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CHANGES FROM NORMAL. 891

exposed to their influence. While this organ^ from its large supply of
nerve-ti-bres, is very sensitive and easily disturbed by impingement of
foreign matter, it very frequently bears this exposure without indications
of pain ; indeed, it not unfrequently happens that it passes through all
the stages enumerated A\ithout any sign more than an occasional imcom-
fortable sensation. This is not, however, always the case. Fresh expos-
ures always, when visible, present a rich red appearance, from the fact
that the red blood-corpuscles have not been given time to take on the
condition of stasis, or stagnation, in the progress of inflammation. The
bright-red spot so familiar to all practitioners has, therefore, only a lim-
ited duration, and gives place to the secondary, or dark, stage peculiar
to areas of inflammation, whether limited to minute or covering large
surfaces. The red spot is therefore the indication of a pulp in a nor-
mal condition, or as near that as it is possible to have it and still
require treatment. The exposure may not be visible to sight, as it
may have occurred through the cracks always possible in dentine in
defects of structure or by accident. It M'ill, therefore, in such cases, be
manifestly impossible to diagnose its condition or judge the length of
time of exposure or the extent of the inflammation. The red presenta-
tion is the indication for a favorable judgment as to the propriety of the
so-called process of capping. In proportion as the pidp has degenerated
toward pulpitis will the possibility of success be decreased. This has
been the experience of the writer, and is fully in accord with the gen-
eral professional sentiment on this subject.
The difficulty in diagnosing a slight exposure is oftentimes very great,
and, as it is of vital importance that this should be correctly done, the
examination should be thorough. The simulation of exposure of the
pulp by sensitive inner tubular fibres is always a source of difficulty.
If it has been exposed to irritation for some days, the excavator may
foil to find it ; resort must be had then to some agent that will penetrate
minute openings and act as a searcher. For this purpose nothing is
superior to finely-carded cotton. The fibres of this insinuate themselves
into minute orifices, and the opening must be very small indeed that
will not be entered by them. The result is momentary pain, more or
less acute, depending on the size of the aperture. While this simple
test is not Avholly to be relied on, it is the best at present at command,
as it certainly is a very delicate one. Sensitive dentine is not affected
by it, for the reason that the test is only available after excavation of
all debris of decay ; and this process cuts off* all fibres level with the
orifices of the tubes, into which, on account of their microscopical
.
minuteness, the fibres of cotton cannot penetrate.
Superficial Pulpitis.—Inflanmiation of the pulp proceeds by the usual
stages accompanying other inflammations—first, the irritation caused by
the foreign matter ; then the period of excitement or increased flow of
blood, followed by the static period ; then gradual loss of vitality in the
part most affected ; eventual death, followed by a putrescent condition.
The first stage is that comprised under this heading, which may be
described as superficial pulpitis from the fact that it frequently retains
that character for a long time, and may therefore be properly considered
as a distinct variety. When it assumes a chronic character, it is evi-