by Jon Scieszka
Quantum Physics
A teensy tiny entity,
An eensy piece of energy,
Is called a quantum
(Plural quanta).
I could say more,
But just don’t wanta.
Quantum physics says that energy comes in very small packets called quanta (singular quantum). Those packets behave both as particles and waves. Their movement seems random. It is impossible to know both the position and momentum of a particle at the same time. The world of atoms is very different from our everyday world.
THIS WON’T HURT A BIT:
THE PAINFULLY TRUE STORY OF DENTAL CARE
BY JIM MURPHY
When I was six years old, my mother took me to the dentist for the first time. The dentist was a nice man with a warm, reassuring smile. He was also a family friend, so I knew and trusted him.
I remember climbing into the big chair. I wasn’t nervous at all. At least I wasn’t until the dentist said, “Open wide, Jimmy,” and leaned in to take a look at my teeth. “This won’t hurt a bit,” he said as he brought a shiny, pointy, metal instrument closer and closer to my mouth.
It is hard to describe the blood-curdling sound that exploded from my six-year-old mouth, but the scream was loud enough to make the dentist jump back. The next moment I bolted from the chair and ran out of the examination room and out of his office, trailed by the dentist, his assistant, and my mother. After circling the building twice, the adults decided I didn’t have to have my teeth examined that day.
There was no good reason for my panic. No one had told me scary stories about visiting the dentist. I’d never seen a TV show or movie that depicted a mean dentist. Yet something in me—some deep-seated, primal fear—told me that a visit to the dentist could be a very painful experience.
The brief history of dental care that follows is a story of one painful and gruesome encounter after another. Before the invention of effective painkillers and advent of scientific research in the late nineteenth century, the standard treatments for bad teeth were some amazingly horrifying procedures resulting in thousands of years of excruciating pain, broken teeth, and blood. And death. Readers should be forewarned: Everything in here is absolutely true.
Now sit back, relax, and enjoy this. I promise: It won’t hurt a bit.
Sixty-five hundred years ago, one of our Neolithic ancestors from present-day Slovenia (which is up there near northern Italy) had a toothache. It started as a little toothache, then got more and more painful as the days went along, until his mouth throbbed and pulsed and caused him excruciating agony day and night.
His family and friends did what they could to help this young shepherd. Some brewed up a hot tea of bark, leaves, and flowers. Others brought him cold, refreshing water. The problem for our twenty-six-year-old Neolithic man was that his tooth had cracked down the center and the top had rotted out, leaving the sensitive pulp exposed. Every time something hot or cold touched the pulp (in fact, every time he sucked in cool air), an agonizing electric shock of pain racked his body.
Finally someone mixed beeswax with a little honey (when honey dries out, it turns remarkably hard). Then they used a stick to pack the beeswax-honey mixture into the hole and to fill in the large crack. Almost immediately the pain began to lessen. It seemed that a simple bit of dentistry had solved his problem. Only it hadn’t.
No one knew that the inside of his tooth was infected (it would be another 4,900 years before anyone discovered bacteria). Filling this young man’s tooth trapped the infection inside, where it grew and caused his tooth to hurt once again. More of the delicious tea and cold water was brought to him, but it was already too late. The toxic bacteria had entered his bloodstream and quickly made its way to his heart and brain. He died a few days later, delirious and writhing in pain.
Paleoanthropologists (these are really smart men and women who study prehistoric folk) believe this beeswax filling is the first known instance of actual dental work. It may also be the first time a would-be “dentist” inadvertently killed a patient. It wouldn’t be the last time.
Of course, not all prehistoric “dentists” killed their patients. Some were surprisingly skilled. Recently scientists scraped the calcified crud from between the teeth of a Neanderthal man who lived in Spain 48,000 years ago. Analysis showed someone had packed tiny bundles of plants there, which included yarrow and chamomile. Both plants helped cleanse and ease the toothache.
