Читать книгу A History of Dentistry from the most Ancient Times until the end of the Eighteenth Century - Vincenzo Guerini - Страница 7

Table of Contents

Among the people of ancient times, the Egyptian nation was, without doubt, the one in which civilization first took its rise and had its earliest development. From the time of Menes, first King of Egypt (3892 B.C.), the inhabitants of the valley of the Nile were well advanced on the path of civilization, and under the fourth dynasty, dating from 3427 years before the Christian era, they had already attained a high degree of progress.

Medical art and science in every country have always progressed in proportion to the general civilization, for the treatment of disease is one of the first and most important manifestations of civilized life. It is therefore natural that the healing art should have flourished earlier in Egypt than elsewhere, that is, in the midst of the oldest civilized people.

There, as in other countries, medicine was practised for some time only by the sacerdotal caste; but not all the members of this caste were doctors and priests at one and the same time; there was a special class among them, called “pastophori,” whose mission it was to cure the sick.

Our knowledge of medicine as practised among the Egyptians of old is now no longer limited to the scanty notices handed down to us by Greek and Roman writers. The researches made by students of Egyptian lore have placed original medical writings in our hands, now already partly interpreted, that permit us to form a sufficiently exact idea of the science of Medicine in ancient Egypt.

These valuable documents, denominated papyri, from the material on which they are written, now exist in great numbers in the Berlin Museum, in the British Museum, and in those of Leyden, Turin, Paris, and other cities; but the most important of the papyri treating of medical subjects is certainly the papyrus of Ebers, in the library of the Leipzig University.1 This very valuable papyrus—the most ancient of all known works on Medicine—is the best written of all the Egyptian medical papyri, and is also the best preserved and most voluminous. In size it is 30 centimeters high, 20 meters long, and the whole text is divided into 108 sections or pages, each one of about 20 to 22 lines. The celebrated Egyptian scholar, Prof. George Ebers, procured it, toward the beginning of the year 1873, from an inhabitant of Luxor, in Upper Egypt. He published a beautiful edition of it two years later in Leipzig; and in 1890 Dr. Heinrich Joachim published a German translation of the whole papyrus, with an introduction and explanatory notes.

The Ebers’ papyrus is written in hieratic characters. We here reproduce some passages of it, so as to give our readers an idea of the style of writing.2

Lepsius and with him the greater part of Egyptologists are of opinion that the Ebers’ papyrus is not an original work at all, but simply a copy of medical writings of still earlier date, belonging to different epochs, and which were collected and reunited to form a kind of manual on medicine.

Fig. 1

Part of Ebers’ papyrus in Egyptian hieratic characters containing three dental prescriptions..

From some indications existing in the papyrus itself, Ebers has been able to argue, with quasi certainty, that the papyrus was written toward the year 1550 B.C. But some parts of it have their origin in a far more remote epoch; they go back, that is, to thirty-seven centuries or more before the Christian era. In fact, at page ciii of the Ebers’ papyrus3 one reads:

“Beginning of the book about the treatment of the uxedu in all the members of a person, such as was found in a writing under the feet of the God Anubis, in the city of Letopolis; it was brought to His Majesty Usaphais, King of Upper and Lower Egypt.” Now, as Joachim remarks, the Usaphais herein named was the fifth king of the first Egyptian dynasty, and he reigned toward 3700 before the Christian era. Hence, it may be argued that some, at least, of the writings from which the Ebers’ papyrus was taken were composed in the very remote epoch to which we have just alluded, or perhaps still farther, for it is impossible to know whether the book, deposited by unknown hands at the foot of the statue of the God Anubis, had been written but a short time previous or at a much earlier epoch.

Fig. 2

Part of Ebers’ papyrus in Egyptian hieratic characters containing eleven dental prescriptions.

Dental and gingival maladies are in no way neglected in the Ebers’ papyrus. At page 72, a remedy is prescribed “against the throbbing of the bennut blister in the teeth,” then two other remedies “to cure the bennut blisters in the teeth and to strengthen the flesh (gum).”

It is somewhat difficult to say what is meant by bennut blisters; but perhaps it means small, gingival abscesses of dental origin. The first of the above remedies—probably meant to calm the pricking or throbbing pain that, in such cases, often accompanies the dental malady—consisted of:

“Seps-grains	Part 1
Dough	” 1
Honey	” 1
Oil	” 1
To be applied on the part as a plaster.”

