Abscess of the Antrum Caused by a Tooth. [Volume: 2, Issue: 10, May, 1861, pp. 538-540]

540

THE DENTAL COSMOS.

The antrum was syringed with tepid water for five or six days, twice a
day, a large quantity of pus escaping with the water through the nose.
The water was then medicated in the ratio of about five grains of nitrate
of silver to the ounce at first, but was increased to about fifteen grains to
the ounce; the weaker solution was used three days, twice a day; the
stronger was used two days, once a day; and then, owing to the healthy
appearance of the pus and its small quantity, and absence of any fetor,
and also because there were manifestations of granulations forming around
the orifice leading from the alveolus to the antrum, which was discovered
by the difficulty of passing in the nozzle of the syringe, and when removed
was found stained with blood, the injection was discontinued in order to
allow the orifice to close up and prevent a fistulous communication being
kept up between the antrum and mouth, and because it was thought
nature was now able to carry on the process of reparation. It is a difficult thing to know when this period has arrived; the above symptoms,
however, were considered sufficient. The alveolus was kept patulous by
a pledget of cotton until there was a certainty of its bottom, which communicated with the antrum, showed signs of healthy granulations. This
must always be recollected. The cotton should then be left out, the parts
will rapidly close and fill up, as did the present case, which is now a perfect cure.
The patient was seen a few days ago and was perfectly well; he has
not had an untoward symptom since the termination of the case, which
was about two months ago.
It may be interesting to some pathologists to know the condition of the
extracted tooth. The buccal roots were almost entirely denuded of periosteum, and very rough; about one line from their apices were found
very small fragments of apparently mucous membrane, evidently that from
the floor of the antrum. This was all that was of importance.
Connected with this case was a coincidence which at first greatly
alarmed the patient: he had frequently visited a horse belonging to his
father which had a profuse discharge from the nose and which was thought
to be glanders, but the veterinary surgeon decided otherwise; and finding
a carious molar in the horse's upper jaw proposed to extract it, for which
he wished thirty-five dollars as a fee. The gentleman was unwilling to
pay that amount, but offered to give him the horse if he cured it. To
this the surgeon disagreed. The horse was then shot, which is unfortunate for science and curiosity. The horse's malady was prior to that of
the patient, and caused him to fear that he had contracted the disease
from it.
PHILADELPHIA, April, 1861.