There’s also evidence that prehistoric “dentists” in Pakistan were very good at drilling holes in teeth nine thousand years ago. They accomplished this by placing a flint-tipped arrowhead against the painful tooth and wrapping the string of a bow around it. Cupping the top of the arrow with a stone, they would pull the bow back and forth very quickly, making the arrow spin one way, then the other. It’s estimated that it might take only a minute or two to drill a very neat hole through a tooth’s hard enamel. By the way, when the flint tip is placed on a piece of wood, this is the same method used to start a fire. Most prehistoric tooth sufferers probably felt that a burning-hot mouth was better than a lingering toothache.
None of these nine-thousand-year-old holes had fillings in them. So why drill them? One idea is that this might be evidence of the first theory on how toothaches happened. They blamed it on worms!
A very common belief that lasted all around the world, from ancient times until well into the nineteenth century, was that very small worms were living and feeding inside the tooth. The Babylonians developed a detailed story of the worm in 5000 BC that included this delicious worm-eyed view of what it did: “Out of the tooth I will suck his blood, and from the gum I will chew the marrow.”
Not to worry. The Babylonians had suggestions for a cure. They usually began by paying a priest to say prayers and provide an amulet that had been blessed. The amulet was worn around the patient’s neck to drive out the worm and to insure that no new ones would drop in later for a visit.
If the pain persisted, the patient was given pulverized henbane and beeswax and told to stick it on top of the painful tooth. Warm saliva would allow this mixture to slowly dissolve, bathing the tooth with the medicine. A small amount of henbane can relax a person enough to put him or her to sleep; an overdose can put the patient into convulsions or even kill him or her. Unfortunately not many early priest-dentists knew when too much was too much.
The other cure was to take henbane or other painkiller plants, light them on fire, and blow the smoke into the patient’s mouth. The notion was that the smoke would upset the worms, and they would slither to escape the tooth and mouth. Of course, some cultures took this to an extreme. The Japanese decided that if smoke was good, fire was better. They took herbal plants and combined them with cotton or wool, placed this wad on the painful tooth, and set it on fire. The hope was that the worms would die, but the patient wouldn’t.
Sometimes this treatment didn’t work and the pain became so horrible that the sufferer begged for relief. This usually meant removing the tooth. To accomplish this, a stick was placed against the side of the offending tooth and hit with a rock or hammer. A few solid whacks would get the job done, though shattered teeth and broken jawbones were fairly common. Cost-efficient “dentists” in Japan simply used their fingers to wiggle the tooth loose. By the way, the increase in tooth extractions might very well have resulted in a new sort of job—a dental assistant was required to hold the patient down as his or her tooth was knocked out.
Clearly enough of these treatments failed that they eventually drew the attention of authorities. Around 1772 BC a code of laws was issued by the great ruler of Babylon, Hammurabi. According to King Hammurabi, “Should a patient lose his life owing to an unsuccessful operation, the surgeon’s two hands should be struck off as punishment.” No record exists about Hammurabi’s encounters with his day’s priest-dentists, but this law suggests they probably weren’t pain-free.
At around the same time, the Egyptians were establishing their own medical and dental practices. Temple priests b
egan to train to handle all medical problems (including tooth- and gum-related ones). These physician-dentists soon came to the conclusion that worms had nothing to do with toothaches, and that prayers and blessed amulets did little good. The real problem, they insisted, was an imbalance of the body’s humors. According to ancient Egyptian medical experts, the human body had four humors—yellow bile, blood, black bile, and phlegm. Without a bit of real scientific research, they decided that having too much or too little of one or more of these humors accounted for any and all medical problems, from headaches to broken bones to acne and, yes, toothaches. Like the worm-invasion idea, the theory of humors was still being accepted well into the nineteenth century.
Curing an imbalance of humors was fairly straightforward. The physician-dentist would begin by having the patient drink teas made of various kinds of bark, leaves, and flowers, including those from opium and cannabis plants. The latter two plants would certainly calm a patient but could also result in hallucinations and unconsciousness.
