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THE LIBRARY

OF

THE UNIVERSITY
OF CALIFORNIA

LOS ANGELES



DENTAL MEDICINE

GORGAS



Standard Books on Dentistry



BROOMELL. Anatomy and Histology of the Human
Mouth and Teeth. By DR. I. NORMAN BROOMELL,
Professor of Anatomy, Dental Histology, and Pros-
thetic Technics in the Pennsylvania College of Dental
Surgery, Philadelphia. Handsomely illustrated with
284 engravings. Large octavo. Cloth, net, $4.50.

HARRIS. Principles and Practice of Dentistry.
Thirteenth Edition. Including Anatomy, Physiology,
Pathology, Therapeutics, Dental Surgery, and Mech-
anism. By the late CHAPIN A. HARRIS, M. D.,
D. D. S. Edited and Thoroughly Revised by FER-
DINAND J. S. GORGAS, A. M., M. D., D. D. S., Pro-
fessor of the Principles of Dental Science, Dental
Surgery, and Prosthetic Dentistry in the University
of Maryland. 1250 Illustrations. 1180 pages. 8vo.
Cloth, net, $6.00 ; Leather, net, $7.00.

HARRIS. Dictionary of Dentistry. Sixth Edition,
Revised. Including Definitions of such Words and
Phrases of the Collateral Sciences as Pertain to the
Art and Practice of Dentistry. By the late CHAPIN
A. HARRIS, M. D., D. D. S. Rewritten, Revised,
and Enlarged by FERDINAND J. S. GORGAS, M. D.,
D. D. S., Professor of Principles of Dental Science,
Dental Surgery, and Prosthetic Dentistry in the
University of Maryland. Octavo.

Cloth, net, $5.00; Leather, net, $6.00.

RICHARDSON'S Mechanical Dentistry. Seventh
Edition. By JOSEPH RICHARDSON, D. D. S. Thor-
oughly Revised and Enlarged by GEORGE W. WAR-
REN, A.M., D.D.S., Professor of Clinical Den-
tistry and Oral Surgery, Pennsylvania College of
Dental Surgery, Philadelphia. 691 Illus. 8vo.

Cloth, net, $5.00; Leather, net, $6.00.



P. BLAKISTON'S SON & CO.

Publishers, Philadelphia



DENTAL MEDICINE



A MANUAL



OF



Dental Materia Medica

AND THERAPEUTICS



BY

FERDINAND J. S. GORGAS, A.M., M. D., D. D. S.

Editor of "Harris" Principles and Practice of Dentistry" and "Harris 1 Diction-
ary of Medical Terminology and Dental Surgery," Author of "Questions
and Answers for Dental Students" Professor of the Principles
of Dental Science, Oral Surgery, etc., in the
University of Maryland, Baltimore



SEVENTH EDITION. REVISED AND ENLARGED



PHILADELPHIA
P. BLAKISTON'S SON & CO

1012 WALNUT STREET
1901



Entered, according to Act of Congress, in the year 1901, by

P. BLAKISTON'S SON & CO.
In the Office of the Librarian of Congress, at Washington, D. C.



Preface to Seventh Edition.



IN presenting the Seventh Edition of the " Dental Medicine,"
the author entertains the hope that his labors have resulted in
such an improvement of this work as to render the present edi-
tion more valuable than the one that preceded it.

The success which has attended the issue of the different
editions has been very gratifying, and its popularity has been
shown by the short time which has elapsed between them.

The number of opportunities thus offered to revise its editions
have been taken advantage of to increase its usefulness as a text-
book for dental students, and also as a reference book for dental
practitioners.

The advance of Dental Materia Medica and Therapeutics has
been such as to render it necessary to increase the size of this
work in every revision, in order that it may fulfil the object of
its preparation ; hence, among the remedial agents, and combina-
tions of such agents which have been added to the present edi-
tion are the following : Vapocaine, Chloretone, Enzymol, Eu-
formal, Phenalgin, Airol, Actol, Glucide, Glutol, Orthoform,
Caffein, Digitalis, Sozoiodol, Liquid Air, Nitrous Oxide and
Oxygen, Nitrous Oxide and Atmospheric Air, Pressure Anaes-
thesia by compressed Air, Sulpho-Carbolate of Zinc, Silver Sul-
pho-Carbolate, Anestile, The Treatment of Dental Caries with
Nitrate of Silver, The Hypodermic Syringe, etc., etc. A new
Table of Doses of Medicinal Agents has been substituted for the
one in former editions.

