DENTISTRY AMONG THE CHINESE.
For above 4000 years science and religion among the Chinese, as well
as their customs, have remained quite unchanged. The inhabitants of
the Celestial Empire can vaunt a most ancient civilization; which is,
however, altogether stationary; neither has their medicine made any
progress, and its actual state represents with sufficient exactness
what it was in primitive ages.
In Europe, various works have been written about the medicine of the
Chinese, one of the best being that of Dabry,[25] taken from the most
celebrated medical books of China,[26] and which may be considered as a
compendium of the medical science of this people.
In this work we find two chapters relating to our specialty: the first
of these (p. 286) speaks of toothache, the second (p. 292) treats of
all the other dental and gingival diseases.
The Chinese call the toothache _ya-tong_, and distinguish a great many
varieties of the malady, that is:
1. _Fong-je-tong._ This kind of toothache is caused by sudden cold,
and has the following characteristic symptoms: Red and swollen gums,
which after a little time discharge purulent and fetid mucus; abundant
salivation; acute pain; swelling of the cheek. It is to be cured with
draughts, mouth washes, and various kinds of frictions.
We consider it useless to give the particulars of the various receipts,
because Dabry hardly ever translates the names of the drugs of which
they are compounded. These formulæ are therefore incomprehensible by
most people.
2. _Fong-lan-tong._ This kind of toothache is also caused by cold. The
pain is very great, but the gums are neither red nor swollen.
3. _Ye-tong._ Is also produced by chill. The gums are red and swollen;
there is no discharge of mucus; great pain, which is aggravated by cold
liquids. If the malady lasts for some time, the gums end by becoming
black, and the teeth are loosened; the pain becomes more intense in
spitting. In this stage of the malady the sufferer no longer fears
cold drinks, but rather desires them, to soothe the pain. The cure
varies according to whether the malady be of recent or of old date;
it consists in the use of internal remedies (pills, potions), or of
frictions on the part where the pain is situated.
4. _Han-tong._ This is also owing to the action of the cold. Pains in
the cheek and forehead proceeding from the teeth; no diseased condition
either of the gums or of the alveoli.
5. _Tou-tan-tong._ Violent cough and toothache at the same time;
difficulty in masticating.
6. _Yn-hiue-tong._ The gums are pale, or violet-red, hard and lumpy,
sometimes bleeding; the toothache is continuous. Among the numerous
remedies recommended against this malady (mouth washes, frictions,
draughts, pills), one particularly deserves mention: it is the urine of
a child used as a mouth wash.
7. _Tchong-che-tong._ Pain in the teeth after mastication; there is
also sometimes excoriation of the gums; flow of purulent mucus mixed
with blood; bad-smelling breath; the tooth falls; it is decayed,
and one can perfectly well distinguish a small hole; the root is
unsound; in extracting the tooth one sometimes brings away together
with it a little white worm, with a black spot on the head, which
can be distinguished by the aid of a magnifying glass. A remedy must
immediately be administered to destroy these worms, otherwise the
patient runs the risk of having his other teeth attacked in the same
manner, and of their falling out. The remedies against this affection
are most numerous, and belong for the most part to the oftentimes cited
categories. One of them presents a certain interest, its basis being
arsenic.
In Dabry’s book it is described in the following manner: “Arsenic (gr.
1.80), _houang-tan_ (gr. 3.60); pulverize, mix with water, and with a
part of the mass form a small pill, which put close to the aching tooth
or into the ear, if afraid of the arsenic; then sleep. Cure certain.”
8. Toothache, the effect of general weakness, following principally on
abuse of coition. It is to be cured by the use of internal medicine,
or by local remedies to be rubbed on the painful spot. Some of the
medicaments registered in this paragraph have reference to the special
case, in which the teeth are loosened through excess of coition.
Among others there is a prescription for a dentifrice powder for
strengthening the teeth, to be used every morning.
9. Toothache following on a blow. It is to be cured by using a certain
dentifrice powder, composed of six ingredients. Another medicament
consists in heating about an ounce and one-half of silver in some
recipient, and then pouring wine upon it, and rinsing the mouth with it.
