49

la.vja.nsky* has experimentally demonstrated such an

emigration into the alveoli of the lung in rabbits andguinea-pigs.

Manchester.

AN INTERESTING CASE IN DENTALSURGERY.

BY ADAMS PARKER, L.D.S. R.C.S.,LATE SURGEON-DENTIST TO THE QUEEN’S HOSPITAL, AND CONSULTING

DENTIST TO THE BIRMINGHAM DENTAL HOSPITAL.

A LADY consulted me in November last under the follow-

ing circumstances. She complained that for the last fiveor six months she had suffered continual pain night andday in the left side of the face, and more particularly on thetop of the head. There was no toothache, nor could sheidentify the pain in connexion with any tooth. Further-

more, a very careful examination of all the teeth on theaffected side failed to detect the slightest trace of caries.40n the same side the first bicuspid tooth was absent, thesecond bicuspid was turned half round, so that the outercusp was presented to the first molar and the inner cusp tothe- canine, and immediately over this tooth was to all ap-pearances a very small piece of necrosed bone, quite firm,and the most minute investigation failed to detect any-thing in the nature of a tooth or stump. There had beenno blow, no recollection of any fall, or injury of any cha-racter, that would account for it.

Upon my suggesting that it was a case that should comeunder the more immediate care of a surgeon than that of adentist, she informed me that she believed there was thestump of a tooth there, for some twelve years previously atooth grew out from the gum horizontally, and directlyover the second bicuspid. This decayed very early, andbroke off, leaving no after ill-effects.Such a communication as this led, of course, to a further

search for the missing fangs, without any correspondingsuccess, when I determined upon an operation, the resultof which proved satisfactory.

I made an incision over the second bicuspid, laying barethe alveolar process, and, placing my thumb against thelingual surface to prevent loosening the tooth, firmlypressed a straight elevator into the cavity by the side ofthe small portion of necrosed bone, when, without theslightest further movement of the instrument, two smallfangs, joined together, evidently those of the first bicuspid,slipped into the mouth. The diagnosis of the case was

now complete; the opening caused by this almost painlessoperation was plugged with cotton-wool saturated withstyptic colloid, and the patient sent home, and ordered toremove the wool and frequently rinse the mouth with warmwater.

I .BerncM-A-s.—This case calls for one or two remarks, themost important of which is the necessity for making verycareful and even long examinations of all teeth when painin the neighbourhood is supposed to have its origin in oneor more of them, before resorting to any extreme measures.In this case a very searching one had been instituted, andnothing could be found to indicate the cause of so muchsuffering. If the patient had failed to mention the fact ofthe early-decayed tooth (her age at the time of its decaybeing only fourteen), I do not see any justification for anoperation on the part of the dentist; but having done so,and the partial knowledge of the patient that a stump wassomewhere about, no doubt could exist as to the proprietyof one, for in the absence of something being done at thisperiod of the case, in all probability at some future time anoperation of a more formidable character would have had tobe performed to arrest disease that must have inevitablycommunicated itself to the surrounding parts. Anothercurious phase in the history of this case was the almosttotal absence of pain for nearly twelve years after thebreaking off of the tooth, and the continuous agony fornearly six months previous to my attending her.

Dec. 5tb. -I have this day heard from the patient’smedical adviser, Dr. Sharpe, of Walsall, that she has made

, a complete recovery.l Old-square, Birmingham.

DESCRIPTION OF

A FORM OF STRETCHER.BY CHARLES R. B. REETLEY,

ASSIST. DEMONSTRATOR OF ANATOMY AT ST. BARTHOLOMEW’S HOSPITAL.

IN many cases of typhoid and other fevers, of peritonitis,and other inna-mmations, of bedsore, of various chronicdiseases, i:i many surgical and in obstetric cases, it is verydesirable to have a mode of moving a patient from room toroom or from bed to bed, and a mode of changing thepatient’s bed and body-linen without causing the leastavoidable disturbance or excitement. For such cases this

apparatus has been contrived.The chief principles on which it is constructed are: 1. It

can be placed under the patient piecemeal, and afterwardseasily and without danger of mistake fitted together again.2. It is only a skeleton of webbing in the part which sus-

tains the back and buttocks, and thus allows bedsores andblisters to be easily dressed. 3. The cutaneous sensibilityof the back is so extremely blunt that the network ofwebbing, coarse as it is, feels like a whole and undividedpiece.

Its chief advantages are : 1. The most sensitive or feeblepatient can be freely moved with no sense of discomfortand no dangerous disturbance. 2. Bedsores and blisters onthe back can be easily dressed through its means, and eventhe back percussed or auscultated through it. 3. Its detailscan be easily modified by any needle-woman to suit the

. ViKto’9 ArchiT, xiviii., p. 326.

necessities of particular cases without altering the apparatusin principle. 4. It is light and portable, it packs into aparcel three feet long and five inches in diameter.

In using it the pieces s, s’, s", w, and w’, are passed underthe patient gently, one by one; and the poles then slippedthrough the hems and loops. Two chairs, each having oneof the cross pieces, B, upon it, can sustain the patient whilethe bed is made, &e.The stretcher has been used with satisfaction at the

Qneen’s Hospital, Birmingham, and at St. Bartholomew’s

Hospia.1, London. It is made by Messrs. Arnolds, WestSmithfield, London, E.C.