Part 1 (1/2)
Remarks on the Subject of Lactation.
by Edward Morton.
PREFACE.
Several cases which I witnessed led me to believe, some years ago, that inflammation of the brain, or its membranes, might be produced in children, owing to their being suckled for an undue length of time.
Since that period, having enjoyed opportunities of observing infantile diseases on a much more extended scale, and my attention being expressly directed to the point in question, I not only became fully convinced of the correctness of my previous conclusions, but was induced to carry them still farther.
My opinions on this subject were briefly drawn up and published in the _Medical and Physical Journal_ for August 1827, and have not pa.s.sed altogether unnoticed by my professional brethren[1], some of whom have done me the honour to speak of them in flattering terms, while no one, I believe, has attempted to disprove the existence of the important fact I was the first to announce.
[1] Vide Medico-Chirurgical Review, Gazette of Health, Dendy on Cutaneous Diseases, &c.
The bare statement of that fact was, indeed, nearly all that my approaching departure from England, at the time last mentioned, left in my power: upon the present occasion I have offered arguments for, and endeavoured to antic.i.p.ate those against, the deductions I then made public; and however imperfect may have been my success in either, the welfare of society at large is too deeply involved in the establishment of my opinions with respect to the custom I condemn, (if those opinions be correct,) for me to hesitate while again committing them to the press in a more extended form.
These considerations, I respectfully submit, will render any apology for the appearance of the following pages unnecessary, and will, I trust, secure for them a candid and favourable reception from the Profession and the Public.
_15, Eaton Street, Grosvenor Place, October 8, 1831._
CHAPTER I.
_Of the Breast-Milk, &c. &c._
No sooner has the child been ushered into the world than the b.r.e.a.s.t.s of the mother pour forth their milk for its sustenance. This bland fluid is secreted from the blood, and varies, in quality and quant.i.ty, according to the time which has elapsed from delivery, being peculiarly and wonderfully adapted at every period to the wants of the individual for whose use it is destined. Thus, that first secreted, called _colostrum_, possesses a purgative quality evidently intended by the all-wise Author of our being for the purpose of removing _the meconium_[A],--a process which experience has sufficiently proved to be necessary for the welfare of the newly-born infant. Afterwards, ceasing to possess this aperient property, it is calculated solely for affording nutrition; and finally, at a certain period from delivery, it gradually becomes impoverished, loses its former healthy qualities altogether, and acquires others which are injurious to life. This important change, as above noticed, generally happens at a certain period after delivery; varying, however, somewhat in particular women, and in the same female on different occasions: but, from disease, or other circ.u.mstances, the milk may become deteriorated before the time to which reference has just been made. If, for instance, the mother labour under any serious disorder, it is universally admitted that her milk may also become unhealthy; and this may take place even a short interval after delivery.
Although we cannot explain how the brain and nerves act, and probably never shall be able to do so, yet we are well aware that their influence is absolutely requisite for the healthy performance of every function in the human body.
That mental inquietude will impede digestion is a fact familiar to almost every one; but, I believe, it is not so generally known, that it will with no less certainty r.e.t.a.r.d and alter the nature of the secretion furnished by the b.r.e.a.s.t.s of the lactescent female. Violent affections of the mind will cause the milk to become thin and yellowish, and to acquire noxious properties: even the fond mother's anxiety, while hanging over the couch of her sick infant, will be sufficient to render it unfit for the sustenance of the object of her solicitude.
The state also of the stomach and bowels and the diet of the nurse materially and constantly influence the nature of the lacteal secretion.
The milk, besides, is liable to deterioration from another cause, namely, the recurrence of the usual periodical appearance--for should this take place in a nurse, it is agreed that her milk is liable to produce disorders in the child who imbibes it; which could not happen, if the former possessed its ordinary component parts, and retained its natural properties.
The recurrence, moreover, of pregnancy in the lactescent female may render the milk of a bad quality, and will invariably lessen its quant.i.ty. Mr. Burns a.s.serts that in these cases the milk 'does not become hurtful,' but in this opinion I must beg leave to differ from him; since I have repeatedly seen it, from this cause, palpably altered in appearance, and have observed diarrha and great debility produced in the children who were suckled with it.
An almost universally received opinion among females, and, indeed, one very frequently entertained by members of the medical profession, is, that while a woman continues to nurse her infant she will not again become pregnant; but this, as a general proposition, is unquestionably erroneous; it is even doubtful whether such opinion will hold good in a majority of instances. The continuance of lactation will very generally, it is true, tend to prevent the recurrence of the periodical phenomenon; yet, nevertheless, it will not in every instance prevent pregnancy[B].
Should, however, a woman with an infant at the breast again become pregnant, (a circ.u.mstance that very frequently occurs, and of which, from the _general though not invariable_ absence of those criteria by which this fact is accustomed to be recognised, she is not aware until it has made some progress,) one of two things will usually take place; either she will miscarry, or her milk will become impoverished in quality and diminished in quant.i.ty. Nor is this wonderful:--it was not intended by Nature that the processes of pregnancy and lactation should go on simultaneously, but, on the contrary, that the one should commence when the other had terminated; and experience sufficiently proves that they will not proceed well together: the reason of which, as it appears to me, may be easily given. During pregnancy, and particularly during its latter periods, the vessels of the womb gradually enlarge, and a much greater quant.i.ty of blood than usual is determined to that organ for the increase and perfection of the embryo and its appendages; which, after delivery, becomes transferred to the b.r.e.a.s.t.s to supply the material for the secretion of the milk: but if, during pregnancy, lactation be also persevered in, the blood becomes directed at the same time to two different parts of the body, somewhat remote from each other, namely, to the womb, and to the b.r.e.a.s.t.s; hence, neither is likely to receive its due proportion of this vital fluid, and, consequently, the functions of one or the other, or both, are liable to become impeded or suspended. If the b.r.e.a.s.t.s continue to receive a sufficient quant.i.ty of blood, the secretion of milk goes on properly, but the womb is deprived of its necessary supply; the embryo, in consequence, languishes and dies, and, becoming an extraneous body, is thrown off, producing abortion; while, on the other hand, should the womb still obtain its due proportion of blood, the b.r.e.a.s.t.s are robbed of it, and the secretion of milk, if not altogether suppressed, is rendered either deficient in quant.i.ty or deteriorated in quality.
Finally, the breast-milk may become depraved and injurious by the process of lactation being continued too long, a practice which is, unfortunately, in this, as well as other countries, extensively prevalent.
I have not yet had an opportunity of examining the breast-milk in these diseased conditions except by the eye, and that rarely--but even this slight examination has enabled me to state, that it was greatly altered from its natural condition;--that it was more fluid than usual, and changed in colour, resembling a yellowish turbid serum, instead of displaying its well-known bluish hue.
I propose in future to attend carefully to this subject, and I would beg leave to recommend it as one well worthy the notice of those members of our profession who have made animal chemistry a particular study, having no doubt that they would be able, by a series of accurate experiments upon the breast-milk at different periods after delivery, and under various conditions of the mother, to collect many interesting and important facts--such, perhaps, as would tend very materially to augment our knowledge of pathology, and improve our practice in the treatment of certain diseases[C].
We cannot but believe that the Supreme Being has done nothing without an infinitely wise and good object, and it is obviously our interest, no less than our duty, to be guided by those indications of the Divine purpose which are distinctly to be traced throughout the creation.