XLVII. The Breasts.
Much inconvenience and suffering may be obviated by paying proper attention to the breasts during pregnancy. It is then especially necessary to examine whether the nipples are of the proper size and shape, for in many instances the nipple is naturally deficient, or has been so thoroughly compressed by tight clothes, that after confinement it can scarcely be said to exist. The pain thus induced is often very severe. A very simple and efficient plan has been suggested in these cases: it consists in winding woollen tread or yarn two or three times around the base of the nipple (Which is to be previously drawn out sufficiently), and tying it moderately tightly, but not so tightly as to interfere with the circulation. In this way the nipple may be kept sufficiently prominent; the woollen threads may be worn for many days without the least inconvenience.
During the last two or three months of pregnancy, the breasts should be regularly bathed with cold water every morning, and perfectly dried by means of a coarse towel
For simple excoriation or tenderness, the nipple may be washed two or three times daily with water in which a few drops of the tincture of Arnica have been mixed, or the Glycerol of Hydrastis may b applied.
Soon after delivery a pricking sensation is generally felt in the breasts, which gradually swell and harden during the next day or two, until they feel very heavy to the mother. Sometimes this is attended with a rigor, and slight general febrile action; this is commonly called “Milk-fever.: In some cases the disease borders on, or runs into, Puerperal, or Child-bed fever, when the patient suffers from headache, pains in the loins, alternate chills and heat, and thirst; the pulse is full and firm, thee tongue white, and thee Lochia suppressed or diminished, Usually, however, Milk-fever is but a slight temporary disease; the symptoms, if not aggravated by any improper exposure, subside in a few hours, and the breasts having in the meantime acquired their function, the milk finds vent at the nipples. Exposure to cold will greatly aggravate the symptoms.
TREATMENT. In severe and prolonged cases, and especially with women who do not intend to nurse their offspring, one or more of the following medicines may be necessary.
Bryonia. Distended breasts, oppression and shooting pains in the chest, etc. This remedy is often alone sufficient.
Aconitum. Full and strong pulse, pain in the head, dry skin, and thirst. A dose every two hours, in turns with Bryonia
Belladonna. Violent pains in the head, confusion or wandering of ideas, redness of the face, glistening eyes, and other symptoms indicating cerebral disturbance. This medicine may follow Aconite, or be alternated with it, every two or three hours, till the above symptoms subside.
XLIX. Sore Nipples.
In most cases, if the preparatory treatment suggested, page 157-8, has been adopted, soreness of the nipples will be prevented. But where there is a tendency to excoriation and soreness, the nipples and the breasts around should be bathed several times daily with a lotion made by adding twenty drops of the pure tincture of Arnica 1. If there is a predisposition to Erysipelas, Calendula lotion will be preferable to Arnica, and may be applied in the same manner or or Hydrastis to a tumbler of water. The author can testify to the entire success of one of these applications in a very large number of cases which he has treated. The lotion should be applied after thee infant has sucked, and the nipple moistened with saliva or mucilage before nursing.
In obstinate cases, in which thee complaint apparently arises from constitutional causes one or more of the following remedies may be administered: Calcarea, Graphites, Mercurius, Silicea, or Sulph.
Administration. A dose of Calcarea every six hours for two or three days; if the in convenience is diminished, the remedy should be continued twice a day for a few days longer; if there be but little improvement, another medicine may be administered in the same manner.
ACCESSORY MEANS. In order to prevent sore nipple, as often as the child is nursed they should be gently washed with tepid water immediately afterwards, very carefully dried, and then dusted with very fine wheat flour. As before recommended, the wheat flour. As before recommended, the entire breast and chest should receive ablutions in water, night and morning-using cold water if the patient can bear it, but if not, tepid, and gradually reducing it to thee natural coldness.
In these, as in all personal ablutions, rainwater will be found highly beneficial; and we are persuaded that if its salutary effects upon the skin, both remedial and preventive, were more generally known, grater pains would be taken in storing it for such purposes.
L. Gathered Breast. (Mammary Abscess.)
This disease may arise at any time during the nursing period, but is most likely to occur about the fourth or fifth day after delivery.
