THREATENED ABORTION. — Absolute nental and physical rest is imperatively The patient should be kept n bed, with her hips slightly elevated, and be given only light and cool food.
To arrest the uterine contractions of opium, 12 drops every two lours, may be given by the mouth; or of opium, 1 grain in a supposi :ory, every three hours. If the pain is morphia, , grain, and atropia, j„ grain, should be administered hypo lermically. Laudanum enemata, 25 hops to pint of water, are also ef 'ective. If an idiosyncrasy preclude the use of opium, chloral-hydrate, 10 grains, and bromide of potassium, 20 grains, very two hours, then every three hours, may be used instead.
A good method is to administer opium, one-half of the dose ender the form of laudanum enemata and the other half is subcutaneous injections of morphine (Bibemont). Constipation from the ef rect of the opium is to be avoided.
The fluid extract of viburnum Finn folium, 7, to 1 drachm every three hours sr 10 drops every half-hour, with chloral hydrate, S grains, is valuable to arrest uterine contractions when opium cannot he used on account of its constipating tendency.
The tincture of viburnum prunifolium is useful in eases where the have been ruptured and the liquor ruption of pregnancy has only been apparent.
Tubal abortion may simulate common abortion. The ovum is not invariably expelled from the ostium of the tube and discharged into the uterus. Case in which a complete decidua was dis charged. the ovum being subsequently expelled. The diagnosis was supported by the detection of a thickening of the right corna. Skntsch (Centralb.
No. 25, '97).
Spurious abortion. A class of cases in which a mimicry of early pregnancy and of abortion occurs quite different in its I characters from the condition known as ( "spurious pregnancy." They are not associated with hysteria, and the usual functional disturbances of pregnancy are not exaggerated. They differ from pseudocyesis in the existence of definite changes in the uterus, and from preg nancy, either topic or ectopie, in the essential point of the absence of an ovum, a mimic abortion: in the occur rence of a period of amenorrhoea with enlargement of the uterus and forma lion within it of a body, the detachment ( and expulsion of which is followed by a ( return to menstrual regularity and the former condition of general health. The
body expelled is not an ovum, but is formed entirely from menstrual struet ures. Three eases recorded.
A membrane having the essential characters of the decidua of pregnancy. Diagnosis impossible until after the dis charge of the cast. T. W. Eden (Lou don Lancet, Sept. 25, '97).
Tubal abortion and operation. A low ; mortality follows removal of a gravid tube in early pregnancy, when there are symptoms of internal haemorrhage. On the other hand, a good number of diffuse intraperitoneal hcemorrhages do not kill, : but end in the formation of an hm matocele. Prognosis is very uncertain, - and any case may end fatally. An ploratory incision through the vagina is advised, preparations being made, in any case, for abdominal section. The escape of blood-clot and broken-down tissue when Douglas's punch is opened con firms the diagnosis of tubal abortion. The uterus and tubes can then be ex I-4 amnii discharged, but where there are still hopes of preventing a miscarriage. It should not be given, however, when the foetus is dead, when a miscarriage has actually commenced, or when there is any reason why it is not best that birth should be delayed. Auvard (Bos ton Med. and Surg. Jour., Mar. 22, '88).
Viburnum paralyzes both the centres of voluntary motion and the reflex func tions of the spinal cord without impair ing sensation or consciousness, and it is consequently destined to become an ap proved remedy in all diseases character ized by increased excitability of the motor centres. The solid extract of the drug is recommended, in doses of from 5 to 10 grains, and the fluid extract in doses of from '/;„ drachm to ounce. R. L. Payne (Med. News, Apr. 2, '92).