This partition, the _septum uro-rectale_, develops symmetrically on each side, appearing first as paired folds on the right and left sides called the _internal perineal folds_ (Figs. 28 and 29). When these folds have reached the cloacal membrane they complete the separation of the cloaca into two adjacent canals. Each of these canals is still closed caudad by its respective portion of the cloacal membrane, now divided into an _anal_ and _uro-genital_ segment. These two portions of the original cloacal membrane become perforated separately, the uro-genital before the anal. Hence the external opening of the uro-genital sinus is the first to appear, to be followed by the anal perforation. The internal perineal folds are supplemented by the formation of similar external folds, ridges of mesoderm tissue which surround the anal orifice in the form of a low wall and thus deepen the anal ectodermal invagination into the fossa of the proctodæum.
These developmental stages in the formation of the end-gut are of importance because they offer the explanation of the pathological conditions which result from an arrest of development and from the failure of either the uro-genital or anal opening to form in the usual manner. These malformations must date back to an early stage, and probably have their inception in disturbances occurring in the normal development between the 15th and 23d day (embryos of 3-6 mm.). Perhaps in some cases of atresia there may be a secondary obliteration of a previously formed opening. In Fig. 31 the proctodæum persists but the perforation of the anal membrane into the end-gut has not occurred. The ectoderm of the anal fossa and the intestinal entoderm remain separated by a transverse mesodermal partition. Different degrees of this malformation are observed. The layer separating the skin from the blind end of the rectum may be so thin that the meconium contained in the latter can be felt through it. On the other hand the rectum may terminate high up in a blind pouch, which is separated from the skin by a distance of several centimeters.
[Illustration: FIG. 31.--Section of pelvis of human fœtus, showing atresia recti. (Esmarch.)]
We may now briefly consider the genetic, histological and mechanical conditions which the above-outlined course of development imposes on the alimentary tract.