General These are constituted by the symptoms accom panying what was formerly called milk-fever, the existence of which is denied to-day, and which, according to those who believe in it, manifests itself by cephalalgia, neuralgic pains, slight chills followed by heat and perspiration, thirst, anorexia, coated tongue, rapid pulse.
For our part, we do not believe in milk fever; without denying its very existence, we believe it to be exceptional. In 1863, we cited a number of instances, and we have since noted others, which are incontestible, where the appearance of the milk was accompanied by high febrile reaction, preceded by a marked chill, and disappearing at the end of twenty-four hours, aside from any treatment, but purely because the function of lac tation was established. The rise of temperature, it was impossible to consider due to a morbid phenomenon, and which we, consequently, be lieve we are right in attributing to the physiological congestion of the mamma alone.
Chantreuil, in his study of milk-fever, analyzes the symptoms which have been enumerated, and says that he has never observed the chill in any one of the fifty cases under his own observation. Blot has noted it twice, and we have seen it twice in the same woman, in different confinements.
The pulse, according to Lorrain, might be modified in its form and fre quency, when lactation passes the physiological limits. In fifty women Chantreuil found the pulse: In leabove 76; in 21 between 76 and 100; in 13 above 100.
In the first series, no fever, but the physiological slowing of the pulse was less marked.
In the second series, there were sub-febrile phenomena, but in the women there existed great distension of the milk ducts, faulty develop ment of the nipple, tardy appearance of the milk or incomplete, either from the mother's unwillingness to nurse or congenital weakness of the infant, fissures, ulcerations of the nipples, after-pains, slight metritis, scarlatiniform eruptions.
In the third series, alarming abdominal affections, variola.
The temperature, taken in the axilla, was never, in the normal cases, elevated more than one half degree. Chantreuil's researches included the entire time requisite for the establishment of the function, that is to say, during the third, fourth and fifth day. He concludes: " 1st. The mor bid entity, called milk-fever, exists only very exceptionally. 2. In nor mal cases, the pulse does not range above 76 while lactation is becoming established, and hence, there is no question of fever. 3. The tempera..
tore ranges with the pulse. A. In normal cases, the absolute temperature is not elevated, while the function is establishing, above 98.2 to 99.4 F., figures which have, by common consent, been adopted as normal. B. Our researches teach us that the temperature after rising immediately after labor, falls the next day, rises during secretion of the milk about + a de gree, and then falls, or rises later according to circumstances. C. This slight rise in temperature may be attributed to the physiological work the mamma) are performing, but also to solutions in continuity of the genital organs, and to the modifications which are occurring throughout the body as a whole at this time. D. A rile above one degree points to the pres ence of some morbid factor with the establishment of lactation." [In one hundred puerperal, primiparce and multiparie, noted especially in regard to the so-called " milk-fever," our own conclusions accord with Chantreuil's. Septic causes aside, a rise of temperature above 1° F., during the first three days after labor, calls simply for a cathartic. True milk-fever we have never seen.—Ed.]