Vincenzo Guerini

“ How is it that the dental appliances of the Phœnicians, Greeks, Etruscans, and Romans should have come down to us, notwithstanding cremation?
In the first place, if one reflects that the teeth offer an altogether special resistance to the action of fire, and if one also remembers that gold was the substance employed for the construction of the appliances in question, and that this metal does not melt save at a very high temperature, it no longer appears marvellous if, in many cases at least, the dental appliances should have been able to resist the cremating process. ”

“ In the ox the penetration of bloodvessels into the roots of the teeth can be more readily ascertained than in man. It may be admitted that the same occurs in the human teeth; and this, for the reasons already given, and also because only by admitting the existence of an artery within the cavity of the tooth can be explained the copious flow of florid red blood from a decayed tooth, which has, in some cases, been known to imperil the life of a patient. And I myself, says Eustachius, have observed with my own eyes an accident of this kind. ”

“ If, before passing to the middle period, we cast a glance over the ground already traversed, it is easy to perceive that dental art, in ancient times, reached its highest degree of development at the time when the Roman civilization was in its greatest splendor, when, in the capital of the world, wealth, luxury, and the refinements of social life marvellously increased its needs, and by this also gave an impulse to the evolution of all human activity. ”

“ Scientific medicine, whose most ancient representative is Hippocrates, was preceded for the course of many centuries by sacerdotal medicine and by popular medicine.
Necessity, instinct, and even mere chance must have taught primitive man some simple curative practices, in the same manner that they taught him gradually to prepare his food and to satisfy the other wants of life. It was in this way that popular medicine, which is found without exception among all races and is perhaps as ancient as man himself, had its earliest beginning. ”

“ Neither in Celsus nor in Pliny, nor in any other Roman writers on medicine, do we find any allusion to the art of dentistry. The doctors of those days probably had no idea of the advantages which could be derived from dental prosthesis in regard to digestion and consequently to the health of the whole body. They therefore must have considered artificial teeth as something totally foreign to their art, and intended solely to hide a physical defect. ”

“ With the lapse of time, various traditions formed around his name, among which there was, however, finally such discrepancy that the popular voice spoke no more of one, but of many Æsculapii,42 and to one of these was attributed, among other merits, that of having invented the probe and the art of bandaging wounds, while another was held to be the inventor of purgatives and of the extraction of teeth.
According, therefore, to these traditions, dental surgery had its origin with Æsculapius, the god of Medicine. But what was the precise epoch in which this benefactor of humanity lived? ”

“ Pierre Auzebi, a dentist at Lyons, published a treatise on odontology in 1771, which is only remarkable for certain strange ideas that he therein exposes, the entire book being in complete contradiction with the great progress already realized, at that period, in dental science. Auzebi likens the human body to a hydraulic machine, formed by the union of solid and liquid parts. For him the bones are merely folded membranes and the teeth are bones composed of small membranes. ”

“ Paracelsus, a man of powerful genius, but not well balanced in mind, of corrupt morals, and of an unlimited pride, had, notwithstanding these undeniable defects, the merit of beginning a healthy reform in the science and practice of medicine, by substituting the study of nature for the authority of the ancients and by giving a great importance to chemistry, both for the explanation of organic phenomena and for the cure of disease. ”

“ Hippocrates, therefore, considers affections of the teeth to depend in part on natural dispositions, that is, on congenital weakness of the dental system, in part on accumulations of pituita, and the corroding action of the same. If a painful tooth were not loose, it was not to be extracted; but one was to have recourse to cauterization and to masticatories, intended the one and the other to dissipate the accumulation of pituita, believed by him to be the cause of toothache. ”

“ In this town, those who intend to become dentists are now obliged to undergo an examination, but although the examiners be most learned and well versed in all the other parts of surgery, I think, if I may be allowed to express my opinion, that as they do not ordinarily themselves practise dental surgery, it would not be amiss on these occasions to admit an able and experienced dentist, who might sound the aspirant as to the difficulties which have come before him in the course of the long practice of his art, and who could communicate to them the means of surmounting them. ”

“ But those who, very wrongly and with deplorable levity, consider Bunon as nothing more than a vulgar empiric, ought to reflect that even the greatest men cannot altogether avoid the influence of the ideas and the prejudices of their time. Some tribute they are almost fatally bound to pay to these prejudices. It is, therefore, not to be wondered at, if one finds in Bunon’s works, as well as in those of many other old writers, indications given of more or less strange remedies. ”

