Biorned. WU • 9 A934a 1874 G 000 005 893 3 THE LIBRARY OF THE UNIVERSITY OF CALIFORNIA LOS ANGELES ADDRESS DKTilVEKKD KKFORE THE ^iiicrjraii ^tailfiiiji of |}ental jdcnte, AT THEIR SIXTH ANNUAL MEETING, I^ELD IN ^OSTON, JSePT. 29, 1873, BY P. H. AUSTEN, M. A., M. D. BOSTON : I^K-INTED HY JAS. HARHIS & CO. No. 19 Spring Lane. 1874. ADDRESS /^c. DELIVERED BEFORE THE ^nurudu ^aitemu 0! |}ental $deute. AT THEIR SIXTH ANNUAL MEETING, ]4eld in Boston, ^^pt. 29, 1873, BY P. H. AUSTEN, M. A., M. D. BOSTON: JPR,IT>rTE13 BY J^^S. IiA.IlR,IS & CO, No. 19 Spring Lane. 18 7-i. Boston, Sept. 29, 1873. nn Prof. P. H. Austen, — Dear Sir: At the Sixth Annual Meeting of the American Academy of Dental Science, held this day, in Uoston, it was unanimously Rewlved, "That the hearty thanks of the Academy be presented to Prof. P. H. Austen, of Baltimore, for his very able and excellent address, and that a copy be requested for publication and for preservation in the archives of the Academy." Sincerely hoping that you will comply with this request, I am, with high regard, Very truly yours, EDWARD N. HARRIS, Corresponding Secretary. Baltimore, Dec. 18, 1873. Dr. E. N. Harris, Cor. Sec^y American Academy of Dental Science, — My Dear Sir : I must repeat to you my regret that the paper forwarded for reading before your honorable Society was completed under circum- stances of ill health, which forbade that full and careful treatment of my subject originally intended. A recent relapse will prevent me, for I know not how long, from sending you a revised copy for publication. The original manuscript is, however, with all its deficiences, the property of the Society. Should they think its publication calculated to elicit fuller discussion of the very important subjects therein imperfectly presented, I will not, in view of so desirable a result, urge any objection. Believe me ever, with high regard for yourself and your fellow Academ- icians, Very sincerelv vours, P. H. AUSTEN. ADDR ESS Mr. Pvesklent and Fellows of the American Academy of Dental Science : Medicixe is as old as liumau disease, which it seeks to cure ; and Mechanism dates as far ]:>ack as the wants of mankind, to which it ministers. Youngest born of these two is Dentistry, bearing more distinctly than any known art the impress of its double lineage. For what branch of Medical Art so dependent upon mechanical genius ; and what branch of Mechanism so directly addressed to the relief of those ills which human flesh is heir to ? The childhood of Dentistiy has been unfortunate, in that, while disowned by one parent, it has been taught to look down upon the other. For Medicine, in all ages, has been prone to despise Hand-craft, as beneath the attention of those wlio claim that, by pure mi<>ht of intellect, they can conquer the many-headed hydra — Disease. But medical practice is no longer the unit it once was ; and the ' ' Fam- ily Physician" is soon destined to become an institution of the past. As the centuries roll on, the boundaries of Science and Art are enlarged, but the measure of indiyidual capacity remains the same. Hence, Medical Practice diyides and 6 subdivicles, in order to the fullest deYelopment of its several departments . The ph^'sieian has no longer time for Pharmacy or Sur- gery ; nor dare he hereafter affect to despise Arts quite as essential to life as his own advice and prescription. Even this advice, to be most effective, grows out of the special study of separate organs. Thus the Body Medical, like the human body which it studies, is composed of man}^ members. " The eye can no longer say to the hand, I have no need of thee;" for so close is this union, that when one member sufters, all must suffer ; and when one is honored, all should rejoice. Why in this great family of the ]\Iedical Arts is young Dentistry- so neglected and excluded from the family circle ? Partly because he don't like his books, and this family is proud of its intellect and high education ; partly because he is too fond of his grandfather's workshop. The first is a grave fault, to be hereafter noticed ; but is the second a just ground of reproach ? Shall we stigmatize Dentistiy, born in this 19th century — the century of in- vention — for having so large an element of mechanism? Gentlemen of this Academy, guardians of Dentistry, (as A^et a minor) , do you also share in this one-sided pride of lineage? If Mechanism, j)er se, is discreditable, so is Den- tistry ; for it is its very life blood. As well might a man be ashamed of his own mother. I have elsewhere divided Dental Art into Medical, Sur- gical, and Prosthetic. The two first connect it with the healing art, and demand