Fig. 57

Fig. 58

This author, too, attributes great importance to dental worms, believing them to be one of the principal and most frequent causes of odontalgia. To kill them he recommends the usual fumigations and several other remedies, among which the juice of the leaves of the centaury or of the peach tree, but especially applications of aqua vitæ.

When it is thought well to have recourse to opium to calm toothache, he advises this to be used with the utmost prudence; and on this point, he relates having witnessed a fatal case, in the person of a gentleman of Padua, by the incautious use of this remedy.

In extraction Benedetti repeats all the precautionary measures recommended by the ancients, and he, too, advises that recourse should not be had to this operation, if not as a last remedy, that is, when every other means of cure has been found useless.267

Giovanni of Vigo. The celebrated surgeon Giovanni of Vigo (1460 to 1520), speaking of abscesses of the gums,268 says that the abscess must be first brought to maturity by fitting remedies, if it has not ripened spontaneously, then it must be opened with a lancet, and lastly, to cleanse the diseased part and to aid cicatrization, honey of roses or Egyptian ointment must be used. This latter is thus composed of: “℞—Verdigris, rock alum, ana two ounces; honey of roses, one ounce; plantain water and pomegranate wine, ana two and one-half ounces. The whole to be made to boil, and to be stirred with a small rod, until the mixture is reduced to the consistency of honey.”

For the cure of old fistulas he employs not only the above-mentioned Egyptian ointment, but also arsenic and corrosive sublimate.

Giovanni of Vigo is very brief in speaking on the treatment of dental caries, doubtless because he attributed little or no value to the numerous methods of cure recommended by his predecessors. The treatment advised by him is, however, very noteworthy. He says that by means of a drill, file, scalpel, or other suitable instrument, it is necessary to remove the whole of the putrefied or corroded part of the teeth, and then, to preserve it, to fill the cavity with gold leaf.

This clear and simple manner of speaking of gold filling as a cure for caries makes us suppose that Giovanni of Vigo was not at all a stranger to the practice of dentistry, as we must think of many preceding writers, but, on the contrary, that he was not less skilled in dental operations than he was in the other branches of surgery. Again, history tells us that Giovanni of Vigo was surgeon to the Roman court; so it would have been strange, indeed, if the Pope, if the haughty prelates, accustomed as they were to all kinds of refinement and comfort, should have intrusted the care of their teeth to lowborn barbers and quacks, whilst they could dispose of the services of so eminent a surgeon.

It may, however, be seen from the very book of Giovanni of Vigo,269 that in his days doctors and surgeons were, in general, little skilled in dental matters. Speaking of the extraction of teeth, he says: “For this operation there is need of a practised man, and, therefore, many medical and surgical authorities have expressed an opinion that this operation should be left to expert barbers and to the itinerant quacks who operate in public places. He, therefore, who desires to perform this manual operation in the best manner will derive great advantage by frequenting men who are expert in performing it and by seeing and impressing well on his memory their manner of operating.”270

PART III.

THIRD PERIOD—MODERN TIMES.

CHAPTER X.

THE SIXTEENTH CENTURY.

We have now arrived at the sixteenth century. The middle ages, that is, the period of transition between ancient and modern civilization, has now come to an end. Events of the highest importance, such as the invention of printing (1436), the taking of Constantinople by the Turks (1453), with the consequent emigration of many Greek men of letters and science, who took up their residence in the West and especially in Italy, and lastly, the discovery of America (1492), marked the beginning of a new era, and are the most essential factors in bringing about the revival of art and science.

In the midst of the vigorous intellectual life which characterized the sixteenth century, dentistry, too, like many other branches of science, made very notable progress; we, therefore, in this period shall have to record many important facts and many important names.

It is, indeed, in the sixteenth century, and, to be more precise, about the year 1544, that we meet for the first time with a monograph, in which dental affections are spoken of independently of general medicine and surgery. The book we allude to, by Walter Hermann Ryff, is also noteworthy because it is not written like the preceding works, in Latin, the customary language of the learned, but, instead, in German, that is, in a living tongue.

As we are now mentioning the first German author on Dentistry, it may be permitted us briefly to glance at the beginning of medicine and dental art among the German peoples.

