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416 CONSERVATIVE TREATMENT OF THE PULP.

nmsliii to cover an areii of one-half by three-fourths of an inch should
be tilled with the prescription, then squeezed out nearly to dryness between
folds of a napkin to prevent an excess flowing over the mouth and with
the saliva entering the fauces, to which it is extremely irritating as well
as unnecessarily medicating the patient. Before the pledget is applied
the surface of the gum should be cleansed of the coat of mucus cover-
ing it, otherwise the remedy will fail to come in contact with the mem-
brane. It is equally important that dryness of the surface be secured.
This application should be maintained for from twelve to fifteen seconds.
If allowed to remain too long upon the j)art, vesication takes place.
The general after-treatment consists in the repeated application of aco-
nitum as above directed, the repetitions not being made at the same point
more frequently than at intervals of forty-eight hours. When it is
desired to increase the counter-irritation, the gum may be scarified very
superficially by quick, light movements of a small scalpel. The patient
should be instructed to avoid subjecting the tooth to extremes of tem-
perature in either direction. The control period of conservatively
treated cases is usually within the first fortnight after the capping.
It is important that treatment be given at the beginning of the dis-
turbance, when a few applications may suffice. Neglected cases, from
the tendency to pulp disorders, are liable to pass beyond the curative
stage.
The interesting phenomenon is frequently observed that when the
heat rate rises the pulp at first becomes more intolerant of cold. In
case the pulp continues to respond to the remedy the range of tolera-
tion should increase in both directions.
Examples: No. 1, W. H. J., + 108°--73° ; 112^-76°; +120°
— 74° 124° - 74° 128° - 67° ; + 130° - 66°. No. 2, I. A. W.,
; ;
+ 120° -84°; +120° -86°; 128° -86°; + 124°-76° + 134°-70° ;
;
+ 140° -67°; +142° -66°; +142° -64°.
It sometimes becomes necessary to open the cases and recap. This
iisuallv occurs when in reviewing the case it is considered that some
oversight has befallen. There may have been two exposures. The
cap may not have completely covered the exposed part. There may
have been some compression from forcing the cap, or it may have been
displaced during the after-procedures.
Most careful records of all cases should be kept, with a relation of
the condition and of the controlling symptoms. These records should
be methodically preserved in a book kept for this purpose. Should sub-
sequent irritation occur, a new diagnosis may be formed from the recorded
facts and the new conditions. The record of conservatively treated pulps
should be carried forward to the examination chart at each recurring
periodic examination of the teeth. It is better that they be marked in