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252 ANATOMY.
of the face passes imoard to the brain-case and to the interior of the
facial region, while the remaining portion flows doumward to join the
external and anterior jugular veins.
" It is of interest to note that in facial phlebitis the disease has a tend-
ency to extend upward, except when the exciting cause lies at a point
in or about the lower lip ; in which case, as a rule, the inflammation
extends downward. In a case reported by M. Bechez,^ illustrative of
of the fact just stated, a soldier, aged forty-two, was attacked with fever,
followed bv redness and slio;ht swellino; of the forehead. This swellino;
soon became more pronounced along the temporo-frontal veins, which
Avere hard, prominent, and of a violet color. The eyelids were oede-
matous and the conjunctiva chimosed. The patient died about the
seventh day, A somewhat similar case, recorded by Mr. T. H. Sylves-
ter, is interesting from the fact that the frontal veins determined the
extent of the inflamed tract. A puncture of the lip excited the phle-
bitis, wliich extended to a small vein at the outer side of the nose,
thence to the inner canthus, and from that point along the frontal
vein to the scalp, which became extensively inflltrated with pus. The
case terminated fatally at the end of five weeks.
" The relations existing between the venous blood of the face and that
of the brain-case are rendered evident by the fact that the state of the
circulation of the external nose is sometimes an index of the condition
of the vessels of the brain."
The Temporo-maxillary Vein is a short trunk which commences
at the termination of the temporal and internal maxillary vein. It
extends downward within the parotid gland and along the outer sur-
face of the external carotid artery, between the sterno-cleido-mastoid
muscle and the ramus of the jaw, to a point near its angle, where it
divides into two brandies. One branch passes downward and slightly
forward, uniting with the facial to form the common facial vein ; tlie
other branch passes downward and backward, terminating in the
external jugular vein.
The Commox Temporal Yeix is the medium through which, in
great measure, the l)lood is returned from the region of the distribution
of the temporal artery; the vein, however, does not accompany the
artery in its course. It originates above the base of the zygoma at the
termination of the superficial and middle temporal veins. It passes
downward and inward beneath the parotid gland, and unites with the
internal maxillary vein at the point of origin of the temporo-maxillary
vein.
The Ti-ihutaries of the Common Temporal Vein are the superficial and
middle temporals, tlie jiarotid, the articular, the anterior auricular, and
the transverse facial veins.
The Superftcial Temporal Vein originates through the union
of numerous small branches in the form of a plexus w^hich is situated
over the region of the vertex and side of the head. It anastomoses
with the corresponding artery of the opposite side, the frontal, supra-
orbital, occipital, and jiosterior auricular veins. These branches pass
downward, converge toward two central stems which finally unite, con-
^ Oaz. heb., 1863, 716.