Apart from what has been mentioned, Ætius does not tell us, in regard to dental diseases, anything worthy of note, and in many places he only repeats Galen’s observations. PAUL OF ÆGINA (seventh century) establishes a very clear distinction between epulis and parulis. The epulis is a fleshy excrescence of the gums in the neighborhood of a tooth; the parulis is an abscess of the gums. To cure the former affection it is necessary, says the author, to seize and stretch the tumor with a vulsella or with a hook and to perform its excision. As to the parulis, although not unfrequently it is sufficient, for curing it, to give an exit to the pus by means of a slight incision, the author, however, usually prefers the method of cure recommended by Ætius, viz., excision. After such operations he orders the patient to rinse his mouth with wine and on the morrow with hydromel.[196] From the third day onward he sprinkles the wound with a cicatrizing powder, until a complete cure is obtained. But if the wound, instead of healing, be transformed into a putrid ulcer resisting all the ordinary means of cure, it is necessary to cauterize the part affected with an oval-shaped cautery.[197] In extracting a tooth, the operation is begun by detaching the gum all around it as far as the alveolar border; then the tooth is seized with the forceps, shaken loose, and drawn out. Paul of Ægina, like Celsus, recommends that before extracting a tooth deeply attacked by caries, the cavity be filled up with lint, in order to avoid the crumbling of the tooth under the pressure of the instrument. On the other hand, he too is convinced that a diseased tooth can be made to fall out without pain, by the use of suitable remedies. When supernumerary teeth cause an irregularity of the dental arches, this must be corrected, says the author, either by resection of such teeth, if they are very firm, or by their extraction. If a tooth projects above the level of the others, the protruding part must be removed with the file. This instrument must also be employed to remove the sharp edges of broken teeth. Tartar incrustations must be removed either with scrapers or by means of a small file.[198] During the period of dentition one must not give children any food which requires mastication, and to soften the gums they must be anointed with hen’s fat or with hare’s brain.[199] To preserve the teeth and to keep them healthy, Paul of Ægina recommends all tainted food to be avoided, and also all possibility of indigestion and frequent vomitings; the use of very hard or glutinous food or of such as may easily leave a residuum between the teeth, for example, dried figs, and likewise very cold food and such as set the teeth on edge. He also advises that hard things should never be broken with the teeth and that the latter be carefully cleaned, especially after the last meal of the day.[200]