Next is the exercise for which the leg-flexion exercises prepare the patient, and which are discontinued when this one is adopted. It is started, as a rule, about the seventh day, or three or four days before the patient gets up. Both legs are slowly lifted to a position at right angles to the body (Fig. 134) and slowly lowered, but not far enough for the heels to touch the bed (Fig. 135), and the movement repeated. As this exercise requires a good deal of effort, it must be taken up very gradually, as follows: The legs should be raised on the first day, once in the morning and twice in the evening; second day, three times in the morning and four times in the evening; third day, five times in the morning and six times in the evening and so on, if the patient is not fatigued, until the exercise is repeated ten times each morning and evening. It is continued for several months. [Illustration: FIG. 135. ] The knee chest position (Fig. 136) is intended to counteract the tendency toward retroversion, from which so many women suffer after childbirth. It is usually started about the seventh day and the patient begins by remaining in that position for a moment or two, gradually lengthening the time to about five minutes each morning and evening for about two months. [Illustration: FIG. 136.—Knee chest position. ] [Illustration: FIG. 137.—Walking on all fours. (From a photograph taken at the Long Island College Hospital.) ] Walking on all fours is violent exercise and has to be taken up very gradually. Some patients are able to attempt it on the first day out of bed, if they have been taking the other exercises, but as a rule it is not started until the second or third day. The patient’s clothes should be free from all constrictions; the knees should be held stiff and straight with the feet widely separated, to allow a rush of air into the vagina, and the entire palmar surface of the hands should rest flat on the floor. (Fig. 137.) The patient should start by taking only a few steps each morning and evening, gradually lengthening the walk to five minutes twice daily and continuing it for about two months. It is believed that as the patient walks in this position the uterus and rectum rub against each other producing something the same result as would be obtained by massage. The effect of the exercise is to promote involution and diminish the tendency toward constipation and retroversion, apparently preventing malposition entirely in a large percentage of cases. Though not widely used, its beneficial effects are unquestioned by those doctors who employ it.