That is all the data that I can give you, Mr. President, excepting that I know, in my own practice that a majority of the pulps that I have treated and capped in that way are still alive, and I am a believer in capping certain exposed pulps. This is an exception: A patient came to my office something over two years ago. On a lower right second bicuspid was an exposure near the margin of the gum, which was capped, and that patient had not been in to see me since that day until yesterday, and would not have come then had there not been a pain in that locality. In examination I found that decay had started below the gutta-percha, upon the cervical wall, which I had placed there for protection, after the first capping, and had again exposed the pulp. The patient had suffered for two or three weeks with neuralgia before coming in. I thought it was useless to try to preserve any exposed pulps for that patient, so a new opening was made and the pulp devitalized.
I do not hesitate, however, in destroying a pulp to-day so much as I did some years ago, when we were taught to believe that the devitalizing of an exposed pulp was almost a certain forerunner to the total destruction of the tooth. There has been a radical change in that theory, Dr. Atkinson, of New York, has written a paper in which he speaks of the amputation of a pulp. If I remember rightly, he claims that you may amputate a pulp up to the bifurcation of the roots, that it is good surgery and it will live. I do not agree with him; and yet when I have been trying to destroy pulps up in the canals, I have sometimes thought they would live, no matter what you did to them. I do not hesitate to destroy pulps to-day, because we have such an excellent knowledge of the structure of the tooth, and we now know that simply because the pulp is lost we must not suppose the tooth to be entirely dead, but there is still life from the membranes of the root. So I am now inclined to cap only those pulps which present the best conditions for capping. If a pulp presents any symptoms of congestion or inflammation, I believe you had better dispatch it at once, in order to give the best results to the patient, but I am not a believer in the wholesale destroying of pulps. I believe, gentlemen, in conservative treatment.