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278 EXPOSED PULPS.

those eases, where there is a discharge through the
root of the tooth, such treatment should be adopted,
as will most speedily and effectually suppress it; and
if it proceeds from a remaining portion of the pulp-tis-
sue near the point of the root, this should he removed,
and such application made as will prevent a recur-
rence of the discharge, and assist the part to recover
its health. The discharging surface may be broken
up by cutting it away with an instrument, or be

destroyed with an escharotic—either nitrate of silver,
creosote, or chlorid of zinc, in the use of which, seve-
ral applications will, in many cases, be necessary.
From their action, the secreting surface is destroyed,
healthy granulations spring up, and a healthy condi-
tion is established.
The discharge should be wholly suppressed before
the tooth is filled ; otherwise, alveolar abscess would
be speedily formed. In cases where there is periosti-
tis, it must be subdued before the tooth will tolerate

the operation of filling. To attain this end, the treat-
ment to be adopted will be dictated by the nature of
the causes which operate to induce the disease.

General treatment will be indicated where there is a
constitutional condition favorable to the local affection
but where there is no such general predisposition, the
treatment should be chiefly local, and may consist of
the following or similar appliances : depletion, either