1594 AN INTERESTING ACTION FOR MALPRACTICE AGAINST A DENTIST.

working men themselves had not elected them) to vote,and some acrimonious remarks were made. He also movedthe adjournment of the meeting, but this was defeated

by a large majority. An allegation having been made thatthe board of management had not allowed the proper repre-sentatives of works to be on the list or register of repre-sentatives sent in each year, the chairman of the board of

management said that he had no knowledge of any namebeing on the list of voters that ought not to be on. Heunderstood from the secretary that the names of the works’representatives were sent in at the proper time and puton the register, and he took it from a business pointof view that those names were those of the nomineesof the works from which the money came. As faras the board of management was concerned he did

not agree with the speaker (Dr. F. Rees) that these menhad been improperly elected. It was for the men at theworks to put the matter right themselves. He thoughtthat the method of electing a medical officer was not

very dignified and it might very well be left with anelective body. It would be more dignified for the professionand more useful to the institution. The election afterwards

proceeded by a show of hands, the successful candidate

having a large majority. A poll, however, was demanded,but on the proxies being handed in it was withdrawn.

AN INTERESTING ACTION FOR MALPRACTICEAGAINST A DENTIST.

THE last issue of the British Journal of Dental Sciencecontains a short account of an important action tried beforea jury in the Lord Mayor’s Court against a dentist for allegednegligence. The facts of the case, as gathered from thereport and also a letter from the defendant, are briefly asfollows. The tooth in question was a mandibular molar. Thecavity in this was dressed with carbolic on a Tuesday and onthe following Thursday the nerve canals were cleaned outand filled with a dressing of carbolic acid and iodoform. A

cement filling was inserted and the plaintiff was told to returnif any pain or trouble occurred, which he did not do. It was

only intended to retain this tooth for a few weeks. The same

night pain commenced and by the following morning whenseen by his medical man there was so much swelling as tocause trismus. His temperature was stated to be 104’F.and it was also said that it was impossible to remove

the tooth. The face was poulticed on the outside for threedays and incisions were made both inside and outside themouth. The tooth was allowed to remain for three weeksand even during this time no attempt was made to removethe filling. The dental surgeon who gave evidence in

support of the plaintiff stated that it was wrong practice toput a cement filling in a tooth if the nerve was dead, andstated that such teeth required to be dressed with antisepticwool sometimes two or three times before being filled. He

also stated that with a temperature of 104° it would havebeen wrong to administer nitrous oxide and to remove thetooth. Other evidence was given on both sides and averdict was returned for the plaintiff with R40 damages.This case is of great interest because if such a

decision could be upheld there are few dentists whowould not be liable to be mulcted in damages in

performing such an operation, since septic inflammationmust always be regarded as a possible complication.The operation as performed by the dentist was a perfectlyjustifiable one; he cleared the pulp canals of septicmatter, placed in a dressing of antiseptics, and sealed themwith a plastic filling which he would have removed if painhad occurred. This was stated to be wrong practice by thedentist called in support of the case, but it is neverthelessthe method adopted by the best dental practitioners of theday, while the method stated as correct by the dentist is one

which, perhaps, may be regarded as a relic of the past. In-our opinion the defendant was in no way to blame.A temperature of 104° is no bar to an anaestheticif an operation is necessary. Still further, there is no

reason whatever that should have prevented the removal ofthe tooth. If a consultation had taken place between thedentist and the medical practitioner in all probability thetooth would have been removed at an early date and theburrowing of pus prevented. The treatment, too, of applyingpoultices to the outside of the face is open to much criti-cism. In the report before us there is no mention of an

appeal having been applied for, but it is to be hoped that thecase may be heard of again before a higher court and withevidence given by a practitioner holding not only dental butalso medical qualifications.

GLASGOW UNIVERSITY CLUB, LONDON.

THE winter dinner of this club will be held at the Cafe

Royal, Regent-street, on Wednesday, Dec. 5th, at 7.30 P.M.,Professor Sir Hector C. Cameron, M.D. Glasg., in the chair.Lord Lister and Surgeon-General J. Jameson, C.B. (Director-General of the Army Medical Service) have promised to

attend, and amongst the club guests will be Major Babtie,R.A.M.C., whose conspicuous bravery at the battle ofColenso in the early part of the present war secured forhim the Victoria Cross. Major Babtie, who is a graduate ofGlasgow University, has just returned from South Africa,and we anticipate that his welcome home by his old friendsand fellow-students is likely to be a hearty one. Memberswho intend to be present at the dinner should communicateimmediately with the honorary secretary, Mr. Norman

MacLehose, 13, Queen Anne-street, Cavendish-square, W.

THE DIAGNOSTIC VALUE OF KERNIG’S SIGN INCEREBRAL AFFECTIONS.

DR. PAUL ROGLET in his These de Paris (1900) makesan important contribution on the pathogenesis and the

diagnostic value of Kernig’s sign in cerebral affections. In

1884 Kernig described the presence of a certain clinical

sign as characteristic of meningitis-viz., the inability toextend the knee fully when the patient was seated inbed with the thigh extended at right angles to the trunk.The cause of this functional inability was due to a con-

tracture of the flexors of the knee. When the patient,however, was allowed to lie on the back this contracture

disappeared and complete extension of the leg at the

knee-joint was possible. Dr. Roglet made a carefulseries of observations on this point in 35 patients andhas concluded that the sign is not exclusively present inmeningitis but may be met with in other forms of cerebralirritation. In 85 per cent. of cases of meningitis, whetherdue to meningococci, pneumococci, streptococci, or staphy-lococci, it was easily elicited. In tuberculous meningitis itis somewhat less frequent. It makes its appearance whenthe disease is well-established, but it varies in intensity fromday to day, and a case is recorded by Dr. Roglet where itwas found to be present in a patient convalescing fromcerebro-spinal meningitis. Spinal meningitis need not bepresent co-extensively with cerebral to give rise to this sign,for in one fatal case at least of meningitis followed bynecropsy no indication of spinal implication could be foundthough the sign was easily elicited during life. The patho-genesis of this sign is thus explained. In a normaland healthy subject seated in a bed and with the

legs fully extended and at right angles to the trunk theflexor muscles of the knee are stretched to their utmostand their elasticity is thus completely exhausted. If, how-ever, owing to some irritation of the spinal (motor) nervessupplying these muscles, there is produced an increase in the

tonicity (hypertonicity) of the muscles the result is that