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TREATMENT OF ALVEOLAR ABSCESS. : 949
root-canal. After the wasliing is completed the pulp-canals should be
filled with cotton saturated \vith a disinlectant, and the cavity temporarily
filled as directed above.
In any of the forms of alveolar abscess cases will occur in which it
will be impossible to open the apical foramen and gain access to the
abscess by that route. This is always to be regretted, as the treatment
succeeds best when directed through the canals ; but in such cases the
medicaments may with a fair degree of success be applied through the
fistulous opening by injection with Farrar's or other suitable syringe.
The nozzle of the syringe should, if practicable, be carried through the
fistula directly to the apex of the root.
For some years I have quite largely used the following
Take of Oil of cinnamon, 1 part
Carbolic acid (crystals), 2 parts ;
Oil of gaultheria, 3 parts. Mix.
This I use in those cases that require a stimulant disinfectant. The
compound seems to possess properties quite different from carbolic acid.
It may be used freely on the mucous membranes of most persons with-
out the least danger of producing an eschar. Its antiseptic properties
are sufficient for use in the pulp-chamber and root-canals. But its
principal use is as a stimulant antiseptic to tissues that have lost their
tone from long-continued inflammation ; hence it is especially useful in
the second form of chronic abscess. It may be injected into the apical
space without danger of destroying tissue. It may be diluted with oil
of lemon or oil of anise.
If after a week's time the fistulous opening should still be maintained,
or in case of blind abscess pus should appear on opening the root, the
treatment should be repeated. If the abscess does not heal in the course
of another week or ten days, it may be regarded as belonging to the
second class, or possibly to the third ; and an examination may now be
made, to ascertain whether or not there is a deposit of serumal calculus
on the end of the root. Whether this should be done or not, however,
will depend on conditions that must be decided in each case for itself.
If there is no such deposit, the case will generally heal after time is given
for the recuperation of the tissues of the apical space. A stimulating
treatment is indicated. Caustics can do no good, but, on the con-
trary, may destroy what tissue remains. It is true that such cases
will often get well after the use of caustics, but my experience is
that they will require more time than if the caustics were not
used. My observation is that too much is done for these cases by
many operators. The main thing is to keep them clean and give
them a chance to get well.
If the case does not heal within a reasonable time, the examination
for deposits of serumal calculus should be made. An opening should
be effected or the existing fistula should be sufficiently enlarged for an
examination of the root ; and if calculus be found, it should be thor-
oughly removed with suitable instruments. There is positively no
chance for the case to heal as long as any of this deposit remains. It
is better to cut away the end of the root than to leave the least trace of
TREATMENT OF ALVEOLAR ABSCESS. : 949
root-canal. After the wasliing is completed the pulp-canals should be
filled with cotton saturated \vith a disinlectant, and the cavity temporarily
filled as directed above.
In any of the forms of alveolar abscess cases will occur in which it
will be impossible to open the apical foramen and gain access to the
abscess by that route. This is always to be regretted, as the treatment
succeeds best when directed through the canals ; but in such cases the
medicaments may with a fair degree of success be applied through the
fistulous opening by injection with Farrar's or other suitable syringe.
The nozzle of the syringe should, if practicable, be carried through the
fistula directly to the apex of the root.
For some years I have quite largely used the following
Take of Oil of cinnamon, 1 part
Carbolic acid (crystals), 2 parts ;
Oil of gaultheria, 3 parts. Mix.
This I use in those cases that require a stimulant disinfectant. The
compound seems to possess properties quite different from carbolic acid.
It may be used freely on the mucous membranes of most persons with-
out the least danger of producing an eschar. Its antiseptic properties
are sufficient for use in the pulp-chamber and root-canals. But its
principal use is as a stimulant antiseptic to tissues that have lost their
tone from long-continued inflammation ; hence it is especially useful in
the second form of chronic abscess. It may be injected into the apical
space without danger of destroying tissue. It may be diluted with oil
of lemon or oil of anise.
If after a week's time the fistulous opening should still be maintained,
or in case of blind abscess pus should appear on opening the root, the
treatment should be repeated. If the abscess does not heal in the course
of another week or ten days, it may be regarded as belonging to the
second class, or possibly to the third ; and an examination may now be
made, to ascertain whether or not there is a deposit of serumal calculus
on the end of the root. Whether this should be done or not, however,
will depend on conditions that must be decided in each case for itself.
If there is no such deposit, the case will generally heal after time is given
for the recuperation of the tissues of the apical space. A stimulating
treatment is indicated. Caustics can do no good, but, on the con-
trary, may destroy what tissue remains. It is true that such cases
will often get well after the use of caustics, but my experience is
that they will require more time than if the caustics were not
used. My observation is that too much is done for these cases by
many operators. The main thing is to keep them clean and give
them a chance to get well.
If the case does not heal within a reasonable time, the examination
for deposits of serumal calculus should be made. An opening should
be effected or the existing fistula should be sufficiently enlarged for an
examination of the root ; and if calculus be found, it should be thor-
oughly removed with suitable instruments. There is positively no
chance for the case to heal as long as any of this deposit remains. It
is better to cut away the end of the root than to leave the least trace of
