~A^~- ---ember ^    Carrel-Dakin  Solution  on  Mouth  Surgery.  513 
teeth.  Often  the  inflammation  is  so  marked  and  the  bleeding  so 
excessive  that  thorough  prophylactic  treatment  is  almost  impossible. 
To  overcome  this  condition,  have  the  patient  rinse  the  mouth  every 
four  hours  with  Dakin's  solution  for  two  days  before  presenting 
himself  for  the  prophylactic  treatment.  The  operator  will  find,  after 
two  days'  treatment  with  Dakin's  solution,  that  most  of  the  inflam- 
mation and  bleeding  has  subsided,  and  that  the  heretofore  painful 
scaling  and  polishing  of  the  teeth  can  be  effected  with  little  or  no 
pain.  After  the  prophylactic  treatment  use  the  solution  in  a  glass 
syringe  with  a  platinum  needle.  If  the  solution  reaches  the  point 
of  infection  without  being  diluted  with  saliva  the  flow  of  pus  will 
stop  in  a  few  hours.  If  the  pus  persists,  the  solution  has  not  reached 
the  seat  of  infection  and  the  treatment  should  be  continued.  In  ex- 
treme cases  of  pyorrhea  where  very  large  and  deep  pockets  are 
found  we  have  used  the  following  treatment  with  most  gratifying 
results :  First,  the  pocket  and  surrounding  tissue  is  walled  off  with 
cotton  rolls  and  kept  as  dry  as  possible.  Then  a  small  pellet  of  cotton 
is  saturated  with  Dakin's  solution  and  inserted  into  the  pocket,  pack- 
ing it  about  the  neck  of  the  tooth  and  well  down  into  the  pocket. 
Caution :  The  packing  should  not  be  tight.  This  dressing  should  be 
changed  every  four  hours  for  two  days,  and  usually  the  flow  of  pus 
will  cease  in  two  or  three  treatments.  If  the  flow  of  pus  stops,  the 
cotton  dressing  should  be  omitted  but  the  pocket  should  be  flushed 
out  with  the  solution  for  three  or  four  days.  In  several  bad  cases 
where  it  seemed  impossible  to  reach  the  point  of  infection  with 
Dakin's  solution,  we  have  inserted  a  fine  wire  into  the  pocket,  made 
a  radiograph  to  ascertain  the  location  and  depth  of  the  pocket,  and 
with  this  help  have  succeeded  in  getting  Dakin's  solution  to  the  seat 
of  infection  and  have  been  able  to  arrest  the  flow  of  pus. 
Treatment  Following  Root  Amputation. — Spray  the  wound 
even*  two  hours  with  Dakin's  solution.  Use  no  other  drug  or  treat- 
ment, and  the  result  will  be  all  that  could  be  desired.  Caution :  Do 
no  use  more  than  10  lb.  pressure  in  the  atomizer;  a  spray  forced 
into  a  wound  of  inflamed  tissue  with  25  lb.  or  30  lb.  pressure  is 
most  injurious. 
Method  of  Disinfecting  the  Mucous  Membrane  Before 
Hypodermic  Injections  of  Xovocaine-Suprarenin. — In  con- 
ductive anesthesia  or  in  local  injections,  spray  the  mouth  first  with 
Dakin's  solution,  and  after  a  few  minutes  wipe  off  the  mucous  mem- 
brane with  70  per  cent,  alcohol  about  the  area  where  the  needle  is 
