1 Introduction: a Monk From Lorsch
When considering human health in the past, few sights are more compelling than a skeleton that shows clear signs of disease. Figure 8 offers one such encounter, presenting a skull with evidence of a variety of dental problems, including caries, deposits of dental calculus, and periodontal disease. Figures 9 and 10 provide a closer look at the state of this individualâs dentition, highlighting carious lesions (pointed out by arrows in Figure 9), deposits of calculus (seen as the deposits on the surface of the teeth in Figure 10), and dental enamel hypoplasia, deh (evidenced by the horizontal bands across the teeth in Figure 10). This individual, a male aged thirty-five to forty years old at the time of his death, was uncovered in excavations at Lorsch in 1999.1 His burial was part of the so-called Mönchsfriedhof, a cemetery within the Abbey complex that is thought to have been used primarily by the monastic community. Radiocarbon dating indicates that he lived during the late Carolingian period.2 What can be learnt about early medieval dental health by studying this monk and other individuals from this period? And how do their teeth compare to the descriptions of dental problems recorded in recipes?
A skull from an individual buried in the monastic burial area at Lorsch
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Carious lesions visible on skeletal remains excavated at Lorsch
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Dental calculus and deh visible on skeletal remains excavated at Lorsch
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Teeth provide a wealth of information. The oral pathologies recorded in the Lorsch monkâs dentition, for example, do not present a straightforward case of disease but can offer a much more nuanced picture of the state of his health, both at the time of his death and in earlier phases of his life. Unlike bones, which remodel throughout an individualâs life, teeth can provide a snapshot of the period in which their growth occurred, generally infancy or childhood, while simultaneously recording later dietary and disease experiences. Thus, the presence of carious lesions and calculus point to poor dental hygiene as an adult and illustrate the state of his oral health at the time of his death. The existence of deh, on the other hand, reveals that he may have suffered from malnutrition or serious, growth-interrupting disease(s) at a young age.
2 Oral Health in the Skeletal Evidence
Dental remains represent one of the best materials to study when investigating health and disease in the past, and not simply because of the range of information they can provide as noted above. Crucially, teeth tend to âresist destruction and taphonomic conditions better than any other body tissueâ due to their protective layer of enamel.3 Before examining the state of dental health as seen in early medieval skeletal assemblages, I shall provide a brief review of dental anatomy and common conditions and address several tooth-specific methodological challenges.
2.1 Dental Disease in the Archaeological Record: an Overview
All mammals have two sets of teeth: a set of primary, deciduous teeth that are lost after weaning and a set of secondary, permanent teeth; in humans, the primary dentition contains twenty teeth while the secondary has thirty-two.4 The permanent dentition is made up of four types of teeth (incisors, canines, pre-molars, and molars), each with a different function related to processing food.5 Teeth consist of four primary tissues: enamel, dentine, cementum, and
Turning to the types of pathologies recorded in the skeletal remains, caries, a term derived from the Latin caries, meaning decay or rottenness, is âthe most common cause of oral pain and tooth lossâ and âone of the few conditions which has been recorded unfailingly in almost all reports on human remains from archaeological sitesâ.9 As seen in Figure 9, the Carolingian monk from Lorsch was suffering from multiple carious lesions when he died. The disease is a progressive bacterial condition that affects the calcified dental tissues, demineralising the inorganic material and destroying the organic components.10 Caries tend to occur at two different locations on the tooth surface, either at the crown or the root, resulting in several types of lesions with differing aetiologies.11 Coronal caries begin with the destruction of the enamel, then the dentine, and eventually penetrate the pulp chamber; molars and pre-molars tend to be the most affected by this type of lesion due to their complex network of fissures, fossae and groves.12 Root caries occur more frequently in later life due to the effects of periodontal disease (addressed below), whereby the recession of the gingivae and underlying supporting tissues exposes a toothâs cementum and roots, making them susceptible to infection.13
In their review of evidence for caries from prehistory to the present day, Luis Pezo Lanfranco and Sabine Eggers reported that the disease reached a
The aging process has been linked to a number of degenerative changes in the dentition, including attrition (wear), erosion, and abrasion.17 Paradoxically, the rate of attrition and abrasiveness of an individualâs diet have been tied to both the development and inhibition of caries.18 On the one hand, abrasive foods and extensive wear may increase the risk of chipping teeth, creating spaces in which dental plaque can collect while simultaneously exposing lines of weakness and/or areas of dentine.19 On the other hand, a high level of dental wear and abrasion can erode the carious tissue and dislodge plaque, protecting the teeth from the accumulation of bacteria.20 The degree to which these processes support or inhibit the initiation of caries remains a contentious issue in the field.
Dental calculus also presents a complex relationship with caries. Deposits of calculus are formed over time as plaque, a biofilm made up of bacteria and fragments of food particles, accumulates on the surface of a tooth and eventually mineralises.21 In theory, there is an inverse relationship between the development of caries and the build-up of calculus since the latter requires an alkaline environment (resulting in net mineralisation) while the former requires an acidic environment (resulting in net demineralisation).22 Both
Periodontal disease, or periodontitis, is a chronic, destructive inflammatory process that affects the tissues of the periodontium over time.24 This occurs as plaque accumulates at the gum margin and is one of the main causes of ante-mortem tooth loss (amtl), a topic addressed in more detail below.25 In the archaeological record, the condition is identified by a receded alveolar margin and the bone often exhibits signs of inflammation and remodelling.26
Cysts, abscesses, and granulomas are three different types of lesions found at the apex of the tooth that are caused by an infection of the dental pulp.27 If the infected tooth is not removed, the infection induces an immune response in the periapical tissue, a cavity.28 While acute abscesses and granulomas tend to be less than 3 mm, cysts and chronic abscesses can be much larger, making them easily recognisable in the archaeological record (as seen in Figures 12 and 13 below).29
Tooth loss, though not necessarily pathological, must also be mentioned since many teeth may be missing from excavated skeletal remains. It is often possible to determine whether teeth were lost before or after death based on the appearance of the toothâs socket. Post-mortem tooth loss (pmtl), which can occur as a result of taphonomic processes or during excavation and conservation, leaves a âpristineâ tooth socket with no signs of remodelling.30 In the case of amtl, the alveolar bone will âshow some degree of remodellingâ and the socket will eventually smooth over (an example of a jaw with extensive amtl can be seen below in Figure 14a).31 amtl is a useful measure of dental health since teeth tend to be lost as a result of carious lesions, periodontal disease, and/or intentional extraction due to these causes, though it must be remembered that they can also be lost due to trauma, non-medical extraction (e.g., ritual or cosmetic extractions), and other diseases (such as scurvy).32 Although
Finally, temporomandibular joint disease and deh will not be discussed in this chapter. Temporomandibular joint disease, or osteoarthritis of the jaw, is less concerned with oral health, though it occurs in the same area of the body, and more reflective of osteoarthritic changes over time.34 deh, mentioned in relation to the Lorsch monk pictured above (see especially Figure 10), documents periods of stunted growth that coincided with the time at which the tooth was developing. The disruption of growth in infancy and childhood is generally due to poor nutrition, starvation, or disease at a âlife-threatening magnitude of severityâ.35 As such, deh is understood as a non-specific indicator of stress and is studied in relation to diet, nutrition, and overall disease load. Although the striations caused by enamel hypoplasia create areas that are more prone to developing caries, the condition is not otherwise linked to dental disease and will therefore be omitted from the following analysis.36
2.2 Skeletal Evidence for Oral Pathologies in Early Medieval Europe
Stereotypes of medieval dentition are often extremely negative. Caricatures of medieval people have ensured that the popular image of pre-modern teeth is one of decay, disease, and poor hygiene. Is this picture an accurate portrayal of the situation or a gross exaggeration? The review of caries over time conducted by Pezo Lanfranco and Eggers noted that carious lesions, as recorded by archaeological evidence, increased throughout Antiquity and then peaked in roughly 750 ad.37 Their findings suggest that common assumptions about the state of medieval oral health may not be far from the truth.
