This section is from the book "Smith's Family Physician", by William Henry Smith. See also: Natural Physician's Healing Therapies: Proven Remedies that Medical Doctors Don't Know.
By abortion is to be understood the expulsion of the contents of the gravid womb at a period of gestation so early as to render it impossible for the foetus to live. It is an accident or disease of frequent occurrence; which is always attended with disagreeable circumstances; and which, although it seldom proves immediately fatal, may still be productive of much mischief at a future period. Abortions may happen at any period of pregnancy, but they take place most frequently about the third or fourth month.
From the end of the third month to the period of quickening there is a greater susceptibility in the womb to have its action interrupted than either before or afterwards, which is the reason of more miscarriages happening at that time than at any other, and points the necessity of carefully watching and guarding against the operation of any of the causes, from the tenth to the sixteenth week, that may be likely to excite abortion.
When a woman happens to part with her burthen before the seventh month, she is said to have miscarried or aborted; but when delivered of it after this time, the term labour is usually applied.
Children born at the end of the seventh month are seldom reared; and when they are they usually prove small and weekly; but those of eight months are frequently preserved by bestowing proper care on them.
In consequence of an imperfect conception, it sometimes happens that moles or substances of a fleshy nature (which upon being cut open, contain not the smallest vestige of a child), are formed in the womb; and these at length becoming detached; give rise to a considerable degree of flooding.
As some women menstruate during the first months of pregnancy, it will be necessary to distinguish between the regular monthly flow and an approaching miscarriage. The latter generally arises from some fright, surprise or accident, and does not flow gently and regularly, but bursts out of a sudden, and again stops all at once, and is also attended with severe pains in the back and bottom of the belly; whereas the former is marked by no such occurrences.
Voluptuous women who are of a plethoric habit, as well as those who are of a weak and irritable frame, are most apt to miscarry; but accidents of this nature sometimes occur from a general defective constitution, or from a malformation of the sexual organs.
The causes which give rise to floodings during a state of pregnancy are numerous: violent exertions of strength, lifting some heavy weight, severe exercise, as dancing, skating, or much walking, the fatiguing dissipations of fashionable life, sudden surprises and frights, violent fits of passion, great uneasiness of mind, uncommon longings, over-fulness of blood, partial spasmodic action about the mouth of the womb, aloetic purges, profuse evacuations, excessive venery, former miscarriages, weakness in the parts immediately concerned, a diseased state of the womb, the death of the child, general debility of the system, external injuries, as blows and bruises, strong acrid medicines, which are-often taken for the express purpose of exciting abortion.
A pregnant woman may be attacked with a flow of blood from the womb in consequence of any cause which is capable of separating a part of the ovum from the corresponding part of the womb. In a good many instances it is caused by a part of the placenta or afterbirth being planted immediately over the mouth of the womb, which cause is the most important, because it is the most dangerous.
Abortions are sometimes caused by what is termed a retrovertion of the womb, in which the body of the womb is upset, as it were, and pressed down between the rectum and the vagina. This rarely occurs, however, beyond the first or second month of gestation, and is generally preceded by a difficulty in making water, and a consequent tumour of the bladder; a violent pain about the perinceum is thus caused, and a miscarriage is liable to follow.
Abortions are often preceded by a general sense of coldness, flaccidity of the breasts, slight pains in the loins and lower region of the belly, and sometimes with a slight febrile state of the system. After a short continuance of these symptoms, a slight discharge of blood ensues, coming away sometimes in clots, and at others gushing out in a florid stream, then stopping perhaps for a time, and again returning violently. When the contents of the womb are expelled a bloody discharge continues for a few hours, and is then succeeded by a serous fluid.
When the pregnancy is advanced beyond the third month, and abortion is likely to ensue, we have much bearing down, together with a derangement of the stomach, causing sickness and faintness, and we have likewise a most rapid discharge, owing to the increased size of the blood-vessels. In this stage the membranes often give way, and the foetus escapes with the waters, while the rest of the ovum is retained for some hours, or even days, when it is at length expelled with coagulated blood. In some instances the whole ovum comes away entire. After the expulsion the hemorrhage ceases, and is succeeded by a discharge somewhat resembling the lochia.
With regard to the symptoms and duration of abortion, there is a great diversity in different instances. In some cases the pains are very severe, and long-continued; in others short and trifling. Sometimes the hemorrhage is profuse and alarming; at other times, although circumstances may not be apparently very different, it is moderate or inconsiderable. Often the state of the stomach and bowels are scarcely productive of inconvenience, whilst in most cases they are a good deal out of order. As there is a diversity in the symptoms, so there is also a diversity in the duration of abortion; for whilst a few hours in many, and not above three days in the majority of cases, are sufficient to complete the process, we meet with other instances in which it threatened for a long time, and possibly some weeks elapse before the expulsion takes place.