If the tea cure failed, they used slightly more aggressive tactics. They might have the sufferer drink a toxic mixture that could include arsenic or a poisonous plant called belladonna (commonly referred to as deadly nightshade). This would induce vomiting or diarrhea (or ideally both) to bring the humors back into balance and end the toothache.
Another technique was to use a scalpel to slice open a vein in the patient’s wrist to drain off some blood. A few tablespoons of blood was thought to cure a mild toothache. More blood was drained according to the severity of the pain. No one back then had any clue about how much blood the human body contained, so physicians routinely drained so much that the patient fainted. This didn’t worry clever physician-dentists; they simply declared that the patient was resting, which was another good way to balance the humors.
Naturally some Egyptian physician-dentists cooked up (literally) imaginative cures for tooth problems. One recipe found in a vast collection of medicinal cures called The Papyrus Ebers suggests how to create a soothing paste that would be slathered on the sore tooth and gums: “Cook the blood of a woman, and mix it into oil. Then kill a mole, cook it, and drain it into oil and follow by mixing in the dung of an ass in milk.”
You might think that such a gourmet cure would drive off clients, but you would be wrong. The Egyptian diet included breads made from refined flour and cakes sweetened with honey, dates, and carobs. And when refined flour and sugar becomes lodged between the teeth, they can ferment and eat away at the enamel, causing cavities and gum disease. More and more people began to suffer from teeth and gum problems and begged for some sort—any sort—of relief.
If you had enough money, you sought out the help of a physician. But the vast majority of Egyptians couldn’t afford a professional, so they had to visit a local “dentist.” And since there were no laws to regulate who could work on teeth, there were plenty of practitioners. Ordinary people hoping to build lucrative careers set up dental shops, as did butchers (who were used to cutting into animal flesh and bones) and barbers (who not only cut hair with sharp instruments, but could open a vein and drain an ounce or two of blood while a patient was on lunch break).
Other specialists and specialty items began appearing to help with a variety of dental matters. Because jewelers were used to working with tiny metal wires, they often tightened loose teeth by wiring them to more firmly anchored ones, thus creating the first braces. They also developed reusable toothpicks made out of gold, silver, or ivory to replace the old-fashioned and low-class splinter of wood or pointy quill feather. The average Egyptian could also consult an expert on their foul-smelling breath. One cure called for the patient to gargle with wine every night just before going to bed, and freshwater upon waking. For difficult cases of halitosis the “dentist” might suggest a morning rinse with the patient’s own urine, though the urine of young boys seems to have been the preferred boutique item.
Ancient Greece (which lasted from 800 BC to around 150 BC) and Ancient Rome (800 BC to AD 400) carried on most of these proud dental practices—smoking out worms, purging and bleeding the humors, and gargling regularly with whatever the local “dentist” sold (see above!).
Both cultures also showed a creative streak when it came to getting teeth out of a patient’s mouth. Around 400 BC Hippocrates, known as the Father of Western Medicine, described his country’s advanced tooth-pulling device, which had a name that was a real mouthful—the plumbeum odontagogon. This metal instrument resembled an oversize pair of forceps. The physician-dentist would clamp the needle-nose tip around the bad tooth and wiggle it out. This was accomplished, it should be pointed out, without any sort of painkiller.
The Romans advanced the art of tooth care and extraction. Around AD 10 the young physician Celsus suggested a mouthwash of vinegar and bitter plants to ease toothache pain. When this failed (as it usually did), he suggested the area around the tooth be “cauterized with a red-hot iron.”
Celsus, ever the creative chap, also came up with a new way to remove a rotten tooth. He suggested cutting the gum away from around the tooth and pulling the skin free, thus exposing the tooth’s roots. The tooth could then be extracted, with either the fingers or dental forceps. Celsus estimated that the recovery time from this procedure could be anywhere from fourteen to twenty-one days.
Dental advances slowed with the weakening of the Egyptian, Greek, and Roman empires (possibly saving thousands of lives). Of course, smoking out worms, bleeding and purging to relieve tooth and gum pain, and the reliable urine gargle for fresh morning breath continued.
