ABORTIVE TREATMENT OF 
MAMMARY ABSCESSES, 
AND 
THC CURE OF FISSURED NIPPLES BY MEANS OF 
A NEW AND EFFECTUAL COMPRESS. 
BY 
GEO. H. NOBLE, M.D., 
ATLANTA, GEORGIA. 
Reprinted from the Atlanta Medical Register, October, 1882. ABORTIVE TREATMENT OF MAMMARY 
ABSCESSES, 
THE CURE OF FISSURED NIPPLES BY MEANS OF A NEW ANl> 
AND 
EFFECTUAL COMPRESS. 
GEO H. NOBLE, M.D., Atlanta, Ga. 
A little more than eighteen months ago I 
tient, a few days after confinement, strongly 
with a mammary abscess. Indeed there was considerable 
inflammation of the left breast, it being greatly swollen," 
indurated and sensitive to the touch. An abscess seemed 
imminent, and the pain and distress called for immediate 
relief. 
Having no adhesive plaster with me, and being quite 
distant from where it could be procured, ray time would 
not allow me to wait until a messenger could be sent for 
it; so I accordingly asked for a piece of cotton goods wide 
enough to cover the gland and sufficiently long to little 
more than encircle the chest. This I split up a* each end 
into three tails of equal width, extending the rents down 
very near to the center of the cloth, thus leaving a body, 
as it were, its entire width, with the three tails attached 
on either side, as seen in Fig. 1. 
Of this I made a compress, as will subsequently be 
shown, and brought firm pressure to bear upon the entire 
breast, which effected the most surprising, yet favorable 
results. 
After smoothly and evenly applying my compress, I 
left the patient, only to return twenty four hours later, 
when I found that the gland had lost half of its increased 
size, the hardness was very much lessened and the sore- 
ness greatly ameliorated. The improvement was so great 
that it seemed scarcely necessary to continue the applica- 
tion. I however, drew the apparatus tighter and left it 
until the following day, when I found that the breast had 
returned to its normal size, and that the hardness and sore- 
ness were no longer present. Even upon the very first- 
application she expressed herself as being very greatly 
relieved of the pain, weight, and heavy dragging sensa- 
tion. The improvement was so very rapid that at the 
end of forty-eight hours all unpleasantness had subsided, 2 
and the further wearing of the apparatus was deemed 
unnecessary. This, I consider, was a remarkably rapid 
restoration in such an urgent case. 
You will remember that the best means of treatment 
heretofore at our command, (adhesive plaster), has not 
established resolution in so short a time. This is one of 
the points of superiority that I advance over the plaster. 
Perceiving this and other advantages, hearing no com- 
plaint of discomfort on the part of my patient, and being 
greatly encouraged by the success in the preceding case, I 
determined to try its efficacy in such other cases as might 
come before me. I did so, and with the most gratifying 
results; so I now present it to the profession that it may 
have the test of all unprejudiced professional minds. 
Yet I ask that they will not render a decision until they 
have given it.a fair trial and have observed all the points 
as to accuracy of application that I shall give. 
The compress may be made of almost any ordinary cot- 
ton goods, such as sheeting, shirting etc.; and these are 
usually at hand either in one form or another. 
Fig. 1. 
Measure over the nipple in a vertical direction from 
base to base of the gland, and take about four-fifths of this 
for the width of the bandage—if the breasts are very large 
it may require a little more. Next cut the cloth long 
enough to little more than encircle the chest over the 
affected mammae. Divide each end into three equal parts 
and split down to quite near the middle of the cloth, leav- 
ing the space between the tails of the opposite ends about 
half the width of the apparatus, or wide enough to about 
half cover the gland in a horizontal line. Fasten a buckle 
on the tails at one end of the compress, the width of 
which must be equal to that of each tail. In case buckles 
of sufficient width cannot be obtained, they can easily be 
made with a pair of nippers and a piece of wire. 
If there should be much milk in the breast, it is best 
to make a small aperture in the centre of the compress, 
that the nipple may protrude and allow the slow and steady escape of that fluid. I find that when the milk is 
permitted to escape in this manner the reduction in size 
is much more readily effected. 
The margins of the compress should not be hemmed, as 
the thick edges will cause some inconvenience where they 
press upon the inflamed organ; neither will they lay as 
close and smoothly as the raw borders. In the first case or 
two that I applied the compress I tied the tails, but as the 
knots caused some little annoyance, I substituted the 
buckles. The tails might be left one-third longer on one 
end than upon the other, so that the buckles will be 
brought around to the anterior part of the chest; this, 
however, is a matter of no great importance, as a small 
pad may separate them from the chest walls. 
The application is simple and easy. First have an 
assistant to elevate the breast to its utmost extent, and 
then place the bandage underneath it so that the lowest 
pair of tails (c.c. Fig. 2) will lay upon the under side and 
base of the gland close to the chest wall. Draw the tails 
(c.c.) upwards, the one under the axilla of the affected 
side, and the other over the shoulder of the side opposite 
to the inflamed organ ; draw tightly and buckle so as to 
take the entire weight of the breast. 
