Payne's case was of a woman of thirty-five, well formed, who had been in labor thirty-six hours, when the physician examined and looked in vain for a vaginal opening; the finger, gliding along the perineum, came in contact with the distended anus, in which was recognized the head of the fetus.

The woman from prolongation of labor was in a complete state of prostration, which caused uterine inertia.

Payne anesthetized the patient, applied the forceps, and extracted the fetus without further accident.

The vulva of this woman five months afterward displayed all the characteristics of virginity, the vagina opened into the rectum, and menstruation had always been regular.

This woman, as well as her husband, averred that they had no suspicion of the anomaly and that coitus (by the anus) had always been satisfactory.
Opening of the vagina upon the parietes, of which Le Fort has collected a number of cases, has never been observed in connection with a viable fetus.
Absence of the labia majora has been observed, especially by Pozzi, to the exclusion of all other anomalies.