Dr. Burns has given us a sad picture of what not unfrequently results from mammary abscess; and that the reader may have, on good authority, an account of the sad condition which sometimes results from the affection, I quote his own words:
“It sometimes happens, if the constitution be scrofulous, the mind much harrassed, or the treatment not at first vigilant, that a very protracted, and even fatal disease, may result. The patient has repeated and almost daily shivering fits, followed by heat and perspiration, and accompanied with induration or sinuses in the breasts. She loses her appetite, and is constantly sick. Suppuration slowly forms, and perhaps the abscess bursts, after which the symptoms abate, but are soon renewed, and resist all internal and general remedies. On inspecting the breast at some point distant from the original opening, a degree of œdema may be discovered, a never-failing sign of the existence of deep-seated matter there, and, by pressure, fluctuation may be ascertained. This may become distinct very rapidly, and therefore the breast should be examined carefully, at least once a day. Poultices bring forward the abscess, but too slowly to save the strength, and, therefore, the new abscess, and every sinus which may have already formed or existed, must be, at one and the same time, freely and completely laid open, and, so soon as a new part suppurates, the same operation is to be performed. If this be neglected, numerous sinuses form, slowly discharging fetid matter, and both breasts are often thus affected. There are daily shiverings, sick fits, and vomiting of bile; or absolute loathing of food, diarrhea, and either perspiration or a dry, scaly, or leprous state of the skin; and sometimes the internal glands seem to participate in the disease, as those of the mesentery, or the uterus is affected, and matter is discharged from the vagina. The pulse is frequent, and becomes gradually feebler, till, after a protracted suffering of some months, the patient sinks. It is observable, that often, in those cases which seem to depend on a constitutional cause, and when there is great debility, the sinuses heal rapidly, after being laid open, but a new part instantly begins to suppurate. Internal remedies cannot be depended on here, for they cannot be retained. If they can be taken, they are those of a tonic nature that we would employ, with opiates to abate diarrhea and procure sleep.”
LETTER XXXVII.
CASES IN MIDWIFERY.
A Collection of Facts Illustrative of the Effects of Water-Treatment before, during, and after Childbirth.
In the year 1843, at which time the water-cure had been heard of this side of the Atlantic only by a very few, I for the first time applied water-treatment in a case of midwifery. I had, it is true, been for months, and I may say years, studying upon the matter, as a student of medicine who is determined, above all things, to learn and practice the truth, ought; yet I had no opportunity of bringing the principles which I believed in to bear directly upon any given case previously to the period referred to. The following then, are some of the leading particulars of my first case:
Case I.—The lady was a resident of this city, of a feeble constitution by inheritance, and, I think, twenty-one or two years of age. For three or four years previous to her confinement her health had been, on the whole, much improved. Her constitution seemed, indeed, to undergo a remarkable change for the better, in consequence of leaving off tea, coffee, spices, butter, and flesh-meat, and at the same time practicing the daily bath. She, in short, became, as her flesh-eating friends said, “a thorough Grahamite.” Notwithstanding her improvement, however, she suffered miscarriage two or three times in as many years.
During the period of pregnancy of which I am speaking, I advised her to be very particular in keeping up her baths, exercise, diet, etc. She followed the advice faithfully. She suffered somewhat from neuralgic pains in the abdomen, but these were in general readily checked by the use of wet compresses, and the sitting and other baths. Few patients have ever been as faithful as she was in carrying out all good rules. She kept up her bathing and exercise to the very day of labor.
There was one circumstance which operated against her a good deal toward the close of the period. A worthy and skillful medical friend advised that she should have premature delivery brought on, because her pelvis was, as he said, too small to allow of the birth of a full-grown child. This advice, however, she would not, on any account, entertain, notwithstanding she had the utmost confidence in the skill and honesty of her friend. She resolved to trust God for the result, although she was well aware that she was to pass through a most fearful ordeal of danger and suffering. As it proved afterward—for she has borne a number of children since—her own instinct was better than all the knowledge of her medical friend.
Her labor was a very severe one, and she met it with most praiseworthy courage. She was at length delivered safely. The child was of more than average size, but owing to a malformation it could not live. Her maternal feelings were of the strongest kind, and the loss of her child was a great blow upon her spirits. She was, however, up daily, more or less, from the very first. Indeed, it was not two hours after the birth—she having been awake all night—before she stood up, and was thoroughly washed in cold water from head to foot. She knew what cold water had done for her before, and she was not afraid that it would fail her now in her time of need.
She pursued the treatment from day to day, observing the greatest care not to overdo. She understood well, young as she was, the great importance of mental quiet under such circumstances, and saw no company for many days. On the sixth day she had so far recovered as to be able to walk to the Battery, a distance of a mile and a half. The weather being hot, she rested awhile upon the shady seats of that beautiful inclosure, and was much refreshed with the sea breezes which are so genial at that season of the year. Afterward she walked back home, making, in all, a morning excursion of three miles.