A clinical treatise on diseases of the breast / by A. Marmaduke Sheild.

  • Sheild, A. Marmaduke (Arthur Marmaduke)
Date:
1898
Catalogue details

Licence: Public Domain Mark

Credit: A clinical treatise on diseases of the breast / by A. Marmaduke Sheild. Source: Wellcome Collection.

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    notably enlarge concomitantly with the establishment of the menstrual flow. Enlargement, with uneasy sensations, is also not uncommon in the male at this period. The increase of size is due not only to extension of glandular structures in a peripheral direction, but also to the formation of a cushion of fat beneath the skin, which gives to the virgin breast its rotundity and smoothness. In pregnancy and during lactation the breasts increase enormously in size, new gland tissue being formed in all directions, and in delicate skins, blue veins can plainly be seen which before were invisible, marking the great increase in vascularity of the parts. At the same time the areola round the nipple loses its pink colour and becomes dark and pigmented, the small accessory glands then formed (tubercles of Montgomery) projecting upon the surface. During lactation, especially early lactation, the lymphatic glands become considerably enlarged. This is due to increased vascularity, and the stuffing of the gland, with cellular pro- ducts, some of which resemble colostrum cells. This physiolo- gical enlargement of the glands, must be taken into careful account in the diagnosis and apparent increase of morbid growths during lactation. After lactation the breasts become flaccid and pendulous, and their smoothness and plumpness are superseded by a granular and lobulated condition, the disappearance of the fat allowing the mammary tissue to be ]3lainly obvious (Fig. C, Plate I.). In old age the gland shrinks and atrophies to a marked degree, being represented by wrinkled flaccid folds of integument, with a wart-like pigmented nipple in the centre. No trace of glandular structure remains, beyond a few atrophic cells embedded in dense fibrous tissue (Fig. D, Plate I.). In exceptional instances the enlargement of the mamma in pregnancy becomes so great as to cause alarm, and constitutes a veritable disease. After lactation, however, such conditions usually again subside, and the surgeon must not hastily advise operative measures. Warren ^ relates the case of a young woman aged twenty-two, whose breasts, always large, underwent rapid growth during pregnancy. The left breast measured 27 inches in circumference, the right 26 inches. 1 Boston Med. and Surg. Jolim. 3rd August 1893.