Treatment of the Inevitable Abortion.—­If the cervix is hard and the canal is not dilated, especially if the bleeding is free, the vagina should be packed full at once, if possible, with iodoform gauze.  Rolls five yards long and two inches wide can be bought perfectly adapted to this purpose.  A speculum should be used (Sims’ or Graves’) and the gauze should first be packed tightly into corners (fornices) around the cervix, then over the cervix and well down to the outlet.  This should be held in place by a proper (T) bandage.  The gauze can be removed in from twelve to twenty-four hours, and the ovum will generally be found lying upon the upper part of the packing, or in the canal that is now dilated, from which it can easily be removed.  Sometimes it is necessary to repack and allow it to remain for another twelve hours as the canal has not been sufficiently dilated by the first packing.  This packing not only causes the canal to dilate but usually stops the bleeding.  After the ovum has been expelled an antiseptic vaginal douche should be given twice a day for a week or longer.

If at the first examination the cervix is found softened and the mouth of the womb is open, but the womb has not yet expelled its contents, the sterile (clean) finger may be introduced into the womb and the ovum and membranes loosened and taken away, while this is being done counter pressure should be made over the abdomen.  After the womb has been cleared of all its contents an antiseptic solution should be used, carefully, in the womb to wash it out, and this followed by washing out of the vagina.  The after treatment is the same as that for labor at full term.  The woman should remain in bed at least ten days.

Placenta Praevia.—­The after-birth is placed in the lower part of the womb; (after-birth before the child).  This is a dangerous condition and terrible bleeding may occur.  It occurs about one time out of every one thousand.  The main symptom is bleeding and this may occur at any period of pregnancy.  It usually appears from the seventh to the ninth month.  The outset is without any appreciable reason and without pain.  The amount of blood lost at the first attack may be so slight as to escape notice or copious enough to endanger the life of the mother.  This flow may occur at any time during these months, and it may be small or great.  If during the course of pregnancy the bleeding occurs at intervals in the increasing amount, the greater will be the loss of blood during the labor.

Treatment.—­There is little danger of dangerous bleeding before the seventh month, and a waiting treatment may be adopted, but the woman should be closely watched and told what the trouble is, so she will be willing to remain quiet.  Rest in bed, the avoidance of all muscular exercise and quieting medicines may enable the mother to carry the child until it can live, when pregnancy must be quickly terminated.  If the child is dead the womb must be emptied at once.  After