A GLANCE AT DENTAL HISTORY.

ADDRESS

DELIVERED BEFORE THH

Massachusetts Dental Society,-i

AT ITS

TWELFTH ANNUAL MEETING,

DECEMBER 14, 1876,

BY

R. R. ANDREWS, D. D. S.,

OF CAMBRIDGE.

II

SALEM: IPRINTED AT THE SALEM PRESS.

1877.

PRINTED BY ORDER OP THE MASSACHUSETTS DENTAL SOCIETY.J. H. BATCHEEDER, CHAIRMAN, EXECUTIVE COMMITTEE.

ADDRESS.

Mr, President, and Gentlemen:You have assigned me both an honorable and a

difficult task on this occasion of our annual gather-ing. Permit me to thank you at the outset, for thehonor you have thought fit to extend to me, while,at the same time, I shall accept the difficulty of thetask with every limitation of circumstance which Imay deem to be favorable to myself.

There are themes without number which we mightdiscuss, both profitable and interesting at such a timeas this, and before this Brotherhood of Dentists; for,in the realm of scientific research, new phases of de-velopment are constantly adding treasures to dentalknowledge, which it would be interesting to criticizein their freshness and originality; but this is toowide a range, and far too speculative in character,for either our purpose or my inclination. Theoriesare unsafe until they have crystallized into facts,—then they become practical.

It is my intention, in my address, to present to youwhat has grown into—what has become woven intothe very texture of the history of Dentistry. His-tory is a growth: the things that enter into it musthave had their times of being, or else they could not

have been recorded; and growth indicates age. Aday’s experience may indeed be history, but until ithas grown into a long series of like experiences itwill not be regarded as history in the truest sense.An experiment may indeed be a matter of history,but until the experiment grows into something more

tangible than itself, it does not pass into history.Dentistry has a history,— has had one for centu-

ries,— has been groping through all the ages, bysteps, from darkness to the light. As a specialty ofthe surgeon’s art, it has developed with surgery. Ithas had its epoch of growth; its honorable mentionin the writings of the sacred past; its champions,who speak from behind the shadowy hills of distantages gone; handed down from sire to son until itcomes to us, who must improve the trust and hand itdown to other generations, an enlarged power. Intheir relation to human beauty the teeth have figuredin poetry and prose from the earliest times. It wasOvid who wrote the significant lines,—

“Let not the nymph with laughter much abound,Whose teeth are black, unsightly, or unsound.”

"While Laurence Sterne, of more modern fame, speaksof " a pearly set of teeth so beautiful that Royaltywould have pawned her choicest jewels for them.”

The teeth demand a peculiar treatment, a separateprofessional skill, which, in its kind, is unlike that ofany other. This is why we limit the name of our

profession, and call it Dentistry,— a special practice

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which involves truly the science of the teeth. Ontfrom among the dim ages of past wisdom,— awayback amid the shadows of perished times,—we havepreserved for ns the record of the first effects of den-tal skill. Five centuries before the time of Christ,we find it mentioned in Herodotus, that in Egyptthere were physicians for the sole care of the teeth,

the dentists of twenty-three hundred years ago.Cicero has left the mention of the name of JEscula-pius in his writings, whom he says was the first toextract teeth; and also mentions that the leaden in-strument, called odontagogon, used by him, was hungin his temple by the ancients.

Pursuing further this first epoch of dental history,there is scarcely room for doubt that the teeth wereobjects of special care, inasmuch as gold was foundabout the teeth of the dead; for one of the laws ofPome, formed by the Decemveri, was that gold foundabout the teeth of the dead should be burned withthe corpse. I find it stated by one writer that it wasHDsculapins, the third, who first extracted teeth, andthat Hippocrates, his successor, was the first to leaveany writings in regard to their maladies. In thesewritings, he notices that dentition is easiest with child-ren in winter, and that when the bowels are in a

relaxed state there is less danger of convulsions.Very cold drinks, he says, hurt the teeth; diseasedteeth he finds to be the cause of many disorders, andin this case he counsels extraction. When a firmtooth ached he used the cautery. Pough edges of

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decayed teeth, he states, cause ulcers on the tongue,and swellings of the gums he attributed to caries.Loose and painful teeth he extracted; such as weremerely loose he tied to adjoining teeth with threadsof gold and with silk. He lived four hundred andfifty years before the time of Christ.

