Читать книгу A History of Dentistry from the most Ancient Times until the end of the Eighteenth Century - Vincenzo Guerini - Страница 10

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For above 4000 years science and religion among the Chinese, as well as their customs, have remained quite unchanged. The inhabitants of the Celestial Empire can vaunt a most ancient civilization; which is, however, altogether stationary; neither has their medicine made any progress, and its actual state represents with sufficient exactness what it was in primitive ages.

In Europe, various works have been written about the medicine of the Chinese, one of the best being that of Dabry,25 taken from the most celebrated medical books of China,26 and which may be considered as a compendium of the medical science of this people.

In this work we find two chapters relating to our specialty: the first of these (p. 286) speaks of toothache, the second (p. 292) treats of all the other dental and gingival diseases.

The Chinese call the toothache ya-tong, and distinguish a great many varieties of the malady, that is:

1. Fong-je-tong. This kind of toothache is caused by sudden cold, and has the following characteristic symptoms: Red and swollen gums, which after a little time discharge purulent and fetid mucus; abundant salivation; acute pain; swelling of the cheek. It is to be cured with draughts, mouth washes, and various kinds of frictions.

We consider it useless to give the particulars of the various receipts, because Dabry hardly ever translates the names of the drugs of which they are compounded. These formulæ are therefore incomprehensible by most people.

2. Fong-lan-tong. This kind of toothache is also caused by cold. The pain is very great, but the gums are neither red nor swollen.

3. Ye-tong. Is also produced by chill. The gums are red and swollen; there is no discharge of mucus; great pain, which is aggravated by cold liquids. If the malady lasts for some time, the gums end by becoming black, and the teeth are loosened; the pain becomes more intense in spitting. In this stage of the malady the sufferer no longer fears cold drinks, but rather desires them, to soothe the pain. The cure varies according to whether the malady be of recent or of old date; it consists in the use of internal remedies (pills, potions), or of frictions on the part where the pain is situated.

4. Han-tong. This is also owing to the action of the cold. Pains in the cheek and forehead proceeding from the teeth; no diseased condition either of the gums or of the alveoli.

5. Tou-tan-tong. Violent cough and toothache at the same time; difficulty in masticating.

6. Yn-hiue-tong. The gums are pale, or violet-red, hard and lumpy, sometimes bleeding; the toothache is continuous. Among the numerous remedies recommended against this malady (mouth washes, frictions, draughts, pills), one particularly deserves mention: it is the urine of a child used as a mouth wash.

7. Tchong-che-tong. Pain in the teeth after mastication; there is also sometimes excoriation of the gums; flow of purulent mucus mixed with blood; bad-smelling breath; the tooth falls; it is decayed, and one can perfectly well distinguish a small hole; the root is unsound; in extracting the tooth one sometimes brings away together with it a little white worm, with a black spot on the head, which can be distinguished by the aid of a magnifying glass. A remedy must immediately be administered to destroy these worms, otherwise the patient runs the risk of having his other teeth attacked in the same manner, and of their falling out. The remedies against this affection are most numerous, and belong for the most part to the oftentimes cited categories. One of them presents a certain interest, its basis being arsenic.

In Dabry’s book it is described in the following manner: “Arsenic (gr. 1.80), houang-tan (gr. 3.60); pulverize, mix with water, and with a part of the mass form a small pill, which put close to the aching tooth or into the ear, if afraid of the arsenic; then sleep. Cure certain.”

8. Toothache, the effect of general weakness, following principally on abuse of coition. It is to be cured by the use of internal medicine, or by local remedies to be rubbed on the painful spot. Some of the medicaments registered in this paragraph have reference to the special case, in which the teeth are loosened through excess of coition. Among others there is a prescription for a dentifrice powder for strengthening the teeth, to be used every morning.

9. Toothache following on a blow. It is to be cured by using a certain dentifrice powder, composed of six ingredients. Another medicament consists in heating about an ounce and one-half of silver in some recipient, and then pouring wine upon it, and rinsing the mouth with it.

