these tissues is that they, being absorbable, can be left within or upon the wound, thereby avoiding the danger of stripping off the coagulum.

In the present contribution, Harvey describes a method [for details, see original] for converting the fibrin of beef blood into a fabric easily kept, sterilized, and applied.

This fabric is found to correspond in effectiveness and amenability to absorption with the untreated fibrin, while being far more adaptable to the operating room technique. In dental practice this agent would lend

itself easily wherever a hemostatic was indicated, e.g. the moistened and softened "paper" could be packed under compress into a persistently bleeding tooth socket, and left there to be absorbed without further trouble.

Silver Nitrate in Root-canals.-We are being taught to deposit silver, from ammoniatreated silver nitrate, in root-canals by using formalin. Since experiments have probably shown that in electric ionization we drive our ions into and not through the root tissue, it occurred to me that this was the best way to deposit the silver in the root tissue, and experiments in practice seem to fully justify this treatment. Use a silver wire electrode. -F. D. PRICE, Oral Health.

To Measure the Circumference of a Tooth for a Gold Band.-Run a copper or aluminum wire through the rolls to make a very thin ribbon, or use the flat aluminum wire used in wireless work, but rolled thinner and annealed. It can be passed around the tooth and easily slips under the gum margin if desired, and may be pinched with the tweezers, as we make orthodontia bands. The correct measure of the circumference of a tooth or root can be obtained in this way quicker than the wire can be adjusted in the dentimeter.-F. D. PRICE, Oral Health.

Aid for Shoulder Crown Technique.— When adapting the gold base or fitting upon which the wax contour is to be developed, we frequently have trouble in making a good adaptation. This difficulty may be overcome by looping a gold wire around the upper axial third of the fitting. Twist it up tightly and then drive it down to the shoulder in a similar manner to the method employed for driving a hoop on a barrel. This wire loop will give a perfect and snug-fitting cap. If the wire is of 22-k. or 24-k. gold it may be left in situ while the crown is being developed, and finished in the usual manner.— F. W. FRAHM, Pacific Dental Gazette.

Sphagnum Moss as a Surgical Dressing. --Sphagnum moss is being extensively collected in England and her colonies for use as a surgical dressing. A number of eminent English surgeons and the army medical service have indorsed its use in the present emergency, and one eminent surgeon has declared that sphagnum dressing is superior to any cotton dressing, and that it has better absorbent qualities.

A number of the pharmacists, especially those in certain sections of Scotland, have aided in this service, and their botanical knowledge was highly useful in this connection.

It is stated that all that is necessary is to collect the moss, dry it in convenient clean places, and pack it in bags. Sphagnum moss grows so extensively in the marshes, bogs, and wet places throughout a very large portion of the United States that its value as a surgical dressing or packing and for other war purposes where cotton, oakum, or similar materials are now being used should be determined, and this problem is well worth the investigation of Red Cross and army medical authorities. If its usefulness for such purposes can be established, an endless supply is available at a normal cost.-EDIT., Amer. Journ. of Pharmacy.

Sterilization of Local Anesthetics.-A simple but effective method of preparing a sterile solution of cocain or other local anesthetic which may also contain epinephrin chlorid is described by Macnaughton-Jones. It consists in preparing a solution of sodium chlorid together with the anesthetic or anesthetics and epinephrin chorid, each constituent being present in such quantity that a dilution with many (for instance, forty) times the volume of water will give a solu

tion containing the requisite percentage of each. The preparation is placed in a sealed phial or ampule and kept until required. Sterile water is added immediately before injection. Experiments demonstrate that even if the preparation be inoculated with the ordinary forms of bacterial contamination, the presence of concentrated salt renders it sterile in a few days. A simple method of preparing the concentrated solution is to take the quantities of anesthetic, salt, etc., required per 1000 and dissolve in water, but make up to 25 instead of to 1000. The concentrated solution which Macnaughton-Jones prepared contains procain 3.25 (13 per cent.), sodium chlorid 3.25 (13 per cent.), epinephrin chlorid solution (1 in 1000) 8.0 (32 per cent.), water by weight (or metric), add 25.0 (100). If a 2 in 1000 (0.2 per cent.) solution of cocain be desired, the formula would be modified as follows: The osmotic pressure of such a solution is only equal to that of a 0.35-1000 sodium chlorid, and consequently about 3.65-1000 of this salt is added, but inasmuch as cocain produces anemia the epinephrin may be reduced if desired. The concentrated solution: Cocain hydrochlorid 2.0 (8 per cent.), sodium chlorid (approximately) 3.75 (15 per cent.), epinephrin chlorid (1 ́in 1000) 6.0 (24 per cent.), water by weight to 25.0 (100).-Journ. Amer. Med. Association.

