78 CLEFT PALATE: 



menced before the patient has arrived at years of 

 discretion, so that he may afford every facility for 

 its accompHshment. An attempt may now be made 

 to close the fissure by adhesion of its margins. But 

 it is only in very favourable instances that this 

 velo- synthesis should be attempted." 



Fergusson, in 1844, presented a paper to the 

 Medico-Chirurgical Society on Cleft Palate and on 

 Staphyloraphy, in which he pointed out an improved 

 mode of performing the operation. He says — " Up 

 to a recent period, the results have been so unsatis- 

 factory, that I have had little confidence in recom- 

 mending the operation." Up to this period the 

 operation had been performed very much in the 

 same way by all surgeons, slight differences of opinion 

 as to whether the sutures should be carried through 

 the velum first, and then the edges pared, or whether 

 the edges should be pared first, and then the sutures 

 passed ; whether the edges should be pared with a 

 knife or scissors, existed ; but with the exception of 

 these, or equally unimportant differences, the opera- 

 tion was the same as performed by all men. Thus, 

 from 1760 to 1840, little or no real advance had 

 been made in the operation for fissure of the soft 

 palate. 



Liston, with his skill as an operator, pursued, 

 with very little modification, the same plan as that 

 devised by Mounier, the French dentist, nearly a 

 century before. 



Up to this date no one had ever attempted to 



