The third stage is that of absorption or the gradual disappearance of the exudation; this is usually a slow process, and may take from three to six months. I have known residues of the exudation, in the form of fibrous bands or adhesions or solid lumps to remain for years in the pelvic or peritoneal cavity. These bands may tie or fix the uterus to the rectum or to the pelvic walls, so that it will resist all ordinary efforts to replace it. Pelvic hematocele, or an effusion of blood into the pelvic peritoneum, inclosed either by anatomical structures or previously-existing inflammations, greatly resembles the sero-fibrinous exudation of perimetritis. The pallor of the countenance aided by other signs of hemorrhage must assist in distinguishing the affections. Chronic perimetritis is developed in numerous affections of the womb that exert a continuous irritation of its peritoneal covering. These are fibroid and malignant tumors, painful and difficult menstruation, as well as enlargement of the tubes and ovaries. Inflammation of the uterus and a discharge of blood or matter through the tubes and into the peritoneal cavity, may bring about a chronic pelvic peritonitis from the beginning. Chronic perimetritis or chronic pelvic peritonitis, for the terms are often interchangeable, is most abrupt in its development, because it is not heralded by fiery, acute febrile symptoms, but a close inquiry will usually recall to the minds of patients the commencement of the trouble. The fact that the peritoneum is also reflected on the bladder, causes an irritability of this organ, to be the first and only symptom, for quite a while. There is nothing stereotyped in the development of any disease, so that the symptoms may or may not be painful from the beginning. The pains in the pelvis are more or less continual, there is an incapacity for bodily exertion, the bowels are out of order, either there is constipation or a chronic diarrhœa; these morbid conditions destroy the appetite and the patient becomes lean and weakly. From time to time all these abnormal signs become aggravated, so that the sufferer may be forced to take to her bed. Some women have great powers of resistance and endure suffering with great fortitude, so that they are comparatively free from harassing pain, although their pelvic organs are tied down by inflammatory adhesions, and unless they lift or make other unusual muscular efforts, that increase the intra-abdominal pressure, so as to drag on the adhesions, they suffer little or no pain. Another sign of chronic perimetritis is painful intercourse, which jars the adhesions, and this is particularly the case if the womb comes down quite low. The danger to be apprehended is that no one knows at what moment some indiscretion will light up an acute attack with all its serious consequences.