ITS SURGICAL AND MECHANICAL TREATMENT. 93 



of the gold plate, which has a single line of holes 

 punched in it for this purpose. The exact size of 

 the larger piece will vary in each case, for it is 

 necessary that its free convex margin should not 

 touch the back of the pharynx when the sides of the 

 fissure approximate in the act of deglutition; as, 

 however soft the material of which it is formed may 

 be, a raw and painful spot will quickly be the result ; 

 but at the same time it must be close to the back of 

 the pharynx, or otherwise the articulation will be 

 more or less indistinct, as the sound will not be 

 retained in the cavity of the mouth long enough to 

 undergo the coining-like process of articulation, but 

 will escape into the cavity of the nose, and produce 

 more or less of the characteristic nasal sound of this 

 lesion. This piece should also be extremely thin, 

 as it is absolutely necessary that it should adapt 

 itself with great readiness and completeness to 

 the ever- varying sides of the fissure; but a piece 

 of such tenuity as is necessary to secure this vital 

 point, weighted with mucus, would quickly droop, 

 but for the support which is given to it by the 

 smaller and stouter piece which lies immediately 

 underneath it. 



These two pieces of sheet rubber sewn to the 

 posterior margin of the gold plate, — the thinner 

 to its upper surface, and the thicker to its lower, — 

 have been found in more than one instance to 

 restore to the person using them a distinct articu- 

 lation. 



The fact appears therefore established, that not 



