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“Pippin: A Pioneer” by E. S. Khalifah, 1945

Elias S. Khalifah

The following article, published in the May 1945 issue of the Washington University Dental Journal, was written by Elias Salim Khalifah (1904-1963).  Khalifah, an associate professor of Dental History and Clinical Dental Medicine, served as editor of the Dental Journal from 1945 to 1954.  The article was “written at the request of the Editorial Board of Washington University Dental Journal, on the occasion of Bland N. Pippin’s retirement after forty-three years of conscientious service to Washington University in the field of dental education.”

E. S. Khalifah

PIPPIN: A PIONEER
by E. S. KHALIFAH

For the past three years many friends of Bland Nixon Pippin deemed it appropriate to compile the story of his fidelity to dentistry.  He has repeatedly avoided giving the details of this narrative or permission to print it.  Fortunately, the recent request of the Editorial Board of this Journal was favorably received.

It is the opinion of many that he was misunderstood and criticized for his beliefs and actions.  In this fair land of freedom and tolerance, it is meet and proper that his devotion and loyalty to dentistry should no longer go unrecorded.

Glad as I am to write this dramatic story, I feel unequal to the task.  The subject is too deep to fathom, and just as a masterpiece requires an artist, an account of his life demands a competent biographer, not one who is disqualified by vocation, avocation, or knowledge of the language.  Imagine a dabbler trying to paint with oil.

Like the uncle who raised him, Doctor Pippin is a man of wisdom, high ideals and vision.  These traits, coupled with a strong determination and courage of convictions, and backed by an unconquerable spirit, compel one to say: “This is a man.”  He is a pioneer and a descendant of pioneers.  He shapes his opinions slowly, but once formed they stand firm.  He was born and reared in rural country – the Ozarks of Missouri – of which he is cheerfully proud.  His experience is wide and varied.  In practice no task was too great, no hour too late for a professional service to render comfort or relief.  It is impossible not to have deep respect for a man of his fiber.  He merits praise.

Bland Nixon Pippin was born October 3rd, 1874, to William Carroll and Nancy Jane (Tilley) Pippin.  He is the youngest son and tenth child in a family of seven boys and four girls.  His father’s people are descendants of one of two brothers, Matthew Pippin who came on the ship “Expectation” and landed in Northampton County, Virginia, in 1635, and William Pippin who came later and settled in Northumberland County, Virginia, in 1638.  One of the brothers remained in Virginia, the other went to North Carolina.  “I do not know which branch I belong to,” he said, “but since my father’s people came to Tennessee from the east, and inasmuch as the Tennessee Pippins most probably came from Virginia originally, via Maryland, it is reasonable to presume that I belong to the Virginia Pippins, but by no means is this certain.  The North Carolina Pippins are reported as having chiefly migrated south to Georgia and Alabama.”  The Pippins of Virginia are the originators of the Pippin apple which met with favor with Queen Elizabeth and through her recommendation it attained unusual popularity.

The Pippin family is recorded in English history as being descended from the Merovingian kings who ruled early in the history of England, and from the Carlovingians (or Carolingians, after Charlemagne, its most illustrious member) of the Frankish kingdom.  The Carlovingian history reaches back to the seventh century to Pippin of Lamden (or de Landis, died 639) through Pippin of Heristal, Charles Martel and Pippin the Short who sired Charlemagne.  There are several branches of the family in different countries of Europe, namely, Pippin, Peppin, Pippen, Pepin, Papin, Pippinos and von Papen.  Incidentally, the name has been changed so much that upon investigation such names as Pepping, Tippin and Flippen are found to be descendants of the original Pippin de Landis.

Doctor Pippin’s father was born in Tennessee, the son of Hill Pippin and Nancy Birdsong, a woman of Indian extraction reported to be not many generations removed from the original primitive stock.  As a small boy he went with the family to Alabama (near Birmingham) where he grew to young manhood.  The family turned back to Tennessee and later, came to Hickory County in Missouri.  As this part of the country was sparsely settled it was customary to go long distances in search of wheat for seed or food, and this is how William Carroll Pippin came to Waynesville where he met and married Nancy Jane Tilley.  They lived for a few years in Hickory County where they established a homestead, lived there for several years, and in the course of time sold the home, removed to Pulaski County and settled on a farm near Waynesville.

