ill _, G 000 005 582 2 CO 2 > P5 q O I a PI H 5 THE LIBRARY OF THE UNIVERSITY OF CALIFORNIA LOS ANGELES ELECTRO. DENTI ST R Y FACTS, AND OBSERVATIONS. THIRD EDITION. By JOSEPH ^NAPE, L.D.S., R.C.S., Dental Surgeon to the Liverpool Royal Lnjirmary, a?id Lecturer on Dental Surgery at the Liverpool Royal Lfifirviary School of Medicifie. LONDON : SIMPSON, MARSHALL & CO. LIVERPOOL: EDWARD HOWELL. INTRODUCTION. m That the application of Electricity during the extraction of a tooth will produce local anaethesia, is a fact which, during the last sixteen years, I have had opportunities of verifying many thousands of times, as scarcely a day has passed without my having several operations. When in 1858 the results of my first experiments were published the subject excited intense and general interest, which a few in the profession still feel, and who continue the use of the electrical anaesthetic with success to themselves and comfort to their patients. By the majority, however, it has been abandoned, chiefly on account of the character of the anaesthesia produced, — the want of manageable electrical machines, — forceps properly insulated, and other minutiae necessary to success, which time, attention, and persever- ance can alone develope. The first edition of my little monograph was published chiefly for the purpose of saving both my health and time, by sending it, instead of writing long letters in answer to many hundreds received upon the subject. Not wishing to mislead the public, and having arrived at anything but a definite conclusion as to the best method of operating, I simply related facts, accompanied with observations ; and in the British Journal of Dental Science, vol. ii,, page 294, explained my method of operating. Had I been a minute as well as a general observer, my first experiments might have been more carefully con- ducted ; still it is satisfactory to be abjc to state that were I now called upon to give an opinion on the results, after sixteen years of constant practice, I could not possibly give it in better words, or in a more appropriate manner, than in my first letter to the Times. In this edition, the text is published as it originally stood ; and all the practical information obtained up to the time the sheets were sent to the press, is given in the form of Notes and an Appendix. Since they were printed I have ceased to use the machine described in Appendix IV No. I, and have substituted for it, and used with great success, a neat electric machine and battery, easily- managed, and so small as not to be obtrusive. These may be obtained at Messrs. C. Ash and Sons, with direc- tions for use. I have also been fortunate enough to have for a patient a gentleman who from studious observation has expressed his sensations, whilst undergoing the opera- tion, in a much clearer manner than hitherto related, and I therefore consider this case worthy of record. The gentleman, a foreigner, called upon me late one afternoon to have a tooth extracted under the influence of chloroform or gas. Informing him it was not safe to use either of those agents without the assistance of a practi- tioner who was accustomed to their administration, and as he wished it done that afternoon it would be dark before one could be procured ; further, that it was not advisable to operate by artificial light, I suggested that without any assistance he might have the tooth safely and painlessly removed through the agency of Electricity. This he had never heard of as being so employed, and the recollection of the excruciating suftering he had endured during a former extraction made him tremble with apprehension ; consequently it was only after hesitating a considerable time and remembering that he had to commence a long voyage on the following day, that he took courage from what I said and submitted to the ordeal. The tooth was a right upper molar, much decayed, and broke during the extraction, one fang being left in its socket. With his tongue he felt this and requested me to remove it, which I did, and it is needless to state that this gave electricity a very severe test, yet after the operation he expressed himself delighted with the result. The next day he had to sail for South America, where he said he hoped they could operate in the same manner. On giving him two copies of my pamphlet I told him it was probable that any practitioner, feeling an interest in the subject, would therein find ample directions to enable him to perform a similar operation. The next morning brought a letter from him, couched in the following terms : — Dear Sir,— Having perused your book on Electro-Dentistry which you kindly gave me yesterday, and having read the ten cases of extracting teeth with Electricity, 1 must say that I think none of ihem expresses the feelings of the patient in such a way as to make it clear to a person who never had any conversation on the subject, and therefore 1 wish to give expression to my feelings in the case, perhaps, for the benefit of some of your patients, who like me, before seeing your way of extracting teeth, might be afraid of undergoing the operation. When the beaks of your forceps entered between the gum and the tooth, I felt a sensation in the gum the same as I should feel in the hands touching the handles of an electric battery, such as shown in fairs ; the action of drawing the tooth I did not feel, either pleasantly or unpleasantly. The difference of feeling expressed in the ten different statements submitted in your treatise, arises from the fact that electricity acts differently upon different individuals, or is differently expressed by them. I have watched people grasp the handles of a small electric battery such as yours, and some will laugh and stand it quite a while and say, " how nice ; " others will let the handles drop and say, '■ how very unpleasant, it is a dreadful sensation," (S:c., ike, and as this tickling sensation in the gums is the only perceptible sensation, such persons may then call it pain. Thankful to you for your kindness both before and after the operation, if operation it can be called. I remain, yours most obediently, Washington Hotel, T. SPRINGLE. August 26th^ 1873. By referring to the ten cases recorded in 1858 (page 17), it will be seen that the general remarks bear the same testimony, though perhaps more vaguely expressed. A