The principle of the operation consisted in carrying each lateral incision through the bony palate by means of a chisel, and prising the detached portions towards the middle line. Prior to this, however, the edges of the cleft were pared, and sutures were passed through holes previously drilled in the bony margins. The intention was to secure the union of flaps containing bone in the median line. Unfortunately, the results were anything but satisfactory, for in many instances the detached portions became necrosed and set up active inflammation and suppuration, leading to non-union. The bone, moreover, did not always cleave in the desired direction, and although the late Mr. Mason endeavoured to obviate this by punching holes, as a preliminary step, along the line the chisel was subsequently to take, on the postage-stamp principle, the results were not improved. One great objection to this lies in the difference of level which often exists between the two sides of the palate, especially when the vomer is attached to one margin. It is then excessively difficult to get the detached segments accurately together, whereas in Langenbeck’s operation the muco-periosteal flaps drop readily into position. Consequently, this method of osteoplasty has long since fallen into disuse. In cases where the vomer is attached to either side of the cleft with a wide gap and scanty tissues, Mr. T. Smith has suggested the utilisation of the mucous membrane covering the vomer as a means of bridging the cleft. He incises it in a direction parallel to the edge, and at such a distance above the palate margin as is thought advisable; detaches it from above downwards by a hooked raspatory, and stitches it to the pared margin of the opposite side. Owing to the extreme delicacy of the membrane in this situation and the tendency it has to curl up, the success of this manœuvre is not always to be assured.