61B. Smooth-nosed forceps. 61C. Knife for paring edges of cleft (_Mason_). 62. Angular long-handled catch forceps. 63. Various forms of needles. 64, 65. Diagrams to illustrate the effects of tightening the sutures on the needle-tracks. 66. Wire twister (_Messrs. Maw, Son, and Thompson_). 67A. Diagram to show extent and position of incisions in uranoplasty. 67B. Diagram of position of sutures and condition of palate after operation. 68. Double-curved raspatories. 69. Loop method of passing sutures (_Mason_). 70. Method of tying slip-knot (_Fergusson_). 71. T. Smith’s palate needle (_Messrs. Arnold and Son_). 72-74. Various form of artificial vela (_Coles_). 75. Appearance in profile after operation for double harelip, including removal of os incisivum (_Coles_). ON HARELIP AND CLEFT PALATE. CHAPTER I. GENERAL INTRODUCTION. _Harelip—Cleft palate—Frequency—Occurrence in animals—Associated deformities—Median harelip—Facial clefts—Macrostoma—Mandibular clefts—Causes of these deformities._ The congenital fissures and deformities of the mouth and lips form a group which is considerably larger than might be imagined from the scanty notice given them in ordinary text-books; and although many are extremely rare, yet possibly if more attention were drawn to them, fresh cases would be noted and recorded, and the somewhat scanty materials from which we have to work out their development and characteristics would be increased. In order to facilitate subsequent description, I append a classified list of the deformities which we shall pass under notice, premising that the more practical part of this work will be occupied exclusively with two of them. Six different classes may be described:— (1) Median harelip (inter-intermaxillary). (2) Ordinary harelip (intermaxillary). (3) Facial cleft (maxillo-intermaxillary). (4) Buccal cleft, or macrostoma (maxillo-mandibular). (5) Mandibular cleft, or median fissure of the lower lip. (6) Cleft palate. Inasmuch as ordinary harelip and cleft palate are the conditions most commonly met with, it will be convenient to describe them first, alluding subsequently to the others. HARELIP. French, _bec-de-lièvre_. German, _Hasenscharte_—or if with complete cleft palate, _Wolfsrachen_ (wolf-jaw). [Illustration: FIG. 1.—Hare’s lip to show the median cleft in the lower part prolonged upwards into either nostril. (_Sutton._)]