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. Zacutus Lusitanus relates
the history of a case of uterine occlusion, with the flow from
the lips of the cervix. There is mentioned an instance of
menstruation from the labia.

The occurrence of menstruation after removal of the uterus or
ovaries is frequently reported. Storer, Clay, Tait, and the
British and Foreign Medico-Chirurgical Review report cases in
which menstruation took place with neither uterus nor ovary.
Doubtless many authentic instances like the preceding could be
found to-day. Menstruation after hysterectomy and ovariotomy has
been attributed to the incomplete removal of the organs in
question, yet upon postmortem examination of some cases no
vestige of the functional organs in question has been found.

Hematemesis is a means of anomalous menstruation, and several
instances are recorded. Marcellus Donatus and Benivenius
exemplify this with cases. Instances of vicarious and
compensatory epistaxis and hemoptysis are so common that any
examples would be superfluous. There is recorded an inexplicable