A UNIQUE PERFORATION OF THE SIGMOID FLEXURE, CAUSED BY AN ENEMA FROM GARDEN HOSE

History of Injury.  —A middle-aged Italian was referred to me by Dr. Guagliata with the following history: The patient, a chronic sufferer with constipation, had long been in the habit of getting relief by attaching a piece of garden hose to the kitchen faucet, inserting the other end into his anus, and then turning on the stream. He had employed this procedure many times before successfully and with no untoward effects. On the day in question he had, before going to work in the morning, employed his customary flushing. This time, however, something unusual happened, for he was seized with severe pains in the abdomen. He went out and worked as a common laborer for several hours without experiencing much discomfort. Then, however, the pains recurred or became more severe and he went home. The abdominal pains were intense and were accompanied by vomiting. The patient was then seen by