chap, viii.] THE TONGUE. 107 



time the right half of the tongue began to waste, and 

 continued to waste until it was less than half the size 

 of the unaltered side. A.n abscess formed over the 

 occiput, from which fragments of the lower part of 

 the occipital bone were removed. After the removal of 

 all the dead bone the tongue began to recover, and in 

 one month had nearly regained its normal aspect." 

 Here the atrophy was due to wasting of the lingual 

 muscles produced by pressure upon the hypoglossai 

 nerve, which leaves the skull through the anterior 

 condyloid foramen in the occipital bone (Clin. Soc. 

 Trans., vol. iii.). The case illustrates the importance 

 of remembering even small foramina, and the structures 

 they give passage to. 



The tongue contains much lymphoid tissue, a 

 considerable part of which is massed under the 

 mucous membrane at the posterior part of the organ. 

 The lymphatics also are large and numerous, and for 

 the most part follow the ranine vessels. With regard 

 to glandular infection in lingual cancer, it is well to 

 note that these lymphatics enter one or two small 

 glands lying on the hyo-glossus muscle before they 

 reach the deep glands in the neck, where they finally 

 end. 



In the strange congenital affection known as macro- 

 glossia the tongue becomes much enlarged, and in some 

 cases may attain prodigious dimensions. Thus, in one 

 case it measured six and a half inches in length and 

 ten inches in circumference. It has protruded so far 

 from the mouth as to reach even to the episternal 

 notch. It has been so large as to deform the teeth 

 and alveolus, and in one case dislocated the jaw. 

 The enlargement is primarily due to the greatly 

 dilated condition of the lymphatic channels of the 

 organ (hence the name, lymphangioma cavernosum, 

 proposed by Yirchow), and to an increased develop- 

 ment of lymph tissue throughout the part. The 



