MASTITIS (BREAST ABSCESS)

Clinical Manifestations
  • Acute infection of the breast (abscess)  often seen in first-time mothers during the third or fourth week of postpartum breast feeding
  • Symptoms are usually unilateral and characterized by chills and fever and tachycardia
  • The breast is red hot
  • The main complaint is pain
  • About 10% of women with mastitis develop a breast abscess when the source of infection is the mouth and pharynx in the newborn
  • Distended, painful, swollen breast with lumps
  • If caught early, it can be massaged out and treated with warm moist herbal washes and compresses.
  • If left untreated or unnoticed it may manifest with flu like symptoms (toxic Heat). 
  • As it grows and fills with pus it can get very painful and lead to an abscess which can get red and hot. 
  • Internal blockages are deeper and generally can’t be seen on the surface.
  • They grow slower, are harder to detect and are tougher to move or break-up. 
  • The major cause is the milk stagnates (from irregular feeding, not enough stimulation, etc.) during breast feeding resulting in blocked duct(s) and creating infection.
  • There are two types:
    1. Late pregnancy
    2. Postpartum
Treatment Principle
Herb Formulas
  • Tuo Li Xiao Du Yin
  • Mastitis #4
  • For early-stage acute mastitis: mix equal portions of powdered Bul. Bolbostemmae Tu Bei Mu and Angelicae Dahuricae Bai Zhi and take 9g per day. If the patient is strong, take 15g per day.
  • Topical:
    Jin Huang San
    Qing Fu Yao
    Xiang Fu Bing
    Mastitis #3
    Cong Yun Fa (Scallion Ironing Method): Apply mashed Cong Bai to the affected area. Place a piece of smoldering charcoal on this and cover with a jar. Leave in place until the patient begins to perspire profusely. The swelling should be alleviated when the jar is withdrawn.
Points
Clinical Manifestations
  • Starts with feeling a deep hard lump or lumps
  • The skin gets red hot and painful
  • Fever
  • Flu -like symptoms may appear
  • This takes longer to manifest (1 month)
Treatment Principle
  • Soothe the Liver
  • Clear Stomach Heat
  • Calm the fetus
Herb Formulas
Points
Clinical Manifestations
  • Starts with feeling a deep hard lump or lumps
  • Chills and fever
  • Anhidrosis
  • Stiff and rigid neck, shoulders and upper back
  • Intolerance of Wind
  • Dislike of Cold
  • Inflammation
  • Diarrhea
  • Muscle spasms
  • Mucosal swelling
  • Nasal congestion
  • Sensitivity to dust
  • Headache
  • Wind-Cold Bi (few joints affected, inflammation intense but short lived, changes over days or weeks)
  • T: Normal
  • C: Thin and white
  • P: Floating and tight.
Treatment Principle
  • Release Wind-Cold in the exterior and muscle layer
  • Generates Fluids
Herb Formulas
Points
  • General points
Clinical Manifestations
  • Alternating chills and fever
  • Restlessness
  • Irritability
  • Anorexia
  • Sometimes fatigue
  • Fullness in the chest
  • Dizziness
  • Irritability
  • Nausea
  • Occasional vomiting
  • Headaches (side of head)
  • Hypochondriac pain, distention or tenderness
  • A bitter taste in the mouth
  • Rib pain
  • Achiness
  • Ear infection
  • Hearing difficulty
  • Red eyes
  • Stiff shoulders
  • Throat pain
  • Hip pain
  • T: Normal with bumps or dots on side
  • C: Thin white
  • P: Wiry
Treatment Principle
  • Harmonize the Liver and Gall Bladder
Herb Formulas
Points
Clinical Manifestations
  • Inflammation of throat and/or tongue
  • Fever and chills with more fever than chills
  • Perspiration
