I 4 LANDMARKS MEDICAL AND SURGICAL. 



The muscles of the features are generally described as 

 arising from the bony fabric of the face, and as inserted into the 

 nose, the corners of the mouth, and the lips. But this descrip- 

 tion gives a very inadequate idea of their true insertion. They 

 drop fibres into the skin all along their course, so that there 

 is hardly a point of the face which has not its little fibre to 

 move it. The habitual recurrence of good or evil thoughts, 

 the indulgence in particular modes of life, call into play cor- 

 responding sets of muscles which, by producing folds and 

 wrinkles, give a permanent cast to the features, and speak a 

 language which all can understand, and which rarely mis- 

 leads. Schiller puts this well when he says that ' it is an 

 admirable proof of infinite wisdom that what is noble and 

 benevolent beautifies the human countenance ; what is base 

 and hateful imprints upon it a revolting expression.' 



THE NECK. 



23. Subcutaneous veins. Notice first the direction of 

 the subcutaneous veins. The chief subcutaneous vein is the 

 external jugular. Its course corresponds with a line drawn 

 from the angle of the jaw to the middle of the clavicle, where 

 it joins the subclavian. It is made more prominent by putting 

 the sterno-mastoid into action, or by gentle pressure on the 

 lower end of the vein. It is exceptionally joined by a branch 

 which runs over the clavicle, and is termed ' jugulo-cephalic.' 

 The anterior jugular generally runs along the front border of 

 the sterno-mastoid. 



24. Parts in central line. Os-hyoides. Immediately 

 below and nearly on a level with the lower jaw we feel the 

 body of the os-hyoides, and can trace backwards on each side 

 the whole length of the cornua. They might easily be broken 

 by the grasp of a garotter. Below the body of the os-hyoides 

 is the gap above the thyroid cartilage. This gap corresponds 

 with the anterior thyro-hyoid ligament and the apex of the 

 epiglottis ; so that in cases of cut throat in this situation, 

 nearly the whole of the epiglottis lies above the wound. 



