Inflammation of the Breast. Broken Breast.
The mammary gland, or gland which secretes milk in the human breast, consists of a number of ducts, passing inward from their termination in the nipple, and then spreading around like the roots of a tree, and terminating in minute glands. The mammillary tubes are straight ducts, ten or twelve in number, having their mouths at the centre of the nipple, dilating at its base into larger reservoirs, which extend some distance into the gland. (Fig. 146.)
When milk is first formed, after confinement, these tubes and reservoirs sometimes get so full and hard that they crowd and compress each other, making it difficult to remove the milk, and under these circumstances, the breast will inflame.
Symptoms. The inflammation generally begins with a chill, followed by fever, and pain of a shooting kind, which is much increased by pressure. An examination will generally reveal a circumscribed, hard, and painful tumor, even before there is any redness on the surface. After a time, the swelling spreads, the skin becomes of a dusky red, is hot and shining, will frequently pit a little on pressure, and soon gives a sense of fluctuation. Upon the formation of matter, the breast is enlarged, and there is local tenderness and throbbing pain.
This complaint may be caused by taking cold, irregularities in diet, or by mental emotion; but more commonly it is caused by accumulation of milk within the ducts; still more commonly by septic matter from the uterus entering +,he circulation and causing a localized blood poisoning.
Treatment. These afflictions may generally be prevented by keeping the breasts well drawn. It is the duty of a nurse to look well after this matter, and see that the breasts do not get hard and distended with milk.
But when the inflammation has fairly set in, the first aim should be to prevent, if possible, the formation of matter.
Active purging should be resorted to at once (29), (32). Sweating should be encouraged by the tincture of veratrum viride. If the object be to prevent the formation of matter, cold lotions, or cold water compresses should be used freely; but if two or three days have passed before active treatment, the suppuration will go on, and it is better to use warm applications. Dewees says warm vinegar is the most beneficial as well as the most comforting. Poultices and warm fomentations are much used. Some apply stimulating liniments, made of essential oils, etc. (195), (198). Leeches are often used with advantage. They should be applied, not upon the breast, but just below it.
During the progress of the disease, especially after the abscess is opened, the breast should be supported, and prevented from hanging down, by long strips of adhesive plaster carried below and around it. By this means a gentle pressure is kept up by which the matter is more easily evacuated.
The breast should be opened with a lancet as soon as the abscess points, or fluctuation is discovered. Should the ulcer not heal, an astringent wash, such as a weak solution of nitrate of silver (211), may be applied to it once or twice a day.
During the discharge of matter, the system of the patient should be supported by a nourishing diet, wine, tonics, etc. To lift up the breasts, and at the same time gently compress them with a gauze or thin flannel bandage, is one of the best methods of treatment.
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