It must not be forgotten, however, that though gentle rubbing afford relief to the breasts when they are hard, knotty, and over-distended, any friction is injurious if gathering has actually commenced. In all cases, therefore, it is of importance to distinguish between over-distension (which may lead to inflammation) and a condition of already established gathering of the breasts. This it is not difficult to do. In the former case the skin is pale, there is little or no tenderness, and the hardness is evenly diffused over the whole of the breast; whereas, when gathering has taken place there is a blush of redness on some portion of the breast, which is always painful to the touch, and which will be found to be particularly hard and sore in some one spot.
The symptoms of gathered breasts we have just described in part. The severity of the symptoms will depend upon the extent and depth of the inflammation. The affection is always ushered in by shivering, followed by fever and a shooting pain in the breasts. A small, hard, painful swelling will be noticed in the breast even before the skin shows any sign of redness. This swelling increases in size and the suffering becomes very great and difficult to bear, preventing sleep and prostrating the whole system. The secretion of milk is suspended at least during the first active stage of the disease.
The object of treatment is to prevent the formation of an abscess by subduing the inflammation as speedily as possible. This is to be sought first by keeping the breast as nearly empty as possible. For this reason the child should be assiduously applied to the affected rather than to the well side, although suckling will be painful. Indeed, it is better, if it can be done, to procure an older child and let it keep the milk under. When, however, the inflammation is fully established, the pain will compel the restriction of the child to the well side. The application of warmth is both grateful to the part and beneficial. This may be done by means of poultices or fomentations, or by immersing a wooden bowl in hot water and putting the breast, wrapped in flannel, within it. This latter means will be found an easy and agreeable one of keeping up the application of dry heat. The bowels should be briskly purged by a dose of citrate of magnesia or cream of tartar. The diet must be mild, and the breasts supported in a sling. If, in spite of all these efforts, an abscess actually forms, the attending physician will doubtless advise its immediate opening, to which advice the patient should accede, as that is the course which will afford her quicker and more effectual relief than she can hope for from nature's unaided efforts at effecting a discharge of the pent-up matter.
It is interesting for the mother to know that if her child be still-born, or if unfortunately she be unable from any of the reasons mentioned in our chapter on Hindrances to Nursing to give the breast at all to her child, she is not liable to gathering on this account. This is contrary to what might be expected. It is not the mother who is unable to nurse at all who suffers, but she who does so in an unsatisfactory manner and who fails to have her breasts properly emptied.
The first milk which makes its appearance in the breast towards recovery from inflammation is likely to be stringy and thick, and should, therefore, be rejected before nursing is resumed.
THE SINGLE LIFE.
A few words, ere we pass to another branch of our subject, on the physical relations of her who by choice or other reasons never marries. It is a common observation among physicians who have devoted themselves to the study of woman's physical nature, that, in spite of those perils of maternity which we have taken no pains to conceal, the health of single women during the child-bearing period is, as a general rule, not better, not even so good, as that of their married sisters. Those insurance companies who take female risks, do not ask any higher premium for the married than the unmarried.