414 
J. B. NEWBY. 
move the offending member, expose to the owners eye the true 
condition with a free lecture about such fair surgery, he has 
o-ained the owners confidence and will, perchance, hold it and it 
o 
is all this way that empyrism lives to this day. I think I have 
seen cases that might have been a success from filling, but as a 
positive diagnosis is so often uncertain that I say be sure you are 
rierht in making an extract of a carious tooth; the first essential 
thing and one of the most, is light, and plenty of it; next expose 
the crowns; have them washed clean oy flushing out all food, etc., 
then examine with instruments; but what I use is a drill like this 
or a scorcher to top the crown; if there be pus in alveoli there 
will be an cedematous swelling externally. I have watched 
two or three cases where the swellings were manifest and every 
one came in to be extracted in from a few weeks to a few months 
later. This oedema will disappear in a few days after the tooth 
is removed; how to do this best; I prefer extracting first three 
superior molars if the crown will permit ; when not trephine. Some 
practitioners split the bones Avith a chisel, take a punch and drive 
them out. I do not approve of this for I have seen several cases 
operated,on in this manner that have done very badly; the rea¬ 
son being that the operation was only immediate, leaving some 
necrosed bone shut up to produce various diseased conditions of 
the surrounding parts. I observe some of our dentists recom¬ 
mend operating standing; I have tried this manner, but prefer the 
later recumbent position with a strong operating halter holding 
the nose up when the assistant’s labors will be very much les¬ 
sened and your work less annoying. If you have removed a 
great deal of bone for any special reasons, antiseptic dressings 
must be used after, and a favorite method of mine is to take 
a two, three or four quart syringe, make a creoline solution 
i to 20, gradually reducing each day until I to 60 is reached 
and flush freely all the exposed inner structures; this solution, 
when about the temperature of the body, is non-irritating; after 
this is done dust the cavity with camphorated boracic acid 4, 
iodiform 1, and fill same with absorbent cotton. I believe as 
Prof. Sayres, that carbolic acid, though an antiseptic, produces a 
