The Causes of Abortion are—

1. Natural or Accidental

(a) Maternal.—Among the maternal causes may be mentioned excessive lactation; any irritation of the rectum or bladder; loss of blood, which, by increasing the amount of carbonic acid in the blood, acts as an excitant to the spinal cord; excessive irritability and excitability of the uterus, &c. Certain states of the system conduce to abortion—albuminuria, syphilis, certain fevers, scarlet fever, smallpox, &c. Abortion may become habitual in some women. Great joy or sudden sorrow have not infrequently been the cause of abortion. The tendency to abortion is greatest at the menstrual periods, that is, at the time when, had not the woman become pregnant, menstruation would have taken place. Slight causes acting at these times are very liable to produce abortion.

(b) Fœtal.—The death of the ovum, or a diseased condition of its uterine coverings, or of the placenta, probably of an inflammatory nature.

2. Violent

(a) Mechanical.—Under this head may be mentioned the passage of certain instruments into the cavity of the womb, and the rupture by violence of the membranes which surround the fœtus; also the injection of fluids into the uterus. A medical man practising in Yorkshire informed Husband that so great was the dread of large families, that he knew of several ladies who, if they went a day over their monthly period, passed a catheter into the uterus, with the desired result. “It was wonderful,” he added, “how clever they were.” In India a twig of the Euphorbium nivulia, anointed with assafœtida, is used for the same purpose. “The fœtus is never delivered alive, but there is said to be no great danger to the woman” (Chevers). Women may use hairpins, knitting-needles, and the idea is to pass the instrument “until blood comes,” which is accepted as a sign that abortion will be sure to follow. In some cases it is by no means easy to procure abortion, and women have been known to undergo a considerable amount of violence without abortion taking place. In some women, however, on the other hand, the slightest violence—such, for instance, as slipping from a step or low chair—will cause them to abort.

(b) Medicinal.—Certain drugs, among which may be mentioned ergot, savin, pennyroyal, rue, tansy, saffron, perchloride of iron, diachylon which contains lead, and others, have been used for the induction of abortion. In India unripe pineapple has a great reputation as an abortive (Medical Jurisprudence for India, Chevers). It is scarcely necessary to mention each drug individually, but it must be remembered that there is not one single internal medicament of which it can be consistently with experience asserted that, even when an abortion has followed its use, it must have produced this abortion, and that cause and effect are in such a case “indirect and necessary connection.” All the so-called abortives are most uncertain in their action, and their use is attended with considerable risk to the woman. In the case of diachylon profound lead poisoning may be the result. Be this as it may, they are more frequently used to induce abortion than mechanical procedure, from the fact that the latter requires some amount of anatomical knowledge and manipulative skill.

The dangers of abortion from any cause are hæmorrhage, sepsis, and peritonitis. In mechanical interference, especially where proper precautions have not been taken to prevent them, sepsis and peritonitis from local injury and perforation are prone to occur.

A medical man may be required to—(1) Examine into the nature and characters of the substances expelled from the womb; (2) Examine the woman stated to have aborted.