OF THE SEXUAL ORGANS. 79 



the tubes in such a manner as to be extricated with difficuUy, as in 

 a case that fell under my own notice. 



201. Vicious conformations of the vagina are not less frequent 

 than those of the womb. Its total absence is pretty common. MM. 

 Boyer, Caillot, Willaume, and an infinity of others, have seen it 

 terminate in a cid de sac above the vulva, and not open externally 

 at all; in some cases its vulvar opening exists, but is obliterated 

 above and does not extend to the uterus. All the students of the 

 school of Paris may have seen a woman of this conformation a few 

 months since in the wards of the Hotel Dieu. I have observed a 

 similar disposition in a woman of about thirty years of age, who had 

 been delivered of a child five years previously, and had not had her 

 menses since that period.* In M. Sue's case the rectum opened 

 into the vagina, and the vagina into the bladder; nevertheless, the 

 vulvo-uterine passage may open into the bladder of urine, without 

 the bowel being at all deviated from its natural course, as is proved 

 in the cases related by Maret, Palfin and Cassan; the vagina is more 

 frequently found to terminate in the rectum at various distances 



* I have now a patient under care who is about 19 years of age. The exter- 

 nal organs are well formed. The pudendum being covered with hair as in a 

 healthy individual. Upon separating the labia it is found that there is no va- 

 gina. A shallow cul de sac is all that exists at the bottom of the vulva. A style 

 in the urethra and a finger in the rectum enable me to know that no vagina is 

 interposed between the rectum and the urethra. The uterus, or what is sup- 

 posed to be the uterus, is so large as to occupy the whole excavation, and to be felt 

 two inches above the brim of the pelvis by a hand externally applied. The pa- 

 tient has suffered for several years from monthly attacks of the most violent pain, 

 which is only to be mitigated by large anodyne doses. Hoping to find a portion 

 of vagina attached to the cervix. Dr. Randolph, by means of horizontal strokes of 

 a bistoury effected an opening which was large enough to receive the thumb, and 

 at least 3^ inches in depth — yet, no vagina was discovered, nor coiJd we learn 

 where the cervix uteri was placed. This artificial vagina was kept dilated with 

 a golden bougie, which at last was abandoned on account of the pain and irrita- 

 tion it caused. The distress of the patient increased pari passu with the monthly 

 growth of the pelvic tumor, which we supposed to be the womb filled with 

 menstrual blood, and hermetically enclosed. As a last resource, it was deter- 

 mined to tap the womb, and accordingly Dr. Randolph with great precautions 

 pushed the point of a curved trocar at least 2i, inches in a direction perpendicu- 

 lar to the surface of the tumor. No fluid followed the puncture. The patient 

 had a slight fever afterwards from which she recovered in a few days. Such is 

 the lamentable situation of this young and estimable girl. The agonies she en- 

 dures at each menstrual period are pitiable. 



For a case of Atresia vaginae in which the womb was tapped, a remarkably 

 successfiil operation performed by Dr. Randolph, see the Phil. Prac. of Midwifery 

 by C. D. Meigs, p. 360.— M. 



