is one in which the abutments and the dummies are subjected to the same physical stress, that is a physical stress exercised in the same direction. (Example). Supplying a second upper or lower molar, using the third and first molars as abutments.

Ex

A compound bridge is one in which the artificial substitute, by virtue of its position and acquired occlusal relation, is subject to a stress different from that which works upon the abutments. ample: Supplying a lateral incisor upper or lower, using the cuspid and central as abutments; or supplying a second lower bicuspid, using the first molar and first bicuspid as abutments.

A complex bridge is one in which the artificial substitutes are subjected to a stress wholly foreign to the stress of the abutments, and where the abutments are situated upon opposite sides of the arch. Example: Supplying four anterior teeth, using the cuspids as abutments, or supplying the four incisors and the four bicuspids and first molars, using the cuspids and second molars as abutments or piers.

That, according to mathematics and physics and according to the bridgebuilding would be the correct definitions of simple, compound and complex bridgework.

To these must be added the cantilever bridge, which is one attached to natural abutments at one end only, and depends upon the resilient mucosa for its major support. Combinations of complex and cantilever bridges may exist, such as cases presenting anterior abutments upon both sides of the arch and posterior abutments on one side only.

Now let us for a moment see where the essayist has brought us to. We are today in the throes of change. All of us are dissatisfied with the results of fixt bridgework. The best thought in the country and in the dental profession, during its history, has been applied to the solu

tion of the problem of getting away from fixt bridgework. And why? All of us know that every bit of living organism is in a state of constant motion. There isn't an atom in our body that is in a state of complete rest. Every molecule is in a state of constant rythmic motion, which motion is in definite relation to the motion of the molecules neighboring it, which warrants the conclusion that the molecules influence one another to the point of causing corresponding geometric gyrations or movements in each other. How inconsistant with this law must be the fixation of any two, three or four teeth by a denture fixt in the mouth! There isn't a bit of tissue in your body, in any organ, that isn't subject to constant motion, and that does not need this exercise to replenish it with vitality and nutriment to re-stimulate it which comes only from that exercise. And when you fix two teeth in the human mouth and cause them to carry two more artificial teeth, and when you put them in the jaw and rob them and the surrounding structure of the motion it is intended they should have, during mastication, you cause retroactive changes in their structure which makes it impossible to have a condition of perfect physiological bal

ance.

I speak with vehemence on this, because I have devoted years to the elimination of that fixation problem, and I thought we had come to the point where the schools of the country recognized that normal exercise of every tissue is what is needed by that tissue, and that we haven't a right to rob it of that.

What would happen to your arm if you tied it up in a sling? It would atrophy. When you exercise a tooth in mastication, the stress is distributed to the structures surrounding the tooth by way of its peridental membrane, in a series of motion waves, until a complete physical change of these structures has taken place. When you remove the mastica

tory stress, there is a return to normal, providing your teeth are not immovably fixt to one another, and your surrounding structures are unhampered by tooth fixation.

But if you enjoin these teeth, by putting a fixt artificial denture upon them, then you rob the surrounding structure of its motion wave, and the thing you accomplish is the elimination of the possibility of the action of these tissues. You get an inhibition of the restimulating mobility of these tissues, and you get an atrophy. I thank you. (Applause).

DR. BUSH: I want to thank those who have taken part in this discussion.

My object in giving you this classification of fixt bridgework was to classify something that we are doing in every day work. I care nothing about entering into a discussion of the advisability of the employment of this class of work, neither do I care to say anything as to the indications or contra-indications governing the use of bridgework. Those who wish to discard fixt bridgework may do so, but I do not consider my efforts in attempting its classification as entirely lost. It is very gratifying to me to know that this work is appreciated by those who I was most hopeful would appreciate it. I wish to thank you again very much. (Applause).

T

HE first thought that came to the writer when an invitation came from the chairman of the section to write upon this subject for this meeting, was that nothing new can be said about Pyorrhea and that "repetition is useless." Yet a growing interest upon the part of the public regarding this condition and the possibilities for relief demand that our attention to the matter be not abated and especially regarding so-called new methods of controlling the conditions, for condition it is and not a disease Per Se.

The new methods referred to relate especially to the vaccine treatment and embrace inoculations to raise the opsonic index. In some parts of our country this new fad has spread like wildfire and there is at least one bacteriologist who will mail to any dentist an autogenous vaccine if pus samples are furnished according to directions. So that any country dentist can treat his patients at home. When we consider the care demanded before inoculation, thru physical examination, urine analysis, fecal examination, blood tests, etc., before inoculation is practised, it is hardly possible that this would be carefully done in the "mail order way."

The practise has become so frequent that one asks-why? The most intelli

gent of the specialists who rely upon vaccines claim only an aid to local instrumentation and local remedies, and while acknowledging that irritants must be mechanically removed, claim that recurrence of Pyorrhea is prevented by the inoculation.

The writer has in the last thirty-five years observed hundreds of cases of Pyorrhea and in many patients there has been a recurrence after relief had been given-but in not a single case was the return due to anything but a new deposit of calcic matter or other evident local irritation due to a lack of oral care.

If then the vaccine advocates acknowledge that mechanical irritants are the chief causes of the condition-and also declare that these must be removed surgically-how is recurrence to be prevented without again using local means? Do they acknowledge that the condition originates from irritants? Yes I quote from Dr. Medalia, page 705, Cosmos, 1913, "As to the causes of this disease I found that the mechanical causes are by far the most important ones in starting the disease while the local infective causes I found more important in keeping it up." "Among the local mechanical causes," he continues, "tartar deposits and calculi are the most important." Now if the disease does not start without me

chanical irritants, and when once relieved from inflammation, pain and effusions, recurs again, does not local, irritation again supervene? And how pray does inoculation prevent the precipitation of calcic matter? It has been claimed that vaccines do away with the over saturation of the blood and lymph with calcic matter-but Adami has clearly proved that theory is incorrect.