Overall, the dental remains excavated at Lorsch contain a relatively high percentage of teeth affected by caries.38 Figure 11, for example, illustrates two teeth excavated at Lorsch that have been severely damaged by carious lesions. Many teeth also exhibit calculus deposits, and often of a higher degree than that seen in the opening example. Compare the relatively light presence of calculus seen in Figure 10 with the much heavier accumulation seen in Figure 12. The deposits of calculus are clearly visible in the three remaining molars of the maxilla. A large cyst in the mandible is also observable in Figure 12. It is likely that this stemmed from a carious lesion in the molar, now missing, under which it is located. Similarly, Figure 13 provides evidence of both extensive calculus deposits (best seen on the left-most tooth) and a deep abscess in the
A close-up of carious lesions from skeletal remains excavated at Lorsch
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Evidence of calculus build-up and a cyst seen on skeletal remains excavated at Lorsch
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Evidence of calculus deposits and an abscess on skeletal remains excavated at Lorsch
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Contrasting dental health visible in the skeletal remains excavated at Lorsch
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Despite these general signs of dental disease, it must be stressed that the sample from Lorsch displays a high degree of variability. Consider, for example, the two jaws pictured in Figure 14. The image on the left shows clear signs of extensive amtl: not a single tooth remains in this mandible and nearly all sockets appear to have been fully remodelled, suggesting that the vast majority of teeth were lost at least several years before the individual died. This example fits with the evidence highlighted above, adding further weight to the picture of poor dental health. The image on the right, however, provides a stark contrast. In this case, all of the teeth are present and intact; none exhibits signs of caries, major calculus build-up, or periodontal disease; and there is little evidence of attrition. This serves as a valuable reminder, demonstrating that, even
The Lorsch assemblage offers a visual entry point into this overview of evidence for early medieval dental disease, and one that is particularly significant given that the monastic centre is known to have produced medical texts containing recipe collections during this period. Yet, just as the skeletal remains excavated at a single site can vary immensely, so, too, can there be major differences between sites. While, in some cases, this may be due to differing excavation and recording systems, on the other hand, variation may arise due to differences in diet and other health factors. So, how do the findings at Lorsch compare to other sites in early medieval Europe?
To illustrate the potential for variation between sites, consider the disparities between the results of the excavations of Biel-Mett and San Lorenzo di Desenzano. The report from Biel-Mett, a cemetery in the present-day Canton of Bern used from the late sixth or early seventh centuries to the late eighth or early ninth centuries, included an assessment of the dentitions from forty-three skulls. The authors noted that âmost of the individuals had suffered from periodontal diseaseâ and that the population exhibited a high degree of abrasion as well as a relatively high frequency of caries (30% of recovered teeth were affected) and amtl (23%).39 In contrast, archaeologists working at San Lorenzo di Desenzano, a northern Italian site whose second phase of use has been dated to the Carolingian period, recorded significantly fewer incidences
Age is another factor that sometimes helps to explain the high level of variation between sites. Excavations at a Merovingian-Carolingian cemetery in Cherbourg, for example, uncovered 111 subadult individuals dating from the seventh to eleventh centuries.41 Within this sample, there was no evidence of carious lesions on permanent teeth, while only 1.3% of deciduous teeth were affected by the disease.42 This is a strikingly low incidence of caries and unlike any other site involved in the present study: barely any carious lesions were reported despite the relatively large sample size. The results appear less unusual, however, when the age of the individuals is considered. This study focused on a sample of subadults, meaning that, at the time of their death, their teeth had been exposed to cariogenic environments for only a short period of time. Since caries is an age-linked disease that progresses over time, this very low frequency would be expected.
Excepting cases such as Cherbourg, the evidence from most sites looks more like that from Lorsch or Biel-Mett, exhibiting some intra-site variation but, on the whole, moderate to high levels of caries and amtl. The excavation report of the cemetery at Santa Maria Assunta di Cairate, a rural monastic site used from the late sixth to ninth centuries, provides a detailed assessment of the
In the excavation reports of early medieval cemeteries in Acqui Terme and Rivoli, the former in use between the seventh and ninth centuries and the latter between the sixth and eighth centuries, it was noted that individuals exhibited high levels of amtl and caries.50 Indeed, at least one carious lesion was recorded on all of the female individuals studied and nearly two-thirds of the males.51 Likewise, a higher incidence of caries was noted among females excavated at the Saint Servatius complex in Maastricht, a site from which eighty-three individuals have been dated to the so-called âBasilica Phaseâ of its use,
Other sites present a similar picture. Caries were reported for approximately two-thirds of the fifty-eight adults excavated at San Lorenzo di Quingentole, a cemetery used from the late sixth or early seventh to eighth centuries.54 At Bolgare, a late Lombard necropolis containing the remains of over 400 individuals, the widespread presence of carious lesions was also noted.55 However, in contrast to these particularly high frequencies, only two out of eleven individuals (18.2%) uncovered at the Church of San Zeno, Campione dâItalia, a site thought to have been used by the descendants of the Lombard merchant Totone, exhibited signs of caries.56 One of these individuals, however, a male aged roughly fifty years old at the time of his death, presented numerous carious lesions, reflecting the progressive nature of the disease.57
While caries are typically the dental pathology most thoroughly addressed in archaeological reports, other aspects of dental health, such as patterns of attrition, evidence of periodontal disease, and the presence of calculus and abscesses are often noted, as well. The dental remains of the single burial found in the church of San Vito di Illegio in Tolmezzo, Udine, for example, were
The three groups at Santa Maria Assunta di Cairate display some differences in the degree to which they were affected by the long-term processes of wear as well as their level of calculus accumulation. It was recorded that individuals from Group A, despite their relatively poor preservation, exhibited evidence of periodontitis and a significant build-up of calculus, especially on the canines and pre-molars.61 Moderate levels of attrition and two cases of abscesses were also recorded. In Group B, all recovered teeth exhibited evidence of wear, though it was fairly light, and, in one case, a large amount of calculus had accumulated.62 Attrition was greater in Group C, with most individuals exhibiting a moderate level of wear; four individuals, however, showed signs of exceptionally intense wear, resulting in the erosion of the dental crown to the dentine in some teeth.63 Calculus was noted on the teeth of many individuals, with a particularly large amount reported on two males. Four severe abscesses were recorded, three of which affected females.