Three hundred years later we find that Celsus, acelebrated surgeon of his time, wrote much about theteeth. He left many recipes for the cure of achingteeth, which he regarded as one of the greatest ofhuman afflictions. One treatment was to restrict hispatient to a low diet, and he employed emollient ap-plications, in the form of vapor, to the teeth andgums, wrapping up the head and using blisters on

the breast or shoulders. He was averse to extrac-tion. He treated the gums about loosened teeth withthe cautery, afterwards anointing with honey. Whena tooth was decayed and rough he filed it ” with aniron file.”

Thus we observe more light is gradually thrownon the treatment of the teeth. In the middle of thefirst Christian century we find it written that one Ar-chigenes, a Homan surgeon, invented an instrumentfor boring a small hole in the teeth, in cases wheremedical applications failed to give relief. Is not thisthe operation we call rizodontrophy? About thistime Scribonius makes the first mention of the tooth-pick, a little instrument to be made of mastic woodor of quills.

Later, in the early part of the second century, we

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find a bit of literature on the care of the teeth, whichis most opportune to our present purpose, and al-

though not written by a surgical writer, is sufficientlyinteresting and pertinent to be given entire. It is a

chapter which I find in a discourse on magic, writtenby one Apuleius,— seventeen hundred years ago,and it is so terse on the subject of the teeth, that it

gives us a good commentary on ancient ideas of theircare. It seems Apuleius had been sharply criticizedfor writing certain lines, which he sent to one Cal-purnianus, with a dentifrice, and in the chapter re-

ferred to says: —

"I will now take up the argument in reference tothe lines,— compositions of mine:

“In hurried verse, I bid Calpernian hail I

I’ve sent, as you requested, the dentifrice,—

Arabian produce,—brightener of the mouth;A fine, choice powder,— a rare whitener,—

A soother of the swollen, tender gums,—A cleaner out of scraps of yesterday,That no unsightly blemish may be seenIf you should chance, with open lips, to laugh!

”And now, pray, what do these lines contain, inmeaning or in language, that I should be ashamedof ? What is there that a philosopher should be atall unwilling to acknowledge as his own composition?Unless, perchance, I was deserving of reprehensionfor sending to Calpurnianus a powder made of Ara-bian drugs, seeing that he was a person who might

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have, with much more propriety, after the filthy man-ner of the Iberians,—

“ ‘With his own water, wash his teeth and rusty gums,

"As Catullus says." I perceived just now some who could hardly con-

trol their laughter, when the orator inveighed withsuch asperity against cleaning of the teeth, and pro-nounced the word dentifrice with more indignationthan anyone else would speak of poison. And whyshould he not? No doubt it is a crime to be over-looked in a philosopher if he is particular in his pre-caution against dirt; if he allows no part of his bodythat is exposed to view to be unclean and filthy,—the mouth especially, which man makes frequent useof, openly and conspicuously, whether he kisses an-other, or discourses on any subject, or lectures beforean audience, or repeats his prayers in a temple • forso it is that words precede every act of mankind,—words which, as the first of poets says, issue forthfrom the hedge of the teeth. If you could, at thepresent day, produce anyone gifted with powers ofutterance as grand as those with which he was en-dowed, he would declare in his usual manner, thatfrom him, above all men, who has any care for theart of speaking, the mouth requires more sedulousattention than all the rest of the body, seeing that itis the vestibule of the mind, the gateway of speech,and the outer court of the thoughts. At all events,according to my way of thinking, I should say that

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nothing so ill becomes a man who is of free birth andof liberal education as inattention to the appearanceof the mouth. Yon look upon no feature before thisin a man while he is silent; no one more frequentlywhile he is in the act of speaking.

