Mastitis in Traditional Chinese Medicine

Understanding different mastitis patterns according to TCM theory

Educational content Consult qualified practitioners for medical advice

Overview
What causes it 4 TCM patterns documented
How to recognize Symptoms specific to each mastitis pattern
Classical remedies 8 herbal formulas documented

Traditional Chinese Medicine (TCM) approaches mastitis not just as a localized infection but as a symptom of imbalance within the body's energy, or Qi. It is seen through the lens of Qi Stagnation, Heat, and Phlegm, affecting the smooth flow of energy and fluids in the breast tissue. TCM practitioners seek to identify the unique pattern of disharmony causing the issue, as treatment is tailored to the individual's specific imbalance to restore harmony and health.

TCM Patterns for Mastitis

Each pattern represents a distinct underlying imbalance that can cause mastitis

Qi Stagnation

Liver Qi Stagnation

Symptoms 15

Diagnostic signs

Pulse

Wiry (Xian)

Tongue

The tongue body is typically normal or light red. In early or uncomplicated cases, the tongue may appear entirely normal. The most distinctive feature is redness or a slightly purplish hue along the sides of the tongue, which correspond to the Liver zone in tongue diagnosis. Some patients show frothy saliva along the tongue edges. The coating is usually thin and white. If the stagnation has begun to generate Heat (a common progression), the sides may become redder and the coating may start to thin or turn slightly yellow. If there is concurrent Spleen involvement, the coating may become slightly greasy.

Accompanying symptoms you may experience

Hypochondriac distention Chest distension Upper abdominal distension Abdominal distention Sighing Melancholia Depression Mood swings

Understanding this pattern

If a nursing mother is easily impacted by anger and her emotions are repressed, her Qi will rebel upwards and stagnate in the Liver, which connects to the nipples through the Liver Channel. This leads the milk ducts or nipple orifices to clog, milk cannot come out and thus forms lumps or nodules in the breasts. The nursing mother feels swelling and hardness in the breasts and a strong sharp pain during breastfeeding. Sometimes, only one of the breasts' nipples are clogged and it leads to an uneven milk supply. 

If Liver Qi does not flow properly for a while and it is left untreated, it accumulates toxic Heat that can transform into blisters, abscesses and pus discharge. Fever often comes along in this situation.  

The formula Unblock Nursing Tea is recommended because it contains herbs ideally suited to fight this pattern. The treatment principle is to invigorate Qi and Blood (Unblock Nursing Tea contains the herbs Dong Quai and Platycodon which are ideal for this), to expel Heat and toxins (Dandelions, Honeysuckle flowers and Chrysanthemum flower), pacify the Liver (Goji berries) and clear pus (Angelica root).

Another important point is that during breastfeeding, the nursing mother is recommended to massage the breast lumps or nodules to soften them. As home remedies, she can apply hot pad right before the feeding to speed up the milk flow and apply cold pad to ease pain when necessary. She is highly encouraged to breastfeed or pump more often so as to ease the breast engorgement and clogged milk duct.

Diagnostic signs

Pulse

Empty (Xu), Wiry (Xian), Weak (Ruo)

Tongue

The tongue body is typically pale, reflecting the underlying Qi deficiency of the Lungs, and may be slightly puffy or tender with teeth marks on the edges, indicating that Qi is too weak to properly manage fluids. The coating is usually thin and white. A distinctive feature is that the sides of the tongue (the area corresponding to the Liver in tongue diagnosis) may appear slightly reddish or a bit darker than the rest of the body, reflecting the constraint and early signs of Qi stagnation generating mild Heat in the Liver area. The overall tongue is not red, which differentiates this from patterns where Liver stagnation has already transformed into Liver Fire.

Diagnostic signs

Pulse

Floating (Fu), Slippery (Hua)

Accompanying symptoms you may experience

Toothache Headaches Loose teeth Bleeding gums Irritability Thirst Stomatitis Periodontitis

Diagnostic signs

Pulse

Choppy (Se), Rapid (Shu), Wiry (Xian)

Tongue

The tongue body is characteristically reddish-purple, combining the red of heat with the purple of blood stasis. Stasis spots or patches (purple or dark-red dots) are often visible on the tongue surface, and the sublingual veins are typically distended and darkened. In more severe cases, the tongue surface may develop prickles or thorns, especially at the tip, reflecting heat. The coating tends to be thin and yellow, often dry, reflecting the heat consuming fluids. The overall appearance is darker and drier than a pure heat tongue, and more reddish than a pure cold-stasis tongue.

Toxic-Heat

Toxic-Heat

Diagnostic signs

Pulse

Rapid (Shu), Full (Shi), Overflowing (Hong)

Tongue

The tongue is characteristically red or deep red, reflecting intense interior Heat. Prickly raised papillae (thorns) may appear, especially on the tip and centre, indicating Heat has become concentrated into toxin. The coating is yellow and dry, sometimes thick, showing Heat consuming body fluids. In severe cases progressing toward the Blood level, the tongue may become crimson (jiang), but in the typical Toxic-Heat presentation at the Qi level, bright red with dry yellow coating is the hallmark finding.

Herbal Formulas for Mastitis

Traditional Chinese Medicine formulas used to address mastitis

Gua Lou San

Addresses these mastitis patterns:

Qi Stagnation Heat

Tuo Li Xiao Du San

Traditional formula for mastitis

Da Huang Mu Dan Pi Tang

Traditional formula for mastitis

Er Qing Gao

Traditional formula for mastitis

Shi Wei Bai Du San

Traditional formula for mastitis

Si Ni San

Traditional formula for mastitis

Wu Wei Xiao Du Yin

Traditional formula for mastitis

Xiao Chai Hu Tang

Traditional formula for mastitis