(2) Symptoms directly threatening Miscarriage – Slight and increasing discharge of blood; cutting pains in the loins and abdomen, recurring in paroxysms, and with increasing intensity.
(3) Miscarriage – Pains, at first slight and irregular, now become severe and recur at regular intervals, with bearing-down, watery discharges, and expulsion of the foetus.
CAUSES – The predisposing causes are – feebleness of constitution; too slight an attachment of the embryo to the womb during the early part of pregnancy; profuse menstruation; too great rigidity of the walls of the womb, which opposes the due expansion of the organs; a relaxed condition of the uterus or of its neck; long-continued Leucorrhoea; excessive sexual indulgence; acute diseases, particularly those of the uterus and abdominal viscera; exposure to malignant forms of disease-Small- pox, Scarlatina, Diphtheria, etc.; want of sufficient healthy exercise; late hours, as in nursing the sick, especially if combined with anxiety; and unrelieved by daily recreation in the open air.
The most frequent exciting causes are the following; Over- reaching, as in hanging a picture; falls and blows; taking a false step in going up or down stairs; lifting heavy weights; long walks; horseback exercise, or riding in carriages over rough roads; climbing steep or difficult steps; dancing; excessive use of the sewing machine; late hours; tight garments, especially such as exert undue compression upon the abdomen; indigestible food; acute diseases and inflammatory affections of the womb or adjacent organs; purgatives, especially such as operate directly upon the uterus; violent mental emotions, as in care, anger, grief, fright, etc. Also all circumstances which immediately or remotely excite abnormal contractions of the uterus. The causes just enumerated are not usually followed by Miscarriage; indeed, muscular efforts, moderately and regularly performed, are favourable to gestation. The danger arises in women who ordinarily take but little exercise, either in or out of doors, but who under excitement or the stimulus of unusual circumstances do an amount or the stimulus of unusual circumstances do an amount or kind of work and perform feats which result in the mischief under consideration. Abortion, again, is more likely to arise from the above causes when a predisposition to it already exists, more especially at the end of the third month, or at the period corresponding to that at which it previously occurred. But the most powerful exciting cause is the recurrence of the time when, but for pregnancy, menstruation would have taken place, for at this period Abortion is a hundred times more likely to occur than at any other time. To those who have once aborted, therefore, the return of what would have been the monthly period is always a critical event.
EPITOME OF MEDICINAL TREATMENT –
1. THREATENED ABORTION – Aconite, Arnica, Hamamelis, Sabina, Secale
2. ACTUAL ABORTION – Croc., Ipecac., Sabina, Secale
3. PREVENTIVE TREATMENT. Aletris, Calcarea C., Caulophyllum, Cin., Pulsatilla, Sabina, Secale
LEADING INDICATIONS FOR THE PRINCIPLE REMEDIES.
Aconitum. In full-blooded patients with strong, quick pulse. If indicated, this remedy may be alternated with another.
Chamomilla. Extreme sensitiveness to the pains, with nervousness and irritability; threatened Miscarriage consequent on anger, fright, or other strong emotion.
Crocus. Profuse discharge of darkish clotted blood.
Hamamelis. Discharge of blood without pain.
Ipecacuanha. Flooding of bright-red blood, with nausea and tendency to faintness. Also useful in preventing Miscarriage when the patient first experiences pressure downwards, sickness, coldness, and after any discharge of blood.
Nux Vom. Constipation attended with straining.
Sabina. Abortion with a sense of heat and soreness in the womb, especially at about the third or fourth month, even if labour pains and a red discharge have set in.
Secale.- Severe, forcing, bearing-down pains like those of labour, with no discharge, or with excessive dark discharge; and when the patient has previously suffered from painful menstruation; also after Miscarriage. Dr. Dalziel informs us that when decided haemorrhage is present he uses the ordinary Tinct. Secale (of the B.P.), in ten-drop doses every three or four hours, and thus checks severe haemorrhage, pregnancy going to the full time. The medicine should not, however, be taken in this form except under the direction of a medical man.
Viburnum. This will prevent Miscarriage, if given before the membranes are injured, and when the pains are spasmodic.