" I only wish now that my censor, JEmilianns,would answer me this question,—whether he is everin the habit of washing his feet, or whether, if hedoes not deny this fact, he would contend that greatercare ought to be bestowed upon the cleanliness of thefeet than upon the teeth? If, indeed, a person likeyourself, JEmilianus, will hardly ever open his mouthexcept to utter calumnies or revilings, I am clearlyof the opinion that he ought to bestow no attentionwhatever on his mouth, nor to clean his teeth withpowder brought from abroad, when he might muchmore appropriately rub them with charcoal snatchedfrom the funeral pile; and that he ought not so muchas to rinse them with common water. On the con-

trary, let his malignant tongue, the caterer of false-hoods and ofbitter abuse, forever lie amid the stenchand foulness which so well become it; for how in thename of misfortune is it consistent with reason thatone should have a clean and purified tongue, and atthe same time a loathsome and offensive voice? Thathe should, like the viper, instil black venom fromteeth white as snow? On the other hand, in the caseof him who knows he is going to utter language thatis neither inappropriate nor unpleasing, it is withgood reason that his mouth is washed beforehand,

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just like a cup when it is prepared for containing- apleasant draught.

"But why enlarge further upon this topic with re-gard to mankind? That huge beast, the crocodile,

which is produced in the Nile,— even it, as laminformed, opens wide its jaws, and without inflictinginjury, allows its teeth to be cleansed; for it has animmense mouth and no tongue, and generally lies con-cealed beneath the water; numbers of leeches fastenabout its teeth,—wherefor it repairs to the banks ofthe river and opens its mouth, and one of the river-birds, a friend to it, thrusts in her beak and picks itsteeth without incurring any risk. No more of this.”

And so ends, probably, the first chapter ever writ-ten on the care of the teeth. Marked by a vigorousoriginality, this discourse is one of peculiar force andshould live in the annals of dentistry as an appealfrom the dead past to the living present.

Later we find Galen, a celebrated physician of histime, writing much in regard to the teeth. He findsa difference in odontalgia, the pain sometimes beingin the tooth, sometimes in the gum. He writes thata dentist once tried to extract a tooth for him, butonly succeeded in lifting it a little from the socket;but this caused all pain to cease, and the tooth wasretained for use a number of years. Masticating theroot of purslane, or a decoction of it used as a lotion,was his cure for an aching tooth. He speaks of usingapplications to make faulty teeth fall out; these, itwould seem, were secrets with him.

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In the year six hundred and thirty-six,— the lastwell defined period of dental history until after theexcitements and disturbances of the decline of Ro-man power and the superstitions of the Dark Ages,—we find Panins, of AEgina, writing much that isinteresting to ns. He says, that to save the teethone must avoid indigestion and obstipation. He rec-ommends cleansing the month after every meal, toavoid eating sweets, or anything very cold, or bitingvery hard substances, as this, he notices, injures theenamel.

"About this time,” in the words of an old writer," the barbarous nations began to overrun the wholeearth, and surgery was so far from increasing that itreceived the same fate with all other parts of knowl-edge, and suffered under the common calamity.”

Sometime between this and the tenth century, Mo-hammed Arrasi, an Arabian dentist, is mentioned ashaving filled the hollow of carious teeth with a com-

position of mastic and alum, afterwards rubbing theteeth and gums with pepper and powdered gall-nuts;he used astringent applications when the teeth wereloose. For odontalgia he recommended oil of roses,pellitory root, opium, scarification, and leeches to thegum; if these failed, he touched the roots of thetooth with cautery, and then endeavored to eradicateit by means of certain specifics. Albacasis, an Ara-bian physician, sometime in the twelfth century, issaid to have given certain rules for replacing lostteeth by artificial ones made of animal bone or ivory.

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The method used by the Arabians at this time to de-stroy the pulp, was to push on it a red-hot needlethrough a metallic tube.

To Avicenna belongs the honor of publishing thefirst work giving the anatomy and physiology of theteeth. He believed worms to be the cause of thetooth-ache, and gives many hints in regard to toothpowders and narcotics as odontalgic remedies. Herecommends boring carious teeth to let out any ac-cumulation of humors, as well as to apply eradicatingspecifics with greater ease. To eradicate a tooth, thegum was first scarified, and the specific applied cau-tiously to the tooth; to keep them from injury, theneighboring teeth were covered up until the toothoperated upon became completely loosened. MichaelSarvonarola, who died in 1162, in his " Practical Com-pendium,” says that after the great pestilence of 1318the number of teeth found in the human jaws wereonly twenty-two,—sometimes twenty-four,—and thatbefore this pestilence there had always been thirty-two.