a medical education ;'bnt the char- acteristic element of Dentistry is its Prosthetics, — just as Therapeutics is the specific function of the l^hysician. To remove diseased structure, and replace it Avith gold, — to remove diseased organs, and replace them with porcelain, — is the work Avhich demands nine-tenths of the dentist's time ; success in which gives him his reputation. You may call the one Operative Dentistr}^, and the other Mechanical Dentistry, if you choose ; but each consists in a series of operations, and both are purely mechanical manipu- lations of material, by means of instruments ; both, also, are acts of replacement. I think it, therefore, more exact and descriptive to subdivide the peculiar work of Dentistry into — Structural and Organic Prothesis. Both are so difficult, that highest excellence in either department is rare, and scarceh^ ever do we meet with a " double first class." Hence, the practice of Dentistry is itself subdivided, following the example of its parent art. But subdivision does not imply less honor in the pursuit, so long as we recognize, in preparation for it, the necessity of a knowledge of the whole art of which it forms a part. This brings us to the only valid objection against the recognition of Dentistry as a specialty of Medicine. If it be true that dentists, as a class, have a more defective education than other specialists ; if it be true that a large number of recognized members of the Dental profession have no medical education whatever, there is good reason for this hesitancv. 8 Is Dentistry, then, a liberal profession ? Yes, certainlvy if the majority of its members are men of liberal education. Medicine numbers among its practitioners very many half- educated and not a few wholly ignorant men. But such are not the men who to-day control that profession; or who, in the past, have given it dignity and reputation. I have already intimated that Dentists are too prone to spend in mechanical details time which should be given to study, and to adopt the popular error that a "mechanical turn" is the one grand element of success. It is indeed a si7ie qua non, without which the selection of the Dental branch of medicine would be a sad waste of eifort. But skill without education, art without science, cannot be called a Profession — I mean in the modern sense in which that term is applied to Law, Medicine, and the Ministry. How shall we separate from the mass of those who call themselves Dentists such as may justly claim to be members of the profession of Dentistry, and, by virtue of this claim, members also of the Medical profession? This is the most imperative, as it is the most difficult, duty which to-day lies before this Academy. Effort in this direction must be co- operative : it must also be harmonious. Personally you are each responsible for your individual reputation ; personally, however, you can do no more than add a unit to the collective reputation of the profession. But, by associate action, you can decide who shall unite wit;h you in establishing a general professional character. Dental societies, associations, and academies have here- 9 tofore suffered other and less important objects to engross the hours of conference. Undoul^tedly much good has been done l)y such meetings. But to what purpose do you im- prove the tiehl of your hil)ors unless you tirst enclose it, and have a well guarded entrance ? What harvest can ]:>e gathered on an open common? Gentlemen, I call upon you, first of all, to establish your metes and bounds, and enclose your domain; for then, and only then, can you hope to reap the fruit of your toil. Then, with some hope of general adoption, can you frame a code of professional ethics, and encourage gentlemen to enter the profession by guaranteeing them the courtesy due to gentlemen. Then can you establish a higher standard of work than cheapness, and bring about a more generous rivalry than underbidding and defamation. For you well know that there is a large class whose actions, unnecessary to be here specified, gTeatly damage the character of the pro- fession which it is your pride to honor. You must exclude or reform them — and that by no half-way measures — or you must fall to their level. You must also establish a Dental Literature. I do not mean text books, although these might be increased in num- ber, and, in some departments of the art, greatly improved. I do not refer to so-called Dental journals, which, for the most part, are chiefly advertising media of depots or col- leges. Xow and then we find in them an excellent article ; but alas I what an iteration, ad nauseam, of experiences, 10 which a little