cause, than to be attempting from time to time to remove or palliate the effect." Wasting time trying to palliate effects, while the cause is allowed to act, lets many a little innocent go unnecessarily and speedily into the grave. Drs. Meigs and Pepper "have long been convinced, from personal observation, that a resort to the operation merely because the child is passing through the period of dentition, is at least useless." It is rather strange that they were ever otherwise than "convinced." No sensible physician cuts a child's gums indiscriminately. Resorting to the lancet when there is no evident need for it, no matter how the child is affected, is, as Dr. West fitly says, "barbarous empiricism." The idea that it is the approach of the teeth" near to the surface" which produces the troubles which are met with in dentition is not of necessity a truth. At least the main source of trouble in the appearance of a tooth is not at the surface; it is at the base. The backward pressure on the sensitive nerves and other parts gives rise largely to the pain and irritation about the gum. This backward pressure may set up trouble a considerable time before the tooth nears the surface, the tension then being almost or quite as great as later. In fact it often, or perhaps I should say generally, happens that there is a spell of trouble some time before the tooth is about to make its appearance. In some it is very marked and it may be repeated. The capsule becomes distended and the surrounding parts hyperæmic and painful, and there is a free flow of saliva. In any case where there is evidently decided irritation about the gum the lancet should be used. It should be used even if for no other reason than to relieve the child of local pain, of toothache, an affliction which, as many know, and Burns told in expressive poetic phrase, is something awful enough in itself, a pain which ts worst Bacon had reason in believing 66 to be one of the sharpest of pains." There need be no hesitancy in using the lancet repeatedly if the gum is at any point tense and angry looking. Says Hunter: "I have performed the operation above ten times upon the same tooth, where the disease had recurred so often, and every time with the absolute removal of the symptoms.' That the lancet will afford relief in the presence of very marked symptoms every one surely is aware who knows how to use it. It is an instrument by which much may be done to lessen suffering, cure disease and save life. Here is a delicate child, somewhat over a year old, languid, pale, the victim of one or two convulsions, with contracted brows, a temperature of from 101° to 102°, a tendency to diarrhoea, and a slight bronchitic cough. I lance his cutting tooth, and within a few hours he is almost entirely well. I have done the thing so often in his case that I know precisely what the result will be. This lymphatic child of fifteen months has a developing croup; the hurried breathing, the noise in the throat and all the other symptoms are becoming decided. I lance his appearing eye teeth and he begins immediately to get well. There is a strong looking boy, nearly two years old, with a temperature of 103°, and a marked cold on his chest. I prescribe appropriate remedies, but at the end of two days he is no better. I lance a pair of coming molars, and next day there is no fever hardly, and the cough speedily vanishes. That poorly cared for child, who has about completed her first year, is evidently, from the high fever, (103.5°) nausea and tendency to diarrhoea, drifting into the fatal grasp of cholera infantum, the midsummer heat favoring the development of that serious infantile disease. I look at her mouth and find that the gums over both the eye and the stomach teeth are tense and angry looking. I lance these points, and very simple measures restore the patient, within forty-eight hours, to her usual state of health. But I need not give an extended recital of cases. I am of the opinion that early, and, if need be, repeated lancing, would save many who should otherwise perish from convulsions, bronchitis, cholera infantum and other diseases. Especially in spent children, in the warmer part of the year, should there be no delay. Statistics of the census year ending June 30th, 1870, show that there are more deaths attributable to dentition in the third quarter of the year than in the two preceding ones together, and many more. than in the first and fourth together. The Philadelphia bills of mortality present a very similar showing. In order that lancing the gums may do as much good as possible it must be done well, but, of course, not butcherly. A plain incision with a very sharp lancet is not enough; it will generally do only a little good. This is what is not uncommonly done. Let there be several more or less irregular incisions made, with a somewhat dull lancet, and the hoped for result will very certainly follow. In bad In bad cases the gum should be very thoroughly scarified, so thoroughly that there will be little or no likelihood of the parts uniting over the tooth. And it is proper to extend the incisions well to the sides of the coming tooth. This may be called for after the tooth has partly appeared. Whatever bleeding occurs will be beneficial; it will serve to relieve the hyperæmia and pain; in fact, in not a few cases it is the bleeding that is principally called for. Local depletion affords immediate relief. It will not be harmfully profuse, likely, in any case. Says Hunter: "I never saw a case where the bleeding proved either inconvenient or dangerous." What harm may result from lancing the gums, under any but very extraordinary circumstances, it would be hard to state. I do not feel sure that it can do any, and in this belief I am fortified by the opinions of perhaps all dentists and others who have carefully studied the matter. It may cause temporary pain. Still, this is not very marked. Many a child will open its mouth and have several teeth thoroughly lanced without giving a whimper. As for the tenderness of the gum, which there may be for a day or two, from thorough lancing, it