Besides these nine kinds of toothache, the Chinese doctors recognized
a peculiar morbid condition of the teeth and their surrounding parts,
which is thus described in Dabry’s book:
“It sometimes occurs, after recovery from illness, that convalescents,
in order to acquire strength, drink too great a quantity of wine; and
that this after a certain time produces a beginning of inflammation of
the stomach. In such cases the teeth often fall out, the breath becomes
fetid, and if the patient eats hot food, the empty alveoli as well as
the cheeks are painful.”
Various internal medicaments and dentifrice powders are prescribed for
combating this morbid condition. One of these latter includes a great
number of ingredients in its composition; among others, the bones of
mice.
Mention is also made of certain remedies, to which recourse may be had
at times, for allaying violent dental pains, of whatsoever kind, or
whatever be the cause that occasions them.
One of these remedies is composed of different substances (among them,
garlic and saltpetre), to be pulverized and made into pills. If the
pain be on the left side, one introduces one of the pills into the
right ear, and _vice versa_.
The formula is also given for a very complicated medicated powder,
to be snuffed up in the left nostril if the person suffering from
toothache be a man; in the right if a woman.
Another powder is to be smelt with the right nostril or with the left,
corresponding to the side on which the pain is located.
Abscesses and fistulæ of the gums are spoken of as follows:
“It sometimes occurs that an abscess forms in some one point of the
gum; this communicates great pain to the tooth near it; the abscess
is white, with discharge of purulent matter.” The treatment consists
in the use of different medicated powders, to be rubbed on the
affected part. Two of the powders contain musk, besides several other
ingredients. A lotion is also prescribed.
In the next chapter the following affections are described:
1. _Ya-heou._ Gums are red, soft, and swollen, and a fetid and purulent
matter exudes from them; the teeth are not painful; if the gums are
lanced, blood of a pale red color flows from them in abundance. This
malady is to be treated with various internal medicines and sometimes
with scarification.
2. _Ja-suen._ Gums swollen; little by little they are corroded and
destroyed by ulceration, which leaves the roots of the teeth bared;
the patient has an aversion for hot food; continued pain in the teeth;
discharge of purulent and fetid mucus; by the slightest exposure to
cold the pain becomes very violent. This affection is to be combated
with internal remedies and local treatment (frictions with medicated
powders; application of an ointment of very complicated preparation).
3. _Tchuen-ya-kan._ The gums are painful for a few days; apparition
of the root of the tooth; absence of ulceration. Children of five or
six years of age are frequently exposed to this malady. The best means
of cure consists in the extraction of the tooth. There are, besides,
various internal and external remedies prescribed. One of these latter
contains verdigris and three other ingredients. Among those to be used
internally there is a decoction prepared with twelve different drugs,
two of which are mint and rhubarb. The quantity of rhubarb is about
seven and one-half grams; therefore, this prescription is certainly
intended to act as a purgative.
4. _Ya-ting._ The right or left gum suddenly swells; a tumor forms
of about the size of a grain of sorgo; in the beginning it is red,
afterward black; severe pain in the cheek and neck; itching in the
cheek; the tumor afterward bursts, giving exit to blood, and becomes
black; it ought to be pricked directly (before it opens of itself)
with a silver needle; blood of a violet color will flow from it, which
should be left free course until it regains its ordinary color. The
sufferer has at the same time pains in the stomach, great thirst,
abdominal pains, and sometimes even delirium.
5. _Ya-jong._ Gums swollen and painful, abscess, fever, swollen cheeks;
great thirst, and vomiting of a liquid kind; dejections dry. The
treatment consists in the methodical use of certain medicines to be
used internally, among which is rhubarb. If one neglects to make use of
this treatment, an ulceration sets in with discharge of a purulent and
sanguine mucus; it is then necessary to rub the part with a medicinal
substance called by the Chinese, _ping-pang-san_. Should the tooth be
somewhat loose, it ought to be extracted and the gum rubbed again with
the substance just now named.
