PURULENT COLLECTIONS IN THE MAXILLARY SINUS. 329 



100° Fahr. ; and, secondly, in injecting antiseptic and astringent solutions 

 so as to check the formation of pus. Among such may be mentioned 

 3 per cent, carbolic solution, 5 per cent, carbolic glycerine, 2 per cent, 

 solution of iodine in iodide of potassium, etc. 



Whatever the drugs employed, the cavities should be washed out 

 every day, first with plain sterilised water, and then with antiseptic 

 solutions at the body temperature, since cold solutions often cause 

 inflammation of the mucous membrane of the opposite sinus. 



PURULENT COLLECTIONS IN THE MAXILLARY SINUS. 



This disease is much rarer than that of the frontal sinus, and only 

 within the last few years (Eies, 1899) has a really good description been 

 given of it. 



The causation is imperfectly understood. Injuries to the suborbital 

 region and maxillary ridge, caries of the molar teeth, and inflammation 

 occurring during the development of general diseases represent the 

 princii^al causes. 



The dominating and characteristic symptom of the presence of pus 

 in the maxillary sinus consists in incessant snorting, accompanied by 

 violent movements of the head and the discharge of purulent or muco- 

 purulent material. 



At the beginning of these attacks of snorting, which are produced 

 by the reflux of pus from the sinus towards the nasal cavities, the 

 respiration becomes snoring and rapid, and the animal makes sniffing 

 movements as though the nasal cavities were partially obstructed. After 

 these crises, the respiration again becomes silent. 



Contrary to what has been observed in purulent collections in the 

 frontal sinus, the discharge is unilateral, reddish yellow in colour, 

 viscous in consistence, and is accompanied by clots of a gelatinous 

 material or even of blood. 



During the attacks of snorting, the discharge resembles that of 

 croupal or pseudo-membranons bronchitis, but the material discharged 

 is not moulded on the internal shape of the bronchi. The masses of 

 discharge are irregular in form, and appear as though made up of fibrous 

 tissue matted together. Attention having been attracted by the dis- 

 charge, exploration of the trachea and chest reveals nothing ; on an 

 examination of the sinuses, however, palpation and percussion betray 

 a certain amount of sensitiveness, together with partial or comj^lete 

 dulness, and the lesion is discovered. 



Diagnosis. Confusion between pus formation in the maxillary and 

 frontal sinuses can be avoided by careful examination. 



Prognosis. The prognosis is not very grave ; the animals maintain 



