=Symptoms.= In a frank hemorrhage, the chief symptom is an escape of blood from the vagina, occasionally accompanied by pain. A frank accidental hemorrhage occurs once in about every two hundred cases, according to Dr. Edgar’s estimate, but, although more frequent than placenta prævia, it is much less serious. A concealed accidental hemorrhage, on the other hand, is an extremely grave complication for both mother and child, for according to observations made by Dr. Goodell, the death rate is 51 per cent. among mothers and 94 per cent. among babies.[4] The symptoms are acute anemia, abdominal pain, a general state of shock, and usually an increased enlargement of the uterus. The blood may be retained between the uterine wall and the placenta or membranes, or its escape from the vagina may be prevented by the child’s presenting part fitting tightly into the outlet and acting as a plug. =Treatment.= The treatment of a frank hemorrhage depends upon its severity. If the bleeding is only moderate, labor is ordinarily allowed to proceed normally and unassisted. If the bleeding is profuse, however, the patient is usually delivered promptly. The treatment for a concealed hemorrhage consists of emptying the uterus speedily in order that the muscles may contract and stop the bleeding by closing the uterine vessels; and of treating the accompanying shock which may be almost, if not quite, as serious as the hemorrhage itself. It is very disappointing to have to realize that there is very little that a nurse may do, before the arrival of the doctor, for a patient who is having an ante-partum hemorrhage. As has been explained, it is often necessary to pack the cervix or introduce a bag, for the purpose of stopping the bleeding by pressure, and of stimulating the uterine contractions which will expel the child and empty the uterus. These measures are surgical operations and quite evidently the nurse cannot attempt to perform them. She can, however, put the patient to bed and have her lie flat, without a pillow, and, partly for the mental effect upon the patient, apply ice-bags or compresses to her abdomen. As nervousness and excitement only tend to increase the bleeding, the nurse has an excellent opportunity to try to soothe and quiet a frightened woman, and convince her that she can help herself, in this emergency, by quieting her mind and body. Pending the doctor’s arrival, the nurse should have a large receptacle of water, boiling, to sterilize the instruments and bags that he may want to use; clean towels and sheets, a nail brush, hot water, soap, and a basin of an antiseptic solution for his hands. TOXEMIAS OF PREGNANCY