gentleman says : — " the only pain, which was very slight, was when the tooth was first grasped ; " a young lady that '' no pain, only a little feeling like mesmerism;" anotlier young lady says: "there was no pain, there was a dancing about the eyes, but could not tell when the tooth was out." Now when these des- criptions of sensations, experienced and expressed sixteen years since, are analysed, they amount to much the same as the more accurate explanation given by Mr. Springle. Since receiving that letter, it has been my custom to question my patients most minutely, and the result has been that all confirm this vievv^. The most intelligent of them upon being ques- tioned, give me to understand the only unpleasant sensation felt is momentary and at the time the tooth is first grasped (in fact, the instant the circuit is completed), and that during the extraction neither the sensation of pain or electricity is experienced, but only the " hard tug " VI as described in my little patient's case, page 19. Since writing the above, I have removed from the mouth of an excitable Irish girl, a lady's maid, a lower molar tooth. I asked her whether she experienced any pain. " Oh yes ! " she said, " it was dreadful ! " Yet in a few moments she begged me to remove an upper molar. Enquiring whether I should take it out without Electricity, as she was so much hurt, she replied : " No, Sir, if you please, you did not hurt me half so much as when I had a tooth taken out before." My next patient, who presented herself immediately afterwards, was a bright, intelligent, and well educated young lady. I removed for her a lower molar, and making the same enquiry as to whether she experienced much pain, her reply was that when I first seized the tooth she felt a queer shaking sensation, but no pain during its removal. The next operated upon was a young medical gentle- man, Mr. A. G. Sandberg, resident clinical assistant at the Liverpool Royal Infirmary. He had suffered two days and nights the most excrutiating torture and wished me to remove the tooth, a lower molar, under the influence of gas or chloroform. I persuaded him to let me use as a substitute Electricity. The extraction, was made, after which I requested him to put on paper the sensations he experienced, and he wrote as follows : — Liverpool Royal Infirmary, Sept. 18, 1874. Dear Sir, — The feelings I experienced during the extraction of one of my lower molars were : — First, on the tooth being grasped by the forceps, I could feel a tingling sensation in it, just like what one feels in the hands when receivmg a sli-ht electric shock. Secondly, I felt a slight jerk as if the tooth were being withdrawn, but without any pain ivhatever. In fact, so quietly and painlessly did you extract the tooth that I could hardly believe it was out until I saw it before me. Yours very truly, A. G. SANDBERG. P.S. — I feel very glad that I took your advice, and let you extract the tooth by Electricity, instead of insisting upon having chloroform or nitrous oxide gas, which I at first asked you to use. The senior editor of the American Journal of Dental Science says (see page 9) : " When the tooth can be grasped and extracted without the instrument coming in contact with the gum, the operation has been comp.ei:ely success- ful, but when it is pressed against the surrounding tissues VI 1 the entire current of Etectricty does not pass through the tooth, and we presume that it is for this reason the operation is not successful." Here we find one great source of failure, for when the forceps are properly insu- lated this is not the case, as the Electricity can only flow through the bright points that come in contact with the tooth — the insulation protecting the gum. Although Electricity does not produce general insensibility as in the use of chloroform or gas, I am perfectly satisfied the ordinary pain of extraction is not felt, and that this is accomplished, not by the substitution of one pain for another as has been frequently asserted, but by th.^ action, sui generis, which Electricity has upon the nervous system. This edition of the pamphlet although printed, would never have been issued had not a friend from London happened to call upon me at a time I was actually engaged upon one of these operations. As this gentleman possessed an experience with chloroform and gas as extensive as any man living, I was gratified in being able to introduce him into my operating-room in order that he might see my arrangements, and from the patient's own lips, after the removal of two upper molars, hear what had been the sensation felt during the operation. He expressed himself as delighted with what he had witnessed, and told me that hundreds of my fellow- practitioners had a great aversion to the use of chloroform and gas, and were longing for any safe agent that could be satisfactorily substituted. That this opinion is en- tertained by many practioners on the other side of the Atlantic, may be inferred from the observations made at the American Dental Convention by several of them, and recorded in the Dental Cosmos for November, I873- Dr. Drake said he dreaded nothing so much as the adminis- tration of anaestheties. He had carried his patients as near death's door as he cared to, and never takes up a sponge without a nervous feeling which makes him dread its administration. Dr. Atkinson classified all anaestheties under one head, and opposed the use of aU of them. The testimony V1 11 of patients who have just come out of an anaesthetic state is unreliable, they are in a state of intoxication, and will sign their names to anything and testify to anything. The fact that there is no apparent injury at the time of their leaving the office is no proof that they have not suffered serious damage to their health. Dr. Ambler wished to state that to his own knowledge there had been many patients seriously injured by the gas itself, and could mention the names of at least fifty who have admitted having received temporary injury. Dr. Walker's experience with gas had resulted in his ceasing to use it He had numerous cases of patients sick for weeks from taking the gas ; believ^es in avoiding the use of anaesthetics if possible. In the August number of the British Joiirnal of Dental Science comes a timely caution from. Mr. S. H. Cartwright. Having myself had several most dis- tressing cases similar to that mentioned by him, some of which would doubtlessly have terminated fatally had not the greatest care and promptitude been exerted ; and having frequently in consequence suffered an amount of nervous exhaustion which those only can appreciate who have had a like experience, I do not hesitate to say that no fee, however great, would be an adequate compensation for such a terrible infliction.