Tumours of U2:)per Jaiv. 407 



right side, shooting to the crown of the head. These soon became so 

 severe that he was unable to tell whether they originated in the gums or 

 in the head. They were augmented in the night, but fortunately some 

 times were relieved by perspiration, to which he was somewhat subject. 

 The right side of the face, from the eye downwards to the moiith, now 

 began to swell, attended by a degree of numbness, affecting chiefly the 

 wing of the nose and the upper lip. The patient, conceiving the numbness 

 to depend on languid circulation, used friction, which, having no eff'ect, 

 he tried bathing the neighbouring parts with rum. This, however, 

 aggravated the j^ain. He then put himself upon low diet, bathed his feet 

 now and then at bed-time, and took occasionally laxatives, but all to no 

 purpose. His eyes now became tender and sore, but showed little 

 tendency to inflame. The eye of the attected side soon became weaker 

 and the vision to be so much impaired that he dreaded he would lose the 

 sight of it. It shortly afterwards became swollen and protruded. 



" On the day of his arrival in town he had a robust constitution, 

 had a firm step, a hale voice, and a round full face. But the right eye 

 was swollen and protruded, the eyelid tumid and oedematous, with tunica 

 conjunctiva bulging out from beneath them, thus completely shutting up 

 the eye. He complained of the same toothache-like pains aff"ecting the 

 jaw and darting to the crown of the head ; the benumbed sense of feeling 

 in the ala nasi and mouth. These parts hung loosely, and quivered when 

 he spoke, indicating paralysis. On opening the eyelids, the eye itself 

 was sound and of its natural form and size, but evidently raised from its 

 socket. There was no swelling in the cheek, no obstruction in the nostril, 

 no disease of the teeth, no tumour in the throat. But by introducing the 

 finger within the mouth, there could be felt a small tumour immediately 

 above the first grinding tooth of the afl'ected side ; and on the outside 

 this felt soft. By pi-essing this tumour a yellow serum flowed out at the 

 nostril. The gum covering the bulbous process of the superior maxillary 

 bone, and where the three backmost grinders had been, felt soft and 

 spongy, resembling softened bend-leather. These teeth had gradually 

 decayed. They had not been forced out by the disease. He was able to 

 eat pretty heartily, and take a walk around the town." 



The tumour increased rapidly, and the patient's system sunk 

 accordingly. 



On 6th September, Mr Bell, under whose care he was, attempted 

 partial operation, but the tumour was not removed, and the patient got 

 rapidly worse, and died on the 28tli. 



^''Dissection. — The ball of the eye had suppurated and burst. The 

 cheek was one great abscess. The cheek bone and walls of the antrum 

 were completely carious. The tumour was now seen arising from the 

 fatty substance at the bottom of the eye, and the upper and part of the 

 antrum, and from these running obliquely outwards to the cheek, where it 

 was bound down to the alveolar processes by adhesions. In some places 

 the tumour was lobular, and resembled in form and colour a salivary gland, 

 while in others it was granular and gristly. Around the membranous 



