96 CLEFT palate: 



depends, as given by the most recent writer on the 

 subject, are : A perfect state of health of the patient, 

 without which the operation must be postponed or 

 deferred altogether. Union by first intention must 

 take place, otherwise the operation is as abortive as 

 if it had never been attempted. Careful dissection 

 of the soft parts, without bruising or tearing of the 

 flaps. Ample flaps to enable their edges to meet 

 readily without the traction of the sutures. Eepeated 

 operations rather than any extensive separation of 

 the soft tissues at one proceeding. 



As to the first condition, the importance of which 

 cannot be too strongly insisted upon, it is, unfor- 

 tunately, but too well known to all operating sur- 

 geons, that no one can with unerring certainty be 

 pronounced to be in a state of health to render an 

 operation safe. 



It was but a short time back that a young gen- 

 tleman, apparently in vigorous health, came to town 

 to be operated upon for varicocele, not because it 

 troubled him much, but simply, as he was about to 

 get married, to rid himself of the inconvenience. 

 The veins were tied, but within a week the patient 

 was dead. It is scarcely a month since a healthy- 

 looking country lass was admitted into St. George's 

 to have a goitre cured ; a single thread of silk was 

 carried through and left in it as a seton, but in 

 three days she was dead. It was subsequently 

 ascertained that she had diseased kidneys. 



Another risk of a fatal termination to this opera- 



