The Daily times. [volume] (Richmond, Va.) 1886-1889, 1888-07-13
OPERATION For HARElIP.
Performed Upon "a Child Of -Four Months.
4 Surgical Success.

'ii'
months Of age, ThO 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 hi birth. and bi- mother had given
birth Il three other children who wcrc in
mo- WAY dpfornled. \ strange circum-
stance TO which the hareiip may have
been due i, that three months before the
child's birth its mother discovered foI
the first time that It's father lad been
born with both harelip and cleft Palate,
! and that he had been success fu.is oDor-
ated ON while an infant for the former.
the scals Of which operation were totally
Ind bv hs heavy must2che, While tot tic
latter hc wore a false palate with several
teeth in lis mouth. So perfect had been
the work of the surgeon and dentist in
his case. that It would never have been
known bv any one had hc not. IN the
occasion of lis wiie'5 discovery had a
! favcra ~tO0tbache. which had made the
removal Of .he false teeth necessary.
Very unUi.eiy he thea told her that he
and two Of bis brothr~, had been born
with harclip and cleft palate. Being a
nervous om1 and IN q peculiar state
Of mind. she took o notion That her child
would have tie same deiormitr IS Its
father. The i,ca haunted her. and in
some way II seems 10 have affected The
infant Development. When it was born
he saw az The first glaDcc that the baby
had harclip. The chiid Wa3 unable to
take food an thc way it should havc. 1t
could moi. nurse. FOOD had 10 be given
DIS the spoonfll. and the result was that
The infant suffered for proper and sniff
oient noruishneui. At Last it was cyi-
deui than hlO,c maa mcs must be re-
,ortol 40 or the child would Jic.
Al inst the mother wouid not consent
TO am operation. bat she did AZ last. and
Oh n,ay Il ID. McBurncy performed 1t
in tie operating room Of the b. pital.
Lthcr WIS given the little patient in such
"qrantitei as vas safe for T. 50 Young,
and. that no evil consequence might re
salt from lis struggle les if pain shoali be
fclt ia spite Of the anasthctic. the patient
was put into a tight fitting rubber bag.
which wa closed around IL neck. Tic
urreon tlsn. selecting a sharp curved
bi5toufy. OK knife with q pointed blade,
commenced the operation. Tie NAL
formation TO be corrected as The FIST
-tep was 10 close the broad issurc which,
like tie letter \, divided tie unpcr lip.
The next step was 10 dissect the flesh.
muscle and all. from the bone beneath
on both sides Of the mouth for some
little distance. \ slight incisiOn was
,hen made from the let corner
II the mouth in the direction
# the ear, IS the mouth was
n little short on that side. An incision
was now made from the left nos
tril directly into the flap on the right
side. in tie direction of the right Cornc
Of the mouth. This was planned 50 t..ct
it left Il triangular vacancy, the apes Of
which triangle was midway between The
center Of The nose and mouth. Tie flap
on the other side was now cut Il fix ills
vacancy ana drawn into it with six
snturcs and carefully stitched. Su,cAcs
were uhen passed into the mucU0us lining
Of the flaps in such a way as TO overt IL
and bring sufficient to the outside along
the lower border 10 form the vcimiiiOn
border Of the lip The assure ~ the
check was then suturei together care
iuliy and the external operation was
finished.
IL now remained fcr the surgeon TO
bring the hony roof OF the mouth to-
gethcr in the middle. lbs which means il
was hoped that the assured palate could
be closed and the patient saved the in
convenience of being obliged 10 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 lisSuro. and.
taking care not to wound the blood YES
sells, raised the peliosteal membrane from
the bong wall of the cavity beneath, and
uniting this flap from each side in the
middle Of the assure, thus formed a
periosteal tent over the mouth. for the
protection of which against the tonguc's
action ne put q 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 completely closing the cleft.
The periosteal membrane above re.
ferred to has the property OF forming
new bone, which is deposited on its IN
mel 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 periostcum that was made TO
close the assure. When this bony root
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 q firm,
bony arch Is forming over the roof Of the
mouth. The child's W mother scarcely
recognized it after the first bandages
We're removed. IL a few days the little