Licence: Public Domain Mark
Credit: The works of John Hunter. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
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![The eye is also affected ; and it is very common for people with such a disease to have a severe pain in the forehead, where the frontal sinuses are placed; but still the symptoms are not sufficient to distinguish the disease. Time must disclose the true cause of the pain; for it will commonly continue longer than that which arises from a diseased tooth, and will become more and more severe; after which a redness will be observed on the fore part of the cheek, somewhat higher than the roots of the teeth, and a hardness in the same place, which will be considerably circumscribed. This hardness may be felt rather highly situated on the inside of the lip. As this disease has been often treated of by surgeons, I shall only make the following remarks concerning it. The first part of the cure, as well as of that of all other abscesses, is to make an opening, but not in the part where it threatens to point: for that would generally be through the skin of the cheek. If the disease is known early, before it has caused the destruction of the fore part of the bone, there are two ways of opening the abscess : one by perforating the partition between the antrum and the nose, which may be done; and the other by drawing the first or second grinder of that side, and perforating the partition between the root of the alveolar process and the antrum, so that the matter may be dis- charged for the future that way. But if the fore part of the bone has been destroyed, an opening may be made on the inside of the lip, where the abscess most probably will be felt; but this will be more apt than the other perforation to heal, and thereby may occasion a new accumulation ; which is to be avoided, if possible, by putting in practice all the common methods of prevent- ing openings from healing or closing up : but this practice will rather prove troublesome ; therefore the drawing the tooth is to be preferred, because it is not so liable to this objection11. a [The true nature of this affection is generally mistaken, and the error is perpetu- ated by the misapplication of the term abscess. It consists of nothing more than an altered secretion of the mucous lining of the antrum, produced by a condition of the part perfectly analogous to that of the lining of the urethra in gonorrhoea. It does not always happen that the opening into the nose becomes impervious in this disease. Yet even where this communication remains free, and allows of a ready exit for the muco- purulent secretion, no remedies can be applied to the diseased membrane without re- moving a tooth for the purpose of perforating the floor of the antrum. The usual modi of effecting this is by means of a small trocar; and the treatment is similar to that of gonorrhoea, as far as relates to the injection of stimulant or astringent applications, which are not of course liable to the same objections in the present instance as in the disease just mentioned ]](https://iiif.wellcomecollection.org/image/b21996635_0002_0098.jp2/full/800%2C/0/default.jpg)
