tion, shall be sentenced to pay a fine of not less than fifty nor more than two hundred dollars for each offense for the use of the proper county.

G. W. KLUMP, Williamsport, Pa.
E. P. KREMER, Lebanon, Pa.
C. S. BECK, Wilkesbarre, Pa.
Committee.

TREATMENT OF HEART DISEASE.

There seems to be in this city, and perhaps it is equally noticeable in other communities, a growing complaint of heart affections, and the Medical and Surgical Reporter had an article recently on this subject, in which rest is recommended as the best remedy for some kinds of heart troubles.

By this, says the editor, we mean not positive, but comparative rest; neither do we refer to inflammatory affections of the heart, wherein, from the very gravity of the disease, confinement to bed and consequent rest become necessarily assured. We are thinking of those cases of heart exhaustion, so to speak, of individuals whose general health and tonicity is much run down, from overwork or abuse, and in whom the heart shares in this general vitiation. Possibly the organ is not in itself diseased; its organic integrity may be perfect, but its muscular walls may be flabby and weak, ready to yield, or, more properly, unable to resist any great strain. If, when in this condition, the man resorts to any violent muscular exercise, or subjects himself to the influence of violent physical emotions, this weak heart may become mechanically distended, in its efforts to perform the extra labor demanded of it. Or it may be that dilation has already taken place to some extent; then does it become important to allow the organ time for the development of the beneficent hypertrophy that will do so much to preserve its integrity. By rest we mean to advise your patients who are threatened with or already have dilation of the heart to do everything slowly, to perform every act of life deliberately, and to avoid, as far as possible, all occassions calculated to excite the passions or emotions. We must ever remember what a delicate machine the heart is, and how easily it can become deranged, and realizing this, must consider how much more care this organ requires when it is already diseased. We

-THE Lancet says: "It is high time that attention were directed to the subject of narcotics generally, and the use of chloral and bromide of potassium in particular. Incalculable injury is being done, and public opinion is being grievously misled by the tolerance given to the use of sleeping draughts,' falsely so-called. In regard to this matter and that of the reckless use of hypodermic injections of morphia, the profession should seek to form a deliberate judgment and gravely deliver itself. At the present moment we are under a heavy responsibility, which it is idle to deny and vain to disown.""

-A NEW DISINFECTANT.-A cheap and useful disinfectant is a solution of chloride of lead. It is inodorous, effective, and its cost very small. Take half a drachm of nitrate of lead and dissolve in a pint or more of boiling water. Dissolve two drachms of common salt in a pail or bucket of water, pour the two solutions together, allow the sediment to subside. The clear supernatant fluid will be a saturated solution of chloride of lead, and hung up in a room will sweeten a fetid atmosphere instantaneously, or the solution thrown down a sink, watercloset, or drain, or over a heap of refuse, will produce a like effect.-Progress of Science.

Published by

GIDEON SIBLEY.

Edited by

THE BUSINESS QUALIFICATIONS OF

PROFESSIONAL MEN.

BY L. ASHLEY FAUGHT, D. D. S.
(Continued from last Month.)

In addition to the personal equipment already suggested and discussed, there are many little points, acquired principally by experience, which will contribute no little to successful practice.

Make no promise, of any nature whatever, unless we fully intend to remember and keep it Steady and careful attention to this one matter will make our word our bond. That in the press of more important business, a promise, trivial in character escapes our memory is no excuse for its non-fulfillment. The less its importance, the greater the expression of character in its fulfillment. "What!" you say. "Shall we burden our mind with every little promise made in the ordinary exchange of every day courtesies?" Certainly, the easy sentences, the easy promises to "write," to "come," etc., made so gracefully, sounding so friendly, costing so little because forgotten almost as soon as spoken; are, if broken, lies, and steadily undermine our reputation for truthfulness.

We must discriminate in our bearing toward patients, according to their temperament. What will do for one will not do for another. So on the other hand receive their action toward us in the same light; for instance, a patient in the chair, of a bilio-nervous tendency, makes unreasonable objections to the use of the

engine in excavating; possibly, after having borne it for some time, absolutely refuses to allow its further application, even though explanation is made that it is positively necessary in order to complete the operation. Let not such things anger us, but recognize promptly that it is not the patient, but the patient's temperament that is at fault.

In conducting a line of treatment or work, of any nature whatever, never give expression to feelings of surprise at any unlooked for change or result. Patients expect that we are conversant with all possible points in whatever we do, and such manifestations to the contrary are sure to weaken our position in their estimation, as they will attribute them to a lack of knowledge or experience.