Important additions have been made to many articles such as
those on Inflammation, Diagnosis and Treatment of Mouth

9



10 PREFACE TO SEVENTH EDITION.



Affections, embracing Abscess, Ulceration, Caries and Necrosis
of Bone, Gangrene, Septicemia, Pyemia, Opening Abscesses,
Erosion of Teeth, Stomatitis, Sterilizing Instruments, Adminis-
tering Anaesthetic Agents, both Local and General ; together
with important additions, including recent investigations on the
physiological and medicinal actions and properties, and Thera-
peutic and Dental Uses of many of the remedies, including
anaesthetics, before noticed in this work.

FERDINAND J. S. GORGAS.
HAMILTON TERRACE, BALTIMORE, MD.



Preface to Sixth Edition.



IN preparing the Sixth Edition of the " Dental Medicine," the
author has conscientiously endeavored to further improve a trea-
tise which has become a text-book for the dental student, and a
work of reference for the dental practitioner.

It has been his aim not only to make additions to the present
volume, but also to so improve it as to render it worthy of a
continuance of the favor heretofore so generously bestowed upon
those which have preceded it.

The general arrangement of this new edition is the same as in
the previous one, and all parts have been carefully revised and
corrected.

A work of this character should, as far as is possible, be a com-
plete, as well as a practical exposition of the source or derivation,
properties and methods of application or administration, and also
the uses of the various drugs now employed in dental practice.

And, as cases often occur in the treatment of which old and
familiar remedies are employed in vain, it is well that we should
possess a knowledge of other and more recent ones to the use of
which we may successfully resort. A number of drugs and
combinations have been recently introduced, some of which
appear to be very valuable additions to the dental materia medica;
and it has been the aim of the author to bring the description
and application of such drugs as are useful up to the date of pub-
lication of this new edition. As a general rule, such information
has only appeared in domestic and foreign journals, which are often
practically inaccessible ; hence, the necessity for a work on dental

11



12 PREFACE TO SIXTH EDITION.

medicine, and its frequent revision in order to meet the advance
of this branch of dental science.

Important additions have been made to the text, a new chapter
on Cataphoresis has been inserted, and among the new remedies
which have been added are : Eucaine, Borolyptol, Ammonol,
Euthymol, Formaline, Glyco-Thymoline, Pasteurine, Sanitol.
etc., etc.

FERDINAND J. S. GORGAS.
HAMILTON TERRACE, BALTIMORE, MD.



Preface to the First Edition.



THIS work has been prepared by the author in deference to
many requests from former pupils, and has been compiled from
lectures delivered by him in dental institutions during the past
twenty-five years, and notes obtained from the standard works
on Materia Medica and Therapeutics, and also from personal
experience as a dental practitioner and teacher.

While the author claims the credit of the compilation, he does
not claim originality in the sources, derivations, medical proper-
ties and action of the various articles of dental materia medica
which are given in this work.

His intention has been to present not alone his own ideas as
to the particular application of remedies, but also those of well-
known and acknowledged authorities, and in such a manner as
may be of service to the dental student in acquiring a knowledge
of this important branch of his profession ; hence nothing has
been presented in this work that, in the author's opinion, is not
applicable to dental practice, and that will not be of benefit to
the dental student.

The dental formulary comprises many valuable combinations,
and credit has been given, in every case where it was possible,
to the authors of the different preparations.

The necessity for an American work of this kind has long
been apparent, and after years of delay and promises the author
gratefully dedicates this work to his former pupils in the dental
institutions with which he has been and is now connected, in the
capacity of a teacher.

FERDINAND J. S. GORGAS.

