Age 11 years; this case was discovered by a dental school inspector who referred the case to me for operation for cleft-palate. Inquiry revealed the fact that the cleft was of less duration than two years standing and that there was an absence of the nasal septum.

A Wassermann reaction proved positive and the child excluded from school. We are still uncertain as to whether the disease was acquired or hereditary. We expect to make a Wassermann reaction on the parents blood as soon as possible. This child was a menace to the whole school population, and is another case evidencing the value of dental inspection in the schools, as many cases of disease are found within the mouth.

department. Without this we could not arrive at a proper conclusion as to the value of the work done by each individual.

Thru our co-operation with the Board

of Education a so-called "Merit System" has been introduced in the schools in which the children are credited on their monthly report card for Oral Hygiene the same as for arithmetic or writing. Since introducing this system we have found that their pride would not permit them to fall behind in this subject.

When they called at the clinics and could not be treated, owing to the large attendance they felt that they were being neglected and they repeated their visits until treatment was received. This is a demonstration of true American pride.

We also desire to establish clinics in hospitals where it is practical. Our object in doing this is to increase the efficiency of these clinics and thus gain 16.5%. Altho in some schools we find it possible to maintain a clinic six days a week in others we are unable to get heat and janitor service on Saturdays as repairing, cleaning, etc., is usually done on that day. In hospitals it does not occur and the clinic is continuous, hence the increase in efficiency which is a big factor in any enterprise.

To the visiting nurses, employed in contagious disease work, we intend to deliver a course of lectures on Oral Hygiene, demonstrating to them the methods of examination and the results obtained thereby, in order that they may intelligently observe and report oral conditions.

Dentists instructing patients in their offices on Oral Hygiene should bear in mind that the office should be an exact counterpart of their teachings. Patients will give little heed to such instructions if the dentist is negligent in his person and slovenly about his office.

In conclusion the writer might mention the names of many in the dental profession who are leaders in this work but they are well known to you all.

This paper has taken up briefly the claims and benefits of Oral Hygiene, and

in particular a short resume of the campaign which has been waged in its behalf in the City of Detroit, this campaign being one with which the writer has been closely connected, and in which he has been able to closely observe every step taken in the work, and is offered with the hope that it may serve to stimulate the zeal of those who are about to take up this cause.

The spirit of altruism is ever increasing in the dental profession and we must constantly bear in mind that by ever keeping it before us we may attain that goal where it shall be said unto us "Well done, good and faithful servants."

Discussions.

*Dr. George Edwin Hunt, Indianapolis, Ind.

We have listened to a valuable paper. Valuable not for any theories or speculations which it contains but because it recites facts accomplished and in that will be an inspiration to others who wish to accomplish things.

The Oral Hygiene campaign in the United States today shows the same variations in progress in different localities as is shown by any other sociologic or economic movement. This is perfectly natural and to be expected. In most communities nothing is being done. In many municipalities one or more men have realized the necessity for taking up the work and are inquiring concerning the best way to begin. In still others, the stage of work has progressed to the yearly inspection, the first tangible step to be taken. In a few municipalities, free clinics for the children of the poor are being supported by private donations and by organizations and sporadic instances may be cited where municipal supported clinics are to be found as in Detroit. These latter are generally limited to caring for the teeth of the children. Of course, the greatest good from the movement for better mouth conditions will only see fruition when clinics

*Deceased.

are universally established where the indigent of all ages may have their dental needs attended to without price and those of meager means can receive services at a price they can afford. But that is a dream for the future.

The movement has suffered reverses in some localities, due to over-enthusiasm and bad judgment on the part of the promoters. One who has previously been engaged in movements looking to whether innovations in a community,

they be economic, sociologic or political, has been schooled to the delays inevitable in such work and is prepared to labor for what often seems an unconscionably long time in educating the public mind and arousing public interest before getting tangible results. The average oral hygienist has not had that experience and has not been trained along those lines. He recognizes the truth of his contentions and thinks everyone else should recognize them as he does. He gets impatient with delay, attempts to establish clinics before the field is ready for it, becomes discouraged at repeated rebuffs, and finally gives up in despair. Then he sits down and writes me pessimistic letters.

In considering how the general public will meet any economic sociologic or scientific question brought to their notice for the first time, there is only one thing of which you may be perfectly sure and that is that the mental attitude of the general public concerning that question will be wrong. It has never failed since history was. Jenner and his theory of vaccination were reviled and ridiculed beyond all reason-and still are by some. Force was employed to compel Galileo to retract his assertion that the world is round. Jesus was crucified because he claimed sonship of God.

