. An American text-book of obstetrics. For practitioners and students. eous, in whichthe connective tissue lying immediately beneath the skin is attacked. The thirdvariety is the rare and insidious inflammation of the post-mammary or sub-glandular connective tissue between the gland and the chest-wall. This divisionof mastitis should not obscure the fact that clinically two or all three varietiesmay be combined, especially in cases which do not receive prompt treatment inthe beginning, since either variety may end in a combination of all commonly begins as the parenchymatous var
. An American text-book of obstetrics. For practitioners and students. eous, in whichthe connective tissue lying immediately beneath the skin is attacked. The thirdvariety is the rare and insidious inflammation of the post-mammary or sub-glandular connective tissue between the gland and the chest-wall. This divisionof mastitis should not obscure the fact that clinically two or all three varietiesmay be combined, especially in cases which do not receive prompt treatment inthe beginning, since either variety may end in a combination of all commonly begins as the parenchymatous variety and approaches theskin-surface of the gland. Etiology and Pathology.—The etiology of puerperal inflammations of thebreast has actively been discussed in recent years, and, although the investiga-tions of bacteriologists have wrought a change in our notions of the pathologyof mastitis, the subject is not wholly free from uncertainty. Formerly it wasbelieved that engorgement of the gland with stasis of the milk was invariably PATHOLOGY OF THE PUERPEBIUM. 757 n!. the cause of all mammary inflammation ; but this idea has disappeared largely,since most pathologists consider inflammation, wherever found, of microbicorigin. Recent experiments have shown that stasis of the milk will not pro-duce mastitis except when the milk contains bacteria. Ligation or stoppageof the milk-ducts by collodion (Kehrer) failed to produce inflammation of thebreast in animals. The extreme rarity of mastitis in supernumerary breasts,and the fact that the frequency of the disease has been lessened so greatly sinceantisepsis has been extended to the careof the breasts, have also been advancedas arguments in favor of the unimport-ance of stagnation of the milk. Thereis, however, a clinical side to this ques-tion, which forces the belief that milk-stasis continues at least a predisposingfactor in mastitis, especially in the veryimportant parenchymatous variety. Sta-sis certainly is a frequent precursor
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectobstetrics, bookyear1
