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tality, the fangs of which, by their irritation, had produced
the exostosis.
The tumour adhered to the mucous membrane of the left
nostril, and was about two-thirds of an inch in length, and a
quarter of an inch in diameter ; and I gave it as my opinion
that a permanent removal of the exostosis, and a complete
cure of the disease, could not be obtained without the ex-
traction of every tooth, which, from the loss of its vitality,
or deprivation of a considerable part of its sockets, and
irregularity of its situation, acted as a powerful permanent
exciting cause of the disease ; and the truth of this assertion
will be particularly proved by the sequel of the case.

The Treatment.

It was in the beginning of March, 1827, when the excres-
cence was removed by Mr. Lawrence, and soon after the
operation, the patient called on me, and stated that it was the
request of this surgeon, that I would do every thing the case
might require.
March 9th.—Five teeth were extracted, and the patient
directed to wash his gums with an astringent lotion eight or
ten times a day.
March 13th.—Two teeth were removed, and the use of
the lotion requested to be continued.
March 16th.—Four teeth were extracted and the removal
of three teeth more was particularly urged, but the patient
would not submit to the operation.
March 21st.—The teeth were scaled, and the use of a
proper powder and brush directed.
March 27th.—The scaling of the teeth was repeated, and
every direction given to preserve a perfect cleanliness of the
mouth : I again very particularly explained the necessity for