Read Ebook: The American Journal of Dental Science Vol. XIX. No. 6. Oct. 1885 by Various Gorgas Ferdinand J S Ferdinand James Samuel Editor

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Editor: F. J. S Gorgas

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THE

AMERICAN JOURNAL

DENTAL SCIENCE

NERVOUS ENERGY.

BY DR. E. PARSONS, SAVANNAH, GEORGIA.

GENTLEMEN--The subject I have chosen for your consideration at this, our Annual Meeting, is "Nervous Energy, how Actuated, and its Varied Phenomena." No one can question the importance of knowing all that can be known about it.

There is an invariable law by which means mind acts on matter, and it is my purpose, in this paper, to briefly elucidate what I have learned by reading, observation and experience on the subject. The great advantage of meeting in council is an increase in knowledge on all subjects in any way relating to our profession. We have many things yet to learn that will be, when known, of great benefit to both ourselves and the public.

Science demands a full and free investigation of all or any causative principle by which life is manifested, or death produced. So long as we draw our conclusions only from appearances, we shall often be deceived in a correct diagnosis; consequently often fail to cure diseases that come within the legitimate bounds of our specialty.

Proper remuneration for our services are absolutely necessary for the respectable maintainance of ourselves and those dependent on us; but our best men are laboring unweariedly in their endeavor to elevate our standard throughout the world, but particularly in our own country, and this Society can do much to help them in their onward march, developing all possible improvements in Scientific Dentistry.

Again, we all have a full consciousness of three things--we love, we think, we act. But few have a scientific knowledge of the means employed by which mind acts on matter. There are such varied forms and circumstances controlling its development, that we need not marvel at anything that comes within the sphere of our observation. As we are brought face to face with almost every possible condition of the nervous system, our opportunities for investigating the various manifestations of nervous energy, its source and supply, may we not equal any other specialty in solving the great problem of cause and effect manifesting nervous energy? As the brain is the seat of all sensation, I briefly present some of the best authenticated views of its organization. I think you all will agree with me that it is wonderfully constructed by Infinite Wisdom for the development of the finite mind. In the elucidation of my subject, let us not forget the fact that the blood has much to do with the various conditions of the nervous system. It holds, or should contain in solution, all the elements necessary for the growth and sustenance of every organ in the body; it is both a receiver and a giver; it is fed from what we eat and drink, without which it cannot perform the office intended.

THE BRAIN.

The brain is divided by the septum into two lobes, right and left sides; also, into the cerebrum and the cerebellum, front and back sides. Phrenologists divide the lobes into about forty convolutions, assign to each a distinct office, and by careful observation of each as to their development, profess to know individual character, and point out what kind of occupation one, by nature, is best fitted for.

In the Fall of 1844, I invited several of our most eminent physicians to meet me at my office to witness some experiments in magnetism. My subject for demonstration was a young man of unimpeachable character, twenty-three years of age. My visitors were very skeptical on the subject of magnetism. There had been some public exhibitions, but the result did not satisfy them.

I said, as the science of phrenology is ridiculed by some, I wished first to exhibit each convolution of the brain, in a state of exaltation, while he is as wide awake as we are. To prevent any suspicion of collusion, I handed them a chart containing the names of the different convolutions of the brain, and requested them to write on paper any question or the name of the organ, for me to excite.

The first paper had on it mirth. I placed the point of my finger over the organ, and he immediately broke out into an uncontrollable fit of laughter. I passed off the influence and he instantly became calm. They asked him what he laughed at. He said he did not know; he could not help it.

The second paper had on it veneration. I excited the organ, and he immediately bowed his head and assumed the attitude of the most zealous pietist, and appeared to be in earnest prayer.

The next paper had on it music. I excited the organ, and he immediately commenced singing with as much earnestness as if his life depended on it.

The next paper had on it combativeness. I excited the organ; he immediately doubled his fist and pitched into an imaginary enemy in the most vigorous manner possible.

Not to take up too much space in this paper, I will only add, we went through with about twenty of the organs with equally marked results, which both pleased and astonished my friends. They said they now thought there was much more truth in the science of phrenology than they had supposed possible. I then said you have seen the effect of so-called animal magnetism; I will now exhibit a different phase of it. I magnetized him in the usual way, and said he is now as oblivious to all external impressions as if his five senses had no existence. Examine him and satisfy yourselves.

After a thorough examination, Dr. Richardson said he believed he could cut off his leg and he would not feel it. I demagnetized him, which restored him to full consciousness. They questioned him about it. He said he did not remember anything done in that state. They then said if it was practicable it would be a good thing in surgical operations. They thanked me for the pleasure of witnessing the experiments, and retired.