HAMILTON TERRACE, BALTIMORE, MD.

13



CONTENTS.



PAGE

PREFACES ........ 5-9

Definition of Subjects . . . . . . 17

Action of Medicinal Substances . . . . . .17

Tables for preparing Percentage Solutions and Rule . . .20, 22

Abbreviations, with Latin and English Terms .... 22

Approximate Measurements ...... 24

Measuring Liquids by Drops ...... 25

Fineness of Powder ....... 25

Weights and Measures ....... 26

Metric or French Decimal System of Weights and Measures . 27
Table of Equivalents . ... . . . .29

Rules for Regulating Doses ...... 30

Topical Remedies ....... 32

The Endermic Method ...... 32

The Hypodermic Method . . .... 32

Counter-irritants ....... 33

Setons and Issues ....... 34

General Bloodletting ...... 34

Local Bloodletting by Leeching, Cupping and Scarifications . . 34

Electricity as a Therapeutic Means in the Treatment of Disease . 35

Incompatibility ........ 41

Table of Doses of all Officinal Medicines, Expressed in Terms of both
the Apothecaries' and the Decimal Metric System of Weights and

Measures ....... 43

Poisons Symptoms and Antidotes ..... 61

The Pulse ........ 68

Pulsation per Minute at Various Ages . 69

Respiration at Various Ages . . . . . . 71

Thermometers . . . . . . . .71

Temperature ........ 72

Table of Elementary Substances ..... 73

15



CONTENTS.



PAGE

Table of the Solubility of Chemicals in Water and Alcohol . 74

Natural Distribution of Remedies ..... 77

Classification of Medical Substances ..... 78

Definitions of the Various Classes of Medicinal Agents ... 78
Forms in which Medicinal Substances are employed . . . 108
Inflammation, with Special Reference to Oral Mucous Membrane . 1 1 1
Important Points in Diagnosing Affections of the Mouth, with a Synop-
sis of Treatment ...... 148

Characteristic Indications of the Tongue .... 187

Source, Derivation, Medical Properties and Action, and Therapeutic
Uses of Medicinal Substances Employed in Dental Practice ; To-
gether with their Dental Uses and Application . . 190
Administration of General Anaesthetic Agents .... 255

The Dangers of Anaesthesia ...... 261

Preventive Measures Against the Dangers of Anaesthesia . . 261

Treatment of Dangerous Symptoms of Anaesthesia . . . 261
Methods of Resuscitation Sylvester's Method Hall's Ready Method 262, 263

" " Howard's Method, etc. . . . 264 ,

Local Anaesthesia ...../. 266

Pressure Anaesthesia by Compressed Air ..... 269

Liquid Air as an Anaesthetic ..... 269

Rapid Breathing as a Pain Obtunder . . . . .271

Combination of Nitrous Oxide and Oxygen .... 478

" Nitrous Oxide and Atmospheric Air . . . 478

Antiseptics in Dental Practice . . . . 581

Cataphoresis . . . . . . . -591

Periods for the Eruption of the Teeth .... 596



Authorities Consulted



599



Index to Dental Formulary and Dental Diseases . . . 600

General Index ........ 609



DEFINITION OF SUBJECTS.

Materia Medico, is that branch of medical science which refers
to and describes the methods and substances known as " medici-
nal agents," which are employed in the prevention and treatment
of disease; also their source or derivation, preparation, composi-
tion, and properties.

Therapeutics is that branch of medical science which comprises
the doctrine of the management of disease. Generally, however,
the term is restricted to a description of the modus operandi of
medicines, or, in other words, their use, application, effects, and
doses, when applied in the treatment of various morbid condi-
tions.

Pharmacology is the science of the action of medicines, and is
expressed by what is termed their " physiological action."

Pharmacy is the art of preparing medicines, and dispensing
them by direction of the therapeutist.

An accurate knowledge of the principles and rules which
govern the administration and action of medicinal substances
enables the practitioner to restore disordered functions, and to so
impress the organism as to maintain harmonious conditions, by
means of which the various functions, in a state of health, are
intimately connected by relation and sympathy.

