Page 229 - My FlipBook

PREPARATORY TO FILLING 213
freely expose a pulp without causing the patient
great pain, even with the lightest manipulation ; and
unless the patient is suffering severe pain at the time,
he finds it inadvisable to attempt it. When, how-
ever, an arsenical application causes great pain, and
the case admits of it, a free opening may be made
with an engine-bur, and if, as frequently happens,
this is followed by an immediate and complete
relief, owing first of all to the haemorrhage, and
secondly to some soothing application which may
also contain some arsenic, the patient will forgive the
dentist, and bless him for his thoroughness. One
of the writer's friends, who practises abroad, once
informed him that he had no trouble after applying
arsenic, his method being to always freely expose
a pulp, and then give it a good cut with an
excavator to make it bleed well. This is a heroic
proceeding that the writer has never had the hardi-
hood to attempt.
The resistance of pulps to the action of arsenic
varies considerably, and this by no means entirely
depends on inflammation, so far as can be
judged by the presence or absence of pain before
making the application. It is very often an ex-
tremely difficult matter to succeed in destroying a
pulp with arsenic in anything like a reasonable
time. Time after time a patient will return; the