THE PRESIDENT’S ADDRESS.
The President then delivered his address, and said:—
Gentlemen,—It is my pleasing duty in the first place to thank you, not only for the kindness you have shown in electing me to the responsible position of President of your Branch, but also for having given me the honour of being the First President of the First Branch of the British Dental Association.
I need scarcely say that the fact of our meeting here to-day as we are now doing is a subject for congratulation, and the presence of so many, and the distance some of you have come, proves the interest you take in the great movement of the day, which has called into existence the central Society of which we now form a branch.
Every new movement is sure to give rise to more or less excitement and sometimes to great expectations, and I must, therefore, beg, first for myself, your kind forbearance for my numerous shortcomings, of which I am only too conscious; and secondly, for your society I must also ask your kind consideration, if at the first it seems to you scarcely to come up to the high standard of your anticipations, requesting you to remember that it is still in its infancy, that it has commenced its existence under difficulties, and I regret to say, not without some opposition. It will, therefore, require care and energy, not only on the part of the Executive body, but also in each individual member, to bring it to that state of maturity we all are anxious to see it attain. I feel certain from your presence here to-day that you have the interest of the Society at heart, but I venture to remind you that the simply feeling an interest in a thing is not sufficient in itself to command success. That is a result which requires, especially in these days, both energy and labour, and we must never forget that our future position and progress as a Society, will mainly depend on our own individual efforts, since we are each of us an individual unit, the aggregate of which units forms the Society itself.
It would be natural for you to expect in this, the first introductory paper, a history of the origin and objects of the Society, but these were so ably treated of by the worthy Secretary of the Society on his visit to Manchester, and so many of you were present at the London meetings, and so much has been already written on the subject, that it would not only be superfluous but also presumptuous for me to attempt what has already been done by others so much more competent than myself, and I am therefore deprived of what would have been an interesting topic for an address; but although the past and the present have thus been taken from me, there still remains the future; and as I hope that in that future our Midland branch will ultimately form a not unimportant unit, I will therefore restrict what I have to say mainly to the subject of the branch itself, and in doing so must crave your kind indulgence for the many imperfections in my efforts, urging as my excuse the little time that numerous professional and other engagements leave at my disposal.
Here, I think, we may congratulate ourselves, that we exist as a branch of the British Dental Association and not as an independent Society, for I am sure we all feel that the scheme for the elevation of our profession to its proper position, which that Society has been formed to promote, has been most judiciously planned, and has thus far been most efficiently carried out—a scheme, which whilst it in no way discourages the attainment of the higher qualification of full membership of the Royal College of Surgeons, in those who are anxious to distinguish themselves, and possess the means and opportunity for so doing, provides an efficient education in all those scientific and practical subjects which it is necessary for a Dentist to know, and by means of the Dental Diploma, affords the public a guarantee that the possessor of that diploma has passed through a curriculum of such a standard as fully to qualify him for the practice of the branch of surgery which he professes. Nor must we allow to pass unnoticed the utter unselfishness of its promoters, who laboured out of pure love for their profession, knowing that they could never expect to see the good result of their labours in their lifetime, unlike the man who is said to have remarked that he never could see the good posterity had done for him that he need trouble himself about posterity: and as was the case with many of those grand memorials of the loving zeal and devotion of our ancestors, those noble cathedrals with which so many parts of our country are adorned, one generation was satisfied if they were able to lay the foundations and were permitted to see some portion of the superstructure erected during their lifetime, so in like manner, we must wait and not be discouraged if we are unable to see the full development of the present movement, but should consider it a privilege to be permitted to assist in however humble a degree, in taking part in what we fondly and reasonably hope will prove the formation of a grand future for our branch of surgery.
To our Secretary and Treasurer are due, I believe, the credit of having originated the branch, and I take this opportunity of saying that I am unable in any way to claim a portion of that credit for myself, for I gather from a letter in one of the journals, that I was not only believed to have been one of the promoters, but that I was thought to have been guilty of an act of discourtesy in what I had done, or rather in what I had not done. I knew nothing of the project till I received a printed circular inviting my co-operation, and it was not till after the lapse of many weeks that I found myself able to join in the scheme. The promoters worked hard in drafting the bye-laws and arranging the other necessary preliminaries, but I am sure I may say for them that they feel amply rewarded by seeing their pet child, over which they have laboured so long, fully recognised as a legitimate offspring of the British Dental Association.