Among the Germans, as in other nations, the first to practise the healing art were priests, priestesses, and wise women. To cure disease they used partly empirical remedies, and partly witchcraft and superstitious means of every kind. Thus, to facilitate dentition, it was thought an excellent thing to pass a thread through the eyes of a mouse and then to tie the blood-covered thread around the neck of the child. It was held, besides—and this prejudice has left even until now some traces—that the putting of the milk teeth, when they fall out, into the nest of a mouse assures the cutting of new teeth.

We must here mention, with regard to the origin of dentistry among the Germans, a very important fact related by Joseph Linderer,271 a fact which shows that even among the ancient Germans recourse was had to the application of artificial teeth.

We here reproduce the very words of the said author, translated literally:

“Being by chance a few years ago at Dresden and visiting the Museum of Antiquities, my attention was attracted, in the last room, to two osseous pieces, which with other objects were enclosed in a glass case, with the written inscriptions: Comb-shaped osseous pieces, found in ancient German urns. As soon as I had observed them, I saw at once that they were artificial teeth; but as I had to be contented with examining them through the glass of the case, it was not possible for me to decide whether these pieces were really of bone, as they seemed to be, or of another substance. Taking into account their antiquity, their whiteness is very notable. Every piece is composed, if I remember rightly, of five teeth, that is, of a canine and four incisors; the chief difference of these pieces from the prosthetic pieces in ivory still in use (the author is writing in 1848) consists in this, that the pieces of which I speak have not at all a broad base, designed to rest on the gums, the base having instead the same thickness as the rest. The five teeth are well separated from one another. Besides, the canine makes the proper angle with the incisors, and at each side of the piece is found, in a convenient place, a hole, which shows that these teeth were fastened to those of the subject by means of a metallic or other kind of thread. As the above-described pieces are white, we must infer that they were removed from the mouth of the respective individuals before the body was burnt, and afterward put into the urn with the ashes, just as they used to put in coins, bits of arrows, and the like.”

For many centuries dental surgery—which, however, was still in a very primitive state—was practised in Germany, as in many other countries, principally by barbers. These in certain places, and at certain periods, formed corporate bodies, whose members were legally authorized to extract teeth and to practise minor surgery in general. But besides barbers, there were various kinds of individuals, unfurnished with any authorization—tooth-drawers, charlatans, wandering story-tellers, necromancers, Jews, and even hangmen—who invaded the field of medical practice, in spite of its being forbidden them, except in fairs, to administer medicaments and to perform surgical operations.272

In 1460 there appeared in Germany a book on Surgery by Heinrich von Pfolsprundt, Knight of the Teutonic Order.273 The author had acquired great experience as surgeon in the military expeditions of his order, and we see from his book that he was very skilled in the cure of wounds and fractures. On the other hand, he shows himself hostile to every bloody operation with the exception of rhinoplast. Pains of the teeth and gums were cured by him by means of beverages.274

The book, therefore, lacks importance from a dental point of view, except in the sense that it shows how little skilled in the cure of dental affections were the German surgeons of those days.

It is worthy of note that this author, also, speaks of anesthetic inhalations; he, however, only translates, almost to a word, what Guy de Chauliac says on this subject.

Toward the end of the fifteenth century and in the first half of the sixteenth there were published in German, by anonymous authors, some short translations and compilations on dental subjects, taken especially from Greek and Arabian authors.275 Of these writings, the first one known, taken from Galen and Abulcasis, was printed at Basle in 1490; and another—one of the best—saw the light at Mayence in 1532. These works were perhaps due to intelligent barbers, or perhaps—and this seems to be the most probable—they were written, through the initiative of enterprising printers, by doctors and surgeons, who wished to remain unknown, on account of the special subject treated; for, owing to the fact that the diseases of the dental system were generally left in the hands of barbers and other unprofessional persons, the doctors and surgeons of those days would have been ashamed to interest themselves in such things.

Walter Hermann Ryff, of Strasburg, was born in the beginning of the sixteenth century, and died about 1570. He was a rather mediocre doctor and surgeon, and a man of the worst morals, so much so that many cities expelled him from their midst.276 He wrote many medical works, in which, however, there is very little original matter. Their principal merit consists, perhaps, in the fact that they were written not in Latin, as then was universally customary, but rather in the vernacular of the author and in a popular style; so that Ryff may be looked upon as the first who endeavored to diffuse among the people useful medical and hygienic knowledge.

