. Diseases of the rectum and anus: designed for students and practitioners of medicine. esent the number ofthese cases met with, for the reason that they are not of suffi-cient interest to the average physician to urge him to recordthem. The author knows of at least 10 children who have beenoperated on for congenital occlusion, and not a single case hasbeen recorded. CLASSIFICATION Authors differ in their classification of these most complete classification is that of Papendorf, whichhas been adopted, with slight modifications, by Bodenhamer, (73) 74 DISEASES OF THE RECTUM AND
. Diseases of the rectum and anus: designed for students and practitioners of medicine. esent the number ofthese cases met with, for the reason that they are not of suffi-cient interest to the average physician to urge him to recordthem. The author knows of at least 10 children who have beenoperated on for congenital occlusion, and not a single case hasbeen recorded. CLASSIFICATION Authors differ in their classification of these most complete classification is that of Papendorf, whichhas been adopted, with slight modifications, by Bodenhamer, (73) 74 DISEASES OF THE RECTUM AND ANUS Esmarch, Molliere, Mathews, Ball, and others. The authorprefers the arrangement of this subject as made by Cooperand Edwards,^ which includes the following six varieties undertwo general headings:— 1. Imperforate Anus.—1. Congenital narrowing of the anus,without complete occlusion, but sometimes accompanied by afecal fistula. 2. Closure of the anus by membranous tissue. 3. Entire absence of the anus, the rectum ending in ablind pouch at a varying distance from the Fig. 33.—Narrowing of the Anus Witiiout Complete Occlusion. 4. Imperforate anus, with fecal fistula opening (a) intothe vagina; (b) into the bladder or urethra; (c) upon thesurface of the body. II. Imperforate Rectum, with Anus in Normal Position 5. Membranous obstruction of the rectum. 6. Extensive obliteration or total absence of the rectum. 1. Congenital Narrowing of the Anus, Without CompleteOcclusion.—In this variety (Fig. 33) the rectum or anus isunusually tight, and the alvine discharges are evacuated withgreat difficulty; in exceptional cases the constriction is so close 1 Diseases of the Rectum and Anus, Cooper and Edwards, second edition, page44, 1892. CONGENITAL MALFORMATIONS 75 that the meconium is retained or dribbles out slowly. Thedefect may be due to extension of the skin or musculature ofthe anal outlet across the anal margin. 2. Closure of the Anus by Membranous Tissue.—The
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