Breaststroke

“ But I don't believe you have any more cancer in your breast than I have. There is an obstruction and hardening of the glands, and that is about all."
"But Mrs. N—'s breast was just like mine, for Mrs. A—says so. She described the feeling Mrs. N—had, and mine is precisely like it."
"Mrs. A—neither felt the peculiar sensation in Mrs. N—'s breast nor in yours; and, therefore, cannot know that they are alike. She is an idle, croaking gossip, and I wish she would never cross our threshold. She always does harm." ”

“ On the third day, more especially after a first confinement, the breasts are apt to become very much swollen, painful, and distended. If such be the case, it might be necessary, for a few days, to have them drawn, once or twice daily, by a woman who makes it her business, and who is usually called either a breast-drawer, or, in vulgar parlance, a suck-pap. A clean, sober, healthy, respectable woman ought to be selected. There is, in nearly every large town, one generally to be found who is at the head of her profession. ”

“ Diseases of the Mammary Gland.—Inflammation of the breast (mastitis) is apt to occur in a woman who is suckling, and is due to the presence of septic micro-organisms, which, as a rule, have found their way into the milk-ducts, the lymphatics or the veins, through a crack, or other wound, in a nipple which has been made sore by the infant’s vigorous attempts to obtain food. Especially is this septic inflammation apt to occur if the nipple is depressed, or so badly formed that the infant has difficulty in feeding from it. ”

“ The ulcer remained firm, and the whole breast was softened: her foot mended; and all went on for the better till the 18th, when the ulcer on the upper part of the breast opened again in three places, and discharged a thick yellowish matter. The nipple of the left breast also became inflamed, and surrounded with pimples, which discharged a little lymph. In the mean time the cancerous breast was more painful than on the preceding days. The [84] 19th the pain less, tho' continual. Some discharge from the foot still; but the ulcers on the thigh were healed, and another blister arose. ”

“ Wounds of the genital organs of the female may cause fatal hæmorrhage, which takes place from the plexus of veins which, in these parts, are devoid of valves. A kick from behind whilst the woman is stooping or kneeling may rupture the labial vessels and death supervene.
Blows and kicks upon the abdomen do not often injure the non-gravid uterus, but during gestation may produce abortion and hæmorrhage. If the pregnancy be advanced the uterus may be ruptured or the placenta separated. ”

“ There is evidently a close relation between the functions of the breasts and of the uterus and accordingly involution is likely to progress more satisfactorily in women who nurse their babies than in those who do not. The so-called “after-pains,” also, are affected by nursing, being more severe, as a rule, when the baby is at the breast than at other times. These pains are caused by alternate contractions and relaxations of the uterine muscles and are more common in women who have had other children than after the first baby. ”

“ When will mothers awake from their lethargy? It is high time that they did so! From the mother having "no nipple," the effects of tight lacing, many a home has been made childless, the babe not being able to procure its proper nourishment, and dying in consequence! It is a frightful state of things! But fashion, unfortunately, blinds the eyes and deafens the ears of its votaries!
6. BAD BREAST.—A gathered bosom, or "bad breast," as it is sometimes called, is more likely to occur after a first confinement and during the first month. ”

“ The bandages over and about the lower limbs, and as high up as the breast, are loose, and repeatedly taken off in the same day, as the child may require cleansing; but the head and shoulders are kept strictly in the same position, and the breast given to the child by holding it up in the cradle, loosing the outer end of the lever that comes over the nose, and raising it up of turning it aside, so as to allow the child to come at the breast, without moving its head. ”

“ Sensation, on making the least motion, as though a hollow body were moving about in the chest quickly and with a noise, after which she fancies she will faint, early in the morning. Prickling as from a thousand pins, on the inner surface of the sternum. Violent stitching pain above the right breast. The mammæ are painful, especially when raising the arm. Congestions to the chest. 80. Acute pain in the left side, like a stitch. Painful stitches in the right side. Palpitation of the heart, for moments; at night; when lying; when raising one’s-self; as though the heart would turn ”

“ If infection occurs and an abscess develops, it results from the entrance, through the nipples, or cracks, or fissures in the nipple, of bacteria into the breast. There is fever, with chills and prostration, and very soon it is impossible to nurse the child because of the pain. Nursing should be immediately discontinued, the breast supported by a bandage and the milk drawn, with a breast pump, at the regular nursing intervals. An ice-bag should be constantly applied to the painful area and the bowels kept freely open with a saline laxative. ”

“ The breast should always be left free to grow in all its parts; and if there had never been any corsets, busks, or tight dresses among us, we should not meet that troublesome affection, the countersink of the nipple. If young ladies could know how great an amount of suffering they are rendering themselves liable to, when they compress their bodies in this way, they would, I am sure, one and all, avoid that which can do them no good at the time, and must end in inevitable harm. ”

“ In the majority of cases, this inflammation is managed without much difficulty; but in some cases it would appear that the part must suppurate, or break, as we say, forming what we call the mammary or milk abscess. This is one of the most troublesome things women are ever brought to endure; but however much pain and discomfort milk-abscess may cause the patient, it never kills; and yet the patient may be kept for months in the sick room, suffering from the affection more than tongue can tell.
Inflammation of the breast may come on at any time during lactation. ”

“ Should a post-partum hemorrhage occur, in the absence of the doctor, the nurse should massage the fundus, unless she has been instructed not to, and have some one elevate the foot of the bed on blocks or the seat of a firm, straight chair. The use of ice bags or cold compresses on the abdomen is sometimes helpful and some physicians advise placing the baby at the mother’s breast immediately, since the suckling stimulates the uterine muscles to contract. ”

