By Andrew Spielman, DMD, PhD
Professor of Basic Science & Craniofacial Biology; Associate Dean for Academic Affairs
It was the 2005 winter break, and Dr. Andrew Spielman was browsing eBay when he was astonished to find a 1728 first edition of Pierre Fauchard’s Le Chirurgien Dentiste (The Surgeon Dentist) for sale. The first comprehensive study of dentistry, Le Chirurgien Dentiste established dentistry as a profession and earned Pierre Fauchard recognition as the Father of Dentistry.
Fauchard described in minute detail the full range of treatment modalities that existed for oral and dental conditions in the early 18th century. He spent five years having his manuscript peer-reviewed by a group of 19 esteemed scientists, knowing that the delay in publication would be worth the greater accuracy resulting from the peer-review process.
Dr. Spielman knew immediately that this remarkable first edition belonged at NYUCD, but not where he was going to find $10,000 to have a chance at a successful bid. He contacted former Dean Michael C. Alfano, who agreed that NYUCD should own the book and advised him to ask the Director of the Waldmann Library, Mr. Van Afes, to fund the purchase from his budget. Van’s reply shocked Dr. Spielman: We already own not only Pierre Fauchard’s 1728 first edition, but also the 1746 second edition, and the 1786 third edition.
It turns out that NYUCD is one of only a handful of institutions in the world to own both the first and second editions, not to mention the third edition. The source of these rare books was a bequest from Dr. Bernhardt W. Weinberger (1886-1960), a University of Pennsylvania School of Dental Medicine graduate, an orthodontist and historian in his own right, and an NYUCD faculty member during the 1920s.
His appetite whetted by these discoveries and by his physical proximity to the first edition, Dr. Spielman decided to look into the process whereby Le Chirurgien Dentiste came into being. All of the historical photos in this article were taken by Dr. Spielman, mostly from the first edition, providing him with a portal through which to enter the life, times, and temperament of the Father of Dentistry.The following essay recounts that experience.
What must it have been like to write a textbook in a new field, like dentistry, at the dawn of the 18th century? Pierre Fauchard worked on his famous manuscript on and off while practicing as a certified mâitre chirurgien-dentiste,or master surgeon-dentist. When he first registered his manuscript in 1723, it contained 600 handwritten pages. But it took five more years of revisions based on feedback from 19 highly respected peer reviewers, who provided approbations - a sort of seal of approval or endorsement - and a subsequent reduction of close to 200 pages, to bring it to its final form.
All of Fauchard’s reviewers were socially prominent and illustrious physicians, scientists, scholars, and teachers. Clearly, Fauchard was astute enough to know that he needed a buy-in from those at the top if he was going to make his case for dentistry as a profession, rather than a trade. Long before marketing became a popular concept, Fauchard’s understanding of the need to establish his credibility ranks him as a marketing pioneer. By contrast, the first textbook on prosthodontics, Essai d’odontotechnie (Essay on Dental Technique) by Claude Mouton, published in 1746, was reviewed and approved by one person.
Pierre Fauchard coined the term chirurgien dentiste to refer to a trained surgeon, like himself, as opposed to untrained individuals, often barbers, who extracted teeth. While apprenticing in his youth as a naval surgeon, and witnessing the ravaging effects of scurvy on sailors’ dentition, he became interested in dentistry, and subsequently set out to write the first-ever systematized, scientific, and complete work documenting the state of the art and science of dentistry.
While great scientists and artists of the time, including Vesalius, DaVinci, Eustachio, and Paré, had published material about dentistry as part of more comprehensive medical works, never before had there been a separate, self-contained extensive text devoted to dentistry. With the publication of Le Chirurgien Dentiste, Fauchard literally founded a new profession.
The final manuscript, housed at the Library of the National Academy of Medicine in Paris, is 422 pages, and contains three discrete handwriting styles. The majority of the text is written in a hand that most likely belongs to Fauchard. I say this not only because it appears throughout the manuscript, but also because it contains significant spelling errors, which, in 1723, would not have been considered a major problem for a writer like Fauchard, who had to work for a living from a very early age and therefore did not have a formal education.