is comparatively a small matter. The idea that lancing will retard the development of the tooth. has, I believe, no just foundation. It would appear to be based on the erroneous notion that when lancing is practiced the tooth should immediately appear. It is probable that in no case is there any more than an apparent delay. As already stated, the irritation about the calls for the use of the lancet may arise weeks before the tooth approaches the surface. A tooth does not receive its nourishment from the structures above or about its crown. The cicatrix and hemorrhage I have already spoken of at sufficient length. In all proper cases the lancet may, then, be used, with confidence that it is a markedly non-injurious, as well as an almost infallible means of relief-Medical and Surgical Reporter. gum which THE TEETH FROM A MEDICO-LEGAL ASPECT. From a Medico-legal aspect the teeth have not received the attention to which their importance, in many particulars, entitles them. It is, indeed, astonishing to find how seldom they are referred to in standard works on Forensic Medicine; even that much appreciated and consulted work of Casper's does not, so far as we can gather, allude to them. Yet that they have an importance in such matters is evident from the information they have furnished from time to time. One of the earliest appeals to this portion of the human frame was as a test of age. About the year 1836, our Legislature was engaged in amending an Act which was designed to limit the age of children employed in factories, and as physical development was known to be a very uncertain criterion of age, some better test, to prevent the evasion of the Act, was anxiously sought for. To a member of our own body, Mr. E. Saunders, belongs the credit of having first shown that, within certain periods of life, the teeth may be relied on as affording evidence of age. This gentleman undertook the collection of a large number of statistics derived from the inspection of the mouths of children. The data thus obtained by Mr. Saunders, and published as a monograph in 1837, entitled, "The Teeth, a test of Age," were generally confirmed by the collection of the results of a very much larger number of examinations conducted by the present Mr. S. Cartwright. From the tables founded upon these observations the ages of persons varying from six to fourteen years can be pretty correctly ascertained. But the teeth afford valuable evidence of age at other periods of life as well, though the fact has been much neglected. Thus whilst Casper gives some excellent data, embodied in tables, for ascertaining the age of the foetus and newly-born child, these are derived from the development of the bones and organs other than the teeth, yet the researches of J. Tomes, Legros and Magitot, and others, in this direction, have added to our knowledge facts which would afford most valuable assistance in such investigations. Again, the periods occupied in the eruption of the temporary teeth are now, for the average, pretty well ascertained, whilst the later researches of Magitot enable us to fill up the gap between the completion of the first, and the commencement of the second dentition. In another point of view the teeth may serve to afford evidence useful in Medicolegal investigation. For instance, there are the now well recognized syphilitic teeth, which may hereafter occupy no mean place in the decisions of divorce courts. But the teeth doubtless are of more importance in the matter of identification than in any other, and it is surprising how little this line of inquiry has been pursued. In a few cases suggestions of their value under the above conditions have been offered. In one of the most important trials ever recorded, viz. : that of the impersonation of a supposed dead person, both counsel for plaintiff and defendant were advised that much valuable information could be obtained by an examination of the mouth; the former by the dentist who had attended the individual supposed to be dead, and who confidently stated that he could recognize the true man by his teeth, but that counsel, for good reasons, no doubt, declined such evidence. In the matter of the lamented Prince Imperial, whose life was sacrificed in Zululand, when a doubt was raised as to the identification of his remains, two eminent dentists who had operated upon his teeth offered to give, if necessary, information which would have been conclusive. It was under this phase of the question that Mr. Turner, at the last meeting of the Odontological Society, exhibited to the members casts of both jaws, also the lower jaw itself, of the unfortunate victim of a presumed murder. The information afforded by the models and maxilla pointed to the age as being about fifteen. From the development of the third molars, Mr. Hutchinson suggested a rather later age; but the small amount of wear the teeth had undergone, in the opinion of Mr. Turner, Mr. C. S. Tomes and Mr. Coleman, led them to fix the age at between fourteen and sixteen. A singular. circumstance was that the two lower second temporary molars were retained, their successors being just below them, and this might, under certain conditions, have led to an identification of the unfortunate being. Both Mr. Turner and Mr. C. S. Tomes strongly insisted on the greater value the teeth were able to afford in medico-legal questions than had hitherto been assigned to them.