Lorenz Heister.
CHAPTER XII.
THE EIGHTEENTH CENTURY.
Although there have been, even from the most remote times, individuals who have dedicated themselves exclusively to the cure of dental maladies, or to repairing the losses of the dental system by artificial means, and notwithstanding the progress gradually accomplished in this branch of the medical art, which progress was especially remarkable during the sixteenth and seventeenth centuries, it is not to be denied that, up to the beginning of the eighteenth century, dentistry was, in great part, considered one with medicine and surgery in general. It is but natural that dental art (and the same may be said of every special branch of medicine) could not assume a real individuality until it had attained to the higher grades of its development. As a matter of fact, dentistry, toward the end of the seventeenth century, was already a true specialty, although it counted but few worthy representatives at that time. The definite separation between the science and art of dentistry and general medicine and surgery, although it may have been retarded, could not fail to take place; and this, as we shall presently see, was effected by the celebrated French dentist Pierre Fauchard.
But, to remain faithful to chronological order, we will first speak briefly of some other writers.
Ludwig Cron, a barber of Leipsic, in a pamphlet published in 1717, with the title The barber’s apprentice versed in bleeding and tooth pulling,[397] declares, in a still more emphatic and general way than De Lavauguyon, that it is useless to detach the gum before proceeding to extract a tooth. This barber, strong in his own experience, dares to assert absolutely useless this ancient practice, advised first by Cornelius Celsus, and recommended after him, and in homage to his authority, by many other writers. It is, therefore, possible that even previous to Cron and De Lavauguyon many operators had dispensed with the practice recommended by Celsus, although this had become an accepted canon of the high medical profession.
Lorenz Heister (1683 to 1758), of Frankfort-am-Main, one of the most celebrated surgeons of the eighteenth century, wrote a dissertation on toothache,[398] treating besides very extensively of dental affections and their cure in a masterly work on surgery, published for the first time in 1718, and which went through numerous editions in various languages.
When the caries of a tooth is superficial, Heister advises the removal of the decayed part with the file; or, when the caries is deep down, the cavity ought first to be well cleaned with a toothpick or other like instrument, then filled with heated white wax, or mastic, the stopping being renewed as often as may be necessary. When a molar tooth is decayed, especially in the centre, the best way, says Heister, is to fill it with gold or lead leaf, or with a piece of the latter fitting into the cavity. If the carious cavity of a painful molar cannot be cleaned as it ought to be, the dropping of a little oil of cloves or of cinnamon or of guaiacum into it will be found useful, or even a few drops of spirit of vitriol; for in this manner one obtains at the same time the double advantage of destroying the impurities contained in the carious cavity and of soothing the pain. But if by chance the pain should persist, recourse must be had to the cauterizing iron, or to extraction. Sometimes, however, even the most violent toothache can be made to cease, either by scarifying the gums (a method already recommended by Pliny), by cauterizing the antitragus, or by pressing the aching tooth hard between the fingers, as Schelhammer[399] and some other writers had advised.
Heister writes at length on the extraction of teeth, on the indications and counterindications appertaining thereto, on the instruments with which the operation should be carried out, and so on. Regarding the position of the patients, he thinks it best to place them on a low seat or on the ground, if the tooth to be extracted is situated in the lower jaw, but if an upper tooth is to be extracted, patients should be placed on a chair or on a bed.