a condition of hyperæmia of the pulp which brought about the formation of secondary dentine. This condition of progressive degeneration of the pulp ended finally in its death and the formation of a true alveolar abscess.

When I assured my patient that he would recover without further surgical measures he expressed much delight and told me that he had that day been examined by a surgeon who had assured him that he would have to have several teeth extracted from the affected side and a large portion of the jaw bone sawed out. He had submitted himself to me feeling that he would be fortunate to come off with his life and a part of his face, and, oh joy! he was only minus one useless wisdom tooth. The last time I saw my patient, something like two weeks after the extraction of the tooth, he was doing well. There had been no further discharge and the external opening had about closed.

DISCUSSION OF DR. NOEL'S PAPER.

Dr. T. P. Hinman, Atlanta :-In opening the discussion of this paper, I beg to say that I do not think it has advanced any special theoretical point. It simply shows the great importance of the dental surgeon in diagnosing these conditions. I believe, if the patient had submitted himself to the dentist, there never would have been an opening on the outside of the face. We very often see cases of this kind. The case seems more one of maltreatment on the part of the physician than anything else. If the dental surgeon had been consulted, the opening could have been made just as readily on the inside of the mouth as on the outside.

With regard to the theory that the nerve became involved through conditions outside of the tooth, we cannot find any other theory that would cover the case. As I stated above, it is a case that simply emphasizes the importance of the dental surgeon in this particular class of work.

Dr. M. F. Finley, Washington, D. C.-I would like to bring out a few points in regard to the knowledge of the general surgeon as to the proper treatment of the oral cavity. I have seen two or three instances where surgeons of much repute had lanced simple dental abscesses on the outside of the face, instead of raising the lip and cutting inside the mouth, as any dentist would have done. I

had a case lately of a young lady patient, who was taken with a spell of sickness and had an extensive swelling on the right side of the face below the ear at the angle of the jaw. The family physician being out of town, I was sent for to see if the swelling was in any way connected with the teeth, I having made a treatment a day or two before in a lower first molar on that side. I examined the case, and decided that it was not caused from the teeth the instant the mouth was opened. There was much swelling and soreness at the angle of the jaw, but none about the teeth. She was wearing a poultice when I arrived, this I removed immediately, and directed simply that she wear a soft flannel cloth to keep in the body heat, as she said she felt more comfortable when the face was warm. I diagnosed the case as one of unilateral mumps, and advised treatment accordingly. My diagnosis was confirmed by the family physician on his return to the city.

Dr. J. Y. Crawford, Nashville:-I enjoyed the report of the case very much, as I had the opportunity of being consulted in the same case. I am much interested with the report of the case and with the management of it, but I am rather inclined to dissent from the gentleman with regard to the appearance of the case. I am rather inclined to think that the tooth had not the appearance of a perfectly sound tooth; also that the devitalized. condition was due to conditions outside the tooth. In but very few cases have I seen the pulp of a tooth become involved as the result of outward conditions. I have seen it from exposure of the roots of teeth. I have seen edema of the glottis caused from conditions existing in the tissues around the teeth. As I said above, I was especially interested in the report of the case, and I advised the same thing that Dr. Noel did, which was to extract the tooth.

In many cases of this character, where there is inflammation and swelling around the teeth, caused from external conditions, and especially in cases of the third molar, where they are trying to erupt, and causing irritation to the parts, we had better keep the knife out of them. We had better resort to propping the mouth open. Disarticulate the teeth by the use of an old crown, you have lying around in the laboratory-put it on one of the teeth, and relieve the pressure from the parts surrounding the tooth. We

can very often get good results from this practice, often saving. the teeth, without the necessity of an operation.

Dr. R. C. Young, Anniston, Ala. :-Gentlemen, these lower third molars are something to be dreaded. I remember a case I had once. I extracted a wisdom tooth, administering cocaine to anæsthetize the parts, and afterwards it resulted seriously by developing a case of œdema. I had a very hard time treating the case. I thought after that I would not use cocaine in the extraction of teeth.

Another case, fresh in my mind:—A gentleman came to me a few weeks ago, a subject of tuberculosis, looked like he was about in the second stage, suffering extremely with his jaw. After examining the case, I found all the teeth in good condition with an impacted lower third molar, and I decided this tooth was giving the trouble. I tried to put him off. I did not want to tackle the case, but I could not get rid of it. I sent for a physician to assist me in administering the chloroform. I found the third molar pointing towards the second molar. The patient insisted on my extracting the tooth. The physician administered chloroform. I then got my elevator-these are the best instruments for extracting third molar teeth-extracted the tooth and the patient came through very nicely. We have some trouble in getting him under the influence of the anæsthetic. In the afternoon his wife came down to my office and said her husband could not swallow. I gave her a prescription of lead water and laudanum to foment the jaw with, and in three hours after fomenting the parts well with this prescription, the patient was taking raw oysters.