Among Ryff’s books there are two which are very important to us. One is his Major Surgery, and the other is a pamphlet entitled Useful Instruction on the Way to Keep Healthy, to Strengthen and Reinvigorate the Eyes and the Sight. With Further Instruction on the Way of Keeping the Mouth Fresh, the Teeth Clean, and the Gums Firm.277

Of these books, there now only exist some extremely rare copies; so much so that neither Albert von Haller nor Kurt and Wilhelm Sprengel, who rendered such great services to the history of surgery, ever had the pleasure of examining them. Dr. Geist-Jacobi has been more fortunate than they, and has therefore been able to give us some very interesting information about their contents.

The Major Surgery is a mere compilation which does not contain anything new of importance. It was published in part in 1545, and in part in 1572, after the death of the author. The work is illustrated with very beautiful wood engravings; and it is just this which gives the principal value to this book. Some of the illustrations contained in the first part of it—that is, in that published in 1545—represent dental instruments, notwithstanding dental surgery is not treated in this part of the book. The author gives notice that he will treat all that concerns dental affections in the latter part of this book, in a special chapter. Unfortunately, this chapter was never written, because death prevented Ryff from completing the second part of his work.

Fig. 59

The dental instruments represented in his Major Surgery are many in number. Among them, first of all, are found the fourteen dental scrapers of Abulcasis, then the “duck-bill”—designed for the extraction of dental roots and broken teeth—various kinds of pelican (Fig. 59 A), the “common dental forceps” (Fig. 59 B), the “goat’s foot,” and many other kinds of elevators, among which, observes Geist-Jacobi, may be seen instruments even now in use, and even some which are said to have been recently invented.

Ryff’s other book is especially noteworthy because, as we have already mentioned, it treats, for the first time, of dental matters, independently of general medicine and surgery. This pamphlet, printed at Würzburg about the year 1544, is made up of sixty-one pages, and is divided into three parts, the first of which is dedicated to the eyes, the second to the teeth, and the third to the first dentition. It is written in popular style, and the author certainly intended it for the instruction of the public, and not for professional men; so true is this, that in it he does not speak of the technical part of the extraction of teeth, or of gold filling—a method already known for a long time—or of dental prosthesis.

The first part, relative to diseases of the eyes and the manner of curing them, has no importance for us. The second part begins with the following paragraph:

“The eyes and the teeth have an extraordinary affinity or reciprocal relation to one another, by which they very easily communicate to each other their defects and diseases, so that the one cannot be perfectly healthy without the other being so too.”278

This last statement is absolutely false, as a disease of the eyes may very well exist with a perfect condition of the teeth, and vice versa. However, Ryff has the merit of being, perhaps, the first who has noted the undeniable relation which exists between the dental and ocular affections.

After a rapid glance at the anatomy and physiology of the teeth, the author enumerates the causes of dental disease, which, according to him, are principally heat, cold, the gathering of humors, and traumatic actions.

The prophylaxis of dental diseases is beyond any doubt one of the best parts of the book; however, the ten rules counselled by Ryff for keeping the teeth healthy—rules which Dr. Geist-Jacobi has made known to us in full—are reproduced, almost to a word, from Giovanni d’Arcoli’s work; therefore, the author has no other merit than that of having translated them into the vulgar tongue, thus diffusing the knowledge of useful precepts for preventing dental diseases. We refrain from reproducing the aforesaid rules here, as they are, with slight variations, identical with those which we gave when speaking of Arculanus.

Nor can any credit be given to Ryff for the rules which he gives in regard to the diagnosis of dental pains, as this part of his work is also taken wholly from the Italian author just mentioned.

After these diagnostic rules Ryff, continuing to translate from the book of Giovanni d’Arcoli, adds:

“If the pain comes from the gums, extraction is of no use; if it comes from the tooth, extraction makes it cease; when, lastly, it is in the nerve, sometimes extraction removes it, and sometimes it does not, according as the matter obtains or not a free exit.”

The barbers and tooth-drawers, he says, must well remember this rule, in order to avoid extracting, thoughtlessly and with no benefit, sound teeth, since then the pain persists in spite of the operation. Also, it must be borne in mind that, in case of violent pain, it is necessary to operate as soon as possible, so that the patient may not faint or be attacked by the falling sickness, if the pain should be communicated to the heart or brain.