Remember, that though in many ways we are public servants, we are never bound to serve all who may call upon us. Indeed, great discrimination and judgment is necessary in deciding who we are willing to have on our roll of patients. Reference here is particularly made to cases like the following: Ladies of wealth and refinement will not infrequently ask us to give an appointment to their maid or nurse, explaining that they would not ask such a favor except for the fact that she has been in their employ for some time, and is altogether nice in person; and that their interest is such that they are willing themselves to settle the bill at our usual fees. In all such cases, we will find that our own interests are best served, in the long run, by declining to

operate. It need not be done brusquely, for in a pleasant way we can say to them, that itwould give us great pleasure to do as they request, but for a rule made long ago by us not to operate for such; and that having never broken it, we would not like to do so now. It is also well not to be deceived by the appearance of those who may come to as patients. There are many whose fine manners and faultless attire are but the means to secure work for which they never intend to pay; and on the other hand some with unpretentious air are unworthy of, and able to pay for the best attention. It is a good rule, and one that will save much loss, to give all strangers calling upon us for a line of work an appointment at a sufficiently distant date to allow us time to institute enquiries as to their financial standing.

Always record on the day-book a concise discription of the details of an operation, including the length of time occupied. Such record will be our guide in treating any additional trouble that may occur, even if an interval of many years has elapsed. A knowledge of the amount of time spent over work will be our security în case of legal disputation; as it is very often, the only tangible criterion by which such judgment can be entered. As only a few moments, at best are needed to make these entries, it is an excellent plan to do so immediately on completing a service, while the patient is leaving the chair, adjusting wraps, etc. By so doing By so doing no confusion can possibly arise with other cases, nothing will be forgotten, and the mind is free for the next sitting.

The ability to nicely adjust a fee-list for our guidance, suitable to ourselves personally, acceptable to our patients, and fair to our professionol brethren among whom we labor, is a quality which will contribute largely to successful practice. In arranging this schedule we may safely suppose that the majority of patients, though not wealthy, will pay a fce for a service which we ourselves

would be willing to render for similar service. Have too, the element of consistency between one fee and another in allied kind of work. Hap-hazard, indiscriminate charges, without system, will surely work us ruin. The following is suggested as an illustration of a proper table. Gold fillings at the rate of $5.00 an hour; platsic fillings, involving one surface of a tooth only, $3.00; involving two or more surfaces $4.00; lining teeth $1.00 in addition to the usual charge for filling; treating, $3.00 to 6.00 in addition; consultation, $3.00; full denture on gold, (16 teeth) $100.00; 8 to 16 teeth, $90.00; 4 to 8 teeth, $50.00; 1 to 4 teeth, $25.00; full denture on silver (16 teeth) $75.00; 8 to 16 teeth, $50.00; 4 to 8 teeth, $25.00; 1 to 4 teeth, $15.00; full denture on vulcanite, $20.00; 8 to 16 teeth, $15.00; 4 to 8 teeth, $7.00; 1 to 4 teeth, $5.00.

Having once conscientiously fixed a fee-table by which to be governed, never deviate from it, except in very special cases, and then be sure that no charge is ever made for a service of which we would be unwilling to have made the most searching public investigation. Above all things, never make a reduction in a bill once rendered. If there is a mistake in the account, correct it, but to take less is bad business policy, and always supposable evidence that you could afford to work for a smaller fee, and have dishonestly over-charged.

It is also well to render our accounts monthly rather than quarterly or semiannually. Time effaces the details, and makes them far more likely to be disputed than if received while the memory is fresh. Moreover they are then smaller, and therefore more easily paid. Many patients are forced into the position of dishonest persons by their inability to meet a large account, when capable of settling the same amount in several smaller bills, obtained at intervals. This sending of bills promptly when due

teaches our patients that we live by our practice, and if such impression is once made upon their minds we will be far more able to do so than if they suppose we have some additional income. Have our rate of fees throughly understood by our patients at their first sitting. It will save much future unpleasant embarrassment. Never refuse a fee when tendered for the nearer we keep our practice to a cash basis the better for ourselves and patients. For ourselves, in that it aids us to pay promptly, our own indebtedness. For our patients, because long standing unsettled accounts keep them from returning promptly for needed attention to their teeth. Always insist upon giving a receipt for money received and be extremely careful to immediately credit the proper account with it, before placing the amount in our pocket or drawer.

In rendering accounts never itemize, for patients are thus prevented from making unjust comparison between statements of the relative value of which they know nothing and on the whole they will more readily pay without question an amount stated in bulk. Always, however, be prepared to furnish such items if requested.

We should be careful not to incur debt ourselves, and endeavor to meet all honest debts punctually.

