NEOPLASMS OP THE GUMS AND ALVEOLI. 303 



turbinated bones become loose, and pass out with the nasal 

 discharge. 



Where, however, perforation of the nostril and necrosis have not 

 taken place, recovery usually occurs soon after removal of the tooth. 

 But it is unwise to prophesy the termination — time alone can 

 determine. To detect perforation into the nostril, Giinther's catheter 

 for the guttural pouch may be employed. On introducing it into 

 the lower meatus, the point where the fistula opens will be felt as 

 a raised and uneven patch. 



Treatment may be attempted without sacrifice of the tooth if 

 the fistula has resulted from an external injury, and produces no 

 serious inconvenience, and if the tooth in question gives no evidence 

 of disease. Proceeding on general surgical principles, the canal is 

 washed out, its walls scraped with the curette, and dressed with 

 chloride of zinc (1 — -10), or iodoform dissolved in ether. Solution 

 of lactic acid has been recommended. If the alveolus is diseased 

 the tooth is removed, and little further attention is required. Healing 

 is hastened by inserting a plug of tow, saturated with a disinfectant. 

 This may be renewed daily. In dogs the molar should always be 

 removed, even though the crown appear sound. 



NEOPLASMS OF THE GUMS AND ALVEOLI (EPULIS). 



Under the common title of epulis are grouped all tumours 

 originating in the gum or alveolus. In former times growths due, 

 in the horse to botryomyces, and in the ox to actinomyces, were 

 included under the general designation " Epulis." Dammann saw 

 in horses cancerous tumours of considerable size, which sprang from 

 the incisor necks. Roloff has described sarcomatous epulis in horses 

 and cattle, and we have repeatedly seen such cases both in horses 

 and dogs. The case illustrated (Figs. 304 and 305) was a myxo- 

 sarcoma of very rapid growth, affecting a mastiff bitch. Beginning 

 on the left side of the upper jaw, it extended from the first canine 

 tooth for a distance of three inches backwards, involving all the 

 pre-molars and molars, across the mouth to the left side, causing 

 loosening of all the molars of that side ; in an upward direction it 

 affected the whole of the superior maxilla on both sides. The lower 

 jaw, especially on the left side, was also involved. Sections revealed 

 cystic spaces filled with blood-stained fluid ; the interior of the 

 superior maxilla resembled a piece of hepatised lung and the bones 

 cut like those affected with osteoporosis. (Mettam, The Veterinarian, 

 1901.) 



