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President’s Address, Section XIV*
Proceedings o f the Seventh International Dental Congress
lies in the character o f our national constituency. “ It is the distinguishing happiness o f our governm ent that civil order should be the result o f choice and not o f necessity, and the common wishes o f the people become the la w o f the lan d ; their public prosperity and even existence very much depend upon the suitable fo rm in g o f the minds and morals o f its citizens.” T h is is the task o f education. I agree w ith P rofessor H olland o f the U niversity o f Nebraska: “ M en are
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becoming more humane, more benevo lent and sympathetic, m ore re g a rd fu l o f the rights o f others, more sensible o f a common bond o f h u m anity; and a l though the paths are still toilsome and o f times discouraging, the race o f man is constantly reaching a higher level by rising to higher conceptions o f duty which in due time w ill find expression, embodiment and glorious fru itag e in the still higher and better la w o f the fu tu re, built upon a firm foundation o f equity and u tility .”
PRESIDENT’S ADDRESS, SECTION X IV * By ROBERT T. OLIVER, D.D.S., F.A.C.D., D.S.M., New York City
T A K E pleasure in extending a hearty w elcom e to all members and guests o f Section X I V , M ilitary S u r gery. M ay the deliberations o f its ses sions in professional, m ilitary and scientific subjects be fra u g h t w ith signal success, prove o f appreciable value to the cause and develop a spirit o f fe llo w ship and m utual respect among the m ilitary men o f the w o rld . T h e Seventh International D ental Congress, an activity o f the Sesquicentennial held in celebration o f the one hundred and fiftieth anniversary o f the signing o f that great human document, T h e A m erican D eclaration o f Inde pendence, promises to m ark an im por tant epoch in the history o f dentistry. In the midst o f these shrines o f patriotic devotion, at the very threshhold o f L iberty, our hearts and our minds are filled w ith varied emotions. W e th rill w ith adm iration at the mental vision o f that wondrous day— the as-
I
* Section on Military Surgery.
sembled patriots w aiting turn to step up and affix their names to the docu m ent— tense m om en ts, those— dedicat ing their lives, their fortunes and their sacred honor to the cause; yet, with happy repartee, relieving the situation and preserving the charm o f perfect dignified self-possession. T h e n : the rapid strident clatter o f the bell, peal ing fo rth that God-ordained message, molded around its flange: “ Proclaim liberty throughout a ll the land, and to a ll the inhabitants th ereo f.” Y o u , m y con freres fro m fo reig n lands, w here ere you be, who catch the spirit o f such contagious sentiment, join w ith us in mental review o f those momentous hap penings, that a ll may m arvel at the wonders w rou gh t on that occasion, which so w e ll have reawakened the w o rld , made incomparable changes in this fa ir land and given unheard o f op portunities fo r advancement to its people, w ithin so short a period. R ecalling our truant thoughts to the
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duties at hand, let us consider the char acter o f dentistry available in this country one hundred and fifty years ago. Such as was offered was found in the larger cities, w ith a scant fo llo w in g o f itinerants in the lesser communities. A s to type, those practitioners w ere o f fo u r general varieties— the sturdy, honest artisan who handled mechanical dentistry as a sort o f side line to his regular trade, as the silversmiths and jew elers; barber surgeons or barber dentists, leaches and tooth-pullers, who still practiced in this f a r aw ay land even though the royal edicts o f both Louis X V and George I I I had already separated the respective vocations; the carvers o f ivory and bone, w ith their ingenious artistry in attaching to bases the carved reproductions o f teeth, or reset human teeth, w ith the retention o f dentures by curved spiral springs; and lastly, the charlatan whose raucous voice proclaimed his superior skill in extracting and transplanting teeth, and whose handbills offered to pay 4 guineas each fo r good sound live teeth, “ to be implanted in the jaw s o f the gen try.” D uring the R evolution, dentistry fo r both the patriots in the field, officers and men, and those le f t at home, con sisted m ainly o f sim ple professional at tendance fro m medical men fo r the quick alleviation o f sufferings, a service in which the lancet and the modified pelican or the early type turnkey largely figured. A m erican dentistry may be called a heritage o f w ar, its advent occurring during the R evolution, on the arrival o f French convoys at N ew port and Providence, in 1 7 S 0 - 1 7 8 1 . W ith these troops came tw o surgeons o f the French navy, Joseph L eM a ire (N ew p ort) and Jam es G ard ett (P ro vid en ce), both edu
cated medical gentlem en o f the period, G ard ett a graduate o f the R oyal M edi cal School, Paris. O ne o f the required qualifications fo r a surgeon o f the French navy at that time was the knowledge and a practical application o f dentistry. L e t us rem em ber that France then led the w o rld in the science and art o f dentistry. T h e doctrines o f Pierre Fauchard, which constituted the first scientific treatise on dental surgery, as revised in 1 7 4 7 , w ere then in vogue. T his volum e set a higher standard fo r dentistry, which, claim ing ju st recogni tion fro m medicine, resulted in a course o f dental instruction being included in the curriculum at the R oyal M edical School. T hus, Jam es G ard ett’s de barkation at Providence heralds the ar rival o f the first m edically trained dentist on A m erican soil. T h e frie n d ly association o f these two compatriots, m utually interested in dentistry, and their desire to improve health situations under their observa tion, moved them to undertake the in struction o f a num ber o f bright, intelligent young C ontinental soldiers, am ong whom was Josiah F lagg , the brightest, and hence the most favored , pupil o f the group. T h is sm all class, m arking the first instance o f dental instruction in A m erica, places Joseph L eM aire, its dom inant figure, as the first A m erican dental preceptor, Josiah F lagg, the first student, and the N ew port camp the site o f the first dental clinic— an item o f special interest to M ilitary dental men. Such records serve to establish the facts that A m erican dentistry, chal lenging alike the adm iration and re spect o f the entire w o rld , is, a fte r a ll, the precocious offspring o f m ilitary
Proceedings o f the Seventh International Dental Congress
