Mastitis

==**Definition:** == Infection of the (female) breast.
 * IBIS:**

==**Etiology:** == Most cases of mastitis occur while the woman is breast-feeding. Staphylococcus is an implicated organism though others may be involved.

==**Nutrition:** == eating principles: • eat as little as possible: if nursing, steamed vegetables, fruits and juices • increase foods rich in Vitamins C and A • increase fluids • a short fast

therapeutic foods: • Cooling foods, cabbage, cucumber, dandelion, lettuce, malt, lotus root (Ni, p. 146)

specific remedies: • drink plenty of water and cooling juices • tea from malt (sprouted oats) and drink three times daily (Ni, p. 146) • dandelion and honey tea drink three times daily for 5 days (Ni, p. 146) • external poultice of cabbage, lettuce, and dandelions (Ni, p. 146) • simmer 500 g papaya with 500 ml rice vinegar and 30 g fresh ginger over low heat for 40 minutes. Drink as tea twice daily, l small glass each time (Lu, p. 152) • apply hot poultice of parsley, comfrey leaves, or a cold poultice of grated raw potato (Weed, p. 87) • take 15 g of dried orange or mandarin orange seeds and crush them, add 30 g of rice wine and water, steam and serve twice daily, may be used topically as well (Yin-fang and Cheng-jun, pp. 59, 84) • take 15 g fruit seed, cover with an equal amount of water and wine and simmer. Drink three times daily (Yin-fang and Cheng-jun, p. 97) • cold poultice of crushed heart of sweet potato, renew poultice when it becomes hot (Chao-liang, Qing-rong, Bao-zhen, p. 15) • crush 100 g scallions and stir-fry with a little salt. While still warm, press and bind the pulp to the breast (Chao-liang, Qing-rong, Bao-zhen, p. 85)

avoid: • spicy foods, hot foods, coffee, alcohol, dairy products, stimulating foods • heavy protein foods, fats, meats, vinegars, shellfish, sugars

==**Botanicals** == • Achillea millefolium: poultice of leaf, flower and root; antiseptic, anodyne (Stansbury) • Aconitum napellus (toxic): to prevent suppuration (Felter, p. 154) • Althea officinalis: poultices or compresses to draw out infection (Weed, p. 87) • Atropa belladonna (toxic): topically as a plaster or liniment on breasts to reduce swelling and inflammation, wash off thoroughly before nursing (Felter, pp. 239-240) • Bentonite clay: mix with hot water or warm castor oil and apply topically to draw out infection, or fill sink with hot water and 1-2 cups clay powder, bend forward and soak breasts (Stansbury) • Bryonia alba (toxic): mammary infection with tender, knotted, swollen glands and sharp cutting pains that are worse with motion (Felter, pp. 250, 252) • Cimicifuga racemosa: mastitis with breast pain (Felter, p. 469) • Cinnamomum camphora: topically to breasts to reduce inflammation (Felter, p. 266) • Hypericum perforatum: topically and internally for mastitis, tenderness and burning pain worse with pressure (Felter, p. 424) • Phytolacca decandra (toxic): has marked action on the mammary glands, indicated for hard glandular swellings (Felter, p. 535; Weed, p. 88) • Symphytum officinale (toxic): steam the fresh or dried leaves in a clean wet cloth and apply to breasts (Weed, p. 87)

==**Chinese Formulae** == • Bupleurum and Schizonepeta C.: Wind-Heat (Hsu, 1980, p. 624; Dharmananda, 1986, p. 366) • Lithospermum and Oyster Shell C.: chronic benign mastitis, anemia, weakness (Hsu, 1980, p. 632; Dharmananda, 1986, p. 478) • Myrrh Tablets (patent) plus Blue Citrus (patent): Acute mastitis (Dharmananda, 1990; Myrrh, p. 52: Blue Citrus, p. 38) • Tang Kuei Sixteen C.: Dissolves masses and abscesses: breast swelling and chronic fibrocystic disease (Hsu, 1980, p. 402) • Chuang Xin Lian Antiphlogistic Pills (patent): Xue (Blood) Heat with Fire Toxin (Fratkin, p. 76) • Bupleurum and Chih-shih F. (Si Ni San): cold fingers and toes, irritability and fullness in breasts, red tongue with yellow coat (Hsu, 1980, p. 112; Yeung, p. 216; Bensky and Barolet, p. 145) • Xian Fang Huo Ming Yin: Fire Toxin: early stage mastitis, fever, mild chills (Bensky and Barolet, p. 83) • Niu Huang Xiao Yan Wan (patent): Fire Toxin. May be used by nursing mother, but may cause diarrhea in the baby (Zhu, p. 190) • Shen Xiao Tuo Li San: Fire Toxin with Qi Xu (Deficiency) and Xue Xu (Blood Deficiency): acute mastitis with strong fever and chills (Bensky and Barolet, p. 86) • Wu Wei Xiao Du Yin plus trichosanthes fruit (gua lou), fritillaria thunbergii (zhe bei mu) and blue citrus (qing pi): Fire Toxin: acute mastitis, deep-rooted and hard lesion, fever and chills, breast abscess (Yeung, p.248; Bensky and Barolet, p. 84)

