466 Anatomy Applied to Medicine and Surgery. 



forwards ; whistling is impossible or imperfectly perform- 

 ed ; the mouth cannot be closed, and in some cases taste is 

 lost on the anterior part of the tongue. Site of the lesion. 

 If supranuclear, reflex actions are unchanged, the ac- 

 tions of the eyelids are not interfered with, i.e., the patient 

 can still close the eyelids. The reason that the orbicularis 

 palpebrarum and the anterior part of the occipital-fron- 

 talis are not affected, is that, while these muscles are, ap- 

 parently, supplied by the facial, this nerve, in reality, 

 merely carries fibres, which, derived from the nucleus of 

 the third nerve, join the facial at its knee-like bend in the 

 pons, and, therefore, in a supra-nuclear lesion, 

 this fasciculus is unaffected and the actions of these mus- 

 cles are not interfered with. Should the lesion be nuclear, 

 i.e., in the pons, then there may result crossed paralysis. 

 If at the base of the brain or in the internal auditory mea- 

 tus, the auditory nerve, which runs in these situa- 

 tions along with the facial, would also be affected, so that 

 deafness would be present along with the paralysis of the 

 face, and there would probably be, in addition, loss of 

 taste for the anterior portion of the tongue, since the 

 nerve for this the pars intermedia would likely be 

 affected as it lies between the facial and auditory nerves. 

 Loss of the sense of taste in the anterior two-thirds of the 

 tongue, with paralysis of the face alone, would indicate a 

 lesion of the nerve above the point where the chorda tym- 

 pani leaves it, i.e., anywhere in the petrous bone above 

 the stylo-mastoid foramen, generally, however, in the Fal- 

 lopian canal. When the muscles of the face, including 

 the orbicularis palpebrarum and the anterior part of the 

 occipito-frontalis are affected, with no involvement of 

 hearing or taste, the lesion is probably in the trunk of the 

 nerve below its exit from the stylo-mastoid foramen. 



