Scribonius Largus mentions alum among his remedies; and we may remark, by the way, that this medicine is recommended for toothach by many of the earlier modern authorities. (V. Guido de Cauliaco, vi, 2.)
Celsus delivers very judicious instructions for the treatment of toothach. He circumscribes the use of wine, enjoins restricted diet, and food which does not require mastication; then fomentations of hot water by means of sponges are to be applied to the tooth, and so forth. If the pain is more violent, the belly is to be opened, hot cataplasms applied, and some warm liquid retained in the mouth, and often changed. The liquid may be a decoction of some narcotic, such as poppies, mandragora, and hyoscyamus. He praises hot oil applied by means of a probe wrapped round with wool. He also mentions compositions containing pellitory, alum, bitumen, and mustard. He directs us not to be in haste to extract the tooth.
Aëtius gives a variety of applications for removing teeth without an operation. One of them contains red arsenic; another sori and the juice of spurge. Modern dentists are ignorant of such remedies. His account of the nerve which supplies the teeth with sensibility is accurate, but borrowed from Galen.
Octavius Horatianus, like our author, affirms that the juice of spurge (tithymallus) will make the teeth fall out. For the same purpose he likewise praises the power of pellitory and mugwort. After Hippocrates he approves of the application of small bags containing salts or millet.
The medicinal substances recommended by Marcellus, the Empiric, are the same as those already mentioned. He praises strongly a composition consisting of acrid vinegar, alum, and cedar rosin, boiled to the consistence of honey and applied to the carious tooth. To prevent hollow teeth from falling out he directs us to fill the hole with the gum which grows upon the ivy. The juice of poppies pounded in a woman’s milk and applied to a carious tooth is said to remove the pain instantly. As a dentifrice he recommends finely-powdered glass with spikenard.
Cælius Aurelianus recommends abstinence, rest, and rinsing the mouth with some astringent decoction containing white poplar, mandragora, poppies, henbane with vinegar, hot oil, milk and honey, and the like. He applies bags containing hot flour. If the pain does not abate, venesection is to be had recourse to, a cupping-instrument applied near the affected part, and the belly opened afterwards by a clyster. Sometimes the gums are to be scarified or separated from the teeth by means of a scarificator. Respecting anodyne medicines, he remarks that they diminish sensibility, but do not remove pain. He says, like the other authorities, that the juice of the tithymallus, or spurge, breaks the teeth—“dentes infringit.” He disapproves very much of early extraction, and mentions that Herophilus and Heraclides of Tarentum relate cases of persons who had died in consequence of this operation. He says that in the temple of Apollo at Delphos there hung a tooth-extractor of lead, which was meant as a hint not to exert great force in extracting teeth. For bleeding of the gums he recommends alum with honey, and the like.
Serapion, like the Greek authorities, mentions a variety of remedial means for diseases of the teeth. One of his prescriptions consists of burnt alum, with vinegar, salt, and sumach. When the pain is violent he directs us to fill the hole with opium or some other narcotic. Avicenna recommends general bleeding, the application of leeches to the gums, opening the ranal veins, and cupping below the chin. His compositions contain opium, burnt alum extinguished in vinegar, galls with vinegar, and the like. He mentions the juice of tithymallus, and several other substances, as possessing the property of making the extraction easy.
Avenzoar recommends in particular bleeding from the ranal veins. Mesue’s general treatment is very judicious, but similar to that of our author and the others. He also makes mention of alum and vinegar. He says that some apply the actual cautery to the tooth. Haly directs us to heat two needles red hot, and then, having dipped their extremities in oil, to burn the hole of the tooth with them. He recommends us to fill the hole with a composition consisting of pellitory, sal ammoniac, opium, and wax. Some of his applications contain arsenic. That this article would deaden sensibility, and might destroy the vitality of the diseased parts, we can readily suppose, but of course it would require to be used with extreme caution. Certainly not more than two grains should be used, and every precaution ought to be taken to prevent the patient from swallowing his saliva. Haly, like most of the others, makes mention of alum. Alsaharavius recommends general bleeding, cupping, scarifications, and leeches; then warm vinegar, or some warm anodyne infusion, is to be held in the mouth; or the part fumigated with the vapour of water in which opium, camphor, or henbane has been boiled. He speaks also of the actual cautery. Rhases recommends bleeding, cupping, alum in vinegar, opium, henbane, &c.
The dentifrices and applications to the gums recommended by the Arabians are similar to those of the Greeks. See in particular Haly Abbas (Pract. v, 78); Rhases (Cont. v); and Alsaharavius (Pract. viii, 2.) Like our author’s, theirs contain such astringents and aromatics as balaustine, sumach, galls, spikenard, wild mint, cinnamon, salt of gem, and the like. The pumice-stone in particular was much used for this purpose; but, as Dr. Hill remarks, it is apt to hurt the enamel.
On ranula. Aëtius, Actuarius, and most of the other authorities recommend similar applications. They consist of astringents and escharotics.