==**Acupuncture** == after assessing the person and palpating, consider these patterns: Liver Qi Stagnation, Stomach Heat; Damp-Heat Accumulation; Wind-Heat; Xue Xu (Blood Deficiency), esp. with Qi Xu (Deficiency); dysfunction of the Chong Mai (Penetrating Vessel)

» therapeutic note: see also "lactation: excess/deficiency" if that is a factor

» illustrative combinations: • CV-17, SI-1 and St-18, with moderate stimulation and 30 minutes retention (can also add: PC-6 and/or TW-10) for acute mastitis (Shanghai, p. 637) • Lv-14, Lv-2, PC-6, PC-1 and GB-21 for mastitis due to Stagnant Liver Qi; also consider St-18, St-34, PC-7 and GB-41 (Qiu and Su, p. 22) • St-16, St-39, St-40 and LI-7 for mastitis due to Stomach Heat; add LI-4 and GV-14 if fever is present; add CV-17 and SI-1 if accumulation of milk is present (Qiu and Su, p. 23) • St-16, St-39, St-40 and LI-7 (can also add: CV-17, SI-1, LI-4, GV-14, GB-20 and tai yang) for mastitis due to Stomach Heat (Qiu and Su, p. 22-23) • CV-17, LI-4 and LI-11 for mastitis (Shanghai, p. 177) • St-16, St-18, Sp-18, Kd-22, CV-17, GB-21, LI-11, Ht-1, PC-7, PC-2, SI-1, UB-16, UB-38/43, UB-39/44, UB-18, UB-54/40 and St-36 for mastitis (Shanghai, p. 638) • St-16, St-18, GB-21, LI-11, St-37 and Lv-3 (strong stimulation) for acute mastitis (Shanghai, p. 179) • GB-21, SI-11 and SI-1 for mastitis (Shanghai, p. 194) • CV-17, LI-4, LI-11, St-37 and Lv-3 (moderate stimulation) for mastitis (Shanghai, p. 638) • LI-8, St-36, GB-43, Lu-10, UB-54/40 and SI-1 for mastitis (Shanghai, p. 638) • GB-21, St-36, PC-6 and GV-14, together with bloodletting of minute bright red spots on the back, for breast abscess due to Heat obstructing Xue (Blood) and Qi in the Stomach channel (Jirui and Wang, p. 256) • GB-21, Lu-7 and UB-54/40 (can also add: UB-17 and Sp-10) for breast abscess due to Liver Qi Stagnation and Stomach Heat (Mann, p. 142) • St-16, GB-41, Kd-23, St-18, St-36, St-39, LI-8, Sp-18 and GB-43 for abscessed breast (Shanghai, p. 638) • Lu-7 and SI-1; Sp-18 and GB-41; LI-8 and St-34; PC-7 and CV-17 for breast abscess (Mann, p. 142) • Lv-14, Lv-2, PC-6, PC-1 and GB-21 (can also add: St-18, St-34, PC-7 and GB-41) for breast abscess due to Liver Qi Stagnation (Qiu and Su, p. 22-23) • St-30, GB-22 <-> Sp-21 area and SI-11 are "essential" points for treating breast problems; St-15 <-> St-16 area along with PC-6 and Sp-4, to effect the Chong Mai (Penetrating Vessel), are secondary points; palpation, of course confirms the points' appropriateness (Matsumoto) • GB-21 and St-18: regulate Qi circulation, disperse Accumulation, and relieve swelling in the breast (Finkelstein, p. 66) • St-18 and SI-1 for most breast problems (Ambrose) • SI-1 and Lu-10: remove Obstruction of the breast; increase lactation (Finkelstein, p. 34) • CV-17 and SI-1: resolve milk accumulation and breast distension (Qiu and Su, p. 23); regulate Qi circulation and remove Obstruction of lactation (Finkelstein, p. 34) • PC-6 and TW-10 (-): spread Qi in Triple Warmer and Pericardium channels; suppress Rebellious Qi; pacify Stomach