An extraordinary case from Seckenheim, a cemetery used from the sixth to eighth centuries, deserves special mention.64 The individual buried in grave 595 exhibited dental calculus on seven of nine recovered teeth, with two teeth displaying an extremely large build-up of calculus, âalmost dwarfing the teeth
The findings reviewed above indicate that many early medieval individuals suffered from a number of different oral health problems. Although there are large variations between sites, it is evident that dental disease would have been a serious concern for all populations: carious lesions were recorded at all sites involved in the present study and are a common cause of amtl. The loss of teeth in life was probably not only a very painful process, but also potentially debilitating, affecting an individualâs ability to eat as well as their appearance. Although most reports did not comment on sex-based differences, at several sites, such as Saint Servatius, Acqui Terme, and Rivoli, it appears that females were more frequently affected by caries, a result that fits with studies from other periods.68 Molars and pre-molars were often noted as being particularly affected by carious lesions in several reports (and illustrated by Figures 9 and 11), findings that also correspond with the scientific literature on the disease.69 Although many excavation reports focus more on caries, there is still an extensive record of periodontal disease, abscesses, and calculus build-up within the literature. Overall, the generally high frequency of caries and amtl, combined with the presence of a number of other pathologies reported at some sites, suggests that dental disease took a significant toll on many individuals during this period.
3 Recipes to Treat Dental Disease
As might be expected based on the osteological record, early medieval medical texts preserve many examples of treatments for dental problems. An in-depth
Within the recipe sample, 248 recipes are presented as treatments for conditions of the teeth and mouth, such as tooth pain, cavities, and ulcers. In other words, approximately five percent of all recipes analysed in this study address dental disease and related concerns. While many other recipes concern conditions near the mouth, such as those intended to treat sore throats, inflamed tonsils, and cracked lips, only recipes that clearly indicate that they were intended to treat symptoms that can be linked to dental conditions have been selected for analysis (this includes recipes in which dental conditions are the only treatment target named as well as recipes in which dental conditions are one of multiple possible targets). A number of prescriptions with ambiguous phrasing that could potentially treat problems of the teeth and mouth have been excluded given their uncertainty.
As seen in Table 10, the recipes can be divided into six general categories according to the information they record. That is, if an early medieval reader came across this text, what would the recipe seem to be intended to treat? Or if an individual were seeking a treatment for a particular condition, such as toothache or putrid breath, what key words would they look for in a recipe collection? As a result, this categorisation is often based on the titles of recipes, though, where applicable, any additional information provided within recipes is also taken into account. The categories are: 1) toothache, 2) ulcers, sores, wounds, and burns, 3) cavities and tooth loss, 4) putridity and cosmetics, 5) general, unspecified mouth complaints, and 6) gum problems.
Categories of dental pathologies
| Categories | # of recipes | % of total (248) |
|---|---|---|
| Toothache | 121 | 48.8% |
| Ulcers, sores, etc. | 33 | 13.4% |
| Cavities and tooth loss | 31 | 12.5% |
| Putridity and cosmetics | 26 | 10.5% |
| Mouth complaints (unspecified) | 20 | 8.1% |
| Gum problems | 17 | 6.9% |
Specificity of dental pathologies
| Specificity | # of recipes | % of total (248) |
|---|---|---|
| NSp | 22 | 8.9% |
| SSp | 34 | 13.7% |
| HSp | 192 | 77.4% |
Before considering each category, the specificity of these recipes must be mentioned (see Table 11). As discussed in Chapter 6, it can be helpful to sort recipes into non-specific, semi-specific, and highly specific categories. Non-specific recipes represent very broad, cure-all treatments (typically antidotes) whereas
Categories of dental pathologies with breakdown of specificity
| Categories | Total | NSp | SSp | HSp |
|---|---|---|---|---|
| # of recipes % of 248 |
# of recipes % of 22 |
# of recipes % of 34 |
# of recipes % of 192 |
|
| Toothache | 121 49.1% |
11 50.0% |
27 79.4% |
83 43.2% |
| Ulcers, sores, etc. | 33 13.3% |
1 4.5% |
2 5.9% |
30 15.6% |
| Cavities and tooth loss | 31 12.5% |
5 22.7% |
1 2.9% |
25 13.0% |
| Putridity and cosmetics | 26 10.5% |
2 9.1% |
2 5.9% |
22 11.5% |
| Mouth complaints (unspecified) | 20 8.1% |
2 9.1% |
2 5.9% |
16 8.3% |
| Gum problems | 17 6.9% |
1 4.5% |
0 | 16 8.3% |
Specificity of dental pathologies with breakdown of categories
| Specificity | Toothache | Ulcers, sores, etc. | Cavities and tooth loss | Putridity and cosmetics | Mouth complaints (unspecified) | Gum problems |
|---|---|---|---|---|---|---|
| # of recipes % of 121 |
# of recipes % of 33 |
# of recipes % of 31 |
# of recipes % of 26 |
# of recipes % of 20 |
# of recipes % of 17 |
|
| NSp | 11 9.1% |
1 3.0% |
5 16.1% |
2 7.7% |
2 10.0% |
1 5.9% |
| SSp | 27 22.3% |
2 6.1% |
1 3.2% |
2 7.7% |
2 10.0% |
0 |
| HSp | 83 68.6% |
30 90.9% |
25 80.7% |
22 84.6% |
16 80.0% |
16 94.1% |
3.1 Category 1: Toothache
Twenty-seven toothache recipes can be considered semi-specific, all of which are intended for a more general condition (or range of conditions) relating to the head and include toothache as part of this broader treatment package. On pp. 257aâ258b of cod. sang. 217, for example, a cluster of ten recipes can be found under the heading Ad capitis, though the first recipe immediately clarifies that it is intended to treat not only head pain but also problems of the ears, nose, mouth, and, more specifically, long-standing tooth pain, dentem diutius dolentibus.77 Additional examples of recipes aimed at treating head problems and tooth pain jointly can also be found in cod. sang. 217 as well as cod. sang.