* Firmly believing that with the judicious use of Electricity all these troubles and anxieties may be avoided, it is to be regretted that so few by their own experiments endeavour to make this ubiquitous and mysterious agent subservient, safely to mitigate pain, in an operation dreaded by all, and which not one in a thousand entirely escapes. 75, Rodney Street, Liverpool, September, 1874. •These observations are not made in antagonism to the legitimate use of anaesthetics in important surgical operations and midwifery. In such cases I consider chloroform to be one of the greatest blessings ever conferred upon suffer- ing humanity. ELECTRO-DENTISTRY FACTS, AND OBSERVATIONS. When the results of my first experiments in Electro- Dentistry were published, the desire to abandon the use of anaesthetics altogether, or to find one less dangerous than chloroform amongst dental practitioners, had become very nearly universal ; this, together with the novelty of the subject, induced numbers to repeat them. And as many who attempted to do so failed to produce like results, at the suggestion of many of my friends, I am induced to publish, in as brief a form as possible, what information upon the subject I possess. In order to do this in the most satisfactory manner, it may be well to commence by giving a short account of my connexion with it. When first apprised of Electricity being used for the purpose of producing local anaesthesia, I had never heard of Mr. Francis, or his modus opa-andi ;^ the only inform- * There can be no doubt that Mr. Francis of Philadelphia was the first person to use electricity in a systematic manner, for the purpose of producing local anaesthesia in dental extractions ; but to whom the merit of the discovery is really due remains a mystery, though many claim it. Mr. Morrison of Edinburgh, in a letter to the editor of the Times, also published in the British Journal of Dental Science, vol. ii , page 296, claims to be the discoverer. Mr. George of Paris, who was the first to repeat my experiments in France, wrote to me at the time, saying that two persons in that city claimed the invention, and said ation I had was from a friend in America, and contained in these words : " They are drawing teeth on this side the water without pain, by means of Electricity/' I thought this might prove deserving of notice ; and having by me a magneto-electric machine, which I had purchased more as a philosophical toy than for any practical purpose, I began to consider how to proceed ; and having procured some copper wire, attached one pole of the battery with a moistened sponge to the spine, and the other to the tooth and gum, and extracted a tooth whilst the current was flowing. Operations so conducted were unsatisfactory- and cumbrous, as with the machine I then used, two assistants were necessary as well as the operator. My next thought was to attach the wire to the forceps, and I immediately adopted it. M) next experiments were made upon poor, and, in many instances, ignorant people, who, when asked they had been using it for years. No proofs, however, were brought forward to substantiate their assertions. The friend from whom I had the earliest mformation respecting it, told me the following anecdote illustiative of its origin : — In one of the American cities there was a certain medical electrician or galvanist, who professed to cure all kinds of diseases, and to remove all sorts of pains, by means of electricity. One day he was applied to by a man who was dreadfully tormented with toothache, who NWshed to be re- lieved from his pain. For this purpose a wire from each pole, termi- nating with a metal disc and a piece of moistened sponge, was applied to each cheek, without, however, producing any mitigation of the symptoms ; and after various trials, with like unsuccessful results, the galvanist thought of applying electricity more directly to the tooth itself; and for this purpose he attached one of the wires to a pair of forceps, which exactly fitted the offending masticator, keeping the wire which was attached to the opposite pole, against the cheek. Feeling un- certain whether he should be able to remove the pain, and havmg then a fast hold of the tooth, the temptation to remove it was so great, that he extracted it without saying a word to his patient, who, when it was out. declared that it was removed without pain. I have no doubt the discovery was made in some such manner. if they felt anything, answered in the affirmative. Not recollecting at the time the distinction between sensation and pain, I concluded that my experiments were failures; * feeling, however, assured that, had those made in America succeeded, there would certainly be an account of them in the Dental journal published in that country, (which for many years was the only medium exclusively devoted to dentistry the profession in this country possessed,) I waited for its appearance before proceeding further, and received it about the time there was so much congratulation in this country, and so much rejoicing on the opposite shores of the Atlantic, on account of the apparent success with which Electricity was enabled to whisper secrets through two thousand miles of submerged cable. After successfully repeating my experiments upon three gentlemen, on whom I could place the greatest reliance, (which experiments I now know were the first made in this country,) and looking upon the subject more from a scientific than a professional point of view, I published the following letter and accompanying paragraph in the CJiester Courant : — ANOTHER TRIUMPH OF ELECTRICITY. To the Editor of the Chester Courant. Sir, — As every one is desirous of avoiding pain, especially in the extraction of a tooth, you will, I hope, excuse my requesting you to insert in your next publication the following paragraph from the American JoHr7ial of Denial Science. I may add that, although I * This I believe is an error into which many operators have fallen, and they fancy Electricity will do away with feeling as well as pain. This is a mistake ; and to operate successfully with Electricity, there must be no bungling, or the pain of the extraction will be increased. It is a great disappointment to many that this agent will not, like chloroform hide defective operations. 