Cleft Lip in the Middle Ages

I find out so many interesting Medieval tidbits doing the research for The Fairytale Keeper series.  Today, I want to share what I’ve learned and concluded based on my research on cleft lip in the Middle Ages.

cleft lip hare lipCleft Lip Defined

Approximately 1 in 700 children in the US are born with a cleft lip or palette. Cleft lip is a split in the upper lip that, in normal development, fuses together around the 35th day of fetal development.  A cleft palate is when the split also occurs in the roof of the mouth.

Cleft Lip in the Middle Ages

Cleft lip certainly occurred during The Middle Ages, but to what extent, we do not know.

Difficulty breast feeding is a common complication of cleft lip and palette.  One wonders how many children died as a result of their inability to feed correctly.  When a child with a cleft lip breast feeds, he can have trouble getting enough suction, milk can leak out the nose, and choking can occur.

Medieval Peasant Field WorkingThe majority of the Medieval population was poor and worked long hours in fields.  They didn’t have money to pay a wet nurse to drip feed a child who couldn’t latch on, and they wouldn’t have had the time to experiment with different methods of feeding.  Most people, during the time period, lived in small villages and never ventured 20 miles from home.  It seems a likely conclusion that most people would have never seen a cleft lip or palette during their lifetimes; therefore, it seems unlikely that a treatment for the deformity and its complication would have been widely-known.  But, perhaps, my speculations are wrong.

We do know that some people made it to adulthood with cleft lip because it’s documented that Arab physician, Albucasis used a different surgery method on adults than he did with children.

Medieval Treatment of Cleft Lip

Portrait of Arab Physician Abulcasis

We do see evidence of treatments for cleft lip in the Middle Ages. The following is an Anglo-Saxon treatment for cleft lip, referred to it as harelip,  mentioned in Bald’s Leechbook.  ‘For harelip: pound mastic very fine, add white of an egg and mix as you do vermilion, cut with a knife, sew securely with silk then anoint with the salve outside and insde before the silk rot.  If it pulls together, arrange it with the hand, anoint again immediately.’

As mentioned earlier, famous Medieval Muslim physician, Albucasis, and his fellow surgeons had more than one treatment for cleft lip.  They preferred cauterizing with gold to cutting with a scalpel when treating adults.  In the cases of young children, they realized that hot metal was too harsh and opted for surgery instead. The surgery involved making a small incision in the lip, placing a garlic clove in the gap, and leaving it for 15 hours. After removing the garlic, the gaps were sealed with a bandage that had been dipped in butter.

These, however, were not the first documented treatments.  In 390 BCE, a physician who was well-known for successfully mending cleft lips performed surgery on 18 year-old Wey Young-Chi in Nanking, China. The surgery was successful, and after his surgery, Wey Young-Chi joined the army.  He later became a governor.

Article written by Andrea Cefalo, author of The Fairytale Keeper: a novel of corruption, devotion, and the origins of Grimm’s fairytales.  To follow Andrea Cefalo and hear more about The Fairytale Keeper series, please visit: