Periscope. [Volume: 27, Issue: 1, January, 1885, pp. 49-63]

60 THE DENTAL COSMOS.
Thomas N., aged 47, a clerk, was admitted into the hospital under
the care of Mr. Godlee. His personal and family history are good.
He is of temperate habits, and there is no cancer or tendency to
tumors in his family.
Present Illness.-Just before Christmas last year he received a
blow from the leg of a couch over the left brow, which made him feel
silly for a time. A large lump formed at the seat of injury. This
became discolored, and lasted about ten days. A week after the injury, while eating his breakfast one morning, he noticed an offensively smelling discharge from his left nostril. This has continued
for some time, and then goes away. He has had severe headache at
times, lasting for several days and then going away. This pain begins over the spot where he received the blow; thence shoots up to
his occiput. The discharge from the nose comes on after the headache. For three months past he has completely lost the sense of
smell.
Present State.-Examined with a speculum, there is seen a yellowish discharge from the floor of the middle fossa of the left side of
the nose; the mucous membrane is red and congested.
He was ordered flying blisters over the position of' the frontal
sinuses, under which there was at first considerable improvement.
He was then temporarily discharged.
September 3. On re-admission he still complained of the pain
over the left frontal sinus, which extended backwards in a defined
manner for about the length and breadth of a forefinger. There
was very offensive discharge from his nose.
He was chloroformed, and it was determined to explore the antrum before opening the frontal sinuses, where the mischief was,
however, expected to exist. A trocar and canula were passed in
above the first molar, and a quantity of creamy offensive pus was
evacuated. Mr. Godlee now gouged an aperture through the anterior wall of the antrum, after first separating the gum and mucous
membrane from the alveolar border.
The cavity was scraped out with a sharp spoon, and it was
plugged with wet boracic lint, dusted with iodoform, after being irrigated with chloride of zinc solution.
September 4. Patient passed a very good night; all pain from the
frontal region had disappeared.
September 5. He was discharged greatly relieved.
Remarks by Mr. Godlee.-The interest of this case consisted in the
fact that both the history and symptoms appeared clearly to indicate disease of the frontal sinus, whereas there was no swelling, tenderness or discomfort in the region of the antrum. The pain was
referred to the inner part of the superciliary eminence, and was thus
clearly not due to supra-orbital neuralgia, which not unfrequently
accompanies suppuration in the antrum. —University College Hospital
Reports, in Medical Times and Gazette.
ABSCESS OF THE ANTRUM OF HIGHMORE.-Mr. B., 64 years of age,
was compelled to have a tooth, the upper last molar of the right
side, extracted on account of a severe pain referred to that locality.
This operation was performed by a dentist of this city on the 1st of
May last. The tooth proved to be sound, and showed no evidence