The Tilley family is of English descent also.  It first settled in Virginia then removed to Tennessee.  Wilson Tilley and his young wife walked from Tennessee, leading a mare with their belongings strapped on the mare’s back, to their new location in the southern part of Pulaski County in Missouri.  Here they settled and lived for a short time, then moved to the Roubidaux Valley near Waynesville.  They had thirteen children most of whom grew to manhood and womanhood.  Grandfather Tilley was killed during the Civil War by a band of Northern soldiers under the pretense that he harbored bushwhackers.  He was reputed of having buried considerable gold – a custom generally followed by early pioneers.  Having dug all over the estate and found nothing, the soldiers threatened to kill him, and did so when he steadfastly refused to reveal the whereabouts of the treasure.  The farm land owned by the Tilleys together with that on which Doctor Pippin was born is now included in the Fort Leonard Wood area.  All the buildings and improvements have been wrecked.

Doctor Pippin’s father died a poor man in 1879 when Bland was about five years old.  When his mother passed on two years later, he and his baby sister (aged four) were taken to the home of their aunt (mother’s sister) and her husband, William L. Bradford, to live.  This couple had no children of their own.  They were familiarly known and spoken of throughout the county as “Uncle William and Aunt Niah.”  William L. Bradford was a descendant of William Bradford who was a passenger on the Mayflower that landed at Plymouth Rock in 1620 and was Governor of the Plymouth Colony from 1621, with the exception of five years, until his death in 1659.

William L. Bradford, like his Puritan ancestors, was a man of upright character.  He was a Confederate Civil War Veteran, and a model citizen of the country.  He was so loved and respected by the county residents that public office was thrust upon him.  He served in different official capacities and represented Pulaski County one term (1866) in the legislature at Jefferson City.  When he departed at the ripe old age of ninety-five (1934) he left behind a host of friends with cherished memories and a better world than he found.  This man inspired, and in no small measure influenced, the life of young Pippin whom he raised as his own son.

Doctor Pippin’s early schooling began at the age of five at Mt. Gibson district school, two and one-half miles away from the Roubidaux farm on which he was born, and later, equally distant from his uncle’s home.  He at first walked to and from school with an older brother.  The steep hill he originally had to climb has not been forgotten, even to this day.  Not unlike others of the time, this school was not graded; it began in August in order that the six month term be terminated before severe cold weather set in.  When he completed this character of schooling at fourteen he went to the Waynesville school where more advanced subjects were taught.  He concluded what was considered a high school training at eighteen.

During a good portion of winter, spring and summer months he was engaged in farm work just like all country boys.  He helped clear new ground, split rails out of the likely timber that was cut in the clearing, made fence posts, built fences out of the rails that were split.  In the early spring he would break the ground with what was known on the farm as a bull-tongue and colter plow, and would average about two acres of new ground a season.  He states that “Any one who has had the experience of breaking new ground with a bull-tongue and colter plow can verify the statement that such work is most conducive to perfect profanity, especially when a severed root springs back to crack the operator of the plow on the shins.”  He began this type of work at fourteen and continued it until eighteen.  As modern farm machinery was non-existent the plow he used was of the “walking” type.  He did have the “Drop Wheat” reapers and mowing machines, but the “five-finger” cradle was the one usually used at wheat harvest time.  He began cradling wheat and binding bundles by hand at sixteen.  In fact he performed all types of farm labor in the old fashioned hard way in a manner in which it was done at the time.

At eighteen he taught a country school for a six month term and worked at his uncle’s farm during the summer months, entering the University of Missouri, at Columbia, in the spring of 1893, being enrolled in a special course for teachers.  With meager savings from the repetition of this schedule of teaching, studying and farming for several years, he matriculated at the Dental Department of Washington University in September 1897, and received the degree of Doctor of Dental Medicine in the spring of 1900.

While still a Middleman (in his second year) he married Miss Nancy May Vaughan, a neighbor and high school classmate, May 31, 1898.  Their first-born arrived about a year later.  A great deal could be said about this charming lady who has stood by him very faithfully all these years.  Two children were born to this couple.  A son, Dru L. Pippin, who now lives at Waynesville, Mo., and a daughter, Mrs. Lauramae Pippin Eckert of St. Louis.

A classmate of his observed: “He was a good student, serious in his studies, proficient in his work, and well-liked by his classmates.  He is as witty as Mark Twain, and with that moustache he had, he also looked like him.”  At the Alumni banquet preceding the graduation exercises he gave the valedictory address as class historian.  However, at graduation he was so completely penniless that he had to borrow a stamp from his landlady to write to his uncle for money to return home with the newly acquired sheepskin.

His Alma Mater soon offered him the position of Demonstrator in Operative Dentistry.  In 1901 Dean Fuller appointed him Demonstrator in Clinical Prosthetics.  Dean Kennerly, the following year, so well appreciated his services that his salary was doubled.  During the summer, while the school clinic was closed, the young dentist obtained portable equipment and would go to Waynesville to practice.  In reality, the summer practice was more remunerative than the remaining nine months in dental education.

