Lectures on certain diseases of the jaws : delivered at the Royal College of Surgeons of England, 1887 / by Christopher Heath, F.R.C.S.

  • Heath, Christopher, 1835-1905.
Date:
[1888?]
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on certain diseases of the jaws : delivered at the Royal College of Surgeons of England, 1887 / by Christopher Heath, F.R.C.S. Source: Wellcome Collection.

Provider: This material has been provided by University of Bristol Library. The original may be consulted at University of Bristol Library.

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    certain points being so absorbed that fluctuation is readily perceptible. Occasionally the other walls of the jaw yield, though more slowly, to the persistent pressure, the palate becoming flattened, and the nostril blocked by the bulging of the internal wall. On the extraction of a molar tooth and perforation through its socket, as described under the previous section, or more frequently by an incision through the osseo- membranous wall of the cyst, a quantity of clear or yellowish serous fluid is evacuated, which frequently contains flakes of cholesterine floating in it. After the evacuation of the fluid the swelling ordinarily subsides, the maxilla resuming its normal relations, and the opening closing. The old explanation of these phenomena was that the aperture between the antrum and the nostril having become accidentally obstructed, the mucous secretion, which was presumed to be constantly taking place within the cavity, was thought to be imprisoned, and, by its gradual accumula- tion, to produce the symptoms which have been described. Following up this idea, we find surgeons, and among others Jourdain, of Paris (17G5), who very accurately described the affection, recommending the restoration of the nasal orifice by probing—a useless operation, still described in many foreign manuals of operative surgery. Bordenave, in his Observations on Diseases of the Maxillary Sinus (Sydenham Society's translation, 1848), gives full details of this method of probing and injecting, but, after showing that there is great difliculty and uncertainty in finding the natural orifice, remarks that there are very few cases in which the employment of injections through the natural openings, in the manner above described, would efi'ect a complete cure. It is certain, however, that some of these cases, and very })robably all of them, originate in the growth of a cyst or cysts within the antrum, or more commonly in the wall of the antrum, which either grow to such a size as to be mistaken for the cavity of the antrum when opened, or break into the antrum by absorption of the cyst-wall, so that on subsequent examination no evidence of cyst-formation can be discovered. This ex})lanation is, as pointed out by Coleman, supported by the fact that in these cases of so-