dentistry, born in a w a r camp o f the R evolution, suckled at the breast o f patriotism, reared under service condi tions and a perturbed post-w ar read justm ent, trained under years o f harsh experiences, yet alw ays holding a lo ft the traditions o f its ancestry, until fin ally it blossomed fo rth into fu ll manhood, w ith a higher self-respect, greater importance to mankind and larg er recognition as a w o rth y and a n eed fu l profession. Such f u ll stature was obtained only through its own declaration o f independence, made sixty-three years a fte r the signing o f the original document, which brought complete severance fro m medicine, the establishment o f its own school and the creation o f its own degree. O f Horace Hayden it may be said that his was the honor o f “ bearing the torch o f know ledge” fro m his illu s trious preceptor, Jo h n G reenw ood, a patriot o f the R evolution, contem porary o f Josiah F lagg, and later the dental practitioner to President W ashington, down through the years to 1 8 4 0 ; there to im plant it as an everlasting shrine w ithin the edifice o f his creation, the first dental school o f the w o rld , an in stitution which served definitely to es tablish dentistry as a profession by proving to the w o rld its f u ll intent and its m anifest preparation fo r perpetuity. I t may be observed that the basic principles o f that initial class at N ew port, w e ll grounded upon the theories o f Fauchard, and taught through the generosity o f L eM aire and G ard ett, w ere destined to become a large part o f the very foundation o f dental edu cation, this again inviting to our atten tion the kinship o f A m erican dentistry to its humble m ilitary progenitor. D urin g the next fifty-e ig h t years
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fro m the date o f the separation, we find a period o f gradual transition o f dentistry fro m the status o f a trade or vocation to that o f a recognized pro fession. W o n d e rfu l developm ent in professional attainments occurred during this period, abreast i f not in advance o f those in the other professions, in the active industries, or in the country it self. T h e organization o f schools throughout the land, the creation o f state law s and governing bodies fo r the practice o f dentistry, the increasingly broader professional education, with higher prelim inary education as a re quirem ent f o r entrance, and the change fro m the one and tw o year courses o f instruction to the universal three year course, all w ere im portant factors to such development. A l l such changes had the tendency to attract greater num bers o f desirable young men to a career in dentistry, u n til, in 1 9 0 0 , we had approximately 3 0 ,0 0 0 practitioners w ithin the U nited States. D uring the Spanish-Am erican W a r, in 1 8 9 8 , the last w a r fo u g h t by volun teers, w e find large numbers o f dentists in the ranks serving in grades from company officers dow n to privates— there w ere no opportunities fo r serving in any m ilitoprofessional capacity. T h e presence o f these representatives in the service, in addition to the fa c t that our dentally educated people early realized the dental needs o f the mobilized arm y in the several training camps o f the country, led to a reaw akening o f the dental profession to its long established ambition o f providing a corps o f dental surgeons fo r the A rm y . T h e National D ental Association seriously took up this question at its annual meeting in 1 8 9 8 and appointed a special legislative committee to represent its interests in
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the m atter, to d ra ft a b ill and to under take its passage through Congress. A void ing details, it may be said that the efforts o f the legislative committee in securing early enactment o f their measure in time fo r service during that w a r were unsuccessful. T h e m ilitary campaign lasted too short a time to secure such special legislation, in the face o f other more im portant m ilitary legislation. W ith commendable zeal, the legislative committee continued its efforts through the sessions o f 1 8 9 9 and 1 9 0 0 , which culm inated in the passage o f the bill, som ewhat modified, it is true, w ith the general reorganization act o f the A rm y , passed and approved, Feb. 2, 1 9 0 1 . T h e advent o f the A rm y D ental Corps marked an epoch in the history o f dentistry. Its vast importance as a health service was quickly demonstrated in the m ilitary establishment. T he presence o f our sm all arm y o f more than 6 0 ,0 0 0 in the Philippines, operat ing against insurgents, an arm y to which a m ajority o f the n ew ly appointed dental surgeons were tran sferred , and the type o f prim ary dental service there rendered fo r the re lie f o f pain and suffering readily accounts fo r the early and keen appreciation o f this special service o f the medical department. T h a t the wisdom o f its creation was proved many times over during the first three years o f its service stands an un refu ted fact. Consistent e ffo rt was made by the N ational D ental Associa tion fro m year to year, a fte r the w orth o f m ilitary dental service had been fo rm a lly established, to secure fu rth e r legislation that w ould give fu ll rights and privileges o f commissioned officers to the A rm y dental surgeons. I t was ten years before this was accomplished,
by the A ct o f M arch 3, 1 9 1 1 , which granted commissions in the grade o f first lieutenant to all dental surgeons then in the service. T h e advent o f the N avy D ental Corps in August, 1 9 1 2 , may be re garded as but a natural sequence, ex pected alike by the N avy, the profession and the citizens o f our country. T he m anifest health benefits accruing to the m ilitary establishment, observed by higher ranking naval officers, ably as sisted by the w e ll organized activities o f the N ational D ental Association, easily account fo r the lessening diffi culty o f convincing Congress o f its necessity. Provisions fo r promotion o f den tal officers came w ith the reorganization bill o f Ju n e 3 , 1 9 1 6 , which gave the grade o f captain to those officers long est in the service with a promise o f one extra grade under certain more or less discouraging provisions. It again re quired serious interference by the N a tional D ental Association to secure equal rights fo r its dental representa tives in the m ilitary service. This culm inated as w ar-tim e legislation, on O ctober 6, 1 9 1 7 , and imm ediately granted absolute equalization to dental officers in regard to rank, pay a llo w ances and the rights o f retirem ent. T h e influence o f the A rm y D ental Corps on our profession and our N a tion has been alike beneficial. It has brought a greater recognition o f den tistry and made fo r the popular appre ciation o f the profession. It has proved the fo reru n n er to and a strong facto r in all subsequent organizations o f indus trial dentistry and in institutional clinics (schools), in oral hygiene, both endowed and m unicipal, and, later, in the organization o f dental service in
Proceedings of the Seventh International Dental Congress
