History of medical practice in Illinois - Bushnell Historical Society

the following:Plastic and Reconstructive Surgery 337The eldest was normal. The second had the double cleftlip and cleft palate deformity. The third had a cleft lip. The fourth had adouble cleft lip and cleft palate. The fifth was normal, and the sixth had asingle cleft lip and a cleft palate. The paternal grandfather was similarlyafflicted. Dr. Brophy believed that nearly all such cases have a hereditaryorigin.Dr. Brophy described his operative procedure in detail. He transfixed themaxilla with two silver wire sutures which were twisted over lead plates toapproximate the bone edges at the margin of the defect. In difficult casesthe bone was severed through the malar processes. The tooth germs were"sometimes" disturbed. The operation caused the palate arch to be contractedbut "this will not be permanent." The lead plates might causeabrasion of the mucous membrane but this "need not disturb the operator."The lead plates were left in situ for a period of four to eight weeks. In thediscussion which followed this lecture, Dr. W. M. Barrett hailed itpresentation of a "modern miracle."as theIn his lectures on oral surgery at Northwestern University in 1899 and1900, Dr. Gilmer discussed cleft palate and harelip. He stated that he hadhad satisfaction from using the Langenbeck method of palatoplasty, andhe described his method of reconstruction of the harelip deformity.The puzzling questions of the basic causation of cleft palate troubledthe thinking surgeons of that period. One of the more erudite men of thetime was Dr. E. S. Talbot of Chicago. He proposed 16 that embryogenycould be modified by the various influences of growth, of atavism and ofheredity. Feeling that some newer experiments with extract of thehypophysis had influenced growth, Dr. Talbot suggested that this extractbe tried on cleft palate cases on the theory that the arrested development ofthe affected oral tissues was an arrest of potentiality rather than of growth,and that there might still be the possibility of further development evenafter birth which could be stimulated by this hormone. This was an unusualspeculation but unfortunately subsequent literature did not recordwhether anything further came of it.With this presentation the turn of the century has been reached and thedevelopment of plastic surgery has been traced from its earlier days ofabout 1850 to 1900. At times this branch of surgery was considered as partof general surgery. At other times it was only a diversion in the routine ofone of the older specialties, namely ophthalmology, otolaryngology ordermatology. Occasionally specialists in urology, gynecology, and orthopedicdiseases performed plastic procedures. The maxillofacial and oral"Talbot, E. S.: Etiology of cleft palate, Section on Oral Surgery, jth International DentalCongress, 1904.