9 SURGICAL APPLIED ANA TOMY. [Chap. vn. 



malar bone, the chin, the upper lid, are struck by a 

 blunt instrument or in a fall, the wound produced 

 has often the appearance of a clean incised wound, 

 just as obtains in contused wounds of the scalp. 



The mobility of the facial tissues renders this 

 part very suitable for the performance of plastic 

 operations of various kinds, and their Yascularity 

 generally insures a ready and sound healing. Al- 

 though there is a large quantity of fat in the subcu- 

 taneous tissue in this region, yet fatty tumours are 

 singularly rare upon the face. They appear, indeed, 

 to avoid this region. Thus M. Denay reports the case 

 of a man who had no less than 215 fatty tumours 

 over different parts of his body, but not one upon his 

 face. The thickness of the tissues of the cheek and 

 lips favour the embedding of foreign substances in 

 those parts. Thus, a tooth that has been knocked 

 out has remained for some time embedded in the lip. 

 Henry Smith reports a remarkable case, where he 

 removed a piece of tobacco-pipe three inches long from 

 the cheek, in the tissues of which it had been em- 

 bedded for several years. The soft tissues of the 

 cheek greatly favour the spread of destructive pro- 

 cesses. Thus in cancrum oris, a form of gangrene of 

 the face attacking the young, the whole cheek may 

 be lost in a few days. Great contraction is apt to 

 follow upon loss of substance in the cheek, so that in 

 some cases the jaws may be firmly closed, as is seen after 

 recovery from advanced cancrum oris. The face is 

 peciiliarly liable to be the seat of certain ulcers, espe- 

 cially the rodent and lupoid ulcer, and is the part 

 most often attacked by " malignant pustule," a disease 

 transmitted to man from cattle afflicted with a malady 

 known in this country as " murrain," and in France as 

 " charbon." 



Blood supply. The tissues of the face are very 

 vascular, and are liberally supplied with blood- vesse?s in 



