University of Maryland Baltimore Dental School - Mirror Yearbook (Baltimore, MD)

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INTRODUCTORY LECTURE Delivered before the Class of the Baltimore College of Dental Surgery At the opening of its first session, November 3, 1840 by Chapin a. Harris, M.D., Professor of Practical Dentistry In enccrinj; upon the duties ot the chair, to which I have been called, in the Baltimore College of Dental Surgery, allow me to observe, that howsoever much of interest or curiosity the establish- ment of this institution — the first of the kind that has ever existed, either in this or any other country — may have awakened, it consti- tutes an era in the history of a most useful and valuable depart- ment of medicine; and if it be properly conducted, cannot be other- wise than productive of great good. Practiced as this branch of surgery too frequently has been, and in many instances even is at the present day, by individuals not having been specialty educated for it, it is little better than a wide spread system of quackery; and that under such circumstances unfavourable results should often be experienced, is most reasonable to suppose. Few facilities have hitherto existed for obtaining the necessary preparatory instruc- tion, and it has only been by unwearied industry, and patient per- severing toil, that those who have obtained respectability and use- fulness in the profession, acquired the information that enabled them to do it. But of the number now engaged in its practice, few comparatively, have thought it necessary, or had the ambition to attempt to surmount the obstacles that presented to the acquisition of a thorough and scientific knowledge of the art. Rather than do this, the majority have been content to exercise its duties the best way they could — seeming to care little, whether the principles upon which they practiced were correct, or the services they rendered their patients of value or not, but depending more, for public notoriety and favour, upon artful management, than skill; they, as in too many instances has been the case, have sought the former to the neglect of the latter. Of the qualifications necessary to be possessed by a dental prac- titioner, and the time required for their acquisition, few seem to be aware. On this subject an erroneous opinion seems pretty gen- erally to prevail. A little mechanical tact, or dexterity, is thought by some, to be all that is requisite to a practitioner of dental sur- gery, and that this could be obtained in, at most, a few weeks. The prevalence of this belief, has given countenance to the assumption of the profession, by individuals totally disqualified to take upon themselves the exercise of its complicated and difficult duties. But it is to be hoped that the day is not remote, when it will be re- quired of those to whom this department of surgery shall be en- trusted, to be educated men, and well instructed in its theoretical and practical principles. Elevate the standard of the qualifications of the dental surgeon to a level with those of the medical practi- tioner, and the results of his practice will be always beneficial, which, at present arc frequently the reverse. Require of the prac- titioner of dental surgery to be educated in the collateral sciences of anatomy and physiology, surgery, pathology and therapeutics, and the sphere of his usefulness and his respectability will be in- creased. Require of him to be thus qualified, and he will be able to contribute to the advancement and dignity of his calling, and by a zealous devotion to it, he will soon arrive at an excellence, to which, heretofore, but few comparatively, have attained, and enjoy the high gratification of knowing that he is a benefactor of his fellows. But although, among the practitioners of dental surgery, there are very many possessed of talents and education, and who, by dint of unwearied industry, have acquired distinguished, and justly- deserved high reputations for skill; yet they, by their individual exertions, have been unable to free the profession from the reproach that has been brought upon it, by the hundreds of ignorant and disqualified individuals, by whom its duties are still exercised. Encouraged, however, by wh at has been done by associated influence, and free interchange of sentiment, among the practitioners of medi- cine and surgery, they are beginning to lay aside that selfish ambi- tion, and petty jealously, which in times past have kept them apart, and are uniting their efforts to raise the standard of professional qualification — hoping thereby to secure for their vocation a confi- dence and a respectability that it has not hitherto enjoyed. That they may be successful in so commendable an undertaking, should be the ardent desire of every one; yet filled as the ranks of the profession are, with individuals who have never learned the first rudiments of science, it will doubtless require some time to effect the wished reformation, and will only be accomplished, as they