160 

 means must be found for its escape. To this end 

 the finger is employed to probe the alveolar cavity, 

 whence the tooth was taken, and it will probably prove 

 to be of no great depth. An instrument constructed 

 for the purpose is now used, and with it a hole is 

 made through the walls of the alveolar, directly into 

 the maxillary sinus — his knowledge of anatomy 

 teaching the operator so to direct his hand that none 

 of the important nerves and vessels, which ramify 

 through the parts he is penetrating into, may be 

 injured. On the withdrawal of the instrument, pus 

 will mostly follow, but not gush forth as from an 

 ordinary abscess. A dependent orifice has now been 

 established, and if the case is not a severe one, that 

 may be sufficient : if, however, the disease is aggra- 

 vated, it will be necessary to trepline the frontal and 

 perhaps the maxillary bone, leaving in each a free 

 space, from which a circular piece has been removed. 

 Through the superior opening, warm water is in- 

 jected ; but if the stench be very offensive, a weak 

 solution of chloride of lime or of creosote may be 

 employed, and must be daily repeated. None of 

 the coarse applications which some ignorant persons 

 recommend, ought to be used. A strong solution of 