To understand the different nervous conditions of patients is of vast importance to both dentists and physicians. This cannot be attained without close observation and experience. If the nervous temperament of a patient is known, we shall have a key to guide us in our treatment in every individual case. Temperament is usually divided into six distinct classes:

You have doubtless observed a difference in the quality of human teeth. We usually find the best in the nervous bilious temperament, and the poorest in the lymphatic nervous. Viciated tastes and habits do not change the shape of the teeth when once formed, but their quality. Science demands discrimination under varied circumstances; it is not possible to treat all alike, and be equally successful. I shall refer to this again below.

I now present you with a few incidents in practice which may serve as a basis for a better elucidation of my subject:

I soon had a chance to test it. A lady called to have an ulcerated tooth extracted. She was in delicate health: face swollen, hands cold. She said she would like to take chloroform, but her physician said she must not take it; she knew she would faint without it. I told her I thought that could be prevented. I took a doily, folded it small, and poured about a teaspoonful of the essence on it. I told her to inhale through her nose, and exhale through her mouth. She continued this until her brain was pretty well stimulated, and the tooth extracted. She showed no signs of syncopy, and could hold a glass of water as still as I could. I have not had any one to faint away in my office since.

In the Spring of 1874, a lady, aged about sixty, came to consult me. She said that her teeth were so bad she could not eat any ordinary food; had disease of the lungs; was forbidden to take chloroform. After an examination, I told her she had eight teeth in the upper jaw that could not possibly be made useful, and she had better have them extracted. She said she had never had one extracted without fainting dead away. She could not think of having more than one out at a time. Her temperament, nervous sanguine, emaciated hands cold, pulse very feeble. I told her if she would follow my directions I would take them all out and she would not mind it more than one, and guaranteed she could not faint if she tried. I explained the effect of the wintergreen, and said it would do no more harm than a glass of good wine. I administered the article, as before described, until her face flushed, tears ran down her cheeks, then extracted the eighth teeth without her closing her mouth. She asked if they were all out, and I said yes. She said, "Is it possible?" I gave her a glass of water. It did not show the least tremor of the nerves. She left, giving me many thanks, saying that she felt much better than when she came into the office.

I could relate many more similar cases, but do not deem it necessary. My object is to show what may sometimes be done to advantage in cases of syncopy, and also the means of preventing it while performing a painful operation.

As before said, the brain is the seat of all sensation; and our patients, no matter how nervous they are, if the brain is properly stimulated, cannot faint--caused by the extraction of teeth. When my patients are known to be pregnant, I always use the stimulant above described before performing any painful operation; it always prevents any severe shock of the nervous system when in this condition. If any one wishes to know how to prepare the Essence, it is as follows: To one pint of alcohol add one ounce of the Oil of Gaultheria, commonly called Wintergreen. Shake it well and it is fit for use.

In passing from a conscious to an unconscious state, all the Clairvoyants I have questioned on the subject say it is affected by a change of polarity of the sensatory organs, and the principle is the same whether caused by animal magnetism, syncopy or anaesthetic agents, and if only the voluntary organs are affected thereby, there is no danger to life, but if polarity in the involuntary is reversed, the heart ceases to beat and death is instantly the result. I was the first in this city to administer ether for the purpose of extracting teeth without pain. In a few cases it developed paroxysms of hysteria; otherwise no harm was done. I have administered ether, chloroform and gas to over two thousand persons. With chloroform, I had three cases that barely escaped death in my chair; with gas, some after deleterious effects followed in two cases.

Admitting man's physical organization to be a magnetic machine, the deaths that have occurred are easily explained, when caused by these powerful drugs. The voluntary organs are under the control of the will, and during our waking hours there is a constant draft on our magnetic supply; it is best recuperated by sleep, when the will is at rest.

The involuntary organs do not sleep until death ends our earth life. We can readily understand that if by any cause polarity in the two large poles in the cerebrum are reversed, the gateway by which we gain a knowledge of things about us is closed so perfectly that physical sensation is impossible. On the other hand, if the equilibrium between the two large poles in the cerebellum are not well balanced, just in this proportion some kind of ailment is the result. Let us not forget that the will has no control over these poles, and all medicine that does not beneficially act on them is non-curative. Now, just in proportion as anaesthetic agents disturb their equilibrium, they are dangerous, it makes no difference whether polarity is reversed or destroyed; in either case the principle of life can no longer act on the nerves by means of its intermediate; the heart ceases to beat, and restoration is impossible. Chloroform is more easily administered than ether or gas, and most convenient when the patient cannot come to the office; but we should remember that many deaths have occurred when given for the purpose of extracting teeth, and that, too, when least expected. The public mind is more horrified at one death in the dentist's office than twenty caused by a railroad smash-up. We have now the means that will stimulate the nerves, greatly mitigate the pain and not endanger either life or health.

