For Sale: Jane Austen’s Wince-Inducing Descriptions of 19th-Century Dentistry

After dinner one evening in September 1813, Jane Austen sat down to write a letter to her sister Cassandra. Austen, who had published Pride and Prejudice earlier that year, had much to report from the home front. She had accompanied three nieces and her brother Edward to a Wedgewood china shop, she wrote, where they’d perused the wares. Other news was less pleasant: Earlier that day, they’d been to the dentist for an hour of “sharp hasty screams.”

“The poor Girls & their Teeth!” Austen wrote. “Lizzy’s were filed & lamented over again & poor Marianne had two taken out after all.” The dentist—a Mr. Spence, who could have been one of several Spences working as dentists at the time—had even gone after her niece Fanny’s teeth, though they had seemed in decent shape. “Pretty as they are,” Austen recounted, the dentist had “found something to do them, putting in gold & talking gravely.” That didn’t sit right with Austen, who wrote that the tool-happy man “must be a Lover of Teeth & Money & Mischief.” Austen remarked that she “would not have had him look at mine for a shilling a tooth & double it.” Her note, which is going under the hammer at Bonhams on October 23, is an intriguing (if squirm-inducing) dispatch from an era of grisly dental work.

At the time Austen penned the letter, dentistry was still painfully unstandardized. Treatments varied widely, and troublesome teeth were often yanked out by people from all sorts of professions. “In London and large towns, surgeons were available to pull out teeth, but elsewhere, apothecaries, quack tooth-drawers, and even blacksmiths might oblige,” write historians Roy Adkins and Lesley Adkins in Jane Austen’s England: Daily Life in the Georgian and Regency Periods.

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Austen’s reference to filings in the letter “shows the diversity of practice because of the lack of scientific understanding of the causes of decay,” explains Rachel Bairsto, head of museum services at the British Dental Association Museum, in an email. There was a lot of disagreement about whether various interventions would offer the patient relief, or just plunge them deeper into pain. Though filing had historically been used to smooth out uneven teeth, Bairsto adds, some practitioners recommended it as a way to prevent cavities. Others disagreed, arguing that it “made more space to trap food.” In any event, Bairsto writes, “overzealous filing could make the teeth more sensitive.”

Even where tooth-pullers and oral hygiene tools were available—and it was mostly the wealthy who could access them—they weren’t necessarily a good idea. “Early toothbrushes with their horsehair bristles often caused more problems than they prevented,” writes medical historian Lindsey Fitzharris in The Guardian. “Toothpastes or powders made from pulverised charcoal, chalk, brick or salt were more harmful than helpful.” Eighteenth- and 19-century animal-hair bristles were breeding grounds for bacteria, which could make any existing mouth trouble even gnarlier.

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Though holes in teeth were sometimes patched, fillings “were not commonly practiced, as they were expensive and often didn’t last long,” Bairsto writes. Extraction was the more common, and decidedly miserable, route. An extraction was often accomplished with the help of a dental key (also called a tooth key), which Bairsto describes as “rather a fearsome-looking instrument.” It’s a nightmarish claw-and-rod contraption, and it would have been wielded without anesthetic. Bleeding and infection often followed.

Once the infected incisors or meddlesome molars were out, they would sometimes be replaced with dentures, which could be made from walrus or hippo ivory, porcelain, or teeth removed from other unfortunate people, living or dead. (When the Battle of Waterloo felled thousands of soldiers, “clients back in England were happy to wear dentures made from the teeth of fit young men killed in battle, which became known as ‘Waterloo teeth,’ or, more coyly, ‘Waterloo ivory,’” Adkins and Adkins note.) Dentures weren’t without their drawbacks, Bairsto writes: They had a tendency to stink and rot in the mouth, “and the use of a fan was required to waft the stench.”

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By the middle of the 19th century, the world’s first dental school had opened in Baltimore, Maryland, reported, and across the pond, Queen Victoria had helped make it fashionable to own a personal set of dental tools. Her scalers—tools used to scrape off gunk—were outfitted with mother-of-pearl handles and gold detailing. That was of no help to Austen.

Because oral hygiene was expensive, Bairsto writes, “it is unclear” whether the Austens routinely used toothbrushes. For the most part, writes historian and Austen biographer Lucy Worsley in Jane Austen at Home, “Jane and her family simply had to put up with the small aches and ailments of life.” Even so, references to dentistry—and the anxiety that a visit to a dentist might incite—appear in some of the writer’s fiction. In Emma, Harriet has “a tooth amiss,” and is reported to appear a bit “out of spirits.” That’s “perfectly natural,” readers are told, “as there was a dentist to be consulted.” In Austen’s realm, even fictional characters knew that a visit to a dentist could sour an afternoon.