8 only received the Journal yesterday, I have already made several apparently very successful operations, performed under the most unfavourable circumstances. I ha\ e, however, great hopes that this application of electricity will prove an inestimable boon to suffering humanity. I am, Sir, your obedient servant, JOSEPH SNAPE. Bridge Street j Auf^ust 24. Local Anaesthesia bv the Application of an Electric Current. — Many, if not most of the readers of the Journal, have doubtless heard of this novel method of producing local anaesthesia, and its application in the extraction of teeth. It was brought to the notice of the senior editor about two months ago, by one of the Agents of Mr. Jerome B. Francis, of Philadelphia, the inventor, with the request that he would give it a fair trial. Having consented to do so, he requested the Agent to place in the infirmary of the Baltimore College of Dental Surgeiy one of the small galvanic batteries w^hich had been gotten up for the purpose, and, at the time appointed for the experiment, a number cf persons, having decayed and aching teeth, presented themselves for the purpose of undergoing what they had been led to believe would be a painless operation, and in nearly every case their hopes were seemingly realized. Between thirty and forty teeth were extracted by Dr. Arthur, late Professor in the Philadelphia Dental College. The experiment at the college was continued two afternoons. On the second day the senior editor was not present, but Dr. Arthur informed him that it was quite as successful as on the tirst, and, with a view of ascertaining how much the imagination might influence the feelings of the patient, he, in the case of a boy, who wished to have two teeth extracted, applied the electric current while removing the first : the lad affirmed that he suffered no pain ; but in the removal of the second it was not applied, and the pain occasioned by the operation was so great that he screamed lustily. The apparent success of these experiments induced the senior editor to apply the invention of Mr. Francis in his private practice, and the result thus far has certainly been very satisfactor}', a large majority of his patients, for whom he has extracted teeth, having assured him that they experienced no pain while undergoing the operation ; and, as a general thing, those who did sufter stated that the pain v.as much less than what they usually suffered under the operation. The anaesthetic effect of the electric current seems to be different in different individuals. When the tooth can be grasped and extracted without the instrument coming in contact with the gum, the operation has been apparently completely successful ; but when it was pressed against the surrounding soft tissues, the entire current of electricity does not pass through the tooth, and we presume it is for this reason, that the operation is not then successful. How is it that local anaesthesia is thus produced we cannot understand, but that it is, at least, in a large majority of the cases, seems to be well established.— ^7;/^;7r^;/ Journal of Dental Science. A number of copies of this letter, and the paragraph from the American journal, were procured in the form of slips, which the editor had the kindness to have struck off for me, before the type was distributed. One of these slips I forwarded to the editors of each of the Liverpool and Manchester papers, and to those of Shropshire, Staffordshire, and North Wales, hoping they would insert them in their respective journals, and, by so doing, be the means of bringing me into correspondence with some neighbouring practitioner, who might possibly be engaged in similar ex- periments; for I had no conception that I was the only indi- vidual inthis country that was givingthe subject any attention. I was, however, much surprised and disappointed to find that, with the exception of two of the Chester papers, my short note, calling attention to the paragraph, was not inserted in any one of them. In some the paragraph was inserted, but in such a manner that it looked as if it was merely put in to fill up space, and so, for a time, the matter was entirely overlooked, both by the profession and the public. In the meantime I continued experimenting with a success that astonished me ; I must say that I was fairly puzzled. The evidence given was so strange, of so entirely new a charac- ter, yet, at the same time, so strongly confirmatory, I could not doubt that a local anaesthetic had been discovered. In 10 order to get as good evidence as possible, I persuaded my youngest son to have a temporary molar tooth removed, and he fully confirmed the evidence. My cook, who greatly dreaded the extraction of a tooth, had been suffering some days with toothache, and upon hear- ing my son's testimony, asked me to remove one for her ; after the operation she told me she felt no pain, she " would as- sure m.e there was no pain." Including private, Infirmary^ and gratuitous patients, I had, by this time, extracted nearly Two Hundred teeth with the assistance of the electric current, so that, when I read in the Times an account of the melan- choly accident from chloroform, at Epsom, I felt that it was a duty I owed to society, to make known the results of my experiments. I therefore determined to send them to the editor of that journal, unaccompanied by any extract. The following was the letter: — CHLOROFORM IN DENTISTRY SUPERSEDED. To the Editor of the Times. Sir, —Having seen in the papers an account of a death from chlo- roform, administered by Mr. Keehng, of Epsom, formerly a pupil of mine, I should wish, with your kind permission, through the medium of your columns, to call the attention of dentists to the discovery that the application of the electrical current will produce local anaesthesia. Some few days since I was informed of this discovery, and immediately put it into operation, with results which have amply realized my anticipations. In the course of the