"When we consider that at this period the wholeearth was overrun with barbaric tribes of men, whoseinstincts were savage, and whose customs were rudeand untempered, we may not wonder that dental sur-gery, in common with almost every other branch ofknowledge and industry, became largely contami-nated with absurd systems, and partook of the super-stitious veneration for charms and nostrums whichcharacterized the history of the Middle Ages. It

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may not be uninteresting at this juncture, to cite someinstances of the crude manner in which, at this time,fact was adulterated with superstitious fancy; theymay serve to show one of the stages of developmentthrough which dentistry has passed.

Thus Gaddesden, court physician to Edward 11.,speaks of using the grease of a green frog to curean aching tooth, and says that if the gums are rubbedwith this remedy the offending tooth will soon fall out.In cases of retarded and difficult dentition, the greaseof animals was used,— sometimes the brain of a hare,or what was considered better, the milk of a slut,— tobe rubbed over the gums of the little sufferer until theteeth were cut. And John Arculanus, whom I findto be the first writer to speak of filling carious teethwith leaves of gold (about 1430), makes this curiousand unintelligible statement: "In performing thisoperation, regard must be had to the complexion ofthe patient, warm ingredients being employed forthose of a cold constitution, and vice-versa .”

Lawrence Phries, in his "Mirror of Medicine”(1529), says that pain in the teeth is caused by aneffusion from the brain into the tooth; if this effusionwas hot, the pain was sticking and sharp; but if theeffusion was cold, there was no sharp pain, but thegums and face were swollen. Bad vapors from thestomach also caused pain, and this could be knownby the pain becoming less either before or aftermeals: the treatment for this form was a system ofdiet. He says that if pain in the teeth is not cured

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by the simplest drugs, recourse may be had to thenarcotics* if then the pain could not be stilled, andit was certainly located in the tooth, and not in thenerve, the tooth must be broken out. Phries gives along prescription, the principal ingredient of whichwas arsenic, to eradicate a tooth; he also inventednumerous tooth powders.

Thus, until about the sixteenth century, the dark-ness of ignorance and blind fanaticism prevailed, andthen the dawn of a brighter period began. Early inthis century the effect of mercury on the teeth andgums was noticed.

Yersalius, a noted surgeon of his time, whose la-borious investigations are said to have given birth toanatomy, found that in cases of difficult dentitionnature might be much assisted by making incisionsin the gums, cutting quite down to the crown of thetooth. He also recommended turpentine to facilitatethe protrusion of the teeth, in place of the disgustingremedies before in use. Ambrose Pare, whose greatreputation saved his life at the massacre of the Hu-guenots (he being a Protestant), wrote much in re-

gard to the teeth. He relates to us the case of a ladywho, having had a tooth extracted, had it replaced byone taken fresh from the mouth of her serving wo-man. The origin of this operation has been, by some,ascribed to John Hunter; but this is a mistake. "Wehave the record of it here two centuries before Hun-ter’s time. Many of the dental instruments inventedby Pare resemble those in present use. About this

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time it was recommended to stop up a defective pal-ate, when the bone was eaten through by caries, witha piece of sponge or with a silver plate.

Dupont (A. D. 1633) was of opinion that the bestway to cure an aching tooth was to extract it, andthen to immediately replace it. He makes the state-ment that a tooth so treated will never afterwards bepainful.