  • Cough with sticky yellow sputum
  • Aversion to Wind and Heat
  • Yellow nasal discharge
  • Thirst with desire for cold drinks
  • Red bumps around mouth and lips (herpes simplex)
  • Headache
  • Nasal obstruction
  • Sore, swollen throat
  • Dyspnea
  • Chest pain
  • Dry mouth
  • Rapid breathing
  • Maybe constipation
  • Maybe scanty urine
  • T: Red tip
  • C: Thin and yellow
  • P: Floating and rapid
Treatment Principle
  • Disperse Wind
  • Clear Heat
  • Clear the Lungs
Herb Formulas
Points
Clinical Manifestations
  • Postpartum breast swelling and pain
  • Difficulty breast feeding
  • Cracked nipple
Treatment Principle
  • Dispel Wind
  • Transform Dampness
Herb Formulas
Points
Clinical Manifestations
  • Postpartum breast swelling and pain
  • Difficulty breast feeding
  • Cracked nipple
  • Localized burning
  • Heat
  • Maybe redness
  • Palpable nodular lumps which are worse with pressure
  • Aversion to Cold
  • Fever
  • Anhidrosis
  • Headache
  • Muscular soreness and pain
  • Whole body joint pain
  • Chest oppression
  • T: Normal
  • C: Thin and yellow or Thin and white
  • P: Floating and rapid or Floating and tight
Treatment Principle
  • Dispel the Exterior
  • Detoxify
  • Dredge the Liver
  • Clear the Stomach
Herb Formulas
Points
Clinical Manifestations
  • The milk secretion is not smooth
  • Emotional stress
  • Starts with a hard lump
  • Breast engorgement
  • Redness, swelling,distention and mass formation in the breast
  • Heat and pain of the breast
  • Aversion to Cold
  • Fever
  • Maybe chills and fever
  • Headache
  • Chest oppression
  • Nausea
  • Irritability
  • Thirst
  • T: Normal or Red edges
  • C: Yellow or Slimy yellow
  • P: Wiry and rapid or Floating and rapid
Treatment Principle
  • Soothe the Liver
  • Clear Stomach Heat
  • Promote lactation
  • Dissolve hardness
Herb Formulas
Points
Clinical Manifestations
  • The milk secretion is not smooth
  • Emotional stress
  • Starts with a hard lump
  • Breast engorgement
  • Epigastric pain (worse when emotionally upset)
  • Abdominal distention and pain
    Belching with acid regurgitation
    Nausea / vomiting
  • Gas
    Borborygmus
    Diarrhea
    Anorexia
    Epigastric distention
    Distention and pain in the sides or flanks
    Suffocating sensation in the chest
    Tendency to sigh
    Melancholy
    Depression
    Irritability
    Inappropriate anger
  • Irregular menses
    Dysmenorrhea
    Breast distention and pain before and during menses
    T: Pink
    C: Thin and white or White and greasy
    P: Wiry or Slippery and wiry
Treatment Principle
  • Soothe the Liver
  • Harmonize the Spleen and Stomach
  • Promote lactation
  • Dissolve hardness
Herb Formulas
Points
Clinical Manifestations
  • Yang jaundice (sclera and skin bright yellow)
  • Pain and fullness in ribs on both sides
  • Maybe pain in the right hypochondrium
  • Bitter taste in mouth
  • Nausea
  • Vomiting sour and bitter fluids
  • Anorexia
  • Maybe alternating chills and fever
  • Concentrated, dark urine
  • Abdominal distention
  • Women:
    Yellow vaginal discharge with foul smell
    Pruritis vulvae
  • Men:
    Pain, swelling and burning sensations of testicles
  • T: Pink
  • C: Yellow and greasy or sticky
  • P: Wiry and rapid or Slippery and rapid
Treatment Principle
  • Clear Dampness
  • Purge Heat from Liver and Gall Bladder
Herb Formulas
Points
Clinical Manifestations
  • Abdominal pain
  • Irritability
  • Slight chills
  • Spasms of the calf muscles
