A treatise on the diseases and surgical operations of the mouth, and parts adjacent; with notes of interesting cases, ancient and modern / Translated from the French of M. Jourdain.

  • Jourdain, M. (Anselme Louis Bernard Bréchillet), 1734-1816.
Date:
1849
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the diseases and surgical operations of the mouth, and parts adjacent; with notes of interesting cases, ancient and modern / Translated from the French of M. Jourdain. Source: Wellcome Collection.

    45/418 (page 43)
    the urine, carbon from the lungs, and perspiration ; and secretions which are to answer some given purpose, as milk, bile, semen, etc.] Instances are frequent where the retention of this ex- cretion, consequent on the closure or obstruction of the open- ings of this cavity, has given rise to very serious accidents. Palfin, and after him most others, have thought that the se- cretions of the antrum could be voided only in a certain posi- tion of the head—lying on the right side to evacuate the left antrum, and vice versa. The idea is plausible ; but in this case these cavities could, ordinarily, be emptied only at night; and, apart from the absence of proof, a reference to the structure of these parts, and the glutinous nature of mucus, will show the insufficiency of these positions of the head to accomplish the purpose mentioned. 1st. The natural opening is on the side of the posterior part of the nasal canal, which is not so low as the floor of the sinus. 2dly. The opening itself is con- siderably above this floor. 3dly. This floor passes obliquely backward [downward and outward] to the side of the dens sapientiæ. 4thly. The inferior edge of the middle turbinated bone seems to touch the convexity of the inferior, thus leaving between the two a kind of groove. After this examination of the subject, it is not very easy to admit that the positions spoken of are the only means which nature adopts for the evacuation of this cavity.* There are cases in which the sinus will empty itself, no mat- ter in what position; when, from any cause, the secretion is thin and watery, as in ordinary coryza ; or in case of abundant sup- puration—here, however, there is an overflow of matter. We should remark that it is necessary to this overflowal, in the first case, that the natural opening be free; for if it be to a cer- tain degree obstructed, there will occur, instead of an efficient discharge, only a slow dropping. The same will happen, in the second case, if the pus is thin; but if thick, it can be evacu- ated only at the expense of the parts, as when caries occurs, and wholly or in part destroys the nasal opening. * The ver}’’ positions suggested by Palfin would seem, by the horizontal direc- tion given to the nasal wall of the antrum, to obviate some of these objections of Jourdain.— TV.