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.