_History_ (taken from her mother).—When ten years old, had inflammation of the womb, and after she recovered began to menstruate. The function continued regularly until about eight months ago, since when the catamenia have appeared every ten days, and, in fact, have been hardly ever absent. In the latter part of last April she left home for change of air, and returned May 15th, when her mother noticed that she was thinner than before her departure, and, on inquiry, it appeared that during the latter part of her stay she had been very excited, at other times very low, sometimes laughing and singing, and requiring port wine and brandy at all times of the day, though generally abstemious, and never taking wine or other stimuli. The first night after her return home she went to one of her sisters’ rooms and began to talk of being married; did not sleep all that night. May 17th. Was found to be rather wild in the morning; was taken out for a drive during the day; did not sleep that night, from constant excitement of the genitals. Had been seen by her ordinary medical attendant, who ordered opiates, but without the effect of giving her sleep. On the 28th, another physician saw her, and ordered opiates, but without effect, as she did not have an hour’s sleep night or day. May 22nd. An eminent authority in female diseases was called in, and also, among other remedies, ordered opiates at night-time, but with no effect. She continued raving and rambling till June 8th, when a physician, who devotes himself to mental diseases, saw her; he said that her mind was not affected, but that her behaviour was caused simply by debility, and ordered wine, eggs, &c., and a _strong opiate_, but without the desired effect. June 17. Was much worse. The last physician again saw her; said that she was quite mad, must be taken from home, and could never recover. She called her mother “Monsieur le Diable,” and her father “God.” She was constantly irritating her clitoris, and indulged in most immodest behaviour. Was ordered ext. cannabis indicæ, and slept three hours. 19th. No better, and on this day I first saw her; she was then wild in expression of countenance, and on entering the room she addressed me as “Your Majesty,” and said “I was the Queen.” She also asked, “Why has your Majesty condescended to visit me?” June 21. Before operating, the patient being under chloroform, I made an examination, and found my diagnosis verified by the existence of all the ordinary local symptoms. The hymen was quite absent. (In one of her paroxysms she had stuffed a pocket handkerchief into the vagina.) I performed my usual operation, and immediately administered two grains of opium. She passed a tolerable night, not being noisy, but not sleeping. June 22. Tolerably quiet. Not aware of what is passing around her, but apparently comfortable. To have broth and milk diet—_no stimulants_.