more reading, study, and general education might have spared both writer and readers I I speak of thouohtful and well written monographs and treatises, which shall not only interest the dental, but command the notice and approval of the medical profession ; articles, showing that there are able and experienced men in your profession willing to spend some hours for its advance- ment, not measured by the golden rule of the operating chair. Making ample allowance for difference in the number of physicians and dentists, Ave are forced to the conclusion that Dentistry is the least literary of all the departments of Med- icine. Let us charitably attribute this to the modesty of a young profession, and hope for better da3^s. A much neglected yet most important element of Dental art is its ^"Esthetics. It is a fact, much to the discredit of the profession, that many forms of great beauty in ceramic art lie in dental depots unsought for, because of the inca- pacity of dentists to appreciate and use them. Thus artistic genius is repressed in its efforts to benefit Dentistry, and the Art itself suffers in reputation, because it seems to be incapable of what it can really accomplish. Take this in connection with one other fact — that second and third rate appai-atus, implements, and materials find more ready sale than lirst class and higher priced ones — and we are brought to the melancholy conclusion that not only is there too little Science amono^ dentists, but that the much boasted "Art 11 and skill " which is to take precedence of all other (jualifi- cation, is really not of the highest order. I frravelv doubt if the averao^e mechanical skill exercised in dental offices and laboratories would l)e tolerated for a day in any machine-shop in the land. When I said that in mechanism ^er se there Avas nothing degrading, I referred to no such work as this. For there is here an incompetence or a neglect Avhich has nothing to excuse or redeem it, and which is, in the highest degree, disgraceful. It argues nothing against the Dental profession to condemn such workers, for they do not l^elong to it. I have reserved for hnal consideration the duty of your Academy in the matter of Dental Education ; for in this work the Academies and Societies of the profession must take the lead, — the Colleges play only a subordinate part, however important. ^Misapprehension on this point has led some of the best men of the profession to censure our col- leofes with undue severitv. They have done great good, and their teachers have gen- erously given a vast amount of time, thought, and labor to the cause of education. I say given; for the compensation, as compared with that awarded to dental services, has ever been paltry,, and has often been in the form of actual loss. Had those who blame been half so faithful to their office students, as college professors to theirs, the schools would have had better material to deal with. Had societies en- forced compliance with the standard of the colleges, low as it is, we should to-day have had a far higher standard of 12 professional education. As it is, the better half of the young men of the profession owe more to the colleges, than to any other single influence. Although therefore not failures, in that they have done much good, yet must we Avrite on the walls of our colleges the sad word " tekel." They have been " weighed in the balances, and found wanting," not only because unsustained, but because organized after the model of American Medical schools. ^Medicine gains no honor through the average medical graduate ; and more credit is given to the average dental graduate, only because so mau}^ dentists lack even that amount of preparation. The American physician supplements the defect of his education by walking the hospitals of England and Europe. But American dentistry so far excels the transatlantic in her Prosthetics, that Europe comes here to learn. Where, then, can we go to make up our shortcomings in the other branches of Dental Education ? I answer : by remodelling the entire s^^stem of dental instruction. All Dental Colleges south of Boston are organized upon the plan of the Baltimore College of Dental Surgery, ta whose principal founder. President Chapin A." Hakkls, the profession is so greatly indebted. You will, I trust, acquit me of disparagement or disrespect to my college, the Alma Mater of some meml)ers of this Academy, if I tell you what I think are the grave defects of this organization, as time and experience have revealed them. First, then : it receives students without preliminary ex- 13 amination. Xo literary college does this ; aud no pro- fessioual school can