I have long desired a perfectly safe anaesthetic that can be administered no matter what the condition of the patient. I am now creditably informed that Dr. Mayo, of Boston, some eighteen months ago, by various experiments, produced a compound article that satisfied him was harmless. He would not put it on the market until it had been thoroughly tested by both dentists and surgeons. All who tested its effect and efficiency testified to its great superiority over all other known anaesthetics for dental and minor surgical operations. It is now only a few months since he made arrangements for its manufacture and appliances, and put it on the market. He has named it Mayo's Vegetable Vapor Anaesthetic. I have been using it for extracting teeth very successfully. The nitrous oxide causes the patient, when fully under its influence, to have very like the appearance of a corpse. The action of this new anaesthetic does not act on the vital organs, and the patient appears like one in a natural sleep, and, in my opinion, is perfectly safe and without danger to life or health.

Our patients come to us for either a preventative or curative treatment. As before said, we are brought face to face with almost every conceivable condition of the nervous system, and the more true knowledge we have of it the better are we able to satisfactorily manage them. Some come in a very excitable, and some in a very depressed state. We need means to quiet the former and stimulate the latter.

Again. To be fully entitled to the name of Scientific, we must know something of the laws of life, in order that we may obey them and fight life's battles manfully--doing justice to others and with credit to ourselves. Life, in itself, is not creatable, but given to us with power to properly use or abuse, the end being the creation of the finite mind. I have explained above the means by which it acts on matter, but as a further illustration, let me say, you drop an article on the floor, gravitation holds it there; you desire to pick it up, how can you do it; if you have sufficient will-power it will act on the magnetic element, this on the nerves, these on the muscles. You stoop down and pick it up, and probably not one in ten thousand have a single thought about the necessary means by which you are enabled to do so, so little do we reflect about causative principles involved in what we do.

So far as our voluntary organs are concerned they may be compared to a locomotive engine. They are both useless if the motive power is wanting. To make the engine useful, steam must be generated by means of fire and water; and to make our voluntary organs useful, animal magnetism must be generated by means of life and the atmospheres. The engineer controls the steam power, and human will controls the magnetic power, and when properly applied, if the machine is in good order, locomotion is the result in both cases. I will only add, the steam acts on the piston heads and causes the crank to move and the wheels to rotate. Magnetism acts on the nerves, then on the muscles, and man moves in any direction he chooses. A dentist with a strong will, if he uses the proper means, can more easily and favorably impress his nervous patient than one with a weak will, and the reason is, he imparts more of his animal magnetism, which has a stimulating effect on the nerves of his patient. There is a magnetic sphere emanating from both man and beast, particularly when in motion. Were it not so, no dog could follow their tracks successfully. All pain is the result of an obstruction of a normal flow of the magnetic current, whether caused by disease or otherwise.

Arsenic, applied to the nerve of a tooth, destroys its polarity, and applied to any other nerve it is no longer capable of being actuated by the magnetic current, without which there can be no sensation, and death is the result. Physical endurance depends largely on the mind and the state of the nervous system. The difference in individuals to bear pain is marvelous; some one can have a tooth extracted and seem to care but little about it, while others, without the use of a preventative, appear to suffer intensely, and in some cases the operation causes syncopy.

In conclusion allow me to say, a vast field lies before us, and if cultivated properly this Society will in due time reap a rich harvest, the benefits of which cannot now be estimated.

The grand distinction between mind and matter may be seen thus: If we give any physical object to another, we part with it, but if we give a new idea on any subject, we do not part with it, but in so doing its boundaries are enlarged in our minds.

PULPLESS TEETH.

BY DR. WILSON, OF BURLINGTON, MEMBER OF THE FACULTY OF THE DENTAL DEPARTMENT OF THE STATE UNIVERSITY.

He goes on to say that "since dentistry had become such a popular business, and diseased teeth had been so carefully retained in the jaws, nervous diseases about the head were becoming alarmingly common."

The same number of the above journal contained an editorial on "Dead Teeth in the Jaws," which read as follows: "Perhaps the time is near at hand when medical men should be themselves better informed concerning diseases of the jaws and mouth, rather than refer the ailments of this region to individuals whose limited knowledge of medicine does not prevent them from 'treating' dead teeth long after their presence in the jaws has given rise to alveolar abscesses and neuralgias more or less painful. It would not be strange if in the course of events, the day would soon come when all teeth without pulps, and hence in process of more or less rapid decay, as well as those which the deposit of tartar, or other cause, had become entirely divested of periosteal nourishment, would be promptly condemned as unfit to remain in the jaws, regarded in fact as foreign bodies liable to give rise, not only to cerebral irritation and disease in the organs of special sense, through the propagation of local disturbances in the mouth to the regions mentioned, but to endanger likewise the general health through purulent matter discharged into the mouth from alveolar abscesses, to be continuously swallowed for a long time, or, indeed, in some instances, to be absorbed and thus produce septicaemic poisoning. It is certainly gratifying to note the establishment of instruction in oral surgery in some of the medical schools, and it is to be hoped that this subject will receive the attention its importance demands."