In our own day and age, after years of endeavor, the campaign against tuberculosis is as yet ineffective; the sweatshop evil, the tenement house evil, the liquor evil, the social evil, and a score

more of flagrant sociologic and economic putrescenses on the body politic, flourish practically unabated. Any and all of them could be minimized and many of them eradicated, if the general public willed that it should be done. But to abate them would be contrary to custom and anything contrary to custom is to be viewed with suspicion and only accepted after long delay and with much trepidation. Had I appeared before you today clad in a loose burnous and with sandals on my feet, instead of the conventional, extremely uncomfortable, and decidedly ugly costume that you and I are wearing, no explanation on my part that the costume was more comfortable and more pleasing to the eye, would have excused me in your minds in my deviation from the conventional- in departing from established custom. So we cannot expect the people generally to immediately accept and adopt our ideas. They have never done it in other things and will not in this. It is not customary to care for the mouths of the poor, hence it cannot be the correct thing to do. The majority of people believe that not only what is, is right, but go further and believe that whatever was, is right. It will, therefore, be necessary for those interested in the movement to be patient and persistent, laboring constantly in an educative way. By such efforts only can success be attained.

The example of Detroit is stimulative. If we could get Dr. Oakman's at the head of health boards in one hundred cities over the United States the mouth hygiene movement would be advanced two decades in its rate of progress, but this is impossible. And in the meantime we can point to Detroit, Providence and a few other progressive cities when confronted with the time worn but ever effective argument that "it is not being done elsewhere and has never been done here, so why should we take it up?"

There may be a universal one best way to educate the general public but if

there is it has not yet been announced. Varying local political conditions, and variations in the temperament and in the ability of the promotors have so far necessitated differing plans to produce the same results.

In all and every case it will be necessary to arouse the civic conscience by educative endeavors before material advance can be made.

Dr. C. S. Parker, Norfolk, Nebr.

The speaker finds himself in a rather embarrassing situation, for I submit, to be sandwiched between the head and front and back-bone of this movement as personified in the persons of Drs. Ebersole and Hunt, is disconcerting to say the least, for you will observe the only anatomical feature left for me to represent is the wind-pipe-hence my embarrassment.

I don't know how it may have been with other wind-pipes, but for this one I assure you a tracheaotomy would be a blest relief.

When asked to discuss Dr. Oakman's paper I felt rather foolish the moment I had consented, for I supposed that everything had been said upon the subject of Oral Hygiene dozens of times and I wondered at the necessity or excuse for its repetition, and then I recalled that down thru the ages from time immemorial the history of every reform is the story of preaching and preaching, in season and out of season, in the highways and byways, on the housetops and in the forum, and only by the constant repetition of the oft reiterated doctrine have reforms been brought about. And the Oral Hygiene movement is not going to accomplish its mission until it has been literally pounded-if you please-into the people, until it has become a part of our everyday existence, and until it will be as much a disgrace for the little children of the poor to have unclean mouths and aching teeth as empty stomachs.

The importance of this gospel is no

longer questioned; it matters not whether we can prove that T. B. can be transmitted thru carious cavities or that scarlet fever epidemics have been stopt by putting the mouths of the convalescents into a hygienic condition. We know positively enough, to be very sure that as Dr. Vincaizo Guerine of Naples said in an address before the Anti-Tuberculosis Congress held in Rome two years ago: "There are immense numbers of children and young people who succumb to tuberculosis because the weakness of their organism renders them incapable of resisting the infection; there are also a very great number of adults who die of tuberculosis either because a temporary weakness of the organism by whatever cause produced, renders possible the re-awakening of a latent tuberculosis contracted during infancy or because their weak condition prevents them from offering resistence in the event of a recent tubercular infection" and concluding, says: "If tuberculosis be a scourge of humanity, diseases of the teeth with their enormous frequency and with the numerous deleterious consequences derived from them, are an equally terrible Scourge; they in fact, predispose the organism not alone to tubercular infection but to maladies of every kind."

If, therefore, it be necessary to combat tuberculosis with the utmost energy, no less energy is required in combating dental maladies. The masses of the people ought to be enlightened in all possible ways as to the extraordinary importance of Oral Hygiene and how to practise it.

In a most instructive article in the Cosmos of June, 1912, Baker gives the bibliography of 125 diseases, the origins of which have been at times traced to mouth conditions. The article is especially significant because nearly all the authors are M. D's.

