BREAST, INFLAMMATION OF.—A condition which is essentially the result of the resistance offered by the body against bacteria which have invaded the glandular tissue of the breast. In order to combat this invasion, the organism sends an increased amount of blood to the part, causing, as a result, pain, swelling, local heat, and redness. This reparative effort may be sufficient to overcome the bacteria and render them harmless. If in any given locality the bacteria gather in preponderating numbers, the leuco cytes, or white-blood-cells, leave the blood-channels in hordes and literally devour the offending invaders. This process results in suppuration and abscess formation, and the further advance of the bacteria is halted by a surrounding wall of inflammatory tissues. Minute collections of pus scat tered among the tissue-spaces may be entirely absorbed by the lymphatics. As .the bacteria, in addition to their local destructive action, also produce toxic substances which are taken up by the system, severe general disturb ances may be observed from the very first. These consist in increase of temperature and pulse-rate, and in more or less marked prostration. These symptoms are especially severe, because the blood and lymph vessels, par ticularly in the breasts of nursing mothers, are well developed and consider ably dilated, wherefore the toxic materials are taken up by the system in large amounts. When there is a constantly increasing collection of pus in any one locality, the surrounding tissues become separated, or may even be destroyed. In this manner the abscess gradually Works its way to the skin, and finally breaks through the latter. This process may be hastened by the application of hot poultices, mustard-plaisters, etc.
In addition to the general symptoms already noted, there are those due to the local process, similar to those from any other inflammation : local redness and heat and a gradual loss of function, the milk giving out, although the breasts are tense and apparently distended. The temperature may rise to 1o4°F. (40°C.) or more, but this does not seem to be of any great moment. Life is endangered only in exceptional instances, where there is a very virulent infection in the presence of lowered vitality and consequent dimin ished resistance in the patient ; or where some method of treatment has been employed which retards rather than aids the natural process of resolution.
Unfavourable conditions and neglect in giving the trouble proper atten tion may lead to very extensive suppuration of one gland, with involvement of the second, so that nursing is not only entirely interrupted, but the mother's recovery may be protracted for weeks and months. When suppuration
has once begun, it can with difficulty be retarded ; but it io possible to re strict the inflammation in the early stages by the continued application of cold, which must be done under the direction of the physician. As soon as pain and discomfort is observed during the period of nursing, medical advice should be sought at once.
It is, however, even more important to avoid the possibility of this trouble. The points of entrance for the infectious organisms are usually small cuts and tears on the tender skin of the nipples, which give rise to a burning pain when the child is given the breast. Under these conditions the child should be nursed only with the aid of a nipple shield. If the sen sitiveness continues, even after the application of alcohol, antiseptic solution (boric acid), or other cooling lotions, nursing from the affected breast should be stopped at once. The physician had better be called in consul tation, especially if portions of the breast have become red and tender. The abrasions are often hard to find ; nevertheless bacterial contamination may readily take place from contact of the wounded nipple with the under clothes, from the mouth of the infant while nursing, or from being touched with dirty fingers. The cloths used for the antiseptic applications should be changed every half hour ; if adherent they should not be pulled off roughly, but only after being thoroughly wet. The manner of avoiding the production of these abrasions and 'subsequent infection will be found fully described in the article on NURSING. .
Inflammations of the breast also occur in infants. The glands may swell to the size of a walnut, and become red and tender. Suppuration rarely follows, such as that which in adults leads to deformity of the nipple and inability to nurse properly. In these cases the inflammation should also be treated from the very beginning with antiseptic applications. In no case should the inflamed gland be subjected to pressure The infectious organisms usually reach the interior of the little ducts in the nipples either during delivery, \\hen there is a contagious vaginal secretion present, or later on from uncleanliness.