Inflammation of one or both breasts, with a manifest tendency to suppuration, is apt to be of frequent occurrence in nursing women. And in some persons this difficulty, originally arising from constitutional predisposition, becomes almost a confirmed habit, since they seldom or never can nurse a child without experiencing the exceeding distress and annoyance of a gathered breast.
The inflammation may be located principally in the external mamma, affecting particularly the adipose tissue, and partaking of the nature of erysipelas. Or the inflammation may be seated more deeply in the substance of the breast. Or again the inflammation may be developed principally and especially in the mammary gland itself. Finally, there are cases in which the inflammation seems to involve the entire substance of the breast and structure of the organ in one indistinguishable mass. More often, however, the pains scattered through the breast, and the various diverging painful indurations, lead to the conclusion that the gland with its ramifications is the particular seat of the disease.
And in thus determining the nature of the affection, the cause of it, or the manner in which it arises, will often be of service. For if the breast evidently become inflamed from undue exposure to cold air, in the delicate state of early lactation, a general inflammation may be expected to ensure; while difficulties belonging to the process of the secretion and discharge of the contents of the lactiferous tubes, may sometimes be seen plainly to precede inflammation in those tubes and in the gland itself. Much is due also to previous history and constitutional diathesis; influences which in some would prove perfectly innocuous, in others rapidly develop inflammation, which no less rapidly tends to suppuration. In such cases the greatest care, assisted by a dose or two of the antipsoric which seems most suited to the patient’s constitution, will go far to prevent the suffering inseparable from a gathered breast.
Where the milk is copiously secreted, and either from inability on the part of the child, in its absence, or from obstruction of the milk-tubes, or from deficiency of the nipple, the milk cannot be be freely drawn in the natural way, every effort should be made without loss of time to secure this end by such other means as may be possible. Sometimes the breast may be drawn by another child, or by a friend, or by young puppies; the proper remedy in the mean time should be carefully selected and faithfully administered, in order as should be carefully selected land faithfully administered, in order as rapidly as possible to remove all difficulty which may be amenable to such medication, or which may be resulting from the obstruction. In cold weather the inflamed breasts should be kept warmly protected; and besides this, the external application is made to them the better. If the inflammation is caused and kept up by a tender and ulcerated state of the nipples, let these be particularly attended to in accordance with the directions already given. Properly used, the Homoeopathic remedies may be made effectual in resolving the inflammation and averting suppuration, in a great majority of cases that are attended to at once.
Aconite. When a chill in dry, cold air, has been the exciting cause, and a true, synochal fever prevails.
Belladonna. When the breasts feel heavy; there are red streaks running like radii from a central point; she is occasionally chilly; a dull and stupid feeling prevails.
Bryonia. Her breasts have a stony heaviness in them; they are hot, hard and painful, but not very red. She feels sick on first sitting up in bed or in a chair; and still more sick on standing up. Rough, dry lips, thirst, and constipation; stools dry, looking as if burnt.
Carbo animal. Darting in the mamma, arresting the breathing, and aggravation by pressure.
Cistus c. Particularly indicated in scrofulous subjects, when there is the greatest sensibility to cold air. Inflammation and suppurating of the breast, with a sense of fulness in the chest.
Graphites. In all cases where there are so many old cicatrices from former ulcerations that the milk can scarcely flow. This remedy, high, will now cause the milk to flow easily, and ward off the impending abscess; it has proved perfectly efficacious in many such cases. The same success is claimed for Phytolacca, in similar cases. I have, however, the greatest confidence in Graphites; this remedy, although many times tried, has never failed me in a single case.
Hepar. When suppuration seems inevitable, and there is no other particularly characteristic symptom. Give a single dose, high, and await the result, either in resolution, or in suppuration.
Lachesis. When the breast has a bluish or purplish appearance and she has chills at night and flushes of beat by day.
Mercurius sol. Hard swelling of the breast, with sore and raw sort of pain; the milk is not good, so that babe refuses it. She has scorbutic gums and other general symptoms of Mercury.
Phosphorus. Inflammation of the mammae even threatening ulceration, with stitching or cutting pain. (Hectic fever and night sweats.) In fistulous ulcers with the blue appearances.
Phytolacca dec. Particularly where the hardness is very apparent from the first. Sensitive, and more or less painful; even after suppuration has taken place these characteristics continue.
Silicea. In fistulous ulcers particularly; the discharge being him and watery, or thick and offensive. The substance of the mamma seems to be discharged in the pus; lobe after another seems to ulcerate and discharge into the one common ulcer, often with great pain; or thee may be several orifices, one for each lobe.
Sulphur. Inflammation running in radii from the nipple. Suppuration profuse, with chilliness in the fore part of the day and heat in the after part. Some hemorrhoids, in complication.
Veratrum viride. Bids fair to be serviceable in all cases where these troubles are complicated with great arterial excitement.
In some cases the milk seems spoiled. The child refuses to nurse after tasting the milk; it turns away with disgust, or with crying. In such case, administered to the mother, according to other circumstances, Borax, Cina, Lachesis, Mercurius, Sulphur, or Silicea.
In case the child vomits the milk soon after nursing, give the mother Calcarea c., Silicea, or Sulphur.
DIRECTIONS FOR WEANING.
Weaning ought not to be attempted under ordinary circumstances until the child has become accustomed to other articles of diet. See in this connection the subsequent chapter on the Nutrition of Infants.
If the mother’s health cannot be kept strong and vigorous, the child may be gradually taught to depend upon other sources at the age of six months; and in a short time it may thrive while receiving but little from the matter mother for the three or four subsequent months. The mother should never allow the child, from the first day, to sleep at the breast. Once let the child acquire this habit, and it will terribly exhaust the mother by lying on her breast all night. For this reason it is important that the children never begin to acquire the habit referred to. Other things being equal, it is better that the child should not be weaned until it has six or eight teeth.
The process of dentition is accomplished in groups; and the child should never be weaned during the evolution of one of these groups. The first group consists of the two middle, lower incisors-these usually make their appearance at about the sixth or seventh month, and within from one to fifteen days of each other. Then the child usually rests from four to six weeks. The second group consists of the two middle, upper incisors, and after their appearance there is another interval or rest, of a few weeks. From the sixth to the tenth month the lateral incisors appear, the two lower first, and after a brief interval, the two upper ones. Now a longer period of best of rest intervenes, nearly two months; and for the twelfth to the fourteenth month, the anterior molars appear, two below first, then two above.
There is now another, and still longer period of rest, and from the fifteenth to the twentieth months the canine, or stomach and eye-teeth come forth, the two lower first, then the upper two. And again, after another period of rest, and any the time the child is twenty-four or thirty months old, the last four molars are cut, making in all twenty teeth. This work being fully accomplished, the period of infancy is completely passed, and the limit of this period of teaching ended. Yet if we are tempted to look a little further, we shall see that childhood properly ends with the casting of the deciduous teeth; youth extends to the complete establishment of puberty, and adolescence, or manhood and womanhood, ever after.
From the above review, it appears how necessary it is that we select for so important an event as weaning, one of those periods of rest from the evolution of teeth. For the infant to be deprived of its mother’s breast is a great change morally and physically, and this change is much less chocking to the infant’s system, and much more easily borne in all respects, if imposed when it is not cutting teeth.
