954 
and that of taste see Par Vacum, Sprnat 
Accessory, GLOsso-PHARYNGEAL.) The fur- 
ther of the food through the esophagus 
into the stomach (see (Esopuacus) constitutes 
the third stage of deglutition and occurs invo- 
luntarily. 
MORBID ANATOMY OF THE PHARYNX AND 
MOUTH. 
Congenital malformations.—The pharynx in 
a very few instances only, presents any mal- 
formation ; when such exists the pharynx ter- 
minates in a cul-de-sac. Sir A. Cooper has 
recorded a case of this kind, in which also the 
esophagus was altogether wanting and ‘the 
stomach without a cardiac orifice: the child 
lived eight days. In acephalous monsters a 
' total deficiency of the pharynx has been no- 
ticed, but this is of very rare occurrence. The 
hard and soft palates are occasionally liable to 
congenital fissure: owing to an arrest of de- 
velopement they fail to unite in the median 
line, and the result is what has been termed 
the cleft palate: this defect may be confined 
to the velum palati, or it may include the bony 
te, and will sometimes extend through the 
ront of the jaw: where the bony palate is 
involved the defect may vary from a mere fis- 
sure to an entire absence of the palatine arch, 
so that the nose and mouth are converted into 
acommon cavity. The upper lip is not un- 
frequently fissured either on one or both sides 
of the median line, constituting the single or 
double hare-lip. This deformity may exist 
with or without the fissured palate, but cannot 
be considered as dependent simply on an arrest 
of developement; for at no period of fetal 
life is the lip known to present this peculiar 
condition: the fissure may only partially divide 
the lip, or it may extend into the nose in an 
oblique or vertical direction. It is very rare 
to find the lower lip fissured. 
Foreign bodies in the pharynx may produce 
immediate suffocation, either by mechanically 
obstructing the opening of the larynx or by 
inducing spasm of the glottis; when any dif- 
ficulty occurs in the extraction of these bodies, 
it is more generally dependent on their form 
than size. Angular portions of bone, needles, 
&ec. are likely to become fixed by the con- 
traction of the pharyngeal walls upon their 
pointed edges. 
Structural changes—The mucous mem- 
brane of the pharynx and posterior part of the 
fauces is very frequently the seat of inflam- 
mation, either simple or of a specific cha- 
racter; thus, it rarely escapes in scarlatina and 
syphilis without exhibiting the effects of these 
poisons: the latter often producing, by ulce- 
ration and sloughing, total destruction of the 
soft or even of the hard palate and causing 
fearful mischief. The tonsils generally parti- 
cipate in these inflammatory affections, or they 
may become inflamed primarily. In quinsy, 
the swelling of the tonsil is excessively rapid, 
and the disease is prone to terminate in sup- 
puration. One effect of frequent inflammatory 
attacks is an indolent enlargement of the tonsil, 
a condition which is often with difficulty re- 
PHARYNX. | 
medied, and occasionally requires excision of . 
that organ. 
Abscess sometimes occurs in the reticular 
tissue between the pharynx and cervical ver- 
tebre, and protrudes the posterior wall of the 
former forwards, so as to interfere with de- 
— fins 
Iceration of the pharynx occasionally hap 
pens; it may be the result of a lea 
specific inflammation, and will aR 
ceed to the destruction of its walls: 
openings between it and the larynx or other 
neighbouring parts may be thus produced. 
Cancer of the pharynx is fortunately not com- 
mon, but cases have been noticed in which it 
has occurred. 
Polypi have sometimes been found to take — 
their growth from the mucous membrane of — 
the pharynx, and most commonly spring from 
that portion of it which covers the 
aspect of the larynx. Dr. Monro mentions a 
case of this kind in which the polypus was 
of considerable length, hanging down in the 
cesophagus; another seat of origin in the 
pharynx is from the membrane as it invests the 
under surface of the basilar of the 
occipital bone: they have been seen to grow 
also from the soft palate. . 
A pouch is occasionally formed either be- 
hind or on either side of the pharynx be fe 
extrusion through the muscular coat of its 
mucous membrane. A preparation in the Mu- — 
seum at St. Thomas’s Hospital exhibits such 
an arrangement: a blind pouch about three 
inches in length, and of course communicating: 
with the interior of the pharynx, descends by 
the side of it: the muscular parietes do not 
appear to have been at all prolonged upon i 
surface. 
The cheeks, gums, and lips in children are 
sometimes involved in a destructive ulceration, 
to which the term cancrum oris has been ap- 
plied; it may extend to almost any length, 
destroying the cheek, the lips, the — and | 
teeth: it is seldom seen in adults. gums 
besides the softened and spongy change im 
duced by scurvy and the well known effe 
caused by the introduction of mercury into th 
system, are also affected with the disease cal 
epulis. In this case the gum is enlarge 
reddened, and ulcerates, and demands @ 
cision of the entire diseased structure : 
generally considered of a malignant na 
The lower lip is sometimes the seat of ¢ 
cerous ulceration ; it has been questioned 
ther this disease is really true cancer. Sir 
Cooper, however, says, in his lectures, * T 
the disease is of a scirrhous nature, eve 
the beginning, any surgeon must be satisfi 
it is hard, has a bleeding surface, ev 
edges, and, as it proceeds in its destru 
course, communicates disease to the gla 
there is likewise felt in it, at particular pei 
the most dreadful pain. An operation for 
complete removal of the disease is the patiet 
only real hope of succour.” It is very rat 
the same disease to originate in the upper I 
( William Trew. 