the U nited States Public H ealth B u reau. I t was the pacemaker fo r o r ganized m ilitary dental service in the armies o f other nations. In general, it m ay be said that a ll such organizations have proved beneficial to dentistry as shown by the universal recognition o f its importance as a health-conserving service by governm ent agencies, state boards o f health, the medical profession and civil communities. T h e service o f dentistry during the W o rld W a r is one in which w e a ll have an unbounded pride. T h e call o f 6 ,0 0 0 dental men to the colors, under the provisions o f the A c t o f O ct. 6, 1 9 1 7 , is the first instance in our history o f dentists responding to the call o f their country and accepting commissions in the m ilitary service as dental officers, in the various grades o f rank. T h e estab lishm ent o f such an agency through which dental men o f the nation could give f u ll expression to their patriotism and render special m ilitary service dur ing a national emergency was o f itself one o f the most beneficial acts o f leg islation ever coming to any profession. I t marks an epoch in the history o f dentistry. T h e com m ingling o f dental w ith medical officers as professional brothers in arms brought closer understanding, m utual respect and increased benefits. T h e professional cooperation necessary in the great w a r hospitals brought higher appreciation o f both the m ilitary and the professional value o f the dental officer, as did their special surgical services rendered w ith face and ja w casualties o f battle. Im provem ents in the understanding o f each other’s value also was augmented when medical and dental officers became brother students at the several schools in the A . E. F .,
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and later in the home cou n try; partic u la rly so at the M edical F ield Service School, C arlisle, w ith the assignment o f a dental officer as a teacher in the A rm y M edical School and the organi zation o f the A rm y dental school ( 1 9 2 1 ) , in which equal numbers o f medical and dental officers constituted the fa c u lty, w ith a curriculum arranged to embrace dental, medical and scien tific subjects. Since the W a r, we may trace the serious beginning o f a general trend, the d r ift o f dentistry back to the m other profession. It may tru th fu lly be said that the A rm y D ental School stands out prom inently as a high beacon light serving to attract attention and as sist in directing the return o f dentistry to the great professional highw ay common to all branches o f the healing art. M edicine, surgery and dentistry belong alike to the health conserving service and to each other, i f they are to confer the greatest benefits on m ankind. H ar monious cooperation, close affiliations, complete understanding o f each other’s value and m utual appreciation are the prime essentials to such a coalition. A t the time o f the separation, a chart would have shown the rather abrupt line o f divergence fro m medicine, fo l low ed a little later by a change o f direction, to a line exactly p arallel to that o f medicine, a route which it has traveled fo r approxim ately sixty-seven years. T h e present tendencies indicate a convergence o f that line back to the mother groove, w here it n atu rally be longs. O bjection to such m erger may be expected, possibly fro m both profes sions. From the dental standpoint, any act o f recession fro m its splendid inde pendence, having a tendency to cramp its style, w ill prove distasteful, and the
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age-old tradition o f resentment tow ard the sister profession, fo r indifference and condescension in past years, w ill have to be overcome by unmistakable evidences o f am ity and good w ill. T h e great strides made by the younger profession in higher educa tional refinem ent, technical application and scientific study have been accom plished alone and unaided, and since it has reached the fu ll stature o f an hon orable, able, respected and necessary health serving profession o f scientific attainm ent, and recognized as such by our G overnm ent w h o lly on its own merits, quite n atu rally it looks with some degree o f skepticism on any plan fo r coalition in which any compromise o f its rights m ight be expected. Those men o f both professions who believe in m edically trained dentists must be pre pared to encounter such opposition in addition to another equally important one economic in character— the increase in both years and fees necessary to the acquirem ent o f a double education. Should the one degree be contemplated fo r one extended profession, the con tention w ill concern a menacing loss o f f u ll technical education, and the pos sible degeneracy o f art and fin g ercraft, a ll o f which have served to make den tistry famous. R e fe rrin g to the m ilitary service, it m ay be said that until the great day arrives w hen, i f ever, medicine and dentistry w ill actually coalesce and the dental corps possibly become a group o f oral or dental specialists o f the medical corps, it w ill be necessary fo r each, the medical and the dental corps, to operate more or less separately under the super vision o f their respective heads, subor dinate to the Surgeon G en eral o f the A rm y , director o f the entire medical
department. I t fu rth e r may be said that only w ith a ch ief o f its own kind, under the supervision o f the greater ch ief, the Surgeon G eneral, complete autonom y under a protectorate (to bor ro w terms fro m the diplomatic service) and a personnel, both commissioned and enlisted, adequate to the fu ll needs o f the A rm y , can the dental corps ever be able to exploit modern dentistry satis fa cto rily in the service during peace time or to reorganize its activities best fo r w ar. Such an ideal organization w ould o f course require legislation affecting the entire medical department, as it w ould mean a t least its partial reor ganization. Speaking only o f the den tal corps organization in such a plan, it w ould require a c h ief o f the D ental Corps selected fro m the senior officers o f the corps, holding the grade o f brigadier general (as w ould both the M edical and the V eterinary Corps under such a plan o f departm ent reor gan ization ), the ch ief o f corps to be vested w ith fu ll authorization o f law fo r the autonomous control o f his corps under the protectorate o f the Surgeon G eneral and governed by specific in structions pertaining thereto covering every activity o f his official adm inistra tion. Some such organization w ith a chief and an adequate personnel is bound to come in time, and it is hoped that our present Surgeon G en eral, M a jo r G en eral M . E. Irelan d , alw ays a strong partisan fo r the dental service, may have both the opportunity and the great pleasure o f celebrating its accomplish ment. In closing, I desire to express great appreciation o f the m anifest interest shown in the w e lfa re o f Section X I V , M ilitary Surgery o f the Seventh
Proceedings o f the Seventh International Dental Congress
International D ental Congress, by the attendance and cooperation o f the splendid men o f our sister nations and the equally representative men o f A m erican dentistry. M y best wishes go out to our con freres present in the m ilitary dental service o f their respec tive countries, w ith the hope that all they may seek in the w ay o f im prove ment in such service m ay graciously be granted them. DISCU SSIO N
