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anot uncommoncomplication ofimperforate vagina in thenewborn. We donotpropose todiscuss the relatively commonproblem ofvaginal occlusion duetolabial adhesions (Fig. 1),whichcanbe easily separated withlittle ornobleeding. Hydrocolpos inthenewborn femaledueto imperforate hymenortoocclusion byamembrane inthelowerthird ofthevagina isnotexcessively rare.Atorshortly after birth theinfant presents withlower abdominal swelling andabulging membraneisseenatthevaginal orifice (Fig. 2).This bulging membrane looks like acystocele andwhen gently reduced theurethral orifice canbeseen anteriorly. Occasionally theremay be a tiny opening intheoccluding membrane through which a whitemucoidmaterial canbeextruded. The anomaly hasbeenfully described byMahoney andChamberlain (1940), byGross(1953), byCaffey (1956), andbymanyothers andforthepurposes ofthepresent communication a brief description oftheir findings will besufficient. Inthis condition thevagina isinvariably greatly distended-hydrocolpos-and onoccasions theaccumulated fluid canstretch thecervical canal andthe bodyoftheuterus aswell-hydrometrocolposthough wehaveseentheuterine cavity distended onlyononeoccasion. Theballooned genital tract arises fromthepelvic floor intotheabdominal cavity. Thecyst isfilled withclear ormucoid fluid whichtendstobecomepurulent frombacterial invasion, giving risetopyocolpos. Theuterine tubes havenotbeeninvolved inanyofthereported cases. The distended genital tractmay cause urinary obstruction andtheenlargement ofthe bladder mayhinder palpation ofthevaginal cyst. Megaloureter andhydronephrosis mayfollow and pyuria willbea further complication. Posterior pressure maycause rectal obstruction. Theremay * A paperreadatameeting oftheBritish Association ofPaediatric Surgeons heldinLondoninJuly1960. berespiratory embarrassment through theupward displacement of theabdominal contents. On digital rectal examination thepelvis isfilled bya massprojecting against thehollow ofthesacrum. On inspection ofthevagina abulging membrane isseenatorabovethehymen.Insuchpatients a needle isinserted through themembraneandfluid isaspirated toconfirm thediagnosis. Radioopaquefluidmay be instilled to outline the obstructed vagina(Fig.3).Havingmadethe diagnosis theoccluding membraneisslit witha knife andthecystcontents areevacuated. Lesscommonly thehydrocolpos isduetoatresia ofthelower vagina (White andDennison, 1958) and

To the Editor:— Mouth-to-mouth resuscitation is the preferred method of assisting ventilation in the emergency situation and is being taught to many lay groups such as lifeguards and firemen. However, there are complications attendant with the use of the technique, particularly by the less experienced. Complications include partial or total airway obstruction resulting in air being vented via the esophagus into the stomach when the operator exhales forcibly, and active or passive regurgitation of the victim's stomach contents into the upper airway. Since the report of Sellick, 1 many anesthesiologists have used posterior displacement of the cricoid cartilage to prevent active or passive regurgitation during the induction of anesthesia prior to insertion of an endotracheal tube in the patient with a full stomach. The cricoid cartilage is signet-ring shaped with the large flat plate just anterior to the esophagus. By applying posterior pressure to the skin over the anterior surface