In a special pamphlet, published in 1764,[486] Bourdet treats of the diseases of Highmore’s antrum. To facilitate the exit of pathological humors from the sinus, after the Cowper operation, he introduced a small cannula, forked at one end, into the antrum and fixed the two branches of the fork to the neighboring teeth by tying.
In some diseases of the maxillary sinus (polypus, sarcoma, etc.) Bourdet recommends cauterizing.
Besides his principal work, the pamphlet on the diseases of Highmore’s antrum, and some others of less importance, Bourdet wrote an excellent book on dental hygiene,[487] which had the honor of two translations, one German, the other Italian; the latter published in Venice in 1773.
This celebrated author inveighs bitterly against charlatans and quack dentists, and throws light on all their impostures. It appears, however, that in the midst of this despicable class, so justly condemned by him, there existed a courageous though unscientific operator, to whom posterity would have attributed due honor had his name been handed down, for he was the first, in all probability, to try the implanting of teeth in artificial alveoli. This is, at least, what we deduce from a passage in one of Bourdet’s works, in which we read that a charlatan sought to impose on the public the belief that he could make a hole in the jawbone and plant therein an expressly prepared artificial tooth, which in a brief space of time would become perfectly firm and as useful as a natural one. Bourdet adds that an attentive investigation led to the recognition of the said tooth being simply that of a sheep. It would appear, therefore, that the operation had been in reality performed, it matters but little whether with the tooth of a sheep or with one of another kind.
Jourdain was another eminent writer on dental matters, at this period. Rather than a true surgeon-dentist like Fauchard and Bourdet, Jourdain was a general surgeon who had dedicated himself with particular predilection to the study and treatment of oral and maxillary diseases. And precisely for this reason his writings, although of great scientific importance, are far from possessing for dental art, properly so-called, the same value as the works of Fauchard, Bourdet, and other great dentists of the eighteenth century. His works, as Geist-Jacobi justly observes, give us the impression of his having been a theorist rather than a practical dentist.
In 1759 Jourdain described in the Journal de Médecine[488] an improved pelican and another instrument to be used for straightening teeth inclined inward. Two years later he published his treatise on the diseases of Highmore’s antrum and on fractures and caries of the maxillary bone.[489] After this, appeared his book on the formation of the teeth.[490] He therein describes with great accuracy the dental follicle from its first appearing to the moment of birth, following it throughout its evolution. This lengthy book is most interesting, for it is not a mere compilation, but gives the results of personal research and experience. But by far the most important of all the works of this author is his treatise on the diseases and surgical operations of the mouth.[491] This book went through several French editions, was translated into German in 1784, and has had, besides, two English editions in America of comparatively recent date, that is, at Baltimore in 1849, and at Philadelphia in 1851; all of which proves the great value of the work; it treats, however, much more of general surgery of the mouth and neighboring regions than of dental art properly so called. The first volume of 626 pages is almost entirely dedicated to the diseases of the maxillary sinus, which, for this author, were ever the object of favorite and particular study. He is not in favor of carrying out irrigation of the antrum through the mouth, even when an alveolar opening has resulted spontaneously through the extraction of a decayed tooth; he prefers instead, whenever this is possible, the reopening of the nasal orifice, by means of sounds and cannulæ adapted for the purpose, that is, varying in thickness and in length, and curved according to the necessities of the case. The natural opening of the antrum being reëstablished, one irrigates the cavity through it by means of a cannula to which a small syringe has been screwed. When the teeth are sound, notwithstanding the diseased condition of the antrum, Jourdain is absolutely contrary to the performing of the Cowper-Drake operation. When, on the contrary, the malady owes its origin to decayed teeth, Jourdain extracts them, but, as already said, carries out the detersive and medicated injections through the natural opening.
The author divides the collections of the maxillary sinus into purulent and lymphatic. The purulent are painful and corrode the bone, the lymphatic are not painful and do not corrode the bone, but distend and soften it, producing external tumefaction which yields to pressure, and, on this being diminished, gave out a characteristic sound. These so-called lymphatic gatherings referred to by Jourdain are none other than mucous cysts of the maxillary sinus. Also the other diseases of Highmore’s antrum (polypi, etc.) are taken by this author into attentive and minute consideration.
The second part of the work is dedicated to the other diseases of the maxillary bones (especially of the inferior one), as well as to those of the lips, cheeks, salivary ducts, gums, frenum linguæ, etc. Dental hemorrhage and difficult dentition are also spoken of in this volume.
The author relates, with regard to the latter subject, that he had observed, in corpses of infants who had succumbed to a difficult dentition, that the crowns of the erupting teeth were covered by the alveolar margins folded upon them. This, according to him, must be the reason why even lancing of the gums proves useless in some cases of difficult dentition; it is therefore necessary, whenever it is possible to recognize the existence of this state of things, to destroy the bony margins that oppose the erupting of the teeth; the author declares that he has frequently done this, with fortunate results.
In 1784 Jourdain published a treatise on artificial dentures.[492] He therein specially speaks of a complete denture with four springs, perfectly adapted to the purpose of mastication. The author attributes the merit of its invention to Massez, who had imagined it toward 1772. If we may judge, however, by what Joseph Linderer says,[493] this denture appears to have been too complicated, even when compared with those described by Fauchard.