OBSTETRICS.
Vicarious Menstruation.
[Communicated to a distinguished Medical Gentlemen in Philadelphia.J
Dear Sir :—Yesterday, quite an interesting, and,so far as my know-
ledge extends, somewhat unique case was presented to rhe for medical
advice. The following is a brief summary of the case, as detailed to
me by the individual herself.
Miss M., mt. 20, of medium size, and dark complexion, was attacked
with severe pains in the uterine region, about one year or more ago.
She labored under a severe spell of sickness, under the care of Dr.
Atlee and other physicians of Lancaster. For some time her life was
despaired of, but she ultimately recovered, and for more than nine
months subsequently was unable to urinate, save by the aid of the
catheter. Her catamenial discharge appears monthly, and, according
to her account, plentifully. Her menstruation continues usually about
four days; but the most interesting fact is, that, at each menstrual
period, she spits up large coagula of blood, and there is also a discharge
from one of her nipples of a sanguineous fluid, both commencing, con-
tinuing and stopping at the same time with that of the menses. Now
I have heard of vicarious menstruation, but then there was no discharge
from the uterus at the same time, or, if any, it was very scanty. Can
it be owing to an engorgement of the stomach and mammm at the same
time with that of the uterus ? and if so, whence the cause ? Would it
be dangerous to attempt arresting these periodical flows from the
stomach and mammas ? And if so, why should it be dangerous, inas-
much as a goodly discharge is going on from the uterus at the same
time ? The young woman is not any ways emaciated, but, on the
contrary, looks quite plump, or as the French would say, embonpoint.
She is troubled with considerable pain in the small of her back. Time
will not allow me to say more at present. I wish you to answer this
immediately, and give me your opinion on the subject, treatment, &c.
Yours respectfully,	W. R. B.
[Boston Medical Journal.