With the aforementioned non- and semi-specific toothache recipes collectively comprising less than a third of the total toothache recipes identified in the sample, the majority of this category of recipes (68.6%) are highly specific. Of these eighty-three recipes, essentially all are titled Ad dentium dolorem or present very similar variants. Consider, for example, three different two-recipe clusters in cod. sang. 759: Ad dentes dolorem trociscus (âA pill for pain of the teethâ, p. 48), Ad dentes ut numquam doleant (âSo that the teeth never hurtâ, p. 73), and Ad dentium dolorem (âFor pain of the teethâ, pp. 75â6).79 A recipe titled De dentes dolores in BnF lat. 2849A provides a simple treatment using ivy juice and âthe roots [of a plant] called spanaâ (de illa radice que dicitur spana).80 In addition to these individual recipes or small groupings, toothache treatments can be found in larger clusters. In cod. sang. 217, for example, a group of fourteen recipes for tooth pain is listed under the heading Item ad dentium dolorem.81
Paradoxically, although there are many more highly specific toothache recipes than non- or semi-specific recipes (eighty-three compared to eleven and twenty-seven, respectively), they comprise a smaller percentage of their specificity category (43.2% as opposed to 50.0% and 79.4%, respectively). The remaining five categories, making up just over half of the dental disease-related treatments in the sample (51.2%), present a somewhat different picture, and I shall return to the significance of these different trends after reviewing the findings from Categories 2â6.
3.2 Categories 2â6: the Other Half of the Recipes Concerning Oral Health
Categories 2â6 share a number of features. First, in contrast to the very large number of treatments that fall under Category 1, each of the remaining five
Furthermore, while the majority of the recipes in Category 1 can be classified as highly specific (68.6%), the percentages of highly specific recipes in Categories 2â6 isâwithout exceptionâeven higher. Collectively, nearly ninety percent of these recipes are highly specific (109 out of 127 recipes), while non- and semi-specific recipes (with eleven and seven recipes, respectively) comprise less than ten percent each. To put it another way, although the toothache recipes of Category 1 are predominantly highly specific, non- and semi-specific recipes still represent a sizeable minority. In contrast, nearly all recipes in Categories 2â6 are highly specific, with only eighteen recipes categorised as either non- or semi-specific. These trends will be reconsidered below.
3.2.1 Category 2: Ulcers, Sores, Wounds, and Burns
In contrast to the consistent Latin phrase seen in Category 1, dentium dolorem, several different terms are frequently paired with the standard word for âmouthâ, os (genitive oris), such as ulcus (ulcer, sore), uulnus (wound, injury), and ustio (burn), that suggest various types of mouth sores. The words ulcus and uulnus have a wide range of meanings, so I have tended to take a broad and flexible approach to interpreting their use in recipes and translate accordingly. Ulcers or sores, ulcera, occur most frequently, appearing in nineteen of the thirty-three recipes. Examples include Ad ulcera oris, âFor sores of the mouthâ, in bav pal. lat. 1088; Ad ulcera quae in ore nascuntur, âFor sores that grow in the mouthâ, in cod. sang. 751; and Ad ulcera oris uel quicquid in labia fuerint, âFor sores of the mouth or that are in the lipsâ, in cod. sang. 44.82 Treatments that mention wounds appear in codd. sang. 217 and 759, such as Ad uulnera in ore, âFor wounds in the mouthâ, in the latter manuscript.83 All but three of the thirty-three recipes that mention these different types of mouth sores (90.9%) are highly specific treatments. Two treatments found in BnF lat. 11219, including the Puluis ad uuam leuandam uel oris ulcera, a powder intended to lift the uvula and treat ulcers of the mouth, align with the semi-specific category,
3.2.2 Category 3: Cavities and Tooth Loss
The thirty-one recipes making up Category 3 all concern various aspects of tooth loss, including cavities, lost teeth, and loose teeth. Like the varied vocabulary seen in Category 2, an assortment of terms is used to describe to these related issues, associated symptoms, and approaches to treatment. As examples in codd. sang. 44, 751, and bav pal. lat. 1088 demonstrate, some recipes bear the title Ad dentem cauum, offering treatments for cavities.85 In other cases, teeth are described as moving. Cod. sang. 751, for example, contains a recipe for teeth that move labelled Item ad dentes qui mouentur, while bav pal. lat. 1088 includes a âPowder for movement of the teethâ titled Puluis ad dentium commotionem.86 Loose teeth are also described, as seen in treatments in cod. sang. 759 and bav reg. lat. 1143 titled Ad dentes laxos.87 While many of these recipes mention putridity, confirming that there is often overlap between categories, it appears that for all recipes grouped in Category 3, the primary concerns are cavities, tooth loss, and/or tooth mobility whereas putridity is secondary to, or dependent on, the cavities and lost/loose teeth. Consider, for example, the recipe titled Ad dentes stringendos uel si dolent uel putriscunt aut sanguinant: keeping or stabilising the teeth is the first stated aim of the treatment, while it also addresses tooth pain and putrid or bleeding teeth.88
Twenty-five of the thirty recipes, including all those highlighted so far, represent highly specific treatments; of the remaining six, five are non-specific panaceas while one is a semi-specific recipe. Three of the non-specific recipes are found together in BnF lat. 11218: the first in this group is a plaster titled Inplastrum Afrodites and the following two recipes, both beginning with Item,
3.2.3 Category 4: Putridity and Cosmetics
As seen in Category 3, putridity is noted with some frequency as a secondary or linked dental issue. In other recipes, however, it is named as the primary concern, as illustrated by a cluster of recipes titled Ad fetorem oris (âFor foul smells of the mouthâ) in cod. sang. 217.93 Also included in this category are recipes that seem to put a more positive spin on the attempts to mask rotten teeth and bad breath, such as dentifrices intended to whiten the teeth and/or improve the breath. bav pal. lat. 1088, for example, includes a âDentifrice for brightness of the teethâ, Dentifricium ad dentium splendorem, followed by one to counteract bad smells emerging from the mouth, Dentifricium odoris fetorem.94
While the vast majority (84.6%) of these treatments are highly specific, this category also includes two semi-specific and two non-specific recipes. The aforemetioned Dentifricium odoris fetorem speculare as well as another dentifrice in cod. sang. 44, Dentisfritium bonum et salubrem, can both be considered semi-specific since, in addition to treating bad breath, the recipes address a wider range of issues; although these conditions are largely in the same area
3.2.4 Category 5: General, Unspecified Mouth Complaints
While the types of tooth and mouth problems listed in some of the preceding categories, such as âwoundâ or âulcerâ, usually do not provide much, if any, detail regarding the nature of these ailments, other recipes are even broader in their approach. Category 5 includes all recipes that list oris uitia, âcomplaints of the mouthâ, as their intended target. Nineteen such recipes appear in the sample, as does a single recipe for unspecified tooth complaints, Ad dentium uitiae.97 Like the cluster of recipes in BnF lat. 11218 listed under the title Ad oris uicia noted above, codd. sang. 217 and 751 also contain small groups of treatments under the headings Ad uitium oris and Ad uitia oris, respectively.98 Despite their broad remit, eighty percent (sixteen of the twenty recipes) are classified as highly specific treatments because their only named purpose relates to healing these general afflictions of the mouth.
