320 
MR. BELL ON THE NERVES OF THE FACE. 
has been divided in the extirpation of a tumour from before the ear, and the 
immediate effect has been horrible distortion of the face by the prevalence of 
the muscles of the opposite side, but without the loss of sensibility ; and that 
distortion is unhappily increased when a pleasurable emotion should be re- 
flected in the countenance. 
These facts are so distinct, that I cannot presume to detain the Society with 
the instances of the lesser defects which I have witnessed from the more partial 
injuries or temporary diseases of the nerve ; — such as distortion of the features 
produced by glands pressing on this nerve, paralysis from suppurations in the 
ear affecting the nerve in its passage, or temporary derangement disturbing 
one or more of its functions. 
As to the fifth nerve, the facts are equally impressive, and correspond with 
our former experiments and opinions. By a small sacculated tumour affecting 
the roots of this nerve, the sensibility was destroyed in all the parts supplied 
by its widely extended branches ; that is, in all the side of the head and face 
and the side of the tongue, whilst the motion of the face remained. Two cir- 
cumstances affecting this nerve have occurred with most curious coincidence 
in the symptoms. By the drawing of a tooth from the lower jaw, the nerve 
which comes out upon the chin to supply one half of the lip was injured, and 
exactly this half of the lip was rendered insensible. When the patient put 
his mouth to a tumbler he thought they had given him a broken glass ! 
Precisely the same thing occurred from the division of that branch of the fifth 
nerve, which goes to one half of the upper lip. A gentleman falling, a sharp 
point entered his cheek and divided the infra orbitary nerve : the effect was 
loss of sensation without loss of motion, in that half of the upper lip to which 
the nerve is distributed. The remarkable circumstance was, that this indivi- 
dual made the same remark when the cup was put to his lip : — that they had 
given him a broken one ! The part of the cup which was placed in contact 
with the insensible portion of the lip appeared to him to be broken off. 
I have had two or three instances before me of disease affecting the 
ophthalmic branch of the fifth nerve, and producing total insensibility of the 
eye and eyelids, without loss of vision ; whilst the eyelids continued to be 
closed and the eyebrow to be moved by the influence of the portio dura of the 
seventh nerve. 
