MAMMITIS. 451 



well as within the ducts and cavities of the vulvo-vaginal glands 

 and even the cervical canal or uterus. 



Absorption of septic products by the lymphatics of the vulva 

 induces lymphadenitis in the inguinal region ; absorption by the 

 lymphatics of the lowest part of the vagina also infects the 

 inguinal glands, but absorption by those of the upper part of the 

 vagina involves the iliac lymphatic glands. 



THE MAMMARY GLANDS. 



Mastitis (inflammation of the nipple). Inflammation of the 

 nipple is common during lactation. The skin surmounting the 

 nipple, although covered by stratified epithelium, is delicate and 

 becomes easily cracked. Fissures infected by bacteria thus 

 readily arise and may be extremely painful, sensations being 

 conveyed by the third and fourth thoracic nerves. In the areola 

 around the nipple are numerous large sebaceous cysts, which are 

 sometimes the seat of inflammation which may terminate in 

 suppuration giving rise to one form of supra-mammary abscess. 



Mammitis (inflammation of the mamma or breast proper). 

 The usual variety of mammitis is the acute, caused by septic 

 absorption from the nipple. The summit of the nipple is 

 slightly fissured, and opening upon it are the orifices of the 

 radiating milk ducts which, in the adult, and particularly during 

 lactation, are sufficiently large to admit a bristle. Just beneath 

 the surface the ducts are somewhat dilated. Each duct repre- 

 sents the excretory tube of a lobe of the gland, there being some 

 twelve to fifteen lobes and ducts. Each lobe is separated from its 

 neighbour by an intervening septum of fibrous tissue, often called 

 a suspensory ligament. It will thus be seen that there is a direct 

 and open channel along which organisms may pass from the 

 surface to the depth of the gland, through the orifices of the milk 

 ducts, and along the ducts themselves to the acini of the lobes. 

 There is also another track along which infection may occur, 

 namely the lymphatic, setting up an acute lymphangitis of the 

 mammary tissue. 



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