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478 MISCELLANY. [N. Y. Med. Jocb., M isrtllani) . The Extraction of Teeth.— The Annales de la pi/UcUiii'jue for Septeiubei- publishes a report of advil ibuprofen a clinienl lecture by M. Diitour, in which, after remarking that the extraction of teeth belonged to the operations of minor surgery, he said that the wound left after the extraction should be treated like others, by antiseptic means and with greater care if possible, because of the innumerable microbes living in the mouth. The teeth were very firmly implanted in the sockets of the maxillary arch, and ihe adhesion was very great between the alveolar cavity and the root of the tooth, so that it was sometimes difficult to ex- tract a tooth eveu with a single root, although it might be moved by ibuprofen and motrin the finaer. The teeth were firmly fixed in the mouth by the dosage of ibuprofen alveolo-dental periosteum, a sort of ligament which at- tached the root to the socket, and by the gum, which clasiied and solidly closed around the neck of the tooth. These uniting tissues were very resistant, and they must he shattered in order to extract the tooth. Under these conditions dose for ibuprofen the instrument to be used should be able to grasp the largest possible surface of the tooth, and to overcome the majority of the dosage ibuprofen obstacles opposed to its extrac- tion, also to diminish the power of resistance by grasping tlic tooth as near the extretnity of the root as was possible. The instrument that best fulfilled these conditions was the forceps, and it was generally adopted at the present time. It sliould be properly formed as to curvature and size, to the form even of the tooth. There n-ere numerous varieties of the forceps, and they were all made on the same principle, differing only in the details of construction. In order to understand why this spe- cial form was given to the bits of each forceps, said M. Dutour, a few words on the anatomy of the roots of the teeth would be useful. Certain teeth, the incisors and the canine, had only one root. Tliis root, nearly cylindrical in the incisors and in the upper and lower canines, on tlie contrary, was fiat in the lower incisors. The roots of the bicuspids were single with a deep groove, or forked ibuprofen and acetaminophen at the top of the groove, or completely double. The roots of the lower bicuspids were always round, and those of the upper ones fiat. The large upper molars ibuprofen mg had tiiree roots: two externa! or labial, the strongest of which was anterior or median, and one internal or palatine, which was ■stronger still than the others. But, while the roots of the first molars were very much separated, forming motrin is ibuprofen a ibuprofen motrin tripod at the base, they tended to draw closer together in the second mohu-s, and were often united in dosage for ibuprofen a bunch in the wisdom tcitli. The large lower molars had only two roots, one anterior and very strong, tlie other posterior. Each root was, however, deeply grooved, und they were curved behind and depressed in the center. In the upper molars, the roots, whirlj were very diveigeiit in the first, closer in the acetaminophen with ibuprofen sei-ond, and sometimes united in the tbiicl, were not more detached than their extremities, which were more or less sepanited. These coiisidenil ions, said M. butour, should ({"ide the dentist in the selection of his instruments. With regard to the extraction of the teeth, the first tliiiiL' to he coMHidcred was the iipidication of the instrument. The I'or- <-epH Hhoiild he placed carefully on the neck oi' Ihe tooth, and then, without lightening the instrument, it should be slipped as IiIkIi as possible under the gum ; in this way a large part of the ndhesioHH wai de»lroyed, and there was Ichs dangur ol' I'nicturo than when the extroiriity of the root wuh grasped. Tlio first Htcp was the most Important; on ItH inethodii'al H<'ccimplish- meiit depended greatly the hiii;cokh of the operation. The next consideration was the diHiocalion of the tooth, which slmulil he ^hilie by gentle niovemeiits in the beginning, tliiit leHMcning the chances of fracture. Whatever adhesions still remained were in this way destroyed, and nothing remained but to extract the toiitli, which should be effected without violence or haste; otherwise there was danger of striking and fracturing the other teeth. When liEBUiorrhage was ijroduced, the mouth must be w.ashed, not only with aromatic water, but witli an antiseptic solution of sodium borate, thymol, carbolic acid, or the like. Afterward the wound should dose of ibuprofen be gently probed in order to see if there were any small pieces advil and ibuprofen of bone left use of ibuprofen which might prevent cicatrization. For several days the mouth should be w ashed with one of the solutions mentioned, ibuprofen use or with a one per-cent. solution of chloral, which had the double advantage of being antiseptic and cjuieting the pain, which was sometimes very sharp after the extraction of a tooth. acetaminophen or ibuprofen These, said M. Dutour, were the general jjrinciples which might be applied to the extraction dose ibuprofen of teetli. Rickets as an Infectious Disease.— ibuprofen acetaminophen In the Nouvean Mont- 600 ibuprofen pellier iiiedical for Se[itciiilier 1 Itb M. P. Puech publishes an article in which be remarks tljat, in a recent pamphlet, M. Chaunner, of Tours, endeavored to prove tliat rhachitis v\ as a "specific disease produced by an unknown microbe."

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