71 
04 PARTURITION, 
1817 ; and in twenty days theftrength cf the patient was 
completely re-eltablilhed, and the returned home to her 
village. 
Imperforated Uterus .— In the Algemeine Medizinifche 
Annaleii for 1819, a cafe is related by Dr. Bonifch of 
Leipfic, which is (fated to have been an inftance of want 
of mouth of the uterus. This point is, however, not 
well eftablilhed. The fubjedt was a woman who was 
married in her twenty fourth year to a healthy man; 
but, though they cohabited for eleven years, fne did not 
become pregnant. She had every month the menftrual 
orgafrn, and fuffered much pain in the belly : but only 
a few drops of blood were evacuated from the vagina. 
After the death of her firfthufband (he foon married again, 
and became pregnant. After (lie had been fome time in 
labour, Dr. Bonifch was called to her. She was much 
exhaufted. On making an examination, he could find 
no os uteri; but a fpherical body prefented in its place, 
which was evidently the uterus. He determined to make 
an artificial opening in this; which was eftedted. The 
head of the feetus prefented, and was born alive. No 
very confiderable quantity of blood was loft. No great 
degree of inflammation came on in the parts about the 
wound. The lochire were difeharged from it in the or¬ 
dinary way. The edges of the wound had healed at the 
end of eight weeks; leaving, however, an opening like 
an artificial os uteri. The mother has fincebeenin good 
health, and has menftruated like other women ; but, al¬ 
though three years had elapfed at the time this hiltory 
was drawn up, (lie had not again become pregnant. 
The want of the flow of the menfes before the opera¬ 
tion, and the appearance of them fince, certainly fome- 
what favour the notion of the want of the exiftence of 
an os uteri: otherwifeit might beconfidered merely as a 
cafe of retroverfion of the uterus. The fadt, however, 
of the favourable refult of fuch an operation merits being 
recorded. Dr. Hutchinfoii's Proemhnn to the 43d vol. of 
the London Med. Journal. 
A!;fence of the Uterus. —We can have little hefitation in 
referring the peculiarities of the female charadter and 
conftitution to the adtion of the generative organs taken 
all together. But, although the great importance of the 
uterine fyftem is fo ftrenuoufiy infilled on, and fo uni- 
verfally admitted, that Van Helmontfays Propter uterum 
fulurn mulier eft id quod eft ;—yet we lhall find, that, du¬ 
ring theentire abfence of the uterus, a woman may en¬ 
joy a good Hate of health, and perform all the fundtions 
of life except menllruation and conception ; and live to 
a mature age, and marry, without being aware of the 
want of this important organ. 
The hiltory of this interefting cafe is related with 
much minutenefs by Profelfor Stein, of Bonn in Prufiia. 
A lady, twenty-four years of age, had been married 
five years without having ever menftruated ; although 
the orgafrn generally accompanying the appearance of 
the menfes, with lome diftrefs about the pubes, had re¬ 
curred at the ordinary periods. After having expedted 
the eftablilhment of this fundtion until her hopes were 
almoft loft, and perceiving her health to be on the de¬ 
cline, being a fie died with opprelfion of refpiration, and 
occafional fits of fainting, fhe permitted a midwife to ex¬ 
amine her, for the purpOfe of afeertaining if there exifted 
any mechanical obftrudtion. A firm membrane, fuppofed 
to be the hymen in a ftate of unufual thicknefs, was de- 
tredled ; Profefior Stein was confequently confulted. He 
deferibes the patient as prefenting the molt perfedt cha- 
radteriftics of the female form : (lender and delicate ; with 
full breafts, a fair complexion, and an animated coun¬ 
tenance, exprellive of the fineft fenfibility : her manners 
were particularly delicate; and fne feerned, indeed, to be 
a model for her fpecies. On making a flight examination 
in the eredt polture of the patient, the account of the 
midwife appeared to be corredt ; and the ufual inftru- 
■ ments were prepared for dividing the membrane in the 
ordinary way: but, on making prefiure on it with the 