The idea that violent dental pains could give rise to syncope or to epilepsy (in regard to which we only observe that even very recent writers enumerate dental caries among the causes of the so-called reflex epilepsy) is also found in Giovanni d’Arcoli, who expresses himself in regard to this in the following terms: “Such very violent pains are sometimes followed by syncope or epilepsy, through injury communicated to the heart or brain.”279

“The most atrocious pain,” says Ryff, “is when an apostema ripens in the root;” literal translation of words written about a century before by Arculanus: “Fortissima dolor est, qui provenit ab apostemate, quod in radice dentis maturatur.”

Likewise taken from Arculanus is the observation (already made, however, by much more ancient writers) that “when the cheeks swell, toothache ceases.” Arculanus, however, expresses himself in a less absolute manner, and therefore more corresponding to the truth, since he says “the pain generally ceases” (secundum plurimum dolor sedatur).

Even in regard to the therapeutics of dental pains, Ryff does not tell us anything new. Dr. Geist-Jacobi gives this author the merit of having made, in regard to the cure of dental pains, a distinction between cura mendosa (that is, imperfect, palliative, tending simply to calm the pain) and cura vera (that is, directed against the causes of the disease). But this very important distinction is also taken from Arculanus, who in his turn took it from Mesue. In fact, after having spoken of the general rules relative to the cure of dental diseases, Giovanni of Arcoli adds: “As to the particular therapy, it is divided into cura mendosa and cura vera, as may be found in Mesue. And the cura mendosa is so called because it calms the pain by abolishing sensibility, not by taking away the cause of it. Such is, for the sake of example, the cure, consisting in fumigations of henbane, made to reach the diseased tooth by means of a small tube, adapted to a funnel.”

The third part of Ryff’s pamphlet has as its title:

“How the pains of the gums should be calmed or mitigated in suckling infants, so as to promote the cutting of the teeth without pain.”

This part, as Geist-Jacobi informs us, is very brief, not taking up more than a page and one-half of print. Neither does it contain anything of importance. To render the cutting of teeth easier, Ryff advises that infants should have little wax candles given to them to chew and the gums anointed with butter, duck’s fat, hare’s brains, and the like. The tooth of a wolf may be hung around the neck of the child, so that it may gnaw at it. It is also recommended that the head of the child should be bathed with an infusion of chamomile.

From what has been said, one may see very clearly that the aforesaid book is, from the scientific point of view, entirely valueless, because the best part of it is merely copied from the work of Giovanni d’Arcoli. However, the author has the indisputable merit of having endeavored to diffuse the knowledge of useful precepts of dental hygiene. His book, besides, we repeat, has great historical value, for from it dates the beginning of odontologic literature, properly so called.

On this point we believe it is necessary to correct an error into which Dr. Geist-Jacobi has fallen. At the beginning of his very valuable article on Walter Hermann Ryff280 he says: “In the fifth century of the Christian era, the iatrosophist Adamantius of Alexandria published an exclusively odontalgic work, of which, however, we only know the title.” The same he repeats in his History of Dental Art (pp. 55 and 56), without, however, giving us any proof of his statement. “Of the odontologic treatise of Adamantius,” he says, “unfortunately the title alone is known to us, and even that has reached us indirectly, that is, by means of Ætius; it is of the following tenor.”

Now, whoever takes the trouble to translate these Greek words will easily perceive that they do not constitute one title, but two distinct ones (which even Dr. Geist-Jacobi has had to unite by the conjunction and). These, however, are nothing more than the titles of two chapters of the Tetrabiblos of Ætius, as anyone may see for himself by turning over the pages of this work either in the Greek original, or in the beautiful Latin translation of Giano Cornario (Venice, 1553). In this great composition of Ætius dental diseases are treated of in Chapters XXVII to XXXV of Sermo IV, Tetrabiblos II; and the two Greek titles above referred to are the titles of Chapters XXVII and XXXI.

In the translation of Giano Cornario they read as follows:

Cura dentium a calido morbo doloroso affectorum, ex Adamantio sophista (cure of teeth affected by warm, painful disease, according to Adamantius the sophist).

Cura dentium a siccitate dolore affectorum, ex Adamantio sophista (cure of teeth affected by pain from dryness, according to Adamantius the sophist).