Besides these nine kinds of toothache, the Chinese doctors recognized a peculiar morbid condition of the teeth and their surrounding parts, which is thus described in Dabry’s book:

“It sometimes occurs, after recovery from illness, that convalescents, in order to acquire strength, drink too great a quantity of wine; and that this after a certain time produces a beginning of inflammation of the stomach. In such cases the teeth often fall out, the breath becomes fetid, and if the patient eats hot food, the empty alveoli as well as the cheeks are painful.”

Various internal medicaments and dentifrice powders are prescribed for combating this morbid condition. One of these latter includes a great number of ingredients in its composition; among others, the bones of mice.

Mention is also made of certain remedies, to which recourse may be had at times, for allaying violent dental pains, of whatsoever kind, or whatever be the cause that occasions them.

One of these remedies is composed of different substances (among them, garlic and saltpetre), to be pulverized and made into pills. If the pain be on the left side, one introduces one of the pills into the right ear, and vice versa.

The formula is also given for a very complicated medicated powder, to be snuffed up in the left nostril if the person suffering from toothache be a man; in the right if a woman.

Another powder is to be smelt with the right nostril or with the left, corresponding to the side on which the pain is located.

Abscesses and fistulæ of the gums are spoken of as follows:

“It sometimes occurs that an abscess forms in some one point of the gum; this communicates great pain to the tooth near it; the abscess is white, with discharge of purulent matter.” The treatment consists in the use of different medicated powders, to be rubbed on the affected part. Two of the powders contain musk, besides several other ingredients. A lotion is also prescribed.

In the next chapter the following affections are described:

1. Ya-heou. Gums are red, soft, and swollen, and a fetid and purulent matter exudes from them; the teeth are not painful; if the gums are lanced, blood of a pale red color flows from them in abundance. This malady is to be treated with various internal medicines and sometimes with scarification.

2. Ja-suen. Gums swollen; little by little they are corroded and destroyed by ulceration, which leaves the roots of the teeth bared; the patient has an aversion for hot food; continued pain in the teeth; discharge of purulent and fetid mucus; by the slightest exposure to cold the pain becomes very violent. This affection is to be combated with internal remedies and local treatment (frictions with medicated powders; application of an ointment of very complicated preparation).

3. Tchuen-ya-kan. The gums are painful for a few days; apparition of the root of the tooth; absence of ulceration. Children of five or six years of age are frequently exposed to this malady. The best means of cure consists in the extraction of the tooth. There are, besides, various internal and external remedies prescribed. One of these latter contains verdigris and three other ingredients. Among those to be used internally there is a decoction prepared with twelve different drugs, two of which are mint and rhubarb. The quantity of rhubarb is about seven and one-half grams; therefore, this prescription is certainly intended to act as a purgative.

4. Ya-ting. The right or left gum suddenly swells; a tumor forms of about the size of a grain of sorgo; in the beginning it is red, afterward black; severe pain in the cheek and neck; itching in the cheek; the tumor afterward bursts, giving exit to blood, and becomes black; it ought to be pricked directly (before it opens of itself) with a silver needle; blood of a violet color will flow from it, which should be left free course until it regains its ordinary color. The sufferer has at the same time pains in the stomach, great thirst, abdominal pains, and sometimes even delirium.

5. Ya-jong. Gums swollen and painful, abscess, fever, swollen cheeks; great thirst, and vomiting of a liquid kind; dejections dry. The treatment consists in the methodical use of certain medicines to be used internally, among which is rhubarb. If one neglects to make use of this treatment, an ulceration sets in with discharge of a purulent and sanguine mucus; it is then necessary to rub the part with a medicinal substance called by the Chinese, ping-pang-san. Should the tooth be somewhat loose, it ought to be extracted and the gum rubbed again with the substance just now named.

