Nausea accompanied or not by vomiting may appear at the very time of conception, but it usually appears about the fourth or fifth week of pregnancy and continues until the sixteenth week or longer.  In some cases it may last but a short time, in others it may continue until confinement.  It may be light or severe; It generally manifests itself upon arising in the morning and subsides in a short time, but it may occur at any time of the day and continue during the entire waking hours.  It may be absent entirely and, in rare instances, manifest itself in the husband alone.  I have known of one such case.  This nausea may be excited only by various odors or sights or may be caused by constipation.  An increased secretion from the salivary glands usually accompanies the stomach disturbances and in some cases it may amount to salivation.  An irresistible desire for certain articles of food or drink, generally of a sour or acid nature, is often developed.  Indigestion, gas in the bowels and belching of gas are frequently present.  The appetite is often capricious or it may be entirely lost (anorexia).

Breasts.—­Changes in the breasts also constitute a sign of pregnancy.  As an early symptom, there may be a feeling of fullness, sometimes pain.  They become larger and firmer from the development of the individual lobules, which have an irregular knotty feel.  A fat deposit takes place between the lobules and in the other parts of the breast.  The nipples increase in size, are harder to the touch, become more prominent.  A few drops of a turbid fluid, colostrum, may be pressed from the nipple as early as the third month.  The veins under the skin become larger and more conspicuous.  The rose-colored circles (rings) around the nipples are broadened and are slightly elevated above the surrounding skin and there is a marked increase in their pigmentation, the color varying with the complexion of the individual from reddish pink to brown and black.  These changes usually occur at the beginning of the third month, and if the woman has already had a child the question of pregnancy has been decided by inspection of these breast changes.

Bladder.—­This is sometimes irritable in the later months, causing a frequent desire to pass urine.  It sometimes occurs in the second or third week and is sometimes followed, later, by an inability to retain the urine which escapes at any time.  This, however, is not frequent.

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Abdominal changes.—­There is a slight flattening of the lower abdomen at the second month, due to the sinking of the womb.  There is also a slight retraction (drawing back) of the navel.  After the third month, when the womb begins to ascend out of the pelvis, a progressive enlargement of the abdomen begins and continues until near the end of pregnancy, when the womb again sinks and the so-called lightening occurs.  The protrusion of the abdomen is more marked usually on the right side.  There is often an increased deposit of fat in the lower portion of the abdomen, as well as on the hips and thighs.  The navel may protrude after the sixth month,