Postpartum galactorrhea and related syndromes:an introduction of postpartum galactorrhea syndromes, periodical breast milk stoppage, galactostasis, mammary abscess, acute mastitis.


 TCM Knowledge:Gynecology Syndromes,Women Syndromes ✵Gynecology of TCM is a branch to study the physiological and pathological characteristics of women and to prevent and treat syndromes specific to women. Gynecology of TCM research scope including irregular menstruation, amenia, metrorrhagia, infertility, postpartum syndromes, breast syndromes, and miscellaneous syndromes, etc.

Postpartum galactorrhea and related syndromes.
 
 ✵The postpartum galactorrhea syndrome is also known as the loss of breast milk syndrome of women after childbirth. The related syndromes are other syndromes due to related or similar pathogenic reasons.

 ✧ In the TCM system, the pathogenic reasons for the postpartum galactorrhea syndrome normally are deficiency and weakness, hurt by strains from childbirth, etc. Common related symptoms observed are loss of breast milk after childbirth, fever, dizziness, and pain in the head and eyes, difficulty in defecation. The related syndromes are understood due to similar reasons and also specific reasons, with different symptoms and specific symptoms observed.

 ✵The women galactorrhea syndrome after childbirth, and related syndromes are introduced: postpartum periodical breast milk stoppage, No milk, short of breast milk, postpartum galactorrhea(loss of breast milk), postpartum galactostasis, postpartum mammary abscess(acute mastitis), postpartum Ru Yan(mammary cancer), etc.

Postpartum periodical breast milk stoppage, No milk, short of breast milk.
Postpartum periodical breast milk stoppage 
 ✵The postpartum periodical breast milk stoppage is a case of periodical breast milk stoppage occurring following childbirth, due to various pathogenic reasons. It is also known as a periodical breast milk stoppage after childbirth.

 ✧In the TCM system, the pathogenic reasons for the postpartum periodical breast milk stoppage normally are weakness and deficiency of Qi and blood, irregularity of meridian and channels. In the case of first childbirth breast swelling but milk stoppage, it is the case of young age with wind and heat pathogen in the interior, in case several times childbirth and milk stoppage, it is the case of exhaustion liquid and humor(body fluid). As the milk of a lady is supported by the Chong meridian and connects with the stomach meridians, for cases several times childbirth but milk does not stop that is because the Qi and blood are not deficient. In most cases of lady syndrome in the meridian of Ren and Chong, lead to less milk and color turns yellowish, the baby is also weak and suffers from diseases.

 ✧Ancient herbalists who hold a syndrome differentiation viewpoint with similar explain of pathogenic reasons, and the relevant representative work are introduced and quoted:

 "Breast milk stoppage or No milk after childbirth:...for the first childbirth, a woman's galactophore is growing, collaterals are not in circulation, or a woman experienced several childbirths, then Qi and blood are deficient and weak, short of breast milk..." [04].Different types are introduced:
 ⑴.A woman suffers from breast milk stoppage for the first childbirth, galactophore is growing, collaterals are not in circulation.
 ⑵.A woman experienced several childbirths, Qi and blood are deficient and weak, short of breast milk.
 ⑶.A woman suffers from a milk stoppage after childbirth, great fever of the body, distention, and stagnancy in the chest and diaphragm.

 "No milk after childbirth: a woman suffers from short of breast milk after childbirth, blood deficiency condition is known yet, ...due to spleen deficiency and poor appetite, ...due to blood stasis and milk stopped, distention and pain in breasts..." [05].



 ✵The postpartum periodical breast milk stoppage common types are known including:

 ⑴.Postpartum periodical breast milk stoppage, stagnant and obstacles in Qi channels, milk stoppage and stagnant in the Ren and Chong meridians, swelling and pain in breast, pathogens stay in the interior and might grow carbuncle and swellings.

 ⑵.Postpartum periodical breast milk stoppage, weakness of Qi and deficiency of blood after childbirth, Chong and Ren meridians are blocked and little milk or milk stoppage.

 ⑶.Postpartum periodical breast milk stoppage, no milk or milk stoppage after childbirth.

 ⑷.Postpartum periodical breast milk stoppage, breast milk stoppage after childbirth.

 ⑸.Postpartum periodical breast milk stoppage, breast milk stoppage, or no milk after childbirth, milk knot, or acute mastitis.