The objects of the branch, you see by the bye-laws, are fourfold:—
1. To render assistance, as far as possible, in carrying out the provisions of the Dentists Act.
2. The general consideration of subjects affecting the interests of the profession.
3. The reading and discussion of papers on Dental Surgery and Mechanics.
4. The cultivation of a generous professional spirit amongst practitioners throughout the district.
With respect to the first object, I think the purport of the Act is so clear that it requires but few remarks from me. It is impossible to draw any definite line where the help of an unqualified person must cease and that of the duly qualified practitioner commence. Any one who dresses a wound or a bruise, or reduces a dislocation, practises surgery, and no one could for a moment imagine that a law would ever be passed to prevent his doing so; and in like manner, we could not expect that the legislature would ever allow the drawing of a tooth or any other similar operation to be made a penal action, although the person so doing may be said to be practising Dentistry; but as soon as any one endeavours to make the public believe he is a qualified practitioner, by assuming the title of Dentist or any other name implying the possession of the Dental diploma, so soon he becomes amenable to the law; the act thus guaranteeing to the public, that for the future, any one who claims the professional title shall of necessity have obtained the necessary qualification. Any person, or any number of persons, who may wish to put the act in force in any particular case can do so, but before taking action it will be necessary to obtain the sanction of the Medical Council. This at first sight may seem to be an unnecessary precaution, yet I think on further consideration you will admit that it is a very wise provision, as it entirely prevents the possibility of any one being proceeded against from personal pique or any other improper motive; and if in any case it is thought desirable that a person’s name should be removed from the register, all that is necessary is to collect sufficient reliable evidence, and transmit it to the central board in London, who will bring the matter before the Medical Council, the only body by whom such action can be taken. And in cases where these proceedings may be necessary, I am sure they can be carried out without earning for ourselves the opprobrium of acting as spies or professional police, which some have already been willing to assign to us.
With regard to the second object of the Society, we must all feel that the interests of the profession will at times require the careful consideration of its members, and necessitate the existence of some organised body which shall be able to act with the authority of the bulk of its members, and for this, no better scheme can be devised than the one we are now so much interested in—the formation of a central society, with recognised branches in the more distant parts of the country, constituting an organisation by which the feeling of the majority of the profession may at any time be ascertained on any question that may arise bearing on the well being of the profession.
In the third object, “The reading and discussion of papers on Dental Surgery and Mechanics,” the surgery you will notice is placed first, and justly so, as the higher branch; though in early times, and I fear even to a more recent date, the order in importance was more frequently reversed in practice. The mere mechanical calling of former times—for in its infancy Dentistry was little else—has now been developed into a profession and gained admission within the sacred portals of the College in Lincoln’s Inn Fields, and it is for the present and future generations to prove by the exercise of their highest mental as well as mechanical faculties, that the profession is worthy of the position which has been accorded to it.
It has been noticed by those who most frequently attend the meetings of our speciality, that papers on mechanical subjects are more easily procured, and often prove more attractive than those on surgical subjects, but this will no doubt become less as the educational facilities of the present day are brought to bear more and more on the whole body of the profession. Surely the preservation of the natural organs is of far more importance and value to the patient than the substitution of others, however efficiently supplied.
What should we think of the surgeon who allowed himself to be deterred from directing all his energies to the preservation and restoration to health, of a diseased or injured limb, by the thought that an artificial substitute could be provided for it. No! No! Whatever our politics may be let our surgery be conservative. Far be it from me to appear to undervalue any branch of my profession, for no one can have been long in practice without having experienced the well earned gratification derived from noticing the relief from pain, and in many instances the perfect restoration to health, that follows the substitution of efficient members in the place of useless and diseased ones; but far greater is the credit and higher the appreciation of the patient, when the diseased natural organs themselves can be preserved and restored to a state of efficiency; and how great are the facilities for so doing in the present day, compared with the early reminiscences of many of our older brethren. All of us who were fortunate enough to hear the interesting paper read before the General Meeting of the Society in August last, must have been forcibly struck with the contrast between the paucity and quality of the instruments there mentioned, and the appliances of the present day. What would have been the feelings—I might almost say the bewilderment of the practitioner therein described, could he have been transported into one of the large depôts with which we are so familiar. The numerous and beautifully adapted instruments for the variety of operations unknown in those days. The admirably adjusted forces for each form of tooth, the endless variety of excavators and pluggers, the wonderfully delicate nerve extractors, the rubber dam and its adjustments, the saliva pump, the electric mallet, the improvement in our chairs, and that greatest of all boons, both to patient and operator, the Morrison engine, the name of the inventor of which valuable instrument, ought to be indelibly inscribed in letters of gold in the Archives of Dentistry, to say nothing of the application of vulcanite and celluloid, and the many ingenious appliances for the workshop. Surely these should lead us to value the benefits we enjoy, and teach us to strive to use them to the best of our ability, not influenced by the thought of self-glorification in attempting to surpass all others, in the performance of this or that brilliant operation, but ever remembering that the ultimate aim of all our efforts should be the increased amount of good which we are thereby enabled to accomplish for the benefit of our suffering fellow-creatures.
