FASCIA. 



229 



more especially the iufra-orbitar. Neuralgia 

 of the lower part of the face seems, however, in 

 some instances to follow the course of those 

 branches of the cervical plexus which proceed 

 toward this region. Division of the nerves, 

 though it sometimes checks, seldom cures this 

 painful affection, for the divided nerves spee- 

 dily reunite, and the complaint returns ; and 

 this takes place even after a portion of the 

 nerve has been removed. Spasmodic affections 

 of the face are connected with the branches of 

 the portio dura : both nerves are of course sub- 

 ject to palsy. 



The cellular tissue of the face is abundant, 

 vascular, mingled generally with more or less 

 fat, and in some places, as on the eyelids, is so 

 lax as to be peculiarly liable to infiltration 

 with fluids. Sometimes it becomes emphyse- 

 matous, in cases of wounds of the frontal sinuses 

 and larynx. It is easily affected by erysipelas, 

 and is the common seat of abscesses, which, 

 however, as there is no fascia to confine the 

 matter, rarely attain any considerable size, but 

 soon make their way towards the surface of the 

 skin. When, indeed, the pus forms on the 

 forehead between the muscles and the pericra- 

 nium, or beneath the fascia covering the parotid 

 gland, or beneath that investing the masseter 

 and posterior part of the buccinator muscles, 

 the matter being more confined is longer in 

 arriving at the surface, and is productive of 

 more pain than in the former instance. En- 

 cysted tumours are not unfrequently formed in 

 this structure of the face. 



The skin of the face, from its vascularity and 

 the almost homogeneous mass which it forms 

 with the subjacent tissues, readily unites after 

 incised wounds, and hence the success which 

 has attended the attempts at reparation of some 

 parts of this region, such as the nose, cheek, 

 and lips ; the extensibility of the skin also 

 favours such operations. Punctured and con- 

 tused wounds of the face are apt to produce 

 erysipelas when they affect those parts where 

 the cellular tissue is most dense, as on the nose 

 and the prominence of the cheek. Abscesses 

 are the more common result where the cellular 

 tissue is looser. The skin of the face becomes 

 swollen and thickened in some complaints 

 which attack it, such as scrofula, which produ- 

 ces enlargement of the lips and nose, and ele- 

 phantiasis, cancer, and a few other diseases 

 which affect it more permanently. It is sub- 

 ject also to freckles, stains, and discolorations 

 of various kinds, enlargement, inflammation, 

 and induration of its follicles; to a variety of 

 cutaneous eruptions ; to ulcerations from scro- 

 fula, scirrhus, lupus, &c. which frequently 

 make great ravages not only in the soft parts of 

 the face, but even in the bones ; to tubercles, 

 warts, tumours, and anomalous growths of 

 various kinds ; and finally to boils. Its vas- 

 cularity renders it more liable than in other 

 parts of the body to receive the impression of 

 small-pox pustules. Like the bones, the soft 

 parts of the face are subject to congenital mal- 

 formation. 1. Its apertures may be closed 

 more or less firmly ; this happens with the eye- 

 lids, nostrils, and lips. 2. There may be de- 



fects of growth, as fissures in the lips, or hare- 

 lip, which may be single or double, and exist 

 alone or in combination with fissures of the 

 palate. The fissure may vary in depth, some- 

 times, in the upper lip, extending into one of 

 the nostrils, and at others only affecting the 

 border of the lip. Congenital cleft of the lower 

 lip is very rare, and is never combined with 

 fissure of the bone. The nose is sometimes 

 fissured, presenting no cartilaginous septum, 

 and but one large orifice or nostril. Occasion- 

 ally a congenital fissure has been observed in 

 the cheek. The abnormal conditions of the 

 teeth, the orbits and their contents, of the 

 lachrymal apparatus, and of the cavities of the 

 nose and mouth, will be found under the seve- 

 ral articles on these subjects. 



For the BIBLIOGRAPHY of thia article, t see 

 ANATOMY (INTRODUCTION). 



(R. Partridge.) 



FASCIA, (in general anatomy,) (Binde, 

 sehinge Scheide, Flechsenh'dute, Germ.) This 

 term is applied to certain membranous expan- 

 sions, existing in various regions of the body, 

 and forming coverings to particular parts. 

 These expansions are composed either of cellu- 

 lar tissue, more or less condensed, or of fibrous 

 tissue, the former being the cellular fascia, the 

 latter the aponeuroses or aponeurotic fascia. 

 The structure and connexions of a considerable 

 number of the fasciae are highly interesting, as 

 well with reference to correct diagnosis and 

 prognosis in surgical disease, as in regard to 

 the mode of proceeding in various operations. 



1. Cellular fascia. These are lamellae of 

 cellular membrane of variable density, some- 

 times loaded with fat, at other times totally 

 devoid of it, The best example of this form of 

 fascia is the layer of cellular membrane which 

 is immediately subjacent to the subcutaneous 

 cellular tissue all over the body, and in most 

 places so intimately connected with it as to be 

 inseparable ; these in fact form but one mem- 

 brane, which, although essentially the same 

 everywhere, yet exhibits characters peculiar 

 almost to each region of the body; it is gene- 

 rally known under the name of the superficial 

 J'ascia. Although this fascia is universal, there 

 are, nevertheless, certain regions where, from 

 its greater importance, it has been more care- 

 fully examined than in others, and to which we 

 may best refer in order to investigate its pecu- 

 liar characters. Of these regions those of the 

 abdomen and the neck stand pre-eminent; here 

 this fascia constitutes a distinct membraniform 

 expansion, and the principal variety it pre- 

 sents in different subjects is as regards the 

 greater or less quantity of fat deposited in it. 

 Where a tendinous or fibrous expansion does 

 not lie immediately under it, this fascia sends 

 processes from its deep surface to invest the 

 subjacent muscles and other parts; this is very 

 manifest in the case of the fascia of the neck ; 

 and in general it may be stated that the super- 

 ficial fascia has a more or less intimate connec- 

 tion with the proper cellular covering of sub- 

 jacent organs, whether muscles or tendons. 