Dr. Rhein's address before this body in Washington two years ago on "Mouth Infection," is perhaps the most compre

hensive discussion of the subject that has yet appeared, and shows conclusively that the mouth and its contained organs and tissues are in the closest relationship with the entire organism and that the closest relationship exists between infected mouths and various forms of bodily disease.

Dr. Oakman in his paper directs our attention to the need of better mouth conditions and illustrates by a case from practise, the evil that is being done thru ignorance and gives some examples of ways and means of spreading the gospel that seems to me to be very sensible and practical. The Doctor brings up a very nice question when he contendes infant mortality to be greatly increased by lack of mouth hygiene, and it seems altogether reasonable to suppose there would be a direct relation between the debilitated condition of the mother and her unborn child.

I am a little surprised our essayist didn't mention the very important work being done by Bunting of Ann Arbor and Pickerill of Australia. My own conviction is that we shall have some valuable data before long concerning the saliva, and I am expecting Bunting to do it. Pickerill has given a great impetus to the importance of Dietetics and the saliva, in his work on prevention of dental caries and contends that by proper food selection, the teeth can be kept clean and their structure strengthened and immuned to caries.

So you will observe, we are getting away from the notion that mouths can be kept clean by brushing the teeth, and coming to realize that something vastly more important than this is necessary to bring about true Oral Hygiene.

I once heard Dr. Ebersole referred to as a star-if it be the function of the Milky Way to give birth to stars I think she has been particularly kind to the city of Cleveland, and the dental profession, for Dr. Ebersole has distinguished the one and is slowly but surely reform

ing the latter, and it is up to you and me, my friends, to help him in every way

we can.

Dr. W. G. Ebersole, Cleveland, Ohio.

Mr. Chairman, Fellow Members of the National Dental Association, Ladies and Gentlemen: It is a privilege to discuss a subject in the city in which has taken place the first effective and lasting work on that subject. To the city of Rochester belongs the credit of doing the first effective and lasting work in mouth hygiene. (Applause). I know there are those in this audience who will question that statement. I do not say that Rochester and her dental profession thought first of this work nor did the first work; I said did the first effective and lasting work in that field. It is a greater honor still to be requested to discuss the paper of a man who is doing more effective local work in this line than any other man in this country today. I refer to Charles H. Oakman, of Detroit. (Applause). To him belongs the credit of receiving the first appointment as a dentist by a governor of a great state on a board of health. Dr. Oakman is the president of the city board of health of the city of Detroit, holding that position by virtue of the appointment by the governor of that state. To the state of New York belongs the credit of first giving the dental profession recognition in connection with a state health department. On Dec. 7, 1910, the former commissioner of health of this state appointed two prominent dentists to his health department. To the state of Ohio belongs the credit of the first appointment by a governor of a dentist to the state board of health. We have in Ohio at the present time a member of the state department of health who is simply a D. D. S., a dentist pure and simple, not an M. D., D. D. S., Dr. Homer C. Brown. In addition to the other honor that is due Dr. Oakman in connection with his mouth hygiene

work is the fact that he is the first dentist in the universe to become the president of a city board of health. That means something, ladies and gentlemen, for mouth hygiene. Dr. Oakman does not hold the position which he holds in Detroit by virtue of political influence. He holds it by virtue of work he has done, and because he has been backed up by the dental profession as a unit, and that is the way things are accomplished today. Detroit leads the world today in successful mouth hygiene propaganda. (Applause).

I have heard several times since I have been in Rochester that the profession and the people were becoming tired of the discussion of mouth hygiene? If it is, God save us. Those of you who heard last night the report of the Research Commission, those who attended the clinics over here this morning and heard Dr. Best, of Minneapolis, discuss the question of root canal filling, a man who in Cleveland a month and two days ago made the statement before 400 dentists that 90 per cent of root canal fillings of all de .sts were defective and were producing disturbances of greater or less degree, should be awake to this mouth hygiene proposition. There was not a dentist in that audience who took issue with Dr. Best. Many of you will remember the paper read by Dr. Hunter. of London, a few years ago, and you will remember the storm of protest that went up from American dentists. My own blood boiled as I read some of the statements but I want to say that that paper was the best thing that ever happened to American dentistry. Our own men are today substantiating the claims made in that paper. But in spite of all that has been said, written and done, we have only begun to scratch the surface, as it were, of knowledge in mouth hygiene. If Dr. Best's and Dr. Hunter's statements are true, what is the answer? Mouth hygiene. Preventive dentistry.