Ill 



Observations on the Structure of the Tongue ; illustrated by Cases in 

 which a Portion of that Organ has been removed by Ligature. By 

 Everard Home, Esq. F.R.S. Read February 3, 1803. [Phil. 

 Trans. 1803, p. 205.] 



These observations will be allowed to have a considerable degree 

 of importance, when we find that they ultimately lead to a safe and 

 effectual method of removing a portion of the tongue, when that 

 organ has assumed a diseased action or morbid excrescences of a 

 cancerous nature, to which this, as well as many other glandular 

 structures, are known to be liable. In a physiological view they will 

 likewise be found to merit particular attention, as they tend to prove 

 that the internal structure of the tongue is not of that delicate and 

 sensible nature which, from its being the organ of taste, we should 

 be led to imagine. 



The first case here mentioned, and from which various inferences 

 are derived which lead to a new mode of treating the disorders of 

 the tongue, was that of a gentleman whose tongue had been acci- 

 dentally bit near the tip, and had hence become completely insen- 

 sible, insomuch that every article of nourishment he took was equally 

 insipid, and that the tip felt like a bit of wood in his mouth. No de- 

 gree of inflammation, however, or spasmodic tendency having accom- 

 panied these symptoms, Mr. Home inferred that the nerves supplying 

 this, and perhaps the other organs of sense, are not so liable to irri- 

 tation as those which belong to other parts of the body. 



Encouraged by this observation, he in three instances performed a 

 new operation upon the tongue, which consisted in removing a portion 

 of that organ by means of ligatures, and with that portion certain 

 fungous excrescences which might have been productive of fatal 

 consequences. The first patient was a boy eight years of age, who 

 had been born with a small excrescence on the right side of the an- 

 terior part of the tongue. It had been removed no less than eleven 

 times by ligatures round its base, caustics and amputation, but al- 

 ways with considerable and dangerous haemorrhages ; and after all 

 without success, the fungus always reappearing soon after the ope- 

 rations. Mr. Home at length resolved to take out the portion of the 

 tongue upon which the fungus grew. This was effected by passing 

 a crooked needle, armed with a double ligature, through the sub- 

 stance of the tongue, somewhat within the excrescence : the needle 

 was drawn out below, leaving the ligatures, one of wlu'ch was tied 

 very tight before the excrescence, and the other equally so behind it, 

 so that a segment of the tongue was confined between these two 

 ligatures, in which the circulation was completely stopped. On the 

 fifth day after the operation this portion of the tongue came away 

 with the ligatures, leaving a sloughy surface, which likewise sepa- 

 rated on the fifteenth day. The excavation a few days after this be- 

 came completely cicatrized, leaving only a small fissure on that side 

 of the tongue. 



The two other operations were performed on persons above forty 



