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 AN ESSAY BY 
 
 C. STODDARD^MITH^P. D. S., 
 
 Of 3iTE-";77-.^K.IC, -^iTSr:^ TEieSE-ST, 
 
 BEAD BEFOEE THE 
 
 lllittois ^tate gewtal ^0det§^ 
 
 At its Session held at Rockford. 
 
 May 14, 15 and 16, 1878. 
 
 CHICAGO: 
 
 Jameson & Morse, Peintees, 162-164 Claek Steeet. 
 1878.
 
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 Is Dentistry a Specialty of Medicine? 
 
 BY C. STODDARD SMITH. 
 
 The common, in fact almost universal and generally accepted 
 answer to the question contained in the caption is, that dentistry is a 
 specialty of medicine. That such is the case has heen assumed by 
 colleges, which embody this idea in their announcements and curricu- 
 lums ; by societies which so state in their constitutions ; and by writers, 
 journalists, and practitioners generally. 
 
 In this paper we shall take issue with this view of the matter, 
 and shall present such reasons as occur to us in suj)port of the proj^o- 
 sition -that dentistry j-s not, or at least oru/ltt not to he, a specialty of 
 medicine. 
 
 If dentistry ivas a specialty of medicine, it would follow that the 
 medical text books and curriculums should embrace a more or less 
 complete exposition of dental science ; that a medically-educated 
 man would /;// virtue of his medical education and knowledge, be at 
 least measurably fitted to practice dentistry. Are these propositions 
 true? Is either of them true? Let us see. 
 
 First, do the medical text books contain, and do the medical pro- 
 fessors teach, anything which by any means could be considered an 
 approach to correct dental teachings? It is notorious that they do 
 not, as could be al^undantly shown by extracts from standard medical 
 works, which want of space will not permit us to make. 
 
 Incomplete, as applied to these teachings is not the Avord; inaccu- 
 rate is better, but does not express the fact; ridiculous nonsense is 
 nearer to it in many cases. These books show that the writers, emi- 
 nent men in their profession, had not the shghtest idea of the true 
 cause of dental troubles, or their appropriate remedies. This is not 
 to be wondered at. It is but a short time since they were, on strictly 
 medical subjects, floundering in the depths of ignorance; treating dis-
 
 eases as "humors," blistering, purging and dosing in a wholly empirical 
 manner; and, — the more's the pity, — they have not wholly gotten over 
 it yet. But does this indicate that they are competent to teach dentists 
 what they need to know in order to practice dentistry successfully? Do 
 the teachings or the books in any degree lit the student for such a 
 practice ? 
 
 Then, second. Is a medicaUy-educated man able, hy virtue of 
 his medical education, to practice dentistry properly"? A moment's 
 reflection wiU, I think, convince a thoughtful and observant mind that 
 such is not the case. Every one of you kuoir^ it is not. You know, 
 and I know, that if the preservation of our own teeth, or those of our 
 families, depended upon the treatment they could receive, not from 
 the young medical graduate merely, with the odcn- of the hospital and 
 dissecting-room stiU chnging to him, but from the educated and tal- 
 ented physician or surgeon, of large ex^ierienee and great success, 
 posted in all the hterature of the profession, eminent in diagnosis, we 
 should stand but an exceedingly shm chance of retaining any of tliem 
 longer than Dame nature and the destructive influences of the mouth 
 would allow them to remain. Imagine yourself for a moment, with a 
 carious cavity in close proximity to the pulp, and dependent for treat- 
 ment upon the village doctor, or even on the most skillful medicus you 
 can caU to mind. Do you think you would sit calmly and aUow him 
 to scrape and punch that tooth because he was a fine anatomist, or 
 because he had eminent skill in the treatment of typhoid or scarlet 
 fever? In aU candor, would you not rather trust the village jeweler, 
 (supposing him to be an intelUgent man,) to whom in a half hour's 
 talk and demonstration you could explain the location of the pulji, and 
 the operation necessary? We had almost said woidd you not rather 
 trust the village blacksmith, or the machinist from the shop? For our 
 own part, we would not only sooner trust the jeweler, but if we wanted 
 to make a successful and a skillful dentist, we would select the intelli- 
 gent jeweler, or even machinist, in preference to the doctor, and there 
 would be reason in the choice. The training in the one case would 
 have been in the line of the daily requirements of the dentist; in the 
 other it would have been in quite another direction. Medical educa- 
 tion, be it ever so thorough, does not in any degree qualify, it does not 
 evenprejyare its possessor for dental practice; at least not nearly as 
 much so as does the work of the jeweler, or mathematical instrument 
 maker, who are accustomed to handling dehcate instruments and to 
 making fine adjustments. Even as regards the comparatively simple 
 and measurably surgical operation of extracting teeth, do you know 
 any, or at least many general practitioners who perform it with any 
 degree of skill? Do you not have any number of broken teeth coming
 
