If the patient is exsanguinated, the foot of the bed is raised, coffee given by mouth, camphorated oil hypodermically, and normal saline transfused under the breasts. Pituitrin may be continued in larger doses. 1 c.c. will raise the blood pressure very definitely. Adrenalin also may be employed for this purpose. The following summary may be found convenient: =Post Partum Hæmorrhage= _Etiology, Functional.—_ Atony of the uterus, especially after rapid artificial or natural emptying of the organ. More common after uterus has previously been greatly distended. Premature version and extraction. Hydramnios and twins. Imperfect development of uterine musculature. Precipitate labors. Haste or improper management of third stage. _Etiology, Mechanical.—_ Retention of placenta—partial, total or solitary cotyledons. Inversion of the uterus. Placenta succenturiata. Inflammation of decidua serotina. Conduct of third stage, i.e., wait until placenta separates. _Etiology, Systemic, Hæmophilia.—_ _Kind of hæmorrhage._ Hæmorrhage _before_ expulsion of placenta due to laceration of the soft parts, or Partial release of placenta and failure of uterus to contract, or Placenta may be attached to periphery or to one side. Attempts to expel placenta without waiting for uterine contraction are sometimes productive of hæmorrhage. Hæmorrhage _after_ expulsion of placenta. Hæmorrhage in interval between pains—comes from placental site. Hæmorrhage in stream not checked by uterine contraction is due to laceration of the canal. Hæmorrhage in abnormal quantities at beginning of pains. Pure atony—comes early. Hæmophilia again. _Diagnosis.—_ Palpation of uterus through abdomen. Placental site excluded from contraction (paralysis). View of vulva. Injuries. Flow continuous, fluid and bright red, shows arterial origin, probably from cervix. Examine. Atony—bleeding at intervals, clotted and dark. Hæmorrhage from a tear begins at once. Uterus contracted and hæmorrhage continues. Look for tear. If hæmorrhage does not begin within ten or fifteen minutes after labor it is not from a tear. Always have hæmophilia in mind. _Management.—_ Third stage must be conducted properly. Before expulsion of placenta—early expression. Credé or manual removal—then secure contraction by massage. Pituitrin, Ergot, or both. _After Third Stage.—_ Restore an inverted uterus. Repair lacerations. See that cavity is clear and clean. Massage, intrauterine hot water douche, hand in uterus and hand outside and rub, ergot.