In addition to these sixteen highly specific recipes, four recipes represent non- and semi-specific treatments. Two recipes, the Oleo lentisscinum of cod. sang. 44 and Emplastrum somato filax of cod. sang. 761, are catch-all panaceas. Like the aforementioned rose oil preparation, the Oleo lentisscinum (mastic oil) is said to be applicable for a wide-ranging list of different ailments, including uterine pain, hardness of the stomach, dysentery, and mouth problems.99 The Emplastrum somato filax claims to treat an even more detailed and diverse list of conditions, opening with dog bitesârabid or otherwiseâand also including problems of the eyes, ears, and parotid glands; kidney stones; coughs; gout; etc. The phrase oris uitia curat, âit cures complaints of the mouthâ, is found near
3.2.5 Category 6: Gum Problems
Seventeen recipes present gum problems as their primary target, such as the several recipes titled Ad gengiuas, treatments for the gums, in cod. sang. 751 or those under the heading Ad exasperationem gingiuarum, treatments for irritation of the gums, in cod. sang. 44 and bav pal. lat. 1088.103 A dentifrice in cod. sang. 44, Dentisfritium ad gingiuas confortandas et dissicandas, is more specifically intended to heal and dry out the gums, while a treatment in cod. sang. 217 tackles swollen gums.104 All but one of the recipes (94.1%) are highly specific; the one exception, the non-specific Trociscus Eraclio, is presented as a cure for a diverse assortment of conditions, from ear complaints to various wounds and sores, and problems of the gums are included in this mix.105
3.3 Summary
With treatments for dental disease and related conditions appearing in nearly five percent of all recipes analysed in this study, oral health represents a significant area of interest within the sampled recipe literature. Treatments intended to combat toothache represent about half of these recipes, while treatments
4 The Applicability of the Recipe Sample to Early Medieval People
The evidence analysed in this chapter indicates that there is a significant degree of overlap between the skeletal remains and the textual record: the conditions and symptoms that dental remedies claim to treat largely fit with what is observed in the osteological evidence. The early medieval dental remains show clear evidence of dental disease, and this was most often manifested by carious lesions and amtl, though signs of periodontal disease, calculus build-up, and abscesses were also noted. The recipes, meanwhile, target standard issues that would have arisen from poor dental hygiene, such as toothache, mouth sores, loose or lost teeth, gum problems, and foul-smelling breath. Some of these treatment targets, such as those for cavities and lost or loose teeth, mirror the skeletal remains. Others, including the many recipes for toothache or the dentifrices intended to improve bad breath, treat symptoms that are impossible to see in the osteological record directly. However, the surviving skeletal evidence makes clear that such symptoms would have been pressing concerns for many individuals. Indeed, the regular occurrence of dental disease and its ensuing symptoms may help to explain why the vast majority of the recipes offer fairly simple and relatively focused treatments. Ultimately, the parallels between the textual and archaeological evidence indicate that many of the recipes would have been relevant to the individuals who had access to these texts and suggest that these treatments could have been written with the intention of being used in the context of therapy.
4.1 Specific Types of Teeth
As noted above, molars and pre-molars, due to their fissured surfaces and less accessible location at the back of the mouth, are the teeth most susceptible to the development of carious lesions. This fact is not only illustrated by Figures 9 and 11 but was also emphasised in a number of reports; at Santa Maria Assunta di Cairate, for example, molars and pre-molars were recorded as being particularly affected in the second and third burial groups. If, then, these teeth were typically the ones most frequently and severely affected by caries, it is particularly notable that several recipes within Category 1, toothache, mention the molars explicitly. A total of six recipes, such as Ad dentes molares of codd. sang. 217 and 1396, are named as molar-specific treatments.106 Intriguingly, these are the only recipes to target an individual type of tooth. Overall, the osteological evidence suggests that treatments intended for the molars would have been highly relevant, adding further weight the argument that many of the dental recipes would have been applicable to individuals in early medieval Europe.
4.2 Specific Types of People
The skeletal evidence at some sites, such as Acqui Terme, Rivoli, and the Saint Servatius complex in Maastricht, suggests that females were more prone to developing carious lesions. These results fit with known, though not fully understood, sex-linked differences regarding the experience and severity of dental disease: certain biological and cultural factors may predispose females to developing caries. Given the direct parallel seen above in the case of molars, it might have been expected that the textual evidence would reflect this difference, as well. However, no treatments are presented as being intended to treat women specifically, and there is no apparent gender-based division of recipes. While the listing of uterine issues in a number of non-specific recipes could be seen as a possible exception to this general finding, gynaecological problems are often included in panaceas, and I would therefore suggest that a gendered reading of these recipes is inappropriate.
While treatments for women are not recorded, a different person-based category did emerge: age. Four recipes targeted teething infants, such as the
When considering whether different types of patients are recorded in the recipes, it is also important to reflect on another group of people: the potential practitioners (if, of course, these treatments were being consulted in the context of practice). Given that the treatment of dental conditions is found alongside all other types of health concerns rather than separated into distinct treatises focused exclusively on dentistry, there is no sign of specialisation in this respect. Such a finding fits with the general observation that the terminology used to distinguish between different types of medical practitioners expanded in later centuries and was less specialised during the early Middle Ages.108 It remains possible, however, that the medical marketplace included more specialised practitioners whose activities were not recorded in the surviving written record.
4.3 Cosmetics
Given the evidence for severe dental disease, it may seem that dentifrices and tooth whitening treatments are somewhat frivolous: why worry about the whiteness of teeth if they have already been lost or are on their way out? A consideration of the contexts in which these recipes were produced, however, suggests the opposite. As discussed in Chapter 2, the locations in which medical texts were written and housed, whether monastic centres or courtly libraries, were generally elite sites that involved the upper-most strata of society. The privileged circles of the court, aristocratic households, and the ecclesiastical elite represent groups of individuals who may have been especially
4.4 Possible Sources for Dental Recipes
As mentioned above, it has been suggested that dental health declined between c. 1200 bc and c. 750 ad.111 With this in mind, it is important to think about how these recipes compare to classical texts and to reflect on the origins of these treatments. Do many recipes derive from classical and late antique medical writings? Or does a wave of new material appear to have been introduced, coinciding with increasing demands for dental care? As the case studies of Part 1 have shown, both of these patterns, that of preservation and that of addition, have been identified in the recipes under analysis. Within newly compiled recipe collections, some entire clusters of recipes can be traced to known sources while, in other cases, single recipes appear to have been selected from earlier texts individually. A recipe titled Ad dentium uitiae noted in Category 5, for example, is located in a short section of recipes derived from Pseudo-Antonius Musaâs De herba vettonica liber in cod. sang. 751.112 Here, in the middle of an enormous recipe collection, two groups of recipes on pp. 408â9 present
For many recipes, however, a direct link a classical or late antique treatise has yet to be identified and their origins remain unknown. In fact, in a handful of cases, some of the new developments in pharmaceutical literature discussed in Part 1 can be seen: the second recipe within a cluster titled Ad dentium dolorem, âfor tooth painâ, in cod. sang. 759, for example, includes beer in its ingredients.114 The overall range of recipes relating to dental healthâi.e., that many have a basis in classical and late antique traditions, while others reflect new influencesâdocuments an active process of selection. Carolingian scribes engaged with a variety of sources and brought together this assortment of information in new and different ways. As demonstrated in Part 1, the hybrid nature of recipe collections further supports the idea that they were intended to be used in practice.
