Australian Dental Journal, February, 1978
14
Volume 23, No. 1
Australian dentists and dentistry around 1900 Sydney Levine, M.D.S., F.R.A.C.D.S.
The end of the 19th and the beginning of the 20th century was a period in the history of this country when important social and political changes very rapidly occurred. These were changes which were to have a most significant effect on the lives of all Australians and in fact alter the whole structure of Australian Society. This was especially so with the advent of Federation of the Australian Colonies on January lst, 1900, after protracted negotiations. It was at this time too, that we see the beginnings of both formal dental education and dental journals and a growth in dental legislation to control the practice of Dentistry. So this is also an important as well as interesting period in Australian dentistry history. Australian society
What was Australia like at this time? How many dentists were there? What was the extent of their knowledge? How did they acquire this knowledge and what kind of equipment did they use? Firstly, what kind of Australia did the dentist of this time live in? T o quote Greenwoodl ( a social historian) :Editor’s Note: An extensive bibliography was prepared by the author from which a selection has been made. G.-Australia. A Social and Political History. Sydney, Angus and Robertson, 1969 (p. 145).
1 Greenwood,
“Although in the years between 1880 and 1900 Australian Society continued to be deeply influenced by ideas from Britain and by the presence of immigrants who had grown to maturity in the old world, the characteristic attitudes of the people were a product of the new. After 1880 Australian nationalism is an essential component of Australian Political and Social Life.” The population of the Australian Colonies had increased from 2,323,000 in 1881 to 3,771,000 in 1901, but more significantly was the increase of native born Australians from 60 percent to 77 percent. Three quarters of the community of the 1880s and 1890s were urban and rural wage and salary earners, and this in many ways reinforced this feeling of nationalism and the need to break away from the older British tradition of a classstructured society. The feeling of nationalism also produced a new breed of literary figures, among whom were Roderick Quinn, Bernard O’Dowd, Henry Lawson and Joseph Furphy, the latter two laid stress on an Australian way of life and crusaded against the prevailing poverty and the British class-based society of the times. The Bulletin, which had started in 1880, flourished with a nationalistic fervour. Amongst artists, too, there was a new movement - Tom Roberts and Arthur Streeton, to name two, showing the way. There was no doubt that a break from Britain was wanted in some form. Some even advocated that Australia should become a republic and with this
Australian Dental Journal, February, t 978 nationalism arose a feeling of egalitarianism and an anti-class attitude. The foundations of Australian Unions were well laid by 1885 and whereas they were originally non political, began to take political action which eventually led to the formation of the Australian Labour Party. The economy had reached a peak in 1889 but
a depression followed in the early 1890s with bank failures - the worst hit being Victoria which began to lose people to New South Wales after having had a bigger population for many years. From then until 1900 was a period of diminishing prosperity, compared with the previous twenty years. Western Australia was something of an exception with the discovery of gold in Coolgardie in 1892. Life was not easy in those days, and to lessen the prevailing industrial hardship, Victoria, in 1896, passed an Act limiting the work of women and boys under 16 years t o 52 hours per week with a maximum of nine hours on five days and eleven hours on the others; New South Wales and Queensland followed much later. Nevertheless a greater degree of social conscience was shown when New South Wales and Victoria in 1900 adopted an old age pension scheme: prior to this the old were cared for basically by private charities. So t o quote Greenwood2 again:“Thus by the end of the nineteenth century the governments of all the colonies had written into the statute books a great deal of socio-economic legislation, the common factor in it being the idea that the state had a responsibility to concern itself in a more positive way with the economic and social life of the country.” The Australiari Hatidbook for 1900, in its notes for immigrants, lists some of the wages and costs at the time3. For example, New South Wales coach trimmers started with a wage of 21.15.0 per week, masons’ labourers earned 6/- a day and plumbers started at 9/- per day, and there was very little difference in the other States; but of course, costs were low, Blankets were quoted at 7/6 and stockings six pence a pair, while the rent in a Sydney suburb for a small cottage with 3-4 rooms and kitchen was advertised for 6/- t o 9/- per week. As for dental fees, looking at the Sydney Morning Herald for 1900 we see full upper and lower dentures from €1.0.0 to f2.10.0 and the same in 18 ct gold from f3.0.0 to f5.0.0 Extractions I / - and 2/6, amalgams 2/6, crowns 10/6 to 12/6. These, of course, were the fees charged by the advertising dentists and the lowest were those
?Greenwood G.-Op. cit. p. 179. 3 Australian ’Handbook fdr 1900. London, Gordon and Gotch, 1900.
15
of a dental company. So one could expect somewhat higher fees to have been charged by the well trained ethical dentist. I t might be interesting to look at practice prices and the figures are for January, 19044. Thei-e were three dental practices for sale, one in Queensland with a twelve months takings of f387.0.0 (the asking price being f150) in a town with a population of 6000. Another in an “unopposed country practice, cold climate”, had takings of f650.0.0, price f300.0.0 including plant and the third, a city practice in a leading thoroughfare, cost fSOO.O.O. the vendor did not say how much he earned. At that time, Sydney and Melbourne each had populations just less than one million. Of course the differences between those cities then and now were much more than population. This is so aptly illustrated in the Australian Handbook of 19003, which says of Sydney:
“The telephone continues to make rapid progress throughout the city and suburbs and is proving a great benefit and convenience t o business men.” and later, “The streets are lighted by gas, and electric light is availed of t o a great extent by business people”. Other cities also had electric light and all had cables or electric trams. Very few of the pages of newspapers at the end of the 19th century carried news. Nevertheless the Boer War seemed t o be fully covered, taking up most of the pages available and there was some concern over an outbreak of bubonic plague in the Sydney suburb of Redfern during March 1900. But on the brighter side, the amusement columns of the Sydney Morning Herald, January 6 , 1900 tell us that in Sydney we could go to the Opera House on King Street where we could see a spectacle of the Boer War with 30,000 square feet of battle scenery for the popular prices of 2/-, I / or 6 pence, and of course, naval and military forces half price. The more sporting minded could also see South Australia play New South Wales in the inter-colonial cricket series for I/-.
So this is something of the social and economic scene around 1900. Those days were not very prosperous, wages and costs were low, working hours were long, technical amenities as we know them now, hardly existed and one even had a chance of catching bubonic plague. Nevertheless, what those people lacked in material comforts they made u p in a new social and cultural awareness and a feeling of national pride, all of which were unknown 20 years before.
~-
4Comm. Dent. Rev., 2: 15 (Ian.) 1904.
16
Australian Dental Journal, February, 1978
Dental practitioners and their qualifications
TABLE 1
So the dentist of 1900 must have been influenced by the social events of his day and may even have been personally involved in many of the social and political movements, outside as well as within dentistry which were themselves by-products of the times. How many dentists were there? A look at the lists of dentists in Wise’s Comniercial Directories for the year of 1900 Sydney, Brisbane, Adelaide, Hobart, Melbourne and Perth proves very interesting. The numbers of people stating their occupations as dentists is not necessarily the true number of those practising dentistry. This is because where there is more than one directory for a colony the names and numbers of dentists differ; also in some colonies there were no dental boards and consequently no register of dentists. So the figures arrived at (Table 1 ) are for those men and women who wanted themselves listed, and in practical terms it must be very close to the true figures. An examination of Table I shows that there were 738 dentists listed of whom seven were women. This gives a dentist-patient ratio of about 1:5000 throughout Australia and 1: 1900 for New South Wales, and of course the figures would have been better for the capital cities. So that in the cities at least there was adequate provision for dental care if required or if it could be paid for. Almost half of those dentists listed, practised in New South Wales and Victoria as one might expect, with New South Wales having 92 more than Victoria and in most of the colonies more than half practised in the capital cities. Fifty-one (about seven per cent) had DDS degrees from American universities, and using as a guide the list of graduates from the United States dental schools, as published in Denial Cosmos5 for the previous ten years, they would most likely have received their degrees from either the Philadelphia Dental College or the University of Pennsylvania Department of Dentistry, the former being by far the more popular of the two. As well as listing the names of dentists, the directories listed organizations called dental companies or dental institutes with or without the name of the managing dentist. Examples of this in Sydney are “Ideal Dentists”, “City Painless Dentistry”, “Imperial Dental Company”, and “London Dental Institute”6. In some cases the dentist was also a pharmacist or was listed as Dentist, Dental Surgeon, Surgeon-Dentist or Surgeon and Mechanical Dentist.
Australiaii dc,riii.sts iri 1900 (Information f r o m Wise’s Post Office Directories)
Dental Cosmos, 32-42: 3890-1900. Sands Sydney Suburban and Country Commercial Dir. rectory 1900. Sydney, John Sands, 1900 (p. 251).
N.S.W. Qld. S.A. Tas. Vic, W.A. Total
Women
D.D.S.
Other qual.’
