PREFACE.
In bringing this book before the notice of the profession I have given the results of my experience, which has now been considerable, in a department of surgery always of special interest to me, and to which I have devoted particular attention. The privilege enjoyed for many years of assisting the late Sir William Fergusson gave me an early insight into these operations, and an unusual opportunity of learning their details at the hands of so distinguished a surgeon. I have endeavoured to make the work as complete as possible, and to bring its contents up to date, and in this am greatly indebted to the assistance of my colleague Mr. Albert Carless, who has not only revised the whole work, indexed it, and seen it through the press, but has also written the chapter on Development. I gratefully acknowledge the kindness I have received from various sources in permitting the use of blocks for illustrations, notably from Mrs. Mason, the widow of the late Mr. Francis Mason, whose work on the subject is well known, from Mr. Oakley Coles, and many others, whose names will be found in the list of illustrations.
17, Harley Street, W.; 1891.
CONTENTS.
| PAGE | |
| CHAPTER I. General Introduction. | |
| Harelip—Cleft palate—Frequency—Occurrence in animals—Associated deformities—Median harelip—Facial clefts—Macrostoma—Mandibular clefts—Causes of these deformities | [1-25] |
| CHAPTER II. Anatomy and Physiology of the Normal Palate. | |
| The hard palate—The velum and its muscles—The mucous membrane—The blood supply—The shape and size of the hard palate—Functions | [26-35] |
| CHAPTER III. Development. | |
| Normal development of mouth, face, nose, and teeth—Ossification—Development of intermaxilla; old ideas (Goethe’s, &c.); Albrecht’s theory—Harelip; position of cleft in alveolus, and in lip—Dentition; accessory teeth—Development of other deformities | [36-59] |
| CHAPTER IV. The Anatomy and Physiology of Harelip and Cleft Palate. | |
| Harelip—Effect of labial muscles on deformity—Structure of os incisivum and labial segments. | |
| Cleft palate—Arrangement and action of muscles—Shape of bony segments—Associated irregularity in shape of skull—Physiological effects in nutrition, articulation, &c. | [60-71] |
| CHAPTER V. Operative Treatment of Harelip. | |
| Period of operation—Statistics—Precautions to be adopted. | |
| Operation for single harelip: incisions; sutures; dressing; after-treatment—Various plans adopted. | |
| Operation for double harelip: treatment of os incisivum—extirpation or reposition; treatment of soft parts | [72-100] |
| CHAPTER VI. Operative Treatment of Cleft Palate. | |
| Period of operation—Preparation of patient—Anæsthesia—Duties of the assistant—Instruments—Description of uranoplasty; of staphyloraphy—After-treatment—Complications—Modifications of the operation | [101-138] |
| CHAPTER VII. | |
| On Obturators and Artificial Vela | [139-145] |
| CHAPTER VIII. | |
| Results of Treatment—After-treatment | [146-153] |
| CHAPTER IX. | |
| Syphilitic Affections of the Palate | [154-156] |
| ADDENDUM. | |
| Rectal Anæsthesia | [157, 158] |
| INDEX | [159] |