TREATMENT OF DISEASES. 259 



In the first stage the woman merely " threatens to miscarry ; " there is pain in 

 the lower part of the belly, or about the back and loins, with unusual lepres- 

 siou of spirits and faintness without any apparent cause. If these syn \ptoms 

 do not pass off, they are succeeded by a discharge of blood from the external 

 parts, sometimes light, at other times profuse and alarming; accompanied or 

 succeeded by sharp pains in the back, the loins, and the lower part of the 

 belly, not constant, but intermitting, like those of regular labor. Often there 

 is vomiting, sickness, or pains of the bowels, and headache; and from the 

 quantity of blood lost, fainting fits frequently occur, and there is commonly 

 a sense of weakness, much greater than can be accounted for by the copious- 

 ness of the discharge. This is the second stage; and in it the child has become 

 partially separated from the womb. If by the efforts of nature or the assist- 

 ance of art these symptoms abate or cease, the embryo may be retained, and 

 many continue to grow . But in other cases the discharge of blood continues 

 and the signs of approaching expulsion of the contents of the womb become 

 more evident. Regular pains ensue, there is a feeling of bearing down, \vith 

 a desire to make water; and at last the foetus comes away, either surrounded with 

 its membranes, if the whole ovum be small, or the membranes break, the 

 waters are discharged, and the foetus comes away, leaving the after-birth 

 behind. This constitutes the third stage, in which the child is altogether separ- 

 ated and must be expelled. 



Causes. — 1. Abortion may be caused by external violence, 99, kicks or 

 blows, a fall, or violent action, as dancing, riding, jumping, or much walking. 

 Women in the state of pregnancy should avoid many of the domestic opera- 

 tions so proper at other times for good housewives to engage in. As our aln> 

 is to be practically useful, we venture at the risk of exciting a smile, to men- 

 tion some exertions that ought to be avoided, viz., hanging up curtains, bea- 

 making, washing, pushing in a drawer with the foot, careless walking up or 

 down a stair. 2. Straining of the body, as from coughing. 3. Costiveness. 

 4. Irritation of the neighboring parts, as from severe purging, falling down of 

 the gut, or piles. 5. Any sudden or strong emotion of the mind, as fear, joy, 

 surprise. 6. The pulling of a tooth has been known to produce a miscarriage; 

 and though toothache is occasionally very troublesome to women in the preg- 

 nant state, the operation of drawing teeth should, if possible, be avoided at 

 that time. 7. Women marrying when rather advanced in life are apt to mis- 

 carry. It would be hazardous to name any particular age at which it is too 

 late to marry, but the general observation is worth attending t-o. 8. Constitu- 

 tional debility from large evacuations, as bleeding or purging: or from disease, 

 as dropsy, fever, emall-pox 9. A state the very opposite of this is sometimes 

 the cause of abortion, viz., a robust and vigorous habit, with great fullness of 

 blood and activity of the vascular system. 10. The death of tlie child. 



Treatment. — Miscarriage is always an undesirable occurrence, and is to 

 be prevented by aU proper means, as a single miscarriage ma5 irretrievably 

 injure the constitution, or give rise to continual repetitions of the accident. 



