From antiquity, individuals, tribes, and cultures have sought the abilities of singular individuals to try to heal them or to help them to endure the onslaughts of disease. For thousands of years before recorded history, these services were provided by the medicine man or shaman of the tribe, whose secret treatments were passed from generation to generation by the apprenticeship methods of teaching. For the most part, their therapies were at best palliative and their effects were placebo and psychological in nature. Reliable written records of healing practices began with the ancient Greek civilization about 400 years before Christ. The written recording of rational therapies and practices established the "physician" as one of the premier occupations (or "professions") of ancient Greek society. About 160 years after Christ, the Greek physician Galen began the practice of examining the post-mortem anatomy of various animals and extrapolating his findings in an attempt to understand the structure of the human body. This was the first well-recorded and documented effort in what we, today, would term "biomedical research". While Galen's efforts and written production were massive, his impact on medical practices beyond Greece was minimal due, at least partially, to the lack of mass printing and distribution methods. Ironically, at almost the same time that Galen's complete works were published, Andreas Vesalius of Brussels published the most startling and exquisite book in the history of medicine. Vesalius' De Humani Corporporis Fabrica (1543)2 was a lavish and beautiful exposition of human anatomy. This event, for all intents and purposes, formalized the separation of the science of medicine from its art. We suggest that this event established the division of medicine into two historical streams--the "healers" and the "scientists" (or Streams "H" and "S"). However, even to the present, the biomedical scientists remain dependent on the established institutions of the healers for their very existence and continuity. Very early the dental healers developed as a distinctly separate branch of the H Stream, due to the efficacy and directness of the therapy of tooth extraction and the need for mechanical aptitude for its execution. This was exemplified in the long and successful history of the barber-surgeons, or their earlier equivalents, as therapists in every society on Earth, including the U.S., up to nearly the turn of the 20th century.(ABSTRACT TRUNCATED AT 400 WORDS)

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A retrospective study was conducted of 620 patients in a periodontal practice over the years 1960 to 1982. Various periodontal therapies were assessed by using careful office protocols, meticulous record-keeping and well-defined outcome criteria. Four treatment outcome categories were used: two representing satisfactory outcomes (referred to as "STABLE"), and two unsatisfactory outcomes ("UNSTABLE"). The percentages of patients in the STABLE categories following different therapies were: (1) nonsurgical treatment, 63.6%; (2) closed curettage, 73.1%; (3) open curettage, 95.0%; (4) modified Widman flap, 91.6%; (5) full flap and osseous surgery, 71.1%. The major conclusions were that the modified Widman flap and open curettage were more effective than flap and osseous surgery, and much more effective than closed curettage when it was employed as an alternative treatment (54.8% STABLE) to the osseous surgery (71.1% STABLE). Thus, moderate surgical therapies appear to be at least as effective as ostectomy procedures in the treatment of periodontal disease, while nonsurgical and closed curettage therapies appear to be less effective.

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