Defects in these three parts, if they be small(18), may be cured: if considerable, they either do not admit of a cure, or by the cure itself are so deformed, that they were less offensive before. And in the ear indeed, and the nose, deformity is the only thing to be feared: but in the lips, if they are too much contracted, there is also a disadvantage in respect of their use; because the food is taken, and the speech is articulated with more difficulty. For flesh is not generated there; but is brought from the adjacent part. Which though in a slight mutilation it may both cause no defect, and escape observation, in a great one cannot. Now an old person is not a proper subject for this operation, nor one in a bad habit of body, nor one in whom ulcers heal with difficulty; because there is no part, where a gangrene more quickly seizes, or is harder to remove.

The method of cure is this; to reduce that, which is mutilated, into a square; from its interior angles to cut in transverse lines, so as to divide the part, that lies within these lines, from that beyond them; then to draw together the parts we have thus opened: if they do not fully meet, then beyond the lines we made before, to cut in two places in a lunated form, with the horns turned towards the wound, so as only to separate the surface of the skin: for by this means what we draw together will be more at liberty to follow; which is not to be forced by violence, but gently drawn, so as it may easily follow, and when let go, not recede far.

Sometimes however, the skin not being altogether brought from one side, renders the part, which it has left, deformed(19). In such a place an incision must be made only on one side, and the other kept untouched. Therefore we must not attempt to draw any thing either from the lower part of the ears, or the middle of the nose, or the lower parts of the nostrils, or from the angles of the lips. We may draw on both sides, where there is any defect in the upper parts of the ear, or the lower parts or the middle of the nostrils, or the middle of the lips: which however are sometimes mutilated in two places; but the method of cure is the same. If a cartilage projects in the part where the incision is made, it must be cut off; for it neither unites again, nor is safely pierced by the needle. Neither must much of it be cut away, lest between the two extremities of the skin freed from it on both sides, there should be a collection of pus. Then the lips of the wound being brought into contact, must be stitched together, the skin being taken up on both sides; and where the lines above mentioned are, there also the suture must be used. In dry parts, as the nostrils, the application of litharge does very well. Into the interior and lunated incisions lint must be put; that granulations of flesh may fill up the wound. And that the part thus sewed must be attended to with the greatest care, may appear from what I said before of a gangrene. Therefore every third day, it must be fomented with the steam of hot water, and the same medicine applied again, which commonly on the seventh day unites it. Then the stitches ought to be taken out, and the ulcer healed up.