Page 831 - My FlipBook

HYPERyEMIA OF THE DENTAL PULF. 841

pulp-tissue, and partly on account of the distortion of the tissues by
shrinkage. Then, too, the blood in the vessels at the time of extraction
has generally been lost. The question of retaining and displaying in
microscopic section the natural injection occurred to me a number of
years ago ; and after some experiment I found it possible to do this in
such a manner as to display the difference between the healthy and the
hyperciemic pulp in very striking contrast. The first object to be accom-
plished in this study is to capture the condition, or, in other words, to
be able finally to place the pulp in section under the lens with the ves-
sels containing the blood just as they did at the moment the tooth was
removed from the alveolus, at least without their having lost the red
blood-globules. This process I will give very briefly.
When a suitable case is presented, first examine the condition of the
tooth itself as seen in the mouth. Tlien obtain its history, the symp-
toms it has presented from the first painful impressions until the pres-
ent. If the pain has been paroxysmal, find if possible what has been
the disturbing cause that has ushered in the paroxysms, the duration of
the paroxysms, the occurrence of soreness on closing the mouth, and, in
short, a full history of the case. The condition of the tooth at the mo-
ment of extraction, especially as to pain, is a matter of pjritne importance
in this study.
Now extract the tooth and drop it at once into Miiller's fluid. It
should not be handled nor disturbed in any way. It should lie in this
fluid for at least one week, at the expiration of which time it will be
found that the blood in the vessels has become so hard that it will not
be displaced if carefully handled, and that the red globules have pre-
served their form perfectly, and will do so during the subsequent hand-
ling. After the expiration of this period the tooth should be cracked
in the vise, as recommended by Salter. This is done by wrapping it in
muslin and placing it in the jaws of a powerful vise (this should be so
strong that there will be no springing together of the jaws on cracking
the tooth, as that would be liable to crush the pulp), and l)ringing them
together steadily until the tooth cracks open. If it is skilfully placed,
the line of fracture will generally follow the long axis. Then place the
tooth in clear, freshly-filtered Miiller's fluid and carefully remove the
pulp from its bed. In some instances the layer of odontoblasts will
remain adherent to the walls of the pulp-chamber, in others they will
remain with the pulp, and often the dentinal fibrils will be pulled
out of the dentine to a considerable length. The pulp is now to be
placed in a thin solution of gum arable to which some gum camphor
has been added to prevent mould. The strength of this solution is very
important ; it should in no case be strong enough to float the pidp. This
should be the test of its strength. If the fluid be of greater specific
gravity than the pulp, its tissue w'ill shrink, otherwise not. The gum-
arabic solution should now be slowly evaporated in any convenient way,
so that it is not done too rapidly, to the consistence of very thick jelly.
This should require three or four days, and it will be found that the
impregnation of the pulp-tissue with the gum will keej) even j^ace with
the thickening of the solution, and that the tissue will remain at the
bottom of the vessel. When the solution has become as thick as is con-