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32 PYORRHCEA AXVEOLARIS. Pre-application of hot water hightens and quickens the ef- fect of the cocaine solution, apparently stimulating the tissues and promoting receptiveness in them. Immediately after the third or fourth application of cocaine, as herein described, the surgical operation should be commenced, and usually it should be painless altogether. In very deep " pockets " it often is necessary to inject the cocaine solution in order to bring it in contact with all parts, but care must be exercised that the injection is made into the " pocket " only. It is not possible to protect an injected case from encroach- ment of saliva always, but in excessive flow of saliva the dentist will have to repeat the cocaining process two or three times extra in order to be fully successful. If patience and perseverance are exercised there will be splendid results from the application of cocaine, as here given. For most cases the most convenient, effective and economi- cal device, for applying any of the preparations used in this treatment, is a common goose-quill shaped like a slender tooth- pick and scraped thin to secure flexibility, leaving the long feather stem for a convenient handle. A quill is practically unaffected by medicinal agents used in dental practice. This indestructible property is particularly valuable in the secondary treatment, where some of the remedies used are highly cor- rosive. But this will be fully explained in its proper place.