Fig. 2. Showing "side cuts," and passage, and twisting of silver-wire sutures in the writer's method of closing a cleft palate. See "Medical Record, Aug. 7, 1886;" also "Trans. of American Medical Assc. 1869." Fig. 3. From a Photograph. The instruments used by the writer in his operations for cleft palate; include his gag, his siezing forceps, his curved needle and his knives; made for him by Tiermann & Co., of New York. See Am. Journal Med. Sciences, July, 1871, January, 1872, for description of the instruments in use. The writer's gag is shown in position in the System of Surgery of Gross, Vol. II, p. 540, and also elsewhere, as in the Work of Koenig of Berlin, Vol. 1, p. 402, Specielle Chirurgie. THE WRITER'S CASE OF CLEFT PALATE IN NEW YORK MEDICAL JOURNAL OF APRIL, 1869. Case of Maria D., aged 7 years: Followed by reproduction of bone in the new palatine vault. Speech improved. From the plaster cast of the roof of the mouth and palate, taken before operation. (Natural size.) Case of Miss S., aged 15 years. See following figure for result after the operation. Probably the most common cause of failure in the operation for cleft palate is cutting at, and not properly cutting the muscles which move the palate, and to illustrate this, a notable case is cited of a former eminent surgeon, author of a wellknown "Treatise on Fractures and Dislocations." He asked me to witness a cleft palate operation, and used my gag and cleft palate instruments for that purpose. He had some years before bridged over a part of the soft palate in his case. He was very proud and confident of success. In the presence of a roomful of medical students and a few doctors, he remarked to me harshly and reproach fully: "These flaps, sir, do not fall together as you have written they will!" I looked into the Case of Miss S., aged 15 years. Appearance of the mouth after operation for an extensive cleft of the hard and soft palate. (From a photograph.) See the writer's Report on Cleft Palate in Transactions of American Medical Association, 1869. Followed by production of new bone in the palatine vault. Speech improved. |