-lip. When the severe forms
occur they cause great trouble. Fluids pass freely into the nose, and
unless the child is carefully fed by hand it will soon die, as it is
unable to suck. In the less severe forms the child soon learns to swallow
properly, but when he learns to speak he cannot articulate properly and
his voice is nasal.

Treatment.--For this reason an early operation is advisable, not so early
as for hare-lip, but before the child has learned to speak, say between
the age of three and four when faulty speech (articulation) may be
overcome by successful closure of the palate. When the operation is done
late, the patient will not be able to overcome the bad habits of
articulation acquired in his childhood.

[370 MOTHERS' REMEDIES]

Operation.--The anaesthetic is necessary. The end of one-half of the cleft
palate is seized with an instrument and the edge freely pared with a thin
bladed sharp knife; same with the other half. Then the stitches are put in
of silk worm, gut or wire. The patient is fed on liquid food for three or
four days, and afterwards on soft food until the stitches are removed.
They are removed about the sixth or eighth day, and the wound should be
completely healed.

CROOKED FEET. Talipes.--There are many varieties. The treatment should be
begun, under the instructions of a physician, and continued from infancy
and many a good foot can be obtained.

KNOCK KNEE. (Genu Valgum).--This is due to an overgrowth of the internal
knuckle (condyle) on the knee joint, and curving inward of the shaft of
the thigh-bone (femur) in its lower parts, with relaxation and lengthening
of the ligaments of the knee joint.

It usually shows itself soon after the child begins to walk, but may not
do so until puberty,--rarely later. It is due in the child to rickets; in
the latter form, it is caused by an occupation that requires continued
standing, by a person of feeble development of the muscles and ligaments.
"Flat-foot" is often associated with it and, at times, may be the real
cause. It may affect one or both knees, may be so slight as to escape
detection, except upon a very careful examination, or so severe as to
separate the feet very widely and render walking difficult and wobbling.
In children other symptoms of rickets can generally be found. If not
severe it may often get better spontaneously as the rickets condition
improves and the general strength increases. This result is common in the
case