The progress in different cases is, however, quite dissimilar. In the beginning of pregnancy the expulsion of the ovum might closely follow the accident that caused it. For example, a woman might slip in descending a staircase and fall violently on her seat, causing immediate expulsion of the ovum, with a large quantity of fluid blood. There are some women who have acquired the habit of aborting, and the ovum passes out of the womb with scarcely any pain, little or no hemorrhage, and the woman speedily recovers. But it will very seldom happen, after the first six weeks, that there is not some interval between the accident and the consequent abortion, and that there is not considerable and protracted pain. If the cause of the abortion affects the mother instead of the ovum, she generally experiences, at the time of the accident, a sharp pain about the loins or abdomen, which may continue slightly for several days, and then be renewed, with violent uterine contractions, and some serous and then bloody discharges from the vagina. The progress of a miscarriage is not as regular as a labor at full term. In many cases there are shiverings succeeded by fever for a day or more preceding the hemorrhage. Severe indisposition may continue for several days. There may be not only considerable uterine pain, but much pain in the bladder and loins; a sense of sinking in the epigastrium, of weight near the vulva and anus, and an ineffectual desire to urinate. Such symptoms continue a longer or shorter time, and then usually the fœtus alone is expelled, the placenta being retained. The latter is generally detached after a time, or it may (if within the first three months) be discharged and pass out in a dissolved condition, with the lochia. Very alarming hemorrhage may precede and accompany abortion; this makes the case one of danger at the time, and may permanently affect the health of the woman afterwards. The flooding may continue after the expulsion of the ovum; but I have always found that in such cases there was a portion of the placenta that was detached, and that might be removed, though not perhaps without some difficulty. A good physician should always be called in cases of continued flooding. The patient ought always to preserve any and every substance discharged, that it may be showed to the physician. He should make a digital examination, and he usually finds the os uteri to be partially dilated, and a portion of the placenta hanging in the orifice. It has always been my practice to see that all was removed before leaving my patient, and I have known very dangerous hemorrhage to occur where this rule was not observed. The placenta can generally be seized by two fingers and removed; but if persevering efforts are necessary, they should not be relinquished until the safety of the mother is assured, which cannot be while the ovum, or membranes, or placenta remain in the uterus separated from their connections.