-Journal of British Dental Association. "THE DANCE OF DEATH." The immortal and matchless Burns tells us that "The De'il came.fiddlin' through the town, We wish good luck wi' your prize, man." And in order that the sources of amusement may be equalized to society, it would be well to have, not the De'il, but the law come fiddlin' through the country, to dance away with the quack Johns in the dental profession, who, without professional, or even lay knowledge, advertise dangerous operations performed painlessly, under the influence of "vitalized air," "laughing gas," "medicated ether," etc. The pilot and engineer on a steamboat undergo careful examinations by competent parties, before they are allowed to take the responsibility incident to their positions. Who would knowingly ride with an engineer ignorant of the nature of steam, and unfamiliar with the movements of an engine? Yet every day men, and especially women, allow parties wholly ignorant of the laws of life, without even slight knowledge of anatomy and physiology, ignorant, too, of the nature and action of anesthetics, as well as of remedial agents and measures in cases of danger they allow such as these, we say, to take them a voyage on the deep, narrow river that divides this world from the next, without the precaution of rafts or life-preservers in the shape of practical knowledge. These things ought not to be. Often we have heard the most popular dentists, with good medical, as well as dental educations, remark, each in his place, that if he should conclude to use anaesthetics in his practice, he would go to some one competent and experienced, and take a thorough course of instruction from him before presuming to engage in a practice involving such great responsibility. But "Fools rush in where angels fear to tread." The following remarks, taken from the Commercial Gazette, of Cincinnati, are to the point, and worthy of attention. Their author, Prof. Wright, is high authority: A LEGAL SAFEGUARD IN THE DANCE OF DEATH. To the Editor of the Commercial Gazette: It may not be known to all your readers that Ohio enacted the first law for the regulation of the practice of dental surgery, and that neighboring States, after spending some time in sneering at her, followed her example. Fifteen States now have "State Boards of Dental Examiners.' There is, however, an evil of a very serious character not sufficiently under the control of the State Boards, and Ohio is again first to recognize it, or, rather, to make a real effort of doing something toward correcting it. The medical and dental professions have long been aware that many entirely unqualified and ignorant men are daily administering "laughing gas," "vitalized air," "ether," etc., for the extraction of teeth, and have wondered that fatal accidents have not oftener occurred in the dentist's chair. It is well known that many who "give gas are entirely ignorant of the effects of the agent on the heart, the blood-vessels, the lungs, the brain, or the nerves of the patient; as, also, of even the names of restorative agents and means, should the patient refuse to wake up promptly. Many good people have gone directly from the dentist's chair to "mansions in the skies," without having left any "last words" to their friends. Thousands of others have hung by a hair over their graves, and, like Rogue Riderhood, have come back to life, not, however, to “have the law on it," but to laugh and cry a little hysterically, and then to write their names in a big book, as an evidence that they have escaped death. Hundreds of these have "never felt quite well" since. Every cultivated physician and dentist knows that death stands grinning at his side (as in Holbein's picture) when his patient's consciousness is passing away under the effects of any anaesthetic, and only the ignorant dentist can be reckless and perfectly fearless at such a time. The people have a right to demand that every man who proposes to use an anesthetic should be able to furnish them with some evidence that he has given special study to the subject. The Mad River Valley Dental Society appointed a committee on the 22d of May, at their meeting in Dayton, to urge this matter on the attention of other dental societies of the State, on the people, and on the Legislature, with a view to the getting of a new law on the subject a law which shall simply make it obligatory for any person who wishes to give anæsthetics, to satisfy by an examination, or by any other means, the State Board, of his special knowledge and qualification on this point. This will be a move in the right direction, and will no doubt be appreciated by the public and by the medical and dental professions in other States. Respectfully yours, C. M. WRIGHT. If dentists generally would try to have the above remarks of Prof. Wright inserted in their local papers, great good would result in the way of educating the public on this important subject.-Ohio State Journal of Dental Science. THE COMPOSITION AND EFFECTS OF CHLORAL HYDRATE. Chloral was first prepared in 1832, when Liebig, the famous chemist, obtained it by acting with chlorine gas on absolute alcohol. Its name, which consists of the first syllables of the words chlorine and alcohol, is a convenient reminder of its composition. It is a heavy, oily, colorless liquid of a specific gravity considerably greater than that of water, but boiling at a somewhat lower temperature. Among its properties may be cited a greasy, bitter taste, and a pungent odor, which has an irritating effect on the eyes. Of more interest than chloral itself is chloral hydrate, å solid crystalline substance formed by the union of chloral with a certain proportion of water. This, when dissolved in water in varying proportions, constitutes a drug extensively used, and, as is well known to the student of medical literature, not unfrequently with disastrous results. For a long time, however, chloral hydrate was a scientific curiosity" belonging to a series of compounds much studied by Stadeler and the distinguished French chemist, M. Dumas, who showed that in a presence of an alkali, such as soda or potash, chloral hydrate is broken up into formic acid and chloroform. This was the 66 turning point of its career, as from the fact that it could be thus decomposed in a test-tube. Another chemist, Liebreich, was led to conjecture that a similar decomposition might be produced in the blood. Experiment confirmed his anticipation, chloroform being set free in the blood and producing effects analogous to those produced when the vapor of that drug is inhaled. He accordingly, in 1869, introduced the aqueous solution. of chloral hydrate to the medical profession as an anesthetic and hypnotic. Judiciously used, under the guidance of competent physicians, it has been found to |