130 Mr. Shaw on the Facial Nerves. 



has suffered paralysis from apoplexy. But when he spoke 

 or laughed, the distortion was much increased, the mouth 

 being pulled more to the left side, than I ever saw in any other 

 patient. 



The following are the notes that were taken at this time: 

 There appears to be total paralysis of the muscles of the 

 right side of the face. When he smiles or laughs, they are 

 passive, while those of the left are regularly iu action. If 

 he attempts to whistle, he cannot close his lips sufficiently ; 

 when he blows, the right cheek is dilated, but passive like a 

 distended bladder ; he can smoke, by putting the pipe into the 

 left side of his mouth ; he throws the smoke out of the right 

 side, but in doing this, the action is all, evidently, in the 

 muscles of the left cheek. These several circumstances were 

 sufficient to prove that those actions of the muscles of the cheek 

 and mouth, which axe regulated by the respiratory nerve, were 

 deficient. The next question was, how far the actions of the 

 same muscles, which we conceive to be regulated by the 5th 

 pair, were perfect. 



The cheek and mouth hang down, as in the common case of 

 hemiplegia — ^he cannot by a voluntary act move his cheeks ; 

 when a piece of bread is put between the cheek and teeth of 

 the right side, he cannot push it out with the buccinator, but 

 picks it out with his tongue. He cannot hold his pipe or my 

 pencil with the right side of his lips. 



Our next inquiry was into the degree of sensibility in the para- 

 lyzed side. The difference of the sensibility in the two cheeks was 

 most distinct. When I pulled a hair of the right whisker, he was 

 not conscious of my doing it, but he started immediately on 

 my pulling one from the left. When I pricked his cheeks with 

 a needle, his expression was — " I feel you push against the 

 right side, but in the left you prick me." When he brought 

 his jaws forcibly together, he said he was not conscious of 

 striking his teeth on the right side, though he felt them most 

 distinctly on *he left. On examining the state of the nose, we 

 found that it was impossible to excite the muscles of the 

 right nostril to any action. We forgot to try the degree of sen- 



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