124 SURGICAL APPLIED ANATOMY. [Chap. vin. 



The tongue is well supplied with nerves, that endue 

 it riot only with the special sense of taste, but also 

 with caramon sensation. According to Weber's ex- 

 periments, tactile sensibility is more acute on the tip 

 of the tongue than it is on any other part of the 

 surface of the body. It should be borne in mind that 

 the lingual nerve supplies the forepart and sides of 

 the tongue for two-thirds of its surface, while the 

 glosso-pharyngeal nerve supplies the mucous mem- 

 brane at its base, and especially the papillae vallatse. 

 In painful affections of the tongue in the district sup- 

 plied by the lingual nerve, the patient often is troubled 

 with severe pain deep in the region of the meatus of 

 the ear. The pain in such instances is referred along 

 the course of the third division of the fifth, of which 

 trunk the lingual nerve is a branch. In like manner 

 spasmodic contraction of the masticatory muscles is 

 sometimes found to accompany painful lingual ulcers 

 when involving the region of the gustatory nerve. 

 There would seem to be but little connection between 

 an abscess over the occipital region and wasting of one 

 half of the tongue. But Sir James Paget reports the 

 following case : " A man received an injury to the 

 back of his head that was apparently not severe. In 

 time the right half of the tongue began to waste, and 

 continued to waste until it was less than half the size 

 of the unaltered side. An abscess formed over the 

 occiput, from which fragments of the lower part of 

 the occipital bone were removed. After the removal of 

 all the dead bone the tongue began to recover, and in 

 one month had nearly regained its normal aspect." 

 Here the atrophy was due to wasting of the lingual 

 muscles produced by pressure upon the hypoglossal 

 nerve, which leaves the skull through the anterior 

 condyloid foramen in the occipital bone. The case 

 illustrates the importance of remembering even small 

 fjiMiniu.1, and the structures they transmit 