Although the Transactions of the Odontological Society contain a very voluminous and valuable collection of papers bearing on one speciality, there still remain numerous subjects and modes of operating which may be made productive of profitable discussion. Such are the replantation of teeth now attracting so much attention, the erosion of the surfaces of the teeth of which so little is known in the present day. The various improvements in the materials for filling, and amongst a variety of subjects, far too numerous to be mentioned here, the startling announcement of the so-called New Departure Creed.
As this last is a subject which I think we all feel greatly interested in, and also bears on the branch of Dentistry which we are now considering, I will venture a few remarks on some of the articles of the accepted and new departure creeds as tabulated in the Dental Cosmos.
I am not aware that the so-called accepted creed has been the recognised standard of practice in this country. The doctrine that gold, and nothing but gold, should be used for permanent fillings, has certainly been extensively promulgated by those of our Transatlantic brethren who have settled in this country; and I cannot but look upon this new departure, as the natural reaction which might be expected to follow the over anxiety to build up large adhesive gold fillings, on fragments of weak and often disorganized teeth, totally unsuited for such an operation; but until I can see some stronger reason than has been hitherto adduced by the advocates of this new departure, I must, in any case suitable for a good gold filling, confess my unwillingness to abandon for any other of the fillings now in use, a material that we know from past experience is capable, when judiciously applied, of preserving and restoring to a state of efficiency, in some cases for a period of twenty years or even for a much longer time, teeth which otherwise would have been lost in about the same number of months. For the efficient use of this material much must of course depend on the manipulative ability of the operator, but it has often seemed to me a matter of doubt, whether, in the case of those large adhesive gold fillings, the patient has received an equivalent for the tedious and necessarily expensive operation that has been undergone.
The choice between contour fillings and separation of the teeth in the case of approximal cavities, must, I think, depend in a measure on the aptitude and judgment of the operator, since the two plans when successfully performed, may be made equally efficient. The latter however—separation—seems to afford greater facilities for operating, and also for cleanliness in those patients who are unable or unwilling to devote the time and attention necessary for that object.
The professed incompatibility of gold as a filling material with tooth bone, seems to me to be at variance with the frequent success which we all must have experienced, in the use of that filling in cavities on the labial surface of the roots of the upper incisors. I mention this particular position as being easy of access for operating, and also as being one where the enamel, tooth bone, gold, and saliva, are in constant contact with each other. In those cases where the success of the operation has not equalled our expectations, in endeavouring to estimate the probable incompatibility of the filling material as a cause of failure, it is, I think, necessary to consider whether in the ordinary operation for filling, the whole of the diseased dentine has been so thoroughly removed, as to admit of its proving a satisfactory test case, for the microscope reveals to us a change in the dentine in the sides of a decayed cavity, even when it appears sound to the eye, and also to the feel of the instrument; and in those portions of the margin of the cavity which we undercut for the retention of the filling, we have the dentine not only denuded of its nutrient covering, the periosteum, but also deprived of its nutrition from the pulp by the severance of the tubes of the dentine, and the intervention of the filling material, and in this deteriorated condition, in all probability still exposed to the continuous action of the same deleterious influences (whatever they may have been) which first caused the decay; and I cannot but think that the failure when it occurs, is in a greater measure due to the above named causes, rather than to the incompatibility of the gold with the tooth bone; but with all the success that has attended the use of gold for so many years, we must still, I am sure, be willing to admit the want of a perfect plastic filling, which shall be able to withstand the friction of mastication, and also the deleterious action of the fluids of the mouth.
The dictum that, “a tooth that can be so treated as to be satisfactorily filled with anything, is worth filling,” is one, I think, that all who value conservative surgery must readily agree with.
