s; the birth then
progressed promptly, the child being born alive.

Guerard notes an instance in which the opening barely admitted a hair;
yet the patient reached the third month of pregnancy, at which time she
induced abortion in a manner that could not be ascertained. Roe gives a
case of conception in an imperforate uterus, and Duncan relates the
history of a case of pregnancy in an unruptured hymen, characterized by
an extraordinary ascent of the uterus. Among many, the following modern
observers have also reported instances of pregnancy with hymen
integrum: Braun, 3 cases; Francis, Horton, Oakman, Brill, 2 cases;
Burgess, Haig, Hay, and Smith.

Instances in which the presence of an unruptured hymen has complicated
or retarded actual labor are quite common, and until the membrane is
ruptured by external means the labor is often effectually obstructed.
Among others reporting cases of this nature are Beale, Carey, Davis,
Emond Fetherston, Leisenring, Mackinlay, Martinelli, Palmer, Rousseau,
Ware, and Yale.

There are many cases of stricture or complete occlusion of the vagina,
congenital or acquired from cicatricial contraction, obstructing
delivery, and in some the impregnation seems more marvelous than cases
in which the obstruction is only a thin membranous hymen. Often the
obstruction is so dense as to require a large bistoury to divide it,
and even that is not always sufficient, and the Cesarean operation only
can terminate the obstructed delivery; we cannot surmise how conception
could have been possible. Staples records a case of pregnancy and
parturition with congenital stricture of the vagina. Maisonneuve
mentions the successful practice of a Cesarean operation in a case of
congenital occlusion of the vagina forming a complete obstruction to
delivery. Verdile records an instance of imperforate vagina in which
rectovaginal wall was divided and the delivery effected through the
rectum and anus. Lombard mentions an observation of complete occlusion
of the vagina in a woman, the mother of 4 living children and pregnant
for the fifth time. Thus, almost incredible to relate, it is possible
for a woman to become a mother of a living child and yet preserve all
the vaginal evidences of virginity. Cole describes a woman of
twenty-four who was delivered without the rupture of the hymen, and
Meek remarks on a similar case. We can readily see that, in a case like
that of Verdile, in which rectal delivery is effected, t