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March 15, 1924

Cleft Lip and Palate.

JAMA. 1924;82(11):914. doi:10.1001/jama.1924.02650370082043

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Out of a rich experience Dr. Brophy has presented a thesis worthy of serious consideration. He is entitled to first credit as a pioneer in demanding early surgical correction of congenital defects of the lip and palate. He has encountered severe opposition and criticism, but his arguments have come to be recognized as sound. The term "cleft lip" employed by the author is a good substitution for harelip. The author rightly claims a priori rights in advocating early treatment and for the use of lead plates and silver tension sutures in correcting the bony defect. Exception to the radical nature of the Brophy operation is, however, justified. The resulting trauma and shock are not compensated; the introduction and adjustment of silver sutures and lead plates produce the major trauma and shock. By a simple molding process the cleft may be easily reduced and the bones held in position by a

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