Janeites are a devoted bunch—the sight of her writing table, at the Jane Austen’s House Museum in Chawton, England, often prompts rapt reverence, or even tears—and the letter is likely to be catnip for her most enthusiastic reader-disciples. (Bonhams expects the letter to sell for somewhere between $80,000 and $120,000.) For everyone else, it’s a macabre memento from a time when the sharp end of a dentist’s tool was a place you really, truly did not want to be.

This content was originally published here.

As He Attacks Medicare for All, Mayor Pete Gets Campaign Cash From Health Care Executives

Thirty-seven-year-old South Bend, Indiana mayor and presidential candidate Pete Buttigieg has undergone a dramatic shift in health care policy in less than two years.

Responding to criticism of his vague health care policies in early 2018, Buttigieg “declared” on Twitter that, “Most affirmatively and indubitably, unto the ages…I do favor Medicare for All.”

Later, as he entered the Democratic presidential primary, he landed on a kind of compromise: a single-player option he likes to call “Medicare for All Who Want It” that lets him show support for those frustrated by the high costs and substandard results of the American health care system while preserving the profit-driven forces that have contributed to that system.

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Now, as he continues to promote his plan, which critics call “Medicare for Some,” he’s taken an antagonistic approach to true Medicare for All, as proposed in the Medicare for All Act, and to his opponents who support it: Sen. Bernie Sanders (D-Vt.), who “wrote the damn bill,” and frontrunner Sen. Elizabeth Warren (D-Mass.), who is cosponsoring and continues to support it.

In a new digital video ad from Buttigieg’s campaign, corporate consultant and former Facebook executive Joe Lockhart says, “Bernie Sanders and Elizabeth Warren believe that we have to force ourselves into Medicare for All, where private insurance is abolished.” Lockhart cofounded Glover Park Group, a corporate consulting and lobbying firm with current and recent clients in the health sector including ​Boehringer Ingelheim Pharmaceuticals, Horizon Therapeutics, Intuitive Surgical, and Sanofi U.S.

A still from Buttigieg’s recent anti-Medicare for All digital video ad.
Pete for America

Pharmaceutical, health insurance, and hospital industry donors have flocked to Mayor Pete all year. As of mid-2019, he was second only to Donald Trump in overall campaign cash from donors in the health sector. Among Democratic candidates, he was second to former Vice President Joe Biden in terms of pharmaceutical and health insurance donations.

A Sludge review of Buttigieg’s recent third-quarter campaign finance report shows that as he rails against Medicare for All, executives and other managers in the health sector have kept the money flowing.

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Over 100 individuals in leadership, legal, consulting, or financing roles in health sector donated $200 or more to Pete for America between July and September. These donors include pharmaceutical industry leaders such as the chief corporate affairs officer at drugmaker Pfizer, the president of Astex Pharmaceuticals, a state lobbyist for Biogen, a vice president of public policy at Novartis, and the deputy vice president at the nation’s largest pharmaceutical trade association, PhRMA, as well as attorneys for AbbVie, Johnson & Johnson, and Merck.

The donors identified by Sludge gave a total of close to $97,000 to the Buttigieg campaign in the third quarter of 2019. Below are these donors’ employers, occupations, and total amount donated from July through September.

The Buttigieg campaign provided Sludge with the following statement:

Pete has always supported making Medicare (or a similar public health insurance vehicle) available to all Americans in order to achieve universal health care. He consistently describes his health care plan as a pathway to Medicare for All, which is likely why the health insurance industry has attacked his plan. For instance, our campaign website says, “If private insurers are not able to offer something dramatically better, this public plan will create a natural glide-path to Medicare for All.” Simply put, he has the same end goal as some of the other candidates in the race but differs on how to get there. 

Health sector interests including pharmaceutical manufacturers, health insurers, and hospital groups generally oppose Medicare for All, as it would allow the government to negotiate down drug and care costs, cutting into industry profits. Democratic Party political groups have accepted significant amounts of money from lobbyist bundlers who have pharmaceutical and health insurance clients, as Sludge and Maplight have reported.

In July, Sanders created and signed a pledge to reject all contributions over $200 from the PACs, executives, and lobbyists of pharmaceutical and health insurance companies, urging his opponents to join him. Biden, who did not sign it, has, like Buttigieg, reaped the benefits of large donations from industry executives.

According to the Center for Responsive Politics, Buttigieg’s campaign has recieved $1,266,225 from individual donors in the health sector through the third quarter.

Mayor Pete is no stranger to special-interest support. His very first successful political campaign was fueled by lobbyist fundraisers, as the Center for Public Integrity/TYT reported, and as of July 2019, this year’s effort has been led by 94 contribution “bundlers,” or well-connected supporters who raised at least $25,000 in campaign checks for him.


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This content was originally published here.