Observations on the operative measures necessary in the treatment of hare-lip / by Richard G.H. Butcher.

  • Butcher, Richard G. H., 1819-1891.
Date:
1856
Catalogue details

Licence: Public Domain Mark

Credit: Observations on the operative measures necessary in the treatment of hare-lip / by Richard G.H. Butcher. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    maxillary and the intermaxillary bone, so as to leave the latter with the incisor teeth suspended to the vomer. In contradistinction to the opinion of Meckel and others, expressed in the foregoing observations, I may mention, Cru- veilhier, Dupuytren, and Velpeau, regard such theory erro- neous, as applied to the soft parts, and consider hare-lip to be, like many other monstrosities, the result rather of some diseased action; the latter indeed denies that the lips are formed of several pieces at any period of intra-uterine life; and indeed I may here state that I have never been able to observe in the foetal mouth, even at the youngest period which it was visible to me, any deviation from a simple oval or circular form in the aperture; fortunately, in a practical point of view, as affect- ing operation, it matters but little how such differences are reconciled. Louis has pointed out an inference of conside- rable importance, did it maintain, namely, that the defect in hare-lip, whether it be single or double, is not accompanied by any loss of substance in the lip. My observation, how- ever, does not confirm this deduction; such an expression is, I conceive, a play upon the words: there is not only a -want of development in the fissure, but I have sometimes seen the lip thin, and, as it were, fined down to the edge; while I admit, in the great majority of cases, there will be found a fleshy and rather prominent margin, a condition which, whe- ther it be the result of a shrivelling up of the textures, or actual thickening from disease, becomes highly advantageous to the operator, by enabling him to remove a considerable portion, and still find enough left wherewithal to make a per- fect lip. I contend that the most judicious way of dealing with this subject is that by detailing cases, from the most complicated form to the simplest kind, describing accurately the condition of the soft and hard parts, and conjointly the practice adopted and best fitted in each instance; next making reference to the period of life at which the operation is most likely to be followed by a favourable issue and suc- cess ; and lastly, the instruments used by different operators in its performance, and the modes prescribed by the most eminent.