Postpartum galactorrhea(postpartum loss of breast milk).
postpartum loss of breast milk 
 ✵The postpartum galactorrhea is a syndrome of galactorrhea(loss of breast milk) mainly due to Qi disorder of asthenia occurring following childbirth, due to various pathogenic reasons. It is also known as loss of breast milk after childbirth.

 ✧In the TCM system, the pathogenic reasons for the postpartum galactorrhea(postpartum loss of breast milk) normally are deficiency and weakness, hurt by strains from childbirth.

 ✵The postpartum galactorrhea(postpartum loss of breast milk) common types are known including:

 ⑴.Postpartum galactorrhea, loss of breast milk after childbirth.

 ⑵.Galactorrhea before childbirth, loss of breast milk before childbirth, it is also known as breast cry(Ru Qi), it is a scare case not recorded in works, after childbirth, most cases the lady will turn to infertility.

 ✧Ancient herbalists who hold a syndrome differentiation viewpoint with similar explain of pathogenic reasons, and the relevant representative work are introduced and quoted:

 »"Case postpartum galactorrhea(loss of breast milk), strong fever of body, dizziness and pain in head and eyes(dizziness, headache, pain in eyes), difficulty in defecation(constipation)..." [02].
  »"Case postpartum galactorrhea(loss of breast milk), troubled with excess syndrome..." [02].
  »"Case postpartum galactorrhea(loss of breast milk), troubled with deficiency syndrome..." [02].

 "Loss of breast milk after childbirth:...a woman suffers from galactorrhea..." [04].Different types are introduced:
 ⑴.A woman suffers from galactorrhea after childbirth, breast milks flow out involuntarily without feeding a baby, due to deficiency of water and excess of fire.
 ⑵.A woman suffers from galactorrhea after childbirth, breast milks flow out involuntarily without feeding a baby, due to blood heat of Yang Ming.
 ⑶.A woman suffers from galactorrhea after childbirth, breast milks flow out involuntarily without feeding a baby, due to liver fire flow upward from anger.

 "Ru Yong(breast milk spring out) after childbirth: a woman suffers from Ru Yong(breast milk spring out), in case physical strong, ...in case deficiency, ..." [05].



Postpartum galactostasis.
Postpartum galactostasis. 
 ✵The postpartum galactostasis is a syndrome of galactostasis occurring following childbirth, due to various pathogenic reasons. It is also known as galactostasis after childbirth.

 ✧In the TCM system, the pathogenic reasons for the postpartum galactostasis normally are baby not suck milk timely, and milk not discharged, or swelling breast, lead to milk accumulation and stagnant, combat with Qi and blood, high fever great thirst and drink much water, dragging pain, the hand could not touch. In the early stage massage to discharge milk, or grow carbuncle with pus, in case excess heat, will surely form carbuncle. The galactorrhea, galactostasis, and mammary abscess have similar pathogenic reasons, differences are based on mild or seriousness.

 ✵The postpartum galactostasis common types are known including:

 ⑴.Postpartum galactostasis, loss of breast milk after childbirth, form carbuncle.

 ⑵.Postpartum galactostasis, accumulation distention of breast after childbirth, form carbuncle.

 ⑶.Postpartum galactostasis, breast swelling after childbirth, gradually form carbuncle.

 ⑷.Postpartum galactostasis, form breast carbuncles, high fever, thirst, internal heat, drink much water.

Postpartum mammary abscess(acute mastitis).
Postpartum mammary abscess 
 ✵The postpartum mammary abscess is a syndrome of a mammary abscess occurring following childbirth, due to various pathogenic reasons. It is also known as mammary abscess after childbirth.

 ✧In the TCM system, the pathogenic reasons for the postpartum mammary abscess normally are breast swelling and accumulation, affected skin thus form a mammary abscess. The Foot Yang Ming meridian is weak and blood is blocked, blood returns to it again, Qi stagnant and not dissipating, form abscess. Ancient book Qian Jin Fang proposed that in case mammary abscess for lady age below forty, treatment normally gets a good result and relieved, for lady age over fifty it should be treated as soon as possible, or might die in the middle-age years. In case mammary abscess during pregnancy, this is not very harmful to the syndrome related to Yang Ming meridian, the Yang Ming is the channel of the stomach, main for muscles, and not hurt Zang-viscera, thus no harm. Diagnose Guan pulse at the right hand, if the pulse is sunken, it is the case of Yin deficiency, normally troubled with mammary abscess, if not relieved in a long period, it will develop to breast fistula.

