80 CLEFT palate: 



at the present day. The first step is the improve- 

 ment recommended by Mr. Fergusson, the division 

 of the levatores palati, and the palato-pharyngei 

 muscles. One great obstacle to the success of this 

 operation, previous to Mr. Tergusson's paper, was 

 the violent muscular action which the irritation of 

 the operation appeared to provoke ; this Mr. P. 

 was induced, after dissecting a cleft palate, to 

 attribute to the combined action of the before- 

 mentioned muscles, and therefore he divided them 

 rather than, as had hitherto been the fashion, 

 inflict sundry empirical gashes upon the soft palate 

 with the object of relieving tension, and paralysing 

 the muscular action of the part. The result of this 

 more reasonable practice has been to make the 

 operation more frequently successful. After this 

 step has been taken, the edges of the fissure should 

 be pared with a probe-pointed bistoury, and then 

 brought together and retained in apposition by 

 means of two or three interrupted sutures. All 

 motion of the parts should be guarded against as 

 much as possible. Fluid food should alone be taken 

 for the first forty-eight hours, and of this but 

 sparingly. The stitches should be carefully cut out 

 on the second or third day. 



The surgical treatment of the hard palate is, as 

 has been already said, of very recent date. Dr. 

 Mason Warren must be considered as the originator 

 of this operation, which consists in dissecting the 

 soft tissues from the bones of the palate by means 



