File:Interstate medical journal (1903) (14782069815).jpg

Identifier: interstatemedica1019unse (find matches)
Title: Interstate medical journal
Year: 1903 (1900s)
Authors:
Subjects: Medicine
Publisher: St. Louis, : Interstate Medical Journal
Contributing Library: The College of Physicians of Philadelphia Historical Medical Library
Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

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ce, promotes digestion and servesas an excellent tonic to the whole nervous system. As convalescence progresses,the patient should be encouraged to live in the open air, take exercise gradu-ally, and thus pave the way to a resumption of duties and cares of life. CLINICAL REPORT. WHAT THE v. LANGENBECK OPERATION ACCOMPLISHES IX INDI-VIDUALS WITH CLEFT PALATE. By Willard Bartlett, A. M., M. D., of St. Louis. Mo., DEMONSTRATOR OF SURGICAL PATHOLOGY, MED. DEPT., AND LECTURER ON ORAL SURGERY, DENT. DEPT., WASHING-TON UNIVERSITY. The three cases to which attention is called illustrate the value of this pro-cedure even where the operation has been deferred until the patient is fullygrown (two instances), and some of the difficulties which the operator has toovercome. The last patient upon whom I operated for this deformity is a sturdy youthof eighteen. The lip had been repaired by the late Dr. H. H. Mudd many yearsago, but with the exception of this one structure, everything was divided, in-
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Fig. L Fig. 2. eluding the uvula. The two halves of the vault were almost vertical and the in-terior of thenares were perfectly exposed. Motility of the soft palate was unim-paired. There was do pronounced catarrhal affection, the young man could swallowperfectly when the head was held well back, but the voice was so imperfect thatI could not understand a word he uttered. The v. Langenbeck operation was done at St. Anthonys hospital, March 20,1903, under chloroform anesthesia with the head in the Rose (hanging) posi-tion. The steps of the procedure, as well as the appearance of the vault beforeoperation will be best understood by consulting cut No. 1. This piece of workmay be divided into the following steps: (1) freshening of the edges of thecleft; (2) incisions along the alveolar margins for the relief of tension; (3) ele-vations of the flaps (mucous membrane and periosteum) from the remnants of thebony arch; (4) section of muscles where necessary to allow flaps to meet with-out ten

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