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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    while the formation of matter beneath or within the breast, as the result of necrosis of the chest-walls or spine, is quite exceptional. Abscess in the breasts of infants has been frequently recorded, and appears to be largely a preventable malady. The milky exudation which flows from the nipples of some infants, is almost entirely due to disintegration of the central cells of the columnar epithelial masses of which the primary gland is formed. When ignorant nurses in these cases pull or rub the nipples a breach of surface is effected by the rupture of a milk- duct or abrasion of the integument of the nipple, and, organ- isms entering, an abscess is the result. In the well-conducted large lying-in hospitals of this city abscess of the breast in infants is practically unknown, yet the swelling and hyperemia associated with secretion of spurious milk are not uncommon, and often lead to feelings of alarm in the mind of the medical attendant. These cases are now very exceptional. A case of mammary abscess in an infant tliree weeks old is related by Dr. Stephen of Lettercairn.i It is said to have been caused by retention of milk. The child, a female, was sixteen days old when the right breast inflamed, pointed, and was opened ; aboat an onnce of thick greenish pus escaped. On examination a milky secretion was found issuing from the left breast, which was examined with the microscope and found to resemble the maternal milk except that the latter contained more corpuscles. Similarly a case of double mammary abscess in a male infant is related by Dr. Wilks of Ryde.2 Attention being drawn to the subject, quite a number of cases of abscess in infants are recorded by various practitioners.^ Most^ observers refer the occurrence of the abscess to the practice prevalent among ignorant nurses of pulling and rubbing the nipples. Dr. Eobert Barnes* supports' this assertion, and states that when he was house-surgeon to a lying-in hospital, he encountered several cases of abscess in the breasts of infants due to the manipulations of nurses. Numerous other instances may be found in surgical literature where experienced practitioners attribute cases of abscess in infants to this practice. ' Bril. Med. Journ. 25th July 1874. md. 8th August 1874. ^ Ihid. 1st August 1874. Ibid. 15th August 1874.
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