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THE EIGHTEENTH CENTURV 335

Against the accidents connected with this niorhid conchrioii, he prefers,
in general, the use of gentle aperients or ot t luetics, and regards the
scarification of the gtmis as opportime onl\ in cases where s\mptonis
indicating a high degree of nervous tension manifest themselves.
Against incipient caries, Hirsch used simple cauterization, which he
held to be capable of arresting the morbid process, at least in many
cases. He says, however, that when a real carious cavity exists, it is
absolutelv necessary to stop it; and for this purpose, rather than metallic
or resinous fillings, he prefers a cement of turpentine and (juicklime,
made into a paste with varnish of oil of linseed. Nevertheless, when it
is a case of the lower teeth, tin-foil is also, according to him, an excellent
filling material.
Like some of the preceding authors, Hirsch admitted the existence of
interior caries in apparently health}' teeth, and was the first to indicate
a good mode of diagnosticating these occult dental affections. It consists
in tapping the suspected teeth with a sound until one finds the one in
which the percussion provokes pain, and this will be the diseased tooth.
One detaches the gum from the neck of this tooth, and at the point, on
the neck itself or on the beginning of the root, where a small protrusion
is found, one perforates the tooth with a chisel, or some other fit instru-
ment, so as to penetrate to the interior of it. Through this passage one
introduces into the tooth a fine, curved, red-hot sound, repeating the
operation several times. Lastly, one fills the cavity with lead; and in this
manner the tooth will be cured and no longer painful.
In speaking of the correction of dental anomalies, Hirsch relates a case
in which the deformit\- consisted in the union of tw^o central incisors, wdiich
formed one single piece, resembling a paddle, and spoiled the appearance
of the face. He divided them with a saw, cauterized the surfaces of the
section, scarified the gum, and, to gain a little space, introduced a small
wedge, until the gum had grown up within the new dental interstice, thus
giving an altogether normal appearance to the part.
It is noteworthy that Hirsch made use almost exclusi\el\ ot the goat's
foot for the extraction of teeth, of whatever kind the\ migiit be, the instru-
ment being rather longer, however, than that ordinarily known by this
name, and making his left hand serve as a lever rest.
To arrest strong hemorrhage ensuing from the extraction ot teeth,
Hirsch used scraped parchment, which he introduced into the alveolus
and pressed with force into it by means of a sound; then he superposed
compresses and kept the jaws tight together with a bandage passed around
the head.
This author, too, was very favorable to replantation. As to trans-
plantation, he says that even when the gum and the alveolus are quite
health\-, the individual entirely free from scurvy and syphilis, and not