Gynecological diagnosis . dder. Theexternal genitals were alsowanting. Children born withsuch defects must necessarilybe short lived. Imperforate Rectum. — Thisis a common malformation, thebowel ending in an open tubeon a level with the reflection ofthe peritoneum on the rectum,presumably due to the failureof the hind-gut to send out abud, the post-allantoic gut, tomeet the proctodeum. Thecondition may or may notbe associated with imperforateanus. If it is, the condition isrecognized at once by inspec-tion ; if not, the infant is gener-ally dosed with cathartics, and only when grave symptoms o
Gynecological diagnosis . dder. Theexternal genitals were alsowanting. Children born withsuch defects must necessarilybe short lived. Imperforate Rectum. — Thisis a common malformation, thebowel ending in an open tubeon a level with the reflection ofthe peritoneum on the rectum,presumably due to the failureof the hind-gut to send out abud, the post-allantoic gut, tomeet the proctodeum. Thecondition may or may notbe associated with imperforateanus. If it is, the condition isrecognized at once by inspec-tion ; if not, the infant is gener-ally dosed with cathartics, and only when grave symptoms ofobstruction supervene, is a thorough examination made. Thephysician should make it a rule to institute a thorough physicalexamination if an infants bowels have not moved within the firsttwenty-four hours of life. If the anus appears to be normal ex-ternally, introduce the well-anointed tip of the little finger anddetermine whether the anal canal is Rectum with Outlet into the Urethra or Bladder.—In. Fig. 192.—Cast of Rectum and AnalCanal. (Tuttle, after Quenu and Hart-mann.) ANOMALIES 497 this anomaly there has been a persistence of the allantoic openingwith failure of the rectum to end in the anus. If the opening isinto the urethra (a condition usually found in the male) there isan escape of flatus and meconium from the urethra together withthe mine; if, on the other hand, the opening is into the bladder themeconium and feces become mixed with the urine and sooner orlater the individual succumbs to ascending infective ureteritis andkidney disease, even if the outlet is large enough to obviate intes-tinal obstruction. Imperforate Rectum with Outlet into the Vagina.—This is a per-sistence of the urogenital sinus and is met with not opening may occur at any point in the vagina and is generallylarge enough to permit the passage of meconium or even solid imperforate hymen may obstruct the escape of the feces fromthe vagina, and
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