The other two remedies, very likely intended for the cure of dental fistulæ, were to be used as masticatories. The first consists of:

“Fennel seeds	Part 1
Dough	” 1
Anest-plant	” 1
Honey	” 1
Incense	” 1
Water	” 1”

The other was still more complicated and thus compounded:

“Dâm-plant	Part 1
Anest-plant	” 1
Incense	” 1
Amaa-plant	” 1
Man-plant	” 1
Saffron	” 1
Aloe wood	” 1
Annek-plant	” 1
Cyperus	” 1
Onion	” 1
Water	” 1”

At page 89 of the papyrus4 we find two other remedies, having the same object, that is, “to cure the bennut blisters in the teeth and to strengthen the flesh.”

The first is compounded in this way:

“Cow’s milk	Part 1
Fresh dates	” 1
Uah corn	” 1
To be left stand and then to be masticated nine times.”

This is the second receipt:

“Anest-plant	Part 1
Dough	” 1
Green lead	” 1
Sebests5	” 1
Cake	” 1
Dâm-plant	” 1
Fennel seeds	” 1
Olive oil	” 1
Water	” 1
To be used like the preceding one.”

In this same page 89 many other remedies corresponding to various indications are prescribed.

“To strengthen the teeth:
Powder of the fruit of the dum-palm	Part 1
Green lead	” 1
Honey	” 1
To be mixed and the teeth rubbed with it.”

The following is another remedy for the same purpose:

“Powder of flint stones	Part 1
Green lead	” 1
Honey	” 1
To be rubbed on the teeth.”

Next comes a remedy “to cure the growth of uxedu in the teeth,” that is:

“Dough	Part 1
Beans	” 1
Honey	” 1
Verdigris	” 1
Green lead	” 1
To be powdered, mixed, and applied on the teeth.”

The word uxedu recurs more than thirty-five times in the Ebers’ papyrus, in relation to affections of the most different parts of the body. By confronting all the passages of the papyrus in which one finds the word uxedu, Joachim deduces that it does not indicate any special disease, but has the general signification of “a painful swelling.” According to Geist-Jacobi, by “growth of the uxedu in the teeth” may be understood an alveolar abscess and the consequent swelling of the surrounding parts.

Another remedy is intended for “the cure of the tooth that gnaws unto the upper part of the flesh.”

The translator of the papyrus remarks that by the “upper part of the flesh” is to be understood the gum. The remedy would, therefore, correspond to the indication of curing a tooth “that gnaws or gives pain unto the gum.” But as one sees, even putting it in these words, the meaning is anything but clear. Perhaps the destructive action of the carious process, reaching as far as the gum, is what is here meant to be alluded to. Meanwhile here is the receipt:

“Cumin	Part 1
Incense	” 1
Onion	” 1
To be reduced to a paste, and applied on the tooth.”

Besides the remedies already given, the two following are prescribed for strengthening the teeth:

“Incense	Part 1
Verdigris	” 1
Green lead	” 1
Mix and apply on the tooth.”

The other is compounded of:

“Water	Part 1
Absinth	” 1
To be used as above.”

We next find a formula, preceded by this very vague indication: “Chewing remedy for curing the teeth.”

“Amaa-plant	Part 1
Sweet beer	” 1
Sut-plant	” 1
To be masticated and then spit on the ground.”

Another masticatory is intended to “strengthen and cure the teeth,” and is compounded thus:

“Saffron	Part 1
Duat-plant	” 1
Sweet beer	” 1
To be masticated and then spit on the ground.”

Finally, we have a medicament “for curing the gnawing of the blood in the tooth.” It is complicated enough, being compounded with:

“The fruit of the gebu	Part ⅓2
Onion	” ⅙4
Cake	” 1/16
Dough	” ⅛
Anest-plant	” ⅓2
Water	” ½
One leaves it to stand and then chews for four days.”

But what meaning is to be attributed to the “gnawing of the blood in the tooth?”

It is almost certain that this figurative expression referred to the pain deriving from caries and pulpitis. It may have had its origin in the observation of two phenomena, that is, first of all, the pulsating character which the pain alluded to often assumes, and the eventual issuing of blood from the cavity of a tooth affected by caries and pulpitis, when the pulp is exposed. At any rate, the Egyptian doctors of remotest antiquity undoubtedly did not ignore the presence of blood in the interior of the tooth.

From what we have related, it clearly appears that at that remote epoch many remedies were already in use for combating dental affections. These must consequently have been frequent enough, which demonstrates the erroneousness of the opinion held by some, who affirm, as does Mummery,6 that in ancient times diseases of the teeth were extremely rare.

