66 



SURGERY. 



should it occupy the orifice of the Eustachian tube. It may be 

 removed by twisting it off by the forceps ; and the hemorrhage is to 

 be arrested by astringent injections and lint. A dense fibrous poly- 

 pus is best removed by a ligature or wire, applied by means of a 

 double canula, for the purpose of strangulation. Mali g7ia?it polypi 

 may be regarded as incurable. 



Lipoma of the Nose, is a hypertrophied condition of the skin and 

 fat of the apex, and alee of the nose; seldom occurring but in aged 

 free-livers. When the growth is large, it is to be removed by the 

 knife. 



Ozcena. — Is an obstinate, profuse, and foetid discharge from the 

 mucous membrane of the nose, with disease of the bones beneath. 

 The disease often extends to the frontal sinus and antrum. In aduhs, 

 it is often dependent upon syphilis, or the abuse of mercury ; in 

 children, upon scrofula. 



The treatment will in a great measure be constitutional, although 

 benefit and comfort will be derived from the use of astringents and 

 chlorine washes, and promoting the free discharge of the matter. 



Abscess of the Antrum. — May result from a blow, or the irrita- 

 tion of a decayed tooth. It is attended with permanent, deep-seated 

 aching of the cheek, the pain often becoming intense, together with 

 rigors and fever. The cavity bursts, either internally or externally, 

 which gives great relief. The earlier that leeches and emollient 

 poultices are applied, the better ; but, after the cavity has become 

 filled with matter, there is necessity for immediate puncture just 

 over the third molar tooth ; or, a tooth must be extracted, and a trocar 

 pushed through the socket. The discharge of pus can be facilitated 

 by syringing with warm water. 



Epulis. — Is a solid tumour of the gum, of a non-inflammatory 

 character. It commences in the form of a seed-like excrescence 

 upon the gums, between the interstices of ihe teeth. Being without 

 sensibility, it may occasion but little inconvenience, except by its size. 

 As it grows, it loses its dense fibrous structure, and may become 

 fungous ; sometimes it becomes malignant. 



Ti-eatment. — Nothing will suffice but complete extirpation of the 

 adjacent portion of the gum and alveolar process. Several perfectly 

 sound teeth may have to be drawn, in order to apply a fine saw or 

 bone-pliers. The hemorrhage is to be arrested by muriated tincture 

 of iron, and pressure by lint. 



Parulis. — Is a gum-boil ; occasioned usually by a decayed tooth, 

 or a stump, or a tooth whose nervous pulp had been destroyed pre- 

 vious to plugging. The swelling is slow at first, though the pain is 

 intense while the pus is forming. Unless the tooth is extracted, an 

 opening will be formed through the alveolar process and gum, for 

 the discharge of the matter, which may remain fistulous. 



The treatment will consist of leeches and fomentations, and the 



