Converse: Chapter 43 THE UNILATERAL CLEFT LIP

The wide distribution of clefts in lower animals suggests that cleft lip is a disease older than man himself. It is unfortunate that our knowledge of the early evolution of lip repair is extremely sketchy. Undoubtedly the first sporadic attempts at approximating the raw edges of a cleft went unrecorded. Celsus, the first century Roman dilettante who was an encyclopedist and not a surgeon (Garrison, 1968), is generally credited with the first description of a cleft lip repair. Although Velpeau (1851) considered this description "obscure" and Barsky (1964), after his own study of original texts, concluded that Celsus actually was reporting of traumatic rather than congenital cleft, the writings of Celsus nevertheless mark the entry into the classical literature of at least cursory references to the repair of lip defects. By the tenth century, mention of lip repair had crept into Old English writings. Bald's Leech-Book, a compilation of folk medicine produced at Winchester about A.D. 950, described cutting the "false edge" of a harelip and suturing the wound with silk. Subsequently a salve of mastic and egg was applied (Cockayne, 1961).