158 THE PATHOLOGY OF THE TEETS. 



seen, and also the vegetations springing from it. At 

 the bottom of the sinus, toward the alveolar border of 

 the jaw, among the vegetations, is a hard, granulated, 

 dry surface, resistant to the touch, of a grayish tint, 

 and analogous to sphacelated bone. This is the sum- 

 mit of the root of the tooth. 



" The surgeon then arms himself with an iron punch, 

 rounded at the point, which he applies to the root in 

 the sinus, and having further separated the jaws by a 

 few turns of the speculum oris, commands an assistant 

 to strike short, hard blows, the surgeon looking at the 

 tooth to see the effect of each blow. Usually the tooth 

 soon gives way, and falls into the mouth generally in 

 two fragments, according to the direction of the caries. 

 Sometimes, however, from the length of the tooth, it 

 cannot be punched entirely into the mouth, being 

 stopped by the opposite lower tooth; but it may be 

 wrenched out with a pair of long pincers, the handles 

 of which should be separated to increase the power of 

 the operator. When the operation is terminated, the 

 vegetations of the mucous membrane, as far as they 

 can be reached, must be excised. To stop the hem- 

 orrhage, and to modify the state of the membrane, 

 pledgets of tow, moistened with a diluted solution of 

 nitric acid, or some other caustic, should be applied. 



"It is really extraordinary with what rapidity the 

 structural breaches resulting from this operation are 

 restored by the reparatory efforts of the organic econ- 

 omy. The first time we performed the operation we 

 doubted the animal's recovery. The sinuses, laid open 

 by a breach nearly two inches and a half in diameter, 

 communicated with the mouth by an enormous open- 

 ing, the root of the tooth having acquired nearly three 

 times its normal volume. The lining membrane of 



