with castor-oil, or Pullna water; and if this is effected, no other medicine will be necessary. Let the quantity of food be diminished, taking sparingly of meat, selecting that kind only, and but once a day, to which reference was made before; dining from vegetables rather than from animal food; taking no wine or stimulant of any kind; no fermented liquor, the beverage with dinner being water only. Fashionable hours and habits must be given up; for they tend to keep up that excited state of the whole system which it ought to be the grand object to allay. Sleep in a large and airy room, with little clothes about the person, to prevent the accumulation of too much heat. Rise early. Use the salt-water shower or sponge-bath every morning, the quantity of the water being considerable, and from the first, cold; observe the precautions before alluded to, in reference to rapidly drying the body. Take considerable, but regular, exercise between breakfast and dinner-horse exercise, if it can be accomplished, is best-but never to fatigue. Change of air is not absolutely necessary; but in spring and the early part of the summer great benefit will arise from pursuing this plan. In midsummer and autumn the seaside is most desirable; as bathing, instead of the shower-bath, may be employed in this case, with great advantage.

After pregnancy has taken place, the same precautions and hygienic measures must be continued, and as the period approaches when miscarriage formerly occurred care and attention must be more than ever exercised. The directions already given in the previous case must be rigidly followed out, especially in reference to any physical exertion. If slight pain in the back is experienced, it must not create alarm, but

it will be right at once to seek medical advice. If, however, the individual has acted up to the rules laid down for her guidance, both for before and after conception, miscarriage need not be feared; in all human probability the patient will go her full time, and thus be amply rewarded for all her continued care and little privations.

Sect. 2. The Means which are to be employed to put a stop to Miscarriage when it is threatened.

Now and then, particularly when it occurs for the first time, the whole process of a miscarriage does not occupy more than six or seven hours from the very earliest symptom of its approach to its final completion. But in by far the majority of cases, more especially when it has become 'habitual,' its progress is not terminated in as many days, or even weeks. When this is the case, it may evidently be divided into Three Stages. This arrangement will tend to set this important portion of my subject in a clearer light before the reader, and at the same time assist me considerably while pointing out, though with necessary brevity, those directions which are to be followed in the different stages of this accident.

The First Stage. I shall speak of that as the 'First Stage' in which the child has as yet sustained no injury, and the symptoms are only those menacing miscarriage.

It commences usually by the woman experiencing a great depression of strength and spirits, without any assignable cause. She loses her appetite, and has a little fever. Pains about her loins and hips soon follow; these are at first transitory-they go and

come, and, after a while, increase in frequency. Or if the patient be of a strong and vigorous constitution, there will be an excited condition of the circulation, manifested by a full pulse, throbbing in the temples, followed by a smart headache, a hot skin, thirst, and no inclination for food, and united with pains in the loins, and a sense of weight and tension. These are so many symptoms threatening miscarriage, but of course much modified by the constitution and previous state of health of the individual. For instance, some will experience only an indistinct dull aching pain in the loins, with slight languor, continuing for many days without any other symptom; but if these feelings come on about the same period from conception at which miscarriage formerly occurred, it behoves the patient at once to attend to them, for, if she does not, she may depend upon it the same event will befall her, however apparently trifling and unimportant the symptoms may be considered.

If, then, any of the foregoing symptoms present themselves, the medical attendant ought immediately to be sent for. This is the time at which he can interfere with the most certain prospect of success; everything depends upon getting advice at a sufficiently early period. And the patient must feel the imperative necessity of a strict and unvarying attention to the rnles and regulations which are enjoined.

It has already been intimated that, at the first approach of these symptoms, the female must at once retire to her bed. She must strictly confine herself to it, resting on a mattress, with few clothes upon her, no curtains about her bed. The diet must be most sparing a little toast-and-water, lemonade, or thin gruel, tapioca, or sago; and whatever is taken must

be given cool. Some gentle aperient may be taken, if the bowels are costive. By this time, in all probability, the medical man will be at the bedside.

The Second Stage.-But suppose the patient has not heeded these symptoms; that she has thought nothing of a little pain in the back, &c., and, never having before miscarried, she has looked upon them as of no consequence; the local pains will increase in frequency and power, and soon a discharge of blood, in clots, will be discovered, or, if the loss of blood be greater, it will be of a bright colour. This indicates that a partial separation of the child has taken place, and brings us to what I call the 'Second Stage.'

Now, although it must be apparent that, under these circumstances, the probability that the process of miscarriage will go on is much greater than in the former stage, still I have no hesitation in saying that even here it is frequently possible to check it. But in a situation so critical, it will require a prompt and vigorous practice on the part of the medical man, and an equally decided and vigilant conduct on the part of the patient herself; and let her recollect, when tempted to disobey the instructions she receives, because they may appear trifling or a little too rigorous, that no man who deserves her confidence would willingly lay down one rule too strict, or one injunction, the performance of which was unimportant; and remember also, that by one act of disobedience she may blast every hope of success, and thus throw away, at a single moment, the result of hours, nay of days and weeks, of careful and persevering deprivation. The only directions advisable for adoption before the medical man arrives are strict rest in bed.

A woman never ought, if the premonitory symptoms

have been present, to advance to this stage of the accident; but it may be brought about very quickly by the shock from a fall, or any great exertion, when the first and second stages will frequently merge into one— separation of some portion of the child having taken place from the first. Under these circumstances, let the above directions be followed, until further advice can be obtained.

The Third Stage. If the previous means for stopping the progress of the threatened miscarriage are unsuccessful, if the discharge continues, the pains increase, become slightly bearing down, and the other signs follow which have before been pointed out, the 'Third Stage' is far advanced, and of course every expectation of success on the part of the patient or her attendant must have fled; and it only remains for the latter to conduct her safely through to the end, and afterwards adopt means for restoring her health and strength.

One remark, however, it is important to make here. Whenever miscarriage occurs as late as the third month, or at any time after this period, the strictest observance of the recumbent posture is as necessary after this accident has taken place as it is after delivery at the full period, particularly if there has been much discharge prior to the expulsion of the ovum. This direction will gain weight by my observing that very lately I was called to a case where discharge was a second time induced, and life nearly lost, owing to the neglect of this caution, the lady getting out of bed an hour or two after a miscarriage of between three and four months. And it may be useful also to add, that patients, after a miscarriage, generally go about too early. The womb at this time