Remember that one cannot labor incessantly. That where an attempt is made so to do, nature will be sure to call for a cessation. To the end, therefore, that we may serve the greater number of years, and that in each hour of them, good, efficient work shall be done, see to it that we secure proper rest to our mind and body. Particularly secure ourselves from intrusion at meal time. Our success in many trying cases of daily occurrence will be largely compromised by dyspeptic suffering produced by irregular eating.

As every large manufacturing concern stops at intervals for repairs,and thorough

ly renovates its machinery, so once a year,

at least, everything connected with a dental office used in our daily work, should receive a thorough cleansing and restoration to absolute perfection. We, too, need to pause at times and reflect upon our business relations, to see that we are not rusting, not falling into bad ruts, or progressing too rapidly for healthy success.

In conclusion we may say that the object of our paper has been to endeavor to awake an interest in that which will contribute to success in the business side of professional life. There is much that we might yet refer to, but omit, trusting that it may soon be better said by some one of more extended experience. One thing, though, is sure; that many wrinkles are gained in our daily experience which help us greatly as an individual, and for a statement of which the gratitude of professional brethren would freely flow.

-AN exchange lets fly the following: "Pulverized alum and salt put on a piece of cotton and chucked into a hollow tooth, will shut up its aching so quick you will want to hug us for telling."

-POLITICAL ECONOMY IN A NUTSHELL.-Tennyson can take a worthless sheet of paper, and, by writing a poem on it, make it worth $5,000. That's genius. Vanderbilt can write a few words or a sheet and make it worth $5,000,000. That's capital. The United States can take an ounce and a quarter of gold and stamp upon it an eagle bird" and twenty dollars." That's money. The mechanic can take the material worth $5, and make it into a watch worth $100.That's skill. The merchant can take an article worth 25 cents, and sell it to you for $1. That's business. A lady can purchase a very comfortable bonnet for $10, but prefers to pay $100. That's foolishness. The ditch digger works ten hours and shovels out three or four tons of earth for $1. That's labor.-The Alli

ance.

IMPRESSIONS.

Plaster is undoubtedly the best material for the great majority of cases presented for artificial dentures. Its quick and easy adaptation to all the inequalities of the teeth and gums, together with the celerity with which the operator can judge of its correctness, commend it to all who are familiar with its good qual

ities.

The preparatory wax impression should never be omitted; it requires to be trimmed so as to conform as much as possible to the shape of the mouth, the object of which is to force the plaster into every crevice between the teeth, and to hold it there until it becomes hard enough for removal, when, if successfully accomplished, all the ruga and lines in the gum and forms of the teeth can be distinctly seen and every defect discovered at a glance an advantage not to be despised. It is here where plaster is so satisfactorywhen perfect, you know it.

Waxing the tray before the impression is taken faciliates its removal, after the plaster cast is poured and becomes hard, by plunging it into warm water, the tray is easily taken away.

Many failures occur from using too much salt in the water—the plaster begins to harden before it can be pressed into position. When there is some difficulty in introducing the tray, warm water without salt is preferable. Other failures come from too much pressure on the posterior portion of the tray, causing folds in the soft palate; the pressure should be directly on the centre-upwards and backwards; moderate pressure is the best, just sufficient to keep the plaster firmly to the gum. After the tray is in position let the patient set upright, with the head inclining forward, thus allowing the saliva to pass out of the mouth instead of trickling down the throat; a towel placed

over the patient's dress will catch all that may fall.

It may be interesting to the reader to give the history of a peculiar case that I have just brought to a satisfactory conclusion; it will also illustrate one of the difficulties we frequently have to over

ocme:

The patient, a lady of middle age, had lost all of her upper teeth, at different times; the bicuspids and first molars were the first extracted; the absorption of the gum and alveoli was very complete, making the jaw just here very narrow-about one inch and a fourth in width. After wearing a plate of rubber for a few years, the remaining teeth were extracted, the alveoli of the molars absorbed, leaving the gum unusually full, soft and pendulous, swinging in and out with the motion of the tongue. In taking the impression, the plaster was placed in the mouth very thin, yet thin as it was the soft parts of the gum were pressed outwards. My usual plan in such cases is to cut off enough from these prominent parts of the plaster-cast to allow for the displacement by the impression. I thus prepared my cast, stamped a silver trial plate with a cut-out air chamber; when this plate was tried in the mouth, I found but little suction, the plate moving from With another impression right to left. and another trial plate the result was very little better. As the patient was very anxious to have some teeth for appearance sake, I mounted the teeth and let her wear them until I could make a

better fitting plate. After thinking over the subject, I determined to try some plan to press inward the soft parts at the san.e time the impression was taken; this was accomplished with the preparatory wax impression, by allowing the side wax to press the soft parts in. The impression taken in this way was perfect, the plate fitted well, the suction was excellent.

W. R. HALL.