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296 DENTAL PERIOSTITIS.

Simple scarification of the gum, cutting it more or less
deeply, will secure sufficient hemorrhage, especially
if the gums are quite vascular ; when this fails, cup-
ping, or the artificial leech, may be employed ; but
the natural leech is the most efficient means of local
depletion, in this treatment; and every dentist should
always have these at command, and be familiar with
their use. The application of a leech in very many
cases will, in a very short time, subdue the most
violent attack of acute periostitis.
In the treatment of this affection, hyperdermic

injections give promise of most desirable results; for
this purpose, the solution of morphine, or tincture of
opium from ten to twenty drops, may be injected,
with a proper syringe, beneath the mucous membrane,
when the pain would be found to subside in a few
moments, and the severest symptoms be abated in a
few hours.
In all cases of periostitis, the sooner it can be
brought under proper treatment after the attack, the
more easily will it be subdued.
In cases of longer standing where the affection has
assumed a chronic form, the membrane more or less
thickened and indurated, and a persistent soreness of
the tooth affected, heroic and persevering treatment

will be required to overcome the difficulty; in the
great majority of cases, however, the result is the