Lite f at y Notices, xci 



Restricted Hemiatrophy of tlie Face.^ 



A case of limited atrophy of the face in a child of seven years 

 who had no family history of neuritis or other nerve lesion is reported 

 by Dr. Gulland. No assignable cause could be found and the gener- 

 al health was good. The atrophy is confined to the left side of the 

 face, beginning in the middle of the forehead by a well-defined ridge 

 gradually disappearing in the region of the coronal suture. On the 

 side of the face the atrophy extends to the outer canthus and upper 

 border of the zygoma. The skin and subcutaneous tissue as well as 

 the bones are affected. The skin is slightly reddened and glossy and 

 the hair of the scalp is thinned. The sensation and motions of the 

 face, tongue, etc. are unimpaired, an occassional pain running down 

 the affected side of rhe nose is the only subjective symptom. The 

 author regards the cause as peripheral rather than central. 



Effects of tlie Pneiimogastric and Synipatliic Nerves on Dis^estion.^ 



The vagus nerve of the batrachia supplies motor fibres to the 

 stomach, especially to the longitudinal fibres and sphincters, also in- 

 hibitory fibres for reflex motions. Under the influence of curare 

 after double vagotomy, the fluids of the mouth can not be swallowed 

 on account of the contraction of the cardiac sphincter which contin- 

 ues for hours to pulsate rhythmically. The stomach continues for 

 days its peristaltic motions. These motions are due to the loss of the 

 inhibitory influence of the vagus leaving the muscles hyperexcitable. 



If not curarized the loss of motor function is most prominent. 

 The air cannot pass the glottis during inspiration by reason of paraly- 

 sis of the extensors of the glottis and thus is swallowed. 



The sympathic fibres affect chiefly the circular muscle fibres. Irrita- 

 tion of the sympathic, the ganglion coeliacum or the lumbar cord when 

 separated from the higher regions have the same effect. The con- 

 traction begins at the pylorus. Removal of the c^eliac ganglion in 

 the toad causes the stomach to perform diastole and systole. Besides 

 vasoconstrictor fibres the vagus supplies to the stomach vaso-dilators 

 while the sympathic is chiefly vaso-constrictor in function. 



The secretion of the stomach is directly dependent on the vagus 



'Gulland, G. L. A Case of Hemiatrophy of the Face, Confined to the 

 Area of Distribution of the first Division of the Fifth Nerve. Edinburgh 

 Hasp. Rep., vol. i, 1893. 



'CoNTEjEAN, C. Action des nerfs pneumogastrique et grand sympathique 

 sur I'estomas chez les batraciens. Arch, de phys. [5] IV, 4. 



