History of medical practice in Illinois - Bushnell Historical Society

334 History of Medical Practice in Illinoisimpressed with the fact that "it is remarkable that even the most generousremoval of either upper or lower jaw creates so little disfigurement in comparisonwith what one would expect from such an operation."Early Management of Cleft PalateBy the end of the igth century, interest was increasing in oral surgery,especially as applied to plastic procedures for the correction of cleftand cleft palate. Few articles found their way into the medical literature,the majority being published in the dental literature of that time. The oralsurgeons themselves stimulated this trend. It is interesting to note that someof these men had an M.D. degree, some a D.D.S. and some had both.The problem of correcting the special speech defects resulting from congenitalcleft palate received much attention. Then, even as at the presenttime, keen students of the problem were aware of the fact that mere surgicalclosure of a cleft palate did not produce satisfactory function and speech.Therefore, the use of artificial vela was advocated to remedy this situation.C. S. Case, M.D., D.D.S. , who was first located in Jackson, Michigan, butlater came to Chicago, was an early and a thorough investigator in the useof obturators and artificial vela. His paper on "Artificial Vela for CongenitalCleft of the Palate" 8 stressed the advantage of artificial vela, themethod of construction and the importance of proper speech training. Hismanner of dealing with that problem has a very modern touch, as judgedby present-day concepts.In 1889 Dr. Case wrote on "Soft Rubber Palates for Congenital Clefts." 9He decried the lack of instruction in dental colleges and in textbooks onthe art of constructing soft rubber palates. He believed that such a devicefulfilled most of the requirements of closing the defect as well as "perfectingimpaired tone and articulation." Dr. Case expressed the belief thatfailures were the result of fixed habits of faulty speech formation and abnormalmuscle action, and he emphasized the need of commencing the useof appliances in youth and early adult life. He stated that there existed areluctance to remake artificial palates or obturators to conform to changescaused by muscle development, and that many appliances were worn afterthe rubber had deteriorated and become distorted in shape. He describedhis improved methods of construction, and exhibited models, dies andimpression cups for the making of artificial vela and obturators, giving afull and explicit description of the process of construction.At the Columbian Dental Congress in 1893, "Surgical Treatment ofPalatal Defects" was discussed.8 Case, C. S., Artificial vela for congenital cleft of the palate, Dental Register, Vol. XLII,1888)9 Case, C. S., Soft rubber palates for congenital clefts, Trans. III. State Dental Soc. 1889.lip