 ✵The postpartum mammary abscess common types are known including:

 ⑴.Postpartum mammary abscess, galactostasis after childbirth.

 ⑵.Postpartum mammary abscess, mammary abscess after childbirth, in early stage.

 ⑶.Postpartum mammary abscess, mammary abscess after childbirth, observe abnormal in the early stage.

 ⑷.Postpartum mammary abscess, mammary abscess after childbirth, or carbuncle is not relieved in a long period, pus flows out, pain is unbearable and similar to as if will die.

 ⑸.Postpartum mammary abscess, mammary abscess dissipated before formed after childbirth, already formed but ulcerated, extreme pain, and unbearable.

 ⑹.Postpartum mammary abscess, mammary abscess for baby blow milk.

 ⑺.Postpartum mammary abscess, mammary abscess after childbirth, nipple break up.

 ⑻.Postpartum mammary abscess, mammary abscess, deficiency fever in limbs, great thirst, rot and pus blood flow out.

 ⑼.Postpartum mammary abscess, mammary abscess after childbirth, exude pus, pains.

 ⑽.Postpartum mammary abscess, mammary abscess after childbirth, pus exuded yet, open sore.

 ⑾.Postpartum mammary abscess, mammary abscess after childbirth, pain in breast, unbearable pain and could not suffer.

 ⑿.Postpartum mammary abscess, mammary abscess after childbirth, consumption of milk, toxin not accumulated or toxin accumulated yet.

 ✧Ancient herbalists who hold a syndrome differentiation viewpoint with similar explain of pathogenic reasons, and the relevant representative work are introduced and quoted:

 »"Case a woman suffers from Ru Yong(acute mastitis), and no pains, blood stasis clotting and circulation are not smooth..." [02].
  »"Case Ru Yong(acute mastitis), women at age Qi and blood are just prosperous, distention in the breast region, aversion to cold and fever..." [02].



 ✧Postpartum mammary abscess due to toxic heat in the gallbladder and stomach, stasis and stagnant of Qi and blood.

 ✧Ancient herbalists who hold a syndrome differentiation viewpoint with similar explain of pathogenic reasons, and the relevant representative work are introduced and quoted:

 "Ru Yong(mammary abscess), belongs to the toxic heat in the gallbladder and stomach Fu-viscera, Qi and blood are stagnant and stasis. In the initial stage distension and pains, observed at the skin surface, color red, the lady feels the heat in the exterior and fever, or affected by chills and fever, or aversion to cold and cephalea(headache), polydypsia(vexation and thirst) and lead to cold...; In the condition of Qi and blood are weak deficient, ...not collect in days, pus cleared and the pulse is big, is the case difficult to treat." [03].

  »"Case a woman suffers from internal heat and distension in the hypochondria regions, irregular pains at breasts, feel spicy and hot in the mouth, feel dragging pains below the belly button if get up rashly in sleep, is the condition due to belt vessel." [03].

  »"Case a woman suffers from distension of breasts due to anger, accompanied by cephalea(headache), alternating chills and fever(alternative cold and heat)..." [03].

  »"Case a woman suffers from fever and thirst, turns severe at night, sudden distention in the breasts region, the liver pulse is bounding and rapid, is the condition of heat entering into the blood chamber..." [03].

 "Ru Yong(acute mastitis) after childbirth: a woman suffers from red swelling of breasts, hard and pains, aversion to cold and fever, the milk stopped and will form Yong(acute mastitis), due to Foot Yang Ming and Jue Yin two meridians are affected by wind and heat pathogens..." [05].



Postpartum Ru Yan.
Postpartum galactostasis. 
 ✵The postpartum Ru Yan, literally it means postpartum breast rocks, from ancient records this syndrome is almost the same as today's "mammary cancer", it is a case occurring following childbirth, due to various pathogenic reasons. It is also known as breast rocks after childbirth.

 ✧ In the TCM system, the pathogenic reasons for the postpartum Ru Yan(mammary cancer) normally are depression accumulation, anger accumulation, etc. Symptoms observed including there is a kernel distention inside the breast region, size is like chess pieces, not pains and not itching, form a sore in five to seven years, after the sore is formed, shape like a hole in rocks, or as a mouth with lips, red liquid and pus spread around the chest to abdomen, Qi attacking and pains. In the case, sore is not broken it is still treatable, in the case broken it could not be treated.