Some days ago a young lady came into my office suffering extremely with a lower wisdom tooth that was trying to erupt. I thought of Dr. Crawford right away. He told me to disarticulate these teeth. I disarticulated them as you told me several years ago. When these third molars are being erupted, do not lance the tissues, simply disarticulate the teeth, and with a wisp of cotton. wrapped around a dressing probe, saturated with Pyrozone, wipe out the pocket around the tooth. In like manner follow with trichloracetic acid, full strength, and thus rid the parts of this colony of pus forming bacterium streptococcus pyogenes albus-but do not break the continuity of the soft tissues, and thus give entrance to

greater infection. If the inflammation is excessive, foment with lead water and laudanum.

On motion of Dr. T. P. Hinman, Dr. W. Mitchell, of London, England, was elected an honorary member of the Association. Meeting adjourned until 8:30 p. m.

SECOND DAY-NIGHT SESSION.

Meeting called to order at 8:30 by President. Paper by Dr. R. C. Young, Anniston, Ala., on

ASEPSIS.

Infective inflammation is a bacterial invasion of living tissue after an injury or at the time when nature is so impaired that the normal cell elements cannot resist their attack. Infection occurs through the skin, mucous membrane or alimentary canal respiratory tract and genitory nuritory tract and by inoculation during injury and surgical operation.

Cleanliness is akin unto Godliness; a duty well performed is godly, and as cleanliness is the first principal of surgery, it follows as the day follows night, that a want of cleanliness in a surgical operation is ungodly.

Let us differentiate between the terms, antisepsis and asepsis, for indeed there is a vast difference in their practical meaning. The lack of the latter will necessitate the former; the presence of the former demands the latter.

Lister, the great London surgeon, may well be called the Archbishop of Antiseptic Surgery, for undeniably it was through his demonstrations that the gates were thrown open, inviting modern surgery to a field rich in alleviation of suffering humanity.

But it is not here that we hear of the first Aseptic operation. Far down the vista of history, made hoary by the touch of time, in the early dawn of creation. When the first sunbeam kissed awake sleeping life in one grand melody of praise to the great Architect. A deep sleep fell upon the Prince of Creation and from his side was removed a rib, and low, his Queen, fair, beautiful, selfsacrificing, noble woman, the greatest gift of God to man.

Nor was the good Semaritan far behind the present day treat

ment of wounds, when he found the poor unfortunate, cut and bleeding from the treatment of the thieves; he dressed his wounds with wine and oil, did he know that the alcohol of the wine. was detergent, that the acid (for no doubt it was a dry one) was a germaside? The oil excluded the tropic air no doubt ladened with pathogenic germs.

Can we, as Dentists, practice aseptic surgery? Yes, and no. Here we have a field already occupied by countless germs, often those who demand our attention are suffering from abscess, a circumscribed cavity containing pus. Here the pus germ has already possession, or a very common picture, a mouth filled with roots and broken down teeth, gums festering in a bath of pus. Can aseptic surgery be practiced here? No, one must rely on antiseptisism. But you say aseptisism is imperative in all surgical operations, why do we not have pyemina septicemia or a host of evils following the removal of such roots and teeth? May it not be that the patient is immune from germs which are cultivated upon themselves, or is it because this reagon has some special resistive power? There must be a charm, for the countless number of teeth expected with a total disregard to cleanliness, not to mention sterility, is a fact that cannot be denied, and did you ever hear of a person dying from tooth extraction? Perhaps not, but we do see patients who have suffered for weeks after such operation with ulcers, sulff, osteitis, etc., which beyond a doubt could have been prevented.

It is a very uncommon thing for a Dentist to extract a tooth, lance an abscess or do some act of minor surgery, wipe or rinse off the instrument, dry it on a napkin or towel which has been used or exposed to the air of a room which has never been disinfected since it was built. Patient number two comes along, the same instrument is taken from the place where it is kept, not even washed this time, or a tooth is broken in an effort of extracting. After several futile efforts to remove the roots, a digital examination is made, the finger is poked into the hole and the roots felt for. This finger has been in a dozen mouths, handled all sorts of things, possibly money, and a dirtier thing in the germ science is hard to find. It may have been washed with a little water and soap, which was made from the carcus of an animal, dead with