MAMMITIS 
815 
Indirectly much that is apparently done for other objects 
operates in a similar manner. Belladonna, hyoscyamus and 
other members of their group probably are in a degree directly 
antiseptic, but largely indirectly by stimulating the vessel walls, 
causing their contraction and leading to a more effective circu¬ 
lation, always inimicable to the life of the germs of wound in¬ 
fection. Blood stasis on the other hand favors their growth. 
Massage and fomentations tend in the same way to check 
bacterial production. For the same reason Vennerholm and 
many other writers favor the use of suspensories with poultices, 
while still others commend the application of various adhesive 
applications which in drying contract and tend to relieve con¬ 
gestion by mechanical support. 
Systemic disturbances demand the practitioner’s attention 
and it is questionable in many cases whether the local or con¬ 
stitutional treatment is the more important. We know that pa¬ 
thogenic bacteria largely lose their power of multiplication and 
of injury in the absence of their products, hence if the system 
can successfully eliminate these an essential arrest in the pro¬ 
gress of infection has been made. 
The eliminative agent recommended is purgation, and in the 
past this has been largely confined to the use of saline and ole¬ 
aginous cathartics. While their value cannot be denied they 
are defective because of slowness of action in acute cases where 
time is all important. 
More effective theoretically are pilocarpine and eserine, 
which act within ^ to i ^2 hours. They have the advantage 
of promptness, they can be quickly repeated until desired effect 
is had, and while stimulating the action of the bowels, at the 
same time arouses, with energy, excretion by almost every gland 
in the body, markedly the salivary and cutaneous, and it has 
appeared to us the milk glands also. These drugs have an 
effect closely allied to the hypodermic or intravenous injection 
of salt solution and the intra-mammary injection of Schmidt in 
the treatment of parturient paresis. This latter is, of course, not 
available in mainmitis. 
