This is a condition in which the anterior wall of the vagina, together with the bladder, falls downward in such a way as to produce a bulging. In some cases the parts protrude. The most common cause of this condition is rupture of the perinaeum in childbirth. In consequence of the falling down of the lower portion, the bladder is never entirely emptied of urine, and as a result, decomposition of the retained urine takes place, which gives rise to catarrh of the bladder, pain, heat, painful contractions, and difficulty in urination. The appearance of these symptoms after an unusually hard childbirth, from which the parts have been exceedingly sore and long in healing, may well give rise to apprehension of this condition, and a good surgeon should be consulted. We have frequently met with cases of this kind, which had been treated for disease of the bladder for many years without the real cause of the trouble being discovered, to whom we have been happy to bring relief by the performance of a surgical operation, by means of which the parts were restored to their natural condition.