“ Such cleansing protects the breasts against infection, a complication which the nursing mother must spare no pains to prevent. Now and then, in spite of conscientious efforts to harden them, the nipples become sore. If they crack, the baby's mouth must not come in direct contact with them, since nursing with a cracked nipple is a common source of a gathered breast. Fortunately when a nipple cracks we may employ a shield, obtainable at any drug-store, which enables the infant to nurse without any danger to the mother. Most babies will take the shield as well as the breast itself ”

“ The important form of a gathered breast I will now describe: A severe gathered bosom is always ushered in with a shivering fit. Let this fact be impressed deeply upon my reader’s mind. This shivering is either accompanied or followed by sharp lancinating pains of the bosom. The breast now greatly enlarges, becomes hot, and is very painful. The milk in the affected bosom either lessens or entirely disappears. If the child be applied to the breast (which he ought not to be) , it gives the mother intense pain. She is now feverish and ill; she loses her strength and appetite, and is very thirsty. ”

“ The whole of its breast was raw from the blister, and its mouth, lying open, showed, with painful distinctness, the dreadful injury wrought by the mercury thrown, with such a liberal hand, into its delicate system. All the life seemed to have withdrawn itself from the skin; for the vital forces, in the centre of its body, were acting but feebly. ”

“ In this wonderful fact, as in many others of the living body, we see the ever-beautiful order of nature, in adapting her means to her ends. If every thing happened by chance, we might just as soon find the breasts containing less blood when milk is needed, as more. But the doctrine of chance is too palpably absurd to need comment.
Symptoms of Inflammation of the Breast.—A day or two, or a few days after delivery, we often find the patient apparently so well and in such good spirits that we conclude there is no further need of our attentions. ”

“ An accidental blow, likewise, so slight that it would scarcely be felt upon almost any other part of the system, may cause a mammary inflammation and abscess. And, worst of all, to think of many a poor mother who has so poor a habitation, is so much oppressed by the cares and perplexities of domestic life, and has such poor care and nursing that she is always in great danger of suffering with inflamed breasts. ”

“ The inflamed breast is enlarged, tender and painful, and the skin over it is hot, and perhaps too reddened. The woman feels ill and feverish, and she may shiver, or have a definite rigor—which suggests that the inflammation is running on to the formation of an abscess. The abscess may be superficial to, or beneath, the breast, but it is usually within the breast itself. The infant should at once be weaned, the milk-tension being relieved by the breast-pump. ”

“ A sore on the womb, lip or tongue, or lump on the breast that continues for a little time without getting better, is dangerous. It may soon spread in the surrounding tissue and general system. Operations on the womb and breast, performed in time, are very successful. Such tumors or sores should not be neglected. A lump in the breast should be examined early. The womb should be examined if there is a discharge from the vagina that continues. ”

“ Should the breasts be much swollen relief can be obtained by massage with warm olive oil and by the use of a breast pump. The tips of the fingers only should be used in giving massage and the stroke should be light, from the circumference to the center. Roughness and pressure must be avoided.
INFLAMMATION OF THE BREAST, Abscess; Broken Breast.—This usually results from germs. The breast inflames, the milk tubes are choked and distended, there may be fever. There is sometimes severe local pain, hard swelling and an abscess forms and if this breaks it is called broken breast. ”

“ Whatever the lump may be, it has no business there in the breast, any more than a bullet has. If it is only a small benign tumor, the process of taking it out is very simple, and there is nothing further to do. ”

“ Not so with sickness arising from disease, or disordered condition of the stomach.
Shooting pains through—enlargement of—and other changes of the breast. When two months of pregnancy have been completed, an uneasy sensation of throbbing and stretching fulness is experienced, accompanied with tingling about the middle of the breasts, centring in the nipple. A sensible alteration in their appearance soon follows: they grow larger and more firm. The nipple becomes more prominent, and the circle around its base altered in color and structure, constituting what is called “the areola.” ”

“ Breast abscess occurs most commonly in nursing mothers, as where a part is most active there is most danger of abscess. Many benign tumors of the breast, as the fibrous tumors, occur and are especially common in young women. If a fibrous tumor is allowed to develop it may become cancerous. Cancer, however, generally occurs after the age of forty and is usually due to some irritation, as to a blow from a ball.
The arteries of the breasts are the thoracic branches of the axillary, the intercostal, and the internal mammary.
The nerves are from the thoracic cutaneous. ”

“ When the uterus lies in the vagina it is spoken of as prolapse, when it protrudes through the vulva it is procidentia. The causes are directly due to increased intra-abdominal pressure, increased weight of the uterus by fibroids, violent straining, chronic cough and weakening of the supporting structures of the pelvic floor, such as laceration of the vagina and perinaeum. Traction on the uterus from below (as a cervical tumour) may be a cause; advanced age, laborious occupations and frequent pregnancies are indirect causes. ”

“ I have previously alluded to the mistake 285into which mothers and nurses are led by the appearance of a swollen breast; it is not evidence that the gland can secrete freely, and it is in this turgid state that the excessive irritation tells most severely. This hyperæmic [plethoric] condition seems to be a step toward inflammation, and the irritation supplies that which is wanting to complete the process. If a woman will only remove the child from the breast directly the act of sucking produces pain, she may be pretty sure to avoid abscess. So long as the milk can be obtained there is no pain. ”

“ This ulcer is often so exceedingly painful, that the mother is unwilling to nurse the child as often as it should be done; thus exposing her to the evils of an over-distended and inflamed breast; and we may judge something of the anguish which the poor patient endures, when we see the tears streaming from her eyes every time the child attempts to nurse. We see, too, how difficult it must be, in many cases, to cure this kind of sore nipple, since every time the child takes it into its mouth it holds and stretches the part, thus causing the crack to become larger and worse. ”