Imágenes de páginas

dinner speeches, stretching out into page after page of valuable space of the Journal, could not they be summarised for reporting purposes? They could, of course, be read in extenso at meetings, for the opportunity may be the only one in the man's life when he can say the things he wants to say and to the people he wants to say them.

Some of the presidential addresses may be read with much pleasure, interest and edification; they are concrete masterpieces of reasoning, having for their object the propounding of some definite theory or theories, that appeal to the thoughtful mind as complete gems of knowledge worthy to be treasured and remembered.

Will gentlemen to whom is allotted the honour of filling the presidential chair realise that the listeners are there with the expectation of hearing the very best it is in the man's power to give them; and that it is not their fault if they go away disappointed. If those who are anxious to have their utterances reported would but remember that the record once made is beyond recall, and that what seemed to them, when the thoughts were penned, as quite a clever example of reasoning, when transferred to the pages of a journal may bear an altered and disappointing complexion.

Is it possible in directions other than those indicated to render the pages of the Journal more interesting to general professional readers? There is, for instance, a column headed "New Inventions, Drugs, &c.," which seems to receive scant patronage from subscribers. Now I think this column might very easily be made very instructive if space can be found for more copious extracts from journals devoted to general science, as in these there often appears valuable information in the form of recipes and special articles. I have read, for instance, in some of the recent copies of the Scientific American and Supplements, some remarkably well-written articles on the cultivation and chemistry of rubber; on the property of alloys; on the behaviour of plaster in its use as a modelling material; on the moulding of delicate objects in sand; on the laws of stresses and strains as applied to small constructive work in metals and plastic materials. No one will say that such information is not useful to dental enquirers. Then we have the English Mechanic, which overflows. weekly with useful formulæ and description which might be made of immense help in the dental workroom. There is also La Science pour tous-a valuable paper of this kind.

This may seem as going far afield for material for dental mechanical training, but I do not think it is doubted that the weak spot in the curriculum is the mechanical; and teachers in our schools, no doubt, realise the importance of culling information from whatever source that may aid them in turning out efficient students. Even to the practitioner who has settled down to the routine of his professional duties the period of learning is never at an end; and it may be

accepted as axiomatic, that he who is best informed in the wide domain of general mechanics is the greatest adept in the specialism of dental mechanics.

In some of the earlier American journals the editorial management was ever ready to welcome, examine and describe new inventions used in dentistry, and not, by the way, leaving this to be done by the individual interested. Thus the judgment of unbiassed experts, whose names did not transpire, was available to the practitioner in the selection of instruments, appliances and preparations. I am well aware that the functions of a jury of experts would not be undertaken lightly; yet this system pertains in the allotment of awards at general exhibitions, and upon the whole seems to serve the purpose. The testing of the suitability or value of an appliance or preparation is often a complicated process, quite beyond the means at the command of the average practitioner. The experimenting on patients to ascertain what could more properly and systematically be discovered by an analysis, assay, or other chemical tests, means risking patients to unnecessary discomfort and the dentist to avoidable annoyance.

There is truly a great quantity of very useless things put before the profession by manufacturers and dealers, and the unwary are frequently ensnared. This may be considered good business by those engaged in such commercial enterprise, but, unfortunately, it is open to another interpretation by no means flattering to professional men.

I may now fittingly draw these remarks to a close with a word or two of explanation. I am not disposed to endorse in any sense the unfavourable opinions that have been expressed with regard to the management of the Journal, for I think it reflects great credit on those gentlemen who have that thankless task to perform. For my own. part I can only say, on the few occasions that I have asked leave to use its pages, I have received the greatest kindness and courtesy from the editor. Criticism has been the farthest thought from my mind in making these observations. They are suggestions pure and simple, which if found to be impracticable need no further consideration.

Restoration of Facial Contour.



THE case which I have the honour to bring before your notice is the result of a gunshot wound in South Africa, by which the whole of the mandible was carried away. The case was sent to me by Colonel Charlton, P.M.O., of Netley Hospital, to see if I could make an apparatus which would check the flow of saliva down the patient's chest, and at the same time restore the contour of the chin.

I commenced by taking a plaster impression of the parts to which I intended fitting an apparatus, and an impression of the upper jaw, afterwards adjusting the two together, as will be seen in the model I now send round—and photo as well. It will be understood that in a case of this kind much, if not all, of the fitting was done on the actual parts and not on the model. I then fitted a piece of vulcanite on either side, the external surface of which was to restore the contour of the cheek, and the internal surface to divert the flow of saliva from Steno's duct into a cup, or what was practically an artificial floor of the mouth. This apparatus was lined with soft rubber, and held in position by tapes tied round the patient's neck, but the result was an utter failure, owing to the fact that the apparatus could not be kept in position with the tapes; and also that when in the act of swallowing the larynx was drawn upwards and forwards, it carried the apparatus with it and the saliva flowed freely down the patient" chest, owing to the fact that the tape being non-elastic it could not pull back the apparatus once it had been pushed forwards. After several attempts on similar lines, each of which were failures, I finally arrived at the apparatus which I now send round. The essentials of this apparatus are:

(1) A thin steel frame, about of an inch in width, accurately fitting the patient's head; this frame is lined with soft leather and covered with hair; to it are soldered four hubs.

