ng the nose. When the septum
is damaged and the bridge of the nose tends to fall in, rubber tubes
may be placed in the nostrils to give support, or, if this is not
sufficient, a soft lead or gutta-percha splint should be moulded over
the nose, and the splint and the fragments transfixed with one or more
hare-lip pins. These may be removed on the fourth or fifth day. Rigid
appliances introduced into the nostrils are to be avoided if possible,
as they are uncomfortable and interfere with proper cleansing and
drainage of the nose. The inside of the nose should be smeared with
vaseline to prevent crusting of blood, and the nasal cavities should
be frequently irrigated.

#Deformities of the Nose.#--The most common deformity is that known as
the _sunken-bridge_ or _saddle nose_ (Volume I., p. 174). It is most
frequently a result of inherited syphilis, the nasal bones being
imperfectly developed, and the cartilages sinking in so that the tip
of the nose is turned up and the nostrils look directly forward. The
bridge of the nose may sink in also as a result of necrosis of the
nasal bones, particularly in tertiary syphilis, and less frequently
from tuberculous disease. A similar, but as a rule less marked
deformity may result from fracture of the nasal bones or from
displacement of the cartilages.

When the condition is due to mal-union of a fracture, the contour of
the nose may be restored by operation. A narrow knife is passed in at
the nostril and the skin freely separated from the bone; the bone is
then broken into several pieces with necrosis forceps, and the
fragments moulded into shape. A rubber drainage tube introduced into
each nostril maintains the contour of the nose till union has taken
place.

When it results from disease, it is much less amenable to treatment.
The present-day tendency is to discard the use of subcutaneous
paraffin injection and to employ grafts of cartilage or bone. An
artificial bridge has been made by turning down from the forehead a
flap, including the periosteum and a shaving of the outer table of the
skull, or by implanting portions of bone or plates of gold, aluminium,
or celluloid.

Portions of the alae nasi may be lost from injury, or from lupus,
syphilis, or rodent cancer. After the destructive process has been
arrested, the gap may be filled in by a flap taken from the cheek or
adjacent part of the nose. When the tip of the nose is lost, it may be
replaced by Syme's operation, which