‘We have been informed on reliable authority that permanent incontinence of fæces has occasionally followed these examinations.’ Lastly, we think it right to insist upon the important fact that, in some subjects, even a small hand cannot be passed up the rectum beyond the reflection of the peritoneum over the second part of the gut. In such instances the peritoneum offers a resistance like a tight garter, and prevents the farther advance of the hand without great risk of laceration of the parts.[12] _EXAMINATION PER VAGINAM._ For this report I am indebted to Dr. Godson, of St. Bartholomew’s Hospital:-- ‘The finger introduced into the vagina comes upon the carunculæ myrtiformes, which are vascular membranous processes independent of the hymen, variable in number, size, and form. It also feels the transverse ridges known as “rugæ.” ‘Along the anterior wall of the vagina the finger readily detects the track of the urethra, which feels like a prominent cord and forms an excellent guide to the orifice of the meatus urinarius in passing a catheter. The orifice is indicated by a slight semicircular prominence, situated about one-third of an inch above the orifice of the vagina. Behind the urethra the finger comes upon the posterior wall of the bladder. But the bladder is not perceptible, as such, to the touch unless distended. With a catheter previously introduced it is much more readily explored. ‘The septum between the vagina and the rectum is so thin that, should the rectum contain fæcal matter, its presence becomes at once apparent to the finger. ‘The cervix uteri is felt protruding from the roof of the vagina in a direction downwards and backwards--that is, in a line from the umbilicus to the coccyx. The os uteri is felt, small and round, in the centre of the cervix. The posterior lip feels a little lower than the anterior. The cul-de-sac formed by the vagina in front and behind the cervix should be perfectly elastic to the touch, and not communicate the sensation of a resisting body. Any resistance here bespeaks an abnormal condition. ‘The bony landmarks within reach of a finger, or perhaps two, in a woman who has not borne a child, are the symphysis pubis, the rami of the pubes and ischia. The coccyx and part of the hollow of the sacrum may also be felt, but not without exerting much pressure on the posterior wall of the vagina, which gives considerable pain. If the promontory of the sacrum can be felt, it is a sign that the conjugate diameter of the pelvis is abnormal. ‘The finger in the rectum can detect almost everything which has been mentioned in connection with the vagina. The shape and direction of the cervix uteri are almost as perceptible, and the posterior wall of the uterus can be examined. The peritoneal fold termed recto-vaginal (Douglas’s space) can also be well explored, and anything abnormal detected in this direction--a point of great importance in the diagnosis of diseases and displacements of the uterus.