A second handwriting style and tone are discernible on the margins of the manuscript. These jottings are more mature and learned-sounding, and most likely belong to Jean Devaux (1649-1729), Fauchard’s first reviewer. The third set of jottings, which are very carefully, indeed painstakingly, composed, are most likely the notes Fauchard made based on reviewers’ changes.
Devaux knew little about dentistry, but he brought to Fauchard’s enterprise the prestige, experience, and authority that Fauchard lacked. Most of Devaux’s suggested changes and corrections appear in the medical/surgical sections of the first volume. The second volume, which deals with technical aspects of dentistry; (i.e., denture making, instruments, etc.), has no similar marginalia. For the next 16 months, Fauchard made corrections to his manuscript before submitting it to other reviewers.
Fauchard’s second reviewer was Philippe Hecquet (1661-1737), Regent-Doctor, Professor of Medicine, and former Dean of the Faculty of Medicine at the University of Paris, and personal physician to Henry-Jules de Bourbon (Prince of Conde), the Duchess of Vendôme, and even to the young Louis XV. When Fauchard sought his approval, Hecquet was 64 and at the height of his illustrious career, and his was an especially important endorsement.
Fauchard next sought approval from Jean-Claude Adrien Helvetius (1685-1755), the son of an Amsterdam-born physician, Jean Adrien Helvetius, famous for introducing the ipecacuanha root, used to cure dysentery, to the French court.
Within days, Fauchard obtained another approval, this one from Jean Baptiste Silva (1682-1746), Regent-Doctor at the Faculty of Medicine in Paris, physician to the Duke, and consulting court Physician to King Louis XV, Karl the elector of Bavaria, and Tsarina Anna of Russia.
On July 26, 1725, Fauchard secured the endorsement of Antoine DeJussieu (1686-1758), physician, botanist, Member of the French Academy of Science, and Professor at the famed Jardin du Roi in Paris. DeJussieu was a respected Regent-Doctor at the Faculty of Medicine in Paris and Member of the Royal Societies of London and Berlin.
Several months later, Fauchard turned to Raymond-Jacob Finot (1673-1747), a distinguished physician on the Faculty of Medicine at the University of Paris and the personal physician to the Prince and Princess of Conti. Several years earlier, Finot had referred a patient suffering from an oral tumor to Fauchard.
Fauchard next sought the approval of Jacob Benignus Winslow (1669-1760), Regent-Doctor at the Faculty of Medicine in Paris, Member of the Royal Academy of Science, and later Professor of Anatomy and Surgery at the Jardin du Roi, where DeJussieu was a professor of Botany. Winslow’s patients included King Louis XIV, the Sun King. Winslow had earlier referred several patients to Fauchard, including one with parulis (an abscess of the gingiva).
The next six months found Fauchard busy revising his manuscript. That spring, in rapid succession, he sought the approval of six additional colleagues, all formally trained, guild-certified Parisian surgeons. Then on June 9, 1728, after almost five years spent preparing his manuscript, Fauchard turned for the first time to a dentist, Monsieur Laudumiey, surgeon-dentist to His Majesty, Philip V, King of Spain, for an approbation.
The final approbation, dated July 7, 1728, is from a group of guild-certified surgeons in Paris, lieutenants to the Chief Surgeon of the King, one of whom is likely to have been the famous Claude Mouton, author of the aforementioned Essai d’odontotechnie.
History does not record the identity of all 19 individuals who gave their seal of approval to Fauchard, but the fact that he initially sought approval from the most established physicians of his time shows that he was well aware of the social and professional pecking order that prevailed. To recruit and implement all 19 approbations meant that Fauchard had to wait five years between completing his manuscript and publishing Le Chirurgien Dentiste, but history proves that the wait was well worthwhile.
* An extended version of this article was published in the October 2007 issue of the Journal of Dental Research. ↩