they be separated simply because a membrane of small importance and having no physiological part to play, has been respected in one case and ruptured in another? I do not think so, and I believe that the crime is the same whether the hymen is or is not ruptured, and it does not seem logical nor right that the question of the degree of penetration should have anything whatsoever to do in the trial of one of these cases. In a given case the expert may be positive that defloration has taken place if the hymen is found ruptured, but he cannot conclude with the same certainty that penetration has not taken place if the hymen is found intact.

It would seem that logically rape and assault with intent to commit rape are in the point of view of medical jurisprudence, one and the same crime, which is useless to endeavor to characterize by so inconstant a sign as that of the condition of the hymen. . From all this it follows that the medical expert during his examiuation, should in the first place discover whether or not the hymen is present, which is not a difficult thing to establish, and once this first point decided, it only remains to ascertain, if the membrane is present, what are its characters and how much resistance it offers to the introduction of foreign bodies. I have pointed out how certain types of hymen allow the penetration of large foreign bodies without being ruptured, and it is the duty of the expert to examine in what manner the hymen in a given case would have reacted against a presumed penetration.

In closing the question of rape I cannot refrain from reproducing here the report of the medical examiners in a case of rape in the year 1706, because it shows how even at this date medical jurisprudence and forensic medicine were far from being neglected.

"Nous soubsignéz médecin et chirurgiens jurez royaux aux fais des rapports ordonnés estre fait en justice, establis a Laon, y demeurant, et Antoinette Besville, maitraisse sagefemme audit Laon. Certiffions que cejourshuy vingt-quatre du mois de décembre mil sept cent et six, en vertue de ladite ordinnance ci-dessus, nous avons veii et visitez la nommec Magdeleine Genouille, demeurante a la cense de Caillau, paroisse de Monanteuil, jeune fille agee de quinze ans ou environ, au fin de juger de l'etat de sa virginité, ce qu'aiant fait en presence de sa mere

nous aurions trouvé les caruncules myrtiformes ecartéz et la petite membranne, qui les joints et qui par cette jonction fait le pucelage entiérement rompue et dilacérée, et mesme pour le peu que nous l'aions touchez, nous avons veu que la sang en sortait, ce qui nous a fait juger quelle a été defflorée, de force et violence.—Le tout nous affirmons estre véritable, fait ce jour et ans cij-dessus."

J. Paty.

Couly.

+

Marque de ladite,

Beuzeville.

J. Gambart, med. Divorce on the ground of impotence may be obtained in the United States by simply establishing its existence so far as the intercourse with the petitioner is concerned. A failure to consummate the marriage after three years of cohabitation is presumptive evidence of impotence. (Annonymous, 22 Eng. Law and Eq. Rep. 637.)

A woman, consequently, who wishes a divorce from her husband may make the demand, basing her right on the fact that the marriage has never been consummated, and as a proof shows the integrity of her hymen. In this case the medical expert should demonstrate that coitus has or has not been able to be practiced. In a case tried in France in 1868, in which the hymen intactus was used as a proof that the marriage act had not been consummated, the Court, after hearing the expert testimony of two phy sicians, rendered judgment in favor of the wife. This case was the object of a discussion at the Medico-Legal Society of Paris, and the conclusion of the Commission appointed to examine the question was as follows: "The Commission, in the particular case which has been submitted to it, believes it right to conclude that the existence of the hymen in Mrs. X. cannot be invoked as an absolute proof of her virginity. The numerous cases that we have mentioned in the Report only confirm this, and we believe that the physician ordered to make a report in a case of this kind should conduct his examination with the idea of not proving that the woman is a virgin, but more especially to establish whether or not coitus has been possible. The rest remains to be appreciated by the judge."

