Judging from the large number of cases of this sort which have come to our notice, laceration of the perinaeum is an accident which probably occurs fully as frequently as the form of laceration just described. A slight degree of laceration almost always occurs at the birth of the first child. When this is very slight, no harm results; but when it extends into the muscular tissue, serious injury is done. The laceration may be so extensive as to bring the two passages together in one, as we found in a case which came under our care a few weeks ago. A complete laceration of this sort is usually discovered at the time of its occurrence; but when it is smaller in extent, the rupture is most frequently overlooked. The symptoms of rupture of the perinaeum are, an unusual amount of soreness and long delay m healing. When the patient attempts to get upon her feet, she soon begins to suffer from the various symptoms of prolapsus, or retroversion. She is unable to walk but a short distance, suffers with pain in the back, weakness, and various other local disturbances. If the rupture is complete, there will be a loss of power to retain the contents of the bowels, especially when the bowels are loose.