The work of Adamantius, from which Ætius took the contents of the chapters thus entitled, is lost to us, but we have no reason, and not even the least indication, for supposing that this work was a treatise on dental diseases, and not one on general medicine. It is absurd to consider the above-mentioned titles as belonging to an odontological monograph, on the one hand, because, admitting for a moment the existence of such a work, it should have had but one title and not two, and on the other hand, because it is by no means to be supposed that a great and wise physician, such as Adamantius undoubtedly was, should have had the whim to write a book, not on dental disease or on dental pains in general, but only and exclusively on dental pains caused by heat or by dryness. What reason would there have been for not extending the treatment of the subject to those cases of odontalgia resulting from humidity or from cold, that is, from causes as common and, according to the ideas of that time, very frequently associated with one of the first two (as humidity with heat, and cold with dryness)?

Besides, if the titles of the two chapters spoken of be compared with those of the others, in which Ætius treats of dental affections, such analogy will be noticed between the various titles as to make us consider that they have been formulated by Ætius himself, even when the contents of these chapters are taken from other writers. So that the two aforesaid titles not only do not belong to any dental work, but probably they have never existed, even as simple titles of chapters, in the medical book of Adamantius, from which the contents of the two chapters of Ætius above mentioned have been taken.

In order that every one may easily be convinced that the two titles made so conspicuous by Dr. Geist-Jacobi have nothing particular about them, but are, instead, perfectly analogous to the titles of various other chapters of Ætius, we give here the translation of the titles of five chapters, all concerning dental maladies, that is, the two chapters in discussion and other three:

Chapter XXVII: Cure of teeth affected by warm, painful disease, according to Adamantius the sophist.

Chapter XXIX: Cure of teeth affected with pain from humidity.

Chapter XXXI: Cure of teeth affected by pain from dryness, according to Adamantius the sophist.

Chapter XXXII: Cure of teeth affected by pain from heat and humidity.

Chapter XXXIII: Cure of decayed teeth, according to Galen.

It appears very clear, therefore, from the great analogy existing between the headings of all the above-mentioned chapters, that the titles referred to by Geist-Jacobi have not at all the historical importance and significance that he attributes to them, and that the same have been formulated by Ætius himself. To argue from such titles that Adamantius was the author of a book on dentistry is not only inadmissible, for all the reasons already given, but also because if it were allowable to reason with such lightness, it might also be stated—by arguing from the title of Chapter XXXIII—that Galen was the author of a monograph on the treatment of dental caries; a thing which is absolutely untrue. Consequently, the beginning of odontologic literature cannot be traced back to Adamantius, but, as Dr. Geist-Jacobi would have it, to an author much less ancient, that is, to Walter Hermann Ryff, or, if it is preferred, even to the anonymous writers of the odontologic compilations which appeared in Germany at the end of the fifteenth century.

Andreas Vesalius. We must now speak of Andreas Vesalius, an extraordinary man, who by his genius infused new life into medical science, and who, although he gave but little attention to dental matters, yet fully deserves a place of honor in the history of dentistry; for this, like every other branch of medicine, received great advantage from his reforming work, which broke down forever the authority of Galen, thus freeing the minds of medical men from an enslavement which made every real progress impossible.

Andreas Vesalius was born at Brussels, December 31, 1514. He studied at Louvain and then at Paris, where at that time great scientists taught, and among others the celebrated anatomist Jacques Dubois, generally known by the Latinized name of Sylvius.281 The latter, a great admirer of Galen, whose anatomical writings served as texts for his lectures, became jealous of the young Belgian student, who was his assistant, and who gave undoubted proofs of great genius, and of extraordinary passion in anatomical research. Vesalius often defied the greatest dangers in order to obtain corpses either from the cemetery of the Innocents or from the scaffold at Montfaucon. He soon surpassed his most illustrious masters, and at only twenty-five years of age published splendid anatomical plates, which astonished the learned. He acquired also great renown as surgeon, and in this capacity he followed the army of Charles V in one of his wars against France. After having been professor of anatomy in the celebrated University of Louvain (Belgium), he was invited by the Venetian Republic to teach in the University of Padua, which, through him, became the first anatomical school in Europe. Yielding to the requests of the magistrates of Bologna and Pisa, he also taught in those famous universities, before immense audiences.

Before Vesalius, Galen’s anatomy had served as the constant basis for the teaching of this science. Although even from the end of the fifteenth century dead bodies were dissected in all the principal universities, the teachers of anatomy always conformed, in their descriptions, to those of Galen, so that the authority of this master, held infallible, prevailed even over the reality of facts.

