VOL. 2

No. 3

"T

WHE connection of mind and body

is such that a given state of mind tends to echo itself at once in the body."

1.

"If a psychosis or mental state is produced by a neurosis or a material nerve state, as pain by a prick, so also is a neurosis produced by a psychosis. That mental antecedents call forth physical consequents is just as certain as that physical antecedents call forth mental consequents." 2.

"Mind, thru sensory, motor, vasomotor and trophic nerves, causes changes in sensation, muscular contraction, nutrition and secretion." 3.

"If the brain is an outgrowth from a body corpuscle and is in immediate

relation with the structures and tissues that preceded it, then tho these continue to have their own action, the brain must be expected to act upon the muscular tissue (whether striped or unstriped), the organic functions and upon the nervous system itself." 4.

Just as the iniquities of parents are visited upon children of the third and fourth generations, patients who apply for dental operations, have accumulated, have inherited the sum total of fear and dread that have been transmitted thru three or four generations.

An approaching major surgical operation for some member of a given family, does not begin to affright the other members of the family to the same extent

that a series of dental operations covering a period of two or three months. In the case of a surgical operation, the patient at the appointed time goes to the hospital, an anesthetic is administered, and the patient remains in the hospital till all pain and inconvenience is over. The members of the family hear little or nothing of the patient during convalescence. The member of the family who is visiting the dentist three or four times a week for a period of two or three months, brings home with him after each sitting a description of the suffering and distress incident to the work performed, magnifying it, and complaining, at every meal of teeth too sore for mastication, pain from food that is cold and food that is hot, bites accidentally on the stopping covering and arsenical application, leaves the table in distress -all of which psychologically effects every other member of the family, each one of who knows full well that he must sooner or later visit a dentist, and to a greater or less extent, undergo the same. In the case of the surgical operation, he understands that he may never be called upon to undergo such an operation, but each member of the family understands full well that there is no escaping the dentist.

Thus it is that thru inheritance and environment, the connection of mind and body is such that a given state of mind tends to echo itself at once in the body, and years of such accumulating influence, have demonstrated that "mental antecedents call forth physical consequents, just as certain as that physical antecedents call forth mental consequents."

"A lady saw a heavy dish fall on her child's hand, cutting off three fingers. She felt pain in her hand, and on examination, the corresponding three fingers were swollen and inflamed. In twentyfour hours incisions were made and pus evacuated." 5.

"A hypnotized subject can hold out

his arm indefinitely in painless contraction, can inhale strong ammonia under the name of otto of roses with unwatered eyes." 6.

"There seems no reasonable grounds for doubting that, in certain chosen subjects, conjestions, burns, blisters, raised papules, bleeding from the nose or skin can be produced by suggestion." 7

"The affects of a purgative pill has been rendered nil and it has produced sleep in the belief that it was an opiate pill, tho consisting of a strong dose of colocinth and calomel. On the other hand, an opium pill given for sleep has failed to produce it, but proved a strong purgative in the belief it was so intended." 8.

Unfortunately a state of mind has been induced in our patients thru inheritance and from constant complaint on the part of friends and companions that dental work to be performed entails discomfort, physical hardship and suffering, consequently, these mental conditions must be dispelled or the least painful operation we are called upon to perform will be interpreted as unbearable.

"The only exception is a child who has not experienced any previous dental operations, or has not experienced pain from toothache, or been subject to the complaints of others, or to whom the parent has not held up the dentist as a bogy man. Such a patient I have no trouble to work for-never deceiving them, letting them know they will feel this and that when you know feeling will result from the part of the cavity you are working in. They, not being scared, will receive no greater pain sensation than from the same amount of feeling in any other part of the body." 9.

The brain receives impressions thru the five senses; hearing, sight, smell, taste, and touch. We have already made reference to the mental impressions resulting from hearing, but in addition to this, "we can hear thru the teeth about as well as thru the ears.

It is the noise from the jump of the bur in the cavity or the click of the bur upon the enamel that automatically records a false impression of pain. We have all had the experience of operating on a devitalized tooth and the patient experiencing all the pain sensations that would come from a vital tooth." 10. This is an example of the false registration of pain thru the sense of hearing.

Sight has a potent influence in suggesting pain. How often patients shudder, cringe and blanch from pain impressions excited upon seeing the dentist approach them with a hypodermic needle, nerve broach or a pair of forceps. I have known patients to faint when being approached by a dentist with only a mouth mirror and explorer for the purpose of an examination.

Smell plays its part in the false registration of pain sensations. The odor of carbolic acid and oil of cloves recalls its application on some previous occasion for pulpitis; the odor of ether and chloroform makes vivid the distress incident to recovery from some surgical operation. It is highly important that the odor of drugs be eliminated from our operating rooms.

False registration of pain thru touch is met with constantly when performing dental operations. Few, if any of our patients, are capable of distinguishing the difference between the sen sation arising from the touch of instruments-pain sensations will be interpreted by the patient even when there is no pain, and in the analgesic stage, it must be imprest upon the mind of the patient that they can feel the pressure of the bur and hear the sound of the bur but there is no pain.

