chap, viii.] THE TONGUE. 123 



farther open, until the tongue, having lost all its 

 anterior support, turns over into the pharynx, and is 

 firmly embraced by the muscles of deglutition, which 

 force it down upon the epiglottis, and the latter upon 

 the larynx, until suffocation is produced " (Holmes' 

 "System of Surgery," vol. ii.). In complete anaesthesia, 

 as in that produced by chloroform, when all the 

 muscular attachments of the tongue are relaxed, the 

 organ is apt to fall back and to press down the epi- 

 glottis, so causing suffocation. 



The tongue is firm and dense, but contains, never- 

 theless, a sufficient amount of connective tissue to 

 cause it to swell greatly when inflamed. Foreign 

 bodies may easily be embedded in its substance. In 

 the Lancet for 1846 is noted a case where a portion 

 of a fork is said to have been buried in the tongue for 

 thirty-two years. The surface epithelium is thick, 

 and in chronic superficial inflammation of the organ 

 it often becomes heaped up, forming dense opaque 

 layers, ichthyosis linguae, plaques des fumeurs, 

 leucoma, etc. From the mucous glands, situated 

 chiefly beneath the mucous membrane near the base 

 of the tongue, the mucous cysts are developed that are 

 sometimes met with in this part. 



The tongue is very vascular, and is in consequence 

 often the seat of naevoid growths. Its main supply is 

 from the lingual artery. This vessel approaches the 

 organ from the under surface, and as cancer usually 

 shows a tendency to spread towards the best blood 

 supply, it is to be' noticed that carcinoma of the tongue 

 nearly always tends to spread towards the deep attach- 

 ment of the member. At the same time it must be 

 observed that the main lymphatics follow the same 

 course as the main blood-vessels. The vascularity 

 of the tongue is the great bar to its easy removal, 

 haemorrhage being the complication most to be dreaded 

 in such operations. 



