1162 



TONGUE. 



morbid anatomy of the tongue with some re- 

 marks on faulty positions which the organ oc- 

 casionally obtains. I have already spoken of 

 prolapsus of the tongue, and there now re- 

 main for consideration tongue-tie, tongue- 

 swallowing, and adhesion of the tongue to ad- 

 jacent parts. 



Tongue-tie. This is a congenital malform- 

 ation, consisting in the fraenum extending too 

 far forwards and being short, thus tying down 

 the tongue behind the incisor teeth of the 

 lower jaw. This may occur to any degree, 

 from an amount that is scarcely observable, 

 to the complete tying down the tip of the 

 tongue behind the necks of the middle incisors 

 of the lower jaw. The fraenum generally con- 

 sists simply of a small amount of fibrous tissue 

 contained in the fold of mucous membrane; 

 but it sometimes contains fibres of the genio- 

 glossus, which occasionally extend a con- 

 siderable way forwards: in the former case 

 the fraenum is thin, in the latter it may be of 

 some thickness. When left to nature the tie 

 gradually lengthens, and, at the same time, 

 recedes, and any unusual thickness arising 

 from the presence of muscular fibres gra- 

 dually lessens. This condition, to a slight 

 extent, is very frequent, and appears to be 

 hereditary. The cases are, however, extremely 

 rare where the fraenum is so short as to inter- 

 fere with sucking, mastication, deglutition, or 

 articulation. 



Tongue-swallowing. This arises from the 

 opposite of the last condition : the move- 

 ments of the tongue are too free ; it can be 

 inverted, and its apex thrown back into the 

 pharynx, which embraces it, and thus closes 

 the aperture leading to the lungs, and symp- 

 toms of suffocation are the result. It most 

 frequently happens to infants. It is enume- 

 rated by writers on Medical Jurisprudence, as 

 one of the modes of suicide among negroes. 

 Dr. Gordon Smith, Majendie, and Beck refer 

 to cases of it. Mr. Crosse tells of an instance, 

 where it could be performed at pleasure with- 

 out the slightest inconvenience. 



Adhesions of the tongtte. Bernard relates 

 an instance, in which adhesions, of the thick- 

 ness of two lines and a half, had agglutinated 

 the lateral parts of the tongue to the internal 

 surface of the cheeks, to the extent of more 

 than an inch on each side. These adhesions 

 had succeeded an inflammation in the inside 

 of the mouth and tongue, the circumference 

 of which had ulcerated ; they interrupted the 

 functions of speech and mastication. M. Ber- 

 nard divided them by a single clip of the 

 scissors. 



Necrosis of the hyoid bone. The only in- 

 stance of disease of the hyoid bone with which 

 I am acquainted, is one related by Mr. Spry. 

 The disease was necrosis, the result of ex- 

 tended ulceration, which commenced in the 

 throat, and continued till the bone was laid 

 bare and dead. It was then expectorated en- 

 tire. The patient died several weeks after- 

 wards. The bone was entirely deprived of 

 periosteum, irregular on its surface, and in a 

 perfect state of necrosis. 



[Since this Article has been in the press I 

 have become acquainted with a discovery of 

 Prof. Kolliker's, that the muscular fibres in 

 certain situations are bifurcated and branched. 

 In a letter to Prof. Bowman he says, that this 

 is brilliantly exhibited by the muscles of the 

 tongue, and he gives a pen and ink illustration 

 of the method of branching. There can be no 

 doubt about a fact so detailed by such an au- 

 thority, but I must confess that I have not 

 recognised the appearances described.] 



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