🌿 Folk Prescriptions

Acute mastitis is an acute purulent infection of breast tissue caused by bacterial infection, mostly occurring within one month postpartum in lactating women, especially primiparas. Pathogenic bacteria invade directly through breast ducts or enter via cracked nipples, spreading along lymphatic vessels to fat and fibrous tissues between mammary lobes, leading to purulent infection and subsequently abscess formation. Milk retention is the primary cause, as it promotes bacterial growth. Mild cases present with poor milk drainage, painful swelling lumps with tenderness. Severe cases show obvious systemic symptoms such as high fever, marked local redness, swelling, heat, pain, enlarged axillary lymph nodes, and abscess development. Superficial abscesses exhibit skin redness and fluctuation; deep abscesses show less obvious redness but firm hardness and deep tenderness. Prevention should include maintaining nipple hygiene during late pregnancy, regularly washing nipples and areolae with warm water, soap solution, or alcohol to strengthen skin resilience. For inverted nipples, manually pull them outward to protrude. During lactation, maintain regular feeding schedules; if not fully emptied, express remaining milk. If nipples are cracked or injured, stop breastfeeding temporarily and use a breast pump to extract milk; apply antibiotic ointment to cracks until healed before resuming breastfeeding. This condition corresponds to the category of "Ruyong" and "Shi Ru" in Traditional Chinese Medicine. The disease arises due to liver Qi stagnation, stomach heat accumulation, external pathogenic invasion, and obstruction of meridians, resulting in blocked milk flow and disharmony of Qi and blood. Common clinical types include: 1. Liver Qi Stagnation Type: Hard lump and pain in the breast, mild redness and swelling, blocked milk flow, chills, chest tightness, belching, poor appetite, emotional depression, thin yellow tongue coating, wiry rapid pulse. 2. Exuberant Stomach Heat Type: Increasing breast lump size, diffuse redness and swelling, severe pain, chills and fever, alternating chills and fever, yellow greasy tongue coating, slippery rapid pulse. 3. Qi and Yin Deficiency Type: After abscess rupture, pain and swelling subside, toxins discharged with pus, fever subsides, swelling reduces, residual wound remains, physical weakness, red tongue, thin white coating, deep fine pulse. I. Western Medications That May Be Used: 1. Drugs to Stop Milk Secretion: (1) Diethylstilbestrol: 1–2 mg each time, orally three times daily for three days; (2) Estradiol Benzoate: 2 mg each time, intramuscular injection once daily until milk secretion stops. 2. Antibiotics: Use effective antibiotics to control infection. 3. Local Application: Apply 25% magnesium sulfate solution as wet hot compress on affected area. II. Chinese Patent Medicines That May Be Used: 1. Liver Qi Stagnation Type: (1) Huoxue Jiedu Wan: 3 g each time, twice daily, taken with warm rice wine or warm water; (2) Ruchuang Wan: 9 g each time, twice to three times daily, taken with warm water; (3) Pu Gong Ying Pian (Powder): 3–5 tablets each time, four times daily, taken with warm water; powder: 15 g each time, three times daily, dissolved in boiling water. Dosage may be increased appropriately for severe cases. (4) Ruyi Jinhuang San: External use—mix with green tea, oil, plant oil, or honey and apply to affected area; (5) Niuhuang Jiedu Wan: 1 pill each time, twice daily, taken with warm water; (6) Yin Qiao Jiedu Wan: 1 pill each time, twice daily, taken with warm water; (7) Chaihu Shugan Wan: 6–9 g each time, three times daily, taken on empty stomach with warm water; (8) Si Ni San: 4.5–9 g each time, twice daily, taken with warm water. 2. Exuberant Stomach Heat Type: (1) Shengji Yuhong Gao: Apply externally after abscess has drained; (2) Lianqiao Baidu Wan: 1 pill each time, twice daily, taken with warm water; (3) Qingwei Huanglian Wan: 9 g each time, once to twice daily, taken with warm water. 3. Qi and Yin Deficiency Type: (1) Simiao Wan: 6 g each time, once to twice daily, taken with warm water; (2) Bazhen Wan (Pill, Syrup, Powder): Large honey pill: 1 pill each time, or water honey pill: 6 g each time, twice daily; or concentrated pill: 8 pills each time, twice to three times daily, taken with warm water. Decoction: 15–20 g each time, twice daily. Powder: 1 packet each time, twice daily, dissolved in boiling water.<Acute Mastitis>