  • Convulsions
  • Cramps in the hands
  • Weak legs
  • Hypertonicity of the extremities characterized by difficult flexion and extension
  • Wheezing
  • Coughing
  • Vomiting
  • Diarrhea
  • Sciatic pain
  • Severe and painful muscle spasms in the Stomach, bronchi, Gallbladder and uterus. Intestines
  • Shoulder pain
  • Pain in the head, body or limbs due to arterial spasms characterized by a severe pulling pain
  • T: Normal or Reddish
  • C: None or Yellowish
  • P: Wiry and rapid or Thready and rapid
Treatment Principle
  • Soften the Liver
  • Nourish the Blood
  • Nourish Yin
  • Moderate painful spasms
  • Relieve pain
  • Harmonize the Middle Jiao
  • Replenish Body Fluids
Herb Formulas
Points
  • General points
Clinical Manifestations
  • Headache
  • Brain ringing
  • Swelling with no change in skin color
  • Fever
  • Irritability
  • Abdominal fullness
  • Vomiting
  • Dry heaves
  • Thirst
  • Constipation
  • Reduced urination
  • Reddish urination
  • T: Reddish
  • C: Turbid and yellow
  • P: Deep and excess
Treatment Principle
  • Clear Heat
  • Resolve toxicity
  • Invigorate the Blood
  • Reduce swelling
  • Reduce constipation
  • Alleviate pain
Herb Formulas
Points
Clinical Manifestations
  • Initial stage
  • Chronic, stubborn skin lesions
  • Sores
  • Enlarged lymph nodes
  • Nodules
  • Malignant abscesses and sores
  • Syphilitic sores
  • Red itching skin
  • Hardness
  • T: Pale with red spots
  • P: Rapid and pecking
Treatment Principle
  • Clears Heat
  • Cool the Blood
  • Dissipates swellings
  • Dispels noxious sores
  • Disperses nodules and hardness
Herb Formulas
Points
Clinical Manifestations
  • Postpartum swollen lumps in the breast
  • The lumps begin soft and gradually harden
  • Stagnant breast milk
  • Local distention and pain
  • Chest oppression
  • Vexation
  • Agitation
  • T: Normal
  • C: Slimy
  • P: Deep and wiry
Treatment Principle
  • Move Qi
  • Open the breasts
  • Scatter nodulation
Herb Formulas
Points
Clinical Manifestations
  • Suppurative toxic swellings
  • Coughing and wheezing with copious, dilute, white, frothy or lumpy sputum
  • Chest and epigastric congestion
  • Cold legs
  • Pain and full feeling in the chest
  • Dizziness
  • Vertigo
  • Palpitations
  • Dyspnea - worse lying down
  • Sometimes asthma
  • Throat rattle
  • Nausea
  • Vomiting
  • Shortness of breath with labored inhalation and smooth exhalation
  • Acute attack of panting with a high pitched wheezing sound and rapid exhalation
  • Leg Qi
  • Acute cramping
  • Muscle wasting
  • Diarrhea in response to cold or hot weather
  • Maybe anorexia
  • Insensitivity in the lower abdomen
  • Headache
  • Facial edema
  • Palpitations
  • Lumbar pain
  • Weakness in the body and feet
  • Numbness, weakness and aching of the feet and legs
  • Edema of the extremities
  • Fever
  • Dysuria
  • Weakness below the umbilicus
  • Fatigue with a desire to curl up
  • Epigastric distention
  • Disorientation
  • Disordered speech
  • Tinnitus
  • T: Pale
  • C: Thick, white and greasy or sticky
  • P: Slippery or Soft
Treatment Principle
  • Disperse and Descend Lung Qi
  • Warms and transforms Phlegm-Cold
Herb Formulas
Points
  • General points
Clinical Manifestations
  • Hard, red lump, with Heat on skin
  • May feel pulse on the lump
  • The lump may also have a soft center (pus)
  • When pressed, there is a wavelike sensation
  • High-fever
  • T: Red
  • C: Slimy and yellow
  • P: Wiry, slippery and rapid
Treatment Principle
  • Clear Heat
