42 INFLAMMATION OF THE 



its walls." He was about to operate upon this 

 patient for the removal of a morbid growth. 



Sijm'ptoms. — In acute inflammation of the 

 antrum there is a deejp^ dull, heavy pain, accom- 

 panied by a sense of weight and fulness in the side 

 affected. Occasionally lancinating pains pass to 

 the frontal sinus, orbit, and various parts of the 

 face; the cheek is swollen, red in patches, and 

 tender to the touch : there is feverishness, with 

 or without rigors. 



If the symptoms be not subdued, the cavity 

 may become dilated by fluid, the cheek and palate 

 enlarged, the superior wall pressed upwards, the 

 nostril contracted, and its secretion diminished. 

 The anterior wall has even been known to ex- 

 foliate, and to allow fluid to escape into the cheek. 



Chronic inflammation is attended by less severe 

 pain, which is either dull or of a grinding rheu- 

 matic character. The walls of the antrum are 

 more gradually dilated, and are said to have 

 become so thin as to crepitate upon pressure. 

 Occasionally they are hypertrophied. In some 

 cases the pain is altogether inconsiderable, and a 

 discharge passes into the mouth or nostril, for 

 years unheeded by the patient. 



Character of the fluid. — If we remember that 

 the lining membrane of the antrum is continuous 

 and identical in structure with the Schneiderian 

 membrane, and call to mind the morbid changes 

 which take place in the secretions of other air- 



