be pointed out, the rules of which, when strictly observed, shall eventually remove this tendency when it has grown into a 'habit,' and reward the female by carrying her securely and safely through to the termination of gestation when next she becomes pregnant? In the majority of cases, I reply with confidence in the affirmative; and because the success of such a plan depends for the most part upon the prudence and perseverance of the patient-for a medical man can do little to arrest a miscarriage when the process is once set up-she ought to be fully acquainted with the means of prevention, which, be it remembered, are not only to save her own health, but the very life of her offspring.

The Period at which it occurs. -This is uncertain. The usual term of pregnancy is forty weeks, or two hundred and eighty days. At any time, however, within this period, the child may be expelled; and if this take place before the commencement of the seventh month, it is usually called a miscarriage. The process of gestation may be checked from its earliest period; for many of the causes producing miscarriage which can operate afterwards, may operate through the entire term, and hence miscarriage occurs not unfrequently within three weeks after conception; it most frequently, however, takes place between the eighth and twelfth weeks.

Its Symptoms.-With regard to the nature of this process, and the mode by which it is effected, we have in this place little to do. In warning the female of its probable approach, I have only to mention certain local appearances, and other general and constitutional symptoms, which indicate its commencement.

Thus, if during pregnancy a woman experiences

an unusual depression of strength and spirits, without any apparent cause if this is accompanied with attacks of faintness, pains going and coming about the lower part of the stomach, loins, and hips-she threatens to miscarry. If these symptoms are after a time followed by the discharge of more or less blood, a partial separation of the child has already taken place. If the pains in the loins and hips increase, becoming sharper and more expulsive-bearing down— with a free discharge of clotting bright-coloured blood, the child is altogether separated. And, in fine, if the blighted and dead child is not quickly expelled, thus terminating the whole process, this event may be looked for before many days elapse; preceded, however, in such a case, by the breasts becoming flaccid, the stomach and bowels more or less disordered, and the discharge altered in appearance and offensive in character.

Here, then, the presence of the discharge, the quantity poured forth, and the subsequent alteration in its colour, are, as will be afterwards pointed out, signs of considerable importance in marking the progress of a miscarriage

The Causes.-The causes of miscarriage are numerous: they are either of an accidental or constitutional kind. The most important of these are the following:

Accident may give rise to it. The facility with which the attachment between the offspring and parent may be destroyed has already been alluded to. If, then, a sudden shock by a fall, or a blow on the stomach, occur to a woman while pregnant, she can readily perceive how miscarriage may take place as a

consequence.

Violent exercise or exertion is a very frequent cause. Immoderate exercise in dancing, riding, or even walking; lifting heavy weights; the fatiguing dissipation of fashionable life—all or any of these will sometimes produce so much disturbance of the nervous and vascular systems as seriously to affect the welldoing of the child, and frequently produce miscarriage.

Violent purgatives, emetics, &c. may produce miscarriage. It is well known that drastic purgative medicines, by their cathartic influence upon the lower bowel, now and then cause miscarriage, and that the violent action upon the stomach of powerful emetics may produce a like effect. Both, therefore, should be carefully avoided during pregnancy.

This leads me to observe that strong purgative medicines, used with a view to promote miscarriage, are necessarily taken in such quantities as generally to produce inflammation of the stomach and bowels, and, if abortion is thus intentionally and wilfully effected, not unfrequently at a sacrifice which is never calculated upon the death of the mother! It cannot be too generally known that savine, rue, iron-filings, squills, black hellebore, and preparations of the Spanish fly, all of which have acquired considerable popular repute as substances capable of producing abortion, have no such influence directly upon the uterus; that they rarely affect the uterus at all; and that when this is the result, and abortion is obtained, it is generally at the expense of the life of the mother.

Violent mental emotions are capable of disturbing the organs of the body, and so producing miscarriage. It is notorious that our physical condition is affected by the state of the mind. In the peculiarly sensitive condition of the pregnant woman, any extra

ordinary excitement or depression, especially when produced suddenly, may therefore give rise to the evil of which I am speaking.

The force of habit on the part of the womb to expel the child at a certain period of pregnancy is the most frequent cause of miscarriage. What I mean is this miscarriage having once occurred, from accident or any other cause, there is a tendency to its repetition. A woman goes on in a very promising way to a certain time, and then miscarries; and again and again this occurs. Thus ‘a habit’is induced on the part of the constitution of the individual to the production of this accident; and then also slighter causes, applied at the period when miscarriage formerly happened, will be sufficient to induce it than would be required at another time.

Delicacy of constitution, arising from habits of indulgence, tends to produce miscarriage. In high and fashionable life, among those who use little exercise, live luxuriously, and sleep in soft warm beds, there is often produced a weak condition of the vessels which convey the blood from the parent for the nourishment of the child; and the increased impetus and force given to the circulating fluid, induced by these habits, detaches one or more of these vessels, so that the supply necessary for the growth of the child is cut off—and it withers, dies, and is expelled.

In a naturally robust and vigorous constitution, a similar course of indulgence may produce a similar result, viz. miscarriage; but then it will be under somewhat different circumstances. An increased quantity of blood is made, more than is compatible with health ; it is propelled, as a consequence, with unnatural power through the vessels of the body; the vessels of the

womb participate in the irresistible vehemence of this action; and if they do not suddenly give way, a sensation of weight and tension is experienced about these parts, with shooting pains about the loins, hips, and in the neighbourhood, which symptoms, if not relieved by appropriate medical treatment, will speedily be followed by rupture of the vessels, and finally by miscarriage.

Lastly, a peculiarly excitable state of constitution; continuing to be unwell during pregnancy; marrying late in life; piles, in an inflamed state; as also severe and large loss of blood, from their rupture-these, and some other causes to which it is unnecessary to refer, may give rise to this accident.

The Means to be adopted for its Prevention.This subject divides itself into two parts; viz. the plan to be followed for preventing miscarriage by those who are subject to it, and the means of arresting miscarriage when it is actually threatened.

Sect. 1.-The Plan to be followed for preventing Miscarriage by those who are subject to it.

This plan has reference to two distinct periods: before the woman becomes again pregnant, and after she conceives. And I may illustrate the subject in two kinds of constitution, widely differing from each other, and requiring, in part, rules and directions directly opposite :—

1. The plan to be adopted by a woman of delicate and feeble health and spare habit.

Before she again becomes pregnant her object should be to invigorate her general health, especially