NOSE. 
which is in Sandifort’s museum, and in which 
the olfactory nerves and the nasal, lachrymal, 
and ethmoid bones are all absent.. 
Next to these are cases in which the nose 
exists, but has not its naturally complex form. 
Otto* describes two such in mature female 
anencephalous children. The nose was in both 
flat and broad; it had but one nostril, and the 
septum was absent. The inferior turbinated 
__ bones were approximated posteriorly, so as in 
_ one case to close the nasal cavity, and in the 
_ other to reduce it to a very narrow aperture 
_ pening into the pharynx. In one of these 
children, also, the olfactory nerves were absent. 
Sometimes a state like this exists on one side 
only. Vrolik+ mentions a child still living in 
which the right half of the nose was fully deve- 
 loped, but on the left side there was a kind of 
_ snout hanging from the root of the half nose, 
orated and giving passage to mucus and air. 
rofessor Broers cut off this appendage and the 
ure closed. 
The floor of the nasal fosse remaining in the 
_ state which it naturally presents up to the third 
_ month, constitutes cleft palate, a slight degree 
_ of which, since it produces no inconvenience, 
_ is more common than is generally supposed. 
_ When the membrane described as closing the 
nostrils after about the ninth week is not 
_ removed, the atresia narium results. Several 
_ cases fairly referable to this arrest of develope- 
_ ment have been recorded. 
_ Defects of developement at a later period 
_ are seen in the cases of absence of one or more 
sinuses, of which also several cases have been 
recorded. And with these, as errors of deve- 
lopement produced perhaps by some accidental 
presstre, may be enumerated the examples of 
extreme obliquity or curvature of the septum, 
in which the apex of the nose is turned com- 
pletely to one side or even backwards towards 
the cheek. Such are the cases for the remedy 
of which Dieffenbach has lately applied with 
success the subcutaneous division of the carti- 
_ tages and the adjacent contracted tissues.§ 
Another slight defect is that in which part of 
_ the septum is deficient, or in which the bone is 
ie ot but is closed by membrane. Haller] 
_ describes a case in which the vomer was com- 
_ pletely and widely perforated; but much more 
_ commonly the defect is in the vertical plate of 
the ethmoid bone. Very rarely there is an 
aperture in the cartilaginous part of the septum. 
‘The excellent anatomist Hildebrandt had a 
defect of this kind.{ 
| Aclass of cases, which, though congenital, 
cannot be certainly referred to-arrest of deve- 
_fopement, are those of fissure of the nose. 
Sometimes the nose alone is said to be divided 
deeply in the median plane,** and this may 
ee 
8 * Monstrorum sex centoram descr.anat.N.vii.viii. 
 t Lic. p. 260. 
__ t See Vrolik, 1. c. and Meckel, Handb. der pa- 
‘thologischen Anatomie, Bd. i. p. 107. 
asper’s Wochenschrift, Sept. 18, 1841. 
|| Elementa Physiologie, v. 137. 
Hildebrandt’s Anatomie, by E. H. Weber, iv. 
_™ Isidore St. Hilaire, Traité des Anomalies, t. i. 
p. 603. 
VOL. ILI, 
737 
represent the foetal state in which the frontal 
processes have not united, or in which the 
septum is not yet formed. But the cases are 
more numerous in which the fissure exists on 
one or both sides of the face. In some it 
extends from the angle of the mouth, through 
one or both ale of the nose, to the internal or 
external angle of the eye, laying into one the 
cavities of the mouth, nose, and one or both 
orbits. Four such cases, differing but little 
from each other, are recorded by Vrolik. He 
possesses also an example in which, in a much 
less degree of the same defect, there is only a 
fissure of the skin from the mouth to the eye 
by the side of the right ala nasi; and another, 
in which a deeper fissure extends in the same 
direction on both sides. These cases, how- 
ever, like those of hare-lip, cannot be regarded 
as mere arrests of developement: there is no 
period in which the foetus is known to present 
these as normal conditions. 
A very remarkable congenital defect in which 
the nose is concerned, is that of which the 
subjects have been called Cyclopian or Cyclo- 
cephalian monsters. It has been admirably illus- 
trated in a special memoir by Dr. Vrolik,* who 
points out five varieties of it, In the first, the 
eyes are absent or not externally visible, and 
the nose is either absent altogether or replaced 
by a kind of proboscis or snout-shaped member, 
consisting of little more than skin, and attached 
above the orbit. In the second there is a single 
orbit in the middle of the forehead which con- 
tains a single eye-ball, and above which there 
is sometimes a proboscis representing the nose. 
In the third, the eye appears externally to be 
single, but is internally double; and with this 
again the nose may exist in the form of a pro- 
boscis. In the fourth, the two eye-balls are 
separated, but they lie in one orbit in contact, 
or with only a narrow partition between them, 
and above them there is a proboscis which, as 
in the other cases, may be curved either 
upwards or downwards. In the fifth, the pro- 
boscis, approaching more nearly to the form of 
a natural nose, has an osseous nucleus, and is 
directed downwards; and the eye, above which 
it is placed, is either double or single. In this 
series, therefore, there is a regular gradation 
from the natural to the most unnatural condi- 
tion, in regard to both the nose and the eyes. 
For the eyes, there is in some no eye at all; in 
some a single eye-ball placed in the middle 
liné; in some again ar eye-ball, which appears 
single, contains parts of two; and in some two 
eye-balls lie close together in a single median 
orbit. For the nose, it is in some altogether 
absent; in some it exists in the form of a snout , 
which is little more than a prolongation of skin; 
in others it has a more or less well-formed 
osseous nucleus; in some it is curled upwards 
and backwards, in others directed obliquely 
downwards: and among all these there are 
numerous gradations of deformity. Now, any 
of these conditions of the nose may co-exist 
with any of those of the eye: there is no regular 
* Over den aard en oorsprong der Cyclopie, in 
the Transactions of the Netherlands Institute, Am. 
sterdam, 1836, and in his Handboek, D. ii. p, 14, 
3B 