R odriguez Ottolengui, N ew York C ity: It is indeed most interesting, and to many it w ill prove enlightening, to learn that our American dentistry practically had its origin in tw o military men, Joseph LeM aire and James Gardette, both o f the French Navy, who came over with the allied troups o f Louis X V I, bringing with them the accepted knowledge o f modern dentistry. Particularly does it appeal to those o f us who recall the events and who participated in the great struggle to introduce regularly organized den tal service into our Arm y and Navy. H aving come out o f the military service, how strange it seems, in retrospect, that subsequently it required so much energy to make dentistry an integral part o f our great military depart ment. Colonel Oliver recalls the period be tween 1898 and 1901 when the National Dental Association was urging the creation o f a dental corps in our Arm y. He touches lightly on the provisions o f that bill as finally passed, and naively adds, “ somewhat modified it is true,” but he fails to mention the fact that we were obliged to accept the so-called Contract Dental Corps, the active members o f which had no standing as regular officers; a condition which was not corrected until 1911. There is a fact in connection with this state o f affairs which should become a matter o f permanent record. T he creation o f a contract dental corps, in stead o f an officered dental corps, was largely due to, let us say, the fear am ong military medical men that the dentist w ould not prove himself fitted to hold rank. It was, therefore, tremendously fortunate that such men as John S. Marshall and Robert T . Oliver should have been selected to serve as the first nominal heads o f the newly organized Contract Dental Corps. Both o f these men
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were W ar veterans and held medical degrees, I think, and both had already distinguished themselves in the field o f oral surgery and as educators. W hat more splendid links could have been forged to unite the existing medical corps with the apparently insignif icant little group o f men known as the Contract Dental Corps. A nd what did these men do? Far from failin g to conduct them selves in a manner befitting a soldier and an officer, it soon became apparent that they w ould not only grace such positions and ren der valuable service, but that, without rank o f some sort, their usefulness in the Army would be greatly limited. M en in the ranks readily recognize their superior officers and take orders from them, but unless the soldier had been made to see that his dentist was, in a sense, his superior, whose orders and instructions must be obeyed, dental service never w ould have achieved the results that were obtained. T h e medical officers early recognized this fact, and themselves provided a remedy, through regulations, without wait ing fo r further action o f Congress. I well remember an incident during1 a visit to West Point: while walking from his quarters to the Academy Headquarters, at the side o f Colonel, then plain D octor, Oliver, I noticed that every soldier that we passed saluted him. This surprised me, and then fo r the first time I observed that Dr. Oliver wore shoulder straps. I inquired about this and was told that the straps did not carry rank insignia but merely the letters, “ D . C .” meaning Dental Corps, which, to the minds o f the soldiers, converted the wearer into an officer, o f sorts, and at once commanded respect. Not only these facts: the conduct o f all these “ hired dentists” was so correct that they were admitted to officers’ messes and social entertainments, and to fu ll companionship, showing that they were w ell received on a basis o f social equality. There is no doubt that the splendid conduct o f these pioneers o f the dental corps helped to pave the way and make it possible f o r them to receive higher recognition and regular rank. I here appeal to you all to place the names o f Marshall and Oliver side by side in dental history, with those o f LeM aire and Gardette. The latter brought dentistry out o f the military service, and the form er again established it in the service, on an organized and highly respected basis. M ark L . Finley, W ashington, D . C .:
The
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exigencies o f war have always led to de velopment and to progress, in spite o f the horrors that accompany its campaigns. In dentistry, the late W ar has developed skilful methods o f treating m ajor breaks o f con tinuity in the facial, maxillary and oral regions, the marvelous results obtained ex citing the wonder and the admiration o f all professional observers. In consequence o f my own activity in the earlier efforts to secure legislation f o r placing the dental sur geon in the military service, I have watched with jealous eye, the record being written, and I am fu lly satisfied that dentistry has played its part well through the men who have conducted its great perform ance tests through the years. I pay my respects to our presiding officer, Col. Robert T . Oliver, and to others who have written fo r our pro fession a record commensurate with the pro gress o f human effort and advancement in other activities. H enry S. Dunning, N ew York C ity: I wish to compliment Colonel Oliver on his collection o f these most important data re garding the practice o f military dental sur gery. I was one o f the members o f the B. P. Club o f the A . E. F., and feel that we members o f the m axillofacial section o f the A rm y owe Colonel Oliver a great debt for all that he did f o r us, in the early days o f our w ork in France. Perhaps some o f you present are not fam iliar with the B. P. Club o f the A . E. F. T h e members o f this Club landed in France prior to the com ing over o f our Chief, General Pershing, and laugh ingly form ed a little club we called the B. P. Club, meaning Before Pershing. We saw the A . E. F. grow from a handful o f men that didn’ t know what it was a ll about into a mighty organization o f trained sur
geons, dentists and other specialists, and incidentally combatants, who had gained much experience from our allies on many fronts. Colonel Oliver was always a tremendous help to members o f the m axillofacial section, and more than once my Chief, Colonel Blair, and I went from our headquarters in N euf Cha teau to Colonel O liver’ s headquarters in Tours to ask his advice and help, which was always cheerfully and enthusiastically given. The cooperation that was shown between the den tal section o f the A rm y under Colonel Oliver and our special branch o f the surgical sec tion was w onderful and I believe opened the eyes o f the medical men in the armies o f our allies to a great extent. T he m axillo facial teams were worked out to a logical conclusion chiefly through the efforts o f C ol onel Blair and Colonel Oliver, and I think that, had the war lasted a little longer, we w ould have had the pleasure o f showing many more w onderful results through the repair o f the terrible facial wounds that the late war brought about. This section o f the International Dental Congress is a most useful one, and I hope it w ill be perpetuated and the members’ enthusiasm w ill continue, at least until the next war. It would be too bad if , during peace times, we lost track o f the wonderful lessons that we learned during the time o f stress and i f we allow ed our interest to lag to such an extent that these lessons that were so painfully learned by bit ter disappointments had to be learned all over again by the com ing generation o f younger men who w ill carry this w ork on. In other words, I hope that we can keep up at least a skeleton section, with our re cords and data obtained during the W ar, fo r future needs, and be prepared to carry on where we left o ff in 1918.
PRESIDENT’S ADDRESS, SECTION X V * By ALFRED P. LEE, D.D.S., Philadelphia, Pennsylvania M e m b e rs and. G u ests o f the Seven th In te rn a tio n a l D e n ta l C o n g r e ss:
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present dental Congress.