CAUSES. Exposure to cold, by not covering the breast during nursing; sitting up in bed to nurse thee child; too small, too depressed, or sore nipples, so that thee breast becomes distended with milk, favouring inflammation and suppuration; strong emotions; mechanical injuries; too prolonged nursing; in the latter case, the Abscess may not appear until a late period-from the tenth to the twelfth month. Thee great predisposing cause is constitutional debility.
TREATMENT. Bryonia. LArge collection of milk, hard, heavy, hot, and painful breasts. A dose every three hours. Belladonna may be alternated with Bryonia every three hours, if the surface of the breast has an erysipelatous and glossy appearance; or Aconite if there is much feverishness.
Phytolacca. Inflammatory engorgements of the gland; it may bee used internally and as a lotion. The testimony to its value is very strong.
Phosphorus. Fistulous mammary Abscess.
Silicea. If suppuration be tardy, or seem to require aid. HeparS. is also good in these conditions.
China. Much weakness from excessive discharge. If the suppuration continue profuse, this remedy should be alternated with Silicea
Arsenicum. Abscesses with burning pain and great debility.
ACCESSORY MEANS. The preventive treatment consists in applying the infant to the breasts in order to empty them as soon as they are filled, when the milk is unaffected; in keeping the breasts and person of the patient warm; and in moderate diet. The enlarged breast should be supported by a broad handkerchief, so as to take off the weight, which aggravated the patient’s sufferings greatly; also a linseed poultice, when suppuration is threatened, or a piece of spongio-piline immersed in hot water, should be applied to the part; this will allay the pain by relieving tension. Fomentations with hot water are also highly useful. In extensive engorgements and induration an opening may bee necessary, which should be made, as soon as fluctuation is discovered, in the most dependent part.
LI. Retarded, Scanty, or Arrested Flow of Milk.
The secretion of milk may be tardy or deficient; or may be suddenly suppressed from exposure to cold, powerful emotions of the mind, or from any circumstances likely to cause febrile symptoms.
TREATMENT. Pulsatilla. Tardy flow, or partial or entire suppression. The immediate administration of this remedy almost invariably arrests these symptoms, and indeed exerts a healthful influence over the female constitution, in almost every departure from the normal course during the whole period of nursing.
Calcarea. Deficiency in the secretion of milk at the outset, or fulness or enlargement of the breasts, with tardiness in the formation of milk. This remedy may follow Pulsatilla.
Aconitum. Febrile symptoms; a dose every hour or two for three or four times; afterwards every four hours for several times.
Coffea. Great restlessness or sleeplessness. A dose or two will generally remove these symptoms.
Chamomilla. Suppression caused by a fit of anger; Ignatia-by grief; Dulcamara-by a chill.
ACCESSORY MEANS. When the distension and consequent irritation have been relieved by the appropriate medicine, the milk which has been arrested will generally flow freely Should the discharge continue imperfect, the breast-pump may be used, or better still, a stronger child may be applied; or the following may be tried:
METHOD FOR PROMOTING THE FLOW OF MILK. Take a decanter, or a soda-water bottle, and fill it with boiling water. When it is thoroughly hot, suddenly empty it, and press it gently on the breast, with the nipple in the neck of the bottle. The discharge of the water, and the gradual cooling of the decanter will create a vacuum; the nipple will be drawn into it without pain, and in almost every instance the milk will immediately flow. The experiment may safely be repeated, after a short interval, if it does not happen to be successful at first.
DIET. A nutritious and digestible not an extra-diet is necessary. Good cocoa is one of the best auxiliaries in improving the quality and increasing the quantity of the mother’s milk. The writer has known it to succeed admirably when other means had failed. During the whole period of nursing this nourishing beverage will be found highly conducive to health.
LII. Excessive Supply of Flow of Milk
TREATMENT. Bryonia. Secretion of milk so considerable as to distend the breasts and produced pain and oppression.
Calcarea. Profuse and continued flow of thin milk.
Cimicifuga. Depression of spirits, accompanying the excessive flow.
China. Debility, consequent on the profuseness.
