THE FACE. 15 



margin is marked by a slight elevation, the papilla lacrimalis, which is much better 

 developed in the lower lid than the upper, and on drawing the lid forwards a minute 

 opening, the punctum lacrimale, is seen on the summit of the papilla, leading into 

 the canaliculus by which the tears are conveyed into the lachrymal sac. In the 

 neighbourhood of the inner canthus the lids are separated from the eyeball by the 

 caruncula lacrimalis, a red fleshy-looking portion of skin, which supports a few fine 

 hairs, and by the fold of mucous membrane known as the plica semilunaris. 



The lids can be readily everted, the lower one by simply pulling it downwards, 

 the upper one by turning it over a probe, and the ocular and palpebral conjunctiva 

 can thus be completely examined ; the former is transparent and smooth, presenting 

 only a few minute vessels in the healthy state ; the latter is more or less red and 

 velvety in appearance. The Meibomian glands are seen at the same time, appearing 

 through the conjunctiva as lines of yellowish granules arranged perpendicularly to 

 the edges of the lids ; and along the latter the openings of their ducts are visible in 

 the form of minute spots within the line of the eyelashes. 



If the eyelids are drawn forcibly outwards, the internal tarsal ligament, or tendo 

 palpebrarum, is made to project between the inner canthus and the margin of the 

 orbit ; and this band can also be felt as it is tightened during the act of winking. 

 Behind the tarsal ligament, and reaching to a somewhat higher level, is the lachrymal 

 sac ; into the latter the canaliculi open, taking a course from the puncta lacrimalia, 

 at first vertically, and then nearly horizontally, the one above and the other below 

 the ligament. A knife entered immediately below the internal tarsal ligament will 

 open the lower part of the lachrymal sac, and a probe may then be passed through 

 the incision, in a direction downwards and slightly backwards and outwards, along 

 the nasal duct into the nose. 



Mouth and fauces. On looking into the mouth, the teeth are seen, and by 

 everting the lips, the outer surface of the gums may be inspected, and the alveolar 

 processes can be examined with the finger. The smooth mucous membrane lining 

 the lips is thus exposed, and in the middle line, passing from each lip to the jaw, is 

 a thin fold termed the fraenum ; of these the upper one is the larger. On pulling 

 the angle of the mouth outwards, the lining membrane of the inside of the cheek 

 can be examined, and the papilla on which the duct of Stensen opens may be seen 

 and felt opposite the second molar tooth of the upper jaw ; with some difficulty a 

 fine probe may be made to enter the aperture. A little farther back, if the mouth 

 be alternately opened and shut, it is easy to distinguish the anterior borders of the 

 masseter and temporal muscles, as well as the edge and inner surface of the ramus of 

 the jaw. 



By raising the tongue, the inner aspect of the gums and the floor of the mouth 

 are brought into view. The under surface of the tongue is smooth, and is connected 

 in the middle line with the floor of the mouth by the frcenum linguae,, a fold of 

 mucous membrane similar to, but much larger than, the frsena of the lips ; from 

 this a fine line is continued forwards to the tip of the tongue. Somewhat less than 

 half an inch external to the frsenurn, on each side, the ranine vein is clearly seen 

 through the delicate mucous membrane ; the corresponding artery is more deeply 

 placed and does not come into view ; an elevated and fringed line of the mucous 

 membrane, plica fimbriata, lies superficially to these vessels, and may be followed, 

 converging towards its fellow, almost as far as the tip of the tongue. Between the 

 alveolar border and the tongue, on each side, is the alveola-lingual sulcus, at the 

 bottom of which the mucous membrane is raised into a well-marked ridge, directed 

 obliquely forwards and inwards, over the sublingual salivary gland. Each ridge 

 ends close to the middle line in a small papilla, and on this is seen, in the form of a 

 minute spot, the opening of Wharton's duct, into which a fine probe may be easily 



