AN ADDRESS 
BY 
CHARLES S. TOMES, M A., M.R.C.S., L.D.S AN ADDRESS 
DELIVERED AT THE 
COMMENCEMENT EXERCISES 
OF THE 
DENTAL DEPARTMENT 
IN 
HARVARD UNIVERSITY, 
February 12, 1873. 
BY 
CHARLES S. TOMES, M.A., M.R.C.S., L.D.S., 
Fellow of the Royal Medico-Chirurgical and Odontological Societies, Lecturer on 
Dental Anatomy and Physiology, and Assistant Surgeon to the 
Dental Hospital of London. 
PRINTED AT THE OFFICE OF T1IE MISSOURI DENTAL JOURNAL. 
s A'ifcw; jUjawM' 
i«73- ADDRESS. 
Mr. President ami Gentlemen:—The fulfillment of good intentions, 
it is to be feared, is but a rare occurrence in our lives, and I hold 
myself to be exceptionally fortunate in that a long desired project 
has been carried out by this visit to America; and I feel that I owe 
a lasting debt of gratitude to the Dental Faculty of Harvard Uni- 
versity for supplying the stimulus which induced me to break away 
from the trammels of practice, and present myself here. 
For, at the time when the invitation to deliver your commence- 
ment address reached my hands, my project of visiting America had 
not assumed any tangible form, and was in a fair way never to be 
executed; but the compliment thereby proffered was one which I felt 
I could hardly decline, so that I can say, in all sincerity, that I have 
crossed the Atlantic in order to enjoy the honor and the pleasure of 
addressing you here to-day. 
And, whilst this honor, no less than the most cordial reception 
accorded to me, cannot but be a source of life long gratification to 
me individually, there is a satisfaction far transcending any which 
could be afforded by any mere personal compliment, in the fact that 
we recognize in your invitation a pledge of amity and good fellow- 
ship towards my countrymen, of whom I am but the unit that 
chances to be here. And, whilst the welcome received by my friend 
and colleague, Mr. Turner, and myself, has given us a gratification 
which words are inadequate to express, I trust and believe that the 
time is not far distant when our meetings will be an every day mat- 
ter, and I most cordially echo the words of a recent speaker, at 
New York, who hoped that ere long such a reception as that ac- 
corded to us would be altogether out of date; a sentiment which 
you happily express when you term the wide Atlantic “The Ferry.” 
Yet, flattered and happy as I cannot but feel at the circumstances 4 
which attend our meeting in this place, it is with no great confi- 
dence that I approach my task; for, apart from the intrinsic dif- 
ficulty which surrounds the framing of an address, it is but a year 
since you had the good fortune to listen to the words of one whose 
genial humor and happy language are co-extensive with the English 
tongue, and it is indeed no hopeful task to follow on the track over 
which the facile pen of Dr. Oliver Wendell Holmes has passed. 
On that occasion the claims of dental surgery were set forth in 
some detail; but, even though it is to this cause that we owe the 
utterance of Dr. Oliver Wendell Holmes’ address, the very exist- 
ence of claims not yet fully recognized is a thing which the dentist 
neither can, nor ought to, view with complacency. 
Rash indeed would he be who fancied that he could supplement 
that exposition of our claims; but it is left for us to enquire how we 
can get them satisfied, and win for the leaders of our profession that 
homage which is ungrudgingly, and indeed unconsciously, accorded 
by the public to preeminence in other learned professions. And 
there is much left for us to do; we have to convert the dental pro- 
fession into, a body of highly educated men, commanding respect 
alike by their conduct and acquirements, from whose ranks the igno- 
rant and incompetent shall be rigorously excluded. Until we can 
say that it is so, each day that passes by and leaves us associated, 
even though it be but in name, with ignorant charlatans, is a fresh 
reproach to us. Full well may we cry, 
While yet I live to say ‘ This thing ’s to do; ’ 
Sitli I have eause, anil will, and strength, and means, 
To do ’t. ” 
“ I do not know 
So soon as we can point to our profession as being a coherent body 
of men duly qualified by study and tested by examination, our 
claims will need but little urging. 
