The lonely tooth

Has your tooth ever hurt? In earnest? Then you will realize that this illustration of an Ottoman manuscript, in which there is nothing else in the whole universe, but the painful tooth, in whose red-hot inside snakes and devils provoke hellish torments, and the unsympathetic cold space around it, is not a naive metaphor, but the most accurate representation of reality.


As many teeth, so many hellish pains. If you heroically browse through the medical manuscripts and loose illustrations of the small shops in the Istanbul book bazaar, you will wander through more circles of hell than Dante.

This tooth model, carved out of ivory, has a number of photos on the web, without a proper source reference. A seemingly reliable site regards it a Souther French work of around 1780. The date is probably correct, but the origin is rather Ottoman, since its manuscript models can be still found in the Istanbul book bazaar.

But where the need is greatest, the help is the closest. In fact, the above illustrations come from manuscripts, which, aftter presenting the severity of the problem, immediately offer cures and preventive procedures against it.


Islamic dentistry leads back its origins to Mohammad, who instructs the believers in a special hadith to wash their teeth at least twice or thrice a day. He is also referred by the great 10th-century Arabic physician, Ibn Sina or Avicenna, whose famous Al kanun fi al-tibb (The canon of medicine) gives instructions for treating teeth, drilling, pain relief, and fixing dentures with gold wire to the jaw.


Avicenna’s work was also the kanun, the basic reference of Ottoman physicians. One of the indispensable institutions of Ottoman cities was the hospital, darüşşifa, where also dental surgeries were performed. The surgeries needed professionals, and the professionals passed on their knowledge in manuals. The first Ottoman medical manuscripts, Bereket’s Tuhfe-i Mubrizi, Ahmadi’s Tarvih al-ervah and Hacı Paşa’s Müntehab al-şifa, all come from the 14th century, and they also deal with the treatment and anatomy of teeth.

In the 15th century, two important factors led to the boom of Ottoman dentistry. On the one hand, Sultan Mehmet II established a glorious court in Constantinople, occupied by him in 1453, which attracted qualified doctors from all over the empire. Here the first Ottoman surgical encyclopaedia and at the same time the first illustrated Ottoman medical work, Cerrâhiyyetüʿl-Hâniyye (Surgery of the Empire) was composed in 1465 by chief physician Şerefeddin Şabuncuoğlu. Among its pictures there are also many illustrations of dental surgeries.



On the other hand, the Ottoman praxis was further enriched by the knowledge brought to Constantinople by the Jewish doctors expelled from Spain in 1492. The first Ottoman dental monograph was written by the Sephardic Moses Hamon (Ibn Hamun) in the court of Sultan Suleiman. Its illustrations further develop those of Şabuncuoğlu.



Ibn Hamun’s knowledge and illustrations were taken over, expanded and varied by a number of further manuscripts, from Şemseddîn-i İtâkki’s medical compendium of 1632, which already includes the Renaissance anatomical charts of Andreas Vesalius’ De humani corporis fabrica of 1543, to the great Marifetname encyclopaedia, compiled in 1765 by the Sufi doctor İbrahim Hakkı, which was the crowning and last great creation of Ottoman medical science.


This manuscript literature flourished in many variants until the end of the 19th century, when European medicine and book printing gradually replaced it. To which of these works belonged the solitary teeth, suffering alone in the universe, with a little hell in their cavity? We do not know. These metaphors of disconsolate suffering are now sold by pages in the Istanbul book bazaar, torn away from  a thousand years of accumulated medical knowledge, which could help them.