Abstract

The etiology of membranous dysmenorrhea is obscure. It has been found as a complication of certain pelvic diseases, and it has developed after an attack of one of the exanthems. Whenever it has been observed, marked nutritive changes seem to be closely related to the production of this rare condition. The case reported here illustrates a metabolic disease, apparently the etiologic factor. Mrs. E., aged 40, came to the Ashland State Hospital, May 14, 1924, her chief complaint being the passing of a fleshy mass at menstruation, which she had been observing for the past year. The fleshlike mass escaped about the seventh day of her periods, which were quite regular. She also complained of a great loss in weight, and frequent urgent urination. Examination of the blood showed the sugar content to be 0.25 mg. The urine also contained sugar. The patient was placed on a diet, and in

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