“None are, for being what they are, in fault, 
But for not being what they would be thought, ” 
might aptly have been spoken of the dental profession, and this lies 
at the root of that lack of appreciation which galls us all so sorely. 5 
Let us make it what we would have it thought—a guarantee of edu- 
cation and acquirement, and we shall have little left to complain of. 
Such an elevation of the dental profession as that for which we 
are striving is only to be effected by unanimity; such an unanimity 
as is, I venture to hope, foreshadowed by the fact that I, an alien, 
have been invited to address you here on the occasion of your for- 
mal admission to the ranks of that profession. 
And in the firm belief that each year will knit us more closely 
together in the bonds of fellow feeling, I will endeavor to enlist 
your sympathies with your European brethren ; and I do not know 
that I can better embody the position of dental surgery in England 
than by giving a brief account of our diploma and its establishment. 
Before a student can present himself for examination, he must 
have been engaged for four years in the acquirement of professional 
knowledge—the first two years of this time being usually spent in 
the laboratory and operating room of some established dentist, and 
the last two in attendance upon hospital practice. The dental prac- 
tice and special courses of dental lectures at some recognized dental 
hospital, and the anatomical and surgical instruction at some gen- 
eral hospital, must be attended during the same period of two years. 
Hence, it happens that our students for the most part attach them- 
selves to two hospitals, generally selecting for their anatomical and 
surgical studies those general hospitals which are situated nearest to 
the dental hospital, and in passing through these courses become 
associated with the students who intend to practice medicine and 
surgery. And I am proud to be able to say that the anatomical and 
surgical prizes at some of our leading medical schools have been 
carried off by students of the dental hospital, and that, after a tol- 
erably extensive experience of medical students, I find that our den- 
tal students contrast very favorably with the others, both in re- 
spect to diligence and ability—an experience which is fully borne 
out by that of our medical teachers. 
At the completion of the term of study comes an examination, 
conducted, partly by written papers, and partly viva voce, before a 
board of examiners, consisting of three surgeons and three dentists, 6 
the student being examined by the surgical section of the board in 
anatomy and surgery, and by the dental section in the matters more 
strictly appertaining to our specialty. 
Thus, both in the course of study and the final examination, the 
fact that dentistry is a branch of surgery, is kept prominently in 
view; and not only is the future dentist associated with students of 
medicine during his studies, but his examination is conducted and 
his diploma conferred by the Royal College of Surgeons—a body of 
the highest standing—which takes no part in medical education 
beyond prescribing what the curriculum shall be; and I am inclined 
to attach some importance to this complete independence of the 
examining body. 
In England there is but one dental diploma, and this is not con- 
ferred by any of our Universities; to Harvard, then, be all honor, 
as the first to institute a dental department, and thus to assume the 
true function of a university, as a pioneer in education and a pro- 
moter of knowledge—putting to shame our old Universities of 
Oxford and Cambridge, where natural science has but just fought its 
way to a tardy recognition, and the study of medicine languishes 
beneath a cold neglect. 
After the qualification has been obtained, its holder very generally 
makes his entry into private practice by becoming an assistant to, 
or partner with, some older practitioner; but should he elect to 
establish a practice for himself, the chief source of patients will be 
the recommendations of those medical men who have formed a 
favorable opinion of his diligence and abilities during his student 
days. 
It may, perhaps, interest you to hear of some few points in which 
our manner of conducting practice differs from that pursued in 
America, and I do not think I shall find a more favorable moment 
for speaking of it than the present. 
In the earlier part of the present century, dental, and indeed all 
medical, practice, was conducted with no small amount of ceremony 
and formality, it being usual for the dentist to dress himself in even- 
ing costume. It was, moreover, held to be essential that the rela- 7 
tions between the dentist and his patient should be of a confidential 
character, and so far was this carried that it was considered unde- 
sirable to show more than one patient into the same waiting room, 
so that it would sometimes happen that every room in the dentist’s 
house would be thus occupied, and his family driven up, step by step, 
into the attics. 