Some medicinal agents exert their influence on primary nour-
ishment, converting food, by digestion, into the substance of
organic beings, while other remedies, without interfering with
digestion, by a modification of the process of assimilation exert
2 17



DENTAL MEDICINE.



a destructive influence upon the tissues. Some medicinal agents
affect the nervous system, and others are so irritant in their effects,
as to cause their speedy expulsion ; while others, again, have a
particular affinity for certain organs, and are eliminated by them,
the effect ceasing as soon as the evacuation is completed. Other
medicinal agents prevent septic decomposition, and the growth
of micro-organisms.

What are known as topical or external remedies act directly
upon the parts to which they are applied, and their general effects
are produced through the nervous system.

The methods of treatment which have for their objects the
prevention, and relief of pain, and the cure of disease, include
preventive or prophylactic treatment, which embraces all hygienic
conditions which will obviate any tendency to disease, prevent its
extending to others, and the employment of antiseptic agents ;
for example, in dental practice attention to the hygiene of the
oral cavity, which consists in keeping the teeth and associate
parts clean, and preventing dental caries, and affections of the
oral mucous membrane : also palliative treatment, which affords
relief from pain, such as that of odontalgia, neuralgia of dental
origin, etc.; also curative treatment, which eradicates the disease
completely ; for example, in dental practice the proper prepara-
tion and filling of carious cavities, the cure of alveolar abscesses,
alveolar pyorrhoea, etc.

The indications for treatment will depend upon the nature and
location of the affection, and the symptoms present. The con-
dition of vital organs, such as the heart, lungs, and kidneys, also
influences the treacment ; for example, in the administration of
anaesthetics.

Medicines enter the circulation by either external application or
internal administration. Externally by such methods as the epi-
dermic, or by inunction the application of medicines to the skin
by rubbing or friction; the en-epidermic, the application of plas-
ters, poultices, lotions, etc., to the skin ; the endermic, the appli-
cation of a blister, which is followed by that of a medicine to
the raw surface thus produced ; the hypodermic, the injection of
medicines into the skin and mucous membrane to obtain a more



DEFINITION OF SUBJECTS. 19

rapid effect than when administered by the mouth internally.
Internally, by the mouth ; by inhalation ; by the rectum, when it is
inadvisible to administer them by the mouth.

The changes which medicines undergo when taken into the
system depend upon the condition of the system, the temperature
of the body, the food and drink, and the tendency of medicines
to combine with other substances and form different compounds.
The rapidity with which medicines enter the circulating fluid is
governeJ by their composition. The crystalloid substances pass
into the blood very readily, while colloid substances enter slowly,
or not at all. Arsenious acid is an example of the crystalloid.
Corrosive poisons not only destroy life, but also the parts with
which they come in contact, while other poisons destroy life
alone. The blood conveys medicines to different parts of the
body, and during such a passage they change the character and
composition of the blood ; and are eliminated from the system
bv the excretory organs, such as the lungs, kidneys, skin, urinary
and salivary organs. The form in which medicines are adminis-
tered and applied, also modify their effects.

The action of drugs is also modified by pharmaceutical combi-
nation, as the joint effect of two medicines is different from that
one of them may cause, for opium given with mercury will pre-
vent the purgative action of the mercury. The action of medi-
cines may be direct so as to produce local effects ; or it may be
general or indirect when the entire body, or remote organs are
affected. A large number of medicines operate physically on the
body and affect remote parts through the agency of the nervous
system ; among such are electricity, cold, heat, mechanical irri-
tants, etc., which affect remote pans by the influence of the
cerebro-spinal and ganglionic systems. The afferent or sensory
nerves convey impressions to the nerve-centre, and the efferent
or motor nerves transmit impressions from the centre to muscles,
vessels, glands, etc., and the effects of medicines are transmitted
to the brain, producing an excitement of a nerve-centre and a
reflex action is carried along the efferent nerves, producing cer-
tain symptoms. The effects of medicines are modified by the
age of the patient, as young children require small doses as a



