tive stature, and was in labor a long
time. After labor, sloughing of the parts commenced and progressed to
such an extent that in one month there were no traces of the labia,
nymphae, vagina, perineum, or anus. There was simply a large opening
extending from the meatus urinarius to the coccyx. The rectovaginal
septum, the lower portion of the rectum, and the neck of the bladder
were obliterated. The woman survived, although she always experienced
great difficulty in urination and in entirely emptying the rectum. A
similar instance is reported in a woman of thirty who was thirty-six
hours in labor. The fundus of the uterus descended into the vagina and
the whole uterine apparatus was removed. The lower part of the rectum
depended between the labia; in the presence of the physician the nurse
drew this out and it separated at the sphincter ani. On examining the
parts a single opening was seen, as in the preceding case, from the
pubes to the coccyx. Some time afterward the end of the intestine
descended several inches and hung loosely on the concave surface of the
rectum. A sponge was introduced to support the rectum and prevent
access of air. The destruction of the parts was so complete and the
opening so large as to bring into view the whole inner surface of the
pelvis, in spite of which, after prolonged suppuration, the wound
cicatrized from behind forward and health returned, except as regards
the inconvenience of feces and urine. Milk-secretion appeared late and
lasted two months without influencing the other functions.

There are cases in which, through the ignorance of the midwife or the
physician, prolapsed pelvic organs are mistaken for afterbirth and
extracted. There have been instances in which the whole uterus and its
appendages, not being recognized, have been dragged out. Walters cites
the instance of a woman of twenty-two, who was in her third
confinement. The midwife in attendance, finding the afterbirth did not
come away, pulled at the funis, which broke at its attachment. She then
introduced her hand and tore away what proved to be the whole of the
uterus, with the right ovary and fallopian tube, a portion of the round
ligament, and the left tube and ovarian ligament attached to it. A
large quantity of omentum protruded from the vulva and upper part of
the vagina, and an enormous rent was left. Walters saw the woman
twenty-one hours afterward, and ligated and severed the protruding
omentum. On the twenty-