E. D., aged 31, a short, stout, dark-featured woman, attended at the out-patient department of the Grosvenor Hospital on February 22nd, 1892. She gave the following history:—Healthy girlhood. Menstruation appeared at the age of 11. The periods were regular, but she had much pain during the flow, which usually lasted for four days, and never was excessive. Married at 27. No family. Two years ago she had an attack of “inflammation in the belly,” and was admitted into a London General Hospital. When there she was told she had a tumour, but nothing further being done she left that institution and went home. Had been in good health and quite regular up to Christmas, 1891, at which date her last period occurred. Soon afterwards she began to feel ill, and had attacks of sickness throughout the month of January. On the evening of February 10th she was suddenly seized with acute pain in the abdomen, and had attacks of sickness and faintness during the night. Turpentine stupes were applied, and gave some relief, and the pain passed off towards morning. Her doctor was then sent for, and he attended for three days, during which time she was kept in bed. At the patient's request, however, he discontinued his visits, but two days later, in consequence of a second attack of a similar nature, he was again called in, and remained in attendance for four days, the patient being kept in bed and under the influence of morphia. At the end of that time she got up, and not being satisfied about her condition she came to the Grosvenor Hospital, where she was seen by my colleague, Dr. Gibbons, who strongly advised her to come into the Hospital. Two days later she was admitted under his care.