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The first case is one of defective speech due to a cleft palate. The boy, J. C., was born in Ireland eleven years ago with a cleft running back through the lip, alveolar arch, hard palate and soft palate. The hare-lip was beautifully closed by Dr, Hamilton of Dublin, when the child was 7 months old. He always had great difficulty in swallowing and his speech was entirely unintelligible. When he was 9 years of age Dr. John B. Roberts of this city did a very successful operation for closing the palatal cleft. This made the boy comfortable in every way, but it did not improve his speech to any appreciable extent. Even had he been given a perfect palate and perfect lips his speech would still have been defective, because for nine years the other organs of speech had been trying to adapt themselves to very imperfect conditions, and
MAKUEN GH. SOME DEFECTS OF SPEECH; THEIR CAUSE AND TREATMENT, WITH EXHIBITION OF CASES.. JAMA. 1898;XXX(11):604–606. doi:10.1001/jama.1898.72440630030001l