20 DENTAL MEDICINE.



general rule ; by the sex, as females possess greater susceptibility
of the nervous system, and more excitability of the vascular
system than males ; they have also less energy, and medicines act
on them more powerfully and rapidly and for a less period than
on males; also climate influences the effects of medicines, as
some, such as narcotics for example, act more energetically in
hot climates, and others less energetically, calomel for example >
habit also influences the action of medicines, as some become
inert after long continued use ; also diseased conditions modify
the effects of medicines, such as mercury in fevers ; the idiosyn-
crasy also, as is shown by the effects manifested in different indi-
viduals ; mercury for example will cause profuse salivation in
susceptible patients when a very small quantity is adminis-
tered ; also the mind, as the cheerful convalesce sooner than the
despondent.

Some medicines have a specific action on certain tissues and
organs of the body, as alcohol on the brain, strychnine on the
spinal cord.

Temperaments are peculiarities of organization characterizing
the different classes of individuals, the nervous patient being more
easily affected by medicinal, than he is by other agencies, while
the phlegmatic patient is not.

Idiosyncrasies are peculiarities belonging to single individuals,
and they are so numerous that a knowledge of them is important
for the practitioner.

TABLES FOR PREPARING PERCENTAGE SOLUTIONS.

The following tables of Dr. Sherrard, Ph. C., are simple and
require but little explanation. The first table gives percentage
solutions, as, for instance, 4 per cent, cocaine muriate solution ;
the second table gives parts in 1,000 or 5,000, as, for instance,
corrosive sublimate i in 1,000. The use of the first table is as
follows: Run down column I until the correct percentage
wanted is found, then move to the right along the line until the
column is found giving the amount of the fluid measure to be
made up ; at the intersection will be found the weight of the salt
required. For example, suppose it is desired to make 4 fl. oz.



TABLES FOR PERCENTAGE SOLUTIONS.



21



of 4 per cent, cocaine muriate solution, run down the left-hand
column to 4, then along to the right till the column headed 4 fl.
oz. is reached. At the intersection of the two will be found
72912, and this is the number of grains needed. It must be re-
membered that this is the amount of water to take, and not q. s.
water to make the volume, and also that these tables are true
only for water, and not for alcohol, or any other fluid. The
second table is similarly employed. If other amounts of a solu-
tion are required than those given in the tables, a simple mathe-
matical calculation will determine the amount of drug or salt re-
quired for a specified amount of solution. For example, if 8
fluid ounces of a four per cent, solution is required, follow down
the 4 fluid ounce column until opposite 4 per cent. ; the number
of grains required are 72912. Now, to make 8 fluid ounces,
just twice as much (145,824 grs.) is required. For all dispensing
and administering purposes in any prescribed doses, the figures
thus given are correct. It is therefore clear that if a drachm of
a 2 per cent, solution be prescribed, exactly 2 per cent, of that
drachm is the salt in the solution, the other 98 per cent, being
the water.

FOR MAKING ANY QUANTITY OF PERCENTAGE SOLUTIONS.





c : "^


S -


. u_


BOJ


1*0*!


aoj


rf*0*J






K 1


o "3


^


nj'rt


. "i


j^l




a t.

* -f o


N " 5


^ ^
ro-


T}- O


10*^ 5


1 "1 u






"o <U 3
rt "rt ~


"o U 3


^ *- 2r

CJ O - 3

2 ?


cj " I-

" ?


- i. M ^ i- M

t) J 3 V S


a u ea

"i - 2

C3 ri er-<

u >




1-1 Q)


I. * U


l_ ^ <U




I- "^ O L. *


fa O




-


i_


. <~ ~


<




, >- -=


o < *-




fi O


^ o ^


^ ~


to o *"


^ o -


fe o


ta o **


To make [ Grains, j Grains. Grains.


Grains. Grains. | Grains.


Grains.


I per cent. .


4.557 9.114 13.671 18.228 22.785 45.57


72.912


2 per cent. .


9.114 18.228 27.342 36.456 45-57, 9i-H


145.824


3 per cent. .


