72 SURGICAL APPLIED ANATOMY. [Chap. vi. 



nose is supplied by the second division of the fifth, and 

 is the seat of pain in neuralgia of that trunk. The 

 fact that the nasal nerve is a branch of the ophthalmic 

 trunk, and has intimate connections with the eye, 

 serves to explain the lachrymation that often follows 

 painful affections about the nostril, as, for example, 

 when the edge of the nostril is pinched (page 48). 



The cartilaginous part of the nose is often 

 destroyed by lupus, by syphilitic ulceration, and other 

 destructive affections. The parts so lost have been 

 replaced by the various methods included under the 

 head of rhinoplasty. It is well to bear in mind 

 the limits of the cartilaginous segment of the nose, and 

 to remember that in introducing a dilating speculum 

 the instrument should not be passed beyond those 

 limits. In the subjects of inherited syphilis the bridge 

 of the nose is often found to be greatly depressed. 

 This depends upon no actual loss of parts, but rather 

 upon imperfect development from local mal-nutrition, 

 that mal-nutrition following upon a severe catarrh 

 of the mucous membrane. The deformity only 

 occurs, therefore, in those who have had "snuffles" 

 in infancy. 



The nasal bones are often broken by direct 

 violence. The fracture is most common through the 

 lower third of the bones, where they are thinnest and 

 least supported. It is rarest in the upper third, 

 where the bones are thick and firmly held, and where, 

 indeed, considerable force is required to produce a 

 fracture. Since no muscles act upon the ossa nasi, 

 any displacement that occurs is clue solely to the 

 direction of the force. Union takes place after these 

 fractures with greater rapidity than perhaps obtains 

 after fracture of any other bone in the body. In one 

 case noted by Hamilton, " the fragments were quite 

 firmly united on the seventh day." If the mucous 

 membrane of the nose be torn, these fractures are apt 