finger and fcalpel, it retreated inwards, about half the 
common depth of the vagina, and it was then difeovere-d 
that this membrane formed a fort of fac. But, from the 
charadteriftic habit of the lady, and the maladies die had 
experienced, no fufpicion of a want of the uterus was 
entertained : it was confidered that the fac had been ori¬ 
ginally a plane membrane of the kind fo commonly met 
with in the vagina of females, which had been ftretched 
into its prefent form by fexual intercourfe and by irri¬ 
tation, and from the fame caufes made to acquire the 
great thicknefs and firmnefs it prefented. Difficulty at¬ 
tended the divifion of the end of this fac, from the firm- 
nefs of its texture, and the narrownefs of the vagina; 
but this was effedted by making a perforation in it, and 
then bringing it down as far as poffible by the finger in¬ 
troduced into the incifion. A rather copious hemor¬ 
rhage enfued. The abfence of the uterus was now dis¬ 
covered : on introducing the finger beyond the opening 
in the lac, it encountered a foft, fpongy, penetrable, fub- 
Itance, evidently a mafs of cellular tifl'ue. Some fimilar 
cafes, which Profefior Stein found by fearching literary 
records, which we (hall immediately notice, with a fub- 
fequent examination, confirmed him in his former con- 
clufion. The wound united very well by the ufe of ban¬ 
dages, &c. and - no ferious accident enfued. 
We (hall here adduce the account given by Theden of 
a cafe precifely fimilar in charadter to that of Profeflbt 
Stein ; and then a defeription of the appearances difeo- 
vered, on difledtion, in two bodies, by Engel, and 
Schmucker. 
Theden’s cafe was that of a young woman who had 
never menftruated, although the orgafrn had regularly 
been manifeft. Marriage was advifed, as a probable means 
for remedying this diforder: and it was accordingly re¬ 
torted to. An obftrudtion of the vagina was then de- 
tedted : but the hufband had, before Theden was con¬ 
fulted on the cafe, diftended the obftrudting membrane 
into a fort of pouch of the fize of a hen’s egg : this was 
hanging without the external orifice of the vagina, and 
was removed by incifion. On introducing the finger be¬ 
hind the pubes, a cavity was difeovered, terminated by 
a mafs of cellular texture, through which the preffure of 
the inteftines was fuppofed to be difeerned ; but not the 
fmalleft evidence of the exiftence of a uterus could be dif¬ 
eovered. The incifed parts united very well, and no 
accident is laid to have enfued. 
Schmucker, in his Vermifchte Scliriften, fpeaks of a 
body that was brought to him, which had been found in 
a field, prefenting, externally, the female charadteriftics: 
the breafts were remarkably prominent; but the genital 
parts were of fmall fize, and the orifice of the vagina clofed 
by a membrane, externally, apparently a continuation of 
the (kin. The uterus and vagina were wanting; the 
place which the former fhould have occupied, was filled 
with a mafs of loofe cellular texture, in which the ovaries 
and fallopian tubes were fituated. Engel’s patient was 
alfo a woman whole habits were not known: it appears 
that the body accidentally came under his obfervation. 
The breafts were remarkably full; the orifice of the ge¬ 
nitals was clofed ; there was neither vagina nor uterus: 
the ovaries and fallopian tubes were found attached to 
the bladder. 
The phyfiological indications which thofe cafes furnifli 
had been already pretty well afeertained; but they ferve 
to confirm the opinion that it is the ovaries in which the 
menftrual orgafrn originates, and which, by their in¬ 
fluence, give to the woman her charadteriftics in refpedt 
to form and manners. When the ovaries have been ori¬ 
ginally wanting, the hermaphroditical charadter of the 
body generally has been conftantly prefent. A curious 
cafe in the Philofophical Tranfadtions for 1805, in which 
the ovaria were deficient, (hows that fuch a deficiency oc- 
cafions the female to approach in fome points to the 
male formation. The lubjedt of this narrative died at 
the age of twenty-nine. “ Having ceafed to grow at 
ten 
