Traduction par Malcolm Bishop (Grande Bretagne)
Humans and tool-using animals use their intelligence
to devise instruments as an extension of the hand and
brain to make actions possible, or easier.
It has been known for a long time that tooth extraction could be
performed with finger and thumb. The ‘Kul Oba’ vase
(Hermitage Museum St Petersburg), found In 1830 in a
fourth century BC Scythian burial mound, seems to show
an early example of this sort of operation. The warrior
‘patient’ in a defensive gesture familiar to dentists
holds the operator’s arm.
Writing 2,000 years ago, Aulus Cornelius Celsus (c.25
BC – 50 AD) recommended extraction by hand following
loosening of the tooth with forceps. His extraction
technique is surprisingly modern (pericision,
subluxation and extraction) (Medicina VII. 12). Celsus
elsewhere compares the action of removing a projectile
stuck within a joint to that required to extract a
tooth. (De Medicina VII. 5.4).
Ancient instruments, although not definitely
attributable to specialised dental use, were clearly
capable of adaptation, whether to remove bone splinters,
broken arrow heads, or teeth. It did not take much to
modify these instruments to suit dental extractions. At
Athens, Naples, and Pompei, examples of instruments were
found which were more or less suitable for dental use,
either for whole teeth or root extractions.
By the mid 3rd century BC such a specialised
instrument was known as an ‘odontogagum’ [-on] in Greek,
Thanks to Caelius Aurelianus of Sicca (fl. 6th C. AD in
Numidia), who translated some sections of the Greek
medical texts of Erasistratus of Chios (304-250 BC), it
is known that forceps (denti-ducum - tooth-drawers - in
Latin) made of lead were on show in the Temple of Apollo
at Delphi.
Possibly originally a votive offering, both
Aurelianus and Eristratus, writing some 800 years apart,
used these leaden forceps to stress the point made also
by Celsus that extreme care is needed when extracting
teeth. (Aurelianus: De Morb.Chron. Lib. II. Ch.4)
The Hippocratic corpus (disorders 4) advised forceps
to extract a mobile or broken down tooth, or
cauterisation. Many remedies in the form of medications,
fumigations, fomentations, or topical applications were
recommended by the ancients to effect relief in the
absence of a cure. It would seem that before resorting
to cold steel, practitioners used hot iron to cauterise,
with classes of cautery instrument for the gums and
teeth, with others for filing and scaling and
extractions. Gags and mouth props also feature.
Celsus in his encyclopedic De medicina, demonstrates
the existence of such instruments with the specific
therapeutic indication of each, together with materia
medica. (VII, 12, 1). " (VII, 12, 1). Some simple
orthodontics is described in the same passage.
Thanks to the printing press, the works of the
ancients, and of mediaeval writers, were reproduced in
Latin, and were often translated into French (and
English), and their wide distribution gave a significant
impetus to the medico-surgical literature. As a result,
from the sixteenth to the seventeenth centuries, these
numerous books make it possible to provide evidence for,
and to study, the instruments with which in many cases
the surgeons illustrated their works. These pictures of
instruments, accompanied by short descriptions, are
presented chronologically (from the date of appearance
in the texts on the shelves) together with the most
representative instruments that have been identified in
the museums or in private collections. After the
presentation of each instrument, a set of similar ones
is shown
Forceps, pelicans, punches, elevators (simple, goats-foot,
and ‘pieds de biche’), mouth-props, cauteries and
scalers evolved very slowly from the sixteenth to the
twentieth century, often appearing under different names
depending on author and periods. In the eighteenth
century, the Golden Age of French dentistry, the first
significant improvements were made which were to come to
full development in the nineteenth century.
