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Abdominal

pains, severe, hot, uterus and abortion

ABDOMINAL PAINS.—Pains which originate in the stomach, intestine, peritoneum, in the liver, spleen, uterus, or in the kidneys and in the genital organs situated in the. abdominal cavity. They may occur either tempo rarily, in attacks (see COLIC), or they may exist more or less permanently. They are caused by quite varying affections of the above-named organs : Inflammations, suppurations, adhesions, ulcers, tumours, etc. The pains are sometimes restricted to only one, or several places, at other times they extend over the entire abdomen. The direction in which the pains may radiate is of importance in recognising the causative disease, or in determining its significance. The intensity of abdominal pains, even in one and the same disease and in the same patient, is subject to great variations. At times such pains are very slight, while at other times, as a result of impacted gall-stones or kidney-stones, they may be so severe as to cause even robust men to faint. The pains are brought about by marked irritation of the nerves of the affected organs.

The best remedy for abdominal pains of any kind is hot compresses (moist or dry) which must be renewed as soon as they become lukewarm. Most suitable are linseed poultices and hot plates, or hot-water bags. A hot-water enema may relieve many a severe attack of colic, particularly if there has been persistent constipation. The physician is also able to com bat very intense pains effectually by medicines which are given internally or injected under the skin. Every patient with severe abdominal pains who is not relieved easily by hot applications or hot enemas needs professional advice.

ABORTION.—The expulsion from the uterus of the ketus before it is viable. Abortion may be brought about accidentally or wilfully. The wilful

act, no matter at what time of pregnancy it is perpetrated, is severely pun ished by the laws of most civilised countries. In the German statutes, for instance, a pregnant woman who purpOsely induces abortion or kills the foetus in the uterus is liable to imprisonment for a period not exceeding five years. The same punishment applies to those who provide her with the means of doing this, or in any way assist her in the act. Similar laws are on the statute books of Great Britain, where the causing of an abortion is a very serious offence which may amount to murder. The means referred to include certain internal medicaments and instrumental procedures—intra-uterine injections intended to rupture the membranes or separate the embryo from its attachments. Mechanical means are cer tain to bring on labour pains and the expulsion of the ovum ; but the action of the popular, internal remedies is very uncertain and often harmful. Their use may lead to severe and sometimes fatal poisoning or to perma nent injury to health. The mechanical methods without proper precau tions in regard to absolute antisepsis may cause general blood-poisoning and, if the instruments are unskilfully used, a rupture of the uterus. Both of these may lead to a fatal issue.

Severe illness of various kinds in pregnancy may require the induc tion of abortion in order that the woman's life be saved. The physician should, however, exercise this right only after due consultation with a colleague. Many abortions, called also miscarriages, are due to accidental causes.