Clinical lectures on the diseases of women and children / by Gunning S. Bedford.

  • Bedford Gunning S., 1806-1870.
Date:
1872
Catalogue details

Licence: Public Domain Mark

Credit: Clinical lectures on the diseases of women and children / by Gunning S. Bedford. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    MAMMARY ABSCESS. and this constitutes not only an efficient, but the natural cathartic for iJie new-born infant—this cathartic removing from the system that dark viscid matter known as the meconium^ and which, if it be suffered to remain in the intestines, very frequently gives rise to convulsions, etc. 5th. The early application of the child to the breast will, as a general rule, ensure the free discharge of milk, and, therefore, prevent the unnat- ural distention of the breast, which is the common cause of milk ab- scess. But there may be some circumstances, which will obstruct the flow of milk from the nipple notwithstanding the early application of the child—and these may arise from the infant itself—such for example as debility, tongue-tied, sore mouth, malformation, etc., etc. ; or from the mother, because of the flattened condition of the nipple, so that it is impossible for the infant to grasp it. Under such circumstances, there is a very simple and effectual means of overcoming this difficulty—take a pint bottle, and fill it with hot water—then pour the water out, and apply the bottle over the flattened nipple—as the bottle cools a vacuum results, and a powerful suction is exercised on the nipple, which becomes at once elongated, and the milk is seen to spout out. As soon as the bottle is removed, the child must be applied to the breast, and it grasps the nipple without difficulty. This is far better than suction pumps, and other irritating contrivances usually resorted to. You are to bear in mind that the great remedy for the prevention of milk abscess is to ‘protect the breasts against undue distention. When the milk does not escape with sufficient freedom, it is important, in order to control, to a certain extent, its too abundant secretion, to place your patient on solid food, such as boiled rice, potatoes, etc., and forbid drinks, for these increase the mammary engorgement. The bowels, too, should be kept soluble by saline medicines, which are preferable to all others in these cases, for they produce, as you know, serous discharges. The following may be administered with advantage : 5 Sulphat. Magnesias .... § iss Inf. Rosar. C. . ... § viij FL soL A wine-glass once or twice a day as circumstances may indicate. In the case before us, however, there is a large secretion of matter—the breast is filled with it. What is to be done 1 The indication is obviously to evacuate it without delay by a free opening with the lancet. Make your incision below so that the matter may escape without obstruction. [Here the Professor introduced the lancet into the depending portion of the abscess, and not less than a pint and a half of matter escaped; a small piece of lint was inserted between the lips of the opening, with directions to remove it every four hours to allow the matter still further to escape—the breast to be poulticed for two or three days.] In addi- lion, genth'.men, to what has just been done for this patient, it is neces-
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