A NOTE ON HAEMATOCOLPOS

place. The vessels in the hiluim of the organ appeared lhealthly. On section the diagnosis of subeapsular haematoma was confirmed, and it was in addition seen that a considerable portion of the spleinic substance had been ploughed up by the lhaemorrhage. Microscopical Examination.-A portion of the spleen wlliclh appeared to be undamaged by the haemorrlhage w-as submitted to microscopical examination. A niormal histological picture was foulnd. A portion of the splenic artery was also examined, but no ablnormality was discovered. As far as could be judged, therefore, apart firom the damage caused by the lhaemorrhage, the spleen was a normal liealtlhy organ of the usual size and with healthy blood vessels. The patient was repeatedly questioned as to whether he had received any injury, buit this was denied. A diagnosis was therefore made of spontaneous rtupture of a normal spleen. Slhortly after his discharge the patient was asked to attend in order that lie might be further examined, and investigations were made to see if some cause could be discovered to accouint for the apparently spontaneous rupture. No abnormal signs were found in the heart, lungs, or abdomen. The urinie u-as acid, and contained no abnormal cotnstituents. The arteries we-re slightly tlhickened and the blood pressure was 140/85. While the examination was in progress the patienlt stated that lie lhad lately remembered that at 10.30 a.m. on the day of the onset of hiis illness he was leaning over a ledge in order to openIhis shop window, when he slipped and fell on to his left side against the edge of the ledge. He had only slight discomfort, and, tlhinking nothing of hiis injury, dismissed it from his mind until our repeated questionings recalled, the inicident. Undoubtedly thlis forgotten trauima was the primary cause of the rupttured spleen.