injected into fowls caused death, and the organism was found in the blood and cord. An exactly similar disease. was produced in fowls by feeding them on fermented rice obtained in the rice-liquor shops and on mouldy rice from the lower bags of damp godowns, by intraperitoneal injection of rice-water liquor, by subcutaneous or intraperitoneal injection of the venous blood of beriberi patients, and by re-injection from fowls suffering from the condition produced. The blood of beriberi patients used in the same way in pigeons produced symptoms in from one to three weeks, followed by death. Of 390 patients treated for beriberi in one institution in one year, all were adults and but few were women, and Rost believes the disease to have been due to a liquor made from damaged rice according to a process which he describes. As some outbreaks cannot be traced to the use of rice liquor or to diseased rice, he deems it probable that rice is not the only cereal in which the cause of the disease can grow, and he believes, moreover, that it is possible for the disease to be communicated through fowls suffering therefrom. Dr. L. W. Sambon supports the rice theory, and points out the fallacies in certain observations which have been brought forward to disprove it. He believes that rice may be related to beriberi as the vehicle and not the cause of the infection. Paddy keeps sound for years, but the hulled rice is soon damaged by vegetable parasites. He cites Eijkman's statistics applying to 280,000 prisoners in Java, where one convict in thirty-nine fed on white rice has the disease, while but one in 10,000 fed on red rice acquires it. He believes that the specific agent may remain latent in the system, and thus accounts for the numerous outbreaks at sea and among people who have gone where the disease did not previously exist, and for the limitation of the infection to those who have introduced it. Infection does not spread in hospitals to other patients, and it does not attack nurses or attendants. Yet the disease is essentially a disease of collective buildings (institutions), a fact which, at first sight, might suggest contagion. Overcrowding may not be looked upon as a leading cause, for change in this regard appears to bring about no improvement. The disease breaks out just as often in new as in old buildings, and in modern battleships as well as in old wooden merchantmen. Ronald Ross brings forward additional evidence in support of the claim that arsenic is connected with the disease. He had already published the results of analysis of the hair of twenty-two patients with the disease, arsenic having been found in traces of that of seven, principally the most recent cases. The cases which yielded negative results were, with two exceptions, of from one month to two years' duration. He records, now, the analysis of samples from eight new cases, the three most recent of which yielded positive results. The negative cases were all of more than thirty-two days' duration. The New Method of Treating Typhoid Fever. Benzoyl-Acetyl Peroxide, or Acetozone, as an Intestinal Antiseptic in Typhoid Fever. Frederick G. Harris, of Chicago (Therapeutic Gazette, March, 1903), reports 128 cases of typhoid treated in Cook County Hospital, Chicago, with Acetozone. The cases first admitted seemed to indicate that the epidemic was of a mild form, but later the disease proved to be of a severe type and complications were numerous. The author obtained the most satisfactory results with aqueous solutions of 15 grains to the quart, which the patients were urged to use very freely to quench the thirst, while in addition four to six fluid ounces of the solution were given every four hours as a therapeutic measure. The movements of the bowels were regulated with sodium phosphate or magnesia phosphate. The temperatures of the patients, on, admission, were high, as a rule. In 117 cases under Acetozone treatment, the average duration of the fever was 18 days. The number of recoveries was 117, or 91.4 per cent, while 11 patients died, a mortality of 8.59 per cent. Statistics of the cases of typhoid fever in the same hospital (Cook County), not treated with Acetozone, show a death rate of 13.1 per cent. The author is of the opinion that under the Acetozone treatment, in favorable cases, the duration of the disease was materially shortened, and the most disagreeable symptoms were ameliorated. He declares that the characteristic fetor of the stools and the peculiar odor of wards was greatly diminished; there was less stupor and delirium and less tympanites, and the usual diarrhea was checked. An average of 138.12 grains of Acetozone was used in each case. Finally, he reaches the conclusion than when cases can be seen during the first week of the attack and large amounts of Acetozone given, assisted by a gentle laxative, the temperature will return to the normal in from ten to twelve days. Four .cases of typhoid fever, in which Acetozone was employed with satisfactory results, were reported by Charles Emil Brack, of Baltimore (Medical Age, January 25). In each case the treatment consisted in the use of Acetozone in solution. The first three patients, adults, received 30 grains of the drug per diem; the fourth, a child of four years, received 8 grains each 24 hours. Prompt recovery occurred in each case. James Billingslea, of