Daily Yellowstone journal., 1888-08-24
OPERATION FOR hAREllP.
Uniformed Upon q Child Of Four Months
A Surgical Success.

There Is at present under treatment at
the Roosevelt hospital a child not quite 4
months of age, who has been the subject
Of a very difficult and delicate surgical
operation, in spite Of which he still lives
and seems to enjoy life. The child's
parents had been married ten years be-
fore his birth. and his mother had given
birth to three other children who were in
no way defprmed. A strange circum-
stance to which the harelip may have
been due is that three months before the
child's birth its mother discovered for
the first time that its father had been
born with both harelip and cleft palate,
and that he he'd been successfully oper-
ated on while an infant for the former,
the scars Of which operation were totally
hid by his heavy mustache. while for the
latter he wore a false palate with several
teeth in his mouth. So perfect had been
the work of the surgeon and dentist in
his case, that it would never have been
known by any one had he not, on the
occasion of his wife's discovery, had a
severe toothache, which had made the
removal of the false teeth necessary.
Very unwisely he then told her that he
and two OF his brothers had been born
with harelip and cleft palate. Being a
nervous m and in a peculiar state
of mind, she took q notion that her child
would have the same dcformity as its
father. The idea haunted her. and in
some way it seems to have affected the
infants development. When it was born
she saw at the first glance that the baby
had harelip. The child was unable to
take food in the way it should have. Ii
could not nurse. Food had 10 be given
by the spoonful, and the result was that
the infant suffered for proper and suiii-
Gent nourishment. AT last it was evil
dent that heroic measures must be re-
sorted to or the child would die.
AT first the mother would not consent
to an operation, but she did at last, and
on May 81 DR.. McBurney performed it
i'm the operating room If the hospital.
Ether was given the littl patient in such
quantities as was safe FOR one so Young,
and, that no evil consequences might re.
suit from its struggles if pain should be
felt in spite Of the n ,thetic, the patient
was put into n tight lifting rubber bag,
which was closed around its neck. The
surgeon then, selecting a sharp curved
bistoury, or knife with a pointed blade,
commenced the operation. The NAL
formation to lie corrected as the first
step was to close the broad assure which,
like the letter A, divided the upper lip.
The next step was to dissect the flesh,
muscle and all, from the bone beneath
on both sides Of the mouth for some
little distance. A slight incision was
then made from the left corner
of the mouth in the direction
of the eur, as the mouth WAS
a little short on that side. An incision
was. now made from the left nos.
tril directly into the flap on the right
side. in the direction of the right corner
Of the mouth. This was planned so that
il left a triangular vacancy, the apex Of
which triangle was midway between the
center of the nose and mouth. The flap
on the other side was now cut to fit this
vacancy and drawn into it with silk
sutures and carefully stitched. Stitches
were then passed into the mucuous lining
" Aft llhIo III CuNAl a way dn W tNfll ~
and bring sufficient to the outside along
the lower border to form the vermilion
border Of the lip. The fsSure in the
cheek was then sutured together care
fully and the external operation was
finished.
1t now remained fer the surgeon TO
bring the bony roof Of the mouth to-
gether in the middle, by which means il
was hoped that the iissurcd palate could
be closed and the patient saved the iu-
convenience Of being obliged u use an
artificial set of teeth and mouth roof HE
his,father's. With a sharp knife the
surgeon incised the soft mucuous MEM
brane on both sides Of the ti-sure. and.
taking care not To wound the blood YES.
sells, raised the periosteal membrane from
the bony wall Of the cavity beneath, and
uniting this flap from each side in the
middle Of the iisSure, thus formed a
periosteal tent over the mouth, for the
protection Of which against the tongues
action he put a thin silver plate, made
for the occasion, in the mouth under
said tent. At the interior end of tine
assure he united the two parts Of the
soft palate. thus forming a good palate
and completely closing the cleft.
The periosteal membrane above re-
ferred TO has the property Of forming
new bone, which is deposited on its In
ner side. 1t forms the outer or hard
layer Of all bones, and its finely ramify-
ing blood vessels supply the outer layer
of all bones with nourishment. 1t is ex-
pected that a bony roof Nill grow over
the tent Of periosteum that was made to
close the fissure. When this bony roof
is formed the silver guard will be taken
from the child's mouth, where it must
remain until then.
The little patient is rapidly recovering
from the effects Of the operation. The
wounds are all healed with the exception
of that in the hard palate, and a firm,
bony arch is forming oyer the roof Of the
mouth. The child's own mother scarcely
recognized it after the first bandagcs
were removed. In a few days the little
one will leave the hospital cured New
York Cor. Globe-D Democrat.