James Milman Coley

“ The incomplete obstruction usually admits of a minute aperture at the upper portion of the hymen, through which part of the urine is forced out in drops, or a small stream, with great pain, resembling that produced by stone in the bladder. As this pain and distress exist from birth, not more than three or four years elapse before the malformation is discovered; the little patient being then able to describe her sufferings. Many such cases have come under my care, and have been permanently cured by a free incision. When allowed to proceed without relief, the disease has terminated in death. ”

“ The obstruction in the vagina, occasioned by a preternatural formation of the hymen, may be either complete or incomplete. In the former case the imperfection may remain undiscovered, until the menstrual secretion has accumulated within the cavities of the uterus and vagina, and has distended the former, so as to excite suspicion of the existence of pregnancy. As the aggregation of the menses, and consequent enlargement of the uterus advance, some difficulty in discharging the urine takes place, constituting dysury ”

“ In performing the operation of dividing the morbid vaginal membrane, great circumspection is requisite; as death has been the consequence in several instances. De Haen, in the sixth part of his Ratio Medendi, mentions a misfortune of this kind, occasioned by the operator having carried his incision, by mistake, into the bladder; and Denman lost a patient with peritonitis, produced by the operation. ”