Besides this, it is fully evident, from the Ebers’ papyrus, that at the time in which this was written, dental pathology and therapy were still in a very primitive condition, and formed a part of general medicine, from which they showed as yet no tendency to separate; so true is this, that the remedies intended for the treatment of the teeth do not constitute a special section of the work, but are to be found among medicaments of an altogether different nature. Thus, at page lxxii of the papyrus7 we find, first, three remedies against the itch; then five remedies for the cure of pustules in various parts of the body; next an ointment and a potion for the bennut blisters in whatever part of the body they may occur; after this, three medicaments against the bennut blisters of the teeth; and lastly, a plaster for curing crusts and itching in whatsoever part of the body.

One finds no mention of dental surgery in the Ebers’ papyrus. No conclusions could be drawn from this fact if the work only spoke of medical treatment, for then it might reasonably be supposed that the compiler had purposely occupied himself with this subject only; but, on the contrary, the Ebers’ papyrus frequently makes mention of operative interventions, and among these, of the use of the knife and of the red-hot iron for the treatment of abscesses and of certain tumors. Therefore, there being no mention made in the papyrus of any dental operation, not even of extraction, gives us reason to suspect that at that remote epoch no surgical operation was carried out on the teeth, and that, as yet, no instruments existed for practising extraction.

In the time of the celebrated historian Herodotus, of Halicarnassus, who lived in the fifth century previous to the Christian era (about from 500 to 424 B.C.), that is, more than a thousand years after the time in which the Ebers’ papyrus was written, the dental art in Egypt had made remarkable progress, and was exercised by specialists. In fact, in the second book of Herodotus we find the following passage: “The exercise of medicine is regulated and divided amongst the Egyptians in such a manner that special doctors are deputed to the curing of every kind of infirmity; and no doctor would ever lend himself to the treatment of different maladies. Thus, Egypt is quite full of doctors: those for the eyes; those for the head; some for the teeth; others for the belly; or for occult maladies.”8

Having here had occasion to refer to the History of Herodotus, we will quote two passages of this famous work, which have a certain interest for our subject;

“Whilst the tyrant Hippias, after having been driven out of Athens (510 B.C.), was marching against Greece at the head of the Persian army and had already arrived at Marathon, he happened one day to sneeze and to cough in a more vehement manner than usual; and he being already an old man, and his teeth all shaking, a violent fit of coughing suddenly drove one of them out of his mouth, and it having fallen into the dust, Hippias set to work, with great diligence, to search for it; but the tooth not coming to light, he drew a long sigh, and then said, turning to those who were standing by: ‘This land is not ours, neither shall we ever be able to have it in our power; what clings to my tooth is all of it that will ever belong to me.’ ”9

In another part of the History, that is, in the ninth book, Herodotus recounts as follows:

“When the corpses buried after the battle of Platea were already despoiled of their flesh, a curious fact was seen; for the people of Platea having collected the bones of those who had perished, there was found amongst them a skull altogether devoid of commissures, and composed of one single bone. A jaw was also found, the teeth of which, comprising the molars, appeared to be made all of one piece, as though composed of a single bone.”

Relative to this last passage of Herodotus, we may remark, as does Stark, that the total synostosis of the skull bones is certainly very rare, but that, nevertheless, one has authentic examples of the same, not only in ancient but also in relatively modern times, witness the famous skull of Albrecht von Brandenburg, surnamed the German Achilles, who died in 1486, and was buried in the monastery of Heilbronn. As to teeth united together and forming a single piece, no example exists save in very ancient authors, for instance, in Valerius Maximus, who recounts a similar marvellous fact of Prusia, King of Bithynia, and in Plutarch, who attests to a similar fact in the person of Pyrrhus, King of Epirus.

It is very difficult to establish within what limits the activity of the dentists alluded to by Herodotus was displayed. It has been affirmed by some that dental art in ancient Egypt was very far advanced, and that not only the application of artificial teeth, and even of pivot teeth, but also stoppings, were practised by the Egyptian dentists of those days. Here are some data on this subject:

Joseph Linderer10 tells us that, according to Belzoni11 and others, artificial teeth made of wood and very roughly fashioned have been found in Egyptian sarcophagi.

