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THE SEVENTEENTH CENTURY 249

If, however, even this renied\' fails to produce the desired eftect, it will
then be necessar\' to lance the g;i.ini at the point where the tooth is to erupt,
or to press it hard with the thitinh, that the tooth ma\ the easier come
through.
The sole merit of tiiis author (as to what concerns our specialt\)
consists in his having declared bleeding useless, or even harmful in the
treatment of toothache, and, besides, in his having recommended, with
great warmth and in most impressive terms, cleanliness of the teeth.
What is more beautiful, sa\s he, than a mouth furnished with white teeth,
similar to so man\- pearls.'' And what is more abominable than black
or livid teeth, covered with a fetid deposit or with tartar } Unclean teeth
spoil the appearance of the person, and nauseate those who behold
them.'
William Cow^per (1666 to 1709). Toward the end of the seventeenth
centurv the celebrated English doctor and anatomist, William Cowper,
opened up a new held of action to oral surgery by inaugurating the
rational treatment of the diseases of the maxillary sinus. In order to
emptv Highmore's antrum of deposits and to be able to carry out the
necessary irrigations, he extracted in most cases the first permanent
molar, and then penetrated through its alveolus into the sinus with a
pointed instrument.
James Drake, also an Englishman and a contemporary of Cowper,
operated in the same manner; and it was this author who made known
in a book of his- the operative method of Cowper; for which reason
the above-mentioned proceeding is sometimes called "the Cowper-
Drake operation." A certain time elapsed, however, before it became
generalh' known. Thus, in a book published by Johann Hoffmann
in 1713 there is no mention made of this operation, albeit the author
refers therein^ to the case of a young girl, one of whose canine teeth having
been extracted by him, there ensued a considerable flow ot whitish pus
from the maxillary sinus. In speaking of this case, Hoffmann stigmatizes
manv of the surgeons of his time who wxre not acquainted with the
existence of Highmore's antrum, and therefore, in cases of patients whose
teeth had fallen out as an effect of syphilis, if the\- happened to penetrate
with the sound into the maxillary sinus, believed this to be an accidental
excavation of the bone, produced by caries.
However, the honor of having initiated the rational treatment of dis-
eases of the maxillary sinus is not exclusively due to William Cowper
and to James Drake; a large share is also due to the celebrated German

^ Caroli Musitani opera omnia, pp. 121 to ia8, Venetiis, 1738.
-J. Drake, Antfiropologia nova, London, 1707.
* J. M. HofFmann, Disquisiriones anatomico-pathologicae, Altorf, 1713, p. 321.