There were some notable advances in dentistry. The Romans filled cavities by pushing a soft, malleable metal, such as lead, into the hole. By the 1400s dentists were digging out the decayed matter in a tooth with sharp, pointed tools, then pounding in gold foil. Real improvement came in the late 1700s, when combinations (called amalgams) of mercury and one or two other metals were used. Unfortunately mercury is a poison and often leaked into the patient’s mouth. Another drawback was that the amalgams had to be heated to around 200 degrees before the molten concoction could be poured directly into the cavity.
Drawing blood was still a favorite way to balance the humors and relieve a toothache, but some humane dentists found a less gruesome way to do this: leeches. A leech was placed on the gums and allowed to suck blood for up to a half hour. This took great skill, as Charles Edmund Kells made clear in 1917. “Sometimes a lively little fellow . . . will start going down the patient’s throat,” Kells warned, and “said patient may manifest a slight doubt as to one’s being a real leech artist.”
But the centerpiece of dentistry after AD 500 became the traveling professional tooth puller. Most large cities and medium-size villages in Europe had an established physician-dentist to extract teeth. Patients would lie on their backs, and the dentist would straddle them, pinning the sufferers’ arms with their knees. Sometimes a dental assistant was hired to hold down the patients’ legs.
But the real showmen of the tooth-drawing trade were the folk who traveled the back roads from town to town. They came in two varieties. Some traveled on their own by horseback and were commonly referred to as mountebanks. These traveling tooth-drawers would enter a village with a banner draped over their horse’s rump advertising their skills. They usually carried a parasol that had a small alligator dangling from it. After a tooth was extracted, pieces of alligator tail would be used to pack the empty tooth socket of a patient.
Mountebanks collected their fee in advance and performed extractions from the saddle. They would use a long forceps to clamp on to the infected tooth, then have the horse pull away from the patient (who was usually being held by a friend or two). One advantage of working from the horse was that it allowed for a quick getaway if the procedure went wrong.
The larger tooth-drawing operations resembled a circus more than a well-organized dental practice. The troupe would set up a raised platform in the town square or marketplace. A band would play lively music to at
tract a crowd, then jugglers, tight-rope walkers, and puppeteers would entertain the assembled. When the crowd was large enough, a member of the troupe, called a zany, would talk up the skills of their tooth-drawer, who would then appear onstage wearing a long necklace of human teeth.
The tooth-drawer would announce he could perform painless extractions and ask if anyone had a tooth that needed pulling. Eventually a volunteer would step hesitantly forward, pay his few pennies, and sit on a tiny stool. The tooth-drawer would insert his forceps, wiggle it around dramatically, and a few drama-filled minutes later hold up an extracted tooth dripping blood for the crowd to see. It should be noted that the volunteer was a member of the troupe who had placed someone else’s old tooth, plus pig’s blood, in his mouth before going onstage.
After such a convincing and painless performance, reluctant toothache sufferers would begin to come onstage, though their extractions took a great deal more muscle power and created much more pain. Fortunately the cries and screams of these hapless victims were carefully drowned out by the blaring horns and the loud drumbeat of the band that always accompanied a public extraction.
Did these public tooth yankings ever cure the patient? Sometimes. If infection didn’t set in, the gaping hole would eventually stop bleeding and heal itself. It might take a week or so, but the patient would be pain-free once again. Until, that is, another tooth began to ache.
Of course, some tooth-drawers came up with new and creatively cruel ways to help toothache sufferers. A Frenchman who is identified only as La Roche Operator traveled from village to village during the 1730s proclaiming a new and painless way to deal with dental problems. He took a tool ordinarily used to grip and pull a tooth and placed it on the top of the offending fang. But instead of yanking on the tool, Monsieur La Roche pounded the tool with a rock, which drove the tooth into the roof of the patient’s mouth. Oddly enough, the patient felt no pain. At first. By the time he did, La Roche Operator was long gone.