Mr. Sliavv on the Facial Ne7-ves. 133 



influence given by the 7th. The cause of the paralysis in this 

 case is, I think, to be ascribed not to any affection of the brain 

 generally, but to an injury of the portio dura, and to a great 

 part of the fifth nerve, either at ^their origin, or in their passage 

 through the bones of the head. 



My reasons for forming this opinion are, that the- state of 

 the actions regulated by the portio dura, is similar to what is 

 found in cases and experiments where this nerve has been 

 injured or cut*. The bleeding from the ear, and the conse- 

 quent deafness may be taken as proofs that the petrous portion 

 of the temporal bone through which the nerve passes, has been 

 injured. 



The evidences that we have of the 5th having been injured in 

 its transit through the bones are, first, that the paralysis is on 

 the same side of the head, as that struck in the fall ; secondly, 

 only those two divisions of the 5th are affected, which are in their 

 course through the bones of the head, nearest to the portio 

 dura. Thirdly, that the hemorrhage from the ear and nose 

 at the time of the accident, lead us to suspect that there was 

 injury to the deep bones of the face. Fourthly, that the sen- 

 sations both of common feeling and of taste are destroyed on 

 one side of the tongue, which is not ahvays the consequence of 

 apoplexy, but which must happen if the trunk of the third 

 division of the 5th be injured. And lastly, that the pheno- 

 mena accord with those which are observed when the branches 

 of the 5th are cut. 



The symptoms of general affection of the brain appeared to 

 have been caused by that inflammatory state t, which is often 



* See the several examples given in my last communication. 



■f- The symptoms ohservable during the first three months, led me to 

 suppose that the bones through which the 5th and 7th nerves passed 

 liad been injured. I have so late as the 1st of February seen this patient, 

 and he had so far recovered the power over the parts regulated by the 

 5th nerve, that it then appeared possible that the sheaths of the nerves 

 might have partaken of the inflammatory state of the membranes of the 

 brain, or have suffered from extravasation of blood into them. By either 

 of these causes, partial paralysis might have been produced ; but still, on 

 consideration of all the circumstances, ] am more disposed to adhere to 

 tiic opinion I lirst formed. 



