well developed, flaccid, the nipple prominent, and the
superficial veins larger and more tortuous than usual. The
patient stated that the right mamma had always been larger than
the left. The areola was large and well marked, and 1/4 inch from
its outer edge, immediately under the nipple, there was an ulcer
with slightly elevated edges measuring about 1 1/4 inches across
the base, and having an opening in its center 1/4 inch in
diameter, covered with a thin scab. By removing the scab and
making pressure at the base of the ulcer, drops of thick,
mucopurulent matter were made to exude. This discharge, however,
was not offensive to the smell. On March 17, 1846, the breast
became much enlarged and congested, as portrayed in Plate 1. The
ulcer was much inflamed and painful, the veins corded and deep
colored, and there was a free discharge of sanguineous yellowish
matter. When the girl's general health improved and menstruation
became more natural, the vicarious discharge diminished in
proportion, and the ulcer healed shortly afterward. Every month
this breast had enlarged, the ulcer became inflamed and
discharged vicariously, continuing in this manner for a few days,
with all the accompanying menstrual symptoms, and then dried up
gradually. It was stated that the ulcer was the result of the
girl's stooping over some bushes to take an egg from a hen's
nest, when the point of a palmetto stuck in her breast and broke
off. The ulcer subsequently formed, and ultimately discharged a
piece of palmetto. This happened just at the time of the
beginning of the menstrual epoch. The accompanying figures, Plate
1, show the breast in the ordinary state and at the time of the
anomalous discharge.

Hancock relates an instance of menstruation from the left breast