(2) Four flat elastics screwed on to the chin, their free ends having "eyes" sewn on to them so that the patient can easily fix them on to the hubs mentioned above.

(3) The inflated pad which acts as a perfect dam. As will be seen the cup is too deep. I have therefore roughly fitted this piece of gutta percha in the cup and whilst still soft requested the patient to press the tongue into it, so that I may now say that when this gutta percha is replaced with soft rubber the apparatus will for all practical purposes be efficient.

The PRESIDENT thanked Mr. Farmer for bringing forward so interesting a case, and asked if the steel head-piece went over the hair of the patient.

Mr. FARMER, in reply, said there was a very thin framework, which accurately fitted; it was made so that the patient could comb his hair over it in some places.

Valedictory Address.



GENTLEMEN, I have now only one thing to do, that is to read my valedictory address, and to thank you for the courtesy you have shown to me during my year of office. The reader of a valedictory address is usually a reader of the retrospect, but to-day, if you will listen to me, I would rather speak of the future. No one can deny that since the Dental Association has been founded the science of dentistry has advanced in a remarkable way, and the social position of dentists generally has greatly improved. This year we have had a great honour paid to us in the War Office sending to the Association to supply them with dental surgeons to go to the front. A new degree has been established, and let us hope that it will prove instrumental in making better dentists at the chair side and better mechanics in the laboratory. The Dental Hospital in Leicester Square is a movement in the right direction; and it cannot now be said that the best cannot be got out of the student on account of inadequate accommodation. The whole building is a credit to the designer and those in authority in the institution. Everything is now being done for the youth who shall choose dentistry as his profession that science and care can do. But what are we doing to protect him from the charlatan and the quack who will beset his path at every turn as soon as he is able to run alone? This Association was formed to see the Dental Act was properly carried into effect. Has it done its duty-well or indifferently? Has it, or has it not, with its full strength and power endeavoured to suppress unqualified practice, or has it been satisfied with an occasional prosecution? Are there not cases all around us still that the Dental Act is capable of dealing with that remain unpunished? Who can say what construction the courts will put on flagrant cases or wilful evasion until they have been tried before a judge? Has not the Association money with which to fight and find the sinews of war for these cases; if so why have men been compelled on occasions to associate themselves together to prosecute unqualified practitioners, yea, and prosecute them successfully too? This should not be; it is the duty of the parent association to do this, and it is cowardice on their part not to do it.

'Tis better with poor lean maw to stand with duty done,
Than to be fat and sleek with shirked responsibility.

The sleeping lion requires awakening, for he has slept long and heavily. Let us hope that his drowsiness will now be of short

duration, and that when he awakes he will be fresh and keen to his duty in stopping unqualified practice.

Gentlemen, this is the last time that I shall have the opportunity of speaking to you from the chair, and I have endeavoured to put this serious question before you without heat. Let me implore you by your actions and by your deliberations in council to force forward the primary duty of the Association-to see that the Dental Act is properly carried out, and that it is not a byword to be laughed at by every unqualified practitioner. It is a duty that we older men owe to the younger members of our profession.

For 'tis the battle of the present day

Shall shape the destiny of future years.

Pernicious Anæmia.

A Case in Practice.


THE following case is rather out of the common, hence I thought it would be of interest. Some three weeks back, I was called in by two physicians to report upon the condition of a gentleman's mouth, the supposed diagnosis being "pernicious anæmia," his age was just over 70. This was my report: Although wearing both an upper and lower denture, he has several teeth left in both jaws, his mouth is fœtid, gums white, flabby, and somewhat swollen; teeth are all loose and tender, with approaching ulceration along the cervical margins." A day or two after this the patient rapidly got worse, and died about a week afterwards of the above disease. The condition of the mouth was quite consistent with pernicious anæmia.

The treatment, as far as the dentist is concerned, is to see that there is no pressure upon the gums from the plates, as the slightest irritation will produce ulceration; to avoid making the gums bleed; never to remove any teeth, however bad they may be, as dangerous hæmorrhage would result. Suitable mouth washes, such as Listerine, should be constantly used.

Army Recruits and Artificial Teeth.

We learn that a War Office instruction just issued to recruiting officers says that army recruits wearing artificial teeth which are well fitted in every respect for purposes of mastication are not to be rejected on enlistment on account of defective dentition.

« AnteriorContinuar »