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12 HISTORY OF DENTAL SURGERY

sagacity he suggests that before attempting the cure of toothache an endeavor
sliould be made to become acquainted with the cause of it, as, if that can
be removed, the pains appease themselves. DentaLcaries, m_ajgreat number
of cases, proceeds equally from internal causes. He extols as a remedy for
toothache the use of vapor baths and tlie introduction into the tooth of a
small piece of wax, pressed well in by means of a probe. He recommends
ojiening, or trephining, the tooth when the pain cannot be appeased other-
wise and, if finally it is incumbent to remove the tooth, he says it can be done
without pain to the patient by the application of pirethrum root and strong
vinegar, from the action of which the remaining teeth may be preserved by
covering them with a layer of wax. At the expiration of an hour he says, the
tooth becomes so loosened as to be easily removed, and it will also fall out by
itself if placed in contact witli sulphate of copper and strong vinegar.
Galen also tells how black hellebore, or ginger, inserted into the tooth,
removes the pain, and prevents foetidity of the breath. When a tooth is
loosened and projects beyond the level of the others, he recommends filing down
the projecting part, for which purpose a small file was used, the tooth being
held between the fingers, so as to prevent its being further loosened. As soon
as tlie operation caused pain it was suspended and anodynes were admin-
ii-tered. After the lapse of a few days the filing was repeated.
Tie, as well as his early followers, continued to employ the grotesque, if
not frivolous, formulae for nostrums styled dentifrices. "The ashes of burnt
mouse dung and of burnt angle worms" seem for a long time to have been
greatly appreciated as essential ingredients for a dentifrice. Coelius Aurel-
ianus, who lauds their elRcacv, entertains the same aversion to tooth extraction
as his predecessors, but gives as his reason the fatal results from this opera-
tion. He advocates the iise of extracting instruments made of lead, and the
methods otherwise already mentioned. He speaks in criticism of the plugging
of teeth with iron.
Galen transmitted several formulae for dentifrices written in verse, an-
nouncing that they were composed of the finest drugs of Arabia. "It is an ex-
cellent powder," he writes, "very fine, which has the property of whitening
th.e teetli, causing the disappearance of the swelling of the gums, and of re-
movino- that which adheres to them so completely that no cases of tartar can
be seen, even when the gums are exposed by laughter.'"
Scribonius observes that many believed that there was no better remedy
for toothache than extraction, but that it was not necessary to proceed at once
to extraction even though caries existed, "for by removing the decayed portion