After a lengthy enumeration of medicaments to be used against toothache, which we pass over in silence because already known, the author speaks of two remedies which carry us back absolutely to the days of Pliny! He relates us a fact experienced by himself, that, by touching an aching tooth with the leg of a frog completely cleaned of the flesh, the pain ceases altogether. Also, if the aching tooth be touched with the root of a tooth extracted from the jaw of a corpse, the pain ceases, the tooth becomes as cold as ice, and often, after a certain time, it falls to pieces.
As to worms, the best mode of destroying them is by using bitter substances, such as myrrh, aloes, colocynth, centaurea minor, etc., but sometimes the use of sweet substances, such as honey, is a good means of drawing them out of the carious cavities!
Musitano also cites a great number of remedies against the setting on edge of the teeth. Among the best of these he mentions urine applied to the teeth whilst still warm! Alkali in general, and particularly lye, such as is used for washing purposes, are good remedies against the setting on edge of the teeth.
The treatment of loose teeth ought to vary according to whether this pathological condition depends on old age, or on scurvy, on syphilis, on superabundance of humors, etc. Sometimes, especially in old persons, it may be useful to bind the teeth with gold wire, in order to prevent their falling out, but this operation must be very ably performed, otherwise it may give rise to inflammation.
Relative to artificial teeth, Musitano says that they are made of ivory or hippopotamus tusks; of these last he does not speak as of a novelty; we may, therefore, deem it probable that hippopotamus tusks were used in Naples for making artificial teeth even before the Dutchman Anton Nuck (contemporary of Musitano) made mention of them in his writings.
In cases of difficult dentition, the best remedy, according to Musitano, for facilitating the eruption of the teeth consists in friction of the gums, once, or at most twice, with blood drawn fresh from the comb of a cock! If, however, even this remedy fails to produce the desired effect, it will then be necessary to lance the gum at the point where the tooth is to erupt, or to press it hard with the thumb, that the tooth may the easier come through.
The sole merit of this author (as to what concerns our specialty) consists in his having declared bleeding useless, or even harmful in the treatment of toothache, and, besides, in his having recommended, with great warmth and in most impressive terms, cleanliness of the teeth. What is more beautiful, says he, than a mouth furnished with white teeth, similar to so many pearls? And what is more abominable than black or livid teeth, covered with a fetid deposit or with tartar? Unclean teeth spoil the appearance of the person, and nauseate those who behold them.[383]
William Cowper (1666 to 1709). Toward the end of the seventeenth century the celebrated English doctor and anatomist, William Cowper, opened up a new field of action to oral surgery by inaugurating the rational treatment of the diseases of the maxillary sinus. In order to empty Highmore’s antrum of deposits and to be able to carry out the necessary irrigations, he extracted in most cases the first permanent molar, and then penetrated through its alveolus into the sinus with a pointed instrument.
James Drake, also an Englishman and a contemporary of Cowper, operated in the same manner; and it was this author who made known in a book of his[384] the operative method of Cowper; for which reason the above-mentioned proceeding is sometimes called “the Cowper-Drake operation.” A certain time elapsed, however, before it became generally known. Thus, in a book published by Johann Hoffmann in 1713 there is no mention made of this operation, albeit the author refers therein[385] to the case of a young girl, one of whose canine teeth having been extracted by him, there ensued a considerable flow of whitish pus from the maxillary sinus. In speaking of this case, Hoffmann stigmatizes many of the surgeons of his time who were not acquainted with the existence of Highmore’s antrum, and therefore, in cases of patients whose teeth had fallen out as an effect of syphilis, if they happened to penetrate with the sound into the maxillary sinus, believed this to be an accidental excavation of the bone, produced by caries.
However, the honor of having initiated the rational treatment of diseases of the maxillary sinus is not exclusively due to William Cowper and to James Drake; a large share is also due to the celebrated German physician and anatomist, Heinrich Meibom. The mucous membrane of the maxillary sinus was considered by him as the real point of departure of the diseases which occur in this cavity, it being liable to become inflamed and to suppurate, thus giving rise to much pain and to various accidents. Meibom rejects the operation of Molinetti, that is, the trepanning of the cavity from the front, the lesion produced in the soft parts of the face being likely to give rise to unpleasant consequences. “Some, he adds, try the introduction of medicated vapors into the antrum,[386] but the best way is to open the maxillary sinus by extracting a tooth, as the pus generally makes its way as far as the roots of the teeth.”[387] The author says that his father, who was also a physician, had already used the above method with success. He does not speak at all of the artificial opening of the antrum by perforation; but, as is well known, this is not necessary in many cases, so that, even now, the operation is sometimes reduced to procuring the opening of the sinus by the simple extraction of a tooth, as was, in fact, practised by Heinrich Meibom and his father.