  • Eliminate toxins
  • Reduce swelling
  • Soften hardness
  • Activate Blood circulation
  • Stop pain
Herb Formulas
Points
  • GB-21, LIV-14, PC-6 + General points
  • Cupping: Place appropriate size glass fire cups over lesion and suction to draw out pus
  • External: Lance, drain the pus and apply  Jin Huang Gao
Clinical Manifestations
  • Severe sore and swollen throat
  • High fever with convulsions in infants
  • Difficulty swallowing
  • Carbuncles
  • Acute localized infection
  • Lymphangitis
  • Furuncles
  • Abscesses Boils
  • T: Red
  • C: Greasy and yellow
  • P: Rapid
Treatment Principle
  • Clear the Lungs
  • Resolve Phlegm-Fire
  • Clear Heat
Herb Formulas
Points
Clinical Manifestations
  • Dizziness
  • Red, sore eyes
  • Difficulty swallowing
  • Nasal congestion
  • Thick, sticky nasal discharge and saliva
  • Bitter taste in the mouth
  • Dry mouth
  • Focal distention in the chest and diaphragm
  • Stifling sensation in the chest and diaphragm
  • Manic behavior
  • Carbuncles
  • Heat rash
  • Headache
  • Sore throat
  • Skin ruptures or ulcers
  • Tense abdomen
  • Shoulder stiffness
  • Numb extremities
  • Fatigue
  • Constipation
  • Dysuria with reddish urine
  • Dark, rough urination
  • Obesity
  • Heaviness in the head
  • T: Red
  • C: White or yellow, greasy
  • P: Flooding and rapid or Wiry and slippery or Floating, smooth and rapid
Treatment Principle
  • Disperse Wind
  • Release the Exterior
  • Drain Heat
  • Unblock the bowels
Herb Formulas
Points
Clinical Manifestations
  • Pallor
  • Fatigue
  • Somnolence
  • Less severe pain in the breast
  • The swelling is rock hard
  • Difficulty erupting
  • T: Pale
  • C: Thin white
  • P: Thready and weak
Treatment Principle
  • Tonify Qi and Blood
Herb Formulas
Points
Clinical Manifestations
  • Discharge of pus from the breast
  • Gradual return of normal body temperature
  • Relief from severe aversion to Cold
  • Relief from fever
  • Disappearance of swelling and pain
  • Gradual healing of the superficial lesions
  • May still be redness of the breast with pain
  • If there are lesions, there may be a thick, yellowish exudate with itch around the affected (this is a sign of healing)
  • If there are multiple lesions with heartburn, nausea and vomiting, recovery may be difficult
  • If there are ulcerous lesions surrounded by dark flesh with pain radiating to the Heart and a thin, weak constitution, the condition may be critical
  • T: Pink
  • C: Thin and yellow
  • P: Rapid or Weak
Treatment Principle
  • Regulate Qi and Blood
  • Clear remaining evils
  • For alternating swelling and softness, local brightness of the skin and hot sensations over the area with thick, yellow pus, surgery is indicated.
Herb Formulas
Points
Clinical Manifestations
  • Suppuration
  • Delicate constitution
  • Polyps
  • Pain
  • Fever
  • Headache
  • Muscle spasms
  • Inflammation
  • Swelling
  • Congestion
Treatment Principle
  • Induce sweat
  • Release the Exterior
  • Dispel Wind
  • Resolve Phlegm
  • Detoxify
  • Clear Heat
Herb Formulas
Points
  • General points
Clinical Manifestations
  • Pus filled water which is clear and dilute
  • The opening of the sore is slow to close or endures for days without healing
  • Lassitude
  • Lack of strength
  • Shortness of breath
  • Doesn't want to speak
  • Insomnia
  • Profuse dreams
  • A lusterless complexion
  • T: Pale
  • C: Thin white
  • P: Thready and weak
Treatment Principle
  • Tonify Qi and Blood
Herb Formulas
Points