rbuncles_, and _anthrax pustules_
frequently occur on the face, and when situated near the middle line,
and particularly on the upper lip, are liable to give rise to general
infection and to intra-cranial complications which may prove fatal.
The primary infection of _glanders_ and of _actinomycosis_ may also
occur on the face.

The various forms of _tuberculous lupus_ are met with more frequently
on the face than in any other situation (Fig. 237). _Tuberculous
disease of the facial bones_, particularly of the lateral half of the
orbital margin at the junction of the zygomatic (malar) bone with the
maxilla, is not uncommon in children.

[Illustration: FIG. 237.--Illustrating the deformities caused by Lupus
Vulgaris, which dated from adolescence.

(Mr. D. M. Greig's case.)]

The primary lesion of _syphilis_, and the various forms of secondary
and tertiary syphilides, may simulate tuberculous lupus, cancer, and
other ulcerative conditions.

#Tumours.#--The simple tumours met with on the face include sebaceous
and dermoid cysts, naevus, plexiform neuroma and adenoma; the malignant
forms include the squamous epithelioma, and rodent, paraffin, and
melanotic cancers.

_Epithelioma_ occurs most frequently in men beyond the age of forty.
The affection usually begins at the margin of the lip, the edge of the
nostril, or the angle of the eye. There is generally a history of
prolonged or repeated irritation, or the condition may develop in
connection with a scar, a wart, a cutaneous horn, or an ulcerating
sebaceous cyst. It may begin as a hard nodule, or as a papillary
growth which breaks down on the surface, leaving a deep ulcer with a
characteristically indurated base--the _crateriform ulcer_. The
neighbouring lymph glands are infected early, but metastases to other
organs are not common. The treatment consists in excising the growth
and the associated lymph glands as early and as freely as possible.
When excision is impracticable, benefit may be derived from the use of
radium or of the X-rays.

The face is the commonest seat of _rodent cancer_ (Volume I., p. 395).

THE ORBIT

#Injuries.#--_Wounds of the eyelids_ are liable to be complicated by
damage to the lachrymal apparatus, leading to stenosis of the
canaliculus and persistent watering of the eye. If the wall of the
lachrymal sac or nasal duct is torn, the patient should be warned not
to blow his nose for some days lest air be forced into the tissues and
produ