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:
900 DISEASES OF THE DENTAL PULP, AND TREATMENT.
be m(3re satisfactorily performed, as in the case of capping, npon pnlps
the least irritated or nearly freshly exposed. The fact also having been
demonstrated that quantity increases inflammation, and proportionately
so to the amount used, it follows as a necessary sequence that it is better
and safer to use minute quantities ; and it has been further found by
experience that this amount, -when properly applied, may be reduced to
the ^^ ^ grain and be effectual to the extent of destruction desired.
Y^Q
It has been further demonstrated that an amount sufficient to devitalize
the entire pulp at one application is too large, as the destructive effect
may be continued through the tissue in the apical foramen to the
periosteum, and that the limitations of amount should be confined
to the quantity that will carry destruction to the upper third of the
tissue in the canal Avithout comprising all of it. Keeping, then,
this general statement in mind, its preparation and use may be
described.
The preparation of arsenious acid for use in devitalizing the pulp was
in the earlier days of its introduction regarded as of more importance
than at present. Various agents were from time to time suggested
either to reduce the pain or to limit the action of the arsenic to the part
for which it was intended, or else to give bulk to the mass. For the
first purpose morphia was recommended, and for the second charcoal
and othei- materials. AVliy charcoal should have been used is not very
clear, nor did it come into general use. Morphia, however, still retains
its place with many, but the majority, probably, of operators use at
present arsenic without any other combination than creasote or carbolic
acid. One of the first to recommend morphia in connection with arse-
nious acid and creasote was Dr. J. D. White of Philadelphia. His for-
mula was
I^. Acidi arseniosi, gr.
j ;
Morphinse sulphatis, gr. ij
;
Creasoti, q. s.* M.
S. To be made into a thick paste by severail hours' trituration.
The proportional amounts of arsenic and morphia varied with differ-
ent ojierators, and Dr. Foster Flagg suggested the use of acetate of
morphia in place of the sulphate. His formula was
^. Acidi arseniosi, gr.
MorphiujB acetatis
Acidi carbolici, gtt. iij. M.
Garretson makes it equal quantities of arsenious acid and acetate of
morjihia. Dr. J. D. AVhite regarded thorough trituration as of great
iui])()rtauce, to the end that the arsenic and morphia might be com-
])U'tcly combiued, but, the specific gravity of the former being greater
than that of the latter, the arsenic would mainly sink to the bottom of
the receptacle, thus introducing an element of uncertainty in its applica-
tion ; so that the preparation of small amounts and the spreading the
mass over a consid(>rab]c surface became a necessity if the operator would
make the application with a reasonable degree of certainty of having
received sufficient arsenic to accomplish the end desired. Owino; to the
:
900 DISEASES OF THE DENTAL PULP, AND TREATMENT.
be m(3re satisfactorily performed, as in the case of capping, npon pnlps
the least irritated or nearly freshly exposed. The fact also having been
demonstrated that quantity increases inflammation, and proportionately
so to the amount used, it follows as a necessary sequence that it is better
and safer to use minute quantities ; and it has been further found by
experience that this amount, -when properly applied, may be reduced to
the ^^ ^ grain and be effectual to the extent of destruction desired.
Y^Q
It has been further demonstrated that an amount sufficient to devitalize
the entire pulp at one application is too large, as the destructive effect
may be continued through the tissue in the apical foramen to the
periosteum, and that the limitations of amount should be confined
to the quantity that will carry destruction to the upper third of the
tissue in the canal Avithout comprising all of it. Keeping, then,
this general statement in mind, its preparation and use may be
described.
The preparation of arsenious acid for use in devitalizing the pulp was
in the earlier days of its introduction regarded as of more importance
than at present. Various agents were from time to time suggested
either to reduce the pain or to limit the action of the arsenic to the part
for which it was intended, or else to give bulk to the mass. For the
first purpose morphia was recommended, and for the second charcoal
and othei- materials. AVliy charcoal should have been used is not very
clear, nor did it come into general use. Morphia, however, still retains
its place with many, but the majority, probably, of operators use at
present arsenic without any other combination than creasote or carbolic
acid. One of the first to recommend morphia in connection with arse-
nious acid and creasote was Dr. J. D. White of Philadelphia. His for-
mula was
I^. Acidi arseniosi, gr.
j ;
Morphinse sulphatis, gr. ij
;
Creasoti, q. s.* M.
S. To be made into a thick paste by severail hours' trituration.
The proportional amounts of arsenic and morphia varied with differ-
ent ojierators, and Dr. Foster Flagg suggested the use of acetate of
morphia in place of the sulphate. His formula was
^. Acidi arseniosi, gr.
MorphiujB acetatis
Acidi carbolici, gtt. iij. M.
Garretson makes it equal quantities of arsenious acid and acetate of
morjihia. Dr. J. D. AVhite regarded thorough trituration as of great
iui])()rtauce, to the end that the arsenic and morphia might be com-
])U'tcly combiued, but, the specific gravity of the former being greater
than that of the latter, the arsenic would mainly sink to the bottom of
the receptacle, thus introducing an element of uncertainty in its applica-
tion ; so that the preparation of small amounts and the spreading the
mass over a consid(>rab]c surface became a necessity if the operator would
make the application with a reasonable degree of certainty of having
received sufficient arsenic to accomplish the end desired. Owino; to the
