bridle in question. Still I did not understand the case until, having withdrawn the indicator, I examined with it the structure of the external parts, and then learned that the lady was possessed of a double vagina. Supposing that such a revelation would not be agreeable to her, I kept my own counsel, hoping that the child's head would come down through the right or the left channel without injuring the septum. But after the head escaped from the circle of the os uteri, the bridle or partition would not go definitively to the left or to the right, although I thrust it first one way and then the other. The tie was so strong that the fleshy septum extending from the anterior to the posterior columna of the vagina, would not admit of the dilatation of the lower or outer third of the tube. And as the lady was very strong, and had powerful uterine pains, I began to perceive some danger of the vagina being ruptured by the vain efforts for expulsion.

I now explained to the monthly nurse, and to a relative of my patient, the cause of the delay and the necessity that had arisen. I therefore procured the requisite permission to expose the parts to an inspection. Upon this, the two orifices of the vagina were seen to be exactly alike, and the partition stretched across the head from front to rear of the passage, which by it was wholly preventing from dilating.

I now with a strong scissors divided the wall by a single stroke of the instrument, whereupon the child's head advanced, dilated the os magnum, and was speedily delivered with safety to both. the mother and her infant. She never complained afterwards relative to the operation, and within a month I met her on foot in the streets.

A week later, I was called to a lady in her 30th year, in labor of her first child. Upon examining the state of the os uteri, I found the circle not much bigger than a quarter dollar, with thin margin, and within it the penis of the child; the scrotum being detected within the os uteri after the pain ceased. As it was night, I went to another apartment and slept an hour, when being called, I found the os uteri very much dilated, and a buttock, near which was the right foot, presenting.

While inquiring into the state of the cervix, I hooked my finger into a bridle, just as I had done in the case above mentioned, and I confess that the same thought was obvious to me, viz., that she had broken off a half ring of the circle of the os uteri, but I im

mediately afterwards discovered that I had another case of double vagina under management. In this case the partition was very firm and thick, extending from the os magnum almost up to the os tincæ. I inspected the external structures, and the two vaginas were each perfect and alike, included within labia pudendi common to both.

I was glad to find that only one foot of the child would come down, being fearful that if both should descend, I might not readily prevent one from entering the right and the other the left vagina.

I now disengaged the right foot and brought it down the right channel; the left leg was flexed upon the belly and thorax of the fœtus. With a little assistance the foot was delivered, and the buttock of the child coming downwards, thrust the vaginal wall to the left, and so the trunk was delivered. I had great difficulty to extricate the head of the child, which remained long in the vagina; the infant breathing from time to time the air that I admitted through the hollow of my hand and fingers to its mouth and nostrils. The child, a male, was alive, and is in good health; the mother is quite well recovered.

Some years ago I was called by the late venerable Dr. Ruan to consultation upon a case of double vagina in a primiparous woman. I delivered the child with the forceps through the right canal, without difficulty or any injury, and had some five weeks later an inspection of the parts, which, ás I remember, were very similar to those described in my second case above.

Farewell, gentlemen; I shall adjourn to my next letter some remarks upon the nymphæ. C. D. M.

LETTER X.

LABIA AND NYMPHE-COHERENT.

GENTLEMEN:-In my 8th letter, I laid before you some observations upon the accidents that happen to the nymphæ, after having spoken of their physiological nature. In the present communication, I have to offer further remarks upon these tissues.

They are frequently found to cohere in very young children; so as to cover up the small triangular superficies lying in front of the symphysis, and which you studied at the dissection, under the denomination of Vestibulum. This triangular space, you remember, is bounded above by the clitoris, on each side by the nymphæ, and below, by the crown of the pubic arch; or in other words, by the upper semi-circumference of the os magnum:-near its lower edge is the meatus urinæ.

A young baby is usually clouted, or to use a gentler phrase, diaper'd. In case its mamma is not scrupulously nice, the diaper is often left too long unchanged, and the irritating salts of the urine come at last to irritate and vex,, and finally to inflame the mucous surfaces that are too continually bathed with it.

A very gentle inflammatory diathesis being in this way acquired by the mucous tissue, whose opposing surfaces are kept in contact, union or fusion of surfaces is likely to take place; and at length, the mother makes the discovery.

