The pain of cancer of the fundus is not a marked symptom. It may be absent even though the whole body of the uterus be involved by the disease. When the peritoneum is affected, and extension takes place to other pelvic structures, the pain is much more pronounced. In other cases the pain may be present in the early stages, before the disease has extended beyond the endometrium. The pain may be referred to the region of the uterus, to the back, or sometimes to parts of the pelvis remote from the uterus, as the crest of the ilium. Bimanual examination shows a patulous external os, cervical canal, and internal os. As has already been said, this patulous condition is characteristic of gross disease of the endometrium. The body of the uterus is usually somewhat enlarged, tender on pressure between the vaginal finger and the abdominal hand, and, in the late stages of the nodular form of cancer, irregular in outline. The causes of death in cancer of the fundus uteri are the same as those that have already been considered in cancer of the cervix. Extension to abdominal organs is, however, more frequent in cancer of the fundus. =Diagnosis.=--It is of the greatest importance to make an early diagnosis of cancer of the fundus uteri, because, of all parts of the body that may be attacked by malignant disease, the fundus uteri offers the best prospect of cure by operation. In the early stages the disease can easily be completely removed. Hemorrhage from the uterus is the universal symptom, and should never be disregarded. The various manifestations of hemorrhage in cancer of the fundus should always be borne in mind, and should always prompt a thorough investigation. Leucorrheal discharge occurring at or after the menopause, in a woman previously free from such discharge, should also excite suspicion. If a careful examination of the cervix fails to reveal any cause for the hemorrhage or the discharge, the interior of the uterus should be thoroughly examined by the curette. A patulous cervical canal and internal os are good indications that there is some gross disease of the endometrium. In cancer of the fundus the cervical canal and the internal os are usually sufficiently open to permit thorough curetting without further dilatation. The Sims sharp curette may be used with safety if ordinary care be observed. If the woman is nervous, an anesthetic should be administered, though in most cases diagnostic curetting gives but little pain and may be performed without ether.