Where a tampon must be put in, it is left in from sixteen to twenty-four hours, even if the temperature goes up. During this time there are painful contractions of the uterus, as a rule, and these are expulsive. No drug is to be given to allay these pains if the intention is to have a dead or viable fetus expelled. If the pains cease suddenly, this is usually a sign that the fetus has been expelled above the tampon. When the tampon is removed and the entire ovum is found, it is best for the ordinary physician not to meddle with the uterus in any manner. Some advise that the physician should go over the uterine lining with a half-sharp curette to make certain that nothing has been left behind, but this is dangerous advice to any one who is not an expert obstetrician. Should the temperature remain above 100 degrees, the uterus must be cleaned out, and flushing with uterine catheters is not enough: if the gloved finger cannot remove the secundines, the curette is needed. If, when the tampon has been removed, no ovum is found and the cervix is still closed, another tampon is to be put in for another twenty-four hours, supposing the removal of the ovum is licit. Forcible dilatation of the cervix is always a dangerous operation, and should never be employed when avoidable. Steel dilators have ruptured the uterus and killed the patients again and again even when used by experts. Laminaria tents are not to be recommended; the tamponade is enough. When the retained ovum cannot be removed by the finger or squeezed out, the free portion of the ovum is to be grasped by an ovum forceps and gently drawn out. The operator should be sure he has a part of the ovum in the forceps and not a part of the uterine wall. If he bites into the uterine wall (a common catastrophe), he may pull a hole in that wall, and then the woman will probably die unless the rent can be closed immediately after opening the belly. When the abdominal cavity has been opened in such an event, the uterus is also to be opened, cleansed, and sutured. This method is safer than curetting where there is a rent. If one is certain the gut has not been injured--and it is extremely difficult to be certain--vaginal anterior hysterotomy may be substituted. Sometimes perforations, when the uterus is not septic and the instruments are clean, are not dangerous. Rest in bed, ice-bags, ergot, and opium cure without operation. Physicians who are called into an abortion case should always be certain that no one has attempted to pass sounds, curettes, or similar instruments, because a perforation may have been made by the meddler which will be charged to the second man himself.