RHINOPLASTIC OPERATION, When a portion or the whole of the nose has teen destroyed by accident or disease. the deficiency may be restored by a transplantation of skin from an adjoining healthy part. When the whole nose has to he replaced, the following course Is usually adopted. A triangular piece of leather is cut into the shape of the.nose. and is extended on the forehead with its base uppermost ; its boundaries, when thus flattened, are marked out on the skin with ink. - Any remains of the old nose are then pared away, and a deep groove is cut round the margins of the nasal apertures. When the bleeding from these incisions has stopped, the marked portion of the skin of the forehead must be carefully dissected away, till it hangs by a narrow strip between the eyebrows. When the bleeding from the forehead Ceases, the flap Must he twisted on itself so that the surface which was oriolnally external may remain external in the new position, and its edges must be fastened withstitches into the grooves prepared for their reception. The nose thus made is supported with oiled lint. and well wrapped in flan nel. td'keep up the:temperature. When complete adhesion has taken place, the twisted str ; of skin may be cut through, or a little slip may be cut out of it, so that the surfaca may he uniformly smooth. When only a part of the nose. as one side only, or the septum, requires to be restored. modifications of the above operation are required, and the skin, instead of being taken from the forehead, is taken from the cheek or the upper lip. For further details regarding this important operation, the reader is referred to ?ergusson's Practical Surgery.
This operation is popularly known as the Taliacotian Operafrion, from its having been first performed by Taliaeotius, who was professor of anatomy and surgery at Bologna, where lie died in 15:53. The work in which the operation is described wits not published
for more than 40 years afterlds death. It appeared in 1597, under the title De Curtorum Chirurgia per Insitionem tart duo. Instead of taking the skin for the new nose from the forehead, he took it from the arm of his patient, and there is no reason why the operation which he describes, although inferior in many respects to that at present adopted, should not he successful. The difficulty of keeping the arm sufficiently long in apposition with the face Of period of about 20 days), was doubtless one of the reasons for selecting the forehead in preference as the part from which to take the skin. The name of Taliacotius has been mainly poptilarized in this country by a well-known coarse joke in Butler's Ifudibras. There is, however, little foundation for the view which Butler takes of the operation. Taliacotius discusses the advantages and disadvantages of taking the skin from the arm (he does not suggest any other. part of the body) of another person, but he comes to the conclusion that it would be impossible to keep two persons so fastened together for the necessary time, that no motion of the parts in apposition should occur, and he adds that he never heard of the plan being attempted. It is almost unnecessary to add that even if a nose were manufactured from the skin of a second person, there is not the slightest reason for apprehending that it would suddenly (lie and drop off on the death of the original proprietor of the skin, notwithstanding the cases to the contrary recorded. as illustrative of the power of sympathy, by Van Helmont, Campanella. sir Kenelm Digby, and others. This astounding notion was resuscitated not many years ago by M. Edmund About in a popular novel, entitled Le Eez d'un Notaire.