Black ice caused havoc on south west Scotland's roads after temperatures fell to minus 5C. Police in Dumfries and Galloway dealt with more than 30 accidents in a four-hour spell and four people were seriously injured on Sunday.
At one stage every available ambulance, nurse and doctor was brought in to deal with casualties at Dumfries Infirmary.
Meanwhile, the A1 south of Haddington was closed after an accident involving several vehicles.
The A76 Dumfries to Kilmarnock Road was also shut between Auldgirth and Closeburn after an accident.
A spokesman for Dumfries and Galloway police described the situation in its area as "pandemonium".
He added: "There were 30 to 40 people waiting to be seen by doctors at one stage and every cubicle was full."
Sister Sheena Thomson, who was in charge at Dumfries Infirmary, said: "At one stage we treated 24 patients in two hours. We are still getting people being brought in."
One breakdown driver from Dumfries said: "It has been absolute chaos but even then some drivers were just not slowing down despite the warnings."
Police in Dumfries issued a warning to motorists as the accident rate rose.
A spokesman said: "The roads are a sheet of ice. Drivers must leave extra time for journeys and only make essential journeys."