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N. P. McGAY, M.D.
JAMA. 1906;XLVI(20):1526. doi:10.1001/jama.1906.62510470040003a.
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Patient.  —M. D., aged 25, married about five years.

History.  —The patient had a miscarriage about three years ago, probably self induced. The uterus had to be "scraped out" about three weeks later. She has always been healthy and has had no disorders of menstruation up to this time. The flow occurred every thirty days, until May 30, 1905, since which time it has been decidedly irregular. On June 29 and 30, she had severe attacks of nose bleed, but no signs of menstrual flow. July 30 and 31, the same thing occurred. On August 19 she became alarmed at the non-appearance of menstruation and consulted me. I made a diagnosis of probable pregnancy from the symptoms then discernible. On August 30 and 31, she had a return of the menstrual flow but no nose bleed. In September and October, however, she again had severe attacks of epistaxis. On November


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