do it, without gross injustice to itself. It is hard enough to be compelled to crowd four years' teaching into eight months. . But when the recipients of this teaching have no trained habits of study ; know nothing of the fu'st elements of science, and have not even such slight knowledge of Latin and Greek as enables them to under- stand the necessary technicalities of Medicine, — then is the work of instruction worse than Egyptian bondage ; it is, truly, "making bricks without straw." Secondly : it examines for graduation after two terms of study. So much has been said upon this point, that I shall dismiss it Avith one remark. The profession that tolerates, for its raw recruits, less than four years of diligent study (mark me, I do not mean simply four courses of lectures), must be content to allow its colleges to send out many grad- uates imperfectly prepared to enter its ranks. Thirdly : the Faculty are the Examiners for graduation. One of three evils is unavoidable. The professor must hold himself sternly aloof from his pupils, thus loosing one of the most effective aids to his teaching — tlie friendly word of advice and encouragement. Or he must do grievous violence to his feelings by rejecting those, whose struggling progress he has watched and aided with such interest. Or he must risk the character of the profession and of his school by giving honor to those unworthy of it. No teacher should be placed in this dilemma. The Eng- lish examiner gets handsomely out of it, by retiring from the 14 room, if the student chances to be even socially and ever so slightly kno>Yn to him. I commend the English custom for American adoption, well satisfied that, until exammers and teachers are totally distinct bodies, no diploma can be quite clear fi*om suspicion of partialit3\ It is said that Faculties are afraid to be rigid in examina- tion, for fear students will prefer a more lenient school. Tli^^^e sooner such a school ceases to have graduates the bet- ter. But gentlemen, in justice to students, permit me to give, as the result of my twenty years' experience, that all students, who deserve the name, respect and love most those teachers who put them through the severest drill. To the Boston Faculty of Dentistry I tender this word of advice : Be as radical in your profession as you were in your politics. Refusing to compromise with slaver}^ you, with a high hand, abolished it. Do not, then, be yourselves slaves to the past, through timid fear of the consequences of radi- cal innovation. As Alumni of the Baltimore School, give your Alma ]\Iater all honor for what she has done, but do not copy her mistakes. Thirt^^-three years is an average human life, but a very short period in the existence of a profession. Dental edu- cation may, without shame, confess the errors of its infancy, especially if this confession throws light upon the pathway of the future. The new experiment can come from no city with better grace, than from the modern Athens. May I, gentlemen of the College and the Academy, wish- ing heartily success to your eftbrts, offer for your considera- tion a few parting words. V) Under the shadow of old Harvtird, do not make your connection with her Faculty a pretence and a sham by accepting students, who haA'e not pursued an honoral^le course of literary study. Working in harmou}' with the ]Medical School, do not dis- honor your specialty b}^ accepting from your graduates any lower grade of medical knowledge, than is required for the occulist, aurist, or general surgeon. Build up for Dentistry what other departments of Medi- cine possess in their magniticent hospitals, asylums, and infirmaries. For medical education is rapidly resolving itself into clinical instruction in specialties. The time, I think, is not very distant when a rigorous examination in the science of general medicine will be demanded as essen- tial to admission to the wards of all hospitals for specific diseases, and when years spent in the best of such institu- tions will be the only recognized qualification for the practice of any medical specialty. If the College will thus acquit itself, and the Academy will labor in connection with other societies in the States for the establishment of a " Supreme Court," whose decisions as to professional character shall be final — Dentistry will enter upon its manhood under auspices which will attract her right proportion of the genius, talent, and energy of the country, and will reflect back upon her nieml)ers the honor and dignity which she receives from them. UNIVERSITY OF CALIFORNIA LIBRARY Los Angeles This book is DUE on the last date stamped below. Form L9-116?n-8,'62(D1237s8)444