 from them as an evidence of their bungling when they attempt to per- 
 form what ordinarily is but a simple operation of what is claimed to be 
 only a " specialty of medicine?" If we are to judge what they know 
 of their profession by what they know or what they can do in what is 
 claimed as a specialty of that profession, they are but a sorry set of 
 men to be intrusted with the life and health of their fellow creatures. 
 I have a better opinion of them than that. I believe their knowledge 
 and ability on this subject, is- not an index of their skill and success in 
 their own department. They do know medicine, but they dont know 
 dentistry; and the best of them know they do not. The more intelli- 
 gent and enlightened they become as regards dentistry, the less they 
 want to meddle with it or its operations, unless indeed they become 
 dentists. 
 
 So much for the skill; now for the knowledge. I need but to 
 refer to the oft-told tales of doctors who treat alveolar abscess for 
 months supposing it to be erysipelas, who treat neuralgia as a consti- 
 tutional disease, because the " teeth are all sound," or have fine " sohd " 
 fillings in them; who do not know that a wisdom-tooth may cause 
 almost any trouble about the face ; of the surgeons who gravely pro- 
 nounce an old root covered with salivary calculus, to be an " osteo- 
 sarcoina " ; of the almost universal practice of the M.D.'s who prescribe 
 acid medicaments in blissful ignorance or willful disregard of thei 
 effect upon the dental structures; of the doctor who assures the parent 
 that the sixth-year molar is a milk tooth, and should be extracted. 
 Every one of us has seen more or less of this sort of thing; every one 
 of us knows that these accounts are usually accompanied by the state- 
 ment that the thing was " done by one of our best physicians." These 
 things show, not only that medical men, as such, have no skill in dent- 
 istry, but that they are wofully deficient in hiowledge as well ; in fact, 
 they are but little above the intelligent non-professional in either respect. 
 
 And further; do medical men necessarily or even usually make 
 the most successful or skillful dentists? We will not say what has been 
 said, that 31. JJ. stands for miserable dentist; but we will say that in 
 our opinion, as a rule the M.I), members of the profession are not 
 at least any better than the rest ; and we do not believe they will aver- 
 age in ability as well as an equal ni;mber of equally intelligent non- 
 medical men. Call to mind those of your acquaintance and see how 
 they stand. Go abroad and see how the long, scholastic and medical 
 European training makes fine operators, or rather see how it does not 
 do it. 
 
 The main reason, as we understand it, for claiming that dentistry 
 is a specialty of medicine, is that the teeth are a part of the human 
 frame; that they and the adjacent parts are subject to disease; and
 
