If this condition of congenital ectropion exists along with a laceration of the cervix, the diagnosis becomes very difficult. If, however, we can exclude the possibility of a former conception, we may by careful study determine the real nature of the case. [Illustration: FIG. 111.--Congenital erosion of the cervix.] Fig. 111 represents the appearance of the cervix in a case of marked congenital erosion in a virtuous single woman twenty years of age. It will be observed that the appearance resembles somewhat that seen in a bilateral laceration of the cervix with eversion. The following are the points of difference: In _laceration_-- There is a history of previous pregnancy. The presenting face of the cervix is oval, with the long axis antero-posterior. The angles of laceration may be determined, by sight or touch, either as more or less well-marked depressions or as hard plugs in case they are filled up by scar-tissue. The mucous membrane of the cervical canal may be made out as a strip on the anterior and posterior lips, from which there extends laterally a more or less well-marked erosion. The vaginal cervix is not of the general mushroom shape seen in the figure. If microscopic examination of the cervix be made, racemose glands will be found discharging only on the mucous membrane of the cervical canal--not all over the vaginal aspect. In the _congenital ectropion_-- There may be no history of pregnancy. The presenting face of the cervix is approximately circular. There is no angle of laceration determined by sight or touch. The erosion may extend evenly around the external os, and there is no one strip that corresponds to the exposed mucous membrane of the cervical canal. The vaginal cervix is mushroom-shaped, with a decided stalk. Microscopic examination reveals racemose glands discharging over the greater part of the vaginal cervix, to the sides of the external os, as well as in front of and behind it. The ultimate test of this condition is the discovery of the glands discharging on the vaginal aspect of a cervix in which the mucous membrane of the cervical canal had not been exposed by laceration. The treatment of congenital erosion of the cervix, when it is so marked as to produce distinct symptoms, is amputation of the cervix. =Congenital Split of the Cervix.=--There is sometimes found a congenital split of the cervix, closely resembling a unilateral or bilateral laceration following labor or miscarriage. The recognition of this fact is of great medico-legal importance. One of the most positive signs of a former conception is a laceration of the cervix. In some cases, however, a condition resembling such a laceration may exist from birth. Marked lateral split of the cervix has been discovered in the new-born infant, and several cases have been observed in which this condition has been found in adults of undoubted virginity.