86 CLEFT palate: 



which appears below with a pair of forceps, the 

 long diameter of the button is made to correspond 

 with the short diameter of the fissure, and so the 

 plate is kept up. 



I will now bring you a century later, and quote 

 from the celebrated work of Heister, published 

 1756. This eminent surgeon, when speaking on 

 the subject, says : " When the palate is perforated 

 into the nose, your remedy is to close or stop the 

 perforation as exactly as possible by art, with a 

 proper instrument, since you cannot procure the 

 bone and flesh to grow so as to fill up the space. 

 The patient must, therefore, have a plate of silver 

 or gold adapted to the perforation, and, furnished 

 with a handle or small tube, which being armed at 

 the top with a sponge, he may thereby exactly close 

 the perforation (Plate IX., Figs, g, h). The sponge 

 being inserted into the perforation, prevents the 

 plate from falling down from the palate, and by 

 that means renders the patient able to speak and 

 swallow as if his palate was entire." 



I will not trouble you this evening with the 

 opinions of the numerous writers on surgery who 

 have referred to this lesion, but will content my- 

 self with one from each century. From those just 

 read it wiU be seen that up to this date the obtu- 

 rator was very ill-adapted for the purpose for which 

 it was made, and we must give our ancestors credit 

 for being easily satisfied with the provisions of 

 art for their relief. 