Vesalius, for the first time, dared to unveil and clearly put in evidence the errors of Galen; but this made him many enemies among the blind followers and worshippers of that demigod of medicine. Europe resounded with the invectives that were bestowed upon Vesalius. Among others, there rose against him Eustachio at Rome, Dryander at Marburg, Sylvius at Paris, and this last did not spare any calumny that might degrade his old pupil, who had become so celebrated. In spite of this, the fame of Vesalius kept on growing more and more, so much so that Charles V called him to Madrid, to the post of chief physician of his Court, a place which he kept under Philip II, also after the abdication of Charles V. The good fortune of Vesalius, unhappily, was not to be of long duration. In 1564 a Spanish gentleman died, in spite of the care bestowed upon him by Vesalius, and the illustrious scientist requested from the family, and with difficulty obtained, the permission to dissect the body. At the moment in which the thoracic cavity was opened the heart was seen, or thought to be seen, beating. The matter reached the ears of the relations of the deceased, and they accused Vesalius, before the Inquisition, of murder and sacrilege; and he certainly would not have escaped death except by the intervention of Philip II, who, to save him, desired that he should go on a pilgrimage to the Holy Land, as an expiation. On his return, the ship which carried Vesalius was wrecked, and he was cast on a desert beach of the Isle of Zante, where, according to the testimony of a Venetian traveller, he died of hunger, October 15, 1564.

Vesalius left to the world an immortal monument, his splendid treatise on Anatomy,282 published by him when only twenty-eight years of age, and of which, from 1543 to 1725, not less than fifteen editions were issued. The appearance of this work marked the commencement of a new era. The struggle between the supporters of Galen and those of Vesalius rendered necessary, on both sides, active research concerning the structure of the human body, so that anatomy, the principal basis of scientific medicine, gradually became more and more perfect, and, as a consequence of this, as well as of the importance which the direct observation of facts acquired over the authority of the ancients, there began in all branches of medicine a continual, ever-increasing progress, which gave and still gives splendid results, such as would have been impossible under the dominion of Galenic dogmatism.

In the great work of Vesalius the anatomy of the teeth is unfortunately treated with much less accuracy than that of the other parts of the body. However, his description of the dental apparatus283 is far more exact than that of Galen, and represents real progress. The number of the roots of the molar teeth (large and small) is indicated by Galen in a very vague and inexact manner, since he says that the ten upper molars have generally three, sometimes four roots, and that the lower ones have generally two, and rarely three. Vesalius, having examined the teeth and the number of their roots in a great number of skulls, was able to be much more precise. In regard to roots, he makes, for the first time, a very clear distinction between the premolars next to the canine (small molars) and the other three, and says that the former in the upper jaw usually have two roots, and in the lower, one only, whilst the last three upper molars usually have three roots and the lower ones two. As everyone sees, these indications are, in the main, exact.

Other important facts established by Vesalius are as follows:

The canines are, of all the teeth, those which have the longest roots. The middle upper incisors are larger and broader than the lateral ones, and their roots are longer. The roots of the last molars are smaller than those of the two preceding molars. In the penultimate and antepenultimate molars, more often than in the other teeth, it sometimes happens that a greater number of roots than usual are found, it being not very rare to meet with upper molars with four roots, and lower ones with three. The molars are not always five in each half jaw; sometimes there are only four, either on each side, or on one side only, in only one jaw or in both. Such differences generally depend on the last molar, which does not always appear externally, remaining sometimes completely hidden in the maxillary bone, or only just piercing with some of its cusps the thin plate of bone which covers it; a thing which Vesalius could observe in many skulls in the cemeteries.

In regard to the last molar, the author speaks of its tardy eruption and of the violent pains which not unfrequently accompany it. The doctors, he adds, not recognizing the cause of the pain, to make it cease have recourse to the extraction of teeth, or else, attributing it to some defects of the humors, overwhelm the sufferer with pills and other internal remedies, whereas the best remedy would have been the scarification of the gums in the region of the last molar and sometimes the piercing of the osseous plate which covers it.

This curative method, of which no one can fail to recognize the importance, was experimented by Vesalius on himself, in his twenty-sixth year, precisely at the time that he had just begun to write his great treatise on anatomy.