6. Tso-ma-ya-kan. An illness common to children after the smallpox; ulceration of the gums, which turn black; fetid breath. In certain cases the gums are hard and the mucous membrane of the cheek is also attacked; all the teeth shake; there is flow of blood from the gums, upon which certain spots begin to form that are clearly distinguishable as small holes. These holes must be filled with a particular medicinal substance (named lay-ma-ting-kouei-sse), and, besides, one ought to make use of various other internal and external remedies.

This is a very serious illness. In the case of recovery, the patient ought to abstain from taking any heating aliment for one hundred days.

7. Tsee-kin-tong or tsee-ly-tong. Gums swollen; slight but continuous pain, aggravated by the effort of the wind; the gums become ulcerated little by little, with discharge of purulent and sanguine mucus; and the root of the tooth is afterward seen to be uncovered. This malady is to be treated by means of draughts, pills, mouth washes, and frictions of various kinds.

After the treatise on the maladies referred to above, we find in Dabry’s book a long series of “general remedies for every kind of toothache.” There are about forty of these, and decoctions and powders predominate among them, the latter to be rubbed on the painful spot. Decoctions are the form of medicament most in use among the Chinese. In this list of about forty anti-odontalgic remedies we find as many as eighteen decoctions, seven for internal use, and the others to be employed as mouth washes. Some of the latter are compounded with vinegar instead of with water.

Four remedies of the above list are to be made into a paste and formed into pills, to be applied upon the aching tooth.

Another medicament is also to be formed into pills and applied inside the ear.

The following remedy is particularly worthy of note:

“One roasts a bit of garlic, crushes it between the teeth, and afterward mixes it with chopped horseradish seeds, reducing the whole to a paste with human milk; one then forms it into pills; these are to be introduced into the nose on the side opposed to that where the pain is situated.”

Two other remedies, in powder, are to be snuffed up through the nose.

A powder to prevent the progress of caries is prescribed, with which the tooth should be rubbed every day, or it may be applied on the decayed spot.

Finally, two powders are also prescribed for whitening the teeth. One of these is compounded of seven ingredients, among which is musk; the other has only three substances in its composition: salt (gram 25), musk (gram 1.8), tsang-eul-tsee (gram 36).

A therapeutic method much in vogue among the Chinese is acupuncture, which is used in the treatment of the greatest variety of affections, including those of the dental system. The doctors of the Celestial Empire have the greatest faith in this operation, which they hold capable of removing obstacles to the free circulation of humors and vital spirits, thus reëstablishing that equilibrium of the organic forces which constitutes health, and the absence of which causes disease.

The Chinese doctors prefer to use gold or silver needles for puncturing; but they also frequently use needles of the best steel. These instruments vary very much in length, in thickness, and in form, and there are not less than nine distinct kinds of puncturing needles.

Every doctor who intends dedicating himself to the practice of this operation has to begin by the most accurate study of the elective points for puncturing according to the various affections; he should also know to what depth precisely to drive the needles in each case, in order to reach the site of the morbific principle and procure convenient exit for it; he ought to know equally well how long to leave the needle in the affected part, so as to obtain the best possible therapeutic results in each case.

The points of election for carrying out puncturing in various maladies are spread over the whole superficies of the body, and amount in number to 388. Each of these is known by a special name. Each site of election stands in determinate relations, as to distance, to the known anatomical points, and may, therefore, be easily and precisely found by appropriate measurement. The unity of length for these measurements is called tsun, and is divided into ten fen; its value varies, however, according to whether the said measurements be taken on the head, the trunk, or the extremities. For the head, the length of the tsun is calculated as equal to the distance existing between the inner and the outer angle of the eye; for the trunk, it is equivalent to the eighth part of the horizontal line between the two breast nipples; and for the extremities, it is equal to the length of the second phalanx of the middle finger, measured with the joints bent.

There are twenty-six points of election upon which to carry out puncturing used as a remedy against toothache. There are also six other points of election for pains in the gums.

