Identifier: textbt00hirs (find matches)
Title: A textbook of obstetrics
Year: 1899 (1890s)
Authors: Hirst, Barton Cooke, 1861-1935
Subjects: Obstetrics
Publisher: Philadelphia : Saunders
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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rtednipples (Fig. 473). The nipples should always be examinedduring pregnancy. If they are inverted, a systematic attemptshould be made during the last month to draw them out with abreast-pump. Should this attempt fail, a nipple-shield mightenable the child to nurse. 044 PATHOLOGY OF THE PUERPERIUM. Abnormalities of the Breasts and Anomalies in the MilkSecretion.—Milk secretion begins usually forty-eight hours afterdelivery. Previous to this time a thin fluid can be squeezed from the breast, containing large cells, within which are contained manyfat-globules. To this substance the name colostrum has beengiven, and these cells are called colostrum corpuscles. It isalways difficult to estimate the exact quantity of milk secreted.The best way is to draw the milk with a breast-pump at regularintervals during the twenty-four hours ; but the breast-pump doesnot excite maternal emotion, and, therefore, it always draws a lessquantity than would be furnished a suckling infant, for the breast
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Fig- 473-—Faulty development of the nipple. is in some degree an erectile organ, and even the sight ofthe child may be sufficient to produce a flow of milk. Allowingfor these errors, there will be found, at the end of the seventh day,about fourteen ounces in the twenty-four hours. During the fivepreceding days the quantity is small and variable. By the endof the fourth week the quantity of milk secreted in the twenty-four hours reaches about two pints. From this time it increasesgradually until the sixth or seventh month, when about threepints of milk can be drawn from the breast in twenty-four hours.After the eighth month tlu- quantity of milk gradually decreases.A curious anomaly of milk secretion is its occurrence independentof the puerperal state, as in very old women or very young girls, ANOMALIES IN MILK SECRETION 645 after operations upon the ovaries,1 at the menstrual period,- oreven in the adult male.3 The most important abnormalities of milksecretion may be grouped under t

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