George H. Perine, a dentist of New York, in an article on the history of dentistry,12 says: “Both filled and artificial teeth have been found in the mouths of mummies, the cavities in the former stopped with gold and in some cases with gilded wood. Whether these fillings were inserted during life for the purpose of preserving the teeth, or after death for ornamentation, it is, of course, impossible to say. That the Egyptians were exceedingly fond of embellishing their persons with gold ornaments and bright colored materials is a fact which has been clearly established, and the discovery of mummies—of exalted personages no doubt—some organs of which were gilded and embellished with showy colors proves that their fondness for display accompanied them even to the grave.” To this may be added, that after an embalmment of the highest class13 it was usual to gild the eyebrows, the point of the nose, the lips, and the teeth of the corpse, and place a gold coin between the teeth, or cover over the tongue with a thin gold plate.

Dr. J. G. Van Marter, a dentist in Rome, in an article on prehistoric dentistry,14 writes, among other things, that the renowned archæologist, Mr. Forbes, had seen mummies’ teeth stopped with gold.

The great defect of all the assertions referred to is that of not being accompanied by any element of proof, wherewith to demonstrate their truth. When, for example, we are told that Mr. Purland possesses, in his collection of antiquities, a tooth pivoted on to the root of a mummy’s tooth, the question suggests itself naturally: If this tooth is, as it appears, separated from the jaw of the mummy to which it is said to have belonged, how can we be certain that the tooth itself is really that of a mummy? Until sufficient proof of this be furnished, we cannot but consider the above assertion as absolutely without value.15

The same may be said as to the assertions of Wilkinson and Forbes with regard to mummies’ teeth stopped with gold. Where and by whom were these mummies found? And where are they preserved? Was the stopping, too, verified at the time of the finding of the mummy, in such a manner as to exclude all possibility of fraud, or was it discovered afterward, in circumstances such as to suggest the possibility of a mistification? It has, in fact, been reported16 that the pretended Egyptian stopping in a mummy existing in an English museum was nothing else than a practical joke, carried out, besides, in a very awkward manner.

In opposition to the above assertions, we have the most absolute contradictory statements on the part of the most competent authorities.

The celebrated Egyptologist, Prof. George Ebers, has only been able, in spite of the most accurate research, to arrive at completely negative results in all that has reference to the dental art of the ancient Egyptians.17

The distinguished craniologist Prof. Emil Schmidt, of Leipzig, who owns a collection of several hundred mummies’ skulls, writes thus on the question now before us: “In no jaw have I ever found anything that could be attributed to the work of dentists: no fillings, no filing or trepanning of teeth, no prosthesis.”18 Virchow, who also examined a great many Egyptian skulls, among which were several belonging to royal mummies, did not find any indications of dentists’ work;19 and Mummery, as well, although he made the most conscientious researches on this subject, could not arrive at any positive results whatever.20

Between the affirmations of some and the negations of others, it is very difficult to say on which side the truth lies. For my own part, I fail to find that there is the least proof of the ancient Egyptians having known how to insert gold fillings and still less to apply pivot teeth. But at the same time I think it cannot be doubted that the Egyptian dentists knew how to apply artificial teeth. And even though it may not be possible to demonstrate this by direct proof, one is equally prone to admit it when one considers, on the one hand, the remarkable ability of the ancient Egyptians in all plastic arts, and, on the other hand, the great importance they attributed to the beautifying of the human body; so much so, that even in so ancient a document as the Ebers papyrus, one finds formulæ for medicaments against baldness, for lotions for the hair, and other kinds of cosmetics. Is it likely, therefore, that so refined and ingenious a people should not have found the means of remedying the deformity resulting from the loss of one or more front teeth?

Fortunately, however, we are not bound to content ourselves with simple suppositions, for a well-authenticated archæological discovery made in the month of May, 1862, has put us in possession of an irrefutable proof.

The discovery to which we allude is registered in Renan’s Mission de Phénicie, and was the result of researches made in the necropolis of Saida (the ancient Sidon) by Dr. Gaillardot, Renan’s colleague in his important scientific mission. In a grave in one of the most ancient parts of the necropolis, Dr. Gaillardot found, in the midst of the sand that filled the grave, a quantity of small objects, among which were two copper coins, an iron ring, a vase of most graceful outline, a scarab, twelve very small statuettes of majolica representing Egyptian divinities, which probably formed a necklace, to judge by the holes bored in them. But among the objects found (which, together with that we are about to mention, are now in the Louvre at Paris), the most important of all is “a part of the upper jaw of a woman, with the two canines and the four incisors united together with gold wire;21 two of the incisors would appear to have belonged to another individual, and to have been applied as substitutes for lost teeth. This piece, discovered in one of the most ancient tombs of the necropolis, proves that dental art in Sidon was sufficiently advanced.”22

Fig. 3