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March 21, 1896


JAMA. 1896;XXVI(12):551-552. doi:10.1001/jama.1896.02430640003001a

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The diversity of opinion which exists as to the causes of membranous dysmenorrhea, with its comparative rarity, makes each case an object of interest to the gynecologist. During the past eighteen months I have had under observation a case of more than ordinary severity and obstinacy. The principal facts in the case are briefly these:

Mrs. L. age 26, married and sterile, menstruated first when 13½ years of age. Menstruation was painless and regular up to the age of 18. At that time the flow suddenly stopped after continuing two days, the cessation being followed by the usual symptoms of pelvic disturbance. One year later patient had an attack of what was probably a vaginitis accompanied by cystitis. There was heat and burning in the vagina, a profuse leucorrhea, and frequent desire to urinate, the act being accompanied by smarting and burning. The painful menstruation, however, dates from the 18th

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