ADMINISTRATIONS. In cases of threatened Miscarriage, a dose every fifteen, thirty, or sixty minutes, according to the urgency of the symptoms; as these abate, once in two to four hours.
ACCESSORY MEANS. Immediately after a patient has had the least “show,” she should lie down in a cool, well-ventilated room, on a sofa or hair mattress, and maintain that posture till all symptoms of Miscarriages have disappeared. Merely resting the legs and feet is quite insufficient. In cases, however, in which Miscarriage is only apprehended, it is not necessary to restrict the patient wholly to the recumbent posture; gentle and moderate out-of-door exercise in necessary, as entire rest weakness the constitution and augments any existing predisposition. Sexual intercourse must be avoided; also coffee, tea, and other kinds of hot drink that occasion flushings, excitement, etc.; also the circumstances tending to produce Abortion, as detailed under “Causes.”
AFTER MISCARRIAGE. When Miscarriage has actually occurred, the immediate after-treatment should be the same as pointed out under “Labour.” The patient should be kept in bed, and in every respect the same care observed as if she had gone through labour in due course. If the patient leaves her bed and goes about household duties before the womb has had sufficient rest and time to return to its unimpregnated size, displacement, subinvolution, prolapse, and subsequent abortions are likely to occur. Abortion and Miscarriage, more frequently than natural parturition, are followed by defective uterine involution; and this is because menstrual discharge is brought on too soon by the resumption of the duties and pleasures of life. The uncontracted womb is thus likely to become permanently over sensitive and congested, and this condition may merge into inflammation in weakly constituted women. (See Section on “Profuse Menstruation.”)
PREVENTIVE REMEDIES. Where a predisposition to Miscarriage exists, one of the followed remedies should be administered as soon as the person is known to be pregnant, and continued once or twice daily for two or three months: Caulophyllum, Cimicifuga, Helonias, Pulsatilla, Sabina, or Secale, according to the local symptoms present. When the general health is at fault constitutional remedies are necessary.
Calcarea. Patients of a strumous constipation.
Helonias. General anaemic symptoms.
Sepia. Previous irregular or scanty menstruation; affections of the skin, sick headaches, etc.
GENERAL PREVENTIVE MEASURES. Every attention should be directed towards maintaining as vigorous a state of constitution as possible. The diet should be good and liberal, but within the limbs indicated in the Section on “General Habits during Pregnancy.” Open-air exercise should be taken for two or three hours a day, if it can be borne without fatigue. For the bed, a hair mattress over a feather bed is the most suitable; and cold or tepid sponging should be practised every morning both in summer and winter. Sometimes a hip-bath should be conjoined with the sponging. The patient should sit in the bath, about half filled with water, for three or four minutes on rising in the morning. Whilst in the bath the water should be dashed over the stomach and back with the hand or by means of a sponge. After the bath, the body should be rubbed with a large towel or sheet until reaction is thoroughly established. When there are threatening of Miscarriage, the patient must strictly confine herself to the recumbent posture, even for weeks would it be necessary; and especially after Miscarriage has taken place must she retain that posture, as if pregnancy had gone on the full term. The uterus must have a period of rest, which is as necessary after Miscarriage as after an ordinary labour. Especial care and rest are necessary whenever the monthly period comes round. If this last precaution were fully acted upon, it would suffice to break what is termed the habit of aborting. In some cases Abortion can only be prevented by a separation of the husband and wife for some months, during which time efforts should be made to reduce the uterus to its natural size and condition. (See Section on “Subinvolution”). Together with the rest of the body here recommended, a quite and tranquil state of mind should, as far as possible, he maintained.
LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS; MEMBER OF THE ROYAL COLLEGE OF SURGEONS; LICENTIATE IN MIDWIFERY, LONDON AND EDINBURGH, ETC. PHYSICIAN TO THE READING AND BERKSHIRE HOMOEOPATHIC DISPENSARY.
Author of "The Stepping Stone to Homeopathy and Health,"
"Manual of Homoeopathic Treatment". Editor of "The Homoeopathic World."