Further Inquiries into Processes of Extraction

Recuperating from a dental procedure provides a swell excuse for continuing my online reading into the history of dental practices. Teeth are a big deal for us humans, and even more so for us vain and image-conscious moderns, so there’s no shortage of interesting material to sift through. My favorite bits today:

–This piece of 1815 advice regarding what we call flossing: “A waxed thread passed between the teeth after every meal will save more teeth from decay than all the brushes and powders that can be used….” That’s from Levi Spear Parmly, a prominent American dentist also notable for being an early advocate of the theory that some sort of acidic substance resulting from the presence of old food particles was responsible for cavities. Despite Parmly’s insight, it took another 80 years after he introduced his waxed-string idea for the stuff to become a commercial product.

–Not strictly tooth-related at all: A short article from Scotland’s wonderfully entertaining (and perhaps defunct) History of Dentistry Research Group Newsletter. Last fall’s number included a short write-up on a piece of early 15th century surgery involving Prince Hal, the ne’er-do-well/king in waiting depicted in Shakespeare’s “Henry IV” (parts I and II) and “Henry V.”

To go back to the early 15th century: In the climactic battle between the prince’s father, Henry IV (viewed by many as a usurper), and his northern enemies, the prince opened the visor of his helmet at an inopportune moment and was struck in the face with an arrow. Problem: The arrow sank so deeply into the skull structure to the left of the prince’s nose that it couldn’t be freed and removed. Enter John Bradmore, surgeon and handyman extraordinaire:

“The aforesaid noble prince was cured by me … at the castle of Kenilworth — I give enormous thanks to God – in the following manner. Various experienced doctors came to this castle, saying that they wished to remove the arrowhead with potions and other cures, but they were unable to. Finally I came to him. First, I made small probes from the pith of an elder, well dried and well stitched in purified linen [made to] the length of the wound. These probes were infused with rose honey. And after that, I made larger and longer probes, and so I continued to always enlarge these probes until I had the width and depth of the wound as I wished it. And after the wound was as enlarged and deep enough so that, by my reckoning, the probes reached the bottom of the wound, I prepared anew some little tongs, small and hollow, and with the width of an arrow. A screw ran through the middle of the tongs, whose ends were well rounded both on the inside and outside, and even the end of the screw, which was entered into the middle, was well rounded overall in the way of a screw, so that it should grip better and more strongly. This is its form [See Fig 2. and note]. I put these tongs in at an angle in the same way as the arrow had first entered, then placed the screw in the centre and finally the tongs entered the socket of the arrowhead. Then, by moving it to and fro, little by little (with the help of God) I extracted the arrowhead. Many gentlemen and servants of the aforesaid prince were standing by and all gave thanks to God. And then I cleansed the wound with a syringe [squirtillo] full of white wine and then placed in new probes, made of wads of flax soaked in a cleansing ointment.

Squirtillo? Have to find a place to use that word.

If you’re wondering what Bradmore’s implement looked like, Hector Cole, a modern English arrowsmith, created a reproduction based on the doctor’s own description and drawing. Again, you wonder at the patient’s fortitude. On the other hand, after two weeks with an arrowhead stuck in your skull, maybe you’d be willing to try just about anything.

The Molar Experiment (II)

Just what I was looking for:

“They passed through the large light room to the operating-chair in front of one of the two largest windows. It was an adjustable chair with an upholstered head-rest and green plush arms. As he sat down, Thomas Buddenbrook briefly explained what the trouble was. Then he leaned back his head and closed his eyes.

“Herr Brecht screwed up the chair a bit and got to work on the tooth with a tiny mirror and a pointed steel instrument. His hands smelled of almond soap, his breath of cauliflower and beefsteak.

” ‘We must proceed to extraction,’ he said, after a while, and turned still paler.

” ‘Very well, proceed, then,’ said the Senator, and shut his eyes more tightly.

There was a pause. Herr Brecht prepared something at his chest of drawers and got out his instruments. Then he approached the chair again.

” ‘I’ll paint it a little,’ he said; and began at once to apply a strong-smelling liquid in generous quantities. Then he gently implored the patient to sit very still and open his mouth very wide – and then he began.

Thomas Buddenbrook clutched the plush arm-rests with both his hands. He scarcely felt the forceps close around his tooth; but from the grinding sensation in his mouth, and the increasingly painful, really agonising pressure on his whole head, he was made amply aware that the thing was under way. Thank God, he thought, now it can’t last long. The pain grew and grew, to limitless, incredible heights; it grew to an insane, shrieking, inhuman torture, tearing his entire brain. It approached the catastrophe. ‘Here we are,’ he thought.’ Now I must just bear it. …”

That’s from “Buddenbrooks,” by Thomas Mann. Just part of that mountain of world literature I’ve never cracked. But that passage, reprinted on a history of dentistry website, comes up pretty high on the list when you Google dentistry history description of extractions. It’s worth checking out the passage. As the item’s commentator notes, “The lack of use of any analgesics, especially narcotics, which were freely available at that time, as well as alcohol, was surprising.”

