On the management of the nipples / by Samuel Sloan.

  • Sloan, Samuel, 1843-1920.
Date:
1878
Catalogue details

Licence: Public Domain Mark

Credit: On the management of the nipples / by Samuel Sloan. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    milk will be more easily withdrawn by the child, the nipple is at the same time in a less protected condition. These results will, of course, be all exaggerated if the nipple is retracted ; as then more forcible suction will be requisite to draw out the nipple ; whilst, in some instances, this difficulty may be insuperable. This brings us to consider the affections to which the nipples, from the foregoing considerations, will be liable. Probably the first suction of a strong child on an average nipple removes all its sebaceous matter, opens up the orifices of the lactiferous ducts, by withdrawing the plugs of hardened colostrum which may have obstructed them, thins the epidermis by solution, and produces to some extent at least extravasation of blood under the cuticle. Of course the ex- tent of these results will also materially depend on the length of time the child remains at the nipple. When the child re- laxes its hold of the nipple after the milk has appeared, were we then to examine the organ we would find it covered with milk mixed with the acid saliva from the child's mouth, and with but little, if any, of the natural unctuous matter on it. In this condition let the nipple be exposed to the cold air and the result will be a drying of the part, which will then become hard and irritable, with probably some exuda- tion from the parts in which the epidermis has been partially eroded. Repeated sucking will exaggerate this, by removing the scabs ; and we have then excoriated nipples. From this results partial destruction of the cutis, causing ulceration of the nipple. Fissure is an elongated ulceration, generally deeper than the simple excoriation. It forms at the bottom ] of the furrows and takes their direction ; sometimes, and then i| most painful, it occupies the grooves separating the base of il the nipple from the rest of the skin. Cracks are an exagge- \ ration of fissures ; they differ from the latter by the cracked, j swollen, and extremely sensitive condition of the surround- ing skin. The reason that these conditions most frequently affect the apex of the nipple, is explained by M. Deluze to be the reception of the nipple in the gutter formed by the tongue and soft palate of the child ; the efforts of suction thus telling on the tip of the nipple, which is then unsup-