PURULENT COLLECTIONS IN THE FACIAL SINUSES AND DENTAL CARIES. II 



Altogether the operation has given very good results, for before the 

 alveolus was closed the sinus was continually full of decomposing food 

 material, etc., and the smell was repulsive. 



In the three cases of simple inflammation of the sinus cure was 

 readily effected ; in two in less than a month, in the other during the 

 fifth week. 



In one of these cases pus had existed in the sinus for four months. 

 The animal, an eight-year-old entire horse, had a running from the left 

 nostril. The discharge was little when at rest, but became abundant 

 during exercise, was whitish, grumous, and offensive. There was no 

 trace of any mechanical injury, and no deformity or tenderness about 



Fig. 3. — The same case as Fig. 2. Lower (palatine) surface. 



the region of the sinus. The contents of the mouth had no unpleasant 

 odour, and there was no dental disease. The submaxillary gland was 

 as large as a nut, superficial, soft, moveable, and indolent. 



The horse being cast, I trephined the left inferior maxillary sinus, 

 giving exit to a large quantity of yellowish-white, very foetid pus. 

 The cavity having been cleansed, I freely broke down the septum 

 between the two maxillary sinuses, and then, by means of a centre-bit, 

 formed a counter-opening into the nostril from the lowest point in the 

 inferior maxillary sinus. Night and morning the patient was dressed 

 according to our usual method, by washing out the sinuses with a warm 



