Acute mastitis
StarEssentials of Chinese Acupuncture (Beijing, Shanghai and Nanjing Colleges of Traditional Chinese Medicine, 1980) — the standard prescriptions of the Chinese colleges.
Points
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Yuan-Source of the Liver; frees constrained liver qi
Reduce.
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Shu-Stream of the Gall Bladder; helps the breast swelling subside
Reduce.
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Front-Mu of the Pericardium and influential point of qi; eases oppression in the chest
Reduce.
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Gall Bladder point on the shoulder; moves qi to stop the breast pain
Reduce.
- ⚠ Pneumothorax
- Pregnancy: contraindicated
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Stomach channel point beneath the breast; moves local qi to relieve pain
Reduce.
- ⚠ Pneumothorax
Needling Safety
Cited hazards for these points. Tick what applies to the patient to see the cautions that follow from it.
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GB21 Jianjing
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⚠ Pneumothorax risk: too deep an insertion can puncture the pleura. Chu H, Kim J, Ha W, et al 2018, Abstract; Wu J, Hu Y, Zhu Y, Yin P, Litscher G, Xu S 2015, Table 1 (Pneumothorax associated with acupuncture)
-
-
ST18 Rugen
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⚠ Pneumothorax risk: too deep an insertion can puncture the pleura. World Health Organization 1999, Section II §5.2 (Lung and pleura), p. 25
-
Treatment Principle
Smooth the flow of qi in the Liver and Stomach channels, release constraint and clear heat.
Indications
Method
Needle with reducing technique, drawing on Liver, Gall Bladder and Stomach channel points; moxa can be added.
⚠ Cautions
Mastitis with a fluctuant lump, high fever or systemic illness may be an abscess or sepsis and needs medical care (drainage, antibiotics); continue breastfeeding or expressing as advised. GB21 must not be needled deeply (pneumothorax over the lung apex) and is contraindicated in pregnancy; ST18 and CV17 lie over the chest wall, so needle obliquely and shallowly. If added, LI4 is contraindicated in pregnancy.
About
The college prescription for acute mastitis, which the book attributes to milk stasis from constrained liver qi or to toxic heat lodged in the Stomach channel.
Rationale
LV3 frees the liver, and GB41 on the paired Gall Bladder channel helps reduce the swelling of the breast. CV17 relieves the sense of pressure in the chest, while GB21 and ST18 together move qi so that pain eases. Distal Liver and Gall Bladder points with local chest points cover both the constraint and the breast itself.
Clinical Notes
For chills and fever add LI4 and TE5. For distending pain of the breasts add ST16, needled obliquely to soften the lump and help the milk flow. The book equates this pattern with the early stage of mastitis. It also lists an ear-acupuncture option.
Sources
- Beijing College of Traditional Chinese Medicine, et al. Essentials of Chinese Acupuncture. Beijing: Foreign Languages Press, 1980. Chapter III, Acute Mastitis, p. 386.
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