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DIAGNOSIS OF MOUTH AFFECTIONS. 165

raising the chin. The jaws should afterwards be secured by a
bandage extending under the chin and over top of head.
Fracture of the Lower Jaw is indicated by inability to close the
mouth, and to speak articulately ; laceration of the gums and
hemorrhage ; irregularity of the teeth from displacement of the
fragments of bone ; crepitation. Fracture of the maxilla may,
however, show no displacement, but a fracture extending
through the angle or ramus, may be diagnosed by grasping the
two sides of the jaw and moving them forcibly. Crepitus,
increased flow of saliva, mobility of fragments, and irregularity
of the teeth, if the fracture is through the body of the bone, are
all signs of fracture. A swollen, red and painful condition of the
tissues covering the lower jaw, occurring some days after the
accident, denote the possibility of fracture, neglect causing a high
degree of inflammation, and in some cases even necrosis of the
bone.
Treatment.—Reduce by bringing the displaced portions into
apposition, being guided by the arch of the teeth, and then secur-
ing them by wire, silk, or waxed sterilized ligatures around the
teeth, and introducing an interdental splint.
Cleft Palate is indicated by a fissure extending through the soft
palate alone, or through both soft and hard palates, and which
mav be combined with single or double hare-lip, in which case
the intermaxillary bones are frequently displaced.
Treatment.—When the cleft is confined to the soft palate, the
operation of staphylorraphy may be performed ; when, however,
the cleft is through both soft and hard palates, the construction
of an artificial obturator and palate combined will often prove
successful in correcting the voice and preventing much incon-
venience in partaking of food and drink.
Hare-lip is indicated by a congenital fissure of the upper lip,
and may be single or double, and may also be complicated with
fissure of the hard and soft palates.
TreatTnent.— Pare the surfaces of the edges of the fissure in such
a manner as will allow a flap on one to cover the edge of the
other when they are brought in apposition, when they are secured
by the aid of pins and the figure-of-eight suture, which, in the