THE MOUTH AND THROAT. 105 



the case figured, the facial vein, as it crossed the mandible, and the transverse facial 

 vein were obliterated by means of acupressure pins passed beneath them, and the 

 growth was excised. 



Cancer or epithelioma of the lip almost always affects the lower and not the 

 upper lip. The disease extends through the lymphatics. These pass down and out 





FIG. 128. Angioma involving the right half of the upper 

 lip in a child. (Personal sketch.) 



FIG. 129. Single harelip. 



from the lips to the submaxillary lymph-nodes and then to the nodes along the 

 great vessels of the neck. It is in these regions that lymphatic infection is usually 

 seen. The middle of the lower lip is drained into a node in the submental region in 

 front of the submaxillary nodes. 

 This also is sometimes involved. 

 In operating for cancerous 

 growths it is advisable to re- 

 move all nodes from both the 

 submental and submaxillary tri- 

 angles. 



Cleft or harelip is so named 

 from its resemblance to the lip ^^ 



of a hare. It is a deformity due 

 to lack of development, in which 

 the lip is cleft or split from the 

 mouth up into the nostril, and 

 sometimes even back through 

 the hard and the soft palate. 

 When the cleft is slight, it may 

 not reach the nostril. It is 

 practically always to one side of 

 the middle, going toward one 

 nostril. Sometimes the harelip 

 is double, involving both sides. 

 In such cases the bone between 

 the two clefts may protrude. In 

 the development of the face, the 

 frontonasal process comes down 

 from above to form the middle 

 portion of the nose, upper lip, 

 and upper jaw. It forms a bone known as the premaxilla and bears the incisor teeth. 

 From the sides spring the nasal and maxillary processes. These join together as one 

 process and grow toward the premaxilla. If this process fails to reach the premaxillary 



FIG. 130. Double harelip, showing the projecting premaxilla. 



