. The principles and practice of surgery. the acne. A few years later the lipoma was partially removed bya surgical operation, but it soon attained a larger size than it had be-fore. When she consulted me it was a huge bulbous mass covering thelower third of the nose including the alse, and falling over the was of a dark-red color; some of the sebaceous follicles were of thesize of a crow-quill, and they constantly exuded a very offensive suffered much from a sense of heat and weight in the nose, andfrom continued headaches. I carefully dissected away all of the hyper-troph
. The principles and practice of surgery. the acne. A few years later the lipoma was partially removed bya surgical operation, but it soon attained a larger size than it had be-fore. When she consulted me it was a huge bulbous mass covering thelower third of the nose including the alse, and falling over the was of a dark-red color; some of the sebaceous follicles were of thesize of a crow-quill, and they constantly exuded a very offensive suffered much from a sense of heat and weight in the nose, andfrom continued headaches. I carefully dissected away all of the hyper-trophied tissues, exposing completely the cartilages of the ridge of thenose and of the alse. It was necessary in this case, as it will be found EPITHELIOMA OF THE NOSE. 597 to be in all cases, to keep the forefinger of the left hand much of thetime within the nose, to avoid the danger of cutting through. Sixweeks later cicatrization had made considerable progress, and afterseveral months I was informed that the cure was completed. Fig. Lipoma of the Nose. If the amount of integument which has to be removed is very great,I would advise immediate repair of the lost tissues by transplantationfrom the forehead. The vessels are generally so much enlarged as tocause a pretty free haemorrhage during the operation; and Gibson statesthat Mr. Blizzard once lost a patient from this cause. Epithelioma of the Nose. Syn., Carcinoma Cutis Nasi, R. O.—Epithelioma of the nose, seldom seen prior to the thirty-fifth or fortiethyear of life, commences usually upon one of the alse ; next in point offrequency upon the side of the nose, in the neighborhood of the innercanthus; occasionally it attacks primarily the end of the nose; and, al-though obstinate and perforating ulcers are often found upon the liningmembranes, and especially upon the septum they have seldom thecharacter of true epithelioma. Upon the integument it appears first as a warty excrescence, or as asmall brown crust, accompanied
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