FIG. 154.-A diagram of the motor points of the face, showing the position of the electrodes during electrization of special muscles and nerves. The anode is supposed to be placed in the mastoid fossa, and the cathode upon the part indicated in the diagram. 1, m. orbicularis palpebrarum; 2, m. pyramidalis nasi; 3, m. lev. lab. sup. et nasi; 4, m. lev. lab. sup. propr.; 5, 6, m. dilator naris; 7, m. zygomatic major; 8, m. orbicularis oris; 9, n. branch for levator menti; 10, m. levator menti; 11, m. quadratus menti; 12, m. triangularis menti; 13, nerves-subcutaneous of neck; 14, m. sterno-hyoid; 15. m. omo-hyoid; 16, m. sterno-thyroid; 17, n. branch for platysma; 18, m. sternohyoid; 19, m. omo-hyoid; 20, 21, nerves to pectoral muscles; 22, m. occipitofrontalis (ant. belly); 23, m. occipito-frontalis (post. belly); 24, m. retrahens and attollens aurem; 25, nerve-facial; 26, m. stylo-hyoid; 27, m. digastric; 28, m. splenius capitis; 29, nerve-external branch of spinal accessory; 30, m. sternomastoid; 31, m. sterno-mastoid; 32, m. levator anguli scapula; 33, nerve-phrenie: 34, nerve-posterior thoracic; 35, m. serratus magnus; 36, nerves of the axillary space. even seek roundabout ways of expressing their meaning by shorter words. Besides this vibratory tremulousness in SPASM AND PARALYSIS OF THE TONGUE. 529 articulation, there is an imperfection in the pronunciation of words-long words especially. Remedy is pronounced 'remdy'; constitution, 'constution'; infallibility, 'infallaby.' The last syllable may be badly sounded, or even omitted. I have known this characteristic speech to be the only wellmarked symptom, and to be followed by dementia, exaltation, etc. Occasionally, a patient comes to us complaining of this defective articulation." Interference with the free action of the hypo-glossal nerve, when not associated with a simultaneous affection of other nerves, may result in the production of spasm or paralysis. Spasm of the tongue may be perceived in connection with the spasmodic diseases, such as chorea, epilepsy, and hys-* teria; also, as a result of slight compression or irritation of the hypoglossal nerve from meningeal exudation; while a fibrillary tremor of the tongue is observed in progressive muscular atrophy. In severe types of facial spasm, and in those forms of disease where the lingual nerve is the seat of a neuralgic affection, the hypo-glossal nerve may create a type of clonic spasm. Paralysis of the tongue is usually unilateral, and may be the result of cerebral hæmorrhage, softening, embolism, tumors, or the progressive paralysis of the insane. In rare cases, this condition has occurred from injury done to the nerve from the removal of a tumor of the tongue itself; while instances have been reported where the nerve was impaired by pressure upon its trunk, either at the base of the brain, or at its point of escape from the anterior condyloid foramen. |