He says, "We never find the blood so full of calcium salts that these become deposited within the vessels." "In all cases the amount of calcareous salts in the blood is far below the point of saturation." "What stands out very prominently is that in a majority of cases a deposit of these salts occurs in dead tis sue, or in the inanimate intercellular parts of living tissue."

"Thus it follows that for calcification to occur it is necessary that lime salts be brought to the parts. This can only be done by the agency of the blood, or more exactly the lymph. We know that both of these fluids contain calcium salts in solution, and as the lymph diffuses into the parts, chemical processes ensue such that the contained salts become converted into insoluble salts, and are precipitated in Situ."

From this quotation it will be seen that to claim the return of Pyorrhea would be prevented because the vaccines clean the blood and lymph of an unusual amount of calcic contents, is untenable, and raise the opsonic index would not prevent precipitation of calcic matter if a proper nidus were established by a lesion for such precipitation. Dr. Gompertz, another advocate of vaccines, endeavors to prove the efficiency of the vaccine treatment; but under the head of

ADJUVANT LOCAL TREATMENT says (p 813) Cosmos, 1913.

"I might mention that appropriate local treatment should also be employed in conjunction with the vaccine and I

believe that the more thoro this treatment the more permanent the results."

Does this not look like a "Confession and Avoidance" as the lawyers would say? It certainly says to the writer that the more careless the treatment the more demand there is for inoculation and that a still more "thoro" local attention might nullify the plea or necessity for vaccines entirely.

We hear frequently writers and speakers upon the subject declare that local surgical treatment did not avail and results only came after the use of vaccines.

(Dr. Gompertz, says Cosmos, 1913, p 811): "That Pyorrhea Alveolaris does not respond to conventional treatment can not be disputed."

(Dr. Beebe, Cosmos, 1913, p 481), "Most of the patients seen by the writer were referred by good dentists being cases they were unable to benefit."

At the last Kansas Meeting a paper upon the "vaccine treatment" related several cases when surgical treatment failed and immediate relief ensued with vaccine.

cases

That

It seems strange does it not? treatment" where "conventional fails are invariably found in the hands of the pro-vaccinationist.

Scores of operators all over the country will testify as does the writer, that intelligent and persistent local treatment completed, will never fail to show satisfactory results.

Then why the discrepancy in clinical testimony? Is it climatic? Is it racial? Is it argumentative? Or is it on the account of the "Personal Equation?" Or the vagaries of an Abnormal Psychology?

Each can draw his individual conclusion. This should be done without prejudice and without bias remembering that "He who knows only one side of a question knows neither."

It has been said there is no danger, no risk in the vaccines treatment.

Such remarks, it will usually be found, come from the uninformed, for the bare

statement that the implantation of disease elements into the bodily tissue be they ever so attenuated, cannot be done without danger, "it is subversive of the fundamental principles of sanitary science," and history proves its danger by long lists of infections and deaths from vaccination.

Risks, however, must and should be taken to preserve human life, and if, in the treatment of a malady a specific micro-organism or Bacillus is known, then measures to render that pathogenic entity inert are taken, and the scientific world approves. In the treatment of Pyorrhea Alveolaris we are not dealing with a condition that per se endangers life, then why subject our patients to the risk of infection from the dead bacteria from the pneumococci, the streptocci, the staphylococci and the M. Catarrhalis which furnish the injections in either autogenous or stock preparations which are usually employed.

It would be an unnecessary task in this paper to place before this assembly the long clinical history of the dangers of vaccination. The record is in literature and can be easily obtained.

"Vaccination will undoubtedly rank as the greatest and most pernicious failure of the century. This conclusion is no longer a matter of opinion but of science." So says Alfred Russel Wallace, co-discoverer with Darwin of the law of Evolution and universally regarded as one of the leading scientists of the day.

I will place before you the record of a few cases from the writer's practise and from conferers who are members of a small club of dental progressives in Kansas City and who have kindly volunteered to give record of cases where good or bad results followed the vaccine treatment.

FIRST CASE.

(In my own practise.)

“Mr. L.—, age 20, presented to me the early part of 1913 with the worst case

of lip, tongue, and cheek ulceration from Pyorrhea I had seen-the face and lips gave every expression of Cheilitis."

History by physician: "Young Lhas been treated by me and previously by two other specialists by making blood tests and by vaccines to raise opsonic index, with little or no result-I noticed gums were bad and have sent him to you." After five treatments taking a few teeth at a time ulcerations on lips and tongue which were always at a point where advanced Pyorrhea Pockets were present, disappeared-later the pimples upon the face healed and now, one year later the cure continues.

Indifferent scaling had been performed prior to the Serum treatment. My treatment was entirely local.

I have received the following letter from his father:

Dr. J. D. Patterson.

June 3, 1914.

Dear Doctor:-I take pleasure in stating that your treatment of my son, greatly benefited his teeth and gums. As a matter of fact prior treatment by specialists did not benefit him. This word of indorsement is made in justice to you. (Signed)

SECOND CASE. (Reported by Samuel Lobenstein, D. D. S.) Mrs. B, age 45 years, nurse, several teeth, upper and lower, affected. Rheumatism, physical condition below par. Pyorrhea Alveolaris quite well marked, recession of gums considerable.

Patient inoculated with autogenous vaccine, micro-organisms present mostly staphyloccus and Streptoccus. No mechanical or medical treatment of the teeth and surrounding tissues until after three or four inoculations. Pus began to diminish in quantity and intensity at once. Pyorrhea cured and patient dismist at the end of four or five weeks physical condition improved greatly, rheumatic pains have entirely subsided.