io6 SURGICAL APPLIED ANATOMY. [Chap. vm. 



The tongue is very vascular, and is in consequence 

 often the seat of nsevoid growths. Its main supply is 

 from the lingual artery. This vessel approaches the 

 organ from the under surface, and as cancer usually 

 shows a tendency to spread towards the best blood- 

 supply, it is to be noticed that carcinoma of the tongue 

 nearly always tends to spread towards the deep attach- 

 ment of the member. At the same time it must be 

 observed that the main lymphatics follow the same 

 course as the main blood-vessels. The vascularity 

 of the tongue is the great bar to its easy removal, 

 haemorrhage being the complication most to be dreaded 

 in such operations. 



The tongue is well supplied with nerves, that endue 

 it not only with the special sense of taste, but also 

 with common sensation. According to Weber's ex- 

 periments, tactile sensibility is more acute on the tip 

 of the tongue than it is on any other part of the 

 surface of the body. It should be borne in mind that 

 the lingual nerve supplies the forepart and sides of 

 the tongue for two-thirds of its surface, while the 

 glosso-pharyngeal nerve supplies the mucous mem- 

 brane at its base, and especially the papillae vallatse. 

 In painful affections of the tongue in the district sup- 

 plied by the lingual nerve, the patient often is troubled 

 with severe pain deep in the region of the meatus of 

 the ear. The pain in such instances is referred along 

 the course of the third division of the fifth, of which 

 trunk the lingual nerve is a branch. In like manner 

 spasmodic contraction of the masticatory muscles is 

 sometimes found to accompany painful lingual ulcers 

 when involving the region of the gustatory nerve. 

 There would seem to be but little connection between 

 an abscess over the occipital region and wasting of one 

 half of the tongue. But Sir James Paget reports the 

 following case : "A man received an injury to the 

 back of his head that was apparently not severe. In 