About the middle of the seventeeth century, ISTa-thaniel Highmore discovered the cavity in the centreof each maxillary bone, extending from the orbit ofthe eye to the roof of the mouth, called in honor ofhis name Antrum Highmori. This was a highly im-portant discovery, giving a clew as it did to manyaffections apparently of the teeth, which had hithertobaffled the skill of all operators. I find it mentionedthat it was the practice at this time to kill the nerve(pulp) of an aching tooth with aquafortis, oil of vit-riol, and the cautery. In the year 1678, Leeuwen-hoeck discovered, with his simple microscope, themicroscopical anatomy of the teeth; but his discov-eries were so much ahead of his time that they hadto wait generations to find themselves confirmed.Peter Diones, a French surgeon, published a work in1696, which evinces that the practitioners of that pe-riod began to take a lively interest in dental surgery.His observations on operations which now belongexclusively to the dentist, are exceedingly pertinentand valuable. He censures the practice, too commonat the present day, of running to the dentist on every

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occasion of the slightest pain, to have the tooth ex-tracted. He enumerates every legitimate cause forextracting, and gives a description of the variousinstruments used for dental operations in his time.

Thus I have tried to convey a tolerably accurateidea of the history of dental surgery from the earliesttimes to the commencement of the eighteenth cen-tury. As we now approach a period better known,and in which the dental art has made such vaststrides, it is neither practical nor essential to noticeall the writings of the last century; indeed, my timewould not allow. I shall therefore content myselfwith a cursory glance at a few.

We find in 1728 the dental art in France in thehands of some very skilful dental operators. PerriFauchard, the most celebrated, wrote a work entitled" The Surgeon Dentist.” He was the first to use aspecial chair for dental operations, instead of havingthe patient sit on the floor, or lie on a couch, as wasthe custom. He treated many cases of caries by re-placing the teeth after extraction, tying them withwire to those adjoining, filling them as soon as theybecame fixed and painless. He used fine pewter forfilling, preferring it to either gold or lead. He regu-lated misplaced front teeth with an instrument calleda pellican, retaining them in place with wire; hespeaks of performing this operation frequently andsuccessfully.

Bunon described an affection of the teeth which heclaims the merit of having discovered, and which he

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calls erosion. About this time Heister, a surgeonpractising in London, writes: "If a tooth aches, cau-

terize it by inserting a red-hot instrument into itscavity, by which practice you will free the patientinstantly of pain, provided you do not burn the adja-cent parts of the mouth.” To extract a tooth hesays,—” If it be a lower one, place your patient on a

low seat; if an upper one, he must be seated on ahigh stool; then take the instrument best adapted tothe case, and thereby draw out the tooth, as thoughyou were extracting a nail out of a piece of board”

Philip Pfaff, a German writer of 1786, informs us

that artificial teeth were first formed of silver, andof mother-of-pearl, subsequently of ivory and neat’shorn, but in more recent times, of copper, coveredwith a delicate enamel. The eighteenth century wasnot without its charms and nostrums, any more thanthose periods of acknowledged ignorance and super-stition, before alluded to. So late as 1794we find itwritten that one Reneiri Gerbi cured six hundred andnine cases of severe odontalgia by using the larva,curculio anti-odontalgicus,

which is found in the blos-soms of the cardnus spinosissimus. Fourteen or fif-teen of the larva were crushed between the forefingerand thumb; the tooth was then touched with these,and the pain entirely removed in a moment. Thefinger and thumb so charged, he says, retain theirhealing power for a year. In 1797 we find Duboisde Chemant, a Frenchman, announcing the inventionof a paste for making mineral teeth. The merit of

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this invention was, however, claimed by Dnchatean,a French apothecary. The writings of Fox andHunter are too well known to need any mentionhere.

Thus have I described, so far as I have been ableto learn, the steps of growth which have marked theprogress of onr profession up to the commencementof the nineteenth century. Gleaning from rare har-vests of treasured thought, from books that havelived on for centuries after their authors have moul-dered into dust, it has been my endeavor to presentin these brief outlines, what the past has done fordentistry. The men of the past who have becomeprominent in giving our profession the high rank ittakes to-day, have been the men who, with unceasingtoil, not content with what they had already acquired,sought to learn more. Shall we be behind them, withall the advantages to be derived from this age of in-tellectual power, and amid the vast multitude ofmodern appliances? Upon our answer depends thefuture of dentistry.

Our work is to preserve what God has made andwhat man has corrupted. The human teeth are tjiecreation of a divine hand, and if we would but real-ize our mission in its highest significance, we shouldknow that we are ministers to heal in Heaven’s name.Let this be our inspiration:—To act nobly and well,that in the mouths of many witnesses our judgmentmay be just.