13.671


27.352 41-013 54-684 68.355 I 3 6 -7 I


218.416


4 per cent. .


18.228


36.456 54.684 72.912 91.14 182.28


291.648


5 per cent. .


22.785


45-57


68.355 9!-!4


113.925 227.85


364.56


10 per cent. .


45-57


91.14 136.71 182.28


227-85 455-7


729.12


15 per cent. .


68-355 I 3 6 -7 I 205.065 273.42 341.775 683.55


1093.68


20 per cent. .


91.14 182.28 273.42 364.56 455-7 9"-4 1458-24


25 per cent. .


113.925 227.85 341.775 455-7 569-625 1139-25


1822.80


40 per cent. .


182.28


364.56


546.84


729.12


911.4


1822.8


2916.48



22



DENTAL MEDICINE.



FOR MAKING ANY QUANTITY OF SOLUTION WHEN STATED IN PARTS PER
THOUSAND, HUNDRED, ETC.





N O ^


rf^


. Vb.


K'Q


. >


"o


EP J




,J
J 3


m'rt


I,"*


u ^


o v ^


D "3


o "^5




" j


03 4^ ""


{*


03 "^ *"


BJ **


qf -^ M


0- _^J ^




"* *- O


N ~


r^-2 C


Tf* 2


u->~ O


o3$


vO ^ o




X i. M

D 5


"i 2


S S 3"


-^ 2


-g 5 =f


" ^ M

-S 2


-Ss I 3




i) rt -O


2 |-5


rt ti H


2 -o


2 F^ *O


o >


rt rt "O




i^. 45


^


O ^


i


<


u.


O u_




*


"


t< O *^


fe o -


0<M


fa o -


tL. -


To make a so-


Grains.


Grains.


Grains.


Grains.


Grains.


Grains.


Grains.


lution of
















in looo . .


4557


.9114


1.3671


1.8228


2.278


4557


7.291


in 500 . .


.9114


1.8228


2.7312


36456


4-557


9.114


14.582


in 400 . .


1. 1 "?Q


2.278


3-4I77


4-557


5-695


11.392


18.228


in 300 . .


I . ^ IQ


3-035


4-557


6.076


7-59


15.19


24.304


in 200 . .


2.2785


4-557


6-8355


9.114


"39


22.785


36-456


in 100 . .


4-557


9.114


13.671


18.228


22.785


45-57


72.912


in 50 . . .


9.114


18.228


27.342


36-456


45-57


91.14


145.824


in 25 . . .


18.228


36.456


54.684


72.912


91.14


182.28


291.648


in 10 . . .


45-570


91.140


136.710


182.280


227.85


455-70


729.120


ins - - -


91.14


182.28


273-42


364-56


455-7


911.4


1458.24



The rule for finding the amount of a drug in a given percentage of solution is
as follows :

Find the number of minims in stated quantity, and multiply this by the num-
bers indicating percentage, placing the decimal two points to the left.

Examples: I. How many grains of drug in 2 fluid ounces of a 2 per cent,
tincture (solution) ? Two fluid ounces = 960 (TTt) X ( 2 P- c -) = 19-20 grains.
2. How many grains of a drug in 100 C.C. of a 4 (p. c.) tincture (solution)?
100 C.C. X l6 - 2 3 = 1623.00 (1TO X 4 (P- c -) = 64.92 grains.

ABBREVIATIONS.

In medical prescriptions, letters, parts of words, or certain
symbols, are employed as abbreviations, to designate the sub-
stance, quantity, etc., as follows :



ABBREVIATION.

A,

A.C.C.,

aa,

Ad.,

Ad Saturand.,

Ad lib.,



LATIN WORD.

Argon. Anterior. Anode,

Anodal closure contraction,

Ana (G.),

Add,

Ad saturandum,

Ad libitum,



ENGLISH WORD.



Of each.

Until saturated.
At pleasure.



ABBREVIATIONS FOR PRESCRIPTIONS.



Online LibraryFerdinand J. S. (Ferdinand James Samuel) GorgasDental medicine; a manual of dental materia medica and therapeutics → online text (page 1 of 60)