If looseness of the teeth follows a blow, it is well, first of all, to let blood, and then to use astringents and excitants. When all this is of no avail, Guy advises that the loose teeth be tied to the healthy ones with a little gold chain,[247] after the manner of Abulcasis. And if, says he, the teeth fall out, they may be replaced with teeth of another person, or with artificial teeth of ox bone, fixing them in their place with a fine ligature; and, he adds, that such teeth are serviceable for a long time. Here are the precise words of the text: “Et si les dents tombent, qu’on y mette des dents d’un autre, ou qu’on en forge d’os de vache, et soient lisez finement, et on s’en sert long-temps.”
This extremely concise manner of treating dental prosthesis, summing all up in some thirty words, is in strong contrast with the usual fulness of explanation and methodical accuracy of Guy de Chauliac, to whom, very justly, could be given the title of founder of didactical surgery. Such a strange contrast cannot be explained, unless by admitting that Guy considered dental prosthesis as foreign to the general plan of his book, that is, as something which did not directly concern surgeons, and for which, therefore, a mere allusion ought to be sufficient. Without the slightest doubt, dental prosthesis was practised neither by doctors nor surgeons, but by the dentatores.
Abulcasis, too, certainly for the same reason, is extremely brief in speaking of artificial teeth, but, on the other hand, he very minutely describes the process of ligating loose teeth. Guy omits this description entirely, and only alludes briefly to this therapeutic practice. From this it is easy to perceive that whilst Abulcasis considered this operation within the province of surgeons, Guy de Chauliac was disposed to exclude it from the field of general surgery, considering that this, too, like the other dental operations, belonged to the dentatores. In his days, in short, dentistry had become much more clearly specialized than it was in the days of Abulcasis.
After having spoken of the looseness of teeth, Guy de Chauliac goes on to treat of caries, in a short chapter, entitled “De la Pourriture, des vers, de corrosion et pertuifement des dents.”
The method of cure, he says, is double, viz., universal and particular. The general treatment embraces the hygienic and therapeutic means already mentioned. As to the particular or local treatment, it consists, first of all, in washing the teeth with aqua vitæ or with a vinous decoction of mint, salvia, melissa, pepper, or pyrethrum. Then it is necessary to fill the carious cavity with gallia[248] and root of cyperus,[249] mastich, myrrh, sulphur, and camphor, wax, ammoniacum, asafetida and the like. As may be seen, Guy does no more than mention the substances used in his days for the filling of carious teeth, and does not tell us what various combinations were formed with the said materials, nor the proportions in which they were used. In short, he does not give us any formula for the composition of a filling mass, and from this may be inferred, without fear of error, that this operation also was never performed by him, consequently it, too, was not practised by doctors and surgeons, but rather by the dentatores.
When the aforesaid means of cure—that is, the mouth washes and the filling—are of no use, Guy advises the margins of the carious cavity being taken away with a scalpel and file, so that alimentary substances may not be retained inside it. However, here are his words, which seem especially to refer to cases of interstitial caries:
“Si ces choses n’y valent rien, la dent soit esbuschaillee avec un ciseau et lime,[250] e qu’on luy fasse un passage, à ce que la viande ne s’arreste au trou.” If advantage is not even derived from such an operation, recourse must be had to cauterization, or, if necessary, to extraction.
Even Guy de Chauliac believes in the worms of the teeth, and against these he recommends the usual fumigations. He advises that the seeds of leek, onion, and hyoscyamus be mixed with goat’s tallow and made into pills of a dram each in weight, one of which is to be used for each fumigation: “Si dans le trou il y a un ver, apres le susdit lavement,[251] la dent soit suffumiguée avec une graine de porreau et d’oignon et semence d’hyosciame, confits avec suif de bouc; et qu’on en fasse des pilules chacune d’une drachme et qu’on y en employe une à chaque fois.”
In the following chapter Guy treats “De la limosite et laide couleur des dents.” Here, too, he recommends, before all, the general hygienic rules above mentioned. Besides, he advises the mouth being rinsed with a vinous decoction of wild mint and of pepper, and then the use of the following dentifrice:
“℞—Cuttle-bone, small white seashells, pumice stone, burnt stag’s horn, nitre, alum, rock salt, burnt roots of iris, aristolochia, and reeds. All these substances must be reduced to powder together, or each one separately.” Use may also be made of a liquid dentifrice thus prepared: