six months or so. Its creator: a president of a dental something or other, a clinician of State reputation; an expert with Ascher's enamel, etc.

FIG. 10. This shows a more comprehensive knowledge of crown construction and was made by a professor of prosthetic dentistry in a Western institution. Presented because it exhibits the folly of attempting to obtain union between crown and dummy anywhere except upon the mesio-morsal and disto-morsal lines respectively; had this been done in the specimen here submitted the inter-dental space would not have been encroached upon, the area would not have become severely inflamed, and the work might yet have been in the oral cavity, although the gingival part of the facia palatal restoration was decidedly wrong.

FIG. 11-A failure of the better class, and perhaps responsible for keeping this kind of infernal bridge work alive so long. Constructed by a so-called top-notcher-yea, with an office on Fifth Avenuefurther remarks would be uncharitable. Let the specimen speak for itself.

FIG. 12.-A vile example of a Sixth Avenue dental faker. This is commonly called bridgework, and while it looks "fierce," as Myra Kelly would have said, in mechanics it is no worse than a good many of the specimens submitted earlier.

FIG. 13.-Two Richmond crowns, showing a great deal of care in construction, a knowledge of what was required, but evidently an impossibility of execution, and hence failure resulted, due directly to an ill-fitting band and consequent peridental irritation. Nevertheless, the effort of a conscientious workman.

FIGS. 14 AND 15.-Specimens from one of Hubbard's Immortals showing such a lamentable lack of knowledge that a summary of their faults will suffice:

(1) Lack of knowledge of tooth preparation.

(2) Lack of knowledge of importance of inter-dental space.

(3) Lack of knowledge of proportionate size of teeth.

(4) Improper labio-lingual restorations.

(5) Ignoring vulnerability of soft tissues of buccal cavity.

(6) Uncleansable area twice as large as cleansable one.

(7) The result of all the foregoing was a year of unspeakable torture for the patient, now fully restored.

FIG. 16.-A central and lateral incisor carried on pivot insufficient to support one tooth, yet asked to support two. The piece shows an absolute disregard of all the rules that should govern the construction of such work, and yet the man responsible for it is a porcelain specialist of New York City, and enjoys a national reputation. If it were possible to reproduce colours in the illustration, it would show an enviable amount of ignorance of the laws that govern the production of colours; enviable, since they say that ignorance is bliss. It is needless to state that the duration of the appliance was just about the time that elapses between two rooster crows, and such is a specimen of time-honoured and long-heralded porcelain bridgework.

TEXT-BOOK TEACHINGS CRITICISED.

A sufficient number of examples have been shown to compel the conclusion that the schools and colleges for dentistry are deficient or such specimens could not exist. The methods for conveying the scientific, the accurate, the absolute in dentistry; the methods of teaching this character of work are wrong because they are constructed upon false foundations, and no amount of trimming will bring them into plumb.

I have but to quote some of the paragraphs from various text-books to convince anyone that, while one of the authors elaborates upon the method of construction of a certain piece of bridgework and indulges in a few beautiful sentences which may lead one, uninitiated, to expect a piece of work perfect in every detail, the same author winds up by illustrating his result with a piece of work deficient from every point of view. He ignores the extent of the proper labio-lingual restoration; he ignores the line and direction of stress; the important inter-dental spaces; the vulnerability of the gum margins, etc., and perhaps, too, the occlusion is worse than poor and articulation greatly interfered with. The two latter points cannot be proved because they are not shown in the illustrations (Richardson's Mechanical Dentistry, seventh edition, 1897, pages 576-587, Williams; 587-589, Knapp; 589,-593, Low).

Right on through various editions of these works the editors keep quoting and illustrating the same unsound methods leading to the same unsatisfactory results. The latest editions of Richardson, Harris, American System, fairly reek with page upon page of worse than useless and lamentably crude, as well as faulty, technique of bridge construction.

One of the worst features of this chaotic jumble is that it reads well and sounds well, and the pupil cannot realize that it is all wrong until he is confronted with the result of what he has constructed while following the text. Even then he fails to see the shortcomings of the appliance until his patients return (if they do) minus one or more valuable teeth.

The men who produced the specimens of bridgework herewith shown all received their initial instruction in various dental schools of the United States-East, West, North and South. Each one of them used one or more of the books quoted, and just how thorough was the knowledge they obtained at these schools and from these books anyone may judge after examining these creations. It would seem, too, that so deeply did the lessons they received become impressed upon them that during an active career of dental practice, covering a period of from ten to twenty-five years, they have been unable to unlearn the infernal teachings of destructive bridgework which they had imbibed, and substitute therefor a common-sense system based on a somewhat better knowledge of what is required, in order to bring about a period of constructive bridgework instead.

There is a certain amount of risk which everyone who starts out with the intention to tell the truth must run; also one meets a substantial share of antagonism among professional brethren, which latter is not always the result of narrow-mindedness, but which has been created by what might best be termed an habitually methodical misconception of prosthesis to which they have clung, despite the cry of their inner conscience to the contrary; despite the numerous failures, wrecks and abominations.

