Mrs. ——, æt. 32, married; admitted into the London Surgical Home August 5, 1862. _History._—Has been married twelve years, but has had no children nor miscarriages. Has always enjoyed pretty good health until about five years ago, when she began to suffer from leucorrhœa and great pain during menstruation. Catamenia regular in time and quantity. Her bladder is so irritable that sometimes she has to pass her water every half-hour; the urine sometimes very much loaded. Suffers from headache and giddiness in the morning. Says that for the last three years the act of coition has been accomplished without the least pleasure, but with pain. Bowels are opened regularly and without pain. August 7. Having diagnosed the cause of the disease, the usual operation was performed. August 9. A severe attack of erysipelas came on, and she was very ill for some days, but she made a good recovery. A few days after the operation this patient was observed to be occasionally very violent and unmanageable, and to have at these times a wild maniacal look. On questioning her husband, it appeared that for several years she had been subject to fits of violent excitement, especially during the menstrual period, and that at such times “she would fly at him and rend his skin, like a tigress.” This patient made a good recovery; she remained quite well, and became in every respect a good wife. CASE XIV. EXTREME HYSTERIA—INCIPIENT INSANITY—OPERATION—CURE. Mrs. R., æt. 42; admitted into the London Surgical Home Aug. 5, 1862. _History._—Has been married, but has been a widow for twelve years. Is companion to a lady. Never had any family. Has been ailing for some years, but has not suffered severely until the last six months. Suffers most from pain in the lower part of the abdomen, and from constant burning and irritation about the vulva. During the last few months has become very nervous and fidgety; never can remain quiet, and says that lately she “has had a sort of lost feeling, particularly when writing; being unable to compose her thoughts, or concentrate her mental energies.” Has suffered from considerable irritability of the bladder; and her urine is often full of thick deposit. Catamenia regular in time and quantity. Cannot sleep. _On examination_, is a very nervous woman, her eyes restless and never quiet; constant twitchings of the limbs, and occasionally an appearance almost of insanity about her expression. There is every evidence of a long-continued inhibitory influence. August 7. The usual operation performed. August 8. Feels very comfortable. Slept better last night than for some years. August 9. Is improving wonderfully: the expression of countenance completely changed.