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As a rule the earliest symptoms in childhood are: more or less persistent headache, particularly frontal, sanguineous and purulent discharge from the nostrils, and the formation of symmetric swellings the size of an almond in the region of the nasal processes of the superior maxilla.
The bull-dog, for example, displays this, but in this instance the deformity is really superior brachygnathism, the superior maxilla being arrested in development. Congenital absence of the nose is a very rare anomaly.
A careful examination of each tooth together with radiograms of the entire maxilla are absolutely essential to determine their presence or absence. Trephining for Glaucoma London, England. Mr. President and Members of The Chicago Ophthalmological Society: As the hour is late I propose to take up only the principal points in connection with my subject and to deal with each one shortly.
Neither Ambrose Pare, 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 Monsieur Bovary when he approached Hippolyte, his tenotome between his fingers.
The inferior maxilla and the frontal bone were both perfect; the ears were well developed and the tongue strong and active; the nostrils were imperforate and there was no roof to the mouth nor floor to the nares. The eyes were curiously free from eyelashes, eyelids, or brows. The cornea threatened to slough.
When attended with suppuration, the condition has been mistaken for disease of the jaw. Fibrous odontomas have been mistaken for sarcoma, and portions of the maxilla removed unnecessarily. Any circumscribed tumour of the jaw, particularly when met with in a young adult, should suggest the possibility of an odontoma. Skiagrams often give useful information both for diagnosis and for treatment.
Steiner mentions a wound from a cannon-ball, which carried away the left half of the inferior maxilla, stripping the soft parts as high as the malar, and on the left side of the neck to within 1 1/2 inches of the clavicle, laying bare the transverse processes of the 2d and 3d vertebrae, end exposing the external carotid and most of its branches.
The facial and carotid arteries had to be ligated and part of the inferior maxilla removed, but the patient insisted upon having the operations performed without an anesthetic, and afterward informed the operator that she had experienced great pleasure throughout the whole procedure. Pain as a Means of Sexual Enjoyment.
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