d in a febrile condition, with abdominal tenderness, etc. On the
21st, while straining as if to discharge the contents of the rectum,
she felt a voluminous body pass through the vagina, and fancied it was
the expected fetus. After washing this mass it was found to be a
portion of the vaginal parietes and the fleshy body of the neck of the
uterus. The woman believed she had miscarried, and still persisted in
refusing medicine. Cicatrization was somewhat delayed; immediately on
leaving the hospital she returned to her old habits, but the pain and
hemorrhage attending copulation was so great that she had finally to
desist. The vagina, however, gradually yielding, ceased to interfere
with the gratification of her desires. Toward the end of June the
menses reappeared and flowed with the greatest regularity. The portions
discharged are preserved in the Milan Hospital.

The injuries received during coitus have been classified by Spaeth as
follows: Deep tears of the hymen with profuse hemorrhage; tears of the
clitoris and of the urethra (in cases of atresia hymenis);
vesicovaginal fistula; laceration of the vaginal fornices, posteriorly
or laterally; laceration of the septum of a duplex vagina; injuries
following coitus after perineorrhaphy. In the last century Plazzoni
reports a case of vaginal rupture occurring during coitus. Green of
Boston; Mann of Buffalo; Sinclair and Munro of Boston, all mention
lacerations occurring during coitus. There is an instance recorded of
extensive laceration of the vagina in a woman, the result of coitus
with a large dog. Haddon and Ross both mention cases of rupture of the
vagina in coitus; and Martin reports a similar case resulting in a
young girl's death. Spaeth speaks of a woman of thirty-one who, a few
days after marriage, felt violent pain in coitus, and four days later
she noticed that fecal matter escaped from the vagina during stool.
Examination showed that the columns of the posterior wall were torn
from their attachment, and that there was a rectovaginal fistula
admitting the little finger. Hofmokl cites an instance in which a
powerful young man, in coitus with a widow of fifty-eight, caused a
tear of her fornix, followed by violent hemorrhage. In another case by
the same author, coitus in a sitting posture produced a rupture of the
posterior fornix, involving the peritoneum; although the patient lost
much blood, she finally recovered. In a third instance, a young girl,
whose lover