It may happen that a woman accused by her husband of adultery refutes the accusation and presents a medical certificate

showing that the hymen is intact. It goes without saying that such cases must be very infrequent indeed, and although the English courts have had to deal with them from time to time, I am not aware that any such have been tried in the United States. However, should such a case come up, the part to be played by the medical expert would be of great importance. For example, in one case that was tried, it was proven that the husband had never had sexual relation with his wife and it was beside proven that the wife had received intimate visits from a certain party that had been presumed to be her lover. It would appear evident that if it were materially proven that the woman had had sexual relation, adultery would have been consummated, and a physician was ordered to make an examination. He found a hymen inHe consequently had one of two alternatives; he could conclude that the presence of the hymen intactus should do away with any presumption of illegitimate coitus having taken place, or, on the other hand, he could conclude, according to the condition, shape and texture of the hymen, that coitus was possible without rupture of the membrane. In a similar case that I have already cited, three physicians declared that a woman accused of adultery was still a virgo intacta, and this conclusion was rendered upon the condition of the hymen. Upon hearing this the jury declared that adultery had not been committed. It is to be remarked that these three English experts not only testified to the presence of the hymen, but they had also examined its condition as well.

tactus.

This medical proof is admitted in the English courts, but not in those of Scotland.

To sum up, it may be said that the medical expert ordered to make an examination in such a delicate matter, should always remember the possibility of coitus having taken place, the hymen remaining intact; and in consequence of this he should only formulate his conclusions according to the condition of the membrane.

It may occur that a woman who has been accused of having had sexual relations, goes to a physician for an examination and is supposed to be a virgin, that is to say, presents a hymen intactus. Armed with this testimony, she proceeds to attack her

defamers. Such cases have not been infrequently tried in the English courts and it is easy to conceive how much judgment should be used in the expert medical examination. It should also be remembered in relation to this, that the laws of the United States suppose that the crime of rape has been committed if a simple proof of penetration can be shown. It is consequently this proof of penetration which is often difficult to obtain that the expert should look for.

In

Various circumstances may give rise to cases of slander. the first place, we have perjury. For example, a witness in ì divorce case swears that he has on many occasions seen the parties in relation of adultery. The defence is examined by experts and according to their report, judgment is pronounced. There are cases in which the persistence of the hymen may seriously attack the veracity or the character of a person who would make an imputation of the absence of chastity; this person may be tried and convicted for slander. A man may publicly brag about having sexual relations with a certain woman; she then furnishes a proof of her virginity and brings a case against the presumed slanderer. In this case, the medical experts alone by their report, will settle the judgment of the case and consequently the condition of the hymen should be examined with the greatest attention.

It sometimes happens that a man who has been accused of either rape or an assault with intent to commit rape brings suit against his accusers. Under these circumstances, the medical examination is very delicate in order to appreciate certain facts, and the physician should not base his conclusions from the fact that he finds a hymen intactus.

The question of certificates will not detain us long. Sometimes a certificate is obtained from a physician for purposes of blackmail, and under these conditions the circumstances under which the pretended violence has been committed will be given him with the most minute detail, and any exaggeration should at once arouse the suspicion of the physician so that he may not be influenced by the story given him.

Other instances may occur in which a woman will come to a physician and say, "Doctor, it is said of me that I am pregnant

and I want you to give me a certificate stating that I am a virgin.” The physician examines the woman, finds a hymen intactus and delivers the certificate, but much to his surprise a few months later he learns that the woman has given birth to a child at term. Here again we can only conclude as in the foregoing cases, that the medical examination does not alone consist in noting the integrity of the hymen, and the physician should also take into consideration both its shape and consistency. From these conditions only will the physician avoid making gruesome blunders which might injure his reputation or even bring him to trial if he should fall into the hands of a certain class.

CONGENITAL DILATATION OF THE COLON.*

I. VALENTINE LEVI, A.B., M.D.,

Pediatrist to the Jewish Maternity Hospital; Assistant Physician to the Children's Dispensary, University Hospital; Assistant Clinician to the Medical Dispensary of the Philadelphia Polyclinic Hospital. This condition is presented because of its rarity. Numerous text books fail even to mention it, while those that do, give it but little space, which is evidence that only little is known of this disease.

The report that I am about to make must be considered only a preliminary one, as the patient is still under treatment. Although there has been some improvement in his condition, it remains to be seen whether this will be permanent or is merely temporary.

The pathology of this disease is obscure, the opinions that are held, vary. Butler says it is due to congenital narrowing of the colon. In Osler's case there was a distinct stricture in the sigmoid flexure. Treves says that the condition is always due to a narrowing low down in the colon. According to Holt it is associated with a marked degree of hypertrophy of the muscular walls of the colon. Formad says of his case: "It is evident from a study of this case, that we deal here primarily with a congenital

*Read before the Philadelphia Pediatric Society, October 13, 1903.