ABOR'TION is the term used in medicine to denote the expulsion of the product of conception (the impregnated ovum) from the womb before the sixth month of pregnancy. If the expulsion takes place after that date, and before the proper time, it is termed a premature labor or miscarriage. In law no such distinction is made. The frequency of abortion as compared with normal pregnancy is very differently estimated by different writers; but the best evidence leads us to the belief that abortion is of far more common occurrence than is generally supposed, and that it takes place on an average in one out of every three or four cases of pregnancy. The following are amongst the causes predispos ing to this accident: (1) A diseased condition of either parent, and especially a syphilitic taint. (2) A peculiar temperament on the part of the mother. Those women who present a strongly marked nervous or sanguine temperament seem to abort with singular facility: and the same tendency is observed in those in whom the catamenial or monthly discharge is abundant or excessive. Again, very fat women, while they have a tendency to sterility, are liable to abort when pregnancy does occur. Any cause interfering with the normal oxidation of the blood—as, for instance, the constant breathing of impure air, may pro voke abortion—a fact excellently illustrated by the experiments of Brown-Sequard on pregnant animals (rabbits), when he showed that the application of a ligature to the windpipe excited uterine contractions, ending, if the experiment were continued long enough, in abortion, but ceasing if air was freely admitted into the lungs. Change of climate, as from India to England, certainly predisposes to this accident; and it has been observed by various writers that great political events, the horrors of war, and famine, exert a similar action. The marvellous events that occurred in Paris in 1848 were speedily followed by an extraordinary number of abortions and of still-born children; and a similar fact had been previously noticed by the elder Nagele and Hoffmann during the famine of 1816 and during the siege of Leyden. Nor can there be a doubt that, amongst the causes predisposing to abortion, must be include:d the employment of such corsets and other garments as by their tightness interfere with the circulation of the blood, and alter the natural position of the womb and of the abdominal viscera. Many diseases supervening during the course of pregnancy, especially the eruptive fevers (as small-pox, scarlatina, ac.), almost invariably lead to abortion of a very dangerous character; and it has been known from the time of Hippocrates that intermittent fevers have this effect. Amongst the direct causes of abortion may be placed blows on the abdomen, falls, any violent muscular efforts, too long a walk or ride on horseback (indeed, women with a tendency to abort should avoid horseback during pregnancy), a severe mental shock, etc.
Moreover, the death of the foetus from any cause is sure to occasion abortion.
The symptoms of abortion vary according to the stage of pregnancy at which it is threatened, and according to the exciting cause. Many of these resemble those of con gestion of the womb, such as a sensation of weight or painful pressure in the region of the loins or sacrum, extending to the bladder and rectum (with or without tenesmus, q.v.); these symptoms being aggravated by standing or walking, and being accompanied by chills, accelerated pulse, loss of appetite, and a general feeling of discomfort. A dis charge of serous fluid, sometimes slightly tinged with blood, is then observed. The feeling of weight is replaced by pains, leading to the expulsion of the ovum; which, during the first two months, is so small as commonly to escape detection. In more advanced stages of pregnancy, the pains are more severe, the discharge is more abundant, and con sists chiefly of blood; and after more or less time, the product of conception escapes either in whole or in part. In the former case, the patient has little further trouble; in the latter, hemorrhage will probably continue, and the parts retained may putrefy, and give rise to serious symptoms. After about the commencement of the fourth month, the symptoms gradually approximate to those presented in ordinary parturition.
In the treatment of abortion, prophylactics (or the guarding against causes likely to lead to it) hold the first place. Women liable to this affection should, on the slightest threatening, assume as much as possible the horizontal position, avoiding all bodily exer tion or mental excitement. They should use non-stimulating foods and drinks, and keep the bowels open by gentle aperients—such as manna and castor-oil, and carefully avoid aloes and other medicines irritating the lower bowel. Moreover, a separate bedroom must be insisted on by the physician. We shall only enter into the curative treatment i so far as to state that if it is deemed necessary to check Inemorrhage before professional aid can be called in, cloths soaked in cold water may be applied locally (care being taken to change them before they grow warm), and iced water containing an astringent, such as a little alum, may be given internally. Further proceedings must be left to the med ical attendant.
There are occasional cases (as where the outlet of the pelvis is very contracted) in which it is necessary to induce abortion by professional means, but it would be out of place to enter into this subject in these pages. It cannot be too generally known that all attempts at procuring criminal abortion, either by the administration of powerful drugs or the application of instruments, are accompanied with extreme danger to the pregnant woman.