A CLINICAL STUDY OF ODONTOMES. 
67 
full blood French draught filly, nearly a year old, and had been 
noted unwell for some two or three months prior to admission 
to our infirmary. 
The first symptoms noticed by the owner was slight 
dyspnoea, shown after a short run, and slight swelling over the 
region of the maxillary sinuses. The dyspnoea and enlarge¬ 
ment rapidly increased until at date of admission she was 
barely able to walk half a mile to and from the cars. There 
was neither any nasal discharge nor fetor of breath. The 
central part of the facial swelling was superior to the normal 
position of the fang of the fourth tooth and, suspecting some 
form of dental trouble, we trephined well down at the lower 
border of the swelling, and passing through the ordinary 
thickness of bone, we came at once upon a very hard substance 
barring our further progress. In enlarging the opening and 
passing to one side of the' hard enamel substance, we per¬ 
mitted the escape of about two pints of a thin, clear, pale- 
yellowish fluid. After freely enlarging our opening and bar¬ 
ing the solid part of the tumor, we placed a punch against it 
perpendicular to the side of the face, and with several sharp 
blows with the mallet, broke the tumor from its attachments, 
but finding it too large for extraction through the already very 
large opening, it was broken up by the aid of tooth-cutting 
forceps. 
This enamel portion of the odontome was very irregular and 
weighed about four ounces (Fig. 14 a). Adjoining this mass of 
enamel was a considerable equally irregular mass of dentine, 
which was next removed in the same manner. A portion of 
this is shown in Fig. 14#. 
We now had free access to the large cyst surrounding, from 
which the fluid had escaped earlier, and found that it had at¬ 
tained such dimensions as to invade all the sinuses on the left 
side, destroying all partitions and converting all into one im¬ 
mense cavity, completely occupied by the cyst, which had 
further encroached upon and occluded the left nasal passage, 
and, pressing hard against the septum nasi, had greatly nar¬ 
rowed the right nasal passage, thus producing serious 
dyspnoea. 
