HARE-LIP, in surgery. _Cleft Palate_ is a congenital
cleavage, or incomplete development in the roof of the mouth, and is
frequently associated with hare-lip. The infant is prevented from
sucking, and an operation is necessary. Cleft-palate is often a
hereditary defect. The most favourable time for operating is between the
age of two weeks and three months, and if the cleft is closed at this
early date, not only are the nutrition and general development of the
child greatly improved, but the voice is probably saved from much of the
unpleasant tone which is usually associated with a defective roof to the
mouth and is apt to persist even if a cleft has been successfully
operated on later in childhood. The greatest advance which has been made
in the operative treatment of cleft palate is due to the teaching of Dr
Truman W. Brophy, who adopted the ingenious plan of thrusting together
to the middle line of the mouth the halves of the palate which nature
had unfortunately left apart. But, as noted above, this operation must,
to give the best results, be undertaken in the earliest months of
infancy. After the cleft in the palate has been effectually dealt with,
the hare-lip can be repaired with ease and success.

_Hare-lip_.--In the hare the splitting of the lip is in the middle line,
but in the human subject it is on one side, or on both sides of the
middle line. This is accounted for on developmental grounds: a cleft in
the exact middle line is of extremely rare occurrence. Hare-lip is often
associated with cleft palate. Though we are at present unable to explain
why development should so frequently miss the mark in connexion with the
formation of the lip and palate, it is unlikely that maternal
impressions have anything to do with it. As a rule, the supposed
"fright" comes long after the lips are developed. They are completely
formed by the ninth week. Heredity has a powerful influence in many
cases. The best time for operating on a hare-lip depends upon various
circumstances. Thus, if it is associated with cleft palate, the palatine
cleft has first to be closed, in which case the child will probably be
several months old before the lip is operated on. If the infant is in so
poor a state of nutrition that it appears unsuitable for surgical
treatment, the operation must be postponed until his condition is
sufficiently improved. But, assuming that the infant is in fair health,
that he is taking his food well and thriving on i