FUNGUS. 
life of his patient, will immediately makeup his mind to 
at with promptitude and decifion. In the. early period of 
the difeafe the tumour itfelf is the ‘only thing which requires antrum and 
removal; but after the {welling has brought on the 
ravages W rhich we ha 
train of 
above enumerated, a cure cannot be 
take along time to be rectified thee 
as the deftruction of the fight, may have become souallyi in- 
curable. 
The longer the diftemper has exifted, the more cage 
will generally be the fur rounding mifchief, and the 
Even when thie ve re- 
inufes, and the re-eftabli dinene uf 
“After fating thefe circumftances, it becomes almoft fuper- 
us to enjoin furgeons to endeavour to difcover the difeafe 
in en infancy, and to attack itin this ftate with powerful and 
effectual means. 
Fungi of the antrum appear frequently to originate from 
the irritation of carious teeth in the upper jaw. Trom this 
caufe, from bad colds in particular habits, from blows, or 
on fome other inexplicable account, we conceive that the 
Schneiderian membrane which ‘lines the cavity is inflamed, 
ut ie lymph, and emits the deftrutive 
fungous ae a) 
ow, by sar “of the concealed fituation of file 
mour, it muft be fomewhat di out the ie 
of the affection before it has rink a certain progrefs, ote. 
cially as the complaints are ufually a aroine as as 
mon eae a or mere rheumatic pains of t 
Hence, whenever a pfecuisaee 
sere fhould at ig ft e to afk a few prudent 
ueftions ; for sabehg ira the invifible fituation of a 
i Soke in the antrum, it 1 n among all well-in- 
ted furgeons that ‘uch : a ‘diftemper feldom — without. 
being attended with fome affections of the adjacent parts. 
It is by pa: thefe latter complaints fate we are led to 
fufpe4t a tu mour in the antrum, arid that we are fometimes 
enabled afcertain - prefence eco 
cena oe the face 
alarming degree .of Goines ifchief. The Greed 
fhould en Lae lea lee the teeth have become loofe, 
as may. 
lee dro aioe jaw 3 
whether there is a se of fanies, or pee from the 
nate “lt the bones of the face 
et hrough. the fin of the cheek, 
has ween alarmingly extenfive.. 
of the gaa grounds of 
ftpicion, fh d long-continued 
n inthe fituation of the upper ja-bone, after hips had 
fome fuch inftrument, through the focket of any difeafed 
grinding tooth which may happen to be fituated under the 
which of courfe fate be in the firft inftance ex- 
tracted. We need not dwell upon the propriety of taking 
fou 
out a carious tooth in thefe cafes inftead of a nd one. 
ing wing one of the 
teeth, and perforating the Soon of i foe ce his beit plan 
is to extract the third or fourth grinder, reckoning from be ee. 
fo 7 - kward. 
will not pofitively condemn the plan of ne an 
phere into the antrum in the foregoing wa tm e 
right in the firft inftance, before the furgeon 1 1S nae oe 
ther the difeafe is a tumour or an abfcefs in that cavity ; be-. 
caufe, in the latter event, the methed will be likely to an- 
{wer every pala ; and fhould there be.a fungus prefent, 
the remova a bad tooth, and perforation of. the- 
ocket, cannot a any harm. Indeed, we may advife, as a 
general practice, that in every inftance -in which a 
patient fuffers violent pain in the face, and ha a- 
c 
rious teeth, thefe fhould always be taken out wiiont the. 
leaft feel 
cution the meafures for ike ffe & 
tumour ; i may, indeed 
‘okie the excrefcence with his probe, &c.; but i: will not. 
a its root, and unlefs this be. 
done, Te had better remain in quiet, 
o 
io) 
ich: 
det 
boldnefsin t cafes, to tamper 
and play with’ 
. which is even ny more culpable and ne ti leaving the 
unhappy patient to his own fate. 
bone was Seauded of all the foft parts 
rating inftrument was applied to the middle of this: furface, 
i teeth, afevere cold, or a ieee he face, the praéti-. and an opening made forward than tke one already ex- 
tioner is called: upon to make a ropa ‘into the antrum, for ifting. The plate of bone, fituated between the two’aper-' 
the purpofe of being able to get at the yery root of the tu- tures, was removed with. a little falciform knife, which, be- 
our. _ ing directed from behind forward, made the divifion with-: 
There are two fituations in which the furgeon may effe ut ulty. .The opening, thus’ obtained, a ‘infofhi- 
elo 
& 4 
this. abjett,. One is 18 to make a \ perforation with a Leis or . 
