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only at a small point near the cutting ends. It is in these cases

that ligatures of various kinds serve an admirable purpose. Take for

instance, the superior central incisors. These usually have but a small

point of contact, with considerable space between them at the gum, and

it is very difficult to put in a wedge of rubber, wood, or tape, that

will not slip up against the gum, or come out altogether. If a ligature

is used, the knots can be so tied that the string will clasp the point

of contact in such a manner as to hold it quite firmly in place. There

are many ways of making the knots; one is to pass the silk once between

the teeth, then tie a surgeon's knot; but, before drawing it up, pass

one of the ends again between the teeth, and then draw the knot so it

will wedge from the gum towards the cutting ends; draw it closely, then

finish by tying so that the last knot will be at the labial, or palatal

side of the teeth. Another way is to make a series of knots like a

chain stitch in crochet work, thus enlarging the silk for a suitable

length; draw this between the teeth and tie as before, omitting the

first knot that is drawn between the teeth. Another, and a very good

way of enlarging the ligature, is, after well waxing it, to roll a

little cotton around the silk as you would around a broach for wiping

out a root canal, and draw this between the teeth and tie the same as

when the silk is knotted. Still another method, easy of application and

very effective in almost all cases where there is a cavity in one or

both of the teeth, is to secure a pellet of cotton with the ligature.

The silk is placed between the teeth in some of the before-mentioned

ways; a pellet of cotton is forced into the cavity, projecting against

the adjoining tooth, then the silk is tied firmly around the cotton.

The swelling of the cotton and silk will make all the space necessary

between any of the front teeth with but one application. The bulging

of the cotton into the cavity or cavities, caused by tying the silk

around it will hold it securely in place. This makes by far the most

satisfactory wedge I have ever used, and, so far as I am aware, is

original with me. It is sometimes well to open the cavity slightly with

an excavator or chisel before wedging, so that the cotton will be more

readily retained. For bicuspids and molars more than one application

may be needed if much space is required. Quick wedging is sometimes

possible, and when it can be done readily is usually desirable. Teeth

that move easily may be separated sufficiently for operations by

placing a wedge at the point of contact, and another near the gum,

applying force gently with the hand, or light blows with a mallet,

first on one, and then on the other, until wedged enough. Then remove

the wedge that interferes most with the operation, leaving the other in

place. Another way that often works well with children and with teeth

that move readily, is to insert a large piece of rubber and let it

remain from fifteen to twenty minutes, when the rubber will have opened

a considerable space. A wooden wedge will keep the teeth from springing

together while the work is being done. The appliances designed by Drs.

Perry, Bogue and others, for making rapid separations, I have not

used, but hear favorable reports in regard to them. Having spoken of

rapid and semi-rapid separations, it is left only to speak of a method

which works very slowly. It applies, as a rule, to the biscuspids and

molars only. In many cases where there are large cavities between these

teeth, and often, when it is desirable that they should be filled with

what I think is very properly called a "treatment filling," it is

well to fill the entire space between the teeth with gutta-percha. In

the course of a few months the process of mastication will force the

gutta-percha toward the gum, and on removing what has not worn away the

teeth will be found well separated, the cervical margins well in view,

and the cavities in good condition for a metal filling.--_Archives of

Dentistry._

ARTICLE VIII.

COCAINE.

WALTER W. ALLPORT, M. D., D. D. S., OF CHICAGO, ILL.

The introduction of cocaine as a local an?sthetic, and the more general

use of peroxide of hydrogen (H_{2}O_{2}) in the treatment of dental and

oral diseases, are the principal advance made in the medical department

of this practice during the year for which this report is made.

The two forms of cocaine which have been most generally used in surgery

are the hydrochlorate and the oleate.

In operations in the mouth, involving the mucous membranes, together

with the immediately subjacent tissues, these preparations have

proven so efficient there is little question of its value as a local

an?sthetic in such cases. But its action on deeper structures, such

as involve the roots of teeth, is so uncertain as to render its

practicable benefits questionable in the operation of extraction.

In the surgical treatment of pockets caused by pyorrhea alveolaris,

the an?sthetic effect of this agent is often so great as to render

this sometimes very painful operation comparatively painless, and

its employment in such cases should rarely be dispensed with. In the

treatment of hypersensitive dentine, as well as in the removal of

tooth-pulps, its action as an an?sthetic has, under some circumstances,

seemed to be all that could be desired. But in far the greater number

of cases it has proved of little practical value. More recently,

however, a new form of cocaine, known as the citrate, has been

introduced in Germany by Merck, and is now being manufactured by

McKesson & Robbins, of New York. In a series of experiments, conducted

by Dr. John S. Marshall, of Chicago, it has been shown that for

operations on sub-mucous tissues, or in the extraction of teeth, it

seems to possess no special advantages over the preparations previously

named. But when applied to dentine or the pulp, its action--though not

always positive--seems to be more reliable, especially on the dentine,

and gives promise of better results. Under favorable conditions it

produces an?sthesia of the parts in from five to ten minutes, and the

duration of the effect is of sufficient length to afford time for

the preparation of the cavity. This effect has, in some cases been

prolonged for more than an hour. The pulp has been extirpated without

pain after the drug has been applied in from three to twelve minutes.

If the citrate of cocaine be kept in solution for more than three

or four days it decomposes and loses its active properties. As

introduced by Mr. Merck for dental purposes, it is made into pills by

incorporating it with gum tragacanth dissolved in glycerine, each pill

containing 1/8 grain of the citrate. In this form it keeps well. A pill

is applied to the sensitive cavity and covered with a cotton pledget,

moistened in tepid water. It should be allowed to remain from five to

twelve minutes, when--if at all--the desired result is produced. In

twenty per cent. of the cases where this remedy has been employed it

has proven unsuccessful, but it is hoped that this percentage will be

reduced by a better knowledge of the drug and the improved methods of

its preparation and use.

