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152 SECOND PERIOD—THE MIDDLE AGES

in some cases, the widening of them, in order to render them shallower
and therefore less liable to retain alimentary residues.
Pietro of Argelata cured dental fistulas by means of caustics and
arsenic. He counselled simple palliative means of cure for hard epulides
of a cancerous nature. In regard to soft, benignant epulides, he was
little favorable to excision, as this might cause hemorrhage ; he preferred
ligating the tumor; or he repeatedly cauterized it with boiling oil or other
caustics, until he caused it to fall.^
Bartolomeo Montagnana, who taught surgery in the University of
Padua and died in 1460, recommended, as an excellent anti-odontalgic
remedy, a mixture of camphor and opium. In his days, faith in the
pretended eradicating virtues of certain substances was being gradually
lost; but, on the other hand, a tendency now arose to neglect, in regard
to the teeth, the conservative principle, to which the ancients had held so
jealously; and little by little the extraction of a tooth began to be considered
an operation of small or no importance, that could be performed with the
greatest indifference. Montagnana himself considers the extraction of a
tooth as the best means of curing odontalgia, whilst the ancients did not
have recourse to it, saving as a last resource. Notwithstanding this, if
the caries was not deep, he preferred to extraction the use of caustics and
a red-hot iron.^
Giovanni Plateario, a professor at Pisa in the latter half of the fif-
teenth century, cauterized carious teeth with a small piece of kindled
ash wood, or with a red-hot iron, and held that cauterization was more
effectual when, before performing it, the carious hollow had been filled
up with theriac.^
He, too, made the administration of purgatives or bloodletting precede
the extraction of a tooth. Plateario has, however, the merit of having
introduced the sitting position for operations on the teeth, whilst preceding
surgeons made the patient lie in a horizontal position, or held his head
steady between their knees, as may be read in Abulcasis and in other
writers. Besides, he recommends taking care, when the extraction of a
tooth had to be performed, that the surrounding air should be pure;
perhaps because he thought that when operating in a place where the
air was tainted, complications might more easily arise, on account of
contagious substances reaching the inside of the wound ; or perhaps
because he judged, not without reason, that certain accidents, such as
syncope, could more easily happen, and were more dangerous in a tainted
atmosphere than in the midst of pure, vivifying air. After the operation,

' Petri de Larstlara chiiurgi:c libri sex, Venetiis, 1480.
^ Bartoloman Monttignaua- Consilia, Venetiis, 1497.
' Johannis Platearii Salernirani practica brevis, Lugduni, 1525.