5 Conclusion
The early medieval skeletal evidence reveals that treatments for tooth problems would have been necessary in the Carolingian world: poor dental health, while not universal, was frequent. All sites reviewed in this chapter provided evidence of dental disease. The recipe literature displays many examples of overlap with the skeletal remains, such as treatments for toothache, tooth loss, and/or mouth sores. Based on the undeniable parallels between the textual and osteological evidence, I argue that the medical knowledge in circulation would have been highly applicable to contemporary populations. Furthermore, certain types of recipes, such as those concerning appearance, suggest that these recipes may have been particularly relevant to the individuals with access to these manuscripts, such as members of royal, aristocratic, or ecclesiastical communities.
This opening case study of Part 2 thus offers a fairly straightforward example of overlap between the two bodies of evidence under analysis: by reading the recipes in the light of the osteological record, it reinforces the idea that these treatments were intended to be put into practice. While this conclusion may not come as a surprise, the process of reaching it has involved a non-traditional
Kropp, Kirsch, Rosendahl, Orschiedt, and Fischer, Begraben und Vergessen?, 38â9.
The date range given by radiocarbon dating is 888â966. Kropp, Kirsch, Rosendahl, Orschiedt, and Fischer, Begraben und Vergessen?, 38â9.
Luis Pezo Lanfranco and Sabine Eggers, âCaries Through Time: An Anthropological Overviewâ, in Contemporary Approach to Dental Caries, ed. Ming-Yu Li (Rijeka: IntechOpen, 2012), 3â34,
Langsjoen, âDiseases of the Dentitionâ, 394.
Langsjoen, âDiseases of the Dentitionâ, 395. As this chapter focuses on the state of dental health generally, I shall not detail the nomenclature and annotation used to describe each tooth and tooth area, but it is important to note that there are several systems used to record the state of teeth uncovered in excavations, including the International Coding System (recommended by the Fédération dentaire internationale) and the Standards System (similar to the ics but with a visual format); differences in recording and analysing teeth and associated pathologies may account for some of the variation observed when comparing results from multiple sites. For more information on tooth anatomy, see Simon Hillson, Dental Anthropology (Cambridge: Cambridge University Press, 1996), 6â105.
Langsjoen, âDiseases of the Dentitionâ, 396.
Ibid.
Ibid.
First quotation from Waldron, Palaeopathology, 236; second quotation from Simon Hillson, âRecording Dental Caries in Archaeological Human Remainsâ, International Journal of Osteoarchaeology 11, no. 4 (2001): 249â89,
Langsjoen, âDiseases of the Dentitionâ, 402.
Hillson, âRecording Dental Cariesâ, 250.
Ibid.
Ibid.
Pezo Lanfranco and Eggers, âCaries through Timeâ, 8.
Ibid, 8â9.
Ibid, 17.
Langsjoen, âDiseases of the Dentitionâ, 398.
Hillson, âRecording Dental Cariesâ, 263â5.
Ibid, 263.
Ibid.
Waldron, Palaeopathology, 240â1.
Ibid.
Hillson, âRecording Dental Cariesâ, 265; Waldron, Palaeopathology, 241.
Langsjoen, âDiseases of the Dentitionâ, 398â9.
John R. Lukacs, âOral Health in Past Populations: Context, Concepts and Controversiesâ, in A Companion to Paleopathology, ed. Anne L. Grauer (Chichester: Wiley-Blackwell, 2012), 553â81, at p. 560.
Waldron, Palaeopathology, 240.
Waldron, Palaeopathology, 241â3; Lukacs, âOral Health in Past Populationsâ, 560.
Waldron, Palaeopathology, 241â3; Langsjoen, âDiseases of the Dentitionâ, 408.
Waldron, Palaeopathology, 241â3.
Ibid, 238â9.
Ibid.
Ibid.
Hillson, âRecording Dental Cariesâ, 264.
Langsjoen, âDiseases of the Dentitionâ, 399â400; Lukacs, âOral Health in Past Populationsâ, 560.
Langsjoen, âDiseases of the Dentitionâ, 405â7.
Hillson, âRecording Dental Cariesâ, 265; Waldron, Palaeopathology, 265â7.
Pezo Lanfranco and Eggers, âCaries through Timeâ, 8â9.
Kropp, Kirsch, Rosendahl, Orschiedt, and Fischer, Begraben und Vergessen?, and supplemented by personal communications with members of the scientific board of Lorsch, including Claus Kropp and Hermann Schefers.
Jean-François Roulet and Susi Ulrich-Bochsler, âZahnärztliche Untersuchung frühmittelalterlicher Schädel aus Biel-Mettâ, Schweizerische Monatsschrift für Zahnheilkunde 89, no. 6 (1979): 526â40, at p. 526.
Alessandro Canci, Alexandra ChavarrÃa Arnau, and Maurizio Marinato, âIl cimitero della chiesa altomedievale di San Lorenzo di Desenzano (bs): note di bioarcheologiaâ, in vi Congresso Nazionale di Archeologia Medievale. Sala Conferenze âE. Sericchiâ, Centro Direzionale CARISPAQ âStrinella 88â. LâAquila, 12â15 settembre 2012, ed. Fabio Redi and Alfonso Forgione (Florence: AllâInsegna del Giglio, 2012), 452â5.
V. Garcin, P. VelemÃnsky, P. Trefny, A. Alduc-Le Bagousse, A. Lefebvre, and J. Bruzek, âDental Health and Lifestyle in Four Early Mediaeval Juvenile Populations: Comparisons between Urban and Rural Individuals, and between Coastal and Inland Settlementsâ, homoâJournal of Comparative Human Biology 61, no. 6 (2010): 421â39,
Garcin, VelemÃnsky, Trefny, Alduc-Le Bagousse, Lefebvre, and Bruzek, âDental Health and Lifestyleâ, 430.