 ✧Ancient herbalists who hold a syndrome differentiation viewpoint with similar explain of pathogenic reasons, and the relevant representative work are introduced and quoted:

 "Case Ru Yan(mammary cancer), in the initial stage distension as a kernel, size is as chess pieces, not pains and not itching, form a sore in five to seven years, after the sore is formed, shape like a hole in rocks, or like a mouth with lips, red liquid and pus spread around the chest to abdomen, Qi attacking and pains. In the case, sore is not broken it is treatable, in the case broken it could not be treated." [02].

 "Ru Yan, is mainly due to anger and depression affect the liver and spleen Zang-viscera, deficiency and hurt of Qi and blood, as a result in the initial stage a small kernel is observed, accumulated inside the breast region, muscle color is as normal, the lady feels internal heat and heat at night, heat from five hearts(five-Zang viscera), tiredness and thin of body and limbs, irregular menstruation... If extended for a long period, the kernel gradually grows big, red color water flows out, erosion in-depth, it is difficult to treat." [03].

  »"Case a woman suffers from distension in the left breast, its size is as a peach, no pains and not red, fever and gradually thinner, ...pus broke and recovered." [03].

  »"Case a woman suffers from chronic depression, there is a mass accumulated in the left breast region, its size is like an almond, not eliminated in three months, heart pulse is uneven and spleen pulse is big, powerless when pressed, ...recovered." [03].

  »"Case a woman's nature is impatient, depression for long days, there is a kernel accumulated in the left breast region, slight pains when pressed, ...recovered." [03].

  »"Case a woman suffers from three kernels accumulated in the right breast region, not eliminated over a year, chills in the morning and fever after sunset, tastelessness in diet, it is the condition of Ru Yan..." [03].

 "Ru Yan(mammary cancer): the Ru Yan of a woman, it is not originally a syndrome after childbirth, ...the Ru Yong(acute mastitis) syndrome attacks...not the same as Ru Yang due to Qi and blood deficiency hurt for several years, in the initial stage, for woman, lost favor and love from her husband and other relatives, or depression and hurt from worrying, chronic stagnancy of the liver and spleen viscera. In the initial stage, a small kernel accumulated and formed in the breast, the appearance is as normal, shape size is similar to a round chess piece, not pain and not itching, develops to ulcer syndrome after 10 years, rotten thoroughly, incurable. In the initial stage, the woman suffers from internal heat, fever at night, dysphoria with feverish sensation in the chest, palms and soles, lassitude and emaciated, irregular menses, it should be treated as early as possible, ...for cases a woman still has menses, it is still mild, but for those age in fifty or sixty and no menses, it should not be identified as a mild case." [04].Different types are introduced:
 ⑴.A woman suffers from Ru Yong, in the initial stage, due to reasons lost favor from husband and relatives, or depression hurt from worrying, chronic stagnancy of the liver and spleen viscera, a small kernel is accumulated and formed in the breast, appearance is as normal, shape size is similar to a round chess piece, not pain, not itching, is still treatable, it will develop to ulcer after 10 years and then rotten thoroughly.
 ⑵.A woman suffers from Ru Yan, developed from Ru Yong, not rotten yet, it is still treatable.
 ⑶.A woman suffers from Ru Yan, rotten and ulcer, its size is enlarged as a rock, color red, and liquid flow out with pus, deep hole and smelly, difficult or incurable.

 "Ru Yan after childbirth: a woman suffers from the hidden kernel in the root region of the breasts, its size is similar to a chess piece, not pain and not itching, skin color not change, or suffers from internal heat or night fever, years later, the ulcer rotten from inside, hollowed inside, as a stone cave...due to middle Qi deficiency and cold, or depression and uncomfortable, lead to Qi and blood condensed and stasis, ...or in case ulcer rotten, should only use tonification method..." [05].



References:
  • 01.Postpartum galactorrhea and related syndromes:an introduction of postpartum galactorrhea syndromes, periodical breast milk stoppage, galactostasis, mammary abscess, acute mastitis.
  • 02.Song Shi Nǚ Ke Cuo Yao(the Synopsis of Song's Gynaecology).By 宋林皋(Sòng Lín Gāo)[Ming].
  • 03.Nǚ Ke Cuo Yao(the Synopsis of Gynaecology).By 薛己(Xuē Jǐ)[Ming].
  • 04.Fù Kē Bèi Kǎo(the References of Gynaecology).By 何应豫(Hé Yīngyù)[1820].
  • 05.Fù Kē Liáng Fāng(the Effective Prescription of Gynecology).By 何梦瑶(Hé Mèngyáo)[1751].

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