The operation was at first deemed applicable only to fissnres of the soft palate, which, of course, are almost the exceptional cases, as out of from 80 to 100 operations for fissure of the palate which have fallen under my own observation, in not more than a tenth, probably, of the whole number was the fissure limited to the soft parts. Nearly all cases of fissure extending into the hard palate were rejected as unfit for operation, although Roux had suggested the idea of relaxing the soft

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... by cut¬ ting it completely away from its attachments at the posterior edge of the plate bones. This operation is very likely to prove abortive, from the division of the vessels which supply the flaps with nourishment; and even if it succeeds, it leaves an unnecessarily large aperture in the bones, still to be covered by artificial means. Being impressed by the very great pro¬ portion of the cases of cleft palate which were deemed incurable, I was led to perform an operation for the especial relief of the more extensive fissures, which include both the soft and hard palate. An account of this operation (TJraniscoplasty) and its results was published in the New England Quarterly Journal of Medicine and Surgery for April, 1843, and also in this Journal for the same year. This operation consisted in dissecting, or rather peeling up the soft parts from the roof of the mouth, as far back in bad cases as the alveolar processes, and then cutting away No. XCIL-Oct. 1863. 20