In 1904, at the time of the World’s Fair, Dr. Pippin decided on private practice and part-time teaching.  He associated with Dr. L. D. Jones, an old Virginian.  They maintained an office in the Jefferson Building, at Jefferson and Olive, for two years, doing reasonably well for new beginners in a big city.  Dean Kennerly then induced him to return to full-time teaching, so he gave up the office and continued in full time service, primarily in prosthetics and lecturing in metallurgy, until 1908 when he was appointed Professor of Operative Dentistry and Head of the Department.

It was back in 1900 (September 10, to be exact) that Pippin and J. R. Pendleton first met when the latter became associated with the school as superintendent of the Operative Clinic.  The friendship that has developed between these two gentlemen is well known to all alumni and friends of this school.  While I was visiting Dr. Pippin recently, Dr. Pendleton came to see him.  It was a pleasure to listen to them talking about the good old days.  Now back to our story.

During those early days, at the turn of the present century, some years the clinic would remain open during the summer even if all the students were gone on vacation.  Pippin and Pendleton would perform practically all the dental services for the patients.  They would vie to see who could turn in the greatest revenue for the school, the former in Prosthetics and the latter in Operative.

In the fall of 1908 Doctor Pippin reverted to private practice and part-time teaching.  He located in the Metropolitan Building for ten years, then removed to the University Club Building where he remained another decade.  For the convenience of his patients he relocated in a more westerly direction, in the Roosevelt Hotel Building, and finally, in the Chase Building when it was made available for occupancy.  In 1934 he was appointed Director of Dental Clinics and the head of the newly established Division of Dental Medicine with the title Professor of Clinical Dentistry.  Later, this was changed to Professor of Clinical Dental Medicine.  In this capacity he continued until his retirement in June 1944, shortly prior to his seventieth birthday.

He joined the St. Louis Dental Society in 1903.  He took active parts in its various affairs and rose through its ranks from the office of Corresponding Secretary in 1904 to the presidency in 1909.  During his administration the Illinois plan of dental organization was favored by the society and presented to the State Association for adoption.  It was mainly due to his efforts, initiative and foresight, together with the assistance of his executive committee and in particular, Dr. H. F. D’Oench, to whose cooperative support, wise counsel and untiring efforts, credit is due for the success of the adoption of this much needed reform; also that the St. Louis Dental Society became the component society of the state and national organizations.  In the light of subsequent knowledge this was a great achievement.  Not only did it keep the St. Louis Dental Society alive but it was its incentive to growth from a membership of approximately 100 when he became its president, to a present membership of nearly a 1,000.

In 1912, following the publication of Pickerill’s text on “Prevention of Dental Caries and Oral Sepsis,” Pippin became more interested in preventive and conservative dentistry than he had previously been, notwithstanding the fact that almost from the beginning of his dental career he was always more interested in prevention and conservation than in technical phases.  He began writing and teaching preventive dentistry with greater enthusiasm.  It was this enthusiasm that led him to a feeling of necessity of closer cooperation and correlation of dentistry and medicine.  His many published articles show the trend of his thoughts and beliefs.  Here, I would like to quote him directly.  Reclining on a couch, he dictated very slowly and thoughtfully:

“Since there has been, and continues to be, a decided division of opinion regarding the trend which dental education should take; one, along lines of more complete information and application of principles of basic sciences leading to a closer affiliation of medicine and dentistry, even to the extent of making dentistry a true specialty of medicine.  On the other hand, there are those who argue that dentistry should be a separate and distinct profession, autonomous in its activities, and that the need is for good dentists turned out with more proficient technical training.  I happen to belong to the adherents of the first group.  Due to differences of opinion I have met with considerable adverse criticisms from many of my professional co-workers.  I am happy to say that there has never been anything of a personal nature entering into the cause of these criticisms.  It has all been because of a difference of opinion founded on principle.  I always advocated getting closer to medicine and with medicine.  Perhaps, to a certain extent I had some influence in the location of the dental school building in its present location.  I could never agree with the other side who said: ‘Stay away from medicine, and don’t get any closer than we already are.’  This does not change my conviction that while we have made strides in cooperation and affiliation with medicine, to the advantage of the dental profession and the medical profession, as well as the public which these two professions are serving, I still would like to live to see the day when our medical and dental clinics would be housed in one commodious clinic building, and dentistry be taught on a plane where dentistry and medicine could together, as one profession, serve mankind in accordance with the fundamental principles of the basic sciences as taught in medicine.”

