History of medical practice in Illinois - Bushnell Historical Society

336 History of Medical Practice in Illinoisfor such palatal surgery; that "bones easily yield to pressure"; that therewas better deglutition and that the muscles developed better. He furtherstated that if the palate were not closed, the clefts would grow broader andbroader. He urged early operation for two reasons:(1) If done early, thepatient could speak as other children did, and (2) it was much easier tocarry out if done before calcification and dental eruption were far advanced.Some of these statements are at variance with the present-daythought. Dr. Brophy also cited the advantage of lead plates to distributepressure and to serve as a splint.In this same year(1897), Dr. Case again demonstrated his keen interestin the cleft palate problem 14 by describing the orthodontic treatment of apatient with a large cleft in the hard and soft palates. The teeth were veryirregular but were brought into good occlusion. Then an obturator wasmade, firsta thin velum, and later the adequate thickness and length toproduce good palate closures. Dr. Case reported that speech was thus improved"phenomenally;" that the patient could not only whistle like a boybut could also produce a "shrill whistle with two fingers in his mouth;" inaddition, he enunciated perfectly with the exception of the sounds C and G.In 1899, Dr. Brophy urged 15 operations in congenital cleft palate as soonafter birth as practicable since injuries sustained by the child at parturitionproduce little immediate or ultimate damaging result.In support of thisbelief he cited these reasons: There was less psychic shock; the bones lendthemselves to bending rather than fracture; an early normal use of thevelum muscle will encourage development; normal occlusion will develop;there will be less subsequent deformity, and speech can developbetter after early surgery than if delayed until faulty habits of articulationare acquired.At this clinic, Dr. Brophy showed a number of cases. One patient aged 9years had been operated upon 10 days after birth for double harelip andcleft of both the hard and soft palates. The occlusion was not quite normal,but Dr. Brophy stated that the upper teeth could be forced farther out toocclude with the lowers. The lips also required shortening and revision.The second case, aged three months, was operated upon for closure ofthe hard palate at the age of three weeks and showed the lead palates andsilver sutures still in place. It was pointed out that there was a dominanthereditary tendency to congenital malformation running in this familyas shown by the following facts:This second patient was a brother of thefirst case. There were six children in this family and examination revealed14 Case, C. S.: Clinic No. 37: Obturators and regulating appliances, Dental Review, Vol.XV, No. 4, April 15, 1897.15Brophy, Truman W.: The radical cure of congenital cleft palate, with exhibition ofpatients, Trans. National Dental Assoc. 1899.