. The breast: its anomalies, its diseases, and their treatment . cess. Primary mammary tuberculosis throughblood-vascular infection means that the bacilli have gained entrance to the blood-streamdirectly, have not caused disease at the point of entry, but have locahzed themselves inthe breast tissues. Secondary Mammary Tuberculosis.—With the few exceptions of direct inoculationof the breast, through abraded surfaces of the nipples and skin and possibly through themilk ducts, all mammary tuberculosis may be looked upon as a secondary manifestationof the disease. In many cases the bacilh can be
. The breast: its anomalies, its diseases, and their treatment . cess. Primary mammary tuberculosis throughblood-vascular infection means that the bacilli have gained entrance to the blood-streamdirectly, have not caused disease at the point of entry, but have locahzed themselves inthe breast tissues. Secondary Mammary Tuberculosis.—With the few exceptions of direct inoculationof the breast, through abraded surfaces of the nipples and skin and possibly through themilk ducts, all mammary tuberculosis may be looked upon as a secondary manifestationof the disease. In many cases the bacilh can be supposed to reach the breast throughlymph channels, probably by retrograde embolic processes. The most important pri-mary foci are located in the axillary, cervical, and retro-sternal lymph nodes, and theadjacent ribs, sternum, pleurte, and lungs. The tubercle bacillus may perhaps reach thebreast through Ijmphatic channels in the absence of lymph-node involvement. We knowthat the urine and bile of tuberculous subjects may contain tubercle bacilli at times in. Fig. io8.—Tuberculous ulcers of the breast. (Sheild.) THE INFECTIOUS DISEASES OF THE BREAST 205 the absence of renal or hepatix; localization. Hirschberger produced tuberculosis inlaboratory animals by inoculation with the milk of tuberculous cows, the udders ofwhich were entirely free of disease. Niepce observed a case of infantile infection in a child born of healthy parents, dueto bacilli-laden milk from a wet-nurse. Rogers and Garnier report a case in which themilk was proved infectious by animal inoculation and the breast found normal at obviously tuberculous mother is of course allowed to nurse her infant, but we believethe restriction should be applied to all mothers who are suspected of harboring a tuber-culous process, however latent. Every case of tuberculous mastitis should be looked upon as harboring the diseaseafter the removal of the involved breast, and should, therefore, be kept under strictr
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectbreast, bookyear1917