That “unskilful and unscrupulous Dentists fill with tin covered with gold, thereby causing galvanic action, pulpitis, death of the pulp, abscess, and loss of the tooth,” has certainly not been an accepted creed in this country, for I was early taught the use of this material both alone, and in combination with gold, when I first commenced the study of my profession with Mr. Sheffield, of Exeter, and long experience, and the retention of a tin filling in my own mouth, in a perfect condition for over five-and-twenty years, has fully proved to me the value of this metal. When used in combination with gold, and exposed to contact with the fluids of the mouth, it certainly undergoes a chemical change, becoming nearly black in colour, but without staining the tooth as some amalgams do; it also becomes harder, and cuts harsh like an amalgam filling, but the change does not appear to cause any alteration in its bulk, or in any respect to interfere with its efficiency as a filling, nor have I ever found it produce any of the evils suggested in the creed, and I cannot but think that it would be more used, were it not for the universal prejudice that exists in the mind of the public in favour of gold, partly arising from the magical charm which resides in the word gold, and partly from the nothing but gold theory (if I may so call it), which has been so largely spread by our American brethren.
That “a filling may be the best known for a tooth and yet leak badly,” seems a simple admission that in some cases bad is the best that we can do for them. If experience has taught us anything, it certainly has proved that it is the leak which does the mischief; and as in warfare no fortress is considered stronger than its weakest part, so is it with a tooth that is filled. A small leaking point will soon undermine the filling, and prove its ruin.
The statement that “gutta-percha properly used is the most permanent filling material we possess,” must make us wish to know the meaning of the words, “properly used,” for the rapidity with which it wears away, in any position in which it is subjected to friction in mastication, seems to me to prevent the possibility of its ever being permanent.
The force of the article which says that “a poor gutta-percha filling, in its proper place, is better than a good gold one,” seems to depend on the question as to what is the proper place for a gutta-percha filling: surely not the place where we can insert a good gold plug, if by “good,” is meant one that is not only solid, but also sufficiently tight to exclude all moisture from the cavity.
It certainly is rather startling to hear from the country from which have come the severest criticisms on the use and the users of amalgam fillings, the admission that “amalgam per se, is an excellent filling material.” With amalgams, as with the other plastic materials, a perfect filling of its kind has yet to be discovered, for a measure of uncertainty seems to exist in all of them; but as a proof that an amalgam may make a good useful filling, I can say that I have seen more than one apparently in a perfect condition after thirty years’ wear, and I cannot but think that much of the discredit attaching to its use, arises from its being the filling we naturally have recourse to in all cases of doubt and difficulty.
That “the use of plastic filling material tends to lower the standard of Dentistry, thereby diminishing its sphere of usefulness,” is scarcely a fair way of stating the matter. The indiscriminate use of them would certainly do so, but the judicious selection of them in cases unsuited for the use of gold, need not necessarily interfere with the acquirement of the manipulative ability necessary for making good gold fillings, nor is it desirable that it should do so, as the power of manipulation required for the successful use of gold, must tend to perfect the powers of the operator in the use of all plastic materials, and must thus extend the sphere of usefulness of that Dentistry which has for its standard of excellency, ability to save teeth.
Time has only permitted me very briefly to notice some portions of this new creed, to show that it contains much that might be productive of profitable discussion, but I think from what has been said, we may reasonably conclude that each material has its own particular advantages, and that until we are in possession of a filling suitable for universal application, a judicious selection is necessary on the part of the operator in each particular case.
The fourth, and not the least important object of the society is “the cultivation of a generous professional spirit amongst practitioners throughout the district,” and to this I hope may be added throughout the whole body of the profession; for the knowledge that we are branches of one central society, should lead to a feeling of fellowship not only with the members of the parent society, but also with the members of the other branches, and surely it is not too much to hope, that with the extension of the Society and its branches, and the feeling of professional brotherhood thereby engendered, we may see the gradual increase of that Christian charity which “thinketh no evil,” and which would scorn all attempts at self-exaltation, by the disparagement of the efforts and qualifications of a fellow practitioner, which I fear has been greatly encouraged by the isolation that has so long existed in our speciality.
Nor must we omit to notice the great benefit to be derived from the friendly discussion of subjects in which we are all mutually interested, not only to the profession at large, but also to each one individually, for which of us in his early days has not felt the wish that he had thought of this or that other mode of treatment in some particular case; and what more likely to impress new ideas on the memory, or, to use a familiar expression, make us “have them at our fingers’ ends” (the place where surely they are wanted when operating), than the friendly discussion of them which it is one of the objects of our Society to encourage?