3 1
33 5 1
5 -
11 1 51
1 2
1
2 7
-
8
Total
307 96 41i
30 215 49 738
*L.D.S., M.R.C.S., M.D. 1 lniludinp four in Broken Hill.
The directories, of course, contain the names of those men and women who made important contributions to dentistry in this country and we see the names of men who were the fathers and grandfathers of men and women practising today. These names comprised a whole spectrum of qualifications and skills. At one end was the highly qualified graduate D D S from an American University or a man with United Kingdom qualifications; at the other end there were men who had neither passed examinations nor had even been apprenticed. In between there were the great majority who had been apprenticed to dentists and some of these would have had t o prove qualifications but some not, depending on whether the colony in which they lived had a Dental Act. Some too, would have been trained in the newly established Australian College of Dentistry in Melbourne. We know, too, that at this time, there were men practising as dentists who were incompetent, dishonest quacks, because this was a frequent topic of discussion at dental meetings; the Dental Acts, of course, were aimed a t eliminating such practitioners. There was not only considerable variation in the qualifications of the dentist, but also ethical standards differed. This was seen most clearly in relation to advertising. Some did not advertise at all except for their names and addresses in a commercial directory, others had very modest notices. In fact advertising was legal and advertising by dentists in New South Wales was not banned until 1934. But some made the most extravagant claims of their skills. Legislation
The extravagant claims made by some dentists and unethical attitudes common a t the time was not in the best interests of the patient. This was as true then as now and it was quite obvious to
Australian Dental Journal, February, 1978 the qualified and ethical practitioner of the time that the situation could only be altered by appropriate dental legislation and the establishment of Registration Boards, Dental legislation and training. By 1900 some of the colonies already had Dental Acts. Surprisingly, Tasmania7 was first in 1884 followed soon after by Victorias in 1888, which amended its Act in 1898, setting up a four year LDS course. In 1894, Western Australia9 passed its first Dental Act, but in New South Waleslo there was none until 1901, and Queensland11 and South Australia12 both waited until 1902. So that in 1900, in three of the colonies, anyone irrespective of how little dentistry he knew and what character of person he was, could carry on the practice of dentistry. Speaking of New South Wales in 1900, Percy Ash13 was to write many years later: “The Profession in those days was at a low standard as compared with law, medicine, divinity and others, but there were men in it who saw that if ever dentistry was t o be recognised as a calling attractive to young men of brains and good standing, a n effort must be made to pass legislation which would place it beyond reproach in the eyes of the public. Only those who undertook the work of reform can tell you of the great difficulties encountered a t almost every turn, and as a consequence the act of 1900 though incomplete in many ways, was the best that could be obtained in face of great opposition’. Education
Once a Dental Act was in force and rules made for dental practice, only then could formal means for assessing the qualifications of dentists be laid down by a Dental Board, examinations would have to be arranged, and courses set up, so dental education had to follow. Before the passing of the Dental Acts and for some years afterwards, a dental education was generally obtained by a young man or woman being apprenticed to a practising dentist. The difference after the passing of Acts was that the apprentice through examinations, had t o satisfy Cyclopaedia of Tasmania, Vol. 11 96. 1900. Iliffe, J.-Dental Education - definition and general aspects In. Proc. First Australian Dental Congress. Edit., Hall, C. Sydney, Government Printer, 1909 (pp. 14-29f . 0 Stockwell, R.-Unpublished data. l o Arnott, A. J.-The historical development of dentistry as a profession in New South Wales. Dent. J. Aust., 24:7-8. 133-143 (Aug.) 1952. ‘1 Lumb, S. F.-The growth of dental education in Queensland. Austral. D . J.. 1:1, 19-22 (Feb.) 1956. Chapman, A.-Edit., History of dentistry in South Australia 1836-1936. Adelaide, Gillingharn and Co., 1937. ’”Ash, P.-The status of the dental profession. Dent. Sc. J. Aust., 3:6, 242-246 (June) 1923. 7
17
examiners chosen by the Dental Boards that he was qualified to be admitted a s ;I practitioner. Nevertheless, even after the passing of the various Dental Acts, men who had been in practice before the passing of those acts were still entitled to practice, so that for many years unqualified men practised alongside the qualified. The young apprentice was indentured and entered into a written agreement whereby he would (and quoting from an indenture of 1897 in New South Wales) “Put himself apprentice to the master to learn his art and business as a dentist and everything relating thereto for the space of three years . . . and the apprentice hereby agrees . . . that during such term he will faithfully, diligently and assiduously serve and obey by night and day his said master . . . that he will at no time absent himself from his master’s business without his consent; and that he will not be accessory to, nor commit or permit any hurt or damage to his said master or his property, nor conceal any such hurt or damage if known to him, but shall d o everything in his power to prevent the same In this instance cited, the apprentice was paid one shilling per week for the three years and he paid 55 guineas for these privileges. A few years later the apprenticeship required four years. As far as academic training was concerned, it was non-existent at this time except for Victoria. In that colony the Australian College of Dentistry8 was established in Melbourne in 1897 associated with the Melbourne Dental Hospital and, in 1904, this College was absorbed by the Faculty of Dentistry within the University of Melbourne. New South Wales10 did not establish formal dental education until 1901 and then as a Department of Dentistry within the Faculty of Medicine, and it wasn’t until 1921 that the Faculty of Dentistry was established in the University of Sydney. In Adelaide the Faculty of Dentistry came into being in 1921 in the University of Adelaide, a course having been started within the Faculty of Medicine in 191912. The University of Queenslandll started its Faculty of Dentistry in 1935 and a Faculty was not established in Perth until 1946, although in 1934 the West Australian College of Dental Science began within the Perth Dental HmpitaP.
. . .”
Dental organizations
Associations of Dentists in most colonies preceded the Dental Act, because it was through the agitation of such associations that Acts came into being to protect the dentists’ own interests and that of their patients. The first Dental Association appeared in the colony of Victorias when the Odontological Society of Victoria was formed in 1884 which was followed by the Dental Associa-
Australian Dental Journal, February, 1978
18
tion of Victoria in 1889. The Dental Association of New South Wales was formed in 189214 and, in 1899, the Odontological Society of New South Walesls. Queensland had its first society in 189916, the Dental Association of Queensland. It is possible that Western Australia9 had a Dental Society prior to 1894, but the information in this regard is scanty. South Australia12 had to wait until 1907 for its first society. As for Tasmania having a dental society at this time I have no information but, as Tasmania had the first Dental Act, it seems likely that the dentists of that colony would have had some kind of an association. If this were so. South Australia was the only colony at the time without a Dental Association. Dental literature
With courses being laid down by Dental Boards, the new breed of dentists wanted to continue learning. Some went abroad as some had for many years before this, but those who could not had to depend on journals and text books as one does now. It was some years before visiting dentists were to lecture here. It is interesting to take a look at the journals and text books available to dentists of 1900. As for journals - was anything published locally? One would expect, as previously suggested, that once an association is established it is logical that a journal will follow soon after. The association needs a medium whereby its members can be kept informed of its proceedings and in which it disseminates as widely as possible the papers read by its members at its meetings. There was one such early journal which catered for the needs of the Associations: this was the Australian Journal of Dentistry, published in Melbourne, which started in 1897 and only ceased publication in 1956 to give way to the Australian Dental Journal, a national journal; and, in 1903, the Commonwealth Dental Review commenced publication in Sydney. However, the Australian Journal of Dentistry, was extremely successful and important. To quote Amies and Tuckfieldl’: “It might be asked whether the Journal [Australian Journal of Dentistry] played any particular part in Victorian Dental Education and the answer is definitely in the affirmative. It published all the Odontological Society, College and hospital news, and it provided a means whereby professional papers read before the odontological societies of Editorial. The Dental Association of N.S.W.-The Australasian Medical Gazette, 289 July, 1892. South Wales Notes-Aust: J. Dent., 3:l, 12-13 ’“New (Aug.) 1899. 10 Dental Association of Queensland-Aust. 1. Dent., 4:2, 45 (Sept.) 1900. ”Amies, A . B. P., and Tuckfield W. J.-Dental education in the State of Victoria. Aust. Dent. J., 1:1, 1215 (Feh.) 1956. I*
Victoria, New South Wales and Queensland and South Australia were published. Also, over the years, it has given freely of its space to original investigation and research. In later years, it became the official organ of several of the State branches of the Australian Dental Association”. So that this journal not only started off well. but continued and Truemanls, discussing journals published in the British Empire between 18431924, had this to say about the Aiistraliari Joirrnol of Dentistry:
“This pioneer dental journal . . . has well held its own as a guardian of professional interests, quietly and steadily, keeping on the job”. It is quite clear that at this time Victoria was by far the leading colony dentally. Its Dental Act with its amendment was the best at the time, insisting on a four-year study course and it had a Dental College to implement it, and at this time it also had the only dental journal. For those who looked for a broader view and wanted information from the world’s most important dentists, there were journals from the United States of America and Great Britain and we know that many of those trained abroad would have subscribed to these journals; they would have heard some of the famous men speak and even had some of them as their teachers. From the United States of America19 there were firstly, the highly influential Dental Cosmos, which had been published since 1859, and later became the Journal of the Anierican Dental Association. Others available were Den f a / ltetiis of Interest, established in 1891, Dental Digest, 1895, and the American Journal of Dental Science which started in 1839, to name the most important. From Great Britain18 the following Journals were avai1able:- The British Journal of Dentof Science, which started in 1856, and the important and influential journal of the British Dental Association which had started originally in 1872 as the Montlily Review of Dental Surgery. In 1903 this Journal became the British Dental Journal as we know it now. There was also from London The Dental Record, which was established in 1881, and the Transactions of the Odontological Society of Great Britain which was one of the older journals, having started in 1857. It is possible, too, that The Dominion Dental Joiirnal from Canada, which
Trueman, W. H._History of the dental eriodical literature of the British Empire 1843-192x In, Index of periodical dental literature 1876-1885. Edit., Black, A. D Buffalo Dental Index Bureau 1925 (p. XLIV). 1s Beh;. W.-List of Dental Journals indexed for years 1896-1900 inclusive. In. Index of periodical dental literature 1896-1900. Edit., Black, A. D . Buffalo, Dental Index Bureau, 1930.
