Observations on Abortion: Containing an account of the manner in which it is accomplished, the causes which produced it, and the method of preventing or treating itBurns, John
Science
Observations on Abortion: Containing an account of the manner in which it is accomplished, the causes which produced it, and the method of preventing or treating it
Burns, John
Miscarriage
In obstinate cases we may, before introducing the plug, insert a little
powdered ice, when it can be procured, tied up in a rag.
Faintness operates in the same way, in many cases, by allowing coagula
to form in consequence of the blood flowing more slowly; and, when the
faintness goes off, the coagula still restrain the hemorrhage in the
same way as when the plug has been used. This naturally points out the
advantage of using the plug, together with the digitalis, as we thus
produce coagulation at the mouths of the vessels, and also diminish the
vascular action. It will likewise shew the impropriety of using
injections at this time, for, by washing out the coagula, we do more
harm than can be compensated by any astringent effect produced on the
vessels.
The principal means, then, which we employ for restraining the
hemorrhage, are bleeding, if the pulse be full and sharp; if not, we
trust to the digitalis, stuffing the vagina, the application of cold to
the external parts, keeping the heat of the body in general at a low
temperature, and enforcing a state of absolute rest, which must be
continued during the whole process, however long it may in some cases
be. The drink should be cold, and the food, if the patient desires any,
light, and taken in small portions.
Opiates have been advised, in order to abate the discharge, and are, by
many, used in every case of abortion, and in every stage. But as we
cannot finish the process without muscular contraction, and as they tend
to suspend that, I do not see that their exhibition can be defended on
rational principles.
If given in small quantity, they do no good in the present point of
view; if in larger doses, they only postpone the evil, for they cannot
check abortion, after it has begun. Nothing can do this, for it proceeds
from the cessation of the action of gestation, which we cannot restore.
But I will not argue against the use of opiates from their abuse. They
are very useful in cases of threatened abortion, more especially in
accidental separation of the membranes and consequent discharge. They do
not directly preserve the action of gestation, but they prevent the
tendency to muscular contraction, and thus do good; for we find in the
animal economy, that when two actions oppose each other, or alternately,
preventing a tendency to the one has an effect in preserving the other.
Opiates are likewise useful for allaying those sympathetic pains about
the bowels, and many of the nervous affections which precede or
accompany abortion. They are also, especially if conjoined with
digitalis, of much benefit in cases where we have considerable and
protracted discharge, with trifling pains, as the uterus is not
contracting sufficiently to expel the ovum, but merely to separate
vessels.
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