0 ] Edinburgh, Session 1865 - 66 . 577 
In six cases where the intermaxillary bones seemed altogether ab^ 
sent— probably cases originally of double cleft' — where these hones 
had been removed by the surgeon — or of others where they had 
never been developed — 
1 case measured |-ths of an inch. 
1 „ „ fths 
2 cases 
1 case 
1 „ 
^ths 
1 inch. 
„ l^th of an inch, 
giving an average measurement of between fths and |ths of an 
inch. 
In ten cases of simple cleft palate alone, or of cleft palate com- 
bined with only unilateral fissure — 
1 case measured fths to fths of an inch, 
t „ „ fths ,, „ 
4 cases ,, fths „ „ 
3 „ „ 1 inch. 
1 case „ Ifth of an inch. 
giving an average measurement of fths of an inch. 
I have selected the inter-bicuspid point of measurement, as being 
that in which the relative width in the infantile, compared with the 
adult jaw, seems to vary least. The increase by expansion of the 
jaw in this direction amounting to very little comparatively from 
infancy to adult age in the healthy subject. 
It would thus appear that while in the infant there is abnormal 
separation, in the adult there occurs abnormal approximation of the 
parts on each side of the fissure. To a certain extent this approxi- 
mation of parts may be fortuitous : a misdirection of growth depend- 
ant upon the absence of the mesial structures, while the superior 
maxilla is becoming, as age advances — elongated downwards by the 
expansion of the antrum. But as the same approximation seems to 
occur even where only a partial fissure exists, — the cleft being- 
limited to the palate, while the maxillary arch is throughout com- 
plete, — there is reason to conclude that it is in some measure to 
be considered as a reparative, or rather an ameliorative effort on 
the part of nature towards remedying the defects existing. And such 
a view becomes practically interesting, as pointing to the probability 
of a certain amount of assistance likely to be obtained in this man- 
ner, by a judicious delay in surgical interference with such cases. 
