PURULENT COLLECTIONS IN THE FACIAL SINUSES AND DENTAL CARIES. 1 3 



upper molar was carious. The purulent inflammation of the sinus 

 was, therefore, of dental origin. 



Treatment was as follows : — The animal having been suitably 

 secured, I first cut away the portion of the fourth lower molar which 

 projected above the others. I then made three closely placed trephine 

 openings in the inferior maxillary sinus, and removed the intervening 

 portions of bony tissue. On introducing the finger into the sinus after 

 free irrigation the root of the carious tooth was discovered. This was 

 punched out. The crown was almost entirety destroyed, but the root 

 was little damaged. The sinus and alveolar wound were then washed 

 out with warm creolin solution and plugged with gauze. 



Next day and the following days the dressing was renewed. The 

 horse only ate a part of his food, but as the temperature did not rise 

 more than a few tenths of a degree, T was not alarmed. As, however, 

 the faeces were scanty and coated, I prescribed daily about four ounces 

 of sulphate of soda. On the third day the bowels became relaxed, but 

 the appetite always remained poor. The day after, the condition was 

 greatly aggravated. The animal was exceedingly depressed and did 

 not touch its food ; there was twitching about the stifle and elbow ; the 

 respiration was accelerated, the pulse frequent, small and hardly per- 

 ceptible ; the conjunctiva was slightly injected: percussion and auscul- 

 tation of the chest revealed nothing abnormal ; there was fever to the 

 extent of about 2w° F. On rectal exploration the bladder was found 

 empty. In the depths of the abdomen towards the right side could be 

 felt a large, hard, slightly doughy mass, which yielded under pressure 

 of the fingers. Palpation of the right flank appeared to indicate that 

 this hard mass was formed by the cacum crammed with food. We 

 attempted to overcome the obstruction by repeated enemas, and by 

 subcutaneous injection of a mixture of pilocarpin and eserin. A little 

 dung was passed. During the day the animal took a small quantity 

 of milk, but steadily became worse, and death occurred on the following 

 day, preceded by symptoms of acute abdominal pain. At the post- 

 mortem examination food material was found distributed in the peri- 

 toneal cavity, and the posterior part of the base of the caecum was seen 

 to be ruptured. The viscus itself was distended by an enormous mass 

 of hard material. The tear was surrounded by a large hyperaemic zone, 

 and the ecchymosis present clearly showed that the lesion was aute- 

 mortem. 



This animal had long suffered from dental caries and difficulty in 

 mastication. The food material had ended by becoming impacted 

 within the caecum. 



I have recalled the history of this horse because it points a moral. 