6. _Tso-ma-ya-kan._ An illness common to children after the smallpox;
ulceration of the gums, which turn black; fetid breath. In certain
cases the gums are hard and the mucous membrane of the cheek is also
attacked; all the teeth shake; there is flow of blood from the gums,
upon which certain spots begin to form that are clearly distinguishable
as small holes. These holes must be filled with a particular medicinal
substance (named _lay-ma-ting-kouei-sse_), and, besides, one ought to
make use of various other internal and external remedies.
This is a very serious illness. In the case of recovery, the patient
ought to abstain from taking any heating aliment for one hundred days.
7. _Tsee-kin-tong_ or _tsee-ly-tong_. Gums swollen; slight but
continuous pain, aggravated by the effort of the wind; the gums become
ulcerated little by little, with discharge of purulent and sanguine
mucus; and the root of the tooth is afterward seen to be uncovered.
This malady is to be treated by means of draughts, pills, mouth washes,
and frictions of various kinds.
After the treatise on the maladies referred to above, we find in
Dabry’s book a long series of “general remedies for every kind of
toothache.” There are about forty of these, and decoctions and powders
predominate among them, the latter to be rubbed on the painful spot.
Decoctions are the form of medicament most in use among the Chinese.
In this list of about forty anti-odontalgic remedies we find as many
as eighteen decoctions, seven for internal use, and the others to
be employed as mouth washes. Some of the latter are compounded with
vinegar instead of with water.
Four remedies of the above list are to be made into a paste and formed
into pills, to be applied upon the aching tooth.
Another medicament is also to be formed into pills and applied inside
the ear.
The following remedy is particularly worthy of note:
“One roasts a bit of garlic, crushes it between the teeth, and
afterward mixes it with chopped horseradish seeds, reducing the whole
to a paste with human milk; one then forms it into pills; these are to
be introduced into the nose on the side opposed to that where the pain
is situated.”
Two other remedies, in powder, are to be snuffed up through the nose.
A powder to prevent the progress of caries is prescribed, with which
the tooth should be rubbed every day, or it may be applied on the
decayed spot.
Finally, two powders are also prescribed for whitening the teeth. One
of these is compounded of seven ingredients, among which is musk; the
other has only three substances in its composition: salt (gram 25),
musk (gram 1.8), _tsang-eul-tsee_ (gram 36).
A therapeutic method much in vogue among the Chinese is acupuncture,
which is used in the treatment of the greatest variety of affections,
including those of the dental system. The doctors of the Celestial
Empire have the greatest faith in this operation, which they hold
capable of removing obstacles to the free circulation of humors and
vital spirits, thus reëstablishing that equilibrium of the organic
forces which constitutes health, and the absence of which causes
disease.
The Chinese doctors prefer to use gold or silver needles for
puncturing; but they also frequently use needles of the best steel.
These instruments vary very much in length, in thickness, and in form,
and there are not less than nine distinct kinds of puncturing needles.
Every doctor who intends dedicating himself to the practice of this
operation has to begin by the most accurate study of the elective
points for puncturing according to the various affections; he should
also know to what depth precisely to drive the needles in each case,
in order to reach the site of the morbific principle and procure
convenient exit for it; he ought to know equally well how long to
leave the needle in the affected part, so as to obtain the best
possible therapeutic results in each case.
The points of election for carrying out puncturing in various maladies
are spread over the whole superficies of the body, and amount in
number to 388. Each of these is known by a special name. Each site of
election stands in determinate relations, as to distance, to the known
anatomical points, and may, therefore, be easily and precisely found
by appropriate measurement. The unity of length for these measurements
is called _tsun_, and is divided into ten _fen_; its value varies,
however, according to whether the said measurements be taken on the
head, the trunk, or the extremities. For the head, the length of the
_tsun_ is calculated as equal to the distance existing between the
inner and the outer angle of the eye; for the trunk, it is equivalent
to the eighth part of the horizontal line between the two breast
nipples; and for the extremities, it is equal to the length of the
second phalanx of the middle finger, measured with the joints bent.
There are twenty-six points of election upon which to carry out
puncturing used as a remedy against toothache. There are also six other
points of election for pains in the gums.
