76 CLEFT palate: 



obliteration of the aperture by some foreign body, 

 and this, we may infer from the plates and descrip- 

 tions on record, must have been most imperfectly 

 accomplished. 



Cleft palate may be either congenital or accidental, 

 and in either case it may be either simple or com- 

 pound ; that is, it may be confined to either the 

 hard or soft palate, or it may extend through both. 

 It may vary in degree from the mere bifurcation of 

 the uvula, or an opening in the hard palate no 

 larger than the smallest probe-point, to the entire 

 absence of the velum, the palatine processes of the 

 palate and maxillary bones, and the intermaxillary 

 bones. A specimen of such a case is before the 

 Society to-night. 



Before proceeding further, it may be well to state 

 the order in which the subject will be treated in this 

 paper. 



I propose to commence by tracing the history of 

 the surgical treatment of this lesion, concluding it 

 with an account of the mode of operating at the 

 present day ; then the history of the mechanical 

 treatment, concluding it with a description of the 

 form of obturator I am in the habit of employing ; 

 then will follow some remarks on the cases supposed 

 most suitable for the one or the other mode of 

 treatment, with reflections on the advantages and 

 disadvantages of the two methods of treatment. 



It is a light task to trace the history of the 

 surgical treatment of cleft palate. The first opera- 