I am conscious of the risk, and I do not dread the possible storm of antagonism, for I realize, too, that I am dealing with men who can reason and think. Again, the major part of what is to follow consists simply of cold mathematical facts, axiomatic truths and physical laws, adapted-modified at times, it is true-in order to make them elastic enough to fit and co-act with the life and activity of the maxillary region of the human anatomy, and that part of this which does not so consist of absolute facts is theory evolved along lines of logical reasoning, and by force of its own argument it must be accepted as reasonable and true until the contrary be proved.

To the sincere worker in the ranks of this profession it is very evident that this paper is not in any way actuated by heresy or any desire to detract credit from those to whom it may be due, but that, on the contrary, it has its birth in the willingness of the writer to do his utmost in an effort to sweep aside and obliterate the cobwebs of chaotic misconception spun across the entrance to the truth about bridgework.

The practice of the bridgework of to-day is, with the great majority, the result of a viciously unsound knowledge gained from volumes of misinformation and entrenched behind that formidable fort—the direction of least resistance. The consequent years of malpractice are alone due directly to the misconception gained from these volumes, and make a combination of diseases not so easy to overcome.

Neither is the present status of the knowledge of bridgework and its kindred divisions in any true sense a matter of evolution; in fact, no more or no greater relationship exists between bridgework as it is and bridgework as it should be than there is kinship between orthodontia as it is and orthodontia as it was; both the former as it is to-day and the latter as it was years ago are blots upon the escutcheon of anything which heroically lays claim to the title of science.

We have got well rid of the one sore, and, please Providence, with hard work and lucid, well-directed efforts, we will get rid of the other abominations.

I said that in no true sense is the knowledge of bridgework as it should be constructed a matter of evolution, and I augment that with the statement that true and successful work of this character owes nothing to the misnamed imposture of the past and present; the latter was misconceived from its very foundation, and every step of its construction added but another error, which we must finally combat and eventually unlearn. The task of letting real daylight into this phase of dentistry is so much more involved because the profession adds hundreds of men to its rooster every year; men who come from schools and colleges which teach nothing but these infernal methods of bridgework. Obviously the mills are grinding coarse and faster than is consistent with good work.

The labour of overthrowing this Horse of Troy would involve the destruction of well-nigh every section that went into its cumbersome and errorful whole, and though here and there we find examples of brilliant, or, rather, painstaking workmanship, the mass of errors will far outweigh the few points of excellence. Hence it will prove more sound to entirely ignore the fact that bridgework has existed at all, either as a science or as an art (because as practised heretofore it cannot lay just claim to either name), and let us take our present knowledge of physics and chemistry; of geometry and general mathematics; of metallurgy and general mechanics; add to that our love for art, our developed æsthetic sense, our honest desire to do our best, and using the latter as a binder, let us combine the former with what knowledge we have of anatomy and physiology and the hygienic requirements of the maxillary region of the genus homo; let us start cautiously, build carefully, be sure of the indisputable correctness of our foundation beyond the shadow of a reasonable doubt, and then step by step let us proceed until we reach the limit of our knowledge and power to add correctly to what we have done; let us then sensibly cease and pass the result on to one more gifted to complete what has been painstakingly and carefully constructed. Then only will the knowledge of crown and bridgework be a matter of cumulative evolution, and then only can we hope to earn for that department of dentistry two names most cherished science and art.-Items of Interest, October, 1910.

METROPOLITAN BRANCH B.D.A.

Mr. C. Peyton Baly, hon. secretary of the Branch, writes to inform us that the following dates have been fixed on for the meeting of this Branch for 1911. January 25th, February 15th, April 26th, June 14th, October 13th (Dinner), November 2nd, December 6th (Annual General Meeting).

Except when otherwise notified all these meetings will be held at the Rooms of the Medical Society, 11, Chandos Street, Cavendish Square, W.*

(*Our readers will note the change of address for the Meetings).

THE following amounts have been awarded from King Edward's Hospital Fund :-National Dental Hospitul, £400, of which 150 is for improvements in accordance with scheme submitted to the Fund; Royal Dental Hospital of London, £1,250, of which £250 is for recent improvements.

BRITISH DENTAL ASSOCIATION.-The annual meeting of the metropolitan branch of the British Dental Association was held in the school buildings of St. Bartholomew's Hospital on the evening of Dec. 7th, Mr. W. B. Paterson, dental surgeon to the hospital and president of the branch, in the chair. After the transaction of formal business, Mr. Paterson delivered an address, in the course of which he described the origin and growth of the dental department of the hospital, the scope of its work as a charity, and its teaching in the medical school. The department was founded in 1837, when Mr. Arnold Rogers was appointed the first dental surgeon, with the duty of visiting the hospital one day in the week. Upon his retirement in 1849 he was succeeded by Mr. Tracy, who in turn was followed by Mr. Alfred Coleman. In 1879 the department was reconstituted and met twice weekly. The department was now in charge of four dental officers and met daily. The dental teaching of medical students was carried out on definite lines, and quarterly classes were held for those about to commence surgical dressing in the wards. The elements of dental surgery were taught, and extraction operations practised in the dissecting rooms. Attendance at the casualty dental department and dressership in the department were open and free to all students, and were specially recommended to those who intended joining the Naval and Army Medical Services. After the address the members visited the great hall of the hospital, the new pathological block, and museum. The proceedings terminated with a conversazione in the library.