Anny Mattucci, Cristina Ravedoni, and Elena Rettore, âAnalisi antropologica e paleopatologica della popolazione rinvenuta nel monastero dellâAssunta di Cairateâ, in Un monastero nei secoli. Santa Maria Assunta di Cairate: scavi e ricerche, ed. Valeria Mariotti (Mantua: sap, 2014), 519â32.
Mattucci, Ravedoni, and Rettore, âAnalisi antropologica e paleopatologicaâ, 520, 524â5.
Ibid, 524â5.
Ibid, 520â1.
Ibid, 524â5.
Ibid, 521â3, 525.
Ibid, 525.
Francesco Mallegni, Elena Bedini, Angelica Vitiello, Laura Paglialunga, and Fulvio Bartoli, âSu alcuni gruppi umani del territorio piemontese dal iv al xviii secolo: aspetti di paleobiologiaâ, in Archeologia in Piemonte, ed. Liliana Mercando, Marica Venturino Gambari, and Egle Micheletto, vol. 3 (Turin: Allemandi, 1998), 233â61.
Mallegni, Bedini, Vitiello, Paglialunga, and Bartoli, âSu alcuni gruppi umaniâ, 233â61.
Panhuysen, âDemography and Health in Early Medieval Maastrichtâ, 206. In total, the excavations of the Saint Servatius site identified 244 individuals buried in and around the church complex dated between c. 350 and c. 950; the âBasilica Phaseâ covers the third and final period of use within this date range (pp. 120â1).
Ibid, 206â8.
Marco Dal Poz, Francesca Ricci, Bruno Reale, Maddalena Malvone, Loretana Salvadei, and Giorgio Manzi, âPaleobiologia della popolazione altomedievale di San Lorenzo di Quingentole, Mantovaâ, in San Lorenzo di Quingentole: archeologia, storia ed antropologia, ed. Alberto Manicardi (Mantua: sap, 2001), 151â98.
Cristina Cattaneo and Andrea Mazzucchi, âPopolazioni tardo antiche e dellâalto medioevo narrate dai resti ossei: il progetto di una banca dati lombardaâ, in La via Carolingia: uomini e idee sulle strade dâEuropa. Dal sistema viario al sistema informativo, ed. Paola Marina De Marchi and Stefano Pilato (Mantua: sap, 2013), 87â98.
Note: this site contains many more individuals when all phases of use are considered; Phase 2, with eleven individuals, was the most relevant period of use to include in this study. Paul Blockley, Roberto Caimi, Donatella Caporusso, Cristina Cattaneo, Paola Marina De Marchi, Lucia Miazzo, Davide Porta, and Cristina Ravedoni, âCampione dâItalia. Scavi archeologici nella ex chiesa di San Zenoâ, in Carte di famiglia. Strategie, rappresentazione e memoria del gruppo familiare di Totone di Campione (721â877), ed. Stefano Gasparri and Cristina La Rocca (Rome: Viella, 2005), 29â80.
Blockley, Caimi, Caporusso, Cattaneo, De Marchi, Miazzo, Porta, and Ravedoni, âCampione dâItaliaâ, 56â8.
Valeria Amoretti, Aurora Cagnana, Paola Greppi, and Andrea Saccocci, âLo scavo della chiesa di San Vito di Illegio (Tolmezzo, UD). Una âEigenkircheâ carolingia nelle Alpi Carnicheâ, in v Congresso Nazionale di Archeologia Medievale. Palazzo della Dogana, Salone del Tribunale (Foggia); Palazzo dei Celestini, Auditorium (Manfredonia); 30 settembre-3 ottobre 2009, ed. Giuliano Volpe and Pasquale Favia (Florence: AllâInsegna del Giglio, 2009), 487â91.
Amoretti, Cagnana, Greppi, and Saccocci, âLo scavo della chiesa di San Vito di Illegioâ, 487â91.
Panhuysen, âDemography and Health in Early Medieval Maastrichtâ, 210.
Mattucci, Ravedoni, and Rettore, âAnalisi antropologica e paleopatologicaâ, 524â5.
Ibid.
Ibid, 525.
J. L. Hansen and K. W. Alt, âAn Exceptional Case of Dental Calculus in a Merovingian Skeleton from Mannheim-Seckenheimâ, Bulletin of the International Association for Paleodontology 6, no. 2 (2012): 70â6.
Hansen and Alt, âAn Exceptional Case of Dental Calculusâ, 72.
Ibid.
Ibid.
Pezo Lanfranco and Eggers, âCaries through Timeâ, 17. See also Belén López MartÃnez, Antonio Fernández Pardiñas, Eva GarcÃa Vázquez, and Eduardo Dopico RodrÃguez, âSocio-Cultural Factors in Dental Diseases in the Medieval and Early Modern Age of Northern Spainâ, homoâJournal of Comparative Human Biology 63, no. 1 (2012): 21â42,
Hillson, âRecording Dental Cariesâ, 250.
Cod. sang. 751, p. 473: Ad gengiuas plenas sanguinem ⦠non solum gengiuas cumtetiris utile est, sed a dentes et faucis et uuam oportum est. See Appendix 2, entry 9.37.1.
BnF lat. 11218, ff. 89râ89v, Ad oris uicia. See Appendix 2, entry 3.5.
BnF lat. 11218, f. 89v, Item ad gingiuas qui reumatizant. See Appendix 2, entry 3.5.6.
Cod. sang. 217, p. 262: Antidotus Atrianus; see Appendix 2, entry 6.2.
Cod. sang. 44, pp. 234â6: Antidotum sotira; cod. sang. 217, pp. 263bâ264b: Antidotum Theodosion; bav pal. lat. 1088, ff. 52vâ53r: Antidotum Adrianum; ff. 53râ53v: Antidotum panchristum; ff. 55vâ56r: Antidotum gera Galieni fortissima, and ff. 59râ59v: Antidotum sotira; bav reg. lat. 598, f. 124r: Antidotum sancti Paulini; bav reg. lat. 1143, ff. 161vâ162v: Antidotus polichristus; and BnF lat. 11218, ff. 113vâ114v: Antidotum sotirie. For transcriptions of each of these recipes, see Appendix 2, entries 5.1, 6.3, 16.19â22, 17.1, 18.6, and 3.12, respectively. As seen in the entries of Appendix 2, even when multiple prescriptions share a title and may be related, their ingredients, aims, and overall presentation can vary enormously.
Cod. sang. 44, pp. 256â7: Oleo roseo. See Appendix 2, entry 5.11.
Cod. sang. 217, pp. 257aâ258b: Ad capitis. See Appendix 2, entry 6.1.
Cod. sang. 217, p. 267: Item ad emigranium seu ad dentium dolorem; and lower on the same folio, the fourth entry under the heading Ad dolorem auricule uel aque ingressu; cod. sang. 751, p. 457: Purgaturium capitis; bav reg. lat. 1143, f. 99r: Ad emigranium siue dentium dolorem; and BnF lat. 11218, ff. 50râ50v: De capite dicit. See Appendix 2, entries 6.4.11, 6.5.4, 9.34, 18.2, and 3.3, respectively.