Such extreme formality and secrecy as existed fifty years ago has 
of course passed away, but not without leaving its mark upon the 
conduct of our practice, and there are many of our patients who 
object to the presence of an assistant, and some who much prefer even 
their own friends to be absent from the room ; and I do not think that 
English patients would tolerate the free communication between the 
waiting room and the operating room, which I find so usual in 
America. Another point of difference, in which also we are tram- 
meled by traditional usage, is that of fees. In days of yore, when, 
as Dr. Oliver Wendell Holmes most aptly expressed it “traffic and 
agriculture were scorned by the descendants of the Norman rob- 
bers,” it was considered derogatory to receive payment for any 
service rendered, so that the bestowal of the honorarium was done 
more or less privily; and a relic of this feeling survives in the fact 
that physicians, formerly regarded as the undoubted chiefs of the 
medical profession, are to this day, of their own free will, unable to 
recover their fees in a court of law. 
English patients commonly offer a fee of one guinea, without 
asking any questions, for each operation, and the existence of 
the diffidence on the question of fees, to which I have just alluded, 
renders it distasteful, and to many of us practically impossible, 
to enter into any discussion upon the subject, and to appraise the 
value of our own services. Thus it by no means uncommonly hap- 
pens that an inadequate fee is accepted, rather than face the un- 
pleasantness of discussing such a topic with the patient, and this 
uniform fee cannot but discourage the operator from performing very 
protracted operations, which are consequently less frequently per- 
formed in England than in this country. A change is, however, 
being gradually effected in this matter, and as systematized dental 8 
education increases every year the number of skilled operators, 
doubtless the fees will become more strictly proportioned to the time 
and labor expended. But in effecting such a change, as indeed in 
everything else, we are hampered by the existence of a large body 
of unqualified men, styling themselves dentists, and we unfortunately 
are not as yet able to obtain any legislative interference to prevent 
such from practicing. 
Indeed, in this respect we are behind America, for I learn that you 
are able in this country, at least in certain States, to obtain the in- 
fliction of a fine upon those who profess the possession of diplomas 
which they have never obtained, while in England we are still 
utterly powerless in this matter. 
And what is still more to be regretted, there are some few capable 
and respectable pratictioners who do not hold any diploma at all, 
though I fancy that their number is greatly overestimated. To 
explain how this has happened, it will be necessary to briefly sketch 
the history of the establishment of the diploma. 
Before the year 1859, no degree in dental surgery had been estab- 
lished in England, so that our dentists were either fully qualified 
surgeons, or held no qualification at all. 
As must always be the case on the introduction of any important 
measure, a considerable amount of fierce opposition was raised up, 
both in the ranks of the dental profession, and, to a less extent, 
in those of the medical profession ; one of the features of the scheme, 
most violently opposed by the dentists being the close association of 
dentistry with surgery, both in the curriculum and in the examina- 
tion. 
The result of this opposition was the formation of the self-styled 
College of Dentists, which undertook the work of education and 
the granting of degrees; and, although few dentists of influence and 
position were ranged upon its side, and those few became speedily 
converts to the views represented by the Odontological Society, it 
survived long enough to do a great deal of harm. For, when our 
diploma was first instituted, the College of Surgeons granted a period 
of grace, during which those already in practice would be allowed 9 
to offer themselves for examination without passing through the pre- 
scribed curriculum; and, as a large number of the profession were 
at first opposed to the whole movement, this period of grace was 
allowed to elapse by a certain number, even of well-informed and 
respectable practitioners, without offering themselves for examination. 
Of course, it is impossible for them now to leave their practices and 
go through the necessary course of studies, so that they are, by their 
own original mistake, excluded from the status of recognized mem- 
bers of the profession. Now, however, that the success of the degree 
is an established fact, they have petitioned the College of Surgeons 
to open its gates to them once more, and although they have no one 
but themselves to thank for the position in which they find them- 
selves, yet inasmuch as the regeneration of dentistry is not a 
thing to be done in a day, and the more we can enroll on the side 
of culture and education the stronger our cause will be, I think that 
their petition might be advantageously granted. 
The dentists of England may be divided into three classes : those 
who, in addition to the dental diploma, hold other surgical or 
medical degrees; those who hold the dental diploma only, and lastly, 
those who, possessing no qualification, have no recognisable status, 
no matter what their personal qualities may be. As I have already 
said, among these latter are some few who are worthy of every 
respect, although, by their neglect to avail themselves of the oppor- 
tunity when it existed, they cannot claim any public recognition as 
members of a learned profession. 
