IF THE FLOODING IS PROFUSE

and uncontrolled by the means before mentioned, one grain and a half of sugar of lead may be given every two or three hours, and washed down with a drink of vinegar and water, to which, if there is much pain, add from five to ten drops of laudanum.

Pieces of linen or cotton cloth should be soaked in a strong solution of alum, or a decoction of oak bark; and then well oiled; with this cloth plug the passage or birthplace; or, some of this astringent wash may be thrown up with a syringe.

But, during the time and after miscarriage, the general strength must be supported by a strengthening diet, such as soups, meat, etc., avoiding stimulants as much as possible. Nevertheless, in some cases wine or malt liquors may be necessary in convalescence, or when recovering, and if so may be assisted by tonic or strengthening medicines, such as contain mineral acid. Bark or iron are generally given as the most appropriate remedies. The bowels will, in some cases, require strict attention, as indeed they do throughout, and for this purpose castor oil is a good medicine, or clysters of cold or tepid water are most useful. A teaspoonful of Epsom salts dissolved in half a pint of water, either cold or slightly warmed, to which add fifteen drops of elixir vitriol, forms a most excellent and mild purgative, which should be taken before breakfast.


 In all cases where the constitution of the woman has a tendency to miscarriage or abortion, a quiet state of mind should be observed, avoiding all violent exertions, particularly lifting heavy weights. These principles of treatment are to be kept in mind in the management of miscarriage:
The first, to prevent it, if possible, by rest, opiates, etc.
The second, to allay pain, moderate the discharge of blood, and to save and support the strength of the patient.

The third, when abortion must take place, to expedite the separation of the ovum and free the contents of the womb. This is generally done by simply occasionally drinking cold water, and in difficult cases, if necessary, by the administration of spurred rye. The dose is a strong infusion or tea given every twenty or thirty minutes until the desired effect is produced, as long as the stomach will bear it.
The health of pregnant females should at all times be an object of great care and interest; and they should be impressed with the conviction that while

BEARING THE FIRST CHILD

they may, by proper care and attention, lay the foundation for their future health and that of their offspring; while by neglect and imprudence in this matter, they may not only enfeeble their constitution, but entail upon their children an inheritance of infirmity and disease.

Miscarriage, or abortion, which includes all cases in which delivery takes place before the sixth month, seldom occurs without being preceded, or accompanied, or followed, by a morbid discharge of blood from the womb, which is commonly known by the name of flooding. Abortion, or miscarriage, takes place with the first pregnancy, and during the first two months; therefore, great care should be observed during this period, as any cause which either destroys the life of the child in the womb or brings on morbid or premature contractions in that organ may induce miscarriage. Coughing severely, or vomiting, a blow or fall, or a misstep leading to an effort to prevent falling, may, and does frequently, result in miscarriage; and this having once occurred, it is, without proper care, exceedingly liable to be the case again at the same period of a subsequent pregnancy.

 The same result may follow any vivid moral impression; for fright, or mental excitement by passion, or witnessing any accident, will be found often to end in miscarriage. In some healthy females, however, it occurs without any other cause than mere fullness of blood. A bleeding from the womb is often in such cases a first symptom of abortion, and should be attended to as early as possible before it goes to any considerable extent. The amount of flooding, in most cases, is in proportion to the early period of pregnancy at which it takes place, for in the latter months there is seldom much blood lost. But there are cases in which pregnant women will lose blood repeatedly from the womb and yet not miscarry, but these are very rare cases.
In most cases, the occurrence of a woman's flooding between the first and fourth months, unless very slight, or quickly relieved, is usually followed by a miscarriage; but as soon as the child and its membranes are both expelled by the contraction of the womb the flooding soon ceases.

 In many such cases it is often very difficult, and sometimes impossible, to deliver the afterbirth and membranes, which remain and finally pass off after putrefaction has taken place, resulting in long and offensive discharges from the womb, and which, unless treated by the most skillful management, frequently result in many internal mischiefs of a serious character, such as ulcers, cancers, etc.

In all cases, those who are constitutionally disposed to abortion, or have a tendency to miscarriage, should take great care to preserve a quiet state of mind and to avoid all violent exertion; and all active purgatives should be avoided, and exposure to great heat or cold, during the time of gestation or pregnancy.
When the miscarriage has really taken place, and the fœtus, or child, is expelled, together with the contents of the womb, the same precautions should in general be observed as in childbirth.