One would naturally be disposed to believe that these points of
election would be situated in proximity to the teeth. Instead, many
of them are situated in distant parts of the body—for example, in the
elbow, in the hands, the feet, the vertebral region, the coccyx, and
so on. However, about half of them are to be found in the labial,
maxillary, and periauricular regions.
The puncturing of every point of election is almost always indicated
for the cure of not only one but several, and, indeed, very often
many, maladies; for example, the puncture carried out on the point of
election, _kin-tche_, situated at the outer extremity of the bend of
the elbow, may be utilized in more than twenty-five morbid conditions;
among which are pains in the arm, paralysis of the arm, edema of the
whole body, excessive perspiring, vomiting, hematemesis, toothache,
boils, gastralgia, hemiplegia, and even cholera!
This mode of cure depends on the special relation of each point of
election to the so-called canals of transmission and communication
(named in Chinese _king_) through which the blood and the vital spirits
circulate, and which serve at the same time to transmit the “innate
heat” and “the radical moisture” to all parts of the body.
And here we must be allowed a brief digression in explanation of what
we have just said.
The anatomical notions of the Chinese are very erroneous;[27] their
ideas on the functions of the human body and of human life in general,
differ considerably from ours. They recognize two natural principles of
vitality, one they call _yang_ (vital, primordial, or “innate heat”),
the other _yn_ (radical moisture). The spirits (that is the air) and
the blood serve as vehicles to these two essential principles of life;
that is, vital heat and radical moisture. The constant equilibrium, the
accord, the perfect union of these two essential principles of life
constitute a state of health. From their alteration, corruption, or
disunion originate all diseases.
There are twelve principal sources of vitality in the human organism;
that is, twelve organs from which the two aforesaid vital principles
are distributed throughout the body: The heart, the liver, the two
kidneys, the lungs, and the spleen are the seat and origin of radical
moisture; the large and the small intestine, the two ureters, the
gall-bladder, and the stomach are the seat and origin of vital heat.
These twelve sources of life are in intimate relation with one another
by means of the canals of communication, through which the blood and
the vital spirits (air) circulate, carrying with them into every part
of the body vital heat and radical moisture.[28]
The points of election upon which to carry out puncturing are situated
along the course of the large lines of communication and transmission;
and that explains, according to the Chinese medical theories, why a
puncture carried out on a given point of the body can prove useful in
relieving a variety of maladies even in distant parts of the organism.
Puncturing is almost always associated with cauterization, for after
having drawn out the needle, it is usual to cauterize the site of the
puncture with the so-called “_moxa_,” that is, with a kind of vegetable
wool obtained from the leaves and dried tips of the artemisia. One
compresses this substance very tightly between the fingers into the
shape of a small cone. One next applies a small coin with a hole in the
centre upon the site of election; the cone of moxa is placed on the
hole in the coin and lighted at its top. As the cone is very compact,
it burns slowly enough, without developing excessive heat, so that,
according to Ten Rhyne,[29] who was an enthusiast for this mode of
cure, “the epidermis is drawn without violence and rises gently into a
small blister. The moxa, whilst burning, draws out the _peccant humors_
visibly, absorbing them in such a manner that they are totally consumed
without destroying the skin itself.”
The application of the moxa is not as painful as might be thought,
and even children support it without much crying. The number of times
for repeating the operation varies according to the malady and the
site of application, etc. Thus, in the point _kin-tche_, which we have
mentioned once before, the cauterization is generally repeated seven
times, but in certain cases the number may be brought up to 200.
There are certain points of election for which puncturing alone is
prescribed without subsequent cauterization; in other instances, the
puncturing is held to be unnecessary or even dangerous; one, therefore,
only applies the moxa in these cases.[30]
In Japan, the moxa was still more in use than in China. According
to Ten Rhyne, from the remotest times the moxa has been the best
and almost the sole mode of treatment for illness in Japan, and was
regarded not only as an excellent remedy, but also as an excellent
preservative; so much so that even convicts condemned to perpetual
imprisonment had permission to go out every six months to undergo this
cure.
Dental affections also were especially treated with the moxa, and,
judging by what Ten Rhyne says on the subject, it would seem that this
caustic, when used against toothache, was usually applied in the region
of the mental foramen.[31]