A CLINICAL STUDY OF ODONTOMES. 
9 
well illustrated by a case occurring in our practice of a four 
year mare in which there was an aberration in the develop¬ 
ment in the fourth superior molar, resulting in the splitting 
of the tooth in two halves, the inner half remaining in situ, 
while the outer was pressed upwards and inwards by the 
gradual impaction of food, until the fang of the detached 
half rested in the nasal passage, against the septum nasi, 
while the crown rested against the fang of the persistent 
inner half. 
Usually, however, the pus from odontomes finds exit either 
into the facial sinuses or directly into the nasal passages, giv¬ 
ing rise to various-colored fetid nasal discharges. 
If the discharge take place directly into the nasal passage, 
dyspnoea rarely occurs, but when into the sinuses and they 
become filled with dry, inspissated pus, which may press their 
internal walls inwardly, encroaching on the nasal passage, 
marked dyspnoea soon becomes evident. When this filling of 
sinuses becomes so great as to press their internal walls over 
completely against the septum, so as to effectually stop any 
overflow of pus from the sinuses through the foramen into the 
nasal passages, as is sometimes; the case, the dyspnoea be¬ 
comes at once urgent and serious, as the further accumulation 
of pus may push the septum nasi over well against the outer 
wall of the opposite nostril. 
In other cases again it may happen that in addition to pus, 
detached, irregular, sharp masses of denticles, like those in 
Fig. 7, may pass into the nostril and slowly gravitate down¬ 
wards, consuming days, perhaps weeks, in gaining an exit, ir¬ 
ritating and lacerating the nasal membrane, causing extensive 
ulcerations, which when healed, leave irregular, large while 
cicatrices which can be very readily mistaken for glanders, 
especially when accompanied by an abundant fetid discharge 
and considerable tumefaction of the sub-maxillary lymphatics. 
In a large proportion of cases of suppurating odontomes, 
there is a well-marked, hard, sometimes nodular and painful 
tumefaction of the submaxillary glands. 
Suppurating odontomes of the sixth, perhaps also of the 
fifth molar, when the exit of pus chances to occur inwardly, 