shall be able to fix a line of distinction between the competent and incompetent. With a view to this and the more rapid improvement of the art, an association has recently been formed in this country under the designation of the American Society of Dental Sur- geons, with such terms of membership as will admit none, except such as are thoroughly qualified to practice the profession. If this feiture be carried out, and from its present organization, no fears need be apprehended on the subject; the association will be able to furnish to its members, credentials of competency, that will, at once, command confidence and respect, and at the same time tend to secure the community against the impositions of the unprin- cipled charlatan nd ignorant pretender. In addition to this, it will contribute in an eminent degree, to establish correct and uniform systems of practice throughout the whole country, and thus an almost incalculable amount of good may result from it. But to Maryland belongs the honor and credit of establishing the first institution that has ever existed, for the education of gentle- men for this particular department of medicine. The legislature of this State at its last session incorporated a College for this special purpose, and thus, facilities are offered for the acquirement of a knowledi e of all the branches of this most valuable art, that have never befo-e existed, and in consequence of which, the majority of those who have assumed its practice, have been compelled to do so without the requisite preparatory qualifications. Had facilities for obtaining the necessary information existed, it is probable that most of those who have thus entered the profession, would have availed themselves of them; but as there were none, they were obliged to depend upon such instruction as they could procure, but relying principally upon what they should learn from practice. Thus, from year to year have numbers been added to the profession, until its ranks have become crowded with Individuals totally disqualified to take upon themselves the exercise of its nice and critical duties. Gentlemen, the profession for which you are preparing, is hon- ourable; it is useful; it is one that will enable you to be serviceable to your fellows, to relieve much of human pain, and to mitigate many mortal woes. Though it may not require of you to combat the more violent and aggravated forms of disease that are incident to man, you will have to treat those that demand nearly or quite an equal degree of acumen and skill; and if you would possess these, it will be necessary that you devote yourselves diligently and per- severingly to their acquisition; that you faithfully employ the time that you design appropriating to your studentship, in acquainting yourselves with the structure of the parts implicated in them — their pathology and therapeutical indications. If you would be able to arrest the diseases that come within the province of the profes- sion for which you are preparing, and prevent the various evils that are frequently consequent thereupon, or, in other words, if you would be able to preserve those invaluable organs, the teeth, and thus secure to those by whom you may be consulted, one of the greatest of earthly blessings, a healthy denture, endeavour to attain the knowledge that will enable you to do it. If you would command respect, and enjoy the confidence of those among whom it may be your lot hereafter respectively to reside, let it be your persevering endeavour to deserve them. Resolve that you will not be satisfied with mere mediocral abilities in the calling for which you are qualifying. Resolve to put forth all your energies for its acquisition, that you may be able to take rank among the most scientific and skil ful. If you do not do this, the fault will be your own, and I am sure that your teachers will labour to little purpose in endeavouring to impart instruction to you, unless you strive to profit therefrom. Let one then, who will feel a deep and anxious solicitude for your success, urge you to diligence in the pursuit of the knowledge you are now seeking. Its possession can alone enable you to discharge in a correct and proper manner, the intricate and complicated duties you are pre- paring to assume. Let then, a pure and high ambition stimulate you to zealous and unwearied exertion, and be assured that you will never be reproached by the future, for time misspent, or for failing to realize to those who shall seek professional aid at your hands, the benefits which the art is capable of bestowing. Page Six