A s stated in
our fo rew o rd to the printed prelim inary program , this section makes its initial bow at this Congress. M an y o f the
T is w ith feelings o f peculiar pleas ure that we address you on the open ing session o f Section X V o f the
subjects to be treated in these sessions
♦Section on History, Science and Libraries.
have appeared in programs o f previous
lies in the character o f our national constituency. “ It is the distinguishing happiness o f our governm ent that civil order should be the result o f choice and not o f necessity, and the common wishes o f the people become the la w o f the lan d ; their public prosperity and even existence very much depend upon the suitable fo rm in g o f the minds and morals o f its citizens.” T h is is the task o f education. I agree w ith P rofessor H olland o f the U niversity o f Nebraska: “ M en are
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becoming more humane, more benevo lent and sympathetic, m ore re g a rd fu l o f the rights o f others, more sensible o f a common bond o f h u m anity; and a l though the paths are still toilsome and o f times discouraging, the race o f man is constantly reaching a higher level by rising to higher conceptions o f duty which in due time w ill find expression, embodiment and glorious fru itag e in the still higher and better la w o f the fu tu re, built upon a firm foundation o f equity and u tility .”
PRESIDENT’S ADDRESS, SECTION X IV * By ROBERT T. OLIVER, D.D.S., F.A.C.D., D.S.M., New York City
T A K E pleasure in extending a hearty w elcom e to all members and guests o f Section X I V , M ilitary S u r gery. M ay the deliberations o f its ses sions in professional, m ilitary and scientific subjects be fra u g h t w ith signal success, prove o f appreciable value to the cause and develop a spirit o f fe llo w ship and m utual respect among the m ilitary men o f the w o rld . T h e Seventh International D ental Congress, an activity o f the Sesquicentennial held in celebration o f the one hundred and fiftieth anniversary o f the signing o f that great human document, T h e A m erican D eclaration o f Inde pendence, promises to m ark an im por tant epoch in the history o f dentistry. In the midst o f these shrines o f patriotic devotion, at the very threshhold o f L iberty, our hearts and our minds are filled w ith varied emotions. W e th rill w ith adm iration at the mental vision o f that wondrous day— the as-
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* Section on Military Surgery.
sembled patriots w aiting turn to step up and affix their names to the docu m ent— tense m om en ts, those— dedicat ing their lives, their fortunes and their sacred honor to the cause; yet, with happy repartee, relieving the situation and preserving the charm o f perfect dignified self-possession. T h e n : the rapid strident clatter o f the bell, peal ing fo rth that God-ordained message, molded around its flange: “ Proclaim liberty throughout a ll the land, and to a ll the inhabitants th ereo f.” Y o u , m y con freres fro m fo reig n lands, w here ere you be, who catch the spirit o f such contagious sentiment, join w ith us in mental review o f those momentous hap penings, that a ll may m arvel at the wonders w rou gh t on that occasion, which so w e ll have reawakened the w o rld , made incomparable changes in this fa ir land and given unheard o f op portunities fo r advancement to its people, w ithin so short a period. R ecalling our truant thoughts to the
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duties at hand, let us consider the char acter o f dentistry available in this country one hundred and fifty years ago. Such as was offered was found in the larger cities, w ith a scant fo llo w in g o f itinerants in the lesser communities. A s to type, those practitioners w ere o f fo u r general varieties— the sturdy, honest artisan who handled mechanical dentistry as a sort o f side line to his regular trade, as the silversmiths and jew elers; barber surgeons or barber dentists, leaches and tooth-pullers, who still practiced in this f a r aw ay land even though the royal edicts o f both Louis X V and George I I I had already separated the respective vocations; the carvers o f ivory and bone, w ith their ingenious artistry in attaching to bases the carved reproductions o f teeth, or reset human teeth, w ith the retention o f dentures by curved spiral springs; and lastly, the charlatan whose raucous voice proclaimed his superior skill in extracting and transplanting teeth, and whose handbills offered to pay 4 guineas each fo r good sound live teeth, “ to be implanted in the jaw s o f the gen try.” D uring the R evolution, dentistry fo r both the patriots in the field, officers and men, and those le f t at home, con sisted m ainly o f sim ple professional at tendance fro m medical men fo r the quick alleviation o f sufferings, a service in which the lancet and the modified pelican or the early type turnkey largely figured. A m erican dentistry may be called a heritage o f w ar, its advent occurring during the R evolution, on the arrival o f French convoys at N ew port and Providence, in 1 7 S 0 - 1 7 8 1 . W ith these troops came tw o surgeons o f the French navy, Joseph L eM a ire (N ew p ort) and Jam es G ard ett (P ro vid en ce), both edu
cated medical gentlem en o f the period, G ard ett a graduate o f the R oyal M edi cal School, Paris. O ne o f the required qualifications fo r a surgeon o f the French navy at that time was the knowledge and a practical application o f dentistry. L e t us rem em ber that France then led the w o rld in the science and art o f dentistry. T h e doctrines o f Pierre Fauchard, which constituted the first scientific treatise on dental surgery, as revised in 1 7 4 7 , w ere then in vogue. T his volum e set a higher standard fo r dentistry, which, claim ing ju st recogni tion fro m medicine, resulted in a course o f dental instruction being included in the curriculum at the R oyal M edical School. T hus, Jam es G ard ett’s de barkation at Providence heralds the ar rival o f the first m edically trained dentist on A m erican soil. T h e frie n d ly association o f these two compatriots, m utually interested in dentistry, and their desire to improve health situations under their observa tion, moved them to undertake the in struction o f a num ber o f bright, intelligent young C ontinental soldiers, am ong whom was Josiah F lagg , the brightest, and hence the most favored , pupil o f the group. T h is sm all class, m arking the first instance o f dental instruction in A m erica, places Joseph L eM aire, its dom inant figure, as the first A m erican dental preceptor, Josiah F lagg, the first student, and the N ew port camp the site o f the first dental clinic— an item o f special interest to M ilitary dental men. Such records serve to establish the facts that A m erican dentistry, chal lenging alike the adm iration and re spect o f the entire w o rld , is, a fte r a ll, the precocious offspring o f m ilitary
Proceedings o f the Seventh International Dental Congress