The President of the Western branch has held out to us the hand of fellowship, which I am sure I need not ask your permission to be allowed to reciprocate most fully—not only in the wish for their future prosperity, but also in the assurance that any of their members who may have an opportunity of attending our meetings, will at all times receive that cordial welcome which it should be our greatest pleasure to extend to all the members of our Society and its branches, thus realizing one of the great objects of our Association, and proving not only by our words, but also by our actions, that we are anxious to encourage that professional intercourse which must tend not only to our mutual benefit, but also to that of the community at large; and if, as their President remarked, it is a pleasure to them to think that in the formation of our branch we show “the benefits resulting from the good example they have set us,” it is no less a subject of congratulation to us to know that they have at last recognised the good which is likely to accrue, both to themselves and to the profession generally, by following our example, and forming themselves into a local branch of the British Dental Association.
And now, fearing that I have already trespassed too long on your time and forbearance, it only remains for me to thank you for the kind reception you have accorded me, and to express the belief that, although the barque which we have so successfully launched will probably meet with the usual amount of storms and difficulties, still the old proverbial “long pull and a strong pull and a pull all together,” in which you are so able and willing to join, will carry it securely through the many undercurrents and quicksands which may threaten it on its course, and secure what we all so ardently hope for—a useful, as well as a long and prosperous career, for the Midland Branch of the British Dental Association.
Mr. Mahonie (Sheffield), moved a vote of thanks to the President for his able and eloquent address, and in doing so, said that when the Association was weak, Mr. Campion had come to their aid in a very courteous manner, and they were now asked to give him their heartiest thanks for the paper which they had just heard read. The paper was one which would last more than a year. It was very instructive, and he (Mr. Mahonie) thought that Mr. Campion was eminently capable of giving them instructions in the way of Dental Reform. He moved “That the best thanks of this meeting be given to the President of the Midland Counties Branch of the British Dental Association, for the able and eloquent paper which he had just read.”
Mr. W. H. Nicol (Leeds), seconded the motion in suitable terms.
Dr. W. H. Waite in supporting the motion, said that it was a very great privilege for them to have such a President as they had in Mr. Campion. His wisdom had been of great service in superintending the efforts which the Executive have had to put forth. They had been delighted that morning with the interesting and instructive address which Mr. Campion had given them, but most of all with the very high and generous tone that breathed throughout the whole of the address, and he (Dr. Waite) thought Mr. Campion had struck a key-note which, when the address came to be printed, would vibrate not only throughout the Midland Counties of England, but through every country where the Dental profession was carried on. The motion was carried with much enthusiasm, and the meeting then adjourned till the afternoon.
The Members assembled in the Memorial Hall at 2.30 p.m., Mr. Campion in the chair.
The President stated that some idea had been started of bringing specimens to the meeting, and in order to show what curiosities might be casually collected, he offered a few specimens to the notice of the Members.
Mr. Roff King, Shrewsbury, then read a paper on “Modelling and Modelling Composition.”
Mr. J. S. Crapper (Hanley) read a paper, entitled “New Ideas in Mechanical Dentistry,” and exhibited specimens of teeth which had been manufactured by a new process and sent to him to exhibit.
The Secretary read a paper received from Mr. F. Richardson, Derby—“Has Vaccination any Effect on the Degeneration of the Teeth?”
Mr. H. Marsh (Manchester) read a paper on the “Use of Nitrous Oxide Gas.”
Mr. Murphy desired to ask the Chairman whether Licentiates in Dental Surgery were legally responsible if a patient expired whilst under the influence of the nitrous oxide gas, or subsequently to the administration.
In the discussion which followed, there appeared to be a unanimous opinion amongst those present that Licentiates were not responsible, but that it would be impossible to define such a position.
The Secretary read a letter from Mr. Kyan of Preston, in which that gentleman expressed his regret at his inability to be present, and hoped the Members would have a successful meeting.
Mr. Renshaw moved a vote of thanks to those gentlemen who had furnished them with such interesting and instructive papers.
Dr. D. A. Wormald, in seconding the resolution, said they could, with a little energy and support, make that Society very successful, and as a representative body on behalf of their profession in the Midland Counties, they could maintain such a position that it would become an honour to belong to it.
The Chairman remarked that it was no light work to prepare such papers as they had heard read; much time and trouble must have been spent in the digest of the various subjects. He gave the hearty thanks of the meeting to the contributors of those papers.
The resolution was carried unanimously.
Mr. Major Stewart proposed a vote of thanks to Mr. Campion for presiding.
Mr. King seconded the motion, which was carried unanimously.
The Chairman (Mr. Campion) returned his best thanks for the kind reception and assistance the Members had rendered him whilst in the chair.