he opposite angle, necessitating
amputation of the protruding portion.

Carnochan reports a case in which hypertrophy of the tongue was reduced
to nearly the normal size by first tying the external carotid, and six
weeks later the common carotid artery. Chalk mentions partial
dislocation of the lower jaw from an enlarged tongue. Lyford speaks of
enlargement of the tongue causing death.

The above conditions are known as macroglossia, which is a congenital
hypertrophy of the tongue analogous to elephantiasis. It is of slow
growth, and as the organ enlarges it interferes with deglutition and
speech. It may protrude over the chin and reach even as far down as the
sternum.

The great enlargement may cause deformities of the teeth and lower jaw,
and even present itself as an enormous tumor in the neck. The
protruding tongue itself may ulcerate, possibly bleed, and there is
constant dribbling of saliva. The disease is probably due to congenital
defect aggravated by frequent attacks of glossitis, and the treatment
consists in the removal of the protruding portions by the knife,
ligation, the cautery, or ecraseur.

Living Fish in the Pharynx.--Probably the most interesting cases of
foreign bodies are those in which living fish enter the pharynx and
esophagus. Chevers has collected five cases in which death was caused
by living fish entering the mouth and occluding the air-passages. He
has mentioned a case in which a large catfish jumped into the mouth of
a Madras bheestie. An operation on the esophagus was immediately
commenced, but abandoned, and an attempt made to push the fish down
with a probang, which was, in a measure, successful. However, the
patient gave a convulsive struggle, and, to all appearances, died. The
trachea was immediately opened, and respiration was restored. During
the course of the night the man vomited up pieces of fish bone softened
by decomposition. In 1863 White mentions that the foregoing accident is
not uncommon among the natives of India, who are in the habit of
swimming with their mouths open in tanks abounding with fish. There is
a case in which a fisherman, having both hands engaged in drawing a
net, and seeing a sole-fish about eight inches long trying to escape
through the meshes of the net, seized it with his teeth. A sudden
convulsive effort of the fish enabled it to enter the fisherman's
throat, and he was asphyxiated before his boat reached the shore. After
death the fish was found i