If the abortion, instead of arising from these causes, and being attended with these symptoms, proceed from passions of the mind, ors relaxed state of the os uteri, the plan to be adopted is the Use of opi um, and the quantity must be considera ble: if it be small it will do nothing; but if large, the pains in the back and uterus will be relieved, and the abortion quite put by. When a habit of miscarrying is acquired, the woman will know the peri od at which it is likely to occur, and, be fore that time come on, laudanum should be had recourse to, from ten to fifteen drops, increasing it gradually till the time of danger is passed over.
The next occurrence demanding atten tion is the hemorrhage : we see clearly that fainting is nature's method of restrain ing a flow of blood. In faintness we know the small vested* are constricted by the whiteness of the skin; we also know that cold is remarkably effectual in stopping a flow of blood from any part, but especial. ly the uterus : not only cold air, but cold water, and even ice, to the back, belly, and parts themselves; every thing should be taken cold, and congealed if possible; ice creams, juices of fruit, seeds, acc.: all the body should be cold, both externally and internally. Considerable benefit is derived from ice being introduced into the vagina, and replaced every two or three hours ; this will restrain uterine hemor rhage more frequently than any thing else ; and if it do not stop it, the constitu tion will still be secured from the effects which a more profuse hemorrhage would have incurred, and the patient be preserv ed from the excessive weakness which wouldJiave been the consequence of it. WherYthere is pain without hemorrhage, there is no necessity for being very anxious ; for in that sort of abortion the pains will gradually increase as in labour, and the ovum will be thrown off; after which the pains will gradually go off again, and abortion must take place here before the pains can subside. Rut it some-. times happens that there is great pain with the loss of blood. and though it may be that nothing good can be done to re strain the hemorrhage directly, yet assist ance may be given in emptying the ute rus; for after the ovum has separated, sometimes it will not come away ; in this case the finger of either hand may be in troduced and some part got away ; and if this should not be practicable, it is sometimes possible to get in two fingers, and by this contrivance pass them through the os uteri, and restrain the hemorrhage by compression.
Should the ovum not be capable of be ing brought away whole, the membranes should never be broken, unless when, af ter the fifth month, the child can be felt through them before tearing them, in which case it will be possible to get hold 'of part of the fcetus, and so get it through and relieve the woman from danger; for though in the earlymonths abortion is not dangerous, the danger increases every day, and when it admits of being treated like premature labour, it always should be, as that treatment ensures absolute safety to the woman; but if the mem branes be ruptured in any early abortion, or before twelve weeks, the odds are, that there will be no more pains, for the waters having escaped which formed the bulk of the ovum, nothing but the thin skin re mains behind, and these are so small, that they will not stimulate the uterus to act, and yet the vessels will continue to bleed.
Abortion is prevented, in the first place, if by observation and knowledge of the patient's life, and knowing her to have been subject to miscarriages, we may in duce her to avoid the same cause which has before produced it. It will next be te cessary to take care that this does not oc cur, even if the former cause is applied, by bleeding and opening the bowels, i where there is sudden occasion, otherwise by laxatives and occasional bleeding only. If, on the contrary, there is reason to be lieve that the woman miscarried from weakness, we may prevent a recurrence of it by strengthening her by good diet, and the use of bitters and follies. There are women who appear to miscarry regu larly from the state of the uterus being, as we have already observed, unfavourable to growth beyond a certain extent : in this state abortion is frequently prevented by immersion in the warm bath ; it lessens the disposition of the uterus to contract. If there be any reason to suspect great weakness in the uterus and uterine ves sels, the application ofcold will be of great advantage in giving the proper tone to the vessels. Many women miscarry in con sequence of the connection between the sexes : when this cause exists, the parties should be separated till the period is gone by ; for after quickening there is infinite ly less risk of its occurrence.