If there be much febrile excitement of the circulation, bleeding may be
sometimes required: we have rarely, however, found it necessary, having
been almost always able to exert a sufficient effect by means of nitre
with small doses of Vin. Antimonii and Sp. Æth. Nitr. Leeches seldom give
more that temporary relief, and that only when applied in large
quantities; in which case so much irritation and inflammation is produced
by their bites as not unfrequently to counteract the benefit arising from
the loss of blood. The patient should preserve the horizontal posture, or
at least have the breast well supported by a soft handkerchief, as
otherwise its weight will produce much painful dragging. It is not always
easy to detect the fluctuation, particularly when it is seated deep
beneath the fascia, which invests the mammary gland; but wherever it is
tolerably distinct, especially in the upper parts of the gland, the
abscess should be let out early, otherwise it will burrow through a large
extent of the breast, and destroy a considerable portion of the gland;
whereas, if it be felt below the nipple, it may be allowed to approach
nearer to the surface and point, by which means it will not be necessary
to make the incision so large or so deep, a point which is worthy of
attention, as otherwise considerable-sized milk tubes and even
blood-vessels may be divided. Dr. Burns has mentioned a case of fatal
hæmorrhage from this cause. In either case, whether the opening has been
made artificially or spontaneously, the breast should be constantly
enveloped in a hot poultice of linseed meal: if this be made with boiling
water it forms a gelatinous mass, which retains its heat for a very
considerable time, and not only acts as a fomentation, but gives great
relief by softening the indurated portions and diminishing the tension. If
the patient can bear it, the breast ought to be drawn by a glass for that
purpose: this is much better than the breast-pump, being simple and easy
of application. Where little or no milk comes, it is useless to persevere,
as we should only expose the patient to much unnecessary pain, and the
breast to a good deal of irritation.
It rarely happens that the breast recovers so far as to enable the mother
to nurse with it, and she will therefore be obliged to nourish the child
entirely from the other, which generally bears the double duty without
inconvenience: in some cases, however, there has been so much fever, and
the process of inflammation and its consequences has been so long, that it
is neither possible nor advisable to keep up or recall the secretions. In
succeeding labours great attention must be paid to a breast which has been
thus injured, and every disposition to distension and accumulation of milk
carefully watched.
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account