DISEASES OF THE FACE, NOSE AND MOUTH. 65 



Woiinds of the External Ear do not afFect the hearing; but when 

 the cartilage is cut, a split will remain, unless the integuments are 

 carefully united. 



Wounds of the Eyeball, produced by great violence, such as gun- 

 shot wounds, of course destroy the sight, and are often followed by a 

 fungous growth, which requires removal and the substitution of a glass 



eye. 



Wounds of the Tongue. — Bleed very copiously, and there is some 

 difficulty in arresting hemorrhage. This is to be effected by a liga- 

 ture and styptics ; and, if necessary, by the actual cautery. Sutures 

 are necessary to approximate the edges of the wound. 



Salivarij Fistula. — This results from a wound or ulcer of 

 Steno's duct, by which the discharge of the parotid gland opens ex- 

 ternally on the cheek, occasioning great inconvenience and de- 

 formity, and interfering with the processes of mastication and diges- 

 tion. A cure is to be effected by making an opening through the 

 mucous membrane of the cheek, that the saliva may enter the mouth, 

 and by closing the fistulous orifice. The edges of this orifice will 

 require caustic, or paring with a sharp knife, or the actual cautery, 

 to make them unite, and the internal orifice is to be kept open by a 

 tent. 



Epistaxis. — This implies hemorrhage from the nostril, produced 

 by injury, plethora, or diseased state of the blood and mucous mem- 

 branes. The treatment will, in a great measure, depend upon the 

 cause. The arrest of hemorrhage by external applications, is only 

 to be made under certain circumstances ; it will be effected by an 

 upright position, cold applied to the head and back, astringents 

 thrown up the nostrils, and compression by lint. In some instances, 

 the lint is to be introduced through the posterior nares, by means of 

 Belloque's canula, or by a flexible catheter and a piece of string, 

 where it must be allowed to remain for several days ; in many in- 

 stances, constitutional treatment is necessary. 



Foreign Bodies in the Nostril.— Feas, beads, and such like sub- 

 stances are often inserted by thoughtless children; and by unwise 

 efforts at removal, they are more deeply lodged in the cavity. The 

 surgeon is to inject a stream of warm water into the nose, which 

 will wash away any coagula of blood, and loosen the foreign 

 body; its position is to be discovered by a probe, when it can be 

 extricated by a scooped end of a director or forceps. A pinch of 

 snuff will sometimes dislodge it. 



Polypus of the Nose.—T\\eve are different varieties of polypi : the 

 most common is a gelatinous, pyriform mass, attached to the mucous 

 membrane of the turbinated bones. The patient has a sensation of 

 a cold in the head, which is much increased in damp weather. It in- 

 terferes with respiration, and frequently alters the tone of the voice. 

 The sense of smell is also impaired, and deafness may be produced, 



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