 that he who treats those diseases properly must understand the human 
 frame, and the treatment of disease; ergo he is a physician. Indeed 
 it has been broadly stated that if we are not medical speciahsts we are 
 a set of cai-penters. But let us see if this statement is really true — if 
 this conclusion necessarily follows. Granted that the teeth are a part 
 of the human organism, and subject to disease, which none will deny. 
 Granted that a knowledge of anatomy, of physiology, of therapeutics, 
 is necessaiy to the proper treatment of dental lesions. Does it foUow 
 because the medical man must also study these, — because both he and 
 the dentist are obhged to get a part of their prehminary information 
 from the same text books, — because certain knowledge underhes both 
 professions, that the one is a branch or speciiUty of the other? All 
 knowledge is founded upon certain substructm-es which are common to 
 aU branches ahke. What sort of an argument would it be to say that 
 architecture was a branch or specialty of astronomy, because both the 
 architect and the astronomer nmst understand mathematics, and must 
 occasionally use the iiile of three in working out their problems; 
 because both make drawings upon paper to record the work of their 
 brains? Shall we say that pharmacy is a specialty of medicine because 
 both reqiiire a knowledge of drugs and chemicals? Shall we say that 
 the maker of artiticial legs is a medical speciahst, because he would 
 need to understand the anatomy of the leg in order to construct his 
 substitute, and because he has to deal with li\-ing tissue when apply- 
 ing it ? The temple of science is not a collection of columns, each 
 standing upon its own pedestal, and each crowned with its appropri- 
 ate biist or sculpture. It is rather a magnificent edifice, whose founda- 
 tion stones are planted upon the solid rock of truth, and are interlaced 
 and interlocked; its lower stories are all communicating, and all 
 subsei*vient to the uses of the upper parts, from which rise the several 
 spires, cupolas, turrets, minarets and towers devoted to the various 
 branches of science and art, differing, it may be, in architectiire, in 
 height, in magnificence, but all ahke parts of one harmonious and 
 imposing whole. 
 
 It is true that the dentist and the physician must have much 
 knowledge in common ; but it is not therefore true that dentistry is a 
 branch of medicine. Though there is much in common, there is 
 more that is not so. What has the physician (as such) to do with 
 metallurgy and plaster-of-paris, and sand and zinc, and tempering 
 steel; with the cohesive properties of gold, the proper vulcanizing 
 point of iiibber, or the manipidation of celluloid? What does he 
 know,— what in the nature of the case can he know, about the thou- 
 sand deUcate manipulations of the skillful dentist? His time and 
 brain are fuU of symptoms and doses ; if he knew ever so much dent-
 
 istry he would not be able to use his knowledge. What has the dentist 
 (as such) to do with obstetrics, with ophthalmology, with cardiac 
 disease, with lung or liver disease, with cerebral disease, with venereal 
 disease? Why should he waste his time, and that to no purpose, in 
 studying these diseases, their symptoms and their treatment? We 
 say waste his time, not because such knowledge is not desirable, and 
 might not be valuable ; so might a knowledge of chem^^try, or of many 
 other things; but who expects a dentist to be a thorough chemist, and 
 how is it possible for him to be one ? Chemistry is not a by-play, a 
 thing to be mastered in odd moments; it is a life-study, and enough 
 so to engage the ablest minds. We say waste his time, because aU the 
 knowledge that he might obtain from books on these subjects, or even 
 from a hospital experience, should he have it, would be utterly useless 
 to him in his hfe work ; not because he might not have occasion to use 
 it, but because when wanted he could not depend on it. Such knowl- 
 edge, to be of any practical use, demands not only jjreliminary study 
 and clinical experience, but .constant and ceaseless observation and 
 practice in order to render it of any rehable service, which, by the 
 nature of the case, is out of the question. Which of you, if you tilled 
 a tooth but once a year or once in five years, could do justice to the 
 work? What graduate (unless he be possessed of an exceptional 
 memory), can tell three years after commencement the names of the 
 muscles, or the bones, or the origin and function of the nervous 
 trunks? Who of you would trust the hfe of a dear one in a crisis, 
 with a man who, though he might knoio the symptoms of the fever, 
 was not practically familiar with the thing itself ? 
 
