lty by the
rectum, and examination showed that the vagina opened into the rectum,
by which means impregnation had been accomplished. Bonnain and Payne
have observed analogous cases of this abnormality of the vaginal
opening and subsequent accouchement by the anus. Payne's case was of a
woman of thirty-five, well formed, who had been in labor thirty-six
hours, when the physician examined and looked in vain for a vaginal
opening; the finger, gliding along the perineum, came in contact with
the distended anus, in which was recognized the head of the fetus. The
woman from prolongation of labor was in a complete state of
prostration, which caused uterine inertia. Payne anesthetized the
patient, applied the forceps, and extracted the fetus without further
accident. The vulva of this woman five months afterward displayed all
the characteristics of virginity, the vagina opened into the rectum,
and menstruation had always been regular. This woman, as well as her
husband, averred that they had no suspicion of the anomaly and that
coitus (by the anus) had always been satisfactory.

Opening of the vagina upon the parietes, of which Le Fort has collected
a number of cases, has never been observed in connection with a viable
fetus.

Absence of the labia majora has been observed, especially by Pozzi, to
the exclusion of all other anomalies. It is the rule in exstrophy of
the bladder.

Absence of the nymphae has also been observed, particularly by Auvard
and by Perchaux, and is generally associated with imperfect development
of the clitoris. Constantinedes reports absence of the external organs
of generation, probably also of the uterus and its appendages, in a
young lady. Van Haartman, LeFort, Magee, and Ogle cite cases of absence
of the external female organs. Riolan in the early part of the
seventeenth century reported a case of defective nymphae; Neubauer in
1774 offers a contrast to this case in an instance of triple nymphae.

The nymphae are sometimes enormously enlarged by hypertrophy, by
varicocele, or by elephantiasis, of which latter type Rigal de Gaillac
has observed a most curious case. There is also a variety of
enlargement of the clitoris which seems to be constant in some races;
it may be a natural hypertrophy, or perhaps produced by artificial
manipulation.

The peculiar conditions under which the Chinese women are obliged to
live, particularly their mode of sitting, is said to have the effect of
causing unusual