50 INJURY OF THE FAOe! 



(about to be described) was performed. He in- 

 formed me that he had undergone different kinds 

 of treatment, and applied various remedies to the 

 face, without deriving the slightest benefit there- 

 from. On examination I found the right malar 

 bone considerably enlarged, the right side of the 

 face a little swollen, and a cloaca existed in the 

 right cheek, situated nearly opposite the upper 

 border of the ala nasi. Having passed a probe 

 into this opening, I detected what I at first sup- 

 posed to be a large piece of necrosed bone, which 

 could be slightly moved. As he could not open 

 his mouth more than a quarter of an inch, I failed 

 in ascertaining the state of its interior. I examined 

 the nasal cavity with the speculum, but discovered 

 nothing abnormal. 



As the man's health was rapidly giving way 

 under the irritation and constant discharges to 

 which he was subjected, I advised him to submit 

 to an operation, to which he most willingly as- 

 sented. On Thursday, June 19th (two days after I 

 first saw him), I proceeded to operate, assisted by 

 Dr. W. C. Simms. The patient having been put 

 under the influence of chloroform, I made one 

 incision from the upper border of the right ala 

 nasi, extending across the cheek towards the 

 prominence of the malar bone, and a second, 

 beginning at the commencement of the first, and 

 extending downwards towards the angle of the 

 mouth, and retracted the flap thus formed, when 



