. The diagnosis and treatment of diseases of women. Fig. 230. The appearance of the externalgenitals in a case of Double Vagina. (Kelly—Operative Gijnecolor/ij.) Fig. 231. Same caseas Fig. 230, with Speculum Intro-duced, exposing the two vaginal canals and the half cervixat the top of each. {Kelly — Ojjerative Gynecology.). Fig. 232. Complete Laceration of the Perineum. Thesphincter ani muscle has been torn and the ends are separa-ted. The small dark area is an exposed portion of the redmucosa of the rectum. (Hirst—/?(,s of Women.) LACERATIONS ABOUT VULVAAND PERINEUM. There are of cours
. The diagnosis and treatment of diseases of women. Fig. 230. The appearance of the externalgenitals in a case of Double Vagina. (Kelly—Operative Gijnecolor/ij.) Fig. 231. Same caseas Fig. 230, with Speculum Intro-duced, exposing the two vaginal canals and the half cervixat the top of each. {Kelly — Ojjerative Gynecology.). Fig. 232. Complete Laceration of the Perineum. Thesphincter ani muscle has been torn and the ends are separa-ted. The small dark area is an exposed portion of the redmucosa of the rectum. (Hirst—/?(,s of Women.) LACERATIONS ABOUT VULVAAND PERINEUM. There are of course slight lacera-tions of the hymen in normal coitus,but the resulting condition belongsunder the normal appearances ofthe genitalia (Fig. 210). The samemay be said of the usual wideningand relaxation of the vaginal open-ing resulting from labor (Fig. 213). Laceration from Labor. Lacera-tion of the perineum and vaginain labor produces changes varyingall the way from a moderate enlarge-ment of the vaginal orifice to com-plete destruction of the perineum,with exposure of the rectal mucosaand incontinuence of feces. Fig. 215 shows a widening of thevaginal opening, due to a moderatesecond degree tear of the various methods of testing the LACERATION OF EXTERNAL GENITALS 187
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