THE TONGUE.

The tongue, being very vaRcular, is often the seat of neevoid growths,and these have a tend-ency to grow rapidly.The tongue is frequently the seat of ulceration, which mav arise from many causes, as from

the irritation of jagged teeth, dyspepsia, tubercle, syphilis, and cancer. Of these the cancerous ulcer is the most important, and probably also the most common. The variety is the squamous epithelioma, which soon develops into an ulcer with an indurated base. It produces great pain, which speedily extends to all parts supplied with sensation by the fifth nerve, especiall;v to the region of the ear. The pain in these cases is conducted to the ear and temporal region by the lingual nerve, and from lt to the other branches of the inferior maxillary nerve, especially the auriculo-temporal. Possibly pain in the ear itself may be due to implication of the fibres of the glosso-pharyngeal nerve, which by its tympanic branch is conducted to the tympanic plexus.                                                                                                                   .

Cancer of the tongue may necessitate removal of a part or the whole of the organ, and many different methods have been adopted for its excision. It may be rerum'ed from the mouth by the ecraseur or the scissors. Probably the better method is by the scissors. usually known as Whitehead's method. The mouth is widely opened with a gu,!!. the toncue transfixed with a stout silk ligature, by which to hold and make traction on it and the reflection of mucous mem­brane from the tongue to the jaw, and the insertion of the Genio-hyo-glossus first divided with a pair of curved blunt scissors. The Palato-glossus is also divided. The tongue can now be pulled well out of the mouth. The base of the tonzue is cut through by a series of short, snips, each bleeding vessel being dealt with as soon as divided, until the situation of the ranine arterv is reached. The remaining undivided portion of tissue is to be seized with a pair of 'Yells's forceps, the tongue removed, and the vessel secured. In the event of the ranine artery being accidentally injured hremorrhage can be at once controlled by passing two fingers over the dorsum of the tongue as far as the epiglottis and dragging the root of the tongue forcibly

forward.