We may rest assured that, in the long run, that class of practi- 
tioners who best fulfil their duties will thrive, to the exclusion of 
the incompetent, and therefore that, given sufficient time, the quali- 
fied men will become numerous enough to satisfy the requirements 
of the community. For the operation of that great truth, known as 
the law of survival of the fittest, a law which is at work as much in 
slowly improving political and social organizations as in modifying 
and bringing into fitness the forms of animals, will, sooner or later, 
bring about this result. But the unaided action of the laws of nature 
is as slow as it is sure, and it daily falls within the province of man’s 10 
intelligence to step in and hurry on, in its details at least, that slow 
course of improvement which we term civilization. 
“If we stand still 
In fear, our motives will be mocked or carped at— 
We shall take root here where we sit;” 
Rather let us examine by what course we may obtain the end which 
we desire—the elevation of the dental profession. 
Eventually, of course, our object is to obtain legislative interfer- 
ence, preventing those who hold no diploma from practising dental 
surgery, but the question before us is, has the time arrived for this? 
Dental surgery is an eminently modern development; its past is 
all but a tabula rasa, and it may fairly be said to be a handmaid of 
an advanced civilization; for the time of the dental surgeon is 
mainly devoted to combating the effects, direct or remote, of dental 
caries, and this is a disease which, all over the globe, and in every 
epoch of time, spares the savage and seizes upon civilized man. 
And it is the opinion of many most competent observers that the 
ravages of dental caries have greatly increased within the last century, 
so that it is even supposed that a distinct average deterioration may 
be traced even in the lapse of a single generation. Thus it is that 
the demand for dentists has in a degree been sudden—too sudden 
for the want to be supplied by men thoroughly suited to the work— 
so that their place has been taken, to a large extent, by mere charla- 
tans, and the dental profession has hardly had time, nor, indeed, 
has it possessed sufficient coherence in itself, to shake itself free from 
such discreditable associates. So soon as we can confidently assert 
that there are a sufficient number of duly educated and certificated 
dentists to meet the requirements of the community, the sooner we 
urge the necessity of legislative interference the better; but prema- 
ture action must lead to a failure, which would long bar the road to 
further progress. Whether the time has arrived here in America for 
vigorous action I cannot tell, but I fear that in England we are 
hardly ripe for such a course, for the number of dentists holding 
diplomas is not yet adequate to meet the necessities of our popula- 
tion; and this fact is a strong argument for once more admitting, 11 
without enforcing the curriculum, those established dentists who wish 
to offer themselves for examination. And even when the number of 
those holding dental diplomas is adequate to the population of the 
country, we shall have some difficulties to contend with, for there 
are not wanting those among our Statesmen who hold so tenaciously 
to the maxim “ caveat emptor," that, for example, they regard the 
prosecution of tradesmen for using false weights, as an act of unde- 
sirable interference on the part of a government. 
If, then, the time for restrictive legislation has not yet arrived, what 
is there for us at the present day to do ? First, let us labor might and 
main at the cause of dental education, so as to render every dentist 
a man of such culture that he may command respect; for education 
is our most potent weapon. 
“That there should one man die ignorant who had capacity for 
knowledge, this I call a tragedy,” wrote Carlyle, and his pregnant 
words might well be applied to our own case; let us then wage war 
upon ignorance, in the full confidence that thus the cause of dental 
surgery will be best advanced. And, besides this, we must cultivate 
fellow feeling toward our professional brethren, so that there may 
be that unity without which no important step can be taken with 
any hope of success. 
And now a few words specially addressed to those who have grad- 
uated to-day, and thus passed from the irresponsible period of pupil- 
age into the onerous duties of professional life. 
Your first feeling on entering upon private practice, will possibly 
be one of disappointment that the public do not sufficiently appre- 
ciate the value of the services which you render—“ they use us, yet 
they love us not ”—and they underrate the difficulties of those oper- 
tions which you have, with much toil, learnt to perform; but this 
will be less disheartening when you reflect that this is really due to 
the exceedingly rapid advance of dental science, an advance so rapid 
that it has shot forward beyond the public ken, a state of things 
which we can in part correct by explaining to our patients what we 
can, and what we cannot, effect. Remember that true self-respect is the first and last step toward 
gaining the esteem of our neighbors, and it is a thing within the 
grasp of each one of us; right proudly may he hold himself, whose 
maxim is “whatsoever thy right hand findeth to do, do it with thy 
might.” 
