However, this is not so; the author treats of instrumental extraction as a very important operation, without being at all afraid of being reproved for contradicting himself. Besides, to anyone who thus reproved him he perhaps would have answered, without being disconcerted, that it is not always possible to have the fat of frogs or the dung of crows in readiness.
The extraction of a tooth is only justifiable, says Gaddesden, when all the remedies employed against odontalgia have proved useless and when, on the other hand, the pain has its seat in the tooth itself and not in the nerves or gums. Before undertaking the operation, however, the patient must be prepared for it with an evacuant cure, that is, by injections and purgatives. For the operation itself the author recommends the same rules given by Celsus, and says, besides, that the head of the patient ought to be held firm by an assistant. In certain cases, the extraction can be performed, better than with the forceps, by means of an instrument in the form of a lever, broad at one end, narrow and sharpened at the other. But when a tooth is very firmly seated, its extraction is always dangerous; therefore, in such a case, Gaddesden recommends, before having recourse to the operation, the use either of acrid substances, such as the milky juice of the euphorbiaceæ (for example, of the tithymal), or else of a red-hot iron; and this, for the purpose of promoting the fall of the tooth, or of rendering it, at least, so far movable that it can be extracted without any difficulty.
Guy de Chauliac, the greatest surgeon of the middle ages, was born about 1300, in a little village on the confines of Auvergne, which still preserves the name of Chaulhac; he died in 1368. This author immortalized his name by a work which even up to the eighteenth century was, as it were, the official code for the teaching of surgery. Guy wrote his Chirurgia magna in barbarous Latin—such as was then used by the learned; but his book was soon translated into French, Provençal, and afterward also into Italian, English, Dutch, and Hebrew. E. Nicaise, who, in 1890, gave to the scientific world a very valuable new edition of Guy de Chauliac,[231] and who made very accurate researches on all that regards this author and his work, has succeeded in finding in the libraries of Europe and America as many as thirty-four manuscript copies of the High Surger.[232] The survival of so many copies, in spite of all the destructive agencies which have been in action during more than 500 years, is a very clear proof of the wide diffusion which this work obtained even before the invention of printing.
Guy’s work was printed for the first time in 1478, and the editions that have been published since then in various countries are in all about 130.
This book is very important for our subject, since we may gather from it very clearly the condition of dentistry in the fourteenth century; but, on the other hand, we see from it, with equal clearness, that this branch of the healing art had not made any progress from the time of Abulcasis to that of Guy de Chauliac (about two centuries and one-half), and that this most famous surgeon did not contribute anything worthy of note to the development of dentistry.
On the anatomy and physiology of the teeth Guy de Chauliac expresses himself very briefly: “Teeth are of the nature of bones, although they are possessed of sensibility, due to some nerves which the third pair sends to their roots. The number of these latter may vary from one to four, according to the different teeth. The uses of these organs are well known.”[233]
Worthy of being recorded are the names which Guy gives to the different kinds of teeth. After having said that these latter are generally thirty-two, but sometimes only twenty-eight, he adds, that the sixteen teeth of each jaw are divided into: deux duelles, deux quadruples, deux canines, huiet maschelieres[234] et deux caisseaux (in the barbarous Latin: duo duales, duo quadrupli, duo canini, octo molares et duo caysales). So that the two middle incisors were then called duales; the lateral incisors were called quadrupli, because, together with the middle ones, they formed a series of four teeth. Guy gives the name of caysales (caisseaux) to the last two molars; but Joubert, one of the translators and commentators of Guy de Chauliac, tells us that the molars in general were called in Languedoc caisseaux: “Les cinq molaires sont appelées en Languedoc caisseaux, parce qu’elles servent à casser les choses dures, comme les noix et semblables.” In regard to the canines of the upper jaw, we learn that they were called oeillères (eye teeth), because their root was believed to reach near the eye.[235]
According to Guy de Chauliac, les dents sont engendrées non seulement en l’enfance, ains aux autres ages.[236] And this passage was commented by Joubert in the following note, which we reproduce textually:
“En Languedoc, près de Pezenas y a une gentil femme, nommé Mademoiselle de Lobatiere, dès long temps vieille édentée, à laquelle (comme tesmoignent beaucoup de gens très-dignes de foy) environ l’an 70 de son age, sont sorties cinq ou six dents nouvelles. Le conciliateur tesmoigne avoir veu, à qui les dents perdues devant l’an 60 ont été derechef engendrées, moindre toutes fois que les premieres et plus foibles.”[237] (In Languedoc, near Pezenas, there is a lady named Mademoiselle de Lobatiere, who having been for a long time old and toothless (according to the testimony of persons well worthy of belief), at about the age of seventy got five or six new teeth. The Conciliator[238] testifies to having seen teeth grow anew—smaller, however, and weaker than the first—in persons who had lost them before the age of sixty years).