Paré’s palatine obturator without sponge.
In the last chapter of Book XVIII, first dentition and the treatment required during this period are spoken of. The cutting of teeth, says Paré, is accompanied by pain, itching, and pricking of the gums; often, as well by diarrhea, fever, epileptic convulsions, which sometimes end fatally. The symptoms by which it may be known that teeth are about to come forth are as follows: The wet-nurse feels the mouth of the suckling infant to be hotter than usual; the gums are swollen; the child is restless, crying often and sleeping but little; it emits a quantity of saliva from the mouth, and frequently puts its fingers in its mouth, trying to rub its gums, and soothe, in this way, the pain and itching which it feels. It is then necessary to treat the nurse as if she had fever, and the infant should be suckled less than usual; some cooling and thirst quenching drinks should be given to it—for a child in such conditions suffers from intense thirst; the nurse should often rub the gums of the little patient with softening and soothing substances, as, for example, oil of sweet almonds, fresh butter, honey, or mucilage made from the seeds of the fleawort or of the quince; the brains of a hare (these may be roasted or boiled) have not only a very soothing action, but also, according to a very ancient belief shared by Paré, possess the occult property of aiding the cutting of the teeth. But oftentimes, neither these nor other remedies are of any use, because the gums are too hard and the teeth cannot cut their way through at all; the tension of the gums then produces very violent pain, fever, and other accidents, death even supervening in some cases. The author, therefore, advises lancing the gums deeply, just above the tooth which ought to appear, thus opening it a way, that it may more easily come out. He relates that he has performed this operation on his own children in the presence of many medical authorities.
Almost as if to show the high value of this operative procedure, Paré tells the case of a child, the son of the Duke of Nevers, who died at the age of about eight months without having cut any teeth. He, together with other doctors, was invited to carry out an autopsy. No lesion whatever was found sufficient to cause death, but the gums were very hard, thick, and swollen; an incision into them showed that the teeth were ready to come out, if only their eruption had been facilitated by lancing at the right time. Paré and the other doctors were of the unanimous opinion that death was caused solely by the impossibility of cutting the teeth on account of the hardness of the gums.
Among the many strange cases given in Book XIX (Des monstres et prodiges), Paré also speaks—trusting to the word of Alexander Benedetti—of the case of a woman, who, after the complete loss of her teeth caused by age, cut them all again at eighty years of age.
Although Paré treats so amply and with such competence all that concerns dental diseases and their cure, he does not make the least allusion to the stopping of teeth, beyond recommending, as had already been done by Celsus, that when a tooth that is to be extracted shows a large cavity, the latter should be well filled with linen or lead, so that the tooth be not fractured under the pressure of the instrument and so leave the root behind in the alveolus.
A century before Ambroise Paré, Giovanni d’Arcoli had already mentioned the filling of teeth with gold leaf, and, as we have seen already, there is very good reason to believe that the practice of this operation dated back to a still earlier period. How is it, then, that the illustrious French surgeon does not say a word about this? Very probably stoppings were not at all in use among French dentateurs and perhaps, even in Italy, this operation was only rarely carried out.
Jacques Houllier (1498 to 1562), a celebrated French physician and surgeon, also known under the Latinized name of Jacobus Hollerius, was the first to stand out, although timidly, against the theory of dental worms. He did not decidedly deny their existence, this having been affirmed by so many illustrious writers; he, however, speaks of them as if the point were a doubtful one: “It is said that worms are generated in the teeth, which corrode the teeth themselves, and produce a pain which is not very violent and causes itching with little or no salivation (vermes ajunt subnasci dentibus, et hos corrodere, à quibus dolor non ita fortis, pruriginosus, nulla aut pauca salivatio).”
But even while putting in doubt the existence of dental worms, he believes it his duty to enumerate the various remedies, recommended for their destruction. As to fumigations with the seeds of the hyoscyamus, Houllier, declares that what is believed by the common people, and what has been written by doctors of antiquity about worms being killed and seen to fall from the teeth by the effect of these fumigations, is all nonsense. In fact, he says, when the seeds of the hyoscyamus are burnt there fly away from them what appear to be little worms, even if the fumes do not reach the worm-eaten tooth. (Quod autem vulgus sibi persuadet, et ab antiquis medicis scriptum est de suffumigio è semine hyoscyami, videtur fabulosum. Nam inde ajunt manifeste vermes excidere. Re vera, incenso semine, evolant tanqua vermiculi, etiam si non attingit fumus vermiculosum dentem.)