Los Angeles herald., 1909-10-17

perform Just as much mental labor and do 1t just
as well as before the accident. The patient really
summed up the effects of his head injury when he
said he had all of his faculties except his sense OF
moral responsibility.
"On January 49, 1907, mapped out the fssure Of
Roando upon the right side and exposed the lower
and middle thirds of the ascending frontal and ad-
jacent frontal cOnyolutions by means of trephlne
and rongeur forceps. There was no depressed bone
popularity of the wall at this point. Inc
dura, however, adherent to the inner plate of the
skull and all three meninges were glued together
broke up the adhesons between the dura on the one
hand, and the archnod and pia on the other, and
stitched the flap of the dura lightly in place Then
closed the wound in the scalp In two weeks the pa
tient discharged from the hospital Up to the
present time the result of this operations has been
satisfactory Two months after the operation the
patient returned to the employ OF the same company
for which he worked before his downfall He handles
large of money has been promoted twice, each
time with increased pay"
There is a convincing example Of the new SURGERY
The and address of this patient are In my pos
session and have talked to his employers for add1-
tional verfcaton of his restored trustworthiness.
Making Over the Nose
Advances of surgery with the knife and by the
boodless method, with which the lay public first be-
came familiar largely through the work Of Lorenz,
of Germany, virtually equal This is well illus
trated in the matter of nasal operations one OF when
has been cited.
Reforming of badly shaped injured noses is
common operation among dermatologsts and skin
specialists, but the rebuilding in Its entirety Of the
rose is uncommon one.
While Meyer, of Philadelphia, under ether for
Babcock laid back from either side Of the face the
skin covering the spot where the old had been
and pulled down the small remaining portion of the
nasal bone to form bridge for the new one. Two
incisions made in the skin of the forehead just
above where the should be, there being an in
tervening space of about threequarters Of an inch
between the cuts which extended almost to the edge
of the hair Prior to making the incisons the outer
surface of the forehead strip was denuded SO that
when pulled down over the art1cally formed bridge
what had been the outer surface OF the forehead pre-
sened a surface that would quickly adhere and grow
to the bridge formation
OF Movers first all that remained was the
septum or bit of cartilage just above the upper lip
and dividing the nostrils The face itself was al
most fiat To this small cartilage the skin that was
stripped down from the forehead was stitched and
the skin facial flaps at either side of the nasal pas
sages were drawn together and seWed down the
centre. The next difficult task was the formation
of new nostrs, that Meyer might breathe as 1t was
intended man should. Short rubber pipes were In
serted at either side of the central nasal cartilage to
the cavity from which the air reaches the bronchial
tubes Three weeks after the first operation Meyer
underwent a second to build up the nose which
until that time had Grecan TIT when dlscharged
he had been relieved of all Disagreement, though the
new nose is possibly just a bit smaller than the
original
The nose has always attracted attention mainly
because of the position it occupies amid the features
1t has been made to speak just as our other bodily
members have. II chseled and pointed it denotes
fnesse; if hooked it is the sign of herosm; If cleft
If proclaims benevoence; if arched, it indicates
tyrannical nature; if straight it bespeaks dignity
and modesty. with deformed nose suffers
no longer need for such distressing situations.
One of the worlds greatest specialists in correcting
nasal alterations is DR.. Jaques Joseph OF Berhh,
some of whose greatest successes have SEEN Before
he began his labors there existed the rhinopastic
method which was often Intellectual and unsatisfac-
tory Rhinoplasty practised to restore vanished
or destroyed Dr. Joseph works to correct I'M
perfections of existing noses that are flshapen.
Scarcely ever does the Berlin surgeon pierce the SKIN
of the nose He operates under the skin by way of
the nasal cavity His work is brought to bear upon
the bony framework Of the nose and consists in
altering the form of that framework, sometimes re-
ducing it or adding to it, sometimes improving its
proportions He removes bone and cartilage or adds
hone and cartilage taken from another part of the
nose To alter the proportion he cuts and forces
scar tissue TO form in new position AS soon as
the bony framework is remodelled the skin adheres
anew and itself takes the outlines of the remodeled
support
Leaves No Scar.
There was a patient, for instance, whose nose was
too broad at its foundations and spread generously
over his face DR.. Joseph introduced bstoury into
tbe nostris cut through the lining of the nose and
then with little separated the bony base OF the
nose from the maxilary. slight pressure brought
tbo base in toward the median line. pincenez held