The next pair of tails (a.a.) should be turned over the 
Fig. 2. 4 
gland and drawn downward, so as to force the breast down 
against the preceding pair of tails, and buckled around the 
lower part of the chest. Next, the middle tails ([b.b.) should 
be carried directly around the chest and fastened in a 
similar manner; but the tail on the side of the sound 
breast should go under and not over that organ. 
Now, begin in the same order and tighten each pair of 
tails until you have brought firm pressure equally upon 
the whole organ. If the gland should tend to protrude 
between the tails, a few stitches with a needle and thread 
or a pin may be used to approximate the edges and to re- 
tain the protruding parts. Fig. 2 shows compress applied. 
As the tumefaction subsides, it will be necessary to 
tighten the apparatus to keep up a continuous pressure. 
This the nurse or patient herself may do, but care must 
be taken that there may be no constriction or greater ten- 
sion on one part than upon another. 
The bandage must look smooth and round; the breast 
must be drawn up higher than its fellow, the healthy 
gland, and be entirely supported by the bandage, so that no 
weight shall drag upon its tissues. This bandage acts up- 
on the same principle as the adhesive strips, by pressure, 
preventing the secretion of milk and causing the absorp- 
tion of all effused matter. But pressure by this compress 
is more direct and continuous, the gland being interposed 
between it on the one hand and the chest-wall on the 
other. 
Its beauty is in its simplicity and efficacy. It can be 
made and applied by any person of ordinary intelligence, 
as it requires no skill or practice; while another appre- 
ciable and valuable feature is that it is always at our 
command—even among the poorer classes. It certainly 
possesses many points of superiority over the adhesive 
straps : 
I. It is more effectual, as it has brought about restora 
tion in a much shorter time than the adhesive straps, the 
latter having to be worn for four to seven days, while in no 
instance have I left my apparatus on longer than four days, 
and in two cases I met with complete restoration in two 
days. (See appended reports.) 
11. It does not give the uneasiness and discomfort that 
the stiff, hard plaster occasions, as the cloth adapts itself 
to the gland, and allows a certain degree of movement 
that the plaster does not permit. 5 
111. We get equal pressure on all parts of the gland by 
close adaptation of the cloth to it, and by tightening and 
retightening the different tails until we have brought the 
cloth in close contact with all parts of the breast. This 
cannot be done with the adhesive plaster, which, if it should 
not be properly put on, must be removed and another ap- 
plied. 
IV. We can determine the amount of pressure we put 
upon the gland by the force with which we draw upon the 
tails. 
V. It affords great advantage over the plaster in en- 
abling us to tighten, from time to time, without remov- 
ing the dressing, thereby bringing increased pressure to 
bear upon the breast as it, from the subsidence of the 
tumefaction, shrinks away from the apparatus. With the 
plaster we are much inconvenienced by the necessity of 
reapplying it as the parts decrease in size. 
VI. It is cooler, more comfortable and easy. 
VII. As above stated, it is always at our command. 
VIII. The cloth possesses a certain degree of elasticity, 
which causes the compress to contract upon the breast as 
the tumefaction subsides. 
IX. The patient or nurse can keep the necessary ten- 
sion on the organ by tightening the apparatus, while 
the doctor has to apply the adhesive strips each time. 
X. It admits of the use of any medicated application 
that may be fancied, though such treatment is unneces- 
sary, 
XT. It is an estimable apparatus for checking the secre- 
tion of milk when the child is suddenly withdrawn from 
the breast. 
XII. It is an adjunct to the weaning of a child. Strap 
the breast and let the child try it. When he finds that 
there is no milk to be had he will turn to another source 
for nourishment. 
XIII. I believe it to be the best means of treating fis- 
sured nipples. Apply the compress, remove the child from 
the breast and in a few days the fissure will be well when 
the child may be returned. 
I subjoin reports of a few cases in which the compress 
has been employed. 
N. 8., aged twenty-four years, on third day after her 
second confinement she was found to be suffering consid- 6 
erably with her left breast. It was greatly swollen, indu- 
rated and sensitive to the touch. 
An abscess seemed imminent, but fortunately I applied 
this many tailed bandage or compress with the most re- 
markable results. In this case I intended merely to make 
temporary use of it and to apply the adhesive strips on 
the following day; but upon my return I was so greatly 
astonished and so agreeably surprised that I determined 
to continue the treatment with this apparatus. 
I found that the tumefaction had more than half dis- 
appeared, the induration was almost entirely removed, 
while no soreness was found to be present. 
As I have just stated, my great surprise at the results 
of the temporary bandage caused me to make further use 
of it; so I tightened it and again brought firm pres- 
sure to bear upon the breast for twenty-four hours more. 
This proved sufficient to effect complete restoration of the 
organ to its natural or normal condition; the child being 
withheld from the breast for some three or four days 
only. 
