but a fatty infiltration of the epithelial cells associated with anemia of the organ.”  The urine may also contain casts.  Whatever the cause it indicates a condition of insufficiency of the kidney which may lead to serious consequences to the mother and it is also injurious to the (foetus) child.  If this symptom develops suddenly the danger to both is greatly increased.  For this reason physicians should urge pregnant women to have their urine examined frequently, especially during the later months of pregnancy.

Treatment.—­Regulation of the diet; in pronounced cases the diet should consist entirely of milk and the patient should take three or four quarts in twenty-four hours.  Meats, pastry and sweets must be prohibited, but vegetables such as squash, spinach, salads may be added to the dietary in ordinary cases.  Vichy water may be taken alone or with the milk, and may be taken freely.  The bowels should be kept open with citrate of magnesia (one to two teaspoonfuls in water) or epsom salts in peppermint water.  Exercise in the open air can be taken in moderation.  Warm clothing should be worn and flannel next the skin; exposure to cold and draughts should be carefully avoided.  If the more special symptoms appear, such as persistent headache, vertigo, ringing in the ears, black or bright spots floating before the eyes, dimness of vision, an abortion of miscarriage should be induced without delay.  Fortunately such cases are rare and with care from the beginning seldom occur.  Pregnant women should inform their family physician at the beginning of pregnancy of their condition, and in the great majority of cases serious troubles can be prevented.  Physicians expect this information and receive it as a matter of course, and no woman should hesitate to inform her physician either personally or through her husband.

[Obstetrics or midwifery 525]

Abortion, Miscarriage, Premature Labor. (Accidents of pregnancy).—­These three terms indicate a premature expulsion of the products of conception.  Let us medically define these terms as follows; Abortion implies expulsion of the foetus before the sixteenth week.  Miscarriage, the expulsion between the sixteenth and twenty-eighth weeks.  Premature labor designates the time of expulsion as between the twenty-eighth week to within a few weeks before the normal termination of pregnancy.  Miscarriage is the term popularly used for the accidental loss of the products of conception.  Abortion, in the popular mind, expresses the intentional loss of the products of conception.  Abortion in the medical sense, takes place about once in every four or five pregnancies.  It occurs more frequently in those who have borne children, occurring generally in the third or fourth pregnancy, or toward the end of the child-bearing period, and it takes place more frequently between the ninth and sixteenth week, when the after- birth is in process of formation; and it is more liable to occur at the time of the month when