==**Homeopathy** == • Belladonna: comes on quickly; hot, swollen; < least jar • Bryonia: hot, swelling; > pressure (wears a tight bra) • Hepar sulphur: very sensitive, wants it covered and warm; may induce suppuration • Mercurius solubilis: smelly discharge • Phytolacca: very common remedy; stitching, stinging pains; may center around nipple; pains radiate from the spot to axilla and shoulder; chills, aches • Silicea: abscess, esp. if a fissure; sharp pains when nursing; child refuses to nurse • Sulphur: itchy eruptions; < heat of bed; tender, swollen

==**Subtle Support** == • notes: A, C, C#, G, G#

• chords: A Major, C Major (Gimbel, p. 116)


==**Mind/Body** == • Inflammation/Infection: fear; inflamed thinking; seeing red; anger and frustration about conditions in one's life. (Hay, 1984, p. 170-1) • Breasts represent mothering and nurturing. (Hay, 1984, p. 157) • If the infant is not nursed, then the mother is unwilling to feed and protect it on some level, to intervene personally on behalf of the child. In mothers who cannot give milk this problem is more deeply repressed that in those who simply do not want to feed their children and are quite open about it. (Dethlefsen, p. 190)

Chinese psychophysiology: • Liver ~ Gan is the home of the Hun (Ethereal Soul); it relates to decisiveness, control, and the principle of emergence; stores and cleanses the Xue (Blood); maintains smooth flow of Qi and Xue (Blood); and expresses itself in the fingernails, toenails and nervous system; and reflects emotional harmony and movement. » Healthy expressions are kindness, spontaneity, and ease of movement. » Liver Xu (Deficiency) signs include impotence; frigidity; pain in thighs, pelvic region, and throat; ready tendency to "the blahs" (Seem, p. 28); timidity; depression; irritability; vertigo; pruritus; dry eyes, skin, and/or tendons; asthma; aching at the waist; hernia; and difficulty raising head up and down. Liver Xue Xu (Blood Deficiency) predisposes to Xue Yu (Blood Stasis) and Xue (Blood) Heat. » Liver Qi Stagnation reflects and accentuates emotional constraint as the Liver's function of facilitating smooth flow in the body is restricted. Stagnation is associated with frustration, irritability, tension, and feeling stuck. With time this pattern tends to produce a gloomy emotional state of constant resentment, repressed anger or depression, along with tightness in the chest, frequent sighing, abdominal tension or distension, and/or a feeling of a lump in the throat with difficulty in swallowing. (Maciocia, p. 216) Xue Yu (Blood Stasis) often begins with Qi Stagnation.

• Gall Bladder ~ Dan is the source of courage and initiative, and is responsible for decision-making as the bodily Minister of Justice; and controls circulation of the nourishing and protecting energies [Ying Qi and Wei (Protective) Qi]. Its channel purifies Yang energy in the body. » Healthy expressions are kindness, decisiveness, control, and spirit of initiative. » Gall Bladder Xu (Deficiency) signs include insomnia; wandering pains; chest and side pains; swollen breasts (Seem, p. 29); weakness in muscles and tendons of the legs; difficulty standing; asthenia; vertigo; chills; timidity; cowardice; indecisiveness; and excessive sighing.

• Stomach ~ Wei governs the breasts; is the Sea of Nourishment and source of all fluids; transforms and digests food so that the Spleen can separate the distilled food essences; with the Spleen, is the root of post-natal Qi; and as Earth, relates to the ability to assimilate, stabilize, and feel balanced and centered. » Healthy expressions are fairness, openness, and nurturance. » Weakness, dysfunction, and illness associated with worry, anxiety, and overthinking. » Stomach Shi (Excess) signs include nightmares; acne; skin eruptions; excess stomach acid (Seem, p. 28); heat in the abdominal area; overactive digestive system causing hunger and thirst; dark yellow urine; gluttony; halitosis; swollen gums; red dry lips; pains and cramps in legs. » Mental signs of Stomach channel disorders include depression, death wishes, instability, suicidal tendencies, mentally overwrought, doubt, suspicions, tendency to mania, and slowness at assimilating ideas. (Seem, p. 27)

• Spleen ~ Pi governs digestion; transforms food into Qi and Xue (Blood); governs the Xue (Blood); resolves Dampness and Phlegm; and relates to the ability to assimilate, stabilize, and feel centered and balanced. » The excessive use of the mind in thinking, studying, concentrating, and memorizing over a long period of time tends to weaken the Spleen and may lead to Xue Yu (Blood Stasis). This also includes excessive pensiveness and constant brooding. (Maciocia, p. 241) Likewise, inadequate physical exercise and excess consumption of sweet and/or Cold foods will also deplete the Spleen. Environmentally, the Spleen is highly susceptible to attack from external Dampness and Cold.

