10. LACTATION



Sore Nipples. In some cases, if the preparatory treatment just suggested be adopted, sore nipples will be prevented. But where there is a tendency to excoriation and soreness, and in women of fine sensitive skin, the nipples and the breasts around should be bathed several times daily with lotion made by adding twenty drops of the tincture of Arnica 1 (If there is a predisposition to Erysipelas in the patient, Hamamelis lotion will be preferable, and may be applied in the same manner.) to a tumbler of water. We can testify to the entire success of this application in a very large number of cases we have treated. The lotion should be applied after each time of suckling, and the nipple moistened with saliva or mucilage before again allowing the child to suck. Another local remedy for sore nipples Glycerine of Verbascum Vir.- 5 drops of Verbascum Vir. to 3ij of Glycerine.

In obstinate cases, in which the complaint appears to be owing to constitutional causes, one of the following remedies is often required: Calcarea, Mercurius, Graphites, Lyco., Silica., or Sulph., Silica. is especially recommended for retracted nipples.

Painful Nipples. Phellandrium. Pain left in the nipple after each application of the child.

Croton Tig. Neuralgic pain shooting through from the point of the nipple of the shoulder-blade.

ACCESSORY AND PREVENTIVE MEANS. Small compresses, wrung our of the cold water, are very useful, especially if the nipples are sore, hot, and burning. In order to prevent sore nipples, they should be washed over gently with tepid water immediately after the child has been nursed, tenderly dried by means of soft linen, or a fine towel, and then dusted with superfine wheat- fluor, or finely powdered starch. As before recommended, the entire breast should receive daily morning ablution, with water, cold, if the patient can bear it, but if not, tepid may be used for several times, gradually reducing it to cold. The infant should only be allowed to suck at certain periods say every third or fourth hour, as previously directed. The habit of permitting the infant to have the nipple almost constantly in the mouth very frequently leads to tenderness and soreness. The child’s mouth should be examined, and if found to be suffering from Thrush, the treatment recommended in the Manual on the Diseases of Infants and children should be at once adopted. In the meantime the nipple should be washed with a solution of Borax (x grains to an ounce of water).

76. SORE MOUTH OF NURSING MOTHERS

This is an affection from which nursing women occasionally suffer. It consists of inflammation of the lining of the mouth, which is covered with very small ulcers; these cause stinging nd burning sensations, and a cheese-like matter exudes form them. A profuse flow of saliva is also frequently present. The predisposing cause is the scrofulous cachexia. Now and then it proves in intractable disorder.

MEDICINAL TREATMENT. Arsenicum, Borax., Calcarea c., Eup. A., Hydrastis., Mercurius, Murex Ac., Acid nitricum, Sulphur Ac.

INDICATIONS FOR THE PRINCIPAL REMEDIES.

Arsenicum. If ulceration becomes extensive, and there be burning pain in the mouth, with red glazed tongue.

Borax. Is an excellent remedy in the early stage of the malady.

Mercurius. Corroding ulcers with swollen gums, foetid breath, and profuse flow of saliva.

Nitric Acid. On the failure of Mercurius this remedy should be had recourse to.

LOCAL TREATMENT. Borax (x grains to ox.j water), Carbolic Acid (z3aa to z3iss olive oil), Hydrastis (iij grains to z3ij water), Calendula (j to z3iv water), are the various kinds of gargles and washes that have been found most useful as palliatives while the medicines are affecting the necessary blood-changes.

ACCESSORY MEASURES. Acidulated drinks lemonade, etc. and very valuable. Vegetable and animal food in due proportion, with wholesome ripe fruits, oranges, grapes, roasted apples, etc. Fruits containing vegetable acids are often alone curative, and are usually very grateful to patients. Weaning, travel, change of climate, etc., may be necessary in exceptional cases.

77. DETERIORATED MILK.

If the various suggestions we have offered in this Manual are faithfully carried out, there will seldom be cause for complaint of bad milk.