19
Australian Dental Journal, February, 1978
19
commenced in 1889, may have found its way to Australia. One can hardly expect textbooks in the absence of academic education, so that a t this period there were no books of this nature published by Australians. But there were a few small volumes published in this country for lay readers and which would have had little interest for practising dentistszo. Two of them published at that time 1897 were The Early Decay of Children’s Teeth by Leonard Bickle, a physician of Adelaide, and Australia’s Teeth and how to s a w them by W. The0 Shanasy, a dentist also of Adelaide, published in 1900. Another book, the Adinitiistrafion of Cldorofornz in Dentistry by John William Springthorpe, published in Melbourne in 1898 and having only 8 pages, may have been of some interest. These were really not important, however interesting. But, on the other hand, there were many textbooks published abroad both in the United Kingdom and the United States of America that were available t o Australians. In fact, many of these books with the names of dentists of this period inscribed inside them are in libraries or private collections at the present time. These books varied from small pamphlet type publications to very large standard textbooks written by the most eminent men in the field. There were simple practical texts for the busy practitioner written by B. H. Catching, Catching’s Compendium which was published for many years, and W. H. Steele’s Useful Hints For The Busy Dentist. but there were also great encyclopaedic works covering the whole gamut of dental knowledge. Examples of these were the American Textbook of Operative Dentistry, edited by E. C. Kirk, and Chapin Harris’s famous Principles and Practice of Dentistry in its 13th edition, revised by Gorgas. This is an interesting period in the history of dental literature because these all embracing texts were beginning t o give way to books covering special fields as we know them today. Among those were E. H. Angle’s 6th edition of Treatment of Malocclusion of the Tecfh and Fractures of the Maxillae, Descriptive Anatomy of the Human Teeth by G . V. Black, A Manual of Dental Anatomy both Human and Comparative by Charles Tomes, and Anatomy and Histology of the Mouth by 1. N. Broomell. More specialized fields were provided for by C. N. Johnson, Principles and Practice of Filling Teefh, R. Ottolengui, Methods of Filling Teeth, G . Evans, Practical Treatment on Artificial Crorvn and Bridgework, J. E. Garretson, A System of Oral Surgery, and many others in”’ Levine, S.-Early
Australian dental literature
rior to
1900. Austral. D. J., 19:5, 349-358 (Oct.) 1974.
cluding books on prosthetics by C. J. Essig, and J. Richardson, administration of nitrous oxide and oxygen for anaesthesia, the treatment and prevention of diseases of children’s teeth, periodontics, dental medicine, dental therapeutics and dental pathology. The S. S. White Dental Manufacturing Company had published W. D. Miller’s The Microorganisms of the Humart Mouth in 1890, a work of fundamental importance in the understanding of various infections of the oral tissues with special references to dental caries. These examples will suffice to show that all tastes and levels of knowledge were catered for at this time. Fundamental knowledge and new advances in Dentistry were available for those who wanted them. Virtually, all of the textbooks came from the pens of academics as did many of the journal articles from abroad; so that many of the authors would have been known to those Australian dentists who had studied in the United States and Great Britain. It must also not be forgotten that at this time, the Australian dentist was writing original articles for the local dental journal. Dental practice and equipment It is also quite clear just from this list that, by 1900, the major framework of modern dentistry had already been laid down and in general medicine the work of Pasteur, Kock and Lister had been done years before. So that, in his day-to-day practice, the dentist of 1900 did a great number of amalgam fillings but possibly even more gold foils at which he was very adept. (Taggart’s inlay casting technique was not available until 1907.) H e practised endodontics and used vulcanite and swaged metal for his dentures. His partial dentures were designed in a manner almost totally mechanical, virtually no thought being given to the biology of the periodontium so that great damage must have been done to these tissues. The dentist of 1900 practised exodontia and oral surgery too, general anaesthesia was well known and eucaine had been introduced as a local anaesthetic, but it was not until the advent of Novocaine in 1905 that local anaesthesia became more popular. He also practised orthodontics or, as it was then called, regulating the teeth. He scaled teeth and many thought in terms of preventive dentistry. By and large the dentist of 1900 practised adequate dentistry mainly of a mechanical nature. Judging from the advertisements many teeth were extracted which perhaps could have been saved even though the influence of William Hunter21 had not reached Australia.
2’
Hunter, W.-An address o n the role of sepsis and antisepsis in medicine. The Lancet, I : 79-86 (January 14) 1911.
20
Australian Dental Journal, February, 1978
Fig. 1.-A
dental surgery at the beginning of the century.
So there was certainly a lot of sound dental knowledge around 1900. How were dentists able to practise it? What did their surgeries look like? Available pictures at the time are from the United States of America but there is no reason to believe that our successful and influential practitioners did not have similar rooms (the catalogues of furniture, equipment and instruments came from abroad). These surgeries appear extremely cluttered and not at all clinical like today although some of our modern rooms do not look as clinical as they did 20 years ago. The general impression is of a Victorian parlour which is being used as a dental surgery. Pictures and brica-brac adorn the walls, scatter rugs are on the floor and in some cases there are small statutes on pedestals (Fig. 1). Only the popular aspidistra being reserved for the waiting room. The surgery seems so antiquated as to be ludicrous until we realize how difficult dental practice was then many used only natural light to illuminate the mouth. The chair (Fig. 2) looks even modern enough until the advent of the horizontal operating position, a foot engine or two can be seen,
electric motors were in their infancy. A most ornate dust collecting instrument cabinet occupies a prominent place and the plumbing beside the chair is reminiscent of Heath Robinson (Fig. 3). The instrument bracket table does not look so old fashioned, after all it was extremely functional, and in some cases there is some kind of electrical apparatus against a wall for those who were modern. Nevertheless, the dentist of 1900 appeared to be as proud of his surgery then as he is today if one can judge from the existence of photographs and articles about surgeries. As for instruments and equipment, if we looked at a typical instrument catalogue of the times, (Claudius Ash and Sons Limited 1899) there we would find more than 600 pages of instruments and equipment to choose from, and I believe that our younger graduates of today might not recognize many of them as dental instruments at all, although forceps look much the same and so do impression trays. There were pages of surgery furniture, general anaesthetic apparatus, some of the new and very primitive electric apparatus, an operating light and even a very early dental engine,
21
Australian Dental Journal, February, 1978
__ Fig Z.-Dental
Fig. 3.-Dental
equipment.
chair, 1900.
operating instruments in their hundreds of varieties with scalers looking like garden tools and a great section devoted to prosthetic material especially for making metal plate work, which was very popular at the time. There were even tooth brushes, if they can be called such, which I imagine preventive minded dentists perhaps gave their patients. There were also lots of curiously constructed mechanical devices. Many of the instruments seem large and coarse, especially cavity cutting instruments. All in all, it seemed a very mechanical age. The dentist of those days was no more free of worries than the dentist of today. What kind of problems were the dentists concerned with? Our only knowledge of this comes from the matters they discussed at their society meetings, and the papers they read t o them. Both these are recorded in the pages of the Ausfraliari Joirriial uf Deufistry for this period and, if we add editorial matter, we find that:the social problem of great concern was the lack of dental legislation in those colonies which did not already have Dental Acts and provision for dental education. Almost every editorial had something to say about this. These
22
Australian Dental Journal, February, 1978
were genuine concerns and lucky for us, too. These men were the fathers of our profession. Also a popular topic was unethical practice including a plea for a fee for consultation and advice otherwise, so they said, the dentist was behaving like a quack. Death under general anaesthetic was a cause for concern and there are references to bogus diplomas coming from what were known as the “diploma mills’’ in the United States of America, where bogus colleagues offered bogus degrees for a fee. The clinical topics that interested him, gleaned from the articles in the j o i i r u d , were Crown and Bridgework with emphasis on techniques, Replantation of teeth, Endodontics, Pyorrhoea Alveolark and X-rays in relation to dentistry, and it is interesting to note that an article on this subject appeared in the Dental Cosmos of 189622 just one year after Roentgen’s discovery.
