IN HERBIVOROUS ANIMALS. 
237 
collections which are the causes of unceasing fluxes. Why, then, 
witli the aid of cauterization, or any other agent, do we not in a 
case of glanders whose seat is definitely circumscribed in the 
sinuses, procure the cessation of the nasal discharge ; while we can 
obtain so easily this result when the collection in these same cavi- 
ties is caused by simple irritation] This difference in the pheno- 
mena, is it not attributable in the first case to the circumstance of 
the suppuration always finding a ready issue through the alveolar 
orifice, necessarily situated at the most dependant part of the 
cavity ; while the opening made by the trepan is not situated 
conveniently for a free passage to the whole of the pus, of which 
a part always runs off below through the communication between 
the sinuses and the nasal cavities ] 
Would it not be worth trying, if the extirpation of a tooth, com- 
bined with trephining, in the case of a collection circumscribed to 
the sinuses (in fact, what Professor Sewell calls glanders of the 
sinus), without alteration existing in the nasal cavities, would 
change the negative results met with in simple trephining ] We 
certainly shall have recourse to this experiment when an oppor- 
tunity may offer, and the results shall be duly recorded. Many 
cases, however, have fallen under our own immediate observation, 
when simply trephining the frontal and maxillary sinuses, and in- 
jecting detergents and antiseptics have induced recovery : while 
in by far a greater number this treatment was unsuccessful ; yet 
we feel inclined to think that if, in addition to simple trephining, 
a tooth had been extracted, and a communication established be- 
tween the sinus and the mouth through the alveole, the results 
would have been more favourable. 
Caries persisting in the Maxillary Bones after the Extraction of 
the Tooth. 
When the caries of a tooth has induced consecutively interstitial 
suppuration of the spongy tissue of the alveole, it is possible that, 
even after the evulsion of the diseased tooth, this alteration of the 
bone may continue and make new progress. Then, more than ever, 
may we dread tumefaction of the tissues and sarcomatous altera- 
tions, which are ordinarily the result of a persistent suppuration in 
the areoles of the spongy substance of the bones. To prevent these 
dangerous consequences, it is necessary to have recourse to the 
cauterization of the alveole with the actual cautery, and, if it be 
possible, to make a counter-opening by trephining that part of the 
bone correspondent with the depth or end of the alveole, which is 
the seat of the suppuration. In some cases that fell under our 
observation this mode of treatment produced the most happy re- 
VOL. XVII. I i 
