82 CLEFT PALATE: 



surfaces, which are to be kept in contact by means 

 of the interrupted suture, until union has taken 

 place. In those cases where the fissure extends 

 through both hard and soft palates, the operation 

 must be divided into two, three, or even more parts, 

 as, for several reasons, it is injudicious to attempt the 

 onion of a large surface at once. In these cases the 

 operator generally selects the anterior extremity to 

 commence upon. Of the propriety of performing 

 this operation many surgeons have grave doubts. 

 Fergus son says — " In the generality of such cases, I 

 believe that the patient had better remain satisfied 

 with an obturator." 



Erichsen, in his " Science and Art of Surgery," 

 1853, says — "This operation has not been hitherto 

 successful, I believe, in this country. Fissures of 

 the hard palate usually require to be closed by means 

 of an obturator." 



Miller, in his "Practical Surgery," IS 52, says — "If 

 the aperture be large, the deficiency can only be sup- 

 plied by mechanical contrivance. If, however, it 

 resembles merely a fistulous opening, closures of the 

 mucous membrane may be obtained by the occasional 

 application of a heated wire." 



The late Mr. Avery, of Charing Cross Hospital, 

 appears to have been the first English surgeon who 

 attained any encouraging measure of success in this 

 operation. Mr. Pollock records, in a paper published 

 in the last year's volume of the Medico-Chirurgical 

 Society's Transactions, two cases successfully treated 



