Instances in which the presence of an unruptured hymen has complicated or retarded actual labor are quite common, and until the membrane is ruptured by external means the labor is often effectually obstructed. Among others reporting cases of this nature are Beale, Carey, Davis, Emond Fetherston, Leisenring, Mackinlay, Martinelli, Palmer, Rousseau, Ware, and Yale.

There are many cases of stricture or complete occlusion of the vagina, congenital or acquired from cicatricial contraction, obstructing delivery, and in some the impregnation seems more marvelous than cases in which the obstruction is only a thin membranous hymen. Often the obstruction is so dense as to require a large bistoury to divide it, and even that is not always sufficient, and the Cesarean operation only can terminate the obstructed delivery; we cannot surmise how conception could have been possible. Staples records a case of pregnancy and parturition with congenital stricture of the vagina. Maisonneuve mentions the successful practice of a Cesarean operation in a case of congenital occlusion of the vagina forming a complete obstruction to delivery. Verdile records an instance of imperforate vagina in which rectovaginal wall was divided and the delivery effected through the rectum and anus. Lombard mentions an observation of complete occlusion of the vagina in a woman, the mother of 4 living children and pregnant for the fifth time. Thus, almost incredible to relate, it is possible for a woman to become a mother of a living child and yet preserve all the vaginal evidences of virginity. Cole describes a woman of twenty-four who was delivered without the rupture of the hymen, and Meek remarks on a similar case. We can readily see that, in a case like that of Verdile, in which rectal delivery is effected, the hymen could be left intact and the product of conception be born alive.

A natural sequence to the subject of impregnation without entrance is that of artificial impregnation. From being a matter of wonder and hearsay, it has been demonstrated as a practical and useful method in those cases in which, by reason of some unfortunate anatomic malformation on either the male or the female side, the marriage is unfruitful. There are many cases constantly occurring in which the birth of an heir is a most desirable thing in a person's life. The historic instance of Queen Mary of England, whose anxiety and efforts to bear a child were the subject of public comment and prayers, is but an example of a fact that is occurring every day, and doubtless some of these cases could be righted by the pursuance of some of the methods suggested.

There have been rumors from the beginning of the century of women being impregnated in a bath, from contact with cloths containing semen, etc., and some authorities in medical jurisprudence have accepted the possibility of such an occurrence. It is not in the province of this work to speculate on what may be, but to give authoritative facts, from which the reader may draw his own deductions. Fertilization of plants has been thought to have been known in the oldest times, and there are some who believe that the library at Alexandria must have contained some information relative to it. The first authentic account that we have of artificial impregnation is that of Schwammerdam, who in 1680 attempted it without success by the fecundation of the eggs of fish. Roesel, his scholar, made an attempt in 1690, but also failed; and to Jacobi, in 1700, belongs the honor of success. In 1780, Abbe Spallanzani, following up the success of Jacobi, artificially impregnated a bitch, who brought forth in sixty-two days 3 puppies, all resembling the male. The illustrious John Hunter advised a man afflicted with hypospadias to impregnate his wife by vaginal injections of semen in water with an ordinary syringe, and, in spite of the simplicity of this method, the attempt was followed by a successful issue. Since this time, Nicholas of Nancy and Lesueur have practised the simple vaginal method; while Gigon, d'Angouleme (14 cases), Girault (10 cases), Marion Sims, Thomas, Salmon, Pajot, Gallard, Courty, Roubaud, Dehaut, and others have used the more modern uterine method with success.

A dog-breeder, by syringing the uterus of a bitch, has succeeded in impregnating her. Those who are desirous of full information on this subject, as regards the modus operandi, etc., are referred to Girault; this author reports in full several examples. One case was that of a woman, aged twenty-five, afflicted with blenorrhea, who, chagrined at not having issue, made repeated forcible injections of semen in water for two months, and finally succeeded in impregnating herself, and was delivered of a living child. Another case was that of a female, aged twenty-three, who had an extra long vaginal canal, probably accounting for the absence of pregnancy. She made injections of semen, and was finally delivered of a child. He also reports the case of a distinguished musician who, by reason of hypospadias, had never impregnated his wife, and had resorted to injections of semen with a favorable result. This latter case seems hardly warranted when we consider that men afflicted with hypospadias and epispadias have become fathers. Percy gives the instance of a gentleman whom he had known for some time, whose urethra terminated a little below the frenum, as in other persons, but whose glans bulged quite prominently beyond it, rendering urination in the forward direction impossible. Despite the fact that this man could not perform the ejaculatory function, he was the father of three children, two of them inheriting his penile formation.

The fundamental condition of fecundity being the union of a spermatozoid and an ovum, the object of artificial impregnation is to further this union by introducing semen directly to the fundus of the uterus. The operation is quite simple and as follows: The husband, having been found perfectly healthy, is directed to cohabit with his wife, using a condom. The semen ejaculated is sucked up by an intrauterine syringe which has been properly disinfected and kept warm. The os uteri is now exposed and wiped off with some cotton which has been dipped in an antiseptic fluid; introduced to the fundus of the uterus, and some drops of the fluid slowly expressed into the uterus. The woman is then kept in bed on her back. This operation is best carried out immediately before or immediately after the menstrual epoch, and if not successful at the first attempt should be repeated for several months. At the present day artificial impregnation in pisciculture is extensively used with great success.

{footnote} The following extraordinary incident of accidental impregnation, quoted from the American Medical Weekly by the Lancet, is given in brief, not because it bears any semblance of possibility, but as a curious example from the realms of imagination in medicine.

L. G. Capers of Vicksburg, Miss., relates an incident during the late Civil War, as follows: A matron and her two daughters, aged fifteen and seventeen years, filled with the enthusiasm of patriotism, stood ready to minister to the wounds of their countrymen in their fine residence near the scene of the battle of R----, May 12, 1863, between a portion of Grant's army and some Confederates. During the fray a gallant and noble young friend of the narrator staggered and fell to the earth; at the same time a piercing cry was heard in the house near by. Examination of the wounded soldier showed that a bullet had passed through the scrotum and carried away the left testicle. The same bullet had apparently penetrated the left side of the abdomen of the elder young lady, midway between the umbilicus and the anterior superior spinous process of the ilium, and had become lost in the abdomen. This daughter suffered an attack of peritonitis, but recovered in two months under the treatment administered.

Marvelous to relate, just two hundred and seventy-eight days after the reception of the minie-ball, she was delivered of a fine boy, weighing 8 pounds, to the surprise of herself and the mortification of her parents and friends. The hymen was intact, and the young mother strenuously insisted on her virginity and innocence. About three weeks after this remarkable birth Dr. Capers was called to see the infant, and the grandmother insisted that there was something wrong with the child's genitals. Examination showed a rough, swollen, and sensitive scrotum, containing some hard substance. He operated, and extracted a smashed and battered minie-ball. The doctor, after some meditation, theorized in this manner: He concluded that this was the same ball that had carried away the testicle of his young friend, that had penetrated the ovary of the young lady, and, with some spermatozoa upon it, had impregnated her. With this conviction he approached the young man and told him the circumstances; the soldier appeared skeptical at first, but consented to visit the young mother; a friendship ensued which soon ripened into a happy marriage, and the pair had three children, none resembling, in the same degree as the first, the heroic pater familias.