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198 HUNTER OS THE TEETH.
the antrum, so that the matter may be discharged lor the
future that way.
But if the. sore part of the bone has been destroyed, an
opening may be made on the inside of the lip, where the
abcess most probably, will be felt ; but this will be more
apt than the other perforation to heal, and thereby may
occasion a new accumulation ; which is to be avoided, if
possible, by putting in practice all the common methods of
preventing openings from healing or closing up ; but this
practice will rather prove troublesome ; therefore the drawing
the Tooth is to be preferred, because it is not so liable to this
objection, (w)

(w) ["Abscess of the antrum," says Druitt, in his 'Surgeons' Vade
Mecum,' p. 443, 8th edit., "may be caused by blows on the cheek, but
it more frequently results from the irritation of decayed teeth." Speak-
ing of treatment, he observes, " A free aperture may be made into
the cavity. If either of the molar teeth be loose or carious, it should be
extracted, and a trochar be pushed through the empty socket into the
antrum. But if all the teeth are sound, or if they have all been extracted
before, an incision should be made through the membrane of the mouth,
above the alveoli of the molar teeth, and the bone be pierced by a
strong pair of scissors or trochar. The instruments should not be made
of too highly tempered steel, lest they break. The cavity should be
frequently syringed with warm water, in order to clear away the matter,
which is sometimes thick, bike putty. If the discharge continues profuse
and fetid, search should be made with a probe for loose pieces of bone,
which should be removed without delay, the aperture being enlarged if
necessary."
Hunter appears to have confounded true abscess of the antrum, where
pus is accumulated in the cavity, with dropsy of the antrum, which con-
sists of an accumulation of the natural mucous secretion in consequence
of the communication with the nostril having become closed up. The
same distension of the antrum and thinning of its walls takes place as in
the case of an abscess. Druitt quotes a case of this kind which occurred
in the practice of Mr. Ferguson at King's College Hospital, in 1850,
where there was great protrusion of the cheek and of the hard palate,
and other signs of tumour, so that the patient was sent up for the pur-
pose of having the bone extirpated ; but on examination it was discovered
that the antrum was greatly distended with a yellow viscid fluid, con-