“ The tenth chapter of the book of Scribonius Largus treats of the cure of odontalgia. The author begins by saying that it is the opinion of many that the only true remedy against toothache is the forceps. With all this, he adds, there are many medicaments, from which great benefit may be derived against these pains, without it always being necessary to have recourse to extraction. Even when a tooth is affected with caries, says the author, it is not always advisable to extract it; but it is much better, in many cases, to cut away the diseased part with a scalpel adapted for the purpose. ”

“ Bartolomeo Montagnana, who taught surgery in the University of Padua and died in 1460, recommended, as an excellent anti-odontalgic remedy, a mixture of camphor and opium. In his days, faith in the pretended eradicating virtues of certain substances was being gradually lost; but, on the other hand, a tendency now arose to neglect, in regard to the teeth, the conservative principle, to which the ancients had held so jealously; and little by little the extraction of a tooth began to be considered an operation of small or no importance, that could be performed with the greatest indifference. ”

“ Even in our days, notwithstanding the superabundance of duly qualified doctors, there is, especially in certain countries, no small number of quacks, secretists, bone-setters, chiropodists, and the like. It is, therefore, not to be wondered at that in times when dentistry was still in its infancy there should have been persons more or less ignorant who undertook tooth drawing and the concoction and sale of specifics against odontalgia. ”

“ Although Arculanus is the first writer who alludes to the filling of teeth with gold, nevertheless it is by no means admissible that he was himself the inventor of gold filling. His words do not at all sound to us as the announcement of a new discovery, as the enunciation of a new fact, in which the author himself had had, at least, a part, be it great or small. ”

“ The alveolar process is, in his opinion, the principal seat of the disease, to which, as a complication, is added the retraction of the gums. For the diseased alveolus the tooth becomes, in a certain manner, an extraneous body, of which it tends to rid itself. The alveolar margins undergo absorption; the bottom of the alveolus tends to fill up, analogously to what occurs after extraction, and the falling out of the tooth ensues as a natural consequence of this process. An altogether similar process, producing the falling out of the teeth, is the normal consequence of senility. ”

“ Sour or too abundant foods are digested with difficulty, and also those which are ravenously swallowed. As a remedy, vomiting has come into use; but it makes the body cold and is most pernicious to the eyes and to the teeth.”
There is no doubt that the habit of often provoking vomitus—which, in those times of excessive corruption and intemperance, had come into general use—must have resulted in enormous harm to the teeth, especially by the action exercised upon them by the hydrochloric acid contained in the gastric juice, and by the organic acids of fermentation. ”

“ Although there have been, even from the most remote times, individuals who have dedicated themselves exclusively to the cure of dental maladies, or to repairing the losses of the dental system by artificial means, and notwithstanding the progress gradually accomplished in this branch of the medical art, which progress was especially remarkable during the sixteenth and seventeenth centuries, it is not to be denied that, up to the beginning of the eighteenth century, dentistry was, in great part, considered one with medicine and surgery in general. ”

“ Our knowledge of medicine as practised among the Egyptians of old is now no longer limited to the scanty notices handed down to us by Greek and Roman writers. The researches made by students of Egyptian lore have placed original medical writings in our hands, now already partly interpreted, that permit us to form a sufficiently exact idea of the science of Medicine in ancient Egypt. ”

“ But if educated men and those who seemed likely to make more careful scrutiny and experiment on any point, presented themselves, he contorted his countenance, remained silent, and simulated a kind of madness, the idea being that he permitted himself to be examined at stated times only when the conditions allowed. Now, the tooth was covered with a plate, lamina (or layer) , skilfully wrought of the best gold, and the gold was let down so deep into the gum that the cheat was not observed. ”

“ He admits the existence of distinct germs for the enamel and for the dentine. According to him the incisors are formed from three points of ossification, the canines from one, and the molars from three or four. The tooth after its eruption is an extraneous body “with respect to a circulation through its substance, but they have most certainly a living principle by which means they make part of the body, and are capable of uniting with any part of a living body.” The milk teeth, says Hunter, are not shed by a mechanical action of the second teeth, but by an organizing law of Nature. ”

“ The importance and value of dental art and science as a humane service are well recognized, but we are so accustomed to view the question from the modern standpoint that we, generally speaking, overlook the immense work done by our predecessors reaching far back in unbroken line to the mists of antiquity. ”