Lamorier and Russel, contemporaries of Jourdain, also studied the diseases of the maxillary sinus, and published in the Mémoires de l’Académie de Chirurgie, vol. iv, several important cases of polypi and other diseases of the antrum. Lamorier is not in favor of the Cowper-Drake operation. He recommends perforating the antrum immediately above the first molars, or rather between it and the malar bone. In this he seems to have been influenced by the considerations that the wall of the cavity here presents the least thickness, and that this is the most dependent part of the sinus. But he did not always deem it necessary to make a perforation here, when a fistulous opening had previously formed in some other place. His method of operating is as follows: The jaws being closed, the angle of the mouth is drawn outward and slightly upward with a curved instrument called by the author a speculum; this done, the gum is incised below the molar apophysis and the bone laid bare, and then pierced with a spear-pointed punch. The opening is afterward enlarged if found necessary.
Several contributions to the knowledge of the diseases of the maxillary sinus and their treatment were made about this time by Beaupréau, Dubertrand, Caumont, Dupont, Chastanet, Doublet, David, and especially by Thomas Bordenave, who published an important work on this subject, collecting a great number of clinical cases of great interest. Speaking of the Cowper-Drake operation, he expresses the opinion that the tooth to be extracted is not the same in all cases, for if some one of the teeth situated below the maxillary sinus should either show signs of decay or be the seat of persistent pain, the choice should fall upon that one. If, however, these teeth are all apparently sound, the one should be chosen that, under percussion, is most sensible to pain. In those cases in which the choice is altogether free, Bordenave prefers the extraction of the first large molar, for the double reason that it is generally situated in correspondence to the central part of the cavity, and that it is separated from the antrum by a very thin osseous lamina. In certain cases, the maxillary sinus is divided, by body lamellæ, into various cavities, and then, as one easily understands, it may be necessary to extract more than one tooth for the evacuation of the pathological contents. When the teeth situated below the antrum have fallen out, or have been extracted some time, and their alveoli are in consequence obliterated, it will be better to have recourse to Lamorier’s method. This method may besides be useful, according to Bordenave, either when all the teeth are sound and it would consequently be a pity to sacrifice any of them, or in special cases (such as large polypi of Highmore’s antrum, extraneous bodies, etc.) in which the Cowper-Drake operation would not afford sufficient space.
L. B. Lentin, a German, in 1756, published a pamphlet[494] in which he recommended electricity as a means of cure for toothache. Other writers recommended the use of the magnet, which means of cure had already been advised for various affections by Patacelus. During the latter half of the seventeenth century, Talbot, J. J. Weckes, and P. Borelli related several cures of headache and toothache by the use of the magnet. In the eighteenth century F. W. Klaerich, a medical man in Göttingen, wrote that he had used the magnet advantageously in not less than 130 cases of toothache.[495] We find it recommended later by others, Brunner, and particularly J. G. Teske, who, in 1765, wrote a pamphlet entitled New experiments for the curing of toothache by means of magnetic steel.[496]
He considers the use of the magnet as the most efficacious of all remedies against toothache, and believes its action to be similar to that of electricity.
In the following year, however, the belief in the new means of cure was sensibly shaken by F. E. Glaubrecht, who declared that although the magnet calms or causes the cessation of the pain at first, it returns constantly and with much greater violence.[497] The curing efficacy of the magnet in cases of toothache was highly vaunted in France by Condamine.[498]
Pasch attributes the effects of the magnet to the chill produced in the parts to which it is applied; in proof of this he adduces the fact that if the magnet becomes heated by being kept some time in the hand, it loses its efficacy altogether, whilst on the other side one may obtain the very same beneficial results with a simple steel spatula, just on account of the action of the cold; finally, he adds that the chill produced by the magnet on the affected part explains very well not only the good, but also the bad effects which it produces in many cases, such as increase of the pain, inflammation, tumefaction, and even at times spasmodic contractions.[499] Thenceforth the enthusiasm for the magnetic cure diminished gradually, all the more so inasmuch as that shortly after the celebrated English dentist Thomas Berdmore ridiculed it by placing it in the same class as charms, exorcisms, and other foolish and superstitious means of cure.[500]
Adam Anton Brunner. One of the most distinguished German dentists in the second half of the eighteenth century was Adam Anton Brunner. His two principal works are the Introduction to the science necessary for a dentist,[501] and the Treatise on the eruption of the milk teeth.[502]
This author falls into various errors with regard to deciduous teeth. According to him they are twenty-four in number, and without roots; but these may develop in those milk teeth which in exceptional cases remain in their places after the period in which they generally are shed.
A milk tooth, says Brunner, ought never to be extracted unless there be manifest signs of the presence of the corresponding permanent tooth, or when it is painful and decayed. Badly grown teeth can often be put in order solely by the pressure of the fingers frequently repeated, but when this is not sufficient, one must have recourse to waxed threads or to special contrivances.
In applying a pivot tooth, he screws the pivot to the artificial crown and perforates the root canal only just sufficiently to admit the other extremity, which he drives in by little strokes of a hammer upon the crown, without its being necessary to use cement. We learn from this author that in his time there were turners and other craftsmen who occupied themselves with dental prosthesis.[503]