I desire to present some notes on an unusual case of rupture of the rectum, and protrusion of a loop of the small intestine through the opening in the wall, and from the anus.
The patient was a woman of 50, suffering with melancholia of a very active type, accompanied with delusions largely relating to the pelvic organs; she often fancied herself pregnant, or being delivered; and her conversation, which was almost continuous during waking hours, was on subjects forbidden in polite society. She had a remarkable talent for making remarks exceedingly embarrassing to both the physician and the nurses. One result of her delusive ideas of her pregnant condition, was a disposition at times to assist nature by introducing her hand into her vagina or rectum, and pulling or working at those organs, so that a tendency to prolapsus of both uterus and rectum existed, and these conditions had