Acute Mastitis and Breast Abscess

Etiology

The Chinese disease 'Breast Carbuncle' (Ru Yong) is characterized by redness, swelling, heat and pain in the breast and by red nodules which, after some days, rupture with the discharge of sticky pus. This is thought to be caused by emotional causes, such as the mother not knowing the principles of good nutrition, or being affected by indignation and anger, which causes Qi to rebel upwards. Additionally, the ancient Chinese doctors differentiated two stages of breast problems after childbirth; the first, 'Blow Breast' (Chui Ru), was caused by the baby 'blowing' onto the breast and transmitting heat to it; the second, Breast Carbuncle, developed from the first. Modern medicine's pathology of puerperal mastitis is often due to infection with Staphylococcus aureus, with the baby being the most frequent source of infection.

Pathology

The ancient Chinese doctors believed that Breast Carbuncle is due to Toxic Heat in the Stomach and Gallbladder, causing stagnation of Qi and Blood. Fu Qing Zhu gives a similar interpretation, stating that Breast Carbuncle is due to Toxic Heat in the Stomach and Gallbladder, with stagnation of Qi and Blood. It is also thought that the condition 'jealous breast' or 'envious breast' (du ru), characterized by milk not flowing due to the baby's inability to suck properly, could lead to the development of Breast Carbuncle if not treated promptly.

Identification of Patterns and Treatments

• Clinical Manifestations: redness, swelling, heat and pain in the breast, red nodules
• Treatment Principles: overcome the pain and massage the nodules to soften them, allowing milk to flow and the nodules to be dispersed

Prognosis and Prevention

The prognosis for Breast Carbuncle is generally good if treated promptly. Prevention of the condition may be achieved by maintaining good nutrition and avoiding emotional distress during breastfeeding. It is also important to properly treat any infections in the baby to prevent the spread of infection to the mother.

Western Viewpoint

In Western medicine, acute mastitis and breast abscess are considered to be infections of the breast tissue, most often caused by bacteria entering the breast through cracked or damaged nipples. Treatment typically involves antibiotics and, in the case of abscess, surgical drainage. The prognosis is generally good with prompt treatment. Prevention measures include proper breastfeeding technique and hygiene, as well as treating any infections in the baby.