Baltimore (Atlanta Journal-Record of Medicine, February, 1903), reported 25 cases of typhoid fever treated with Acetozone. The diagnosis was confirmed by board-of-health examinations. The treatment consisted in clearing the bowels thoroughly by means of calomel. Liquid diet was prescribed and cold or sponge baths were used as occasion required. The special treatment consisted in shaking 15 or 20 grains of Acetozone powder with one quart of water, allowing the insoluble residue to subside. The patient was given the clear solution to drink freely, the whole amount of one quart being taken during 24 hours. The writer suggests that one part of the Acetozone solution may be mixed with three parts of milk if thought desirable. The action of Acetozone will be materially aided by the use of a mild saline laxative. He found that the feces soon. lost their disagreeable odor by this treatment, and cold baths were required to a much less extent than with other treatment. Furthermore, the nurses universally affirmed that they found patients under this treatment easier to care for. No evil effects were noted from the use of Acetozone. A further contribution to this subject appears from the pen of J. J. Driscoll, of Chicago (The Kansas City Medical Index-Lancet, January, 1903), who relates his experience in six cases. He found that Acetozone reduces the temperature, shortens the duration of the disease materially, while it does not seem to have any ill effects on the heart. The feces are completely deodorized in 36 to 48 hours and tympanites rapidly disappear. VOL. XLVI-28 Department of Dentistry. Editorial Staff. ROBERT E. O'CONNELL, D.D.S. THOMAS MORFFEW, D.D.S. J. O. HENNESSY, D.D.S. CALVIN W. KNOWLES, D.D.S., M.D. THOMAS FLETCHER, D D.S. 0. A. HOOKER, DD S. D. H. LATIMER, D.D S. CHAS. E. JONES, A.B., M.D. R. W. MEEK, D.D S. M. E. CLARK, D.D.S. The Editors of this Department are not responsible for the views of contributors. All communications relating to the Editorial Department of Dentistry should be addressed to PACIFIC MEDICAL JOURNAL, 1025 Sutter St., San Francisco. BLEACHING TEETH. By HERBERT C. MILLER, Portland, Ore. (Read at the fifteenth annual meeting of the Washington State Dental Society, at Tacoma, Wash, May 24, 1902.) When we consider the subject of bleaching teeth we must assume that the pulps of these teeth are dead, and that: 1. The change in color, or the discoloration, is due to pigment resulting from decomposition or changes taking place in the pulp tissues and the substance within the tubuli of the dentin, or 2. The introduction of foreign matter into the interior of the tooth, which either stains the contents of the dentinal tubuli directly, or by the decomposition or changes taking place in the foreign matter either the dentinal tubuli or their contents are stained. The stains that are found in discolored teeth are within the tubuli, or the discoloring substances stain what the tubuli may contain, or they stain the substance that cements the tubuli together. Teeth so affected may change in color through all the various shades from pinkish to yellow, or brown, or grayish, blue or black, almost all shades. Some teeth are so hopelessly discolored or so stained and mutilated that it is useless to spend any time trying to bleach them, because it is impossible to do this sufficiently well to have them retain their bleached appearance after they are filled. The crowns of such teeth had better be replaced by artificial ones. AVOIDANCE OF INFECTION. When we make an opening into a tooth the pulp of which is dead, and in which there has been no external opening, we must be certain that nothing is permitted to enter that contains micro-organisms, any oil, or anything containing coloring matter that can be infiltrated into the dentin of the tooth. There is a legend concerning the Emperor of China in which he is reported to have in his employ four hundred learned doctors, and so long as "his majesty" enjoys good health his physicians receive full pay; but should the emperor become ill the salaries of these physicians stop, and they are in danger of being beheaded. It is much easier to prevent teeth from becoming discolored than it is to bleach some of them after they have become discolored. Having determined that it is worth our while to try bleaching operations, the first thing to consider is the cause of the staining or discoloration. After determining this we must decide how to bleach it and how to maintain the color after the tooth is bleached. If the tooth has been stained by a metal filling containing either silver or copper, or from the use of an essential oil containing a gum resin, we will have to employ different methods than those made use of to bleach a tooth discolored by blood stains, decomposed pulp, food, tobacco, saliva, etc. We must assume that all of the preliminaries in the way of opening the tooth, removal of all debris, treatment and filling of root-canals with something that gases from bleaching materials will not penetrate, have been attended to. Let us first consider that class of cases which is the most frequent, those due, viz., to blood pigment, decomposed pulp, food, etc. MODE OF PROCEDURE. (a) Apply the rubber dam and remove as much of the discolored dentin as can be removed without weakening the tooth too much, wash the interior, and dry with hot air. |