To

Gold Foil Fillings.-What do we seek to accomplish in the operation of filling a tooth? Is not the primary object to stop the progress of decay toward the dental pulp, and save its life? To preserve it in its health? immunize the tooth surfaces? To restore the tooth to its original form and function, and to protect the investing tissues? If this then is our duty, I ask what material has time proved to be first in accomplishing these results? With the rubber dam in place, the cavity is prepared under dry conditions, with less pain, and we know we secure a superior cavity. We know when we fill that cavity with gold foil, fresh from the flame, we are using a sterile material, and we have had demonstrated for forty years the immunity of those fillings by men who have gone before us. When properly performed, these operations have stood the test of time, first in order of all the filling materials. I plead with you, do not let the meteor going through the heavens hide from view the stars of the first magnitude. Do not let the inlay draw your attention away from the technique of gold foil, because in the average number of cases I believe we know and can prove that gold foil can be not only better adapted to

those cavity walls, but quicker. It is foolishness to discuss which is the quicker. That is not what we are after. Which is the better? What is the material with which we may use to our great advantage the elasticity of the dentin, and place in the cavity a filling which the dentin will grip continuously and hold there secure against moisture and bacterial invasion? Only one material— gold foil. Somebody said it was "so difficult to use." I challenge that statement. It is difficult because we have not studied it; it is difficult because we do not comprehend the facts entering into the operation. Five or six things are necessary, we are told, in securing a good inlay-temperature, change in volume of materials used, etc. The operator in gold foil may secure absolute adaptation of the material to sterile cavity walls and eliminate all chances, in one operation. Where gold foil is indicated let us use it honestly, carefully, and scientifically. It will then demonstrate its wonderful possibilities.-J. M. PRIME, Journ. N. D. A.

Synthetic Technique.—Prepare the cavity as for a gold filling, with square margins and no bevels whatever. Chill the slab to a temperature of about 65° to 70° F. and wipe the slab and spatula with grain alcohol. Have ready instruments of tantalum, ivory or agate always an agate spatula-celluloid matrix strip, pliers, and cocoa butter. Next dry out the cavity with alcohol, and wherever feasible, especially when deep, line the cavity with Caulk's cavity lining; then adjust the celluloid matrix.

Place the powder and liquid on the slab, taking out about twice the amount of powder as of liquid. Mix promptly on exposure on the slab, that is, complete the mixing within a minute and a half. This is easily accomplished if a large quantity of powder is introduced into the liquid and spatulated only enough to saturate it, followed with successive small quantities until the mass is just past the point where it is wet, but is still plastic.

With the celluloid matrix strip in position. introduce the synthetic cement into the cavity, working it well into the undercuts and against the cavity walls. Fill the cavity with slight excess, bring the celluloid matrix strip around the filling and hold it stationary for 34 minutes by the watch, with a firm pressure but without burnishing. At the expiration of 3 minutes the strip will release itself. Immediately coat the filling with cocoa butter to exclude the air, and allow it to stand undisturbed for ten or fifteen minutes, accord

ing to the size of the filling; then dress down with abrasives carrying cocoa butter.

In approximal cavities it is permissible to use bud-shaped, fine grit, clean carborundum points carrying cocoa butter on the lingual surfaces, where they are inaccessible to disks and strips. Follow with fine-grit sandpaper disks and strips, and finish with finest cuttlefish disks and strips, always carrying cocoa butter. It will be found that a better color and finish will be obtained if the final finishing is deferred until a subsequent sitting. Before removing the dam, wipe off the cocoa butter with dry cotton, and immediately coat the filling with varnish. Do not use a varnish containing alcohol, as it will dehydrate and change the color of the filling.-GEO. D. SMITH, American Dentist.

Chlorin Antiseptics.-The antiseptics of the chlorin group which are most commonly employed in the treatment of infected wounds are the following: (1) Hypochlorous acid and its sodium and other salts, including Dakin's solution. (2) Chlorazene (chloramin-T), the abbreviated name for sodiumtoluene-sulfon-chloramid, which is employed in an aqueous solution. (3) Dichloramin-T, the abbreviated name for toluene-sulfon-dichloramin, which is used only in an oily solution.

In most respects, the action of the various chlorin compounds is essentially similar, though each possesses certain properties which render it more or less suitable for particular purposes. As a matter of convenience, it may be desirable to give a short résumé of these considerations, the results of which are mostly taken from the experiences of Dakin, Carrel, Dunham, Lee, and others, as well as our experiences at the West Side Hospital.

(1) Hypochlorous acid and hypochlorites are best suited to cleansing septic wounds by irrigation. They markedly assist in the dissolution of necrosed tissue; they are unstable and very reactive, and must be renewed frequently in all parts of the wound, this being best accomplished by an intermittent method of instillation. But the complexity of the apparatus necessary to obtain the ideal result, that is, by frequently renewing the antiseptic, makes this method quite cumbersome.

(2) Chlorazene (chloramin-T), used in aqueous solution, is more stable, exerts more prolonged antiseptic action, and is considerably more effective than the hypochlorite when acting in the presence of blood. For details concerning the preparation of solutions of the hypochlorites and chlorazene, we refer to the publications of Dakin and Carrel.

