There are various methods of treatment, and much depends on the position of the abnormally placed placenta. The treatments all consist in stopping the hemorrhage for the instant, emptying the uterus, insuring permanent hemostasis, and meeting the anemia. The Braxton-Hicks version is one method. The child is quickly turned so that the head is upward in the uterus, and a leg is pulled down to plug the cervix uteri until there is enough dilatation to extract the child. Very many children are lost by this method. When the placenta praevia is marginal to the cervix or lateral in the uterus the child has a better chance when a colpeurynter, or inflatable rubber bag, is inserted in the cervix as a plug. Much skill and discrimination is required in the management of this bag until the child is delivered. The obstetrician may be obliged to sit by the bed and hold on to the bag for from three to twelve hours. Hasty extraction through a poorly dilated cervix is a very dangerous process, as a tear cannot be repaired quickly enough, as a rule, to check the hemorrhage, which will be fatal. When version has been done haste may compress the head in the tight cervix and asphyxiate the child. When the child is viable a cesarean section is by far the best method for the child, as it lowers the fetal mortality from 61 to about 5 per cent. The mother, too, has a better chance by the cesarean section, provided it is done by a competent man, early in labor before infection has set in, and in a hospital. If the child is not viable the hemorrhage must be stopped to save the woman's life. As a rule, the hemorrhages are not dangerous before the seventh month. In the 128 deaths of Müller's statistics there was not one before the seventh month of gestation. Hirst, however, says he has been obliged to empty the uterus at the fifth month for placenta praevia. The woman must be kept in bed, the foot of the bed elevated, sedatives used, and so on, as in threatened abortion, and the vagina tamponed securely with cotton. If it is evident that the fetus is dead, it must be extracted as in the case of a viable fetus. If it is probable that the fetus is alive, it is to be treated as in a case of inevitable abortion as described in the chapter on Abortion. The tamponing of the vagina to stop the hemorrhage will cause the abortion of the fetus indirectly. This is another double-effect case, and the tamponing is morally permissible provided the intention is correct. Abruptio placentae is a tearing loose of a placenta which is situated in the normal position, not abnormally as in placenta praevia. The cause may be a disease of the placenta or decidua; for example, syphilis, chronic metritis, traumatism from a blow or fall, jumping from a carriage-step, and so on. Nephritis is often found where there is abruptio placentae. In labor the placenta may be torn loose by a version, by the delivery of the first of a pair of twins, or because the cord is too short.