generally associated with congenital occlusion, or complete absence of
the vagina, the two will be considered together.

Complete absence of the vagina is quite rare. Baux a reports a case of
a girl of fourteen in whom "there was no trace of fundament or of
genital organs." Oberteuffer speaks of a case of absent vagina. Vicq
d'Azir is accredited with having seen two females who, not having a
vagina, copulated all through life by the urethra, and Fournier sagely
remarks that the extra large urethra may have been a special
dispensation of nature. Bosquet describes a young girl of twenty with a
triple vice of conformation--an obliterated vulva, closure of the
vagina, and absence of the uterus. Menstrual hemorrhage took place from
the gums. Clarke has studied a similar case which was authenticated by
an autopsy.

O'Ferral of Dublin, Gooch, Davies, Boyd, Tyler Smith, Hancock, Coste,
Klayskens, Debrou, Braid, Watson, and others are quoted by Churchill as
having mentioned the absence of the vagina. Amussat observed a German
girl who did not have a trace of a vagina and who menstruated
regularly. Griffith describes a specimen in the Museum of St.
Bartholomew's Hospital, London, in which the ovaries lay on the surface
of the pelvic peritoneum and there was neither uterus nor vagina; the
pelvis had some of the characteristics of the male type. Matthews
Duncan has observed a somewhat similar case, the vagina not measuring
more than an inch in length. Ferguson describes a prostitute of
eighteen who had never menstruated. The labia were found well
developed, but there was no vagina, uterus, or ovaries. Coitus had been
through the urethra, which was considerably distended, though not
causing incontinence of urine. Hulke reports a case of congenital
atresia of the vagina in a brunette of twenty, menstruation occurring
through the urethra. He also mentions the instance of congenital
atresia of the vagina with hernia of both ovaries into the left groin
in a servant of twenty, and the case of an imperforate vagina in a girl
of nineteen with an undeveloped uterus.

Brodhurst reports an instance of absence of the vagina and uterus in a
girl of sixteen who at four years of age showed signs of approaching
puberty. At this early age the mons was covered with hair, and at ten
the clitoris was three inches long and two inches in circumference. The
mammae were well developed. The labia descended laterally and expanded
into folds, resembling