—Male child, born Nov. 22, 1909. The mother had previously given birth to two children normal in every respect and both living. The weight of child at birth was 9 pounds. It was a fine, healthy-looking baby, but examination of the perineum revealed entire absence of the anus. A median raphé extended from scrotum to coccyx without so much as a dimple to indicate the usual location of the anus. There was no bulging of the perineum. The external genitals were normal and well developed.
—November 23, at 10 p. m., forty-two hours after birth. Under light ether anesthesia an incision was made in median line of the perineum. No muscle tissue was encountered. The dissection was carried inward through fibrous tissue to a depth of two inches and careful search was made from the urethra anteriorly to the