ACCESSORY MEANS. Warm fomentations applied so as to maintain an equal temperature around the distended breasts are often very soothing to the patient. Gentle fractions with warm oil over the surface are useful in promoting absorption. As long as the involuntary discharge continues nipple-glasses for receiving the milk may be worn; but it is better to dispense with them, as they occasionally sustain the secretion.
The mother may suffer from the consequences of suckling, though not extended beyond the usual term, if her constitution is too feeble to sustain the drain even for a short time.
SYMPTOMS. A dragging sensation in the back when in the act of nursing the child, and a exhausted feeling of sinking and emptiness afterwards; general weariness and fatigue; unrefreshing sleep; dimness of vision; loss of appetite; dyspnoea and palpitation after exertion or ascending stairs. IF the nursing is continued, the patient become pale, thin, and weak; the night-sweats, swelling of the ankles, and nervousness follow..
CAUSES. The symptoms of prolonged nursing may occur, as before intimated, from inherent delicacy of constitution; from bearing children in to rapid succession; from imperfect nutrition; haemorrhage, abortion, Leucorrhoea, or nay other accidental cause of debility. Injurious consequences may result in the case of some women from nursing their children twelve, fourteen, or even eighteen months, under the erroneous impression that they will thus prevent pregnancy.
TREATMENT. China. Great weakness, noises in the ears, palpitation, swelling of the legs, etc., especially if the patient has been subject to night-sweats, excessive menstruation. Haemorrhages, or Leucorrhoea.
China is prime remedy in this condition.
Ferrum may follow, or be alternated with China.
Causticum. A sense of emptiness soon after satisfying a good appetite; irritable, easily vexed, or vehement nd resolute disposition; impaired memory, nervousness, and despondency; throbbing headache and noise in the ears; threatened Amaurosis; twitchings of the muscles; profuse Leucorrhoea.
Calcarea. Scrofulous or chlorotic symptoms, with loss of appetite, emaciation, and tendency to Consumption.
Lycopodium, Pulsatilla, Rhus., Bryonia, Phosphorus, or Cimic., may also be required.
ACCESSORY MEANS. Weaning should be commenced at once, as nothing short of this will in general avail; the attempt to force the supply of milk by large and frequent quantities of beer, wine, or spirits, will only tend to the more perfect exhaustion of the mother. In slighter cases, and when the infant is but a few months old, a good supply of plain, nourishing food will be productive of the happiest results in augmenting the secretion of milk. But unless the patient be strong, no attempt should be made to encourage the further flow of milk. The child should be fed in part with Sugar-of-Milk, which is the best substitute for breast milk. This article has now been extensively used; and in all cases in which infants are wholly or party deprived of the natural supply of milk, they should be fed with it, since it answers every purpose. It is readily and economically prepared, entirely supersedes the necessity for a wet nurse, and divests hand-feeding of danger. 1. Sugar-of-Milk, suitable for the above purpose, may be procured at any Homoeopathic Pharmacy.
The ordinary period for weaning is about the ninth month; and the time that the child is in good health, and free from the irritation of teething, should be chosen as the most appropriate. When weaning is decided upon, if the infant is strong, and especially if it has been accustomed to little varieties of food, it should take place at once. The mother may take the child as usual, and diminishing the supply from the breast, take care to satisfy its cravings with suitable food. As soon as the weaning is commenced, the mother should remain perfectly quite for a few days, in order that the swollen breasts may may not suffer form the motion of the arms or the pressure of the stays, and that the system may be free from excitement. She should take very light nourishment; refrain from food likely to induce thirst; take as little fluids as possible; and keep the breasts covered with some light, warm material.
TREATMENT. Bryonia Excessive quantity of milk, and painful distention of the breasts.
Belladonna. Redness of the breasts, and congested headache.
Calcarea, Pulsatilla, and Rhus., are sometimes required.
ACCESSORY MEANS. In addition to the suggestions offered above, if the flow of milk continue too abundant during the first few days of weaning, nipple-glasses may be used; but the breasts must not on any account be drawn. The skin may be softened by gentle frictions with the hands, lubricated with olive oil; and a bandage employed if necessary.