Instead of a surgical operation, which has come unexpectedly and undesired; a disaster in which some part of the body is removed or altered by means of a procedure associated with extreme pain, mental tribulation and large expense, a much-wished for addition is brought to the family, with pain, to be sure, but a pain that is soon forgotten in the general joy. This is the normal condition that causes the nurse and the doctor to rejoice that such a delightful specialty has been chosen. Then comes a case in which the labor may be complicated by some dreadful anomaly, or the puerperium burdened or disordered by some unwelcome invasion that tortures the souls of the family and may cost the life of the mother, or child, or both. At such a time the nurse and the doctor feel the full weight of their responsibility, and after a series of anxious days and sleepless nights, they wonder why they did not choose gardening or a clerical position for their life work. The disorders of the puerperium are many and various, but naturally the breasts and the pelvic organs are most frequently affected. =The breasts= of the human female are not reservoirs of milk like the cow’s, but a pair of highly sensitive organs that functionate and produce only as the demand is made. It follows that when the milk comes in, the breasts become engorged and all the neighboring structures are involved in the new process. However, it is not milk that is overfilling the breasts, but serum, lymph and venous blood, which congest the tissues surrounding the glands and produce a hard painful mass. The breasts become heavy, hot, and painful; supernumerary glands in the axillæ enlarge, but there is no fever. There is but little more reason for a fever when the mammary gland begins to functionate than when the lungs fill for the first time except in the case of nervous patients who bear discomfort badly. If fever appears simultaneously with the milk, the cause must be sought in some atrium of infection, possibly in the breasts, but usually elsewhere. There is no such thing as “milk fever.” The enlarged glands, the tense mottled skin on which blue veins run visibly here and there, the nipple, flattened and drawn into the swelling, so that the child can not grasp it with the mouth, all produce a sense of disorder that ought to be associated with fever—but is not. This is the “caked breast” of the laity, and if let alone, the hyperæmia subsides and the function remains. The temperature in possibly two cases out of five may rise to 100° F. for twenty-four hours, but it promptly subsides. These temperatures generally occur in neurotic women. If the breasts are irritated by binders, breast pumps, or massage,—like the blacksmith’s arm, with exercise—the trouble, if not increased, is at least much slower in disappearing. It is reported that the young virgins of some African tribes nurse the babies in the family, the breasts being stimulated to produce milk largely by massage.