Cases of vicarious menstruation are not rare, but cases of long-standing vicarious bleeding from the lungs are tolerably uncommon.
On consulting the literature one is struck by the small number of such cases that have been reported in this country.
The Index Medicus from 1888 to June, 1896, has only about twenty-five distinct references, the American Journal of Obstetrics from 1886 less than ten, and the American Journal of the Medical Sciences for the same time has but one case indexed.
The chief interest of these cases lies in their connection with the question of tuberculosis. Some of them are mistaken for phthisis, while many of them really are tuberculosis, and only later develop the signs of the disease.
Thomas1 reports a case of a patient, age 40 years, who, after twenty years of normal menstrual life, slowly began to have hemorrhages from the lungs. She lost weight greatly