The above words, to the medical mind, signify different things. The first means the casting off of the foetus before the life has quickened it. The second implies the same event subsequent to that period, or to the fifth month.
No child, however, born previous to the seventh month, has any chance of being reared; and to the majority brought into the world even thus far matured, existence is very problematical.
Abortion, however, will in this Essay serve, as it does in general language, to convey a notion of immature or premature delivery. Any one not in the profession can hardly conceive how frequently such circumstances occur in private families. The health of many ladies is positively ruined by these events; they become debilitated, feverish, hectic, dropsical; and, in short, they are the habitats of almost every disease to which the female frame is liable.
Not a few of these evils are induced by the unjustifiable interference of medical men. These gentlemen are frequently far too officious their remedies far too powerful; and their manipulations often unwarranted and uncalled for.
The lady subjected to them naturally aborts. The wonder would be, could she do otherwise; and, by the act, a disposition is promoted which renders very doubtful the full period of gestation being subsequently undergone. It is well known, and proved, that a habit of abortion is easily engendered. Nay, so readily do some women imbibe this propensity, that there are now many ladies alive who periodically relieve the uterus, and are even hardly conscious when that event occurs.
For the above reason, ladies are entreated to hold themselves sacred from all those meddlings, which, indeed, present weakness, and ultimately destroy the constitution.
It is the natural function of a healthy woman to bear children.
This ordination may entail upon her certain pangs; but the Being who made her, framed her equal to undergo these sufferings, and ordained that the agonies of maternity should not otherwise than benefit the constitution. In proof of this, how many smiling, happy, and blooming mothers do we not encounter; and who expects an old maid to be otherwise than debilitated and disappointed.
The premonitory symptoms of abortion are those of general derangement of the system. A certain lassitude or weakness steals over the entire frame. The lady feels desirous of retiring to bed before she is well aware of the cause, being thoroughly wearied previous to any conscious exertion; there occurs a pain in the back; the breasts become flaccid; and a general uneasiness rapidly increases.
After a little time pains occur, and a liquid drains from the body; this liquid may be perfectly colourless, or may be more or less soiled; but with its appearance the pains generally augment; the loins, abdomen, and thighs are involved; the agonies recur at certain periods, and each time with augmented strength. The stomach frequently rejects its contents; the pulse is accelerated; the skin is feverish; the patient cannot forbear from certain voluntary efforts, and the climax is soon attained.
The pain attending upon the above symptoms may, or may not, be fully equal to those attending actual labour.
There is no rule in cases of this kind; but during the first three months the lady usually suffers least; though I have attended cases in which the reverse has been exhibited.
The cause of abortion are varied and numerous. A few only of the most prominent will here be mentioned. They are, severe coughs, a blow or sudden compression of the uterine region, violent vomiting, sea-sickness, sudden fright, the extraction of the tooth, the repeated use of irritating medicines and drastic purgatives, repeated bleedings, strong mental emotions, or unusual bodily efforts. For these latter causes ladies should be careful how they exert themselves during the period of gestation. I do not mean that they should avoid everything like healthful exercise, but that they are not to encounter any of those domestic broils in which some females are too apt to engage.
I would likewise advise ladies to avoid excitement; and, for the above reasons, I would recommend those who may be about them at this time to shun every topic of irritation. While obeying this injunction, it does not follow that I am recommending a patient should be pampered in her fancies, or humoured in her whims. But I simply mean, that the feelings and passions of a lady in this critical situation, deserve, and should receive, a certain degree of respect.
Any sudden fright will frequently induce premature labour. Often, causes which in themselves would appear harmless, at this time have an injurious influence. A great deal necessarily depends upon the susceptibility of the patient; but as the extent of this can only be learned through symptoms by which it is declared, a certain degree of caution and forbearance is requisite in all those moving around a lady at this particular period.
It is customary with some medical men to endeavour to arrest a miscarriage. Attempts of this kind usually add much to sufferings of the patient, weaken the constitution, and endanger the life of the lady. Too many cases are known of the abnormal retention of the foetus to render such a course either safe or expedient.
Delivery, when once announced, should be expedited by every means in the physician’s power; and if this is done, none of those distressing measures will be necessary which students are taught to employ by books which treat of midwifery.
However, subsequent to abortion, copious and even dangerous flooding may ensue. This is not invariably the case. The haemorrhage may be so slight as to hardly deserve notice; and in other, but exceptional cases, may be so great as to endanger existence.
It is customary for medical men of the Allopathic ranks to bleed from the arm, as though the patient had not been sufficiently drained by emission from another source. It is also the custom with practitioners of this doctrine, to order that the patient be kept perfectly quiet. I certainly would advise all excitement, and anything calculated to distress the mind, should be withheld after so serious a juncture; but as to that kind of quiet which approaches to a deathly silence, and depresses the individual who is forced to endure it, I assuredly must object. The patient herself, under most circumstances, will be the best able to judge who should be admitted to her presence; of course, everybody about the sickbed fully understanding that nothing ought to be permitted which possibly might tax the patience or fatigue the mind.
I know ladies, after a misfortune of this kind, are often so much debilitated as to require absolute rest. In this case the feelings should be respected, but when a desire is expressed for quiet society, such a wish should not be ruthlessly opposed. The medical man is, in these circumstances, the best judge. There are times when the slightest exertion may be followed by symptoms which shall endanger the life: only when this peril has passed, too absolute a seclusion should not be enforced. When haemorrhage occurs, it is common to endeavour to arrest it by means of a plug formed of different materials. Now, to confine a discharge is not necessarily to stop it; therefore I object to this mode of practice; especially as the warm fluid filling the vacant cavity is likely to promote further depletion.
Cold applications have a decided effect over white fibre, of which the muscular coat of the uterus is composed. Could we induce the viscus to contract with the lessened dimensions, the sinuses would be obliterated, and the possibility of further flooding be rendered impracticable.
The Gullet has, in its composition, a certain amount of white fibre; and everybody is aware of the opposition which renders it impossible to take a long draught of very cold water.
I may here allude to another and more convincing instance. The muscular coat of the bladder is likewise composed of white fibre. Every person is aware how much fluid can be imbibed while seated in a warm room; but no sooner have they left the apartment, and entered the cold air, than a desire for relief is experienced; which last effect is occasioned by the lower temperature producing contraction of the muscular coat of that viscus.
Cold therefore should, in every form, be restored to; as drinks, injections, baths, etc.; and it is the more to be recommended because it exists in every house, and requires little skill in its application.
Certain gentlemen of the old school like warm applications, and recommend their unscrupulous use; but I have yet to learn upon what rational or physiological grounds such a practice is established.
It is the popular belief that abortion is attended with much more danger than natural labour.
In the early months, I am sure, such is not the case; though in the after periods the peril may be almost balanced. After every process of labour, however, a certain period of rest is advisable. The patient should recline on a mattress; never on a feather bed. The chamber should be large, cheerful, airy, and well ventilated. The bedclothes light; all anxiety and depression of spirits should be encountered by a calm and gentle persuasion of a successful termination.