548 OF SECRETION. 



able matter (sugar) which it contains. The instances of the vicarious secre- 

 tion of milk are not numerous ; and in no "instance is there any proof that the 

 elements of the fluid were pre-existent in the blood. Some of the most curious 

 are those in which it has been poured out from a gland in the groin ; but it 

 is probable that this was in consequence of the existence of a real repetition, 

 in that place, of the true mammary structure, this being the situation of the 

 mammae of many of the inferior animals, of which the analogues in Man are 

 usually undeveloped. 



691. The following is a more unequivocal case of vicarious secretion ; and 

 it is peculiarly interesting as exhibiting the injurious effects of the re-absorp- 

 tion of the secretion, and the relief which the system experienced when it was 

 separated from the blood by the new channel. " A lady of delicate constitu- 

 tion (with a predisposition to pneumonia) was prevented from suckling her 

 child, as she desired, by the following circumstance. Soon after her delivery 

 she had a severe fever, during which her breasts became very large and hard ; 

 the nipples were swollen and firm ; and there was evidently an abundant 

 secretion of milk ; but neither the sucking of the infant, nor any artificial 

 means, could draw a single drop of fluid from the swollen glands. It was 

 clear that the milk-tubes were closed ; and as the breasts continued to grow 

 larger and more painful, purgatives and other means were employed to check 

 the secretion of milk. After three days the fever somewhat diminished, and 

 was replaced by a constant cough, which was at first dry, but soon after was 

 followed by the expectoration of simple mucus. After this, the cough dimi- 

 nished in severity, and the expectoration became easy ; but the sputa were no 

 longer mucous, but were composed of a liquid, which had all the physical 

 characters of genuine milk. This continued for fifteen days ; the quantity of 

 milk expectorated amounting to three ounces or more in the twenty-four hours. 

 The breasts gradually diminished in size : and by the time that the expecto- 

 ration ceased, they had regained their natural dimensions. The same com- 

 plete obstacle to the flow of milk from the nipples recurred after the births of 

 four children successively, with the same sequelae. After the sixth, she had 

 the same symptoms of fever, but this time, they were not followed by bron- 

 chitis or the expectoration of milk ; she had in their stead copious sweatings, 

 which, with other severe symptoms, reduced her to a cachectic state, and 

 terminated fatally in a fortnight."* 



692. Of the quantity of Milk ordinarily secreted by a good Nurse, it is im- 

 possible to gain any definite idea; as the amount which can be artificially 

 drawn affords no criterion of that which is secreted at the time of the draught 

 ( 426). The quantity which can be squeezed from either breast at any one 

 time, and which, therefore, must have been contained in its tubes and reser- 

 voirs, is about two ounces. The amount secreted is greatly influenced by the 

 mental and physical condition of the female, and also by the quantity and cha- 

 racter of the ingesta. In regard to the influence of the mental state upon this 

 secretion, ample details have already been given (Chap. vn.). With respect 

 to the physical state most favourable to the production of an ample supply of 

 this important fluid, it may be stated generally, that sound health, a vigorous 

 but not plethoric constitution, regular habits, moderate but not fatiguing exer- 

 cise, and an adequate but not "excessive amount of nutritious food, furnish the 

 conditions most required. It is seldom that stimulating liquors, which are so 

 commonly indulged in, are any thing but prejudicial; but the unmeasured 

 condemnation of them in which some writers have indulged, is certainly inju- 

 dicious ; as experience amply demonstrates the improvement in the condition 



* Bulletino delle Scienze Mediche, Apr., 1839; and Brit, and For. Med- Review, Jan., 

 1840. 



