, 1888-07-21
OPERATION FOR HAReLIP.
Performed Upon a child 81 Four month";.
A Surgical Success.

.ISA 49, - aeNA an
A Surgical Success.
There is at present under treatment at
he Roosevelt hospital n 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 deformed. \ strange circum-
stance to which the harelip may have
been due is that three months before the
child's birth its mother discovered for
tine first time that its father had been
born with both harclip and cleft palate,
and that he had 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 lie 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 nave been
known by any one had he not, on the
occasion of his wife's discovery, had q
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 woman and in a peculiar state
of mind, she tool a notion that her child
would have the same deformity 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
bad harelip. The child was unable to
take food in the way it should have. 1t
could not nurse. Food had to be given
by the spoonful, and the result was that
the infant suffered for proper and suffi-
cient 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 "a DIR. McBurney performed it
in the operating Dom of the hospital.
Ether was given thel little patient in such
quantities as was safe for one so young,
and, that no evil consequences might re-
suit from its struggles il pain should be
felt in spite of thea nesthetic, the patient
was put into a tight fitting 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 be corrected as the first
step was to close the broad fissure 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
OF the mouth in the direction
of the ear, 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 80 that
it 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
of the flaps in such a way as to evert it
and bring sufficient to the outside along
the lower border to form the vermilion
border of the lip. The assure in the
cheek was then sutured together care
fully aud the external operation was
finished.
1t now remained for the surgeon to
bring the bony roof of the mouth to-
gether in the middle, by which means it
was hoped that the assured palate could
be closed and the patient saved the in
convenience of being Obliged to use an
artificial set OF teeth and mouth roof like
his fathers. With a sharp knife the
surgeon incised the soft mucuous mem
brane on both sides of the fissure, 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 thu
middle of the ~fissure, 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 the
fissure he united the two parts of the
soft palate, thus forming a good palate
and completely closing the cleft.
h 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 will grow over
the tent of periosteum that was made to
close the assure. 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 over the roof of the
Mouth The childis own mother scarcely
recognized it after the first bandages
We're removed. In a few days the little
one will leave the hospital cured.-New
York Cor. Globe Democrat.
A Plant That Catches Files.