ITS SURGICAL AND MECHANICAL TREATMENT. 79 



operate upon fissure of the hard palate.* Syme 

 writes, in 1832 — "Split palate does not admit of any 

 remedy for the division of the hard part, except the 

 closure of the communication between the nose and 

 the mouth by a piece of silver, enamel, or other 

 substance, so fitted as to remain in it without 

 shifting." Liston, in his " Operative Surgery," 

 published in 1840, appeared to consider it so 

 entirely out of the province of the surgeon, that 

 he did not even refer to it ; his remarks on spHt 

 palate being entirely confined to fissure of the 

 velum pendulum palati. 



Fergusson, in 1844, says — "Until a recent date, 

 the cleft in the hard palate has been deemed beyond 

 the reach of surgical skill, but Dr. Mason Warren, 

 of Boston, has recently, by a proceeding strictly 

 surgical, closed the fissure here as well as in the soft 

 parts. I have resorted to the operation in several 

 instances, but without success. The process is ex- 

 ceedingly difficult." 



The history of the surgical treatment of the hard 

 palate dates from this period. Since Dr. Warren's 

 paper, which appeared in the "New England Journal" 

 for 1843, many surgeons in this country, as well as 

 on the Continent and in America, have performed 

 the operation with success. 



I wiU now proceed to describe the operation on 

 the soft palate, called staphyloraphy, as performed 



* Unless Mourner's operation extended through the hard palate, 

 which appears somewhat doubtful. 



