If the gums are much swollen, in near relation to the molar teeth, the use of the red-hot iron, says Fabricius, becomes very difficult from the want of space, and from the close vicinity of the healthy parts, which must not be injured. In such a case, it is necessary to remove, with suitable cutting instruments, as much as is possible of the morbid tissue (caro crassa et putrida); then to cauterize the remaining part, making the cautery, if necessary, pass through a tube, so as not to injure the surrounding parts. When, however, the gingival swelling bleeds very easily, and its excision thus might give rise to a profuse hemorrhage, it will be best to perform the operation with cutting instruments heated red-hot.
Fabricius remarks that although other authors do not make any allusion to these large gingival excrescences, he had had occasion to observe several cases, and had also had various instruments especially constructed for their cure.[325]
Johann Heurn, or in Latin Heurnius (1543 to 1601), of Utrecht, in his book on the diseases of the eyes, ears, nose, teeth, and mouth, treats sufficiently at length of dental diseases and their cure, but without adding anything of importance to what had been written by preceding authors. His work is a mere compilation, which would be without any importance whatever if it did not serve to show what credit was still given at that period to all the errors and prejudices which are to be found in the writings of the ancients.
Heurnius, although he wrote a long time after Vesalius, still adheres, in regard to the number of teeth, to the already mentioned opinion of Aristotle; he says, in fact, that women rarely have thirty-two teeth like men.[326]
He warns those who suffer from odontalgia not to have recourse thoughtlessly to tooth-drawers, but to recur, instead, to the doctor, who will always treat the affection according to the cause on which it depends.
And here the author repeats the numerous distinctions found in many preceding writers, and especially in Arculanus. The pain may be located in the gums, in the dental nerve, or in the very substance of the tooth; and in each of these cases it may depend on warm or cold matter, on dryness, humidity, etc.
A Dutch dentist. (From a picture of the XVI century.) By Lucas Van Leyden.
The method of treatment must vary in all these cases; and in regard to this the author enters into minute particulars, commencing with dietetic cure—which itself must be varied according to the causes of the affection—and then treats of all the other therapeutic means—purgatives, bloodletting, revulsives, local narcotic or resolvent medicaments, and so forth. The letting of blood was, it seems, a very favorite method of cure; not only were the veins of the arm opened, but also those of the tongue, of the gums, of the lips, and of the ears!