 We say waste his time, not because there is not much in these 
 things that is desirable and proper for a dentist to know, but because 
 it is utterly impossible that he shoidd know all or even any consider- 
 able portion of what is just as desirable and proper to be known. 
 Dentistry itself is a life-work, a life-study; it takes a whole man to be 
 a dentist, and it should occupy the whole attention. Foi* a man to 
 undertake to thoroughly master all that is collateral to it, would be 
 like the attempt of the landshark to buy all the land that joined him. 
 He would soon find himself upon a hmitless expanse. The thing is 
 impossible; it cannot be done. To attempt it would be to frustrate 
 the objects aimed at, for no time or strength would be left for the thing 
 itself. And when it comes to choosing, as it certainly must come, it 
 is the part of wisdom to choose that which will best fit one for the 
 practical realities of one's chosen pursuit. In ordinary education this 
 is being more and more generally realized; it is recognized that the 
 study of the classics and other branches, do not tend to fit men, — 
 indeed it is sometimes claimed that they vnjit them— for the practical
 
 business of life; and, consequently, technical and i^olytechnic and 
 other practical courses of study are more popular than classical. The 
 ideal dentist may be fully educated in chemistiy, in metallurgy, in 
 physiology, in therapeutics, in anatomy, and aU kindred and cognate 
 sciences ; biit that ideal dentist will never exist while flesh and blood 
 and human capacity remain as they now are, simply because his exist- 
 ence would invc^ve physical impossibilities. 
 
 Let us not be misunderstood. We go for the broadest, the high- 
 est, the deepest culture possible, in all departments of human activity. 
 But life is short and art is long. It is given to but few men to become 
 possessed of eminent or even of tolerable knowledge in more than one 
 department; it is, in fact, given to but few to become really eminent 
 in even one department. The great mass must rest content if they 
 attain sufficient knowledge to enable them to become efficient workers 
 in any single department of the world's great work-shop". But let 
 every man first possess himself of just as much jireliminai-y education 
 as his position, means, and ambition wiU enable him to get; then, 
 having settled upon his caUing, master that ; aftenvarih, let him 
 acquire just as much collateral or other knowledge, as his situation 
 and justice to his chosen occupation will pei-mit. But let him not 
 flitter away his energies in an attempt to make a quart measure hold 
 a peck, or a blanket cover an acre ; to master all the branches of medi- 
 cine becaiise he washes to be dubbed a specialist. 
 
 Far better will it be, both for him and his patients (if he is to be 
 a dentist), that he spend his time and j^owers in obtaining that skill 
 which he will need every day, and of which there is no danger of his 
 having too much. 
 
 But it is said that the greater includes the less, and that anything 
 else than a full M. D. is but a "partial culture." The greater does 
 include the less; bvit who said that dentistiy was less than medicine? 
 That is assuming the very point under discussion ; arguing in a circle. 
 Those who claim that dentistry is a specialty of medicine, would make 
 it less' roe claim that it is the proud ^jee*- of medical science. Not in 
 age, it is true; we cannot look down the vistas of the past and see an 
 unbroken siiccession from the times of Galen and Esculapius. But in 
 our vigorous young manhood, in the skill and certainty we have attained 
 in the performance of our operations, in the "good that we can do" to 
 suffering humanity, jjalliative, remedial and prophylactic, we are 
 certainly the peers of any craft, profession or calling, be it ancient or 
 modern, be it professional or mechanical. We are not "the less," 
 nor are we included in the greater. 
 
 "Anything short of a full M. D. is a 'partial culture.'" We 
 have shown in what seems to us an unanswerable argument, that an
 
 M. D. does not imply, or eveu indicate, a capacity to j)ractice dentistry. 
 As to the statement, that an education which fits a man only to prac- 
 tice dentistry, is but a "partial culture;" Ave admit it; it is but a 
 "partial culture." But show us the inhabitant of this sublunary 
 sphere, who has anything else than a partial culture. What title 
 conferred by mortal man, indicates that its professor has mastered all 
 that is to be known ; that no worlds in the realms of knowledge 
 remain for him to conquer; that all the cosmogony and theology, of 
 the here and the hereafter, is to him but as a lesson learned? A "partial 
 culture," it is true; but alas for human nature; it must await transla- 
 tion to another sphere, where knowledge and existence are alike 
 infinite, before it c;in hope for more than this. A "partial culture;" 
 yes; but Newton, the great and erudite philosopher, to whose acquire- 
 ments, few if any, can aspire, much less attain, was forced to admit 
 at the close of his life, that so far from crossing the great ocean of 
 knowledge, all that he had done was to stroll along its shores and 
 gather a few pebbles from the beach. 
 
