Seeing that Heinrich Meibom was born twenty-eight years before William Cowper, and was already known to the scientific world when Cowper was still a child, it is very probable that his operative method, having come to the knowledge of the latter, was only followed up and perfected by him.
Charles St. Yves (1667 to 1733), oculist in Paris, records an interesting case of a secondary affection of the maxillary sinus. The point of departure of the evil was an abscess in the orbit. The suppurative process, after having produced an erosion and the perforation of the orbital plane, had reached by propagation the antrum of Highmore, whence the pus took its way, issuing through the nose. St. Yves had a molar tooth extracted on the affected side (we do not know which side it was), after which, day by day, he made injections of detersive liquids through the orbital fistula, which returned constantly through the alveolus of the extracted tooth. By this means the cure of the patient was obtained.[388]
Christopher Schelhammer (1649 to 1716), who was professor in various German universities, and distinguished himself specially as an anatomist and as an ear doctor, strongly recommends stopping decayed teeth as the best means of causing pain to cease. If, however, the stopping does not hold, by reason of the cavity being too extended, it is then necessary, says Schelhammer, to extract the tooth; this, however, may very well be stopped after extraction, and then replanted, for it will take root again, but no longer be the cause of any pain.[389]
Pierre Dionis, a celebrated surgeon and anatomist of Paris (died 1718), in his Anatomie de l’homme,[390] admits the possibility of a double dental series, holding the case, however, to be of very rare occurrence.
Another work of his, entitled Cours d’operations de Chirurgie, wherein he treats very extensively of diseases of the teeth and mouth, and their surgical cure, is of much more importance in relation to dentistry. He recognizes the high importance of this part of surgery, but expresses the opinion that one of the dental operations, that is the extraction of teeth, ought to be left entirely to the tooth-pullers, not only because they are, by reason of great practice, better qualified to perform it than general surgeons, but also because the output of force required for this tooth-pulling operation renders the hand heavy and tremulous, and, lastly, because, according to him, it always has something of charlatanism about it. (This is a luminous example of how preconceived ideas can influence the minds even of men of the greatest talent.)
Pierre Dionis, like many of the preceding authors, had frequently occasion to observe cases of epulis. He speaks at great length of the treatment of this affection, as well as of parulis, but says nothing on the subject of sufficient importance to be worth recording.
Dental operations, according to Dionis, are of seven kinds:
1. The opening of the dental arches in the case of spasmodic constriction of the jaws. This operation, of the greatest importance for nourishing and keeping patients alive, is carried out by means of a lever and of a screw dilator.
2. The cleaning of the teeth. For this, as for the other operations, says Dionis, a certain amount of skill is required. The author advises the use of gold instruments if one be called upon to clean the teeth of persons of rank. This appears rather strange in the present levelling times, but Pierre Dionis lived in the days of Louis XIV, whose doctor he was, that is, in a period of unbridled luxury, when the nobles and those in power would have nothing in common with the lower classes.
3. Operations for the preservation of the teeth. These, says Dionis, are of the greatest importance, it being necessary to oppose a barrier to the destructive processes of the teeth. Caries, when so situated as to permit of it, ought to be scraped away; for approximal caries one ought to have recourse to the file; in the case of caries of the triturating surfaces, cauterization should be used, by applying a drop of oil of vitriol with a miniature paint brush. Should the caries, however, be in a very advanced stage, it is better to make use of the cauterizing iron. But in cases of intense and persistent pain there is no other remedy than extraction.