I make it a practice to send my patients to the dentist and, in my teaching, frequently call attention to the wonderful progress made by your profession, pointing to the growing infrequency of certain aural diseases as a reason for my confidence in dentistry.

It were carrying coals to Newcastle to tell you how necessary it is to keep the teeth in perfect condition. Your education has made you realize this fact, and within a few weeks, another and, if possible, more potent reason, the bread and butter problem, will lead you to advance the idea in season, out of season.

The necessity of examining into the condition of the teeth in inflammation of the eyes is illustrated by many recorded cases. Herpes seems frequently to be dependent on dental irritation, as all the symptoms may disappear after the removal of a decayed molar. Panas observed a case of blindness, followed by death from purulent meningitis, secondary to dental caries. The inflammation extended to the maxillary sinus, then perforated the orbital wall, causing orbital phlegmon, and extended into the cranial cavity.

It is of frequent occurrance to find ocular disease or nasal disease secondary to dental lesions. This may be caused by the presence in the mouth of decayed stumps of teeth, inducing inflammation of the antrum and by extension reaching the other structures.

(Here followed some interesting personal observations concerning dentists, with some illustrative and amusing stories. Ed.)

The man who can so readily adapt himself to a situation must belong to a profession equally ready to accept truth wherever it may be found. This leads me to say there is a possible field of usefulness in the relief of pain and in the cure of dental lesions by the employment of internally administered remedies.

Beside the local action upon the teeth of certain drugs, others, through the system, affect the dental tissues. For instance: For several years I have experimented more or less on the possibility of the cure of cataract by the administration of remedies. I am convinced that this disease, or condition, is due to the excessive amount of lime salts taken into the system

through the drinking water. To bear out the theory, which I must not now discuss at length, it may be said that in certain localities cataract is almost unknown. In others, it is commonly met. More remarkable still is that the localities where we find cataract are limestone districts. Take this county for instance. Doubtless you have noticed how impregnated with lime is the drinking water. Flirted from the finger-tips upon a glass pitcher, this water will leave a limey spot where every drop rested. Therefore, we expect to find cataract more or less frequent in this locality and we we do. In other districts, the Saginaw Valley for instance, where other salts, notably common salt, are plentifully found and lime salts are absent, cataract is uncommon and, in my experience, has always been an imported article.

With this theory of cataract formation in mind, I was lead to prescribe in a series of cases the fluoride of calcium. As you know, senile cataract is likely to attack both eyes. When ready for operation, I made the extraction in one eye and placed the patient upon a daily dose of the calcarea fluorica. While the results are not flattering and are hardly worth mentioning, I am positive I found improvement in a few cases-in one quite marked.

Carrying the experiment further, I prescribed the same remedy in cases of congenital cataract. When the drug was continued for some time I invariably found a rapid and unaccountable giving way of the teeth. This must have been more than a coincidence, for I have since compared notes with men who have observed the same thing.

It would be interesting to know whether or not this result is due to the direct appropriation by the teeth of the calcium salt or whether there is a tissue change from the specific action of the drug upon the dental structures.

If it is possible to carry this action to the point of breaking down of tissue why may not drugs administered to a point short of such destructive effect be used remedially? As a matter of fact they are. The literature of the school to which I belong has many references to the relief and cure of dental diseases. Without further comment I commend to you at least a casual glance into the merits of internal medication-not to

supplant your own excellent methods, but to assist you to still greater perfection in your art.

There is a relationship between dental and eye conditions in the association of abnormal teeth with a form of partial cataract, known as lamellar or zonular cataract. This is a peculiar and well-marked form, in which the superficial laminæ and the nucleus of the lens are clear. A layer or shell of opacity is present between them. This opacity is present at birth. It is always associated with rickets and with a marked deformity of the permanent teeth. The dental changes are quite different from those characteristic of inherited syphilis. There is an absence of the enamel on the edge farthest from the gums, or the deficiency may be in "streaks," making "terraces" across the tooth. I believe you call this condition "mercurial," "stomatitic," "strumous," or "rickety" teeth. I suppose the condition is commonly seen by you and frequently met in people without this or any other form of cataract, but it is found in all cases of lamellar cataract. In spite of the fact that this dental defect is usually considered a result of stomatitis and its mercurial treatment, I believe Nettleship's hypothesis is tenable. The crystalline lens and the enamel are both of epiblastic origin, and the associated defect may be due to a common influence.

