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—At 2 o'clock one afternoon I was called to see a woman who had given birth to a 20-inch normal child early that morning. The woman was a primipara, aged about 20, and of healthy, strong constitution.
—On examination I found an ugly tear through the perineal floor in the median line, not extending to the anus or involving the vaginal outlet. The approximate position and size of the laceration are shown in the accompanying diagram. The introitus vaginæ was very small and inelastic. The laceration had occurred through the raphe. Birth occurred through the tear and not through the introitus.
—The delivery had been rapid—four hours—and the pains and efforts at expulsion had been violent. The woman had been attended by a friend who was not even a midwife.
—At the first visit the parts were so edematous and swollen that immediate repair
PIETRI A. AN INTRAPERINEAL TEAR. JAMA. 1910;LIV(10):793. doi:10.1001/jama.1910.92550360001001l