University of the Pacific School of Dentistry - Chips Yearbook (San Francisco, CA)

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THE CO-OPERATION OF PHYSICIAN AND DENTIST IN THE TREATMENT OF DISEASES. S. B. Fontaine, D. D. S. CAsst. Oral Surgeon to College of Physicians and Surgeons of San Francisco, Dental Surgeon to French Hospital of S. FQ When we consider the close relationship between certain diseases of the human mechanism and that of the beginning of the alimentary tract, it is hard to realize that we are only now awakening to the fact that the physician and dentist are depen- dent upon each other for the thorough and scientific treatment of various diseases. To consider all the diseases which are analogous to one another would take up more space than is at my disposal, so I will content myself with mentioning the most important only. In the vicinity of the oral cavity we have the diseases of the faucial tonsils, and of the circle of Waldeyer, which includes the adenoids. We also have the influence of the thyroid body upon the eruption of the teeth. It is only of. recent years that the significance of the thyroid body in the human system and its therapy has been discovered. Dr. Dunogier of Paris, who has made a special study of that body, cites several cases, one of which I will mention. The pa- tient,'an infant, who was greatly retarded in general development, and exhibited myxedema, had erupted but seven teeth by the age of three. After thyroid treatment had been given for three months nine additional teeth had erupted. Other cases in the oro-pharynx are the sequelae of genital diseases, i. e., secondary syphilis in the form of mucous patches and the third state or gumma. VVe also have the initial stage of syphilis in the form of chancre, and last, but not least, on account of rarity, gonor- rheal stomatitis. Thorough knowledge of these cases should be had by both members of the medical profession, not only for the rational treatment of the unfortunate victim, but for the danger of inoculating other innocent people. As we leave the oro-pharynx we come to skin diseases which are attributed to pyorrhea alveolaris, among the most common we find acne rosacea areola, eczema, edema, etc. The two explana- tions of this phenomena are: the irritation of one branch of the fifth nerve inside the mouth, producing by refiex action, a lesion of the integument by an associate branch of the same nerveg the other, the more complex condition or septic absorption from diseased gums. I r Next we have infiammation of the eyes, infection of the brain, and insanity. In cases of neurasthenia and insomnia, not due to obvious physical cause, i. e., disorders of the digestive organs and eye strain, possibly one-half of them are due to den- tal diseases, the remainder maybe caused by genital diseases. In mentioning genital disorders it is not amiss for me to men- tion a few facts on dentistry and gynecology. 34

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A FRESHMAN'S WAIL OF JOY. At last the great day has arrived, For which so long we much have strived. No, we're not bound for the theater, South Pole, the moon, or the equator. From all such play we must keep away, 'Cause life's real work is here to stay. We go to lectures and quizzes, too, And cut at arms and phizzes, boo hoo! At first it's nauseating and enervating, But folks cry for doctors they're always waiting, So try we must to live up to our tru. ., And buckle down to hard study o ' bust, For there's more than one examin Lion, And if we work not with animation To home they'll send us with little fur Wliile all we'll do will be to cuss The profs for making things so hard As if in God's art they took part! Yes, much study makes us quite rurl ly 3 Indeed, we shout Hee haw ! like i.landie! Ah, study's a cinch, just six days at ix .-wir. From eight to five only, then one peek At the sky and street, and we -e on. ' 1 1-at Of the thing we have studied- -nic: , neat! And as soon as we're through witl, It's time to spread our books cut flat, To study and cram till twelve or one. At last it's to bed-Ctired out and donej- VVhere we dream of big skulls staring madly. They seem to say You fooled us badlyg Advice you gave, managed to pave The way to our untimely grave l Then they all make a start, fast as a dart, And rush toward us, to tear us apart Wliile we stand amazed, transfixed we gaze, And think here's the end of our earthly days! A terrible screech-and long arms they reach To us-but we just stare, devoid of speech! We shake and quake-when, oh dear good Lord! But that's enough for our spinal cord! Ah, it's fine to still be able To take our seats at the table, Then seizing a book from every nook, We're off again like Tennyson's brook'g And so it goes on, day in and day out, With hardly a moment to look about. Now, my friends, after reading this, Dont' you think study is full of bliss? ALEX. M. SHAPIRO, Sophomore Medical 33

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Toothache and the loosening of the teeth during gestation is an every day observation and has given rise to a popular adage - For every child a tooth. In the affections of the teeth and gingivae at this stage, various forms have to be distinguished, i. e., notable sensitiveness of teeth, odontalgia, without apparent causesg loosening of teeth with hyperemia and hypertrophy of the gingivae, brittleness of teeth, and caries of the teeth which is usually of progressive character. These symptoms appear generally in the third and fourth months. The causation of these symptoms seems to be more from a topic reflex from the geni- talia than from disturbances of the circulatory system. Vomit- ing during gestation is commonly caused by an acid saliva which is contaminated by putrifactive bacteria. Postponement of treat- ment until after delivery is to be strongly condemned. During the third, eighth and ninth months dental operations should be avoided if possible as abortion is most likely to take place at that time. There is no possible danger otherwise, providing the oper- ation is performed without undue pain. Novocain may be used as a local and ether Cor nitrous oxide with oxygenj as a general anaesthetic in those conditions. Uric acid ailments are next in order. Gouty diathesis, rheu- matism and pyorrhea alveolaris, all caused by an excessive de- posit of uric acid in the body. Local conditions as unsanitary and ill-adjusted bridges and crowns, old roots, etc., all tend to aggravate pyorrhea. The treatment for pyorrhea should be both constitutional and local. The last subject to be taken up is children's mortality. The Census Bureau of the Department of Commerce and Labor at Wasliington, D. C., has recently presented some interesting in- formation on the mortality of children which should receive the consideration not only of sanitarians in general, but especially those concerned with the hygiene of the mouth. The death rate of tuberculosis decreased from 173.9 in 1908 to 167.5 per one thousand in 1909, it being the lowest rate on record. Mortality of pneumonia and influenza has also decreased. In the estimated population of the United States it showed that 26.8 per cent were children under five years of age and that 19.1 per cent were infants under one. The above decrease is no doubt a result of the recent hygi- enic movements. The human mouth is a habitat and breeding ground of many bacteria which are the causes of definite pathol- ogical conditions. Mortality will still further decrease when those in charge of the little patients are made to clearly under- estand the relationship between infantile disorders and difficult dentition, and relieve the distress by the skillful use of the life- saving lance. It is in the foregoing aspects of the question that both mem- bers of the medical profession should fully awake and co-operate in reducing the rate of mortality in our country. ' 35