A quarter of a century ago, Doctor Pippin addressed a meeting of the St. Louis Dental Society on the subject “The Problem of Preventing Dental Caries Must Be Solved.  Why?  How?  When?”  Prevention was uppermost in his mind then, as now.  He concluded that “the problem can only be solved through education brought about by an amalgamation of the medical and dental professions in which dentistry would lose its identity as a separate and distinct profession, and there would be only a medical profession with a specialty of stomatology that would treat dental diseases. . . .  In this way only can the necessary knowledge be acquired to educate the public how to live, to assist in coping with the difficulties confronting us in trying to solve the problem of preventing dental caries.  In this way and only in this way can humanity be treated for its many ills in the manner which it deserves to be treated.  And in this way only can dentistry rightly claim to be a specialty of medicine.”

Doctor Pippin has the rare quality of being able to express himself plainly but effectively, without any ostentation or oratory, and extemporaneously if needs be.  He would state his opinion frankly, sincerely, and irrespective of whether the majority agreed or disapproved.  At the second annual meeting of the American Association of Dental Schools, held in Chicago in 1925, when various plans of dental education were presented and discussed at the time the Carnegie Foundation Report was made public, the important topic of the day was the two-three year plan (two college years entrance requirement and three years of dental training).  When the subject was open for general discussion, Doctor Pippin said, in part:

“I don’t know what the rest of the schools of this country are going to do, but I believe that that the two-three course is going to be carried by the majority of the schools and perhaps, under the existing conditions it may be best, I don’t know.  But I like the two-four plan of New York.  I like the plan which promises soon to reform a medical profession and not have the dental profession subordinate in any sense but coordinate with the medical profession – not subordination but coordination.  I care not what you may do, you can all use your best judgment.  I am saying this unequivocally, I am saying it fearlessly, I am saying it with no axes to grind, no ambitions to gratify, for the little position that I hold doesn’t amount to much, and if it should be snapped away from me tomorrow, I will not starve to death much quicker than I will as it is.”

The two-three year course as advocated by the majority was adopted, but wasn’t it short-lived?  Six years later, 1931, at the Eighth Annual Meeting of the American Association of Dental Schools, in Memphis, Tennessee, the Ozarkian was there as an essayist battling for the “Future of Dental Education.”  Was it a voice in the wilderness?  Again it may be said that he was thinking and lecturing ahead of his time.

Now the correlation and coordination of medicine and dentistry are beginning to loom on a broader horizon.  The evaluation of dental schools today is based very largely by the Council on Dental Education on the relation which they hold in universities, and the degree of correlation and cooperation which they maintain with recognized schools of medicine.

Prevention, conservation and dental education were not the only dental topics in which he was interested.  Professional conduct and professional service were themes that frequently concerned him, lest mankind and the dental profession suffer from commercialism.  As early as 1906, he wrote in the Dental Era (June 1906) on “Some Important Duties of the Dentist.”  Twenty years later, when he gave the response to the Governor’s address (Meeting of the Missouri State Dental Association, Jefferson City, 1926), he was still harping on honesty, efficiency, and conservation in the practice of dentistry.  At Springfield, Illinois, in 1930, he spoke on “Jonahs in Dentistry.”  On that occasion he classified dentists according to conscience and ability.

Social, economic and political problems, both local and national, also interest him and still take their rightful share of his time and thoughts.  Although an ardent democrat (with his heritage he could hardly be anything else) his convictions and actions were above party level.  As far back as he can remember, he never failed to cast his vote.  Even in his present illness, shortly after a surgical operation from which he had not completely recovered and with the rather reluctant consent of his medical advisers, his life-long friend, Charles Knepp, ’05, volunteered to take him to the polls and then return him to the hospital.  He said on that occasion: “This may be the last chance I have to vote, but vote I will.”  And vote he did.  Last February 27, although still convalescing and unable to walk to the polls, nevertheless, he cast his vote for the success of Missouri’s new constitution.  It is his type and his spirit that give promise to the American way of life.

One day in 1936, Doctor Pippin found upon his desk a copy of F. W. Broderick’s “Dental Medicine,” which had been placed there by the dental school librarian.  The book was not only fresh from the publishers but was also new to Dr. Pippin.  He read it through three times before the story the author was relating became reasonably clear to him.

He entered into correspondence with Broderick of England and invited him to come to St. Louis to give a series of lectures in the dental school.  The reply was a gracious acceptance.  Funds for this trip were made available through generous contributions by Dr. Pippin’s patients.  Dr. Broderick came, he saw but he did not conquer.  Pippin states that for many reasons he regards the bringing of Broderick to America was one of the highlights of his entire professional career.