Recently I induced analgesia for the purpose of sensitive cavity preparation. I was certain that the patient could not feel pain in this deep stage of analgesia, but apparently she suffered as severely as without analgesia. A cavity in the left central incisor was being prepared.

To convince the operator that the patient was experiencing a false registration of pain, I inverted his excavator and touched the tooth, not the cavity, touched the tooth with the handle, then went as far away as the right lateral, and I never saw a patient apparently suffering greater pain. The slightest touch was interpreted as pain in this case.

"For a certain patient, preparation of a cavity had become so painful the patient refused to have the operation completed. Analgesia was induced, patient remarked, 'I can feel the pain just the same but have no desire to dodge or pull away from the instrument.' Another patient with as painful a condition remarked, 'I can feel the pain just the same but do not care a d-m.' It is evident that neither of these patients felt the slightest pain, but they failed to properly interpret their sensations." 11.

The dental surgeon stands indicted by the general public as the most cruel, barbarious and inhuman of medical specialists. The opthalmologist, otologist, rhinologist, laryngologist, gynaecologist, oral surgeon and other specialists have adopted methods of pain aleviation thus doing better work and getting better results than formerly, but the rank and file of the dental profession are no more advanced than they were a quarter of a century ago, in the matter of making dental operations less painful.

"It seems almost beyond comprehension, when the means is at hand to prevent pain, and the public are clamoring for it, demanding it, we go on in the same old way, obtaining inferior results, knowing at the time that the operation falls short of what it should be, and will fail in a few months because we cannot remove the carious dentine thoroly or cannot prepare a cavity sufficiently well for the retention of a filling or inlay, and fail utterly in shaping a tooth for a crown, and are defeating in removing calcarious deposits, yet 90 per cent of dental surgeons continue this line of practise." 12.

The solution of this most difficult problem is simple and can be exprest in two words, ANALGESIA and ANESTHESIA.

Sir Frederick W. Hewitt's Table, showing the degrees or stages in the action of the chief general anesthetics upon the human organism, and the phenomena that usually characterize these stages, makes twelve subdivisions for the stage of analgesia. 13. Among them is "excessive ideation," "disturbance of judgment" and "dreams." At the time the patient is experiencing "excessive ideation" and "dreams," HELPFUL SUGGESTIONS ARE IN ORDER. "There is a period under an anesthetic at which many patients, indeed most patients, will see, feel and experience the very things suggested as surely as if they were real, and this period is just before consciousness is lost; just at that stage where painless cavity preparation can be made." 14.

"If suggestion is potent enough when a person is normal to lock up the bowels with a cathartic, liberate the bowels with opium, mistake strong ammonia for cologne, increase or decrease the heart's action, increase or lesson respiration, cause bleeding from the nose or check hemorrhage, surely by the aid of an anesthetic, placing the patient in that stage where they are susceptible to suggestion, the dental surgeon should not find it difficult to induce that frame of mind and condition of body where dental operations can be performed painlessly," or the pain incident to the operation as ordinarily performed can be held in abeyance to such an extent as to elicit no objection on the part of the patient.

"In rabbits subjected to the emotional stimulus of fear alone the brain cells showed precisely the same changes as those which resulted from physical injury, namely, an immediate stage of hyperchromatism and a later stage of chromotolysis; a disturbance of the nucleoplastic relation and the final disin

tegration of many cells. As the result of strong fear repeated daily for two weeks as many as 18 per cent of the Perkenje cells were actually destroyed, and many animals died. In these rabbits acute fear caused a rise in temperature of from one to three degrees." 15. Because of the disastrous results of fear upon the cells and tissues of the brain, crile renders patients insensible to worry and fear preliminary to anesthesia for surgical operations by drug medication, just as I advocate analgesia for the same purpose leading up to and during dental operations. Render patients insensible to the fear and dread incident to dental operations by analgesia, relieve them of worry and apprehension as they sit in the dental chair, and cell destruction dependent upon both traumatism and fear is intercepted.

Gas-Oxygen and Somnoform are almost ideal agents for inducing dental analgesia and anesthesia.

The analgesia movement is progressing rapidly. It is enthusiastically received by the people. Walt Mason, the Kansas philosopher, must have fallen into the hands of some merciful, kind hearted dental surgeon as he pays the following tribute to him:

The Dentist.

"He well deserves a laurel wreath, the man who tinkers with my teeth, when they are out of plumb; he plugs them up with melted lead, and soothes my swelled and aching head, and heals the tortured gum, Upon his skill your comfort hangs when you have trouble with your fangs, and seldom does he fail; his shining instrument he wags and draws the old insurgent snags, then draws his slice of kale. No more you hear in dentist's room the shrieks of those who dread their doom, of those whose souls are sick; the patient calmly sits and smiles, the while the dentist with his files and pincers does the trick. How different in olden days! The den