If the woman has passed the menopause, the hemorrhage of cancer may appear as a re-establishment of menstruation--often to the satisfaction of the woman. This post-climacteric bleeding may occur with more or less regularity--every month or every three or four months--or it may appear as an occasional loss of blood after unwonted effort. All hemorrhage of this kind, in women over thirty years of age, demands immediate and careful physical examination. Any bleeding from the vagina in a woman who has passed the menopause should arouse the gravest suspicion. From the slight hemorrhages just described the bleeding increases in intensity and duration, until there is a continuous loss of blood that saps the strength of the woman and produces the profound anemia characteristic of the last stages of cancer of the cervix, Sudden fatal hemorrhage in this disease is rare. _Pain_ is not a constant accompaniment of cancer of the cervix in the early stages, nor is it in any way characteristic. The intensity and character of the pain may depend upon the direction of the growth of the disease. In some cases pain is absent throughout. The pain may be dull and gnawing in character, or it may be sharp and lancinating. The pain may resemble that of uterine colic. It may be referred to the back in the region of the sacrum, or to one or both ovarian regions, or to some part of the pelvis remote from the uterus, as the crest or the anterior superior spine of the ilium. It may extend down the posterior or anterior aspects of the thighs or into the rectum. In most cases of cancer of the cervix pain is not a prominent symptom until the later stages. _Discharge_ from the vagina may be present in cancer of the cervix before there are any symptoms of hemorrhage or pain. The discharge depends upon the position and character of the growth and the stage of the disease. It may first appear as an ordinary cervical leucorrhea in a woman previously free from such discharge; or the discharge of cancer may first appear as an increase of an accustomed leucorrhea. In such cases it is due to hypersecretion from the irritated cervical glands. Later in the disease, when ulceration takes place or when the friable vascular vegetations appear, the leucorrhea becomes puriform in character and streaked with blood. It then becomes thinner, less mucous in consistency, and of a constant brownish color from the admixture of blood. The pus and débris from the breaking-down cancerous mass increase, and a horrible odor characteristic of the later stages of cancer of the cervix appears. This odor is not peculiar to cancer. It is caused by the sloughing tissue, and is observed when such a process occurs in other conditions, as in sloughing fibroid polyp. The discharge is irritating in character, and the ostium vaginæ, the vulva, and the inner aspects of the thighs become excoriated in those who do not observe strict cleanliness.