A Physiological Account of the Case of Margaret Cutting, Who Speaks Distinctly, Tho' She Has Lost the Apex and Body of Her Tongue: Addressed to the Royal Society, by James Parsons M. D. F. R. S.

man had three Boys, and one Girl, after the Fallopian Tube on the right Side had lost its Action. I am, Gentlemen, With great Respect, Decem. 17. 1747. Your most obedient and Most humble Servant, Starkey Myddleton. XI. A Physiological Account of the Case of Margaret Cutting, who speaks distinctly, tho' she has lost the Apex and Body of her Tongue: Addressed to the Royal Society, by James Parsons M.D. F.R.S. Gentlemen, Read Dec. 17. 1747. As several of the Members of this worthy Society were somewhat divided in their Opinions concerning what was reported of Margaret Cutting, when they were first inform'd of her by Mr. Baker*; it will be necessary (in order to render her Case the better understood) to lay before you the following short Particulars, which * See these Trans. No. 464, Article II. p. 143, &c. which are the Result of an Examination made a few Days since by Dr. Milward and myself; and which, in general, differs not from the Opinion which that learned Gentleman and I mention'd to this Society, upon the Occasion, which the Science of Anatomy necessarily suggested to us at that time. But James Theobald Esq; a worthy Member of the Royal Society, having encouraged her to come to London, and having brought her to this Meeting of the Society, has now given us all an Opportunity of coming at the Truth of her Case; wherefore I shall now, Gentlemen, present you with, first, an Account of her present Condition; and then, some Considerations on the natural State and Uses of the Tongue; which will shew you how far she makes the Lips and Teeth supply the Want of her Tongue in speaking; and also be a Direction to every Gentleman present to judge of the Case before him. Of her present Condition. THE Apex and Body of the Tongue (being the only Parts that naturally fill the Cavity of the Mouth) are intirely wanting in this Woman, as closely to the Region of the Os Hyoides, which is the Root of the Tongue, as can well be conceived; and which is now situated too low in the Throat to be perceived, even when she opens her Mouth at the widest. But let any one lay the Tops of the Finger and Thumb to the Sides of her Throat, and let her at the same time pronounce the Letter k he will feel the remaining Root of the Tongue rise towards the the Roof of her Mouth, in order to perform; it; however, she cannot keep it there any longer than the Moment of thrusting it up, for want of the Ligament (which was destroy'd with the Tongue) that is destin'd, together with the following Muscles, to keep the whole Tongue forwards in its due Situation. The Genioglossi are a Pair of Muscles which arise from the fore Part of the Inside of the lower Jaw, and are inserted into the Body of the Tongue by three different Directions; the anterior Part is carried forward towards the Apex: the posterior runs obliquely backwards towards the Root, sending a narrow Slip on each Side to the Cornua of the Os Hyoides; and the middle Part ends about the middle of the Tongue. Now there are certain Inequalities appearing on, and closely adhering to the Floor of the Cavity of the Mouth, one of which being the most considerable, and having a Resemblance in its Substance to that of the Surface of the Tongue, has been, if I am rightly informed, inadvertently mistaken for a Tongue, by a Gentleman professing Surgery in the Country; and which he thought, for want of a careful Examination, perform'd the Offices proper to the Apex; but a little Care and Circumspection would have inform'd him, that those Apparances are only Fragments of the Genioglossi mention'd before, and that upon the Separation of the sound Parts from those mortified, such Fragments, as had escaped, were retracted, and cicatrized down into their present State; nor is it difficult to conceive how the Root of the Tongue must of Necessity sink lower down into the Throat, by the Lots of these Muscles and the proper Ligament; which, as I have observed observed before, naturally kept it higher than it could remain ever since their Destruction. If the Mortification had reached the Os Hyoides, it must have reached, and destroy'd the Muscles of the Larynx, and then the Voice would have been destroy'd; and also those of the Pharynx, and then Deglutition could never have been perform'd; the dreadful Consequences of which need not be enumerated here; but she swallows well, and her Voice is perfect, and therefore it is not very extraordinary she should command her Voice by the proper Muscles which remain untouch'd. The nasal Opening is quite exposed, because the Uvula which cover'd it was also destroy'd; for one Pair of its Muscles (the Gloso-Staphilini) arise from the Tongue; by which no doubt the Distemper was communicated to this Part also. She has her Taste perfectly, which is hereafter accounted for. Some Considerations on the natural State and Uses of the Tongue. THE Tongue is a fleshy Substance, chiefly made up of Muscles; and consists of a Basis or Root, a Body, and an Apex; the Basis is the thickest and most substantial Part, contains the Os Hyoides, and is naturally situated very low in the Throat: From which the Body rises upwards and forwards, and is terminated by the anterior Part or Apex; proceeding under the Uvula and Roof, and lying upon the Floor (if I may so call it) of the Mouth. As to the more particular Description of all its other Parts, I cannot apprehend it is at all necessary here, since it is not to our Purpose, and would take up too much of your Time. As to its Uses, it is said to be the Instrument of Speaking and Tasting; as to the latter, Experience shows us that the very Apex of the Tongue is less capable of discerning Tastes than the next Part to it, and this than the Parts yet farther back, all along the Body to the Root; so that altho' the Taste of any thing is first perceived by the Apex, yet the Gust increases, the more the Morsel approaches to Deglutition, until it is quite protruded into the Gula; because as the Tongue grows more thick backwards it contains more of the nervous Papillae than the smaller Part, and also because there is a Capacity of tasting in the Membranes of the back Part of the Roof to the Root; as if Nature intended to increase the Gust, that Deglutition may be the better and more eagerly performed for the Service of the Animal: Hence altho' the Apex and Body of the Tongue be gone, yet there is not a Depravation of Taste, which is the Case of the Person now under your Consideration. As to Speech, which is only Sound or Voice articulated into Expression, the Tongue is not the sole Organ for such Articulation; the Lips, Teeth, and Roof of the Mouth are Instruments also for the same Purpose; the two latter for the necessary Resistance to the Apex of the Tongue, and the Lips for the absolute Articulation and Pronunciation of many Letters; however the following short Examination of the Letters of the Alphabet, as expressed by these Organs, will demonstrate it. The Tongue expresses some Letters with its Apex, and some with its Root. Those absolutely proper to the Apex are only five, d, l, n, r, t. And those to which it only assists are the following Letters, as \( c, g, s, x, z \); all which can be performed by the Teeth alone, and which this Person does very well. Now the Lip-Letters, and those expressed by the Root of the Tongue, she also performs as well as any Person; the former are \( b, f, m, p \); and the latter are \( k, q, x \); and as to the Vowels, and the Aspiration \( h \), since they are chiefly founded by the Exhalation of the Voice, commanded partly by the Lips in widening or straitening the Capacity of the Mouth, these she can also express; so that there is no Letter she cannot pronounce but the five Apex Letters; and those she manages so well by bringing the under Lip to her upper Teeth, in the Course of her Conversation, that any one can instantly apprehend every Word she says; and she further plainly proves the Lips are a better Succedaneum to the Apex, than that could be to the Lips if they were wanting: Indeed it is natural enough for those who make the Tongue the absolute and sole Instrument of Speech, to imagine it as absurd to say a Woman spoke without a Tongue, as that she saw without an Eye; but when we consider the provisional assiting Organs ordain'd by the wise Author of Providence, serving to this necessary and expressive Accomplishment, I hope it will not seem so extremely marvellous, that she speaks without the Body and Apex of her Tongue, as to create any further Doubt of the Matter. I am, Gentlemen, December 17. 1747. Your most humble Servant, James Parsons.