Transverse Septal Atresia of the Lower Third of the Genital Tract

The usually accepted form, and by far the simplest, of atresia vaginae is that known as atresia hymenalis. Here the hymeneal opening has not formed, the menstrual blood is dammed back, and when an incision is made through the septum a large quantity of chocolate-like blood escapes. The genital organs in such cases may be otherwise normal. A few rare instances have been recorded where the occluding septum was higher up than the ordinary site of the hymen, and such anomalous cases have been usually regarded as double hymen, or as due to inflammatory adhesions. Such instances deserve, however, very careful scrutiny, as they are opposed to ordinary developmental views, and, instead of being brushed aside, they must be fairly met and explained if possible. What are often termed anomalies are really proofs of the erroneous nature of current explanations. I have had under my care three cases of atresia hymenalis, all in private practice. Of these I describe only two as types. The first case to be recorded occurred in the practice of Dr James Smith. There was the usual bulging membrane at the site