week I have extracted upwards of 150 teeth from persons of all ranks, of both sexes, and of every age, and the tes- timony of each has been most satisfactory. Some persons said they experienced pain, but not so much as usual ; others, that they felt no pain whatever. Some patients have said that they were conscious of the pull^ but the customary pang was absent. The exclamations of many after completion of the operation, have been, " Oh, how very delightful ! " How very nice !" " How very wonderful !" &c. One gentleman, who was rather sceptical, after having a tooth extracted, said, — " Well, I II would not disbelieve a man now if he told me he had learned to fly." Feeling desirous of getting as satisfactory evidence as possible, I per- suaded my youngest son, who is not fonder of having his teeth drawn than other boys of his age, to have a temporary molar tooth removed, in order that he might be able to tell me what he thought of it. As soon as the tooth was out, he exclaimed, "That's the thing! It will do, papa!" I have found children of the most nervous temperament, whom we have had great difficulty in persuading to undergo the operation, after- wards declare, although they cried out, they felt no pain. Other children, when asked if they felt anything, answered, " Only my arm tickled a bit." From these results, I think we may venture to say we have obtained an agent that, in dentistry at least, will supersede the use of chloroform ; for, however useful this chymical may be in the more important operations of surgery, I have never felt reconciled to the use of it in the ordinary operations on the teeth. In the electric current we have an agent without danger or any disagreable accompaniment, most easily applied, and occupying scarcely more time than an operation under ordinary circumstances. I am, Sir, your obedient Servant, JOSEPH SNAPE, Dentist to the Chester Infirmary. Bridge St., Chester, Sept. 2. My name and address, and connexion with the Infirmary, were given, as vouchers for authenticity of my letter. One spark from that great battery electrified the whole of Europe, and numerous individuals in this country, and on the Contin- ent, commenced experimenting. I have no doubt that a wish to give mutual aid originated the various directions that were given, some good, others indifferent, many erroneous, and all necessarily crude from the novelty of the subject. Electrical machines were made and sold, of every ima- ginable form, possessing power sufficient to knock down a bull, but without the means of diminishing the intensity of the force to that gentle current upon which local anaesthesia depends. It cannot, therefore, be a matter of surprise that 12 persons practically unacquainted with electricity, by follow- ing such directions and using such machines, should fail in their operations. These failures excited discussions ; letters for and against the subject were published in the Medical and Dental Journals ; facts were brought forward to prove the efficacy of the new agent, and metaphysical treatises were written to prove the thing impossible ; and a meet- ing of the College of Dentists was called, which was crowded to suffocation, to " discuss the question, whether electricity had the power of deadening pain."* * I received a circular inviting me to attend that meeting, but I did not do so, for I thought that the truth as to whether Electricity did or did not possess anaesthetic powers, would be better arrived at by experiment than by discussion. I had previously made a propo- sition to the late Mr. Robinson, who took great interest in the College of Dentists, to come to town and operate at their Dental Hospital before as many professional men as they chose to admit. This offer was either overlooked or, most probably, forgotten. That such a pro- ceedingwas the only way to bring out the truth I had seen previously con- fiiTTied. Whilst the excitement was at its height, on one of the morn- ings of my attendance at the Chester General Infirmar}', I invited most of the medical men in the city, who were likely to take an interest in the subject, to witness my operations, with what friends they chose to bring, so that a large number of persons were present, and amongst them the representatives of the Press. The following extract from the Chester Coura)>t of September 8th, 1858, will show the character of the impression made upon those present, and publicly announced by their very able representatives, the reporters : — Electricitv and Dentistry. — Mr. Snape, surgeon-dentist, Chester, can claim the honour of having introduced into the science of dentistry in England, an altogether new agent by means of which the anguish of tooth extraction is wholly obviated — this agent is Elec- tricity. When we call to mind the number of cases in which the application of chloroform has proved fatal, and the recent case at Epsom, where a dentist (formerly a pupil of Mr. Snape s) had the mis- fortune to see a patient die while undergoing an operation under the influence of chloroform, we cannot but feel grateful that while the danger to life is obviated, local anaesthesia may be produced so as to 13 In the Times of October 14, may be found a report of that meeting, in which it is stated that the president " passed in review the various methods by which electricity might be appHed, with the intention of rendering the ex- traction of teeth painless : but, unhappily, the results of his own experience did not warrant him in stating that so desirable a condition had as yet been attained ; on the con- trary, he believed that the attention being arrested, and the mind occupied by the application of anything so novel as electricity, would sufficiently explain the power which that agent possessed occasionally, to somewhat mitigate the pain. Several other gentlemen corroborated this conclu- sion by the results of their own experience." I can quite understand why the President and his coadjutors failed to obtain satisfactor}^ results. It is evident the current of electricity used has been too strong ; continuous shocks have been given, instead of a gentle current ; producing convulsive twitching in the hands and arms, instead of a gentle vibratory motion. cause the operation to be painless. We believe the discovery is due to Mr. J. B. Francis, of Philadelphia, and it was communicated