A, Supra-Orbital Vein. B, Supra Palpebral Vein. C, Angular Vein. D, Nasal Vein. E, Facial Vein. F, Temporal Vein. G, Ext.-Jugular Vein. H, Post-Auricular Vein. I, Occipital Vein. J, Post-Ext.-Jugular Vein. K, Sup. Labial Vein. L, Inf. Labial Vein. M, Transverse Facial Vein. N, Communicating Br. Ophtal Vein. O, Angular Artery. P, Ant. Temporal Artery. Q, Post Temporal Artery. R, Sup. Coronary Artery.] CHAPTER XIV SUBCUTANEOUS HYDROCARBON PROTHESES Although the subcutaneous employment of oil and liquefied paraffin has been known for some years, particularly by Corning, who refers to his use of solidifying oils in surgery in an article published in 1891, no actual application for prothetic purposes was made until 1900, when Gersuny first advocated the method. In his published report he says that, “if vaselin, which at the temperature of the body has the consistency of ointment, be liquefied by heat and by the means of a Pravaz syringe is injected into dilatable tissue of the human body, there is produced, at the site where the injection is made, a tumefaction whose volume corresponds to the quantity of vaselin injected. The reaction which results from the procedure is insignificant and the mass appears to rest without change where injected.” This subcutaneous method of vaselin injection he employed in the case of a young girl to correct a saddle or depressed nose. The operation was purely a cosmetic one, and was performed on May 8, 1900, with a very satisfactory result. From the time of the appearance of Gersuny’s paper, “Ueber eine Subcutane Prothese,” a number of operators, such as Halban, von Frisch, Kapsammer, Delangre, Rohmer, Stein, and others, began to follow the method with gratifying results. Pfannenstiel, shortly after, claimed that the injection of vaselin was not wholly without danger, and that pulmonary embolism had been observed by him subsequent to its use. Moszkowicz denied the possibilities of such danger, although at this date it is quite evident that there are many objections to the sole use of sterile vaselin for all subcutaneous cosmetic purposes where such protheses might be indicated. Eckstein, on July 24, 1901, rehearses these objections and advocates the use of “Hart paraffin,” or paraffin with a melting point of 57-60° C. (140° F.). His method was taken up by Brœckært, Baratoux, Brindel, Watson Cheyne, Walker Downie, Leonard Hill, Lake, Scanes Spicer, Karewski, and other prominent surgeons abroad, and by Parker, Harmon Smith, Hamilton, Quinlan, Connell, and others in the United States. Drs. Lynch and Heath were the first American physicians to place themselves on record in the employment of the method of Gersuny for the correction of nasal deformities.