That diseased teeth do cause reflex trouble, not only in the head, but frequently in more remote parts of the body, is a fact well-known to every competent dentist. I am glad that Dr. Sexton has at last discovered the fact, that diseased teeth do frequently cause reflex pain in the ears, and in other neighboring parts, and that alveolar abscesses very often cause catarrhal affections of the maxillary sinus and of the nasal passages, and that diseased teeth will endanger the general health. It is to be regretted, however, that the doctor has found it necessary to charge this unfortunate state of affairs to the ignorance of dental practitioners, who are in no way responsible for but few of the many cases met with in practice, for there can be no doubt but a very large majority of the teeth causing the troubles above referred to have never received any treatment whatever at the hands of dentists, and because Dr. Sexton has discovered that in certain cases pulpless teeth , has caused the ailments above referred to by Dr. Sexton, there can be no doubt. Every dentist of any considerable experience can enumerate such experiences by the score, and the medical profession has only been too slow to recognize the facts discovered by Dr. Sexton.

The only difficulty with these medical gentlemen is, that they have drawn very erroneous conclusions from the important discoveries they have made. Their limited knowledge of the minute structure of the dental tissue, and the source from which each derives its life, is manifested by the erroneous statements upon which they have based their arguments, and then after arguing from false premises, Dr. Sexton says: "In regard to the treatment of pulpless teeth, the practice in vogue seems the reverse of procedures founded on well-established surgical principles." And in an editorial of the same issue we are informed that the treatment of diseased teeth is carried, to what "the medical minds regard as a dangerous extreme."

That some members of our profession have been over zealous in their efforts to save all diseased pulps alive, there can be no doubt. We will occasionally meet with an enthusiast in our profession who will say, "I have no use for forceps, I never extract teeth." I have heard that statement made on the floor of the Iowa State Dental Association.

That incurable diseased teeth should not be tolerated in the jaws does not admit of discussion. Good common sense ought to settle that question. And again, there are extremists who never devitalize diseased pulps, no matter how badly exposed, but "doctor them up," and stupify them, and then bury them in a living grave. Much evil has grown out of this practice.

Some one has said that to cap a badly exposed pulp is to create a slumbering volcano, and he might well have added that such volcanoes have but a limited time to slumber. Gentlemen, there are in our own country ten thousand volcanoes belching forth--not pure molten lava--but impure gases and putrescent matter of the most sickening character. The craters to these volcanoes are not found on the mountain top, but they are found in human mouths--in the antrum of Highmore, in the nasal passages, and externally on the face, neck, or even on the chest.

When the pulp of a tooth is dead and confined within its bony walls an outlet is sought, and must be affected for the escape of impure gases arising from the decomposing pulp and for the putrescent matter associated with it. When thus confined its only way of escape is through the dental foramen, and into tissues adjacent thereto. The pressure thus brought to bear upon the bony walls surrounding the apex of the root will in time perforate it at its weakest point, and the poisonous matter is forced through the opening thus formed and into the soft tissues, which soon yield to the pressure, and the imprisoned mass of corruption is liberated. The pain and swelling now subsides, but a dangerous nuisance has been created. The channel formed from the apex of the root to an external opening will not close while it is used for the passage of foul matter and gases that will flow unceasingly from the pulp canal.

The remedy of course is to remove the cause, and assist nature in affecting a cure, and to do this the pulp chamber must be opened, its contents removed, the canals cleansed and disinfected, the abscess healed, and the roots filled to the exclusion of all fluids and purulent matter. But how often this is not done. How many thousands of suffering mortals are to-day dragging out miserable lives because of these drainage tubes emptying themselves into the oral cavity--into the maxillary sinus or into the meatus of the nose. Such an abiding nuisance in the mouth cannot long exist without ruining health. But how few of the unfortunate sufferers realize the cause of their nervous irritability, their loss of appetite, their feeling of lassitude, their lack of energy, and their general prostration. And here let me say, that but few, in comparison to the number of these unfortunate sufferers seek relief at the hands of the dental practitioner. The patient is neither sick nor well, but debilitated and "good for nothing." The family physician is consulted, nervines and tonics are administered, but to no avail. The septic matter is vitiating the air that is breathed, and poisoning the food that is eaten. The saliva that is poured into the mouth from the various glands must mingle with this poisonous matter and carry it into the stomach.

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