412 Diseases of Bone. 



strongly poiuted out to him, he could not be persuaded to remain in town 

 until he had seen his harvest got in. With this view he set out for his 

 farm, where he remained for nearly two months, scarcely a day of which 

 passed without his losing an alarming quantity of blood. 



"On the 20th of September, when he returned, he looked an 

 emaciated creature, his face ghastlj' and bloodless, his frame languid and 

 exhausted, scarcely able to drag one limb after another. 



"The tumour was now making its way in every direction through tlie 

 carious bones. The right nostril was so occu])ied by the tumour that not 

 a breath of air could be forced through it. The cheek was not swollen, 

 but a small knobby tumour occupied the space between the ala nasi, infra- 

 orbitary hole and canine tooth of the right side. It had forced its way 

 through the walls of the antrum. A portion of the tumour had made its 

 appearance in the form of a small papilla at the alveolar socket of the 

 third grinder. This tooth had been pulled by a dentist, who imagined 

 the disease to be toothache. The tumour likewise passed down behind 

 the palate, obstructing in some degree his swallowing, and affecting a 

 little his voice. 



"Mr Bell first tried the caustic by passing it high into the nostrils ; 

 but finding that its roots were so protected bj' the walls of the antrum 

 that there was no chance of reaching them, he made an oblique incision 

 in the cheek, about three inches long, and found the tumour projecting 

 through a hole in the antrum, the bones of which were completely carious. 

 A probe could be passed through this hole across the cavity into the 

 nostril, and down the throat. Mr Bell now tried to reach its roots by 

 holding down the projecting lobe of the tumour, and directing the caustic 

 towards the angle of the eye, inclining it a little towards the tliroat. In 

 this, however, Mr Bell confesses to have entirely failed, for there inter- 

 vened between this hole in the cheek and the roots so large a portion of 

 the tumour, that, instead of passing over it, he transfixed it. By frequent 

 applications of the caustic this portion was converted into a sac or bag, 

 with a round mouth sufficient to admit the point of the thumb. A happy 

 effect resulted from the applications, for, from the time that the caustic 

 was first applied, the haemorrhage never recurred. 



" The pains which he sufi"ered from the tumour were of the most 

 rending and distracting kind, frequently darting through the head. He 

 had frequent accessions of fever and diarrha-a. At each attack of fever he 

 was confined to bed, and for some days tortured with sickness and retching. 

 During the intervals of these paroxysms he was wont to sit cheerless and 

 moaning over the fire, holding his head in his hands, resting on his knees. 

 His countenance was now more pallid and death-like ; his eyes heavy, 

 sunk, and languid ; his hearing much impaired, and his brain beginning 

 to suflFer. Stupor had alreaily taken place. 



" By slightly astringent injections thrown into the antrum, by 

 occasional opiates and astringent mixtures, by soft nourishing diet, with 

 wine and other cordials, a melancholy existence was dragged out, with 

 many intervening scenes of great distress, until February 1814, when 