to Mr. Snape by a friend in America, where it has been used very successfully for several months. We have had the — pleasure we were going to say — for it really seemed a pleasure to the patients — of seeing Mr. Snape operate in a variety of cases. The first was a young woman who had never had a tooth drawn before and was exceedingly nervous, but the tooth was extracted without the slightest exclamation, and she assured us that during the operation she did not feel the slightest pain. The second was also a young woman, who, when the tooth was drawn, burst out laughing. The third was a gentleman who had suffered severely from the toothache, and upon whom the operation was as completely successful as it had been in the previous cases. The result of the operations was such as to convince us that an agent, in dentistry at least, had been discovered which will quickly supersede the use of chloroform ; and which can be applied without danger, or any dis- agreeable accompaniment. H A few days before that meeting was held, a machine was sent for my inspection, with these printed directions : " One part of sulphuric acid to be mixed with 30 parts of water." I followed the directions ; and when I completed the circuit by grasping the handles attached to each of the poles, I thought every joint in my body would have been dislocated ; and I had great difficulty in letting the handles drop. During the day I experimented with the mxachine, and after numerous trials, found that the nearest approach to a proper current was produced when one part of acid was mixed with 123 parts of water, and even then, the current was too strong ; but upon again diluting the acidu- lated water, there was not sufficient energy to work the machine. It can easily be conceived that electricity applied to a tooth from such a bittery, would not only not deaden pain, but would produce such an aggravation of it, that the mere extraction of a tooth vrould be comparatively noth- ing. The mind would indeed be occupied, and I doubt not that such an application of electricity for deadening pain would be considered novel. This, howevxr, is not the manner in which electricity must be used to obtain satisfactory results. The mind need not be occupied with the application, nor is cogni- zance of it even necessary. My arrangements, which I have explained in the British Journal of Dejital Science , are such, that the patient may take his seat, and have the tooth extracted, not only without pain, but as the apparatus is latent, be absolutely unconscious of the application of electricity.* As an instance, a Railway Porter, who had been con- fined to his bed with fever for seven weeks, and was in a * See Appendix, No. I. 15 very debilitated state, called upon me to have a tooth extracted. The man took his seat : and I removed the tooth. '' There, my man," I said, " that will do." '' It is not out, is it, sir .?" exclaimed the man. " Yes, here it is," shewing him the tooth. " Well," said he, " you are the cleverest man I ever met with — I did not think it was out." '' You have heard that we can now take out teeth by elec- tricity, without pain, have you not .?" " No, sir ; I have been ill so long, that I have not heard what is going on." Now this man had never heard of this employment of elec- tricity, was told nothing about it, and had his tooth taken out without knowing anything more than that it was pain- lessly removed. This one fact, in my opinion, completely nullifies the President's theory. Now for other proofs of the power of electricity to deaden pain. It was necessary for me to remove from the mouth of a lady, ten teeth, chiefly incisors and bicuspids in order to prepare the mouth for a complete artificial set I extracted three with the adjunct of electricity, and my patient sat quite still. I asked her whether the operations hurt her. She said they did. I then enquired whether she experienced as much pain as when she had teeth removed in the ordinary way .-* She said, "I can't tell," and seemed disinclined to say anything in its favour. In fact, all her verbal testimony was of so conflicting a character, that I determined to remove the next tooth without electricity, and to watch her countenance, to see whether there was any indication of increased pain. As soon as I grasped the tooth, there was an agonized expression I had not observed while removing the former three, and when the tooth was out she jumped from the chair, put her hand to her mouth, and uttered meanings as if in great pain ; when she had some- what recovered, I told her that electricity had not been used in that instance. She begged to have it used to the others, and with its aid, the remaining six were removed in less time than was lost by the pain occasioned by the removal of the one without it. A lady of rank, residing in the Principality, and who had never had a tooth removed, called upon me for the purpose of having two upper molar teeth extracted. The first was removed without electricity, and she described the pain as dreadful ; the other was removed with electricity. I made a note at the time, verbatim, of what she said, as I now always do when electricity is used. When asked what she felt, she replied, " there was no pain, the sensation was curious, but there was no pain." I can quite conceive that were I having a chat by the fire-side with my reader, I should not be allowed to have all the talking to myself. As this is not the case, I will endeavour to supply the deficiency by supposing a question that would doubtless be put. Have you never any failures ? I answer candidly, many ; three or four in every twenty operations. I will relate one or two of the last cases of failures. I have not half an hour since removed from a gentleman two teeth with electricity, and two without its aid. He preferred being operated upon without ; the feel- ing of the electricity, he considered, was worse than the pain of extraction ; the teeth were all, more or less, loose. A few days since, I removed for a youth two lower molar teeth, and he said the pain was not lessened. All the known necessary conditions were apparently complied with in this case.