 The fact is, and it cannot be disputed, that nine-tenths of the 
 practice of dentistry, is mechanical. It is worthy of notice, that the 
 more completely we accomplish that thing in regard to which we talk 
 so much, and we fear accomplish so little — the enlightenment of the 
 pubHc — the more complete the mechanical character of the practice 
 becomes; that is, the better care people can be induced to take of 
 their teeth; the oftener they submit themselves and their children for 
 treatment, the less of disease as such, as distinguished from tlental 
 caries, we will have to take cognizance of, and the simpler our opera- 
 tions as a whole will become. If dental caries is a disease at aU, 
 the treatment of it ( simple caries of course, we mean ) is purely 
 mechanical. And sometimes we think that with all our boasted 
 progress, we who can circumnavigate the globe, can put a girdle 
 aroimd the earth in forty minutes, can tunnel under lakes, and rivers, 
 and mountains, can talk through wires, and make the lifeless iron 
 speak, who can count the very stars of the heavens, and weigh the 
 sun as in a balance; ought to be ashamed of ourselves when we are 
 compelled to admit that we cannot put a gold filling into a little 
 miserable cavity in a tooth, so that it will arrest decay, or find some- 
 thing else that wiU do it. 
 
 But dental practice is not all mechanical; else it were a trade as 
 is the tinker's, as it was when it began, or as is the barber's trade 
 to-day. It reqiiires with this mechanical dexterity, education of the 
 brain, to know the characteristics of the parts on which it operates; 
 it requires judgment, study and thought all the way through, and 
 these constitute it a profession. But it is a pursuit sui generis, of its
 
 own exclusive kind, and as I maintain, separate and distinct from all 
 the rest. An education of the fingers far exceeding that of most of 
 the trades; education of the head as well as the hand; judgment, 
 skill, dexterity, and all of the highest order ; are not these qualities 
 sufficient to give us a foundation upon which to rear our own edifice, 
 without asking to he attached like a lean-to to the great temple of 
 Esculapius? Da we gain diguity hy clinging to the coat-tails of medi- 
 cine, clamoring for "recognition," instead of standing boldly uj) and 
 proclaiming ourselves, as did the infant colonies, free and independent? 
 Away with such servile cringing; such degrading sycoj)hancy ! They 
 do not want us within their doors ; let us manfully stay outside, and 
 show them that while we understand onr business, we do not claim 
 to understand theirs. Let us show them that we mean to be dentists, 
 and not medical speciahsts. Let us know enough of the branches 
 common to both professions, to enable us to consult with them intelli- 
 gently ; enough of their profession to know when we should hand our 
 patients over to them. Let us respect their rights and knowledge in 
 their department, as we ask them to respect ours, and not interfere 
 with their jjills and powders, or undertake to treat teething childien 
 or miasmatic influences. Let lis ask them to study so much of our 
 professional knowledge, as to know enough when anything is the mat- 
 ter in the region of the mouth, to consult an intelligent and skillful 
 dentist, and be wiUing to abide by his advice ; and let us during such 
 intercourse, not endeavor to create the impression upon the mind of 
 either the physician or patient, that we are physicians, which we are 
 not, and understand medicine, which from the nature of the case we 
 cannot; but rather let us show by our conversation and opinions, but 
 above all, by our operations, that we are dentists and understand den- 
 tistry. Let each profession know thoroughly so far as necessary to 
 each, those branches which underlie both in common ; let us know in 
 addition, all we can of the other's profession, as we do of all other 
 knowledge which goes to make us intelligent, educated and well 
 informed citizens. Let us make both the medical profession and the 
 community respect oxw skill and attainments ; but do not let us lay 
 claim to being what we are not. Thus, side by side, and hand in hand, 
 let the two sister professions go together, each according to the 
 other, all the honor, dignity and knowledge to which each is entitled ; 
 fraternizing and consulting with each other and laboring together, and 
 in unison, for the good of our fellow men.
 
 UNIVERSITY OF CALIFORNIA LIBRARY 
 
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