dentistry, born in a w a r camp o f the R evolution, suckled at the breast o f patriotism, reared under service condi tions and a perturbed post-w ar read justm ent, trained under years o f harsh experiences, yet alw ays holding a lo ft the traditions o f its ancestry, until fin ally it blossomed fo rth into fu ll manhood, w ith a higher self-respect, greater importance to mankind and larg er recognition as a w o rth y and a n eed fu l profession. Such f u ll stature was obtained only through its own declaration o f independence, made sixty-three years a fte r the signing o f the original document, which brought complete severance fro m medicine, the establishment o f its own school and the creation o f its own degree. O f Horace Hayden it may be said that his was the honor o f “ bearing the torch o f know ledge” fro m his illu s trious preceptor, Jo h n G reenw ood, a patriot o f the R evolution, contem porary o f Josiah F lagg, and later the dental practitioner to President W ashington, down through the years to 1 8 4 0 ; there to im plant it as an everlasting shrine w ithin the edifice o f his creation, the first dental school o f the w o rld , an in stitution which served definitely to es tablish dentistry as a profession by proving to the w o rld its f u ll intent and its m anifest preparation fo r perpetuity. I t may be observed that the basic principles o f that initial class at N ew port, w e ll grounded upon the theories o f Fauchard, and taught through the generosity o f L eM aire and G ard ett, w ere destined to become a large part o f the very foundation o f dental edu cation, this again inviting to our atten tion the kinship o f A m erican dentistry to its humble m ilitary progenitor. D urin g the next fifty-e ig h t years
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fro m the date o f the separation, we find a period o f gradual transition o f dentistry fro m the status o f a trade or vocation to that o f a recognized pro fession. W o n d e rfu l developm ent in professional attainments occurred during this period, abreast i f not in advance o f those in the other professions, in the active industries, or in the country it self. T h e organization o f schools throughout the land, the creation o f state law s and governing bodies fo r the practice o f dentistry, the increasingly broader professional education, with higher prelim inary education as a re quirem ent f o r entrance, and the change fro m the one and tw o year courses o f instruction to the universal three year course, all w ere im portant factors to such development. A l l such changes had the tendency to attract greater num bers o f desirable young men to a career in dentistry, u n til, in 1 9 0 0 , we had approximately 3 0 ,0 0 0 practitioners w ithin the U nited States. D uring the Spanish-Am erican W a r, in 1 8 9 8 , the last w a r fo u g h t by volun teers, w e find large numbers o f dentists in the ranks serving in grades from company officers dow n to privates— there w ere no opportunities fo r serving in any m ilitoprofessional capacity. T h e presence o f these representatives in the service, in addition to the fa c t that our dentally educated people early realized the dental needs o f the mobilized arm y in the several training camps o f the country, led to a reaw akening o f the dental profession to its long established ambition o f providing a corps o f dental surgeons fo r the A rm y . T h e National D ental Association seriously took up this question at its annual meeting in 1 8 9 8 and appointed a special legislative committee to represent its interests in
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the m atter, to d ra ft a b ill and to under take its passage through Congress. A void ing details, it may be said that the efforts o f the legislative committee in securing early enactment o f their measure in time fo r service during that w a r were unsuccessful. T h e m ilitary campaign lasted too short a time to secure such special legislation, in the face o f other more im portant m ilitary legislation. W ith commendable zeal, the legislative committee continued its efforts through the sessions o f 1 8 9 9 and 1 9 0 0 , which culm inated in the passage o f the bill, som ewhat modified, it is true, w ith the general reorganization act o f the A rm y , passed and approved, Feb. 2, 1 9 0 1 . T h e advent o f the A rm y D ental Corps marked an epoch in the history o f dentistry. Its vast importance as a health service was quickly demonstrated in the m ilitary establishment. T he presence o f our sm all arm y o f more than 6 0 ,0 0 0 in the Philippines, operat ing against insurgents, an arm y to which a m ajority o f the n ew ly appointed dental surgeons were tran sferred , and the type o f prim ary dental service there rendered fo r the re lie f o f pain and suffering readily accounts fo r the early and keen appreciation o f this special service o f the medical department. T h a t the wisdom o f its creation was proved many times over during the first three years o f its service stands an un refu ted fact. Consistent e ffo rt was made by the N ational D ental Associa tion fro m year to year, a fte r the w orth o f m ilitary dental service had been fo rm a lly established, to secure fu rth e r legislation that w ould give fu ll rights and privileges o f commissioned officers to the A rm y dental surgeons. I t was ten years before this was accomplished,
by the A ct o f M arch 3, 1 9 1 1 , which granted commissions in the grade o f first lieutenant to all dental surgeons then in the service. T h e advent o f the N avy D ental Corps in August, 1 9 1 2 , may be re garded as but a natural sequence, ex pected alike by the N avy, the profession and the citizens o f our country. T he m anifest health benefits accruing to the m ilitary establishment, observed by higher ranking naval officers, ably as sisted by the w e ll organized activities o f the N ational D ental Association, easily account fo r the lessening diffi culty o f convincing Congress o f its necessity. Provisions fo r promotion o f den tal officers came w ith the reorganization bill o f Ju n e 3 , 1 9 1 6 , which gave the grade o f captain to those officers long est in the service with a promise o f one extra grade under certain more or less discouraging provisions. It again re quired serious interference by the N a tional D ental Association to secure equal rights fo r its dental representa tives in the m ilitary service. This culm inated as w ar-tim e legislation, on O ctober 6, 1 9 1 7 , and imm ediately granted absolute equalization to dental officers in regard to rank, pay a llo w ances and the rights o f retirem ent. T h e influence o f the A rm y D ental Corps on our profession and our N a tion has been alike beneficial. It has brought a greater recognition o f den tistry and made fo r the popular appre ciation o f the profession. It has proved the fo reru n n er to and a strong facto r in all subsequent organizations o f indus trial dentistry and in institutional clinics (schools), in oral hygiene, both endowed and m unicipal, and, later, in the organization o f dental service in
Proceedings of the Seventh International Dental Congress