To this subject of reflexes, there is another side which is quite as essential as the one we have discussed. It is natural for the specialist to look upon his division of the body as the most important part of the entire anatomy. He comes to feel that all the diseases to which flesh is heir may be, and probably are, reflex from the eyes, the orifices of the body or the teeth, according as his specialty is ophthalmology, orificial surgery or dentistry. At least I know this is true of the oculist and orificial surgeon. I hope the dentist is free from this temptation.

I have been much interested recently in a little book written by Ranney, the great nervous specialist. It is called "Eye Strain in Health and Disease."

Heretofore we have looked upon Stevens and Savage as the enthusiasts in my specialty, but since the publication of this book a few weeks ago, certainly we must give the palm to Ranney. To quote a few sentences from Ranney, he says: "Many diseases which are today commonly regarded as of bacterial

origin, owe their development, in my opinion, to some underlying cause that has impaired the nervous function, and thus rendered the patient peculiarly susceptible to deleterious atmospheric influences. * * For many years I have carefully investigated the ocular conditions of every patient who had come to fear the dreaded advent of pulmonary consolidation and softening. I have not yet," Ranney continues, "encountered a case of typical phthisis in which eye-strain did not exist as a factor (more or less potent, in my opinion, in causing and hastening its development)."

The writer goes on to say that had this factor been recognized early in life, before the eyes were employed in study and other occupations, and if all anomalies of refraction and muscular equilibrium had been thoroughly rectified at that time, many of the hopeless sufferers from phthisis would have escaped the disease. He does not argue, of course, that they would have escaped being assailed by the atmospheric germs, but that the vigor of their constitutions would not have been so impaired by the expenditure of nerve energy as to unfit them for resisting disease.

It takes more than one swallow to make a summer, and it requires the enthusiam of an enthusiast to formulate so radical a theory as this. I have quoted so freely from this eminent authority to show you how prone we are, working in special lines, to overlook other organs quite as essential and important to good health. Indeed, the lesson to be learned is that perfect health depends upon perfect function, not of this organ or that, but of all organs."

For this reason I feel it is the duty of the physician to freely consult with his professional brother, the dentist. Also it is the duty of the dentist to consult his colleague, the oculist, the aurist, the stomach specialist, or the general practitioner. Honesty and frankness between the members of two fraternities so closely allied as yours and mine, cannot but increase the percentage of our cures, and win the respect of a public which is as quick to applaud unity as it is to condemn division.

I congratulate you upon your choice of a profession and rejoice with you that in the lecture rooms and laboratories of the University of Michigan you have received an education that,

wherever you decide to locate, will demand the respect of your professional brethren and the liberal patronage of a discriminating public. You go into practice, not to learn the practical elements of a profession known only by theoretical knowledge, but to apply immediately the methods and experimental knowledge so ably taught by the well known thoroughness of your splendid faculty. With the qualities of manhood that should surround the individual in every walk in life, with the preparation of your years of study, you may look forward with confidence to a splendid success. In anticipation of that future I congratulate you.

SOME THOUGHTS ON ALVEOLAR ABSCESS.

BY A. W. HARLAN, M.D., D.D.S., CHICAGO, ILL.

At the present time it may seem somewhat like going into ancient history to present any thoughts on such a subject as alveolar abscess. But this is a subject which must always have for the operative dentist and for the therapeutist an absorbing interest. As long as the pulps of teeth die violently or by design; as long as the roots of teeth are filled indifferently or incompletely, or filled unmechanically or unscientifically, or if they remain unfilled we will have alveolar abscesses. Alveolar abscesses may be found at the apices of the roots of deciduous teeth. Ordinarily, however, these are of little consequence compared with the formation of an abscess at the apex of a permanent tooth. The permanent teeth being thirty-two in number, many of them double and triple rooted, the possibilities for alveolar abscess in the mouth are very great. The injudicious use of separators and regulating appliances, the careless use of forceps, the numerous accidents that are occurring from day to day through casualties in elevators and from riding bicycles, have a tendency to destroy many of the pulps of teeth which would not be destroyed in all probability by dental operations or by agencies producing decay of the teeth. If it were possible for all teeth to be seen by a competent surgeon-dentist shortly after the destruction of the pulp, perhaps there would be few abscesses; but, as a matter of fact, few, if any, are seen at a time when the