84 SURGICAL APPLIED ANATOMY. [Chap.vn. 



all parts. The finer vessels of the skin often appear per- 

 manently injected or varicose in the drunken, or in those 

 who are exposed to cold, or are the subjects of certain 

 forms of acne. Thus, nsevi, and the various forms of 

 erectile tumour, are common about the face. For a 

 like reason also wounds of the face, while they may 

 bleed readily when inflicted, are apt to heal with 

 singular promptness and accuracy. All wounds, 

 therefore, of this part should have their edges care- 

 fully adjusted as soon after the accident as possible. 

 Extensive flaps of skin that have been torn up in 

 lacerated wounds often retain their vitality in almost 

 as marked a manner as do like flaps torn up from the 

 scalp. Extensive injuries of the face associated with 

 great loss of substance are often repaired in a most 

 remarkable manner, as has been illustrated in gunshot 

 wounds, where a considerable portion of the face and 

 upper jaws has been blown away. The low mortality 

 after severe injuries to the face is due, however, not 

 only to the excellent powers of repair the part pos- 

 sesses, but also to the fact that the face contains no 

 organs essential to life, that its bones are soft and thin 

 and do not favour extensive splitting, and that there 

 are several passages and cavities in the region through 

 which discharges may escape. One of the most 

 terrible instances of injury not immediately fatal is 

 reported by Longmore : " An officer of Zouaves, 

 wounded in the Crimea, had his whole face and lower 

 jaw carried away by a ball, the eyes and tongue in- 

 cluded, so that there remained only the cranium, sup- 

 ported by the neck and spine." He lived twenty 

 hours. 



The pulsations of the facial artery can be best felt 

 at the lower border of the jaw, where the vessel 

 crosses just in front of the anterior border of the 

 masseter muscle. It is here covered only by the integu- 

 ment and platysma, and can be readily compressed 