the U nited States Public H ealth B u reau. I t was the pacemaker fo r o r ganized m ilitary dental service in the armies o f other nations. In general, it m ay be said that a ll such organizations have proved beneficial to dentistry as shown by the universal recognition o f its importance as a health-conserving service by governm ent agencies, state boards o f health, the medical profession and civil communities. T h e service o f dentistry during the W o rld W a r is one in which w e a ll have an unbounded pride. T h e call o f 6 ,0 0 0 dental men to the colors, under the provisions o f the A c t o f O ct. 6, 1 9 1 7 , is the first instance in our history o f dentists responding to the call o f their country and accepting commissions in the m ilitary service as dental officers, in the various grades o f rank. T h e estab lishm ent o f such an agency through which dental men o f the nation could give f u ll expression to their patriotism and render special m ilitary service dur ing a national emergency was o f itself one o f the most beneficial acts o f leg islation ever coming to any profession. I t marks an epoch in the history o f dentistry. T h e com m ingling o f dental w ith medical officers as professional brothers in arms brought closer understanding, m utual respect and increased benefits. T h e professional cooperation necessary in the great w a r hospitals brought higher appreciation o f both the m ilitary and the professional value o f the dental officer, as did their special surgical services rendered w ith face and ja w casualties o f battle. Im provem ents in the understanding o f each other’s value also was augmented when medical and dental officers became brother students at the several schools in the A . E. F .,
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and later in the home cou n try; partic u la rly so at the M edical F ield Service School, C arlisle, w ith the assignment o f a dental officer as a teacher in the A rm y M edical School and the organi zation o f the A rm y dental school ( 1 9 2 1 ) , in which equal numbers o f medical and dental officers constituted the fa c u lty, w ith a curriculum arranged to embrace dental, medical and scien tific subjects. Since the W a r, we may trace the serious beginning o f a general trend, the d r ift o f dentistry back to the m other profession. It may tru th fu lly be said that the A rm y D ental School stands out prom inently as a high beacon light serving to attract attention and as sist in directing the return o f dentistry to the great professional highw ay common to all branches o f the healing art. M edicine, surgery and dentistry belong alike to the health conserving service and to each other, i f they are to confer the greatest benefits on m ankind. H ar monious cooperation, close affiliations, complete understanding o f each other’s value and m utual appreciation are the prime essentials to such a coalition. A t the time o f the separation, a chart would have shown the rather abrupt line o f divergence fro m medicine, fo l low ed a little later by a change o f direction, to a line exactly p arallel to that o f medicine, a route which it has traveled fo r approxim ately sixty-seven years. T h e present tendencies indicate a convergence o f that line back to the mother groove, w here it n atu rally be longs. O bjection to such m erger may be expected, possibly fro m both profes sions. From the dental standpoint, any act o f recession fro m its splendid inde pendence, having a tendency to cramp its style, w ill prove distasteful, and the
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age-old tradition o f resentment tow ard the sister profession, fo r indifference and condescension in past years, w ill have to be overcome by unmistakable evidences o f am ity and good w ill. T h e great strides made by the younger profession in higher educa tional refinem ent, technical application and scientific study have been accom plished alone and unaided, and since it has reached the fu ll stature o f an hon orable, able, respected and necessary health serving profession o f scientific attainm ent, and recognized as such by our G overnm ent w h o lly on its own merits, quite n atu rally it looks with some degree o f skepticism on any plan fo r coalition in which any compromise o f its rights m ight be expected. Those men o f both professions who believe in m edically trained dentists must be pre pared to encounter such opposition in addition to another equally important one economic in character— the increase in both years and fees necessary to the acquirem ent o f a double education. Should the one degree be contemplated fo r one extended profession, the con tention w ill concern a menacing loss o f f u ll technical education, and the pos sible degeneracy o f art and fin g ercraft, a ll o f which have served to make den tistry famous. R e fe rrin g to the m ilitary service, it m ay be said that until the great day arrives w hen, i f ever, medicine and dentistry w ill actually coalesce and the dental corps possibly become a group o f oral or dental specialists o f the medical corps, it w ill be necessary fo r each, the medical and the dental corps, to operate more or less separately under the super vision o f their respective heads, subor dinate to the Surgeon G en eral o f the A rm y , director o f the entire medical
department. I t fu rth e r may be said that only w ith a ch ief o f its own kind, under the supervision o f the greater ch ief, the Surgeon G eneral, complete autonom y under a protectorate (to bor ro w terms fro m the diplomatic service) and a personnel, both commissioned and enlisted, adequate to the fu ll needs o f the A rm y , can the dental corps ever be able to exploit modern dentistry satis fa cto rily in the service during peace time or to reorganize its activities best fo r w ar. Such an ideal organization w ould o f course require legislation affecting the entire medical department, as it w ould mean a t least its partial reor ganization. Speaking only o f the den tal corps organization in such a plan, it w ould require a c h ief o f the D ental Corps selected fro m the senior officers o f the corps, holding the grade o f brigadier general (as w ould both the M edical and the V eterinary Corps under such a plan o f departm ent reor gan ization ), the ch ief o f corps to be vested w ith fu ll authorization o f law fo r the autonomous control o f his corps under the protectorate o f the Surgeon G eneral and governed by specific in structions pertaining thereto covering every activity o f his official adm inistra tion. Some such organization w ith a chief and an adequate personnel is bound to come in time, and it is hoped that our present Surgeon G en eral, M a jo r G en eral M . E. Irelan d , alw ays a strong partisan fo r the dental service, may have both the opportunity and the great pleasure o f celebrating its accomplish ment. In closing, I desire to express great appreciation o f the m anifest interest shown in the w e lfa re o f Section X I V , M ilitary Surgery o f the Seventh
Proceedings o f the Seventh International Dental Congress
International D ental Congress, by the attendance and cooperation o f the splendid men o f our sister nations and the equally representative men o f A m erican dentistry. M y best wishes go out to our con freres present in the m ilitary dental service o f their respec tive countries, w ith the hope that all they may seek in the w ay o f im prove ment in such service m ay graciously be granted them. DISCU SSIO N
