Pelicans
Pelicans are instruments for extracting teeth and it is generally accepted that they are so named because of the similarity of the claw to the beak of a bird although it appears in different shapes and with variable features. It was used to remove a tooth from the row sideways and with considerable force. The claw went over the tooth and the bolster pressed against the vestibular alveolar bone. To function well two strong and healthy teeth were needed for the bolster to react against. If the tooth to be extracted was more firmly fixed in the bone than the teeth behind the bolster it is not hard to imagine which teeth were actually forced out. There is no doubt that a lot of damage was done by the pelican. Johann Jacob Joseph Serre, dentist to the King of Prussia, did not think well of the pelican: „The pelican is gover-ned by the whole power of the fist and arm. Briefly it is an awkward instrument. The authors do not show how it is to be used and clearly if the neighbouring teeth are missing it can't be applied." (Praktische Darstellung aller Operationen derZahnarzneykunst, Berlin 1804). Benjamin Bell gave illustrations of two pelicans in his „System of Surgery" (1782), but also did not think well of them since he saw no advantage over the tooth key. Justus Christian Loder (1753-1832), who taught Goethe anatomy, tested all his instruments on dead bodies and had also a pooropinion on pelicans.
Pierre Fauchard had to say "„There are some cutlers who want to get into market for tooth extraction instruments. They want to try out the instruments they have created. But if they don't want to frighten their patients they must hide their instruments." He knew what he was talking about, because his illustrations show coarse and bulky pelicans compared to earlier modeis. They were "manufactured in a manner never seen before."
Pelicans can be divided into four main groups:
- Pelicans with one shaft and one bolster
- Pelicans with two shafts and two bolsters. Both types can have one or two claws to fit dif-ferent sizes of teeth.
- Pelicans with endless screws.
- The „Überwurf"- or overshot-type. Additional to the basic types are special pelicans and types transitional between pelicans and keys and pelicans and forceps.
The first reference to the pelican is probably in the work of Guy de Chauliac (1363). The first drawing of a pelican is in the Venetian edition of Arcoli (1460). Early examples have a straight shaft and a single claw fixed by the rivet to the shaft. The iron bolster is deeply notched and wrapped in leather, linen or other material to minimize damage to the gingival tissue. Nearly one hundred years later pelicans of a similar shape are seen in illustration by Ferrara (1625) and Scultetus (1653), but they are more ornate.
A pelican of this type is also illustrated in Bücking (1782). It has a longer handle and one claw shorter than the other. This type of pelican was manufactured from the sixteenth to the nineteenth Century.The main differences are in the shape of the shafts of the bolster and claws. In the eighteenth Century examples appeared with rounded, ornate shafts of ivory, silver and different woods. The simple type, however, also remained in use.
It is not known when the term pelican was first used. John Woodall mentioned in „The Surgeon's Mate" (1617) the use of a "pullican" in the extraction of teeth. One could imagine an alternative origin of the word if „pullican" comes from the verb to pull. Charles Allen used the word „polican" in his „The Operator for the Teeth" (Dublin, 1686). The use of the „polican" is described as follows: „Your polican being thus made, if you have a mind to use it, you must so apply the claw to the inside of the tooth you intend to pull out, that its branch may stand exactly upon the middle of the said tooth, gently leaning your bolster upon the next to it, the better to take your measures; and then draw then tooth out. But take heed you do not draw obliquely, but in the direct line from the tooth outwardly; for in drawing laterally, you might chance so to force the tooth to be drawn, upon the next to it that you would draw them both together, or at least loosen very much of the sound one, and put a far greater force upon the other in drawing it, than is necessary. Which would occasion and infinitely greater to the patient, than if you had done it rightly. Thus much have I thought fit to teil you concerning the nature and use of the polican; which if you observe punctually, you never fear the drawing well ofany tooth."
There are two main differences between the pelican and the "Überwurf" (overshot-type). The "Überwurf" does not have the broad bolster and thus does not press on the neighbouring tooth when in use. The earliest example was illustrated in Ryff (1545). The shaft of the claw is bent through an obtuse angle and the claw itself is curved. It is also illustrated in Pare (1564), Ferrara (1627), Scultetus (1653), Heister (1719), Fauchard (1728), Leber (1717), Perret (1772), Brambilla (1782), Knaur (1796), Laforgue (1802), Serre (1803) and others. The instrument with the end of the bolster bent away from the claw illustrated in Perret 1772, Brambilla's "Instrumentarum Chirurgicum Viennense" (1782) and in Knaur's „Selectus Instrumentorum chirurgicorum" (1796) was named „tire-toir" or „tirtoir". The first to use the term „Überwurf" was Ludwig Cron in 1717. The „Überwurf" applies the most force of all extracting 'Instruments. An unexperienced user could do great damage with it. For this rea-son this instrument was either praised or con-demned by different practitioners.To reduce the risk of damage it was generally agreed, that it should not be used for molar extraction. In such cases the tooth key would have been the instrument ofchoice. With a key the tooth could easily bebroken, with the „Überwurf", however, there was considerable risk of brea-king the bone. There was very divided opinion among practitioners. Each had his own special methods. Qne's own creations and develop-ments were praised and those of other practitioners rejected or described as unnecessary. For example Franz Nessel reports: „One day I was in a small country town and was asked if I cpuld extractteeth. I did not have my own instruments and requested a tool from the local surgeon. I received hisfavourite instrument, an „Überwurf" with a lot of rust on it, which I remo-ved with as knife. I had also to oil the screw to get it to move and to extend the claw. Additionally there was a lot of blood on it and I got the impression that the surgeon attached no importance to having a clean instrument or to having the claw extend." (Compendium der Zahnheilkunde, Vienna 1856). In the 19th Century the pelican feil out of favour as an extraction instrument. The last were manufactured about 1860 by Charriere and Colin.
Pelicans
