A system of midwifery : including the diseases of pregnancy and the puerperal state / by William Leishman.

Date:
1876
Catalogue details

Licence: Public Domain Mark

Credit: A system of midwifery : including the diseases of pregnancy and the puerperal state / by William Leishman. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    of the corium at some points, so as to give facility to the expansion due to growth of the gland. The secretion of milk in the breasts has very generally been supposed by the vulgar to be an infallible sign of pregnancy, either past or existing. Nothing can be more erroneous than such a conclusion : but, at the same time, the presence of milk in the ducts is, when taken along with other signs, often of very considerable importance. It is proper to mention, however, that not only is milk in the breasts no certain sign of pregnancy, but numerous cases are recorded by Montgomery and others, where the breasts of young women who had never been pregnant, and of old women past child-bearing, have yielded milk in sufficient abundance to suckle a child. A striking case of this nature was narrated to the writer by Dr. Livingstone, the renowned African traveller, who had so investigated the circumstances as to eliminate even the possibility of doubt. A native woman was delivered of twins, and not being constitutionally very robust, was unable to nurse both, whereupon the grandmother, a woman of sixty, took one infant, when, after repeatedly placing it to the breast, the secretion was so abundantly established, that she proved an excellent nurse. Nay, more than this, there have been cases in which the gland in the male has secreted milk in considerable abundance. Surrounding the nipple, and circumscribed by a circle of about three- fourths of an inch radius from its centre, the skin presents, in the adult and unimpregnated condition, a peculiar- appearance, which consists chiefly in an increased depth of colour. It is thin and delicate, and presents to the eye the semblance of a structure intermediate between skin and mucous membrane. From its surface, small glandular emi- nences, varying in number from twelve to twenty, or more, may be seen to project slightly. This area, which is called the Areola, is the seat during pregnancy of changes which are frequently of the greatest importance in strengthening the presumptive proof which may already exist; but it must always be remembered that changes, closely resem- bling those which we are about to describe, may be produced by causes which have their seat in the generative system, but which are inde- pendent of pregnancy; and, moreover, that as the changes are to a considerable extent permanent, it is in first pregnancies that they have the greatest diagnostic value. The following are the appearances referred to :—If the breast be carefully examined about the ninth week, a considerable increase in the size of the nipple will almost always be observed, this structure having become turgid, and, as it were, erect. Simultaneously with this, or closely succeeding it, there is a deepening in the colour of the areola, an increase in its diameter, and a greater