ABORTION. 243 



626. Prognosis. A miscarriage is generally more dangerous 

 than a labor at term, and those authors have erred who find fault 

 with Hippocrates for having uttered this opinion; the former is a 

 disease, while the latter is only the termination of a natural function. 

 But to speak correctly, abortion is sometimes not such a serious 

 matter in itself considered, but because the causes which induce it 

 and the accidents which accompany it generally constitute important 

 diseases; because the pregnancy, which is terminated by it, has re- 

 called to the genital organs the germ of affections whose existence 

 was not suspected, or which perhaps would have never reappeared 

 but for it. The prognosis ought therefore to vary according to cir- 

 cumstances. If it appears to draw in its train a variety of nervous 

 affections, pains in the hypogastrium, chronic inflammation of the 

 womb, ulcers, degenerations, and all sorts of organic lesions, it 

 frequently is so because these alterations existed previously to the 

 miscarriage itself; excepting always those cases of abortion produced 

 by the direct agency of mechanical causes. 



627. The least dangerous abortion is that which is determined by 

 a disease of the ovum, and the most serious is that which a violent 

 occasional cause, unaided by any predisposing one, has given birth 

 to; moreover, all other things being equal, a spontaneous abortion 

 is less to be dreaded than a forced one, and in general, so much the 

 less, in proportion as it is effected with gentleness; the danger, which 

 for the woman is greater in proportion, to the degree of advance- 

 ment of the pregnancy, is, for the foetus, the same at all stages of the 

 gestation. 



Where the cervix is naturally soft and relaxed, while the rest of 

 the womb retains its ordinary density, the miscarriage is both easier 

 and less serious to the woman than in the contrary circumstances; 

 when produced by a very decided molimen, if there are no compli- 

 cations, it may terminate as favorably as the most simple case of 

 parturition; but as this hemorrhagic effort is, most frequently, merely 

 the first degree or the symptom of a more or less extensive inflam- 

 mation, there is reason to fear, especially if fever attends it, either a 

 metritis, an acute peritonitis, or some other phlegmasia equally 

 dangerous. Some authors have contended that abortion may liave 

 its advantages, as for example, to render menstruation regular, 

 or restore fecundity; but it is evident from her miscarrying, that 

 the woman was not sterile; and besides, if the menses sometimes 

 resume llieir original type after an abortion, tliey would have done so 

 with more certainty after a complete pregnancy. 



6J8. I can conceive of only one case in which abortion could be 

 of advantage by being frequently repeated, and that is where the 



