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PREPARATORY TO FILLING 219

In obstinate cases sulphuric acid (twenty to fifty
per cent.) may be used. When everything else
has failed, the writer has often had happy results
with nitrate of silver (full strength)—but this may
cause disao'reeable discoloration of the teeth. When
a fistulous opening exists, the remedy should if pos-
sible be so forced through the apex of the root that
it exudes from the opening in the gum. This can
generally be readily accomplished, particularly if
the canal is filled with the remedy, the cavity
of decay tightly filled with unvulcanised rubber,
and pressure made on the rubber. Should a
fistulous opening remain unclosed for some time
after the roots are filled, the remedy may be applied
to the diseased part through this opening, enlarging
it if necessary. Fusing nitrate of silver into a little
ball at the end of a platinum probe or fine wire is
a convenient means of applying this remedy in
these cases. In cases of blind abscess, an opening
may be made to the end of the root by cutting
or drilling through the outer alveolar plate. This
is often a ready and efiicacious method of treatment
in these cases, but is too heroic a proceeding to
be recommended as a general practice, owing to its
usually causing great pain unless gas or ether is
administered. In some cases the amputation of the
ends of roots is recommended, and in others a good