One would naturally be disposed to believe that these points of election would be situated in proximity to the teeth. Instead, many of them are situated in distant parts of the body—for example, in the elbow, in the hands, the feet, the vertebral region, the coccyx, and so on. However, about half of them are to be found in the labial, maxillary, and periauricular regions.

The puncturing of every point of election is almost always indicated for the cure of not only one but several, and, indeed, very often many, maladies; for example, the puncture carried out on the point of election, kin-tche, situated at the outer extremity of the bend of the elbow, may be utilized in more than twenty-five morbid conditions; among which are pains in the arm, paralysis of the arm, edema of the whole body, excessive perspiring, vomiting, hematemesis, toothache, boils, gastralgia, hemiplegia, and even cholera!

This mode of cure depends on the special relation of each point of election to the so-called canals of transmission and communication (named in Chinese king) through which the blood and the vital spirits circulate, and which serve at the same time to transmit the “innate heat” and “the radical moisture” to all parts of the body.

And here we must be allowed a brief digression in explanation of what we have just said.

The anatomical notions of the Chinese are very erroneous;27 their ideas on the functions of the human body and of human life in general, differ considerably from ours. They recognize two natural principles of vitality, one they call yang (vital, primordial, or “innate heat”), the other yn (radical moisture). The spirits (that is the air) and the blood serve as vehicles to these two essential principles of life; that is, vital heat and radical moisture. The constant equilibrium, the accord, the perfect union of these two essential principles of life constitute a state of health. From their alteration, corruption, or disunion originate all diseases.

There are twelve principal sources of vitality in the human organism; that is, twelve organs from which the two aforesaid vital principles are distributed throughout the body: The heart, the liver, the two kidneys, the lungs, and the spleen are the seat and origin of radical moisture; the large and the small intestine, the two ureters, the gall-bladder, and the stomach are the seat and origin of vital heat. These twelve sources of life are in intimate relation with one another by means of the canals of communication, through which the blood and the vital spirits (air) circulate, carrying with them into every part of the body vital heat and radical moisture.28

The points of election upon which to carry out puncturing are situated along the course of the large lines of communication and transmission; and that explains, according to the Chinese medical theories, why a puncture carried out on a given point of the body can prove useful in relieving a variety of maladies even in distant parts of the organism.

Puncturing is almost always associated with cauterization, for after having drawn out the needle, it is usual to cauterize the site of the puncture with the so-called “moxa,” that is, with a kind of vegetable wool obtained from the leaves and dried tips of the artemisia. One compresses this substance very tightly between the fingers into the shape of a small cone. One next applies a small coin with a hole in the centre upon the site of election; the cone of moxa is placed on the hole in the coin and lighted at its top. As the cone is very compact, it burns slowly enough, without developing excessive heat, so that, according to Ten Rhyne,29 who was an enthusiast for this mode of cure, “the epidermis is drawn without violence and rises gently into a small blister. The moxa, whilst burning, draws out the peccant humors visibly, absorbing them in such a manner that they are totally consumed without destroying the skin itself.”

The application of the moxa is not as painful as might be thought, and even children support it without much crying. The number of times for repeating the operation varies according to the malady and the site of application, etc. Thus, in the point kin-tche, which we have mentioned once before, the cauterization is generally repeated seven times, but in certain cases the number may be brought up to 200.

There are certain points of election for which puncturing alone is prescribed without subsequent cauterization; in other instances, the puncturing is held to be unnecessary or even dangerous; one, therefore, only applies the moxa in these cases.30

In Japan, the moxa was still more in use than in China. According to Ten Rhyne, from the remotest times the moxa has been the best and almost the sole mode of treatment for illness in Japan, and was regarded not only as an excellent remedy, but also as an excellent preservative; so much so that even convicts condemned to perpetual imprisonment had permission to go out every six months to undergo this cure.

Dental affections also were especially treated with the moxa, and, judging by what Ten Rhyne says on the subject, it would seem that this caustic, when used against toothache, was usually applied in the region of the mental foramen.31