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Updated: May 5, 2025
The characteristic greenish-grey or yellow granules are seen in the pus, and when examined microscopically reveal the colonies of actinomyces. Less frequently the maxilla becomes affected, and the disease may spread to the base of the skull and brain.
The extent to which bone which has been lost is reproduced varies in different parts of the skeleton: while the long bones, the scapula, the mandible, and other bones which are developed in cartilage are almost completely re-formed, bones which are entirely developed in membrane, such as the flat bones of the skull and the maxilla, are not reproduced.
In all these particulars, the mandible of Lepisma is comparable with that of certain Coleoptera and Neuroptera. So also are the maxillæ and labium, though we are not aware that any one has indicated how close the homology is. The accompanying figure of the maxilla of a beetle may serve as an example of the maxilla of the Coleoptera, Orthoptera and Neuroptera.
A part of the right malar bone, the two superior maxillary bones, the nasal bones, the cartilage, the vomer, the middle lamina of the ethmoid, the left maxillary bone, a portion of the left zygomatic arch, and a great portion of the inferior maxilla were carried away, or comminuted, and all the soft parts correspondingly lacerated.
A less aggressive form, confined to the maxilla on one side, is sometimes met with, and, in a case of this variety under our own observation, the disfigurement, which was the only subject of complaint, was removed, after reflecting the soft parts, by paring away the excess of bone; this is easily done as the bone is spongy, and at an early stage, imperfectly calcified.
For how was it that Axilla was made Ala, except by the flight of the larger letter? and so the elegant usage of Latin conversation takes this letter x out of maxilla, and taxilla, and vexillum, and paxillum. They also joined words by uniting them at their pleasure; so as to say sodes for si audes, sis for si vis. And in this word capsis there are no less than three words.
Neither Ambrose Paré, applying for the first time since Celsus, after an interval of fifteen centuries, a ligature to an artery, nor Dupuytren, about to open an abscess in the brain, nor Gensoul when he first took away the superior maxilla, had hearts that trembled, hands that shook, minds so strained as had the doctor when he approached Hippolyte, his tenotome between his fingers.
In order to ascertain how far it might be possible for a bar of the size causing the injury to traverse the skull in the track assigned to it, Bigelow procured a common skull in which the zygomatic arches were barely visible from above, and having entered a drill near the left angle of the inferior maxilla, he passed it obliquely upward to the median line of the cranium just in front of the junction of the sagittal and coronal sutures.
Von Langenbeck of Berlin mentions an instance of fracture of the superior maxilla, in which the eyeball was so much displaced as to lodge in the antrum of Highmore. Von Becker of Heidelberg reports the history of a case in which a blow from the horn of a cow dislocated the eye so far back in the orbit as to present the appearance of enucleation.
Bartholomew's Hospital in London there is a congenital tumor which was removed from the anterior mediastinum of a woman of twenty one, and contained portions of skin, fat, sebaceous material, and two pieces of bone similar to the superior maxilla, and in which several teeth were found.
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