The general’s toothache

IN July of last year a rather exquisite automobile came up for auction at Bonhams. A 1913 Rolls-Royce ‘Silver Ghost’ London-to-Edinburgh Tourer – in mint condition – sold for £718,300.

Apart from its rarity, what also made this car special was a well-deserved footnote in World War One history – and most particularly in the eventual establishment of the Royal Army Dental Corps (RADC).

The Silver Ghost was first owned by a wealthy Londoner but later sold in October 1915 to Charles Auguste Valadier, a flamboyant dental surgeon working in Paris. Valadier was born in the city in 1873 but was taken as a boy to live in America where he became a naturalised citizen. Later he attended Philadelphia Dental College and qualified DDS in 1901. He practised in New York City for a number of years before returning to Paris in 1910 to study at the Ecole Odontotechnique de Paris and earned the certificate of Chirurgien Dentiste from the Faculty of Medicine of Paris University. Soon he was married and settled and operating a successful dental practice.

At the outbreak of war in 1914 Valadier was keen to offer his skills as a dental surgeon to the French army but was rejected, not being a national. So he approached the British Red Cross Society in Paris who accepted his services and sent him to the town of Abbeville on the River Somme near the front. Here the tale takes a curious turn.

The army that bites

In August of that year, after the declaration of war, the British Expeditionary Force (BEF) landed in France eager to fight. Sailing across the English Channel with the BEF were elements of the Royal Army Medical Corps but not a single dental surgeon. This is curious considering the British Army’s experiences in the Boer War when over 2,000 soldiers had to be evacuated back to the UK on dental grounds and almost 5,000 declared unfit for duty due to a lack of dentures. The old adage being: “an army that cannot bite, cannot fight”.

The state of general dental health in 1914 Britain had much improved over the previous century but it was estimated that at the time over 70 per cent of British recruits were in need of dental treatment. It was inevitable that many soldiers in the field would suffer from a variety of dental ailments – and not just infantry men in the trenches but also officers. So it happened that in October 1914 General Douglas Haig was said to have developed a severe toothache while commanding First Corps of the BEF around the time of the First Battle of Ypres. Finding that there was no dentist available in the British Army to offer treatment, word was sent to Paris to summon a French dentist.

That dentist is thought to have been none other than Charles Valadier. Later that same month he was formally accepted for duty with the BEF making him the first dental surgeon to provide treatment officially for British troops serving in France. It’s also perhaps no coincidence that in the November after General Haig suffered his toothache, 12 dental surgeons arrived in France from the War Office having been given temporary commissions with the Royal Army Medical Corps. And this was only the beginning. The importance of having an army that bites had again been recognised. Numbers gradually increased to 463 in December 1916 and then year-on-year until a total of 849 dentists were serving at the time of the Armistice in 1918.

Glittering spurs

Early in 1915 a young British ENT surgeon with the RAMC named Harold Delf Gillies was sent to France to work with Valadier who had organised a new medical unit to help treat the growing number of soldiers suffering serious facial trauma. Medicine had never before seen traumatic injury on such a scale. Trench warfare and the use of massive artillery bombardment exposed the head and face to horrific injuries from gunshot wounds and shrapnel. This forced pioneering advances in plastic and reconstructive surgery and Valadier and Gillies were among surgeons at the forefront.

Gillies later wrote of his first encounter with Valadier and the famous 1913 Silver Ghost: “In Boulogne there was a great fat man with sandy hair and a florid face, who had equipped his Rolls-Royce with dental chair, drills and the necessary heavy metals. The name of this man whose high brown riding boots carried equal polish to the glitter of his spurs was Charles Valadier. He toured about until he had filled with gold all the remaining teeth in British GHQ. With Generals strapped in his chair, he convinced them of the need of a plastic and jaw unit, and one was set up nearby in the lovely little town of Wimereux. I was invited by Valadier to accompany him to assist in his initial incision.”

Certainly this must be one of the first examples of a motorised mobile dental unit. Later in 1916 the first fully equipped mobile dental laboratory was kitted out in a modified ambulance and deployed by the army in France. This meant that soldiers could be treated in the field without having to be returned to a casualty clearing station. Eventually each of the five armies in France had similar mobile units.

Valadier ran the facial trauma unit in Boulonge over the course of the war. British authorities gave him a free hand at first and he equipped the unit largely at his own expense employing technicians in Paris to construct the dental appliances needed in treating jaw fractures.

Many of his ideas later proved surgically sound, according to dental surgeon and historian J E McAuley. Valadier recognised the importance of closing facial wounds as soon as possible to avoid retraction in lacerated flaps. To combat infection – a major cause of mortality in WWI – he devised a mobile apparatus for irrigating wounds that was pressured by a bicycle pump and known on the wards as the “fire engine”. In 1917 he published a report on his methods based on the treatment of more than 1,000 cases.

Towards the end of the war Valadier’s surgical activities were curtailed – given his “lesser professional status” – and the unit at Wimereux became more a clearing station with complicated cases being transferred to a unit run by Gillies at Queen Mary’s Hospital in Sidcup. Another ENT surgeon performed emergency procedures with Valadier assisting. The French-American seemed to alienate quite a few of his contemporaries. Just after Armistice the unit was closed down and Valadier left to salvage his own equipment.

Postscript

Valadier was later recognised by Britain for his contributions to the war effort and after being granted a certificate of naturalisation he was awarded a knighthood in 1921. He returned to his successful Paris practice and lived extravagantly, indulging a weakness for gambling. Later he developed a blood disease, possibly leukaemia, and had to retire from practice – though the gambling continued and he died impoverished in 1931.

One legacy that Valadier can claim a part of was the recognition of the serious wastage of fit soldiers through lack of proper dental care as highlighted during World War One. This led to the formation of the Army Dental Corps in January 1921. It was later granted the Royal prefix in 1946 and the RADC today is responsible for the maintenance of dental health among personnel serving throughout the world.

What about the Silver Ghost? Valadier sold the automobile after the war and towards the end of the 1920s it was converted into a breakdown vehicle, complete with jib crane at the rear. It continued in use as a recovery vehicle until around 1948 when the magneto burnt out. Fortunately it was bought and carefully restored in the 1960s and ended up in private ownership – later being rallied extensively throughout Britain and Europe in subsequent years.

May it last another hundred.

Jim Killgore is editor of Summons

Main sources

• McAuley J E. Charles Valadier:A Forgotten Pioneer in the Treatment of Jaw Injuries. Proc. Royal Society of Medicine. Volume 67 August 1974
• Dentistry During WW1. http://www.vlib.us/medical/dentistry.htm
• Palmer P J. Haig’s toothache - Dentistry in the BEF 1914- 18. The Western Front Association. 2009. http://tinyurl.com/n9ep8hz
• RADC History. Army Medical Services Museum. http://www.ams-museum.org.uk/museum/history/radc-history/