738 



NOSE. 



correspondence between their respective degrees 

 of developement. This is confirmed by the 

 cases of the monsters in which the eyes are 

 completely absent, but the orbits are naturally 

 placed and the nose is well formed ; and by 

 those others already mentioned, in which the 

 nose is absent, but the eyes and orbits are 

 natural and almost naturally placed. From all 

 these, and from the constancy of the deformity 

 of the nose when the orbits are united, it may 

 be deduced that the eye and the nose are deve- 

 loped independently, except in regard to their 

 position, and that the displacement of the nose, 

 which constitutes one of the chief features of 

 the Cyclopian monsters, is generally the con- 

 sequence of the orbits having taken up the 

 place of the nasal cavities. It cannot be said 

 that the displacement of the orbits is the only 

 cause of that of the nose, because there are a 

 few cases in which the nose occupied the 

 Cyclops position, though the orbits had their 

 natural place ; and one case in which the orbits 

 and eyes were absent, and yet the nose was 

 elongated like a proboscis and set high upon 

 the forehead. But these do not invalidate the 

 truth of the general deduction already drawn. 



The displacement of the nose is thus ex- 

 plained with much probability by the precedent 

 displacement of the orbits, and the latter is 

 probably due to an arrest in the develope- 

 ment of the eyes. But the cause of the 

 peculiar deformity of the nose is very obscure. 

 There is generally some degree of relation be- 

 tween the approach to completeness of the nose 

 and that of the brain and its nerves, and espe- 

 cially of the anterior lobes and the olfactory 

 nerves : yet these nerves are sometimes present 

 when the nose is most deformed, and when it 

 has neither ethmoid bone nor cavity, nor even 

 any osseous nucleus ; and in other cases they 

 are absent when there is a distinct though mis- 

 shapen external nose. Tiedemann's suppo- 

 sition, therefore, that these, like other malforma- 

 tions of organs, depend on a precedent defect 

 in the corresponding nerves or parts of the ner- 

 vous centres, cannot be maintained. 



Diseases of the nose. These are so far gene- 

 rally similar to those of the similar tissues in 

 other parts that some of their peculiarities only 

 need be mentioned here. 



The skin of the nose is perhaps more than 

 any other part of the face subject to the erup- 

 tions of acne, &c. And these acquire a some- 

 what peculiar character from the small vessels 

 of the nose being so liable to distension. In 

 the common red nose, all the small veins are 

 usually dilated and in a measure varicose; and 

 even in healthy persons the circulation through 

 the skin of the nose is carried on with com- 

 paratively little force, if we may judge by the 

 frequency with which it is partially arrested by 

 cold. This dilatation of the vessels and con- 

 sequent slowness of circulation not only render 

 the diseases of the nose peculiarly obstinate, 

 but permit them to produce changes of structure 

 which are very rarely found among their defects 

 in other parts. Such is the tuberculated indu- 

 ration and thickening with deep red or livid 

 congestion of the skin after long-continued 



acne, in which all the deeper textures appear to 

 be confused in one hard brawny substance. 

 When this state continues very long and the 

 congestion somewhat abates, the thickened 

 tissues remain, and sometimes grow into a kind 

 of pendulous tumour from the end of the nose. 

 Such tumours, (which, however, may form with 

 little precedent acne,) are usually three-lobed, 

 one portion seeming to correspond to the end, 

 and one to the fore part of each of the alse, of 

 the nose. One which I dissected was com- 

 posed throughout of a compact, white, fibro- 

 cellular tissue, like that of which the pendulous 

 tumours consist which grow from other parts of 

 the skin, and especially from the female labia. 

 It seemed very little vascular,* and the hair- 

 follicles and sebaceous glands were enormously 

 enlarged. Some of the latter measured not less 

 than a line in width, and their ducts, which 

 opened at the bottoms of deep fossse, admitted 

 full-sized bristles. The same enlargement of 

 these organs takes place in certain large growths 

 of the skin of the scrotum. 



The position of the cavities of the nose has 

 been an effectual hindrance to the examination 

 of the changes of structure produced by their 

 ordinary diseases. Nothing is known of the 

 state brought on by repeated colds. While they 

 continue, the mucous membrane is gorged with 

 blood, swollen, and red, so as to close, with the 

 assistance of the increased secretion of mucus, 

 the passage to the pharynx. Probably the 

 mucous membrane is in time condensed and 

 thickened ; and from this it may result that in 

 looking over a number of sections of heads, the 

 Schneiderian membrane is found by no means 

 uniform in its thickness, consistence, or vascu- 

 larity even on corresponding parts. 



M. Mareschalf has lately stated that, in the 

 examination of eight persons who had had epis- 

 taxis shortly before their deaths, he found in all 

 a circumscribed portion of the membrane which 

 was very congested, and dark red or livid. In 

 two of them this congested part was situated 

 anteriorly, near the junction of the septum and 

 the floor of the nostrils; in the others poste- 

 riorly on the fold of mucous membrane at the 

 lower border of the inferior turbinated bone. 



Simple abscesses sometimes occur beneath the 

 mucous membrane of the nose, especially after 

 injuries ; and after passing through an ordinary 

 course leave their usual effects in thickening, 

 induration, and unnatural adhesion of the cica- 

 trized tissues. 



A. thickening of the mucous membrane simula- 

 ting polypus has been already mentioned. It oc- 

 curs especially in scrofulous children and young- 

 persons, and presents the same characters, as to 

 its duration and progress, which are observed in 

 the other chronic inflammations to which they 

 are subject, and with one or more of which it is 

 commonly associated. This spongy thickening 



* Sir W. Blizard lost a patient through hemor- 

 rhage after the removal of a tumour of this kind 

 from the nose ; but it is possible that this might 

 have been owing to something wrong in the general 

 state of the patient, for usually little blood is lost 

 in such operations. 



t Annales de CLiruvgie, Janvier, 1843. 



