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236 INFECTIONS OF THE PERI-APICAL TISSUES

several adjoining teeth during the necessary driUing. The
rubber dam should, as a rule, not be applied at the first sitting,
owing to the excessive soreness of the tooth. Broach out
the canals as well as conditions will admit, to relieve the

pressure of the confined gases and allow drainage for pus
formation. Flush out with an antiseptic solution, absorb
pus from the canals on cotton or paper points, and either (i)
pump in an anodyne antiseptic, such as camphophenique.
Black's 1-2-3, ^^ phenol compound, leaving the tooth open

to allow for drainage, repeating the treatment at intervals of a
few hours until relief is secured; or (2) according to Buckley,
seal in for a few hours, to be repeated at increasingly longer
intervals, formocresol, as in an ordinary treatment for putre-
scent pulp. In either case, counter-irritation to the gum or

scarification in the early stages, or, in the later stages free
lancing of the gum, drilling through the bone to the apex of
the affected tooth with a spear point drill or trephine, and the
use of a tent for drainage is frequently indicated.
As counter irritants one of the following remedies may be

applied, viz.: Tincture of iodin and aconite, equal parts,
capsicum plasters, black mustard papers cut to proper size,
cantharidal collodion, or one of the following prescriptions:

I^x. Mentholis gr. xx
Chloroformi 5i
Tincturae Aconiti, q. s ad 'SK^nckley.)
I^x. Tincturae Aconiti 3ii
Tincturae lodi
Chloroformi aa oK^i^ckley.)

In some cases, in the later stages, where other methods fail,
heat may be applied to the gum in the form of hot water, a

split raisin sprinkled with capsicum, or a capsicum plaster, to
hasten suppuration and pointing. Antiseptic mouth washes
should be freely used.