He was President of the first Australian Dental Congress in Sydney in 1907 and a delegate to the third International Dental Congress in Paris in 190024. There are also .people who are interesting in . other ways, one from those days is Annie Praed,
Personalities
I have written about dentists in general terms, but what about individuals? It is obvious that many of those listed in the commercial directories in 1900 must have been associated with important events in dental history and some would have changed the course of this history; some too were interesting people for other reasons. In New South Wales perhaps two names stand out above the others, Richard Fairfax Reading and Alfred Burne. Richard Fairfax Reading was an LDS, MRCS, LRCP from England who was in charge of dental studies at the University of Sydney when courses were first started in 1901 and then became the first Professor and Dean of the Faculty of Dentistry in the University of Sydney in 192110, a position he held until 1934. Apart from his pioneering work and influence in dental education, he played a prominent part in all aspects of dentistry in the early part of this century as a member of the Dental Board of New South Wales and was on the Council of the National Dental Association of Australia when it was founded in 191 1 (Fig. 4). Alfred Burne, a DDS from the United States of America was influential in shaping Dental Legislation in New South Wales and was the first president of the Dental Association of New South Wales when it was founded in 189213 and was still president in 1900. H e was also a member of the first Dental Board in New South Wales when the first Dental Act came into force in 190123.
Fig. 4.-Richard
in the first class of undergraduates when University dental studies were started and, many years later, the first woman to obtain the DDSc and still is the only woman to have done so. Another in New South Wales is John Belisario who was born in England in 1820 and died while still practising in June, 1900. He had been called the “Father of Australian Dentistry” by a biographer, BlackwelPs, who tells us that Dr Belisario had a very successful and fashionable practice in Sydney from 1841-1900. He took a DDS Baltimore in 1854, and travelled abroad often to the United Kingdom and the United States of America to keep abreast of the latest developments and obtain new equipment. He was friendly with the great John Tomes and he was noted for having
1’’
2a
>‘Morton, W. J.-The X-ray and it5 application in dentistry., Dent. Cosmos., 3X:6. 478-486 (June) 1896. 2 : Australian Journal of Dentistry. 4:5, 122 ( D e c . ) 1900.
Fairfax Reading,
British Dental Journal 2 1 : 473 1900. Blackwell. E.-The fa’ther of Australian dentistry. Dr Belisario and his work. In, Proc. First Australian Dental Congress. Edit.. Hall, C. Sydney, Government Printer, 1909 (pp. 34-38).
Australian Dental Journal, February, 1978 given the first general anaesthetic in Australia in 184726 and was honoured in many ways. In South Australia12 names like Peter Crank and Edward J. Counter are worthy of mention. Peter Crank served on the Dental Board from its inception in 1902 until 1907 and was president in
Fig. 5.-Herbert
23 Dentistry, and throughout Australia. The Cyclopedia of Victoria of 1903 says this about him: “Among those who stand at the head of the Dental Profession in Victoria the name of Mr John Iliffe occupies a foremost place, not only on account of the skill he displays in his practice and his art . . . but by reason of the position he has so worthily filled on the Dental Board ever since it came into
Hayes Norman.
1904. He was also honorary dentist to the Adelaide Hospital 1896- 1900. Edward Counter zerved also on the Dental Board from 1902-1905 and was president of the Odontological Society of South Australia in 1907, when it was founded and was Honorary Dentist to South Australia Children’s Hospital 1900-1920 and from 1902-1918 with the Orphan’s Home in Adelaide. H e was also President of the 4th Australian Dental Congress in Adelaide in 192127. Herbert Hayes Norman (Fig. 5 ) , also on the South Australia list at this time, is one worth mentioning. H e came from a pioneer dental family in Adelaide and was the author of the book called Arthur Redivivus or The Arthur System for rlrr Proximate Decay irr Teefli which he published in Adelaide in 189220. Although this book was written for the lay reader it is quite technical and must interesting. John Iliffe would probably be the most outstanding dentist in Victoria at the time (Fig. 6 ) . H e had a most influential effect on Victorian
5;
Grainper. J . K.-The first dental anaesthetic in Aostralia June (1847). Austral. D. J., 17:4, 297-302 (Aug.)
2 :
Report, Proc. Fourth Australian Dental Congress Adelaide, 1921. Adelaide, S.A. Government Prime;, 1923 (P. IV).
Fig. 6.--John
Iliffe.
existance.” In 1884, when the Odontological Society of Victoria was formed he became the first Treasurer, later becoming the second President in 1887 and was certainly still on the Council in 1913. H e played a major part in the drafting of the first Dental Act in Victoria in 1887 and helped in the establishment of the Australian College of Dentistry and the Faculty of Dentistry. H e had lectured at the Australian College of Dentistry and was a n editor of the Australian Journal of Dentktry. H e was also President of the second Australian Dental Congress in Melbourne in 190928 and when the first National Dental Association OF Australia was formed in 191 1 he was the first President. A Victorian dentist who is interesting for quite another reason is E. Lenthall Oldfield, who conducted The Dental College of Victoria in Nicholson Street, Melbourne, opposite the exhibition grounds. He advertised this college in the pages of a Bickles’ Australian textbook (vide supra). H e
1972.
z>
Tranwctions. Second Australian DentLl Congress. Mclhourne, 1909. Melbourne. J . Kemp. 1911 (p. 7 ) .
24
Australian Dental Journal, February, 1978
Fig.
7.--James T. Tunnock.
offered a complete course of study (four years) with special classes for medical and lady students. He also advertised the Dental and Oral Hospital at the same address and stated that attendance was free and a full cover of dental treatment given. This establishment obviously provided the clinical experiences for his students. Information on Western Australia is rather scanty, but J. V. Bingay was the Registrar of the first Dental Board in 18959. Nevertheless in Perth at this time was one, James T. Tunnock, who is listed as practising at Kalgoorlie and who according to Stockwell9 was the first to be registered under Western Australia Dental Act in 1895. He was a most colourful and flamboyant person (Fig. 7). He also practised in Melbourne, and in Sydney. He published a dental students’ textbook in rhyme29 and was at one time principal of the Interstate Dental College in Sydney and he claimed a special formula €or an anaesthetic solution. In Tasmania, the notable man is, I think, Arthur Lucadou-Wells (Fig. 8 ) of Launceston who also had two sons practising at this time. He was mTunnock, J. T.-A dental students’ technical course i n rhyme. Melbourne, Ford and Son, 1909.
educated in the United Kingdom and came to Australia in 1880. In 1882 he published a nine page book written for the public called A Treatise orz the Preservation of Children’s Teefli which I have discussed in a previous paperzo. In 1900 he was on the Dental Board of Examiners in Tasmania. In 1903 he was Honorary Dentist to the General Hospital in Launceston, having played an important part in establishing its Dental Department7. Frederick A. Huet in Queensland was the first President of the Dental Association of Queensland in 1898. In the Queerislarid Post Officeand Official Directory 1900 he described himself as late House Surgeon and demonstrator in gold filling at the National Dental Hospital in London. An interesting name at this time is A. R. Spencer, who advertised himself as a Fellow of the Science Society of London and that he had been awarded the highest honours in Queensland and a Gold Medal at an International Exhibition in 1897. These were some of the dentists of those times. There were the unusual characters and there were very fine men and women to whom we owe so much for the Dental Profession we have today. As dentists they lived in a completely different dental
Australian Dental Journal, February, 1978
25 ment by our standards and very difficult conditions under which to work. All in all the dentist of 1900 could do almost everything we can, even if he didn’t always understand what was happening. His instruments were less delicate and precise, thus in many ways he might have been considered more highly skilled and he did not have all the materials we have and he did not have the wonder drugs we have. The dentist of those times saw three major tasks confronting him in social dental reform. These were 1 ) the enacting or consolidation of dental legislation, which would produce qualified and ethical dentists; 2 ) the provision for academic dental education; and 3 ) the continuation of sound dental associations. There is no doubt that in a very large measure he succeeded in these tasks and laid the foundations for the welleducated, ethical dental profession of today. Acknowledgements
Fig. 8.-Arthur
Lucadou-Wells.
society from ours. With dentistry unregulated they had bigger problems to face than we do and dental patients were unprotected. They had poor equip-
Grateful acknowledgement is made to Mrs. 0. Monkhouse, Dandenong, Victoria, for the photograph for Figure 7, to Mrs. M. Steele, Librarian, Fairfax Reading Dental Library, University of Sydney, Miss Ann Ensted, Librarian, Dental School Branch Library, University of Melbourne, and the Librarian, State Library of New South Wales. 5 Upper Cliff Avenue, Northbridge, N.S.W., 2063.