R odriguez Ottolengui, N ew York C ity: It is indeed most interesting, and to many it w ill prove enlightening, to learn that our American dentistry practically had its origin in tw o military men, Joseph LeM aire and James Gardette, both o f the French Navy, who came over with the allied troups o f Louis X V I, bringing with them the accepted knowledge o f modern dentistry. Particularly does it appeal to those o f us who recall the events and who participated in the great struggle to introduce regularly organized den tal service into our Arm y and Navy. H aving come out o f the military service, how strange it seems, in retrospect, that subsequently it required so much energy to make dentistry an integral part o f our great military depart ment. Colonel Oliver recalls the period be tween 1898 and 1901 when the National Dental Association was urging the creation o f a dental corps in our Arm y. He touches lightly on the provisions o f that bill as finally passed, and naively adds, “ somewhat modified it is true,” but he fails to mention the fact that we were obliged to accept the so-called Contract Dental Corps, the active members o f which had no standing as regular officers; a condition which was not corrected until 1911. There is a fact in connection with this state o f affairs which should become a matter o f permanent record. T he creation o f a contract dental corps, in stead o f an officered dental corps, was largely due to, let us say, the fear am ong military medical men that the dentist w ould not prove himself fitted to hold rank. It was, therefore, tremendously fortunate that such men as John S. Marshall and Robert T . Oliver should have been selected to serve as the first nominal heads o f the newly organized Contract Dental Corps. Both o f these men
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were W ar veterans and held medical degrees, I think, and both had already distinguished themselves in the field o f oral surgery and as educators. W hat more splendid links could have been forged to unite the existing medical corps with the apparently insignif icant little group o f men known as the Contract Dental Corps. A nd what did these men do? Far from failin g to conduct them selves in a manner befitting a soldier and an officer, it soon became apparent that they w ould not only grace such positions and ren der valuable service, but that, without rank o f some sort, their usefulness in the Army would be greatly limited. M en in the ranks readily recognize their superior officers and take orders from them, but unless the soldier had been made to see that his dentist was, in a sense, his superior, whose orders and instructions must be obeyed, dental service never w ould have achieved the results that were obtained. T h e medical officers early recognized this fact, and themselves provided a remedy, through regulations, without wait ing fo r further action o f Congress. I well remember an incident during1 a visit to West Point: while walking from his quarters to the Academy Headquarters, at the side o f Colonel, then plain D octor, Oliver, I noticed that every soldier that we passed saluted him. This surprised me, and then fo r the first time I observed that Dr. Oliver wore shoulder straps. I inquired about this and was told that the straps did not carry rank insignia but merely the letters, “ D . C .” meaning Dental Corps, which, to the minds o f the soldiers, converted the wearer into an officer, o f sorts, and at once commanded respect. Not only these facts: the conduct o f all these “ hired dentists” was so correct that they were admitted to officers’ messes and social entertainments, and to fu ll companionship, showing that they were w ell received on a basis o f social equality. There is no doubt that the splendid conduct o f these pioneers o f the dental corps helped to pave the way and make it possible f o r them to receive higher recognition and regular rank. I here appeal to you all to place the names o f Marshall and Oliver side by side in dental history, with those o f LeM aire and Gardette. The latter brought dentistry out o f the military service, and the form er again established it in the service, on an organized and highly respected basis. M ark L . Finley, W ashington, D . C .:
The
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exigencies o f war have always led to de velopment and to progress, in spite o f the horrors that accompany its campaigns. In dentistry, the late W ar has developed skilful methods o f treating m ajor breaks o f con tinuity in the facial, maxillary and oral regions, the marvelous results obtained ex citing the wonder and the admiration o f all professional observers. In consequence o f my own activity in the earlier efforts to secure legislation f o r placing the dental sur geon in the military service, I have watched with jealous eye, the record being written, and I am fu lly satisfied that dentistry has played its part well through the men who have conducted its great perform ance tests through the years. I pay my respects to our presiding officer, Col. Robert T . Oliver, and to others who have written fo r our pro fession a record commensurate with the pro gress o f human effort and advancement in other activities. H enry S. Dunning, N ew York C ity: I wish to compliment Colonel Oliver on his collection o f these most important data re garding the practice o f military dental sur gery. I was one o f the members o f the B. P. Club o f the A . E. F., and feel that we members o f the m axillofacial section o f the A rm y owe Colonel Oliver a great debt for all that he did f o r us, in the early days o f our w ork in France. Perhaps some o f you present are not fam iliar with the B. P. Club o f the A . E. F. T h e members o f this Club landed in France prior to the com ing over o f our Chief, General Pershing, and laugh ingly form ed a little club we called the B. P. Club, meaning Before Pershing. We saw the A . E. F. grow from a handful o f men that didn’ t know what it was a ll about into a mighty organization o f trained sur
geons, dentists and other specialists, and incidentally combatants, who had gained much experience from our allies on many fronts. Colonel Oliver was always a tremendous help to members o f the m axillofacial section, and more than once my Chief, Colonel Blair, and I went from our headquarters in N euf Cha teau to Colonel O liver’ s headquarters in Tours to ask his advice and help, which was always cheerfully and enthusiastically given. The cooperation that was shown between the den tal section o f the A rm y under Colonel Oliver and our special branch o f the surgical sec tion was w onderful and I believe opened the eyes o f the medical men in the armies o f our allies to a great extent. T he m axillo facial teams were worked out to a logical conclusion chiefly through the efforts o f C ol onel Blair and Colonel Oliver, and I think that, had the war lasted a little longer, we w ould have had the pleasure o f showing many more w onderful results through the repair o f the terrible facial wounds that the late war brought about. This section o f the International Dental Congress is a most useful one, and I hope it w ill be perpetuated and the members’ enthusiasm w ill continue, at least until the next war. It would be too bad if , during peace times, we lost track o f the wonderful lessons that we learned during the time o f stress and i f we allow ed our interest to lag to such an extent that these lessons that were so painfully learned by bit ter disappointments had to be learned all over again by the com ing generation o f younger men who w ill carry this w ork on. In other words, I hope that we can keep up at least a skeleton section, with our re cords and data obtained during the W ar, fo r future needs, and be prepared to carry on where we left o ff in 1918.
PRESIDENT’S ADDRESS, SECTION X V * By ALFRED P. LEE, D.D.S., Philadelphia, Pennsylvania M e m b e rs and. G u ests o f the Seven th In te rn a tio n a l D e n ta l C o n g r e ss:
I
present dental Congress.
A s stated in
our fo rew o rd to the printed prelim inary program , this section makes its initial bow at this Congress. M an y o f the
T is w ith feelings o f peculiar pleas ure that we address you on the open ing session o f Section X V o f the
subjects to be treated in these sessions
♦Section on History, Science and Libraries.
have appeared in programs o f previous