Mrs. L. R., aged 21 years, married two months. Probable gonorrhea two years before; since that time, more or less pelvic pain and very marked pain at menstrual periods. Since marriage has had great pain across lower part of abdomen. Coitus so painful that it became impossible. Examination showed uterus much enlarged, very sensitive, retroflexed and somewhat toward the left side. Enlarged tubes felt on both sides. Operation, Aug. 9, 1897.
The bladder was separated from the uterus without difficulty. Plica opened with scissors. Extensive adhesions over the fundus of uterus and tubes. The uterus was seized with double hooks and delivered through the wound with some difficulty. The left tube and ovary were firmly adherent. The tube was freed from adhesions and on being opened was found to be entirely disorganized and occluded. It was removed, but the ovary was left as it was—normal. The right ovary and tube