Both Breast Had Severe Pain, Red, Heat with body fever for 5 days.
Case
AnPu 000 Female 53 years old 05/10/2013 (time of first visit)
Chief Complaint: Both breast had severe pain, red, heat with body fever for 5 days
Case History
The patient complained that at first she found the breast’s right upper inner side sub-skin is around the size of a quarter. There was pain and skin was red. She started using a heating pad which did not provide her relief but instead the redness and pain spread to her left side of her breast. Pain increased and it was difficult to sleep. The patient had lost appetite and felt tired. She have no breast feeding history. She likes eating spicy food. She had a lot of stress in her life. She denied having diabetes. She did not want to explore western medicine or surgery and opted to find a cure in Chinese medicine.
Examination
Body Temperature – 101.8 F; Tongue – Red, thick yellow greasy coating; Pulse – Wiry, Slippery, Rapid
Right breast: upper inner side skin near the middle of sternum… was very deep red, palpable hot, hard and severe pain. The lesion spread to the left breast until nipple of the left breast. The entire area was 10 inches x 6 inches.
Chinese Medicine Diagnosis
breast carbuncle
Differential Diagnosis
Fire toxin, dampness and blood stasis.
Western Medicine Diagnosis
Breast Infection
Treatment Method
Treatment method was divided into 3 stages. 1st stage is purge the fire toxin and dampness, cool the blood and promote blood circulation. 2nd stage is to promote pus extraction and drainage, continue to purge the fire toxin and dampness, cool the blood and promote blood circulation. The 3rd stage is support normal qi and yin, promote blood circulation and soften local hard skin
Treatment Process
1st stage is purge the fire toxin and dampness, cool the blood and promote blood circulation.
Acupuncture: LI11, SP9 to clear the heat and dampness; Bleed and cupping: DU14, DU12 to clear fire toxin
Herbal: Wu Wei Xiao Du Yin modified – Pu Go Yin 30g, San Zhi Zi 15 g, Ye Ju Hua 15g, Chi Shao 15g, Dan Pi 15g, Dang Shen 12g, Chuang Xiong 6g, Da Huang 12g, Zhi Ke 10g, Gan Cao 6g.
Topical Ointment treatment: Portia Ointment Hu Tu Gao #1
Result: After 2 days treatment red area of the left breast shrunk but the deep red area of the two breast was still severe painful. It seemed that the deep tissue of this area has pus developed and needed to be expelled. The tongue was still red, coating was still yellow, thick and greasy. Pulse was the same but a little weak.
2nd stage is to promote pus extraction and drainage, purge the fire toxin and dampness, cool the blood and promote blood circulation.
1. Acupuncture: LI11, SP9 to clear the heat and dampness; Bleed and cupping: DU14, DU12 to clear fire toxin
2. Herbal: The formula was modified to add Huang Qi 20g, Zao Jiao Ci 15g.
3. Topical Ointment treatment: Portia Ointment Hu Tu Gao #1. When pus come out, use herbal thread as drainage.
Result: After 2 days, about 10 cc of pus came out. Patient temperature decreased and came down to 97 degree. There was much pain relief.
Continue treating and every day changed dressing, This stage lasted 16 days. Then the lesion area decreased from 10 x 6 to 3.5 x 3 inches.
The 3rd stage is supporting normal Qi and Yin promote blood circulation
Acupuncture: LI11, SP9, ST36 to nourish spleen and clear the heat and dampness
Herbal: Tai Zi Shen 15g Huang Qi 15g Pu Go Yin 15g, San Zhi Zi 10 g, Chi Shao 12g, Dan Pi 12g, Dang Shen 12g, Chuang Xiong 6g, Zhi Ke 6g, Gan Cao 6g.
Topical Ointment treatment: Portia Ointment Hu Tu Gao #2. with Wu Miao Shuai Xian Gao
Result: Finally pus drainaged, After 20 days, wound hole closed. Skin became soft, The disease was cured with no surgery or antibiotics. Patient was satisfied and wrote the testimonial as follows.
“Dr. Portia helped me with a serious sub dermal infection. I chose to seek treatment with Dr. Portia instead of my HMO Doctor. They would have cut into me for sure, and I was able to avoid that with Dr. Portia. I highly recommend her.”
… Annet.P….