THE RECENT opportunity to study in the ward and in the pathology laboratory a case of acute fulminating ulcerative colitis with massive perforation and peritonitis stimulated a review of the literature in this regard. Its rarity together with its urgent therapeutic demands prompts me to present the following study of a case with a review of the literature.

REPORT OF A CASEÌý T. H. was a 43 year old, white woman, a divorcee, who was brought to the hospital in a state of profound shock. Her chief complaint was diarrhea of four weeks' duration. Because of her persistently critical condition and the absence of relatives, the history obtained is lacking in detail and probably to some extent in accuracy.She was born in Oregon, had lived in the United States all her life and had come to Boston a few months previously. She had been married and divorced, was childless