There are cases on record in which the menstruation occurs by the
rectum or the urinary tract. Barbee illustrates this by a case in
which cholera morbus occurred monthly in lieu of the regular
menstrual discharge. Barrett speaks of a case of vicarious
menstruation by the rectum. Astbury says he has seen a case of
menstruation by the hemorrhoidal vessels, and instances of relief
from plethora by vicarious menstruation in this manner are quite
common. Rosenbladt cites an instance of menstruation by the
bladder, and Salmuth speaks of a pregnant woman who had her
monthly flow by the urinary tract. Ford illustrates this anomaly
by the case of a woman of thirty-two, who began normal
menstruation at fourteen; for quite a period she had vicarious
menstruation from the urinary tract, which ceased after the birth
of her last child. The coexistence of a floating kidney in this
case may have been responsible for this hemorrhage, and in
reading reports of so-called menstruation due consideration must
be given to the existence of any other than menstrual derangement
before we can accept the cases as true vicarious hemorrhage.
Tarnier cites an instance of a girl without a uterus, in whom
menstruation proceeded from the vagina.
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