Identifier: modernsurgerygen1919daco Title: Modern surgery, general and operative Year: 1919 (1910s) Authors: Da Costa, J. Chalmers (John Chalmers), 1863-1933 Subjects: Surgery, Operative Publisher: Philadelphia : Saunders Contributing Library: Columbia University Libraries Digitizing Sponsor: Open Knowledge Commons

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Text Appearing Before Image: powder as soon as an act of nursing is completed. Washing thenipples regularly with the following solution tends to prevent the formationof a fissure: iodid of mercury, 2 gr.; alcohol, 119 oz.; glycerin and distilled water,of each a pint (Lepage). If a small abrasion appears, order the woman towear a nipple-shield during nursing, and after each act of nursing to wash the partwith hot sterile water, to dry it and to dust borated talc over the surface. Ifa fissure forms, wean the child at once, and dry up the milk on both breasts.It is useless to try to dry it up in one breast. Milk may be dried up by apply-ing ointment of belladonna locally, and administering iodid of potassium, inter-nally; by strapping the breasts with adhesive plaster (Parker); or by applyingto the nipples six times a day a 5 per cent, solution of cocain in equal parts ofglycerin and water (Joise). The fissure is not treated by ointments. Thesepreparations are septic, prevent drainage, and aggravate maceration. Wash

Text Appearing After Image: Fig. 1084.—Hypertrophy of breast. Acute Abscess of the Breast 1575 the fissure twice a day with peroxid of hydrogen, dress it with gauze wet in boricacid solution (10 gr. to i dram of waterj, and cover the dressing with waxedpaper. If the fissure resists treatment, touch it with lunar caustic. Acute Mastitis and Abscess.—Acute inflammation of the breast, asa result of injury of the breast or nipple, may occur in either sex at any timeof life. Very commonly in both sexes a few days after birth the breast be-comes distended with a material which in reality is milk. The fluid is usuallysmall in quantity. The process is physiological, and, as a rule, ceases spon-taneously (Guelliot). If it lingers, the application of belladonna ointment wiHstop secretion. If the nurse meddles with the glands and tries to squeeze outthe fluid, acute mastitis is apt to arise in one gland, or occasionally in both.The skin of the breast reddens, the gland swells and becomes tender and pain-ful, the child

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