METHODS OF INVESTIGATING THE MILK. As a ready method of judging of the quantity and quality of the milk an inspiration of the breasts of the mother or nurse should be made. The breasts should be firm and pear-shaped, and covered with blue veins. Pressure on the gland should excite the flow of milk, while should be opaque, of a dull white colour, and under the microscope present fat globules of fair size. The number of these globules in indicative of the amount of caseine and sugar present in the milk. On a piece glass a drop of good milk maintains its globular form, and does not readily run off the glass. Poor milk, deprived of its solids, lacks these qualities, and run off on the least inclination of the glass. Obviously, however, the most satisfactory test of the excellency of the milk is furnished by observation of the child. If he sucks vigorously, finishing with the milk running over his lips, and requires a meal but three or four times in the day, we may conclude that the milk is sufficient in quantity. But if the frequently desires the breast, sucks with effort or spasmodically, now and then desisting and crying, the milk may be considered insufficient. As a further test of the quantity of the milk the infant may be weighed immediately before and after a meal; the difference in the weight should be three or four ounces.

SYMPTOMS. Vomiting after each act of sucking, or refusing to suck, generally indicates bad milk. When the milk is deprived of its due proportion of solids and becomes watery, it fails to afford the requisite nourishments; on the other hand, if the solids are in excess, it gives rise to ingestion.

CAUSES. Acute and chronic diseases in a nursing mother tend, in various ways, to impair the quality of her milk. Nursing during either of the extreme of age yields generally only innutritious milk. Menstruation, and also pregnancy, deteriorate the milk supply; and although occasionally children nursed under these conditions may appear not to suffer, it is obvious that the active functions of the breasts and of the womb cannot go on healthily at the same time. Emotional disturbance and violent exercise exert great influence on the milk secreted; and if children are nursed immediately, extreme convulsions, and even fatal results, may follow. The effects diet on the milk of nursing ladies have already been referred to.

MEDICINAL TREATMENT. Aconite, Calcarea C., Chamomilla, Ignatia, Nux V., Pulsatilla, Silicea, Sulphur

INDICATIONS FOR THE PRINCIPAL REMEDIES.

Aconitum. The presence of any febrile symptoms would delicate the employment of this remedy.

Calcarea C. Thin, watery condition of milk; delicate constitution.

Nux Vomica. When the deterioration can be traced to the use of alcohol; in cases of the Nux temperament.

Pulsatilla. Alcoholic cases of the Pulsatilla temperament.

ACCESSORY MEASURES. Every means should be adopted to improve the patient’s health by suitable food and abundance of pure air, and by placing hair beyond the reach of household and other cares and anxieties.

78. INSUFFICIENT SUPPLY OF MILK.1

1 In an interesting paper on “The Modifications which Human Milk undergoes in Consequence of Insufficient Food,” read before the Academic des Sciences by M. Decaisne, he remarked that most of the observations that have hitherto been published upon this subject have been made on animals, but the siege of Paris furnished him with the opportunity of examining it in women. Upon an examination of the milk of forty-three suckling women living upon insufficient food, he concluded as follows: 1. The effects as observed in women are very analogous to those produced in animals. 2. They vary according to constitution, age, hygienic conditions, etc. 3. Insufficient alimentation always induces, in varying proportions, a diminution in the amount of butter, caseine, sugar, and salts while it generally increases that of the albumen. 4. In three-fourths of the cases the proportion of albumen was found to be in an inverse ratio to that of the caseine. 5. The modifications in the composition of the milk by means of a reparative alimentation are always manifested in a remarkable manner in four or five days.

CAUSES. The quantity of milk various greatly in different women, but when it is insufficient for the nourishment of the child, the cause may be traced to imperfection in the mother’s health, and measures should, if possible, be adopted to correct this, so that after a subsequent labour she may be able to furnish the infant with sufficient milk.

MEDICINAL TREATMENT. Agnus, Castus, Asafoetida, and of milk, the first two medicines when the cause of the deficiency is undiscovered, the last when the deficiency is the result of haemorrhage, diarrhoea, leucorrhoea, etc.

The external application of the castor-oil plant (Ricinus. Communis) has been used by some physicians with great Success. A strong decoction is applied hot by means of soft rags, and retained until the milk is secreted copiously.

Edward Harris Ruddock
Ruddock, E. H. (Edward Harris), 1822-1875. M.D.
LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS; MEMBER OF THE ROYAL COLLEGE OF SURGEONS; LICENTIATE IN MIDWIFERY, LONDON AND EDINBURGH, ETC. PHYSICIAN TO THE READING AND BERKSHIRE HOMOEOPATHIC DISPENSARY.

Author of "The Stepping Stone to Homeopathy and Health,"
"Manual of Homoeopathic Treatment". Editor of "The Homoeopathic World."