Doctor Pippin states that he derived more pleasure in the eleven years of association with Dean Lischer, teaching in the Division of Dental Medicine, than he did in all his previous years of teaching service in the school.  On the other hand, he says, he endured more criticisms and sinister opposition than he anticipated, but he steadfastly ignored his critics and continued to enthusiastically perform his duties as he saw them until his retirement on July 1st, 1944, just before his 70th birthday anniversary in October.

It was during this period, 1934-1944, that Pippin did his most promising work – work which may prove to be far-reaching in its benefits to suffering humanity.  He regards the papers which he wrote and published during this period as being his best contributions to dental literature.  The paper entitled “Clinical Consideration of Problems in Dental Medicine,” [1] he considers as his best contribution for the consumption of the general practitioner.

Then his two articles – the first, a preliminary report on his research in temporo-mandibular lesions, entitled “Repositioning the Mandible” [2] and his complete report styled “Symposium on Treatment of Temporo-mandibular Lesions Caused by Denture Mutilations,” [3] constitute a summary of his work on this particular research problem, setting out methods of treatment not practiced anywhere else in the world, and a classification of condylar malpositions, serving as original and valuable aids in diagnosis and therapeutic interferences.

Realizing that this type of clinical research belonged in an institution and not in a private office, Doctor Pippin, therefore, took the problem to the dental school and carried this type of work until his retirement.  The conducting of this research was only made possible by the generous financial support by Theron E. Catlin, Pippin’s good friend and patient who made substantial contributions each year.  It must also be stated that this type of research was carried on under extreme difficulties, but nevertheless, Pippin was persistent in his work and, in the decade from 1934 to 1944, approximately one hundred cases had been treated among whom five were diagnosed in the Medical Clinic as suffering from trigeminal neuralgia major (tic-douloureux), a disease for which no known cause had been discovered.  The only treatment up to this time for such a condition was a radical surgical operation.  It may be of interest to add that these tic cases completely recovered and avoided radical operations.

Doctor Pippin says he realized this character of teaching should be done in a post-graduate school of instruction.  He, therefore, organized a nucleus of a staff to teach such a course.  Shortly following his retirement his health became impaired, possibly due to the tremendous amount of work and strain endured from conducting a busy practice, routine teaching, directing the administrative affairs of the clinics and conducting clinical research in the Division of Dental Medicine.  He was directed to Barnes Hospital for diagnosis and treatment in October last, and submitted to an operation soon after.  He has been confined to his home since his dismissal from the hospital, trying to regain his health.  While his health is broken, his spirit is undaunted, for even from his sick-room he attempts to instruct and direct as best he can.

This venerable gentleman possesses an unusually sympathetic, kind and generous disposition, not withstanding his stern visage.  He is, nevertheless, frugal and economical in his living habits.  He says he was made to realize very early in life, through the school of “hard knocks” that the economic system under which his generation must live, if he were to enjoy economic independence in his old age, it must be attained through hard work and some systematic plan of saving.  His love for his native Ozarks, with its wide open spaces, verdant hills, free flowing streams, fed by the most wonderful springs the world, teeming with the choicest of game fish, of which the small mouth black bass is supreme, abounding with gorgeous scenery throughout and offering unusual opportunities for future development, led him to choose investment in real estate there; and it was but natural that he should select the locality of his boyhood days, for as a boy there were spots he fancied when a man he would like to own.  He says he never had any ambition to be rich.  His philosophy with respect to money was first, that enough of it to insure a sound, healthful and pleasant standard of living in keeping with that which those of his generation could acquire and enjoy if they so willed; secondly, to give his children college education and endeavor to train and equip them to successfully meet the problems of their lives by their own efforts; and thirdly, to establish an economic independence for himself and his help-meet in their old days.  These ends Doctor Pippin has succeeded in accomplishing.

On one of my recent visits to see Doctor Pippin, he spoke philosophically of the future.  “You know, Doctor, Father Time throughout my life has been quite lenient with me.  This fact I attributed very largely to my obedience to Nature’s demands for health.  Of course, I realized many years ago that ultimately a struggle must ensue between Father Time and myself as to who should gain supremacy in the regulation of my life’s conduct.  It was not until I had almost reached the proverbial allotted life span of ‘three score and ten,’ that Father Time really became aggressive and dealt me a crippling hook with his mystic scythe in a vital spot, that gave him the unquestioned dominant position in the struggle.  Now I can do nothing else but obey his orders, even if I should desire to do otherwise.  I am glad to attempt to obey my orders which I think I can best do in the big open country.”

[1] Washington University Dental Journal, August-November, 1942.
[2] Washington University Dental Journal, May 1940.
[3] Washington University Dental Journal, May 1944.

 

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