* A girl had an upper bicuspid tooth * At that time a foot-board was used, with a spring, to stop the current at the time the tooth was grasped, and in many cases there was no flow of electricity during the operation. I have now aban- 17 removed ; the pain was very great. A friend, who accom- panied her, observed that she lifted her hands from the conductors, and, in fact, did not get any electricity. A clergyman had an upper '' wisdom" tooth removed. He said the pain was greater than he ever experienced in having a tooth removed ; and I had previously removed from him several. The cause, in this instance, was thus traced : the external wall of the tooth gave way at the moment of extraction, and the beak of the forceps was plunged into the pulp of the tooth. In many instances I have been able thus to trace the cause which might have been, and in future will be obviated. Perhaps the best way to give my readers an idea of the kind of evidence we receive, and of our chances of success, will be to give ten consecutive cases from my note-book : — Case I. A gentleman about 40 years of age had a lower molar tooth extracted ; as he jumped from the chair he exclaimed ''it is all right. Sir, I would not mind being pulled at all day," the only pain, which was very slight, was when the tooth was first grasped. Case 2. A young lady about 20, " no pain ; only a little feeling like mesmerism." Case 3. Lady, middle age, " no more pain than pulling me by the finger." Case 4. Servant girl, ''no pain." Case 5. Young man, about 20, " pain greatly reduced." This tooth was stopped with amalgam. Case 6. Young man, " no pain." Case 7. Gentleman, between 30 and 40 years of age, '* very great pain." doned the use of the foot-board, and also the silk glove worn at the time, as worse than useless. p, i8 Case 8. Pain questionable. In this case two teeth were removed ; the patient, a youn- woman, who was very ner- vous, from whom no satisfactory testimony could be obtained, as she answered yes or no, just as was suggested. Case 9. Young lady, '* no pain ; there w^as a dancing about the eyes but could not tell when the tooth was out ;" the same young lady had a second tooth removed without any pain. Case 10. Young lady, '* no pain, the sensation not unpleasant." I have now extracted many hundreds of teeth with the adjunct of electricity, and the above cases were taken from the centre of my note book, just where I opened it, and I believe them to be fair specimens of evidence. Although I can now speak with greater authority, on account of increased experience, than I could some months since, yet I do not think it possible to give a more faithful statement of the results of my operations, than I did in my first letter to the Times. Up to the present time experiments have been made in a very imperfect manner, owing to the want of properly constructed electrical machines and insulated forceps.* Yet sufficient has been done to warrant a still closer inves- tigation, and to lead to the hope that at no very distant period we shall attain much greater efficiency, and be able to calculate with more certainty under w^hat circumstances, on what constitutions and peculiar temperaments, electricity is likely to act favourably : for, although it may not be in- variably successful as an anaesthetic, it is so even now in the majority of cases ; and possesses this great advantage, that it may be used in dentistry when chloroform would evi- * See Appendix No. I and No. II. ^9 dently be dangerous, and perhaps fatal. The following case, which to me was particularly interesting, will be a good illustration : — A young gentleman, 12 years of age, whose health had been greatly impaired, first from having had brain fever, and afterwards concussion of the brain arising from a fall from a pony, which rendered him insensible for a consider- able period, was brought to me to have two permanent lower molar teeth removed, which were decayed and giving him pain. He was too delicate to be operated upon with- out an anaesthetic, and, under the circumstances, his medi- cal attendant would not for a moment advise the use of chloroform. His friends therefore determined to have re- course to electricity. On taking his seat I removed one tooth, he then stood up, washed his mouth, and smiled at his mother. In less than a minute, without the slightest reluctance, he submitted to have the other tooth removed, which was effected without his giving any indication of pain, either by expression or the utterance of any excla- mation. The following note, which I received a few days after the operation, in answer to enquiries upon the subject, will shew the estimation in which it is held by the lady who witnessed it, and to whose son the result was of so much importance : — Dear Sir, " I have much pleasure in bearing my testimony to the complete success of your application of galvanism in extracting my little boy's two teeth. He is so nervous and sensitive a child, and his teeth are so large and strong, that we much dreaded the effects of a severe operation, and our medical adviser entirely disapproved of chloroform for him. Under your treatment he felt ito pain, nothin 20 (as he described it) but the '■hard tug' Hoping, for the good of society in general,, that the system may become more known and practised. " I am, dear sir, " Yours faithfully, " October 29.'' That electricity possesses great anaesthetic powers is certain, and, as obser\'ed before, the want of success in by far the greater number of cases, results from some imperfection in its administration. In some instances the apparatus ceases to act at the moment of extraction : in others, there is something wrong in the conducting wires, or their attachment to the foot-board, or else patients loose the hold of the conductors. Many cases which are said to be painful, have in reahty been nearly painless. Sensitive patients, when not unconscious, as when under the influence of chloroform, — that is, not entirely divested of feeling, will often exaggerate, and call that pain which other persons would not consider at all a disagreeable sensation. I have no doubt but that as the subject becomes better known and practised, many, if not all, of such difficulties will disappear. Unsuccessful cases, however, often present themselves when all the known conditions have been complied with. In the absence, therefore, of all positive knowledge of the subject, it may not be inopportune to investigate by that light which science already affords, the phenomena of Electro-Dentistry, and attempt