When this gentle adhesive inflammation sets in, as to the nymphæ, it is also almost sure to be established as to the labia majora; of which, after all, the nymphæ are but folds, or rugæ of the labia. I have many times found the labia coherent, without cohesion of the nymphæ. Indeed, the latter are much less likely to become glued than the former, because, when the lower sections of the labia become fused or soldered together, there is nothing to tear them asunder-whereas, at their upper section, there is the repeated issue of a stream of urine, which is of sufficient force to break up a commencing process of the sort; and so it happens that, we do not find cohesion of the labia to extend above the level of the meatus urinarius as a common occurrence.

M. Colombat speaks of a case in which the nymphæ cohered in such a fashion as to cover up the orifice of the meatus and compel the urine to ascend behind the cohering apron, in order to escape, with difficulty, and dribbling, over the genital surfaces. They were separated by an incision, which relieved the child of her dysury.

Dr. Dugés, also, in the introduction to a Pract. Treat. on the Dis. of the Uterus and Appendages, p. 30, gives you the account of a little girl, whose urine escaped by a narrow orifice near the clitoris. The catheter could not be introduced into the bladder from this orifice, but went into the vagina, because the labia were also coherent. Pray do not, however, believe what M. Dugés asserts in the same place; viz., that cohesion of the nymphæ necessarily accompanies that of the labia externa; I am sure you will find, in practice, it is not the case, except very rarely.

It is to be readily concluded that, if a child, suffering from an occlusion, by this cause, of the genital fissure, should by neglect, or from excess of fastidiousness, be suffered to grow up, the fusion of the surfaces might become complete, and thus effectually prevent the fulfilment of her sexual destiny as a parturient creature-for, the longer the union continues, the more complete will it become, and the more absolute the loss or extinction of the mucous structure, whose opposing faces first came into soldering contact.

Whenever the fault is discovered-say up to the sixth or eighth year, and I have known it not to be detected earlier than the tenth year the mucous membranes are not lost, but only coherent. and they may be pulled apart, leaving the newly uncovered superficies true mucous superficies, and not fleshy ones.

The same sort of cohesion I have observed in the glans and preputium of a little boy.

In all the cases that have fallen under my care, I have adopted the following method of cure.

The child is held down on its back, on the nurse's lap; who abducts the left knee with her left hand, while I abduct the right one with my right arm. Then, separating and stretching asunder, as far as I can, the labia with my left thumb on the right labium, and my index finger upon the left one, I draw the bulb of a common probe dipped in oil along the raphe, which it always opens and separates without bleeding; or at least, without the loss of

five drops of blood. The pressure of the probe appears to me to have the effect of pulling out a sort of villi, like a cylindrical epithelium, which had interlocked their floating extremities and become hypertrophied, like placentules in the sheep.

M. Colombat advises, as a measure of precaution, after the division, to touch one of the surfaces, either the right or the left one, with the nitrate of silver; not to touch both of them. His notion is, that by touching one surface only with the nitrate, we institute in that surface a stage or a rate of vital action different from that going on in the one left untouched; and as there is then no parity of vital movement in the two superficies, they will not cohere when they are brought into contact.

I have not adopted his idea. But the idea is a very philosophical one, or rather a truly physiological one, founded on what is well known to be a fixed law in teratology. You would do well to study that beautiful law as it is laid down by M. Serres in his remarkable work, "The Anatomie Transcendantale," a volume which contains the richest stores of fact and reasoning on the nature and operation of the development forces in man. But to return to my subject:

When I have completely destroyed the cohesion, I dip the minimus finger in oil, and draw it downwards to the fourchette, effectually separating the labia, and I then explain to the nurse the necessity of repeating this method once a week at least; as the mere separation of the cohering surfaces does not cure the cohesive tendency; which, being in full force, will soon unite the surfaces again, and give other trouble, besides that of feeing the surgeon. The last motive is an ægis for the baby: if you do not set it fairly before her, you may soon be called again to make it cry; whereupon I advise you not to forget such a prophylactic charm. The last thing the sick think of is the doctor's fee; tell them of it and they sometimes take care of their health.

While I was writing to you about the labia, I did not say anything as to their cohesion, because I wished to make my remarks on it in coincidence with those I should have to make on the same accident as to the nymphæ, and now I have nothing more to offer on the subject worthy of your attention.

The nymphæ are occasionally the seats of a very rebellious sort of ulceration. I have found them at times very difficult to cure. In one example, the nymphæ near their summit or angle, were