Cod. sang. 759, p. 48: Ad dentes dolorem trociscus; p. 73: Ad dentes ut numquam doleant; pp. 75â6: Ad dentium dolorem. See Appendix 2, entries 11.4, 16, and 18.
BnF lat. 2849A, f. 19r: De dentes dolores. See Appendix 2, entry 1.1.
Cod. sang. 217, p. 335: Item ad dentium dolorem. See Appendix 2, entry 6.9.
bav pal. lat. 1088, f. 35v: Ad ulcera oris uel quidquid intra labiis fuerit; cod. sang. 751, p. 435: Ad ulcera quae in ore nascuntur; cod. sang. 44, p. 361: Ad ulcera oris uel quicquid in labia fuerint. See Appendix 2, entries 16.4, 9.26, and 5.26, respectively.
Cod. sang. 217, p. 273: Ad uulnera oris siue tumores gingiuarum; cod. sang. 759, p. 5: Ad uulnera in ore. See Appendix 2, entries 6.7 and 11.2, respectively.
BnF lat. 11219, f. 225rb: Puluis ad uuam leuandam uel oris ulcera. See Appendix 2, entry 4.5.
Cod. sang. 44, p. 360: Ad dentem cauum; cod. sang. 751, p. 472: Item ad dentem cauam; and bav pal. lat. 1088, f. 35v: Item ad dentem cauum. See Appendix 2, entries 5.24, 9.36.3, and 16.2.7, respectively.
Cod. sang. 751, p. 472: Item ad dentes qui mouentur; bav pal. lat. 1088, f. 50r: Puluis ad dentium commotionem. See Appendix 2, entries 9.36.6 and 16.14, respectively.
Cod. sang. 759, p. 5: Ad dentis laxos; bav reg. lat. 1143, f. 148v: Ad dentes laxos. See Appendix 2, entries 11.3 and 18.5, respectively.
Cod. sang. 759, p. 92: Ad dentes stringendos uel si dolent uel putriscunt aut sanguinant. For similar examples, see also cod. sang. 751, p. 472: Ad dentes ne cadent neque putriscant; cod. sang. 899, p. 141: Ne cadant dentes neque putrescant; BnF lat. 11218, f. 122r: Ad dentes stringendas uel si dolent uel putrescunt. See Appendix 2, entries 11.22, 9.36, 14.6, and 3.14, respectively.
BnF lat. 11218, ff. 45vâ46r, Inplastrum Afrodites, f. 46r, Item de Afroditis, ff. 46râ46v, Item catapodias Eufimie. See Appendix 2, entries 3.1.1â2 and 3.2, respectively.
BnF lat. 11218, ff. 45vâ46r, Inplastrum Afrodites. See Appendix 2, entry 3.1.1.
BnF lat. 11218, ff. 45vâ46r, Inplastrum Afrodites. E.g., statim curat et recte dentis capitis plagas. For the full transcription, see Appendix 2, entry 3.1.1.
Cod. sang. 217, p. 338: for the fourth entry of Ad synances. See Appendix 2, entry 6.12.4.
Cod. sang. 217, p. 274: Ad fetorem oris. See Appendix 2, entry 6.8.
bav pal. lat. 1088, f. 50r: Dentifricium ad dentium splendorem; f. 50r: Dentifricium odoris fetorem. See Appendix 2, entries 16.15â16.
bav pal. lat. 1088, f. 50r: Dentifricium odoris fetorem; cod. sang. 44, p. 248: Dentisfritium bonum et salubrem. See Appendix 2, entries 16.16 and 5.8.
Cod. sang. 751, p. 418: Sales ieraticas qui faciunt ad acies oculorum usque senectutÄ et flegma impetum deducit et suspirium relaxat et dentes putresce non sinit. See Appendix 2, entry 9.20.
Cod. sang. 751, p. 409: Ad dentium uitiae. See Appendix 2, entry 9.15.
BnF lat. 11218, ff. 89râ89v: Ad oris uicia; cod. sang. 217, p. 273: Ad uitium oris; cod. sang. 751, p. 435: Ad uitia oris. See Appendix 2, entries 3.5, 6.6, and 9.27, respectively.
Cod. sang. 44, p. 258: Oleo lentisscinum. See Appendix 2, entry 5.12.
Cod. sang. 761, pp. 62â3: Emplastrum somato filax. See Appendix 2, entry 12.3.
BnF lat. 11219, f. 225ra: Puluis uera ad faucium tumorem et omnis oris uitia siue sordicia. See Appendix 2, entry 4.4.
bav pal. lat. 1088, ff. 50râ50v: Dentifritium qui omnem humorem exsiccat. See Appendix 2, entry 16.17.
Cod. sang. 751, p. 473: Ad gengiuas plenas sanguinem; cod. sang. 44, p. 361: Ad exasperatione gingiuarum; bav pal. lat. 1088, f. 35v: Ad experatione gingiuarum. See Appendix 2, entries 9.37, 5.25, and 16.3, respectively.
Cod. sang. 44, p. 248: Dentisfritium ad gingiuas confortandas et dissicandas; cod. sang. 217, p. 337: Item ad uuam reprimendum et gingiuas tumentes. See Appendix 2, entries 5.9 and 6.11.3, respectively.
Cod. sang. 751, p. 364, Item trociscus Eraclio; see Appendix 2, entry 9.4.
Cod. sang. 217, p. 336: Ad dentes molares; cod. sang. 1396, p. 19: Ad dentes molares. See Appendix 2, entries 6.10 and 15.1.
Cod. sang. 44, p. 304, Ut infantibus dentes sine dolore exeant. See Appendix 2, entry 5.16.
Park, âMedicine and Societyâ, 70.
Green, âBodies, Gender, Health, Diseaseâ, 4.
Patricia Skinner, âVisible Prowess?: Reading Menâs Head and Face Wounds in Early Medieval Europe to 1000 ceâ, in Wounds and Wound Repair in Medieval Culture, ed. Larissa Tracy and Kelly DeVries (Leiden: Brill, 2015), 81â101, at pp. 85â9.
Pezo Lanfranco and Eggers, âCaries through Timeâ, 8.
Cod. sang. 751, p. 409: Ad dentium uitiae. See Appendix 2, entry 9.15.
Pseudo-Antonius Musa, De herba vettonica liber, in Antonii Musae De herba vettonica liber. Pseudoapulei Herbarius. Anonymi De taxone liber. Sextii Placiti Liber medicinae ex animalibus etc., ed. Ernst Howald and Henry E. Sigerist, cml 4 (Leipzig; Teubner, 1927), 3â11, no. 7.
Cod. sang. 759, pp. 75â6: Ad dentium dolorem; see Appendix 2, entry 11.18.