to account both for the anaesthetic effects of electricity in some cases, and the negation of those effects in others, under like conditions. According to the theory of ]\Ir. Grove, — if we may call that a theory which is based on fact, and confirmed by the most rigid experiments, — "heat, light, electricity, magnetism, 21 chemical affinity, and motion, are all correlative, or have a reciprocal dependence ; neither, taken abstractedly, can be said to be the essential cause of the others, but either may produce or be convertible into any of the others ; thus, heat may mediately or immediately produce electricity, electricity may produce heat ; and so of the rest, each merging itself, as the force it produces becomes developed." — Groves Correlation of Physical Forces, p. 15. '' I believe that the same principles and mode of reasoning as we have adopted in this essay might be applied to the organic as well as the inorganic world ; and that muscular force, animal and vegetable heat, &c., might, and at some time will be, shown to have similar definite correlations ; but I have purposely avoided this subject, as pertaining to a department of science to which I have not devoted my attention. I ought, however, while alluding to this subject, shortly to mention some experiments of Professor Matteucci, communicated to the Royal Society in the year 1350, by which it appears that whatever mode of force it be which is propagated along the nervous filaments, this mode of force is definitely afi"ected by currents of electricity." — p. 190. " If we apply ourselves to the effect of electricity in the animal economy, we find that the first rationale given of the convulsive effect produced by transmission through the living or recently killed animal was, that electricity itself, something substantive passed rapidly through the body, and gave rise to the contractions ; step by step we are now arriving at the conviction that consecutive particles of the nerves and muscles are affected. Thus the excit- ability of a nerve, or its power of producing muscular contraction, is weakened or destroyed by the transmission of electricity in one direction, while the excitability is 22 increased by the transmission of electricity in the opposite direction ; showing that the fibre or matter itself of the nerv'e is changed by electrisation, and changed in a manner bearing a direct relation to the other effects produced by electricity." — p. 101-2. Now, if according to Mr. Grove's views, what Is com- monly called the nervous fluid, correlates with the physical forces, and as these may all be convertible into motion, we may gain some idea how electricity acts as an anaesthetic. If the motion of the nervous fluid of a tooth in a normal condition is such, that the sensation of pain is occasioned by its luxation : upon the application of electricity to a tooth, the normal direction of the motion may be so altered as to change the functions of the fluid, and an abnormal condition be brought about by which the sensation of pain under similar circumstances may be taken away. And is not this borne out by the fact, that under any very great excitement, such as anger, love, danger, anxiety, &c., in- juries may be inflicted upon various parts of the body, without the consciousness of the person, which under ordinary circumstances would have produced much pain ? And if, as some physiologists with good reason suppose, that the action of the brain is similar to that of a galvanic battery, and the nerves conducting wires, we may easily conceive how the abnormal excitement of passion should assimilate to the abnormal excitement occasioned by the application of electricity.* * "The brain, the agency of thought and volition, exercises upon the origin of the nerves a certain power, which may be aptly enough illustrated by the power wliich a voltaic battery exerts upon a conducting wire ; and by this action, some subtle influence is transmitted along the nervous cord to the muscle, where it terminates, or on the fibres of which, as explained above, it is looped ; and this influence, acting in a specific manner, causes the contraction, which imparts motion to the member with which the muscle is connected." — Lardnet's Animal Physics, p. 17. 23 Although the cause of the negation of the anaesthetic powers of electricity, in some cases in which all the known conditions have been complied with, cannot for a certainty- be determined definitely until we have obtained greater experience ; it may yet be accounted for in various ways. The nervous system from some cause or other at the time, (fear, for instance,) may be in an abnormal condition, or there may be an idiosyncrasy of the constitution,* and what is still more not unlikely, and probably will ultimately * "Our antipathies and sympathies are most miaccountable manifestations of our nervous impressionability affecting our judgment, and imcontrollable by will or reason. Certain antipathies seem to depend upon a peculiarity of the senses. The horror inspired by the odour of certain flowers may be referred to this cause — an antipathy so powerful as to realize the poetic allusion, to " Die of a rose, in aromatic pain." For Amatus Lusitanus relates the case of a monk who fainted when he be- held a rose, and never quitted his cell while that flower was blooming. Orfila (a less questionable authority) gives an account of the painter Vincent, who was seized with violent vertigo, and swooned when there were roses in the room. Valtain gives the history of an officer who was thrown into convulsions and lost his senses by having pinks in his chamber. Orfila also relates the instance of a lady, of forty-six years of age, of a hale constitution, who conld never be pre- sent when a decoction of linseed \vzs preparing, without being troubled in the course of a few minutes wdth a general swelling of the face, followed by fainting and a loss of the intellectual faculties, which symptoms continued for four-and- twenty hours. Montaigne remarks, on this subject, that there were men who dreaded an apple more than a cannon ball. Zimmerman tells us of a lady who could not endure the feeling of silk and satan, and shuddered when touching the velvety skin of a peach : other ladies cannot bear the feel of fur. Boyle records the case of a man who experienced a natural abhorrence of honey ; a y