Clutton[8] records and pictures a curious development of a flap of mucous membrane on the lower lip of a woman with a cleft palate; it was triangular in shape, and with overhanging projecting angles. The teeth in this case were likewise badly developed, and were all extracted at the age of nineteen. Binet[9] reports a case of an old cured right-sided harelip in a man dead from apoplexy (æt. 53 years) with infantile genital organs. Broca[10] describes a much deformed fœtus, stillborn at seven months, which he dissected, showing a double harelip and cleft palate, but the os incisivum retained its usual position, thanks to its mucous covering. The dentition,[11] as noticed elsewhere, was also interesting, and the buccal deformity was associated with a congenital diaphragmatic hernia, and an abnormal condition of the heart and great vessels. Other associated malformations are on record, _e. g._ an extra thumb on each hand; and Sir Morell Mackenzie has reported a case in which there was a congenital fissure between the arytænoid cartilages with a trilobate epiglottis, occurring in conjunction with harelip and cleft palate.[12] * * * * * The remaining deformities to be noticed here are much less common, but demand attention by their rarity and interest, and on account of the light they throw on the embryology of the lip and mouth. MEDIAN HARELIP. This is an exceedingly rare phenomenon, and for long the possibility of the existence of such a condition was doubted. Supposed cases were explained by imagining that from some unknown cause a lateral fissure had been drawn over to the median line. But at the present time there are records of several, mainly, however, in German works; in our own literature there are but few references to the subject. Two varieties of median defect have been described; and the distinction between these has been carefully and thoroughly made by Trendelenburg.[13] 1. _Double cleft of the upper lip with failure of development of the intermaxilla._ Some half-dozen cases of this are indicated in his work; but perhaps one of the best descriptions is that recently given by Bland Sutton,[14] and from whose paper the accompanying picture is obtained (Fig. 16). It occurred in the practice of Mr. Treves, and died within a few weeks of birth. There was a broad median defect, flanked laterally by the curved convex borders of the maxillary processes; the intermaxillæ were entirely absent, and the nose quite flat. In addition to this the eyes were affected with coloboma, the right eye presenting other serious defects. “On examining the child before its death,” the author states, “I felt convinced that there was no ethmo-vomerine plate, and this conviction was strengthened by the peculiar shape of its forehead. When the child died, this opinion was fully confirmed; there was no ethmo-vomerine plate, consequently no nasal septum, and what is more important, the premaxillary bones were absent.”