(3) Dichloramin-T dissolved in a special oily solvent may be sprayed upon wound surfaces or poured into accessible parts of deep wounds. It yields moderate amounts of the antiseptic to watery media such as the secretion from wounds or mucous membranes, but yields much greater amounts when used on dry surfaces. It is suitable for cases requiring prolonged antiseptic treatment and for first dressings of recent wounds which do not require irrigation. It is also used for nasal and oral and for ocular antisepsis.

By reason of its availability in oily solution, dichloramin-T has a great advantage over the other chlorin antiseptics in that it may be used in high concentration, and its action is of much longer duration. The application of the oil is extremely simple, and it ordinarily need not be renewed more than once in twenty-four hours.-L. I. MILLER, Amer. Journ. of Clin. Medicine.

Dr. George A. Maxfield.

[SEE FRONTISPIECE.]

DIED, Tuesday, July 30, 1918, in his seventieth year, at his home in Holyoke, Mass., after an illness of several weeks, GEORGE ARTHUR MAXFIELD, D.D.S.

Dr. Maxfield was born at Chicopee Falls, Mass., October 29, 1848, the son of Arthur

Dr.

L. and Orrissa (Anderson) Maxfield. Maxfield's father was a prominent cotton goods manufacturer of New England, and removed from Merrimac, Mass., to Holyoke in the year 1854.

Dr. Maxfield received his early education in the public schools of Holyoke, and in 1879 entered the University of Pennsylvania, de

partment of dentistry, from which institution he received the D.D.S. degree in 1881. Immediately after his graduation Dr. Maxfield opened an office in Chester, Pa., where he practiced dentistry for two years. In 1883 he returned to Holyoke, where he established himself in the practice of his profession, remaining there until the time of his death.

Dr. Maxfield was conspicuously successful in practice, especially as a consulting dentist in the diagnosis and treatment of unusual and obscure oral diseases. Dr. Maxfield was for years a leading citizen of Holyoke, always interested in every movement which concerned the betterment and uplift of the community. He was an active member of the Second Baptist Church of Holyoke, which he served as clerk for many years.

Dr. Maxfield was long and favorably known as one of the most active and enthusiastic dentists of his district. He was closely associated with every development of the dental profession in the Connecticut Valley, and was particularly active and influential in the Massachusetts State Dental Society. His conscientious endeavor was always for the elevation of the standard of dentistry by his influence and efforts in the various dental societies with which he was connected. He was particularly interested in the younger men of the profession, and was always willing and anxious to lend them a helping hand. He was for eleven years secretary of the Connecticut Valley Dental Society, in which society he continued his activity when it was merged with the New England Dental Society, and later into the present Northeastern Dental Association. He was president of the Massachusetts Dental Society in 1895, and as vice-president of the society the previous year he was one of three members who planned the reorganization of the state society into seven districts, and helped to draft the constitution and by-laws for the reorganized society.

He was appointed a member of the Board of Registration in Dentistry in 1897 by Governor Roger Walcott, and served on that board for fourteen years, retiring in May 1913.

Dr. Maxfield was typical of New England manhood. He was a staunch supporter of the dental law, and, together with those associated with him, was responsible for the high standard which dentistry has attained in New England, and particularly in Massachusetts.

He was a frequent contributor to the dental literature, and also the inventor of several useful dental appliances. He was the joint inventor with Dr. Newton Morgan of the wellknown Morgan-Maxfield disk mandrel, which has for many years been one of the standard dental appliances used by dentists throughout the country.

In addition to the societies already mentioned he was a member of the National Dental Association, and honorary member of the New Hampshire, Vermont, and Connecticut State Dental Societies.

Dr. Maxfield was married in 1871 to Miss Elizabeth R. Bennett of Holyoke, who died in 1882. In 1885 he married Miss Martha H. Currier of Holyoke, who survives him. His remains were interred in the city cemetery of Holyoke, Friday, August 2d.

Dr. Lloyd Allen Osborn.

DIED, Tuesday, July 24, 1918, at Fremont, Iowa, from drowning, LLOYD ALLEN OSBORN, D.D.S.

Dr. Osborn was born August 13, 1890, at Stuart, Iowa, the son of William T. and Mary Osborn. Dr. Osborn obtained his early education in the high school at Valley Junction, Iowa, and later attended Drake University at Des Moines, Iowa. He entered the State University of Iowa dental department in 1912, and was graduated from that institution in 1915. He immediately opened an office in Fremont, Iowa, where he practiced his profession until the time of his sad death.

Dr. Osborn held a commission as 1st lieutenant in the Dental Reserve Corps of the United States army, and was expecting a call into the service when death overtook him. He was active in religious work, and was a regu lar attendant of the Presbyterian Church in Fremont. At one time he was a teacher of a class of boys in sunday-school, and later became interested in the boy-scout movement. He became a scoutmaster, and organized a troop at Fremont. He was on a scouting expedition with his troop on the river near Fremont, and was attempting to save one of the boys of his troop who had accidentally fallen into the swiftly moving current of the river when he lost his life, sacrificing it in