Gnaeus Marcellus Empiricus, of Burdigala (Bordeaux), who lived at the end of the fourth century and at the beginning of the fifth, wrote a book, De medicamenti, which shows, more than anything else, the decadence of the medical science in those days. Regarding the diseases of the teeth and their cure, Marcellus does not tell us anything new. He freely copies Scribonius Largus and other authors, not adding anything save a few methods of cure, which are exceedingly strange and superstitious. To get rid of toothache, it is sufficient that the patient, when the moon is waning, and in the days of Mars (Tuesday) or of Jupiter (Thursday), repeat seven times the words argidam, margidam, sturgidam. It is a great pity that a curative method so simple and easy be efficacious in two days of the week alone, and even then on condition that the moon be waning.
The following method is also a very good one: Whilst in the open country, one must take a frog by the head, open its mouth and spit into it, then having begged the animal to take the toothache with it, must replace it on the ground and let it free. To remove loose teeth easily, it is necessary to keep in reserve some juice of black ivy mixed with a little green oil; in case of necessity, the nose of the patient must be anointed with it, and after having drawn a deep inspiration, he must put a little stone between his teeth, and stay with his mouth open, inclined a little forward, so as to let all the morbid humor flow out, which sometimes flows very abundantly and even may reach to three herminæ.[185] Having afterward rubbed the nose with pure oil, and washed the mouth with wine, the teeth will be free from every pain and may be very easily pulled out. If the root[186] of a tooth be rubbed with dried African sponge, the tooth will fall out within three days; naturally, says the author, care must be taken not to touch, whilst doing this, any healthy tooth. He who desires never to be subject to pain in the teeth, may obtain this end by the following method: When at the beginning of spring he sees the first swallow, he must go in silence to some running water, take some of it in his mouth, rub his teeth with the middle fingers of both his hands, and say: “Hirundo, tibi dico, quomodo hoc in rostro iterum non erit, sic mihi dentes non doleant toto anno.”[187]
The same must be done each following year, so as to continue to enjoy the effects of such a cure!
Adamantius, an Alexandrine philosopher and physician, who probably lived in the fourth century, paid much attention to the diseases of the teeth, as may be argued from two chapters of the Tetrabiblos of Ætius. One of these chapters is entitled, according to the Latin translation of Giano Cornario: “Cura dentium a calido morbo doloroso affectorum, ex Adamantio, sophista.”[188] This writer clearly belonged to the pneumatic school, founded as early as 69 A.D. by Athenæus of Cilicia. According to the pneumatics (so called, because they admitted the existence in the animal organism of an aëriform principle, pneuma, to which they attributed great importance), heat and dryness gave rise to acute maladies; the phlegmatic affections generally arose from humidity, and melancholy was brought on by cold and dryness, as every object dries up and becomes cold on the approach of death. The author says that the cure must vary according as the disease affects in a greater degree the gums or the teeth themselves with or without participation of the dental nerves and neighboring parts. He makes, in regard to this, many subtle distinctions; but the remedies which he counsels do not offer to us any special interest, being almost identical with those that had been recommended by Galen and by other doctors prior to Adamantius. The latter also gives much importance to dietetic therapy; he prescribes that such patients should nourish themselves with pottages of barley, or of spelt, with eggs, lettuce, pumpkins, and other cooling food, abstaining, however, from wine.[189]
The author enumerates among the causes of such dental affections the dryness of the air, the autumnal season, the dry constitution of the individual, a troubled life, and scanty nourishment. The use of sour and piquant substances is not favorable to these patients, so much so that the mulberry preserve produces, not unfrequently, violent dental pains in them. Adamantius, therefore, advises, in such cases, not to use strongly astringent mouth washes, but rather lenitive, moistening, and emollient substances; simple lukewarm water, decoction of bran, licorice juice, starch with boiled must of wine diluted with warm water, milk, especially asses’ milk, decoction of mallows and the like.[190]
The work of Adamantius from which Ætius has taken the above-mentioned chapters is lost to us. Of his writings there only remain to us the treatise on the winds and the one on physiognomics. In this latter book the author attributes great importance to the canine teeth as physiognomonic elements, and from their shape and size he makes deductions in regard to the character of the individual.
Oribasius (316 to 403), the most celebrated of all the compilers who appeared during that long period of decadence, wrote, by order of the Emperor Julian the Apostate, whose physician and friend he was, a whole medical encyclopedia and later on a summary (synopsis) of this same work of his. In the books of Oribasius are found many things about dentition and diseases of the teeth, but they are all taken, substantially, from preceding authors, and therefore it is not worth while repeating them.
Ætius of Amida, a celebrated Greek writer on medicine, lived at the end of the fifth century, and at the beginning of the sixth, and has also left us a kind of medical encyclopedia, which, being divided into four sections, each composed of four books, was called Tetrabiblos. He teaches that the mucous membrane of the gums, tongue, and mouth is provided with nerves from a portion of the third pair of cerebral nerves, and that the teeth, too, by a small hole existing at the end of every root, receive tiny ramifications of sensitive nerves, having the same origin. The nutrition of the teeth is understood by Ætius in the following way: The nourishment which reaches the dental nerves is not entirely assimilated by them; these only appropriate the liquid or soft part and reject the drier part. This accumulates in the alveoli, becomes by degrees more tenacious and denser, finally being transformed into osseous substance and forming the nutriment of the teeth; these, therefore, tend to grow continually, although the waste arising from the mechanical action of mastication prevents them from undergoing any real or visible growth. On the other hand, in the old, from the weakening of the nutritive functions, the teeth become thin and loose, and finally fall out.[191]
Ætius advises that during dentition hard objects to chew should not be given to children, seeing that the gums being hardened by these and becoming almost callous would render the cutting of the teeth very difficult.[192]
For curing parulides, he recommends emollients at the beginning of the disease, and later on astringents. But if the inflammation of the gums does not resolve and passes into suppuration, he prefers to perform the excision of the parulis, instead of making a simple incision, which might very easily cause the abscess to change into a fistula.[193]