90 CLEFT palate: 



apparatus could only be accomplished by the man 

 who first designed it, and hence we find that a few 

 years, later the then best known author on dental 

 surgery, I mean Tox, says, — " Fissure of the hard 

 palate is generally easily remedied, but where there 

 is a loss of the velum pendulum palati the suc- 

 cessful use of any substitute, however ingeniously 

 contrived, is very doubtful." 



During the year 1845, four articles appeared in 

 the " Lancet," by Mr. C. H. Steam, a surgeon of 

 London, on " Congenital Deficiency of the Palate." 

 In the course of these he described a most ingenious 

 apparatus which he had contrived to remedy a con- 

 genital fissure of the soft palate in the person of 

 a near relative of his own. He first fitted a gold 

 plate to the roof of the mouth : to the upper and 

 posterior margin of this plate a flat spiral spring 

 was attached, which could vibrate backwards and 

 forwards ; to the free extremity of this spring an 

 artificial flexible velum was attached. This velum, 

 made of india-rubber, consisted of a body and 

 two wings. The body, which consisted of three 

 pieces overlapping each other, was made the 

 shape and size of the fissure when the parts 

 were at rest ; and the wings, each composed of 

 a single piece, projecting forwards and outwards 

 from each lateral margin of the body, were made to 

 conform to the shape of the columns or fleshy sides 

 of the fissure, and to rest upon their anterior sur- 

 faces. In like manner, from each lateral margin of 



