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261
ally rendered impervious; hence the matter is obliged to
make its exit by an ulceration through one of its sides, which
most frequently is that situated under the cheek. It is com-
mon to membranes under inflammation to become thickened,
and as the opening into the nose is through a membranous
part, it is probable that when inflammation takes place, it is
in consequence of the thickening of this membrane that the
opening of the antrum into the nose becomes closed.
During inflammation in the antrum, the patient at first con-
ceives the pain to proceed from the tooth-ache, but if the
tooth should not be diseased, a more accurate observation is
made upon the peculiar sensations excited. The pain usu-
ally extends towards the forehead, in the direction of the
frontal sinus, and a sensation of tightness and weight, with
throbbing, is felt on the side of the face. In a short time
the cheek becomes red, and appears as if swollen ; it feels
very hard, and on raising the lip a considerable fulness above
the fangs of the teeth may be observed.
If the disease be not attended to in this stage, as the mat-
ter rarely passes out at that side leading into the nose, an ab-
sorption of the bone above the molares takes place, and the
matter discharges itself through the gums ; but this does not
cure the abscess ; the formation of matter still continues, and
the ulcerative process goes on, until so great a destruction of
the bone is caused as to render the disease incurable.
This case requires the same kind of treatment as abscesses
in general, viz. an outlet to be made for the matter ; the best
mode of effecting this is by extracting one of the molares,
and making a perforation into the antrum, through the socket
of the fangs. If it should happen, that either the first or
second molaris be carious, it will be proper to extract it
but when the teeth are perfectly sound, the second molaris
is to be preferred, as the antrum descends the most at that
261
ally rendered impervious; hence the matter is obliged to
make its exit by an ulceration through one of its sides, which
most frequently is that situated under the cheek. It is com-
mon to membranes under inflammation to become thickened,
and as the opening into the nose is through a membranous
part, it is probable that when inflammation takes place, it is
in consequence of the thickening of this membrane that the
opening of the antrum into the nose becomes closed.
During inflammation in the antrum, the patient at first con-
ceives the pain to proceed from the tooth-ache, but if the
tooth should not be diseased, a more accurate observation is
made upon the peculiar sensations excited. The pain usu-
ally extends towards the forehead, in the direction of the
frontal sinus, and a sensation of tightness and weight, with
throbbing, is felt on the side of the face. In a short time
the cheek becomes red, and appears as if swollen ; it feels
very hard, and on raising the lip a considerable fulness above
the fangs of the teeth may be observed.
If the disease be not attended to in this stage, as the mat-
ter rarely passes out at that side leading into the nose, an ab-
sorption of the bone above the molares takes place, and the
matter discharges itself through the gums ; but this does not
cure the abscess ; the formation of matter still continues, and
the ulcerative process goes on, until so great a destruction of
the bone is caused as to render the disease incurable.
This case requires the same kind of treatment as abscesses
in general, viz. an outlet to be made for the matter ; the best
mode of effecting this is by extracting one of the molares,
and making a perforation into the antrum, through the socket
of the fangs. If it should happen, that either the first or
second molaris be carious, it will be proper to extract it
but when the teeth are perfectly sound, the second molaris
is to be preferred, as the antrum descends the most at that