14
Volume 23, No. 1
Australian dentists and dentistry around 1900 Sydney Levine, M.D.S., F.R.A.C.D.S.
The end of the 19th and the beginning of the 20th century was a period in the history of this country when important social and political changes very rapidly occurred. These were changes which were to have a most significant effect on the lives of all Australians and in fact alter the whole structure of Australian Society. This was especially so with the advent of Federation of the Australian Colonies on January lst, 1900, after protracted negotiations. It was at this time too, that we see the beginnings of both formal dental education and dental journals and a growth in dental legislation to control the practice of Dentistry. So this is also an important as well as interesting period in Australian dentistry history. Australian society
What was Australia like at this time? How many dentists were there? What was the extent of their knowledge? How did they acquire this knowledge and what kind of equipment did they use? Firstly, what kind of Australia did the dentist of this time live in? T o quote Greenwoodl ( a social historian) :Editor’s Note: An extensive bibliography was prepared by the author from which a selection has been made. G.-Australia. A Social and Political History. Sydney, Angus and Robertson, 1969 (p. 145).
1 Greenwood,
“Although in the years between 1880 and 1900 Australian Society continued to be deeply influenced by ideas from Britain and by the presence of immigrants who had grown to maturity in the old world, the characteristic attitudes of the people were a product of the new. After 1880 Australian nationalism is an essential component of Australian Political and Social Life.” The population of the Australian Colonies had increased from 2,323,000 in 1881 to 3,771,000 in 1901, but more significantly was the increase of native born Australians from 60 percent to 77 percent. Three quarters of the community of the 1880s and 1890s were urban and rural wage and salary earners, and this in many ways reinforced this feeling of nationalism and the need to break away from the older British tradition of a classstructured society. The feeling of nationalism also produced a new breed of literary figures, among whom were Roderick Quinn, Bernard O’Dowd, Henry Lawson and Joseph Furphy, the latter two laid stress on an Australian way of life and crusaded against the prevailing poverty and the British class-based society of the times. The Bulletin, which had started in 1880, flourished with a nationalistic fervour. Amongst artists, too, there was a new movement - Tom Roberts and Arthur Streeton, to name two, showing the way. There was no doubt that a break from Britain was wanted in some form. Some even advocated that Australia should become a republic and with this
Australian Dental Journal, February, t 978 nationalism arose a feeling of egalitarianism and an anti-class attitude. The foundations of Australian Unions were well laid by 1885 and whereas they were originally non political, began to take political action which eventually led to the formation of the Australian Labour Party. The economy had reached a peak in 1889 but
a depression followed in the early 1890s with bank failures - the worst hit being Victoria which began to lose people to New South Wales after having had a bigger population for many years. From then until 1900 was a period of diminishing prosperity, compared with the previous twenty years. Western Australia was something of an exception with the discovery of gold in Coolgardie in 1892. Life was not easy in those days, and to lessen the prevailing industrial hardship, Victoria, in 1896, passed an Act limiting the work of women and boys under 16 years t o 52 hours per week with a maximum of nine hours on five days and eleven hours on the others; New South Wales and Queensland followed much later. Nevertheless a greater degree of social conscience was shown when New South Wales and Victoria in 1900 adopted an old age pension scheme: prior to this the old were cared for basically by private charities. So t o quote Greenwood2 again:“Thus by the end of the nineteenth century the governments of all the colonies had written into the statute books a great deal of socio-economic legislation, the common factor in it being the idea that the state had a responsibility to concern itself in a more positive way with the economic and social life of the country.” The Australiari Hatidbook for 1900, in its notes for immigrants, lists some of the wages and costs at the time3. For example, New South Wales coach trimmers started with a wage of 21.15.0 per week, masons’ labourers earned 6/- a day and plumbers started at 9/- per day, and there was very little difference in the other States; but of course, costs were low, Blankets were quoted at 7/6 and stockings six pence a pair, while the rent in a Sydney suburb for a small cottage with 3-4 rooms and kitchen was advertised for 6/- t o 9/- per week. As for dental fees, looking at the Sydney Morning Herald for 1900 we see full upper and lower dentures from €1.0.0 to f2.10.0 and the same in 18 ct gold from f3.0.0 to f5.0.0 Extractions I / - and 2/6, amalgams 2/6, crowns 10/6 to 12/6. These, of course, were the fees charged by the advertising dentists and the lowest were those
?Greenwood G.-Op. cit. p. 179. 3 Australian ’Handbook fdr 1900. London, Gordon and Gotch, 1900.
15
of a dental company. So one could expect somewhat higher fees to have been charged by the well trained ethical dentist. I t might be interesting to look at practice prices and the figures are for January, 19044. Thei-e were three dental practices for sale, one in Queensland with a twelve months takings of f387.0.0 (the asking price being f150) in a town with a population of 6000. Another in an “unopposed country practice, cold climate”, had takings of f650.0.0, price f300.0.0 including plant and the third, a city practice in a leading thoroughfare, cost fSOO.O.O. the vendor did not say how much he earned. At that time, Sydney and Melbourne each had populations just less than one million. Of course the differences between those cities then and now were much more than population. This is so aptly illustrated in the Australian Handbook of 19003, which says of Sydney:
“The telephone continues to make rapid progress throughout the city and suburbs and is proving a great benefit and convenience t o business men.” and later, “The streets are lighted by gas, and electric light is availed of t o a great extent by business people”. Other cities also had electric light and all had cables or electric trams. Very few of the pages of newspapers at the end of the 19th century carried news. Nevertheless the Boer War seemed t o be fully covered, taking up most of the pages available and there was some concern over an outbreak of bubonic plague in the Sydney suburb of Redfern during March 1900. But on the brighter side, the amusement columns of the Sydney Morning Herald, January 6 , 1900 tell us that in Sydney we could go to the Opera House on King Street where we could see a spectacle of the Boer War with 30,000 square feet of battle scenery for the popular prices of 2/-, I / or 6 pence, and of course, naval and military forces half price. The more sporting minded could also see South Australia play New South Wales in the inter-colonial cricket series for I/-.
So this is something of the social and economic scene around 1900. Those days were not very prosperous, wages and costs were low, working hours were long, technical amenities as we know them now, hardly existed and one even had a chance of catching bubonic plague. Nevertheless, what those people lacked in material comforts they made u p in a new social and cultural awareness and a feeling of national pride, all of which were unknown 20 years before.
~-
4Comm. Dent. Rev., 2: 15 (Ian.) 1904.
16
Australian Dental Journal, February, 1978
Dental practitioners and their qualifications
TABLE 1
So the dentist of 1900 must have been influenced by the social events of his day and may even have been personally involved in many of the social and political movements, outside as well as within dentistry which were themselves by-products of the times. How many dentists were there? A look at the lists of dentists in Wise’s Comniercial Directories for the year of 1900 Sydney, Brisbane, Adelaide, Hobart, Melbourne and Perth proves very interesting. The numbers of people stating their occupations as dentists is not necessarily the true number of those practising dentistry. This is because where there is more than one directory for a colony the names and numbers of dentists differ; also in some colonies there were no dental boards and consequently no register of dentists. So the figures arrived at (Table 1 ) are for those men and women who wanted themselves listed, and in practical terms it must be very close to the true figures. An examination of Table I shows that there were 738 dentists listed of whom seven were women. This gives a dentist-patient ratio of about 1:5000 throughout Australia and 1: 1900 for New South Wales, and of course the figures would have been better for the capital cities. So that in the cities at least there was adequate provision for dental care if required or if it could be paid for. Almost half of those dentists listed, practised in New South Wales and Victoria as one might expect, with New South Wales having 92 more than Victoria and in most of the colonies more than half practised in the capital cities. Fifty-one (about seven per cent) had DDS degrees from American universities, and using as a guide the list of graduates from the United States dental schools, as published in Denial Cosmos5 for the previous ten years, they would most likely have received their degrees from either the Philadelphia Dental College or the University of Pennsylvania Department of Dentistry, the former being by far the more popular of the two. As well as listing the names of dentists, the directories listed organizations called dental companies or dental institutes with or without the name of the managing dentist. Examples of this in Sydney are “Ideal Dentists”, “City Painless Dentistry”, “Imperial Dental Company”, and “London Dental Institute”6. In some cases the dentist was also a pharmacist or was listed as Dentist, Dental Surgeon, Surgeon-Dentist or Surgeon and Mechanical Dentist.
Australiaii dc,riii.sts iri 1900 (Information f r o m Wise’s Post Office Directories)
Dental Cosmos, 32-42: 3890-1900. Sands Sydney Suburban and Country Commercial Dir. rectory 1900. Sydney, John Sands, 1900 (p. 251).
N.S.W. Qld. S.A. Tas. Vic, W.A. Total
Women
D.D.S.
Other qual.’
3 1
33 5 1
5 -
11 1 51
1 2
1
2 7
-
8
Total
307 96 41i
30 215 49 738
*L.D.S., M.R.C.S., M.D. 1 lniludinp four in Broken Hill.