HYGIENE OF THE MOUTH.-M. Bonnes (Gaz. hebdomad., September 11th, 1910) calls attention to this important matter, and comments on the too general neglect of the teeth. He points out the close relationship the hygiene of the mouth bears to a great variety of pathological processes. Affections of the mouth, indeed, are important factors in nearly all respiratory and digestive ailments, owing to microbal infection from the inspired air and the fermentation of particles of food in the buccal cavity. Buccal sepsis predisposes to anginas, oedema glottidis, leucoplakia, adenitis; while various observers have noted the close connexion of dental troubles with those of the visual apparatus. Septic gastro-enteritis of buccal origin is by no means uncommon. The practice of cleansing the teeth ought to be begun in early childhood, and as much during the first dentition as during the second. The author recommends cleansing the teeth after every meal with a red rubber brush. He believes this does not injure the gums, and their vitality is not lowered by bleeding. The elasticity of the brush, too, allows of more energetic friction without damaging the enamel. The brush can be sterilized by boiling. After reviewing the various forms of dentifrice on the market-several of which, especially the carbolated dentifrice and those of oxygenated water, he condemns as being injurious to the buccal mucosa-the author gives his adherence to the paste form of dentifrice. This, he say, is the best and most practical. It ought to contain an inert and insoluble powder; an antiseptic, miscible and in definite quantity; and a more or less fluid excipient, capable cf maintaining the contact of the other constituents.-British Medical Journal.

NEW ENGLISH DENTAL LICENTIATES.

Licences to practise dentistry have been conferred upon the following forty-two gentlemen, who have passed the requisite examinations and complied with the by-laws:

Albert Frederick Bangert, Middlesex and Royal Dental Hospitals; Charles Holme Barnett, Guy's Hospital; Robert Dudley Bell, Sydney Martin Bell, Harold Edgar Bower and Ralph Chapman, Charing Cross and Royal Dental Hospitals; Charles Repton Faulkner, Birmingham University; Thomas Leonard Fiddick, Guy's Hospital; Guy Leroy Gillett, D.D.Š. Michigan, Michigan University and Middlesex Hospital; Frederick Simpson Glover, Guy's Hospital; John Ferguson Gow and Norman Grellier, Charing Cross and Royal Dental Hospitals; Laurence Edgar Crespine Harrison, Middlesex and National Dental Hospitals; Clement John Henry, Guy's Hospital; Albert Henry Herbert, Birmingham University; Clement Eugene Holburn, Sheffield and Durham Universities; Arthur Percy Livett Johnson, Guy's Hospital; Bertram Howard Jones, Middlesex and National Dental Hospitals; William Joseph Kennealy, Guy's Hospital; Harold William Knowling, Liverpool University; Edward Aubrey Clement Knox-Davies, Guy's Hospital; William Stuart Lang, Middlesex and National Dental Hospitals; Stanley Lawson, Guy's Hospital; Frederic Winbolt Lewis, Middlesex and Royal Dental Hospitals; Harris Raphael Lyons and Leslie Miller, Charing Cross and Royal Dental Hospitals; Arthur Stanley Morgan, Guy's Hospital; Victor Mayfield Morris, Middlesex and National Dental Hospitals; Charles Harry Greville Penny, Guy's Hospital; Fred Quayle, Middlesex and Royal Dental Hospitals; Charleton Edmund Rice, Guy's Hospital; Gordon Evelyn Rowstron, Guy's Hospital; Harry Stobie, St. Thomas's and Royal Dental Hospitals; Patrick Barry Stoner, Harry Sturton and Ernest Sutton Tait, Guy's Hospital; Claude Taylor, Charing Cross and Royal Dental Hospitals ; William Jefferson Wilkinson, D.D.S. Pennsylvaina, Pennsylvania University and Royal Dental Hospital; Frederick Charles Willows, Bristol University; Thomas Edwin Wills, Charing Cross and Royal Dental Hospitals; and William Hector Wotton and Edgar Olyve Yerbury, Guy's Hospital.

A REPORT has been issued from the Privy Council as to the practice of medicine and surgery by unqualified persons in the United Kingdom. The report, which is largely made up of information derived from medical officers of health, is preliminary, it is hoped, to the appointment of a Royal Commission to deal with the subject.

HINTS FOR USING SANDPAPER DISCS.-The sandpaper disc is used at the discretion of the operator, but is never to be used between the teeth-that is, it is not to be used between the contact point and the approximating tooth. It may be and is used to great advantage in dressing down the filling and shaping the contour of the tooth. In order to prevent the sandpaper disc from catching in the dam and tearing it off the teeth, the rubber all around the tooth is greased with vaselin. This will not only prevent the catching of the disc in the rubber, but will as well lubricate the disc and prevent the heating of the filling by friction.—J. V. ConZETT, Dental Digest.

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