ent of Threatened Abortion.--The patient should go to bed, lie down
and remain there, and if possible be not only quiet physically, but also
quiet mentally. The main remedy is opium, and if necessary to obtain a
quick action it can be given hypodermically in the form of morphine.
Otherwise, laudanum may be given by the mouth, twenty drops, repeated
cautiously, every three or four hours as required, or it can be given in
thirty-drop doses combined with a couple of ounces of starch water by the
rectum. Extract of opium in pill form, one grain three times a day by the
month; or a suppository of opium, one grain, may be inserted into the
rectum every four to six hours. After the bleeding and pain have ceased,
the emergency is probably passed; but rest in bed and quiet should be the
routine for one or more weeks, and the patient should always rest in bed
at the usual time of the menstrual period, during the remainder of the
pregnancy.

[OBSTETRICS OR MIDWIFERY 527]

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 s