The directories, of course, contain the names of those men and women who made important contributions to dentistry in this country and we see the names of men who were the fathers and grandfathers of men and women practising today. These names comprised a whole spectrum of qualifications and skills. At one end was the highly qualified graduate D D S from an American University or a man with United Kingdom qualifications; at the other end there were men who had neither passed examinations nor had even been apprenticed. In between there were the great majority who had been apprenticed to dentists and some of these would have had t o prove qualifications but some not, depending on whether the colony in which they lived had a Dental Act. Some too, would have been trained in the newly established Australian College of Dentistry in Melbourne. We know, too, that at this time, there were men practising as dentists who were incompetent, dishonest quacks, because this was a frequent topic of discussion at dental meetings; the Dental Acts, of course, were aimed a t eliminating such practitioners. There was not only considerable variation in the qualifications of the dentist, but also ethical standards differed. This was seen most clearly in relation to advertising. Some did not advertise at all except for their names and addresses in a commercial directory, others had very modest notices. In fact advertising was legal and advertising by dentists in New South Wales was not banned until 1934. But some made the most extravagant claims of their skills. Legislation
The extravagant claims made by some dentists and unethical attitudes common a t the time was not in the best interests of the patient. This was as true then as now and it was quite obvious to
Australian Dental Journal, February, 1978 the qualified and ethical practitioner of the time that the situation could only be altered by appropriate dental legislation and the establishment of Registration Boards, Dental legislation and training. By 1900 some of the colonies already had Dental Acts. Surprisingly, Tasmania7 was first in 1884 followed soon after by Victorias in 1888, which amended its Act in 1898, setting up a four year LDS course. In 1894, Western Australia9 passed its first Dental Act, but in New South Waleslo there was none until 1901, and Queensland11 and South Australia12 both waited until 1902. So that in 1900, in three of the colonies, anyone irrespective of how little dentistry he knew and what character of person he was, could carry on the practice of dentistry. Speaking of New South Wales in 1900, Percy Ash13 was to write many years later: “The Profession in those days was at a low standard as compared with law, medicine, divinity and others, but there were men in it who saw that if ever dentistry was t o be recognised as a calling attractive to young men of brains and good standing, a n effort must be made to pass legislation which would place it beyond reproach in the eyes of the public. Only those who undertook the work of reform can tell you of the great difficulties encountered a t almost every turn, and as a consequence the act of 1900 though incomplete in many ways, was the best that could be obtained in face of great opposition’. Education
Once a Dental Act was in force and rules made for dental practice, only then could formal means for assessing the qualifications of dentists be laid down by a Dental Board, examinations would have to be arranged, and courses set up, so dental education had to follow. Before the passing of the Dental Acts and for some years afterwards, a dental education was generally obtained by a young man or woman being apprenticed to a practising dentist. The difference after the passing of Acts was that the apprentice through examinations, had t o satisfy Cyclopaedia of Tasmania, Vol. 11 96. 1900. Iliffe, J.-Dental Education - definition and general aspects In. Proc. First Australian Dental Congress. Edit., Hall, C. Sydney, Government Printer, 1909 (pp. 14-29f . 0 Stockwell, R.-Unpublished data. l o Arnott, A. J.-The historical development of dentistry as a profession in New South Wales. Dent. J. Aust., 24:7-8. 133-143 (Aug.) 1952. ‘1 Lumb, S. F.-The growth of dental education in Queensland. Austral. D . J.. 1:1, 19-22 (Feb.) 1956. Chapman, A.-Edit., History of dentistry in South Australia 1836-1936. Adelaide, Gillingharn and Co., 1937. ’”Ash, P.-The status of the dental profession. Dent. Sc. J. Aust., 3:6, 242-246 (June) 1923. 7
17
examiners chosen by the Dental Boards that he was qualified to be admitted a s ;I practitioner. Nevertheless, even after the passing of the various Dental Acts, men who had been in practice before the passing of those acts were still entitled to practice, so that for many years unqualified men practised alongside the qualified. The young apprentice was indentured and entered into a written agreement whereby he would (and quoting from an indenture of 1897 in New South Wales) “Put himself apprentice to the master to learn his art and business as a dentist and everything relating thereto for the space of three years . . . and the apprentice hereby agrees . . . that during such term he will faithfully, diligently and assiduously serve and obey by night and day his said master . . . that he will at no time absent himself from his master’s business without his consent; and that he will not be accessory to, nor commit or permit any hurt or damage to his said master or his property, nor conceal any such hurt or damage if known to him, but shall d o everything in his power to prevent the same In this instance cited, the apprentice was paid one shilling per week for the three years and he paid 55 guineas for these privileges. A few years later the apprenticeship required four years. As far as academic training was concerned, it was non-existent at this time except for Victoria. In that colony the Australian College of Dentistry8 was established in Melbourne in 1897 associated with the Melbourne Dental Hospital and, in 1904, this College was absorbed by the Faculty of Dentistry within the University of Melbourne. New South Wales10 did not establish formal dental education until 1901 and then as a Department of Dentistry within the Faculty of Medicine, and it wasn’t until 1921 that the Faculty of Dentistry was established in the University of Sydney. In Adelaide the Faculty of Dentistry came into being in 1921 in the University of Adelaide, a course having been started within the Faculty of Medicine in 191912. The University of Queenslandll started its Faculty of Dentistry in 1935 and a Faculty was not established in Perth until 1946, although in 1934 the West Australian College of Dental Science began within the Perth Dental HmpitaP.
. . .”
Dental organizations
Associations of Dentists in most colonies preceded the Dental Act, because it was through the agitation of such associations that Acts came into being to protect the dentists’ own interests and that of their patients. The first Dental Association appeared in the colony of Victorias when the Odontological Society of Victoria was formed in 1884 which was followed by the Dental Associa-
Australian Dental Journal, February, 1978
18
tion of Victoria in 1889. The Dental Association of New South Wales was formed in 189214 and, in 1899, the Odontological Society of New South Walesls. Queensland had its first society in 189916, the Dental Association of Queensland. It is possible that Western Australia9 had a Dental Society prior to 1894, but the information in this regard is scanty. South Australia12 had to wait until 1907 for its first society. As for Tasmania having a dental society at this time I have no information but, as Tasmania had the first Dental Act, it seems likely that the dentists of that colony would have had some kind of an association. If this were so. South Australia was the only colony at the time without a Dental Association. Dental literature
With courses being laid down by Dental Boards, the new breed of dentists wanted to continue learning. Some went abroad as some had for many years before this, but those who could not had to depend on journals and text books as one does now. It was some years before visiting dentists were to lecture here. It is interesting to take a look at the journals and text books available to dentists of 1900. As for journals - was anything published locally? One would expect, as previously suggested, that once an association is established it is logical that a journal will follow soon after. The association needs a medium whereby its members can be kept informed of its proceedings and in which it disseminates as widely as possible the papers read by its members at its meetings. There was one such early journal which catered for the needs of the Associations: this was the Australian Journal of Dentistry, published in Melbourne, which started in 1897 and only ceased publication in 1956 to give way to the Australian Dental Journal, a national journal; and, in 1903, the Commonwealth Dental Review commenced publication in Sydney. However, the Australian Journal of Dentistry, was extremely successful and important. To quote Amies and Tuckfieldl’: “It might be asked whether the Journal [Australian Journal of Dentistry] played any particular part in Victorian Dental Education and the answer is definitely in the affirmative. It published all the Odontological Society, College and hospital news, and it provided a means whereby professional papers read before the odontological societies of Editorial. The Dental Association of N.S.W.-The Australasian Medical Gazette, 289 July, 1892. South Wales Notes-Aust: J. Dent., 3:l, 12-13 ’“New (Aug.) 1899. 10 Dental Association of Queensland-Aust. 1. Dent., 4:2, 45 (Sept.) 1900. ”Amies, A . B. P., and Tuckfield W. J.-Dental education in the State of Victoria. Aust. Dent. J., 1:1, 1215 (Feh.) 1956. I*
Victoria, New South Wales and Queensland and South Australia were published. Also, over the years, it has given freely of its space to original investigation and research. In later years, it became the official organ of several of the State branches of the Australian Dental Association”. So that this journal not only started off well. but continued and Truemanls, discussing journals published in the British Empire between 18431924, had this to say about the Aiistraliari Joirrnol of Dentistry:
“This pioneer dental journal . . . has well held its own as a guardian of professional interests, quietly and steadily, keeping on the job”. It is quite clear that at this time Victoria was by far the leading colony dentally. Its Dental Act with its amendment was the best at the time, insisting on a four-year study course and it had a Dental College to implement it, and at this time it also had the only dental journal. For those who looked for a broader view and wanted information from the world’s most important dentists, there were journals from the United States of America and Great Britain and we know that many of those trained abroad would have subscribed to these journals; they would have heard some of the famous men speak and even had some of them as their teachers. From the United States of America19 there were firstly, the highly influential Dental Cosmos, which had been published since 1859, and later became the Journal of the Anierican Dental Association. Others available were Den f a / ltetiis of Interest, established in 1891, Dental Digest, 1895, and the American Journal of Dental Science which started in 1839, to name the most important. From Great Britain18 the following Journals were avai1able:- The British Journal of Dentof Science, which started in 1856, and the important and influential journal of the British Dental Association which had started originally in 1872 as the Montlily Review of Dental Surgery. In 1903 this Journal became the British Dental Journal as we know it now. There was also from London The Dental Record, which was established in 1881, and the Transactions of the Odontological Society of Great Britain which was one of the older journals, having started in 1857. It is possible, too, that The Dominion Dental Joiirnal from Canada, which
Trueman, W. H._History of the dental eriodical literature of the British Empire 1843-192x In, Index of periodical dental literature 1876-1885. Edit., Black, A. D Buffalo Dental Index Bureau 1925 (p. XLIV). 1s Beh;. W.-List of Dental Journals indexed for years 1896-1900 inclusive. In. Index of periodical dental literature 1896-1900. Edit., Black, A. D . Buffalo, Dental Index Bureau, 1930.
