The morning news. [volume] (Savannah, Ga.) 1887-1900, 1888-06-30
TIE OPERATION FOR HAREL1p
Performed Upon a Child of Four
M0ntha

From the Globe Democrat.
NEW YORK, June 12.-There is at pres
ent under treatment at the Roosevelt hospi-
tai child not quite months of age, who
has been the subject of 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 before his birth, and his mother had
given birth TO three other children who
were in no way deformed. A strange cir
cumstance 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
had been successfully operated 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
false plate with several teeth in his mouth.
So perfect had been the work of the sur
geon and dentist in his case, that Ii would
lever have been known by any one, had he
not, on the occasion of his wifes discovery,
had a severe toothache, which had made
toe removal of the false plate 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 peculiar state of mind, she
took a notion that her child would have the
same deformity as its father. The idea
haunted her, and in some way il 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. 1t could not nurse. Food
had to be given by the spoonful. and the
result was that the infant suffered for pro-
per and sufficient nourishment. At last it
was evident that heroic measures must be
reSorted 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 Dr. McBurney performed it in the
operating room of the hospital Ether was
given the little patient in such quantities as
was safe for one so young, and, that no
evil consequences might result
from its struggles if pain should
be felt in spite of the anesthe-
tic, the patient was put into tight-fit
ting rubber bag, which was closed around
its neck. The surgeon then, selecting
sharp curved bistoury, Or knife with a
pointed blade, commenced the operation.
The malformation to he corrected as the
first step was to c,ose 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 dis
lance. A slight incsiOn was then made
from the left corner of the mouth in
the direction of the ear, as the mouth was a
little short on that side. An incislon was
now made from the left nostril directly
into the flap on the right side, in the di-
rection of the right corner of the mouth.
This was planned so that it left a triangu-
lar vacancy, the apex of which triangle was
midway between the center of the nose and
mouth. The flap on TIE 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 mucous
lining of the flaps in such way as to evert
it and bring sufficient to the outside along
the lower border to form the vermillion
border Of the lip. The assure in the cheek
was then sutured together carefully and the
external operation was finished.
1t now remained for the surgeon to bring
the bony roof OF the mouth together in the
middle, by which means it was hoped that
the fissured palate could be closed and
the patient saved the Inconvenience
of being obliged to use an arti-
like his fathers. With sharp knife the
surgeon incised the soft mucous membrane
on both sides of the fissure and taking
care not TO wound the blood vessels, raised
the periosteai membrane from the bony
wall of the cavity beneath, and uniting this
flap from each side in the middle OF the fis-
sure 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
assure he united the two parts of the soft
palate, thus forming a good palate and com
pletely closing the cleft.
The periosteal membrane above referred
to has the property of forming new bone,
which is deposited on its inner side. 1t
forms the outer or hard layer of all bones,
and its finely ramifying blood vessels sup
ply the outer layer of all bones with nour-
ishment 1t is expected that a bony roof
viii grow over the tent of periosteun that
was made to close the fissure When this
bOny roof is formed the silver guard will
be taken from the childs 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 child's own mother scarcely recognized
1t after the first bandages were removed.
In few days the little one viii leave the
hospital cured.