The existence of the central chamber of the teeth appears to have been unknown to Galen, as he does not allude to it in the least. Vesalius was the first to put this most important anatomical fact in evidence. He expresses an opinion that the central cavity facilitates the nutrition of the tooth. He says, besides, that when a hole is produced in a tooth by reason of acrid corrosive humors, the corrosion, when once the internal cavity is reached, spreads rapidly and deeply in the tooth, owing to the existence of the said cavity, and sometimes reaches even the end of the root.

In the chapter in which Vesalius treats of the anatomy of the teeth (Chapter XI, p. 40), two very well-drawn figures are found, one of which represents a section of a lower molar, showing the pulp cavity and its prolongation into the two root canals. The other represents the upper and lower teeth of the right side, in their reciprocal positions, and shows very clearly their general shape, the length of their roots, and the number of these.

The changes which take place in the alveolus, after the extraction of a tooth have not escaped the notice of Vesalius. He says that after an extraction the walls of the alveolus approach one another, and the cavity is gradually obliterated.

Aristotle had affirmed that men have a greater number of teeth than women. Vesalius declares this opinion absolutely false—although, after Aristotle, it has been repeated by many other ancient writers—and says that anyone can convince himself that the assertion of Aristotle is contrary to the truth, as it is possible for everybody to count his own teeth.

In spite of this, we find the above-mentioned error even in writers subsequent to Vesalius; for example, in Heurnius (professor at Leyden toward the end of the sixteenth century), who expresses an opinion that rarely do women have thirty-two teeth, like men.

We find but little in Vesalius concerning the development of the teeth. He, indeed, made some observations and researches on this point, but these, from their insufficiency, led him to quite mistaken conclusions. The teeth of children, he says, have imperfect, soft, and, as it were, medullary roots; and the part of the tooth which appears above the gums is united to the root, so to say, as a mere appendix, after the fall of which there grows from the root the permanent tooth. This error arose in the mind of Vesalius from observing that when children lose their milk teeth, these have the appearance of a kind of stump, as if the root had actually remained in the socket. Besides this, he had observed with what facility the milk teeth fall out; and he here calls to mind that, when about seven years old, he himself and his companions used to pluck out their loosened teeth, and especially the incisors, with their fingers, or with a thread tied around the tooth. The softness of the dental roots in children, the easy fall of the milk teeth, and the want of the lower part of the roots in these, must have raised the idea in his mind that the roots of the milk teeth remained in the socket, and that the upper part of the temporary teeth, instead of being a continuation of the root, was joined to this as a simple appendix, and in a very weak way, as though designed to remain in place for a limited length of time only.

In Vesalius284 is found a dental terminology—Latin, Greek, Hebrew, and Arabic—which affords some interest. The incisors are called in Latin incisorii, risorii, quaterni, quadrupli; and the two middle incisors have been denominated by some authors duales. The canines are called in Greek kynodontes, which means the same as the Latin canini, dog’s teeth. In Latin they have been also denominated mordentes, and by some also risorii, a name which by others is given to the incisors, as we have already seen. The molars have also been called in Latin maxillares, paxillares, mensales, genuini.285 But some authors give this last name only to the last molars, or wisdom teeth, dentes sensus et sapientiæ et intellectus. These teeth have also been called serotini (that is, tardy), ætatem complentes (that is, completing the age, the growth), and also, in barbaric Latin, cayseles or caysales, negugidi, etc.

In the rebellion against the authority of the ancients, Vesalius had a predecessor whose name, deservedly famous, may be recorded here. Paracelsus (born in 1493 at Maria-Einsiedeln, Switzerland), on being nominated, in 1527, Professor of Medicine and Surgery at Basle, inaugurated his lectures by burning in the presence of his audience, who were stunned by such temerity, the writings of Galen and Avicenna, just as Luther, seven years before, had burnt in the public square of Wittenberg the papal bulls and decretals. The sixteenth century, in its exuberance of intellectual life, was undoubtedly one of the grandest centuries in history; human thought in that glorious epoch shattered its chains, and declared its freedom both in matters of science and of religion.

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.

It is to be lamented that this man of genius did not contribute in any way to the progress of dentistry. His works have no importance for us. As a matter of mere curiosity we only record here that Paracelsus considered the too precocious development of the teeth as a great anomaly, and regarded as monsters those children who were born with teeth.286