19
Australian Dental Journal, February, 1978
19
commenced in 1889, may have found its way to Australia. One can hardly expect textbooks in the absence of academic education, so that a t this period there were no books of this nature published by Australians. But there were a few small volumes published in this country for lay readers and which would have had little interest for practising dentistszo. Two of them published at that time 1897 were The Early Decay of Children’s Teeth by Leonard Bickle, a physician of Adelaide, and Australia’s Teeth and how to s a w them by W. The0 Shanasy, a dentist also of Adelaide, published in 1900. Another book, the Adinitiistrafion of Cldorofornz in Dentistry by John William Springthorpe, published in Melbourne in 1898 and having only 8 pages, may have been of some interest. These were really not important, however interesting. But, on the other hand, there were many textbooks published abroad both in the United Kingdom and the United States of America that were available t o Australians. In fact, many of these books with the names of dentists of this period inscribed inside them are in libraries or private collections at the present time. These books varied from small pamphlet type publications to very large standard textbooks written by the most eminent men in the field. There were simple practical texts for the busy practitioner written by B. H. Catching, Catching’s Compendium which was published for many years, and W. H. Steele’s Useful Hints For The Busy Dentist. but there were also great encyclopaedic works covering the whole gamut of dental knowledge. Examples of these were the American Textbook of Operative Dentistry, edited by E. C. Kirk, and Chapin Harris’s famous Principles and Practice of Dentistry in its 13th edition, revised by Gorgas. This is an interesting period in the history of dental literature because these all embracing texts were beginning t o give way to books covering special fields as we know them today. Among those were E. H. Angle’s 6th edition of Treatment of Malocclusion of the Tecfh and Fractures of the Maxillae, Descriptive Anatomy of the Human Teeth by G . V. Black, A Manual of Dental Anatomy both Human and Comparative by Charles Tomes, and Anatomy and Histology of the Mouth by 1. N. Broomell. More specialized fields were provided for by C. N. Johnson, Principles and Practice of Filling Teefh, R. Ottolengui, Methods of Filling Teeth, G . Evans, Practical Treatment on Artificial Crorvn and Bridgework, J. E. Garretson, A System of Oral Surgery, and many others in”’ Levine, S.-Early
Australian dental literature
rior to
1900. Austral. D. J., 19:5, 349-358 (Oct.) 1974.
cluding books on prosthetics by C. J. Essig, and J. Richardson, administration of nitrous oxide and oxygen for anaesthesia, the treatment and prevention of diseases of children’s teeth, periodontics, dental medicine, dental therapeutics and dental pathology. The S. S. White Dental Manufacturing Company had published W. D. Miller’s The Microorganisms of the Humart Mouth in 1890, a work of fundamental importance in the understanding of various infections of the oral tissues with special references to dental caries. These examples will suffice to show that all tastes and levels of knowledge were catered for at this time. Fundamental knowledge and new advances in Dentistry were available for those who wanted them. Virtually, all of the textbooks came from the pens of academics as did many of the journal articles from abroad; so that many of the authors would have been known to those Australian dentists who had studied in the United States and Great Britain. It must also not be forgotten that at this time, the Australian dentist was writing original articles for the local dental journal. Dental practice and equipment It is also quite clear just from this list that, by 1900, the major framework of modern dentistry had already been laid down and in general medicine the work of Pasteur, Kock and Lister had been done years before. So that, in his day-to-day practice, the dentist of 1900 did a great number of amalgam fillings but possibly even more gold foils at which he was very adept. (Taggart’s inlay casting technique was not available until 1907.) H e practised endodontics and used vulcanite and swaged metal for his dentures. His partial dentures were designed in a manner almost totally mechanical, virtually no thought being given to the biology of the periodontium so that great damage must have been done to these tissues. The dentist of 1900 practised exodontia and oral surgery too, general anaesthesia was well known and eucaine had been introduced as a local anaesthetic, but it was not until the advent of Novocaine in 1905 that local anaesthesia became more popular. He also practised orthodontics or, as it was then called, regulating the teeth. He scaled teeth and many thought in terms of preventive dentistry. By and large the dentist of 1900 practised adequate dentistry mainly of a mechanical nature. Judging from the advertisements many teeth were extracted which perhaps could have been saved even though the influence of William Hunter21 had not reached Australia.
2’
Hunter, W.-An address o n the role of sepsis and antisepsis in medicine. The Lancet, I : 79-86 (January 14) 1911.
20
Australian Dental Journal, February, 1978
Fig. 1.-A
dental surgery at the beginning of the century.
So there was certainly a lot of sound dental knowledge around 1900. How were dentists able to practise it? What did their surgeries look like? Available pictures at the time are from the United States of America but there is no reason to believe that our successful and influential practitioners did not have similar rooms (the catalogues of furniture, equipment and instruments came from abroad). These surgeries appear extremely cluttered and not at all clinical like today although some of our modern rooms do not look as clinical as they did 20 years ago. The general impression is of a Victorian parlour which is being used as a dental surgery. Pictures and brica-brac adorn the walls, scatter rugs are on the floor and in some cases there are small statutes on pedestals (Fig. 1). Only the popular aspidistra being reserved for the waiting room. The surgery seems so antiquated as to be ludicrous until we realize how difficult dental practice was then many used only natural light to illuminate the mouth. The chair (Fig. 2) looks even modern enough until the advent of the horizontal operating position, a foot engine or two can be seen,
electric motors were in their infancy. A most ornate dust collecting instrument cabinet occupies a prominent place and the plumbing beside the chair is reminiscent of Heath Robinson (Fig. 3). The instrument bracket table does not look so old fashioned, after all it was extremely functional, and in some cases there is some kind of electrical apparatus against a wall for those who were modern. Nevertheless, the dentist of 1900 appeared to be as proud of his surgery then as he is today if one can judge from the existence of photographs and articles about surgeries. As for instruments and equipment, if we looked at a typical instrument catalogue of the times, (Claudius Ash and Sons Limited 1899) there we would find more than 600 pages of instruments and equipment to choose from, and I believe that our younger graduates of today might not recognize many of them as dental instruments at all, although forceps look much the same and so do impression trays. There were pages of surgery furniture, general anaesthetic apparatus, some of the new and very primitive electric apparatus, an operating light and even a very early dental engine,
21
Australian Dental Journal, February, 1978
__ Fig Z.-Dental
Fig. 3.-Dental
equipment.
chair, 1900.
operating instruments in their hundreds of varieties with scalers looking like garden tools and a great section devoted to prosthetic material especially for making metal plate work, which was very popular at the time. There were even tooth brushes, if they can be called such, which I imagine preventive minded dentists perhaps gave their patients. There were also lots of curiously constructed mechanical devices. Many of the instruments seem large and coarse, especially cavity cutting instruments. All in all, it seemed a very mechanical age. The dentist of those days was no more free of worries than the dentist of today. What kind of problems were the dentists concerned with? Our only knowledge of this comes from the matters they discussed at their society meetings, and the papers they read t o them. Both these are recorded in the pages of the Ausfraliari Joirriial uf Deufistry for this period and, if we add editorial matter, we find that:the social problem of great concern was the lack of dental legislation in those colonies which did not already have Dental Acts and provision for dental education. Almost every editorial had something to say about this. These
22
Australian Dental Journal, February, 1978
were genuine concerns and lucky for us, too. These men were the fathers of our profession. Also a popular topic was unethical practice including a plea for a fee for consultation and advice otherwise, so they said, the dentist was behaving like a quack. Death under general anaesthetic was a cause for concern and there are references to bogus diplomas coming from what were known as the “diploma mills’’ in the United States of America, where bogus colleagues offered bogus degrees for a fee. The clinical topics that interested him, gleaned from the articles in the j o i i r u d , were Crown and Bridgework with emphasis on techniques, Replantation of teeth, Endodontics, Pyorrhoea Alveolark and X-rays in relation to dentistry, and it is interesting to note that an article on this subject appeared in the Dental Cosmos of 189622 just one year after Roentgen’s discovery.
