CHAPTER VII. 



THE DIGESTIVE SYSTEM. 

 The Mouth. 



Malformations. 



MALFORMATIONS of the lips and cheeks are usually associated with defective forma 

 tion of the bones of the mouth. The entire process is generally due to an arrest of de- 

 velopment. 



1. The lower jaw is absent; the upper jaw and hard palate are small and imper- 

 fectly formed ; the temporal bones nearly touch in the median line. The lower part of 

 the face is, therefore, wanting; the mouth is absent, or small and closed posteriorly; 

 the tongue is absent. Such a malformation is rare ; the foetus is not viable. 



2. The face remains in its early foetal condition of a large cleft ; the mouth and nose 

 form one cavity ; the orbits may be united in the same cavity. The foetus is not viable. 



3. There is a cleft in the upper lip, upper jaw, and hard palate. The cleft corre- 

 sponds to the point of junction of the processes of the superior maxilla with the inter- 

 maxillary bone. There may be one cleft or two, one on either side of the intermaxillary 

 bone. The cleft involves the lip alone, or the lip and superior maxilla, or the lip, max- 

 illa, and palate. There may be a single or a double cleft in the palate, and the cleft 

 may involve either the hard or soft palate, or both. If there are two clefts of the lip 

 and maxilla the portion of lip and bone between them may be small, or entirely absent 

 so as to leave a large open space. The soft palate may be entirely absent. This is a 

 common malformation and does not endanger life. 



4. Earely we find a cleft involving the middle of the lower lip, and sometimes ex- 

 tending into the inferior maxilla. 



5. Either the inferior, the superior, or both maxillary bones may be abnormally small. 



6. The edges of the lips may be partly or completely joined together. The open- 

 ing of the mouth may be only a round hole. 



7. The lips may be absent or imperfectly developed. 



8. The corners of the mouth may be prolonged by clefts in the cheeks nearly to the 



INFLAMMATION. (Stomatitis.) 



Catarrhal Stomatitis is most frequent in children and occurs with a 

 great variety of local and general disturbances. 



During life the congestion and swelling of the mucous membrane inay 

 be well marked and there are often white patches, produced by the death 

 of the superficial epithelial cells. There may be an increased production 

 of mucus, or, instead of this, the entire mucous membrane is unnaturally 

 dry. In addition to hypersemia and local redema there may be prolifer- 

 ation, exfoliation, and degeneration of the epithelium. 



Extravasated leucocytes may infiltrate to a moderate degree the 

 stroma of the mucous membrane and appear upon its surface. Small, 