With this in view, and at the suggestion of Dr. Marshall, McKesson &

Robbins are now manufacturing granules containing one-sixteenth of

a grain of the citrate of cocaine, without glycerine or any other

saccharine excipient, so that the obtundent may act more promptly

than it can in the presence of sugar.--_Address at American Medical

Association._

Editorial, Etc.

UNIVERSITY OF MARYLAND, DENTAL DEPARTMENT.--The fourth Annual session

of this institution opened with a much larger number of matriculates

than ever before in its history, and the number is so rapidly

increasing that the present class of seniors and juniors bids fair to

be larger than any preceding one.

The reputation of this school has never been sullied by the graduation

of students for fees irrespective of professional ability, and the

consequence of such a course as has been steadily pursued since its

organization, has been to give a professional standing to its diploma

which that of no other dental school excels. The present class consists

of representatives from all parts of this country, and also Germany,

France, South America, Canada, and even Turkey. Many states of this

country are largely represented, such as New York, Georgia, Virginia,

Pennsylvania, South Carolina and Maryland especially, and also the New

England states, while nearly every other state is represented.

Students who have passed a session at other dental schools have entered

on a second session at the University of Maryland, Dental Department,

to complete their course of study and receive its diploma, and not

one of the hundreds of students who have attended a course in this

institution, has ever gone elsewhere to graduate. In matriculating the

present class, the resolutions adopted by the National Board of State

Dental Examiners have been strictly adhered to, and many applicants

of this country and Europe have been refused admission who desired to

make their attendance obligatory on graduation after ONE session's

attendance.

The Infirmary and Laboratory practice is not excelled in size if

equalled by that of any other dental school, and the records will

show hundreds of gold fillings credited to the individual practice of

students for both the regular winter and summer sessions. No other

school can offer greater facilities for practical instruction, nor

present more complete equipment as to building and appliances than

this Dental Department. Dental practitioners are cordially invited to

visit the University and inspect the specimen work of its graduating

classes deposited in the museum. Large and valuable contributions from

all parts of this country and also from Europe are almost daily being

received for the Museum, which will compare favorably with that of any

other dental school for valuable pathological specimens, which are also

utilized for illustrating the lectures of each course.

* * * * *

CORRESPONDENCE.--The following letter was received from a prominent

dental practitioner of Georgia for publication:

AUGUSTA, Sept. 30th, 1885.

EDITOR "AM. JOURNAL OF DENTAL SCIENCE":

DEAR SIR: According to my knowledge of the proceedings of the

organizations known as the "National Board of Dental Examiners," and

the "National Association of Dental Faculties," it was determined that

no dental school would be regarded as reputable that did not after

June, 1885, require TWO FULL SESSIONS OF FIVE MONTHS EACH IN SEPARATE

YEARS FOR GRADUATION. The only exceptions made being those who after

graduation in medicine had passed one year in the study and practice

of clinical dentistry, and also those who had attended a previous

session at a reputable dental school. I believe that the American

Dental Association also adopted the same rule. Am I not correct?

I therefore ask how it is that the dental school of Vanderbilt

University is permitted to offer graduation at the close of but one

session, to a student of this city who has passed one session only,

and that very irregularly, at the Georgia Medical College? I also ask

how the same school can offer similar inducements to another

student from Edgefield, South Carolina, as I understand it has done,

and yet be declared reputable? Was it for the purpose of permitting

such violations of the rules adopted by the different organizations

referred to, that the "National Association of Dental Faculties"

allowed the dental school of Vanderbilt University to abstain from

becoming a member of that Association for the present year, and

accorded to its Dean the privileges of the floor at its late meeting

in Chicago? I cannot see why some schools should be compelled to

conform to a rule that others may violate with impunity, and I think

that the State Boards of Dental Examiners of both my own state and

South Carolina should investigate the matter and act accordingly.

Respectfully, &c.,

"JUSTICE."

We can only reply to the above letter by stating that several students

who as we had learned from their preceptors, intended to matriculate

in the Dental Department of the University of Maryland, on discovering

that they would be required to attend two sessions in the institution,

had, we are informed, been induced to go to Vanderbilt by the promise

of graduation on one session's attendance.

EDITOR OF "AM. JOURNAL OF DENTAL SCIENCE."

Bibliographical.

_A Series of Questions Pertaining to the Curriculum of the Dental

Student._--Embracing Dental Histology, Dental Pathology, Dental

Surgery, Dental Prosthesis, Dental Metallurgy, Dental Materia Medica

and Therapeutics, Anatomy, Physiology and Chemistry. By Ferdinand J.

S. Gorgas, A. M., M. D., D. D. S., University of Maryland. Publishers:

W. K. Boyle & Son, Cor. Baltimore and St. Paul Streets, Baltimore, Md.

1885. Price, $1.50.

This work comprises leading questions on all the branches belonging to

the course of study pursued by the dental student, and its object is to

facilitate the study of dental science and its collateral sciences.

Some years ago the author published a small work embracing in an

abridged form, questions on Dental Science, and the favor with

which it was received by the students of his class, was such as to

rapidly exhaust the limited edition, and induce him to prepare, when

opportunity offered, a more complete series of questions embracing the

entire curriculum of the dental student, and even that of the medical

student so far as related to Anatomy, Physiology and Chemistry.