The hymen is a muscle that basically surrounds the inside of the vagina. (Picture a horseshoe of balloons that an athlete runs through during special events.) SOMETIMES, during intercourse, the muscle can get bruised or torn. It doesn't happen all the time, but it does happen often enough that historically, people saw an intact hymen as proof of virginity.
But intercourse in general can cause exterior bruising around the vagina as well. (It's actually something ER doctors will look for when examining assault victims, because during consensual intercourse, the bruising ends up in a different location than it does if the deed were non-consensual.)
So, to answer your original question, yes, an examination can determine whether or not a woman has had intercourse. IF, the intercourse was relatively recent. (If she hasn't gotten it on in over a year, an exam might not reveal much -- any bruises or tears would have healed.) Since Sayuri's's interaction with the Baron had been within the week (I think), there would still be bruising evident if anything had happened.
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