THE REPRODUCTIVE ORGANS OF THE FEMALE. 



INFLAMMATION. (Mastitis.) 



705 



During lactation the nipple is liable to become inflamed, and ulcers 

 and fissures may form. 



There is a form of eczematous inflammation of the nipple and areola 

 which tends to ulcerate and in which carcinoma may originate. This 

 is known as Paget's disease, and is probably due to the presence of 

 coccidia. 



Acute Exudative Inflammation (Mastitis), This occurs most frequently 

 during lactation ; it also occurs during pregnancy, and occasionally in 

 women who are neither pregnant nor nursing. 



The process may involve the subcutaneous connective tissue, the 

 gland itself, or the connective tissue between the gland and the wall of 

 the thorax. The inflamed tissues are at first congested, swollen, hard, and 

 painful. The inflammation may stop at this point and resolution may 

 take place, but more frequently it is succeeded by suppuration. If the 

 inflammation involves the subcutaneous connective tissue the abscess may 

 be superficial and may soon open through the skin. If the gland be in- 

 volved one lobule after another may become affected (Fig. 461), so that 

 successive abscesses are formed. If the connective tissue beneath the 

 gland be inflamed a deep abscess of large size may be formed, which usu- 

 ally perforates through the skin, but sometimes into the pleural cavity. 

 In both these latter forms of abscess there is apt to be necrosis of large 

 portions of tissue. These abscesses may cicatrize, or they may pass into 

 a chronic condition and remain for a long time as suppurating, fistulous 



'- 



FIG. 461. SUPPURATIYE MASTITIS ix THE NON-FUNCTIONATING GLAND. 

 a. Milk duct ; b, intenstitial tissue ; c, dense collections of pus ; d, diffuse infiltration of lobule with pus. 



tracts. Suppurative mastitis is usually due to the presence of Strepto- 

 coccus and Staphylococcus pyogeues. 



In new-born children there is often a painful swelling of the breasts, 

 which usually subsides in a few days, but may go 011 to suppuration. 

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