During the third and fourth months there may be (1) an abortion of the whole ovum; or (2) the membranes may rupture, the fetus be expelled, and the secundines remain in the uterus, and these may have to be removed by instrument or finger; or (3) the decidua reflexa and the chorion may split and let out the fetus into the amniotic sac: here again the remaining secundines, if they do not come away spontaneously, must be removed. Abortion after the fifth month is like a regular labor at term, but not so energetic. An abortion may be threatened, inevitable, or incomplete. In each of these conditions there is uterine pain and hemorrhage. In inevitable and incomplete abortions we find softening and dilatation of the cervix, and a presentation or expulsion of part or all of the ovum. In pregnancy uterine hemorrhage and uterine pain are symptoms of a threatened abortion, but not certain symptoms. Fromme found that 17.9 per cent. of 157 women who had these signs in the early months went on to term. If the fact of pregnancy is not known it is not always easy to differentiate a threatened abortion from other uterine conditions, like chronic metritis, ectopic gestation, a fibroid or other tumor, hemorrhage from cervical erosions or varices, or malposition of the uterus. If the abortion is inevitable the diagnosis is made more readily. The cervix is then more or less dilated and the ovum is palpable. There is rather profuse hemorrhage, flooding, and painful uterine contractions are evident. The rupture of the bag of waters may be simulated by the escape of secretions in hydrorrhoea gravidarum, or the escape of waters may be a primary symptom of graviditas exochorialis. Hydrorrhoea gravidarum is an intermittent discharge of clear or bloody fluid from a catarrhal endometritis under the decidua. It occurs in anemic, weak women, especially multiparae. In graviditas exochorialis the fetus is left within the womb but outside the ruptured chorion, and it may remain there for some time. When an abortion is incomplete it is absolutely necessary to learn whether the entire ovum and decidual tissue have been expelled or not. When a part or all of the dead ovum is retained the consequences are so grave that they may result in the death of the woman or cause chronic invalidism. Sepsis may result, a placental polyp may form, and even syncytioma malignum may start--this fatal tumor, however, is not so common after incomplete abortion as after hydatid mole formation. The prognosis as regards health is worse after abortion than after normal pregnancy. The involution of the uterus is slower than in full-term cases, and if infection has occurred there is great likelihood of a chronic endometritis and metritis. The woman may be rendered sterile, or she may become a chronic invalid to be cured only by capital operations.