A History of Dentistry from the most Ancient Times until the end of the Eighteenth Century. Vincenzo Guerini
on this treatise of Hippocrates. He says, among other things, that the doctor’s shop ought to be spacious and furnished with wide openings, to let in abundance of light. These medical stations to which the sick and infirm repaired in great numbers to ask advice, to undergo operations, or receive medical dressings, must have been of great importance, as is to be presumed from the cited books of Hippocrates and Galen.
The greatest doctors of antiquity practised the medical art in these places. It is also said that the great philosopher and naturalist, Aristotle, who came of a race of doctors, had inherited a doctor’s shop of great value, but that notwithstanding this he refused to dedicate himself to the medical profession.
The doctors’ shops were at the same time real pharmacies, where doctors prepared medicines, and where all the remedies then in use, either simple or compounded, were kept and sold to the public. Besides, there were to be found instruments of every kind and articles for medicating; and, therefore, bandages, compresses, lint, sponges, cupping glasses, cauteries, knives, bistouries, lancets, sounds, needles, hooks, pincers, files, saws, scrapers, splints, appliances for replacement of luxated bones, speculums, trepans, apparatus for fumigation, trusses, and a thousand things besides.
Naturally, dentistry was also practised in these shops, either by doctors who occupied themselves with dental maladies as with those of any other part of the body, or, later on, by individuals who dedicated themselves exclusively to this specialty.
Medicine and surgery were exercised, however, not only in doctors’ shops, but also at the patients’ houses, and it was Hippocrates who especially inaugurated clinical medicine—that is, the practice of visiting patients in their beds.
But we must not digress from our argument.
Many observations relative to the teeth are to be found in the seven books of Hippocrates on Epidemics. Unfortunately, the observations are not always given in clear and precise terms, which principally depends on the fact that these books consist for the most part of simple and most concise notes, written by Hippocrates on cases observed by him, and not intended for publication under such form, but rather constituting the material for further work.
Here is a passage from the fourth book on Epidemics, which reveals Hippocrates’ extraordinary power of observation, for even teeth that had fallen out were minutely examined by him, to the end of acquiring precise ideas on the anatomical conformation of these organs, held by him to be of the highest importance.
“In the youth suffering from a phagedenic affection in the mouth, the lower teeth fell out, as well as the front upper ones, which left a cavity in the bone. The loss of a bone in the roof of the mouth causes depression in the middle of the nose; the falling out of the upper front teeth sometimes causes a flattening of the point of the nose. The fifth teeth counting from the front ones had four roots (two of which were almost united to the two contiguous teeth), the points of which were all turned inward. Suppurations arising from the third tooth are more frequent than from any of the others; and the dense discharge from the nose and pains in the temples are specially owing to it. This tooth is more apt to decay than the others; but the fifth does so, as well. This tooth had a tubercle in the middle and two in the front; a small tubercle in the internal part, on the side of the other two, had first begun to decay.58 The seventh tooth had only one large, sharp-pointed root. In the Athenian boy, there was pain in a lower tooth on the left, and in an upper one on the right. When the pain ceased, there was suppuration of the right ear.”
This last fact—of the suppuration of the ear—is mentioned by Hippocrates not as a simple coincidence, but as a fact intimately connected with the cessation of the toothache. This may be argued from the general ideas of Hippocrates in regard to the beginning and the resolution of diseases. He considers a malady to be produced by a humor, which becomes localized in a given point of the body. The crisis gives exit to the peccant humor,59 and the mode in which this is evacuated constitutes the critical phenomenon; the same may be represented either by a profuse perspiration, by abundant urine, by diarrhea, by vomiting, by expectoration, by bleeding or discharge of other humors from the nose, by the issuing of pus from the ear, and even by deposits on the teeth.60 If by effect of organic sympathies the morbid humor, instead of being thrown outward, be transported into another region of the body, this constitutes the so-called metastasis.
The hints just given will serve to render some of the passages which we quote from the works of Hippocrates more intelligible.
In the fourth book on Epidemics we find among other clinical cases the following:
“Egesistratus had a suppuration near the eye. An abscess manifested itself near the last tooth; the eye directly got quite well; there was a dense discharge of pus from the nostrils; and small, rounded pieces of flesh were detached from the gums. It seemed as though a suppuration at the third tooth were going to take place, but it went back; and suddenly the jaw and the eye swelled up.”61
And farther on one reads:
“In Egesistratus the two last teeth were decayed in the parts where they touched one another. The last had two tuberosities above the gum, one on the decayed side, the other on the opposite side. In the part in which the two teeth were in contact with one another there were two roots in each, large and similar, and corresponding to those of the contiguous tooth; on the other side there was only a half root62 and rounded.”
Toward the end of the fourth book on Epidemics, we find repeated an observation which we have already noted:
“The third upper tooth is found to be decayed more frequently than all the others. Sometimes a suppuration is produced all around it.”63
In the following passage mention is made of a mouth wash against toothache, the basis of which is castoreum and pepper:
“In consequence of a violent toothache the wife of Aspasius had her cheeks swollen up; but on making use of a mouth wash of castoreum and pepper she found great relief.”64
A little after we find the practice of bleeding mentioned; and contemporarily an allusion to the use of alum—with regard to a painful swelling of the gums, that is to say, a gingivitis:
“Melisandrus suffered severe pain and swelling of the gums; he was bled in the arm. Egyptian alum, if used in this malady, arrests its development.”65
Toward the commencement of the sixth book the following observation is registered:
“Among those individuals whose heads are long-shaped, some have thick necks, strong members and bones; others have strongly arched palates, their teeth are disposed irregularly, crowding one on the other, and they are molested by headache and otorrhea.”66
While we should be tempted to attribute the knowledge of the relations between malformation of the skull, ogival palate, and bad arrangement of the teeth to quite modern studies, we are obliged to admit, and to our great surprise, that these relations were already noted, twenty-four centuries back, by the great physician of Cos.
In the seventh book on Epidemics, a case of scorbutus is described, where incense and a decoction of lentils proved useful against the lesions of the buccal cavity:
“… Large tubercles, of the size of grapes, had formed on the gums close to the teeth, black and livid, but not painful, except when the patient took food. For the mouth, incense powder mixed with some other ingredients proved useful. The internal use of the decoction of lentils also did good to the ulcers of the mouth.”67
In the same book there is a passage in which Hippocrates warns against the use of origanum, as harmful to the teeth and eyes:
“Origanum in drinks is harmful to affections of the eyes, and also to the teeth.”68
Farther on a case of necrosis of the jaw is mentioned:
“Cardias, the son of Metrodorus, by reason of pains in the teeth was subject to mortification of the jaw. Excrescences of a fleshy kind formed on the gums, that grew most rapidly; the suppuration was