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EROSION OF THE TEETH. 57

dissolving the basic substance, setting the calcium salts free,
which are washed away during the chewing of food, the motions
of the lips, fluids of the mouth, and in the artificial cleaning of
the teeth. He claims to have in some degree proven this propo-
sition by experiment with trypsin derived from the pancreas,
which he found to act upon the basic substance of the teeth.
It seems quite possible that trypsin might act upon bone
in this manner, possibly upon dentin, but that it should so act
upon enamel, which has no more than three per cent of basic
substance, seems out of the question. Erosion always begins
in the enamel, except in those cases in which it begins in the
cementum after the recession of the gum tissue, and practically
always cuts the enamel as smoothly with the dentin as if the two
were one and the same tissue.
In the absorption of the roots of the deciduous teeth, and
not very rarely of the permanent teeth as well, all of the parts,
basic substance and calcium salts, are cut away as one tissue. In
the absorption of bone by the normal physiological process, the
same thing occurs, and in my studies of these processes it has
often been observed that the noncalcified bone corpuscles suf-
fered the same fate. But even this process balks at enamel. I
have often met with enamel in position to be acted upon by
absorption, but this had failed. We often see almost the last
trace of dentin removed from the crowns of deciduous teeth
by physiological absorption, but never any part of the enamel.
It appears at the present time that these facts place this process
out of the question, even if the far more general observation —
that the condition is acid in erosion — should be shown to be
an error.
Finally, I can not at present find any theory proposed, nor
have I any to propose, that has not features that seem to render
it impossible. I therefore feel compelled to leave the subject
in this very unsatisfactory condition, hoping that an early solu-
tion of the difficulty may be discovered. It seems highly probable
that this will be found connected with some systemic dyscrasia,
but if so, the conditions leading to its strict localization will
require explanation.
Treatment or Erosion.
At present no treatment with the view of cure or of stopping
the progress of erosion, is known, that gives promise of success
in any considerable variety of the cases. There should be strict
inquiry as to the patient's habits of cleaning the teeth in every
case, and the use of any tooth powders whatever prohibited.