My experience today didn’t resemble what poor Buddenbrook went through. I was thoroughly numbed with Novocain or one of its cousins. Just before the work began, the surgical assistant mentioned the availability of nitrous oxide. I hadn’t ever had any in a dental setting. I thought about it for a minute then said I’d like to try it.

The doctor needed to take out four teeth, and my appointment was for an hour. I imagined a full hour of extractions. But the office was playing a sort of soft rock station, and I think it took about four songs for the the guy to get all four teeth out — I remember Crosby, Stills & Nash, the Goo Goo Dolls and Fleetwood Mac, and the doctor actually hummed or sang along as he worked. I wondered whether he’s so used to working on patients who can’t hear him that he wasn’t thinking about it.

The hour wasn’t painless, but it wasn’t excruciating. And after the job was done, I was perfectly alert and didn’t have to deal with any of the possible issues in more general sedation. If my mouth hadn’t been stuffed full of cotton gauze, I would have had a few bon mots to share; as it was, I could barely say a phone number when the surgical assistant asked for it.

The rest of the day: Well, now it hurts. But not unbearably so, thanks to a combination of hydrocodone and acetominophen (one handy pill; take one or two every four hours). The bleeding’s stopped. My face isn’t too badly swollen. I’m ready for the post-wisdom-tooth era to begin.

The Molar Experiment

Over the past few years, both of my kids had their third molars — their wisdom teeth — extracted. I guess it’s just done routinely now. When I was their age, my wisdom teeth came in and stayed; there was room for them to grow in and they never seriously pushed anything else out of the way. Firmly anchored in my jaw — that’s where they’ll stay until just after noon today.

A couple years ago, our old dentist sold his practice. His philosophy on the wisdom teeth was that unless they were causing real problems, it was more trouble than it was worth to bother with taking them out. Then the new dentist took a look. Among the very first things he told me was that they had to come out; it was a matter of general oral health, he said, and that the presence of the wisdom teeth would make it harder to take care of the rest of my teeth (such as they are: thanks to a younger life filled with an enthusiasm for sweet stuff matched only by my carelessness in brushing and flossing, I’ve got a mouth full of fillings and a variety of interesting dental hardware).

So today’s the day. All four wisdom teeth: out. Generally, I’m told, the method is to sedate patients — knock them out — so that they really don’t experience “the procedure.” Not me, though. Through a misunderstanding with the dentist’s office, I wasn’t told that I couldn’t eat this morning. After I’d had a bear claw and a cup of coffee, it occurred to me that maybe I shouldn’t have been eating. I called the dentist’s office; the person I talked to expressed alarm, consulted the doctor, then told me I had two options: reschedule the appointment (next opening: September) or be numbed but awake for the procedure.

I had to think it over. My desire to just be done with it won out, so I’m going in and having it done without sedation. I figure if I can sit on a bike for three or four days at a time, I can deal with a very uncomfortable hour of having someone wrestle around in my mouth. I should really stop now, before I talk myself out of it.

Detective Mark Fuhrman Bureau of Parking Enforcement

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I’ve got a neighbor who recently showed up with this minivan. Some afternoons, he double-parks it on the street and just leaves it for hours. Yesterday, he attempted to parallel park it. Nice try.

[The Detective Mark Fuhrman Bureau of Parking Enforcement: Dedicated to the proposition that no vehicle should be parked strangely. Details on the DMFBPE after the jump.]

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June 25, 1876

General Custer: Should I go down there, or withdraw? Well? What’s your answer, muleskinner?

Jack Crabbe: General, you go down there. …

Custer: You’re saying, go into the coulee …?

Crabbe: Yes, sir.

Custer: There are no Indians there, I suppose?

Crabbe: I didn’t say that. There are thousands of Indians down there, and when they get done with you, there won’t be nothin’ left but a greasy spot.

–“Little Big Man” (1970)

Back in 1989 or so, my dad and I drove from Chicago out to the Little Bighorn battlefield. Interstate 90 runs within sight of the place, but we had taken a two-lane road, U.S. 212, up from Belle Fourche, South Dakota, northwest of Rapid City. We figured it would be a more interesting trip, and that route also passes close to Rosebud Creek, the site of a battle between U.S. troops and Indian warriors that took place about a week before the Little Bighorn. As I remember it, we drove around on a gravel road for an hour or so before concluding we had no idea where the Rosebud site might be.

Arriving at the Little Bighorn site on 212 is dramatic. You’re crossing a series of low, rolling hills and rather suddenly catch sight of pastures and planted fields in a relatively broad valley; the river is down there, and so is the Interstate. Crow Agency, Hardin and Billings lie to the north and west; to the south and east are Garryowen (named after the Custer’s regimental song), Lodge Grass and Sheridan, Wyoming. It is not heavily populated country.

