590 MANAGEMENT OF LYING-IN WOMEN. 



small and hard is soon developed; the breasts grow hard, swelled, 

 and so painful in the course of a few hours, as to interfere with the 

 motions of the arms and chest; first a moisture, and then a sweat 

 succeed this stage; the pain in the head ceases; the fever abates in 

 the course of six, eight, ten, twelve or twenty-four hours, and, the 

 reaction which produces the milky secretion is completed; but the 

 breasts remain swelled and painful much beyond this period, espe- 

 pecially in women who do not give suck. 



While the fever continues, no broths, nor potages, nor heating 

 drinks should be given. Should it be too high, an attempt to mo- 

 derate its violence should be made by means of a small bleeding. 

 But in general it requires only the hygieinic treatment pointed out 

 higher up. The coming of the milk is pretty often preceded with 

 the suspension, or at least a sensible diminution, of the lochial dis- 

 charges, which soon return to their natural course. Sometimes these 

 two phenomena see'm to have no influence upon each other, the 

 lochia do nQt appear again at all after the milk-fever is gone off. 



For an account of lactation in general, the diet of the foetus, the 

 choice of a nurse, the disease of the breast and nipple; for the his- 

 tory of fistulas, whether recto-vaginal or vesico-vaginal, or other 

 serious lesions which are the effect or consequence of certain labo- 

 rious labors, I can only refer to the general treatises on Physiology, 

 Medicine, or Surgery that treat upon them; particularly those of MM. 

 Bicherand, Magendie, Adelon, Leger, Sabattier, Boyer, &c., and to 

 the excellent articles by M. Desormeaux in the Didionnaire de 

 Medecine. But there are certain accidents of a less redoubtable kind, 

 concerning which 1 cannot dispense with saying a few words in this 

 place. 



1250. Complete or partial Inversion of the womb is recognised 

 by the reddish or livid tumor which projects into the vagina or vulva, 

 by the absence of the uterine globe above the pubis, and by the pains 

 and syncope experienced by the woman, &c.; although none but the 

 grossest ignorance could confound an inversion of the womb with a 

 polypus in that organ, yet men are sometimes seen, even at Paris, to 

 commit this mistake, even though they are clothed with the title of 

 physicians. Haste should be made to reduce the displaced organ. 

 For this purpose the woman should be so placed that her hips may 

 be higher than her breast; then the hand being furnished with a piece 

 of fine linen spread with cerate, the external tumor "should be com- 

 pressed gradually and without shocks,* and in a steady manner, and 



* This is the direction given by almost all the authors. — It is not good to 

 compress the womb; such an action only excites the contractions or after-pains, 