==**Integrative Therapies** == This article discusses mastitis, clogged mamary ducts, and/or breast engorgement.

During nursing, there are several common problems associated with a blocked flow of breast milk. The ducts that deliver milk to the nipples may become clogged, or the breasts may produce too much milk and become engorged. If either condition goes on for too long, mastitis, a breast infection, may develop.

These problems are characterized by painful breasts that may be tender, swollen, hard, hot, or flushed with redness. There may also be a fever and nausea. Other situations contributing to milk flow problems include a sudden decrease in time spent breast feeding, or weaning, spacing feedings too far apart, not getting enough rest, and stress.

If the symptoms are severe, if they last more than 2 or 3 days, or if a fever goes higher than 102 degrees Fahrenheit, a physician should be consulted.

THE FOLLOWING SUPPLEMENTS ARE USED FOR MASTITIS AND CAN BE TAKEN UNTIL SYMPTOMS IMPROVE: 1. Vitamin C – 1,000 milligrams, 4 to 5 times a day. Decrease the dose if diarrhea occurs. 2. Beta-carotene – 50,000 Units, 2 times a day. 3. Vitamin E – 400 Units per day. 4. Vitamin B6 – Use only if you're trying to stop nursing. Take 250 milligrams, 3 times a day.

NOW, LET'S CONSIDER HERBS FOR MASTITIS: • Echinacea Root – Simmer 2 ounces of the root in a quart of boiling water for 5 minutes. Steep for 20 minutes. Drink 4 to 5 cups daily until the fever is near normal, and then for a week drink 2 cups a day even if all the symptoms are gone. If you use a tincture, which is a liquid herbal extract, take 50 drops 5 to 6 times per day until the fever abates. Then take it 2 to 3 times per day for 1 week. • Tincture of fresh Poke Root – 5 drops, 3 times a day. This herb is potent, so do not exceed the recommended dosage. It works well in combination with Echinacea Root. • If you are trying to wean, 2 cups per day of Sage leaf tea will help dry up your breast milk. Add 1 teaspoon of the dried leaves per cup of boiling water. Steep for 20 minutes. Using the Sage from your collection of spices is fine, but do not use the powdered form.

ADDITIONAL MEASURES FOR MASTITIS ARE AS FOLLOWS: • Frequent applications of hot water can help ease pain and congestion. To increase the effectiveness of these applications, add a handful of fresh or dried Parsley or Comfrey leaves to the water and simmer for 10 to 15 minutes. Use a clean cotton cloth to soak up the water. (A cut up diaper will work quite well.) Wring out the cloth and hold against the breast for 5 minutes. Follow by a cold washcloth for 1 minute. Alternate between the two, 3 times. This procedure should be repeated 4 to 5 times per day, right before nursing if possible. To avoid spreading the infection, do not put the cloth back into the water, and discard or disinfect each cloth after use. • Grate 1 or 2 raw potatoes and apply directly to the skin. Cover the breasts with a clean cloth or towel. Remove or replace the grated potatoes when they dry out. Again, discard or disinfect the cloth after use. • Get plenty of bed rest. Take a daily nap and avoid strenuous activity while the problem remains. • Allow the baby to nurse frequently. Even in cases of mastitis, the milk will not spread the infection to the baby. Continue to nurse, otherwise there will be increased discomfort and a decreased milk supply. • To increase the circulation in the breasts, extend your arms to the sides and rotate in a wide circle 5 to 10 times forward and then 5 to 10 times backwards. Do this without wearing a bra. • Massage the area around the nipple. Start under the arms and at the outer edges of the breast and massage inward toward the nipples. Use castor oil or vitamin E oil to do the massage. • Express milk with a pump or by hand to lessen pain and pressure. This works well while standing in the shower and directing warm water onto the breasts. • Ice packs placed against the breast will alleviate the pain associated with engorgement.

HOMEOPATHY: From the following homeopathic medicines, the one that best matches the symptoms is choosen. Three pellets are dissolved under the tongue 3 times a day between meals. • Phytolacca 12C: For redness and swollen lymph glands. • Apis 12C: For a pink swelling of the breast, tenderness to the touch, and if it feels better with cold compresses.