Instead of driving down into the valley, you turn into the Little Bighorn Battlefield National Monument. There’s a rather spare visitor’s center and museum there (remember: information current as of first year of first Bush administration; as for today, I note that the National Park Service’s virtually useless Little Bighorn site includes two live webcams). What I’m sure makes the strongest impression on everyone who visits are the white marble slabs, like headstones, that mark the spot where each member of Custer’s force were believed to have fallen. If you know just the outline of the story, the landscape and those markers tell the rest pretty compellingly. (According to the National Parks Conservation Association, the white markers have been supplemented by red granite ones denoting where Indian warriors fell during the battle.)

Midsummer

Solsticecirrus

So yesterday we started talking about midsummer, and midsummer’s eve, and midsummer’s night. This wasn’t a concept I grew up with. There was the summer solstice, which in my mind had a certain precision and meaning — you can point to an exact minute when it (whatever it is exactly) is said to occur, and there was a convenient shorthand for what it was: the longest day of the year. More facts muddy the meaning. For instance, the whole view is hemisphere-centric; in the antipodes, everything’s reversed. For another thing — and if someone who really knows their stuff happens across this, feel free to correct or clarify or even excoriate — there’s no such thing, really, as a single longest day of the year. Several days around the solstice share the distinction as (to be imprecise) sunrise and sunset times waver and move in different directions.

Then there’s midsummer. To a literalist such as your correspondent, that ought to be a time between the summer solstice and the fall equinox, and at some point I may have tried to puzzle out just when in early August that might be. But midsummer, the one celebrated by nonliteralist northern Europeans and literary types such as Shakespeare, really refers to the solstice time. But with a twist: it doesn’t mark the astronomical solstice day, and depending on which brand of midsummer you subscribe to, it may last for several days.

And that’s something I like. The notion of a single moment in which we mark the reversal of the process that makes the days long, the world full and warm and fruitful, is just a little too bittersweet for me. There’s no denying the change that comes after the solstice as the summer grows long. But I prefer having a few days, anyway, to take in the early dawns (not that I see so many) and the long light of the evenings.

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Johnny Appleseed, from Cincinnati

After week two, the thing I think I like best about David (“Deadwood,” “NYPD Blue”) Milch’s new “surf noir” drama on HBO (“John from Cincinnati“) is the song that plays over the opening credits. I listened the first week and couldn’t really catch any of the lyrics. The second week, I replayed the opening a couple of times, and at least got an intelligible first line: “Lord, there goes Johnny Appleseed.”

Armed with that much, the rest was easy. It’s Joe Strummer, late, and late of The Clash, and the song, “Johnny Appleseed,” was recorded with his last band, The Mescaleros. Finding out it was him, it was easy to hear a link to The Clash; one, anyway: “Lost in the Supermarket.”

Among other Google results for “Joe Strummer” and “Johnny Appleseed”: the band’s original video, shot in London, and a 2001 performance on Letterman.

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Solstice Notebook

In six minutes — no, five! four! — something will click into place somewhere out there in the big celestial machine and we in the Northern Hemisphere will be at summer solstice. Get out and enjoy that daylight, everyone. …

(Official solstice time: 11:06 a.m. PDT.)

And then later: The space station and space shuttle went overheard at quarter to 10 tonight, with the solstice twilight still bright. This (below) is the shuttle, which trailed the space station by about a minute (at least 300 miles, I figure). Both flew right through the Big Dipper. Great Bear Transit.

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Road Trip Placeholder (II)

Stronghold062007

Drove back from Portland yesterday, detouring far east of Interstate 5, across the Cascades down to Klamath Falls, Oregon, then one way or another found myself at Tulelake and Lava Beds National Monument in far northern California. Stronghold is a railroad stop, a grain elevator, just outside Newell, California, in the Tule Lake basin. I’m guessing that the name comes from a bit of local history: the last redoubt of the Modoc leader Kintpuash (known to his new white neighbors as Captain Jack; he led the rebellion known as the Modoc War in 1872-73) was in the lava beds a few miles from here. More local history: Newell was also the site of one of the big World War II internment camps for Japanese Americans; eventually, the camp was designated as a segregation center for internees’ whose loyalty was questioned, and it was operated with a heavy military presence. The area feels fantastically remote. A couple archive pictures from the areas agricultural past here and here.

[In the picture above (looking southeast) : If you click for a larger version, Mount Shasta is just visible in the lower right hand corner. Image below looks north.]

Stronghold062007A

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Road Trip Placeholder

Posting from beautiful and warm Portland; the Oregon one. Came up yesterday to deliver my friend Pete’s car. Oh — Pete has moved up here from Napa (California’s loss, Oregon’s gain) and I’ve been doing a couple of odds and ends to help. So I blasted up I-5 yesterday in his turbocharged ’99 Saturn, taking advantage of the long northern twilight to nearly finish the drive in daylight. Anyway, that’s all for now. Heading south in a rented car tomorrow; I imagine it would have been more environmentally responsible and economically rational to fly, ride a bus, hop a train, or stow away in an Oakland-bound cargo container. But I like the chance to see the country, and tomorrow I’ll try a little different route to get from here to there.

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