This abortion of the mammary abscess in forty-eight 
hours is the quickest that I know of, save in one other in- 
stance the report of which 1 here append : 
11. Mrs. W. M., aged twenty-six years. The condition 
of this patient was very similar to the preceding. The 
symptoms were very urgent and distressing. The presence 
of pus seemed almost conclusive. The compress was the 
sole means of treatment resorted to, and most happily did 
it act. 
The patient expressed great relief immediately upon 
its application, as it relieved the weight and heavy drag- 
ging sensation. 
The bandage was applied with very great tension and 
I left to return the following day, when I found the symp- 
toms were very much ameliorated. 
I again increased the tension and left it for a similar 
period of time. 
Upon the third day recovery was complete. The nip- 
ple did not protude and the milk did not escape as in the 
foregoing case, so the resolution was necessarily prolonged 
to a little greater time than in that of case I. 
111. Mrs. B. 8., aged thirty years, mammitis. Both 
breasts enlarged to twice their natural size, very sore 
and hard. She loses sleep from pain. 7 
Compress applied May 16th, 1881, to both glands, nip- 
ples allowed to protude and milk to slowly escape. 
May 17th. The glands have been reduced until only 
one third larger than their natural size. 
I again brought pressure to bear upon the breasts and 
left the apparatus to complete its work in the resolu- 
tion. 
May 18th. All the trouble has completely subsided 
leaving the mammae in such a good condition that the 
bandage has been removed. 
This case showed no tendency to a recurrence of the 
disorder, so the resolution was effected in three days. 
IV. Mrs. J. A., aged forty-four years, miscarried at 
four months from placenta prsevia. Mammary abscess 
strongly threatened in left breast, could not bear the 
slightest manipulation of that organ. The gland measured 
eighteen inches in circumference. The induration was 
mainly on the inner or right side of the gland. Compress 
brought down the measurement in twenty-four hours to 
fourteen inches. Induration greatly lessened. Compress 
was tightened as in the other cases. On the following 
day the breast’s circumferential measurement was normal, 
being twelve inches only. Restoration in two days. 
V. Mrs. J. F., aged twenty-eight years, miscarried at 
about four and a half months. Both breasts became in 
flamed and greatly enlarged, the right and left measuring 
respectively sixteen, and seventeen and a half inches. In- 
duration through the entire mammae, soreness considerable. 
Compress applied July 11th, 1882. 
July 12th. Each breast measures four inches less, and 
is correspondingly improved as to the other symptoms. 
July 13th. The reduction in size does not appeal’ to be 
so great, being one inch only to each gland. The com- 
press was drawn rather more firm and nipples allowed to 
protrude. 
July 14th. The two glands have resumed their usual 
size, now measuring fourteen inches. All other symptoms 
have so rapidly disappeared that the compress was re- 
moved, and the case set down as a cure in four days, the 
longest period required by any one case, either double or 
single. 
It will be seen by the foregoing reports that two were 
cured in two days, two in three, and the fifth case in four 
days, 8 
This shows better results than the adhesive strips, as 
it usually requires from four to seven days in an ordinary 
case. The compress is more comfortable, convenient, easy 
of application, and I am satisfied all that is necessary for 
any one to convince himself that it is the best means, as 
yet, at our command for the treatment of raammitis and 
for aborting mammary abscess is to observe all the details 
of its application, fit it accurately and comfortably, 
apply all the pressure the patient can bear, and if a fair 
trial is then given it, it will, I feel confident, receive an 
endorsement. 
Since writing the above I have applied my compress 
in a case threatened with mammary abscess in both 
breasts with fissure of both nipples. I applied the com- 
press to one gland and removed the child from that organ. 
In three days the fissure was well, and all other 
toms were gone. 
In the meantime the breast least affected was treated 
with belladonna, camphor and some other medicaments, 
which seemed to hold the symptoms in check until the 
other breast was cured, and the compress removed and 
applied to its fellow. Two days were sufficient to cure the 
second fissure, and to relieve the pain and swelling. 
In a second and very similar case the bandage was 
applied to both breasts and the child removed from its 
mother. The fissures were cured in a day or two, the com- 
press was removed, and the secretion of milk again com- 
menced, and the child was returned to its mother. 
In a third and similar case I applied the compress for 
a medical friend, and instructed him to continue the 
treatment as in the second case of fissure. He reported a 
like improvement. 
From the foregoing it will be seen that the method I 
propose surpasses the adhesive plaster, not only in the 
treatment of mammitis and in securing the abortion of 
mammary abscesses, but it is also the best means of treat- 
ing fissured nipples. Hence, it is hoped that from its use 
great good will accrue. PRIVATE INFIRMARV, 
FOR THE TREATMENT OF 
DISEASES of WOMEN, 
180' A 186 S. PRYOR STREET, 
ATLANTA, - GEORGIA, 
\ / 7 
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