HABITUAL. ABORTION. — Etiology. Habitual abortion may be due to either constitutional or local causes. Of the former the principal are syphilis, lead poisoning, tobacco poisoning, and heart disease.
The local causes are divided into four groups: Malformations of the uterus, displacements of the uterus, active con gestion of the uterus and especially of the cervix, and diseases of the cervix or body of the uterus.
Malformations. — In these cases the uterus has preserved some of the char acters of the infantile uterus, the body being disproportionately small or the cervix disproportionately large. Disten sion of the uterus by the growing ovum causes severe attacks of uterine colic and sympathetic disturbances, which com mence during the second month, and usually lead to abortion about the third or fourth month. These cases are not Common, because fecundation is rare in the malformed uterus.
Displacements.—Flexions are of more importance in this connection than either versions or prolapse. In ante- or retro- flexions there is a thickening of the uterine tissue at the angle of flexion, which interferes seriously with the prog ress of pregnancy, and leads to repeated abortion at the third or fourth month.
Congestions.—In the case of women who habitually lose freely at the monthly periods it is not uncommon to find that during pregnancy they have a periodic loss of blood, accompanied by pain, es pecially during the latter months. Iu plethoric women these hemorrhages during pregnancy are beneficial, and should not be arrested.
Diseases of the Uterus.—Endometritis, new growths of the body of the uterus. and extensive erosion of the cervix usu ally lead to abortion. (Charpentier.) Treatment. — The causes should be sought after and any existing affection removed, if possible. Syphilis especially requires prolonged and curative treat ment. In congestion of the uterus Carpentier recommends wet cupping of the loins to relieve the engorgement, and thus enable the uterus to retain the ovum. Any special irritability of the genital organs that may exist should be treated by rest in bed for some days at the menstrual period during pregnancy.
Viburnum prunifolium, to 1 drachm of the fluid extract twice daily, or asafoetida, 1 grain in pill three times daily, as soon as pregnancy is suspected, and gradually increased. are frequently recommended. Chlorate of potassium, 15 to 30 grains daily, is valuable in this connection, but is more likely to disturb the stomach.
A large number of drugs possess more or less marked powers as abortifacients and hence should be avoided during pregnancy. Quinine, cantharides, pilo carpine, strychnine, erigeron, elaterium, jalap, podophyllin, aloes, senna, scam many, and violent purgatives in general, especially those likely to cause engorge ment of the bremorrhoidal vessels, are the most pernicious agents in this par ticular that are in general use as reme dies for other conditions.
Although quinine appears to have but little oxytocic action in some, in others it excites uterine contractions, especially in delicate, nervous, and anaemic women; it should not be given in large doses un less with some narcotic that will act as sedative upon the uterus. (Coromilas.) To replace quinine, when indicated for malaria. phenoeoll, which, while efficient for malaria, has no action on the uterus: 22 grains divided in four cachets given five, four, three. and two hours before febrile paroxysm. Titone (Brit.
Med. Jour., Mar. 23, '95).
Cases of so-called habitual abortion, which so commonly depends on a dis eased state of the endometrinm, may he overcome by a two minutes' steaming at `212° P.. followed, for six or eight days, with applications of tincture of iodine.
Resnlts in ten eases: In five the fever disappeared speedily by crisis, in two lysis occurred, and in three there was no notable fever to begin with. The occur rence of lysis indicates infection of a moderate grade. In almost all eases the odor ceased at once or became so slight as to be hardly noticeable. Pincus (N. Y. Med. Jour., Mar. 20, '97).