The constant aim of each one of you must be to excel as a prac- 
titioner, and thus to compel the gratitude of your patients; and 
there is no duty so apparently trivial that it is not dignified by the 
strenuous endeavor to perform it excellently well; be “enamoured 
of intensity,” and you will meet with a true satisfaction, the more 
that another has been benefitted by your exertions. 
We are met together to-day to celebrate your formal admission 
into the ranks of the dental profession. From this hour your 
interests and endeavors are enlisted upon the side of education and 
progress, and the task before you is the elevation of that profession. 
Its advancement I hold very dearly at heart, and in this address I 
have borne in mind the maxim, “ If there is anything in which you 
yourself feel interest, in that, or in nothing, hope to interest others; ” 
and though I have failed to find language appropriate to the expres- 
sion of my own feelings, I trust that there are many among my 
audience who will succeed better, not merely in talking, but also in 
carrying out the work of substantial progress. It does not fall to 
our lot to come prominently before the public ; our names will never 
be the theme of popular adulation ; but none the less can we lead 
lives of substantial usefulness, dignified by earnest inquiry, and 
striving after improvement. Let him who is at the outset dis- 
heartened and impatient, turn for comfort to the lives of the great 
ones of this earth, and he will find it in the words of your own 
poet: 
12 
Lives of great men all remind ns. 
We can make our lives sublime; 
And, departing, leave behind us 
Footprints on the sands of time. 
Let us, then, be up and doing. 
With a heart for any fate. 
Still achieving, still pursuing. 
Learn to labor and to wait. HARVARD UNIVERSITY. 
DENTAL DEPARTMENT. 
BOSTON, MASS. 
FACULTY. 
CHARLES WILLIAM ELIOT, LL.D. 
PRESIDENT. 
Oliver W. Holmes, M.D., Professor of Anatomy. 
Henry J. Bigelow, M.I)., Professor of Surgery and Clinical Surgery. 
Thomas II. Chandler, D.M.D., Professor of Mechanical Dentistry. 
Thomas B. Hitchcock. M.I)'., D.M.D., Prof, of Dental Pathology and Therapeutics. 
George T. Moffatt, M.I)., D.M.D., Professor of Operative Dentistry. 
Nathaniel W. Hawes, Assistant Professor of Operative Dentistry. 
Luther I). Shepard, D.D.S., Adjunct Professor of Operative Dentistry. 
Edward S. Wood, M.D , Assistant Professor of Chemistry. 
Henry P. BowditciI, M.D., Assistant Professor of Physiology. 
Edward A. Bogue, M.I)., University Lecturer on Dental Pathology and Therapeutics. 
Ira A. Salmon, D.D.S., University Lecturer on Operative Dentistry. 
Samuel F. Ham, D.M.D.. Demonstrator of Mechanical Dentistry. 
Charles B. Porter, M.I)., Demonstrator of Practical Anatomy. 
Charles Wilson, I).M.D., Demonstrator in Charge. ■ 
This School offers to its students unusual facilities for instruction in every department 
pertaining to the Dental Specialty. Instruction is given by lectures, recitations, and 
clinics; and, under the direction of demonstrators, patients are assigned to the students, 
who thus have an opportunity for operating at the chair, and becoming familiar, by actual 
practice, with all operations demanded of the dental practitioner. 
The Regular Session will begin on the last Thursday in September, and continue 
nineteen weeks. 
The Summer Course of Study and Practical Exercises is designed as an equivalent, en- 
tirely or in part, to pupilage with private preceptors. It commences upon the close of the 
Winter Session, and continues till the 2dtl) of June. 
The Demonstrator is present in the Infirmary and laboratory daily throughout the 
year. 
For further information, address 
THOS. B. HITCHCOCK, M.D., D.M.D., Dean, 
222 Tremont Street, Boston, Mass.