He was President of the first Australian Dental Congress in Sydney in 1907 and a delegate to the third International Dental Congress in Paris in 190024. There are also .people who are interesting in . other ways, one from those days is Annie Praed,
Personalities
I have written about dentists in general terms, but what about individuals? It is obvious that many of those listed in the commercial directories in 1900 must have been associated with important events in dental history and some would have changed the course of this history; some too were interesting people for other reasons. In New South Wales perhaps two names stand out above the others, Richard Fairfax Reading and Alfred Burne. Richard Fairfax Reading was an LDS, MRCS, LRCP from England who was in charge of dental studies at the University of Sydney when courses were first started in 1901 and then became the first Professor and Dean of the Faculty of Dentistry in the University of Sydney in 192110, a position he held until 1934. Apart from his pioneering work and influence in dental education, he played a prominent part in all aspects of dentistry in the early part of this century as a member of the Dental Board of New South Wales and was on the Council of the National Dental Association of Australia when it was founded in 191 1 (Fig. 4). Alfred Burne, a DDS from the United States of America was influential in shaping Dental Legislation in New South Wales and was the first president of the Dental Association of New South Wales when it was founded in 189213 and was still president in 1900. H e was also a member of the first Dental Board in New South Wales when the first Dental Act came into force in 190123.
Fig. 4.-Richard
in the first class of undergraduates when University dental studies were started and, many years later, the first woman to obtain the DDSc and still is the only woman to have done so. Another in New South Wales is John Belisario who was born in England in 1820 and died while still practising in June, 1900. He had been called the “Father of Australian Dentistry” by a biographer, BlackwelPs, who tells us that Dr Belisario had a very successful and fashionable practice in Sydney from 1841-1900. He took a DDS Baltimore in 1854, and travelled abroad often to the United Kingdom and the United States of America to keep abreast of the latest developments and obtain new equipment. He was friendly with the great John Tomes and he was noted for having
1’’
2a
>‘Morton, W. J.-The X-ray and it5 application in dentistry., Dent. Cosmos., 3X:6. 478-486 (June) 1896. 2 : Australian Journal of Dentistry. 4:5, 122 ( D e c . ) 1900.
Fairfax Reading,
British Dental Journal 2 1 : 473 1900. Blackwell. E.-The fa’ther of Australian dentistry. Dr Belisario and his work. In, Proc. First Australian Dental Congress. Edit.. Hall, C. Sydney, Government Printer, 1909 (pp. 34-38).
Australian Dental Journal, February, 1978 given the first general anaesthetic in Australia in 184726 and was honoured in many ways. In South Australia12 names like Peter Crank and Edward J. Counter are worthy of mention. Peter Crank served on the Dental Board from its inception in 1902 until 1907 and was president in
Fig. 5.-Herbert
23 Dentistry, and throughout Australia. The Cyclopedia of Victoria of 1903 says this about him: “Among those who stand at the head of the Dental Profession in Victoria the name of Mr John Iliffe occupies a foremost place, not only on account of the skill he displays in his practice and his art . . . but by reason of the position he has so worthily filled on the Dental Board ever since it came into
Hayes Norman.
1904. He was also honorary dentist to the Adelaide Hospital 1896- 1900. Edward Counter zerved also on the Dental Board from 1902-1905 and was president of the Odontological Society of South Australia in 1907, when it was founded and was Honorary Dentist to South Australia Children’s Hospital 1900-1920 and from 1902-1918 with the Orphan’s Home in Adelaide. H e was also President of the 4th Australian Dental Congress in Adelaide in 192127. Herbert Hayes Norman (Fig. 5 ) , also on the South Australia list at this time, is one worth mentioning. H e came from a pioneer dental family in Adelaide and was the author of the book called Arthur Redivivus or The Arthur System for rlrr Proximate Decay irr Teefli which he published in Adelaide in 189220. Although this book was written for the lay reader it is quite technical and must interesting. John Iliffe would probably be the most outstanding dentist in Victoria at the time (Fig. 6 ) . H e had a most influential effect on Victorian
5;
Grainper. J . K.-The first dental anaesthetic in Aostralia June (1847). Austral. D. J., 17:4, 297-302 (Aug.)
2 :
Report, Proc. Fourth Australian Dental Congress Adelaide, 1921. Adelaide, S.A. Government Prime;, 1923 (P. IV).
Fig. 6.--John
Iliffe.
existance.” In 1884, when the Odontological Society of Victoria was formed he became the first Treasurer, later becoming the second President in 1887 and was certainly still on the Council in 1913. H e played a major part in the drafting of the first Dental Act in Victoria in 1887 and helped in the establishment of the Australian College of Dentistry and the Faculty of Dentistry. H e had lectured at the Australian College of Dentistry and was a n editor of the Australian Journal of Dentktry. H e was also President of the second Australian Dental Congress in Melbourne in 190928 and when the first National Dental Association OF Australia was formed in 191 1 he was the first President. A Victorian dentist who is interesting for quite another reason is E. Lenthall Oldfield, who conducted The Dental College of Victoria in Nicholson Street, Melbourne, opposite the exhibition grounds. He advertised this college in the pages of a Bickles’ Australian textbook (vide supra). H e
1972.
z>
Tranwctions. Second Australian DentLl Congress. Mclhourne, 1909. Melbourne. J . Kemp. 1911 (p. 7 ) .
24
Australian Dental Journal, February, 1978
Fig.
7.--James T. Tunnock.
offered a complete course of study (four years) with special classes for medical and lady students. He also advertised the Dental and Oral Hospital at the same address and stated that attendance was free and a full cover of dental treatment given. This establishment obviously provided the clinical experiences for his students. Information on Western Australia is rather scanty, but J. V. Bingay was the Registrar of the first Dental Board in 18959. Nevertheless in Perth at this time was one, James T. Tunnock, who is listed as practising at Kalgoorlie and who according to Stockwell9 was the first to be registered under Western Australia Dental Act in 1895. He was a most colourful and flamboyant person (Fig. 7). He also practised in Melbourne, and in Sydney. He published a dental students’ textbook in rhyme29 and was at one time principal of the Interstate Dental College in Sydney and he claimed a special formula €or an anaesthetic solution. In Tasmania, the notable man is, I think, Arthur Lucadou-Wells (Fig. 8 ) of Launceston who also had two sons practising at this time. He was mTunnock, J. T.-A dental students’ technical course i n rhyme. Melbourne, Ford and Son, 1909.
educated in the United Kingdom and came to Australia in 1880. In 1882 he published a nine page book written for the public called A Treatise orz the Preservation of Children’s Teefli which I have discussed in a previous paperzo. In 1900 he was on the Dental Board of Examiners in Tasmania. In 1903 he was Honorary Dentist to the General Hospital in Launceston, having played an important part in establishing its Dental Department7. Frederick A. Huet in Queensland was the first President of the Dental Association of Queensland in 1898. In the Queerislarid Post Officeand Official Directory 1900 he described himself as late House Surgeon and demonstrator in gold filling at the National Dental Hospital in London. An interesting name at this time is A. R. Spencer, who advertised himself as a Fellow of the Science Society of London and that he had been awarded the highest honours in Queensland and a Gold Medal at an International Exhibition in 1897. These were some of the dentists of those times. There were the unusual characters and there were very fine men and women to whom we owe so much for the Dental Profession we have today. As dentists they lived in a completely different dental
Australian Dental Journal, February, 1978
25 ment by our standards and very difficult conditions under which to work. All in all the dentist of 1900 could do almost everything we can, even if he didn’t always understand what was happening. His instruments were less delicate and precise, thus in many ways he might have been considered more highly skilled and he did not have all the materials we have and he did not have the wonder drugs we have. The dentist of those times saw three major tasks confronting him in social dental reform. These were 1 ) the enacting or consolidation of dental legislation, which would produce qualified and ethical dentists; 2 ) the provision for academic dental education; and 3 ) the continuation of sound dental associations. There is no doubt that in a very large measure he succeeded in these tasks and laid the foundations for the welleducated, ethical dental profession of today. Acknowledgements
Fig. 8.-Arthur
Lucadou-Wells.
society from ours. With dentistry unregulated they had bigger problems to face than we do and dental patients were unprotected. They had poor equip-
Grateful acknowledgement is made to Mrs. 0. Monkhouse, Dandenong, Victoria, for the photograph for Figure 7, to Mrs. M. Steele, Librarian, Fairfax Reading Dental Library, University of Sydney, Miss Ann Ensted, Librarian, Dental School Branch Library, University of Melbourne, and the Librarian, State Library of New South Wales. 5 Upper Cliff Avenue, Northbridge, N.S.W., 2063.
