§ 252. Mastitis, Inflammation of the mammae.

Mastitis occurs most frequently after parturition. At such periods the breasts require particular care and attention. Affections of the breast do not always arise from bad management after parturition; they frequently occur in consequence of the increased functions which those organs are called upon to perform at such periods.

§ 253. Soreness of the nipples is one of the most frequent occurrences during lactation, and induces many mothers to wean their infants at an early period. The nipples become painful, particularly while the infant is engaged in the act of nursing; upon close examination, it will be found that the epidermis has become detached, and that the parts where this has taken place are inflamed. If this inconvenience should not soon be removed, the nipples crack, and blood is apt to be drawn from such rhagades by the infant.

An excellent remedy for this affection is the tincture of Arnica, five, ten, fifteen or more drops to one hundred drops of water applied externally. The nipples require to be moistened with this solution every time the infant has been nursing, and before putting it again to the breast, the nipples have to be washed with tepid water. If the soreness should not be completely removed under the use of Arnica within two days, Sulphur should be exhibited, inasmuch as the affection, in such a case, evidently depends upon psora. In some cases Chamomilla, Calcarea, Lycopo-dium, Phosphorus, Silicea, Sepia, Graphites, are indicated from the commencement. The last-named remedy has been found particularly suitable when the inflammation around the nipple was of an erysipelatous nature. Graphites is likewise indicated when the mother had been formerly affected with scrofulous cutaneous eruptions, particularly tinea capitis, and continues to complain of a corrosive itching of the scalp, with a quantity of bran-like scales.

§ 254. Mastitis generally arises from stagnation of the milk in the breasts, from violent emotions, etc. When the breasts are inflamed, they are generally hard; the lactiferous tubes feel like knotty cords affected with tension and pressure, and which afterwards become inflamed. The surface of the breasts either wholly or here and there only, becomes red; a violent stinging pain is experienced, with burning, swelling, hardness, heat, and general febrile symptoms. When the inflammation is very violent, the secretion of milk ceases. A similar condition frequently sets in after weaning.

If the inflammation be not fully developed, Bryonia. is the principal remedy; but if it should be very acute, Belladonna has to be exhibited. These two remedies, even if they should not remove the difficulty entirely, yet meliorate the condition of the breasts, leaving slight hardnesses here and there, without much pain.

In females tainted with dyscrasia of one kind or another, these remedies will prove insufficient, and Sulphur, Conium, Carbo anim. or veg., Graphites, Phosphor., Silic, will have to be resorted to. Phosphorus is an excellent remedy in erysipelatous inflammation of the breasts, when inflammation is on the point of setting in or has actually commenced.

In suppuration of the breasts, which is exceedingly apt to set in after inflammation, Silic, Kreasot., Mer-cur., Carbo anim., Phosphorus, are excellent remedies. Silicea is particularly useful when portions of the breast have been destroyed by the suppurative process.