Observations on cleft palate : with cases illustrating the new operation of staphyloraphy / by William Fergusson.

  • Fergusson, William.
Date:
[1849]
Catalogue details

Licence: Public Domain Mark

Credit: Observations on cleft palate : with cases illustrating the new operation of staphyloraphy / by William Fergusson. Source: Wellcome Collection.

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    i “ On the first occasion, I think in 1842, I simply pared the edges and brought them together, and enjoined him not to swallow till the third day; in this respect adopting the views of the distinguished French surgeon, some of whose operations I had previously witnessed in Paris, and one in London. During two days, the stomach wras much disturbed with repeated vomiting; and though the wound appeared to be agglutinated when the stitches were removed on the fourth day, ulceration gradually extended from the top to the bottom, and the whole parted asunder, to my great regret. “ In 1845, after the publication of your views on this subject, this gentleman again applied to me, and expressed a strong desire that I should make another attempt to procure union. 1 had already made up my mind to adopt, on the next opportunity, your proposal with regard to the preliminary section of the muscles, and also to give food on at least the second day, if not earlier. I accordingly noticed the situations in which the lateral halves of the palate were dragged, during his efforts at movement in the throat, while the mouth was open, and with your well-contrived knife made the requisite division, I suppose, of the levator palati on each side, with the immediate effect of causing the flaps to hang more loosely towards the median line. I then passed three ligatures. This was at ten a.m., and he had pre¬ viously had his usual breakfast. He thought he could easily manage without food till the next morning, and accordingly took none; but I was then sorry to find him suffering again from repeated vomiting, with severe sick headache, to which he was liable, and I was almost ready to abandon hope. I gave him a small dose of calomel, and some beef tea; the vomiting recurred seven or eight times during the day, but left him towards evening, and did not return. He assured me that neither the effort of vomiting, nor that of swallowing, caused any drag¬ ging upon the threads, as far as he could judge from his sensations. To lie brief, these apparently untoward circumstances had no injurious effect on the process of union, which seemed to take place as perfectly as possible, and in the whole extent, except a minute space next the hard palate, where a kind of pin-hole remained and still exists, but without any bad influence on his voice. “ Since the operation, his voice has considerably improved ; but he has still some peculiarity and indistinctness of utterance, which will probably now be permanent, as it has resisted the efforts of a well- known teacher of elocution to overcome it. “ You ask me for my opinion of the anatomical grounds on which you have founded your improved method of performing stapliyloraphy. I think them in all respects sound, and likely to stand the test of expe¬ rience ; at least I intend to operate according to the plan you have so ingeniously framed upon them, when opportunities present themselves. —Believe me most sincerely yours, W. Bowman.” “14 Golden square, Nov. 23, 1848. I had the honour of assisting Mr. Bowman in the operation which he first performed, and cannot speak too highly of the able manner in which it was conducted. There appeared to be, at the time, every prospect of success.