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The Dawn of Dentistry As long as man has been an inhabitant of the earth, there have been pain, disease, and injury ever present to destroy his well-being and happiness. But shrouded in the obscurity of superstition, fear, and ignorance, these ills were merely a cog in the wheel of life, which, turn- ing incessantly, made his existence a survival of the fit- test. Man, however, is endowed with a thinking brain, to distinguish him from the animals he outlived. In the course of hundreds of years, science took its place in his environment, slowly alleviating his sufferings one by one, until finally, life for him is no longer a drab strug- gle, but an opportunity for a full and beautiful exist- ence. He has learned now that his ills and pains can be treated, if not wholly cured, by men well trained for their tasks, and the knowledge of this protection is to him a security which he carefully treasures. Not the least source of man ' s tribulations have been his teeth, which, while they may not have pained him, might have caused him sorrow by their unsightliness, disintegration, or total absence. It was but a question of time before a field of health service would be devoted entirely to the progress of what had been conceded to be one of the branches of medicine. To dentistry ' s develop- ment as an individual science we wish to devote the fol- lowing narrative. A study of antiquity perhaps first leads us to the Hindus and Chinese. Among the former, physicians were held in high regard, second only to the priests. Those concerned with dentistry were classed with hair- cutters, ear-borers, nail trimmers, and blood-letters, all of whom were certainly not of Brahmin caste. The Chinese, although their writings are full of prescriptions and remedies for all sorts of tooth pains, are important mainly for their operation known as acupuncture, which consisted of puncturing the gums or other sus- pected parts of the body with gold or silver needles of various sizes, for the purpose of relieving any abscesses that may have been present, and thus removing obstacles to the circulation of spirits or humors. About 2100 B. C, Hammurabi was the ruler of Baby- lon. Under him, the cure of disease was allotted to ■ The Father of Medical Science priests. Hammurabi is credited with one of the first law codes, and there have been unearthed many stone tablets upon which cuneiform script tells the story of his great- ness. One of these quotes the following as an antidote for the Tooth Worm, which was then believed to cause toothache: As the God Anu created the sky, the sky created the earth, the earth created the rivers, the rivers created the canals, and the canals created the marsh. The marshes created the Worm, the Worm came crying before Samas, the Son, before Ea, his tears streamed down. ' What do you give me to eat? ' I will give you dried figs or apri- cots. ' For me! What is this? Dried figs or apricots! Let me insert myself in the inner of the tooth and give me his flesh for my dwelling. Out of the tooth I will suck his blood, and from the gum I will chew the mar- row. So I have entrance to the tooth! ' Because you have said this and have asked for. Worm, may God Ea strike you with the might of his hands. You shall mix Emmer- mischbier with oil. The text of the incantations y ou shall say three times and to his tooth you shall bring it. These tablets were among a number of similar tablets contributed to the temple upon which were inscribed an account of the symptoms of the patient ' s ailment, as well as the remedies used, and the results, so that, taken altogether, these tablets were really the medical text- books of that time. Babylonian culture was preceded, however, by that of the Egyptians, concerning whom much was brought to light in the Ebers papyrus, which covered a period from 3700 to 15 50 B. C. In the parts devoted to the art of healing, many remedies can be found dealing with the cure of the tooth that grows into the upper part of the flesh (gums?), while other prescriptions recom- mend methods of strengthening the teeth and gums. But since the papyrus seems a mere collection of cures for a polyglot of ailments, there cannot be found any definite mention of well-known dental operations, such as fillings and extractions. Thus, Dr. Guerini concludes that no surgical operation was performed in the mouth at all, mainly because there were no specified instru- ments then existent for their accomplishment. Then, as before, dentistry was a part of medical science, which, in turn, was bound closely to magic and the super- natural. The ministers to the sick were called Pasto- phori, and these were acknowledged members of the sacerdotal caste. There were no definite attempts at pros- thesis unless one would like to consider as such wire at- tachments for loose teeth; nor were any attempts made toward filling cavities or replacing missing teeth with artificial substitutes. Prosthesis of any sort does not cross the horizon of history until the next stage in civilization — that of the Phoenicians, which flourished about 1000 B. C. In one of their tombs was found an appliance consisting of two cuspids to which are bound by gold wire four incisor teeth. We think that this is the first attempt at bridge- work of any kind. We now come to the first one who really attempted to raise this veil of obscurity — Hippocrates (460 to 370 B. C). He advocated that disease should be Pag,e Eight