We report this case because it is an example of carcinoma of the rectum arising from an internal prolapsing hemorrhoid of long duration. It also is of value in pointing out certain important facts. REPORT OF CASE History. —W. H., an Englishman, aged 47, single, an orderly, was admitted to the hospital, Oct. 31, 1927, because of rectal prolapse. For the last seventeen years he had been bothered with rectal trouble. At first he noted a small protrusion at the time of defecation, which could be returned. He frequently passed small amounts of blood from the rectum, and had had one severe hemorrhage fifteen years before. The prolapse has gradually been getting worse, and the last three years he had not been able to reduce it. During that time there had been considerable mucous discharge from the everted rectum. He had not noted any change in the character of the